{"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":[1003861725],"tin":{"type":"npi","value":"1003861725"}}]},{"provider_group_id":2,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1000000000],"tin":{"type":"npi","value":"1000000000"}}]},{"provider_group_id":3,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1003378845],"tin":{"type":"npi","value":"1003378845"}}]},{"provider_group_id":4,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1003575085],"tin":{"type":"npi","value":"1003575085"}}]},{"provider_group_id":5,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1184935264],"tin":{"type":"npi","value":"1184935264"}}]},{"provider_group_id":6,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1487790259],"tin":{"type":"npi","value":"1487790259"}}]},{"provider_group_id":7,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1003042672],"tin":{"type":"npi","value":"1003042672"}}]}],"in_network":[{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86053","name":"Aqaprn-4 antb flo cytmtry ea","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; flow cytometry (ie, fluorescence-activated cell sorting [facs]), each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0209","name":"Inj, sod thiosulfate (hope)","description":"Injection, sodium thiosulfate (hope), 100 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0887T","name":"End-tidal ctrl inhaled anes","description":"End-tidal control of inhaled anesthetic agents and oxygen to assist anesthesia care delivery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0606U","name":"Hem red cll memb do rbc oge","description":"Hem red cll memb do rbc oge","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0750T","name":"B1 str&fx rsk asmt dxrbmd1vw","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0551","name":"Phn/intr svs fr dx treat 30m","description":"Interprofessional telephone/internet/electronic health record referral service(s) provided by a treating/requesting practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, 30 minutes","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63052","name":"Lam facetc/frmt arthrd lum 1","description":"Laminectomy, facetectomy, or foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s] [eg, spinal or lateral recess stenosis]), during posterior interbody arthrodesis, lumbar; single vertebral segment (list separately in addition to code for primary ","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37268","name":"Revsc evasc fpvt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67505","name":"Inject/treat eye socket","description":"Retrobulbar injection; alcohol","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4439","name":"Instagraft per sq cm","description":"Instagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0708T","name":"Id ca immntx prep & 1st njx","description":"Intradermal cancer immunotherapy; preparation and initial injection","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0874T","name":"Rmvl pertl ascites pmp sys","description":"Removal of a peritoneal ascites pump system, including implanted peritoneal ascites pump and indwelling bladder and peritoneal catheters","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6593","name":"Grad com accessory gmt_wrap","description":"Accessory for gradient compression garment or wrap with adjustable straps, not-otherwise specified","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4323","name":"Splint extra-coronal","description":"Splint extra-coronal","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"Endoskel posit rotat unit","description":"Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86042","name":"Acetylcholn rcptr blckg antb","description":"Acetylcholine receptor (achr); blocking antibody","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4286","name":"Nudyn sl or slw, per sq cm","description":"Nudyn sl or nudyn slw, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33886","name":"Delayed plmt dstl xtn prosth","description":"Delayed placement of distal extension prosthesis(es) from the level of the left subclavian artery to the celiac artery, after endovascular repair of descending thoracic aorta, including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological superv","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1199.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4262","name":"Dual layer impax, per sq cm","description":"Dual layer impax membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81015","name":"Microscopic exam of urine","description":"Urinalysis; microscopic only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0964T","name":"I&cust prep jaw xpnsj 1arch","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; single arch, without mandibular advancement mechanism","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0276U","name":"Hem inh thrombocytopenia 23","description":"Hematology (inherited thrombocytopenia), genomic sequence analysis of 23 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1004T","name":"Elec alys s-scl eeg wo prgrm","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; without programming","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2008","name":"Theragenesis, per sq cm","description":"Theragenesis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1352","name":"Suicd c-ssrs assessment, equ","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs or equivalent assessment","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17004","name":"Destroy premal lesions 15/>","description":"Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (eg, actinic keratoses), 15 or more lesions","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":186.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94625","name":"Phy/qhp op pulm rhb w/o mntr","description":"Physician or other qualified health care professional services for outpatient pulmonary rehabilitation; without continuous oximetry monitoring (per session)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3375","name":"Inj, vanco (tyzavan) 10mg","description":"Injection, vancomycin hydrochloride (tyzavan), not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1503","name":"Vascular surgery mvp","description":"Vascular surgery mips value pathway","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0689T","name":"Quan us tis charac w/o dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained without diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55840","name":"Extensive prostate surgery","description":"Prostatectomy, retropubic radical, with or without nerve sparing;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1463.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0269U","name":"Hem aut dm cgen trmbctpna 14","description":"Hematology (autosomal dominant congenital thrombocytopenia), genomic sequence analysis of 14 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93597","name":"R&l hrt cath chd abnl nt cnj","description":"Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); abnormal native connections","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0684","name":"App non-sheet skin sb g addl","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area or part thereof, or each additional 1% o","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4020","name":"Ophthalmology/optometry ss","description":"Ophthalmology/optometry mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1274","name":"Pts snf exl mo","description":"Patients who were admitted to a skilled nursing facility (snf) during the month of evaluation were excluded from that month","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1398","name":"Bslne and  fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4436","name":"Renati ac membrane per sq cm","description":"Renati ac membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90637","name":"Vacc qirv mrna 30mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 30 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D8671","name":"Periodic orth treat w surg","description":"Periodic orth treat w surg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5135","name":"Inj, tyenne, 1 mg","description":"Injection, tocilizumab-aazg (tyenne), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0777T","name":"R-t prs sensing edrl gdn sys","description":"Real-time pressure-sensing epidural guidance system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37286","name":"Revsc evasc tpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33860","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2687.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87593","name":"Orthopoxvirus amp prb each","description":"Infectious agent detection by nucleic acid (dna or rna); orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus), amplified probe technique, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":51.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8006","name":"Grip glove replacement only","description":"Powered, cable driven grip assist glove, hand, finger, includes pressure sensors, glove replacement only","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58970","name":"Retrieval of oocyte","description":"Follicle puncture for oocyte retrieval, any method","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22838","name":"Rev rplc/rmv thrc vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracic vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49616","name":"Rpr aa hrn rcr 3-10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9245","name":"Admin mod sedation-enteral","description":"Admin mod sedation-enteral","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36406","name":"Vnpnxr<3yrs phy/qhp other vn","description":"Venipuncture, younger than age 3 years, necessitating the skill of a physician or other qualified health care professional, not to be used for routine venipuncture; other vein","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":17.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4418","name":"Biolab wrap flow per sq cm","description":"Biolab membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4036","name":"Urgent care ss","description":"Urgent care mips specialty set","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1295","name":"Pt hx tot col or colon ca","description":"Patients with a diagnosis or past history of total colectomy or colorectal cancer","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43290","name":"Egd flx trnsorl dplmnt balo","description":"Esophagogastroduodenoscopy, flexible, transoral; with deployment of intragastric bariatric balloon","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4027","name":"Plastic surgery ss","description":"Plastic surgery mips specialty set","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9275","name":"Inj cosibelimab-ipdl, 2 mg","description":"Injection, cosibelimab-ipdl, 2 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9247","name":"Mod sedation noniv-sub15min","description":"Mod sedation noniv-sub15min","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9248","name":"Inj melphalan (hepzato) 1 mg","description":"Injection, melphalan (hepzato), 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1329","name":"Pts act pvd 2 wks 8 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 8 weeks after initial acute pvd encounter","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8541","name":"Oral, hemady, 0.25 mg","description":"Dexamethasone (hemady), oral, 0.25 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4387","name":"Neothelium ft per sq cm","description":"Neothelium ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37285","name":"Revsc evasc tpvt st sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37283","name":"Rvsc evsc tpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89132","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1017T","name":"Elec aly npgs esoph sbsq w/o","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0272U","name":"Hem genetic bld do 51 genes","description":"Hematology (genetic bleeding disorders), genomic sequence analysis of 51 genes, blood, buccal swab, or amniotic fluid, comprehensive","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54830","name":"Remove epididymis lesion","description":"Excision of local lesion of epididymis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4328","name":"Most, per sq cm","description":"Most, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1222","name":"Glaucoma pln of care not doc","description":"Glaucoma plan of care not documented, reason not otherwise specified","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2045","name":"Novashield/novogen pr sq cm","description":"Novashield or novogen wound matrix, per square centimeter","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"Non-adju cgm supply allow","description":"Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KF"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0745T","name":"Car ablt rad arr n-invas loc","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; noninvasive arrhythmia localization and mapping of arrhythmia site (nidus), derived from anatomical image data (eg, ct, mri, or myocardial perfusion scan) and electrical data (eg, 12-lead ecg data), and identification of areas of avo","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26432","name":"Repair finger tendon","description":"Closed treatment of distal extensor tendon insertion, with or without percutaneous pinning (eg, mallet finger)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":695.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37296","name":"Revsc evasc imvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93896","name":"Vsrctv std tcd icr art compl","description":"Vasoreactivity study performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9948","name":"Adjust sleep apnea appliance","description":"Adjust sleep apnea appliance","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0211","name":"Inj, nithiodote, 3mg / 125mg","description":"Injection, sodium nitrite 3 mg and sodium thiosulfate 125 mg (nithiodote)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G3002","name":"Chronic pain mgmt 30 mins","description":"Chronic pain management and treatment, monthly bundle including, diagnosis; assessment and monitoring; administration of a validated pain rating scale or tool; the development, implementation, revision, and/or maintenance of a person-centered care plan that includes strengths, goals, clinical needs,","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0830T","name":"Dgtz gls mcrscp cytp slctv","description":"Digitization of glass microscope slides for cytopathology, selective-cellular enhancement technique with interpretation (eg, liquid-based slide preparation method), except cervical or vaginal (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77089","name":"Tbs dxa cal w/i&r fx risk","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; using dual x-ray absorptiometry (dxa) or other imaging data on gray-scale variogram, calculation, with interpretation and report on fracture-risk","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81353","name":"Tp53 gene known famil vrnt","description":"Tp53 (tumor protein 53) (eg, li-fraumeni syndrome) gene analysis; known familial variant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0530","name":"Adult daycare center, 8 hr u","description":"Adult day center, 8-hour unit, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4322","name":"Splint intra-coronal","description":"Splint intra-coronal","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0666","name":"Team remote e/m est pt 15 mn","description":"Team remote e/m est. pt 15mins","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0155","name":"Dronabinol (syndros) 0.1 mg","description":"Dronabinol (syndros), 0.1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0523","name":"Mgt nw pt dem mod-high cmplx","description":"Management of a new patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65770","name":"Keratoprosthesis","description":"Keratoprosthesis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1395.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0831T","name":"Dgtz gls mcrscp cytp c/v","description":"Digitization of glass microscope slides for cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1238","name":"Doc 2nd recom hzv 2-6 mo int","description":"Documentation that administration of second recombinant zoster vaccine could not occur during the performance period due to the recommended 2-6 month interval between doses (i.e, first dose received after october 31)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4394","name":"Surgraft aca per sq cm","description":"Surgraft aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83670","name":"Assay of lap enzyme","description":"Leucine aminopeptidase (lap)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1028","name":"Take home supply 8mg per 0.1","description":"Take-home supply of nasal naloxone; 2-pack of 8mg per 0.1 ml nasal spray (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4261","name":"Tag, per square centimeter","description":"Tag, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36466","name":"Njx noncmpnd sclrsnt mlt vn","description":"Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate, inclusive of all imaging guidance and monitoring; multiple incompetent truncal veins (eg, great saphenous vein, accessory saphenous vein), same leg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":1272.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5946","name":"Max implt sup fix","description":"Max implt sup fix","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0817T","name":"Opn insj/rplcmt ins ptn subf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9601","name":"Flortaucipir inj 1 millicuri","description":"Flortaucipir f 18 injection, diagnostic, 1 millicurie","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1246","name":"Pt othr thn true imprt to me","description":"Patient provided a response other than completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6605","name":"G com bandage padded foam","description":"Gradient compression bandaging supply, padded foam, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0495U","name":"Onc prst8 alys crcg plsm prt","description":"Onc prst8 alys crcg plsm prt","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29882","name":"Arthrs kne srg mnisc rpr m/l","description":"Arthroscopy, knee, surgical; with meniscus repair (medial or lateral)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":794.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0969T","name":"Removal epicranial nstim sys","description":"Removal of epicranial neurostimulator system","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1178","name":"Doc med rsn no pcv","description":"Documentation of medical reason(s) for not administering pneumococcal vaccine (e.g., prior anaphylaxis due to the pneumococcal vaccine)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1288","name":"Doc rsn no hbp scrn or f/u","description":"Documented reason for not screening or recommending a follow-up for high blood pressure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0848T","name":"Dgtz gls mcrscp ish 1st","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50320","name":"Remove kidney living donor","description":"Donor nephrectomy (including cold preservation); open, from living donor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1561.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66991","name":"Xcapsl ctrc rmvl insj 1+","description":"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); with insertion of intraocular (eg, trabecular meshwork, supraciliary, suprachoroidal) anterior segment aqueous drai","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37277","name":"Rvsc evsc fpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64584","name":"Rmvl hpglsl nstim ary pg","description":"Removal of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9612","name":"Inj, fluorescein, 1 mg","description":"Injection, fluorescein, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0949T","name":"Rem interrog dev ccm tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87468","name":"Anaplsma phgcytophlm amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); anaplasma phagocytophilum, amplified probe technique","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1300","name":"Flu imm no admin doc rea","description":"Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1406","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1449","name":"Inj eflapegrastim-xnst 0.1mg","description":"Injection, eflapegrastim-xnst, 0.1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36818","name":"Av fuse uppr arm cephalic","description":"Arteriovenous anastomosis, open; by upper arm cephalic vein transposition","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":879.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78647","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0872","name":"Daptomycin (xellia) unrefrig","description":"Injection, daptomycin (xellia), unrefrigerated, not therapeutically equivalent to j0878 or j0873, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6073","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (predominantly base metal)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9272","name":"Inj, dostarlimab-gxly, 10 mg","description":"Injection, dostarlimab-gxly, 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0293U","name":"Psyc suicidal idea mrna 54","description":"Psyc suicidal idea mrna 54","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29040","name":"Appl bdy cst sho to hip head","description":"Application of body cast, shoulder to hips; including head, minerva type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86903","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15016","name":"App skn cl ssp agrf t/a/l ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; each additional 480 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0756T","name":"Dgtz gls mcrscp sld spc grpi","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group i, for microorganisms (eg, acid fast, methenamine silver) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1492","name":"No reported fall","description":"Patients who did not report a fall","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0355U","name":"Apol1 risk variants","description":"Apol1 risk variants","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4329","name":"Singlay, per sq cm","description":"Singlay, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87149","name":"Dna/rna direct probe","description":"Culture, typing; identification by nucleic acid (dna or rna) probe, direct probe technique, per culture or isolate, each organism probed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7021","name":"Suppl and access lung expan","description":"Supplies and accessories for lung expansion airway clearance, continuous high frequency oscillation, and nebulization device (e.g., handset, nebulizer kit, biofilter)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90911","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45563","name":"Exploration/repair of rectum","description":"Exploration, repair, and presacral drainage for rectal injury; with colostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1651.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1267","name":"Pt no act kid transplt wtlst","description":"Patients not observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0539U","name":"Onc sol tumor cfctdna 152gen","description":"Onc sol tumor cfctdna 152gen","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86053","name":"Aqaprn-4 antb flo cytmtry ea","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; flow cytometry (ie, fluorescence-activated cell sorting [facs]), each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99427","name":"Prin care mgmt staff ea addl","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49429","name":"Removal of shunt","description":"Removal of peritoneal-venous shunt","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":528.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0442U","name":"Nfct ds respir nfctj mxa&crp","description":"Nfct ds respir nfctj mxa&crp","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50392","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2056","name":"Ciltacabtagene car-pos t","description":"Ciltacabtagene autoleucel, up to 100 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0306U","name":"Onc mrd nxt-gnrj alys 1st","description":"Onc mrd nxt-gnrj alys 1st","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82965","name":"Assay of gdh enzyme","description":"Glutamate dehydrogenase","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1165","name":"Pt use hspc dur meas pd","description":"Patients who use hospice services any time during the measurement period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4388","name":"Neothelium 4l per sq cm","description":"Neothelium 4l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87337","name":"Entamoeb hist group ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; entamoeba histolytica group","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3471","name":"Surg rep root res anterior","description":"Surg rep root res anterior","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7939","name":"Indexing for osteotomy","description":"Indexing for osteotomy","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0301U","name":"Iadna bartonella ddpcr","description":"Iadna bartonella ddpcr","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5151","name":"Inj, eculizumab-aagh, 2 mg","description":"Injection, eculizumab-aagh (epysqli), biosimilar, 2 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0902T","name":"Qtc ntrvl augmnt alg aly ecg","description":"Qtc interval derived by augmentative algorithmic analysis of input from an external, patient-activated mobile ecg device","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6112","name":"Imp/abut rem dent part max","description":"Imp/abut rem dent part max","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0022","name":"Comm hlth intg svs add 30 m","description":"Community health integration services, each additional 30 minutes per calendar month (list separately in addition to g0019)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0519","name":"New pt-cg dyad dem low cmplx","description":"Management of new patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1456","name":"Inj, fosaprepitant (teva)","description":"Injection, fosaprepitant (teva), not therapeutically equivalent to j1453, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4420","name":"Nuform per sq cm","description":"Nuform, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99211","name":"Off/op est may x req phy/qhp","description":"Office or other outpatient visit for the evaluation and management of an established patient that may not require the presence of a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":8.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3472","name":"Surg rep root res premolar","description":"Surg rep root res premolar","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49621","name":"Rpr parastomal hernia rdc","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; reducible","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0137","name":"Inj, acetaminophen (hikma)","description":"Injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0442U","name":"Nfct ds respir nfctj mxa&crp","description":"Nfct ds respir nfctj mxa&crp","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37282","name":"Rvsc evsc tpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0413U","name":"Onc hl neo opt gen mapg dna","description":"Onc hl neo opt gen mapg dna","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78071","name":"Parathyrd planar w/wo subtrj","description":"Parathyroid planar imaging (including subtraction, when performed); with tomographic (spect)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1185","name":"Imm ckpt inhib not hld no rx","description":"Documentation of immune checkpoint inhibitor therapy not held and/or corticosteroids or immunosuppressants prescribed or administered was not performed, reason not given","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0764T","name":"Asstv alg ecg rsk asmt cncrt","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to concurrently performed electrocardiogram (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82131","name":"Amino acids single quant","description":"Amino acids; single, quantitative, each specimen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1338","name":"Pt f/u 30-180 dys no + imprv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who did not demonstrate positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4014","name":"Nephrology ss","description":"Nephrology mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9959","name":"Unspec sleep ap proc","description":"Unspec sleep ap proc","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15013","name":"Prepj skn cll ssp agrft 1st","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; first 25 sq cm or less of harvested skin","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1459","name":"Pt hosp/pal care dur perf pd","description":"Patient was in hospice or receiving palliative care services at any time during the performance period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4414","name":"Simplichor per sq cm","description":"Simplichor, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1351","name":"Pt cmplt suicd saf pln 120dy","description":"Patients who had a suicide safety plan initiated, reviewed, or updated and reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29035","name":"Appl body cast sho to hips","description":"Application of body cast, shoulder to hips;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2516","name":"Inj, pentamidine isethionate","description":"Injection, pentamidine isethionate, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1370","name":"Rehab support msk care mvp","description":"Rehabilitative support for musculoskeletal care mips value pathway","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4401","name":"Absolv3 per sq cm","description":"Absolv3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87277","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97811","name":"Acup 1/> w/o estim ea add 15","description":"Acupuncture, 1 or more needles; without electrical stimulation, each additional 15 minutes of personal one-on-one contact with the patient, with insertion of needle(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":23.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0975T","name":"Slctv nzmtc dbrdmt s/n/hf 1","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; first 100 sq cm","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7957","name":"Tiss regen edent nonresorb","description":"Tiss regen edent nonresorb","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4337","name":"Artecent trident, per sq cm","description":"Artacent trident, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22523","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":740.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98007","name":"Synch audio-video est hi 40","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high medical decision making. when using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4400","name":"Polygon3 per sq cm","description":"Polygon3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0409U","name":"Onc sld tum dna 80 & rna 36","description":"Onc sld tum dna 80 & rna 36","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6613","name":"Onlay cst base mtl >=3 surfa","description":"Onlay - cast predominantly base metal three or more surfaces","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4148","name":"Enteral feed elastomer daily","description":"Enteral feeding supply kit; elastomeric control fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0718T","name":"Adrc ther prtl rc tear njx","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; injection into supraspinatus tendon including ultrasound guidance, unilateral","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63052","name":"Lam facetc/frmt arthrd lum 1","description":"Laminectomy, facetectomy, or foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s] [eg, spinal or lateral recess stenosis]), during posterior interbody arthrodesis, lumbar; single vertebral segment (list separately in addition to code for primary ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1013T","name":"Lap srg imp/rpl eso nea&pg/r","description":"Laparoscopy, surgical, implantation or replacement of lower esophageal sphincter neurostimulator electrode array and neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver, including cruroplasty and/or electronic ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0928T","name":"Rem interrog dev ccm-d phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system with interim analysis and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30469","name":"Rpr nsl vlv collapse w/rmdlg","description":"Repair of nasal valve collapse with low energy, temperature-controlled (ie, radiofrequency) subcutaneous/submucosal remodeling","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1399","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81464","name":"So gsap cll fr mcrstl ins","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants, microsatellite instability, tumor mutation burden, and rearrangements","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4302","name":"Complete aca, per sq cm","description":"Complete aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2045","name":"Novashield/novogen pr sq cm","description":"Novashield or novogen wound matrix, per square centimeter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0548U","name":"Gfap cleia plasma","description":"Gfap cleia plasma","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61705","name":"Revise circulation to head","description":"Surgery of aneurysm, vascular malformation or carotid-cavernous fistula; by intracranial and cervical occlusion of carotid artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2968.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0560U","name":"Onc mrd gsa cfdna baseline","description":"Onc mrd gsa cfdna baseline","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0608U","name":"Reprdtve med ema rtpcr 10bct","description":"Reprdtve med ema rtpcr 10bct","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4270","name":"Complete sl per sq cm","description":"Complete sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2011","name":"Supra sdrm, per sq cm","description":"Supra sdrm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76070","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1288","name":"Doc rsn no hbp scrn or f/u","description":"Documented reason for not screening or recommending a follow-up for high blood pressure","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9561","name":"Tc99m oxidronate","description":"Technetium tc-99m oxidronate, diagnostic, per study dose, up to 30 millicuries","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0858T","name":"Ext trnscranl mag stimj meas","description":"Externally applied transcranial magnetic stimulation with concomitant measurement of evoked cortical potentials with automated report","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61559","name":"Excision of skull/sutures","description":"Extensive craniectomy for multiple cranial suture craniosynostosis (eg, cloverleaf skull); recontouring with multiple osteotomies and bone autografts (eg, barrel-stave procedure) (includes obtaining grafts)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2809.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15365","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4436","name":"Renati ac membrane per sq cm","description":"Renati ac membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0532U","name":"Rare ds whlgen&mitochdrl dna","description":"Rare ds whlgen&mitochdrl dna","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1410","name":"No gmln brca1/brca2 couns","description":"Patients who did not have germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15952","name":"Exc trchntr pr ulc flp clsr","description":"Excision, trochanteric pressure ulcer, with skin flap closure;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":936.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50230","name":"Removal kidney open radical","description":"Nephrectomy, including partial ureterectomy, any open approach including rib resection; radical, with regional lymphadenectomy and/or vena caval thrombectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1404.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4415","name":"Alexiguard st-l per sq cm","description":"Alexiguard sl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0446","name":"Intens behave ther cardio dx","description":"Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":38.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59200","name":"Insert cervical dilator","description":"Insertion of cervical dilator (eg, laminaria, prostaglandin) (separate procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":64.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21451","name":"Cltx mndblr fx w/mnpj","description":"Closed treatment of mandibular fracture; with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":638.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92631","name":"Hearing aid slctn svc 1st 30","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0399U","name":"Neuro cere folate defncy srm","description":"Neuro cere folate defncy srm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2037","name":"G4derm plus/suprello, pr ml","description":"G4derm plus/suprello, per milliliter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0375U","name":"Onc ovrn bchm asy 7 prtn alg","description":"Onc ovrn bchm asy 7 prtn alg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1019T","name":"Lymphovenous bypass per xtr","description":"Lymphovenous bypass, including robotic assistance, when performed, per extremity","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27638","name":"Remove/graft leg bone lesion","description":"Excision or curettage of bone cyst or benign tumor, tibia or fibula; with allograft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":942.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0663","name":"Team remote e/m new pt 45 mn","description":"Team remote e/m new pt 45mins","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11043","name":"Dbrdmt musc&/fsca 1st 20/<","description":"Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); first 20 sq cm or less","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":156.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95875","name":"Limb exercise test","description":"Ischemic limb exercise test with serial specimen(s) acquisition for muscle(s) metabolite(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28510","name":"Treatment of toe fracture","description":"Closed treatment of fracture, phalanx or phalanges, other than great toe; without manipulation, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6092","name":"Recement supp crown","description":"Recement implant/abutment supported crown","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6525","name":"G com garm lwrleg/ft ngt cus","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, custom, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":773.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62330","name":"Dcmprn prq rmv lig flv 1lmbr","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; one interspace, lumbar","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1201","name":"Med rsn no ace-i/arb rx","description":"Documentation of medical reason(s) for not prescribing ace inhibitor (ace-i) or arb therapy during the measurement period (e.g., pregnancy, history of angioedema to ace-i, other allergy to ace-i and arb, hyperkalemia or history of hyperkalemia while on ace-i or arb therapy, acute kidney injury due t","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4006","name":"Gastroenterology ss","description":"Gastro-enterology mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7608","name":"Acetylcysteine non-comp unit","description":"Acetylcysteine, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per gram","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0853T","name":"Dgtz gls mcrscp mphmtrc ea m","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0249","name":"Tocilizumab for covid-19","description":"Injection, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0790T","name":"Revj rplcmt/rmvl vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracolumbar or lumbar vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1183","name":"Doc imm ckpt inhib hld","description":"Documentation of immune checkpoint inhibitor therapy held and corticosteroids or immunosuppressants prescribed or administered","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0869T","name":"Njx b1 sub mtrl hw fixj aug","description":"Injection(s), bone-substitute material for bone and/or soft tissue hardware fixation augmentation, including intraoperative imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0675","name":"Inj, carboprost, 0.1 mg","description":"Injection, carboprost tromethamine, 0.1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0601U","name":"Nfct ds pji alys 11 bmrks ia","description":"Nfct ds pji alys 11 bmrks ia","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4438","name":"Adhesive clip ext ens contr","description":"Adhesive clip applied to the skin to secure external electrical nerve stimulator controller, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35371","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; common femoral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1064.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35381","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1156.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96380","name":"Admn rsv monoc antb im cnsl","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection, with counseling by physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85400","name":"Fibrinolytic plasmin","description":"Fibrinolytic factors and inhibitors; plasmin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2598","name":"Inj, vasopressin, 1 unit","description":"Injection, vasopressin, 1 unit","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24605","name":"Tx clsd elbow dislc req anes","description":"Treatment of closed elbow dislocation; requiring anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2001","name":"Suct pum ext mgmt sys","description":"Suction pump, home model, portable or stationary, electric, any type, for use with external urine and/or fecal management system","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4032","name":"Rheumatology ss","description":"Rheumatology mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0876T","name":"Duplex scan hemo fstl lmtd","description":"Duplex scan of hemodialysis fistula, computer-aided, limited (volume flow, diameter, and depth, including only body of fistula)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7356","name":"Inj foscarb/foslevodopa 5 mg","description":"Injection, foscarbidopa 0.25 mg/foslevodopa 5 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5125","name":"Inj, releuko 1 mcg","description":"Injection, filgrastim-ayow, biosimilar, (releuko), 1 microgram","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0237","name":"Inj, tocilizumab-anoh, hospi","description":"Injection, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81418","name":"Rx metab gen seq alys pnl 6","description":"Drug metabolism (eg, pharmacogenomics) genomic sequence analysis panel, must include testing of at least 6 genes, including cyp2c19, cyp2d6, and cyp2d6 duplication/deletion analysis","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1598","name":"Inj glycopyrrolate fres kabi","description":"Injection, glycopyrrolate (fresenius kabi), not therapeutically equivalent to j1596, 0.1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6518","name":"Grad com wrap w strap arm cu","description":"Gradient compression wrap with adjustable straps, arm, each, custom","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12021","name":"Tx supfc wnd dehsn w/packing","description":"Treatment of superficial wound dehiscence; with packing","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":201.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33509","name":"Ndsc hrv uxtr art 1 sgm cab","description":"Harvest of upper extremity artery, 1 segment, for coronary artery bypass procedure, endoscopic","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0668","name":"Team remote e/m est pt 40 mn","description":"Team remote e/m est. pt 40mins","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87537","name":"Hiv-2 dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); hiv-2, direct probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4398","name":"Summit ac per sq cm","description":"Summit ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7414","name":"Excision malig lesion>1.25cm","description":"Excision of malignant lesion greater than 1.25 cm","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1295","name":"Pt hx tot col or colon ca","description":"Patients with a diagnosis or past history of total colectomy or colorectal cancer","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23330","name":"Remove shoulder foreign body","description":"Removal of foreign body, shoulder; subcutaneous","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0609","name":"Ferric citrate orl 3 mg iron","description":"Ferric citrate, oral, 3 mg ferric iron, (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0461","name":"Testing for cracked tooth","description":"Testing for cracked tooth","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78232","name":"Salivary gland function std","description":"Salivary gland function study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1053.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42802","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0458U","name":"Onc brst ca s100 a8&a9 elisa","description":"Onc brst ca s100 a8&a9 elisa","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1486","name":"Pt admitted to snf dur eval","description":"Patients admitted to a skilled nursing facility (snf) during the period of evaluation","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0464U","name":"Onc clrct scr qrtsa dna mrk","description":"Onc clrct scr qrtsa dna mrk","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53260","name":"Treatment of urethra lesion","description":"Excision or fulguration; urethral polyp(s), distal urethra","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81524","name":"Onc cns tum dna mthyl 10,000","description":"Oncology (central nervous system tumor), dna methylation analysis of at least 10,000 methylation sites, utilizing dna extracted from formalin-fixed tumor tissue, algorithm(s) reported as probability of matching a reference tumor family and class, and mgmt (o-6-methylguanine-dna methyltransferase) pr","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4401","name":"Absolv3 per sq cm","description":"Absolv3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9293","name":"Fertility cycl tracking soft","description":"Fertility cycle (contraception & conception) tracking software application, fda cleared, per month, includes accessories (e.g., thermometer)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1486","name":"Pt admitted to snf dur eval","description":"Patients admitted to a skilled nursing facility (snf) during the period of evaluation","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98007","name":"Synch audio-video est hi 40","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high medical decision making. when using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0989T","name":"Revj/rmvl ins ptn subq&subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0262U","name":"Onc sld tum rt-pcr 7 gen","description":"Oncology (solid tumor), gene expression profiling by real-time rt-pcr of 7 gene pathways (er, ar, pi3k, mapk, hh, tgfb, notch), formalin-fixed paraffin-embedded (ffpe), algorithm reported as gene pathway activity score","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4002","name":"Ep cardio ss","description":"Electrophysiology cardiac specialist mips specialty set","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0393U","name":"Neu prksn msfl a-syncln prtn","description":"Neu prksn msfl a-syncln prtn","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86161","name":"Complement/function activity","description":"Complement; functional activity, each component","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93702","name":"Bis xtracell fluid analysis","description":"Bioimpedance spectroscopy (bis), extracellular fluid analysis for lymphedema assessment(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0350U","name":"Rx metab/pcx dna 27 gen alys","description":"Rx metab/pcx dna 27 gen alys","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61321","name":"Crnec/crnot drg icr abs ittl","description":"Craniectomy or craniotomy, drainage of intracranial abscess; infratentorial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2384.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0993T","name":"N-invas assmt car rsk w/ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat with concurrent computed tomography scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional (list s","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25671","name":"Perq skel fix rad/uln dislc","description":"Percutaneous skeletal fixation of distal radioulnar dislocation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0681","name":"App of non-sheet skin sub","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; first 25 sq cm or less of wound surface area","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37266","name":"Rvsc evsc fpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5657","name":"Add low ext man aut vol any","description":"Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4281","name":"Barrera slor dl per sq cm","description":"Barrera sl or barrera dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98981","name":"Rtm tx mgmt ea addl 20 min","description":"Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least 1 real-time interactive communication with the patient or caregiver during the calendar month; each additional 20 minutes (list separately in","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4275","name":"Esano aca, per sq cm","description":"Esano aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20550","name":"Njx 1 tendon sheath/ligament","description":"Injection(s); single tendon sheath, or ligament, aponeurosis (eg, plantar fascia)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":38.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":70.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7284","name":"Exc biopsy of saliv glands","description":"Exc biopsy of saliv glands","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64473","name":"Lwr xtr fscl pln blk uni njx","description":"Lower extremity fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0463U","name":"Onc crvx mrna genxprsn 14bmk","description":"Onc crvx mrna genxprsn 14bmk","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2184","name":"Inj, meropenem (b. braun)","description":"Injection, meropenem (b. braun), not therapeutically equivalent to j2185, 100 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4274","name":"Esano ac, per sq cm","description":"Esano ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1448","name":"Injection, trilaciclib, 1mg","description":"Injection, trilaciclib, 1mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1169","name":"Doc med rsn no flu vax","description":"Documentation of medical reason(s) for not administering influenza vaccine (e.g., prior anaphylaxis due to the influenza vaccine)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24116","name":"Exc/crtg b1 cst/tum hum algr","description":"Excision or curettage of bone cyst or benign tumor, humerus; with allograft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0709","name":"Intraoral cmplt radio images","description":"Intraoral cmplt radio images","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1375","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0299U","name":"Onc pan tum whl gen opt mapg","description":"Onc pan tum whl gen opt mapg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4406","name":"Xwrap fenestra per sq cm","description":"Xwrap fenestra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5128","name":"Inj, cimerli, 0.1 mg","description":"Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53453","name":"Tprnl balo cntnc dev rmvl ea","description":"Periurethral transperineal adjustable balloon continence device; removal, each balloon","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26686","name":"Treat hand dislocation","description":"Open treatment of carpometacarpal dislocation, other than thumb; complex, multiple, or delayed reduction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0462","name":"Atropine sulf, nte, 0.01 mg","description":"Injection, atropine sulfate, not therapeutically equivalent to j0461, 0.01 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9563","name":"Ht inj immuno diem","description":"Home injectable therapy, immunotherapy, 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":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37200","name":"Transcatheter biopsy","description":"Transcatheter biopsy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0547","name":"Phone/internet svs 11-20 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5126","name":"Inj alymsys 10 mg","description":"Injection, bevacizumab-maly, biosimilar, (alymsys), 10 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1938","name":"Inj, furosemide, 1 mg","description":"Injection, furosemide, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0437U","name":"Psyc anxiety do mrna 15 bmrk","description":"Psyc anxiety do mrna 15 bmrk","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4431","name":"Pma skin substitute, nos","description":"Pma skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0717T","name":"Adrc ther prtl rc tear","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; adipose tissue harvesting, isolation and preparation of harvested cells, including incubation with cell dissociation enzymes, filtration, washing, and concentration of adrcs","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92286","name":"Ant sgm img i&r speclr mic","description":"Anterior segment imaging with interpretation and report; with specular microscopy and endothelial cell analysis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1165","name":"Pt use hspc dur meas pd","description":"Patients who use hospice services any time during the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2021","name":"Inj, linezolid (hospira)","description":"Injection, linezolid (hospira), not therapeutically equivalent to j2020, 200 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64657","name":"Rmvl bat modulj sys tot sys","description":"Removal of baroreflex activation therapy (bat) modulation system; total system, including lead and pulse generator","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2247","name":"Inj, micafungin (par pharm)","description":"Injection, micafungin sodium (par pharm) not thereapeutically equivalent to j2248, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42508","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":835.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0523","name":"Mgt nw pt dem mod-high cmplx","description":"Management of a new patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0593U","name":"Nfct ds gu pthgn dna 46trgt","description":"Nfct ds gu pthgn dna 46trgt","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0921T","name":"Rmvl perm ccm-d sys 1 dfb ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous defibrillation lead only","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2055","name":"Idecabtagene vicleucel car","description":"Idecabtagene vicleucel, up to 510 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0617U","name":"Cv ascvd dna alys >20000","description":"Cv ascvd dna alys >20000","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0737T","name":"Xenograft impltj artclr surf","description":"Xenograft implantation into the articular surface","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0033","name":"2+ benzo seiz","description":"Two or more benzodiazepine prescriptions ordered for patients who had a diagnosis of seizure disorders, rapid eye movement sleep behavior disorder, benzodiazepine withdrawal, ethanol withdrawal, or severe generalized anxiety disorder on or between january 1 of the year prior to the measurement perio","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0536U","name":"Rbcag ftl rhd pcr alys exon4","description":"Rbcag ftl rhd pcr alys exon4","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0723T","name":"Qmrcp w/o dx mri sm anat ses","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained without diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) during the same session","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":726.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"U0002","name":"Covid-19 lab test non-cdc","description":"2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61582","name":"Craniofacial approach skull","description":"Craniofacial approach to anterior cranial fossa; extradural, including unilateral or bifrontal craniotomy, elevation of frontal lobe(s), osteotomy of base of anterior cranial fossa","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3047.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0728T","name":"Dx alys vstblr implt uni 1st","description":"Diagnostic analysis of vestibular implant, unilateral; with initial programming","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9320","name":"Streptozocin injection","description":"Injection, streptozocin, 1 gram","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31253","name":"Nsl/sins ndsc total","description":"Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior), including frontal sinus exploration, with removal of tissue from frontal sinus, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86362","name":"Mog-igg1 antb cba each","description":"Myelin oligodendrocyte glycoprotein (mog-igg1) antibody; cell-based immunofluorescence assay (cba), each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0671T","name":"Insj ant sgm aq drg dev 1+","description":"Insertion of anterior segment aqueous drainage device into the trabecular meshwork, without external reservoir, and without concomitant cataract removal, one or more","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98003","name":"Synch audio-video new hi 60","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high medical decision making. when using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0336U","name":"Rare ds whl gen seq bld/slv","description":"Rare ds whl gen seq bld/slv","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0621U","name":"Nfct ds lb dna alys>10000","description":"Nfct ds lb dna alys>10000","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1492","name":"No reported fall","description":"Patients who did not report a fall","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1374","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37278","name":"Rvsc evsc fpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1026","name":"Pt hemo > 3mo","description":"The number of adult patient-months in the denominator who were on maintenance hemodialysis using a catheter continuously for three months or longer under the care of the same practitioner or group partner as of the last hemodialysis session of the reporting month","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0184","name":"Inj, amisulpride, 1 mg","description":"Injection, amisulpride, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4003","name":"Emergency med ss","description":"Emergency medicine mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30469","name":"Rpr nsl vlv collapse w/rmdlg","description":"Repair of nasal valve collapse with low energy, temperature-controlled (ie, radiofrequency) subcutaneous/submucosal remodeling","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J1510","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5877","name":"Dup of complt dent-maxill","description":"Dup of complt dent-maxill","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70471","name":"Cta h&n c+ w/noncontrast img","description":"Computed tomographic angiography (cta), head and neck, with contrast material(s), including noncontrast images, when performed, and image postprocessing","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4032","name":"Rheumatology ss","description":"Rheumatology mips specialty set","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0755T","name":"Dgtz gls mcrscp sld level vi","description":"Digitization of glass microscope slides for level vi, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0691T","name":"Auto alys xst ct std vrt fx","description":"Automated analysis of an existing computed tomography study for vertebral fracture(s), including assessment of bone density when performed, data preparation, interpretation, and report","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0842T","name":"Dgtz gls mcrscp pth cslt ea","description":"Digitization of glass microscope slides for pathology consultation during surgery; each additional tissue block with frozen section(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37274","name":"Rvsc evsc fpvt athrc cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22837","name":"Ant thrc vrt body tethrg 8+","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; 8 or more vertebral segments","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":1598.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4436","name":"Renati ac membrane per sq cm","description":"Renati ac membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0510U","name":"Onc pncrtc ca alg alys 16gen","description":"Onc pncrtc ca alg alys 16gen","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0931T","name":"Ephys eval ccm-d ld separate","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), separate from initial implantation or replacement with testing of cardiac cont","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0803T","name":"Tcat rmv&rpl2chmb ldls pm rv","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ve","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1013T","name":"Lap srg imp/rpl eso nea&pg/r","description":"Laparoscopy, surgical, implantation or replacement of lower esophageal sphincter neurostimulator electrode array and neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver, including cruroplasty and/or electronic ","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93596","name":"R&l hrt cath chd nml nt cnj","description":"Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); normal native connections","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0491","name":"Inj anifrolumab-fnia 1mg","description":"Injection, anifrolumab-fnia, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1247","name":"Pt resp true best int","description":"Patient responded completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57291","name":"Construction of vagina","description":"Construction of artificial vagina; without graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":617.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4287","name":"Disp col sto bag breast milk","description":"Disposable collection and storage bag for breast milk, any size, any type, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1308","name":"Inj, famotidine, 0.25 mg","description":"Injection, famotidine, 0.25 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2025","name":"Miro3d per cubic cm","description":"Miro3d, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26548","name":"Reconstruct finger joint","description":"Repair and reconstruction, finger, volar plate, interphalangeal joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1018.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5411","name":"Dentures adjust cmplt mand","description":"Adjust complete denture - mandibular","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49622","name":"Rpr parastomal hrna ncr/strn","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; incarcerated or strangulated","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5148","name":"Inj, nyposi 1 mcg","description":"Injection, filgrastim-txid (nypozi), biosimilar, 1 microgram","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98000","name":"Synch audio-video new sf 15","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 15 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1425","name":"Surgical care mvp","description":"Surgical care mips value pathway","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1195","name":"Rpt wo imp/con mmr/msi","description":"Surgical pathology reports that do not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both, reason not given","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1325","name":"Doc med rsn not seen","description":"Patients who were not seen for reasons documented by clinician for patient or medical reasons (e.g., inadequate time for follow-up, patients who received a prior intravitreal or periocular steroid injection within the last six (6) months and had a subsequent iop evaluation with iop <25mm hg within s","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11981","name":"Insertion drug dlvr implant","description":"Insertion, drug-delivery implant (ie, bioresorbable, biodegradable, non-biodegradable)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":100.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":127.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0815T","name":"Us rems b1 dns hips plvs/spi","description":"Ultrasound-based radiofrequency echographic multi-spectrometry (rems), bone-density study and fracture-risk assessment, 1 or more sites, hips, pelvis, or spine","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81463","name":"So gsap cl fr cpy nmbr&mcrst","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis, copy number variants, and microsatellite instability","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1272","name":"Pts kid transplt wtlst","description":"Patients observed on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0730T","name":"Trabeculotomy lsr w/oct gdn","description":"Trabeculotomy by laser, including optical coherence tomography (oct) guidance","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38572","name":"Laparoscopy lymphadenectomy","description":"Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy and peri-aortic lymph node sampling (biopsy), single or multiple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1132.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0562","name":"Complex simulation w/pet-ct","description":"Therapeutic radiology simulation-aided field setting; complex, including acquisition of pet and ct imaging data required for radiopharmaceutical-directed radiation therapy treatment planning (i.e., modeling)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0522","name":"Mgt nw pt dementia low cmplx","description":"Management of a new patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1459","name":"Pt hosp/pal care dur perf pd","description":"Patient was in hospice or receiving palliative care services at any time during the performance period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98985","name":"Rtm dev sply mscsk sys 2-15d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of musculoskeletal system, 2-15 days in a 30-day period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33901","name":"Perq p-art revsc 1 nm nt bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, bilateral","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4322","name":"Caregraft, per sq cm","description":"Caregraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4391","name":"Amnioplast double per sq cm","description":"Amnioplast double, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0392U","name":"Rx metab genrx ia 16 genes","description":"Rx metab genrx ia 16 genes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0674T","name":"Laps insj nw/rpcmt prm isdss","description":"Laparoscopic insertion of new or replacement of permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including an implantable pulse generator and diaphragmatic lead(s)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0945T","name":"Intraop assmt abnl tum tiss","description":"Intraoperative assessment for abnormal (tumor) tissue, in-vivo, following partial mastectomy (eg, lumpectomy) using computer-aided fluorescence imaging (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58301","name":"Remove intrauterine device","description":"Removal of intrauterine device (iud)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":68.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":36.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97551","name":"Caregiver traing ea addl 15","description":"Caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patie","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0559","name":"Unrelat prac follow up visit","description":"Post-operative follow-up visit complexity inherent to evaluation and management services addressing surgical procedure(s), provided by a physician or qualified health care professional who is not the practitioner who performed the procedure (or in the same group practice) and is of the same or of a ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80504","name":"Path clin consltj mod 21-40","description":"Pathology clinical consultation; for a moderately complex clinical problem, with review of patients history and medical records and moderate level of medical decision making when using time for code selection, 21-40 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53865","name":"Cysto insj dev ischmc rmdlg","description":"Cystourethroscopy with insertion of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7414","name":"Excision malig lesion>1.25cm","description":"Excision of malignant lesion greater than 1.25 cm","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98979","name":"Rtm tx mgmt 1st 10 min","description":"Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least 1 real-time interactive communication with the patient or caregiver during the calendar month; first 10 minutes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6180","name":"Implnt maint proced","description":"Implnt maint proced","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6073","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (predominantly base metal)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99416","name":"Prolng clin staff svc ea add","description":"Prolonged clinical staff service (the service beyond the highest time in the range of total time of the service) during an evaluation and management service in the office or outpatient setting, direct patient contact with physician supervision; each additional 30 minutes (list separately in addition","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1390","name":"Pt no doc exm for rec","description":"Patients who do not have a documented exam performed for recurrence of melanoma or no documentation within the performance period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0537","name":"Risk ascvd tst once pr 12 mo","description":"Administration of a standardized, evidence-based atherosclerotic cardiovascular disease (ascvd) risk assessment, 5-15 minutes, not more often than every 12 months","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1010","name":"Inj, methylpred acetate 1 mg","description":"Injection, methylprednisolone acetate, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0394U","name":"Pfas 16 pfas compnd lc ms/ms","description":"Pfas 16 pfas compnd lc ms/ms","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0509","name":"Crit care telehea consult 50","description":"Telehealth consultation, critical care, subsequent, physicians typically spend 50 minutes communicating with the patient and providers via telehealth","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34709","name":"Plmt xtn prosth evasc rpr","description":"Placement of extension prosthesis(es) distal to the common iliac artery(ies) or proximal to the renal artery(ies) for endovascular repair of infrarenal abdominal aortic or iliac aneurysm, false aneurysm, dissection, penetrating ulcer, including pre-procedure sizing and device selection, all nonselec","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":352.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0966T","name":"I&cst prp jw xpn dl arch fxd","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, fixed hinge mechanism","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0723T","name":"Qmrcp w/o dx mri sm anat ses","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained without diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) during the same session","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4370","name":"Aeroguard per sq cm","description":"Aeroguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37290","name":"Revsc evsc tpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1360","name":"Suicd c-ssrs assessment","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20612","name":"Aspirate/inj ganglion cyst","description":"Aspiration and/or injection of ganglion cyst(s) any location","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1286","name":"Bmi doc onl fup not cmpltd","description":"Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4340","name":"Simpligraft, per sq cm","description":"Simpligraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0313U","name":"Onc pncrs dna&mrna seq 74","description":"Onc pncrs dna&mrna seq 74","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4353","name":"Xceed tl matrix per sq cm","description":"Xceed tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27422","name":"Revision of unstable kneecap","description":"Reconstruction of dislocating patella; with extensor realignment and/or muscle advancement or release (eg, campbell, goldwaite type procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":895.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7519","name":"Inj. mycophenolate mofetil","description":"Injection, mycophenolate mofetil, 10 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4384","name":"Axolotl dual ult per sq cm","description":"Axolotl dualgraft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9996","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0367U","name":"Onc bldr 10 flwg trurl rescj","description":"Onc bldr 10 flwg trurl rescj","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0220","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0914T","name":"Prq tcat thr rx ntrc bal sep","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting) performed on a separate target lesion from the target lesion treated with balloon angioplasty, coronary stent placement or coronary atherectomy, including mechanical dilation b","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0936T","name":"Photobiomodulation ther rta","description":"Photobiomodulation therapy of retina, single session","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5149","name":"Inj, aflibercept-abzv, 1 mg","description":"Injection, aflibercept-abzv (enzeevu), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67808","name":"Remove eyelid lesion(s)","description":"Excision of chalazion; under general anesthesia and/or requiring hospitalization, single or multiple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2027","name":"Matriderm per sq cm","description":"Matriderm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9220","name":"Indigotindisulfonate sod 1mg","description":"Injection, indigotindisulfonate sodium, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64784","name":"Remove nerve lesion","description":"Excision of neuroma; major peripheral nerve, except sciatic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":806.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9432","name":"Med food non inborn err meta","description":"Medical foods for non-inborn errors of metabolism","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0311U","name":"Nfct ds bct quan antmcrb sc","description":"Nfct ds bct quan antmcrb sc","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64476","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4038","name":"Vascular surgery ss","description":"Vascular surgery mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26455","name":"Incision of finger tendon","description":"Tenotomy, flexor, finger, open, each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0209","name":"Inj, sod thiosulfate (hope)","description":"Injection, sodium thiosulfate (hope), 100 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9949","name":"Repair sleep apnea appliance","description":"Repair sleep apnea appliance","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4296","name":"Rebound matrix, per sq cm","description":"Rebound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57455","name":"Biopsy of cervix w/scope","description":"Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":91.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99427","name":"Prin care mgmt staff ea addl","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1495","name":"Fall w/ poc, no fall","description":"Patients that reported a fall occurred who had a plan of care for falls documented or patients that did not report a fall","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1482","name":"Pos quan hep c or qual rna","description":"Positive/detectable hepatitis c virus quantitative or qualitative rna test result during the denominator identification period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77318","name":"Brachytx isodose complex","description":"Brachytherapy isodose plan; complex (calculation[s] made from over 10 sources, or remote afterloading brachytherapy, over 12 channels), includes basic dosimetry calculation(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0708","name":"Intraoral bite radio image","description":"Intraoral bite radio image","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0975T","name":"Slctv nzmtc dbrdmt s/n/hf 1","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; first 100 sq cm","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0577","name":"Inj, brixadi, 7 days or less","description":"Injection, buprenorphine extended-release (brixadi), less than or equal to 7 days of therapy","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69730","name":"Rplc oi implt sk tc esp>=100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0175","name":"Inj, donanemab-azbt, 2 mg","description":"Injection, donanemab-azbt, 2 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2351","name":"Inj ocrelizumab 1mg hya-ocsq","description":"Injection, ocrelizumab, 1 mg and hyaluronidase-ocsq","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0787T","name":"Revj/rmvl nea sac w/nstim","description":"Revision or removal of neurostimulator electrode array, sacral, with integrated neurostimulator","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0672T","name":"Ndovag cryg rf remdl tiss","description":"Endovaginal cryogen-cooled, monopolar radiofrequency remodeling of the tissues surrounding the female bladder neck and proximal urethra for urinary incontinence","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0651","name":"Inj, levothyroxine, freskabi","description":"Injection, levothyroxine sodium (fresenius kabi), not therapeutically equivalent to j0650, 10 mcg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86364","name":"Tiss trnsgltmnase ea ig clas","description":"Tissue transglutaminase, each immunoglobulin (ig) class","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4310","name":"Procenta, per 100 mg","description":"Procenta, per 100 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4424","name":"Revive ft per sq cm","description":"Revive ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21138","name":"Rdctj forehead cntrg&prostc","description":"Reduction forehead; contouring and application of prosthetic material or bone graft (includes obtaining autograft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1062.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6038","name":"Multiax rotation attachment","description":"Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3503","name":"Surg exp root surf molar","description":"Surg exp root surf molar","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12016","name":"Rpr fe/e/en/l/m 12.6-20.0 cm","description":"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 12.6 cm to 20.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0482U","name":"Ob pe biochem asy sfit1&pigf","description":"Ob pe biochem asy sfit1&pigf","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84085","name":"Assay of rbc pg6d enzyme","description":"Phosphogluconate, 6-, dehydrogenase, rbc","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97037","name":"Appl modality 1+lllt po pain","description":"Application of a modality to 1 or more areas; low-level laser therapy (ie, nonthermal and non-ablative) for post-operative pain reduction","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4318","name":"Fem urinary cup w/wo attch","description":"Female external urinary collection cup, with or without ring attachment, per day","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":8.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1439","name":"Sig ocu cond imp surg out","description":"Significant ocular conditions that impact the visual outcome of surgery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84081","name":"Assay phosphatidylglycerol","description":"Phosphatidylglycerol","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54560","name":"Exploration for testis","description":"Exploration for undescended testis with abdominal exploration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":754.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90958","name":"Esrd srv 2-3 vsts p mo 12-19","description":"End-stage renal disease (esrd) related services monthly, for patients 12-19 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 2-3 face-to-face visits by a physician or other qualified health care professional per m","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0874T","name":"Rmvl pertl ascites pmp sys","description":"Removal of a peritoneal ascites pump system, including implanted peritoneal ascites pump and indwelling bladder and peritoneal catheters","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1241","name":"Pt no resp seen as person","description":"Patient did not respond to the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4376","name":"Duograft aa per sq cm","description":"Duograft aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4373","name":"Membrane wrp lt per sq cm","description":"Membrane wrap lite, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0470U","name":"Onc orop detcj mrd 8 dna hpv","description":"Onc orop detcj mrd 8 dna hpv","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0615U","name":"Bbrgdrferi ld antb detcj 26","description":"Bbrgdrferi ld antb detcj 26","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4284","name":"Dermabind sl, per sq cm","description":"Dermabind sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0449U","name":"Car scr sev inh cond 5 genes","description":"Car scr sev inh cond 5 genes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9998","name":"Doc med rsn <3 colon","description":"Documentation of medical reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., last colonoscopy incomplete, last colonoscopy had inadequate prep, piecemeal removal of adenomas, or sessile serrated polyps >= 20 mm in size, last colonoscopy found greater than 10 adenomas, lo","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9076","name":"Inj, cyclophos (baxter) 5mg","description":"Injection, cyclophosphamide (baxter), 5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50075","name":"Nl rmvl lg staghorn calculus","description":"Nephrolithotomy; removal of large staghorn calculus filling renal pelvis and calyces (including anatrophic pyelolithotomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1612.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71047","name":"X-ray exam chest 3 views","description":"Radiologic examination, chest; 3 views","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90759","name":"Hep b vac 3ag 10mcg 3 dos im","description":"Hepatitis b vaccine (hepb), 3-antigen (s, pre-s1, pre-s2), 10 mcg dosage, 3 dose schedule, for intramuscular use","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1161","name":"Pt anphx due to dtp bef 13","description":"Patient had anaphylaxis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87467","name":"Hepatitis b surface ag quan","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; hepatitis b surface antigen (hbsag), quantitative","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0233","name":"Intra inf, toci, first dose","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0684","name":"App non-sheet skin sb g addl","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area or part thereof, or each additional 1% o","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0566","name":"3d bn img algor drvd fr mri","description":"3d radiodensity-value bone imaging, algorithm derived, from previous magnetic resonance examination of the same anatomy","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4005","name":"Family medicine ss","description":"Family medicine mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0457","name":"Tlso flex trnk sj-ss pre ots","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":982.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11401","name":"Exc tr-ext b9+marg 0.6-1 cm","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 0.6 to 1.0 cm","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":90.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1236","name":"Baseline mrs > 2","description":"Baseline mrs > 2","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0964T","name":"I&cust prep jaw xpnsj 1arch","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; single arch, without mandibular advancement mechanism","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93571","name":"Iv dop vel&/press c flo 1st","description":"Intravascular doppler velocity and/or pressure derived coronary flow reserve measurement (coronary vessel or graft) during coronary angiography including pharmacologically induced stress, when performed; initial vessel (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0706","name":"Intraoral occlus radio image","description":"Intraoral occlus radio image","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0654","name":"Inj, liothyronine, 1 mcg","description":"Injection, liothyronine, 1 mcg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21401","name":"Closed tx orbit w/manipulj","description":"Closed treatment of fracture of orbit, except blowout; with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86596","name":"Voltage-gtd ca chnl antb ea","description":"Voltage-gated calcium channel antibody, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0788T","name":"Elec aly smp iins sp/sac nrv","description":"Electronic analysis with simple programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detecti","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59020","name":"Fetal contract stress test","description":"Fetal contraction stress test","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0684T","name":"Peri-px dev eval isdss ip","description":"Peri-procedural device evaluation (in-person) and programming of device system parameters before or after a surgery, procedure, or test with analysis, review, and report by a physician or other qualified health care professional, permanent implantable synchronized diaphragmatic stimulation system fo","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0268","name":"Removal of impacted wax md","description":"Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27175","name":"Treat slipped epiphysis","description":"Treatment of slipped femoral epiphysis; by traction, without reduction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":758.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87513","name":"H pylri clrthmcn rst amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); helicobacter pylori (h. pylori), clarithromycin resistance, amplified probe technique","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2251","name":"Inj midazolam in 0.9% nacl","description":"Injection, midazolam in 0.9% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4367","name":"Amniocore sl, per sq cm","description":"Amniocore sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72074","name":"X-ray exam thorac spine4/>vw","description":"Radiologic examination, spine; thoracic, minimum of 4 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1159","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0606U","name":"Hem red cll memb do rbc oge","description":"Hem red cll memb do rbc oge","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0558","name":"Adv prim care mgmt lvl 3","description":"Advanced primary care management services for a patient that is a qualified medicare beneficiary with multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, which place the patient at significant risk of death, acute exacerbation/decompensat","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21116","name":"Injection jaw joint x-ray","description":"Injection procedure for temporomandibular joint arthrography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49591","name":"Rpr aa hrn 1st < 3 cm rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, reducible","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1229","name":"Pt w/ +hcv +vir ref win 1 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, is referred within 1 month of the reactive hcv antibody test to a clinician who treats hcv infection","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2013","name":"Innovamatrix fs, per sq cm","description":"Innovamatrix fs, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9272","name":"Inj, dostarlimab-gxly, 10 mg","description":"Injection, dostarlimab-gxly, 10 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99424","name":"Prin care mgmt phys 1st 30","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0305U","name":"Hem rbc fnclty&dfrm shr strs","description":"Hem rbc fnclty&dfrm shr strs","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1010","name":"Inj, methylpred acetate 1 mg","description":"Injection, methylprednisolone acetate, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2022","name":"Innovabrn/innovamatx xl sqcm","description":"Innovaburn or innovamatrix xl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":4.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0074A","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87110","name":"Chlamydia culture","description":"Culture, chlamydia, any source","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0571","name":"Intraop nerve cryoablation","description":"Intraoperative nerve(s) cryoablation for post-surgical pain relief (list separately in addition to code for primary service)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6111","name":"Implnt/abut remov dent mand","description":"Implnt/abut remov dent mand","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1462","name":"Pt clin ind hd image","description":"Patients with clinical indications for imaging of the head","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0427U","name":"Monocyte dstrbj wdth whl bld","description":"Monocyte dstrbj wdth whl bld","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0548","name":"Phone/inter svs 21-30 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37299","name":"Revsc evsc imvt angio cpx ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1286","name":"Bmi doc onl fup not cmpltd","description":"Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4337","name":"Artecent trident, per sq cm","description":"Artacent trident, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0336U","name":"Rare ds whl gen seq bld/slv","description":"Rare ds whl gen seq bld/slv","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5947","name":"Mand implt sup fix","description":"Mand implt sup fix","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1215","name":"Med rsn for no doc spiro","description":"Documentation of medical reason(s) for not documenting and reviewing spirometry results (e.g., patients with dementia or tracheostomy)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3394","name":"Inj, lovotibeglogene autotem","description":"Injection, lovotibeglogene autotemcel, per treatment","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95805","name":"Multiple sleep latency test","description":"Multiple sleep latency or maintenance of wakefulness testing, recording, analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0235","name":"Intrav inf, mon anti, fir do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0865T","name":"Quan mri alys brn w/o dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion identification, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31760","name":"Tracheoplasty intrathoracic","description":"Tracheoplasty; intrathoracic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1598.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1368","name":"Prev trt inf d/o hiv/hep mvp","description":"Prevention and treatment of infectious disorders including hepatitis c and hiv mips value pathway","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26608","name":"Treat metacarpal fracture","description":"Percutaneous skeletal fixation of metacarpal fracture, each bone","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":573.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1194","name":"Med rsn no imp/con mmr/msi","description":"Documentation of medical reason(s) surgical pathology reports did not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both tests were not included (e.g., patient will not be treated with checkpoint inhibitor therap","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4010","name":"Infectious disease ss","description":"Infectious disease mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0773T","name":"Vr px dissoc svc oth phy 1st","description":"Virtual reality (vr) procedural dissociation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports; initial 15 min","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42975","name":"Dise eval slp do brth flx dx","description":"Drug-induced sleep endoscopy, with dynamic evaluation of velum, pharynx, tongue base, and larynx for evaluation of sleep-disordered breathing, flexible, diagnostic","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1315","name":"Crc no doc no rsn","description":"Colorectal cancer screening results were not documented and reviewed; reason not otherwise specified","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0409U","name":"Onc sld tum dna 80 & rna 36","description":"Onc sld tum dna 80 & rna 36","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94617","name":"Exercise tst brncspsm w/ecg","description":"Exercise test for bronchospasm, including pre- and post-spirometry and pulse oximetry; with electrocardiographic recording(s)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87070","name":"Culture othr specimn aerobic","description":"Culture, bacterial; any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4000","name":"Dermatology ss","description":"Dermatology mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4337","name":"Artecent trident, per sq cm","description":"Artacent trident, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82948","name":"Reagent strip/blood glucose","description":"Glucose; blood, reagent strip","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7299","name":"Intraut copp cont (miudella)","description":"Intrauterine copper contraceptive (miudella)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4407","name":"Xwrap tribus per sq cm","description":"Xwrap tribus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7261","name":"Primary closure sinus perf","description":"Primary closure of a sinus perforation","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0337U","name":"Onc plsm cell do&myeloma id","description":"Onc plsm cell do&myeloma id","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0855T","name":"Dgtz gls mcrscp b1 marow smr","description":"Digitization of glass microscope slides for bone marrow, smear interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4437","name":"Revival ac per sq cm","description":"Revival ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1340","name":"Indx whodas 2.0 or sds","description":"Index assessment completed using the 12-item whodas 2.0 or sds during the denominator identification period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45383","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":374.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2045","name":"Novashield/novogen pr sq cm","description":"Novashield or novogen wound matrix, per square centimeter","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27566","name":"Treat kneecap dislocation","description":"Open treatment of patellar dislocation, with or without partial or total patellectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1079.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0797T","name":"Tcat ins 2chmbr ldls pm rv","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ventricular pace","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0904T","name":"Ecg alg 12 ld rdcd trcg only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; tracing only","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58180","name":"Partial hysterectomy","description":"Supracervical abdominal hysterectomy (subtotal hysterectomy), with or without removal of tube(s), with or without removal of ovary(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1081.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0362U","name":"Onc pap thyr ca rna 82&10","description":"Onc pap thyr ca rna 82&10","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0955T","name":"Tot impl amei removal","description":"Totally implantable active middle ear hearing implant; removal, including removal of sound processor and all implant components","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0951T","name":"Tot impl amei 1st plmt","description":"Totally implantable active middle ear hearing implant; initial placement, including mastoidectomy, placement of and attachment to sound processor","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0975T","name":"Slctv nzmtc dbrdmt s/n/hf 1","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; first 100 sq cm","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0618","name":"Inj, calcium chloride, 2 mg","description":"Injection, calcium chloride, 2 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0002","name":"Opt care kidney hlth mvp","description":"Optimal care for kidney health mips value pathways","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44408","name":"Colonoscopy w/decompression","description":"Colonoscopy through stoma; with decompression (for pathologic distention) (eg, volvulus, megacolon), including placement of decompression tube, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42410","name":"Excise parotid gland/lesion","description":"Excision of parotid tumor or parotid gland; lateral lobe, without nerve dissection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6634","name":"Onlay titanium","description":"Onlay - titanium","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90846","name":"Family psytx w/o pt 50 min","description":"Family psychotherapy (without the patient present), 50 minutes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":114.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45303","name":"Proctosigmoidoscopy dilate","description":"Proctosigmoidoscopy, rigid; with dilation (eg, balloon, guide wire, bougie)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4317","name":"Vitograft, per sq cm","description":"Vitograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96380","name":"Admn rsv monoc antb im cnsl","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection, with counseling by physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19288","name":"Perq dev breast add mr guide","description":"Placement of breast localization device(s) (eg clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; each additional lesion, including magnetic resonance guidance (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":764.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53447","name":"Remove/replace ur sphincter","description":"Removal and replacement of inflatable urethral/bladder neck sphincter including pump, reservoir, and cuff at the same operative session","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":913.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83655","name":"Assay of lead","description":"Lead","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1181","name":"Gr 2 or> dia or gr2 or> col","description":"Grade 2 or above diarrhea and/or grade 2 or above colitis","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92623","name":"Dx aly aud oi snd prcsr each","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; each additional 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0033","name":"2+ benzo seiz","description":"Two or more benzodiazepine prescriptions ordered for patients who had a diagnosis of seizure disorders, rapid eye movement sleep behavior disorder, benzodiazepine withdrawal, ethanol withdrawal, or severe generalized anxiety disorder on or between january 1 of the year prior to the measurement perio","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1373","name":"Mst rec gsa >=8 and <=9","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 8.0% and <= 9.0%","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1342","name":"Pts died perf per","description":"Patients who died during the performance period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0901T","name":"Plmt bone marrow smplg port","description":"Placement of bone marrow sampling port, including imaging guidance when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26756","name":"Pin finger fracture each","description":"Percutaneous skeletal fixation of distal phalangeal fracture, finger or thumb, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":497.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0990T","name":"Trncrv inst biod hydrgl mtrl","description":"Transcervical instillation of biodegradable hydrogel materials, intrauterine","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2427","name":"Inj, invega hafyera/trinza","description":"Injection, paliperidone palmitate extended release (invega hafyera, or invega trinza), 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9129","name":"Photobio therpy-sub 15 mins","description":"Photobio therpy-sub 15 mins","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0040","name":"Pt phys/occ therapy","description":"Patient already receiving physical/occupational/speech/recreational therapy during the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82166","name":"Assay anti-mullerian horm","description":"Anti-mullerian hormone (amh)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2544","name":"Dental onlay metl 4/more sur","description":"Onlay - metallic - four or more surfaces","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27355","name":"Remove femur lesion","description":"Excision or curettage of bone cyst or benign tumor of femur;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":720.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1421","name":"Dermatological care mvp","description":"Dermatological care mips value pathway","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1338","name":"Pt f/u 30-180 dys no + imprv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who did not demonstrate positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4376","name":"Duograft aa per sq cm","description":"Duograft aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1223","name":"Glaucoma plan of care doc","description":"Glaucoma plan of care documented","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4290","name":"Membrane wrap hydr per sq cm","description":"Membrane wrap-hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77081","name":"Dxa bone density appendiculr","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1396","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0020M","name":"Onc cns alys 30000 dna loci","description":"Oncology (central nervous system), analysis of 30,000 dna methylation loci by methylation array, utilizing dna extracted from tumor tissue, diagnostic algorithm reported as probability of matching a reference tumor subclass","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0542","name":"No pt prsnt train add 15","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7509","name":"Marsupialization odon cyst","description":"Marsupialization odon cyst","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0930T","name":"Ephys eval ccm-d ld 1st impl","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), at time of initial implantation or replacement with testing of cardiac contrac","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6610","name":"G com stcking bk 18-30 custm","description":"Gradient compression stocking, below knee, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7471","name":"Rem exostosis any site","description":"Removal of lateral exostosis (maxilla or mandible)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2027","name":"Matriderm per sq cm","description":"Matriderm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7411","name":"Excision benign lesion>1.25c","description":"Excision of benign lesion greater than 1.25 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1485","name":"Neg viro resp hep c/qual rna","description":"Patients who did not achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4259","name":"Celera per sq cm","description":"Celera dual layer or celera dual membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31259","name":"Nsl/sins ndsc sphn tiss rmvl","description":"Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior), including sphenoidotomy, with removal of tissue from the sphenoid sinus","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":425.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0781T","name":"Brnchsc rf dstrj pulm nrv bi","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; bilateral mainstem bronchi","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72146","name":"Mri chest spine w/o dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; without contrast material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1387","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55867","name":"Laps surg prst8ect smpl stot","description":"Laparoscopy, surgical prostatectomy, simple subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy), includes robotic assistance, when performed","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1150","name":"Lvef <=40% or mod/sev l vsf","description":"Current or prior left ventricular ejection fraction (lvef) less than or equal to 40% or documentation of moderately or severely depressed left ventricular systolic function","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4423","name":"Biolab tri wrap fl per sq cm","description":"Biolab tri-membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99483","name":"Assmt & care pln pt cog imp","description":"Assessment of and care planning for a patient with cognitive impairment, requiring an independent historian, in the office or other outpatient, home or domiciliary or rest home, with all of the following required elements: cognition-focused evaluation including a pertinent history and examination, m","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":333.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0224","name":"Pemivibart infusion","description":"Intravenous infusion, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppr","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D8671","name":"Periodic orth treat w surg","description":"Periodic orth treat w surg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0526","name":"Est pt-cg dyad dem hig cmplx","description":"Management of established patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1206","name":"Isa not red 3pts/no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4258","name":"Enverse, per sq cm","description":"Enverse, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86325","name":"Other immunoelectrophoresis","description":"Immunoelectrophoresis; other fluids (eg, urine, cerebrospinal fluid) with concentration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2267","name":"Inj, mirikizumab-mrkz, 1 mg","description":"Injection, mirikizumab-mrkz, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0623U","name":"Ai ms dna mthyl alys >5000","description":"Ai ms dna mthyl alys >5000","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0679T","name":"Laps rmvl lead isdss","description":"Laparoscopic removal of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9154","name":"Artificial saliva, 1 ml","description":"Artificial saliva, 1 ml","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7771","name":"Alveolus clsd reduc stblz te","description":"Alveolus closed reduction stabilization of teeth","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0290U","name":"Pain mgmt mrna gen xprsn 36","description":"Pain mgmt mrna gen xprsn 36","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0968T","name":"Insj/rplcmt epcrnl nstim sys","description":"Insertion or replacement of epicranial neurostimulator system, including electrode array and pulse generator, with connection to electrode array","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54670","name":"Repair testis injury","description":"Suture or repair of testicular injury","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":457.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1395","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1247","name":"Pt resp true best int","description":"Patient responded completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0687T","name":"Tx amblyopia dev setup 1st","description":"Treatment of amblyopia using an online digital program; device supply, educational set-up, and initial session","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26504","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":987.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31242","name":"Nsl/sinus ndsc rf abltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by radiofrequency ablation, posterior nasal nerve","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0717T","name":"Adrc ther prtl rc tear","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; adipose tissue harvesting, isolation and preparation of harvested cells, including incubation with cell dissociation enzymes, filtration, washing, and concentration of adrcs","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0708","name":"Intraoral bite radio image","description":"Intraoral bite radio image","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0999T","name":"Autol musc cell therapy hrvg","description":"Autologous muscle cell therapy, harvesting of muscle progenitor cells, including ultrasound guidance, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77091","name":"Tbs techl calculation only","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical calculation only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1443","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1834","name":"Inj, isoniazid, 1 mg","description":"Injection, isoniazid, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0514","name":"Prolong prev svcs, addl 30m","description":"Prolonged preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient contact beyond the usual service; each additional 30 minutes (list separately in addition to code g0513 for additional 30 minutes of preventi","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":53.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3389","name":"Topi adm prad zami per treat","description":"Topical administration, prademagene zamikeracel, per treatment","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6599","name":"G comp bandage short stretch","description":"Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0941T","name":"Cysto flx ins&xpns urtl scaf","description":"Cystourethroscopy, flexible; with insertion and expansion of prostatic urethral scaffold using integrated cystoscopic visualization","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88241","name":"Frozen cell preparation","description":"Thawing and expansion of frozen cells, each aliquot","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1257","name":"Cvd risk assess not perf","description":"Cvd risk assessment not performed or incomplete (e.g., cvd risk assessment was not documented), reason not otherwise specified","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5147","name":"Inj, aflibercept-ayyh, 1 mg","description":"Injection, aflibercept-ayyh (pavblu), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99437","name":"Chrnc care mgmt phys ea addl","description":"Chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, or funct","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2019","name":"Kerecis marigen shld sq cm","description":"Kerecis omega3 marigen shield, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4297","name":"Emerge matrix, per sq cm","description":"Emerge matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4321","name":"Renograft, per sq cm","description":"Renograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0810T","name":"Subrta njx rx agt w/vtrc","description":"Subretinal injection of a pharmacologic agent, including vitrectomy and 1 or more retinotomies","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1783","name":"Vac admin human pap dose 3","description":"Vac admin human pap dose 3","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74018","name":"Radex abdomen 1 view","description":"Radiologic examination, abdomen; 1 view","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7295","name":"Eth estr and eton monthly","description":"Ethinyl estradiol and etonogestrel 0.015mg, 0.12mg per 24 hours; monthly vaginal ring, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4300","name":"Acesso tl, per sq cm","description":"Acesso tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85652","name":"Rbc sed rate automated","description":"Sedimentation rate, erythrocyte; automated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0685T","name":"Interrog dev eval isdss ip","description":"Interrogation device evaluation (in-person) with analysis, review and report by a physician or other qualified health care professional, including connection, recording and disconnection per patient encounter, permanent implantable synchronized diaphragmatic stimulation system for augmentation of ca","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82943","name":"Assay of glucagon","description":"Glucagon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0571","name":"Intraop nerve cryoablation","description":"Intraoperative nerve(s) cryoablation for post-surgical pain relief (list separately in addition to code for primary service)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2792","name":"Crown full cast noble metal","description":"Crown-full cast noble metal","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33287","name":"Rmv&rplcmt phrnc nrv stim pg","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5938","name":"Resct proth max comp remov","description":"Resct proth max comp remov","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93586","name":"Vngrph chd coronary sinus","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; coronary sinus (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1271","name":"Inj doxycycline hyclate 1 mg","description":"Injection, doxycycline hyclate, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4383","name":"Axolotl graft ult per sq cm","description":"Axolotl graft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0527U","name":"Hsv 1&2 vzv amp prb tq pthgn","description":"Hsv 1&2 vzv amp prb tq pthgn","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6111","name":"Implnt/abut remov dent mand","description":"Implnt/abut remov dent mand","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4260","name":"Signature apatch, per sq cm","description":"Signature apatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1306","name":"Injection, inclisiran, 1 mg","description":"Injection, inclisiran, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1270","name":"Pts no kid transplt wtlst","description":"Patients not on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9061","name":"Inj, amivantamab-vmjw","description":"Injection, amivantamab-vmjw, 2 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4415","name":"Alexiguard st-l per sq cm","description":"Alexiguard sl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D8671","name":"Periodic orth treat w surg","description":"Periodic orth treat w surg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1371","name":"Mst rec gsa<7","description":"Most recent glycemic status assessment (hba1c or gmi) level < 7.0%","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0880T","name":"Augmnt alys ch ct ild i&r","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27345","name":"Removal of knee cyst","description":"Excision of synovial cyst of popliteal space (eg, bakers cyst)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":574.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1472","name":"Hep b vaccine not received","description":"Patient did not receive recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97007","name":"Mchnl sclp cool meas fitg","description":"Mechanical scalp cooling, including individual cap supply with head measurement, fitting, and patient education","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9249","name":"Inj, melphalan (apotex) 1 mg","description":"Injection, melphalan (apotex), 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0719T","name":"Pst vrt jt rplcmt lmbr 1 sgm","description":"Posterior vertebral joint replacement, including bilateral facetectomy, laminectomy, and radical discectomy, including imaging guidance, lumbar spine, single segment","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0871T","name":"Rplcmt subq prtl ascites pmp","description":"Replacement of a subcutaneous peritoneal ascites pump, including reconnection between pump and indwelling bladder and peritoneal catheters, including initial programming and imaging, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63032","name":"Lamot rpr anulr dfct 1 lmbr","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; with repair of annular defect by implantation of bone-anchored annular closure device, including all imaging guidance, 1 interspace, lumbar","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93150","name":"Therapy activation ipnss","description":"Therapy activation of implanted phrenic nerve stimulator system, including all interrogation and programming","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3393","name":"Inj, betibeglogene autotemce","description":"Injection, betibeglogene autotemcel, per treatment","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2003","name":"Inj, lidocaine hcl, 1 mg","description":"Injection, lidocaine hydrochloride, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36465","name":"Njx noncmpnd sclrsnt 1 vein","description":"Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate, inclusive of all imaging guidance and monitoring; single incompetent extremity truncal vein (eg, great saphenous vein, accessory saphenous vein)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":1515.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37296","name":"Revsc evasc imvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1391.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93793","name":"Anticoag mgmt pt warfarin","description":"Anticoagulant management for a patient taking warfarin, must include review and interpretation of a new home, office, or lab international normalized ratio (inr) test result, patient instructions, dosage adjustment (as needed), and scheduling of additional test(s), when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49596","name":"Rpr aa hrn 1st > 10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, incarcerated or strangulated","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28232","name":"Incision of toe tendon","description":"Tenotomy, open, tendon flexor; toe, single tendon (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0369","name":"Max mri capture & interprete","description":"Max mri capture & interprete","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6590","name":"Urinary cath disp suc pump","description":"External urinary catheters; disposable, with wicking material, for use with suction pump, per month","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2277","name":"Inj, motixafortide, 0.25 mg","description":"Injection, motixafortide, 0.25 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0308U","name":"Crd cad alys 3 prtn plsm alg","description":"Crd cad alys 3 prtn plsm alg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0350U","name":"Rx metab/pcx dna 27 gen alys","description":"Rx metab/pcx dna 27 gen alys","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55710","name":"Bx prst8 tprn us w/mri fus 1","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant) with mri-fusion-guidance biopsy, first targeted lesion","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0323U","name":"Iadna cns pthgn next gen seq","description":"Iadna cns pthgn next gen seq","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37265","name":"Revsc evsc fpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4006","name":"Gastroenterology ss","description":"Gastro-enterology mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85014","name":"Hematocrit","description":"Blood count; hematocrit (hct)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6600","name":"G com bandge hgh dn foam sht","description":"Gradient compression bandaging supply, high density foam sheet, per 250 square centimeters, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69716","name":"Impl oi implt sk tc esp<100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or resulting in removal of less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92634","name":"Hearing aid fitg svc 1st 60","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; first 60 minutes","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77421","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78492","name":"Myocrd img pet mlt rst&strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); multiple studies at rest and stress (exercise or pharmacologic)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2003","name":"Inj, lidocaine hcl, 1 mg","description":"Injection, lidocaine hydrochloride, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1322","name":"Pts 7wk inj, scrn iop =<25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop =<25 mm hg for injected eye","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0051","name":"Traditional healing service","description":"Traditional healing service","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0784T","name":"Ins/rplmt eltrd ra spi nstim","description":"Insertion or replacement of percutaneous electrode array, spinal, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1005T","name":"Elec alys s-scl eeg prgr 1st","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, first 15 minutes face-to-face time with physician or other qualified hea","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4540","name":"Trans elec nerv periph nerv","description":"Distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4386","name":"Acesso trifaca per sq cm","description":"Acesso trifaca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2801","name":"Inj, rykindo, 0.5 mg","description":"Injection, risperidone (rykindo), 0.5 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0209","name":"Inj, sod thiosulfate (hope)","description":"Injection, sodium thiosulfate (hope), 100 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0948T","name":"Rem interrog dev ccm phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system with interim analysis, review, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1408","name":"Gmln brca bef dx ca","description":"Patients who have germline brca testing completed before diagnosis of epithelial ovarian, fallopian tube, or primary peritoneal cancer","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1808","name":"Inj, folic acid, 0.1 mg","description":"Injection, folic acid, 0.1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1452","name":"Pt dx dementia ever","description":"Patient ever had a diagnosis of dementia","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4388","name":"Neothelium 4l per sq cm","description":"Neothelium 4l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4405","name":"Xwrap fenestra plus sq cm","description":"Xwrap fenestra plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1805","name":"Inj, esmolol hcl, 10mg","description":"Injection, esmolol hydrochloride, 10 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37275","name":"Rvsc evsc fpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0596U","name":"Neuro alzds plsm 3dstnct isp","description":"Neuro alzds plsm 3dstnct isp","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0885T","name":"Colsc flx 1st tndsc dilat","description":"Colonoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17304","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":497.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0578U","name":"Onc cutan mln rna qpcr 10gen","description":"Onc cutan mln rna qpcr 10gen","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0682","name":"App non-sheet skin sub add","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (list separately in addition to code for pri","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0249","name":"Adm tocilizu covid-19 1st","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"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":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1462","name":"Pt clin ind hd image","description":"Patients with clinical indications for imaging of the head","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0320U","name":"Neph rna psttrnspl perph bld","description":"Neph rna psttrnspl perph bld","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37292","name":"Rvsc evsc tpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0567","name":"Screening hep c detect","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis c, screening, amplified probe technique","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0413U","name":"Onc hl neo opt gen mapg dna","description":"Onc hl neo opt gen mapg dna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0718T","name":"Adrc ther prtl rc tear njx","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; injection into supraspinatus tendon including ultrasound guidance, unilateral","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0996T","name":"Ins&sclr fix caps bag prosth","description":"Insertion and scleral fixation of a capsular bag prosthesis containing an intraocular lens prosthesis, with vitrectomy, including removal of crystalline lens or dislocated intraocular lens prosthesis, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20660","name":"Apply rem fixation device","description":"Application of cranial tongs, caliper, or stereotactic frame, including removal (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99254","name":"Ip/obs cnsltj new/est mod 60","description":"Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":65.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1365","name":"Hosp+pall care spec code 17","description":"Patient encounter during the performance period with hospice and palliative care specialty code 17","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4395","name":"Acelagraft per sq cm","description":"Acelagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0752T","name":"Dgtz gls mcrscp sld lvl iii","description":"Digitization of glass microscope slides for level iii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1710","name":"Moderna vacc admin 3rd dose","description":"Moderna vacc admin 3rd dose","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49592","name":"Rpr aa hrn 1st < 3 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, incarcerated or strangulated","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87107","name":"Fungi identification mold","description":"Culture, fungi, definitive identification, each organism; mold","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76019","name":"Mr safety implt pos&/immoblj","description":"Mr safety implant positioning and/or immobilization under supervision of physician or other qualified health care professional, including application of physical protections to secure implanted medical device from mr-induced translational or vibrational forces, magnetically induced functional change","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1496","name":"No doc of fall or poc","description":"Patients that had a fall who did not have a plan of care for falls documented or do not have documentation of being assessed for falls","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1343","name":"Pt pam lvl 4 base or srt lin","description":"Patients who are at pam level 4 at baseline or patients who are flagged with extreme straight line response sets on the pam or with excessive missing responses","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0726T","name":"Rmvl implt vstibular dev uni","description":"Removal of implanted vestibular device, unilateral","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92636","name":"Hearing aid post-fitg f-up 1","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0568U","name":"Neurol dementia bamyl ptau","description":"Neurol dementia bamyl ptau","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4016","name":"Neurosurgical ss","description":"Neurosurgical mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4274","name":"Esano ac, per sq cm","description":"Esano ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78491","name":"Myocrd img pet 1std rst/strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); single study, at rest or stress (exercise or pharmacologic)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0684","name":"App non-sheet skin sb g addl","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area or part thereof, or each additional 1% o","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0708","name":"Intraoral bite radio image","description":"Intraoral bite radio image","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49591","name":"Rpr aa hrn 1st < 3 cm rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, reducible","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0707","name":"Intraoral periap radio image","description":"Intraoral periap radio image","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85004","name":"Automated diff wbc count","description":"Blood count; automated differential wbc count","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1367","name":"Qual care ent disorder mvp","description":"Quality care for the treatment of ear, nose, and throat disorders mips value pathway","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4389","name":"Neothelium 4l+ per sq cm","description":"Neothelium 4l+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2543","name":"Dental onlay metallic 3 surf","description":"Onlay - metallic - three surfaces","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0319U","name":"Neph rna pretrnspl perph bld","description":"Neph rna pretrnspl perph bld","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2041","name":"Foundation drs+ duo pr sq cm","description":"Foundation drs+ duo, per square centimeter","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0399U","name":"Neuro cere folate defncy srm","description":"Neuro cere folate defncy srm","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5100","name":"Inj ustekinumab-kfce, 1 mg","description":"Injection, ustekinumab-kfce (yesintek), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78290","name":"Intestine imaging","description":"Intestine imaging (eg, ectopic gastric mucosa, meckels localization, volvulus)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4376","name":"Duograft aa per sq cm","description":"Duograft aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37285","name":"Revsc evasc tpvt st sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97803","name":"Med nutrition indiv subseq","description":"Medical nutrition therapy; re-assessment and intervention, individual, face-to-face with the patient, each 15 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":24.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0761T","name":"Dgtz gls mcrscp sl imm ea 1","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1378","name":"Med rsn no 10 yr fu colscope","description":"Documentation of medical reason(s) for not recommending a 10 year follow-up interval (e.g., inadequate prep, familial or personal history of colonic polyps, patient had no adenoma and age is >= 66 years old, or life expectancy < 10 years, other medical reasons)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6031","name":"Rep interface handfng molded","description":"Replacement socket/interface, partial hand including fingers, molded to patient model, for use with or without external power","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9382","name":"Inj zenocutuzumab-zbco 1 mg","description":"Injection, zenocutuzumab-zbco, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1253","name":"Pts hu surv no amb plltv","description":"Patients who respond on the patient experience hu survey that they did not receive care by the listed ambulatory palliative care provider in the last 60 days (disavowal)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0615U","name":"Bbrgdrferi ld antb detcj 26","description":"Bbrgdrferi ld antb detcj 26","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2011","name":"Supra sdrm, per sq cm","description":"Supra sdrm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0012","name":"Injection of hiv prep drug","description":"Injection of pre-exposure prophylaxis (prep) drug for hiv prevention, under skin or into muscle","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6602","name":"Cst hgh nble mtl inlay 2 srf","description":"Inlay - cast high noble metal two surfaces","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1809","name":"Inj, fosdenopterin, 0.1mg","description":"Injection, fosdenopterin, 0.1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1407","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15014","name":"Prepj skn cll ssp agrft ea","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; each additional 25 sq cm of harvested skin or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0519","name":"New pt-cg dyad dem low cmplx","description":"Management of new patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0363U","name":"Onc urthl mrna 5 gen alg","description":"Onc urthl mrna 5 gen alg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0862T","name":"Rlcj pg wcs lv battery only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; battery component only","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0902T","name":"Qtc ntrvl augmnt alg aly ecg","description":"Qtc interval derived by augmentative algorithmic analysis of input from an external, patient-activated mobile ecg device","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","name":"Scoliosis orth sag/ cor","description":"Scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla to trochanter, includes all accessory pads, straps and interface, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4312","name":"Acesso ac, per sq cm","description":"Acesso ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5877","name":"Dup of complt dent-maxill","description":"Dup of complt dent-maxill","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J2150","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45398","name":"Colonoscopy w/band ligation","description":"Colonoscopy, flexible; with band ligation(s) (eg, hemorrhoids)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1069.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":245.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0073T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":873.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0859T","name":"Ncntc ifr spctrsc o/t pad ea","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), other than for screening for peripheral arterial disease, image acquisition, interpretation, and report; each additional anatomic site (list separately in addition to code ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0712T","name":"N-nvs artl plaq alys quan","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess atherosclerotic plaque stability","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43889","name":"Gstr rstcv px trnsorl esg","description":"Gastric restrictive procedure, transoral, endoscopic sleeve gastroplasty (esg), including argon plasma coagulation, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1318","name":"Pts no csp doc contact","description":"Patients who did not have documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening or documentation that there was no contact with a csp","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0578","name":"Inj brixadi, more than 7 day","description":"Injection, buprenorphine extended release (brixadi), greater than 7 days and up to 28 days of therapy","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71048","name":"X-ray exam chest 4+ views","description":"Radiologic examination, chest; 4 or more views","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49010","name":"Exploration behind abdomen","description":"Exploration, retroperitoneal area with or without biopsy(s) (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":877.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0905T","name":"Ecg alg 12 ld rdcd i&r only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; interpretation and report only","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3368.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4433","name":"361 hct/p skin subs, nos","description":"361 hct/p skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0163","name":"Epinephrine in nacl (endo)","description":"Injection, epinephrine in sodium chloride (endo), 0.1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0749T","name":"B1 str&fx rsk assmt dxr-bmd","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6212","name":"Bridge noble metal cast","description":"Pontic-cast noble metal","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1308","name":"Inj, famotidine, 0.25 mg","description":"Injection, famotidine, 0.25 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96381","name":"Admn rsv monoc antb im njx","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0013","name":"Esketamine, nasal spray","description":"Esketamine, nasal spray, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1330","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0560U","name":"Onc mrd gsa cfdna baseline","description":"Onc mrd gsa cfdna baseline","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34709","name":"Plmt xtn prosth evasc rpr","description":"Placement of extension prosthesis(es) distal to the common iliac artery(ies) or proximal to the renal artery(ies) for endovascular repair of infrarenal abdominal aortic or iliac aneurysm, false aneurysm, dissection, penetrating ulcer, including pre-procedure sizing and device selection, all nonselec","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0039","name":"Pt no ref, rn spec","description":"Patient not referred, reason not otherwise specified","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33880","name":"Evasc rpr ta ndgft cov lsa","description":"Endovascular repair of thoracic aorta, including pre-procedure sizing and device selection, nonselective catheterization(s), all associated radiological supervision and interpretation; by deployment of an aorto-aortic tube endograft covering the left subclavian artery and all aortic tube endograft e","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2156.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38226","name":"Car-t prep t lymphcyt f/trns","description":"Chimeric antigen receptor t-cell (car-t) therapy; preparation of blood-derived t lymphocytes for transportation (eg, cryopreservation, storage)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1263","name":"Pts hosp dialysis dt","description":"Patients in hospice on their initiation of dialysis date or during the month of evaluation","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4399","name":"Summit fx per sq cm","description":"Summit fx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93595","name":"L hrt cath chd nm/abn nt cnj","description":"Left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone, normal or abnormal native connections","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0146","name":"Nav srv peer sup add 30 pr m","description":"Principal illness navigation - peer support, additional 30 minutes per calendar month (list separately in addition to g0140)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0276U","name":"Hem inh thrombocytopenia 23","description":"Hematology (inherited thrombocytopenia), genomic sequence analysis of 23 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0481","name":"Electron microscopy diagnost","description":"Electron microscopy - diagnostic","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65285","name":"Repair of eye wound","description":"Repair of laceration; cornea and/or sclera, perforating, with reposition or resection of uveal tissue","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1002.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4392","name":"Grafix duo per sq cm","description":"Grafix duo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0794T","name":"Pt spec alg rx-onc tx option","description":"Patient-specific, assistive, rules-based algorithm for ranking pharmaco-oncologic treatment options based on the patients tumor-specific cancer marker information obtained from prior molecular pathology, immunohistochemical, or other pathology results which have been previously interpreted and repor","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4031","name":"Radiation oncology ss","description":"Radiation oncology mips specialty set","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4251","name":"Vim, per square centimeter","description":"Vim, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64655","name":"Revj/rplcmt bat mod sys lead","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; lead only","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4318","name":"E-graft, per sq cm","description":"E-graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27496","name":"Decompression of thigh/knee","description":"Decompression fasciotomy, thigh and/or knee, 1 compartment (flexor or extensor or adductor);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":579.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0746T","name":"Car ablt rad arr cnv loc map","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; conversion of arrhythmia localization and mapping of arrhythmia site (nidus) into a multidimensional radiation treatment plan","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37283","name":"Rvsc evsc tpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":103.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98000","name":"Synch audio-video new sf 15","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 15 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1443","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2402","name":"Chloroprocaine (clorotekal)","description":"Injection, chloroprocaine hydrochloride (clorotekal), per 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0559","name":"Unrelat prac follow up visit","description":"Post-operative follow-up visit complexity inherent to evaluation and management services addressing surgical procedure(s), provided by a physician or qualified health care professional who is not the practitioner who performed the procedure (or in the same group practice) and is of the same or of a ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61541","name":"Incision of brain tissue","description":"Craniotomy with elevation of bone flap; for transection of corpus callosum","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2376.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1032","name":"Sv doula brth wrk per 15 min","description":"Services performed by a doula birth worker, per 15 minutes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0541","name":"No pt prsnt train initial 30","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0563U","name":"Nfct ds pthgn-sna 11vir&4bct","description":"Nfct ds pthgn-sna 11vir&4bct","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1221","name":"Dre w/o rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; without evidence of retinopathy","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1321","name":"Couns for high risk sub use","description":"Couns for high risk sub use","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1253","name":"Pts hu surv no amb plltv","description":"Patients who respond on the patient experience hu survey that they did not receive care by the listed ambulatory palliative care provider in the last 60 days (disavowal)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1348","name":"Pam incr 6 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 6-points in a 4 to 12 month period (excellent)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95180","name":"Rapid desensitization","description":"Rapid desensitization procedure, each hour (eg, insulin, penicillin, equine serum)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1372","name":"Mst rec gsa >=7 and<8","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 7.0% and < 8.0%","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72200","name":"X-ray exam si joints","description":"Radiologic examination, sacroiliac joints; less than 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1432","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0579U","name":"Nfro dbtc ckd elisa apoa4","description":"Nfro dbtc ckd elisa apoa4","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31241","name":"Nsl/sns ndsc lig sphnptn art","description":"Nasal/sinus endoscopy, surgical; with ligation of sphenopalatine artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49617","name":"Rpr aa hrn rcr > 10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, reducible","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1490","name":"Pt status not doc","description":"Patient status not documented","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0013","name":"Hiv prep counsel, clin staff","description":"Individual counseling for pre-exposure prophylaxis (prep) by clinical staff to prevent human immunodeficiency virus (hiv), includes: hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0471U","name":"Onc clrc ca 35 vrn kras&nras","description":"Onc clrc ca 35 vrn kras&nras","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0466U","name":"Crd cad dna gwas 564856 snp","description":"Crd cad dna gwas 564856 snp","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84480","name":"Assay triiodothyronine (t3)","description":"Triiodothyronine t3; total (tt-3)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85291","name":"Clot factor xiii fibrin scrn","description":"Clotting; factor xiii (fibrin stabilizing), screen solubility","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2043","name":"Biobrane, per sq cm","description":"Biobrane, per square centimeter","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0879T","name":"Augmnt alys ch ct ild prep","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; radiological data preparation and transmission","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0286U","name":"Cep72 nudt15&tpmt gene alys","description":"Cep72 nudt15&tpmt gene alys","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67208","name":"Treatment of retinal lesion","description":"Destruction of localized lesion of retina (eg, macular edema, tumors), 1 or more sessions; cryotherapy, diathermy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0619U","name":"Pulm copd dna alys >18000","description":"Pulm copd dna alys >18000","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95018","name":"All tstg perq&iq drugs/biol","description":"Allergy testing, any combination of percutaneous (scratch, puncture, prick) and intracutaneous (intradermal), sequential and incremental, with drugs or biologicals, immediate type reaction, including test interpretation and report, specify number of tests","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93017","name":"Cv stress test tracing only","description":"Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; tracing only, without interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95934","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["LT","AS","81","80","AF","82","RT","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4283","name":"Biovance tri or 3l, sq cm","description":"Biovance tri-layer or biovance 3l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4274","name":"Esano ac, per sq cm","description":"Esano ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9888","name":"5% wl maintnd from bsline wt","description":"Maintenance 5% wl from baseline weight in months 7-12","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0382U","name":"Hyprphenylalninmia mntr quan","description":"Hyprphenylalninmia mntr quan","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1805","name":"Inj, esmolol hcl, 10mg","description":"Injection, esmolol hydrochloride, 10 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0521","name":"Supply fee hiv prep fda appr","description":"Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2151","name":"Inj, mannitol, 250 mg","description":"Injection, mannitol, 250 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0538","name":"Ascvd rsk mng clin stf pr mo","description":"Atherosclerotic cardiovascular disease (ascvd) risk management services; clinical staff time; per calendar month","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11922","name":"Correct skin color ea 20.0cm","description":"Tattooing, intradermal introduction of insoluble opaque pigments to correct color defects of skin, including micropigmentation; each additional 20.0 sq cm, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0461U","name":"Onc rxgenom alys rtpcr 24gen","description":"Onc rxgenom alys rtpcr 24gen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1814","name":"Inj. insulin (lyumjev)","description":"Insulin (lyumjev), per 5 units","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0993T","name":"N-invas assmt car rsk w/ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat with concurrent computed tomography scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional (list s","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2038","name":"Marigen pacto, per sq cm","description":"Marigen pacto, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4032","name":"Rheumatology ss","description":"Rheumatology mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0665","name":"Team remote e/m est pt 10 mn","description":"Team remote e/m est. pt 10mins","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1231","name":"Pt hcv tst no reactive res","description":"Patient receives hcv antibody test with nonreactive result","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0404U","name":"Onc brst semiq meas thym kn","description":"Onc brst semiq meas thym kn","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0286U","name":"Cep72 nudt15&tpmt gene alys","description":"Cep72 nudt15&tpmt gene alys","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1282","name":"Pt scrn tbco id as non user","description":"Patient screened for tobacco use and identified as a tobacco non-user","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43324","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1429.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1412","name":"Met nsclc w/ egfr alk oth ab","description":"Patients with metastatic nsclc with epidermal growth factor receptor (egfr) mutations, alk genomic tumor aberrations, or other targetable genomic abnormalities with approved first-line targeted therapy, such as nsclc with ros1 rearrangement, braf v600e mutation, ntrk 1/2/3 gene fusion, met ex14 skip","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86480","name":"Tb test cell immun measure","description":"Tuberculosis test, cell mediated immunity antigen response measurement; gamma interferon","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87276","name":"Influenza a ag if","description":"Infectious agent antigen detection by immunofluorescent technique; influenza a virus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6598","name":"G comp bandage med stretch","description":"Gradient compression bandage roll, elastic medium stretch, per linear yard, any width, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":0.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4407","name":"Xwrap tribus per sq cm","description":"Xwrap tribus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0680T","name":"Insj/rplcmt pg only isdss","description":"Insertion or replacement of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing lead(s)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97008","name":"Mchnl sclp cool prep plmt","description":"Mechanical scalp cooling; including hair preparation, individual cap placement, therapy initiation, and precooling period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1372","name":"Mst rec gsa >=7 and<8","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 7.0% and < 8.0%","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51785","name":"Anal/urinary muscle study","description":"Needle electromyography studies (emg) of anal or urethral sphincter, any technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":284.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1496","name":"No doc of fall or poc","description":"Patients that had a fall who did not have a plan of care for falls documented or do not have documentation of being assessed for falls","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64577","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1250","name":"Pt resp true heard","description":"Patient responded as completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0964T","name":"I&cust prep jaw xpnsj 1arch","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; single arch, without mandibular advancement mechanism","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9269","name":"Programable ingest capsule","description":"Programable, transient, orally ingested capsule, for use with external programmer, per month","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0225","name":"Inj, vutrisiran, 1 mg","description":"Injection, vutrisiran, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25624","name":"Cltx carpl scphd fx w/mnpj","description":"Closed treatment of carpal scaphoid (navicular) fracture; with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":474.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1398","name":"Bslne and  fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0929T","name":"Rem interrog dev ccm-d tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6112","name":"Imp/abut rem dent part max","description":"Imp/abut rem dent part max","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0554","name":"Add 20 m of monthly tx","description":"Each additional 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing data generated from the","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93260","name":"Prgrmg dev eval impltbl sys","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; implantable subcutaneous lead d","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0567","name":"Screening hep c detect","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis c, screening, amplified probe technique","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0942T","name":"Cysto flx rmv&rplc urtl scaf","description":"Cystourethroscopy, flexible; with removal and replacement of prostatic urethral scaffold","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70473","name":"Ct cere prfu aly c+wo ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed without concurrent ct or ct angiography of the same anatomy","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0201","name":"Pne flu hepb cov home admin","description":"Administration of pneumococcal, influenza, hepatitis b, and/or covid-19 vaccine inside a patients home; reported only once per individual home per date of service when such vaccine administration(s) are performed at the patients home","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2006","name":"Novosorb synpath per sq cm","description":"Novosorb synpath dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0249","name":"Tocilizumab for covid-19","description":"Injection, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0690T","name":"Quan us tis charac w/dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained with diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0684","name":"App non-sheet skin sb g addl","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area or part thereof, or each additional 1% o","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7413","name":"Excision malig lesion<=1.25c","description":"Excision of malignant lesion up to 1.25 cm","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0532U","name":"Rare ds whlgen&mitochdrl dna","description":"Rare ds whlgen&mitochdrl dna","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27275","name":"Manipulation of hip joint","description":"Manipulation, hip joint, requiring general anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1711","name":"Moderna vacc admin booster","description":"Moderna vacc admin booster","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1376","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0468U","name":"Hep nash mir34a5p a2m ykl40","description":"Hep nash mir34a5p a2m ykl40","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1476","name":"Pt dx cog imp or ad","description":"Patients with diagnosis of cognitive impairment or alzheimers disease","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33244","name":"Remove elctrd transvenously","description":"Removal of single or dual chamber implantable defibrillator electrode(s); by transvenous extraction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0452U","name":"Onc bldr mthyl penk lte-qmsp","description":"Onc bldr mthyl penk lte-qmsp","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33332","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1667.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9999","name":"Inj ustekinumab-aauz 1 mg","description":"Injection, ustekinumab-aauz (otulfi), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1365","name":"Hosp+pall care spec code 17","description":"Patient encounter during the performance period with hospice and palliative care specialty code 17","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5228","name":"Immed mand part denture","description":"Immed mand part denture","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1345","name":"Pt bsln pam, 2nd scr 4-12 mo","description":"Patients who had a baseline pam score and a second score within 4 to 12 month of baseline pam score","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2998","name":"Inj plasminogen tvmh 1mg","description":"Injection, plasminogen, human-tvmh, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92511","name":"Nasopharyngoscopy","description":"Nasopharyngoscopy with endoscope (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4394","name":"Surgraft aca per sq cm","description":"Surgraft aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0341U","name":"Ftl aneup dna seq cmpr alys","description":"Ftl aneup dna seq cmpr alys","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94016","name":"Review patient spirometry","description":"Patient-initiated spirometric recording per 30-day period of time; review and interpretation only by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":27.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0019M","name":"Cv ds plasma alys prtn bmrk","description":"Cardiovascular disease, plasma, analysis of protein biomarkers by aptamer-based microarray and algorithm reported as 4-year likelihood of coronary event in high-risk populations","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44800","name":"Excision of bowel pouch","description":"Excision of meckels diverticulum (diverticulectomy) or omphalomesenteric duct","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":804.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87477","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1459","name":"Pt hosp/pal care dur perf pd","description":"Patient was in hospice or receiving palliative care services at any time during the performance period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37565","name":"Ligation int jugular vein","description":"Ligation, internal jugular vein","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":795.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4419","name":"Biolab wrap flw lt per sq cm","description":"Biolab membrane wrap lite flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34708","name":"Evasc rpr ilio-iliac rpt","description":"Endovascular repair of iliac artery by deployment of an ilio-iliac tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, and all endograft extension(s) proximally to the aortic bifurcation ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1551.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31040","name":"Exploration behind upper jaw","description":"Pterygomaxillary fossa surgery, any approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":906.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55712","name":"Bx prst8 tprnl mri-us 1st","description":"Biopsy, prostate, transperineal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1232","name":"Pt hcv tst reactive result","description":"Patient receives hcv antibody test with reactive result","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0616U","name":"Neurol dementia alys >30000","description":"Neurol dementia alys >30000","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31502","name":"Change of windpipe airway","description":"Tracheotomy tube change prior to establishment of fistula tract","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33370","name":"Tcat plmt&rmvl cepd perq","description":"Transcatheter placement and subsequent removal of cerebral embolic protection device(s), including arterial access, catheterization, imaging, and radiological supervision and interpretation, percutaneous (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61885","name":"Insrt/redo neurostim 1 array","description":"Insertion or replacement of cranial neurostimulator pulse generator or receiver, direct or inductive coupling; with connection to a single electrode array","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98011","name":"Synch audio-only new high 60","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 60 ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4315","name":"Regenelink amniotic mem allo","description":"Regenelink amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3105","name":"Terbutaline sulfate inj","description":"Injection, terbutaline sulfate, up to 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77091","name":"Tbs techl calculation only","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical calculation only","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31080","name":"Removal of frontal sinus","description":"Sinusotomy frontal; obliterative without osteoplastic flap, brow incision (includes ablation)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1184.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1236","name":"Baseline mrs > 2","description":"Baseline mrs > 2","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1345","name":"Pt bsln pam, 2nd scr 4-12 mo","description":"Patients who had a baseline pam score and a second score within 4 to 12 month of baseline pam score","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0939T","name":"Xtrnl ecg rec>15d<30d scan","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; scanning analysis with report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1302","name":"Scrn mam perf rslts doc","description":"Screening, diagnostic, film digital or digital breast tomosynthesis (3d) mammography results documented and reviewed","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3432","name":"Guided tissue regeneration","description":"Guided tissue regeneration","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0543U","name":"Onc sol tum ngs dna 517 gens","description":"Onc sol tum ngs dna 517 gens","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4327","name":"Duoamnion, per sq cm","description":"Duoamnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9076","name":"Inj, cyclophos (baxter) 5mg","description":"Injection, cyclophosphamide (baxter), 5 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92576","name":"Synthetic sentence id test","description":"Synthetic sentence identification test","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77089","name":"Tbs dxa cal w/i&r fx risk","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; using dual x-ray absorptiometry (dxa) or other imaging data on gray-scale variogram, calculation, with interpretation and report on fracture-risk","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4030","name":"Pulmonology ss","description":"Pulmonology mips specialty set","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9611","name":"Flurpiridaz f18, diag, 1 mci","description":"Flurpiridaz f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4386","name":"Acesso trifaca per sq cm","description":"Acesso trifaca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1433","name":"Oral chemo wthn 30 days enc","description":"Patient on oral chemotherapy on or within 30 days before denominator eligible encounter","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1183","name":"Doc imm ckpt inhib hld","description":"Documentation of immune checkpoint inhibitor therapy held and corticosteroids or immunosuppressants prescribed or administered","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1153","name":"Pt w/ dx osteo doe","description":"Patient with diagnosis of osteoporosis on date of encounter","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0761T","name":"Dgtz gls mcrscp sl imm ea 1","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0812T","name":"Rem mlt day uroflow dev sply","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); device supply with automated report generation, up to 10 days","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9196","name":"Inj gemcitabine hcl (accord)","description":"Injection, gemcitabine hydrochloride (accord), not therapeutically equivalent to j9201, 200 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0481","name":"Electron microscopy diagnost","description":"Electron microscopy - diagnostic","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1812","name":"Inj. insulin (fiasp)","description":"Insulin (fiasp), per 5 units","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20525","name":"Rmvl fb musc/tdn deep/comp","description":"Removal of foreign body in muscle or tendon sheath; deep or complicated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24920","name":"Amputation of upper arm","description":"Amputation, arm through humerus; open, circular (guillotine)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":822.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1198","name":"Isa not red 3pts /no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0216","name":"Inj, alfentanil hcl, 500mcg","description":"Injection, alfentanil hydrochloride, 500 micrograms","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5992","name":"Low prosth foot shell repl","description":"All lower extremity prosthesis, foot shell for modular foot/non-solid ankle cushion heel (sach) replacement only","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1236","name":"Baseline mrs > 2","description":"Baseline mrs > 2","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0368U","name":"Onc clrct ca mut&mthyltn mrk","description":"Onc clrct ca mut&mthyltn mrk","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57210","name":"Repair vagina/perineum","description":"Colpoperineorrhaphy, suture of injury of vagina and/or perineum (nonobstetrical)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":413.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9612","name":"Thera par drugs 2 or > admin","description":"Therapeutic parenteral drugs two or more administrations different medications","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0739T","name":"Abltj mal prst8 mag fld ndct","description":"Ablation of malignant prostate tissue by magnetic field induction, including all intraprocedural, transperineal needle/catheter placement for nanoparticle installation and intraprocedural temperature monitoring, thermal dosimetry, bladder irrigation, and magnetic field nanoparticle activation","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98010","name":"Synch audio-only new mod 45","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection,","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5128","name":"Inj, cimerli, 0.1 mg","description":"Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87301","name":"Adenovirus ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; adenovirus enteric types 40/41","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1177","name":"Pt recd pcv on/aft 19","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9888","name":"5% wl maintnd from bsline wt","description":"Maintenance 5% wl from baseline weight in months 7-12","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92288","name":"Scr dark adaptation meas i&r","description":"Screening dark adaptation measurement (eg, rod recovery intercept time), with interpretation and report","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9948","name":"Adjust sleep apnea appliance","description":"Adjust sleep apnea appliance","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1186","name":"Pt w/ rx for hspc/plltv care","description":"Patients who have an order for or are receiving hospice or palliative care","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8006","name":"Grip glove replacement only","description":"Powered, cable driven grip assist glove, hand, finger, includes pressure sensors, glove replacement only","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0707T","name":"Njx b1 sub mtrl sbchdrl dfct","description":"Injection(s), bone-substitute material (eg, calcium phosphate) into subchondral bone defect (ie, bone marrow lesion, bone bruise, stress injury, microtrabecular fracture), including imaging guidance and arthroscopic assistance for joint visualization","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3501","name":"Surg exp root surf anterior","description":"Surg exp root surf anterior","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80417","name":"Renin stimulation panel","description":"Peripheral vein renin stimulation panel (eg, captopril) this panel must include the following: renin (84244 x 2)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76800","name":"Us exam spinal canal","description":"Ultrasound, spinal canal and contents","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0290U","name":"Pain mgmt mrna gen xprsn 36","description":"Pain mgmt mrna gen xprsn 36","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37273","name":"Revsc evsc fpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1483.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64466","name":"Thrc fascial pln blk uni njx","description":"Thoracic fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44186","name":"Lap jejunostomy","description":"Laparoscopy, surgical; jejunostomy (eg, for decompression or feeding)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":708.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4323","name":"Splint extra-coronal","description":"Splint extra-coronal","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98008","name":"Synch audio-only new sf 15","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code sel","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0407U","name":"Neph dbtc ckd mult eclia alg","description":"Neph dbtc ckd mult eclia alg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0013","name":"Esketamine, nasal spray","description":"Esketamine, nasal spray, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4035","name":"Thoracic surgery ss","description":"Thoracic surgery mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0377U","name":"Cv ds quan advsrm/plsm lprtn","description":"Cv ds quan advsrm/plsm lprtn","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0681T","name":"Rlcj pulse gen only isdss","description":"Relocation of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing dual leads","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0811T","name":"Rem mlt day uroflow setup","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); set-up and patient education on use of equipment","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1234","name":"Pt hcv rctv aby f/u neg","description":"Patient has a reactive hcv antibody test, and has a follow up hcv viral test that does not detect hcv viremia","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76015","name":"Mr sfty mplt&/fb asmt stf ea","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4371","name":"Neoguard per sq cm","description":"Neoguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1000T","name":"Autol musc cell therapy admn","description":"Autologous muscle cell therapy, administration of muscle progenitor cells into the urethral sphincter, including cystoscopy and post-void residual ultrasound, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1387","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87484","name":"Ehrlicha chaffeensis amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); ehrlichia chaffeensis, amplified probe technique","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0995T","name":"Evasc dlvr a-wal stbl rx opn","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; open","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49595","name":"Rpr aa hrn 1st > 10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, reducible","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98016","name":"Brief comunicaj tech-bsd svc","description":"Brief communication technology-based service (eg, virtual check-in) by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related evaluation and management service provided within the p","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":17.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90968","name":"Esrd svc pr day pt 2-11","description":"End-stage renal disease (esrd) related services for dialysis less than a full month of service, per day; for patients 2-11 years of age","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49623","name":"Rmvl ninfct mesh hernia rpr","description":"Removal of total or near total non-infected mesh or other prosthesis at the time of initial or recurrent anterior abdominal hernia repair or parastomal hernia repair, any approach (ie, open, laparoscopic, robotic) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0615U","name":"Bbrgdrferi ld antb detcj 26","description":"Bbrgdrferi ld antb detcj 26","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0774T","name":"Vr px dissoc svc oth phy ea","description":"Virtual reality (vr) procedural dissociation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports; each additiona","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87070","name":"Culture othr specimn aerobic","description":"Culture, bacterial; any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0164","name":"Epinephrine in nacl (baxter)","description":"Injection, epinephrine in sodium chloride (baxter), 0.1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30469","name":"Rpr nsl vlv collapse w/rmdlg","description":"Repair of nasal valve collapse with low energy, temperature-controlled (ie, radiofrequency) subcutaneous/submucosal remodeling","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0911","name":"Inst tauro 1.35mg/hep 100u","description":"Instillation, taurolidine 1.35 mg and heparin sodium 100 units (central venous catheter lock for adult patients receiving chronic hemodialysis)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9286","name":"Inj glofitamab gxbm, 2.5 mg","description":"Injection, glofitamab-gxbm, 2.5 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0521","name":"Supply fee hiv prep fda appr","description":"Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81517","name":"Liver ds alys 3 bmrk srm alg","description":"Liver disease, analysis of 3 biomarkers (hyaluronic acid [ha], procollagen iii amino terminal peptide [piiinp], tissue inhibitor of metalloproteinase 1 [timp-1]), using immunoassays, utilizing serum, prognostic algorithm reported as a risk score and risk of liver fibrosis and liver-related clinical ","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0293U","name":"Psyc suicidal idea mrna 54","description":"Psyc suicidal idea mrna 54","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0504U","name":"Nfct ds uti id 17 path orgs","description":"Nfct ds uti id 17 path orgs","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5138","name":"Inj, wezlana, iv, 1 mg","description":"Injection, ustekinumab-auub (wezlana), biosimilar, intravenous, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27580","name":"Fusion of knee","description":"Arthrodesis, knee, any technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1203","name":"Inj, cipaglucosidase, 5 mg","description":"Injection, cipaglucosidase alfa-atga, 5 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1501","name":"Pathology mvp","description":"Pathology mips value pathway","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1449","name":"Inj eflapegrastim-xnst 0.1mg","description":"Injection, eflapegrastim-xnst, 0.1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D8671","name":"Periodic orth treat w surg","description":"Periodic orth treat w surg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0782T","name":"Brnchsc rf dstrj plm nrv uni","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; unilateral mainstem bronchus","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19355","name":"Correct inverted nipple(s)","description":"Correction of inverted nipples","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99437","name":"Chrnc care mgmt phys ea addl","description":"Chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, or funct","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0893","name":"Inj, decitabine (sun pharma)","description":"Injection, decitabine (sun pharma), not therapeutically equivalent to j0894, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5136","name":"Inj. denosumab-bbdz, 1 mg","description":"Injection, denosumab-bbdz (jubbonti/wyost), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37291","name":"Revsc evsc tpvt athr cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0438U","name":"Rx metab advrs vrnt alys 33","description":"Rx metab advrs vrnt alys 33","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1028","name":"Take home supply 8mg per 0.1","description":"Take-home supply of nasal naloxone; 2-pack of 8mg per 0.1 ml nasal spray (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5136","name":"Inj. denosumab-bbdz, 1 mg","description":"Injection, denosumab-bbdz (jubbonti/wyost), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82274","name":"Assay test for blood fecal","description":"Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4406","name":"Xwrap fenestra per sq cm","description":"Xwrap fenestra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22848","name":"Insert pelv fixation device","description":"Pelvic fixation (attachment of caudal end of instrumentation to pelvic bony structures) other than sacrum (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2033","name":"Myriad morcells, 4 mg","description":"Myriad morcells, 4 milligrams","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2525","name":"Cl, hydrophilic, dual focus","description":"Contact lens, hydrophilic, dual focus, per lens","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33903","name":"Perq p-art revsc 1 abnor bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, bilateral","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3921","name":"Decor or submerg erupt tooth","description":"Decor or submerg erupt tooth","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37265","name":"Revsc evsc fpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0911T","name":"Elec aly nstm sys vgs nrv wo","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; without programming by physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0345U","name":"Psyc genom alys pnl 15 gen","description":"Psyc genom alys pnl 15 gen","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0699","name":"Inj, cefiderocol, 10 mg","description":"Injection, cefiderocol, 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9432","name":"Med food non inborn err meta","description":"Medical foods for non-inborn errors of metabolism","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4397","name":"Static or dynami afo pre ots","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated, off-the-shelf","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37257","name":"Revsc evsc ivt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1498","name":"Diagnostic radiology mvp","description":"Diagnostic radiology mips value pathway","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9297","name":"Inj pemetrexed (sandoz) 10mg","description":"Injection, pemetrexed (sandoz), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25426","name":"Repair/graft radius & ulna","description":"Repair of defect with autograft; radius and ulna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1599.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0783T","name":"Tc auriculr neurostimulation","description":"Transcutaneous auricular neurostimulation, set-up, calibration, and patient education on use of equipment","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0414U","name":"Onc lng aug alg aly whl sld8","description":"Onc lng aug alg aly whl sld8","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95924","name":"Ans parasymp & symp w/tilt","description":"Testing of autonomic nervous system function; combined parasympathetic and sympathetic adrenergic function testing with at least 5 minutes of passive tilt","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9075","name":"Inj, cyclophosphamide, nos","description":"Injection, cyclophosphamide, not otherwise specified, 5 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4296","name":"Rebound matrix, per sq cm","description":"Rebound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0994T","name":"Evasc dlvr a-wal stbl rx prq","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; percutaneous","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77063","name":"Breast tomosynthesis bi","description":"Screening digital breast tomosynthesis, bilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1213","name":"No hx spiro prs spiro>=70%","description":"No history of spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) and present spirometry is >= 70%","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0761T","name":"Dgtz gls mcrscp sl imm ea 1","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9048","name":"Inj, bortezomib freseniuskab","description":"Injection, bortezomib (fresenius kabi), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85032","name":"Manual cell count each","description":"Blood count; manual cell count (erythrocyte, leukocyte, or platelet) each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1406","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0807T","name":"Pulm tiss vntj alys prev ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with previously acquired computed tomography (ct) images, including data preparation and transmission, quantification of pulmonary tissue ventilation, data re","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1277","name":"Colorectal ca screen doc rev","description":"Colorectal cancer screening results documented and reviewed","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0532","name":"Take home supp nasal spray","description":"Take-home supply of nasal nalmefene hydrochloride; one carton of two, 2.7 mg per 0.1 ml nasal sprays (provision of the services by a medicare-enrolled opioid treatment program);( list separately in addition to each primary code)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1229","name":"Pt w/ +hcv +vir ref win 1 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, is referred within 1 month of the reactive hcv antibody test to a clinician who treats hcv infection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0344U","name":"Hep nafld semiq evl 28 lipid","description":"Hep nafld semiq evl 28 lipid","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1217","name":"Sys rsn no doc spiro","description":"Documentation of system reason(s) for not documenting and reviewing spirometry results (e.g., spirometry equipment not available at the time of the encounter)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88374","name":"M/phmtrc alys ishquant/semiq","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each multiplex probe stain procedure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0759T","name":"Dgtz gls mcrscp sl sp grpiii","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group iii, for enzyme constituents (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2642","name":"Dental onlay porcelin 2 surf","description":"Onlay - porcelain/ceramic - two surfaces","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77091","name":"Tbs techl calculation only","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical calculation only","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83880","name":"Assay of natriuretic peptide","description":"Natriuretic peptide","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9610","name":"Xe129 xenon, diagnostic","description":"Xenon xe-129 hyperpolarized gas, diagnostic, per study dose","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4199","name":"Cygnus matrix, per sq cm","description":"Cygnus matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38226","name":"Car-t prep t lymphcyt f/trns","description":"Chimeric antigen receptor t-cell (car-t) therapy; preparation of blood-derived t lymphocytes for transportation (eg, cryopreservation, storage)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28107","name":"Remove/graft foot lesion","description":"Excision or curettage of bone cyst or benign tumor, tarsal or metatarsal, except talus or calcaneus; with allograft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":474.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58301","name":"Remove intrauterine device","description":"Removal of intrauterine device (iud)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":65.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"Non-adju cgm supply allow","description":"Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0800T","name":"Tcat rmvl 2chmbr ldls pm rv","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right ventricular pacemaker component (when part of a dual-chamber leadless pacem","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97550","name":"Caregiver traing 1st 30 min","description":"Caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patie","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0497U","name":"Onc prst8 mrna rt-pcr 6 gene","description":"Onc prst8 mrna rt-pcr 6 gene","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60661","name":"Abltj 1/+thyr ndul addl prq","description":"Ablation of 1 or more thyroid nodule(s), additional lobe, percutaneous, including imaging guidance, radiofrequency (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33882","name":"Evasc rpr ta dplmt mltpc sys","description":"Endovascular repair of the thoracic aorta by deployment of a branched endograft multipiece system involving an aorto-aortic tube device with a fenestration for the left subclavian artery stent graft(s) and all aortic tube endograft extension(s) placed from the level of the left common carotid artery","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0891","name":"Argatroban nonesrd (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4405","name":"Xwrap fenestra plus sq cm","description":"Xwrap fenestra plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0396","name":"3d print of 3d surface scan","description":"3d print of 3d surface scan","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19328","name":"Rmvl intact breast implant","description":"Removal of intact breast implant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":529.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49591","name":"Rpr aa hrn 1st < 3 cm rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, reducible","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27278","name":"Arthrd si jt plmt iartic dev","description":"Arthrodesis, sacroiliac joint, percutaneous or minimally invasive, with image guidance, includes obtaining bone graft when performed, unilateral; placement of intra-articular device(s), without cortical piercing","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0930T","name":"Ephys eval ccm-d ld 1st impl","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), at time of initial implantation or replacement with testing of cardiac contrac","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0038","name":"Clin pt no ref","description":"Clinician determines patient does not require referral","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63052","name":"Lam facetc/frmt arthrd lum 1","description":"Laminectomy, facetectomy, or foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s] [eg, spinal or lateral recess stenosis]), during posterior interbody arthrodesis, lumbar; single vertebral segment (list separately in addition to code for primary ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4014","name":"Nephrology ss","description":"Nephrology mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0866T","name":"Quan mri alys brn w/dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion detection, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transmissio","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0663","name":"Team remote e/m new pt 45 mn","description":"Team remote e/m new pt 45mins","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1472","name":"Hep b vaccine not received","description":"Patient did not receive recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0941T","name":"Cysto flx ins&xpns urtl scaf","description":"Cystourethroscopy, flexible; with insertion and expansion of prostatic urethral scaffold using integrated cystoscopic visualization","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86821","name":"Lymphocyte culture mixed","description":"Hla typing; lymphocyte culture, mixed (mlc)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86053","name":"Aqaprn-4 antb flo cytmtry ea","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; flow cytometry (ie, fluorescence-activated cell sorting [facs]), each","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0684T","name":"Peri-px dev eval isdss ip","description":"Peri-procedural device evaluation (in-person) and programming of device system parameters before or after a surgery, procedure, or test with analysis, review, and report by a physician or other qualified health care professional, permanent implantable synchronized diaphragmatic stimulation system fo","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54640","name":"Orchiopexy ingun/scrot appr","description":"Orchiopexy, inguinal or scrotal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":498.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0237","name":"Inj, tocilizumab-anoh, hospi","description":"Injection, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0527","name":"Mgt est pt dmentia low cmplx","description":"Management of established patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66989","name":"Xcpsl ctrc rmvl cplx insj 1+","description":"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification), complex, requiring devices or techniques not generally used in routine cataract surgery (eg, iris expansion device,","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2021","name":"Neomatrix per sq cm","description":"Neomatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0318U","name":"Ped whl gen mthyltn alys 50+","description":"Ped whl gen mthyltn alys 50+","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43352","name":"Surgical opening esophagus","description":"Esophagostomy, fistulization of esophagus, external; cervical approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1147.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55867","name":"Laps surg prst8ect smpl stot","description":"Laparoscopy, surgical prostatectomy, simple subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy), includes robotic assistance, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0836T","name":"Dgtz gls mcrscp fna ea addl","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0597U","name":"Onc breast rna xprsn 329gens","description":"Onc breast rna xprsn 329gens","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4357","name":"Xwrap plus, per sq cm","description":"Xwrap plus, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q0224","name":"Inj, pemivibart, 4500 mg","description":"Injection, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, and who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppressive ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0217","name":"Inj velmanase alfa-tycv 1 mg","description":"Injection, velmanase alfa-tycv, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2956","name":"Indirect rest remov","description":"Indirect rest remov","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90836","name":"Psytx w pt w e/m 45 min","description":"Psychotherapy, 45 minutes with patient when performed with an evaluation and management service (list separately in addition to the code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":109.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21550","name":"Biopsy of neck/chest","description":"Biopsy, soft tissue of neck or thorax","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76700","name":"Us exam abdom complete","description":"Ultrasound, abdominal, real time with image documentation; complete","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0666","name":"Inj, bupivacaine liposome","description":"Injection, bupivacaine liposome, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50060","name":"Nl removal calculus","description":"Nephrolithotomy; removal of calculus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0976T","name":"Slctv nzmtc dbrdmt s/n/hf ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; each additional 100 sq cm (list separately in addition to code for p","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5945","name":"Mand implt sup remv part","description":"Mand implt sup remv part","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60254","name":"Extensive thyroid surgery","description":"Thyroidectomy, total or subtotal for malignancy; with radical neck dissection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1938.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5611","name":"Rep resin part dent base man","description":"Rep resin part dent base man","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33287","name":"Rmv&rplcmt phrnc nrv stim pg","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26508","name":"Release thumb contracture","description":"Release of thenar muscle(s) (eg, thumb contracture)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":866.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75820","name":"Vein x-ray arm/leg","description":"Venography, extremity, unilateral, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1442","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0967T","name":"Tranal ins tmp clrc anst dev","description":"Transanal insertion of endoluminal temporary colorectal anastomosis protection device, including vacuum anchoring component and flexible sheath connected to external vacuum source and monitoring system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93595","name":"L hrt cath chd nm/abn nt cnj","description":"Left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone, normal or abnormal native connections","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82108","name":"Assay of aluminum","description":"Aluminum","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0472","name":"Gross exam prep & report","description":"Accession of tissue gross examination preparation and transmission of written report","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76815","name":"Ob us limited fetus(s)","description":"Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35683","name":"Composite byp grft 3/> segmt","description":"Bypass graft; autogenous composite, 3 or more segments of vein from 2 or more locations (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":557.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0754T","name":"Dgtz gls mcrscp sld level v","description":"Digitization of glass microscope slides for level v, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7241","name":"Impact tooth rem bony w/comp","description":"Removal of impacted tooth-completely bony with unusual surgical complications","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80168","name":"Assay of ethosuximide","description":"Ethosuximide","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93609","name":"Intra-vntr mapg tchycar site","description":"Intraventricular and/or intra-atrial mapping of tachycardia site(s) with catheter manipulation to record from multiple sites to identify origin of tachycardia (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81002","name":"Urinalysis nonauto w/o scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; non-automated, without microscopy","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0465","name":"Autolog prp diab wound ulcer","description":"Autologous platelet rich plasma (prp) or other blood-derived product for diabetic chronic wounds/ulcers, using an fda-cleared device for this indication, (includes as applicable administration, dressings, phlebotomy, centrifugation or mixing, and all other preparatory procedures, per treatment)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1242","name":"Pt no resp imprt to me","description":"Patient did not respond to the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4012","name":"Interventional rad ss","description":"Interventional radiology mips specialty set","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9382","name":"Inj zenocutuzumab-zbco 1 mg","description":"Injection, zenocutuzumab-zbco, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11201","name":"Rmvl skin tags ea addl 10","description":"Removal of skin tags, multiple fibrocutaneous tags, any area; each additional 10 lesions, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":13.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0437U","name":"Psyc anxiety do mrna 15 bmrk","description":"Psyc anxiety do mrna 15 bmrk","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9161","name":"Inj denileuk difti-cxdl 1mcg","description":"Injection, denileukin diftitox-cxdl, 1 mcg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0615","name":"Calcium acetate, oral, 23 mg","description":"Calcium acetate, oral, 23 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33882","name":"Evasc rpr ta dplmt mltpc sys","description":"Endovascular repair of the thoracic aorta by deployment of a branched endograft multipiece system involving an aorto-aortic tube device with a fenestration for the left subclavian artery stent graft(s) and all aortic tube endograft extension(s) placed from the level of the left common carotid artery","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64613","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1376","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49190","name":"Opn exc/dstr ntra-abd >30 cm","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); greater than 30 cm","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1305","name":"Inj, evinacumab-dgnb, 5mg","description":"Injection, evinacumab-dgnb, 5mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2404","name":"Inj, nicardipine 0.1 mg","description":"Injection, nicardipine, 0.1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0519","name":"New pt-cg dyad dem low cmplx","description":"Management of new patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2267","name":"Inj, mirikizumab-mrkz, 1 mg","description":"Injection, mirikizumab-mrkz, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5827","name":"Endo knee shin single axis","description":"Endoskeletal knee-shin system, single axis, electromechanical swing and stance phase control, with or without shock absorption and stance extension damping","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4333","name":"Ardeograft, per sq cm","description":"Ardeograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0995T","name":"Evasc dlvr a-wal stbl rx opn","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; open","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7485","name":"Surg reduct osseoustuberosit","description":"Surgical reduction of osseous tuberosity","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0265U","name":"Rar do whl gn&mtcdrl dna als","description":"Rare constitutional and other heritable disorders, whole- genome and mitochondrial dna sequence analysis, blood, frozen and formalin-fixed paraffin-embedded (ffpe) tissue, saliva, buccal swabs or cell lines, identification of single nucleotide and copy number variants","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9563","name":"Ht inj immuno diem","description":"Home injectable therapy, immunotherapy, 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":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0878T","name":"Augmnt alys ch ct ild w/ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained with concurrent ct examination of the same structure","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1737","name":"Inj meloxicam (azurity) 1mg","description":"Injection, meloxicam (azurity), 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0845T","name":"Dgtz gls mcrscp imfluor 1st","description":"Digitization of glass microscope slides for immunofluorescence, per specimen; initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0393U","name":"Neu prksn msfl a-syncln prtn","description":"Neu prksn msfl a-syncln prtn","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0372","name":"Tomo comp series images","description":"Tomo comp series images","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97551","name":"Caregiver traing ea addl 15","description":"Caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patie","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0206","name":"Inj allopurinol sodium 1 mg","description":"Injection, allopurinol sodium, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0164","name":"Epinephrine in nacl (baxter)","description":"Injection, epinephrine in sodium chloride (baxter), 0.1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2249","name":"Inj, remimazolam, 1 mg","description":"Injection, remimazolam, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5909","name":"Max guid prothes w/ flange","description":"Max guid prothes w/ flange","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37266","name":"Rvsc evsc fpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55865","name":"Extensive prostate surgery","description":"Exposure of prostate, any approach, for insertion of radioactive substance; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric and obturator nodes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1469.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0761T","name":"Dgtz gls mcrscp sl imm ea 1","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0557U","name":"Nfct ds bv dna mrk vag fluid","description":"Nfct ds bv dna mrk vag fluid","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55709","name":"Bx prst8 tprnl us guided","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2516","name":"Inj, pentamidine isethionate","description":"Injection, pentamidine isethionate, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0872","name":"Daptomycin (xellia) unrefrig","description":"Injection, daptomycin (xellia), unrefrigerated, not therapeutically equivalent to j0878 or j0873, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0681T","name":"Rlcj pulse gen only isdss","description":"Relocation of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing dual leads","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69729","name":"Impl oi implt sk tc esp>=100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside of the mastoid and resulting in removal of greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9246","name":"Mod sedation noniv-15 min","description":"Mod sedation noniv-15 min","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27380","name":"Repair of kneecap tendon","description":"Suture of infrapatellar tendon; primary","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":719.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22838","name":"Rev rplc/rmv thrc vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracic vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78588","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76819","name":"Fetal biophys profil w/o nst","description":"Fetal biophysical profile; without non-stress testing","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55882","name":"Ablt trurl prst8 tis trnsdcr","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation; with insertion of transurethral ultrasound transducer for delivery of thermal ultrasound, including suprapubic tube placement and placement of ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0282U","name":"Rbc dna gntyp 12 bld grp gen","description":"Red blood cell antigen typing, dna, genotyping of 12 blood group system genes to predict 44 red blood cell antigen phenotypes","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2402","name":"Chloroprocaine (clorotekal)","description":"Injection, chloroprocaine hydrochloride (clorotekal), per 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37277","name":"Rvsc evsc fpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86625","name":"Campylobacter antibody","description":"Antibody; campylobacter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0649","name":"Lso sc r pos/lat pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1277","name":"Colorectal ca screen doc rev","description":"Colorectal cancer screening results documented and reviewed","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6107","name":"Tissue regen non-resorbable","description":"Tissue regen non-resorbable","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49593","name":"Rpr aa hrn 1st 3-10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, reducible","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0597U","name":"Onc breast rna xprsn 329gens","description":"Onc breast rna xprsn 329gens","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9999","name":"Inj ustekinumab-aauz 1 mg","description":"Injection, ustekinumab-aauz (otulfi), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0841T","name":"Dgtz gls mcrscp pth cslt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; first tissue block, with frozen section(s), single specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7972","name":"Surg redct fibrous tuberosit","description":"Surgical reduction of fibrous tuberosity","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2055","name":"Idecabtagene vicleucel car","description":"Idecabtagene vicleucel, up to 510 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47011","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33269","name":"Excl laa thrscp any method","description":"Exclusion of left atrial appendage, thoracoscopic, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65205","name":"Remove foreign body from eye","description":"Removal of foreign body, external eye; conjunctival superficial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0443U","name":"Neurflmnt lt chn ultrsens ia","description":"Neurflmnt lt chn ultrsens ia","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q2006","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37266","name":"Rvsc evsc fpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0460U","name":"Onc whl bld/bucc rtpcr 24gen","description":"Onc whl bld/bucc rtpcr 24gen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0979T","name":"Sbmcsl crylys ther sft palt","description":"Submucosal cryolysis therapy; soft palate only","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5996","name":"Peri medicament w/seal, mand","description":"Peri medicament w/seal, mand","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45390","name":"Colonoscopy w/resection","description":"Colonoscopy, flexible; with endoscopic mucosal resection","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4416","name":"Alexiguard tl-t per sq cm","description":"Alexiguard tl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5909","name":"Max guid prothes w/ flange","description":"Max guid prothes w/ flange","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0875T","name":"Prgrm subq prtl asct pmp sys","description":"Programming of subcutaneously implanted peritoneal ascites pump system by physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49595","name":"Rpr aa hrn 1st > 10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, reducible","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43635","name":"Removal of stomach partial","description":"Vagotomy when performed with partial distal gastrectomy (list separately in addition to code[s] for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93260","name":"Prgrmg dev eval impltbl sys","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; implantable subcutaneous lead d","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4398","name":"Summit ac per sq cm","description":"Summit ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0527U","name":"Hsv 1&2 vzv amp prb tq pthgn","description":"Hsv 1&2 vzv amp prb tq pthgn","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0801","name":"Inj. acthar gel to 40 units","description":"Injection, corticotropin (acthar gel), up to 40 units","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0822T","name":"Mntr psychdlc med cln staff","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; clinical staff under the direction of a physician or other qualified health care professional, concurrent with first physician or other qualified health care p","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49187","name":"Opn exc/dstr ntra-abd 5.1-10","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5.1 to 10 cm","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1337","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0892T","name":"Arhfcmrigtbs sbsq per tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent motor threshold redetermination with delivery and management, per treatment day","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1708","name":"Pfizer vacc admin 3rd dose","description":"Pfizer vacc admin 3rd dose","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4353","name":"Xceed tl matrix per sq cm","description":"Xceed tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1388","name":"Pt doc exm rec melmn","description":"Patients with documentation of an exam performed for recurrence of melanoma","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1179","name":"No pcv recd","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine, on or after their 19th birthday and before or during measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87299","name":"Antibody detection nos if","description":"Infectious agent antigen detection by immunofluorescent technique; not otherwise specified, each organism","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0759","name":"Inj, clevidipine, 1 mg","description":"Injection, clevidipine butyrate, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1337","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5811","name":"Denture interm cmplt mandbl","description":"Interim complete denture (mandibular)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0531","name":"Fclty-based respite, 24 hr u","description":"Facility-based respite, 24-hour unit, for use in cmmi model","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0958T","name":"Rmv s-sclp eltr ra rcvr&tlmt","description":"Removal of sub-scalp implanted electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17110","name":"Destruction b9 les up to 14","description":"Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), of benign lesions other than skin tags or cutaneous vascular proliferative lesions; up to 14 lesions","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":120.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0891","name":"Argatroban nonesrd (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31535","name":"Laryngoscopy w/biopsy","description":"Laryngoscopy, direct, operative, with biopsy;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37280","name":"Revsc evsc tpvt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50783","name":"Reimplant ureter in bladder","description":"Ureteroneocystostomy; with extensive ureteral tailoring","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1351.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69718","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1691.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93593","name":"R hrt cath chd nml nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; normal native connections","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90481","name":"Admn sarscov2 vac ea add cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; each additional component administered (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0602","name":"Sevelamer carbonate pdr 20mg","description":"Sevelamer carbonate (renvela or therapeutically equivalent), oral, powder, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2022","name":"Innovabrn/innovamatx xl sqcm","description":"Innovaburn or innovamatrix xl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6611","name":"Onlay cst hgh nbl mtl >=3srf","description":"Onlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36836","name":"Prq av fstl crtj uxtr 1 acs","description":"Percutaneous arteriovenous fistula creation, upper extremity, single access of both the peripheral artery and peripheral vein, including fistula maturation procedures (eg, transluminal balloon angioplasty, coil embolization) when performed, including all vascular access, imaging guidance and radiolo","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1836","name":"Inj, metronidazole, 10 mg","description":"Injection, metronidazole, 10 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0608U","name":"Reprdtve med ema rtpcr 10bct","description":"Reprdtve med ema rtpcr 10bct","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98014","name":"Synch audio-only est mod 30","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code s","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69209","name":"Remove impacted ear wax uni","description":"Removal impacted cerumen using irrigation/lavage, unilateral","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94200","name":"Lung function test (mbc/mvv)","description":"Maximum breathing capacity, maximal voluntary ventilation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0976T","name":"Slctv nzmtc dbrdmt s/n/hf ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; each additional 100 sq cm (list separately in addition to code for p","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2312","name":"Inj naloxone hcl nos, 0.01mg","description":"Injection, naloxone hydrochloride, not otherwise specified, 0.01 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87285","name":"Treponema pallidum ag if","description":"Infectious agent antigen detection by immunofluorescent technique; treponema pallidum","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0970T","name":"Ablt b9 brst tum perq lsr ea","description":"Ablation, benign breast tumor (eg, fibroadenoma), percutaneous, laser, including imaging guidance when performed, each tumor","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1007T","name":"Eeg impl s-sclp eeg w/o vid","description":"Electroencephalogram from implanted sub-scalp continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7413","name":"Excision malig lesion<=1.25c","description":"Excision of malignant lesion up to 1.25 cm","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1301","name":"Immunization counseling","description":"Immunization counseling","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0576U","name":"Trnsplj med lar quan ddcfdna","description":"Trnsplj med lar quan ddcfdna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0533","name":"Buprenorphone inj weekly","description":"Medication assisted treatment, buprenorphine (injectable) administered on a weekly basis; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid tre","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90482","name":"Imm cnsl not admn sm 3<10","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; 3 minutes up to 10 minutes","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9076","name":"Inj, cyclophos (baxter) 5mg","description":"Injection, cyclophosphamide (baxter), 5 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4260","name":"Signature apatch, per sq cm","description":"Signature apatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1072","name":"Inj, testosterone, azmiro","description":"Injection, testosterone cypionate (azmiro), 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11643","name":"Exc f/e/e/n/l mal+mrg 2.1-3","description":"Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 2.1 to 3.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1812","name":"Inj. insulin (fiasp)","description":"Insulin (fiasp), per 5 units","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7521","name":"Incision/drain abscess extra","description":"Incision and drainage of abscess - extraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27252","name":"Treat hip dislocation","description":"Closed treatment of hip dislocation, traumatic; requiring anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":881.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1597","name":"Inj glycopyrrolate, glyrx-pf","description":"Injection, glycopyrrolate (glyrx-pf), 0.1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9361","name":"Inj, efbemalenograstim alfa-","description":"Injection, efbemalenograstim alfa-vuxw, 0.5 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33267","name":"Excl laa open any method","description":"Exclusion of left atrial appendage, open, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0522U","name":"Ca vi psp&sp1 antb cl semiql","description":"Ca vi psp&sp1 antb cl semiql","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6604","name":"Cst bse mtl inlay 2 surfaces","description":"Inlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2009","name":"Symphony, per sq cm","description":"Symphony, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0268U","name":"Hem ahus gen seq alys 15 gen","description":"Hematology (atypical hemolytic uremic syndrome [ahus]), genomic sequence analysis of 15 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1449","name":"Pt dx scz/pys bef end msr pd","description":"Patients with an active diagnosis of schizophrenia or psychotic disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87110","name":"Chlamydia culture","description":"Culture, chlamydia, any source","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99344","name":"Home/res vst new mod mdm 60","description":"Home or residence visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0578","name":"Inj brixadi, more than 7 day","description":"Injection, buprenorphine extended release (brixadi), greater than 7 days and up to 28 days of therapy","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7511","name":"Incision/drain abscess intra","description":"Incision and drainage of abscess - intraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0996T","name":"Ins&sclr fix caps bag prosth","description":"Insertion and scleral fixation of a capsular bag prosthesis containing an intraocular lens prosthesis, with vitrectomy, including removal of crystalline lens or dislocated intraocular lens prosthesis, when performed","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0321U","name":"Iadna gu pthgn 20bct&fng org","description":"Iadna gu pthgn 20bct&fng org","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1247","name":"Pt resp true best int","description":"Patient responded completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0619U","name":"Pulm copd dna alys >18000","description":"Pulm copd dna alys >18000","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9129","name":"Photobio therpy-sub 15 mins","description":"Photobio therpy-sub 15 mins","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4002","name":"Ep cardio ss","description":"Electrophysiology cardiac specialist mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54231","name":"Dynamic cavernosometry","description":"Dynamic cavernosometry, including intracavernosal injection of vasoactive drugs (eg, papaverine, phentolamine)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9003","name":"Leupro inj, camcevi etm, 1mg","description":"Leuprolide injectable (camcevi etm), 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87076","name":"Culture anaerobe ident each","description":"Culture, bacterial; anaerobic isolate, additional methods required for definitive identification, each isolate","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98980","name":"Rtm tx mgmt 1st 20 min","description":"Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least 1 real-time interactive communication with the patient or caregiver during the calendar month; first 20 minutes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4334","name":"Amnioplast 1, per sq cm","description":"Amnioplast 1, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91319","name":"Sarscv2 vac 10mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 10 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41008","name":"Drainage of mouth lesion","description":"Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; submandibular space","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0941T","name":"Cysto flx ins&xpns urtl scaf","description":"Cystourethroscopy, flexible; with insertion and expansion of prostatic urethral scaffold using integrated cystoscopic visualization","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76016","name":"Mr safety deter phys/qhp","description":"Mr safety determination by a physician or other qualified health care professional responsible for the safety of the mr procedure, including review of implant mr conditions for indicated mr examination, analysis of risk vs clinical benefit of performing mr examination, and determination of mr equipm","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70473","name":"Ct cere prfu aly c+wo ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed without concurrent ct or ct angiography of the same anatomy","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86596","name":"Voltage-gtd ca chnl antb ea","description":"Voltage-gated calcium channel antibody, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7528","name":"Mycophen mofetil for susp","description":"Mycophenolate mofetil, for suspension, oral, 100 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5878","name":"Dup of complt dent-mandib","description":"Dup of complt dent-mandib","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4429","name":"Dermbnd chn, chx per sq cm","description":"Dermabind ch n or dermabind ch x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85032","name":"Manual cell count each","description":"Blood count; manual cell count (erythrocyte, leukocyte, or platelet) each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0072A","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0484","name":"Consult slides prep elsewher","description":"Consultation on slides prepared elsewhere","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0846T","name":"Dgtz gls mcrscp imfluor ea","description":"Digitization of glass microscope slides for immunofluorescence, per specimen; each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91319","name":"Sarscv2 vac 10mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 10 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5144","name":"Inj, idacio, 1 mg","description":"Injection, adalimumab-aacf (idacio), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0904T","name":"Ecg alg 12 ld rdcd trcg only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; tracing only","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1368","name":"Prev trt inf d/o hiv/hep mvp","description":"Prevention and treatment of infectious disorders including hepatitis c and hiv mips value pathway","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0917T","name":"Insj perm ccm-d sys 1 lead","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; single transvenous lead (pacing or defibrillation) only","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0370","name":"Max ultrasound capt & interp","description":"Max ultrasound capt & interp","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21137","name":"Rdctj forehead cntrg only","description":"Reduction forehead; contouring only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":854.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92552","name":"Pure tone audiometry air","description":"Pure tone audiometry (threshold); air only","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4314","name":"Reeva, per sq cm","description":"Reeva ft, per square cenitmeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77310","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87484","name":"Ehrlicha chaffeensis amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); ehrlichia chaffeensis, amplified probe technique","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0996T","name":"Ins&sclr fix caps bag prosth","description":"Insertion and scleral fixation of a capsular bag prosthesis containing an intraocular lens prosthesis, with vitrectomy, including removal of crystalline lens or dislocated intraocular lens prosthesis, when performed","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9291","name":"Pres dig cog behav thera fda","description":"Prescription digital cognitive and/or behavioral therapy, fda cleared, per course of treatment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3244","name":"Inj. tigecycline (accord)","description":"Injection, tigecycline (accord), not therapeutically equivalent to j3243, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64655","name":"Revj/rplcmt bat mod sys lead","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; lead only","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4029","name":"Preventive medicine ss","description":"Preventive medicine mips specialty set","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0440U","name":"Crd chd dna alys 10 snp 6dna","description":"Crd chd dna alys 10 snp 6dna","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54057","name":"Laser surg penis lesion(s)","description":"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; laser surgery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6211","name":"Bridge base metal cast","description":"Pontic-cast predominantly base metal","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25320","name":"Repair/revise wrist joint","description":"Capsulorrhaphy or reconstruction, wrist, open (eg, capsulodesis, ligament repair, tendon transfer or graft) (includes synovectomy, capsulotomy and open reduction) for carpal instability","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1192","name":"Pt w/ dx sq cell ca of esoph","description":"Patients with an existing diagnosis of squamous cell carcinoma of the esophagus","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0689T","name":"Quan us tis charac w/o dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained without diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9183","name":"Gemcitabine intravesical sys","description":"Gemcitabine intravesical system, 225 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0574U","name":"Mtb cfp-10 serum/plsm lc-ms","description":"Mtb cfp-10 serum/plsm lc-ms","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37289","name":"Revsc evsc tpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2469","name":"Palonosetron hcl","description":"Injection, palonosetron hcl, 25 mcg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49188","name":"Opn exc/dst ntra-abd 10.1-20","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 10.1 to 20 cm","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4241","name":"Gngvl flap w rootplan 1-3 th","description":"Gingival flap procedure including root planing - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0278U","name":"Hem gen thrombosis 12 genes","description":"Hematology (genetic thrombosis), genomic sequence analysis of 12 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61596","name":"Transcochlear approach/skull","description":"Transcochlear approach to posterior cranial fossa, jugular foramen or midline skull base, including labyrinthectomy, decompression, with or without mobilization of facial nerve and/or petrous carotid artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2829.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61867","name":"Implant neuroelectrode","description":"Twist drill, burr hole, craniotomy, or craniectomy with stereotactic implantation of neurostimulator electrode array in subcortical site (eg, thalamus, globus pallidus, subthalamic nucleus, periventricular, periaqueductal gray), with use of intraoperative microelectrode recording; first array","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2473.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0995T","name":"Evasc dlvr a-wal stbl rx opn","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; open","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0395U","name":"Onc lng multiomics plsm alg","description":"Onc lng multiomics plsm alg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0218","name":"Inj olipudase alfa-rpcp 1mg","description":"Injection, olipudase alfa-rpcp, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43501","name":"Surgical repair of stomach","description":"Gastrotomy; with suture repair of bleeding ulcer","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1379.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33277","name":"Insj phrnc nrv stim transvns","description":"Insertion of phrenic nerve stimulator transvenous sensing lead (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0598U","name":"Gi ibs igg antb 18food items","description":"Gi ibs igg antb 18food items","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15012","name":"Hrv skn cll ssp agrft ea add","description":"Harvest of skin for skin cell suspension autograft; each additional 25 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4428","name":"Dermbnd sln sl+ slx sq cm","description":"Dermabind sl n or dermabind sl + or dermabind sl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1747","name":"Inj, spesolimab-sbzo, 1 mg","description":"Injection, spesolimab-sbzo, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0890T","name":"Arhfcmrigtbs 1st tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including target assessment, initial motor threshold determination, neuronavigation, delivery and management, initial treatment day","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0452U","name":"Onc bldr mthyl penk lte-qmsp","description":"Onc bldr mthyl penk lte-qmsp","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83987","name":"Exhaled breath condensate","description":"Ph; exhaled breath condensate","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2018","name":"Permeaderm c, per sq cm","description":"Permeaderm c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4317","name":"Vitograft, per sq cm","description":"Vitograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2030","name":"Miro3d fibers, per mg","description":"Miro3d fibers, per milligram","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80204","name":"Drug assay methotrexate","description":"Methotrexate","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0429U","name":"Hpv orop swab 14 hi-risk typ","description":"Hpv orop swab 14 hi-risk typ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55868","name":"Lap srg prst8ct lymph nod bx","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with lymph node biopsy(ies) (limited pelvic lymphadenectomy)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0577U","name":"Onc ovr serum alys 39 gps","description":"Onc ovr serum alys 39 gps","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7023","name":"Mech allergen parti barrier","description":"Mechanical allergen particle barrier/inhalation filter, cream, nasal, topical","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0972T","name":"Asstv alg clsfctn burn hlg","description":"Assistive algorithmic classification of burn healing (ie, healing or nonhealing) by noninvasive multispectral imaging, including system set-up and acquisition, selection, and transmission of images, with automated generation of report","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6561","name":"G stockng full/chap 40+ cust","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, custom, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"Basic vestibular evaluation","description":"Basic vestibular evaluation, includes spontaneous nystagmus test with eccentric gaze fixation nystagmus, with recording, positional nystagmus test, minimum of 4 positions, with recording, optokinetic nystagmus test, bidirectional foveal and peripheral stimulation, with recording, and oscillating tra","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0758T","name":"Dgtz gls mcrscp sl spc hchem","description":"Digitization of glass microscope slides for special stain, including interpretation and report, histochemical stain on frozen tissue block (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86042","name":"Acetylcholn rcptr blckg antb","description":"Acetylcholine receptor (achr); blocking antibody","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0589","name":"Inj daxibotulinumtoxina-lanm","description":"Injection, daxibotulinumtoxina-lanm, 1 unit","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1425","name":"Surgical care mvp","description":"Surgical care mips value pathway","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2037","name":"G4derm plus/suprello, pr ml","description":"G4derm plus/suprello, per milliliter","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4410","name":"Amchomatrixdl per sq cm","description":"Amchomatrixdl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4269","name":"Surgraft xt per sq cm","description":"Surgraft xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0879","name":"Difelikefalin, esrd on dialy","description":"Injection, difelikefalin, 0.1 microgram, (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27327","name":"Exc thigh/knee les sc < 3 cm","description":"Excision, tumor, soft tissue of thigh or knee area, subcutaneous; less than 3 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1223","name":"Glaucoma plan of care doc","description":"Glaucoma plan of care documented","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1807","name":"Inj, ethacrynate sod, 1 mg","description":"Injection, ethacrynate sodium, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1379","name":"10 yr fu no rec rsn not giv","description":"A 10 year follow-up interval for colonoscopy not recommended, reason not otherwise specified","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43288","name":"Esphg thrsc moblj","description":"Esophagectomy, total or near total, with thoracoscopic mobilization of the upper, middle, and lower mediastinal esophagus, with separate laparoscopic proximal gastrectomy, with laparoscopic pyloric drainage procedure if performed, with open cervical pharyngogastrostomy or esophagogastrostomy (ie, th","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4214.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76883","name":"Us nrv&acc strux 1xtr compre","description":"Ultrasound, nerve(s) and accompanying structures throughout their entire anatomic course in one extremity, comprehensive, including real-time cine imaging with image documentation, per extremity","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92945","name":"Prq trl rvs ch occ ant&rtrgr","description":"Percutaneous transluminal revascularization of chronic total occlusion, single coronary artery, coronary artery branch, or coronary artery bypass graft, and/or subtended major coronary artery branches of the bypass graft, any combination of intracoronary stent, atherectomy and angioplasty; combined ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0316","name":"Prolong inpt eval add15 m","description":"Prolonged hospital inpatient or observation care evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the date of the primary service); each additional 15 minutes by the physician or qualified healthcare professi","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":374.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0802","name":"3d dental scan indirect","description":"3d dental scan indirect","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2038","name":"Marigen pacto, per sq cm","description":"Marigen pacto, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2643","name":"Dental onlay porcelin 3 surf","description":"Onlay - porcelain/ceramic - three surfaces","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0546U","name":"Ldns lrp4 antb imflr livecll","description":"Ldns lrp4 antb imflr livecll","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27216","name":"Treat pelvic ring fracture","description":"Percutaneous skeletal fixation of posterior pelvic bone fracture and/or dislocation, for fracture patterns that disrupt the pelvic ring, unilateral (includes ipsilateral ilium, sacroiliac joint and/or sacrum)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1249.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0417U","name":"Rare ds alys 335 nuc genes","description":"Rare ds alys 335 nuc genes","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1260","name":"Pt not doc <= 1 yr dialysis","description":"Patient status not documented within the first year of initiating dialysis","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1503","name":"Vascular surgery mvp","description":"Vascular surgery mips value pathway","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0617U","name":"Cv ascvd dna alys >20000","description":"Cv ascvd dna alys >20000","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64469","name":"Thrc fascial pln blk bi nfs","description":"Thoracic fascial plane block, bilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92623","name":"Dx aly aud oi snd prcsr each","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; each additional 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0053","name":"Ht mental health and care","description":"Historical trauma (ht) mental health and clinical care for indigenous persons","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0580U","name":"Bbrgdrferi antb detc 24rprtn","description":"Bbrgdrferi antb detc 24rprtn","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92275","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94640","name":"Airway inhalation treatment","description":"Pressurized or nonpressurized inhalation treatment for acute airway obstruction for therapeutic purposes and/or for diagnostic purposes such as sputum induction with an aerosol generator, nebulizer, metered dose inhaler or intermittent positive pressure breathing (ippb) device","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0162","name":"Inj epinephrine (fresenius)","description":"Injection, epinephrine (fresenius), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1182","name":"Not elg pre ex ibd/uc/crohn","description":"Patients not eligible due to pre-existing inflammatory bowel disease (ibd) (e.g., ulcerative colitis, crohns disease)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9272","name":"Inj, dostarlimab-gxly, 10 mg","description":"Injection, dostarlimab-gxly, 10 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4368","name":"Amchothick per sq cm","description":"Amchothick, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0447U","name":"Ai ds sle alys 11 cytokine","description":"Ai ds sle alys 11 cytokine","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4312","name":"Acesso ac, per sq cm","description":"Acesso ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9277","name":"Pembrolizumab 1mg berahyalur","description":"Injection, pembrolizumab, 1 mg and berahyaluronidase alfa-pmph","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15657.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9273","name":"Inj tisotu vedotin-tftv, 1mg","description":"Injection, tisotumab vedotin-tftv, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0340U","name":"Onc pan ca alys mrd plasma","description":"Onc pan ca alys mrd plasma","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1217","name":"Sys rsn no doc spiro","description":"Documentation of system reason(s) for not documenting and reviewing spirometry results (e.g., spirometry equipment not available at the time of the encounter)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0801","name":"Inj. acthar gel to 40 units","description":"Injection, corticotropin (acthar gel), up to 40 units","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26531","name":"Revise knuckle with implant","description":"Arthroplasty, metacarpophalangeal joint; with prosthetic implant, each joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9028","name":"Inj, nogapendekin pmln, 1mcg","description":"Injection, nogapendekin alfa inbakicept-pmln, for intravesical use, 1 microgram","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0530U","name":"Onc pan-sol tum ctdna 77 gen","description":"Onc pan-sol tum ctdna 77 gen","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37288","name":"Revsc evsc tpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87426","name":"Sarscov coronavirus ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; severe acute respiratory syndrome coronavirus (eg, sars-cov, s","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2012","name":"Suprathel, per sq cm","description":"Suprathel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0218","name":"Inj olipudase alfa-rpcp 1mg","description":"Injection, olipudase alfa-rpcp, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0422U","name":"Onc pan solid tum alys dna","description":"Onc pan solid tum alys dna","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5142","name":"Inj adalimumab-ryvk, 1 mg","description":"Injection, adalimumab-ryvk biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5147","name":"Inj, aflibercept-ayyh, 1 mg","description":"Injection, aflibercept-ayyh (pavblu), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33011","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0444U","name":"Onc sld orgn neo tgsap 361","description":"Onc sld orgn neo tgsap 361","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0586U","name":"Onc mrna gen xprsn 216 genes","description":"Onc mrna gen xprsn 216 genes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97550","name":"Caregiver traing 1st 30 min","description":"Caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patie","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0548U","name":"Gfap cleia plasma","description":"Gfap cleia plasma","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93736","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0834T","name":"Dgtz gls mcrscp cytp oth xtn","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93150","name":"Therapy activation ipnss","description":"Therapy activation of implanted phrenic nerve stimulator system, including all interrogation and programming","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93644","name":"Ep eval subq impl dfb","description":"Electrophysiologic evaluation of subcutaneous implantable defibrillator (includes defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing for arrhythmia termination, and programming or reprogramming of sensing or therapeutic parameters)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0820T","name":"Mntr psychdlc med 1stphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; first physician or other qualified health care professional, each hour","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0433U","name":"Onc prst8 5 dna reg mrk pcr","description":"Onc prst8 5 dna reg mrk pcr","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1240","name":"Pt no resp best int","description":"Patient did not respond to the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1364","name":"Ascvd risk >=20pct","description":"Calculated 10-year ascvd risk score of >= 20 percent during the performance period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7413","name":"Excision malig lesion<=1.25c","description":"Excision of malignant lesion up to 1.25 cm","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0728T","name":"Dx alys vstblr implt uni 1st","description":"Diagnostic analysis of vestibular implant, unilateral; with initial programming","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28435","name":"Cltx talus fracture w/mnpj","description":"Closed treatment of talus fracture; with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2246","name":"Inj, micafungin (baxter)","description":"Injection, micafungin in sodium (baxter), not therapeutically equivalent to j2248, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4260","name":"Signature apatch, per sq cm","description":"Signature apatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52284","name":"Cysto rx balo cath urtl strx","description":"Cystourethroscopy, with mechanical urethral dilation and urethral therapeutic drug delivery by drug-coated balloon catheter for urethral stricture or stenosis, male, including fluoroscopy, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0491U","name":"Onc sol tum ctc slct er prtn","description":"Onc sol tum ctc slct er prtn","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0642","name":"Lo sag ri an/pos pnl pre ots","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0381U","name":"Maple syrup ur ds mntr quan","description":"Maple syrup ur ds mntr quan","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1015T","name":"Rev/rmv lw esoph sphnc npg/r","description":"Revision or removal, lower esophageal sphincter neurostimulator pulse generator or receiver","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5877","name":"Dup of complt dent-maxill","description":"Dup of complt dent-maxill","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7601","name":"Ensifentrine inh 3 mg","description":"Ensifentrine, inhalation suspension, fda approved final product, non-compounded, administered through dme, unit dose form, 3 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0290U","name":"Pain mgmt mrna gen xprsn 36","description":"Pain mgmt mrna gen xprsn 36","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0461","name":"Testing for cracked tooth","description":"Testing for cracked tooth","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55708","name":"Bx prst8 trct us w/mri fus 1","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant) with mri-fusion-guidance, first targeted lesion","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4295","name":"Amnio tri-core, per sq cm","description":"Amnio tri-core amniotic, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75994","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":890.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15015","name":"App skn cl ssp agrft t/a/l 1","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; first 480 sq cm or less","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1296","name":"Calc bmi norm parameters","description":"Bmi is documented within normal parameters and no follow-up plan is required","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61575","name":"Skull base/brainstem surgery","description":"Transoral approach to skull base, brain stem or upper spinal cord for biopsy, decompression or excision of lesion;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2665.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4540","name":"Trans elec nerv periph nerv","description":"Distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0703","name":"2d oral/facial photo image","description":"2d oral/facial photo image","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4026","name":"Phys/occ therapy ss","description":"Physical therapy/occupational therapy mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0698T","name":"Quan mr tiss w/mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained with diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, target ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1192","name":"Pt w/ dx sq cell ca of esoph","description":"Patients with an existing diagnosis of squamous cell carcinoma of the esophagus","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98977","name":"Rtm dev sply mscskl 16-30 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of musculoskeletal system, 16-30 days in a 30-day period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31257","name":"Nsl/sins ndsc tot w/sphendt","description":"Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior), including sphenoidotomy","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":402.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9607","name":"Lutetium lu 177 vipivotide","description":"Lutetium lu 177 vipivotide tetraxetan, therapeutic, 1 millicurie","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1009T","name":"Rem mntr s-sclp cont eeg sys","description":"Remote monitoring of a sub-scalp implanted continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0932T","name":"N-invs det hrt fail aug echo","description":"Noninvasive detection of heart failure derived from augmentative analysis of an echocardiogram that demonstrated preserved ejection fraction, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36145","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67922","name":"Repair eyelid defect","description":"Repair of entropion; thermocauterization","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78730","name":"Urinary bladder retention","description":"Urinary bladder residual study (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5098","name":"Inj ustekinumab-srlf, 1 mg","description":"Injection, ustekinumab-srlf (imuldosa), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0937T","name":"Xtrnl ecg rec>15d<30d","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; including recording, scanning analysis with report, review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0522","name":"Mgt nw pt dementia low cmplx","description":"Management of a new patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0883T","name":"Intraop ther estim pn ue ea","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; each additional nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99435","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21087","name":"Impres&prep nasal prosth","description":"Impression and custom preparation; nasal prosthesis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2151.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33278","name":"Rmvl phrnc nrv stim sys","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; system, including pulse generator and lead(s)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1323","name":"Pts 7wk inj, scrn iop >25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop >25 mm hg and a plan of care was documented","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J0135","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":577.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7771","name":"Alveolus clsd reduc stblz te","description":"Alveolus closed reduction stabilization of teeth","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0755T","name":"Dgtz gls mcrscp sld level vi","description":"Digitization of glass microscope slides for level vi, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9607","name":"Lutetium lu 177 vipivotide","description":"Lutetium lu 177 vipivotide tetraxetan, therapeutic, 1 millicurie","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0388","name":"Bitewing image capture only","description":"Bitewing image capture only","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8541","name":"Oral, hemady, 0.25 mg","description":"Dexamethasone (hemady), oral, 0.25 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1348","name":"Pam incr 6 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 6-points in a 4 to 12 month period (excellent)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0569U","name":"Onc sol tum ngs tmm>20000dmr","description":"Onc sol tum ngs tmm>20000dmr","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87086","name":"Urine culture/colony count","description":"Culture, bacterial; quantitative colony count, urine","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87564","name":"Mtb rifampin rst amp prb tq","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacterium tuberculosis, rifampin resistance, amplified probe technique","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33269","name":"Excl laa thrscp any method","description":"Exclusion of left atrial appendage, thoracoscopic, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43234","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44369","name":"Small bowel endoscopy","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49591","name":"Rpr aa hrn 1st < 3 cm rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, reducible","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0358U","name":"Neuro alys b-amyl 1-42&1-40","description":"Neuro alys b-amyl 1-42&1-40","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1226","name":"Iop not doc","description":"Iop measurement not documented, reason not otherwise specified","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36837","name":"Prq av fstl crt uxtr sep acs","description":"Percutaneous arteriovenous fistula creation, upper extremity, separate access sites of the peripheral artery and peripheral vein, including fistula maturation procedures (eg, transluminal balloon angioplasty, coil embolization) when performed, including all vascular access, imaging guidance and radi","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0238","name":"Intrav inf, toci, second dos","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9563","name":"Ht inj immuno diem","description":"Home injectable therapy, immunotherapy, 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":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0534","name":"Coordinated care/or referral","description":"Coordinated care and/or referral services, such as to adequate and accessible community resources to address unmet health-related social needs, including harm reduction interventions and recovery support services a patient needs and wishes to pursue, which significantly limit the ability to diagnose","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1007T","name":"Eeg impl s-sclp eeg w/o vid","description":"Electroencephalogram from implanted sub-scalp continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93145","name":"Interrog crtd sins bat ip wo","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1595","name":"Injection glatiramer acetate","description":"Injection, glatiramer acetate, 20 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9278","name":"Inj, carboplatin (avyxa)","description":"Injection, carboplatin (avyxa), 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0381U","name":"Maple syrup ur ds mntr quan","description":"Maple syrup ur ds mntr quan","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55709","name":"Bx prst8 tprnl us guided","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78715","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0030","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1271","name":"Inj doxycycline hyclate 1 mg","description":"Injection, doxycycline hyclate, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99238","name":"Hosp ip/obs dschrg mgmt 30/<","description":"Hospital inpatient or observation discharge day management; 30 minutes or less on the date of the encounter","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0356U","name":"Onc orop 17 dna ddpcr alg","description":"Onc orop 17 dna ddpcr alg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0785T","name":"Revj/rmvl nea spi w/nstim","description":"Revision or removal of neurostimulator electrode array, spinal, with integrated neurostimulator","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25448","name":"Arthrp ntrcrpl/crp/mtcrp ssp","description":"Arthroplasty, intercarpal or carpometacarpal joints; suspension, including transfer or transplant of tendon, with interposition, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0044","name":"Pt mitral stenosis","description":"Patients with moderate or severe mitral stenosis","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0643","name":"Lso sag ctr rigi pos pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7961","name":"Buccal/labial frenectomy","description":"Buccal/labial frenectomy","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76805","name":"Ob us >/= 14 wks sngl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0782T","name":"Brnchsc rf dstrj plm nrv uni","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; unilateral mainstem bronchus","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87181","name":"Sc std agar dilution per agt","description":"Susceptibility studies, antimicrobial agent; agar dilution method, per agent (eg, antibiotic gradient strip)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56501","name":"Destroy vulva lesions sim","description":"Destruction of lesion(s), vulva; simple (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0052","name":"Mmip mental health and care","description":"Missing and murdered indigenous persons (mmip) mental health and clinical care","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0668","name":"Instill, bupivac and meloxic","description":"Instillation, bupivacaine and meloxicam, 1 mg/0.03 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12018","name":"Rpr f/e/e/n/l/m >30.0 cm","description":"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; over 30.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1025","name":"Pt mnth 1 mcp prov","description":"Patient-months where there are more than one medicare capitated payment (mcp) provider listed for the month","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99463","name":"Same day nb discharge","description":"Initial hospital or birthing center care, per day, for evaluation and management of normal newborn infant admitted and discharged on the same date","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":31.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37299","name":"Revsc evsc imvt angio cpx ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0911","name":"Inst tauro 1.35mg/hep 100u","description":"Instillation, taurolidine 1.35 mg and heparin sodium 100 units (central venous catheter lock for adult patients receiving chronic hemodialysis)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4332","name":"Axolotl dualgraft, per sq cm","description":"Axolotl dualgraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0062","name":"Audiology ss","description":"Audiology mips specialty set","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0873","name":"Inj daptomycin (xellia)","description":"Injection, daptomycin (xellia), not therapeutically equivalent to j0878 or j0872, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0263U","name":"Neuro asd meas 16 c metblt","description":"Neurology (autism spectrum disorder [asd]), quantitative measurements of 16 central carbon metabolites (ie, a-ketoglutarate, alanine, lactate, phenylalanine, pyruvate, succinate, carnitine, citrate, fumarate, hypoxanthine, inosine, malate, s-sulfocysteine, taurine, urate, and xanthine), liquid chrom","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0889T","name":"Prsnlz trgt dvl arhfcmrigtbs","description":"Personalized target development for accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation derived from a structural and resting-state functional mri, including data preparation and transmission, generation of the target, motor threshold-starting location, neuro","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4375","name":"Duograft ac per sq cm","description":"Duograft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5130","name":"Inj, fylnetra, 0.5 mg","description":"Injection, pegfilgrastim-pbbk (fylnetra), biosimilar, 0.5 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76819","name":"Fetal biophys profil w/o nst","description":"Fetal biophysical profile; without non-stress testing","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0029","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97607","name":"Neg prs wnd thr ndme<=50sqcm","description":"Negative pressure wound therapy, (eg, vacuum assisted drainage collection), utilizing disposable, non-durable medical equipment including provision of exudate management collection system, topical application(s), wound assessment, and instructions for ongoing care, per session; total wound(s) surfac","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":21.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0803","name":"3d facial scan direct","description":"3d facial scan direct","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24305","name":"Tendon lngth upr a/e ea tdn","description":"Tendon lengthening, upper arm or elbow, each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1182","name":"Not elg pre ex ibd/uc/crohn","description":"Patients not eligible due to pre-existing inflammatory bowel disease (ibd) (e.g., ulcerative colitis, crohns disease)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47715","name":"Excision of bile duct cyst","description":"Excision of choledochal cyst","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1323.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1808","name":"Inj, folic acid, 0.1 mg","description":"Injection, folic acid, 0.1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95076","name":"Ingest challenge ini 120 min","description":"Ingestion challenge test (sequential and incremental ingestion of test items, eg, food, drug or other substance); initial 120 minutes of testing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93596","name":"R&l hrt cath chd nml nt cnj","description":"Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); normal native connections","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1290","name":"Pt not eli d/t act dig htn","description":"Patient not eligible due to active diagnosis of hypertension","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70472","name":"Ct cere prfu alys c+w/ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed with concurrent ct or ct angiography of the same anatomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4271","name":"Home lancing/test cartridges","description":"Integrated lancing and blood sample testing cartridges for home blood glucose monitor, per 50 tests","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84431","name":"Thromboxane urine","description":"Thromboxane metabolite(s), including thromboxane if performed, urine","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2010","name":"Apis, per square centimeter","description":"Apis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87153","name":"Dna/rna sequencing","description":"Culture, typing; identification by nucleic acid sequencing method, each isolate (eg, sequencing of the 16s rrna gene)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4399","name":"Summit fx per sq cm","description":"Summit fx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4389","name":"Neothelium 4l+ per sq cm","description":"Neothelium 4l+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27894","name":"Decompression of leg","description":"Decompression fasciotomy, leg; anterior and/or lateral, and posterior compartment(s), with debridement of nonviable muscle and/or nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1258","name":"Cvd risk assess perf","description":"Cvd risk assessment performed, have a documented calculated risk score","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0975T","name":"Slctv nzmtc dbrdmt s/n/hf 1","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; first 100 sq cm","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4278","name":"Epieffect, per sq cm","description":"Epieffect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0993T","name":"N-invas assmt car rsk w/ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat with concurrent computed tomography scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional (list s","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1386","name":"Exc sx melmn or mlnm is","description":"Patients with an excisional surgery for melanoma or melanoma in situ in the past 5 years with an initial ajcc staging of 0, i, or ii at the start of the performance period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97037","name":"Appl modality 1+lllt po pain","description":"Application of a modality to 1 or more areas; low-level laser therapy (ie, nonthermal and non-ablative) for post-operative pain reduction","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4348","name":"Sentry sl matrix per sq cm","description":"Sentry sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92641","name":"Hearing dev verif eacous aly","description":"Hearing device verification, electroacoustic analysis","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62361","name":"Implant spine infusion pump","description":"Implantation or replacement of device for intrathecal or epidural drug infusion; nonprogrammable pump","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":457.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83529","name":"Asay of interleukin-6 (il-6)","description":"Interleukin-6 (il-6)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4028","name":"Podiatry ss","description":"Podiatry mips specialty set","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01939","name":"Anes nulyt agt crv/thrc","description":"Anesthesia for percutaneous image-guided destruction procedures by neurolytic agent on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9003","name":"Leupro inj, camcevi etm, 1mg","description":"Leuprolide injectable (camcevi etm), 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4331","name":"Axolotl graft, per sq cm","description":"Axolotl graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0660","name":"Team remote e/m new pt 10 mn","description":"Team remote e/m new pt 10mins","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95873","name":"Guide nerv destr elec stim","description":"Electrical stimulation for guidance in conjunction with chemodenervation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0983T","name":"Rem mntr impl ivc snr phys","description":"Remote monitoring of an implanted inferior vena cava sensor for up to 30 days, including at least weekly downloads of inferior vena cava area recordings, interpretation(s), trend analysis, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99424","name":"Prin care mgmt phys 1st 30","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9056","name":"Inj, vivimusta, 1 mg","description":"Injection, bendamustine hydrochloride (vivimusta), 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4262","name":"Dual layer impax, per sq cm","description":"Dual layer impax membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46607","name":"Diagnostic anoscopy & biopsy","description":"Anoscopy; with high-resolution magnification (hra) (eg, colposcope, operating microscope) and chemical agent enhancement, with biopsy, single or multiple","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":127.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0500U","name":"Autoinflam ds vexas synd dna","description":"Autoinflam ds vexas synd dna","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6602","name":"G com bandge hgh dn foamroll","description":"Gradient compression bandaging supply, high density foam roll for bandage, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0764T","name":"Asstv alg ecg rsk asmt cncrt","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to concurrently performed electrocardiogram (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4299","name":"Amniocore pro+, per sq cm","description":"Amniocore pro+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0951T","name":"Tot impl amei 1st plmt","description":"Totally implantable active middle ear hearing implant; initial placement, including mastoidectomy, placement of and attachment to sound processor","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0831T","name":"Dgtz gls mcrscp cytp c/v","description":"Digitization of glass microscope slides for cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1453","name":"Preop vis acu > 20/40","description":"Patients with a pre-operative visual acuity better than 20/40","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84394","name":"Total tau","description":"Tau, total (ttau)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0311U","name":"Nfct ds bct quan antmcrb sc","description":"Nfct ds bct quan antmcrb sc","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1326","name":"Pts dx hypotony","description":"Patients with a diagnosis of hypotony","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1939","name":"Inj, bumetanide, 0.5 mg","description":"Injection, bumetanide, 0.5 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1010T","name":"Cptr oph alys monoc eye mvmt","description":"Computerized ophthalmic analysis of monocular eye movements using retinal-based eye-tracking without spatial calibration, including fixation, microsaccades, drift, and horizontal saccades, when performed, unilateral or bilateral, with interpretation and report","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1428","name":"Bilateral absence of eyes","description":"Patients who have bilateral absence of eyes any time during the patients history through the end of the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0686T","name":"Histotripsy mal hepatcel tis","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant hepatocellular tissue, including image guidance","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77411","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51721","name":"Ins trurl ablt trnsdc thr us","description":"Insertion of transurethral ablation transducer for delivery of thermal ultrasound for prostate tissue ablation, including suprapubic tube placement during the same session and placement of an endorectal cooling device, when performed","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69719","name":"Rplcm oi implt sk tc esp<100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88364","name":"Insitu hybridization (fish)","description":"In situ hybridization (eg, fish), per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53866","name":"Cathj rmvl dev ischmc rmdlg","description":"Catheterization with removal of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99466","name":"Ped crit care transport","description":"Critical care face-to-face services, during an interfacility transport of critically ill or critically injured pediatric patient, 24 months of age or younger; first 30-74 minutes of hands-on care during transport","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":95.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24201","name":"Rmvl fb upper arm/elbw deep","description":"Removal of foreign body, upper arm or elbow area; deep (subfascial or intramuscular)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88355","name":"M/phmtrc alys skeletal musc","description":"Morphometric analysis; skeletal muscle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":503.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0335U","name":"Rare ds whl gen seq fetal","description":"Rare ds whl gen seq fetal","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64466","name":"Thrc fascial pln blk uni njx","description":"Thoracic fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0724T","name":"Qmrcp w/dx mri same anatomy","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained with diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in additio","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6599","name":"G comp bandage short stretch","description":"Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7962","name":"Lingual frenectomy","description":"Lingual frenectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1932","name":"Inj, lanreotide, (cipla) 1mg","description":"Injection, lanreotide, (cipla), 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27125","name":"Partial hip replacement","description":"Hemiarthroplasty, hip, partial (eg, femoral stem prosthesis, bipolar arthroplasty)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1267.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0693T","name":"Compre ful bdy 3d mtn alys","description":"Comprehensive full body computer-based markerless 3d kinematic and kinetic motion analysis and report","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2516","name":"Inj, pentamidine isethionate","description":"Injection, pentamidine isethionate, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0568","name":"Int psych care mng, 1 cal mo","description":"Initial psychiatric collaborative care management, in the first calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required elements: outrea","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4435","name":"Renati membrane per sq cm","description":"Renati membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0520","name":"New pt-cg dyad dem mod cmplx","description":"Management of new patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1481","name":"Pt in hosp/pal care who died","description":"Patients receiving hospice or palliative care or who died during the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6608","name":"G com bandage tub protct pad","description":"Gradient compression bandaging supply, tubular protective absorption padded layer, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1001T","name":"Autol musc cell therapy njx","description":"Autologous muscle cell therapy, injection of muscle progenitor cells into the external anal sphincter, including ultrasound guidance, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4457","name":"Enema tube any type repl","description":"Enema tube, with or without adapter, any type, replacement only, each","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4392","name":"Grafix duo per sq cm","description":"Grafix duo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67516","name":"Sprchoroidal spc njx rx agt","description":"Suprachoroidal space injection of pharmacologic agent (separate procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50860","name":"Transplant ureter to skin","description":"Ureterostomy, transplantation of ureter to skin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1021.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83905","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59160","name":"D & c after delivery","description":"Curettage, postpartum","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":321.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":254.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0919T","name":"Rmvl perm ccm-d sys pg only","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); pulse generator only","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97022","name":"Whirlpool therapy","description":"Application of a modality to 1 or more areas; whirlpool","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87478","name":"Borrelia miyamotoi amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); borrelia miyamotoi, amplified probe technique","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82166","name":"Assay anti-mullerian horm","description":"Anti-mullerian hormone (amh)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0891T","name":"Arhfcmrigtbs sbsq tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent treatment day","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1488","name":"Dx dementia in msr timeframe","description":"Patients with a diagnosis for dementia in the year before or during the period of evaluation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90613","name":"Inf&sarscov2 vacc 40/0.4 im","description":"Influenza virus vaccine, quadrivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 40 mcg/0.4 ml dosage, for intramuscular use","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9024","name":"Inj atezolizumb 5mg hya-tqjs","description":"Injection, atezolizumab, 5 mg and hyaluronidase-tqjs","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99222","name":"1st hosp ip/obs moderate 55","description":"Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 55 minutes ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2781","name":"Crown 3/4 cast base metal","description":"Crown - 3/4 cast predominantly base metal","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4026","name":"Phys/occ therapy ss","description":"Physical therapy/occupational therapy mips specialty set","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4290","name":"Membrane wrap hydr per sq cm","description":"Membrane wrap-hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49187","name":"Opn exc/dstr ntra-abd 5.1-10","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5.1 to 10 cm","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5154","name":"Inj, omlyclo, 5 mg","description":"Injection, omalizumab-igec (omlyclo), biosimilar, 5 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1292","name":"Pt 66+ frail inpt adv ill","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and an advanced illness diagnosis during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0786T","name":"Insj/rplcmt prq ra sac nstim","description":"Insertion or replacement of percutaneous electrode array, sacral, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93898","name":"Ven-artl shunt det mbubb njx","description":"Venous-arterial shunt detection with intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0966T","name":"I&cst prp jw xpn dl arch fxd","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, fixed hinge mechanism","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9616","name":"Gallium gozellix 1 millicuri","description":"Gallium ga-68 gozetotide (gozellix), diagnostic, 1 millicurie","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9324","name":"Inj, pemrydi rtu, 10 mg","description":"Injection, pemetrexed (pemrydi rtu), 10 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98013","name":"Synch audio-only est low 20","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code select","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0727T","name":"Rmvl&rplcmt implt vstblr dev","description":"Removal and replacement of implanted vestibular device, unilateral","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22860","name":"Tot disc arthrp 2ntrspc lmbr","description":"Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression); second interspace, lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0589U","name":"Pfas24cmpnd hi-perf lc-ms/ms","description":"Pfas24cmpnd hi-perf lc-ms/ms","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77436","name":"Surf radj ther tx planning","description":"Surface radiation therapy; superficial or orthovoltage, treatment planning and simulation-aided field setting","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0004","name":"Qual care neurologic cnd mvp","description":"Quality care for patients with neurological conditions mips value pathway","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0280U","name":"Hem vw factor&clgn iv bndg","description":"Hematology (von willebrand disease [vwd]), von willebrand factor (vwf) and collagen iv binding by enzyme-linked immunosorbent assays (elisa), plasma, report of collagen iv binding","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0346","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6198","name":"Remove interim implant","description":"Remove interim implant","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1243","name":"Pt othr thn true heard","description":"Patient provided a response other than completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2025","name":"Miro3d per cubic cm","description":"Miro3d, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85014","name":"Hematocrit","description":"Blood count; hematocrit (hct)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4355","name":"Abio xpl abio xpl hy p sq cm","description":"Abiomend xplus membrane and abiomend xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23332","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4353","name":"Xceed tl matrix per sq cm","description":"Xceed tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0313U","name":"Onc pncrs dna&mrna seq 74","description":"Onc pncrs dna&mrna seq 74","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0337U","name":"Onc plsm cell do&myeloma id","description":"Onc plsm cell do&myeloma id","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93594","name":"R hrt cath chd abnl nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; abnormal native connections","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86701","name":"Hiv-1antibody","description":"Antibody; hiv-1","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1315","name":"Crc no doc no rsn","description":"Colorectal cancer screening results were not documented and reviewed; reason not otherwise specified","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7214","name":"Altuviiio per factor viii iu","description":"Injection, factor viii/von willebrand factor complex, recombinant (altuviiio), per factor viii i.u.","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4026","name":"Phys/occ therapy ss","description":"Physical therapy/occupational therapy mips specialty set","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52597","name":"Trurl rbtc wtrjt rescj prst8","description":"Transurethral robotic-assisted waterjet resection of prostate, including intraoperative planning, ultrasound guidance, control of postoperative bleeding, complete, including vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4252","name":"Vendaje, per square centimet","description":"Vendaje, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0744T","name":"Insj bioprostc vlv fem vn","description":"Insertion of bioprosthetic valve, open, femoral vein, including duplex ultrasound imaging guidance, when performed, including autogenous or nonautogenous patch graft (eg, polyester, eptfe, bovine pericardium), when performed","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90957","name":"Esrd srv 4 vsts p mo 12-19","description":"End-stage renal disease (esrd) related services monthly, for patients 12-19 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 4 or more face-to-face visits by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":889.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1191","name":"Hspc svc any time in meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0413U","name":"Onc hl neo opt gen mapg dna","description":"Onc hl neo opt gen mapg dna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4382","name":"Advograft dual per sq cm","description":"Advograft dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q2022","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46083","name":"Inc thrombosed hroid xtrnl","description":"Incision of thrombosed hemorrhoid, external","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP08","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0337U","name":"Onc plsm cell do&myeloma id","description":"Onc plsm cell do&myeloma id","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0385U","name":"Neph ckd alg rsk dbtc kdn ds","description":"Neph ckd alg rsk dbtc kdn ds","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2221","name":"Ank mcrop plant & dorsi flex","description":"Addition to lower extremity orthosis, ankle system, microprocessor-controlled feature plantarflexion and/or dorsiflexion, includes power source","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0681T","name":"Rlcj pulse gen only isdss","description":"Relocation of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing dual leads","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0921T","name":"Rmvl perm ccm-d sys 1 dfb ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous defibrillation lead only","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9607","name":"Lutetium lu 177 vipivotide","description":"Lutetium lu 177 vipivotide tetraxetan, therapeutic, 1 millicurie","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1720","name":"Influenza vacc admin","description":"Influenza vacc admin","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0093A","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5158","name":"Inj, denosumab-bnht, 1 mg","description":"Injection, denosumab-bnht (bomyntra/conexxence), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81515","name":"Nfct ds bv&vaginitis dna alg","description":"Infectious disease, bacterial vaginosis and vaginitis, real-time pcr amplification of dna markers for atopobium vaginae, atopobium species, megasphaera type 1, and bacterial vaginosis associated bacteria-2 (bvab-2), utilizing vaginal-fluid specimens, algorithm reported as positive or negative for hi","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","name":"Gait mod systm rhym auditory","description":"Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87541","name":"Legion pneumo dna amp prob","description":"Infectious agent detection by nucleic acid (dna or rna); legionella pneumophila, amplified probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0812T","name":"Rem mlt day uroflow dev sply","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); device supply with automated report generation, up to 10 days","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76819","name":"Fetal biophys profil w/o nst","description":"Fetal biophysical profile; without non-stress testing","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6089","name":"Access/retorq implant screw","description":"Access/retorq implant screw","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5148","name":"Inj, nyposi 1 mcg","description":"Injection, filgrastim-txid (nypozi), biosimilar, 1 microgram","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5159","name":"Inj, denosumab-dssb, 1 mg","description":"Injection, denosumab-dssb (ospomyv/xbryk), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0689T","name":"Quan us tis charac w/o dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained without diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99489","name":"Cplx chrnc care ea addl 30","description":"Complex chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":90.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0544","name":"Post d/c phone follow up","description":"Post discharge telephonic follow-up contacts performed in conjunction with a discharge from the emergency department for behavioral health or other crisis encounter, 4 calls per calendar month","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9800","name":"Gallium locametz 1 millicuri","description":"Gallium ga-68 gozetotide, diagnostic, (locametz), 1 millicurie","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87593","name":"Orthopoxvirus amp prb each","description":"Infectious agent detection by nucleic acid (dna or rna); orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus), amplified probe technique, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5128","name":"Inj, cimerli, 0.1 mg","description":"Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0664","name":"Team remote e/m new pt 60 mn","description":"Team remote e/m new pt 60mins","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0490U","name":"Onc cutan/uveal mlnma cd146","description":"Onc cutan/uveal mlnma cd146","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4287","name":"Dermabind dl, per sq cm","description":"Dermabind dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2044","name":"Biobrane glove, each","description":"Biobrane glove, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6624","name":"Inlay titanium","description":"Inlay - titanium","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0663","name":"Team remote e/m new pt 45 mn","description":"Team remote e/m new pt 45mins","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81560","name":"Trnsplj pd lvr&bwl cd154+cll","description":"Transplantation medicine (allograft rejection, pediatric liver and small bowel), measurement of donor and third-party-induced cd154+t-cytotoxic memory cells, utilizing whole peripheral blood, algorithm reported as a rejection risk score","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35533","name":"Art byp grft axill/fem/fem","description":"Bypass graft, with vein; axillary-femoral-femoral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1935.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98004","name":"Synch audio-video est sf 10","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 10 minutes must be met or e","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7912","name":"Suture complicate wnd > 5 cm","description":"Complicated suture-greater than 5 cm","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99493","name":"Sbsq psyc collab care mgmt","description":"Subsequent psychiatric collaborative care management, first 60 minutes in a subsequent month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required el","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":87.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1386","name":"Exc sx melmn or mlnm is","description":"Patients with an excisional surgery for melanoma or melanoma in situ in the past 5 years with an initial ajcc staging of 0, i, or ii at the start of the performance period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59840","name":"Induced abortion d&c","description":"Induced abortion, by dilation and curettage","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":287.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2470","name":"Inj pantoprazole sodium 40mg","description":"Injection, pantoprazole sodium, 40 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0892T","name":"Arhfcmrigtbs sbsq per tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent motor threshold redetermination with delivery and management, per treatment day","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0303U","name":"Hem rbc ads whl bld hypoxic","description":"Hem rbc ads whl bld hypoxic","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2019","name":"Kerecis marigen shld sq cm","description":"Kerecis omega3 marigen shield, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6196","name":"Remv of ind rest on implt","description":"Remv of ind rest on implt","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0748T","name":"Njx stm cl prdct anl sft tis","description":"Injections of stem cell product into perianal perifistular soft tissue, including fistula preparation (eg, removal of setons, fistula curettage, closure of internal openings)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61891","name":"Rev/rplcmt sk-mnt crnl nstm","description":"Revision or replacement of skull-mounted cranial neurostimulator pulse generator or receiver with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0368","name":"Cone beam ct interprete tmj","description":"Cone beam ct interprete tmj","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33280","name":"Rmvl phrnc nrv stim pg only","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator only","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61889","name":"Ins sk-mnt crnl nstm pg/rcvr","description":"Insertion of skull-mounted cranial neurostimulator pulse generator or receiver, including craniectomy or craniotomy, when performed, with direct or inductive coupling, with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76883","name":"Us nrv&acc strux 1xtr compre","description":"Ultrasound, nerve(s) and accompanying structures throughout their entire anatomic course in one extremity, comprehensive, including real-time cine imaging with image documentation, per extremity","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1494","name":"Fall rep since last visit","description":"Patients that reported a fall since the last visit","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96547","name":"Intraop hipec px 1st 60 min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; first 60 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2976","name":"Band stabilization per tooth","description":"Band stabilization per tooth","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37284","name":"Revsc evasc tpvt st sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1026","name":"Pt hemo > 3mo","description":"The number of adult patient-months in the denominator who were on maintenance hemodialysis using a catheter continuously for three months or longer under the care of the same practitioner or group partner as of the last hemodialysis session of the reporting month","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0910T","name":"Rmvl int nstim sys vagus nrv","description":"Removal of integrated neurostimulation system, vagus nerve","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90791","name":"Psych diagnostic evaluation","description":"Psychiatric diagnostic evaluation","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":189.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33771","name":"Rpr tga w/surg enlgmnt vsd","description":"Repair of transposition of the great arteries with ventricular septal defect and subpulmonary stenosis; with surgical enlargement of ventricular septal defect","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2364.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1489","name":"Pt status doc","description":"Patient status documented","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4356","name":"Abio mem abio hyd per sq cm","description":"Abiomend membrane and abiomend hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4327","name":"Duoamnion, per sq cm","description":"Duoamnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0904T","name":"Ecg alg 12 ld rdcd trcg only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; tracing only","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1204","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1308","name":"Inj, famotidine, 0.25 mg","description":"Injection, famotidine, 0.25 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0997T","name":"Precuneus mag stimj tx plng","description":"Precuneus magnetic stimulation; treatment planning using magnetic resonance imaging-guided neuronavigation to determine optimal location, dose, and intensity for magnetic stimulation therapy, derived from evoked potentials from single pulses of electromagnetic energy recorded by 64-channel electroen","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0875T","name":"Prgrm subq prtl asct pmp sys","description":"Programming of subcutaneously implanted peritoneal ascites pump system by physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0529","name":"In home respite care, 4 hr u","description":"In-home respite care, 4-hour unit, for use in cmmi model","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33800","name":"Aortic suspension","description":"Aortic suspension (aortopexy) for tracheal decompression (eg, for tracheomalacia) (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1205.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0343U","name":"Onc prst8 xom aly 442 sncrna","description":"Onc prst8 xom aly 442 sncrna","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38227","name":"Car-t receipt&prepj admn","description":"Chimeric antigen receptor t-cell (car-t) therapy; receipt and preparation of car-t cells for administration","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0439","name":"Ppps, subseq visit","description":"Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1307","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9247","name":"Mod sedation noniv-sub15min","description":"Mod sedation noniv-sub15min","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37254","name":"Revsc evasc ivt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49595","name":"Rpr aa hrn 1st > 10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, reducible","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82679","name":"Assay of estrone","description":"Estrone","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0461U","name":"Onc rxgenom alys rtpcr 24gen","description":"Onc rxgenom alys rtpcr 24gen","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35565","name":"Art byp grft iliofemoral","description":"Bypass graft, with vein; iliofemoral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1635.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3401","name":"Vyjuvek 5x10^9pfu/ml, 0.1 ml","description":"Beremagene geperpavec-svdt for topical administration, containing nominal 5 x 10^9 pfu/ml vector genomes, per 0.1 ml","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1235","name":"Doc pt hcv aby rna tst","description":"Documentation or patient report of hcv antibody test or hcv rna test which occurred prior to the performance period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0373","name":"Tomo bitewing image","description":"Tomo bitewing image","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1381","name":"Pt sec strk wthin 5 days","description":"Patients with secondary stroke (e.g., a subsequent stroke that may occur with vasospasm in the setting of subarachnoid hemorrhage) within 5 days of the initial procedure","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4320","name":"Pellograft, per sq cm","description":"Pellograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0978T","name":"Submucosal cryolysis therapy","description":"Submucosal cryolysis therapy; soft palate, base of tongue, and lingual tonsil","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4292","name":"Lamellas, per sq cm","description":"Lamellas, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93569","name":"Njx cth slct p-art angrp uni","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69726","name":"Rmv ntr oi implt skl prq esp","description":"Removal, entire osseointegrated implant, skull; with percutaneous attachment to external speech processor","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6590","name":"Urinary cath disp suc pump","description":"External urinary catheters; disposable, with wicking material, for use with suction pump, per month","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":446.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80505","name":"Path clin consltj high 41-60","description":"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patients history and medical records and high level of medical decision making when using time for code selection, 41-60 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9273","name":"Inj tisotu vedotin-tftv, 1mg","description":"Injection, tisotumab vedotin-tftv, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5940","name":"Resct proth max part remov","description":"Resct proth max part remov","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99415","name":"Prolng clin staff svc 1st hr","description":"Prolonged clinical staff service (the service beyond the highest time in the range of total time of the service) during an evaluation and management service in the office or outpatient setting, direct patient contact with physician supervision; first hour (list separately in addition to code for out","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0696T","name":"Bdy surf mapg pm/cvdfb f/up","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of follow-up interrogation or programming device evaluatio","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5126","name":"Inj alymsys 10 mg","description":"Injection, bevacizumab-maly, biosimilar, (alymsys), 10 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98981","name":"Rtm tx mgmt ea addl 20 min","description":"Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least 1 real-time interactive communication with the patient or caregiver during the calendar month; each additional 20 minutes (list separately in","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10120","name":"Inc&rmvl fb subq tiss smpl","description":"Incision and removal of foreign body, subcutaneous tissues; simple","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":180.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4333","name":"Ardeograft, per sq cm","description":"Ardeograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2525","name":"Cl, hydrophilic, dual focus","description":"Contact lens, hydrophilic, dual focus, per lens","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0310U","name":"Ped vsclts kd alys 3 bmrks","description":"Ped vsclts kd alys 3 bmrks","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5146","name":"Inj, hercessi, 10 mg","description":"Injection, trastuzumab-strf (hercessi), biosimilar, 10 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10061","name":"I&d abscess comp/multiple","description":"Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); complicated or multiple","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":238.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1474","name":"Pt dx dementia","description":"Patients with diagnosis of dementia","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4425","name":"Revive tl per sq cm","description":"Revive tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0570","name":"Care manage serv, pr cal mo","description":"Care management services for behavioral health conditions, directed by a physician or other qualified health care professional, per calendar month, with the following required elements: initial assessment or follow-up monitoring, including the use of applicable validated rating scales, behavioral he","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0513U","name":"Onc prst8 alg alys msi&hrd","description":"Onc prst8 alg alys msi&hrd","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99427","name":"Prin care mgmt staff ea addl","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1933","name":"Afo rig ant tib tcf/= ots","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, off-the-shelf","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1070.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0488U","name":"Ob fetal ag nipt cfdna alys","description":"Ob fetal ag nipt cfdna alys","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46257","name":"Remove in/ex hem grp & fiss","description":"Hemorrhoidectomy, internal and external, single column/group; with fissurectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28810","name":"Amputation toe & metatarsal","description":"Amputation, metatarsal, with toe, single","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5878","name":"Dup of complt dent-mandib","description":"Dup of complt dent-mandib","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5411","name":"Dentures adjust cmplt mand","description":"Adjust complete denture - mandibular","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3250","name":"Trimethobenzamide hcl inj","description":"Injection, trimethobenzamide hcl, up to 200 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9025","name":"Plasma cryo redu path each","description":"Plasma, cryoprecipitate reduced, pathogen reduced, each unit","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0458U","name":"Onc brst ca s100 a8&a9 elisa","description":"Onc brst ca s100 a8&a9 elisa","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1456","name":"Inj, fosaprepitant (teva)","description":"Injection, fosaprepitant (teva), not therapeutically equivalent to j1453, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0988T","name":"Opn ins/rplc ins ptn sbq&sbf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37270","name":"Revsc evasc fpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6191","name":"Semi precision abutment","description":"Semi precision abutment","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0271U","name":"Hem cgen neutropenia 23 gen","description":"Hematology (congenital neutropenia), genomic sequence analysis of 23 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2015","name":"Phoenix wnd mtrx, per sq cm","description":"Phoenix wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2401","name":"Chloroprocaine hcl injection","description":"Injection, chloroprocaine hydrochloride, per 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0694T","name":"3d vol img&rcnstj brst/ax","description":"3-dimensional volumetric imaging and reconstruction of breast or axillary lymph node tissue, each excised specimen, 3-dimensional automatic specimen reorientation, interpretation and report, real-time intraoperative","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1500","name":"Neuropsychology mvp","description":"Neuropsychology mips value pathway","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0968T","name":"Insj/rplcmt epcrnl nstim sys","description":"Insertion or replacement of epicranial neurostimulator system, including electrode array and pulse generator, with connection to electrode array","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1409","name":"Recd gmln brca1/brca2 couns","description":"Patients who received germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0469U","name":"Rare ds whl gen seq ftl samp","description":"Rare ds whl gen seq ftl samp","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72010","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0934T","name":"Rem mntr wrls l atr prs snr","description":"Remote monitoring of a wireless left atrial pressure sensor for up to 30 days, including data from daily uploads of left atrial pressure recordings, interpretation(s) and trend analysis, with adjustments to the diuretics plan, treatment paradigm thresholds, medications or lifestyle modifications, wh","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5932","name":"Postsurgical obturator","description":"Obturator prosthesis definitive","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0703","name":"Inj, cefepime hcl (b braun)","description":"Injection, cefepime hydrochloride (b braun), not therapeutically equivalent to maxipime, 500 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0391","name":"Inj, artesunate, 1mg","description":"Injection, artesunate, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1490","name":"Pt status not doc","description":"Patient status not documented","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0902T","name":"Qtc ntrvl augmnt alg aly ecg","description":"Qtc interval derived by augmentative algorithmic analysis of input from an external, patient-activated mobile ecg device","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84156","name":"Assay of protein urine","description":"Protein, total, except by refractometry; urine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0467U","name":"Onc bldr dna ngs 60gen&aneup","description":"Onc bldr dna ngs 60gen&aneup","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1359","name":"Indx suicd idea, no 0 scr","description":"Index assessment during the denominator period when the suicidal ideation and/or behavior symptoms or increased suicide risk by clinician determination occurs and a non-zero c-ssrs score is obtained","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88275","name":"Cytogenetics 100-300","description":"Molecular cytogenetics; interphase in situ hybridization, analyze 100-300 cells","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17264","name":"Dstrj mal les t/a/l 3.1-4.0","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), trunk, arms or legs; lesion diameter 3.1 to 4.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0887T","name":"End-tidal ctrl inhaled anes","description":"End-tidal control of inhaled anesthetic agents and oxygen to assist anesthesia care delivery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2016","name":"Permeaderm b, per sq cm","description":"Permeaderm b, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01940","name":"Anes nulyt agt lmbr/sac","description":"Anesthesia for percutaneous image-guided destruction procedures by neurolytic agent on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43287","name":"Esphg dstl 2/3 w/laps moblj","description":"Esophagectomy, distal two-thirds, with laparoscopic mobilization of the abdominal and lower mediastinal esophagus and proximal gastrectomy, with laparoscopic pyloric drainage procedure if performed, with separate thoracoscopic mobilization of the middle and upper mediastinal esophagus and thoracic e","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3786.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9886","name":"In-person attendance g code","description":"Behavioral counseling for diabetes prevention, in-person, group, 60 minutes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0819T","name":"Revj/rmvl ins ptn subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1179","name":"No pcv recd","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine, on or after their 19th birthday and before or during measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4282","name":"Cygnus dual per sq cm","description":"Cygnus dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9004","name":"Va whole health partner serv","description":"Department of veterans affairs whole health partner services","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88346","name":"Imfluor 1st 1antb stain px","description":"Immunofluorescence, per specimen; initial single antibody stain procedure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0866T","name":"Quan mri alys brn w/dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion detection, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transmissio","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80167","name":"Drug assay felbamate","description":"Felbamate","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27842","name":"Treat ankle dislocation","description":"Closed treatment of ankle dislocation; requiring anesthesia, with or without percutaneous skeletal fixation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4352","name":"Overlay sl matrix, per sq cm","description":"Overlay sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2508","name":"Pegunigalsidase alfa-iwxj","description":"Injection, pegunigalsidase alfa-iwxj, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0335U","name":"Rare ds whl gen seq fetal","description":"Rare ds whl gen seq fetal","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44021","name":"Decompress small bowel","description":"Enterotomy, small intestine, other than duodenum; for decompression (eg, baker tube)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":971.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96409","name":"Chemo iv push sngl drug","description":"Chemotherapy administration; intravenous, push technique, single or initial substance/drug","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1303","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9004","name":"Va whole health partner serv","description":"Department of veterans affairs whole health partner services","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9255","name":"Inj, methotrexate (accord)","description":"Injection, methotrexate (accord), not therapeutically equivalent to j9260, 50 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0860T","name":"Ncntc ifr spctrsc scr pad","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), for screening for peripheral arterial disease, including provocative maneuvers, image acquisition, interpretation, and report, one or both lower extremities","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69400","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1233","name":"Pt no hcv aby or result","description":"Patient does not receive hcv antibody test or patient does receive hcv antibody test but results not documented, reason not given","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4344","name":"Tri membrane wrap, per sq cm","description":"Tri-membrane wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93312","name":"Echo transesophageal","description":"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); including probe placement, image acquisition, interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4021","name":"Orthopedic surgery ss","description":"Orthopedic surgery mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0705T","name":"Rem tx amblyopia tech sprt","description":"Remote treatment of amblyopia using an eye tracking device; surveillance center technical support including data transmission with analysis, with a minimum of 18 training hours, each 30 days","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49189","name":"Opn exc/dst ntra-abd 20.1-30","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 20.1 to 30 cm","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35261","name":"Rpr blvsl grf oth/thn vn nck","description":"Repair blood vessel with graft other than vein; neck","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1269.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87076","name":"Culture anaerobe ident each","description":"Culture, bacterial; anaerobic isolate, additional methods required for definitive identification, each isolate","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2792","name":"Crown full cast noble metal","description":"Crown-full cast noble metal","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33902","name":"Perq p-art revsc 1 abnor uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, unilateral","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7412","name":"Excision benign lesion compl","description":"Excision of benign lesion complicated","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0805T","name":"Tcat s&ivc prstc vl impl prq","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); percutaneous femoral vein approach","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92551","name":"Pure tone hearing test air","description":"Screening test, pure tone, air only","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5159","name":"Inj, denosumab-dssb, 1 mg","description":"Injection, denosumab-dssb (ospomyv/xbryk), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37285","name":"Revsc evasc tpvt st sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19297","name":"Place breast cath for rad","description":"Placement of radiotherapy afterloading expandable catheter (single or multichannel) into the breast for interstitial radioelement application following partial mastectomy, includes imaging guidance; concurrent with partial mastectomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1354","name":"Pt no suicd saf pln 120dy","description":"Patients who did not have a suicide safety plan initiated, reviewed, or updated or reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0886T","name":"Sgmdsc flx 1st tndsc dilat","description":"Sigmoidoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86231","name":"Ema each ig class","description":"Endomysial antibody (ema), each immunoglobulin (ig) class","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27700","name":"Revision of ankle joint","description":"Arthroplasty, ankle;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":733.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1334","name":"Pts act pvd 2 wks 2 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 2 weeks after initial acute pvd encounter","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0495U","name":"Onc prst8 alys crcg plsm prt","description":"Onc prst8 alys crcg plsm prt","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99255","name":"Ip/obs consltj new/est hi 80","description":"Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 80 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37283","name":"Rvsc evsc tpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20661","name":"Application halo cranial","description":"Application of halo, including removal; cranial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":506.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0134","name":"Inj acetaminophen -fresenius","description":"Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1207","name":"Pt scrn sdoh","description":"Patient is screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1259","name":"Pt stat doc <= 1 yr dialysis","description":"Patient status documented within the first year of initiating dialysis","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0713T","name":"N-nvs artl plaq alys rvw i&r","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data review, interpretation and report","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86826","name":"Hla x-match noncytotoxc addl","description":"Human leukocyte antigen (hla) crossmatch, non-cytotoxic (eg, using flow cytometry); each additional serum sample or sample dilution (list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93574","name":"Njx cath slct pulm vn angrph","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary venous angiography of each distinct pulmonary vein during cardiac catheterization (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":36.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0880T","name":"Augmnt alys ch ct ild i&r","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1499","name":"Interventional radiology mvp","description":"Interventional radiology mips value pathway","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1248","name":"Pt resp true seen as person","description":"Patient responded completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0611U","name":"Onc lvr alys >1000 mr cfdna","description":"Onc lvr alys >1000 mr cfdna","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4406","name":"Xwrap fenestra per sq cm","description":"Xwrap fenestra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87183","name":"Sc std carbapenem resist gen","description":"Susceptibility studies, antimicrobial agent; carbapenem resistance genes (eg, blakpc, blandm, blavim, blaoxa-48, blaimp), amplified probe technique, per isolate","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76355","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20939","name":"Bone marrow aspir bone grfg","description":"Bone marrow aspiration for bone grafting, spine surgery only, through separate skin or fascial incision (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1501","name":"Pathology mvp","description":"Pathology mips value pathway","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0123","name":"Screen cerv/vag thin layer","description":"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0518U","name":"Ther rx mntr 90+ pn&mtl hlth","description":"Ther rx mntr 90+ pn&mtl hlth","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6192","name":"Semi precision attachment","description":"Semi precision attachment","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9998","name":"Doc med rsn <3 colon","description":"Documentation of medical reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., last colonoscopy incomplete, last colonoscopy had inadequate prep, piecemeal removal of adenomas, or sessile serrated polyps >= 20 mm in size, last colonoscopy found greater than 10 adenomas, lo","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64596","name":"Ins/rplcmt prq eltrd ra pn 1","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; initial electrode array","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":1838.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96367","name":"Tx/proph/dg addl seq iv inf","description":"Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); additional sequential infusion of a new drug/substance, up to 1 hour (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0891T","name":"Arhfcmrigtbs sbsq tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent treatment day","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4224","name":"Hhf10-p per sq cm","description":"Human health factor 10 amniotic patch (hhf10-p), per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8541","name":"Oral, hemady, 0.25 mg","description":"Dexamethasone (hemady), oral, 0.25 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37278","name":"Rvsc evsc fpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2780","name":"Crown 3/4 cast hi noble met","description":"Crown - 3/4 cast high noble metal","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0757T","name":"Dgtz gls mcrscp sl spc grpii","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group ii, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistochemistry (list separately in addition to code for primary","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93586","name":"Vngrph chd coronary sinus","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; coronary sinus (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9246","name":"Mod sedation noniv-15 min","description":"Mod sedation noniv-15 min","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4021","name":"Orthopedic surgery ss","description":"Orthopedic surgery mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1467","name":"Pt dx lynch syn","description":"Patients with an existing diagnosis of lynch syndrome","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0739","name":"Rehab sys active assist rt","description":"Rehabilitation system with interactive interface providing active assistance in rehabilitation therapy, includes all components and accessories, motors, microprocessors, sensors","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"Adju cgm supply allowance","description":"Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1455","name":"Rep/rev cied","description":"Replaced or revised cied","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0394U","name":"Pfas 16 pfas compnd lc ms/ms","description":"Pfas 16 pfas compnd lc ms/ms","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0772T","name":"Vr px dissoc svc sm phy ea","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15788","name":"Chemical peel facial epidrm","description":"Chemical peel, facial; epidermal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50398","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1576","name":"Inj, panzyga, 500 mg","description":"Injection, immune globulin (panzyga), intravenous, non-lyophilized (e.g., liquid), 500 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92137","name":"Cptrz oph img pst sg rta oct","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), posterior segment, with interpretation and report, unilateral or bilateral; retina, including oct angiography","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9361","name":"Inj, efbemalenograstim alfa-","description":"Injection, efbemalenograstim alfa-vuxw, 0.5 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45386","name":"Colonoscopy w/balloon dilat","description":"Colonoscopy, flexible; with transendoscopic balloon dilation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86905","name":"Blood typing rbc antigens","description":"Blood typing, serologic; rbc antigens, other than abo or rh (d), each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0029","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10021","name":"Fna bx w/o img gdn 1st les","description":"Fine needle aspiration biopsy, without imaging guidance; first lesion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9054","name":"Inj bortezomib boruzu 0.1 mg","description":"Injection, bortezomib (boruzu), 0.1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0319U","name":"Neph rna pretrnspl perph bld","description":"Neph rna pretrnspl perph bld","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4362","name":"Cygnus disk, per sq cm","description":"Cygnus disk, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7674","name":"Methacholine chloride, neb","description":"Methacholine chloride administered as inhalation solution through a nebulizer, per 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54055","name":"Destruction penis lesion(s)","description":"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; electrodesiccation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76017","name":"Mr sfty med physics xm cstmz","description":"Mr safety medical physics examination customization, planning and performance monitoring by medical physicist or mr safety expert, with review and analysis by physician or other qualified health care professional to prioritize and select views and imaging sequences, to tailor mr acquisition specific","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0347U","name":"Rx metab/pcx dna 16 gen alys","description":"Rx metab/pcx dna 16 gen alys","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1367","name":"Qual care ent disorder mvp","description":"Quality care for the treatment of ear, nose, and throat disorders mips value pathway","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1444","name":"Del < 39 weeks gest","description":"Delivery at < 39 weeks of gestation","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1475","name":"Pt dx huntington","description":"Patients with diagnosis of huntingtons disease","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0678T","name":"Laps repos lead isdss ea add","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional repositioned lead (list separately in addition to code for primary proce","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37256","name":"Revsc evasc ivt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4440","name":"Curamatrix per sq cm","description":"Curamatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0519U","name":"Ther rx mntr meds p/d/a 110+","description":"Ther rx mntr meds p/d/a 110+","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9886","name":"In-person attendance g code","description":"Behavioral counseling for diabetes prevention, in-person, group, 60 minutes","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0491","name":"Inj anifrolumab-fnia 1mg","description":"Injection, anifrolumab-fnia, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97607","name":"Neg prs wnd thr ndme<=50sqcm","description":"Negative pressure wound therapy, (eg, vacuum assisted drainage collection), utilizing disposable, non-durable medical equipment including provision of exudate management collection system, topical application(s), wound assessment, and instructions for ongoing care, per session; total wound(s) surfac","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":401.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0350","name":"Oral/facial photo images","description":"Oral/facial photographic images","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1382","name":"Enc dur perf pd pos 11","description":"Patient encounter during the performance period with place of service code 11","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27520","name":"Treat kneecap fracture","description":"Closed treatment of patellar fracture, without manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":310.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7473","name":"Remove torus mandibularis","description":"Removal of torus mandibularis","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64628","name":"Trml dstrj ios bvn 1st 2 l/s","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; first 2 vertebral bodies, lumbar or sacral","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82977","name":"Assay of ggt","description":"Glutamyltransferase, gamma (ggt)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61450","name":"Crnec stpl sctj cmprn/dcmprn","description":"Craniectomy, subtemporal, for section, compression, or decompression of sensory root of gasserian ganglion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2113.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67141","name":"Proph rta dtchmnt crtx dthrm","description":"Prophylaxis of retinal detachment (eg, retinal break, lattice degeneration) without drainage; cryotherapy, diathermy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0046","name":"No mrs 90 days post stk","description":"Clinical follow-up and mrs score not assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0554","name":"Add 20 m of monthly tx","description":"Each additional 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing data generated from the","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1236","name":"Baseline mrs > 2","description":"Baseline mrs > 2","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4310","name":"Procenta, per 100 mg","description":"Procenta, per 100 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49507","name":"Prp i/hern init block >5 yr","description":"Repair initial inguinal hernia, age 5 years or older; incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":682.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4259","name":"Celera per sq cm","description":"Celera dual layer or celera dual membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61253","name":"Burr hole treph ittl uni/bi","description":"Burr hole(s) or trephine, infratentorial, unilateral or bilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1041.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84394","name":"Total tau","description":"Tau, total (ttau)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1426","name":"Injection, casimersen, 10 mg","description":"Injection, casimersen, 10 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7111","name":"Extraction coronal remnants","description":"Extraction coronal remnants - deciduous tooth","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4390","name":"Ascendion per sq cm","description":"Ascendion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"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":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99214","name":"Office o/p est mod 30 min","description":"Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met","date_of_service":"2026-06-05","other_properties":[{"name":"BillingTaxonomy","value":["207V00000X","207VB0002X","207VE0102X","207VF0040X","207VG0400X","207VM0101X","207VX0000X","207VX0201X","363LX0001X"]},{"name":"RenderingTaxonomy","value":["207V00000X","207VB0002X","207VE0102X","207VF0040X","207VG0400X","207VM0101X","207VX0000X","207VX0201X","363LX0001X"]},{"name":"ClaimSpecialtyCode","value":["904","905","907","AMGY","APNOB","COLP","FPEM","GYNE","GYON","GYSU","MAFE","NPAG","NPGY","NPOB","OBEM","OBGY","OBHR","OBST","REND","URGY"]},{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TH"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TH"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99424","name":"Prin care mgmt phys 1st 30","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0372","name":"Tomo comp series images","description":"Tomo comp series images","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9002","name":"Intra-vag motion sens biofk","description":"Intra-vaginal motion sensor system, provides biofeedback for pelvic floor muscle rehabilitation device","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0211","name":"Inj, nithiodote, 3mg / 125mg","description":"Injection, sodium nitrite 3 mg and sodium thiosulfate 125 mg (nithiodote)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96413","name":"Chemo iv infusion 1 hr","description":"Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":220.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1177","name":"Pt recd pcv on/aft 19","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4301","name":"Activate matrix, per sq cm","description":"Activate matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1222","name":"Glaucoma pln of care not doc","description":"Glaucoma plan of care not documented, reason not otherwise specified","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1001T","name":"Autol musc cell therapy njx","description":"Autologous muscle cell therapy, injection of muscle progenitor cells into the external anal sphincter, including ultrasound guidance, when performed","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0956T","name":"Prt crn ch cr&tun elt s-sclp","description":"Partial craniectomy, channel creation, and tunneling of electrode for sub-scalp implantation of an electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59414","name":"Deliver placenta","description":"Delivery of placenta (separate procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6198","name":"Remove interim implant","description":"Remove interim implant","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2327","name":"Inj risankizumab-rzaa 1 mg","description":"Injection, risankizumab-rzaa, intravenous, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4266","name":"Neostim per sq cm","description":"Neostim membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0877","name":"Inj, daptomycin (hospira)","description":"Injection, daptomycin (hospira), not therapeutically equivalent to j0878, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1390","name":"Pt no doc exm for rec","description":"Patients who do not have a documented exam performed for recurrence of melanoma or no documentation within the performance period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1234","name":"Pt hcv rctv aby f/u neg","description":"Patient has a reactive hcv antibody test, and has a follow up hcv viral test that does not detect hcv viremia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1448","name":"Pt dx pd bef end meas pd","description":"Patients with an active diagnosis of personality disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7070","name":"D5w infusion","description":"Infusion, d5w, 1000 cc","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6031","name":"Rep interface handfng molded","description":"Replacement socket/interface, partial hand including fingers, molded to patient model, for use with or without external power","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0868T","name":"Hi-res gastric ep mapping","description":"High-resolution gastric electrophysiology mapping with simultaneous patient-symptom profiling, with interpretation and report","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0767T","name":"Tc mag stimj pn ea addl nrv","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; each additional nerve (list separat","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63281","name":"Bx/exc idrl spine lesn thrc","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, thoracic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2367.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98004","name":"Synch audio-video est sf 10","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 10 minutes must be met or e","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0169","name":"Promethazine hcl 12.5mg oral","description":"Promethazine hydrochloride, 12.5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1173","name":"Pt no rec td/tdap 9yrs prior","description":"Patient did not receive at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1353","name":"Sealant repair per tooth","description":"Sealant repair per tooth","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0225","name":"Inj, vutrisiran, 1 mg","description":"Injection, vutrisiran, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0035","name":"Pt ed pos 23","description":"Patient has any emergency department encounter during the performance period with place of service indicator 23","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0327U","name":"Ftl aneuploidy trsmy dna seq","description":"Ftl aneuploidy trsmy dna seq","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97551","name":"Caregiver traing ea addl 15","description":"Caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patie","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1342","name":"Pts died perf per","description":"Patients who died during the performance period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0963T","name":"Anosc sbmcsl njx bulking agt","description":"Anoscopy with directed submucosal injection of bulking agent into anal canal","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4035","name":"Thoracic surgery ss","description":"Thoracic surgery mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12020","name":"Tx supfc wnd dehsn smpl clsr","description":"Treatment of superficial wound dehiscence; simple closure","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":344.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3404","name":"Inj zopapogene per ther dose","description":"Injection, zopapogene imadenovec-drba suspension, per therapeutic dose","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0697T","name":"Quan mr tis wo mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained without diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, targ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0366","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2394","name":"Post >=4srfc resinbase cmpst","description":"Resin-based composite - four or more surfaces posterior","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0826T","name":"Prgrmg evl ldls pm 1chmbr ip","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional, leadless pacemaker system in si","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21616","name":"Exc 1st&/crv rib w/sympth","description":"Excision first and/or cervical rib; with sympathectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":992.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64520","name":"N block lumbar/thoracic","description":"Injection, anesthetic agent; lumbar or thoracic (paravertebral sympathetic)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4337","name":"Artecent trident, per sq cm","description":"Artacent trident, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0804T","name":"Prgrmg evl ldls pm 2chmbr ip","description":"Programming device evaluation (in person) with iterative adjustment of implantable device to test the function of device and to select optimal permanent programmed values, with analysis, review, and report, by a physician or other qualified health care professional, leadless pacemaker system in dual","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98979","name":"Rtm tx mgmt 1st 10 min","description":"Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least 1 real-time interactive communication with the patient or caregiver during the calendar month; first 10 minutes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1351","name":"Pt cmplt suicd saf pln 120dy","description":"Patients who had a suicide safety plan initiated, reviewed, or updated and reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25130","name":"Removal of wrist lesion","description":"Excision or curettage of bone cyst or benign tumor of carpal bones;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":573.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9602","name":"Fluorodopa f-18 diag per mci","description":"Fluorodopa f-18, diagnostic, per millicurie","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0612","name":"Inj, calcium gluconate, nos","description":"Injection, calcium gluconate, not otherwise specified, 10 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"Adju cgm supply allowance","description":"Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KF"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59400","name":"Obstetrical care","description":"Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2403.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S4024","name":"Air polymer foam per study","description":"Air polymer-type a intrauterine foam, per study dose","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0772T","name":"Vr px dissoc svc sm phy ea","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58580","name":"Transcrv abltj utrn fibrd rf","description":"Transcervical ablation of uterine fibroid(s), including intraoperative ultrasound guidance and monitoring, radiofrequency","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9341","name":"Inj thiotepa (tepylute) 1 mg","description":"Injection, thiotepa (tepylute), 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25105","name":"Remove wrist joint lining","description":"Arthrotomy, wrist joint; with synovectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":646.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0605U","name":"All&immunology hat tpsab1","description":"All&immunology hat tpsab1","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9074","name":"Inj, cyclophosphamd, sandoz","description":"Injection, cyclophosphamide (sandoz), 5 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5155","name":"Inj, aflibercept-jbvf, 1 mg","description":"Injection, aflibercept-jbvf (yesafili), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84620","name":"Xylose tolerance test","description":"Xylose absorption test, blood and/or urine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55250","name":"Removal of sperm duct(s)","description":"Vasectomy, unilateral or bilateral (separate procedure), including postoperative semen examination(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1500","name":"Neuropsychology mvp","description":"Neuropsychology mips value pathway","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0566","name":"3d bn img algor drvd fr mri","description":"3d radiodensity-value bone imaging, algorithm derived, from previous magnetic resonance examination of the same anatomy","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91120","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":573.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0894T","name":"Cannulation liver allograft","description":"Cannulation of the liver allograft in preparation for connection to the normothermic perfusion device and decannulation of the liver allograft following normothermic perfusion","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87913","name":"Nfct agt gntyp alys sarscov2","description":"Infectious agent genotype analysis by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), mutation identification in targeted region(s)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5126","name":"Inj alymsys 10 mg","description":"Injection, bevacizumab-maly, biosimilar, (alymsys), 10 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70473","name":"Ct cere prfu aly c+wo ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed without concurrent ct or ct angiography of the same anatomy","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1813","name":"Lyumjev for insulin pump use","description":"Insulin (lyumjev) for administration through dme (i.e., insulin pump) per 50 units","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96522","name":"Refill/maint pump/resvr syst","description":"Refilling and maintenance of implantable pump or reservoir for drug delivery, systemic (eg, intravenous, intra-arterial)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57284","name":"Repair paravag defect open","description":"Paravaginal defect repair (including repair of cystocele, if performed); open abdominal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":947.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8502","name":"Inj, aponvie, 1 mg","description":"Injection, aprepitant (aponvie), 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0943T","name":"Cysto flx rmvl urtl scaffold","description":"Cystourethroscopy, flexible; with removal of prostatic urethral scaffold","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0513U","name":"Onc prst8 alg alys msi&hrd","description":"Onc prst8 alg alys msi&hrd","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","date_of_service":"2026-06-05","zip":"10985","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":3095.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62331","name":"Dcmprn prq rmv lig flv addl","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; additional interspace(s), lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27514","name":"Treatment of thigh fracture","description":"Open treatment of femoral fracture, distal end, medial or lateral condyle, includes internal fixation, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1533.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1709","name":"Pfizer vaccine admin booster","description":"Pfizer vaccine admin booster","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4003","name":"Emergency med ss","description":"Emergency medicine mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1457","name":"Dx asth dur crnt/prv perf pd","description":"Patient had a diagnosis of asthma with any contact during the current or prior performance period or had asthma present on an active problem list any time during the performance period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1472","name":"Hep b vaccine not received","description":"Patient did not receive recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4337","name":"Artecent trident, per sq cm","description":"Artacent trident, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0427","name":"Inpt/ed teleconsult70","description":"Telehealth consultation, emergency department or initial inpatient, typically 70 minutes or more communicating with the patient via telehealth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94375","name":"Respiratory flow volume loop","description":"Respiratory flow volume loop","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4256","name":"Mlg complet, per sq cm","description":"Mlg-complete, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4408","name":"Xwrap hydro per sq cm","description":"Xwrap hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1345","name":"Pt bsln pam, 2nd scr 4-12 mo","description":"Patients who had a baseline pam score and a second score within 4 to 12 month of baseline pam score","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2526","name":"Cntct lens blue violet","description":"Contact lens, hydrophilic, with blue-violet filter, per lens","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5611","name":"Rep resin part dent base man","description":"Rep resin part dent base man","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1172","name":"Doc med rsn no td/tdap","description":"Documentation of medical reason(s) for not administering td or tdap vaccine (e.g., prior anaphylaxis due to the td or tdap vaccine or history of encephalopathy within seven days after a previous dose of a td-containing vaccine)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4020","name":"Ophthalmology/optometry ss","description":"Ophthalmology/optometry mips specialty set","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1240","name":"Pt no resp best int","description":"Patient did not respond to the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2394","name":"Post >=4srfc resinbase cmpst","description":"Resin-based composite - four or more surfaces posterior","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80506","name":"Path clin consltj prolng svc","description":"Pathology clinical consultation; prolonged service, each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83605","name":"Assay of lactic acid","description":"Lactate (lactic acid)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0780T","name":"Instlj fecal microbiota ssp","description":"Instillation of fecal microbiota suspension via rectal enema into lower gastrointestinal tract","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55877","name":"Abltj ire prst8 1+ tum perq","description":"Ablation, irreversible electroporation, prostate, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0552U","name":"Repr med pga gdo te bx locus","description":"Repr med pga gdo te bx locus","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9294","name":"Inj pemetrexed, hospira 10mg","description":"Injection, pemetrexed (hospira), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0356U","name":"Onc orop 17 dna ddpcr alg","description":"Onc orop 17 dna ddpcr alg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1320","name":"Pts scrn + hrsn","description":"Patients who screened positive for at least 1 of the 5 hrsns","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1261","name":"Pts on wtlist bef dialysis","description":"Patients that were on the kidney or kidney-pancreas waitlist prior to initiation of dialysis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1278","name":"Pre-htn or htn doc, f/u indc","description":"Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33460","name":"Revision of tricuspid valve","description":"Valvectomy, tricuspid valve, with cardiopulmonary bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3404","name":"Inj zopapogene per ther dose","description":"Injection, zopapogene imadenovec-drba suspension, per therapeutic dose","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6526","name":"G com garmt full leg/ft nght","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2252","name":"Inj midazolam in 0.8% nacl","description":"Injection, midazolam in 0.8% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1363","name":"Pts no f/u 120 dys","description":"Patients who did not have a follow-up assessment within 120 days of the index assessment","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26476","name":"Tendon lengthening","description":"Lengthening of tendon, extensor, hand or finger, each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":784.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33267","name":"Excl laa open any method","description":"Exclusion of left atrial appendage, open, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92928","name":"Prq tcat plmt ntrac st 1 les","description":"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 1 lesion involving 1 or more coronary segments","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78491","name":"Myocrd img pet 1std rst/strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); single study, at rest or stress (exercise or pharmacologic)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1547.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1391","name":"All pt dx w/ rec mlnm","description":"All patients who were diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1281","name":"Bp scrn no perf at interval","description":"Blood pressure reading not documented, reason not given","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74021","name":"Radex abdomen 3+ views","description":"Radiologic examination, abdomen; 3 or more views","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61892","name":"Rmv sk-mnt crnl nstm pg/rcvr","description":"Removal of skull-mounted cranial neurostimulator pulse generator or receiver with cranioplasty, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0163","name":"Epinephrine in nacl (endo)","description":"Injection, epinephrine in sodium chloride (endo), 0.1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82962","name":"Glucose blood test","description":"Glucose, blood by glucose monitoring device(s) cleared by the fda specifically for home use","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19282","name":"Perq device breast ea imag","description":"Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; each additional lesion, including mammographic guidance (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0046","name":"No mrs 90 days post stk","description":"Clinical follow-up and mrs score not assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56631","name":"Vlvctmy rad prtl uni lymphad","description":"Vulvectomy, radical, partial; with unilateral inguinofemoral lymphadenectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1202.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4540","name":"Trans elec nerv periph nerv","description":"Distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1004T","name":"Elec alys s-scl eeg wo prgrm","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; without programming","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45505","name":"Repair of rectum","description":"Proctoplasty; for prolapse of mucous membrane","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92636","name":"Hearing aid post-fitg f-up 1","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2036","name":"Cohealyx col dml mx pr sq cm","description":"Cohealyx collagen dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4303","name":"Complete aa, per sq cm","description":"Complete aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0675","name":"Inj, carboprost, 0.1 mg","description":"Injection, carboprost tromethamine, 0.1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1003T","name":"Arthrp 1st crp/mtcrpl prostc","description":"Arthroplasty, first carpometacarpal joint, with distal trapezial and proximal first metacarpal prosthetic replacement (eg, first carpometacarpal total joint)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76810","name":"Ob us >/= 14 wks addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2037","name":"G4derm plus/suprello, pr ml","description":"G4derm plus/suprello, per milliliter","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0905T","name":"Ecg alg 12 ld rdcd i&r only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; interpretation and report only","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64647","name":"Chemodenerv trunk musc 6/>","description":"Chemodenervation of trunk muscle(s); 6 or more muscles","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1377","name":"Fu colscop 10 yr doc w/ disc","description":"Recommended follow-up interval for repeat colonoscopy of 10 years documented  in colonoscopy report and communicated with patient","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0921T","name":"Rmvl perm ccm-d sys 1 dfb ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous defibrillation lead only","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0539U","name":"Onc sol tumor cfctdna 152gen","description":"Onc sol tumor cfctdna 152gen","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55712","name":"Bx prst8 tprnl mri-us 1st","description":"Biopsy, prostate, transperineal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0211","name":"Inj, nithiodote, 3mg / 125mg","description":"Injection, sodium nitrite 3 mg and sodium thiosulfate 125 mg (nithiodote)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6252","name":"Bridge resin w/noble metal","description":"Pontic-resin with noble metal","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0379U","name":"Tgsap sl or neo dna523&rna55","description":"Tgsap sl or neo dna523&rna55","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6611","name":"Onlay cst hgh nbl mtl >=3srf","description":"Onlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93603","name":"Right ventricular recording","description":"Right ventricular recording","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87153","name":"Dna/rna sequencing","description":"Culture, typing; identification by nucleic acid sequencing method, each isolate (eg, sequencing of the 16s rrna gene)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65140","name":"Attach ocular implant","description":"Insertion of ocular implant secondary; after enucleation, muscles attached to implant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":824.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1468","name":"Hep b vaccine received","description":"Patient received recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0802T","name":"Tcat rmv&rpl2chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right at","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54352","name":"Revj prior hypspad repair","description":"Revision of prior hypospadias repair requiring extensive dissection and excision of previously constructed structures including re-release of chordee and reconstruction of urethra and penis by use of local skin as grafts and island flaps and skin brought in as flaps or grafts","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1678.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6089","name":"Access/retorq implant screw","description":"Access/retorq implant screw","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0756T","name":"Dgtz gls mcrscp sld spc grpi","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group i, for microorganisms (eg, acid fast, methenamine silver) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27470","name":"Repair of thigh","description":"Repair, nonunion or malunion, femur, distal to head and neck; without graft (eg, compression technique)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1395.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"3077F","name":"Syst bp >= 140 mm hg","description":"Most recent systolic blood pressure greater than or equal to 140 mm hg (htn, ckd, cad) (dm)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0481","name":"Electron microscopy diagnost","description":"Electron microscopy - diagnostic","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"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":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2004","name":"Inj, lidocaine w epinephrine","description":"Injection, lidocaine hcl with epinephrine, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1353","name":"Sealant repair per tooth","description":"Sealant repair per tooth","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0949T","name":"Rem interrog dev ccm tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61889","name":"Ins sk-mnt crnl nstm pg/rcvr","description":"Insertion of skull-mounted cranial neurostimulator pulse generator or receiver, including craniectomy or craniotomy, when performed, with direct or inductive coupling, with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1070.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99204","name":"Office o/p new mod 45 min","description":"Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 45 minutes must be met or excee","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":56.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":205.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2040","name":"Microlyte painguard pr sq cm","description":"Microlyte painguard, per square centimeter","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95017","name":"All tstg perq&iq w/venoms","description":"Allergy testing, any combination of percutaneous (scratch, puncture, prick) and intracutaneous (intradermal), sequential and incremental, with venoms, immediate type reaction, including test interpretation and report, specify number of tests","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98985","name":"Rtm dev sply mscsk sys 2-15d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of musculoskeletal system, 2-15 days in a 30-day period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4036","name":"Urgent care ss","description":"Urgent care mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31253","name":"Nsl/sins ndsc total","description":"Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior), including frontal sinus exploration, with removal of tissue from frontal sinus, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35390","name":"Reoperation carotid add-on","description":"Reoperation, carotid, thromboendarterectomy, more than 1 month after original operation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0567U","name":"Rare ds whl gen seq srs&lrs","description":"Rare ds whl gen seq srs&lrs","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1363","name":"Pts no f/u 120 dys","description":"Patients who did not have a follow-up assessment within 120 days of the index assessment","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0999T","name":"Autol musc cell therapy hrvg","description":"Autologous muscle cell therapy, harvesting of muscle progenitor cells, including ultrasound guidance, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7471","name":"Rem exostosis any site","description":"Removal of lateral exostosis (maxilla or mandible)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1467","name":"Pt dx lynch syn","description":"Patients with an existing diagnosis of lynch syndrome","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9957","name":"Screening sleep disorders","description":"Screening sleep disorders","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28465","name":"Optx tarsal bone fx each","description":"Open treatment of tarsal bone fracture (except talus and calcaneus), includes internal fixation, when performed, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":657.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9292","name":"Pres dig visual therapy fda","description":"Prescription digital visual therapy, software-only, fda cleared, per course of treatment","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2015","name":"Phoenix wnd mtrx, per sq cm","description":"Phoenix wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2040","name":"Coord specialty care, month","description":"Coordinated specialty care, team-based, for first episode psychosis, per month","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1299","name":"Flu immunize order/admin","description":"Influenza immunization administered or previously received","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0208","name":"Inj, pedmark, 100 mg","description":"Injection, sodium thiosulfate (pedmark), 100 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1247","name":"Pt resp true best int","description":"Patient responded completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7294","name":"Seg acet and eth estr yearly","description":"Segesterone acetate and ethinyl estradiol 0.15mg, 0.013mg per 24 hours; yearly vaginal system, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0920T","name":"Rmvl perm ccm-d sys 1 pac ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous pacing lead only","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4394","name":"Surgraft aca per sq cm","description":"Surgraft aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4417","name":"Alexiguard dl-t per sq cm","description":"Alexiguard dl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9291","name":"Pres dig cog behav thera fda","description":"Prescription digital cognitive and/or behavioral therapy, fda cleared, per course of treatment","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1246","name":"Pt othr thn true imprt to me","description":"Patient provided a response other than completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0929T","name":"Rem interrog dev ccm-d tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J1520","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6035","name":"Prosthetic digit mechanical","description":"Single prosthetic digit, mechanical, can include metacarpophalangeal (mcp), proximal interphalangeal (pip), and/or distal interphalangeal (dip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1421","name":"Dermatological care mvp","description":"Dermatological care mips value pathway","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29891","name":"Arthr ank ostchn df tal&/tib","description":"Arthroscopy, ankle, surgical, excision of osteochondral defect of talus and/or tibia, including drilling of the defect","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":790.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0571U","name":"Onc sol tum dna80&rna10g ngs","description":"Onc sol tum dna80&rna10g ngs","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1938","name":"Inj, furosemide, 1 mg","description":"Injection, furosemide, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4286","name":"Nudyn sl or slw, per sq cm","description":"Nudyn sl or nudyn slw, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1358","name":"Pts no <suicd idea 120 dys","description":"Patients who did not have a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1501","name":"Pathology mvp","description":"Pathology mips value pathway","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0723T","name":"Qmrcp w/o dx mri sm anat ses","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained without diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) during the same session","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1252","name":"Pts no cmplt hu survey","description":"Patients who did not complete at least one of the four patient experience hu survey items and return the hu survey within 60 days of the ambulatory palliative care visit","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33425","name":"Repair of mitral valve","description":"Valvuloplasty, mitral valve, with cardiopulmonary bypass;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1973.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0010","name":"Eom meos payment","description":"Enhancing oncology model (eom) monthly enhanced oncology services (meos) payment for eom enhanced services","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70542","name":"Mri orbit/face/neck w/dye","description":"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":771.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43887","name":"Gstr rstcv px opn rmvl port","description":"Gastric restrictive procedure, open; removal of subcutaneous port component only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5140","name":"Inj adalimumab-fkjp, 1 mg","description":"Injection, adalimumab-fkjp, biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30469","name":"Rpr nsl vlv collapse w/rmdlg","description":"Repair of nasal valve collapse with low energy, temperature-controlled (ie, radiofrequency) subcutaneous/submucosal remodeling","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80505","name":"Path clin consltj high 41-60","description":"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patients history and medical records and high level of medical decision making when using time for code selection, 41-60 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76883","name":"Us nrv&acc strux 1xtr compre","description":"Ultrasound, nerve(s) and accompanying structures throughout their entire anatomic course in one extremity, comprehensive, including real-time cine imaging with image documentation, per extremity","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1388","name":"Pt doc exm rec melmn","description":"Patients with documentation of an exam performed for recurrence of melanoma","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52284","name":"Cysto rx balo cath urtl strx","description":"Cystourethroscopy, with mechanical urethral dilation and urethral therapeutic drug delivery by drug-coated balloon catheter for urethral stricture or stenosis, male, including fluoroscopy, when performed","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33268","name":"Excl laa opn oth px any meth","description":"Exclusion of left atrial appendage, open, performed at the time of other sternotomy or thoracotomy procedure(s), any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92137","name":"Cptrz oph img pst sg rta oct","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), posterior segment, with interpretation and report, unilateral or bilateral; retina, including oct angiography","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94664","name":"Demo&/eval pt use inhaler","description":"Demonstration and/or evaluation of patient utilization of an aerosol generator, nebulizer, metered dose inhaler or ippb device","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7411","name":"Excision benign lesion>1.25c","description":"Excision of benign lesion greater than 1.25 cm","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4320","name":"Pellograft, per sq cm","description":"Pellograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0867T","name":"Tpla b9 prst8 hyprplsa>=50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume greater or equal to 50 ml","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0818T","name":"Revj/rmvl ins ptn subq","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0994T","name":"Evasc dlvr a-wal stbl rx prq","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; percutaneous","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33031","name":"Partial removal of heart sac","description":"Pericardiectomy, subtotal or complete; with cardiopulmonary bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1565.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84140","name":"Assay of pregnenolone","description":"Pregnenolone","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0397","name":"Alcohol/subs interv >30 min","description":"Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and intervention, greater than 30 minutes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":65.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1471","name":"Ffs hep b not covered","description":"Documentation that patient is a medicare fee-for-service beneficiary and without additional supplementary insurance coverage for whom hep b vaccination is not reimbursable under current medicare part b coverage rules","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96202","name":"Mlt fam grp bhv train 1st 60","description":"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face with multiple sets of paren","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49593","name":"Rpr aa hrn 1st 3-10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, reducible","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0418U","name":"Onc brst aug alg aly whl sl8","description":"Onc brst aug alg aly whl sl8","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37264","name":"Revsc evasc fpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9026","name":"Inj, tarlatamab-dlle, 1 mg","description":"Injection, tarlatamab-dlle, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4369","name":"Amnioplast 3 per sq cm","description":"Amnioplast 3, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4349","name":"Mantle dl matrix per sq cm","description":"Mantle dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0587U","name":"Ther rx mntr 60-150rx&metabl","description":"Ther rx mntr 60-150rx&metabl","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98925","name":"Osteopath manj 1-2 regions","description":"Osteopathic manipulative treatment (omt); 1-2 body regions involved","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":10.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":37.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49189","name":"Opn exc/dst ntra-abd 20.1-30","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 20.1 to 30 cm","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1203","name":"No rsn ace-i/arb rx","description":"Ace inhibitor or arb therapy not prescribed during the measurement period, reason not given","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1337","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0268U","name":"Hem ahus gen seq alys 15 gen","description":"Hematology (atypical hemolytic uremic syndrome [ahus]), genomic sequence analysis of 15 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0792T","name":"Appl slvr diamn fluoride 38%","description":"Application of silver diamine fluoride 38%, by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1212","name":"Missing gsa not perf","description":"Glycemic status assessment (hba1c or gmi) level is missing, or was not performed during the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98986","name":"Rtm dev sply cbt 2-15 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of cognitive behavioral therapy, 2-15 days in a 30-day period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57288","name":"Repair bladder defect","description":"Sling operation for stress incontinence (eg, fascia or synthetic)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":881.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77439","name":"Surf rad thr img gdn us plmt","description":"Surface radiation therapy; superficial or orthovoltage, image guidance, ultrasound for placement of radiation therapy fields for treatment of cutaneous tumors, per course of treatment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6634","name":"Onlay titanium","description":"Onlay - titanium","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76014","name":"Mr sfty implt&/fb asmt stf 1","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4349","name":"Mantle dl matrix per sq cm","description":"Mantle dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92137","name":"Cptrz oph img pst sg rta oct","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), posterior segment, with interpretation and report, unilateral or bilateral; retina, including oct angiography","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69729","name":"Impl oi implt sk tc esp>=100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside of the mastoid and resulting in removal of greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0502","name":"Other oral pathology procedu","description":"Other oral pathology procedures by report","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87561","name":"M.avium-intra dna amp prob","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacteria avium-intracellulare, amplified probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5144","name":"Inj, idacio, 1 mg","description":"Injection, adalimumab-aacf (idacio), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0350U","name":"Rx metab/pcx dna 27 gen alys","description":"Rx metab/pcx dna 27 gen alys","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98005","name":"Synch audio-video est low 20","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low medical decision making. when using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded.","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0739","name":"Hiv prep, inj, cabotegravir","description":"Injection, cabotegravir, 1mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0737T","name":"Xenograft impltj artclr surf","description":"Xenograft implantation into the articular surface","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1267","name":"Pt no act kid transplt wtlst","description":"Patients not observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79200","name":"Nuclear rx intracav admin","description":"Radiopharmaceutical therapy, by intracavitary administration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37278","name":"Rvsc evsc fpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J9001","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4038","name":"Vascular surgery ss","description":"Vascular surgery mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1194","name":"Med rsn no imp/con mmr/msi","description":"Documentation of medical reason(s) surgical pathology reports did not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both tests were not included (e.g., patient will not be treated with checkpoint inhibitor therap","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0852T","name":"Dgtz gls mcrscp mphmtrc ea 1","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4014","name":"Nephrology ss","description":"Nephrology mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1256","name":"Prior history of known cvd","description":"Prior history of known cvd","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76014","name":"Mr sfty implt&/fb asmt stf 1","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37286","name":"Revsc evasc tpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23031","name":"I&d shoulder infected bursa","description":"Incision and drainage, shoulder area; infected bursa","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4349","name":"Mantle dl matrix per sq cm","description":"Mantle dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4024","name":"Pediatrics ss","description":"Pediatrics mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4033","name":"Skilled nursing facility ss","description":"Skilled nursing facility mips specialty set","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1253","name":"Pts hu surv no amb plltv","description":"Patients who respond on the patient experience hu survey that they did not receive care by the listed ambulatory palliative care provider in the last 60 days (disavowal)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1442","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0663","name":"Team remote e/m new pt 45 mn","description":"Team remote e/m new pt 45mins","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0542U","name":"Nefro renal trnspl ur nmr 84","description":"Nefro renal trnspl ur nmr 84","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46761","name":"Repair of anal sphincter","description":"Sphincteroplasty, anal, for incontinence, adult; levator muscle imbrication (park posterior anal repair)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":938.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3424","name":"Inj hydroxocobalamin iv 25mg","description":"Injection, hydroxocobalamin, intravenous, 25 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5946","name":"Max implt sup fix","description":"Max implt sup fix","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98986","name":"Rtm dev sply cbt 2-15 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of cognitive behavioral therapy, 2-15 days in a 30-day period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35602","name":"Bpg crtd-clat crtd","description":"Bypass graft, with other than vein; carotid-contralateral carotid","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0411U","name":"Psyc genom alys pnl 15 gen","description":"Psyc genom alys pnl 15 gen","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5938","name":"Resct proth max comp remov","description":"Resct proth max comp remov","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP04","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0665","name":"Inj, bupivacaine, nos, 0.5mg","description":"Injection, bupivicaine, not otherwise specified, 0.5 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0954T","name":"Tot impl amei rplc snd proc","description":"Totally implantable active middle ear hearing implant; replacement of sound processor only, with attachment to existing transducers","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99470","name":"Rpm tx mgmt 1st 10 min","description":"Remote physiologic monitoring treatment management services, clinical staff/physician/other qualified health care professional time in a calendar month requiring 1 real-time interactive communication with the patient/caregiver during the calendar month; first 10 minutes","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35151","name":"Repair defect of artery","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, popliteal artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1602.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0701","name":"Pano radio image","description":"Pano radio image","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1178","name":"Doc med rsn no pcv","description":"Documentation of medical reason(s) for not administering pneumococcal vaccine (e.g., prior anaphylaxis due to the pneumococcal vaccine)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0902T","name":"Qtc ntrvl augmnt alg aly ecg","description":"Qtc interval derived by augmentative algorithmic analysis of input from an external, patient-activated mobile ecg device","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1364","name":"Ascvd risk >=20pct","description":"Calculated 10-year ascvd risk score of >= 20 percent during the performance period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1408","name":"Gmln brca bef dx ca","description":"Patients who have germline brca testing completed before diagnosis of epithelial ovarian, fallopian tube, or primary peritoneal cancer","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83876","name":"Assay myeloperoxidase","description":"Myeloperoxidase (mpo)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47000","name":"Needle biopsy of liver perq","description":"Biopsy of liver, needle; percutaneous","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37273","name":"Revsc evsc fpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80220","name":"Drug asy hydroxychloroquine","description":"Hydroxychloroquine","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4310","name":"Procenta, per 100 mg","description":"Procenta, per 100 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0348U","name":"Rx metab/pcx dna 25 gen alys","description":"Rx metab/pcx dna 25 gen alys","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0919T","name":"Rmvl perm ccm-d sys pg only","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); pulse generator only","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9596","name":"Gallium illuccix 1 millicure","description":"Gallium ga-68 gozetotide, diagnostic, (illuccix), 1 millicurie","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9939","name":"Placemnt removable appliance","description":"Placemnt removable appliance","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0350","name":"Oral/facial photo images","description":"Oral/facial photographic images","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0804T","name":"Prgrmg evl ldls pm 2chmbr ip","description":"Programming device evaluation (in person) with iterative adjustment of implantable device to test the function of device and to select optimal permanent programmed values, with analysis, review, and report, by a physician or other qualified health care professional, leadless pacemaker system in dual","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7962","name":"Lingual frenectomy","description":"Lingual frenectomy","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33269","name":"Excl laa thrscp any method","description":"Exclusion of left atrial appendage, thoracoscopic, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1167","name":"Hspc dur meas pd","description":"In hospice or using hospice services during the measurement period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5911","name":"Facial moulage sectional","description":"Facial moulage (sectional)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99195","name":"Phlebotomy","description":"Phlebotomy, therapeutic (separate procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90612","name":"Inf&sarscov2 vacc 31.7/.32im","description":"Influenza virus vaccine, trivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 31.7 mcg/0.32 ml dosage, for intramuscular use","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9021","name":"Inj, aspara, rylaze, 0.1 mg","description":"Injection, asparaginase, recombinant, (rylaze), 0.1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9028","name":"Inj, nogapendekin pmln, 1mcg","description":"Injection, nogapendekin alfa inbakicept-pmln, for intravesical use, 1 microgram","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0677T","name":"Laps repos lead isdss 1st ld","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first repositioned lead","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37290","name":"Revsc evsc tpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1479","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0884T","name":"Esphgsc flx 1st tndsc dilat","description":"Esophagoscopy, flexible, transoral, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for esophageal stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0810T","name":"Subrta njx rx agt w/vtrc","description":"Subretinal injection of a pharmacologic agent, including vitrectomy and 1 or more retinotomies","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9601","name":"Inj linvoseltamab-gcpt 1 mg","description":"Injection, linvoseltamab-gcpt, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94625","name":"Phy/qhp op pulm rhb w/o mntr","description":"Physician or other qualified health care professional services for outpatient pulmonary rehabilitation; without continuous oximetry monitoring (per session)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34711","name":"Dlyd plmt xtn prosth ea addl","description":"Delayed placement of distal or proximal extension prosthesis for endovascular repair of infrarenal abdominal aortic or iliac aneurysm, false aneurysm, dissection, endoleak, or endograft migration, including pre-procedure sizing and device selection, all nonselective catheterization(s), all associate","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4286","name":"Remove non-resorb barrier","description":"Remove non-resorb barrier","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2989","name":"Excavate tooth non-restorabl","description":"Excavate tooth non-restorabl","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1308","name":"Inj, famotidine, 0.25 mg","description":"Injection, famotidine, 0.25 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7354","name":"Cantharidin top, applicator","description":"Cantharidin for topical administration, 0.7%, single unit dose applicator (3.2 mg)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43810","name":"Gastroduodenostomy","description":"Gastroduodenostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1012.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6112","name":"Imp/abut rem dent part max","description":"Imp/abut rem dent part max","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1193","name":"Rpts w/ imp/con mmr/msi","description":"Surgical pathology reports that contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0618","name":"Inj, calcium chloride, 2 mg","description":"Injection, calcium chloride, 2 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0389U","name":"Ped fbrl kd ifi27&mcemp1 rna","description":"Ped fbrl kd ifi27&mcemp1 rna","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1221","name":"Dre w/o rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; without evidence of retinopathy","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1301","name":"Immunization counseling","description":"Immunization counseling","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0048","name":"Pall serv during meas","description":"Patients who receive palliative care services any time during the intake period through the end of the measurement year","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9276","name":"Inj zanidatamab-hrii, 2 mg","description":"Injection, zanidatamab-hrii, 2 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0629U","name":"Nfct ds tb dna aly 1trgt pcr","description":"Nfct ds tb dna aly 1trgt pcr","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0236","name":"Intrav inf, mon anti, sec do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0990T","name":"Trncrv inst biod hydrgl mtrl","description":"Transcervical instillation of biodegradable hydrogel materials, intrauterine","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4355","name":"Abio xpl abio xpl hy p sq cm","description":"Abiomend xplus membrane and abiomend xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97551","name":"Caregiver traing ea addl 15","description":"Caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patie","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92607","name":"Ex for speech device rx 1hr","description":"Evaluation for prescription for speech-generating augmentative and alternative communication device, face-to-face with the patient; first hour","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0625U","name":"Endocrinol op dna alys>5000","description":"Endocrinol op dna alys>5000","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99479","name":"Sbsq ic lbw inf 1,500-2,500","description":"Subsequent intensive care, per day, for the evaluation and management of the recovering low birth weight infant (present body weight of 1,500-2,500 grams)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5162","name":"Inj, denosumab-nxxp, 1 mg","description":"Injection, denosumab-nxxp (bildyos/bilprevda), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0717T","name":"Adrc ther prtl rc tear","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; adipose tissue harvesting, isolation and preparation of harvested cells, including incubation with cell dissociation enzymes, filtration, washing, and concentration of adrcs","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4438","name":"Pretect per sq cm","description":"Pretect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"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":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28020","name":"Exploration of foot joint","description":"Arthrotomy, including exploration, drainage, or removal of loose or foreign body; intertarsal or tarsometatarsal joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9609","name":"F18 fdg, 15 millicuries","description":"Fludeoxyglucose f18 up to 15 millicuries","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0903T","name":"Ecg alg 12 lead reduced i&r","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; with interpretation and report","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4017","name":"Nutrition/dietician ss","description":"Nutrition/dietician mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5130","name":"Inj, fylnetra, 0.5 mg","description":"Injection, pegfilgrastim-pbbk (fylnetra), biosimilar, 0.5 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98001","name":"Synch audio-video new low 30","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0444U","name":"Onc sld orgn neo tgsap 361","description":"Onc sld orgn neo tgsap 361","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0374","name":"Tomo periapical image","description":"Tomo periapical image","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2542","name":"Dental onlay metallic 2 surf","description":"Onlay-metallic-two surfaces","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0900T","name":"N-invas est aqmbf asstv cmr","description":"Noninvasive estimate of absolute quantitation of myocardial blood flow (aqmbf), derived from assistive algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health care profes","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28605","name":"Treat foot dislocation","description":"Closed treatment of tarsometatarsal joint dislocation; requiring anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84433","name":"Asy thiopurin s-mthyltrnsfrs","description":"Thiopurine s-methyltransferase (tpmt)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0711T","name":"N-nvs artl plaq alys dat prp","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data preparation and transmission","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53452","name":"Tprnl balo cntnc dev uni","description":"Periurethral transperineal adjustable balloon continence device; unilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5941","name":"Resct proth mand part remov","description":"Resct proth mand part remov","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71047","name":"X-ray exam chest 3 views","description":"Radiologic examination, chest; 3 views","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4373","name":"Membrane wrp lt per sq cm","description":"Membrane wrap lite, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0387","name":"Comp image capture only","description":"Comp image capture only","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1206","name":"Isa not red 3pts/no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7956","name":"Tiss regen edent resorb","description":"Tiss regen edent resorb","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0534","name":"Coordinated care/or referral","description":"Coordinated care and/or referral services, such as to adequate and accessible community resources to address unmet health-related social needs, including harm reduction interventions and recovery support services a patient needs and wishes to pursue, which significantly limit the ability to diagnose","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4338","name":"Artacent velos, per sq cm","description":"Artacent velos, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3911","name":"Intraorifice barrier","description":"Intraorifice barrier","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0927T","name":"Interrog dev eval ccm-d ip","description":"Interrogation device evaluation (in person) with analysis, review, and report, including connection, recording, and disconnection, per patient encounter, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0977T","name":"Upr gi bld detcj snr capsule","description":"Upper gastrointestinal blood detection, sensor capsule, with interpretation and report","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S4024","name":"Air polymer foam per study","description":"Air polymer-type a intrauterine foam, per study dose","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33278","name":"Rmvl phrnc nrv stim sys","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; system, including pulse generator and lead(s)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61737","name":"Litt icr mlt trj mlt/cplx ls","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; multiple trajectories for multiple or complex lesion(s)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1483","name":"Neg quan hep c or qual rna","description":"Patients who achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5160","name":"Inj, jobevne, 10 mg","description":"Injection, bevacizumab-nwgd (jobevne), biosimilar, 10 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2561","name":"Inj, sezaby, 1 mg","description":"Injection, phenobarbital sodium (sezaby), 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7021","name":"Suppl and access lung expan","description":"Supplies and accessories for lung expansion airway clearance, continuous high frequency oscillation, and nebulization device (e.g., handset, nebulizer kit, biofilter)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1174","name":"Pt w/ 2 hzv 10/2017 - mp","description":"Patient received at least two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63615","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1276.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67036","name":"Removal of inner eye fluid","description":"Vitrectomy, mechanical, pars plana approach;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":953.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55881","name":"Ablt trurl prst8 tis thrm us","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation;","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59514","name":"Cesarean delivery only","description":"Cesarean delivery only;","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":953.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99310","name":"Sbsq nf care high mdm 45","description":"Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 45 minutes must be met or exc","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":183.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0851T","name":"Dgtz gls mcrscp mphmtrc 1st","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1411","name":"Inj, hemgenix, per tx dose","description":"Injection, etranacogene dezaparvovec-drlb, per therapeutic dose","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2058","name":"Obecbtge autol up to 400 mil","description":"Obecabtagene autoleucel, 10 up to 400 million cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per infusion","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1337","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1004T","name":"Elec alys s-scl eeg wo prgrm","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; without programming","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12031","name":"Intmd rpr s/a/t/ext 2.5 cm/<","description":"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 2.5 cm or less","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":155.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":305.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1552","name":"Inj, alyglo, 500 mg","description":"Injection, immune globulin (alyglo), 500 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0376","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7284","name":"Exc biopsy of saliv glands","description":"Exc biopsy of saliv glands","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92137","name":"Cptrz oph img pst sg rta oct","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), posterior segment, with interpretation and report, unilateral or bilateral; retina, including oct angiography","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9224","name":"Gen anes adv air-15 min","description":"Gen anes adv air-15 min","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7356","name":"Inj foscarb/foslevodopa 5 mg","description":"Injection, foscarbidopa 0.25 mg/foslevodopa 5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0876T","name":"Duplex scan hemo fstl lmtd","description":"Duplex scan of hemodialysis fistula, computer-aided, limited (volume flow, diameter, and depth, including only body of fistula)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9913","name":"Admin of neuromod","description":"Admin of neuromod","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25448","name":"Arthrp ntrcrpl/crp/mtcrp ssp","description":"Arthroplasty, intercarpal or carpometacarpal joints; suspension, including transfer or transplant of tendon, with interposition, when performed","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84105","name":"Assay of urine phosphorus","description":"Phosphorus inorganic (phosphate); urine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9074","name":"Inj, cyclophosphamd, sandoz","description":"Injection, cyclophosphamide (sandoz), 5 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3291","name":"Tranexamic acid in sod chlor","description":"Injection, tranexamic acid in sodium chloride, 5 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53660","name":"Dilation of urethra","description":"Dilation of female urethra including suppository and/or instillation; initial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99281","name":"Emr dpt vst mayx req phy/qhp","description":"Emergency department visit for the evaluation and management of a patient that may not require the presence of a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1357","name":"Pt w/red suic idea 120 days","description":"Patients who had a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0849T","name":"Dgtz gls mcrscp ish ea adl 1","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1492","name":"No reported fall","description":"Patients who did not report a fall","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33619","name":"Repair single ventricle","description":"Repair of single ventricle with aortic outflow obstruction and aortic arch hypoplasia (hypoplastic left heart syndrome) (eg, norwood procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3235.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0534","name":"Coordinated care/or referral","description":"Coordinated care and/or referral services, such as to adequate and accessible community resources to address unmet health-related social needs, including harm reduction interventions and recovery support services a patient needs and wishes to pursue, which significantly limit the ability to diagnose","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1302","name":"Scrn mam perf rslts doc","description":"Screening, diagnostic, film digital or digital breast tomosynthesis (3d) mammography results documented and reviewed","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0862T","name":"Rlcj pg wcs lv battery only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; battery component only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4389","name":"Neothelium 4l+ per sq cm","description":"Neothelium 4l+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90815","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6613","name":"Onlay cst base mtl >=3 surfa","description":"Onlay - cast predominantly base metal three or more surfaces","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4399","name":"Summit fx per sq cm","description":"Summit fx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5153","name":"Inj, aflibercept-yszy, 1 mg","description":"Injection, aflibercept-yszy (opuviz), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1427","name":"Doc med rsn bone scn","description":"Documentation of medical reason(s) for performing a bone scan (including documented pain related to prostate cancer, salvage therapy, other medical reasons)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98977","name":"Rtm dev sply mscskl 16-30 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of musculoskeletal system, 16-30 days in a 30-day period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1247","name":"Pt resp true best int","description":"Patient responded completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11960","name":"Insert tissue expander(s)","description":"Insertion of tissue expander(s) for other than breast, including subsequent expansion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":949.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2781","name":"Crown 3/4 cast base metal","description":"Crown - 3/4 cast predominantly base metal","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0790T","name":"Revj rplcmt/rmvl vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracolumbar or lumbar vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15014","name":"Prepj skn cll ssp agrft ea","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; each additional 25 sq cm of harvested skin or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0600U","name":"Nfct ds wnd infctj 65orgs&30","description":"Nfct ds wnd infctj 65orgs&30","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0683","name":"App of non-sheet skin sub g","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3379","name":"Inj, valproate sod, 5 mg","description":"Injection, valproate sodium, 5 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0933T","name":"Tcat impl wrls l atr prs snr","description":"Transcatheter implantation of wireless left atrial pressure sensor for long-term left atrial pressure monitoring, including sensor calibration and deployment, right heart catheterization, transseptal puncture, imaging guidance, and radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1319","name":"Pts csp doc contact","description":"Patients who had documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86318","name":"Ia infectious agent antibody","description":"Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip);","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57456","name":"Endocerv curettage w/scope","description":"Colposcopy of the cervix including upper/adjacent vagina; with endocervical curettage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":128.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":178.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4401","name":"Absolv3 per sq cm","description":"Absolv3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21049","name":"Excis uppr jaw cyst w/repair","description":"Excision of benign tumor or cyst of maxilla; requiring extra-oral osteotomy and partial maxillectomy (eg, locally aggressive or destructive lesion[s])","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1452.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0414U","name":"Onc lng aug alg aly whl sld8","description":"Onc lng aug alg aly whl sld8","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0512U","name":"Onc prst8 alys dgtz img msi","description":"Onc prst8 alys dgtz img msi","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0534","name":"Coordinated care/or referral","description":"Coordinated care and/or referral services, such as to adequate and accessible community resources to address unmet health-related social needs, including harm reduction interventions and recovery support services a patient needs and wishes to pursue, which significantly limit the ability to diagnose","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0048","name":"Pall serv during meas","description":"Patients who receive palliative care services any time during the intake period through the end of the measurement year","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1370","name":"Rehab support msk care mvp","description":"Rehabilitative support for musculoskeletal care mips value pathway","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6553","name":"G com stcking bk 30-40 custm","description":"Gradient compression stocking, below knee, 30-40 mmhg, custom, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0668","name":"Instill, bupivac and meloxic","description":"Instillation, bupivacaine and meloxicam, 1 mg/0.03 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37206","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82166","name":"Assay anti-mullerian horm","description":"Anti-mullerian hormone (amh)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9536","name":"Tc99m depreotide","description":"Technetium tc-99m depreotide, diagnostic, per study dose, up to 35 millicuries","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4330","name":"Total, per sq cm","description":"Total, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83582","name":"Assay of ketogenic steroids","description":"Ketogenic steroids, fractionation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3503","name":"Surg exp root surf molar","description":"Surg exp root surf molar","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24342","name":"Repair of ruptured tendon","description":"Reinsertion of ruptured biceps or triceps tendon, distal, with or without tendon graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":955.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85027","name":"Complete cbc automated","description":"Blood count; complete (cbc), automated (hgb, hct, rbc, wbc and platelet count)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2004","name":"Inj, lidocaine w epinephrine","description":"Injection, lidocaine hcl with epinephrine, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0238","name":"Intrav inf, toci, second dos","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49186","name":"Opn exc/dstr ntra-abd 5 cm/<","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5 cm or less","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0698T","name":"Quan mr tiss w/mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained with diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, target ","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0011","name":"Hiv prep counsel, md 15-30m","description":"Individual counseling for pre-exposure prophylaxis (prep) by physician or qualified health care professional (qhp) to prevent human immunodeficiency virus (hiv), includes hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence, 15-30 minutes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0879T","name":"Augmnt alys ch ct ild prep","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; radiological data preparation and transmission","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0975T","name":"Slctv nzmtc dbrdmt s/n/hf 1","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; first 100 sq cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0363U","name":"Onc urthl mrna 5 gen alg","description":"Onc urthl mrna 5 gen alg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77090","name":"Tbs techl prep&transmis data","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1205","name":"Isa reduced >=3","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0206","name":"Inj allopurinol sodium 1 mg","description":"Injection, allopurinol sodium, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6524","name":"G com garmnt lwr leg/ft nght","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0531U","name":"Nfct ds afb&inv fng 673orgs","description":"Nfct ds afb&inv fng 673orgs","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17000","name":"Destruct premalg lesion","description":"Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (eg, actinic keratoses); first lesion","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":45.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4410","name":"Amchomatrixdl per sq cm","description":"Amchomatrixdl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0760T","name":"Dgtz gls mcrscp sl imm 1st","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1105","name":"Dexmedetomidine film, 1 mcg","description":"Dexmedetomidine, oral, 1 mcg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93574","name":"Njx cath slct pulm vn angrph","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary venous angiography of each distinct pulmonary vein during cardiac catheterization (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0874","name":"Inj, daptomycin (baxter)","description":"Injection, daptomycin (baxter), not therapeutically equivalent to j0878, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7957","name":"Tiss regen edent nonresorb","description":"Tiss regen edent nonresorb","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55707","name":"Bx prst8 trct us guided","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0323U","name":"Iadna cns pthgn next gen seq","description":"Iadna cns pthgn next gen seq","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0787T","name":"Revj/rmvl nea sac w/nstim","description":"Revision or removal of neurostimulator electrode array, sacral, with integrated neurostimulator","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1425","name":"Surgical care mvp","description":"Surgical care mips value pathway","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3472","name":"Surg rep root res premolar","description":"Surg rep root res premolar","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4001","name":"Diagnostic rad ss","description":"Diagnostic radiology mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0858T","name":"Ext trnscranl mag stimj meas","description":"Externally applied transcranial magnetic stimulation with concomitant measurement of evoked cortical potentials with automated report","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1242","name":"Pt no resp imprt to me","description":"Patient did not respond to the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25929","name":"Amputation follow-up surgery","description":"Transmetacarpal amputation; secondary closure or scar revision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":663.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86258","name":"Dgp antibody each ig class","description":"Gliadin (deamidated) (dgp) antibody, each immunoglobulin (ig) class","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7295","name":"Eth estr and eton monthly","description":"Ethinyl estradiol and etonogestrel 0.015mg, 0.12mg per 24 hours; monthly vaginal ring, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76940","name":"Us guide tissue ablation","description":"Ultrasound guidance for, and monitoring of, parenchymal tissue ablation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0811T","name":"Rem mlt day uroflow setup","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); set-up and patient education on use of equipment","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85660","name":"Rbc sickle cell test","description":"Sickling of rbc, reduction","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4272","name":"Esano a, per sq cm","description":"Esano a, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92635","name":"Hearing aid fitg svc ea addl","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; each additional 15 minutes (list separately in addition to code","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1351","name":"Dental sealant per tooth","description":"Sealant-per tooth","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2544","name":"Dental onlay metl 4/more sur","description":"Onlay - metallic - four or more surfaces","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1195","name":"Rpt wo imp/con mmr/msi","description":"Surgical pathology reports that do not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both, reason not given","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0140","name":"Nav srv peer sup 60 min pr m","description":"Principal illness navigation - peer support by certified or trained auxiliary personnel under the direction of a physician or other practitioner, including a certified peer specialist; 60 minutes per calendar month, in the following activities:  person-centered interview, performed to better underst","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69005","name":"Drg xtrnl ear absc/hem comp","description":"Drainage external ear, abscess or hematoma; complicated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37291","name":"Revsc evsc tpvt athr cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1202","name":"Miglustat oral 65 mg","description":"Miglustat, oral, 65 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9161","name":"Inj denileuk difti-cxdl 1mcg","description":"Injection, denileukin diftitox-cxdl, 1 mcg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87478","name":"Borrelia miyamotoi amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); borrelia miyamotoi, amplified probe technique","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35311","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; subclavian, innominate, by thoracic incision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1874.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0270","name":"Mnt subs tx for change dx","description":"Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face to face with the patient, each 15 minutes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":35.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2040","name":"Coord specialty care, month","description":"Coordinated specialty care, team-based, for first episode psychosis, per month","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9225","name":"Gen anes adv air-sub 15 min","description":"Gen anes adv air-sub 15 min","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92553","name":"Audiometry air & bone","description":"Pure tone audiometry (threshold); air and bone","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6604","name":"G com bandge low dn foam flt","description":"Gradient compression bandaging supply, low density flat foam sheet, per 250 square centimeters, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6634","name":"Onlay titanium","description":"Onlay - titanium","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0137","name":"Inten outpt svs,min 9 pr 7 d","description":"Intensive outpatient services; weekly bundle, minimum of 9 services over a 7 contiguous day period, which can include individual and group therapy with physicians or psychologists (or other mental health professionals to the extent authorized under state law); occupational therapy requiring the skil","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6603","name":"Cst hgh nble mtl inlay >=3sr","description":"Inlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0953T","name":"Tot impl amei rev/rplc w/o","description":"Totally implantable active middle ear hearing implant; revision or replacement, without mastoidectomy and replacement of sound processor","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15011","name":"Hrv skn cll ssp agrft 1st 25","description":"Harvest of skin for skin cell suspension autograft; first 25 sq cm or less","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4355","name":"Abio xpl abio xpl hy p sq cm","description":"Abiomend xplus membrane and abiomend xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5911","name":"Facial moulage sectional","description":"Facial moulage (sectional)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99308","name":"Sbsq nf care low mdm 20","description":"Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 20 minutes must be met or exce","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":84.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63053","name":"Lam factc/frmt arthrd lum ea","description":"Laminectomy, facetectomy, or foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s] [eg, spinal or lateral recess stenosis]), during posterior interbody arthrodesis, lumbar; each additional vertebral segment (list separately in addition to code for","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0012","name":"Injection of hiv prep drug","description":"Injection of pre-exposure prophylaxis (prep) drug for hiv prevention, under skin or into muscle","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1331","name":"Pts eval ini xm 8 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 8 weeks from initial exam","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83655","name":"Assay of lead","description":"Lead","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9225","name":"Gen anes adv air-sub 15 min","description":"Gen anes adv air-sub 15 min","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15018","name":"App skn cll ssp f/n/g/hf ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 480 sq cm or part thereof (list separately in addition to code for prima","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7962","name":"Lingual frenectomy","description":"Lingual frenectomy","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9994","name":"Pall serv during meas","description":"Patient is using palliative care services any time during the measurement period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15014","name":"Prepj skn cll ssp agrft ea","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; each additional 25 sq cm of harvested skin or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0437U","name":"Psyc anxiety do mrna 15 bmrk","description":"Psyc anxiety do mrna 15 bmrk","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1465","name":"F/u > 180 days after rx","description":"Patient follow up more than 180 days after treatment","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9394","name":"Inj, fulvestrant (fresenius)","description":"Injection, fulvestrant (fresenius kabi) not therapeutically equivalent to j9395, 25 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0491","name":"Oral dv nm mouthpc hw remote","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1315","name":"Crc no doc no rsn","description":"Colorectal cancer screening results were not documented and reviewed; reason not otherwise specified","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7284","name":"Exc biopsy of saliv glands","description":"Exc biopsy of saliv glands","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0557","name":"Adv prim care mgmt lvl 2","description":"Advanced primary care management services for a patient with multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, which place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline, provided by c","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2471","name":"Inj pantoprazole(hikma) 40mg","description":"Injection, pantoprazole (hikma), not therapeutically equivalent to j2470, 40 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0943T","name":"Cysto flx rmvl urtl scaffold","description":"Cystourethroscopy, flexible; with removal of prostatic urethral scaffold","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0527","name":"Mgt est pt dmentia low cmplx","description":"Management of established patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0926T","name":"Prgrmg dev eval ccm-d ip","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, including review and report, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28666","name":"Treat toe dislocation","description":"Percutaneous skeletal fixation of interphalangeal joint dislocation, with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":259.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4328","name":"Most, per sq cm","description":"Most, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5657","name":"Add low ext man aut vol any","description":"Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0255U","name":"Andrology infertility assmt","description":"Andrology (infertility), sperm-capacitation assessment of ganglioside gm1 distribution patterns, fluorescence microscopy, fresh or frozen specimen, reported as percentage of capacitated sperm and probability of generating a pregnancy score","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4322","name":"Splint intra-coronal","description":"Splint intra-coronal","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1171","name":"Inj, hydromorphone, 0.1 mg","description":"Injection, hydromorphone, 0.1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93594","name":"R hrt cath chd abnl nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; abnormal native connections","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83088","name":"Assay of histamine","description":"Histamine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0272U","name":"Hem genetic bld do 51 genes","description":"Hematology (genetic bleeding disorders), genomic sequence analysis of 51 genes, blood, buccal swab, or amniotic fluid, comprehensive","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5129","name":"Inj, vegzelma, 10 mg","description":"Injection, bevacizumab-adcd (vegzelma), biosimilar, 10 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87150","name":"Dna/rna amplified probe","description":"Culture, typing; identification by nucleic acid (dna or rna) probe, amplified probe technique, per culture or isolate, each organism probed","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0916T","name":"Insj perm ccm-d sys pg only","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator only","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92631","name":"Hearing aid slctn svc 1st 30","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2009","name":"Symphony, per sq cm","description":"Symphony, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4376","name":"Duograft aa per sq cm","description":"Duograft aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6607","name":"G com bandage tub protct lyr","description":"Gradient compression bandaging supply, tubular protective absorption layer, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69729","name":"Impl oi implt sk tc esp>=100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside of the mastoid and resulting in removal of greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0613U","name":"Onc uc dna mthyltn&mut 6bmrk","description":"Onc uc dna mthyltn&mut 6bmrk","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86707","name":"Hepatitis be antibody","description":"Hepatitis be antibody (hbeab)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0663","name":"Team remote e/m new pt 45 mn","description":"Team remote e/m new pt 45mins","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4315","name":"Regenelink amniotic mem allo","description":"Regenelink amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94012","name":"Spirmtry w/brnchdil inf-2 yr","description":"Measurement of spirometric forced expiratory flows, before and after bronchodilator, in an infant or child through 2 years of age","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2151","name":"Inj, mannitol, 250 mg","description":"Injection, mannitol, 250 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93575","name":"Njx cath slct p angrph mapca","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary angiography of major aortopulmonary collateral arteries (mapcas) arising off the aorta or its systemic branches, during cardiac catheterization for congenital heart d","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2404","name":"Inj, nicardipine 0.1 mg","description":"Injection, nicardipine, 0.1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0360U","name":"Onc lung elisa 7 autoant alg","description":"Onc lung elisa 7 autoant alg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6196","name":"Remv of ind rest on implt","description":"Remv of ind rest on implt","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4290","name":"Membrane wrap hydr per sq cm","description":"Membrane wrap-hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0891T","name":"Arhfcmrigtbs sbsq tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent treatment day","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"Evoked auditory test limited","description":"Distortion product evoked otoacoustic emissions; limited evaluation (to confirm the presence or absence of hearing disorder, 3-6 frequencies) or transient evoked otoacoustic emissions, with interpretation and report","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4416","name":"Alexiguard tl-t per sq cm","description":"Alexiguard tl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0479U","name":"Tau phosphorylated ptau217","description":"Tau phosphorylated ptau217","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9333","name":"Inj rozanolixizum-noli 1 mg","description":"Injection, rozanolixizumab-noli, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2359","name":"Inj. olanzapine, 0.5mg","description":"Injection, olanzapine, 0.5 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5944","name":"Max implt sup remv part","description":"Max implt sup remv part","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43287","name":"Esphg dstl 2/3 w/laps moblj","description":"Esophagectomy, distal two-thirds, with laparoscopic mobilization of the abdominal and lower mediastinal esophagus and proximal gastrectomy, with laparoscopic pyloric drainage procedure if performed, with separate thoracoscopic mobilization of the middle and upper mediastinal esophagus and thoracic e","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4006.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6031","name":"Rep interface handfng molded","description":"Replacement socket/interface, partial hand including fingers, molded to patient model, for use with or without external power","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1215","name":"Med rsn for no doc spiro","description":"Documentation of medical reason(s) for not documenting and reviewing spirometry results (e.g., patients with dementia or tracheostomy)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1456","name":"Pt had htx","description":"Patient had a heart transplant","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0373","name":"Tomo bitewing image","description":"Tomo bitewing image","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0596U","name":"Neuro alzds plsm 3dstnct isp","description":"Neuro alzds plsm 3dstnct isp","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0164","name":"Prochlorperazine maleate 5mg","description":"Prochlorperazine maleate, 5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9027","name":"Rbc o2 co2 reduced","description":"Red blood cells, leukocytes reduced, oxygen/ carbon dioxide reduced, each unit","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0032","name":"2+ antipsy schiz","description":"Two or more antipsychotic prescriptions ordered for patients who had a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder on or between january 1 of the year prior to the measurement period and the index prescription start date (ipsd) for antipsychotics","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33969","name":"Ecmo/ecls rmvl perph cannula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; removal of peripheral (arterial and/or venous) cannula(e), open, birth through 5 years of age","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0465","name":"Autolog prp diab wound ulcer","description":"Autologous platelet rich plasma (prp) or other blood-derived product for diabetic chronic wounds/ulcers, using an fda-cleared device for this indication, (includes as applicable administration, dressings, phlebotomy, centrifugation or mixing, and all other preparatory procedures, per treatment)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0800T","name":"Tcat rmvl 2chmbr ldls pm rv","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right ventricular pacemaker component (when part of a dual-chamber leadless pacem","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1449","name":"Inj eflapegrastim-xnst 0.1mg","description":"Injection, eflapegrastim-xnst, 0.1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53852","name":"Prostatic rf thermotx","description":"Transurethral destruction of prostate tissue; by radiofrequency thermotherapy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":653.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0559","name":"Unrelat prac follow up visit","description":"Post-operative follow-up visit complexity inherent to evaluation and management services addressing surgical procedure(s), provided by a physician or qualified health care professional who is not the practitioner who performed the procedure (or in the same group practice) and is of the same or of a ","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83633","name":"Test urine for lactose","description":"Lactose, urine, qualitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9997","name":"Ustekinumab-ttwe iv inj 1 mg","description":"Injection, ustekinumab-ttwe (pyzchiva), intravenous, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82180","name":"Assay of ascorbic acid","description":"Ascorbic acid (vitamin c), blood","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1439","name":"Sig ocu cond imp surg out","description":"Significant ocular conditions that impact the visual outcome of surgery","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25300","name":"Fusion of tendons at wrist","description":"Tenodesis at wrist; flexors of fingers","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":843.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31645","name":"Brnchsc w/ther aspir 1st","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with therapeutic aspiration of tracheobronchial tree, initial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7521","name":"Incision/drain abscess extra","description":"Incision and drainage of abscess - extraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94660","name":"Cpap initiation&mgmt","description":"Continuous positive airway pressure ventilation (cpap), initiation and management","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5161","name":"Inj, denosumab-kyqq, 1 mg","description":"Injection, denosumab-kyqq (aukelso/bosaya), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0815T","name":"Us rems b1 dns hips plvs/spi","description":"Ultrasound-based radiofrequency echographic multi-spectrometry (rems), bone-density study and fracture-risk assessment, 1 or more sites, hips, pelvis, or spine","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54860","name":"Removal of epididymis","description":"Epididymectomy; unilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2025","name":"Miro3d per cubic cm","description":"Miro3d, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97009","name":"Mchnl sclp cool after chemo","description":"Mechanical scalp cooling; provided after discontinuation of chemotherapy, each 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0927T","name":"Interrog dev eval ccm-d ip","description":"Interrogation device evaluation (in person) with analysis, review, and report, including connection, recording, and disconnection, per patient encounter, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69105","name":"Biopsy of external ear canal","description":"Biopsy external auditory canal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1014T","name":"Lap rv/rmv eso sph nstm eltr","description":"Laparoscopic revision or removal, lower esophageal sphincter neurostimulator electrodes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1365","name":"Hosp+pall care spec code 17","description":"Patient encounter during the performance period with hospice and palliative care specialty code 17","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1242","name":"Pt no resp imprt to me","description":"Patient did not respond to the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0738T","name":"Tx pln mag fld abltj prst8","description":"Treatment planning for magnetic field induction ablation of malignant prostate tissue, using data from previously performed magnetic resonance imaging (mri) examination","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27725","name":"Repair of lower leg","description":"Repair of nonunion or malunion, tibia; by synostosis, with fibula, any method","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1374.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93146","name":"Interrog crtd sins bat ip w/","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9026","name":"Cryo fib comp path redu each","description":"Cryoprecipitated fibrinogen complex, pathogen reduced, each unit","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5129","name":"Inj, vegzelma, 10 mg","description":"Injection, bevacizumab-adcd (vegzelma), biosimilar, 10 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7671","name":"Alveolus open reduction","description":"Alveolus - open reduction may include stabilization of teeth","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90635","name":"H5n1 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n1, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4279","name":"Vendaje ac, per sq cm","description":"Vendaje ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1007T","name":"Eeg impl s-sclp eeg w/o vid","description":"Electroencephalogram from implanted sub-scalp continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0613","name":"Calcium glucon (wg critical)","description":"Injection, calcium gluconate (wg critical care), not therapeutically equivalent to j0612, 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0363U","name":"Onc urthl mrna 5 gen alg","description":"Onc urthl mrna 5 gen alg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1000T","name":"Autol musc cell therapy admn","description":"Autologous muscle cell therapy, administration of muscle progenitor cells into the urethral sphincter, including cystoscopy and post-void residual ultrasound, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58822","name":"Drain ovary abscess percut","description":"Drainage of ovarian abscess; abdominal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":733.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97551","name":"Caregiver traing ea addl 15","description":"Caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patie","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4271","name":"Complete ft per sq cm","description":"Complete ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33895","name":"Evasc st rpr thrc/aa x crsg","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; not crossing major side branches","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93150","name":"Therapy activation ipnss","description":"Therapy activation of implanted phrenic nerve stimulator system, including all interrogation and programming","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5931","name":"Surgical obturator","description":"Obturator prosthesis surgical","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3480","name":"Inj potassium chloride","description":"Injection, potassium chloride, per 2 meq","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0739T","name":"Abltj mal prst8 mag fld ndct","description":"Ablation of malignant prostate tissue by magnetic field induction, including all intraprocedural, transperineal needle/catheter placement for nanoparticle installation and intraprocedural temperature monitoring, thermal dosimetry, bladder irrigation, and magnetic field nanoparticle activation","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1421","name":"Dermatological care mvp","description":"Dermatological care mips value pathway","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86403","name":"Particle agglut antbdy scrn","description":"Particle agglutination; screen, each antibody","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0698","name":"Cefotaxime sodium injection","description":"Injection, cefotaxime sodium, per gm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0800T","name":"Tcat rmvl 2chmbr ldls pm rv","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right ventricular pacemaker component (when part of a dual-chamber leadless pacem","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85421","name":"Fibrinolytic plasminogen","description":"Fibrinolytic factors and inhibitors; plasminogen, antigenic assay","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6032","name":"Part handfng ultralite tcf/=","description":"Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":368.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86015","name":"Actin antibody each","description":"Actin (smooth muscle) antibody (asma), each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2643","name":"Dental onlay porcelin 3 surf","description":"Onlay - porcelain/ceramic - three surfaces","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15853","name":"Removal sutr/stapl xreq anes","description":"Removal of sutures or staples not requiring anesthesia (list separately in addition to e/m code)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0977T","name":"Upr gi bld detcj snr capsule","description":"Upper gastrointestinal blood detection, sensor capsule, with interpretation and report","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4341","name":"Simplimax, per sq cm","description":"Simplimax, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4273","name":"Esano aaa, per sq cm","description":"Esano aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0877","name":"Inj, daptomycin (hospira)","description":"Injection, daptomycin (hospira), not therapeutically equivalent to j0878, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1358","name":"Pts no <suicd idea 120 dys","description":"Patients who did not have a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0879T","name":"Augmnt alys ch ct ild prep","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; radiological data preparation and transmission","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37271","name":"Revsc evsc fpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15015","name":"App skn cl ssp agrft t/a/l 1","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; first 480 sq cm or less","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9021","name":"Inj, aspara, rylaze, 0.1 mg","description":"Injection, asparaginase, recombinant, (rylaze), 0.1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0701T","name":"Molec fluor img sus nev ea","description":"Molecular fluorescent imaging of suspicious nevus; each additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0545U","name":"Achr antb id imfluor livecll","description":"Achr antb id imfluor livecll","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93010","name":"Electrocardiogram report","description":"Electrocardiogram, routine ecg with at least 12 leads; interpretation and report only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":9.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0004","name":"Qual care neurologic cnd mvp","description":"Quality care for patients with neurological conditions mips value pathway","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93319","name":"3d echo img cgen car anomal","description":"3d echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac structure(s) (eg, cardiac chambers and valves, left atrial appendage, interatrial septum, interventricular","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4424","name":"Revive ft per sq cm","description":"Revive ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6196","name":"Remv of ind rest on implt","description":"Remv of ind rest on implt","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J0288","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1010","name":"Inj, methylpred acetate 1 mg","description":"Injection, methylprednisolone acetate, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0287U","name":"Onc thyr dna&mrna 112 genes","description":"Onc thyr dna&mrna 112 genes","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0411U","name":"Psyc genom alys pnl 15 gen","description":"Psyc genom alys pnl 15 gen","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5151","name":"Inj, eculizumab-aagh, 2 mg","description":"Injection, eculizumab-aagh (epysqli), biosimilar, 2 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2643","name":"Dental onlay porcelin 3 surf","description":"Onlay - porcelain/ceramic - three surfaces","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1185","name":"Imm ckpt inhib not hld no rx","description":"Documentation of immune checkpoint inhibitor therapy not held and/or corticosteroids or immunosuppressants prescribed or administered was not performed, reason not given","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33320","name":"Repair major blood vessel(s)","description":"Suture repair of aorta or great vessels; without shunt or cardiopulmonary bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1204.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77402","name":"Radiation tx delivery lvl 1","description":"Radiation treatment delivery; level 1 (eg, single-electron field, multiple-electron fields, or 2d photons), including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87811","name":"Sars-cov-2 covid19 w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19])","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0973T","name":"Slctv nzmtc dbrdmt t/a/l 1st","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; first 100 sq cm","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0474","name":"Micro w exam of surg margins","description":"Accession of tissue gross and microscopic examination including assessment of surgical margins for presence of disease preparation and transmission of writte","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0747T","name":"Car ablt rad arrhyt dlvr rad","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; delivery of radiation therapy, arrhythmia","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0930T","name":"Ephys eval ccm-d ld 1st impl","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), at time of initial implantation or replacement with testing of cardiac contrac","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6559","name":"G stckng full/chap18-30 cust","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66625","name":"Removal of iris","description":"Iridectomy, with corneoscleral or corneal section; peripheral for glaucoma (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0433U","name":"Onc prst8 5 dna reg mrk pcr","description":"Onc prst8 5 dna reg mrk pcr","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16036","name":"Escharotomy ea addl incision","description":"Escharotomy; each additional incision (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0845T","name":"Dgtz gls mcrscp imfluor 1st","description":"Digitization of glass microscope slides for immunofluorescence, per specimen; initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36514","name":"Apheresis plasma","description":"Therapeutic apheresis; for plasma pheresis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1598","name":"Inj glycopyrrolate fres kabi","description":"Injection, glycopyrrolate (fresenius kabi), not therapeutically equivalent to j1596, 0.1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38770","name":"Remove pelvis lymph nodes","description":"Pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0883T","name":"Intraop ther estim pn ue ea","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; each additional nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96570","name":"Photodynmc tx 30 min add-on","description":"Photodynamic therapy by endoscopic application of light to ablate abnormal tissue via activation of photosensitive drug(s); first 30 minutes (list separately in addition to code for endoscopy or bronchoscopy procedures of lung and gastrointestinal tract)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0029","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77438","name":"Surf rad thr orthvlt>150-500","description":"Surface radiation therapy; orthovoltage, delivery, >150-500 kv, per fraction","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15016","name":"App skn cl ssp agrf t/a/l ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; each additional 480 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47555","name":"Biliary endoscopy thru skin","description":"Biliary endoscopy, percutaneous via t-tube or other tract; with dilation of biliary duct stricture(s) without stent","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":451.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0320U","name":"Neph rna psttrnspl perph bld","description":"Neph rna psttrnspl perph bld","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55869","name":"Lap srg prst8ct bi pl lmphad","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0584U","name":"Neuro csf prion prtn qual","description":"Neuro csf prion prtn qual","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27278","name":"Arthrd si jt plmt iartic dev","description":"Arthrodesis, sacroiliac joint, percutaneous or minimally invasive, with image guidance, includes obtaining bone graft when performed, unilateral; placement of intra-articular device(s), without cortical piercing","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77091","name":"Tbs techl calculation only","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical calculation only","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1016T","name":"Elec alys npgs esoph intraop","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6602","name":"G com bandge hgh dn foamroll","description":"Gradient compression bandaging supply, high density foam roll for bandage, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0865T","name":"Quan mri alys brn w/o dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion identification, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transm","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95919","name":"Quan puplmtry phy/qhp uni/bi","description":"Quantitative pupillometry with physician or other qualified health care professional interpretation and report, unilateral or bilateral","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0779T","name":"Gi myoelectrical actv study","description":"Gastrointestinal myoelectrical activity study, stomach through colon, with interpretation and report","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J2505","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2273.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0915T","name":"Insj perm ccm-d sys pg&eltrd","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator and dual transvenous electrodes/leads (pacing and defibrillation)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15854","name":"Removal sutr&stapl xreq anes","description":"Removal of sutures and staples not requiring anesthesia (list separately in addition to e/m code)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87279","name":"Parainfluenza ag if","description":"Infectious agent antigen detection by immunofluorescent technique; parainfluenza virus, each type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0366U","name":"Onc bldr 10 prb recr bldr ca","description":"Onc bldr 10 prb recr bldr ca","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0743T","name":"B1 str & fx rsk vrt fx assmt","description":"Bone strength and fracture risk using finite element analysis of functional data and bone mineral density (bmd), with concurrent vertebral fracture assessment, utilizing data from a computed tomography scan, retrieval and transmission of the scan data, measurement of bone strength and bmd and classi","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1404","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3303","name":"Triamcinolone hexacetonl inj","description":"Injection, triamcinolone hexacetonide, per 5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1713","name":"Pfizer vacc adm ped 1st dose","description":"Pfizer vacc adm ped 1st dose","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11043","name":"Dbrdmt musc&/fsca 1st 20/<","description":"Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); first 20 sq cm or less","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":275.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0984T","name":"Iv img xtrc cere vsl oct 1st","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2246","name":"Inj, micafungin (baxter)","description":"Injection, micafungin in sodium (baxter), not therapeutically equivalent to j2248, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0237","name":"Inj, tocilizumab-anoh, hospi","description":"Injection, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1737","name":"Inj meloxicam (azurity) 1mg","description":"Injection, meloxicam (azurity), 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0570U","name":"Neurol tbi alys gfap&uch-l1","description":"Neurol tbi alys gfap&uch-l1","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34713","name":"Perq access & clsr fem art","description":"Percutaneous access and closure of femoral artery for delivery of endograft through a large sheath (12 french or larger), including ultrasound guidance, when performed, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83008","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1201","name":"Med rsn no ace-i/arb rx","description":"Documentation of medical reason(s) for not prescribing ace inhibitor (ace-i) or arb therapy during the measurement period (e.g., pregnancy, history of angioedema to ace-i, other allergy to ace-i and arb, hyperkalemia or history of hyperkalemia while on ace-i or arb therapy, acute kidney injury due t","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2040","name":"Microlyte painguard pr sq cm","description":"Microlyte painguard, per square centimeter","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0781T","name":"Brnchsc rf dstrj pulm nrv bi","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; bilateral mainstem bronchi","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0796T","name":"Tcat ins 2chmbr ldls pm ra","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right atrial pacemaker","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9161","name":"Inj denileuk difti-cxdl 1mcg","description":"Injection, denileukin diftitox-cxdl, 1 mcg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0920T","name":"Rmvl perm ccm-d sys 1 pac ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous pacing lead only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0462U","name":"Melatonin lvl tst slp std7/9","description":"Melatonin lvl tst slp std7/9","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0707","name":"Intraoral periap radio image","description":"Intraoral periap radio image","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4022","name":"Otolaryngology ss","description":"Otolaryngology mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92943","name":"Prq trluml revsc ch occ ant","description":"Percutaneous transluminal revascularization of chronic total occlusion, single coronary artery, coronary artery branch, or coronary artery bypass graft, and/or subtended major coronary artery branches of the bypass graft, any combination of intracoronary stent, atherectomy and angioplasty; antegrade","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":816.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0512U","name":"Onc prst8 alys dgtz img msi","description":"Onc prst8 alys dgtz img msi","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86353","name":"Lymphocyte transformation","description":"Lymphocyte transformation, mitogen (phytomitogen) or antigen induced blastogenesis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0803","name":"3d facial scan direct","description":"3d facial scan direct","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0616","name":"Inj metoprolol tartrate 1 mg","description":"Injection, metoprolol tartrate, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0432U","name":"Klhl11 antb sr/csf asy qual","description":"Klhl11 antb sr/csf asy qual","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6611","name":"Onlay cst hgh nbl mtl >=3srf","description":"Onlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9244","name":"Office min sed drug enteral","description":"Office min sed drug enteral","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0538","name":"Ascvd rsk mng clin stf pr mo","description":"Atherosclerotic cardiovascular disease (ascvd) risk management services; clinical staff time; per calendar month","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1280","name":"Bilat mast/hx bi /unilat mas","description":"Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0536","name":"Peer recover support svs","description":"Peer recovery support services, provided directly or by referral; including leveraging knowledge of the condition or lived experience to provide support, mentorship, or inspiration to meet oud treatment and recovery goals; conducting a person-centered interview to understand the patients life story,","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0162","name":"Inj epinephrine (fresenius)","description":"Injection, epinephrine (fresenius), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01939","name":"Anes nulyt agt crv/thrc","description":"Anesthesia for percutaneous image-guided destruction procedures by neurolytic agent on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0985T","name":"Iv img xtrc cere vsl oct ea","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9043","name":"Plasma protein fract,5%,50ml","description":"Infusion, plasma protein fraction (human), 5%, 50 ml","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0427U","name":"Monocyte dstrbj wdth whl bld","description":"Monocyte dstrbj wdth whl bld","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1233","name":"Pt no hcv aby or result","description":"Patient does not receive hcv antibody test or patient does receive hcv antibody test but results not documented, reason not given","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1291","name":"Pt 66+ frailty and med dem","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37269","name":"Revsc evasc fpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25028","name":"I&d f/arm&/wrst dp absc/hmtm","description":"Incision and drainage, forearm and/or wrist; deep abscess or hematoma","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0559U","name":"Onc brs quan elisa bf9ag srm","description":"Onc brs quan elisa bf9ag srm","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1014T","name":"Lap rv/rmv eso sph nstm eltr","description":"Laparoscopic revision or removal, lower esophageal sphincter neurostimulator electrodes","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4027","name":"Plastic surgery ss","description":"Plastic surgery mips specialty set","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4385","name":"Apollo ft per sq cm","description":"Apollo ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2249","name":"Inj, remimazolam, 1 mg","description":"Injection, remimazolam, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54328","name":"Revise penis/urethra","description":"1-stage distal hypospadias repair (with or without chordee or circumcision); with extensive dissection to correct chordee and urethroplasty with local skin flaps, skin graft patch, and/or island flap","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1040.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0802","name":"3d dental scan indirect","description":"3d dental scan indirect","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49040","name":"Drain open abdom abscess","description":"Drainage of subdiaphragmatic or subphrenic abscess, open","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":961.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1249","name":"Pt resp true imprt to me","description":"Patient responded completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0779T","name":"Gi myoelectrical actv study","description":"Gastrointestinal myoelectrical activity study, stomach through colon, with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0985T","name":"Iv img xtrc cere vsl oct ea","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1316","name":"Tobacco non-user","description":"Current tobacco non-user","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2026","name":"Restrata minimatrix, 5 mg","description":"Restrata minimatrix, 5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33901","name":"Perq p-art revsc 1 nm nt bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, bilateral","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62287","name":"Dcmprn pq nuc pul 1/mlt lmbr","description":"Decompression, percutaneous, of nucleus pulposus of intervertebral disc, any method utilizing needle-based technique to remove disc material under fluoroscopic imaging or other form of indirect visualization, with discography and/or epidural injection(s) at the treated level(s), when performed, sing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45562","name":"Exploration/repair of rectum","description":"Exploration, repair, and presacral drainage for rectal injury;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1074.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1396","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0340U","name":"Onc pan ca alys mrd plasma","description":"Onc pan ca alys mrd plasma","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7912","name":"Suture complicate wnd > 5 cm","description":"Complicated suture-greater than 5 cm","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0201","name":"Pne flu hepb cov home admin","description":"Administration of pneumococcal, influenza, hepatitis b, and/or covid-19 vaccine inside a patients home; reported only once per individual home per date of service when such vaccine administration(s) are performed at the patients home","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1296","name":"Calc bmi norm parameters","description":"Bmi is documented within normal parameters and no follow-up plan is required","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7354","name":"Cantharidin top, applicator","description":"Cantharidin for topical administration, 0.7%, single unit dose applicator (3.2 mg)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0283","name":"Inj, amiodarone (nexterone)","description":"Injection, amiodarone hydrochloride (nexterone), 30 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77436","name":"Surf radj ther tx planning","description":"Surface radiation therapy; superficial or orthovoltage, treatment planning and simulation-aided field setting","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35271","name":"Rpr blvs gr ot/th vn ntrth w","description":"Repair blood vessel with graft other than vein; intrathoracic, with bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1602.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31276","name":"Nsl/sins ndsc frnt tiss rmvl","description":"Nasal/sinus endoscopy, surgical, with frontal sinus exploration, including removal of tissue from frontal sinus, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":662.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1351","name":"Pt cmplt suicd saf pln 120dy","description":"Patients who had a suicide safety plan initiated, reviewed, or updated and reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1808","name":"Inj, folic acid, 0.1 mg","description":"Injection, folic acid, 0.1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0392U","name":"Rx metab genrx ia 16 genes","description":"Rx metab genrx ia 16 genes","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34711","name":"Dlyd plmt xtn prosth ea addl","description":"Delayed placement of distal or proximal extension prosthesis for endovascular repair of infrarenal abdominal aortic or iliac aneurysm, false aneurysm, dissection, endoleak, or endograft migration, including pre-procedure sizing and device selection, all nonselective catheterization(s), all associate","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0040","name":"Pt phys/occ therapy","description":"Patient already receiving physical/occupational/speech/recreational therapy during the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0355U","name":"Apol1 risk variants","description":"Apol1 risk variants","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0616U","name":"Neurol dementia alys >30000","description":"Neurol dementia alys >30000","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1426","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0648","name":"Lso sag r an/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1014.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1217","name":"Sys rsn no doc spiro","description":"Documentation of system reason(s) for not documenting and reviewing spirometry results (e.g., spirometry equipment not available at the time of the encounter)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93024","name":"Ergonovine provocation test","description":"Ergonovine provocation test","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0369","name":"Max mri capture & interprete","description":"Max mri capture & interprete","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0927T","name":"Interrog dev eval ccm-d ip","description":"Interrogation device evaluation (in person) with analysis, review, and report, including connection, recording, and disconnection, per patient encounter, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4421","name":"Biolab wrap solo per sq cm","description":"Biolab membrane wrap solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2003","name":"Inj, lidocaine hcl, 1 mg","description":"Injection, lidocaine hydrochloride, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63180","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1524.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2526","name":"Cntct lens blue violet","description":"Contact lens, hydrophilic, with blue-violet filter, per lens","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4251","name":"Vim, per square centimeter","description":"Vim, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0486U","name":"Onc pan sol tum ngs cfctdna","description":"Onc pan sol tum ngs cfctdna","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90382","name":"Rsv monoc antb seasn .7ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose, 0.7 ml, for intramuscular use","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76005","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0620U","name":"Onc hcc dna mthyln alys>5000","description":"Onc hcc dna mthyln alys>5000","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21256","name":"Reconstruction of orbit","description":"Reconstruction of orbit with osteotomies (extracranial) and with bone grafts (includes obtaining autografts) (eg, micro-ophthalmia)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1327.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78608","name":"Brain imaging (pet)","description":"Brain imaging, positron emission tomography (pet); metabolic evaluation","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37296","name":"Revsc evasc imvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0933T","name":"Tcat impl wrls l atr prs snr","description":"Transcatheter implantation of wireless left atrial pressure sensor for long-term left atrial pressure monitoring, including sensor calibration and deployment, right heart catheterization, transseptal puncture, imaging guidance, and radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4396","name":"Natalin per sq cm","description":"Natalin, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21337","name":"Closed tx septal&nose fx","description":"Closed treatment of nasal septal fracture, with or without stabilization","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37293","name":"Rvsc evsc tpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22315","name":"Closed tx vert fx w/manj","description":"Closed treatment of vertebral fracture(s) and/or dislocation(s) requiring casting or bracing, with and including casting and/or bracing by manipulation or traction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":827.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42835","name":"Removal of adenoids","description":"Adenoidectomy, secondary; younger than age 12","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6093","name":"Recement supp part denture","description":"Recement implant/abutment supported fixed partial denture","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0869T","name":"Njx b1 sub mtrl hw fixj aug","description":"Injection(s), bone-substitute material for bone and/or soft tissue hardware fixation augmentation, including intraoperative imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0429U","name":"Hpv orop swab 14 hi-risk typ","description":"Hpv orop swab 14 hi-risk typ","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93569","name":"Njx cth slct p-art angrp uni","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0658","name":"Seg pneum comp 2 arm chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0677T","name":"Laps repos lead isdss 1st ld","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first repositioned lead","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99487","name":"Cplx chrnc care 1st 60 min","description":"Complex chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":155.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0260U","name":"Rare ds id opt genome mapg","description":"Rare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0734T","name":"Rem r-t mtn nrehab tx mgmt","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; treatment management services by a physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0559","name":"Unrelat prac follow up visit","description":"Post-operative follow-up visit complexity inherent to evaluation and management services addressing surgical procedure(s), provided by a physician or qualified health care professional who is not the practitioner who performed the procedure (or in the same group practice) and is of the same or of a ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3501","name":"Surg exp root surf anterior","description":"Surg exp root surf anterior","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64620","name":"Injection treatment of nerve","description":"Destruction by neurolytic agent, intercostal nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26185","name":"Remove finger bone","description":"Sesamoidectomy, thumb or finger (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":553.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1834","name":"Inj, isoniazid, 1 mg","description":"Injection, isoniazid, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1465","name":"F/u > 180 days after rx","description":"Patient follow up more than 180 days after treatment","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1255","name":"Pts w/ othr rsn vst,+prg tst","description":"Patients who have another reason for visiting the clinic [not prenatal or postpartum care] and have a positive pregnancy test but have not established the clinic as an ob provider (e.g., plan to terminate the pregnancy or seek prenatal services elsewhere)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0894T","name":"Cannulation liver allograft","description":"Cannulation of the liver allograft in preparation for connection to the normothermic perfusion device and decannulation of the liver allograft following normothermic perfusion","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0991T","name":"Cysto lo-nrg lithtrp&mcrsphr","description":"Cystourethroscopy, with low-energy lithotripsy and acoustically actuated microspheres, including imaging","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37718","name":"Lig div&strpg short saph vn","description":"Ligation, division, and stripping, short saphenous vein","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":476.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86803","name":"Hepatitis c ab test","description":"Hepatitis c antibody;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1749","name":"Inj, iloprost, 0.1 mcg","description":"Injection, iloprost, 0.1 mcg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9292","name":"Pres dig visual therapy fda","description":"Prescription digital visual therapy, software-only, fda cleared, per course of treatment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0288U","name":"Onc lung mrna quan pcr 11&3","description":"Onc lung mrna quan pcr 11&3","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1720","name":"Influenza vacc admin","description":"Influenza vacc admin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9076","name":"Inj, cyclophos (baxter) 5mg","description":"Injection, cyclophosphamide (baxter), 5 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91321","name":"Sarscov2 vac 25 mcg/.25ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 25 mcg/0.25 ml dosage, for intramuscular use","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2020","name":"Ac5 wound system","description":"Ac5 advanced wound system (ac5)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93587","name":"Vngrph chd vnvn cltrl at/abv","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating at or above the heart (eg, from innominate vein) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0803","name":"3d facial scan direct","description":"3d facial scan direct","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1462","name":"Pt clin ind hd image","description":"Patients with clinical indications for imaging of the head","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4414","name":"Simplichor per sq cm","description":"Simplichor, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32661","name":"Thoracoscopy w/pericard exc","description":"Thoracoscopy, surgical; with excision of pericardial cyst, tumor, or mass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1028.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0472","name":"Gross exam prep & report","description":"Accession of tissue gross examination preparation and transmission of written report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0042","name":"Ref to therapy","description":"Referral to physical, occupational, speech, or recreational therapy","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1301","name":"Immunization counseling","description":"Immunization counseling","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1025T","name":"Alt elec fld dos&dlv sim mdl","description":"Alternating electric fields dosimetry and delivery-simulation modeling, creation and selection of patient-specific array layouts, and placement verification","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0410U","name":"Onc pncrtc dna whl gn seq 5-","description":"Onc pncrtc dna whl gn seq 5-","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4384","name":"Axolotl dual ult per sq cm","description":"Axolotl dualgraft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0313U","name":"Onc pncrs dna&mrna seq 74","description":"Onc pncrs dna&mrna seq 74","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87150","name":"Dna/rna amplified probe","description":"Culture, typing; identification by nucleic acid (dna or rna) probe, amplified probe technique, per culture or isolate, each organism probed","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54220","name":"Irrg crpra cavrnosa priapism","description":"Irrigation of corpora cavernosa for priapism","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9432","name":"Med food non inborn err meta","description":"Medical foods for non-inborn errors of metabolism","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37279","name":"Iv lithotrp fpvt w/in sm art","description":"Intravascular lithotripsy(ies), femoral and popliteal vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1198","name":"Isa not red 3pts /no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66220","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":680.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0022","name":"Comm hlth intg svs add 30 m","description":"Community health integration services, each additional 30 minutes per calendar month (list separately in addition to g0019)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0255U","name":"Andrology infertility assmt","description":"Andrology (infertility), sperm-capacitation assessment of ganglioside gm1 distribution patterns, fluorescence microscopy, fresh or frozen specimen, reported as percentage of capacitated sperm and probability of generating a pregnancy score","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92622","name":"Dx aly aud oi snd prcsr 1st","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; first 60 minutes","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76088","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0858T","name":"Ext trnscranl mag stimj meas","description":"Externally applied transcranial magnetic stimulation with concomitant measurement of evoked cortical potentials with automated report","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84520","name":"Assay of urea nitrogen","description":"Urea nitrogen; quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37273","name":"Revsc evsc fpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1240","name":"Dimenhydrinate injection","description":"Injection, dimenhydrinate, up to 50 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5143","name":"Inj adalimumab-adbm, 1 mg","description":"Injection, adalimumab-adbm, biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75809","name":"Nonvascular shunt x-ray","description":"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, leveen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0418U","name":"Onc brst aug alg aly whl sl8","description":"Onc brst aug alg aly whl sl8","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45315","name":"Proctosigmoidoscopy removal","description":"Proctosigmoidoscopy, rigid; with removal of multiple tumors, polyps, or other lesions by hot biopsy forceps, bipolar cautery or snare technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0901","name":"Vadadustat oral 1mg for esrd","description":"Vadadustat, oral, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0825T","name":"Tcat rmv&rpl1chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or prog","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1181","name":"Gr 2 or> dia or gr2 or> col","description":"Grade 2 or above diarrhea and/or grade 2 or above colitis","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0970T","name":"Ablt b9 brst tum perq lsr ea","description":"Ablation, benign breast tumor (eg, fibroadenoma), percutaneous, laser, including imaging guidance when performed, each tumor","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45390","name":"Colonoscopy w/resection","description":"Colonoscopy, flexible; with endoscopic mucosal resection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4274","name":"Esano ac, per sq cm","description":"Esano ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1014T","name":"Lap rv/rmv eso sph nstm eltr","description":"Laparoscopic revision or removal, lower esophageal sphincter neurostimulator electrodes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0801","name":"3d dental scan direct","description":"3d dental scan direct","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5944","name":"Max implt sup remv part","description":"Max implt sup remv part","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45905","name":"Dilation of anal sphincter","description":"Dilation of anal sphincter (separate procedure) under anesthesia other than local","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0702","name":"2d cephal radio image","description":"2d cephal radio image","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58356","name":"Endometrial cryoablation","description":"Endometrial cryoablation with ultrasonic guidance, including endometrial curettage, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0548U","name":"Gfap cleia plasma","description":"Gfap cleia plasma","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12002","name":"Rpr s/n/ax/gen/trnk2.6-7.5cm","description":"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 2.6 cm to 7.5 cm","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":66.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5149","name":"Inj, aflibercept-abzv, 1 mg","description":"Injection, aflibercept-abzv (enzeevu), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36589","name":"Removal tunneled cv cath","description":"Removal of tunneled central venous catheter, without subcutaneous port or pump","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0373","name":"Tomo bitewing image","description":"Tomo bitewing image","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28735","name":"Fusion of foot bones","description":"Arthrodesis, midtarsal or tarsometatarsal, multiple or transverse; with osteotomy (eg, flatfoot correction)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":923.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0426U","name":"Genome ultra-rapid seq alys","description":"Genome ultra-rapid seq alys","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0612U","name":"Onc lvr alys >1000 mr cfdna","description":"Onc lvr alys >1000 mr cfdna","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2251","name":"Inj midazolam in 0.9% nacl","description":"Injection, midazolam in 0.9% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1159","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2042","name":"Foundation drs+ solo, sq cm","description":"Foundation drs+ solo, per square centimeter","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9612","name":"Inj, fluorescein, 1 mg","description":"Injection, fluorescein, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0321U","name":"Iadna gu pthgn 20bct&fng org","description":"Iadna gu pthgn 20bct&fng org","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0810T","name":"Subrta njx rx agt w/vtrc","description":"Subretinal injection of a pharmacologic agent, including vitrectomy and 1 or more retinotomies","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0675T","name":"Laps insj nw/rpcmt isdss 1ld","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first lead","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53866","name":"Cathj rmvl dev ischmc rmdlg","description":"Catheterization with removal of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4225","name":"Amnio or derma tl, per sq cm","description":"Amniobind or dermabind tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1312","name":"No pt tbco scrn rng","description":"Patient not screened for tobacco use","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1223","name":"Glaucoma plan of care doc","description":"Glaucoma plan of care documented","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72157","name":"Mri chest spine w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; thoracic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1433.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0681T","name":"Rlcj pulse gen only isdss","description":"Relocation of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing dual leads","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99426","name":"Prin care mgmt staff 1st 30","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0519","name":"New pt-cg dyad dem low cmplx","description":"Management of new patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50590","name":"Fragmenting of kidney stone","description":"Lithotripsy, extracorporeal shock wave","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81524","name":"Onc cns tum dna mthyl 10,000","description":"Oncology (central nervous system tumor), dna methylation analysis of at least 10,000 methylation sites, utilizing dna extracted from formalin-fixed tumor tissue, algorithm(s) reported as probability of matching a reference tumor family and class, and mgmt (o-6-methylguanine-dna methyltransferase) pr","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0024","name":"Pin srv add 30 min pr m","description":"Principal illness navigation services, additional 30 minutes per calendar month (list separately in addition to g0023)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0671T","name":"Insj ant sgm aq drg dev 1+","description":"Insertion of anterior segment aqueous drainage device into the trabecular meshwork, without external reservoir, and without concomitant cataract removal, one or more","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0860T","name":"Ncntc ifr spctrsc scr pad","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), for screening for peripheral arterial disease, including provocative maneuvers, image acquisition, interpretation, and report, one or both lower extremities","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1212","name":"Missing gsa not perf","description":"Glycemic status assessment (hba1c or gmi) level is missing, or was not performed during the measurement period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0349U","name":"Rx metab/pcx dna 27gen rx ia","description":"Rx metab/pcx dna 27gen rx ia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1485","name":"Neg viro resp hep c/qual rna","description":"Patients who did not achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34706","name":"Evasc rpr a-biiliac rpt","description":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-bi-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2214.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92638","name":"Bhvl verif of amplification","description":"Behavioral verification of amplification including aided thresholds, functional gain, speech-in-noise, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2044","name":"Biobrane glove, each","description":"Biobrane glove, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26110","name":"Biopsy finger joint lining","description":"Arthrotomy with biopsy; interphalangeal joint, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53415","name":"Reconstruction of urethra","description":"Urethroplasty, transpubic or perineal, 1-stage, for reconstruction or repair of prostatic or membranous urethra","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1223.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0676T","name":"Laps insj nw/rpcmt isdss ea","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional lead (list separately in addition to code for primary ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0235","name":"Inj, monoclon antibody, 1 mg","description":"Injection, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extraco","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0764T","name":"Asstv alg ecg rsk asmt cncrt","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to concurrently performed electrocardiogram (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4337","name":"Artecent trident, per sq cm","description":"Artacent trident, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J0795","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69209","name":"Remove impacted ear wax uni","description":"Removal impacted cerumen using irrigation/lavage, unilateral","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0332U","name":"Onc pan tum gen prflg 8 dna","description":"Onc pan tum gen prflg 8 dna","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1277","name":"Colorectal ca screen doc rev","description":"Colorectal cancer screening results documented and reviewed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0896T","name":"Connj lvr algrft prfu dev ea","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; each additional hour, including physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary bicarbonate, lactate ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0615","name":"Calcium acetate, oral, 23 mg","description":"Calcium acetate, oral, 23 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0029","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4211","name":"Gingivectomy/plasty per toot","description":"Gingivectomy or gingivoplasty - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9054","name":"Inj bortezomib boruzu 0.1 mg","description":"Injection, bortezomib (boruzu), 0.1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1289","name":"No pt tbco cess interv rng","description":"Patient identified as tobacco user did not receive tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92641","name":"Hearing dev verif eacous aly","description":"Hearing device verification, electroacoustic analysis","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1467","name":"Pt dx lynch syn","description":"Patients with an existing diagnosis of lynch syndrome","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9393","name":"Inj, fulvestrant (teva)","description":"Injection, fulvestrant (teva), not therapeutically equivalent to j9395, 25 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0502U","name":"Hpv e6/e7 mrk hi-rsk typ crv","description":"Hpv e6/e7 mrk hi-rsk typ crv","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86687","name":"Htlv-i antibody","description":"Antibody; htlv-i","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92634","name":"Hearing aid fitg svc 1st 60","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; first 60 minutes","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68841","name":"Insj rx elut implt lac canal","description":"Insertion of drug-eluting implant, including punctal dilation when performed, into lacrimal canaliculus, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9345","name":"Inj, retifanlimab-dlwr, 1 mg","description":"Injection, retifanlimab-dlwr, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5140","name":"Inj adalimumab-fkjp, 1 mg","description":"Injection, adalimumab-fkjp, biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99333","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4412","name":"Choriofix per sq cm","description":"Choriofix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0966T","name":"I&cst prp jw xpn dl arch fxd","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, fixed hinge mechanism","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90631","name":"H5 vaccine pandemic im use","description":"Influenza virus vaccine (iiv), h5, pandemic formulation, split virus, adjuvanted, for intramuscular use","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9074","name":"Inj, cyclophosphamd, sandoz","description":"Injection, cyclophosphamide (sandoz), 5 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2028","name":"Micromatrix flex per mg","description":"Micromatrix flex, per mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5995","name":"Peri medicament w/seal, max","description":"Peri medicament w/seal, max","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83021","name":"Hemoglobin chromotography","description":"Hemoglobin fractionation and quantitation; chromatography (eg, a2, s, c, and/or f)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0743T","name":"B1 str & fx rsk vrt fx assmt","description":"Bone strength and fracture risk using finite element analysis of functional data and bone mineral density (bmd), with concurrent vertebral fracture assessment, utilizing data from a computed tomography scan, retrieval and transmission of the scan data, measurement of bone strength and bmd and classi","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33269","name":"Excl laa thrscp any method","description":"Exclusion of left atrial appendage, thoracoscopic, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0904T","name":"Ecg alg 12 ld rdcd trcg only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; tracing only","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0897T","name":"N-invas augmnt arrhyt alys","description":"Noninvasive augmentative arrhythmia analysis derived from quantitative computational cardiac arrhythmia simulations, based on selected intervals of interest from 12-lead electrocardiogram and uploaded clinical parameters, including uploading clinical parameters with interpretation and report","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28240","name":"Release of big toe","description":"Tenotomy, lengthening, or release, abductor hallucis muscle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87150","name":"Dna/rna amplified probe","description":"Culture, typing; identification by nucleic acid (dna or rna) probe, amplified probe technique, per culture or isolate, each organism probed","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0725T","name":"Vestibular dev impltj uni","description":"Vestibular device implantation, unilateral","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11981","name":"Insertion drug dlvr implant","description":"Insertion, drug-delivery implant (ie, bioresorbable, biodegradable, non-biodegradable)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":52.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1498","name":"Diagnostic radiology mvp","description":"Diagnostic radiology mips value pathway","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0689","name":"Inj cefazolin sodium, baxter","description":"Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1378","name":"Med rsn no 10 yr fu colscope","description":"Documentation of medical reason(s) for not recommending a 10 year follow-up interval (e.g., inadequate prep, familial or personal history of colonic polyps, patient had no adenoma and age is >= 66 years old, or life expectancy < 10 years, other medical reasons)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49188","name":"Opn exc/dst ntra-abd 10.1-20","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 10.1 to 20 cm","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4372","name":"Amchoplast excl per sq cm","description":"Amchoplast excel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4359","name":"Choriply, per sq cm","description":"Choriply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0705","name":"Extra oral post radio image","description":"Extra oral post radio image","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8006","name":"Grip glove replacement only","description":"Powered, cable driven grip assist glove, hand, finger, includes pressure sensors, glove replacement only","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96574","name":"Dbrdmt prmlg les w/pdt","description":"Debridement of premalignant hyperkeratotic lesion(s) (ie, targeted curettage, abrasion) followed with photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosensitizing drug(s) provide","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0463","name":"Inj atropine (fresenius te)","description":"Injection, atropine sulfate (fresenius and therapeutically equivalent), 0.01 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0869T","name":"Njx b1 sub mtrl hw fixj aug","description":"Injection(s), bone-substitute material for bone and/or soft tissue hardware fixation augmentation, including intraoperative imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24640","name":"Cltx rdl head sublxtj nrsemd","description":"Closed treatment of radial head subluxation in child, nursemaid elbow, with manipulation","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":76.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61715","name":"Mrgfus strtctc ablt trgt icr","description":"Magnetic resonance image guided high intensity focused ultrasound (mrgfus), stereotactic ablation of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99437","name":"Chrnc care mgmt phys ea addl","description":"Chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, or funct","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1197","name":"Isa reduced >=3 fr ixv","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1290","name":"Pt not eli d/t act dig htn","description":"Patient not eligible due to active diagnosis of hypertension","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0600U","name":"Nfct ds wnd infctj 65orgs&30","description":"Nfct ds wnd infctj 65orgs&30","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0574U","name":"Mtb cfp-10 serum/plsm lc-ms","description":"Mtb cfp-10 serum/plsm lc-ms","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6524","name":"G com garmnt lwr leg/ft nght","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0435U","name":"Onc chemo rx cytox csc 14 rx","description":"Onc chemo rx cytox csc 14 rx","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6253","name":"Provisional pontic","description":"Provisional pontic","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84145","name":"Procalcitonin (pct)","description":"Procalcitonin (pct)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9256","name":"Inj, nipocalimab-aahu, 3 mg","description":"Injection, nipocalimab-aahu, 3 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55869","name":"Lap srg prst8ct bi pl lmphad","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1268","name":"Pt ac stat kid trnsplt wtlst","description":"Patients observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0112A","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49622","name":"Rpr parastomal hrna ncr/strn","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; incarcerated or strangulated","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3911","name":"Intraorifice barrier","description":"Intraorifice barrier","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0364U","name":"Onc hl neo gen seq alys alg","description":"Onc hl neo gen seq alys alg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9026","name":"Inj, tarlatamab-dlle, 1 mg","description":"Injection, tarlatamab-dlle, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98985","name":"Rtm dev sply mscsk sys 2-15d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of musculoskeletal system, 2-15 days in a 30-day period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1836","name":"Inj, metronidazole, 10 mg","description":"Injection, metronidazole, 10 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54105","name":"Biopsy of penis","description":"Biopsy of penis; deep structures","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2008","name":"Theragenesis, per sq cm","description":"Theragenesis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1406","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0399U","name":"Neuro cere folate defncy srm","description":"Neuro cere folate defncy srm","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0935T","name":"Cysto w/rnl pel symp dnrvtj","description":"Cystourethroscopy with renal pelvic sympathetic denervation, radiofrequency ablation, retrograde ureteral approach, including insertion of guide wire, selective placement of ureteral sheath(s) and multiple conformable electrodes, contrast injection(s), and fluoroscopy, bilateral","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99211","name":"Off/op est may x req phy/qhp","description":"Office or other outpatient visit for the evaluation and management of an established patient that may not require the presence of a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":28.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":8.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4341","name":"Simplimax, per sq cm","description":"Simplimax, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64467","name":"Thrc fascial pln blk uni nfs","description":"Thoracic fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33902","name":"Perq p-art revsc 1 abnor uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, unilateral","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96548","name":"Ntraop hipec px ea add 30min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1501","name":"Pathology mvp","description":"Pathology mips value pathway","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57415","name":"Remove vaginal foreign body","description":"Removal of impacted vaginal foreign body (separate procedure) under anesthesia (other than local)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0687T","name":"Tx amblyopia dev setup 1st","description":"Treatment of amblyopia using an online digital program; device supply, educational set-up, and initial session","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76819","name":"Fetal biophys profil w/o nst","description":"Fetal biophysical profile; without non-stress testing","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2055","name":"Idecabtagene vicleucel car","description":"Idecabtagene vicleucel, up to 510 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66155","name":"Glaucoma surgery","description":"Fistulization of sclera for glaucoma; thermocauterization with iridectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":808.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0777T","name":"R-t prs sensing edrl gdn sys","description":"Real-time pressure-sensing epidural guidance system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23500","name":"Cltx clavicular fx w/o mnpj","description":"Closed treatment of clavicular fracture; without manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61534","name":"Removal of brain lesion","description":"Craniotomy with elevation of bone flap; for excision of epileptogenic focus without electrocorticography during surgery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1781.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91125","name":"Anrct mano rct snsatn&balo","description":"Anorectal manometry, with rectal sensation and rectal balloon expulsion test, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0824T","name":"Tcat rmv 1chmbr ldls pm ra","description":"Transcatheter removal of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography), when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90833","name":"Psytx w pt w e/m 30 min","description":"Psychotherapy, 30 minutes with patient when performed with an evaluation and management service (list separately in addition to the code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":64.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82104","name":"Alpha-1-antitrypsin pheno","description":"Alpha-1-antitrypsin; phenotype","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37293","name":"Rvsc evsc tpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J0610","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16000","name":"Initial treatment of burn(s)","description":"Initial treatment, first degree burn, when no more than local treatment is required","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":45.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0237","name":"Intrav inf, toci, first dose","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0121","name":"Colon ca scrn not hi rsk ind","description":"Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1355","name":"Caries med app per tooth","description":"Caries med app per tooth","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0033","name":"2+ benzo seiz","description":"Two or more benzodiazepine prescriptions ordered for patients who had a diagnosis of seizure disorders, rapid eye movement sleep behavior disorder, benzodiazepine withdrawal, ethanol withdrawal, or severe generalized anxiety disorder on or between january 1 of the year prior to the measurement perio","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99470","name":"Rpm tx mgmt 1st 10 min","description":"Remote physiologic monitoring treatment management services, clinical staff/physician/other qualified health care professional time in a calendar month requiring 1 real-time interactive communication with the patient/caregiver during the calendar month; first 10 minutes","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0477U","name":"Rx metab psy 14&cyp2d6 gn-rx","description":"Rx metab psy 14&cyp2d6 gn-rx","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92568","name":"Acoustic refl threshold tst","description":"Acoustic reflex testing, threshold","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":14.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9225","name":"Gen anes adv air-sub 15 min","description":"Gen anes adv air-sub 15 min","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21242","name":"Reconstruction of jaw joint","description":"Arthroplasty, temporomandibular joint, with allograft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1244","name":"Pt othr thn true best int","description":"Patient provided a response other than completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55882","name":"Ablt trurl prst8 tis trnsdcr","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation; with insertion of transurethral ultrasound transducer for delivery of thermal ultrasound, including suprapubic tube placement and placement of ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0508","name":"Crit care telehea consult 60","description":"Telehealth consultation, critical care, initial , physicians typically spend 60 minutes communicating with the patient and providers via telehealth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37280","name":"Revsc evsc tpvt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75580","name":"N-invas est c ffr sw aly cta","description":"Noninvasive estimate of coronary fractional flow reserve (ffr) derived from augmentative software analysis of the data set from a coronary computed tomography angiography, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9329","name":"Inj, tislelizumab-jsgr","description":"Injection, tislelizumab-jsgr, 1mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45123","name":"Partial proctectomy","description":"Proctectomy, partial, without anastomosis, perineal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1122.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2471","name":"Inj pantoprazole(hikma) 40mg","description":"Injection, pantoprazole (hikma), not therapeutically equivalent to j2470, 40 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1491","name":"Recd esrd mcp dur perf pd","description":"Receiving esrd mcp dialysis services by the provider during the performance period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5147","name":"Inj, aflibercept-ayyh, 1 mg","description":"Injection, aflibercept-ayyh (pavblu), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4368","name":"Amchothick per sq cm","description":"Amchothick, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92130","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84300","name":"Assay of urine sodium","description":"Sodium; urine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4346","name":"Shelter dm matrix per sq cm","description":"Shelter dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1380","name":"2 rx in perf pd any com meds","description":"Filled at least two prescriptions during the performance period for any combination of the qualifying oral antipsychotic medications listed under denominator note or the long-acting injectable antipsychotic medications listed under denominator note","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93224","name":"Xtrnl ecg rec up to 48 hrs","description":"External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage; includes recording, scanning analysis with report, review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0163","name":"Epinephrine in nacl (endo)","description":"Injection, epinephrine in sodium chloride (endo), 0.1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2034","name":"Found drs solo, per sq cm","description":"Foundation drs solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1250","name":"Pt resp true heard","description":"Patient responded as completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4350","name":"Palisade dm matrix per sq cm","description":"Palisade dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89140","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0990T","name":"Trncrv inst biod hydrgl mtrl","description":"Transcervical instillation of biodegradable hydrogel materials, intrauterine","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9291","name":"Pres dig cog behav thera fda","description":"Prescription digital cognitive and/or behavioral therapy, fda cleared, per course of treatment","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4343","name":"Dermacyte ac matrx per sq cm","description":"Dermacyte ac matrix amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2042","name":"Foundation drs+ solo, sq cm","description":"Foundation drs+ solo, per square centimeter","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0805T","name":"Tcat s&ivc prstc vl impl prq","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); percutaneous femoral vein approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93597","name":"R&l hrt cath chd abnl nt cnj","description":"Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); abnormal native connections","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99478","name":"Sbsq ic vlbw inf<1,500 gm","description":"Subsequent intensive care, per day, for the evaluation and management of the recovering very low birth weight infant (present body weight less than 1,500 grams)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4299","name":"Amniocore pro+, per sq cm","description":"Amniocore pro+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4009","name":"Hospitalists ss","description":"Hospitalists mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1370","name":"Inj, esomeprazole sod, 1 mg","description":"Injection, esomeprazole sodium, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1304","name":"No pneum vax admin 19+","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1343","name":"Pt pam lvl 4 base or srt lin","description":"Patients who are at pam level 4 at baseline or patients who are flagged with extreme straight line response sets on the pam or with excessive missing responses","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86480","name":"Tb test cell immun measure","description":"Tuberculosis test, cell mediated immunity antigen response measurement; gamma interferon","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0568","name":"Int psych care mng, 1 cal mo","description":"Initial psychiatric collaborative care management, in the first calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required elements: outrea","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0907T","name":"Coms ther ea addl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; each additional application, total wound(s) surface area less than or equal to 50 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26497","name":"Finger tendon transfer","description":"Transfer of tendon to restore intrinsic function; ring and small finger","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1129.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0560","name":"Safety plan interven","description":"Safety planning interventions, each 20 minutes personally performed by the billing practitioner, including assisting the patient in the identification of the following personalized elements of a safety plan: recognizing warning signs of an impending suicidal or substance use-related crisis; employin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1386","name":"Exc sx melmn or mlnm is","description":"Patients with an excisional surgery for melanoma or melanoma in situ in the past 5 years with an initial ajcc staging of 0, i, or ii at the start of the performance period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92288","name":"Scr dark adaptation meas i&r","description":"Screening dark adaptation measurement (eg, rod recovery intercept time), with interpretation and report","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0828T","name":"Dgtz gls mcrscp cytp smpl fl","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; simple filter method with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4387","name":"Neothelium ft per sq cm","description":"Neothelium ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0795T","name":"Tcat ins 2chmbr ldls pm cmpl","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; complete system (ie, r","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0201","name":"Pne flu hepb cov home admin","description":"Administration of pneumococcal, influenza, hepatitis b, and/or covid-19 vaccine inside a patients home; reported only once per individual home per date of service when such vaccine administration(s) are performed at the patients home","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67516","name":"Sprchoroidal spc njx rx agt","description":"Suprachoroidal space injection of pharmacologic agent (separate procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5155","name":"Inj, aflibercept-jbvf, 1 mg","description":"Injection, aflibercept-jbvf (yesafili), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7961","name":"Buccal/labial frenectomy","description":"Buccal/labial frenectomy","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0372U","name":"Nfct ds gu pthgn arg detcj","description":"Nfct ds gu pthgn arg detcj","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9028","name":"Inj, nogapendekin pmln, 1mcg","description":"Injection, nogapendekin alfa inbakicept-pmln, for intravesical use, 1 microgram","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0675T","name":"Laps insj nw/rpcmt isdss 1ld","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first lead","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25430","name":"Vasc graft into carpal bone","description":"Insertion of vascular pedicle into carpal bone (eg, hori procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":808.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6028","name":"Part hand finger metacar amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s) /thumb, amputation at metacarpal level, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1229","name":"Pt w/ +hcv +vir ref win 1 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, is referred within 1 month of the reactive hcv antibody test to a clinician who treats hcv infection","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0495U","name":"Onc prst8 alys crcg plsm prt","description":"Onc prst8 alys crcg plsm prt","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1260","name":"Pt not doc <= 1 yr dialysis","description":"Patient status not documented within the first year of initiating dialysis","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22837","name":"Ant thrc vrt body tethrg 8+","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; 8 or more vertebral segments","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0384U","name":"Neph ckd rsk hi stg kdn ds","description":"Neph ckd rsk hi stg kdn ds","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77092","name":"Tbs i&r fx rsk qhp","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; interpretation and report on fracture-risk only by other qualified health care professional","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31242","name":"Nsl/sinus ndsc rf abltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by radiofrequency ablation, posterior nasal nerve","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7528","name":"Mycophen mofetil for susp","description":"Mycophenolate mofetil, for suspension, oral, 100 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1413","name":"Inj delandistrogene mox rokl","description":"Injection, delandistrogene moxeparvovec-rokl, per therapeutic dose","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93898","name":"Ven-artl shunt det mbubb njx","description":"Venous-arterial shunt detection with intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1415","name":"No pos pdl1 bef ici ther","description":"Patients who did not have a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0929T","name":"Rem interrog dev ccm-d tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6081","name":"Scale & debride, single imp","description":"Scale & debride, single imp","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0342U","name":"Onc pncrtc ca mult ia eclia","description":"Onc pncrtc ca mult ia eclia","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0604U","name":"All&immunology crae 4bk pep","description":"All&immunology crae 4bk pep","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0183","name":"Software meas of cardiac vol","description":"Quantitative software measurements of cardiac volume, cardiac chambers volumes and left ventricular wall mass derived from ct scan(s) data of the chest/heart (with or without contrast)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2991","name":"App of hydroxyapatite","description":"App of hydroxyapatite","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0568","name":"Int psych care mng, 1 cal mo","description":"Initial psychiatric collaborative care management, in the first calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required elements: outrea","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0569U","name":"Onc sol tum ngs tmm>20000dmr","description":"Onc sol tum ngs tmm>20000dmr","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24500","name":"Cltx humrl shft fx w/o mnpj","description":"Closed treatment of humeral shaft fracture; without manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":337.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0525U","name":"Onc sphrd cell cul 11-rx pnl","description":"Onc sphrd cell cul 11-rx pnl","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37267","name":"Revsc evsc fpvt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0947T","name":"Mrgfus strtctc bl-br disrpj","description":"Magnetic resonance image guided low intensity focused ultrasound (mrgfus), stereotactic blood-brain barrier disruption using microbubble resonators to increase the concentration of blood-based biomarkers of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0547","name":"Phone/internet svs 11-20 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0038","name":"Clin pt no ref","description":"Clinician determines patient does not require referral","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99478","name":"Sbsq ic vlbw inf<1,500 gm","description":"Subsequent intensive care, per day, for the evaluation and management of the recovering very low birth weight infant (present body weight less than 1,500 grams)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0688T","name":"Tx amblyopia assmt w/report","description":"Treatment of amblyopia using an online digital program; assessment of patient performance and program data by physician or other qualified health care professional, with report, per calendar month","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96001","name":"Motion test w/ft press meas","description":"Comprehensive computer-based motion analysis by video-taping and 3d kinematics; with dynamic plantar pressure measurements during walking","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5141","name":"Inj adalimumab-aaty, 1 mg","description":"Injection, adalimumab-aaty, biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95027","name":"Iq tsts seql&incrl airborne","description":"Intracutaneous (intradermal) tests, sequential and incremental, with allergenic extracts for airborne allergens, immediate type reaction, including test interpretation and report, specify number of tests","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4282","name":"Cygnus dual per sq cm","description":"Cygnus dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9048","name":"Inj, bortezomib freseniuskab","description":"Injection, bortezomib (fresenius kabi), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1431","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34520","name":"Cross-over vein graft","description":"Cross-over vein graft to venous system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1272.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4266","name":"Neostim per sq cm","description":"Neostim membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0681","name":"App of non-sheet skin sub","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; first 25 sq cm or less of wound surface area","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0216","name":"Inj, alfentanil hcl, 500mcg","description":"Injection, alfentanil hydrochloride, 500 micrograms","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92631","name":"Hearing aid slctn svc 1st 30","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99392","name":"Prev visit est age 1-4","description":"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; early","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":117.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9011","name":"Datopotamab deruxtecan, 1 mg","description":"Injection, datopotamab deruxtecan-dlnk, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0344U","name":"Hep nafld semiq evl 28 lipid","description":"Hep nafld semiq evl 28 lipid","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5947","name":"Mand implt sup fix","description":"Mand implt sup fix","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3247","name":"Inj secukinumab intrav 1mg","description":"Injection, secukinumab, intravenous, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0946T","name":"Ortho impl mvmt alys pair ct","description":"Orthopedic implant movement analysis using paired computed tomography (ct) examination of the target structure, including data acquisition, data preparation and transmission, interpretation and report (including ct scan of the joint or extremity performed with paired views)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3501","name":"Surg exp root surf anterior","description":"Surg exp root surf anterior","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0391U","name":"Onc sld tum dna&rna 437 gen","description":"Onc sld tum dna&rna 437 gen","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0537","name":"Risk ascvd tst once pr 12 mo","description":"Administration of a standardized, evidence-based atherosclerotic cardiovascular disease (ascvd) risk assessment, 5-15 minutes, not more often than every 12 months","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1193","name":"Rpts w/ imp/con mmr/msi","description":"Surgical pathology reports that contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0175","name":"Inj, donanemab-azbt, 2 mg","description":"Injection, donanemab-azbt, 2 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1209","name":">=2 same hi-rsk med w/o diag","description":"At least two orders for high-risk medications from the same drug class, (table 4), without appropriate diagnoses","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4428","name":"Dermbnd sln sl+ slx sq cm","description":"Dermabind sl n or dermabind sl + or dermabind sl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0901T","name":"Plmt bone marrow smplg port","description":"Placement of bone marrow sampling port, including imaging guidance when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0755T","name":"Dgtz gls mcrscp sld level vi","description":"Digitization of glass microscope slides for level vi, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21400","name":"Closed tx orbit w/o manipulj","description":"Closed treatment of fracture of orbit, except blowout; without manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27222","name":"Treat hip socket fracture","description":"Closed treatment of acetabulum (hip socket) fracture(s); with manipulation, with or without skeletal traction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1129.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4262","name":"Dual layer impax, per sq cm","description":"Dual layer impax membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0888T","name":"Histotripsy mal renal tissue","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant renal tissue, including imaging guidance","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0668","name":"Team remote e/m est pt 40 mn","description":"Team remote e/m est. pt 40mins","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43288","name":"Esphg thrsc moblj","description":"Esophagectomy, total or near total, with thoracoscopic mobilization of the upper, middle, and lower mediastinal esophagus, with separate laparoscopic proximal gastrectomy, with laparoscopic pyloric drainage procedure if performed, with open cervical pharyngogastrostomy or esophagogastrostomy (ie, th","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3747.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49623","name":"Rmvl ninfct mesh hernia rpr","description":"Removal of total or near total non-infected mesh or other prosthesis at the time of initial or recurrent anterior abdominal hernia repair or parastomal hernia repair, any approach (ie, open, laparoscopic, robotic) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87076","name":"Culture anaerobe ident each","description":"Culture, bacterial; anaerobic isolate, additional methods required for definitive identification, each isolate","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82233","name":"Beta-amyloid 1-40 (abeta 40)","description":"Beta-amyloid; 1-40 (abeta 40)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1414","name":"Inj, beqvez, per tx dose","description":"Injection, fidanacogene elaparvovec-dzkt, per therapeutic dose","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23101","name":"Arthrt acrmclv/strnclav jt","description":"Arthrotomy, acromioclavicular joint or sternoclavicular joint, including biopsy and/or excision of torn cartilage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":543.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2372","name":"Inj, biorphen, 20 micrograms","description":"Injection, phenylephrine hydrochloride (biorphen), 20 micrograms","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0234","name":"Intra inf, toci, second dos","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0602","name":"Sevelamer carbonate pdr 20mg","description":"Sevelamer carbonate (renvela or therapeutically equivalent), oral, powder, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2373","name":"Inj, immphentiv, 20 mcg","description":"Injection, phenylephrine hydrochloride (immphentiv), 20 micrograms","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35694","name":"Art trnsposj subclav carotid","description":"Transposition and/or reimplantation; subclavian to carotid artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1361.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0379U","name":"Tgsap sl or neo dna523&rna55","description":"Tgsap sl or neo dna523&rna55","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1024T","name":"Perq tiss dsplmt soft tissue","description":"Percutaneous tissue displacement, any method, including imaging guidance; soft tissue (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49190","name":"Opn exc/dstr ntra-abd >30 cm","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); greater than 30 cm","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0622U","name":"Psyc mdd dna alys >20000","description":"Psyc mdd dna alys >20000","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1736","name":"Inj meloxicam (delova) 1mg","description":"Injection, meloxicam (delova), 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35623","name":"Bpg axillary-pop/-tibial","description":"Bypass graft, with other than vein; axillary-popliteal or -tibial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1697.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48540","name":"Fuse pancreas cyst and bowel","description":"Internal anastomosis of pancreatic cyst to gastrointestinal tract; roux-en-y","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1350.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0651","name":"Inj, levothyroxine, freskabi","description":"Injection, levothyroxine sodium (fresenius kabi), not therapeutically equivalent to j0650, 10 mcg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6747.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1411","name":"Inj, hemgenix, per tx dose","description":"Injection, etranacogene dezaparvovec-drlb, per therapeutic dose","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98015","name":"Synch audio-only est high 40","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selec","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1022T","name":"Prq tis dsplmt ntra-abdl/pel","description":"Percutaneous tissue displacement, any method, including imaging guidance; intra-abdominal/pelvic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1339","name":"Pts f/u 30-180 dys + improv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who demonstrated positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92928","name":"Prq tcat plmt ntrac st 1 les","description":"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 1 lesion involving 1 or more coronary segments","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55859","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":840.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0033","name":"2+ benzo seiz","description":"Two or more benzodiazepine prescriptions ordered for patients who had a diagnosis of seizure disorders, rapid eye movement sleep behavior disorder, benzodiazepine withdrawal, ethanol withdrawal, or severe generalized anxiety disorder on or between january 1 of the year prior to the measurement perio","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93355","name":"Echo transesophageal (tee)","description":"Echocardiography, transesophageal (tee) for guidance of a transcatheter intracardiac or great vessel(s) structural intervention(s) (eg, tavr, transcatheter pulmonary valve replacement, mitral valve repair, paravalvular regurgitation repair, left atrial appendage occlusion/closure, ventricular septal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27645","name":"Resect tibia tumor","description":"Radical resection of tumor; tibia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1305.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4401","name":"Absolv3 per sq cm","description":"Absolv3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49623","name":"Rmvl ninfct mesh hernia rpr","description":"Removal of total or near total non-infected mesh or other prosthesis at the time of initial or recurrent anterior abdominal hernia repair or parastomal hernia repair, any approach (ie, open, laparoscopic, robotic) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4369","name":"Amnioplast 3 per sq cm","description":"Amnioplast 3, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1367","name":"Qual care ent disorder mvp","description":"Quality care for the treatment of ear, nose, and throat disorders mips value pathway","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53866","name":"Cathj rmvl dev ischmc rmdlg","description":"Catheterization with removal of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2468","name":"Inj, palonosetron (posfrea)","description":"Injection, palonosetron hydrochloride (posfrea), 25 micrograms","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4291","name":"Lamellas xt, per sq cm","description":"Lamellas xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9129","name":"Photobio therpy-sub 15 mins","description":"Photobio therpy-sub 15 mins","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31620","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1378","name":"Med rsn no 10 yr fu colscope","description":"Documentation of medical reason(s) for not recommending a 10 year follow-up interval (e.g., inadequate prep, familial or personal history of colonic polyps, patient had no adenoma and age is >= 66 years old, or life expectancy < 10 years, other medical reasons)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86723","name":"Listeria monocytogenes","description":"Antibody; listeria monocytogenes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49622","name":"Rpr parastomal hrna ncr/strn","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4406","name":"Xwrap fenestra per sq cm","description":"Xwrap fenestra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1477","name":"Dx delirium","description":"Diagnosis of delirium","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6253","name":"Provisional pontic","description":"Provisional pontic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27303","name":"Drainage of bone lesion","description":"Incision, deep, with opening of bone cortex, femur or knee (eg, osteomyelitis or bone abscess)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":761.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37284","name":"Revsc evasc tpvt st sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40801","name":"Drainage of mouth lesion","description":"Drainage of abscess, cyst, hematoma, vestibule of mouth; complicated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0665","name":"Inj, bupivacaine, nos, 0.5mg","description":"Injection, bupivicaine, not otherwise specified, 0.5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49592","name":"Rpr aa hrn 1st < 3 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, incarcerated or strangulated","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80440","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6602","name":"G com bandge hgh dn foamroll","description":"Gradient compression bandaging supply, high density foam roll for bandage, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43325","name":"Revise esophagus & stomach","description":"Esophagogastric fundoplasty, with fundic patch (thal-nissen procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1401.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86043","name":"Acetylcholn rcptr modlg antb","description":"Acetylcholine receptor (achr); modulating antibody","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2039","name":"Innovamatrix fd, per sq cm","description":"Innovamatrix fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0577","name":"Inj, brixadi, 7 days or less","description":"Injection, buprenorphine extended-release (brixadi), less than or equal to 7 days of therapy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0412U","name":"Beta amyloid ab42/40 imprcip","description":"Beta amyloid ab42/40 imprcip","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0936T","name":"Photobiomodulation ther rta","description":"Photobiomodulation therapy of retina, single session","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0858T","name":"Ext trnscranl mag stimj meas","description":"Externally applied transcranial magnetic stimulation with concomitant measurement of evoked cortical potentials with automated report","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0858T","name":"Ext trnscranl mag stimj meas","description":"Externally applied transcranial magnetic stimulation with concomitant measurement of evoked cortical potentials with automated report","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95865","name":"Needle emg larynx","description":"Needle electromyography; larynx","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1340","name":"Indx whodas 2.0 or sds","description":"Index assessment completed using the 12-item whodas 2.0 or sds during the denominator identification period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1363","name":"Pts no f/u 120 dys","description":"Patients who did not have a follow-up assessment within 120 days of the index assessment","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0501U","name":"Onc clrc bld quan meas cfdna","description":"Onc clrc bld quan meas cfdna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7330","name":"Cultured chondrocytes implnt","description":"Autologous cultured chondrocytes, implant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16284.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86709","name":"Hepatitis a igm antibody","description":"Hepatitis a antibody (haab), igm antibody","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87468","name":"Anaplsma phgcytophlm amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); anaplasma phagocytophilum, amplified probe technique","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9061","name":"Inj, amivantamab-vmjw","description":"Injection, amivantamab-vmjw, 2 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2928","name":"Prefab porc/cer crown perm","description":"Prefab porc/cer crown perm","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2023","name":"Innovamatrix pd, 1 mg","description":"Innovamatrix pd, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0555","name":"Replacment pt electronic sys","description":"Provision of replacement patient electronics system (e.g., system pillow, handheld reader) for home pulmonary artery pressure monitoring","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0463U","name":"Onc crvx mrna genxprsn 14bmk","description":"Onc crvx mrna genxprsn 14bmk","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0946T","name":"Ortho impl mvmt alys pair ct","description":"Orthopedic implant movement analysis using paired computed tomography (ct) examination of the target structure, including data acquisition, data preparation and transmission, interpretation and report (including ct scan of the joint or extremity performed with paired views)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98007","name":"Synch audio-video est hi 40","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high medical decision making. when using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9947","name":"Sleep apnea appliance","description":"Sleep apnea appliance","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37258","name":"Revsc evasc ivt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1345","name":"Pt bsln pam, 2nd scr 4-12 mo","description":"Patients who had a baseline pam score and a second score within 4 to 12 month of baseline pam score","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2404","name":"Inj, nicardipine 0.1 mg","description":"Injection, nicardipine, 0.1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6039","name":"Passive custom digit/thumb","description":"Passive prosthetic digit or thumb prosthesis not including hand restoration partial hand, full or partial, custom made, any material, initial or replacement, per single passive prosthetic digit or thumb","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":2160.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4315","name":"Regenelink amniotic mem allo","description":"Regenelink amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1412","name":"Met nsclc w/ egfr alk oth ab","description":"Patients with metastatic nsclc with epidermal growth factor receptor (egfr) mutations, alk genomic tumor aberrations, or other targetable genomic abnormalities with approved first-line targeted therapy, such as nsclc with ros1 rearrangement, braf v600e mutation, ntrk 1/2/3 gene fusion, met ex14 skip","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61533","name":"Implant brain electrodes","description":"Craniotomy with elevation of bone flap; for subdural implantation of an electrode array, for long-term seizure monitoring","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1676.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95979","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69726","name":"Rmv ntr oi implt skl prq esp","description":"Removal, entire osseointegrated implant, skull; with percutaneous attachment to external speech processor","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0916T","name":"Insj perm ccm-d sys pg only","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator only","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4352","name":"Overlay sl matrix, per sq cm","description":"Overlay sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43330","name":"Esophagomyotomy abdominal","description":"Esophagomyotomy (heller type); abdominal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1376.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0266U","name":"Unxpl cnst hrtbl do gn xprsn","description":"Unexplained constitutional or other heritable disorders or syndromes, tissue-specific gene expression by whole-transcriptome and next-generation sequencing, blood, formalin-fixed paraffin-embedded (ffpe) tissue or fresh frozen tissue, reported as presence or absence of splicing or expression changes","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52344","name":"Cysto/uretero stricture tx","description":"Cystourethroscopy with ureteroscopy; with treatment of ureteral stricture (eg, balloon dilation, laser, electrocautery, and incision)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0991T","name":"Cysto lo-nrg lithtrp&mcrsphr","description":"Cystourethroscopy, with low-energy lithotripsy and acoustically actuated microspheres, including imaging","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0846T","name":"Dgtz gls mcrscp imfluor ea","description":"Digitization of glass microscope slides for immunofluorescence, per specimen; each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1837","name":"Inj, posaconazole, 1 mg","description":"Injection, posaconazole, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0030","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01937","name":"Anes drg/aspir crv/thrc","description":"Anesthesia for percutaneous image-guided injection, drainage or aspiration procedures on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5411","name":"Dentures adjust cmplt mand","description":"Adjust complete denture - mandibular","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62252","name":"Csf shunt reprogram","description":"Reprogramming of programmable cerebrospinal shunt","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0279U","name":"Hem vw factor&clgn iii bndg","description":"Hematology (von willebrand disease [vwd]), von willebrand factor (vwf) and collagen iii binding by enzyme-linked immunosorbent assays (elisa), plasma, report of collagen iii binding","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0757T","name":"Dgtz gls mcrscp sl spc grpii","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group ii, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistochemistry (list separately in addition to code for primary","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0493U","name":"Trnspl med quan dd-cfdna ngs","description":"Trnspl med quan dd-cfdna ngs","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7174","name":"Injection fitusiran 0.04 mg","description":"Injection, fitusiran, 0.04 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0564U","name":"Nfct ds pthgn-sna 10vir&4bct","description":"Nfct ds pthgn-sna 10vir&4bct","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87154","name":"Cul typ id bld pthgn 6+ trgt","description":"Culture, typing; identification of blood pathogen and resistance typing, when performed, by nucleic acid (dna or rna) probe, multiplexed amplified probe technique including multiplex reverse transcription, when performed, per culture or isolate, 6 or more targets","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1251","name":"Pts proxy cmplt hu surv","description":"Patients for whom a proxy completed the entire hu survey on their behalf for any reason (no patient involvement)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9992","name":"Pall serv during meas","description":"Palliative care services used by patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19357","name":"Tiss xpndr plmt brst rcnstj","description":"Tissue expander placement in breast reconstruction, including subsequent expansion(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1670.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87081","name":"Culture screen only","description":"Culture, presumptive, pathogenic organisms, screening only;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5930","name":"Max guid prothes w/o flange","description":"Max guid prothes w/o flange","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3911","name":"Intraorifice barrier","description":"Intraorifice barrier","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0717T","name":"Adrc ther prtl rc tear","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; adipose tissue harvesting, isolation and preparation of harvested cells, including incubation with cell dissociation enzymes, filtration, washing, and concentration of adrcs","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0846T","name":"Dgtz gls mcrscp imfluor ea","description":"Digitization of glass microscope slides for immunofluorescence, per specimen; each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25440","name":"Repair nonu scphd carpl b1","description":"Repair of nonunion, scaphoid carpal (navicular) bone, with or without radial styloidectomy (includes obtaining graft and necessary fixation)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":977.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0681T","name":"Rlcj pulse gen only isdss","description":"Relocation of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing dual leads","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0762T","name":"Dgtz gls mcrscp sl imm ea m","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, each multiplex antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":680.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9256","name":"Inj, nipocalimab-aahu, 3 mg","description":"Injection, nipocalimab-aahu, 3 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61540","name":"Removal of brain tissue","description":"Craniotomy with elevation of bone flap; for lobectomy, other than temporal lobe, partial or total, without electrocorticography during surgery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2586.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0921T","name":"Rmvl perm ccm-d sys 1 dfb ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous defibrillation lead only","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","name":"Scoliosis orth sag/ cor","description":"Scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla to trochanter, includes all accessory pads, straps and interface, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0267U","name":"Rare do id opt gen mapg&seq","description":"Rare constitutional and other heritable disorders, identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping and whole-genome sequencing","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37272","name":"Revsc evsc fpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33951","name":"Ecmo/ecls insj prph cannula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; insertion of peripheral (arterial and/or venous) cannula(e), percutaneous, birth through 5 years of age (includes fluoroscopic guidance, when performed)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4435","name":"Renati membrane per sq cm","description":"Renati membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0773T","name":"Vr px dissoc svc oth phy 1st","description":"Virtual reality (vr) procedural dissociation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports; initial 15 min","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41155","name":"Tongue jaw & neck surgery","description":"Glossectomy; composite procedure with resection floor of mouth, mandibular resection, and radical neck dissection (commando type)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2561.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31085","name":"Removal of frontal sinus","description":"Sinusotomy frontal; obliterative, with osteoplastic flap, coronal incision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1353.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31637","name":"Bronchoscopy stent add-on","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; each additional major bronchus stented (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1390","name":"Pt no doc exm for rec","description":"Patients who do not have a documented exam performed for recurrence of melanoma or no documentation within the performance period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44100","name":"Biopsy of bowel","description":"Biopsy of intestine by capsule, tube, peroral (1 or more specimens)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29804","name":"Jaw arthroscopy/surgery","description":"Arthroscopy, temporomandibular joint, surgical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":785.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9291","name":"Pres dig cog behav thera fda","description":"Prescription digital cognitive and/or behavioral therapy, fda cleared, per course of treatment","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1233","name":"Pt no hcv aby or result","description":"Patient does not receive hcv antibody test or patient does receive hcv antibody test but results not documented, reason not given","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0180","name":"Dolasetron mesylate oral","description":"Dolasetron mesylate, 100 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 24 hour dosage regimen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1167","name":"Hspc dur meas pd","description":"In hospice or using hospice services during the measurement period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24363","name":"Replace elbow joint","description":"Arthroplasty, elbow; with distal humerus and proximal ulnar prosthetic replacement (eg, total elbow)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1599.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1212","name":"Missing gsa not perf","description":"Glycemic status assessment (hba1c or gmi) level is missing, or was not performed during the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0827T","name":"Dgtz gls mcrscp cytp smears","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; smears with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2045","name":"Novashield/novogen pr sq cm","description":"Novashield or novogen wound matrix, per square centimeter","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2711","name":"Inj neostigmin/glycopyrrolat","description":"Injection, neostigmine methylsulfate 0.1 mg and glycopyrrolate 0.02 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99251","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1382","name":"Enc dur perf pd pos 11","description":"Patient encounter during the performance period with place of service code 11","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85041","name":"Automated rbc count","description":"Blood count; red blood cell (rbc), automated","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0022","name":"Comm hlth intg svs add 30 m","description":"Community health integration services, each additional 30 minutes per calendar month (list separately in addition to g0019)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6603","name":"Cst hgh nble mtl inlay >=3sr","description":"Inlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58565","name":"Hysteroscopy sterilization","description":"Hysteroscopy, surgical; with bilateral fallopian tube cannulation to induce occlusion by placement of permanent implants","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":549.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64629","name":"Trml dstrj ios bvn ea addl","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; each additional vertebral body, lumbar or sacral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0536U","name":"Rbcag ftl rhd pcr alys exon4","description":"Rbcag ftl rhd pcr alys exon4","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88348","name":"Electron microscopy dx","description":"Electron microscopy, diagnostic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":518.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0309U","name":"Crd cv ds aly 4 prtn plm alg","description":"Crd cv ds aly 4 prtn plm alg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0426","name":"Coll, analys of saliva","description":"Coll, analys of saliva","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0568","name":"Int psych care mng, 1 cal mo","description":"Initial psychiatric collaborative care management, in the first calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required elements: outrea","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1806","name":"Inj esmolol hcl wg crit care","description":"Injection, esmolol hydrochloride (wg critical care), not therapeutically equivalent to j1805, 10 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61613","name":"Remove aneurysm sinus","description":"Obliteration of carotid aneurysm, arteriovenous malformation, or carotid-cavernous fistula by dissection within cavernous sinus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3463.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4331","name":"Axolotl graft, per sq cm","description":"Axolotl graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37262","name":"Iv lithotrp ivt w/in sm art","description":"Intravascular lithotripsy(ies), iliac vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37287","name":"Revsc evasc tpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0535U","name":"Pfas lc-ms/ms plsm/srm quan","description":"Pfas lc-ms/ms plsm/srm quan","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76360","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":492.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1216","name":"No spiro doc no res doc","description":"No spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and/or no spirometry performed with results documented during the encounter","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1416","name":"Pt rec hosp","description":"Patient received hospice services any time during the performance period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86698","name":"Histoplasma antibody","description":"Antibody; histoplasma","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1453","name":"Preop vis acu > 20/40","description":"Patients with a pre-operative visual acuity better than 20/40","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25931","name":"Amputation follow-up surgery","description":"Transmetacarpal amputation; re-amputation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":940.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1324","name":"Pts intravitreal/pci","description":"Patients who had an intravitreal or periocular corticosteroid injection (e.g., triamcinolone, preservative-free triamcinolone, dexamethasone, dexamethasone intravitreal implant, or fluocinolone intravitreal implant)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61519","name":"Remove brain lining lesion","description":"Craniectomy for excision of brain tumor, infratentorial or posterior fossa; meningioma","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3429.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1475","name":"Pt dx huntington","description":"Patients with diagnosis of huntingtons disease","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41000","name":"Drainage of mouth lesion","description":"Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; lingual","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3472","name":"Surg rep root res premolar","description":"Surg rep root res premolar","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1332","name":"Pts no eval ini xm no 2 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 2 weeks","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6214","name":"Pontic titanium","description":"Pontic - titanium","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99426","name":"Prin care mgmt staff 1st 30","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6253","name":"Provisional pontic","description":"Provisional pontic","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4344","name":"Tri membrane wrap, per sq cm","description":"Tri-membrane wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95908","name":"Nrv cndj tst 3-4 studies","description":"Nerve conduction studies; 3-4 studies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80506","name":"Path clin consltj prolng svc","description":"Pathology clinical consultation; prolonged service, each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29240","name":"Strapping of shoulder","description":"Strapping; shoulder (eg, velpeau)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1023T","name":"Prq tis dsplmt intrathoracic","description":"Percutaneous tissue displacement, any method, including imaging guidance; intrathoracic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33281","name":"Reposg phrnc nrv stim trnsvn","description":"Repositioning of phrenic nerve stimulator transvenous lead(s)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0860T","name":"Ncntc ifr spctrsc scr pad","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), for screening for peripheral arterial disease, including provocative maneuvers, image acquisition, interpretation, and report, one or both lower extremities","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0738","name":"Hiv prep, inj, lenacapavir","description":"Injection, lenacapavir, 1 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37271","name":"Revsc evsc fpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9432","name":"Med food non inborn err meta","description":"Medical foods for non-inborn errors of metabolism","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15351","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55810","name":"Extensive prostate surgery","description":"Prostatectomy, perineal radical;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1441.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0234","name":"Intra inf, toci, second dos","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92288","name":"Scr dark adaptation meas i&r","description":"Screening dark adaptation measurement (eg, rod recovery intercept time), with interpretation and report","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1782","name":"Vac admin human pap dose 2","description":"Vac admin human pap dose 2","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0561","name":"Temp tube delivery, unil","description":"Tympanostomy with local or topical anesthesia and insertion of a ventilating tube when performed with tympanostomy tube delivery device, unilateral (list separately in addition to 69433) (do not use in conjunction with 0583t)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0566","name":"3d bn img algor drvd fr mri","description":"3d radiodensity-value bone imaging, algorithm derived, from previous magnetic resonance examination of the same anatomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4312","name":"Acesso ac, per sq cm","description":"Acesso ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81458","name":"So gsap dna cpy nmbr&mcrstl","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis, copy number variants and microsatellite instability","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9887","name":"Distance learning attendance","description":"Behavioral counseling for diabetes prevention, distance learning, 60 minutes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86403","name":"Particle agglut antbdy scrn","description":"Particle agglutination; screen, each antibody","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70471","name":"Cta h&n c+ w/noncontrast img","description":"Computed tomographic angiography (cta), head and neck, with contrast material(s), including noncontrast images, when performed, and image postprocessing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44384","name":"Small bowel endoscopy","description":"Ileoscopy, through stoma; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64583","name":"Rev/rplct hpglsl nstm ary pg","description":"Revision or replacement of hypoglossal nerve neurostimulator array and distal respiratory sensor electrode or electrode array, including connection to existing pulse generator","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0341","name":"Percutaneous islet celltrans","description":"Percutaneous islet cell transplant, includes portal vein catheterization and infusion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98014","name":"Synch audio-only est mod 30","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code s","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1340","name":"Indx whodas 2.0 or sds","description":"Index assessment completed using the 12-item whodas 2.0 or sds during the denominator identification period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25924","name":"Amputation follow-up surgery","description":"Disarticulation through wrist; re-amputation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":816.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95919","name":"Quan puplmtry phy/qhp uni/bi","description":"Quantitative pupillometry with physician or other qualified health care professional interpretation and report, unilateral or bilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0525","name":"Inj cefotetan disodium 10 mg","description":"Injection, cefotetan disodium, 10 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0866T","name":"Quan mri alys brn w/dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion detection, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transmissio","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82272","name":"Occult bld feces 1-3 tests","description":"Blood, occult, by peroxidase activity (eg, guaiac), qualitative, feces, 1-3 simultaneous determinations, performed for other than colorectal neoplasm screening","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0282","name":"Amiodarone hcl","description":"Injection, amiodarone hydrochloride, 30 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1239","name":"Pt no resp heard","description":"Patient did not respond to the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0140","name":"Nav srv peer sup 60 min pr m","description":"Principal illness navigation - peer support by certified or trained auxiliary personnel under the direction of a physician or other practitioner, including a certified peer specialist; 60 minutes per calendar month, in the following activities:  person-centered interview, performed to better underst","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0398U","name":"Gi baret esph dna mthyln aly","description":"Gi baret esph dna mthyln aly","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86774","name":"Tetanus antibody","description":"Antibody; tetanus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0874","name":"Inj, daptomycin (baxter)","description":"Injection, daptomycin (baxter), not therapeutically equivalent to j0878, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55712","name":"Bx prst8 tprnl mri-us 1st","description":"Biopsy, prostate, transperineal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6280","name":"Implt maint procd remv implt","description":"Implt maint procd remv implt","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54324","name":"Reconstruction of urethra","description":"1-stage distal hypospadias repair (with or without chordee or circumcision); with urethroplasty by local skin flaps (eg, flip-flap, prepucial flap)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9286","name":"Inj glofitamab gxbm, 2.5 mg","description":"Injection, glofitamab-gxbm, 2.5 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0475U","name":"Hered prst8 ca gsap 23 genes","description":"Hered prst8 ca gsap 23 genes","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1410","name":"No gmln brca1/brca2 couns","description":"Patients who did not have germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6198","name":"Remove interim implant","description":"Remove interim implant","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4024","name":"Pediatrics ss","description":"Pediatrics mips specialty set","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1412","name":"Met nsclc w/ egfr alk oth ab","description":"Patients with metastatic nsclc with epidermal growth factor receptor (egfr) mutations, alk genomic tumor aberrations, or other targetable genomic abnormalities with approved first-line targeted therapy, such as nsclc with ros1 rearrangement, braf v600e mutation, ntrk 1/2/3 gene fusion, met ex14 skip","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92561","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64658","name":"Rmvl bat modul sys lead only","description":"Removal of baroreflex activation therapy (bat) modulation system; lead only","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0803T","name":"Tcat rmv&rpl2chmb ldls pm rv","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ve","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70210","name":"X-ray exam of sinuses","description":"Radiologic examination, sinuses, paranasal, less than 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1265","name":"Cms 2728 completed","description":"Cms medical evidence form 2728 for dialysis patients: initial form completed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0587U","name":"Ther rx mntr 60-150rx&metabl","description":"Ther rx mntr 60-150rx&metabl","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78608","name":"Brain imaging (pet)","description":"Brain imaging, positron emission tomography (pet); metabolic evaluation","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0364U","name":"Onc hl neo gen seq alys alg","description":"Onc hl neo gen seq alys alg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0407U","name":"Neph dbtc ckd mult eclia alg","description":"Neph dbtc ckd mult eclia alg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4025","name":"Physical medicine ss","description":"Physical medicine mips specialty set","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0796T","name":"Tcat ins 2chmbr ldls pm ra","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right atrial pacemaker","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2038","name":"Skill train and dev/diem","description":"Skills training and development, per diem","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4372","name":"Amchoplast excl per sq cm","description":"Amchoplast excel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4007","name":"General surgery ss","description":"General surgery mips specialty set","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0320U","name":"Neph rna psttrnspl perph bld","description":"Neph rna psttrnspl perph bld","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4008","name":"Geriatrics ss","description":"Geriatrics mips specialty set","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2470","name":"Inj pantoprazole sodium 40mg","description":"Injection, pantoprazole sodium, 40 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83987","name":"Exhaled breath condensate","description":"Ph; exhaled breath condensate","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78630","name":"Cerebrospinal fluid scan","description":"Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0492U","name":"Onc sol tum ctc slctn pd-l1","description":"Onc sol tum ctc slctn pd-l1","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":617.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75577","name":"Quan&char c athrosclrtc plaq","description":"Quantification and characterization of coronary atherosclerotic plaque to assess severity of coronary disease, derived from augmentative software analysis of the data set from a coronary computed tomographic angiography, with interpretation and report by a physician or other qualified health care pr","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53215","name":"Removal of urethra","description":"Urethrectomy, total, including cystostomy; male","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1017.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8005","name":"Grip glove w microprocessor","description":"Powered, cable driven grip assist glove, hand, finger, includes microprocessor, pressure sensors, all components and accessories, custom fitted","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4319","name":"Sanograft, per sq cm","description":"Sanograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94657","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4030","name":"Pulmonology ss","description":"Pulmonology mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0426U","name":"Genome ultra-rapid seq alys","description":"Genome ultra-rapid seq alys","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0506U","name":"Gi barretts esophgl cell 89","description":"Gi barretts esophgl cell 89","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2006","name":"Novosorb synpath per sq cm","description":"Novosorb synpath dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0305U","name":"Hem rbc fnclty&dfrm shr strs","description":"Hem rbc fnclty&dfrm shr strs","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92638","name":"Bhvl verif of amplification","description":"Behavioral verification of amplification including aided thresholds, functional gain, speech-in-noise, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49618","name":"Rpr aa hrn rcr > 10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, incarcerated or strangulate","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":694.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0960T","name":"Rpl s-sclp eltr ra rcvr&tlmt","description":"Replacement of sub-scalp implanted electrode array, receiver, and telemetry unit with tunneling of electrode for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2679","name":"Inj fluphenazine hcl 1.25 mg","description":"Injection, fluphenazine hcl, 1.25 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4307","name":"American amnion, per sq cm","description":"American amnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0045","name":"Mrs 90 days post stk","description":"Clinical follow-up and mrs score assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0494U","name":"Rbc ag ftl rhd gene alys ngs","description":"Rbc ag ftl rhd gene alys ngs","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93593","name":"R hrt cath chd nml nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; normal native connections","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5878","name":"Dup of complt dent-mandib","description":"Dup of complt dent-mandib","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0285U","name":"Onc rsps radj cll fr dna tox","description":"Onc rsps radj cll fr dna tox","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78492","name":"Myocrd img pet mlt rst&strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); multiple studies at rest and stress (exercise or pharmacologic)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0613U","name":"Onc uc dna mthyltn&mut 6bmrk","description":"Onc uc dna mthyltn&mut 6bmrk","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1261","name":"Pts on wtlist bef dialysis","description":"Patients that were on the kidney or kidney-pancreas waitlist prior to initiation of dialysis","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2058","name":"Obecbtge autol up to 400 mil","description":"Obecabtagene autoleucel, 10 up to 400 million cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per infusion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64659","name":"Rmvl bat modulj sys pg only","description":"Removal of baroreflex activation therapy (bat) modulation system; pulse generator only","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1183","name":"Doc imm ckpt inhib hld","description":"Documentation of immune checkpoint inhibitor therapy held and corticosteroids or immunosuppressants prescribed or administered","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0494U","name":"Rbc ag ftl rhd gene alys ngs","description":"Rbc ag ftl rhd gene alys ngs","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88332","name":"Path consltj surg ea add blk","description":"Pathology consultation during surgery; each additional tissue block with frozen section(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69729","name":"Impl oi implt sk tc esp>=100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside of the mastoid and resulting in removal of greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0859T","name":"Ncntc ifr spctrsc o/t pad ea","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), other than for screening for peripheral arterial disease, image acquisition, interpretation, and report; each additional anatomic site (list separately in addition to code ","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4018","name":"Ob/gyn ss","description":"Obstetrics/gynecology mips specialty set","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1006T","name":"Elec alys s-scl eeg prgrm ea","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, each additional 15 minutes face-to-face time with physician or other qua","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1428","name":"Bilateral absence of eyes","description":"Patients who have bilateral absence of eyes any time during the patients history through the end of the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1370","name":"Inj, esomeprazole sod, 1 mg","description":"Injection, esomeprazole sodium, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4019","name":"Oncology/hema ss","description":"Oncology/hematology mips specialty set","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1369","name":"Qualcare mental hlth/sud mvp","description":"Quality care in mental health and substance use disorders mips value pathway","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0500U","name":"Autoinflam ds vexas synd dna","description":"Autoinflam ds vexas synd dna","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71047","name":"X-ray exam chest 3 views","description":"Radiologic examination, chest; 3 views","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85610","name":"Prothrombin time","description":"Prothrombin time;","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1160","name":"Pt anphx due to mengb bef 13","description":"Patient had anaphylaxis due to the meningococcal vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1365","name":"Hosp+pall care spec code 17","description":"Patient encounter during the performance period with hospice and palliative care specialty code 17","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65273","name":"Repair of eye wound","description":"Repair of laceration; conjunctiva, by mobilization and rearrangement, with hospitalization","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0459","name":"Telehealth inpt pharm mgmt","description":"Inpatient telehealth pharmacologic management, including prescription, use, and review of medication with no more than minimal medical psychotherapy","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36482","name":"Endoven ther chem adhes 1st","description":"Endovenous ablation therapy of incompetent vein, extremity, by transcatheter delivery of a chemical adhesive (eg, cyanoacrylate) remote from the access site, inclusive of all imaging guidance and monitoring, percutaneous; first vein treated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1973.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":191.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0333U","name":"Onc lvr surveilanc hcc cfdna","description":"Onc lvr surveilanc hcc cfdna","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1423","name":"Opt care urologic cnd mvp","description":"Optimal care for patients with urologic conditions mips value pathway","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0399U","name":"Neuro cere folate defncy srm","description":"Neuro cere folate defncy srm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2598","name":"Inj, vasopressin, 1 unit","description":"Injection, vasopressin, 1 unit","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0798T","name":"Tcat rmv 2chmbr ldls pm cmpl","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; complete system (ie, right atrial and right ventricular pacemaker components)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99424","name":"Prin care mgmt phys 1st 30","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85032","name":"Manual cell count each","description":"Blood count; manual cell count (erythrocyte, leukocyte, or platelet) each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2679","name":"Inj fluphenazine hcl 1.25 mg","description":"Injection, fluphenazine hcl, 1.25 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1410","name":"No gmln brca1/brca2 couns","description":"Patients who did not have germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0842T","name":"Dgtz gls mcrscp pth cslt ea","description":"Digitization of glass microscope slides for pathology consultation during surgery; each additional tissue block with frozen section(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64421","name":"Njx aa&/strd ntrcost nrv ea","description":"Injection(s), anesthetic agent(s) and/or steroid; intercostal nerve, each additional level (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0680T","name":"Insj/rplcmt pg only isdss","description":"Insertion or replacement of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing lead(s)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37258","name":"Revsc evasc ivt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6634","name":"Onlay titanium","description":"Onlay - titanium","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1305","name":"Inj, evinacumab-dgnb, 5mg","description":"Injection, evinacumab-dgnb, 5mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1837","name":"Inj, posaconazole, 1 mg","description":"Injection, posaconazole, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4148","name":"Enteral feed elastomer daily","description":"Enteral feeding supply kit; elastomeric control fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3387","name":"Inj elivaldogene autotemecel","description":"Injection, elivaldogene autotemcel, per treatment","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76984","name":"Dx intraop thoracic aorta us","description":"Ultrasound, intraoperative thoracic aorta (eg, epiaortic), diagnostic","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1326","name":"Pts dx hypotony","description":"Patients with a diagnosis of hypotony","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49188","name":"Opn exc/dst ntra-abd 10.1-20","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 10.1 to 20 cm","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6604","name":"Cst bse mtl inlay 2 surfaces","description":"Inlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1458","name":"Pt died bef end meas pd","description":"Patient died prior to the end of the performance period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9297","name":"Inj pemetrexed (sandoz) 10mg","description":"Injection, pemetrexed (sandoz), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0770T","name":"Vr technology assist therapy","description":"Virtual reality technology to assist therapy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0973T","name":"Slctv nzmtc dbrdmt t/a/l 1st","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; first 100 sq cm","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1338","name":"Pt f/u 30-180 dys no + imprv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who did not demonstrate positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4306","name":"Americ amnion ac per sq cm","description":"American amnion ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1173","name":"Pt no rec td/tdap 9yrs prior","description":"Patient did not receive at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4368","name":"Amchothick per sq cm","description":"Amchothick, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3424","name":"Inj hydroxocobalamin iv 25mg","description":"Injection, hydroxocobalamin, intravenous, 25 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1172","name":"Doc med rsn no td/tdap","description":"Documentation of medical reason(s) for not administering td or tdap vaccine (e.g., prior anaphylaxis due to the td or tdap vaccine or history of encephalopathy within seven days after a previous dose of a td-containing vaccine)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0920T","name":"Rmvl perm ccm-d sys 1 pac ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous pacing lead only","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4014","name":"Nephrology ss","description":"Nephrology mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53453","name":"Tprnl balo cntnc dev rmvl ea","description":"Periurethral transperineal adjustable balloon continence device; removal, each balloon","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87210","name":"Smear wet mount saline/ink","description":"Smear, primary source with interpretation; wet mount for infectious agents (eg, saline, india ink, koh preps)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42700","name":"I&d abscess peritonsillar","description":"Incision and drainage abscess; peritonsillar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9128","name":"Photobio therpy-first 15 min","description":"Photobio therpy-first 15 min","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0387U","name":"Onc mlnma ambra1&amlo","description":"Onc mlnma ambra1&amlo","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53453","name":"Tprnl balo cntnc dev rmvl ea","description":"Periurethral transperineal adjustable balloon continence device; removal, each balloon","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5154","name":"Inj, omlyclo, 5 mg","description":"Injection, omalizumab-igec (omlyclo), biosimilar, 5 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0409U","name":"Onc sld tum dna 80 & rna 36","description":"Onc sld tum dna 80 & rna 36","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1298","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1489","name":"Pt status doc","description":"Patient status documented","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4268","name":"Surgraft ft per sq cm","description":"Surgraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1482","name":"Pos quan hep c or qual rna","description":"Positive/detectable hepatitis c virus quantitative or qualitative rna test result during the denominator identification period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0536","name":"Peer recover support svs","description":"Peer recovery support services, provided directly or by referral; including leveraging knowledge of the condition or lived experience to provide support, mentorship, or inspiration to meet oud treatment and recovery goals; conducting a person-centered interview to understand the patients life story,","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59622","name":"Attempted vbac after care","description":"Cesarean delivery only, following attempted vaginal delivery after previous cesarean delivery; including postpartum care","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1372.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1454","name":"New cied","description":"New cied","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4256","name":"Mlg complet, per sq cm","description":"Mlg-complete, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0367U","name":"Onc bldr 10 flwg trurl rescj","description":"Onc bldr 10 flwg trurl rescj","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2039","name":"Innovamatrix fd, per sq cm","description":"Innovamatrix fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9156","name":"Oral mucoadhesive per 1 ml","description":"Oral mucoadhesive, any type (liquid, gel, paste, etc.), per 1 ml","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1348","name":"Pam incr 6 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 6-points in a 4 to 12 month period (excellent)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78121","name":"Red cell mass multiple","description":"Red cell volume determination (separate procedure); multiple samplings","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76095","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93593","name":"R hrt cath chd nml nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; normal native connections","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94617","name":"Exercise tst brncspsm w/ecg","description":"Exercise test for bronchospasm, including pre- and post-spirometry and pulse oximetry; with electrocardiographic recording(s)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0869T","name":"Njx b1 sub mtrl hw fixj aug","description":"Injection(s), bone-substitute material for bone and/or soft tissue hardware fixation augmentation, including intraoperative imaging guidance, when performed","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0871T","name":"Rplcmt subq prtl ascites pmp","description":"Replacement of a subcutaneous peritoneal ascites pump, including reconnection between pump and indwelling bladder and peritoneal catheters, including initial programming and imaging, when performed","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1255","name":"Pts w/ othr rsn vst,+prg tst","description":"Patients who have another reason for visiting the clinic [not prenatal or postpartum care] and have a positive pregnancy test but have not established the clinic as an ob provider (e.g., plan to terminate the pregnancy or seek prenatal services elsewhere)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0915T","name":"Insj perm ccm-d sys pg&eltrd","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator and dual transvenous electrodes/leads (pacing and defibrillation)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4346","name":"Shelter dm matrix per sq cm","description":"Shelter dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94014","name":"Patient recorded spirometry","description":"Patient-initiated spirometric recording per 30-day period of time; includes reinforced education, transmission of spirometric tracing, data capture, analysis of transmitted data, periodic recalibration and review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0431U","name":"Gly rcptr alpha1 igg srm/csf","description":"Gly rcptr alpha1 igg srm/csf","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75580","name":"N-invas est c ffr sw aly cta","description":"Noninvasive estimate of coronary fractional flow reserve (ffr) derived from augmentative software analysis of the data set from a coronary computed tomography angiography, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0774T","name":"Vr px dissoc svc oth phy ea","description":"Virtual reality (vr) procedural dissociation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports; each additiona","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2247","name":"Inj, micafungin (par pharm)","description":"Injection, micafungin sodium (par pharm) not thereapeutically equivalent to j2248, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1299","name":"Inj, eculizumab, 2 mg","description":"Injection, eculizumab, 2 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0701","name":"Pano radio image","description":"Pano radio image","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10080","name":"I&d pilonidal cyst simple","description":"Incision and drainage of pilonidal cyst; simple","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":121.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9297","name":"Inj pemetrexed (sandoz) 10mg","description":"Injection, pemetrexed (sandoz), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1256","name":"Prior history of known cvd","description":"Prior history of known cvd","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0799T","name":"Tcat rmvl 2chmbr ldls pm ra","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right atrial pacemaker component","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1323","name":"Pts 7wk inj, scrn iop >25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop >25 mm hg and a plan of care was documented","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1474","name":"Pt dx dementia","description":"Patients with diagnosis of dementia","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0356U","name":"Onc orop 17 dna ddpcr alg","description":"Onc orop 17 dna ddpcr alg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76988","name":"Dx ntrop epcr us chd img acq","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; placement, manipulation of transducer, and image acquisition only","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64840","name":"Repair of leg nerve","description":"Suture of posterior tibial nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1010.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53451","name":"Tprnl balo cntnc dev bi","description":"Periurethral transperineal adjustable balloon continence device; bilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0010","name":"Admin hepatitis b vaccine","description":"Administration of hepatitis b vaccine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0972T","name":"Asstv alg clsfctn burn hlg","description":"Assistive algorithmic classification of burn healing (ie, healing or nonhealing) by noninvasive multispectral imaging, including system set-up and acquisition, selection, and transmission of images, with automated generation of report","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0977T","name":"Upr gi bld detcj snr capsule","description":"Upper gastrointestinal blood detection, sensor capsule, with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4241","name":"Gngvl flap w rootplan 1-3 th","description":"Gingival flap procedure including root planing - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1207","name":"Pt scrn sdoh","description":"Patient is screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0476U","name":"Rx metab psyc 14gen&cyp2d6","description":"Rx metab psyc 14gen&cyp2d6","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0945T","name":"Intraop assmt abnl tum tiss","description":"Intraoperative assessment for abnormal (tumor) tissue, in-vivo, following partial mastectomy (eg, lumpectomy) using computer-aided fluorescence imaging (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0018","name":"Crisis psychotherapy add 30m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); each additional 30 minutes (list separately in addition to code for primary service)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1025","name":"Pt mnth 1 mcp prov","description":"Patient-months where there are more than one medicare capitated payment (mcp) provider listed for the month","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57311","name":"Repair urethrovaginal lesion","description":"Closure of urethrovaginal fistula; with bulbocavernosus transplant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":561.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83897","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1939","name":"Inj, bumetanide, 0.5 mg","description":"Injection, bumetanide, 0.5 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0234","name":"Intra inf, toci, second dos","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33370","name":"Tcat plmt&rmvl cepd perq","description":"Transcatheter placement and subsequent removal of cerebral embolic protection device(s), including arterial access, catheterization, imaging, and radiological supervision and interpretation, percutaneous (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1319","name":"Pts csp doc contact","description":"Patients who had documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86305","name":"Human epididymis protein 4","description":"Human epididymis protein 4 (he4)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1274","name":"Pts snf exl mo","description":"Patients who were admitted to a skilled nursing facility (snf) during the month of evaluation were excluded from that month","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0697T","name":"Quan mr tis wo mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained without diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, targ","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86596","name":"Voltage-gtd ca chnl antb ea","description":"Voltage-gated calcium channel antibody, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4021","name":"Orthopedic surgery ss","description":"Orthopedic surgery mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9957","name":"Screening sleep disorders","description":"Screening sleep disorders","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0603U","name":"Rx asy prsmv 77rx/metablt ur","description":"Rx asy prsmv 77rx/metablt ur","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0821T","name":"Mntr psychdlc med 2ndphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; second physician or other qualified health care professional, concurrent with first physician or other qualified health care professional, each hour (list sepa","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97007","name":"Mchnl sclp cool meas fitg","description":"Mechanical scalp cooling, including individual cap supply with head measurement, fitting, and patient education","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0668","name":"Instill, bupivac and meloxic","description":"Instillation, bupivacaine and meloxicam, 1 mg/0.03 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33277","name":"Insj phrnc nrv stim transvns","description":"Insertion of phrenic nerve stimulator transvenous sensing lead (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55712","name":"Bx prst8 tprnl mri-us 1st","description":"Biopsy, prostate, transperineal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0571U","name":"Onc sol tum dna80&rna10g ngs","description":"Onc sol tum dna80&rna10g ngs","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0268U","name":"Hem ahus gen seq alys 15 gen","description":"Hematology (atypical hemolytic uremic syndrome [ahus]), genomic sequence analysis of 15 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2356","name":"Inj tezepelumab-ekko, 1mg","description":"Injection, tezepelumab-ekko, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4361","name":"Epixpress, per sq cm","description":"Epixpress, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0004","name":"Qual care neurologic cnd mvp","description":"Quality care for patients with neurological conditions mips value pathway","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9027","name":"Rbc o2 co2 reduced","description":"Red blood cells, leukocytes reduced, oxygen/ carbon dioxide reduced, each unit","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93153","name":"Interrog w/o prgrmg ipnss","description":"Interrogation without programming of implanted phrenic nerve stimulator system","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0908T","name":"Opn imp int nstm sys vgs nrv","description":"Open implantation of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86367","name":"Stem cells total count","description":"Stem cells (ie, cd34), total count","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99394","name":"Prev visit est age 12-17","description":"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; adole","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":137.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15770","name":"Derma-fat-fascia graft","description":"Graft; derma-fat-fascia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":691.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0460U","name":"Onc whl bld/bucc rtpcr 24gen","description":"Onc whl bld/bucc rtpcr 24gen","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0701","name":"Inj. cefepime hcl (baxter)","description":"Injection, cefepime hydrochloride (baxter), not therapeutically equivalent to maxipime, 500 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1355","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0549","name":"Phone/inter for treat>31m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0845T","name":"Dgtz gls mcrscp imfluor 1st","description":"Digitization of glass microscope slides for immunofluorescence, per specimen; initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1612","name":"Inj glucagon (gvoke) 0.01 mg","description":"Injection, glucagon (gvoke), 0.01 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0461U","name":"Onc rxgenom alys rtpcr 24gen","description":"Onc rxgenom alys rtpcr 24gen","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1237","name":"Pt rsn no scrn","description":"Patient reason for not screening for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety (e.g., patient declined or other patient reasons)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0910T","name":"Rmvl int nstim sys vagus nrv","description":"Removal of integrated neurostimulation system, vagus nerve","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92997","name":"Pul art balloon repr percut","description":"Percutaneous transluminal pulmonary artery balloon angioplasty; single vessel","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":743.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6561","name":"G stockng full/chap 40+ cust","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, custom, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0043","name":"Pt mech pros ht valv","description":"Patients with mechanical prosthetic heart valve","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0900T","name":"N-invas est aqmbf asstv cmr","description":"Noninvasive estimate of absolute quantitation of myocardial blood flow (aqmbf), derived from assistive algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health care profes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30930","name":"Ther fx nasal inf turbinate","description":"Fracture nasal inferior turbinate(s), therapeutic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3265","name":"Injection torsemide 10 mg/ml","description":"Injection, torsemide, 10 mg/ml","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4305","name":"Amer am ac tri-lay per sq cm","description":"American amnion ac tri-layer, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6212","name":"Bridge noble metal cast","description":"Pontic-cast noble metal","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0831T","name":"Dgtz gls mcrscp cytp c/v","description":"Digitization of glass microscope slides for cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61250","name":"Burr hole/treph sttl expl","description":"Burr hole(s) or trephine, supratentorial, exploratory, not followed by other surgery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":931.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1202","name":"Miglustat oral 65 mg","description":"Miglustat, oral, 65 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4427","name":"Dermbnd dln dl+ dlx sq cm","description":"Dermabind dl n or dermabind dl + or dermabind dl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4322","name":"Caregraft, per sq cm","description":"Caregraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4436","name":"Renati ac membrane per sq cm","description":"Renati ac membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0609U","name":"Onc prostate ia tot&free psa","description":"Onc prostate ia tot&free psa","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96547","name":"Intraop hipec px 1st 60 min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; first 60 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9949","name":"Repair sleep apnea appliance","description":"Repair sleep apnea appliance","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4272","name":"Esano a, per sq cm","description":"Esano a, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0326U","name":"Trgt gen seq alys pnl 83+","description":"Trgt gen seq alys pnl 83+","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4291","name":"Lamellas xt, per sq cm","description":"Lamellas xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1980","name":"Hyoscyamine sulfate inj","description":"Injection, hyoscyamine sulfate, up to 0.25 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0941T","name":"Cysto flx ins&xpns urtl scaf","description":"Cystourethroscopy, flexible; with insertion and expansion of prostatic urethral scaffold using integrated cystoscopic visualization","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1313","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4369","name":"Amnioplast 3 per sq cm","description":"Amnioplast 3, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0652","name":"Inj, levothyroxine, hikma","description":"Injection, levothyroxine sodium (hikma), not therapeutically equivalent to j0650, 10 mcg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9245","name":"Admin mod sedation-enteral","description":"Admin mod sedation-enteral","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1251","name":"Pts proxy cmplt hu surv","description":"Patients for whom a proxy completed the entire hu survey on their behalf for any reason (no patient involvement)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96160","name":"Pt-focused hlth risk assmt","description":"Administration of patient-focused health risk assessment instrument (eg, health hazard appraisal) with scoring and documentation, per standardized instrument","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["95","CR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53405","name":"Revise urethra stage 2","description":"Urethroplasty; second stage (formation of urethra), including urinary diversion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":957.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98984","name":"Rtm dev sply resp sys 2-15 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of respiratory system, 2-15 days in a 30-day period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9602","name":"Fluorodopa f-18 diag per mci","description":"Fluorodopa f-18, diagnostic, per millicurie","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98975","name":"Rtm 1st set-up&pt educaj eqp","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); initial set-up and patient education on use of equipment","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6595","name":"G comp bandge liner upr extr","description":"Gradient compression bandaging supply, bandage liner, upper extremity, any size or length, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0372U","name":"Nfct ds gu pthgn arg detcj","description":"Nfct ds gu pthgn arg detcj","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97008","name":"Mchnl sclp cool prep plmt","description":"Mechanical scalp cooling; including hair preparation, individual cap placement, therapy initiation, and precooling period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55705","name":"Bx prst8 any approach nonimg","description":"Biopsy, prostate, any approach, nonimaging-guided","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0474U","name":"Hered pan ca gsap 88gene ngs","description":"Hered pan ca gsap 88gene ngs","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51535","name":"Repair of ureter lesion","description":"Cystotomy for excision, incision, or repair of ureterocele","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":878.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4364","name":"Am bur xp mem xpl hy p sq cm","description":"Amnio burgeon xplus membrane and xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85660","name":"Rbc sickle cell test","description":"Sickling of rbc, reduction","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0685T","name":"Interrog dev eval isdss ip","description":"Interrogation device evaluation (in-person) with analysis, review and report by a physician or other qualified health care professional, including connection, recording and disconnection per patient encounter, permanent implantable synchronized diaphragmatic stimulation system for augmentation of ca","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9225","name":"Gen anes adv air-sub 15 min","description":"Gen anes adv air-sub 15 min","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0493U","name":"Trnspl med quan dd-cfdna ngs","description":"Trnspl med quan dd-cfdna ngs","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0797T","name":"Tcat ins 2chmbr ldls pm rv","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ventricular pace","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1487","name":"Pt adm to hospice dur eval","description":"Patients in hospice in the year before or during the period of evaluation","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0364U","name":"Onc hl neo gen seq alys alg","description":"Onc hl neo gen seq alys alg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60660","name":"Abltj 1/+thyr ndul 1lobe prq","description":"Ablation of 1 or more thyroid nodule(s), one lobe or the isthmus, percutaneous, including imaging guidance, radiofrequency","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6031","name":"Rep interface handfng molded","description":"Replacement socket/interface, partial hand including fingers, molded to patient model, for use with or without external power","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5162","name":"Inj, denosumab-nxxp, 1 mg","description":"Injection, denosumab-nxxp (bildyos/bilprevda), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0955T","name":"Tot impl amei removal","description":"Totally implantable active middle ear hearing implant; removal, including removal of sound processor and all implant components","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35005","name":"Repair defect of artery","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, vertebral artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1269.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5156","name":"Inj, tocilizumab-anoh, 1 mg","description":"Injection, tocilizumab-anoh (avtozma), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"Ctlso a-p-l control custom","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2711","name":"Inj neostigmin/glycopyrrolat","description":"Injection, neostigmine methylsulfate 0.1 mg and glycopyrrolate 0.02 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98004","name":"Synch audio-video est sf 10","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 10 minutes must be met or e","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4352","name":"Overlay sl matrix, per sq cm","description":"Overlay sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0960T","name":"Rpl s-sclp eltr ra rcvr&tlmt","description":"Replacement of sub-scalp implanted electrode array, receiver, and telemetry unit with tunneling of electrode for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6028","name":"Part hand finger metacar amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s) /thumb, amputation at metacarpal level, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":1766.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2027","name":"Matriderm per sq cm","description":"Matriderm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1318","name":"Pts no csp doc contact","description":"Patients who did not have documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening or documentation that there was no contact with a csp","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62305","name":"Myelography lumbar injection","description":"Myelography via lumbar injection, including radiological supervision and interpretation; 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6614","name":"Onlay cst nbl mtl 2 surfaces","description":"Onlay - cast noble metal two surfaces","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20924","name":"Removal of tendon for graft","description":"Tendon graft, from a distance (eg, palmaris, toe extensor, plantaris)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":611.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0527","name":"Mgt est pt dmentia low cmplx","description":"Management of established patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0524U","name":"Ob pe sflt-1/plgf ia srm/pls","description":"Ob pe sflt-1/plgf ia srm/pls","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0784T","name":"Ins/rplmt eltrd ra spi nstim","description":"Insertion or replacement of percutaneous electrode array, spinal, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0566U","name":"Onc lng qpcr-bsd alys 13dmrs","description":"Onc lng qpcr-bsd alys 13dmrs","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11300","name":"Shave skin lesion 0.5 cm/<","description":"Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion diameter 0.5 cm or less","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":29.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1439","name":"Sig ocu cond imp surg out","description":"Significant ocular conditions that impact the visual outcome of surgery","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0709T","name":"Id ca immntx each addl njx","description":"Intradermal cancer immunotherapy; each additional injection (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27332","name":"Removal of knee cartilage","description":"Arthrotomy, with excision of semilunar cartilage (meniscectomy) knee; medial or lateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":769.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35602","name":"Bpg crtd-clat crtd","description":"Bypass graft, with other than vein; carotid-contralateral carotid","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0937T","name":"Xtrnl ecg rec>15d<30d","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; including recording, scanning analysis with report, review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0823T","name":"Tcat ins 1chmbr ldls pm ra","description":"Transcatheter insertion of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or programming), when","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0365U","name":"Onc bldr 10 prb bldr ca","description":"Onc bldr 10 prb bldr ca","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0797T","name":"Tcat ins 2chmbr ldls pm rv","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ventricular pace","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1187","name":"Pt w/ esrd","description":"Patients with a diagnosis of end stage renal disease (esrd)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0520","name":"New pt-cg dyad dem mod cmplx","description":"Management of new patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0762T","name":"Dgtz gls mcrscp sl imm ea m","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, each multiplex antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76857","name":"Us exam pelvic limited","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4312","name":"Acesso ac, per sq cm","description":"Acesso ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1336","name":"Pts eval ini xm 2 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 2 weeks","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0887T","name":"End-tidal ctrl inhaled anes","description":"End-tidal control of inhaled anesthetic agents and oxygen to assist anesthesia care delivery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92638","name":"Bhvl verif of amplification","description":"Behavioral verification of amplification including aided thresholds, functional gain, speech-in-noise, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54380","name":"Repair penis","description":"Plastic operation on penis for epispadias distal to external sphincter;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":908.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0699T","name":"Njx pst chmbr eye medication","description":"Injection, posterior chamber of eye, medication","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33767","name":"Shunt supr v/c p-art bth lng","description":"Shunt; superior vena cava to pulmonary artery for flow to both lungs (bidirectional glenn procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1801.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96380","name":"Admn rsv monoc antb im cnsl","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection, with counseling by physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37184","name":"Prim art m-thrmbc 1st vsl","description":"Primary percutaneous transluminal mechanical thrombectomy, noncoronary, non-intracranial, arterial or arterial bypass graft, including fluoroscopic guidance and intraprocedural pharmacological thrombolytic injection(s); initial vessel","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":545.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92636","name":"Hearing aid post-fitg f-up 1","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85041","name":"Automated rbc count","description":"Blood count; red blood cell (rbc), automated","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0804T","name":"Prgrmg evl ldls pm 2chmbr ip","description":"Programming device evaluation (in person) with iterative adjustment of implantable device to test the function of device and to select optimal permanent programmed values, with analysis, review, and report, by a physician or other qualified health care professional, leadless pacemaker system in dual","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1406","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92638","name":"Bhvl verif of amplification","description":"Behavioral verification of amplification including aided thresholds, functional gain, speech-in-noise, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4542","name":"Supp ext up limb tremor stim","description":"Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67903","name":"Repair eyelid defect","description":"Repair of blepharoptosis; (tarso) levator resection or advancement, internal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0521","name":"New pt-cg dyad dem hig cmplx","description":"Management of new patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0276U","name":"Hem inh thrombocytopenia 23","description":"Hematology (inherited thrombocytopenia), genomic sequence analysis of 23 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0949T","name":"Rem interrog dev ccm tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4021","name":"Orthopedic surgery ss","description":"Orthopedic surgery mips specialty set","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0825T","name":"Tcat rmv&rpl1chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or prog","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0045","name":"Mrs 90 days post stk","description":"Clinical follow-up and mrs score assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98015","name":"Synch audio-only est high 40","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selec","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25680","name":"Cltx trns-scphprlnr fx mnpj","description":"Closed treatment of trans-scaphoperilunar type of fracture dislocation, with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":517.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9997","name":"Ustekinumab-ttwe iv inj 1 mg","description":"Injection, ustekinumab-ttwe (pyzchiva), intravenous, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15018","name":"App skn cll ssp f/n/g/hf ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 480 sq cm or part thereof (list separately in addition to code for prima","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69730","name":"Rplc oi implt sk tc esp>=100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93650","name":"Icar cath abltj av node func","description":"Intracardiac catheter ablation of atrioventricular node function, atrioventricular conduction for creation of complete heart block, with or without temporary pacemaker placement","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":683.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4399","name":"Summit fx per sq cm","description":"Summit fx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1319","name":"Pts csp doc contact","description":"Patients who had documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38226","name":"Car-t prep t lymphcyt f/trns","description":"Chimeric antigen receptor t-cell (car-t) therapy; preparation of blood-derived t lymphocytes for transportation (eg, cryopreservation, storage)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78014","name":"Thyroid imaging w/blood flow","description":"Thyroid imaging (including vascular flow, when performed); with single or multiple uptake(s) quantitative measurement(s) (including stimulation, suppression, or discharge, when performed)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9953","name":"Reline sleep apnea appliance","description":"Reline sleep apnea appliance","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90845","name":"Psychoanalysis","description":"Psychoanalysis","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":95.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1218","name":"Pt copd symptoms","description":"Patient has copd symptoms (e.g., dyspnea, cough/sputum, wheezing)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52402","name":"Cysto trurl rescj ejacul dux","description":"Cystourethroscopy with transurethral resection or incision of ejaculatory ducts","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1203","name":"Inj, cipaglucosidase, 5 mg","description":"Injection, cipaglucosidase alfa-atga, 5 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11300","name":"Shave skin lesion 0.5 cm/<","description":"Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion diameter 0.5 cm or less","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":31.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1332","name":"Pts no eval ini xm no 2 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 2 weeks","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0420U","name":"Onc urthl mrna xprsn 6 snp","description":"Onc urthl mrna xprsn 6 snp","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33852","name":"Rpr hypopl a-arch wo byp","description":"Repair of hypoplastic or interrupted aortic arch using autogenous or prosthetic material; without cardiopulmonary bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1639.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9282","name":"Mitomycin intravesical inst","description":"Mitomycin, intravesical instillation, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0543","name":"Group train w/o patient","description":"Group caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient pre","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0786T","name":"Insj/rplcmt prq ra sac nstim","description":"Insertion or replacement of percutaneous electrode array, sacral, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1781","name":"Vac admin human pap dose 1","description":"Vac admin human pap dose 1","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26483","name":"Transplant/graft hand tendon","description":"Transfer or transplant of tendon, carpometacarpal area or dorsum of hand; with free tendon graft (includes obtaining graft), each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1161.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2032","name":"Myriad matrix, per sq cm","description":"Myriad matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86694","name":"Herpes simplex nes antbdy","description":"Antibody; herpes simplex, non-specific type test","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29065","name":"Appl cst sho to hand lng arm","description":"Application, cast; shoulder to hand (long arm)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37261","name":"Revsc evasc ivt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0237","name":"Inj, tocilizumab-anoh, hospi","description":"Injection, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K1005","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38227","name":"Car-t receipt&prepj admn","description":"Chimeric antigen receptor t-cell (car-t) therapy; receipt and preparation of car-t cells for administration","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60240","name":"Removal of thyroid","description":"Thyroidectomy, total or complete","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1133.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3424","name":"Inj hydroxocobalamin iv 25mg","description":"Injection, hydroxocobalamin, intravenous, 25 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0714T","name":"Tpla b9 prst8 hyprplsa<50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume less than 50 ml","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0978T","name":"Submucosal cryolysis therapy","description":"Submucosal cryolysis therapy; soft palate, base of tongue, and lingual tonsil","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0607U","name":"Reprdtve med ema rtpcr 31bct","description":"Reprdtve med ema rtpcr 31bct","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1163","name":"Inj, diltiazem hcl, 0.5 mg","description":"Injection, diltiazem hydrochloride, 0.5 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0283U","name":"Vw factor type 2b eval plsm","description":"Von willebrand factor (vwf), type 2b, platelet-binding evaluation, radioimmunoassay, plasma","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0987T","name":"Iv img icr cere vsl oct ea","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0423","name":"Genetic test spec analysis","description":"Genetic test spec analysis","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0831T","name":"Dgtz gls mcrscp cytp c/v","description":"Digitization of glass microscope slides for cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4292","name":"Lamellas, per sq cm","description":"Lamellas, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2305","name":"Inj, nitroglycerin, 5 mg","description":"Injection, nitroglycerin, 5 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87106","name":"Fungi identification yeast","description":"Culture, fungi, definitive identification, each organism; yeast","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1272","name":"Pts kid transplt wtlst","description":"Patients observed on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0991T","name":"Cysto lo-nrg lithtrp&mcrsphr","description":"Cystourethroscopy, with low-energy lithotripsy and acoustically actuated microspheres, including imaging","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15822","name":"Blepharoplasty upper eyelid","description":"Blepharoplasty, upper eyelid;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1164","name":"Inj diltiazem in 0.72% nacl","description":"Injection, diltiazem hydrochloride in 0.72% sodium chloride, 0.5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0759","name":"Inj, clevidipine, 1 mg","description":"Injection, clevidipine butyrate, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9181","name":"Etoposide injection","description":"Injection, etoposide, 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6114","name":"Implnt/abut fixed dent max","description":"Implnt/abut fixed dent max","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42650","name":"Dilation of salivary duct","description":"Dilation salivary duct","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28052","name":"Biopsy of foot joint lining","description":"Arthrotomy with biopsy; metatarsophalangeal joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1240","name":"Pt no resp best int","description":"Patient did not respond to the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24352","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":628.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4362","name":"Cygnus disk, per sq cm","description":"Cygnus disk, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0270U","name":"Hem cgen coagj do 20 genes","description":"Hematology (congenital coagulation disorders), genomic sequence analysis of 20 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1269","name":"Recd esrd mcp lst day of mo","description":"Receiving esrd mcp dialysis services by the provider on the last day of the reporting month","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0472U","name":"Ca vi psp&sp1 antb sjogren","description":"Ca vi psp&sp1 antb sjogren","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55707","name":"Bx prst8 trct us guided","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0535","name":"Pt navigat svs direct/ref","description":"Patient navigational services, provided directly or by referral; including helping the patient to navigate health systems and identify care providers and supportive services, to build patient self-advocacy and communication skills with care providers, and to promote patient-driven action plans and g","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83550","name":"Iron binding test","description":"Iron binding capacity","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0482","name":"Direct immunofluorescence","description":"Direct immunofluorescence","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84394","name":"Total tau","description":"Tau, total (ttau)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76014","name":"Mr sfty implt&/fb asmt stf 1","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30400","name":"Reconstruction of nose","description":"Rhinoplasty, primary; lateral and alar cartilages and/or elevation of nasal tip","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1207.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86258","name":"Dgp antibody each ig class","description":"Gliadin (deamidated) (dgp) antibody, each immunoglobulin (ig) class","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0965T","name":"I&cst prp jw xpn dl arch non","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, non-fixed hinge mechanism","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0389","name":"Periopic image capture only","description":"Periopic image capture only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41108","name":"Biopsy of floor of mouth","description":"Biopsy of floor of mouth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0501U","name":"Onc clrc bld quan meas cfdna","description":"Onc clrc bld quan meas cfdna","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56820","name":"Colposcopy vulva","description":"Colposcopy of the vulva;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4306","name":"Americ amnion ac per sq cm","description":"American amnion ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91320","name":"Sarscv2 vac 30mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 30 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4285","name":"Nudyn dl or dl mesh pr sq cm","description":"Nudyn dl or nudyn dl mesh, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87900","name":"Phenotype infect agent drug","description":"Infectious agent drug susceptibility phenotype prediction using regularly updated genotypic bioinformatics","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0758T","name":"Dgtz gls mcrscp sl spc hchem","description":"Digitization of glass microscope slides for special stain, including interpretation and report, histochemical stain on frozen tissue block (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7047","name":"Resp suction oral interface","description":"Oral interface used with respiratory suction pump, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1285","name":"Scrn mam perf rslts not doc","description":"Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed, reason not otherwise specified","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33779","name":"Rpr tga rcnstj rmvl plm bnd","description":"Repair of transposition of the great arteries, aortic pulmonary artery reconstruction (eg, jatene type); with removal of pulmonary band","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2385.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87183","name":"Sc std carbapenem resist gen","description":"Susceptibility studies, antimicrobial agent; carbapenem resistance genes (eg, blakpc, blandm, blavim, blaoxa-48, blaimp), amplified probe technique, per isolate","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4013","name":"Mntal/behav/psych hlth ss","description":"Mental/behavioral and psychiatry mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0765T","name":"Asstv alg ecg rsk asmt prev","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to previously performed electrocardiogram","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0877T","name":"Augmnt alys ch ct ild w/o ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4303","name":"Complete aa, per sq cm","description":"Complete aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0378U","name":"Rfc1 repeat xpnsj vrnt alys","description":"Rfc1 repeat xpnsj vrnt alys","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0422U","name":"Onc pan solid tum alys dna","description":"Onc pan solid tum alys dna","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9249","name":"Inj, melphalan (apotex) 1 mg","description":"Injection, melphalan (apotex), 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0798T","name":"Tcat rmv 2chmbr ldls pm cmpl","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; complete system (ie, right atrial and right ventricular pacemaker components)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75716","name":"Artery x-rays arms/legs","description":"Angiography, extremity, bilateral, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":726.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77089","name":"Tbs dxa cal w/i&r fx risk","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; using dual x-ray absorptiometry (dxa) or other imaging data on gray-scale variogram, calculation, with interpretation and report on fracture-risk","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1381","name":"Pt sec strk wthin 5 days","description":"Patients with secondary stroke (e.g., a subsequent stroke that may occur with vasospasm in the setting of subarachnoid hemorrhage) within 5 days of the initial procedure","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1783","name":"Vac admin human pap dose 3","description":"Vac admin human pap dose 3","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92629","name":"Eval hearing aid cand ea add","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0895T","name":"Connj lvr algrft prfu dev 1","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; initial 4 hours of monitoring time, including hourly physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0865T","name":"Quan mri alys brn w/o dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion identification, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transm","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81464","name":"So gsap cll fr mcrstl ins","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants, microsatellite instability, tumor mutation burden, and rearrangements","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1284","name":"Pt 66+ snp or ltc pos > 90d","description":"Patients age 66 or older in institutional special needs plans (snp) or residing in long term care with pos code 32, 33, 34, 54, or 56 for more than 90 consecutive days during the measurement period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7956","name":"Tiss regen edent resorb","description":"Tiss regen edent resorb","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0797T","name":"Tcat ins 2chmbr ldls pm rv","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ventricular pace","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76016","name":"Mr safety deter phys/qhp","description":"Mr safety determination by a physician or other qualified health care professional responsible for the safety of the mr procedure, including review of implant mr conditions for indicated mr examination, analysis of risk vs clinical benefit of performing mr examination, and determination of mr equipm","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0858T","name":"Ext trnscranl mag stimj meas","description":"Externally applied transcranial magnetic stimulation with concomitant measurement of evoked cortical potentials with automated report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"Ak 4 bar link hydl swg/stanc","description":"Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4339","name":"Artacent vericlen, per sq cm","description":"Artacent vericlen, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2025","name":"Miro3d per cubic cm","description":"Miro3d, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43198","name":"Esophagosc flex trnsn biopsy","description":"Esophagoscopy, flexible, transnasal; with biopsy, single or multiple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86051","name":"Aquaporin-4 antb elisa","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; enzyme-linked immunosorbent immunoassay (elisa)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20101","name":"Expl pentrg wound chest","description":"Exploration of penetrating wound (separate procedure); chest","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2012","name":"Suprathel, per sq cm","description":"Suprathel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01937","name":"Anes drg/aspir crv/thrc","description":"Anesthesia for percutaneous image-guided injection, drainage or aspiration procedures on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84433","name":"Asy thiopurin s-mthyltrnsfrs","description":"Thiopurine s-methyltransferase (tpmt)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92632","name":"Hearing aid slctn svc ea add","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9225","name":"Gen anes adv air-sub 15 min","description":"Gen anes adv air-sub 15 min","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1226","name":"Iop not doc","description":"Iop measurement not documented, reason not otherwise specified","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0871T","name":"Rplcmt subq prtl ascites pmp","description":"Replacement of a subcutaneous peritoneal ascites pump, including reconnection between pump and indwelling bladder and peritoneal catheters, including initial programming and imaging, when performed","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9998","name":"Doc med rsn <3 colon","description":"Documentation of medical reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., last colonoscopy incomplete, last colonoscopy had inadequate prep, piecemeal removal of adenomas, or sessile serrated polyps >= 20 mm in size, last colonoscopy found greater than 10 adenomas, lo","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7997","name":"Appliance removal","description":"Appliance removal (not by dentist who placed appliance) includes removal of archbar","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9292","name":"Pres dig visual therapy fda","description":"Prescription digital visual therapy, software-only, fda cleared, per course of treatment","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66989","name":"Xcpsl ctrc rmvl cplx insj 1+","description":"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification), complex, requiring devices or techniques not generally used in routine cataract surgery (eg, iris expansion device,","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":470.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0830T","name":"Dgtz gls mcrscp cytp slctv","description":"Digitization of glass microscope slides for cytopathology, selective-cellular enhancement technique with interpretation (eg, liquid-based slide preparation method), except cervical or vaginal (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0524U","name":"Ob pe sflt-1/plgf ia srm/pls","description":"Ob pe sflt-1/plgf ia srm/pls","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2056","name":"Ciltacabtagene car-pos t","description":"Ciltacabtagene autoleucel, up to 100 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54163","name":"Repair of circumcision","description":"Repair incomplete circumcision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65800","name":"Drainage of eye","description":"Paracentesis of anterior chamber of eye (separate procedure); with removal of aqueous","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98007","name":"Synch audio-video est hi 40","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high medical decision making. when using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7165","name":"Inj, human-lans, per i.u","description":"Injection, prothrombin complex concentrate, human-lans, per i.u. of factor ix activity","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76801","name":"Ob us < 14 wks single fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0030","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4037","name":"Urology ss","description":"Urology mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4015","name":"Neurology ss","description":"Neurology mips specialty set","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4414","name":"Simplichor per sq cm","description":"Simplichor, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0356U","name":"Onc orop 17 dna ddpcr alg","description":"Onc orop 17 dna ddpcr alg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69209","name":"Remove impacted ear wax uni","description":"Removal impacted cerumen using irrigation/lavage, unilateral","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77412","name":"Radiation tx delivery lvl 3","description":"Radiation treatment delivery; level 3, multiple isocenters with photon therapy (eg, 2d, 3d, or imrt) or a single-isocenter photon therapy (eg, 3d or imrt) with active motion management, or total skin electrons, or mixed-electron/photon field(s), including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6251","name":"Bridge resin base metal","description":"Pontic-resin with predominantly base metal","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1320","name":"Pts scrn + hrsn","description":"Patients who screened positive for at least 1 of the 5 hrsns","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4328","name":"Most, per sq cm","description":"Most, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1404.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1234","name":"Pt hcv rctv aby f/u neg","description":"Patient has a reactive hcv antibody test, and has a follow up hcv viral test that does not detect hcv viremia","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4396","name":"Natalin per sq cm","description":"Natalin, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0675","name":"Inj, carboprost, 0.1 mg","description":"Injection, carboprost tromethamine, 0.1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0554U","name":"Repr med pga 24chrm te bx qc","description":"Repr med pga 24chrm te bx qc","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0692T","name":"Therapeutic ultrafiltration","description":"Therapeutic ultrafiltration","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1354","name":"Int caries med app per tooth","description":"Interim caries med app","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1428","name":"Bilateral absence of eyes","description":"Patients who have bilateral absence of eyes any time during the patients history through the end of the measurement period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99397","name":"Per pm reeval est pat 65+ yr","description":"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 65 ye","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":93.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37268","name":"Revsc evasc fpvt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1238","name":"Doc 2nd recom hzv 2-6 mo int","description":"Documentation that administration of second recombinant zoster vaccine could not occur during the performance period due to the recommended 2-6 month interval between doses (i.e, first dose received after october 31)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43286","name":"Esphg tot w/laps moblj","description":"Esophagectomy, total or near total, with laparoscopic mobilization of the abdominal and mediastinal esophagus and proximal gastrectomy, with laparoscopic pyloric drainage procedure if performed, with open cervical pharyngogastrostomy or esophagogastrostomy (ie, laparoscopic transhiatal esophagectomy","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3389.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99496","name":"Transj care mgmt high f2f 7d","description":"Transitional care management services with the following required elements: communication (direct contact, telephone, electronic) with the patient and/or caregiver within 2 business days of discharge high level of medical decision making during the service period face-to-face visit, within 7 calenda","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":337.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":184.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4231","name":"Ana crown exp 1-3 per quad","description":"Anatomical crown exposure - one to three teeth per quadrant","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0139","name":"Inj, adalimumab, 1 mg","description":"Injection, adalimumab, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0523","name":"Mgt nw pt dem mod-high cmplx","description":"Management of a new patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1834","name":"Inj, isoniazid, 1 mg","description":"Injection, isoniazid, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2041","name":"Coord special care encounter","description":"Coordinated specialty care, team-based, for first episode psychosis, per encounter","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87811","name":"Sars-cov-2 covid19 w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19])","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0261U","name":"Onc clrct ca img alys w/ai","description":"Oncology (colorectal cancer), image analysis with artificial intelligence assessment of 4 histologic and immunohistochemical features (cd3 and cd8 within tumor-stroma border and tumor core), tissue, reported as immune response and recurrence-risk score","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4384","name":"Axolotl dual ult per sq cm","description":"Axolotl dualgraft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0320U","name":"Neph rna psttrnspl perph bld","description":"Neph rna psttrnspl perph bld","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50688","name":"Change of ureter tube/stent","description":"Change of ureterostomy tube or externally accessible ureteral stent via ileal conduit","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6035","name":"Prosthetic digit mechanical","description":"Single prosthetic digit, mechanical, can include metacarpophalangeal (mcp), proximal interphalangeal (pip), and/or distal interphalangeal (dip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1502.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69955","name":"Release facial nerve","description":"Total facial nerve decompression and/or repair (may include graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2276.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0758T","name":"Dgtz gls mcrscp sl spc hchem","description":"Digitization of glass microscope slides for special stain, including interpretation and report, histochemical stain on frozen tissue block (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4440","name":"Curamatrix per sq cm","description":"Curamatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4027","name":"Plastic surgery ss","description":"Plastic surgery mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2794","name":"Crown-titanium","description":"Crown-titanium","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37264","name":"Revsc evasc fpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76802","name":"Ob us < 14 wks addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70471","name":"Cta h&n c+ w/noncontrast img","description":"Computed tomographic angiography (cta), head and neck, with contrast material(s), including noncontrast images, when performed, and image postprocessing","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1197","name":"Isa reduced >=3 fr ixv","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49616","name":"Rpr aa hrn rcr 3-10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, incarcerated or strangulated","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84233","name":"Assay of estrogen","description":"Receptor assay; estrogen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0488U","name":"Ob fetal ag nipt cfdna alys","description":"Ob fetal ag nipt cfdna alys","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5942","name":"Proth max implt sup remv","description":"Proth max implt sup remv","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0034","name":"Pall serv during meas","description":"Patients receiving palliative care during the measurement period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1209","name":">=2 same hi-rsk med w/o diag","description":"At least two orders for high-risk medications from the same drug class, (table 4), without appropriate diagnoses","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4290","name":"Membrane wrap hydr per sq cm","description":"Membrane wrap-hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0860T","name":"Ncntc ifr spctrsc scr pad","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), for screening for peripheral arterial disease, including provocative maneuvers, image acquisition, interpretation, and report, one or both lower extremities","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1298","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44213","name":"Lap mobil splenic fl add-on","description":"Laparoscopy, surgical, mobilization (take-down) of splenic flexure performed in conjunction with partial colectomy (list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0602","name":"Sevelamer carbonate pdr 20mg","description":"Sevelamer carbonate (renvela or therapeutically equivalent), oral, powder, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28302","name":"Incision of ankle bone","description":"Osteotomy; talus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":809.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7171","name":"Inj, adzynma, 10 iu","description":"Injection, adamts13, recombinant-krhn, 10 iu","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2998","name":"Inj plasminogen tvmh 1mg","description":"Injection, plasminogen, human-tvmh, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30469","name":"Rpr nsl vlv collapse w/rmdlg","description":"Repair of nasal valve collapse with low energy, temperature-controlled (ie, radiofrequency) subcutaneous/submucosal remodeling","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3374","name":"Inj, vancomycin (mylan) 10mg","description":"Injection, vancomycin hydrochloride (mylan) not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6036","name":"Prosthetic thumb mechanical","description":"Prosthetic thumb, mechanical, can include metacarpophalangeal (mcp), interphalangeal (ip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59841","name":"Induced abortion dilat&evac","description":"Induced abortion, by dilation and evacuation","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":397.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0167","name":"Dronabinol 2.5mg oral","description":"Dronabinol, 2.5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4422","name":"Ac wrap per sq cm","description":"A/c wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4303","name":"Complete aa, per sq cm","description":"Complete aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9913","name":"Admin of neuromod","description":"Admin of neuromod","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7511","name":"Incision/drain abscess intra","description":"Incision and drainage of abscess - intraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80503","name":"Path clin consltj sf 5-20","description":"Pathology clinical consultation; for a clinical problem, with limited review of patients history and medical records and straightforward medical decision making when using time for code selection, 5-20 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97552","name":"Group caregiver training","description":"Group caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1378","name":"Med rsn no 10 yr fu colscope","description":"Documentation of medical reason(s) for not recommending a 10 year follow-up interval (e.g., inadequate prep, familial or personal history of colonic polyps, patient had no adenoma and age is >= 66 years old, or life expectancy < 10 years, other medical reasons)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0943T","name":"Cysto flx rmvl urtl scaffold","description":"Cystourethroscopy, flexible; with removal of prostatic urethral scaffold","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1341","name":"Pt no f/u 30-180 dys","description":"Patients who did not have a follow-up assessment or did not have an assessment within 30 to 180 days after the index assessment during the performance period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0962T","name":"Asstv alg alys acous&ecg rec","description":"Assistive algorithmic analysis of acoustic and electrocardiogram recording for detection of cardiac dysfunction (eg, reduced ejection fraction, cardiac murmurs, atrial fibrillation), with review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22830","name":"Exploration of spinal fusion","description":"Exploration of spinal fusion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":968.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1323","name":"Pts 7wk inj, scrn iop >25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop >25 mm hg and a plan of care was documented","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4377","name":"Trigraft ft per sq cm","description":"Trigraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1431","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1024T","name":"Perq tiss dsplmt soft tissue","description":"Percutaneous tissue displacement, any method, including imaging guidance; soft tissue (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4382","name":"Advograft dual per sq cm","description":"Advograft dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0893T","name":"N-invas assmt bld oxygnation","description":"Noninvasive assessment of blood oxygenation, gas exchange efficiency, and cardiorespiratory status, with physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0532","name":"Take home supp nasal spray","description":"Take-home supply of nasal nalmefene hydrochloride; one carton of two, 2.7 mg per 0.1 ml nasal sprays (provision of the services by a medicare-enrolled opioid treatment program);( list separately in addition to each primary code)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85007","name":"Bl smear w/diff wbc count","description":"Blood count; blood smear, microscopic examination with manual differential wbc count","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4337","name":"Artecent trident, per sq cm","description":"Artacent trident, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0136","name":"Adm of pa/n assess 5-15 m","description":"Administration of a standardized, evidence-based assessment of physical activity and nutrition, 5-15 minutes, not more often than every 6 months","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3502","name":"Surg exp root surf premolar","description":"Surg exp root surf premolar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1314","name":"Bmi not calculated","description":"Bmi not documented and no reason is given","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5153","name":"Inj, aflibercept-yszy, 1 mg","description":"Injection, aflibercept-yszy (opuviz), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0529U","name":"Hem vte snp f2&f5 gen leiden","description":"Hem vte snp f2&f5 gen leiden","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6604","name":"G com bandge low dn foam flt","description":"Gradient compression bandaging supply, low density flat foam sheet, per 250 square centimeters, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1355","name":"Caries med app per tooth","description":"Caries med app per tooth","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6093","name":"Recement supp part denture","description":"Recement implant/abutment supported fixed partial denture","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0933T","name":"Tcat impl wrls l atr prs snr","description":"Transcatheter implantation of wireless left atrial pressure sensor for long-term left atrial pressure monitoring, including sensor calibration and deployment, right heart catheterization, transseptal puncture, imaging guidance, and radiological supervision and interpretation","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0701","name":"Pano radio image","description":"Pano radio image","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0842T","name":"Dgtz gls mcrscp pth cslt ea","description":"Digitization of glass microscope slides for pathology consultation during surgery; each additional tissue block with frozen section(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0886T","name":"Sgmdsc flx 1st tndsc dilat","description":"Sigmoidoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4560","name":"Nmes disposable","description":"Neuromuscular electrical stimulator (nmes), disposable, replacement only","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99459","name":"Pelvic examination","description":"Pelvic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98011","name":"Synch audio-only new high 60","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 60 ","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33904","name":"Perq p-art revsc each addl","description":"Percutaneous pulmonary artery revascularization by stent placement, each additional vessel or separate lesion, normal or abnormal connections (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4274","name":"Esano ac, per sq cm","description":"Esano ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7521","name":"Tacrolim granules oral susp","description":"Tacrolimus, granules, oral suspension, 0.1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38227","name":"Car-t receipt&prepj admn","description":"Chimeric antigen receptor t-cell (car-t) therapy; receipt and preparation of car-t cells for administration","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0605","name":"Antibody test pub hlth path","description":"Antibody test pub hlth path","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3502","name":"Surg exp root surf premolar","description":"Surg exp root surf premolar","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4366","name":"Dl amnio bur x-mem per sq cm","description":"Dual layer amnio burgeon x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2371","name":"Inj phenylephrine hcl 20 mcg","description":"Injection, phenylephrine hydrochloride, 20 micrograms","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0355U","name":"Apol1 risk variants","description":"Apol1 risk variants","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1153","name":"Pt w/ dx osteo doe","description":"Patient with diagnosis of osteoporosis on date of encounter","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27278","name":"Arthrd si jt plmt iartic dev","description":"Arthrodesis, sacroiliac joint, percutaneous or minimally invasive, with image guidance, includes obtaining bone graft when performed, unilateral; placement of intra-articular device(s), without cortical piercing","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0555","name":"Replacment pt electronic sys","description":"Provision of replacement patient electronics system (e.g., system pillow, handheld reader) for home pulmonary artery pressure monitoring","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3260","name":"Tobramycin sulfate injection","description":"Injection, tobramycin sulfate, up to 80 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1371","name":"Mst rec gsa<7","description":"Most recent glycemic status assessment (hba1c or gmi) level < 7.0%","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2043","name":"Biobrane, per sq cm","description":"Biobrane, per square centimeter","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69726","name":"Rmv ntr oi implt skl prq esp","description":"Removal, entire osseointegrated implant, skull; with percutaneous attachment to external speech processor","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0388U","name":"Onc nonsm cll lng ca 37 gen","description":"Onc nonsm cll lng ca 37 gen","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4325","name":"Acapatch, per sq cm","description":"Acapatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0979T","name":"Sbmcsl crylys ther sft palt","description":"Submucosal cryolysis therapy; soft palate only","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93150","name":"Therapy activation ipnss","description":"Therapy activation of implanted phrenic nerve stimulator system, including all interrogation and programming","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0510U","name":"Onc pncrtc ca alg alys 16gen","description":"Onc pncrtc ca alg alys 16gen","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2394","name":"Post >=4srfc resinbase cmpst","description":"Resin-based composite - four or more surfaces posterior","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12046","name":"Intmd rpr n-hf/genit20.1-30","description":"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 20.1 cm to 30.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0552","name":"Supply of digital device","description":"Supply of digital mental health treatment device and initial education and onboarding, per course of treatment that augments a behavioral therapy plan","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9214","name":"Interferon alfa-2b inj","description":"Injection, interferon, alfa-2b, recombinant, 1 million units","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1234","name":"Pt hcv rctv aby f/u neg","description":"Patient has a reactive hcv antibody test, and has a follow up hcv viral test that does not detect hcv viremia","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9998","name":"Inj ustekinumab-aekn, 1 mg","description":"Injection, ustekinumab-aekn (selarsdi), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92545","name":"Oscillating tracking test","description":"Oscillating tracking test, with recording","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20551","name":"Njx 1 tendon origin/insj","description":"Injection(s); single tendon origin/insertion","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":37.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92626","name":"Eval aud funcj 1st hour","description":"Evaluation of auditory function for surgically implanted device(s) candidacy or postoperative status of a surgically implanted device(s); first hour","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9294","name":"Inj pemetrexed, hospira 10mg","description":"Injection, pemetrexed (hospira), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1465","name":"F/u > 180 days after rx","description":"Patient follow up more than 180 days after treatment","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4344","name":"Tri membrane wrap, per sq cm","description":"Tri-membrane wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0605U","name":"All&immunology hat tpsab1","description":"All&immunology hat tpsab1","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0810T","name":"Subrta njx rx agt w/vtrc","description":"Subretinal injection of a pharmacologic agent, including vitrectomy and 1 or more retinotomies","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2021","name":"Inj, linezolid (hospira)","description":"Injection, linezolid (hospira), not therapeutically equivalent to j2020, 200 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1190","name":"Doc khe not pef w/efgr/uacr","description":"Documentation of a kidney health evaluation was not performed or defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98011","name":"Synch audio-only new high 60","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 60 ","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0718T","name":"Adrc ther prtl rc tear njx","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; injection into supraspinatus tendon including ultrasound guidance, unilateral","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1164","name":"Pt w/ dementia any time","description":"Patients with dementia any time during the patients history through the end of the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1194","name":"Med rsn no imp/con mmr/msi","description":"Documentation of medical reason(s) surgical pathology reports did not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both tests were not included (e.g., patient will not be treated with checkpoint inhibitor therap","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7049","name":"Epap nasal valve","description":"Expiratory positive airway pressure intranasal resistance valve","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71045","name":"X-ray exam chest 1 view","description":"Radiologic examination, chest; single view","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2989","name":"Excavate tooth non-restorabl","description":"Excavate tooth non-restorabl","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0838T","name":"Dgtz gls mcrscp cslt sld els","description":"Digitization of glass microscope slides for consultation and report on referred slides prepared elsewhere (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0276U","name":"Hem inh thrombocytopenia 23","description":"Hematology (inherited thrombocytopenia), genomic sequence analysis of 23 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0525","name":"Est pt-cg dyad dem mod cmplx","description":"Management of established patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0731T","name":"Augmnt ai-based fcl phnt a/r","description":"Augmentative ai-based facial phenotype analysis with report","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4275","name":"Esano aca, per sq cm","description":"Esano aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0490U","name":"Onc cutan/uveal mlnma cd146","description":"Onc cutan/uveal mlnma cd146","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84394","name":"Total tau","description":"Tau, total (ttau)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9595","name":"Piflu f-18, dia 1 millicurie","description":"Piflufolastat f-18, diagnostic, 1 millicurie","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0387","name":"Comp image capture only","description":"Comp image capture only","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76883","name":"Us nrv&acc strux 1xtr compre","description":"Ultrasound, nerve(s) and accompanying structures throughout their entire anatomic course in one extremity, comprehensive, including real-time cine imaging with image documentation, per extremity","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6564","name":"G com stckng waist 40+ cust","description":"Gradient compression stocking, waist length, 40 mmhg or greater, custom, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1445","name":"Pp care visit by 12 weeks","description":"Postpartum care visit before or at 12 weeks of giving birth","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1933","name":"Afo rig ant tib tcf/= ots","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, off-the-shelf","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59425","name":"Antepartum care only","description":"Antepartum care only; 4-6 visits","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":424.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6600","name":"G com bandge hgh dn foam sht","description":"Gradient compression bandaging supply, high density foam sheet, per 250 square centimeters, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33904","name":"Perq p-art revsc each addl","description":"Percutaneous pulmonary artery revascularization by stent placement, each additional vessel or separate lesion, normal or abnormal connections (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99459","name":"Pelvic examination","description":"Pelvic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0970T","name":"Ablt b9 brst tum perq lsr ea","description":"Ablation, benign breast tumor (eg, fibroadenoma), percutaneous, laser, including imaging guidance when performed, each tumor","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0424U","name":"Onc prst8 xom alys 53 sncrna","description":"Onc prst8 xom alys 53 sncrna","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8701","name":"Ewh s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand with single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34970.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1301","name":"Pt recv tbco cess interv","description":"Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0432U","name":"Klhl11 antb sr/csf asy qual","description":"Klhl11 antb sr/csf asy qual","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43219","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0896T","name":"Connj lvr algrft prfu dev ea","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; each additional hour, including physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary bicarbonate, lactate ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0255U","name":"Andrology infertility assmt","description":"Andrology (infertility), sperm-capacitation assessment of ganglioside gm1 distribution patterns, fluorescence microscopy, fresh or frozen specimen, reported as percentage of capacitated sperm and probability of generating a pregnancy score","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9949","name":"Repair sleep apnea appliance","description":"Repair sleep apnea appliance","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5930","name":"Max guid prothes w/o flange","description":"Max guid prothes w/o flange","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42225","name":"Reconstruct cleft palate","description":"Palatoplasty for cleft palate; attachment pharyngeal flap","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1261.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76885","name":"Us exam infant hips dynamic","description":"Ultrasound, infant hips, real time with imaging documentation; dynamic (requiring physician or other qualified health care professional manipulation)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0447","name":"Behavior counsel obesity 15m","description":"Face-to-face behavioral counseling for obesity, 15 minutes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":38.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1736","name":"Inj meloxicam (delova) 1mg","description":"Injection, meloxicam (delova), 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2542","name":"Dental onlay metallic 2 surf","description":"Onlay-metallic-two surfaces","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47741","name":"Fuse gallbladder & bowel","description":"Cholecystoenterostomy; roux-en-y with gastroenterostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1490.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92933","name":"Prq trlml c athrc st angiop1","description":"Percutaneous transluminal coronary atherectomy, with intracoronary stent, with coronary angioplasty when performed, single major coronary artery and/or its branch(es)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":815.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24685","name":"Optx ulnar fx prox end w/fix","description":"Open treatment of ulnar fracture, proximal end (eg, olecranon or coronoid process[es]), includes internal fixation, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":815.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2394","name":"Post >=4srfc resinbase cmpst","description":"Resin-based composite - four or more surfaces posterior","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0557","name":"Adv prim care mgmt lvl 2","description":"Advanced primary care management services for a patient with multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, which place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline, provided by c","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0235","name":"Inj, monoclon antibody, 1 mg","description":"Injection, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extraco","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92972","name":"Perq trluml coronry lithotrp","description":"Percutaneous transluminal coronary lithotripsy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0981T","name":"Tcat impl wrls ivc snr","description":"Transcatheter implantation of wireless inferior vena cava sensor for long-term hemodynamic monitoring, including deployment of the sensor, radiological supervision and interpretation, right heart catheterization, and inferior vena cava venography, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1426","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4288","name":"Dermabind ch, per sq cm","description":"Dermabind ch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1466","name":"Pt disc/lam proc same day","description":"Patient had a lumbar fusion on the same date as the discectomy/laminectomy procedure","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37255","name":"Revsc evasc ivt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97803","name":"Med nutrition indiv subseq","description":"Medical nutrition therapy; re-assessment and intervention, individual, face-to-face with the patient, each 15 minutes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":21.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82274","name":"Assay test for blood fecal","description":"Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93268","name":"Ecg record/review","description":"External patient and, when performed, auto activated electrocardiographic rhythm derived event recording with symptom-related memory loop with remote download capability up to 30 days, 24-hour attended monitoring; includes transmission, review and interpretation by a physician or other qualified hea","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0880T","name":"Augmnt alys ch ct ild i&r","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0396","name":"3d print of 3d surface scan","description":"3d print of 3d surface scan","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4338","name":"Artacent velos, per sq cm","description":"Artacent velos, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37205","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":553.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0996T","name":"Ins&sclr fix caps bag prosth","description":"Insertion and scleral fixation of a capsular bag prosthesis containing an intraocular lens prosthesis, with vitrectomy, including removal of crystalline lens or dislocated intraocular lens prosthesis, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0525U","name":"Onc sphrd cell cul 11-rx pnl","description":"Onc sphrd cell cul 11-rx pnl","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0392U","name":"Rx metab genrx ia 16 genes","description":"Rx metab genrx ia 16 genes","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0586U","name":"Onc mrna gen xprsn 216 genes","description":"Onc mrna gen xprsn 216 genes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0735T","name":"Prep tum cav iort prim crnot","description":"Preparation of tumor cavity, with placement of a radiation therapy applicator for intraoperative radiation therapy (iort) concurrent with primary craniotomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"Non-adju cgm supply allow","description":"Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1413","name":"Pos pdl1 bef init ici tx","description":"Patients who had a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0464U","name":"Onc clrct scr qrtsa dna mrk","description":"Onc clrct scr qrtsa dna mrk","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33362","name":"Replace aortic valve open","description":"Transcatheter aortic valve replacement (tavr/tavi) with prosthetic valve; open femoral artery approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1785.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0982T","name":"Rem mntr impl ivc snr set-up","description":"Remote monitoring of implantable inferior vena cava sensor, physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate), initial set-up and patient education on use of equipment","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85385","name":"Fibrinogen antigen","description":"Fibrinogen; antigen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99445","name":"Rem mntr physiol param 2-15","description":"Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate); device(s) supply with daily recording(s) or programmed alert(s) transmission, 2-15 days in a 30-day period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0557U","name":"Nfct ds bv dna mrk vag fluid","description":"Nfct ds bv dna mrk vag fluid","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37780","name":"Revision of leg vein","description":"Ligation and division of short saphenous vein at saphenopopliteal junction (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61592","name":"Orbitocranial approach/skull","description":"Orbitocranial zygomatic approach to middle cranial fossa (cavernous sinus and carotid artery, clivus, basilar artery or petrous apex) including osteotomy of zygoma, craniotomy, extra- or intradural elevation of temporal lobe","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3491.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49622","name":"Rpr parastomal hrna ncr/strn","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33889","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1033.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4372","name":"Amchoplast excl per sq cm","description":"Amchoplast excel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1736","name":"Inj meloxicam (delova) 1mg","description":"Injection, meloxicam (delova), 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0816T","name":"Opn insj/rplcmt ins ptn subq","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0558U","name":"Onc clrct elisa bf7 ag serum","description":"Onc clrct elisa bf7 ag serum","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0554U","name":"Repr med pga 24chrm te bx qc","description":"Repr med pga 24chrm te bx qc","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1190","name":"Doc khe not pef w/efgr/uacr","description":"Documentation of a kidney health evaluation was not performed or defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23040","name":"Arthrt gh jt expl/drg/rmv fb","description":"Arthrotomy, glenohumeral joint, including exploration, drainage, or removal of foreign body","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":851.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69719","name":"Rplcm oi implt sk tc esp<100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76362","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":730.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15017","name":"App skn cll ssp f/n/g/hf 1st","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 480 sq cm or less","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1303","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0527","name":"Mgt est pt dmentia low cmplx","description":"Management of established patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5129","name":"Inj, vegzelma, 10 mg","description":"Injection, bevacizumab-adcd (vegzelma), biosimilar, 10 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0990T","name":"Trncrv inst biod hydrgl mtrl","description":"Transcervical instillation of biodegradable hydrogel materials, intrauterine","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4309","name":"Via matrix, per sq cm","description":"Via matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0708T","name":"Id ca immntx prep & 1st njx","description":"Intradermal cancer immunotherapy; preparation and initial injection","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1371","name":"Mst rec gsa<7","description":"Most recent glycemic status assessment (hba1c or gmi) level < 7.0%","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0995T","name":"Evasc dlvr a-wal stbl rx opn","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; open","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34808","name":"Endovas iliac a device addon","description":"Endovascular placement of iliac artery occlusion device (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":267.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4026","name":"Phys/occ therapy ss","description":"Physical therapy/occupational therapy mips specialty set","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4342","name":"Theramend, per sq cm","description":"Theramend, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7174","name":"Injection fitusiran 0.04 mg","description":"Injection, fitusiran, 0.04 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0686T","name":"Histotripsy mal hepatcel tis","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant hepatocellular tissue, including image guidance","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0950T","name":"Abltj b9 prst8 tissue hifu","description":"Ablation of benign prostate tissue, transrectal, with high intensity-focused ultrasound (hifu), including ultrasound guidance","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0605","name":"Antibody test pub hlth path","description":"Antibody test pub hlth path","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82382","name":"Assay urine catecholamines","description":"Catecholamines; total urine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37266","name":"Rvsc evsc fpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9361","name":"Inj, efbemalenograstim alfa-","description":"Injection, efbemalenograstim alfa-vuxw, 0.5 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0452U","name":"Onc bldr mthyl penk lte-qmsp","description":"Onc bldr mthyl penk lte-qmsp","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2006","name":"Novosorb synpath per sq cm","description":"Novosorb synpath dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1302","name":"Inj, sutimlimab-jome, 10 mg","description":"Injection, sutimlimab-jome, 10 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1351","name":"Pt cmplt suicd saf pln 120dy","description":"Patients who had a suicide safety plan initiated, reviewed, or updated and reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1448","name":"Pt dx pd bef end meas pd","description":"Patients with an active diagnosis of personality disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0589U","name":"Pfas24cmpnd hi-perf lc-ms/ms","description":"Pfas24cmpnd hi-perf lc-ms/ms","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0722T","name":"Quan ct tiss charac w/ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained with concurrent ct examination of any structure contained in the concurrently acquired diagnostic imaging dataset (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0569U","name":"Onc sol tum ngs tmm>20000dmr","description":"Onc sol tum ngs tmm>20000dmr","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53866","name":"Cathj rmvl dev ischmc rmdlg","description":"Catheterization with removal of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15018","name":"App skn cll ssp f/n/g/hf ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 480 sq cm or part thereof (list separately in addition to code for prima","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4282","name":"Cygnus dual per sq cm","description":"Cygnus dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0418U","name":"Onc brst aug alg aly whl sl8","description":"Onc brst aug alg aly whl sl8","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33268","name":"Excl laa opn oth px any meth","description":"Exclusion of left atrial appendage, open, performed at the time of other sternotomy or thoracotomy procedure(s), any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4403","name":"Xwrap dual plus per sq cm","description":"Xwrap dual plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0766T","name":"Tc mag stimj pn 1st nerve","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; first nerve","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0931T","name":"Ephys eval ccm-d ld separate","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), separate from initial implantation or replacement with testing of cardiac cont","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2401","name":"Chloroprocaine hcl injection","description":"Injection, chloroprocaine hydrochloride, per 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0554","name":"Add 20 m of monthly tx","description":"Each additional 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing data generated from the","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84431","name":"Thromboxane urine","description":"Thromboxane metabolite(s), including thromboxane if performed, urine","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4351","name":"Enclose tl matrix, per sq cm","description":"Enclose tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80503","name":"Path clin consltj sf 5-20","description":"Pathology clinical consultation; for a clinical problem, with limited review of patients history and medical records and straightforward medical decision making when using time for code selection, 5-20 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90951","name":"Esrd serv 4 visits p mo <2yr","description":"End-stage renal disease (esrd) related services monthly, for patients younger than 2 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 4 or more face-to-face visits by a physician or other qualified health care pro","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1340.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":499.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1807","name":"Inj, ethacrynate sod, 1 mg","description":"Injection, ethacrynate sodium, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87581","name":"M.pneumon dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); mycoplasma pneumoniae, amplified probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4260","name":"Signature apatch, per sq cm","description":"Signature apatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0238","name":"Inj, tocilizumab-aazg, hospi","description":"Injection, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59857","name":"Induced ab 1+vag supp hyst","description":"Induced abortion, by 1 or more vaginal suppositories (eg, prostaglandin) with or without cervical dilation (eg, laminaria), including hospital admission and visits, delivery of fetus and secundines; with hysterotomy (failed medical evacuation)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61607","name":"Resect/excise cranial lesion","description":"Resection or excision of neoplastic, vascular or infectious lesion of parasellar area, cavernous sinus, clivus or midline skull base; extradural","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3048.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1105","name":"Dexmedetomidine film, 1 mcg","description":"Dexmedetomidine, oral, 1 mcg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4420","name":"Nuform per sq cm","description":"Nuform, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5995","name":"Peri medicament w/seal, max","description":"Peri medicament w/seal, max","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64713","name":"Revision of arm nerve(s)","description":"Neuroplasty, major peripheral nerve, arm or leg, open; brachial plexus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":840.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78608","name":"Brain imaging (pet)","description":"Brain imaging, positron emission tomography (pet); metabolic evaluation","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87168","name":"Macroscopic exam arthropod","description":"Macroscopic examination; arthropod","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33900","name":"Perq p-art revsc 1 nm nt uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, unilateral","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81003","name":"Urinalysis auto w/o scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; automated, without microscopy","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0865T","name":"Quan mri alys brn w/o dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion identification, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0557U","name":"Nfct ds bv dna mrk vag fluid","description":"Nfct ds bv dna mrk vag fluid","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0707T","name":"Njx b1 sub mtrl sbchdrl dfct","description":"Injection(s), bone-substitute material (eg, calcium phosphate) into subchondral bone defect (ie, bone marrow lesion, bone bruise, stress injury, microtrabecular fracture), including imaging guidance and arthroscopic assistance for joint visualization","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33813","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1560.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6214","name":"Pontic titanium","description":"Pontic - titanium","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0012","name":"Injection of hiv prep drug","description":"Injection of pre-exposure prophylaxis (prep) drug for hiv prevention, under skin or into muscle","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","name":"Scoliosis orth sag/ cor","description":"Scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla to trochanter, includes all accessory pads, straps and interface, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual ","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"Ak 4 bar link hydl swg/stanc","description":"Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9276","name":"Inj zanidatamab-hrii, 2 mg","description":"Injection, zanidatamab-hrii, 2 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16020","name":"Dress/debrid p-thick burn s","description":"Dressings and/or debridement of partial-thickness burns, initial or subsequent; small (less than 5% total body surface area)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":100.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4033","name":"Skilled nursing facility ss","description":"Skilled nursing facility mips specialty set","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38794","name":"Access thoracic lymph duct","description":"Cannulation, thoracic duct","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":364.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0045","name":"Mrs 90 days post stk","description":"Clinical follow-up and mrs score assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82234","name":"Beta-amyloid 1-42 (abeta 42)","description":"Beta-amyloid; 1-42 (abeta 42)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6073","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (predominantly base metal)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0183","name":"Software meas of cardiac vol","description":"Quantitative software measurements of cardiac volume, cardiac chambers volumes and left ventricular wall mass derived from ct scan(s) data of the chest/heart (with or without contrast)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43269","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":517.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9506","name":"Tc-99m graphite crucible","description":"Graphite crucible for preparation of technetium tc 99m-labeled carbon aerosol, one crucible","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49215","name":"Excise sacral spine tumor","description":"Excision of presacral or sacrococcygeal tumor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2304.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99204","name":"Office o/p new mod 45 min","description":"Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 45 minutes must be met or excee","date_of_service":"2026-06-05","other_properties":[{"name":"BillingTaxonomy","value":["207V00000X","207VB0002X","207VE0102X","207VF0040X","207VG0400X","207VM0101X","207VX0000X","207VX0201X","363LX0001X"]},{"name":"RenderingTaxonomy","value":["207V00000X","207VB0002X","207VE0102X","207VF0040X","207VG0400X","207VM0101X","207VX0000X","207VX0201X","363LX0001X"]},{"name":"ClaimSpecialtyCode","value":["904","905","907","AMGY","APNOB","COLP","FPEM","GYNE","GYON","GYSU","MAFE","NPAG","NPGY","NPOB","OBEM","OBGY","OBHR","OBST","REND","URGY"]},{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TH"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TH"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9071","name":"Inj cyclophosphamd auromedic","description":"Injection, cyclophosphamide (auromedics), 5 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5138","name":"Inj, wezlana, iv, 1 mg","description":"Injection, ustekinumab-auub (wezlana), biosimilar, intravenous, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2050","name":"Financial mgt waiver/diem","description":"Financial management, self-directed, waiver; per diem","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9993","name":"Pall serv during meas","description":"Patient was provided palliative care services any time during the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49187","name":"Opn exc/dstr ntra-abd 5.1-10","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5.1 to 10 cm","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86318","name":"Ia infectious agent antibody","description":"Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip);","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0876T","name":"Duplex scan hemo fstl lmtd","description":"Duplex scan of hemodialysis fistula, computer-aided, limited (volume flow, diameter, and depth, including only body of fistula)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98012","name":"Synch audio-only est sf 10","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0540","name":"Train for caregiver add 15","description":"Caregiver training in behavior management/modification for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face; each additional 15 minutes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95919","name":"Quan puplmtry phy/qhp uni/bi","description":"Quantitative pupillometry with physician or other qualified health care professional interpretation and report, unilateral or bilateral","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5130","name":"Inj, fylnetra, 0.5 mg","description":"Injection, pegfilgrastim-pbbk (fylnetra), biosimilar, 0.5 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0349","name":"Inj, rezafungin, 1 mg","description":"Injection, rezafungin, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90695","name":"H5n8 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n8, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0674T","name":"Laps insj nw/rpcmt prm isdss","description":"Laparoscopic insertion of new or replacement of permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including an implantable pulse generator and diaphragmatic lead(s)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0946T","name":"Ortho impl mvmt alys pair ct","description":"Orthopedic implant movement analysis using paired computed tomography (ct) examination of the target structure, including data acquisition, data preparation and transmission, interpretation and report (including ct scan of the joint or extremity performed with paired views)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25530","name":"Cltx ulnar shft fx w/o mnpj","description":"Closed treatment of ulnar shaft fracture; without manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9245","name":"Admin mod sedation-enteral","description":"Admin mod sedation-enteral","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1341","name":"Pt no f/u 30-180 dys","description":"Patients who did not have a follow-up assessment or did not have an assessment within 30 to 180 days after the index assessment during the performance period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0285U","name":"Onc rsps radj cll fr dna tox","description":"Onc rsps radj cll fr dna tox","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93792","name":"Pt/caregiver traing home inr","description":"Patient/caregiver training for initiation of home international normalized ratio (inr) monitoring under the direction of a physician or other qualified health care professional, face-to-face, including use and care of the inr monitor, obtaining blood sample, instructions for reporting home inr test ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4468","name":"Exsuff belt incl all sup acc","description":"Exsufflation belt, includes all supplies and accessories","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3389","name":"Topi adm prad zami per treat","description":"Topical administration, prademagene zamikeracel, per treatment","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87627","name":"Jt spc pthgn&rx rsist gen26+","description":"Infectious agent detection by nucleic acid (dna or rna); joint space pathogens and drug resistance genes, multiplex amplified probe technique, 26 or more targets","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":679.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7521","name":"Incision/drain abscess extra","description":"Incision and drainage of abscess - extraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1433","name":"Oral chemo wthn 30 days enc","description":"Patient on oral chemotherapy on or within 30 days before denominator eligible encounter","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1298","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4211","name":"Gingivectomy/plasty per toot","description":"Gingivectomy or gingivoplasty - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0590U","name":"Nfct ds bct&fngl dna 44 orgs","description":"Nfct ds bct&fngl dna 44 orgs","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81464","name":"So gsap cll fr mcrstl ins","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants, microsatellite instability, tumor mutation burden, and rearrangements","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0629U","name":"Nfct ds tb dna aly 1trgt pcr","description":"Nfct ds tb dna aly 1trgt pcr","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1315","name":"Crc no doc no rsn","description":"Colorectal cancer screening results were not documented and reviewed; reason not otherwise specified","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9697","name":"Inj, magtrace per study dose","description":"Injection, carboxydextran-coated superparamagnetic iron oxide, per study dose","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1205","name":"Isa reduced >=3","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0323U","name":"Iadna cns pthgn next gen seq","description":"Iadna cns pthgn next gen seq","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98978","name":"Rtm dev sply cbt 16-30 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of cognitive behavioral therapy, 16-30 days in a 30-day period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0048","name":"Pall serv during meas","description":"Patients who receive palliative care services any time during the intake period through the end of the measurement year","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44650","name":"Repair bowel fistula","description":"Closure of enteroenteric or enterocolic fistula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1523.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98001","name":"Synch audio-video new low 30","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4347","name":"Rampart dl matrix per sq cm","description":"Rampart dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11312","name":"Shave skin lesion 1.1-2.0 cm","description":"Shaving of epidermal or dermal lesion, single lesion, face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 1.1 to 2.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7961","name":"Buccal/labial frenectomy","description":"Buccal/labial frenectomy","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1304","name":"No pneum vax admin 19+","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9347","name":"Inj, tremelimumab-actl, 1 mg","description":"Injection, tremelimumab-actl, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0614","name":"Inj, treosulfan, 50 mg","description":"Injection, treosulfan, 50 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4294","name":"Amnio quad-core, per sq cm","description":"Amnio quad-core, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0376U","name":"Onc prst8 ca img alys 128","description":"Onc prst8 ca img alys 128","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4004","name":"Endocrinology ss","description":"Endocrinology mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5157","name":"Inj, denosumab-bmwo, 1 mg","description":"Injection, denosumab-bmwo (stoboclo/osenvelt), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27540","name":"Treat knee fracture","description":"Open treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, includes internal fixation, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1131.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3393","name":"Inj, betibeglogene autotemce","description":"Injection, betibeglogene autotemcel, per treatment","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99465","name":"Nb resuscitation","description":"Delivery/birthing room resuscitation, provision of positive pressure ventilation and/or chest compressions in the presence of acute inadequate ventilation and/or cardiac output","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33608","name":"Repair anomaly w/conduit","description":"Repair of complex cardiac anomaly other than pulmonary atresia with ventricular septal defect by construction or replacement of conduit from right or left ventricle to pulmonary artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2240.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83884","name":"Assay neurflmnt light chain","description":"Neurofilament light chain (nfl)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4275","name":"Esano aca, per sq cm","description":"Esano aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0757T","name":"Dgtz gls mcrscp sl spc grpii","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group ii, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistochemistry (list separately in addition to code for primary","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35549","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1654.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0927T","name":"Interrog dev eval ccm-d ip","description":"Interrogation device evaluation (in person) with analysis, review, and report, including connection, recording, and disconnection, per patient encounter, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4021","name":"Orthopedic surgery ss","description":"Orthopedic surgery mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01940","name":"Anes nulyt agt lmbr/sac","description":"Anesthesia for percutaneous image-guided destruction procedures by neurolytic agent on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37260","name":"Revsc evasc ivt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9959","name":"Unspec sleep ap proc","description":"Unspec sleep ap proc","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26075","name":"Explore/treat finger joint","description":"Arthrotomy, with exploration, drainage, or removal of loose or foreign body; metacarpophalangeal joint, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15016","name":"App skn cl ssp agrf t/a/l ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; each additional 480 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1025","name":"Pt mnth 1 mcp prov","description":"Patient-months where there are more than one medicare capitated payment (mcp) provider listed for the month","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0545U","name":"Achr antb id imfluor livecll","description":"Achr antb id imfluor livecll","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35875","name":"Removal of clot in graft","description":"Thrombectomy of arterial or venous graft (other than hemodialysis graft or fistula);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":748.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1241","name":"Pt no resp seen as person","description":"Patient did not respond to the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25825","name":"Arthrd wrist with autograft","description":"Arthrodesis, wrist; with autograft (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2402","name":"Chloroprocaine (clorotekal)","description":"Injection, chloroprocaine hydrochloride (clorotekal), per 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0738","name":"Upper extremity rehab","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1491","name":"Recd esrd mcp dur perf pd","description":"Receiving esrd mcp dialysis services by the provider during the performance period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8701","name":"Ewh s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand with single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34970.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1284","name":"Pt 66+ snp or ltc pos > 90d","description":"Patients age 66 or older in institutional special needs plans (snp) or residing in long term care with pos code 32, 33, 34, 54, or 56 for more than 90 consecutive days during the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84022","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63056","name":"Decompress spinal cord lmbr","description":"Transpedicular approach with decompression of spinal cord, equina and/or nerve root(s) (eg, herniated intervertebral disc), single segment; lumbar (including transfacet, or lateral extraforaminal approach) (eg, far lateral herniated intervertebral disc)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1728.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0582","name":"Bivalirudin (endo) 1 mg","description":"Injection, bivalirudin (endo), not therapeutically equivalent to j0583, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9129","name":"Photobio therpy-sub 15 mins","description":"Photobio therpy-sub 15 mins","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58294","name":"Vag hyst w/enterocele compl","description":"Vaginal hysterectomy, for uterus greater than 250 g; with repair of enterocele","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3431","name":"Biological materials","description":"Biological materials","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44615","name":"Intestinal stricturoplasty","description":"Intestinal stricturoplasty (enterotomy and enterorrhaphy) with or without dilation, for intestinal obstruction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1095.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28050","name":"Biopsy of foot joint lining","description":"Arthrotomy with biopsy; intertarsal or tarsometatarsal joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0797T","name":"Tcat ins 2chmbr ldls pm rv","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ventricular pace","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8612","name":"Oral methotrexate (xatmep)","description":"Methotrexate (xatmep), oral, 2.5 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67420","name":"Explore/treat eye socket","description":"Orbitotomy with bone flap or window, lateral approach (eg, kroenlein); with removal of lesion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1721.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87478","name":"Borrelia miyamotoi amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); borrelia miyamotoi, amplified probe technique","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9342","name":"Inj thiotepa nos 1 mg","description":"Injection, thiotepa, not otherwise specified, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1460","name":"Dx copd, cf, or arf","description":"Diagnosis for chronic obstructive pulmonary disease, emphysema, cystic fibrosis, or acute respiratory failure","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4386","name":"Acesso trifaca per sq cm","description":"Acesso trifaca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76989","name":"Dx intraop epcar us chd i&r","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; interpretation and report only","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4385","name":"Apollo ft per sq cm","description":"Apollo ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9056","name":"Inj, vivimusta, 1 mg","description":"Injection, bendamustine hydrochloride (vivimusta), 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0272U","name":"Hem genetic bld do 51 genes","description":"Hematology (genetic bleeding disorders), genomic sequence analysis of 51 genes, blood, buccal swab, or amniotic fluid, comprehensive","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6611","name":"Onlay cst hgh nbl mtl >=3srf","description":"Onlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92637","name":"Hearing aid pst-fitg f-up ea","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4436","name":"Renati ac membrane per sq cm","description":"Renati ac membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0568","name":"Int psych care mng, 1 cal mo","description":"Initial psychiatric collaborative care management, in the first calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required elements: outrea","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28576","name":"Treat foot dislocation","description":"Percutaneous skeletal fixation of talotarsal joint dislocation, with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":413.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4266","name":"Neostim per sq cm","description":"Neostim membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15015","name":"App skn cl ssp agrft t/a/l 1","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; first 480 sq cm or less","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4353","name":"Xceed tl matrix per sq cm","description":"Xceed tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58580","name":"Transcrv abltj utrn fibrd rf","description":"Transcervical ablation of uterine fibroid(s), including intraoperative ultrasound guidance and monitoring, radiofrequency","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2014","name":"Omeza collag compl 100 mg","description":"Omeza collagen matrix or omeza complete matrix, per 100 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2991","name":"App of hydroxyapatite","description":"App of hydroxyapatite","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0458U","name":"Onc brst ca s100 a8&a9 elisa","description":"Onc brst ca s100 a8&a9 elisa","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0818T","name":"Revj/rmvl ins ptn subq","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5912","name":"Facial moulage complete","description":"Facial moulage (complete)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6598","name":"G comp bandage med stretch","description":"Gradient compression bandage roll, elastic medium stretch, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":0.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9172","name":"Docetaxel (docivyx), 1 mg","description":"Injection, docetaxel (docivyx), 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1202","name":"Miglustat oral 65 mg","description":"Miglustat, oral, 65 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1710","name":"Moderna vacc admin 3rd dose","description":"Moderna vacc admin 3rd dose","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78608","name":"Brain imaging (pet)","description":"Brain imaging, positron emission tomography (pet); metabolic evaluation","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1697.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50930","name":"Closure ureter/bowel fistula","description":"Closure of ureterovisceral fistula (including visceral repair)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1219.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38746","name":"Remove thoracic lymph nodes","description":"Thoracic lymphadenectomy by thoracotomy, mediastinal and regional lymphadenectomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4262","name":"Dual layer impax, per sq cm","description":"Dual layer impax membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29550","name":"Strapping of toes","description":"Strapping; toes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":10.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70150","name":"X-ray exam of facial bones","description":"Radiologic examination, facial bones; complete, minimum of 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2561","name":"Inj, sezaby, 1 mg","description":"Injection, phenobarbital sodium (sezaby), 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4540","name":"Trans elec nerv periph nerv","description":"Distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98000","name":"Synch audio-video new sf 15","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 15 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0464U","name":"Onc clrct scr qrtsa dna mrk","description":"Onc clrct scr qrtsa dna mrk","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64583","name":"Rev/rplct hpglsl nstm ary pg","description":"Revision or replacement of hypoglossal nerve neurostimulator array and distal respiratory sensor electrode or electrode array, including connection to existing pulse generator","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4337","name":"Artecent trident, per sq cm","description":"Artacent trident, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2526","name":"Cntct lens blue violet","description":"Contact lens, hydrophilic, with blue-violet filter, per lens","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37256","name":"Revsc evasc ivt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4431","name":"Pma skin substitute, nos","description":"Pma skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0217","name":"Inj velmanase alfa-tycv 1 mg","description":"Injection, velmanase alfa-tycv, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86359","name":"T cells total count","description":"T cells; total count","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3921","name":"Decor or submerg erupt tooth","description":"Decor or submerg erupt tooth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4348","name":"Sentry sl matrix per sq cm","description":"Sentry sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6073","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (predominantly base metal)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87177","name":"Ova and parasites smears","description":"Ova and parasites, direct smears, concentration and identification","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2989","name":"Excavate tooth non-restorabl","description":"Excavate tooth non-restorabl","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0732T","name":"Immntx admn electroporatn im","description":"Immunotherapy administration with electroporation, intramuscular","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1259","name":"Pt stat doc <= 1 yr dialysis","description":"Patient status documented within the first year of initiating dialysis","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92083","name":"Extended visual field xm","description":"Visual field examination, unilateral or bilateral, with interpretation and report; extended examination (eg, goldmann visual fields with at least 3 isopters plotted and static determination within the central 30 deg, or quantitative, automated threshold perimetry, octopus program g-1, 32 or 42, hump","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0826T","name":"Prgrmg evl ldls pm 1chmbr ip","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional, leadless pacemaker system in si","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87075","name":"Cultr bacteria except blood","description":"Culture, bacterial; any source, except blood, anaerobic with isolation and presumptive identification of isolates","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0045","name":"Mrs 90 days post stk","description":"Clinical follow-up and mrs score assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1349","name":"No pam inc 3 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 3 points within a 4 to 12 month period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0347U","name":"Rx metab/pcx dna 16 gen alys","description":"Rx metab/pcx dna 16 gen alys","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55500","name":"Removal of hydrocele","description":"Excision of hydrocele of spermatic cord, unilateral (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0155","name":"Dronabinol (syndros) 0.1 mg","description":"Dronabinol (syndros), 0.1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0967T","name":"Tranal ins tmp clrc anst dev","description":"Transanal insertion of endoluminal temporary colorectal anastomosis protection device, including vacuum anchoring component and flexible sheath connected to external vacuum source and monitoring system","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24164","name":"Removal prosth radial head","description":"Removal of prosthesis, includes debridement and synovectomy when performed; radial head","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4421","name":"Biolab wrap solo per sq cm","description":"Biolab membrane wrap solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62263","name":"Epidural lysis mult sessions","description":"Percutaneous lysis of epidural adhesions using solution injection (eg, hypertonic saline, enzyme) or mechanical means (eg, catheter) including radiologic localization (includes contrast when administered), multiple adhesiolysis sessions; 2 or more days","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":427.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97537","name":"Community/work reintegration","description":"Community/work reintegration training (eg, shopping, transportation, money management, avocational activities and/or work environment/modification analysis, work task analysis, use of assistive technology device/adaptive equipment), direct one-on-one contact, each 15 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0342U","name":"Onc pncrtc ca mult ia eclia","description":"Onc pncrtc ca mult ia eclia","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0533U","name":"Rx metab advrs gnotyp 16gens","description":"Rx metab advrs gnotyp 16gens","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69605","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1847.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1202","name":"Pt rsn no ace-i/arb rx","description":"Documentation of patient reason(s) for not prescribing ace inhibitor or arb therapy during the measurement period, (e.g., patient declined, other patient reasons)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0752T","name":"Dgtz gls mcrscp sld lvl iii","description":"Digitization of glass microscope slides for level iii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75577","name":"Quan&char c athrosclrtc plaq","description":"Quantification and characterization of coronary atherosclerotic plaque to assess severity of coronary disease, derived from augmentative software analysis of the data set from a coronary computed tomographic angiography, with interpretation and report by a physician or other qualified health care pr","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27557","name":"Treat knee dislocation","description":"Open treatment of knee dislocation, includes internal fixation, when performed; with primary ligamentous repair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1497.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1397","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0807T","name":"Pulm tiss vntj alys prev ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with previously acquired computed tomography (ct) images, including data preparation and transmission, quantification of pulmonary tissue ventilation, data re","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37286","name":"Revsc evasc tpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0736T","name":"Colonic lavage 35+l water","description":"Colonic lavage, 35 or more liters of water, gravity-fed, with induced defecation, including insertion of rectal catheter","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0963T","name":"Anosc sbmcsl njx bulking agt","description":"Anoscopy with directed submucosal injection of bulking agent into anal canal","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31243","name":"Nsl/sinus ndsc cryoabltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by cryoablation, posterior nasal nerve","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2525","name":"Cl, hydrophilic, dual focus","description":"Contact lens, hydrophilic, dual focus, per lens","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"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":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0569U","name":"Onc sol tum ngs tmm>20000dmr","description":"Onc sol tum ngs tmm>20000dmr","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4400","name":"Polygon3 per sq cm","description":"Polygon3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96548","name":"Ntraop hipec px ea add 30min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6603","name":"G com bandge low dn foamchnl","description":"Gradient compression bandaging supply, low density channel foam sheet, per 250 square centimeters, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"14300","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":990.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5161","name":"Inj, denosumab-kyqq, 1 mg","description":"Injection, denosumab-kyqq (aukelso/bosaya), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38222","name":"Dx bone marrow bx & aspir","description":"Diagnostic bone marrow; biopsy(ies) and aspiration(s)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":69.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0522U","name":"Ca vi psp&sp1 antb cl semiql","description":"Ca vi psp&sp1 antb cl semiql","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0691T","name":"Auto alys xst ct std vrt fx","description":"Automated analysis of an existing computed tomography study for vertebral fracture(s), including assessment of bone density when performed, data preparation, interpretation, and report","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37243","name":"Vasc embolize/occlude organ","description":"Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; for tumors, organ ischemia, or infarction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10838.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0369","name":"Max mri capture & interprete","description":"Max mri capture & interprete","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7413","name":"Excision malig lesion<=1.25c","description":"Excision of malignant lesion up to 1.25 cm","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76014","name":"Mr sfty implt&/fb asmt stf 1","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2019","name":"Kerecis marigen shld sq cm","description":"Kerecis omega3 marigen shield, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5932","name":"Postsurgical obturator","description":"Obturator prosthesis definitive","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37263","name":"Revsc evasc fpvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0614U","name":"Iem pmd alys 4 nzm cplx page","description":"Iem pmd alys 4 nzm cplx page","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1423","name":"Opt care urologic cnd mvp","description":"Optimal care for patients with urologic conditions mips value pathway","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1939","name":"Inj, bumetanide, 0.5 mg","description":"Injection, bumetanide, 0.5 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4324","name":"Amniotx, per sq cm","description":"Amniotx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49020","name":"Drainage abdom abscess open","description":"Drainage of peritoneal abscess or localized peritonitis, exclusive of appendiceal abscess, open","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1590.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1453","name":"Preop vis acu > 20/40","description":"Patients with a pre-operative visual acuity better than 20/40","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4311","name":"Acesso, per sq cm","description":"Acesso, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0598U","name":"Gi ibs igg antb 18food items","description":"Gi ibs igg antb 18food items","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0312U","name":"Ai ds sle alys 8 igg autoant","description":"Ai ds sle alys 8 igg autoant","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97552","name":"Group caregiver training","description":"Group caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0987T","name":"Iv img icr cere vsl oct ea","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15760","name":"Composite skin graft","description":"Graft; composite (eg, full thickness of external ear or nasal ala), including primary closure, donor area","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":756.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11981","name":"Insertion drug dlvr implant","description":"Insertion, drug-delivery implant (ie, bioresorbable, biodegradable, non-biodegradable)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":58.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1414","name":"Med rsn no pdl1 bef 1st ther","description":"Documentation of medical reason(s) for not performing the pd-l1 biomarker expression test prior to initiation of first-line immune checkpoint inhibitor therapy (e.g., patient is in an urgent or emergent situation where delay of treatment would jeopardize the patients health status; other medical rea","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0484U","name":"Nfct ds mgen 23s rrna pt mut","description":"Nfct ds mgen 23s rrna pt mut","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0855T","name":"Dgtz gls mcrscp b1 marow smr","description":"Digitization of glass microscope slides for bone marrow, smear interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95953","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":529.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92265","name":"Ndl oculoelectromyography 1+","description":"Needle oculoelectromyography, 1 or more extraocular muscles, 1 or both eyes, with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":11755.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1282","name":"Pt scrn tbco id as non user","description":"Patient screened for tobacco use and identified as a tobacco non-user","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0314U","name":"Onc cutan mlnma mrna 35 gene","description":"Onc cutan mlnma mrna 35 gene","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1301","name":"Immunization counseling","description":"Immunization counseling","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6197","name":"Replace material prosthesis","description":"Replace material prosthesis","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0609","name":"Ferric citrate orl 3 mg iron","description":"Ferric citrate, oral, 3 mg ferric iron, (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98010","name":"Synch audio-only new mod 45","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection,","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0547U","name":"Neurflmnt lt chn cleia plsm","description":"Neurflmnt lt chn cleia plsm","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88329","name":"Path consltj drg surg","description":"Pathology consultation during surgery;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64467","name":"Thrc fascial pln blk uni nfs","description":"Thoracic fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0431","name":"Diag tst detect mucos abnorm","description":"Adjunctive pre-diagnostic test that aids in detection of mucosal abnormalities including premalignant and malignant lesions not to include cytology or biopsy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1033","name":"Sv doula brth wrk per diem","description":"Services performed by a doula birth worker, per diem","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93597","name":"R&l hrt cath chd abnl nt cnj","description":"Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); abnormal native connections","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0520U","name":"Ther rx mntr 200+ rx/sbsts","description":"Ther rx mntr 200+ rx/sbsts","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6039","name":"Passive custom digit/thumb","description":"Passive prosthetic digit or thumb prosthesis not including hand restoration partial hand, full or partial, custom made, any material, initial or replacement, per single passive prosthetic digit or thumb","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99241","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1203","name":"No rsn ace-i/arb rx","description":"Ace inhibitor or arb therapy not prescribed during the measurement period, reason not given","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6515","name":"Grad com wrap w str fu le cu","description":"Gradient compression wrap with adjustable straps, full leg, each, custom","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4393","name":"Surgraft ac per sq cm","description":"Surgraft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0569U","name":"Onc sol tum ngs tmm>20000dmr","description":"Onc sol tum ngs tmm>20000dmr","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9994","name":"Pall serv during meas","description":"Patient is using palliative care services any time during the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J9110","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64891","name":"Nrv grf 1strnd hnd/foot >4cm","description":"Nerve graft (includes obtaining graft), single strand, hand or foot; more than 4 cm length","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1120.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1462","name":"Pt clin ind hd image","description":"Patients with clinical indications for imaging of the head","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0706T","name":"Rem tx amblyopia i&r phy/qhp","description":"Remote treatment of amblyopia using an eye tracking device; interpretation and report by physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2792","name":"Crown full cast noble metal","description":"Crown-full cast noble metal","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4280","name":"Xcell amnio matrix per sq cm","description":"Xcell amnio matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33903","name":"Perq p-art revsc 1 abnor bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, bilateral","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87811","name":"Sars-cov-2 covid19 w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19])","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47384","name":"Abltj ire liver 1+ tum perq","description":"Ablation, irreversible electroporation, liver, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0008","name":"Admin influenza virus vac","description":"Administration of influenza virus vaccine","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0523","name":"Mgt nw pt dem mod-high cmplx","description":"Management of a new patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1185","name":"Imm ckpt inhib not hld no rx","description":"Documentation of immune checkpoint inhibitor therapy not held and/or corticosteroids or immunosuppressants prescribed or administered was not performed, reason not given","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0043","name":"Pt mech pros ht valv","description":"Patients with mechanical prosthetic heart valve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92629","name":"Eval hearing aid cand ea add","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27307","name":"Incision of thigh tendons","description":"Tenotomy, percutaneous, adductor or hamstring; multiple tendons","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45388","name":"Colonoscopy w/ablation","description":"Colonoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":268.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":3129.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1709","name":"Pfizer vaccine admin booster","description":"Pfizer vaccine admin booster","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0660","name":"Team remote e/m new pt 10 mn","description":"Team remote e/m new pt 10mins","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76077","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0424U","name":"Onc prst8 xom alys 53 sncrna","description":"Onc prst8 xom alys 53 sncrna","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0734T","name":"Rem r-t mtn nrehab tx mgmt","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; treatment management services by a physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4322","name":"Splint intra-coronal","description":"Splint intra-coronal","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4353","name":"Xceed tl matrix per sq cm","description":"Xceed tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1275","name":"Pts hosp exl","description":"Patients determined to be in hospice were excluded from month of evaluation and the remainder of reporting period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0257U","name":"Vlcad leuk nzm actv whl bld","description":"Very long chain acyl- coenzyme a (coa) dehydrogenase (vlcad), leukocyte enzyme activity, whole blood","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92641","name":"Hearing dev verif eacous aly","description":"Hearing device verification, electroacoustic analysis","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0563U","name":"Nfct ds pthgn-sna 11vir&4bct","description":"Nfct ds pthgn-sna 11vir&4bct","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1398","name":"Bslne and  fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93555","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":373.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9612","name":"Thera par drugs 2 or > admin","description":"Therapeutic parenteral drugs two or more administrations different medications","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4261","name":"Tag, per square centimeter","description":"Tag, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0866T","name":"Quan mri alys brn w/dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion detection, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transmissio","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0543U","name":"Onc sol tum ngs dna 517 gens","description":"Onc sol tum ngs dna 517 gens","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1708","name":"Pfizer vacc admin 3rd dose","description":"Pfizer vacc admin 3rd dose","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83014","name":"H pylori drug admin","description":"Helicobacter pylori; drug administration","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64583","name":"Rev/rplct hpglsl nstm ary pg","description":"Revision or replacement of hypoglossal nerve neurostimulator array and distal respiratory sensor electrode or electrode array, including connection to existing pulse generator","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1250","name":"Pt resp true heard","description":"Patient responded as completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1204","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1495","name":"Fall w/ poc, no fall","description":"Patients that reported a fall occurred who had a plan of care for falls documented or patients that did not report a fall","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6517","name":"Grad com wrap w strap bn cus","description":"Gradient compression wrap with adjustable straps, below knee, each, custom","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9264","name":"Paclitaxel protein bound","description":"Injection, paclitaxel protein-bound particles, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0823T","name":"Tcat ins 1chmbr ldls pm ra","description":"Transcatheter insertion of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or programming), when","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8612","name":"Oral methotrexate (xatmep)","description":"Methotrexate (xatmep), oral, 2.5 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53866","name":"Cathj rmvl dev ischmc rmdlg","description":"Catheterization with removal of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99285","name":"Emergency dept visit hi mdm","description":"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1460","name":"Dx copd, cf, or arf","description":"Diagnosis for chronic obstructive pulmonary disease, emphysema, cystic fibrosis, or acute respiratory failure","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1364","name":"Erythro lactobionate /500 mg","description":"Injection, erythromycin lactobionate, per 500 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32150","name":"Removal of lung lesion(s)","description":"Thoracotomy; with removal of intrapleural foreign body or fibrin deposit","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1064.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37255","name":"Revsc evasc ivt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86366","name":"Muscle-specific kinase antb","description":"Muscle-specific kinase (musk) antibody","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0481U","name":"Idh1 idh2&tert promoter ngs","description":"Idh1 idh2&tert promoter ngs","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91124","name":"Rct snsatn tone&cmplianc std","description":"Rectal sensation, tone, and compliance study (eg, barostat)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0183","name":"Software meas of cardiac vol","description":"Quantitative software measurements of cardiac volume, cardiac chambers volumes and left ventricular wall mass derived from ct scan(s) data of the chest/heart (with or without contrast)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3391","name":"Inj, atidarsagene autotemcel","description":"Injection, atidarsagene autotemcel, per treatment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85547","name":"Rbc mechanical fragility","description":"Mechanical fragility, rbc","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21740","name":"Reconstruction of sternum","description":"Reconstructive repair of pectus excavatum or carinatum; open","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1229.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57020","name":"Colpocentesis sep px","description":"Colpocentesis (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69421","name":"Incision of eardrum","description":"Myringotomy including aspiration and/or eustachian tube inflation requiring general anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1199","name":"Pt recg rrt","description":"Patients receiving rrt","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0024","name":"Pin srv add 30 min pr m","description":"Principal illness navigation services, additional 30 minutes per calendar month (list separately in addition to g0023)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0843T","name":"Dgtz gls mcrscp cslt cyt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), initial site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1277","name":"Colorectal ca screen doc rev","description":"Colorectal cancer screening results documented and reviewed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37289","name":"Revsc evsc tpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0830T","name":"Dgtz gls mcrscp cytp slctv","description":"Digitization of glass microscope slides for cytopathology, selective-cellular enhancement technique with interpretation (eg, liquid-based slide preparation method), except cervical or vaginal (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86825","name":"Hla x-math non-cytotoxic","description":"Human leukocyte antigen (hla) crossmatch, non-cytotoxic (eg, using flow cytometry); first serum sample or dilution","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9886","name":"In-person attendance g code","description":"Behavioral counseling for diabetes prevention, in-person, group, 60 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0760T","name":"Dgtz gls mcrscp sl imm 1st","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2644","name":"Dental onlay porc 4/more sur","description":"Onlay - porcelain/ceramic - four or more surfaces","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64659","name":"Rmvl bat modulj sys pg only","description":"Removal of baroreflex activation therapy (bat) modulation system; pulse generator only","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0893T","name":"N-invas assmt bld oxygnation","description":"Noninvasive assessment of blood oxygenation, gas exchange efficiency, and cardiorespiratory status, with physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":313.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3244","name":"Inj. tigecycline (accord)","description":"Injection, tigecycline (accord), not therapeutically equivalent to j3243, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4225","name":"Amnio or derma tl, per sq cm","description":"Amniobind or dermabind tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0529U","name":"Hem vte snp f2&f5 gen leiden","description":"Hem vte snp f2&f5 gen leiden","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0841T","name":"Dgtz gls mcrscp pth cslt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; first tissue block, with frozen section(s), single specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1643","name":"Inj heparin, pfizer, 1000u","description":"Injection, heparin sodium (pfizer), not therapeutically equivalent to j1644, per 1000 units","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1271","name":"Pts dem any time/dur mo","description":"Patients with dementia at any time prior to or during the month","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15757","name":"Free skin flap microvasc","description":"Free skin flap with microvascular anastomosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2713.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55714","name":"Bx prst8 in-bore ct/mri 1","description":"Biopsy, prostate, in-bore ct- or mri-guided targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0692T","name":"Therapeutic ultrafiltration","description":"Therapeutic ultrafiltration","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0909T","name":"Rplcmt int nstim sys vgs nrv","description":"Replacement of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1311","name":"Aphlx to vax bef enc","description":"Anaphylaxis due to the vaccine on or before the date of the encounter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37289","name":"Revsc evsc tpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27871","name":"Fusion of tibiofibular joint","description":"Arthrodesis, tibiofibular joint, proximal or distal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":837.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64598","name":"Revj/rmvl nea pn w/int nstim","description":"Revision or removal of neurostimulator electrode array, peripheral nerve, with integrated neurostimulator","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82270","name":"Occult blood feces","description":"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (ie, patient was provided 3 cards or single triple card for consecutive collection)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9220","name":"Indigotindisulfonate sod 1mg","description":"Injection, indigotindisulfonate sodium, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1405","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8006","name":"Grip glove replacement only","description":"Powered, cable driven grip assist glove, hand, finger, includes pressure sensors, glove replacement only","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0486U","name":"Onc pan sol tum ngs cfctdna","description":"Onc pan sol tum ngs cfctdna","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4264","name":"Cocoon membrane, per sq cm","description":"Cocoon membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98006","name":"Synch audio-video est mod 30","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0954T","name":"Tot impl amei rplc snd proc","description":"Totally implantable active middle ear hearing implant; replacement of sound processor only, with attachment to existing transducers","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37276","name":"Rvsc evsc fpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69726","name":"Rmv ntr oi implt skl prq esp","description":"Removal, entire osseointegrated implant, skull; with percutaneous attachment to external speech processor","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2031","name":"Mirodry, per sq cm","description":"Mirodry wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1350","name":"Pt w/ suic saf pln init rev","description":"Patients who had a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1326","name":"Pts dx hypotony","description":"Patients with a diagnosis of hypotony","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64658","name":"Rmvl bat modul sys lead only","description":"Removal of baroreflex activation therapy (bat) modulation system; lead only","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0138","name":"Inj acetaminoph 10mg/ibu 3mg","description":"Injection, acetaminophen 10 mg and ibuprofen 3 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49188","name":"Opn exc/dst ntra-abd 10.1-20","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 10.1 to 20 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":1065.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0684","name":"App non-sheet skin sb g addl","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area or part thereof, or each additional 1% o","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0548U","name":"Gfap cleia plasma","description":"Gfap cleia plasma","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0392U","name":"Rx metab genrx ia 16 genes","description":"Rx metab genrx ia 16 genes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1749","name":"Inj, iloprost, 0.1 mcg","description":"Injection, iloprost, 0.1 mcg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27134","name":"Revise hip joint replacement","description":"Revision of total hip arthroplasty; both components, with or without autograft or allograft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2327.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15015","name":"App skn cl ssp agrft t/a/l 1","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; first 480 sq cm or less","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1393","name":"Pr no dx rec mlnm","description":"Patients who were not diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1016T","name":"Elec alys npgs esoph intraop","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0879","name":"Difelikefalin, esrd on dialy","description":"Injection, difelikefalin, 0.1 microgram, (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75580","name":"N-invas est c ffr sw aly cta","description":"Noninvasive estimate of coronary fractional flow reserve (ffr) derived from augmentative software analysis of the data set from a coronary computed tomography angiography, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0462U","name":"Melatonin lvl tst slp std7/9","description":"Melatonin lvl tst slp std7/9","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1153","name":"Pt w/ dx osteo doe","description":"Patient with diagnosis of osteoporosis on date of encounter","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0262U","name":"Onc sld tum rt-pcr 7 gen","description":"Oncology (solid tumor), gene expression profiling by real-time rt-pcr of 7 gene pathways (er, ar, pi3k, mapk, hh, tgfb, notch), formalin-fixed paraffin-embedded (ffpe), algorithm reported as gene pathway activity score","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7671","name":"Alveolus open reduction","description":"Alveolus - open reduction may include stabilization of teeth","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43341","name":"Fuse esophagus & intestine","description":"Esophagojejunostomy (without total gastrectomy); thoracic approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1511.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76945","name":"Echo guide villus sampling","description":"Ultrasonic guidance for chorionic villus sampling, imaging supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3911","name":"Intraorifice barrier","description":"Intraorifice barrier","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33518","name":"Cabg artery-vein two","description":"Coronary artery bypass, using venous graft(s) and arterial graft(s); 2 venous grafts (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99304","name":"1st nf care sf/low mdm 25","description":"Initial nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward or low level of medical decision making. when using total time on the date of the encounter for code selection, 25 minutes mus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":92.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":80.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99222","name":"1st hosp ip/obs moderate 55","description":"Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 55 minutes ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4287","name":"Dermabind dl, per sq cm","description":"Dermabind dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5657","name":"Add low ext man aut vol any","description":"Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12021","name":"Tx supfc wnd dehsn w/packing","description":"Treatment of superficial wound dehiscence; with packing","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":214.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1325","name":"Doc med rsn not seen","description":"Patients who were not seen for reasons documented by clinician for patient or medical reasons (e.g., inadequate time for follow-up, patients who received a prior intravitreal or periocular steroid injection within the last six (6) months and had a subsequent iop evaluation with iop <25mm hg within s","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2526","name":"Cntct lens blue violet","description":"Contact lens, hydrophilic, with blue-violet filter, per lens","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0478U","name":"Onc nsclc dna&rna dpcr 9 gen","description":"Onc nsclc dna&rna dpcr 9 gen","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28230","name":"Incision of foot tendon(s)","description":"Tenotomy, open, tendon flexor; foot, single or multiple tendon(s) (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92634","name":"Hearing aid fitg svc 1st 60","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; first 60 minutes","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92642","name":"Hearing asstv dev fitg svc","description":"Hearing assistive device, supplemental technology fitting services (eg, personal frequency modulation [fm]/digital modulation [dm] system, remote microphone, alerting devices)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8541","name":"Oral, hemady, 0.25 mg","description":"Dexamethasone (hemady), oral, 0.25 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28490","name":"Treat big toe fracture","description":"Closed treatment of fracture great toe, phalanx or phalanges; without manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0890T","name":"Arhfcmrigtbs 1st tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including target assessment, initial motor threshold determination, neuronavigation, delivery and management, initial treatment day","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1187","name":"Pt w/ esrd","description":"Patients with a diagnosis of end stage renal disease (esrd)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72142","name":"Mri neck spine w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; with contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":806.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9953","name":"Reline sleep apnea appliance","description":"Reline sleep apnea appliance","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1303","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15011","name":"Hrv skn cll ssp agrft 1st 25","description":"Harvest of skin for skin cell suspension autograft; first 25 sq cm or less","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1307","name":"Inj, crovalimab-akkz, 10 mg","description":"Injection, crovalimab-akkz, 10 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":2.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4297","name":"Emerge matrix, per sq cm","description":"Emerge matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4335","name":"Amnioplast 2, per sq cm","description":"Amnioplast 2, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59850","name":"Induced abortion 1+ njx","description":"Induced abortion, by 1 or more intra-amniotic injections (amniocentesis-injections), including hospital admission and visits, delivery of fetus and secundines;","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76018","name":"Mr safety implant elec prepj","description":"Mr safety implant electronics preparation under supervision of physician or other qualified health care professional, including mr-specific programming of pulse generator and/or transmitter to verify device integrity, protection of device internal circuitry from mr electromagnetic fields, and protec","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4415","name":"Alexiguard st-l per sq cm","description":"Alexiguard sl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92945","name":"Prq trl rvs ch occ ant&rtrgr","description":"Percutaneous transluminal revascularization of chronic total occlusion, single coronary artery, coronary artery branch, or coronary artery bypass graft, and/or subtended major coronary artery branches of the bypass graft, any combination of intracoronary stent, atherectomy and angioplasty; combined ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1184","name":"Doc med rsn no cst/ist rx","description":"Documentation of medical reason(s) for not prescribing or administering corticosteroid or immunosuppressant treatment (e.g., allergy, intolerance, infectious etiology, pancreatic insufficiency, hyperthyroidism, prior bowel surgical interventions, celiac disease, receiving other medication, awaiting ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0907T","name":"Coms ther ea addl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; each additional application, total wound(s) surface area less than or equal to 50 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1453","name":"Preop vis acu > 20/40","description":"Patients with a pre-operative visual acuity better than 20/40","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1234","name":"Pt hcv rctv aby f/u neg","description":"Patient has a reactive hcv antibody test, and has a follow up hcv viral test that does not detect hcv viremia","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9432","name":"Med food non inborn err meta","description":"Medical foods for non-inborn errors of metabolism","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80061","name":"Lipid panel","description":"Lipid panel this panel must include the following: cholesterol, serum, total (82465) lipoprotein, direct measurement, high density cholesterol (hdl cholesterol) (83718) triglycerides (84478)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0706T","name":"Rem tx amblyopia i&r phy/qhp","description":"Remote treatment of amblyopia using an eye tracking device; interpretation and report by physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34707","name":"Evasc rpr ilio-iliac ndgft","description":"Endovascular repair of iliac artery by deployment of an ilio-iliac tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, and all endograft extension(s) proximally to the aortic bifurcation ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1203.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1434","name":"Orl chemo wthn 30 d post enc","description":"Patient on oral chemotherapy on or within 30 days after denominator eligible encounter","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33208","name":"Insrt heart pm atrial & vent","description":"Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); atrial and ventricular","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0608U","name":"Reprdtve med ema rtpcr 10bct","description":"Reprdtve med ema rtpcr 10bct","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93701","name":"Bioimpedance cv analysis","description":"Bioimpedance-derived physiologic cardiovascular analysis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0740T","name":"Rem auton alg nsln cal setup","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; initial set-up and patient education","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1400","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86362","name":"Mog-igg1 antb cba each","description":"Myelin oligodendrocyte glycoprotein (mog-igg1) antibody; cell-based immunofluorescence assay (cba), each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37269","name":"Revsc evasc fpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1469","name":"Hx of hep b, or pos bld test","description":"Patient has a history of hepatitis b illness or received a hepatitis b surface antigen, hepatitis b surface antibody, or total antibody to hepatitis b core antigen test with a positive result any time before or during the measurement period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48000","name":"Drainage of abdomen","description":"Placement of drains, peripancreatic, for acute pancreatitis;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1905.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7171","name":"Inj, adzynma, 10 iu","description":"Injection, adamts13, recombinant-krhn, 10 iu","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6252","name":"Bridge resin w/noble metal","description":"Pontic-resin with noble metal","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1271","name":"Pts dem any time/dur mo","description":"Patients with dementia at any time prior to or during the month","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1276","name":"Calc bmi out nrm param nof/u","description":"Bmi documented outside normal parameters, no follow-up plan documented, no reason given","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31243","name":"Nsl/sinus ndsc cryoabltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by cryoablation, posterior nasal nerve","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0804T","name":"Prgrmg evl ldls pm 2chmbr ip","description":"Programming device evaluation (in person) with iterative adjustment of implantable device to test the function of device and to select optimal permanent programmed values, with analysis, review, and report, by a physician or other qualified health care professional, leadless pacemaker system in dual","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27458","name":"Osteot femur imed lngth dev","description":"Osteotomy(ies), femur, unilateral, with insertion of an externally controlled intramedullary lengthening device, including iliotibial band release when performed, imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","name":"Gait mod systm rhym auditory","description":"Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1310","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83013","name":"H pylori (c-13) breath","description":"Helicobacter pylori; breath test analysis for urease activity, non-radioactive isotope (eg, c-13)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0182","name":"Hospice care supervision","description":"Physician supervision of a patient under a medicare-approved hospice (patient not present) requiring complex and multidisciplinary care modalities involving regular physician development and/or revision of care plans, review of subsequent reports of patient status, review of laboratory and other stu","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0539","name":"Initial care training 30 m","description":"Caregiver training in behavior management/modification for caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face; initial 30 minutes","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0570U","name":"Neurol tbi alys gfap&uch-l1","description":"Neurol tbi alys gfap&uch-l1","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0577U","name":"Onc ovr serum alys 39 gps","description":"Onc ovr serum alys 39 gps","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33281","name":"Reposg phrnc nrv stim trnsvn","description":"Repositioning of phrenic nerve stimulator transvenous lead(s)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1484","name":"No rpt hcv rna perf med rsn","description":"Patients who did not have a repeat hcv rna labs performed for medical reasons documented by clinician (e.g., patient with limited life expectancy, delay in treatment of hcv related to treatment of hiv, hbv, hepatocellular carcinoma, decompensated cirrhosis)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24345","name":"Repr elbw med ligmnt w/tissu","description":"Repair medial collateral ligament, elbow, with local tissue","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":825.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1005T","name":"Elec alys s-scl eeg prgr 1st","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, first 15 minutes face-to-face time with physician or other qualified hea","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0140","name":"Nav srv peer sup 60 min pr m","description":"Principal illness navigation - peer support by certified or trained auxiliary personnel under the direction of a physician or other practitioner, including a certified peer specialist; 60 minutes per calendar month, in the following activities:  person-centered interview, performed to better underst","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4424","name":"Revive ft per sq cm","description":"Revive ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50728","name":"Revise ureter","description":"Revision of urinary-cutaneous anastomosis (any type urostomy); with repair of fascial defect and hernia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":816.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0134","name":"Inj acetaminophen -fresenius","description":"Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20974","name":"Estim aid bone healg n-invas","description":"Electrical stimulation to aid bone healing; noninvasive (nonoperative)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0608U","name":"Reprdtve med ema rtpcr 10bct","description":"Reprdtve med ema rtpcr 10bct","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6614","name":"Onlay cst nbl mtl 2 surfaces","description":"Onlay - cast noble metal two surfaces","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0473U","name":"Onc sld tum bld/slv 648 gene","description":"Onc sld tum bld/slv 648 gene","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0475U","name":"Hered prst8 ca gsap 23 genes","description":"Hered prst8 ca gsap 23 genes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0524U","name":"Ob pe sflt-1/plgf ia srm/pls","description":"Ob pe sflt-1/plgf ia srm/pls","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1465","name":"F/u > 180 days after rx","description":"Patient follow up more than 180 days after treatment","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2016","name":"Permeaderm b, per sq cm","description":"Permeaderm b, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4000","name":"Dermatology ss","description":"Dermatology mips specialty set","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3244","name":"Inj. tigecycline (accord)","description":"Injection, tigecycline (accord), not therapeutically equivalent to j3243, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86231","name":"Ema each ig class","description":"Endomysial antibody (ema), each immunoglobulin (ig) class","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65222","name":"Remove foreign body from eye","description":"Removal of foreign body, external eye; corneal, with slit lamp","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95851","name":"Range of motion measurements","description":"Range of motion measurements and report (separate procedure); each extremity (excluding hand) or each trunk section (spine)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23222","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1980.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0567","name":"Screening hep c detect","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis c, screening, amplified probe technique","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0711T","name":"N-nvs artl plaq alys dat prp","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data preparation and transmission","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0534U","name":"Onc prst8 mirna snp 32 vrnt","description":"Onc prst8 mirna snp 32 vrnt","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11755.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4314","name":"Reeva, per sq cm","description":"Reeva ft, per square cenitmeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1498","name":"Diagnostic radiology mvp","description":"Diagnostic radiology mips value pathway","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5159","name":"Inj, denosumab-dssb, 1 mg","description":"Injection, denosumab-dssb (ospomyv/xbryk), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2998","name":"Inj plasminogen tvmh 1mg","description":"Injection, plasminogen, human-tvmh, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1230","name":"Pt hcv rctv aby no f/u tst","description":"Patient has a reactive hcv antibody test and does not have a follow up hcv viral test, or patient has a reactive hcv antibody test and has a follow up hcv viral test that detects hcv viremia and is not referred to a clinician who treats hcv infection within 1 month and does not have hcv treatment in","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9272","name":"Inj, dostarlimab-gxly, 10 mg","description":"Injection, dostarlimab-gxly, 10 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0911","name":"Inst tauro 1.35mg/hep 100u","description":"Instillation, taurolidine 1.35 mg and heparin sodium 100 units (central venous catheter lock for adult patients receiving chronic hemodialysis)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1174","name":"Pt w/ 2 hzv 10/2017 - mp","description":"Patient received at least two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43889","name":"Gstr rstcv px trnsorl esg","description":"Gastric restrictive procedure, transoral, endoscopic sleeve gastroplasty (esg), including argon plasma coagulation, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2394","name":"Post >=4srfc resinbase cmpst","description":"Resin-based composite - four or more surfaces posterior","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0280U","name":"Hem vw factor&clgn iv bndg","description":"Hematology (von willebrand disease [vwd]), von willebrand factor (vwf) and collagen iv binding by enzyme-linked immunosorbent assays (elisa), plasma, report of collagen iv binding","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1168","name":"Pt recd flu vax 7/1-6/30","description":"Patient received an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9026","name":"Inj, tarlatamab-dlle, 1 mg","description":"Injection, tarlatamab-dlle, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1276","name":"Calc bmi out nrm param nof/u","description":"Bmi documented outside normal parameters, no follow-up plan documented, no reason given","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4253","name":"Zenith amniotic membrane psc","description":"Zenith amniotic membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1228","name":"Pt + hcv aby +vir w/ rx 3 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, has hcv treatment initiated within 3 months of the reactive hcv antibody test","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99464","name":"Attendance at delivery","description":"Attendance at delivery (when requested by the delivering physician or other qualified health care professional) and initial stabilization of newborn","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54300","name":"Revision of penis","description":"Plastic operation of penis for straightening of chordee (eg, hypospadias), with or without mobilization of urethra","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":735.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4026","name":"Phys/occ therapy ss","description":"Physical therapy/occupational therapy mips specialty set","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6192","name":"Semi precision attachment","description":"Semi precision attachment","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84305","name":"Assay of somatomedin","description":"Somatomedin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4318","name":"Fem urinary cup w/wo attch","description":"Female external urinary collection cup, with or without ring attachment, per day","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":8.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9912","name":"Pre-visit patient screening","description":"Pre-visit patient screening","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27458","name":"Osteot femur imed lngth dev","description":"Osteotomy(ies), femur, unilateral, with insertion of an externally controlled intramedullary lengthening device, including iliotibial band release when performed, imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0382U","name":"Hyprphenylalninmia mntr quan","description":"Hyprphenylalninmia mntr quan","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87143","name":"Culture typing glc/hplc","description":"Culture, typing; gas liquid chromatography (glc) or high pressure liquid chromatography (hplc) method","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1172","name":"Doc med rsn no td/tdap","description":"Documentation of medical reason(s) for not administering td or tdap vaccine (e.g., prior anaphylaxis due to the td or tdap vaccine or history of encephalopathy within seven days after a previous dose of a td-containing vaccine)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6560","name":"G stckng full/chap30-40 cust","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, custom, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0742T","name":"Aqmbf spect xers/strs & rest","description":"Absolute quantitation of myocardial blood flow (aqmbf), single-photon emission computed tomography (spect), with exercise or pharmacologic stress, and at rest, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61682","name":"Intracranial vessel surgery","description":"Surgery of intracranial arteriovenous malformation; supratentorial, complex","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5063.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55712","name":"Bx prst8 tprnl mri-us 1st","description":"Biopsy, prostate, transperineal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1203","name":"Inj, cipaglucosidase, 5 mg","description":"Injection, cipaglucosidase alfa-atga, 5 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93896","name":"Vsrctv std tcd icr art compl","description":"Vasoreactivity study performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27535","name":"Treat knee fracture","description":"Open treatment of tibial fracture, proximal (plateau); unicondylar, includes internal fixation, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1079.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91304","name":"Sarscov2 vac 5mcg/0.5ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, 5 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0884T","name":"Esphgsc flx 1st tndsc dilat","description":"Esophagoscopy, flexible, transoral, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for esophageal stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6180","name":"Implnt maint proced","description":"Implnt maint proced","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9996","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4286","name":"Remove non-resorb barrier","description":"Remove non-resorb barrier","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4017","name":"Nutrition/dietician ss","description":"Nutrition/dietician mips specialty set","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0530U","name":"Onc pan-sol tum ctdna 77 gen","description":"Onc pan-sol tum ctdna 77 gen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1351","name":"Pt cmplt suicd saf pln 120dy","description":"Patients who had a suicide safety plan initiated, reviewed, or updated and reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0724T","name":"Qmrcp w/dx mri same anatomy","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained with diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in additio","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1203","name":"No rsn ace-i/arb rx","description":"Ace inhibitor or arb therapy not prescribed during the measurement period, reason not given","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4283","name":"Biovance tri or 3l, sq cm","description":"Biovance tri-layer or biovance 3l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4021","name":"Orthopedic surgery ss","description":"Orthopedic surgery mips specialty set","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0666","name":"Team remote e/m est pt 15 mn","description":"Team remote e/m est. pt 15mins","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64629","name":"Trml dstrj ios bvn ea addl","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; each additional vertebral body, lumbar or sacral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0698T","name":"Quan mr tiss w/mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained with diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, target ","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0429U","name":"Hpv orop swab 14 hi-risk typ","description":"Hpv orop swab 14 hi-risk typ","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78457","name":"Venous thrombosis imaging","description":"Venous thrombosis imaging, venogram; unilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7355","name":"Inj travoprost intra impl","description":"Injection, travoprost, intracameral implant, 1 microgram","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4287","name":"Dermabind dl, per sq cm","description":"Dermabind dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2544","name":"Dental onlay metl 4/more sur","description":"Onlay - metallic - four or more surfaces","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0547","name":"Phone/internet svs 11-20 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61892","name":"Rmv sk-mnt crnl nstm pg/rcvr","description":"Removal of skull-mounted cranial neurostimulator pulse generator or receiver with cranioplasty, when performed","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0457","name":"Injection, aztreonam, 100 mg","description":"Injection, aztreonam, 100 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97007","name":"Mchnl sclp cool meas fitg","description":"Mechanical scalp cooling, including individual cap supply with head measurement, fitting, and patient education","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98000","name":"Synch audio-video new sf 15","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 15 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0546","name":"Phone/internet ehr assess","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty   whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patien","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0607","name":"Lanthanum carbonate oral 5mg","description":"Lanthanum carbonate, oral, 5 mg (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0699T","name":"Njx pst chmbr eye medication","description":"Injection, posterior chamber of eye, medication","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7261","name":"Primary closure sinus perf","description":"Primary closure of a sinus perforation","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1814","name":"Inj. insulin (lyumjev)","description":"Insulin (lyumjev), per 5 units","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9297","name":"Inj pemetrexed (sandoz) 10mg","description":"Injection, pemetrexed (sandoz), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97598","name":"Dbrdmt opn wnd addl 20cm/<","description":"Debridement (eg, high pressure waterjet with/without suction, sharp selective debridement with scissors, scalpel and forceps), open wound, (eg, fibrin, devitalized epidermis and/or dermis, exudate, debris, biofilm), including topical application(s), wound assessment, use of a whirlpool, when perform","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9608","name":"Flotufolastat f18 diag 1 mci","description":"Flotufolastat f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4390","name":"Ascendion per sq cm","description":"Ascendion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0678T","name":"Laps repos lead isdss ea add","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional repositioned lead (list separately in addition to code for primary proce","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35482","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81456","name":"So/hl 51/>gsap rna alys","description":"Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic sequence analysis panel, interrogation for sequence variants and copy number variants or rearrangements, or isoform expression or mrna expression levels, if performed; rna analysis","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87154","name":"Cul typ id bld pthgn 6+ trgt","description":"Culture, typing; identification of blood pathogen and resistance typing, when performed, by nucleic acid (dna or rna) probe, multiplexed amplified probe technique including multiplex reverse transcription, when performed, per culture or isolate, 6 or more targets","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87084","name":"Culture of specimen by kit","description":"Culture, presumptive, pathogenic organisms, screening only; with colony estimation from density chart","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1275","name":"Pts hosp exl","description":"Patients determined to be in hospice were excluded from month of evaluation and the remainder of reporting period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2036","name":"Cohealyx col dml mx pr sq cm","description":"Cohealyx collagen dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4426","name":"Dermbnd tl+, tlx per sq cm","description":"Dermabind tl + or dermabind tl x,  per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0505U","name":"Nfct ds vag infctj id 32orgs","description":"Nfct ds vag infctj id 32orgs","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9278","name":"Inj, carboplatin (avyxa)","description":"Injection, carboplatin (avyxa), 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1331","name":"Pts eval ini xm 8 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 8 weeks from initial exam","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0306U","name":"Onc mrd nxt-gnrj alys 1st","description":"Onc mrd nxt-gnrj alys 1st","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92260","name":"Ophthalmodynamometry","description":"Ophthalmodynamometry","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0802T","name":"Tcat rmv&rpl2chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right at","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4388","name":"Neothelium 4l per sq cm","description":"Neothelium 4l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61586","name":"Resect nasopharynx skull","description":"Bicoronal, transzygomatic and/or lefort i osteotomy approach to anterior cranial fossa with or without internal fixation, without bone graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2382.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93153","name":"Interrog w/o prgrmg ipnss","description":"Interrogation without programming of implanted phrenic nerve stimulator system","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99472","name":"Ped critical care subsq","description":"Subsequent inpatient pediatric critical care, per day, for the evaluation and management of a critically ill infant or young child, 29 days through 24 months of age","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":390.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99392","name":"Prev visit est age 1-4","description":"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; early","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":105.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1737","name":"Inj meloxicam (azurity) 1mg","description":"Injection, meloxicam (azurity), 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27097","name":"Revision of hip tendon","description":"Release or recession, hamstring, proximal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":765.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1806","name":"Inj esmolol hcl wg crit care","description":"Injection, esmolol hydrochloride (wg critical care), not therapeutically equivalent to j1805, 10 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0371","name":"Sialoendoscopy capt & interp","description":"Sialoendoscopy capt & interp","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0517U","name":"Ther rx mntr 80+ psyactiv rx","description":"Ther rx mntr 80+ psyactiv rx","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75733","name":"Artery x-rays adrenals","description":"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":726.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1200","name":"Ace-i/arb rx","description":"Ace inhibitor (ace-i) or arb therapy prescribed during the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1813","name":"Lyumjev for insulin pump use","description":"Insulin (lyumjev) for administration through dme (i.e., insulin pump) per 50 units","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4346","name":"Shelter dm matrix per sq cm","description":"Shelter dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67031","name":"Laser surgery eye strands","description":"Severing of vitreous strands, vitreous face adhesions, sheets, membranes or opacities, laser surgery (1 or more stages)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1214","name":"Spiro results wth obs doc","description":"Spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and reviewed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93898","name":"Ven-artl shunt det mbubb njx","description":"Venous-arterial shunt detection with intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0850T","name":"Dgtz gls mcrscp ish ea mult","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55530","name":"Revise spermatic cord veins","description":"Excision of varicocele or ligation of spermatic veins for varicocele; (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69729","name":"Impl oi implt sk tc esp>=100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside of the mastoid and resulting in removal of greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76818","name":"Fetal biophys profile w/nst","description":"Fetal biophysical profile; with non-stress testing","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2544","name":"Dental onlay metl 4/more sur","description":"Onlay - metallic - four or more surfaces","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1808","name":"Inj, folic acid, 0.1 mg","description":"Injection, folic acid, 0.1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0348U","name":"Rx metab/pcx dna 25 gen alys","description":"Rx metab/pcx dna 25 gen alys","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0249","name":"Tocilizumab for covid-19","description":"Injection, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9595","name":"Piflu f-18, dia 1 millicurie","description":"Piflufolastat f-18, diagnostic, 1 millicurie","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1405","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0536U","name":"Rbcag ftl rhd pcr alys exon4","description":"Rbcag ftl rhd pcr alys exon4","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1462","name":"Pt clin ind hd image","description":"Patients with clinical indications for imaging of the head","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4278","name":"Epieffect, per sq cm","description":"Epieffect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0163","name":"Epinephrine in nacl (endo)","description":"Injection, epinephrine in sodium chloride (endo), 0.1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0828T","name":"Dgtz gls mcrscp cytp smpl fl","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; simple filter method with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81464","name":"So gsap cll fr mcrstl ins","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants, microsatellite instability, tumor mutation burden, and rearrangements","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1812","name":"Inj. insulin (fiasp)","description":"Insulin (fiasp), per 5 units","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0320U","name":"Neph rna psttrnspl perph bld","description":"Neph rna psttrnspl perph bld","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25448","name":"Arthrp ntrcrpl/crp/mtcrp ssp","description":"Arthroplasty, intercarpal or carpometacarpal joints; suspension, including transfer or transplant of tendon, with interposition, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0853T","name":"Dgtz gls mcrscp mphmtrc ea m","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22110","name":"Remove part of neck vertebra","description":"Partial excision of vertebral body, for intrinsic bony lesion, without decompression of spinal cord or nerve root(s), single vertebral segment; cervical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1133.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57250","name":"Repair rectum & vagina","description":"Posterior colporrhaphy, repair of rectocele with or without perineorrhaphy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0960T","name":"Rpl s-sclp eltr ra rcvr&tlmt","description":"Replacement of sub-scalp implanted electrode array, receiver, and telemetry unit with tunneling of electrode for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0892","name":"Argatroban dialysis (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4361","name":"Epixpress, per sq cm","description":"Epixpress, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1612","name":"Inj glucagon (gvoke) 0.01 mg","description":"Injection, glucagon (gvoke), 0.01 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0537U","name":"Onc clrct ca cfdna >2500 dmr","description":"Onc clrct ca cfdna >2500 dmr","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0939T","name":"Xtrnl ecg rec>15d<30d scan","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; scanning analysis with report","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0002","name":"Opt care kidney hlth mvp","description":"Optimal care for kidney health mips value pathways","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6252","name":"Bridge resin w/noble metal","description":"Pontic-resin with noble metal","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0500U","name":"Autoinflam ds vexas synd dna","description":"Autoinflam ds vexas synd dna","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99233","name":"Sbsq hosp ip/obs high 50","description":"Subsequent hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 50 minutes m","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0471U","name":"Onc clrc ca 35 vrn kras&nras","description":"Onc clrc ca 35 vrn kras&nras","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49595","name":"Rpr aa hrn 1st > 10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, reducible","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7173","name":"Inj. concizumab-mtci, 0.5 mg","description":"Injection, concizumab-mtci, 0.5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81459","name":"So neo gsap dna/dna&rna","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants, microsatellite instability, tumor mutation burden, and rearrangements","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90483","name":"Imm cnsl not admn sm>10<20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 10 minutes up to 20 minutes","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49596","name":"Rpr aa hrn 1st > 10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0612U","name":"Onc lvr alys >1000 mr cfdna","description":"Onc lvr alys >1000 mr cfdna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0494U","name":"Rbc ag ftl rhd gene alys ngs","description":"Rbc ag ftl rhd gene alys ngs","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8522","name":"Capecitabine, oral, 50 mg","description":"Capecitabine, oral, 50 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0217","name":"Inj velmanase alfa-tycv 1 mg","description":"Injection, velmanase alfa-tycv, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9196","name":"Inj gemcitabine hcl (accord)","description":"Injection, gemcitabine hydrochloride (accord), not therapeutically equivalent to j9201, 200 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7165","name":"Inj, human-lans, per i.u","description":"Injection, prothrombin complex concentrate, human-lans, per i.u. of factor ix activity","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0739","name":"Rehab sys active assist rt","description":"Rehabilitation system with interactive interface providing active assistance in rehabilitation therapy, includes all components and accessories, motors, microprocessors, sensors","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1782","name":"Vac admin human pap dose 2","description":"Vac admin human pap dose 2","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0468U","name":"Hep nash mir34a5p a2m ykl40","description":"Hep nash mir34a5p a2m ykl40","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80061","name":"Lipid panel","description":"Lipid panel this panel must include the following: cholesterol, serum, total (82465) lipoprotein, direct measurement, high density cholesterol (hdl cholesterol) (83718) triglycerides (84478)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4323","name":"Alloply, per sq cm","description":"Alloply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J9270","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1313","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9004","name":"Va whole health partner serv","description":"Department of veterans affairs whole health partner services","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47510","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":586.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0935T","name":"Cysto w/rnl pel symp dnrvtj","description":"Cystourethroscopy with renal pelvic sympathetic denervation, radiofrequency ablation, retrograde ureteral approach, including insertion of guide wire, selective placement of ureteral sheath(s) and multiple conformable electrodes, contrast injection(s), and fluoroscopy, bilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43244","name":"Egd varices ligation","description":"Esophagogastroduodenoscopy, flexible, transoral; with band ligation of esophageal/gastric varices","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":321.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9071","name":"Inj cyclophosphamd auromedic","description":"Injection, cyclophosphamide (auromedics), 5 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0885T","name":"Colsc flx 1st tndsc dilat","description":"Colonoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87478","name":"Borrelia miyamotoi amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); borrelia miyamotoi, amplified probe technique","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1260","name":"Pt not doc <= 1 yr dialysis","description":"Patient status not documented within the first year of initiating dialysis","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0979T","name":"Sbmcsl crylys ther sft palt","description":"Submucosal cryolysis therapy; soft palate only","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6211","name":"Bridge base metal cast","description":"Pontic-cast predominantly base metal","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27245","name":"Treat thigh fracture","description":"Treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; with intramedullary implant, with or without interlocking screws and/or cerclage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60260","name":"Repeat thyroid surgery","description":"Thyroidectomy, removal of all remaining thyroid tissue following previous removal of a portion of thyroid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1246.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4404","name":"Xwrap hydro plus per sq cm","description":"Xwrap hydro plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21050","name":"Removal of jaw joint","description":"Condylectomy, temporomandibular joint (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":980.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37259","name":"Revsc evasc ivt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87210","name":"Smear wet mount saline/ink","description":"Smear, primary source with interpretation; wet mount for infectious agents (eg, saline, india ink, koh preps)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4419","name":"Biolab wrap flw lt per sq cm","description":"Biolab membrane wrap lite flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15775","name":"Hair trnspl 1-15 punch grfts","description":"Punch graft for hair transplant; 1 to 15 punch grafts","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9029","name":"Instill adstiladrin, tx dose","description":"Intravesical instillation, nadofaragene firadenovec-vncg, per therapeutic dose","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61715","name":"Mrgfus strtctc ablt trgt icr","description":"Magnetic resonance image guided high intensity focused ultrasound (mrgfus), stereotactic ablation of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86701","name":"Hiv-1antibody","description":"Antibody; hiv-1","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5159","name":"Inj, denosumab-dssb, 1 mg","description":"Injection, denosumab-dssb (ospomyv/xbryk), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0995T","name":"Evasc dlvr a-wal stbl rx opn","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; open","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75831","name":"Vein x-ray kidney","description":"Venography, renal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1271","name":"Inj doxycycline hyclate 1 mg","description":"Injection, doxycycline hyclate, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1432","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28430","name":"Cltx talus fracture w/o mnpj","description":"Closed treatment of talus fracture; without manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99350","name":"Home/res vst est high mdm 60","description":"Home or residence visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1458","name":"Pt died bef end meas pd","description":"Patient died prior to the end of the performance period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0801","name":"Inj. acthar gel to 40 units","description":"Injection, corticotropin (acthar gel), up to 40 units","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0350U","name":"Rx metab/pcx dna 27 gen alys","description":"Rx metab/pcx dna 27 gen alys","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0979T","name":"Sbmcsl crylys ther sft palt","description":"Submucosal cryolysis therapy; soft palate only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90613","name":"Inf&sarscov2 vacc 40/0.4 im","description":"Influenza virus vaccine, quadrivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 40 mcg/0.4 ml dosage, for intramuscular use","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27500","name":"Treatment of thigh fracture","description":"Closed treatment of femoral shaft fracture, without manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82248","name":"Bilirubin direct","description":"Bilirubin; direct","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0433U","name":"Onc prst8 5 dna reg mrk pcr","description":"Onc prst8 5 dna reg mrk pcr","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9004","name":"Va whole health partner serv","description":"Department of veterans affairs whole health partner services","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4393","name":"Surgraft ac per sq cm","description":"Surgraft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1446","name":"Pt died bef end meas pd","description":"Patients who died any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92930","name":"Prq tcat plmt ntrac st 2+les","description":"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 2 or more distinct coronary lesions with 2 or more coronary stents deployed in 2 or more coronary segments, or a bifurcation lesion requiring ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7671","name":"Alveolus open reduction","description":"Alveolus - open reduction may include stabilization of teeth","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0582","name":"Bivalirudin (endo) 1 mg","description":"Injection, bivalirudin (endo), not therapeutically equivalent to j0583, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6526","name":"G com garmt full leg/ft nght","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4365","name":"Amnio bur dl mem per sq cm","description":"Amnio burgeon dual-layer membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43100","name":"Excision of esophagus lesion","description":"Excision of lesion, esophagus, with primary repair; cervical approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0139","name":"Inj, adalimumab, 1 mg","description":"Injection, adalimumab, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0373","name":"Tomo bitewing image","description":"Tomo bitewing image","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36822","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":477.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76984","name":"Dx intraop thoracic aorta us","description":"Ultrasound, intraoperative thoracic aorta (eg, epiaortic), diagnostic","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6035","name":"Prosthetic digit mechanical","description":"Single prosthetic digit, mechanical, can include metacarpophalangeal (mcp), proximal interphalangeal (pip), and/or distal interphalangeal (dip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1190","name":"Doc khe not pef w/efgr/uacr","description":"Documentation of a kidney health evaluation was not performed or defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0971T","name":"Ablt mal brst tum pq lsr uni","description":"Ablation, malignant breast tumor(s), percutaneous, laser, including imaging guidance when performed, unilateral","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0406U","name":"Onc lung flow cytmtry 5 mrk","description":"Onc lung flow cytmtry 5 mrk","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0417U","name":"Rare ds alys 335 nuc genes","description":"Rare ds alys 335 nuc genes","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0845T","name":"Dgtz gls mcrscp imfluor 1st","description":"Digitization of glass microscope slides for immunofluorescence, per specimen; initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76016","name":"Mr safety deter phys/qhp","description":"Mr safety determination by a physician or other qualified health care professional responsible for the safety of the mr procedure, including review of implant mr conditions for indicated mr examination, analysis of risk vs clinical benefit of performing mr examination, and determination of mr equipm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7939","name":"Indexing for osteotomy","description":"Indexing for osteotomy","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8700","name":"Temozolomide","description":"Temozolomide, oral, 5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1781","name":"Vac admin human pap dose 1","description":"Vac admin human pap dose 1","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7252","name":"Part extract for implant","description":"Part extract for implant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90483","name":"Imm cnsl not admn sm>10<20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 10 minutes up to 20 minutes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4425","name":"Revive tl per sq cm","description":"Revive tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0286U","name":"Cep72 nudt15&tpmt gene alys","description":"Cep72 nudt15&tpmt gene alys","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1365","name":"Hosp+pall care spec code 17","description":"Patient encounter during the performance period with hospice and palliative care specialty code 17","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0801T","name":"Tcat rmv&rpl 2chmbr ldls pm","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; dual-cha","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0912T","name":"Elec alys nstim sys vgs smpl","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; with simple programming by physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0880T","name":"Augmnt alys ch ct ild i&r","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0233","name":"Intra inf, toci, first dose","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1386","name":"Exc sx melmn or mlnm is","description":"Patients with an excisional surgery for melanoma or melanoma in situ in the past 5 years with an initial ajcc staging of 0, i, or ii at the start of the performance period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0479U","name":"Tau phosphorylated ptau217","description":"Tau phosphorylated ptau217","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4273","name":"Esano aaa, per sq cm","description":"Esano aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31239","name":"Nsl/sinus endoscopy surg dcr","description":"Nasal/sinus endoscopy, surgical; with dacryocystorhinostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":774.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0037","name":"Pt not able to participate","description":"On date of encounter, patient is not able to participate in assessment or screening, including non-verbal patients, delirious, severely aphasic, severely developmentally delayed, severe visual or hearing impairment and for those patients, no knowledgeable informant available","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37292","name":"Rvsc evsc tpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0779T","name":"Gi myoelectrical actv study","description":"Gastrointestinal myoelectrical activity study, stomach through colon, with interpretation and report","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63051","name":"C-laminoplasty w/graft/plate","description":"Laminoplasty, cervical, with decompression of the spinal cord, 2 or more vertebral segments; with reconstruction of the posterior bony elements (including the application of bridging bone graft and non-segmental fixation devices [eg, wire, suture, mini-plates], when performed)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1934.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1368","name":"Prev trt inf d/o hiv/hep mvp","description":"Prevention and treatment of infectious disorders including hepatitis c and hiv mips value pathway","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1176","name":"No 2 hzv 10/2017-meas pd","description":"Patient did not receive two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55869","name":"Lap srg prst8ct bi pl lmphad","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76984","name":"Dx intraop thoracic aorta us","description":"Ultrasound, intraoperative thoracic aorta (eg, epiaortic), diagnostic","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26235","name":"Partial removal finger bone","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis); proximal or middle phalanx of finger","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91304","name":"Sarscov2 vac 5mcg/0.5ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, 5 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38228","name":"Car-t admn autologous","description":"Chimeric antigen receptor t-cell (car-t) therapy; car-t cell administration, autologous","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7962","name":"Lingual frenectomy","description":"Lingual frenectomy","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5142","name":"Inj adalimumab-ryvk, 1 mg","description":"Injection, adalimumab-ryvk biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0547","name":"Phone/internet svs 11-20 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0533","name":"Buprenorphone inj weekly","description":"Medication assisted treatment, buprenorphine (injectable) administered on a weekly basis; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid tre","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29880","name":"Arthrs kne srg mnisectmy m&l","description":"Arthroscopy, knee, surgical; with meniscectomy (medial and lateral, including any meniscal shaving) including debridement/shaving of articular cartilage (chondroplasty), same or separate compartment(s), when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":792.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87494","name":"Chlmy trch&neisra gonor mult","description":"Infectious agent detection by nucleic acid (dna or rna); chlamydia trachomatis and neisseria gonorrhoeae, multiplex amplified probe technique","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0508","name":"Crit care telehea consult 60","description":"Telehealth consultation, critical care, initial , physicians typically spend 60 minutes communicating with the patient and providers via telehealth","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26011","name":"Drainage of finger abscess","description":"Drainage of finger abscess; complicated (eg, felon)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":615.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":217.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":88.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1291","name":"Pt 66+ frailty and med dem","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1394","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0372","name":"Tomo comp series images","description":"Tomo comp series images","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0922T","name":"Rmvl perm ccm-d sys dual ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); dual (pacing and defibrillation) transvenous leads only","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43761","name":"Reposition gastrostomy tube","description":"Repositioning of a naso- or oro-gastric feeding tube, through the duodenum for enteric nutrition","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4396","name":"Natalin per sq cm","description":"Natalin, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43410","name":"Repair esophagus wound","description":"Suture of esophageal wound or injury; cervical approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1024.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0274U","name":"Hem gen pltlt do 43 genes","description":"Hematology (genetic platelet disorders), genomic sequence analysis of 43 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6624","name":"Inlay titanium","description":"Inlay - titanium","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2026","name":"Restrata minimatrix, 5 mg","description":"Restrata minimatrix, 5 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3503","name":"Surg exp root surf molar","description":"Surg exp root surf molar","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4199","name":"Cygnus matrix, per sq cm","description":"Cygnus matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9056","name":"Inj, vivimusta, 1 mg","description":"Injection, bendamustine hydrochloride (vivimusta), 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78491","name":"Myocrd img pet 1std rst/strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); single study, at rest or stress (exercise or pharmacologic)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1326.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1414","name":"Inj, beqvez, per tx dose","description":"Injection, fidanacogene elaparvovec-dzkt, per therapeutic dose","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86364","name":"Tiss trnsgltmnase ea ig clas","description":"Tissue transglutaminase, each immunoglobulin (ig) class","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0571","name":"Intraop nerve cryoablation","description":"Intraoperative nerve(s) cryoablation for post-surgical pain relief (list separately in addition to code for primary service)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96116","name":"Nubhvl xm phys/qhp 1st hr","description":"Neurobehavioral status exam (clinical assessment of thinking, reasoning and judgment, [eg, acquired knowledge, attention, language, memory, planning and problem solving, and visual spatial abilities]), by physician or other qualified health care professional, both face-to-face time with the patient ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":104.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0997T","name":"Precuneus mag stimj tx plng","description":"Precuneus magnetic stimulation; treatment planning using magnetic resonance imaging-guided neuronavigation to determine optimal location, dose, and intensity for magnetic stimulation therapy, derived from evoked potentials from single pulses of electromagnetic energy recorded by 64-channel electroen","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2017","name":"Permeaderm glove, each","description":"Permeaderm glove, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0525","name":"Est pt-cg dyad dem mod cmplx","description":"Management of established patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37285","name":"Revsc evasc tpvt st sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0500U","name":"Autoinflam ds vexas synd dna","description":"Autoinflam ds vexas synd dna","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"Evaluation of wheezing","description":"Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1024T","name":"Perq tiss dsplmt soft tissue","description":"Percutaneous tissue displacement, any method, including imaging guidance; soft tissue (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0321U","name":"Iadna gu pthgn 20bct&fng org","description":"Iadna gu pthgn 20bct&fng org","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9959","name":"Unspec sleep ap proc","description":"Unspec sleep ap proc","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4010","name":"Infectious disease ss","description":"Infectious disease mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0539U","name":"Onc sol tumor cfctdna 152gen","description":"Onc sol tumor cfctdna 152gen","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1469","name":"Hx of hep b, or pos bld test","description":"Patient has a history of hepatitis b illness or received a hepatitis b surface antigen, hepatitis b surface antibody, or total antibody to hepatitis b core antigen test with a positive result any time before or during the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0250","name":"Md inr test revie inter mgmt","description":"Physician review, interpretation, and patient management of home inr testing for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria; testing not occurring more frequently than once a week; billing units of servic","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2025","name":"Miro3d per cubic cm","description":"Miro3d, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76810","name":"Ob us >/= 14 wks addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2998","name":"Inj plasminogen tvmh 1mg","description":"Injection, plasminogen, human-tvmh, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0130","name":"Abciximab injection","description":"Injection abciximab, 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90382","name":"Rsv monoc antb seasn .7ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose, 0.7 ml, for intramuscular use","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1301","name":"Pt recv tbco cess interv","description":"Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1025","name":"Pt mnth 1 mcp prov","description":"Patient-months where there are more than one medicare capitated payment (mcp) provider listed for the month","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1426","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7353","name":"Anacaulase-bcdb 8.8% gel 1 g","description":"Anacaulase-bcdb, 8.8% gel, 1 gram","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33268","name":"Excl laa opn oth px any meth","description":"Exclusion of left atrial appendage, open, performed at the time of other sternotomy or thoracotomy procedure(s), any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33278","name":"Rmvl phrnc nrv stim sys","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; system, including pulse generator and lead(s)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0911T","name":"Elec aly nstm sys vgs nrv wo","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; without programming by physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1329","name":"Pts act pvd 2 wks 8 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 8 weeks after initial acute pvd encounter","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0618U","name":"Psyc bd dna mthyl alys>10000","description":"Psyc bd dna mthyl alys>10000","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15778","name":"Impl absrb msh/prsth dly cls","description":"Implantation of absorbable mesh or other prosthesis for delayed closure of defect(s) (ie, external genitalia, perineum, abdominal wall) due to soft tissue infection or trauma","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":214.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"Sup/ext non-ins inf pump syr","description":"Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25446","name":"Arthrp w/prostc dst rds&crps","description":"Arthroplasty with prosthetic replacement; distal radius and partial or entire carpus (total wrist)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1401.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5877","name":"Dup of complt dent-maxill","description":"Dup of complt dent-maxill","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2403","name":"Chloroprocaine opht gel, 1mg","description":"Chloroprocaine hcl ophthalmic, 3% gel, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1553","name":"Inj yimmugo 100 mg","description":"Injection, immune globulin (yimmugo), 100 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9282","name":"Mitomycin intravesical inst","description":"Mitomycin, intravesical instillation, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1191","name":"Hspc svc any time in meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68811","name":"Probe nasolacrimal duct","description":"Probing of nasolacrimal duct, with or without irrigation; requiring general anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0004","name":"Qual care neurologic cnd mvp","description":"Quality care for patients with neurological conditions mips value pathway","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95250","name":"Cont gluc mntr phys/qhp eqp","description":"Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; physician or other qualified health care professional (office) provided equipment, sensor placement, hook-up, calibration of monitor, patient training, removal of sensor, and pr","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1345","name":"Pt bsln pam, 2nd scr 4-12 mo","description":"Patients who had a baseline pam score and a second score within 4 to 12 month of baseline pam score","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60500","name":"Explore parathyroid glands","description":"Parathyroidectomy or exploration of parathyroid(s);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1141.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99282","name":"Emergency dept visit sf mdm","description":"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward medical decision making","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0604U","name":"All&immunology crae 4bk pep","description":"All&immunology crae 4bk pep","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6603","name":"Cst hgh nble mtl inlay >=3sr","description":"Inlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86581","name":"Strptcs pneum antb serot ia","description":"Streptococcus pneumoniae antibody (igg), serotypes, multiplex immunoassay, quantitative","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64473","name":"Lwr xtr fscl pln blk uni njx","description":"Lower extremity fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":30.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1185","name":"Imm ckpt inhib not hld no rx","description":"Documentation of immune checkpoint inhibitor therapy not held and/or corticosteroids or immunosuppressants prescribed or administered was not performed, reason not given","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1363","name":"Pts no f/u 120 dys","description":"Patients who did not have a follow-up assessment within 120 days of the index assessment","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98016","name":"Brief comunicaj tech-bsd svc","description":"Brief communication technology-based service (eg, virtual check-in) by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related evaluation and management service provided within the p","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0930T","name":"Ephys eval ccm-d ld 1st impl","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), at time of initial implantation or replacement with testing of cardiac contrac","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4024","name":"Pediatrics ss","description":"Pediatrics mips specialty set","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9294","name":"Biofeed dig cog behav tx fda","description":"Prescription digital cognitive and/or behavioral therapy, biofeedback, fda cleared, per course of treatment","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0574U","name":"Mtb cfp-10 serum/plsm lc-ms","description":"Mtb cfp-10 serum/plsm lc-ms","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5156","name":"Inj, tocilizumab-anoh, 1 mg","description":"Injection, tocilizumab-anoh (avtozma), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4276","name":"Orion, per sq cm","description":"Orion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9294","name":"Inj pemetrexed, hospira 10mg","description":"Injection, pemetrexed (hospira), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2542","name":"Dental onlay metallic 2 surf","description":"Onlay-metallic-two surfaces","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0891T","name":"Arhfcmrigtbs sbsq tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent treatment day","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0989T","name":"Revj/rmvl ins ptn subq&subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52235","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; medium bladder tumor(s) (2.0 to 5.0 cm)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":337.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99407","name":"Behav chng smoking > 10 min","description":"Smoking and tobacco use cessation counseling visit; intensive, greater than 10 minutes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":23.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92628","name":"Eval hearing aid cand 1st 30","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5142","name":"Inj adalimumab-ryvk, 1 mg","description":"Injection, adalimumab-ryvk biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22838","name":"Rev rplc/rmv thrc vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracic vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9072","name":"Inj cyclophos frindovyx 5 mg","description":"Injection, cyclophosphamide (frindovyx), 5 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1297","name":"Bmi not doc medrsn ptref","description":"Bmi not documented due to medical reason or patient refusal of height or weight measurement","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0530U","name":"Onc pan-sol tum ctdna 77 gen","description":"Onc pan-sol tum ctdna 77 gen","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1933","name":"Afo rig ant tib tcf/= ots","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, off-the-shelf","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1070.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1300","name":"Flu imm no admin doc rea","description":"Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0886T","name":"Sgmdsc flx 1st tndsc dilat","description":"Sigmoidoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0685T","name":"Interrog dev eval isdss ip","description":"Interrogation device evaluation (in-person) with analysis, review and report by a physician or other qualified health care professional, including connection, recording and disconnection per patient encounter, permanent implantable synchronized diaphragmatic stimulation system for augmentation of ca","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4269","name":"Surgraft xt per sq cm","description":"Surgraft xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91124","name":"Rct snsatn tone&cmplianc std","description":"Rectal sensation, tone, and compliance study (eg, barostat)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0958T","name":"Rmv s-sclp eltr ra rcvr&tlmt","description":"Removal of sub-scalp implanted electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64467","name":"Thrc fascial pln blk uni nfs","description":"Thoracic fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0023","name":"Pin service 60m per month","description":"Principal illness navigation services by certified or trained auxiliary personnel under the direction of a physician or other practitioner, including a patient navigator; 60 minutes per calendar month, in the following activities:  person-centered assessment, performed to better understand the indiv","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27618","name":"Exc leg/ankle tum < 3 cm","description":"Excision, tumor, soft tissue of leg or ankle area, subcutaneous; less than 3 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5938","name":"Resct proth max comp remov","description":"Resct proth max comp remov","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0893","name":"Inj, decitabine (sun pharma)","description":"Injection, decitabine (sun pharma), not therapeutically equivalent to j0894, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0238","name":"Inj, tocilizumab-aazg, hospi","description":"Injection, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33267","name":"Excl laa open any method","description":"Exclusion of left atrial appendage, open, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4433","name":"361 hct/p skin subs, nos","description":"361 hct/p skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92920","name":"Prq trluml c angiop 1art&/br","description":"Percutaneous transluminal coronary angioplasty, single major coronary artery and/or its branch(es)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78608","name":"Brain imaging (pet)","description":"Brain imaging, positron emission tomography (pet); metabolic evaluation","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1387.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5949","name":"Mand implt sup fix part","description":"Mand implt sup fix part","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0766T","name":"Tc mag stimj pn 1st nerve","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; first nerve","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36590","name":"Removal tunneled cv cath","description":"Removal of tunneled central venous access device, with subcutaneous port or pump, central or peripheral insertion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q0179","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15136","name":"Drm agrft f/s/n/h/f/g/m ea","description":"Dermal autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99307","name":"Sbsq nf care sf mdm 10","description":"Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 10 minutes must be met or e","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":40.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28112","name":"Part removal of metatarsal","description":"Ostectomy, complete excision; other metatarsal head (second, third or fourth)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":393.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0767T","name":"Tc mag stimj pn ea addl nrv","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; each additional nerve (list separat","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1274","name":"Pts snf exl mo","description":"Patients who were admitted to a skilled nursing facility (snf) during the month of evaluation were excluded from that month","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6634","name":"Onlay titanium","description":"Onlay - titanium","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11400","name":"Exc tr-ext b9+marg 0.5 cm<","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 0.5 cm or less","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":87.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0375U","name":"Onc ovrn bchm asy 7 prtn alg","description":"Onc ovrn bchm asy 7 prtn alg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6560","name":"G stckng full/chap30-40 cust","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, custom, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0503U","name":"Neuro alz ds bamyl&tau prtn","description":"Neuro alz ds bamyl&tau prtn","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99232","name":"Sbsq hosp ip/obs moderate 35","description":"Subsequent hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 35 minut","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0967T","name":"Tranal ins tmp clrc anst dev","description":"Transanal insertion of endoluminal temporary colorectal anastomosis protection device, including vacuum anchoring component and flexible sheath connected to external vacuum source and monitoring system","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7021","name":"Suppl and access lung expan","description":"Supplies and accessories for lung expansion airway clearance, continuous high frequency oscillation, and nebulization device (e.g., handset, nebulizer kit, biofilter)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92639","name":"Hearing aid meas verif","description":"Hearing-aid measurement, verification with probe-microphone (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0522","name":"Mgt nw pt dementia low cmplx","description":"Management of a new patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72125","name":"Ct neck spine w/o dye","description":"Computed tomography, cervical spine; without contrast material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5948","name":"Max implt sup fix part","description":"Max implt sup fix part","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4285","name":"Nudyn dl or dl mesh pr sq cm","description":"Nudyn dl or nudyn dl mesh, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27652","name":"Repair/graft achilles tendon","description":"Repair, primary, open or percutaneous, ruptured achilles tendon; with graft (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":913.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5227","name":"Immed max part denture","description":"Immed max part denture","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0531U","name":"Nfct ds afb&inv fng 673orgs","description":"Nfct ds afb&inv fng 673orgs","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0999T","name":"Autol musc cell therapy hrvg","description":"Autologous muscle cell therapy, harvesting of muscle progenitor cells, including ultrasound guidance, when performed","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99437","name":"Chrnc care mgmt phys ea addl","description":"Chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, or funct","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16020","name":"Dress/debrid p-thick burn s","description":"Dressings and/or debridement of partial-thickness burns, initial or subsequent; small (less than 5% total body surface area)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":62.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0567","name":"Screening hep c detect","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis c, screening, amplified probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0965T","name":"I&cst prp jw xpn dl arch non","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, non-fixed hinge mechanism","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4358","name":"Xwrap dual, per sq cm","description":"Xwrap dual, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7259","name":"Nerve dissection","description":"Nerve dissection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4345","name":"Matrix hd allogrft per sq cm","description":"Matrix hd allograft dermis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2976","name":"Band stabilization per tooth","description":"Band stabilization per tooth","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4306","name":"Americ amnion ac per sq cm","description":"American amnion ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0383U","name":"Tyrosinemia typ i mntr quan","description":"Tyrosinemia typ i mntr quan","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40830","name":"Repair mouth laceration","description":"Closure of laceration, vestibule of mouth; 2.5 cm or less","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0314U","name":"Onc cutan mlnma mrna 35 gene","description":"Onc cutan mlnma mrna 35 gene","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4287","name":"Disp col sto bag breast milk","description":"Disposable collection and storage bag for breast milk, any size, any type, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0567U","name":"Rare ds whl gen seq srs&lrs","description":"Rare ds whl gen seq srs&lrs","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7111","name":"Extraction coronal remnants","description":"Extraction coronal remnants - deciduous tooth","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4337","name":"Artecent trident, per sq cm","description":"Artacent trident, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0802","name":"Inj. (ani), up to 40 units","description":"Injection, corticotropin (ani), up to 40 units","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2472","name":"Inj, pantoprazole sodium chl","description":"Injection, pantoprazole sodium in sodium chloride (baxter), 40 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38228","name":"Car-t admn autologous","description":"Chimeric antigen receptor t-cell (car-t) therapy; car-t cell administration, autologous","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0907T","name":"Coms ther ea addl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; each additional application, total wound(s) surface area less than or equal to 50 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1180","name":"Pt imm ckpt inhib therapy","description":"Patients on immune checkpoint inhibitor therapy","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0742T","name":"Aqmbf spect xers/strs & rest","description":"Absolute quantitation of myocardial blood flow (aqmbf), single-photon emission computed tomography (spect), with exercise or pharmacologic stress, and at rest, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0778T","name":"Smmg cncrnt appl imu snr","description":"Surface mechanomyography (smmg) with concurrent application of inertial measurement unit (imu) sensors for measurement of multi-joint range of motion, posture, gait, and muscle function","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25031","name":"I&d forearm&/wrist bursa","description":"Incision and drainage, forearm and/or wrist; bursa","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":586.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9394","name":"Inj, fulvestrant (fresenius)","description":"Injection, fulvestrant (fresenius kabi) not therapeutically equivalent to j9395, 25 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86037","name":"Anca titer each antibody","description":"Antineutrophil cytoplasmic antibody (anca); titer, each antibody","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":12.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53453","name":"Tprnl balo cntnc dev rmvl ea","description":"Periurethral transperineal adjustable balloon continence device; removal, each balloon","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1409","name":"Recd gmln brca1/brca2 couns","description":"Patients who received germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0570","name":"Care manage serv, pr cal mo","description":"Care management services for behavioral health conditions, directed by a physician or other qualified health care professional, per calendar month, with the following required elements: initial assessment or follow-up monitoring, including the use of applicable validated rating scales, behavioral he","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0460U","name":"Onc whl bld/bucc rtpcr 24gen","description":"Onc whl bld/bucc rtpcr 24gen","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0812T","name":"Rem mlt day uroflow dev sply","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); device supply with automated report generation, up to 10 days","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9949","name":"Repair sleep apnea appliance","description":"Repair sleep apnea appliance","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1010T","name":"Cptr oph alys monoc eye mvmt","description":"Computerized ophthalmic analysis of monocular eye movements using retinal-based eye-tracking without spatial calibration, including fixation, microsaccades, drift, and horizontal saccades, when performed, unilateral or bilateral, with interpretation and report","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0729T","name":"Dx alys vstblr implt uni sbq","description":"Diagnostic analysis of vestibular implant, unilateral; with subsequent programming","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2544","name":"Dental onlay metl 4/more sur","description":"Onlay - metallic - four or more surfaces","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7412","name":"Excision benign lesion compl","description":"Excision of benign lesion complicated","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1270","name":"Pts no kid transplt wtlst","description":"Patients not on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0329U","name":"Onc neo xome&trns seq alys","description":"Onc neo xome&trns seq alys","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2428","name":"Inj, erzofri, 1 mg","description":"Injection, paliperidone palmitate extended release (erzofri), 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76805","name":"Ob us >/= 14 wks sngl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4386","name":"Acesso trifaca per sq cm","description":"Acesso trifaca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9322","name":"Inj pemetrexed (bluepoint)","description":"Injection, pemetrexed (bluepoint), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4433","name":"361 hct/p skin subs, nos","description":"361 hct/p skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86780","name":"Treponema pallidum","description":"Antibody; treponema pallidum","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93896","name":"Vsrctv std tcd icr art compl","description":"Vasoreactivity study performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87811","name":"Sars-cov-2 covid19 w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19])","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0139","name":"Inj, adalimumab, 1 mg","description":"Injection, adalimumab, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0862T","name":"Rlcj pg wcs lv battery only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; battery component only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1416","name":"Pt rec hosp","description":"Patient received hospice services any time during the performance period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24515","name":"Optx humrl shft fx plate/scr","description":"Open treatment of humeral shaft fracture with plate/screws, with or without cerclage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1051.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1430","name":"Ret exm ou no retinopthy doc","description":"Retinal exam finding without evidence of retinopathy in both eyes with severity level documented (in measurement year or in the prior year)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11200","name":"Rmvl skin tags up to&inc 15","description":"Removal of skin tags, multiple fibrocutaneous tags, any area; up to and including 15 lesions","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":78.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55868","name":"Lap srg prst8ct lymph nod bx","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with lymph node biopsy(ies) (limited pelvic lymphadenectomy)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34708","name":"Evasc rpr ilio-iliac rpt","description":"Endovascular repair of iliac artery by deployment of an ilio-iliac tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, and all endograft extension(s) proximally to the aortic bifurcation ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1888.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4335","name":"Amnioplast 2, per sq cm","description":"Amnioplast 2, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9292","name":"Inj, pemetrexed dipotassium","description":"Injection, pemetrexed dipotassium, 10 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52000","name":"Cystourethroscopy","description":"Cystourethroscopy (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6114","name":"Implnt/abut fixed dent max","description":"Implnt/abut fixed dent max","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0526","name":"Est pt-cg dyad dem hig cmplx","description":"Management of established patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2291","name":"Inj, nafcillin (baxter) 20mg","description":"Injection, nafcillin sodium (baxter), 20 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2272","name":"Inj, morphine (fresenius)","description":"Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0419U","name":"Nrpsyc gen seq vrnt aly 13","description":"Nrpsyc gen seq vrnt aly 13","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0304U","name":"Hem rbc ads whl bld normoxic","description":"Hem rbc ads whl bld normoxic","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4391","name":"Amnioplast double per sq cm","description":"Amnioplast double, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1574","name":"Inj, ganciclovir (exela)","description":"Injection, ganciclovir sodium (exela), not therapeutically equivalent to j1570, 500 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6034","name":"Part hand finger distal amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s)/thumb, amputation at distal to metacarpal joint, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l669","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7259","name":"Nerve dissection","description":"Nerve dissection","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55711","name":"Bx prst8 trct mri-us 1st","description":"Biopsy, prostate, transrectal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99478","name":"Sbsq ic vlbw inf<1,500 gm","description":"Subsequent intensive care, per day, for the evaluation and management of the recovering very low birth weight infant (present body weight less than 1,500 grams)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15778","name":"Impl absrb msh/prsth dly cls","description":"Implantation of absorbable mesh or other prosthesis for delayed closure of defect(s) (ie, external genitalia, perineum, abdominal wall) due to soft tissue infection or trauma","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4266","name":"Neostim per sq cm","description":"Neostim membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53865","name":"Cysto insj dev ischmc rmdlg","description":"Cystourethroscopy with insertion of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99469","name":"Neonate crit care subsq","description":"Subsequent inpatient neonatal critical care, per day, for the evaluation and management of a critically ill neonate, 28 days of age or younger","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0287U","name":"Onc thyr dna&mrna 112 genes","description":"Onc thyr dna&mrna 112 genes","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1258","name":"Cvd risk assess perf","description":"Cvd risk assessment performed, have a documented calculated risk score","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9382","name":"Inj zenocutuzumab-zbco 1 mg","description":"Injection, zenocutuzumab-zbco, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4438","name":"Pretect per sq cm","description":"Pretect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86806","name":"Lymphocytotoxicity assay","description":"Lymphocytotoxicity assay, visual crossmatch; without titration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96203","name":"Mlt fam grp bhv train ea add","description":"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face with multiple sets of paren","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4308","name":"Sanopellis, per sq cm","description":"Sanopellis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0266U","name":"Unxpl cnst hrtbl do gn xprsn","description":"Unexplained constitutional or other heritable disorders or syndromes, tissue-specific gene expression by whole-transcriptome and next-generation sequencing, blood, formalin-fixed paraffin-embedded (ffpe) tissue or fresh frozen tissue, reported as presence or absence of splicing or expression changes","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33803","name":"Div aberrant vsl w/reanast","description":"Division of aberrant vessel (vascular ring); with reanastomosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1468.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0138","name":"Iv cipaglucosidase alfa-atga","description":"Intravenous infusion of cipaglucosidase alfa-atga, including provider/supplier acquisition and clinical supervision of oral administration of miglustat in preparation of receipt of cipaglucosidase alfa-atga","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1335","name":"Ertapenem injection","description":"Injection, ertapenem sodium, 500 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76830","name":"Transvaginal us non-ob","description":"Ultrasound, transvaginal","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82948","name":"Reagent strip/blood glucose","description":"Glucose; blood, reagent strip","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49596","name":"Rpr aa hrn 1st > 10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4301","name":"Activate matrix, per sq cm","description":"Activate matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0402U","name":"Nfct agt sti mult amp prb tq","description":"Nfct agt sti mult amp prb tq","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0843T","name":"Dgtz gls mcrscp cslt cyt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), initial site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0283","name":"Inj, amiodarone (nexterone)","description":"Injection, amiodarone hydrochloride (nexterone), 30 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1405","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53620","name":"Dilate urethra stricture","description":"Dilation of urethral stricture by passage of filiform and follower, male; initial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4274","name":"Esano ac, per sq cm","description":"Esano ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0540","name":"Train for caregiver add 15","description":"Caregiver training in behavior management/modification for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face; each additional 15 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4361","name":"Epixpress, per sq cm","description":"Epixpress, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0168","name":"Wound closure by adhesive","description":"Wound closure utilizing tissue adhesive(s) only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0826T","name":"Prgrmg evl ldls pm 1chmbr ip","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional, leadless pacemaker system in si","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1285","name":"Scrn mam perf rslts not doc","description":"Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed, reason not otherwise specified","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6601","name":"Porc/ceram inlay >= 3 surfac","description":"Inlay - porcelain/ceramic three or more surfaces","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1187","name":"Pt w/ esrd","description":"Patients with a diagnosis of end stage renal disease (esrd)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2561","name":"Inj, sezaby, 1 mg","description":"Injection, phenobarbital sodium (sezaby), 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0236","name":"Intrav inf, mon anti, sec do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0291U","name":"Psyc mood do mrna 144 genes","description":"Psyc mood do mrna 144 genes","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1313","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84220","name":"Assay of pyruvate kinase","description":"Pyruvate kinase","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9938","name":"Fab removable appliance","description":"Fab removable appliance","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1191","name":"Hspc svc any time in meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1186","name":"Pt w/ rx for hspc/plltv care","description":"Patients who have an order for or are receiving hospice or palliative care","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3376","name":"Inj vancomycin (hikma) 10mg","description":"Injection, vancomycin hcl (hikma), not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2057","name":"Afamitresgene autoleucel","description":"Afamitresgene autoleucel, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99445","name":"Rem mntr physiol param 2-15","description":"Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate); device(s) supply with daily recording(s) or programmed alert(s) transmission, 2-15 days in a 30-day period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1021T","name":"Active thrc irrigation spx","description":"Active thoracic irrigation (separate procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51596","name":"Remove bladder/create pouch","description":"Cystectomy, complete, with continent diversion, any open technique, using any segment of small and/or large intestine to construct neobladder","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2503.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27425","name":"Lat retinacular release open","description":"Lateral retinacular release, open","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4100","name":"Nosht skin sub fda clrd nos","description":"Non-sheet form skin substitute, fda cleared as a device, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4211","name":"Gingivectomy/plasty per toot","description":"Gingivectomy or gingivoplasty - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1216","name":"No spiro doc no res doc","description":"No spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and/or no spirometry performed with results documented during the encounter","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6607","name":"G com bandage tub protct lyr","description":"Gradient compression bandaging supply, tubular protective absorption layer, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61480","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2247.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0466U","name":"Crd cad dna gwas 564856 snp","description":"Crd cad dna gwas 564856 snp","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1244","name":"Pt othr thn true best int","description":"Patient provided a response other than completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0396","name":"Alcohol/subs interv 15-30mn","description":"Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":33.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95911","name":"Nrv cndj test 9-10 studies","description":"Nerve conduction studies; 9-10 studies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0392U","name":"Rx metab genrx ia 16 genes","description":"Rx metab genrx ia 16 genes","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22554","name":"Arthrd ant ntrbd min dsc crv","description":"Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); cervical below c2","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1631.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0958T","name":"Rmv s-sclp eltr ra rcvr&tlmt","description":"Removal of sub-scalp implanted electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83662","name":"Foam stability fetal lung","description":"Fetal lung maturity assessment; foam stability test","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85651","name":"Rbc sed rate nonautomated","description":"Sedimentation rate, erythrocyte; non-automated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1938","name":"Inj, furosemide, 1 mg","description":"Injection, furosemide, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59612","name":"Vbac delivery only","description":"Vaginal delivery only, after previous cesarean delivery (with or without episiotomy and/or forceps);","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":766.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0899T","name":"N-invas deter aqmbf aug cmr","description":"Noninvasive determination of absolute quantitation of myocardial blood flow (aqmbf), derived from augmentative algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health car","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0807T","name":"Pulm tiss vntj alys prev ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with previously acquired computed tomography (ct) images, including data preparation and transmission, quantification of pulmonary tissue ventilation, data re","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93153","name":"Interrog w/o prgrmg ipnss","description":"Interrogation without programming of implanted phrenic nerve stimulator system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":18.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1275","name":"Pts hosp exl","description":"Patients determined to be in hospice were excluded from month of evaluation and the remainder of reporting period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20553","name":"Njx 1/mlt trigger points 3/>","description":"Injection(s); single or multiple trigger point(s), 3 or more muscles","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":68.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90759","name":"Hep b vac 3ag 10mcg 3 dos im","description":"Hepatitis b vaccine (hepb), 3-antigen (s, pre-s1, pre-s2), 10 mcg dosage, 3 dose schedule, for intramuscular use","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0921T","name":"Rmvl perm ccm-d sys 1 dfb ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous defibrillation lead only","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98986","name":"Rtm dev sply cbt 2-15 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of cognitive behavioral therapy, 2-15 days in a 30-day period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0730T","name":"Trabeculotomy lsr w/oct gdn","description":"Trabeculotomy by laser, including optical coherence tomography (oct) guidance","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11721","name":"Debride nail 6 or more","description":"Debridement of nail(s) by any method(s); 6 or more","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1267","name":"Pt no act kid transplt wtlst","description":"Patients not observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0445U","name":"Abeta42 & ptau181 eclia csf","description":"Abeta42 & ptau181 eclia csf","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9601","name":"Flortaucipir inj 1 millicuri","description":"Flortaucipir f 18 injection, diagnostic, 1 millicurie","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0992T","name":"N-invas assmt car rsk w/o ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat without concurrent computed tomography (ct) scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1259","name":"Pt stat doc <= 1 yr dialysis","description":"Patient status documented within the first year of initiating dialysis","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0692T","name":"Therapeutic ultrafiltration","description":"Therapeutic ultrafiltration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6610","name":"G com stcking bk 18-30 custm","description":"Gradient compression stocking, below knee, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64467","name":"Thrc fascial pln blk uni nfs","description":"Thoracic fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7049","name":"Epap nasal valve","description":"Expiratory positive airway pressure intranasal resistance valve","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0510U","name":"Onc pncrtc ca alg alys 16gen","description":"Onc pncrtc ca alg alys 16gen","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0912T","name":"Elec alys nstim sys vgs smpl","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; with simple programming by physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0553","name":"Monthly tx for dmht 20mins","description":"First 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing information related to the use of","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2543","name":"Dental onlay metallic 3 surf","description":"Onlay - metallic - three surfaces","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94070","name":"Evaluation of wheezing","description":"Bronchospasm provocation evaluation, multiple spirometric determinations as in 94010, with administered agents (eg, antigen[s], cold air, methacholine)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4037","name":"Urology ss","description":"Urology mips specialty set","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0918T","name":"Insj perm ccm-d sys dual ld","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; dual transvenous leads (pacing and defibrillation) only","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4211","name":"Gingivectomy/plasty per toot","description":"Gingivectomy or gingivoplasty - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2006","name":"Kaf sng/dbl swg/stn mcpr cus","description":"Knee ankle foot device, any material, single or double upright, swing and stance phase microprocessor control with adjustability, includes all components (e.g., sensors, batteries, charger), any type activation, with or without ankle joint(s), custom fabricated","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40019.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0256U","name":"Tma/tmao prfl ms/ms ur alg","description":"Trimethylamine/trimethylamine n-oxide (tma/tmao) profile, tandem mass spectrometry (ms/ms), urine, with algorithmic analysis and interpretive report","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9046","name":"Inj, bortezomib, dr. reddys","description":"Injection, bortezomib (dr. reddys), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9329","name":"Inj, tislelizumab-jsgr","description":"Injection, tislelizumab-jsgr, 1mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62330","name":"Dcmprn prq rmv lig flv 1lmbr","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; one interspace, lumbar","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4034","name":"Speech language path ss","description":"Speech language pathology mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1455","name":"Rep/rev cied","description":"Replaced or revised cied","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0263U","name":"Neuro asd meas 16 c metblt","description":"Neurology (autism spectrum disorder [asd]), quantitative measurements of 16 central carbon metabolites (ie, a-ketoglutarate, alanine, lactate, phenylalanine, pyruvate, succinate, carnitine, citrate, fumarate, hypoxanthine, inosine, malate, s-sulfocysteine, taurine, urate, and xanthine), liquid chrom","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0900T","name":"N-invas est aqmbf asstv cmr","description":"Noninvasive estimate of absolute quantitation of myocardial blood flow (aqmbf), derived from assistive algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health care profes","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4479","name":"Transanal irrigation, electr","description":"Electronic transanal irrigation system, includes electronic pump, water reservoir, tubing, and accessories, without catheter, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":706.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2525","name":"Cl, hydrophilic, dual focus","description":"Contact lens, hydrophilic, dual focus, per lens","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43204","name":"Esoph scope w/sclerosis inj","description":"Esophagoscopy, flexible, transoral; with injection sclerosis of esophageal varices","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0358U","name":"Neuro alys b-amyl 1-42&1-40","description":"Neuro alys b-amyl 1-42&1-40","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9256","name":"Inj, nipocalimab-aahu, 3 mg","description":"Injection, nipocalimab-aahu, 3 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6028","name":"Part hand finger metacar amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s) /thumb, amputation at metacarpal level, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9595","name":"Piflu f-18, dia 1 millicurie","description":"Piflufolastat f-18, diagnostic, 1 millicurie","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59140","name":"Treat ectopic pregnancy","description":"Surgical treatment of ectopic pregnancy; cervical, with evacuation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3473","name":"Surg rep root res molar","description":"Surg rep root res molar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87283","name":"Rubeola ag if","description":"Infectious agent antigen detection by immunofluorescent technique; rubeola","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4396","name":"Natalin per sq cm","description":"Natalin, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q0224","name":"Inj, pemivibart, 4500 mg","description":"Injection, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, and who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppressive ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0677T","name":"Laps repos lead isdss 1st ld","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first repositioned lead","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1014T","name":"Lap rv/rmv eso sph nstm eltr","description":"Laparoscopic revision or removal, lower esophageal sphincter neurostimulator electrodes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9914","name":"Admin of dermal fill","description":"Admin of dermal fill","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2402","name":"Chloroprocaine (clorotekal)","description":"Injection, chloroprocaine hydrochloride (clorotekal), per 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0447U","name":"Ai ds sle alys 11 cytokine","description":"Ai ds sle alys 11 cytokine","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0342U","name":"Onc pncrtc ca mult ia eclia","description":"Onc pncrtc ca mult ia eclia","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2865","name":"Inj sulfameth/trim 5 mg/1 mg","description":"Injection, sulfamethoxazole 5 mg and trimethoprim 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0531","name":"Fclty-based respite, 24 hr u","description":"Facility-based respite, 24-hour unit, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1344","name":"No bsln/2nd pam score 4-12mo","description":"Patients who did not have a baseline pam score and/or a second score within 4 to 12 months of baseline pam score","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1020T","name":"Raman spectroscopy 1+skn les","description":"Raman spectroscopy of 1 or more skin lesions, with probability score for malignant risk derived by algorithmic analysis of data from each lesion","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81195","name":"Cytog genom-wid alys hem mal","description":"Cytogenomic (genome-wide) analysis, hematologic malignancy, structural variants and copy number variants, optical genome mapping (ogm)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0676T","name":"Laps insj nw/rpcmt isdss ea","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional lead (list separately in addition to code for primary ","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0695T","name":"Bdy srf mpg pm/cvdfb tm impl","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of implant or replacement","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32420","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64468","name":"Thrc fascial pln blk bi njx","description":"Thoracic fascial plane block, bilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98006","name":"Synch audio-video est mod 30","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9156","name":"Oral mucoadhesive per 1 ml","description":"Oral mucoadhesive, any type (liquid, gel, paste, etc.), per 1 ml","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31577","name":"Largsc w/rmvl foreign bdy(s)","description":"Laryngoscopy, flexible; with removal of foreign body(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19240","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1177.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4310","name":"Procenta, per 100 mg","description":"Procenta, per 100 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59412","name":"Antepartum manipulation","description":"External cephalic version, with or without tocolysis","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59610","name":"Vbac delivery","description":"Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care, after previous cesarean delivery","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2535.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1377","name":"Fu colscop 10 yr doc w/ disc","description":"Recommended follow-up interval for repeat colonoscopy of 10 years documented  in colonoscopy report and communicated with patient","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0623U","name":"Ai ms dna mthyl alys >5000","description":"Ai ms dna mthyl alys >5000","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64654","name":"1st opn implt bat modulj sys","description":"Initial open implantation of baroreflex activation therapy (bat) modulation system, including lead placement onto the carotid sinus, lead tunnelling, connection to a pulse generator placed in a distant subcutaneous pocket (ie, total system), and intraoperative interrogation and programming","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6093","name":"Recement supp part denture","description":"Recement implant/abutment supported fixed partial denture","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0713T","name":"N-nvs artl plaq alys rvw i&r","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data review, interpretation and report","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1193","name":"Rpts w/ imp/con mmr/msi","description":"Surgical pathology reports that contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0922T","name":"Rmvl perm ccm-d sys dual ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); dual (pacing and defibrillation) transvenous leads only","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59820","name":"Care of miscarriage","description":"Treatment of missed abortion, completed surgically; first trimester","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":409.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41100","name":"Biopsy of tongue","description":"Biopsy of tongue; anterior two-thirds","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4008","name":"Geriatrics ss","description":"Geriatrics mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85597","name":"Phospholipid pltlt neutraliz","description":"Phospholipid neutralization; platelet","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0040","name":"Pt phys/occ therapy","description":"Patient already receiving physical/occupational/speech/recreational therapy during the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86596","name":"Voltage-gtd ca chnl antb ea","description":"Voltage-gated calcium channel antibody, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0609U","name":"Onc prostate ia tot&free psa","description":"Onc prostate ia tot&free psa","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9939","name":"Placemnt removable appliance","description":"Placemnt removable appliance","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98002","name":"Synch audio-video new mod 45","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate medical decision making. when using total time on the date of the encounter for code selection, 45 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7997","name":"Appliance removal","description":"Appliance removal (not by dentist who placed appliance) includes removal of archbar","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0536","name":"Peer recover support svs","description":"Peer recovery support services, provided directly or by referral; including leveraging knowledge of the condition or lived experience to provide support, mentorship, or inspiration to meet oud treatment and recovery goals; conducting a person-centered interview to understand the patients life story,","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1241","name":"Pt no resp seen as person","description":"Patient did not respond to the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1002T","name":"Air displacmnt plethysmograp","description":"Air displacement plethysmography, whole-body composition assessment, with interpretation and report","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1298","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0529U","name":"Hem vte snp f2&f5 gen leiden","description":"Hem vte snp f2&f5 gen leiden","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92628","name":"Eval hearing aid cand 1st 30","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0298U","name":"Onc pan tum whl trns seq rna","description":"Onc pan tum whl trns seq rna","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0427U","name":"Monocyte dstrbj wdth whl bld","description":"Monocyte dstrbj wdth whl bld","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21630","name":"Radical resection sternum","description":"Radical resection of sternum","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1435.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87627","name":"Jt spc pthgn&rx rsist gen26+","description":"Infectious agent detection by nucleic acid (dna or rna); joint space pathogens and drug resistance genes, multiplex amplified probe technique, 26 or more targets","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0970T","name":"Ablt b9 brst tum perq lsr ea","description":"Ablation, benign breast tumor (eg, fibroadenoma), percutaneous, laser, including imaging guidance when performed, each tumor","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0714T","name":"Tpla b9 prst8 hyprplsa<50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume less than 50 ml","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91320","name":"Sarscv2 vac 30mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 30 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0927T","name":"Interrog dev eval ccm-d ip","description":"Interrogation device evaluation (in person) with analysis, review, and report, including connection, recording, and disconnection, per patient encounter, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7355","name":"Inj travoprost intra impl","description":"Injection, travoprost, intracameral implant, 1 microgram","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25280","name":"Revise wrist/forearm tendon","description":"Lengthening or shortening of flexor or extensor tendon, forearm and/or wrist, single, each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":967.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0624U","name":"Hep nash dna mthyl alys 5000","description":"Hep nash dna mthyl alys 5000","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87183","name":"Sc std carbapenem resist gen","description":"Susceptibility studies, antimicrobial agent; carbapenem resistance genes (eg, blakpc, blandm, blavim, blaoxa-48, blaimp), amplified probe technique, per isolate","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0280U","name":"Hem vw factor&clgn iv bndg","description":"Hematology (von willebrand disease [vwd]), von willebrand factor (vwf) and collagen iv binding by enzyme-linked immunosorbent assays (elisa), plasma, report of collagen iv binding","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1306","name":"Pt anphx due to pneum","description":"Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4007","name":"General surgery ss","description":"General surgery mips specialty set","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1447","name":"Pt dx bd bef end meas pd","description":"Patients with an active diagnosis of bipolar disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70473","name":"Ct cere prfu aly c+wo ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed without concurrent ct or ct angiography of the same anatomy","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82234","name":"Beta-amyloid 1-42 (abeta 42)","description":"Beta-amyloid; 1-42 (abeta 42)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93596","name":"R&l hrt cath chd nml nt cnj","description":"Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); normal native connections","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65880","name":"Incise inner eye adhesions","description":"Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); corneovitreal adhesions","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":645.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9294","name":"Inj pemetrexed, hospira 10mg","description":"Injection, pemetrexed (hospira), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2428","name":"Inj, erzofri, 1 mg","description":"Injection, paliperidone palmitate extended release (erzofri), 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2468","name":"Inj, palonosetron (posfrea)","description":"Injection, palonosetron hydrochloride (posfrea), 25 micrograms","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26100","name":"Biopsy hand joint lining","description":"Arthrotomy with biopsy; carpometacarpal joint, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6553","name":"G com stcking bk 30-40 custm","description":"Gradient compression stocking, below knee, 30-40 mmhg, custom, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4225","name":"Sup/ext insulin inf pump syr","description":"Supplies for external insulin infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43291","name":"Egd flx trnsorl rmvl balo","description":"Esophagogastroduodenoscopy, flexible, transoral; with removal of intragastric bariatric balloon(s)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92920","name":"Prq trluml c angiop 1art&/br","description":"Percutaneous transluminal coronary angioplasty, single major coronary artery and/or its branch(es)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4438","name":"Adhesive clip ext ens contr","description":"Adhesive clip applied to the skin to secure external electrical nerve stimulator controller, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":1.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87084","name":"Culture of specimen by kit","description":"Culture, presumptive, pathogenic organisms, screening only; with colony estimation from density chart","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":12.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4288","name":"Replacement breastpump valve","description":"Valve for breast pump, replacement","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64583","name":"Rev/rplct hpglsl nstm ary pg","description":"Revision or replacement of hypoglossal nerve neurostimulator array and distal respiratory sensor electrode or electrode array, including connection to existing pulse generator","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4311","name":"Acesso, per sq cm","description":"Acesso, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1933","name":"Afo rig ant tib tcf/= ots","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, off-the-shelf","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0665","name":"Team remote e/m est pt 10 mn","description":"Team remote e/m est. pt 10mins","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1292","name":"Pt 66+ frail inpt adv ill","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and an advanced illness diagnosis during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4264","name":"Cocoon membrane, per sq cm","description":"Cocoon membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0795T","name":"Tcat ins 2chmbr ldls pm cmpl","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; complete system (ie, r","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9038","name":"Inj axatilimab-csfr 0.1 mg","description":"Injection, axatilimab-csfr, 0.1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0619U","name":"Pulm copd dna alys >18000","description":"Pulm copd dna alys >18000","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2312","name":"Inj naloxone hcl nos, 0.01mg","description":"Injection, naloxone hydrochloride, not otherwise specified, 0.01 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9183","name":"Gemcitabine intravesical sys","description":"Gemcitabine intravesical system, 225 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9246","name":"Mod sedation noniv-15 min","description":"Mod sedation noniv-15 min","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1010T","name":"Cptr oph alys monoc eye mvmt","description":"Computerized ophthalmic analysis of monocular eye movements using retinal-based eye-tracking without spatial calibration, including fixation, microsaccades, drift, and horizontal saccades, when performed, unilateral or bilateral, with interpretation and report","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0931T","name":"Ephys eval ccm-d ld separate","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), separate from initial implantation or replacement with testing of cardiac cont","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0584U","name":"Neuro csf prion prtn qual","description":"Neuro csf prion prtn qual","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1708","name":"Pfizer vacc admin 3rd dose","description":"Pfizer vacc admin 3rd dose","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6517","name":"Grad com wrap w strap bn cus","description":"Gradient compression wrap with adjustable straps, below knee, each, custom","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4412","name":"Choriofix per sq cm","description":"Choriofix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84433","name":"Asy thiopurin s-mthyltrnsfrs","description":"Thiopurine s-methyltransferase (tpmt)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5911","name":"Facial moulage sectional","description":"Facial moulage (sectional)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0828T","name":"Dgtz gls mcrscp cytp smpl fl","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; simple filter method with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9063","name":"Inj, elahere, 1 mg","description":"Injection, mirvetuximab soravtansine-gynx, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7252","name":"Part extract for implant","description":"Part extract for implant","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51565","name":"Revise bladder & ureter(s)","description":"Cystectomy, partial, with reimplantation of ureter(s) into bladder (ureteroneocystostomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1409.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1229","name":"Pt w/ +hcv +vir ref win 1 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, is referred within 1 month of the reactive hcv antibody test to a clinician who treats hcv infection","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1306","name":"Pt anphx due to pneum","description":"Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55882","name":"Ablt trurl prst8 tis trnsdcr","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation; with insertion of transurethral ultrasound transducer for delivery of thermal ultrasound, including suprapubic tube placement and placement of ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7509","name":"Marsupialization odon cyst","description":"Marsupialization odon cyst","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17307","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1183","name":"Doc imm ckpt inhib hld","description":"Documentation of immune checkpoint inhibitor therapy held and corticosteroids or immunosuppressants prescribed or administered","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4258","name":"Enverse, per sq cm","description":"Enverse, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0533","name":"Buprenorphone inj weekly","description":"Medication assisted treatment, buprenorphine (injectable) administered on a weekly basis; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid tre","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0513","name":"Prolong prev svcs, first 30m","description":"Prolonged preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient contact beyond the usual service; first 30 minutes (list separately in addition to code for preventive service)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":73.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24615","name":"Optx aqt/chrnc elbow dislc","description":"Open treatment of acute or chronic elbow dislocation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":860.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35602","name":"Bpg crtd-clat crtd","description":"Bypass graft, with other than vein; carotid-contralateral carotid","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0870T","name":"Imp subq prtl ascts pmp sys","description":"Implantation of subcutaneous peritoneal ascites pump system, percutaneous, including pump-pocket creation, insertion of tunneled indwelling bladder and peritoneal catheters with pump connections, including all imaging and initial programming, when performed","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26140","name":"Revise finger joint each","description":"Synovectomy, proximal interphalangeal joint, including extensor reconstruction, each interphalangeal joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36465","name":"Njx noncmpnd sclrsnt 1 vein","description":"Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate, inclusive of all imaging guidance and monitoring; single incompetent extremity truncal vein (eg, great saphenous vein, accessory saphenous vein)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1530.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":126.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3315","name":"Triptorelin pamoate","description":"Injection, triptorelin pamoate, 3.75 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63032","name":"Lamot rpr anulr dfct 1 lmbr","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; with repair of annular defect by implantation of bone-anchored annular closure device, including all imaging guidance, 1 interspace, lumbar","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1326","name":"Pts dx hypotony","description":"Patients with a diagnosis of hypotony","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37281","name":"Revsc evsc tpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46754","name":"Removal of suture from anus","description":"Removal of thiersch wire or suture, anal canal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0760T","name":"Dgtz gls mcrscp sl imm 1st","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0927T","name":"Interrog dev eval ccm-d ip","description":"Interrogation device evaluation (in person) with analysis, review, and report, including connection, recording, and disconnection, per patient encounter, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64597","name":"Ins/rplcm prq eltrd ra pn ea","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; each additional electrode array (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99470","name":"Rpm tx mgmt 1st 10 min","description":"Remote physiologic monitoring treatment management services, clinical staff/physician/other qualified health care professional time in a calendar month requiring 1 real-time interactive communication with the patient/caregiver during the calendar month; first 10 minutes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0815T","name":"Us rems b1 dns hips plvs/spi","description":"Ultrasound-based radiofrequency echographic multi-spectrometry (rems), bone-density study and fracture-risk assessment, 1 or more sites, hips, pelvis, or spine","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0892","name":"Argatroban dialysis (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0490U","name":"Onc cutan/uveal mlnma cd146","description":"Onc cutan/uveal mlnma cd146","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87493","name":"C diff amplified probe","description":"Infectious agent detection by nucleic acid (dna or rna); clostridium difficile, toxin gene(s), amplified probe technique","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37296","name":"Revsc evasc imvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27892","name":"Decompression of leg","description":"Decompression fasciotomy, leg; anterior and/or lateral compartments only, with debridement of nonviable muscle and/or nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":637.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37260","name":"Revsc evasc ivt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1174","name":"Pt w/ 2 hzv 10/2017 - mp","description":"Patient received at least two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44661","name":"Repair bowel-bladder fistula","description":"Closure of enterovesical fistula; with intestine and/or bladder resection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1641.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1153","name":"Pt w/ dx osteo doe","description":"Patient with diagnosis of osteoporosis on date of encounter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53451","name":"Tprnl balo cntnc dev bi","description":"Periurethral transperineal adjustable balloon continence device; bilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0503U","name":"Neuro alz ds bamyl&tau prtn","description":"Neuro alz ds bamyl&tau prtn","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1410","name":"No gmln brca1/brca2 couns","description":"Patients who did not have germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0802T","name":"Tcat rmv&rpl2chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right at","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4306","name":"Americ amnion ac per sq cm","description":"American amnion ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1459","name":"Pt hosp/pal care dur perf pd","description":"Patient was in hospice or receiving palliative care services at any time during the performance period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0859T","name":"Ncntc ifr spctrsc o/t pad ea","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), other than for screening for peripheral arterial disease, image acquisition, interpretation, and report; each additional anatomic site (list separately in addition to code ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0708","name":"Intraoral bite radio image","description":"Intraoral bite radio image","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81464","name":"So gsap cll fr mcrstl ins","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants, microsatellite instability, tumor mutation burden, and rearrangements","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1440","name":"Fecal microbiota jslm 1 ml","description":"Fecal microbiota, live - jslm, 1 ml","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82742","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5161","name":"Inj, denosumab-kyqq, 1 mg","description":"Injection, denosumab-kyqq (aukelso/bosaya), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32905","name":"Revise & repair chest wall","description":"Thoracoplasty, schede type or extrapleural (all stages);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1523.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1358","name":"Pts no <suicd idea 120 dys","description":"Patients who did not have a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1371","name":"Mst rec gsa<7","description":"Most recent glycemic status assessment (hba1c or gmi) level < 7.0%","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38792","name":"Ra tracer id of sentinl node","description":"Injection procedure; radioactive tracer for identification of sentinel node","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1317","name":"Pts counsl cpt opt out","description":"Patients who are counseled on connection with a csp and explicitly opt out","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0681T","name":"Rlcj pulse gen only isdss","description":"Relocation of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing dual leads","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1162","name":"Pt enceph due to dtp bef 13","description":"Patient had encephalitis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1249","name":"Pt resp true imprt to me","description":"Patient responded completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0735T","name":"Prep tum cav iort prim crnot","description":"Preparation of tumor cavity, with placement of a radiation therapy applicator for intraoperative radiation therapy (iort) concurrent with primary craniotomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1466","name":"Pt disc/lam proc same day","description":"Patient had a lumbar fusion on the same date as the discectomy/laminectomy procedure","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2251","name":"Inj midazolam in 0.9% nacl","description":"Injection, midazolam in 0.9% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1352","name":"Suicd c-ssrs assessment, equ","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs or equivalent assessment","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6074","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (noble metal)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88239","name":"Tissue culture tumor","description":"Tissue culture for neoplastic disorders; solid tumor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7511","name":"Incision/drain abscess intra","description":"Incision and drainage of abscess - intraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2542","name":"Dental onlay metallic 2 surf","description":"Onlay-metallic-two surfaces","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0983T","name":"Rem mntr impl ivc snr phys","description":"Remote monitoring of an implanted inferior vena cava sensor for up to 30 days, including at least weekly downloads of inferior vena cava area recordings, interpretation(s), trend analysis, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":313.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0035","name":"Pt ed pos 23","description":"Patient has any emergency department encounter during the performance period with place of service indicator 23","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3263","name":"Inj, toripalimab-tpzi, 1 mg","description":"Injection, toripalimab-tpzi, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9024","name":"Inj atezolizumb 5mg hya-tqjs","description":"Injection, atezolizumab, 5 mg and hyaluronidase-tqjs","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33218","name":"Repair lead pace-defib one","description":"Repair of single transvenous electrode, permanent pacemaker or implantable defibrillator","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4433","name":"361 hct/p skin subs, nos","description":"361 hct/p skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45350","name":"Sgmdsc w/band ligation","description":"Sigmoidoscopy, flexible; with band ligation(s) (eg, hemorrhoids)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":861.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":104.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0163","name":"Epinephrine in nacl (endo)","description":"Injection, epinephrine in sodium chloride (endo), 0.1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1938","name":"Inj, furosemide, 1 mg","description":"Injection, furosemide, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6036","name":"Prosthetic thumb mechanical","description":"Prosthetic thumb, mechanical, can include metacarpophalangeal (mcp), interphalangeal (ip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0808T","name":"Pulm tiss vntj alys w/ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with computed tomography (ct) images taken for the purpose of pulmonary tissue ventilation analysis, including data preparation and transmission, quantificati","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95075","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4308","name":"Sanopellis, per sq cm","description":"Sanopellis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0373","name":"Tomo bitewing image","description":"Tomo bitewing image","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4300","name":"Acesso tl, per sq cm","description":"Acesso tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66991","name":"Xcapsl ctrc rmvl insj 1+","description":"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); with insertion of intraocular (eg, trabecular meshwork, supraciliary, suprachoroidal) anterior segment aqueous drai","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29720","name":"Repair spica body cst/jacket","description":"Repair of spica, body cast or jacket","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G3003","name":"Chronic pain mgmt addl 15m","description":"Each additional 15 minutes of chronic pain management and treatment by a physician or other qualified health care professional, per calendar month. (list separately in addition to code for g3002. when using g3003, 15 minutes must be met or exceeded.)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2327","name":"Inj risankizumab-rzaa 1 mg","description":"Injection, risankizumab-rzaa, intravenous, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2055","name":"Idecabtagene vicleucel car","description":"Idecabtagene vicleucel, up to 510 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78805","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1502","name":"Podiatry mvp","description":"Podiatry mips value pathway","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0800T","name":"Tcat rmvl 2chmbr ldls pm rv","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right ventricular pacemaker component (when part of a dual-chamber leadless pacem","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1496","name":"No doc of fall or poc","description":"Patients that had a fall who did not have a plan of care for falls documented or do not have documentation of being assessed for falls","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32662","name":"Thoracoscopy w/mediast exc","description":"Thoracoscopy, surgical; with excision of mediastinal cyst, tumor, or mass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1228.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76856","name":"Us exam pelvic complete","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7997","name":"Appliance removal","description":"Appliance removal (not by dentist who placed appliance) includes removal of archbar","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23077","name":"Rad rescj tum shoulder<5 cm","description":"Radical resection of tumor (eg, sarcoma), soft tissue of shoulder area; less than 5 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1289.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0299U","name":"Onc pan tum whl gen opt mapg","description":"Onc pan tum whl gen opt mapg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59151","name":"Treat ectopic pregnancy","description":"Laparoscopic treatment of ectopic pregnancy; with salpingectomy and/or oophorectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":934.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0279U","name":"Hem vw factor&clgn iii bndg","description":"Hematology (von willebrand disease [vwd]), von willebrand factor (vwf) and collagen iii binding by enzyme-linked immunosorbent assays (elisa), plasma, report of collagen iii binding","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47120","name":"Partial removal of liver","description":"Hepatectomy, resection of liver; partial lobectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2457.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74019","name":"Radex abdomen 2 views","description":"Radiologic examination, abdomen; 2 views","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9063","name":"Inj, elahere, 1 mg","description":"Injection, mirvetuximab soravtansine-gynx, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28660","name":"Treat toe dislocation","description":"Closed treatment of interphalangeal joint dislocation; without anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37269","name":"Revsc evasc fpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1378","name":"Med rsn no 10 yr fu colscope","description":"Documentation of medical reason(s) for not recommending a 10 year follow-up interval (e.g., inadequate prep, familial or personal history of colonic polyps, patient had no adenoma and age is >= 66 years old, or life expectancy < 10 years, other medical reasons)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95909","name":"Nrv cndj tst 5-6 studies","description":"Nerve conduction studies; 5-6 studies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46614","name":"Anoscopy control bleeding","description":"Anoscopy; with control of bleeding (eg, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1487","name":"Pt adm to hospice dur eval","description":"Patients in hospice in the year before or during the period of evaluation","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4031","name":"Radiation oncology ss","description":"Radiation oncology mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3392","name":"Inj, exagamglogene autotem","description":"Injection, exagamglogene autotemcel, per treatment","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2183","name":"Inj meropenem (wg crit care)","description":"Injection, meropenem (wg critical care), not therapeutically equivalent to j2185, 100 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4263","name":"Surgraft tl, per sq cm","description":"Surgraft tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0609U","name":"Onc prostate ia tot&free psa","description":"Onc prostate ia tot&free psa","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95990","name":"Spin/brain pump refil & main","description":"Refilling and maintenance of implantable pump or reservoir for drug delivery, spinal (intrathecal, epidural) or brain (intraventricular), includes electronic analysis of pump, when performed;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4370","name":"Aeroguard per sq cm","description":"Aeroguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7213","name":"Inj, ixinity, 1 i.u.","description":"Injection, coagulation factor ix (recombinant), ixinity, 1 i.u.","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1406","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99437","name":"Chrnc care mgmt phys ea addl","description":"Chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, or funct","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52597","name":"Trurl rbtc wtrjt rescj prst8","description":"Transurethral robotic-assisted waterjet resection of prostate, including intraoperative planning, ultrasound guidance, control of postoperative bleeding, complete, including vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0435U","name":"Onc chemo rx cytox csc 14 rx","description":"Onc chemo rx cytox csc 14 rx","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42182","name":"Repair palate","description":"Repair, laceration of palate; over 2 cm or complex","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1961","name":"Inj lenacapavir (hiv tx) 1mg","description":"Injection, lenacapavir (only for use as hiv treatment), 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1175","name":"Doc med rsn no hzv","description":"Documentation of medical reason(s) for not administering zoster vaccine (e.g., prior anaphylaxis due to the zoster vaccine)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3921","name":"Decor or submerg erupt tooth","description":"Decor or submerg erupt tooth","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64657","name":"Rmvl bat modulj sys tot sys","description":"Removal of baroreflex activation therapy (bat) modulation system; total system, including lead and pulse generator","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95860","name":"Needle emg 1 extremity","description":"Needle electromyography; 1 extremity with or without related paraspinal areas","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4008","name":"Geriatrics ss","description":"Geriatrics mips specialty set","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0630","name":"Calcitonin salmon injection","description":"Injection, calcitonin salmon, up to 400 units","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0521","name":"New pt-cg dyad dem hig cmplx","description":"Management of new patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1318","name":"Pts no csp doc contact","description":"Patients who did not have documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening or documentation that there was no contact with a csp","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82948","name":"Reagent strip/blood glucose","description":"Glucose; blood, reagent strip","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49617","name":"Rpr aa hrn rcr > 10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, reducible","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19000","name":"Puncture aspir cyst breast","description":"Puncture aspiration of cyst of breast;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0555","name":"Replacment pt electronic sys","description":"Provision of replacement patient electronics system (e.g., system pillow, handheld reader) for home pulmonary artery pressure monitoring","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77080","name":"Dxa bone density axial","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63268","name":"Excise intrspinl lesion scrl","description":"Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; sacral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1484.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3375","name":"Inj, vanco (tyzavan) 10mg","description":"Injection, vancomycin hydrochloride (tyzavan), not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86043","name":"Acetylcholn rcptr modlg antb","description":"Acetylcholine receptor (achr); modulating antibody","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37256","name":"Revsc evasc ivt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1851","name":"Ko single upright prefab ots","description":"Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":665.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0607U","name":"Reprdtve med ema rtpcr 31bct","description":"Reprdtve med ema rtpcr 31bct","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64474","name":"Lwr xtr fscl pln blk uni nfs","description":"Lower extremity fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0744T","name":"Insj bioprostc vlv fem vn","description":"Insertion of bioprosthetic valve, open, femoral vein, including duplex ultrasound imaging guidance, when performed, including autogenous or nonautogenous patch graft (eg, polyester, eptfe, bovine pericardium), when performed","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0010","name":"Admin hepatitis b vaccine","description":"Administration of hepatitis b vaccine","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33270","name":"Ins/rep subq defibrillator","description":"Insertion or replacement of permanent subcutaneous implantable defibrillator system, with subcutaneous electrode, including defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing for arrhythmia termination, and programming or reprogramming of sensing or therapeutic param","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3421","name":"Root surgery bicuspid","description":"Apicoectomy/periradicular surgery-bicuspid (first root)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49323","name":"Laparo drain lymphocele","description":"Laparoscopy, surgical; with drainage of lymphocele to peritoneal cavity","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":675.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1028","name":"Take home supply 8mg per 0.1","description":"Take-home supply of nasal naloxone; 2-pack of 8mg per 0.1 ml nasal spray (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0933T","name":"Tcat impl wrls l atr prs snr","description":"Transcatheter implantation of wireless left atrial pressure sensor for long-term left atrial pressure monitoring, including sensor calibration and deployment, right heart catheterization, transseptal puncture, imaging guidance, and radiological supervision and interpretation","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37280","name":"Revsc evsc tpvt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1180","name":"Pt imm ckpt inhib therapy","description":"Patients on immune checkpoint inhibitor therapy","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0507U","name":"Onc ovr dna whole gen w/5hmc","description":"Onc ovr dna whole gen w/5hmc","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0909T","name":"Rplcmt int nstim sys vgs nrv","description":"Replacement of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0262U","name":"Onc sld tum rt-pcr 7 gen","description":"Oncology (solid tumor), gene expression profiling by real-time rt-pcr of 7 gene pathways (er, ar, pi3k, mapk, hh, tgfb, notch), formalin-fixed paraffin-embedded (ffpe), algorithm reported as gene pathway activity score","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0439U","name":"Crd chd dna alys 5 snp 3 dna","description":"Crd chd dna alys 5 snp 3 dna","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67038","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1665.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92631","name":"Hearing aid slctn svc 1st 30","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0569U","name":"Onc sol tum ngs tmm>20000dmr","description":"Onc sol tum ngs tmm>20000dmr","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43291","name":"Egd flx trnsorl rmvl balo","description":"Esophagogastroduodenoscopy, flexible, transoral; with removal of intragastric bariatric balloon(s)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9998","name":"Doc med rsn <3 colon","description":"Documentation of medical reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., last colonoscopy incomplete, last colonoscopy had inadequate prep, piecemeal removal of adenomas, or sessile serrated polyps >= 20 mm in size, last colonoscopy found greater than 10 adenomas, lo","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92639","name":"Hearing aid meas verif","description":"Hearing-aid measurement, verification with probe-microphone (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15336","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29884","name":"Arthrs knee surg lysis ads","description":"Arthroscopy, knee, surgical; with lysis of adhesions, with or without manipulation (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37279","name":"Iv lithotrp fpvt w/in sm art","description":"Intravascular lithotripsy(ies), femoral and popliteal vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96406","name":"Chemo intralesional over 7","description":"Chemotherapy administration; intralesional, more than 7 lesions","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34710","name":"Dlyd plmt xtn prosth 1st vsl","description":"Delayed placement of distal or proximal extension prosthesis for endovascular repair of infrarenal abdominal aortic or iliac aneurysm, false aneurysm, dissection, endoleak, or endograft migration, including pre-procedure sizing and device selection, all nonselective catheterization(s), all associate","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":827.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1370","name":"Inj, esomeprazole sod, 1 mg","description":"Injection, esomeprazole sodium, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96548","name":"Ntraop hipec px ea add 30min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35211","name":"Rpr blvsl dir ntrathrc w/byp","description":"Repair blood vessel, direct; intrathoracic, with bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1609.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0982T","name":"Rem mntr impl ivc snr set-up","description":"Remote monitoring of implantable inferior vena cava sensor, physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate), initial set-up and patient education on use of equipment","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4413","name":"Cygnus solo per sq cm","description":"Cygnus solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9329","name":"Inj, tislelizumab-jsgr","description":"Injection, tislelizumab-jsgr, 1mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9248","name":"Inj melphalan (hepzato) 1 mg","description":"Injection, melphalan (hepzato), 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4387","name":"Neothelium ft per sq cm","description":"Neothelium ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0759T","name":"Dgtz gls mcrscp sl sp grpiii","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group iii, for enzyme constituents (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4389","name":"Neothelium 4l+ per sq cm","description":"Neothelium 4l+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2023","name":"Innovamatrix pd, 1 mg","description":"Innovamatrix pd, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9274","name":"Inj, tebentafusp-tebn, 1 mcg","description":"Injection, tebentafusp-tebn, 1 microgram","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0265U","name":"Rar do whl gn&mtcdrl dna als","description":"Rare constitutional and other heritable disorders, whole- genome and mitochondrial dna sequence analysis, blood, frozen and formalin-fixed paraffin-embedded (ffpe) tissue, saliva, buccal swabs or cell lines, identification of single nucleotide and copy number variants","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92270","name":"Electro-oculography w/i&r","description":"Electro-oculography with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1214","name":"Spiro results wth obs doc","description":"Spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and reviewed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0844T","name":"Dgtz gls mcrscp cslt cyt ea","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), each additional site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63066","name":"Decompress spine cord add-on","description":"Costovertebral approach with decompression of spinal cord or nerve root(s) (eg, herniated intervertebral disc), thoracic; each additional segment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0051","name":"Traditional healing service","description":"Traditional healing service","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1003T","name":"Arthrp 1st crp/mtcrpl prostc","description":"Arthroplasty, first carpometacarpal joint, with distal trapezial and proximal first metacarpal prosthetic replacement (eg, first carpometacarpal total joint)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26520","name":"Release knuckle contracture","description":"Capsulectomy or capsulotomy; metacarpophalangeal joint, each joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99445","name":"Rem mntr physiol param 2-15","description":"Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate); device(s) supply with daily recording(s) or programmed alert(s) transmission, 2-15 days in a 30-day period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48020","name":"Removal of pancreatic stone","description":"Removal of pancreatic calculus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63305","name":"Remove vert idrl body thrc","description":"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, thoracic by transthoracic approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2533.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0278U","name":"Hem gen thrombosis 12 genes","description":"Hematology (genetic thrombosis), genomic sequence analysis of 12 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1196","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4263","name":"Surgraft tl, per sq cm","description":"Surgraft tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85041","name":"Automated rbc count","description":"Blood count; red blood cell (rbc), automated","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81001","name":"Urinalysis auto w/scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; automated, with microscopy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1353","name":"Pts no cmplt suicd saf pln","description":"Patients who did not have a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9269","name":"Programable ingest capsule","description":"Programable, transient, orally ingested capsule, for use with external programmer, per month","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11750","name":"Excision nail&nail matrix","description":"Excision of nail and nail matrix, partial or complete (eg, ingrown or deformed nail), for permanent removal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75650","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":737.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0771T","name":"Vr px dissoc svc sm phy 1st","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83718","name":"Assay of lipoprotein","description":"Lipoprotein, direct measurement; high density cholesterol (hdl cholesterol)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6608","name":"G com bandage tub protct pad","description":"Gradient compression bandaging supply, tubular protective absorption padded layer, per linear yard, any width, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0482","name":"Direct immunofluorescence","description":"Direct immunofluorescence","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2313","name":"Inj, naloxone (zimhi) 0.01mg","description":"Injection, naloxone hydrochloride (zimhi), 0.01 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6107","name":"Tissue regen non-resorbable","description":"Tissue regen non-resorbable","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90637","name":"Vacc qirv mrna 30mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 30 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J1890","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0687T","name":"Tx amblyopia dev setup 1st","description":"Treatment of amblyopia using an online digital program; device supply, educational set-up, and initial session","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33945","name":"Transplantation of heart","description":"Heart transplant, with or without recipient cardiectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3126.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0870","name":"Injection, imetelstat, 1 mg","description":"Injection, imetelstat, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1184","name":"Doc med rsn no cst/ist rx","description":"Documentation of medical reason(s) for not prescribing or administering corticosteroid or immunosuppressant treatment (e.g., allergy, intolerance, infectious etiology, pancreatic insufficiency, hyperthyroidism, prior bowel surgical interventions, celiac disease, receiving other medication, awaiting ","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0997T","name":"Precuneus mag stimj tx plng","description":"Precuneus magnetic stimulation; treatment planning using magnetic resonance imaging-guided neuronavigation to determine optimal location, dose, and intensity for magnetic stimulation therapy, derived from evoked potentials from single pulses of electromagnetic energy recorded by 64-channel electroen","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6112","name":"Imp/abut rem dent part max","description":"Imp/abut rem dent part max","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55877","name":"Abltj ire prst8 1+ tum perq","description":"Ablation, irreversible electroporation, prostate, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9432","name":"Med food non inborn err meta","description":"Medical foods for non-inborn errors of metabolism","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84126","name":"Assay of feces porphyrins","description":"Porphyrins, feces, quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0543U","name":"Onc sol tum ngs dna 517 gens","description":"Onc sol tum ngs dna 517 gens","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1290","name":"Pt not eli d/t act dig htn","description":"Patient not eligible due to active diagnosis of hypertension","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1350","name":"Pt w/ suic saf pln init rev","description":"Patients who had a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2037","name":"G4derm plus/suprello, pr ml","description":"G4derm plus/suprello, per milliliter","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0926T","name":"Prgrmg dev eval ccm-d ip","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, including review and report, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0237","name":"Intrav inf, toci, first dose","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0545","name":"Inherent visit to inpt","description":"Visit complexity inherent to hospital inpatient or observation care associated with a confirmed or suspected infectious disease by an infectious diseases specialist, including disease transmission risk assessment and mitigation, public health investigation, analysis, and testing, and complex antimic","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0422U","name":"Onc pan solid tum alys dna","description":"Onc pan solid tum alys dna","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0279U","name":"Hem vw factor&clgn iii bndg","description":"Hematology (von willebrand disease [vwd]), von willebrand factor (vwf) and collagen iii binding by enzyme-linked immunosorbent assays (elisa), plasma, report of collagen iii binding","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0961T","name":"Shortwave ifr radiation img","description":"Shortwave infrared radiation imaging, surgical pathology specimen, to assist gross examination for lymph node localization in fibroadipose tissue, per specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1435","name":"Oral chemo in perf pd","description":"Patient on oral chemotherapy during the performance period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9595","name":"Piflu f-18, dia 1 millicurie","description":"Piflufolastat f-18, diagnostic, 1 millicurie","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1287","name":"Calc bmi blw low param f/u","description":"Bmi is documented below normal parameters and a follow-up plan is documented","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0835T","name":"Dgtz gls mcrscp fna 1st ea","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0580U","name":"Bbrgdrferi antb detc 24rprtn","description":"Bbrgdrferi antb detc 24rprtn","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1175","name":"Doc med rsn no hzv","description":"Documentation of medical reason(s) for not administering zoster vaccine (e.g., prior anaphylaxis due to the zoster vaccine)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0713T","name":"N-nvs artl plaq alys rvw i&r","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data review, interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82016","name":"Acylcarnitines qual","description":"Acylcarnitines; qualitative, each specimen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9341","name":"Inj thiotepa (tepylute) 1 mg","description":"Injection, thiotepa (tepylute), 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1246","name":"Pt othr thn true imprt to me","description":"Patient provided a response other than completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27606","name":"Incision of achilles tendon","description":"Tenotomy, percutaneous, achilles tendon (separate procedure); general anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":373.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92930","name":"Prq tcat plmt ntrac st 2+les","description":"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 2 or more distinct coronary lesions with 2 or more coronary stents deployed in 2 or more coronary segments, or a bifurcation lesion requiring ","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0446","name":"Intens behave ther cardio dx","description":"Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":28.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1327","name":"Pts no eval ini xm no 8 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 8 weeks","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4290","name":"Membrane wrap hydr per sq cm","description":"Membrane wrap-hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4271","name":"Complete ft per sq cm","description":"Complete ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0543U","name":"Onc sol tum ngs dna 517 gens","description":"Onc sol tum ngs dna 517 gens","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98978","name":"Rtm dev sply cbt 16-30 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of cognitive behavioral therapy, 16-30 days in a 30-day period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0785T","name":"Revj/rmvl nea spi w/nstim","description":"Revision or removal of neurostimulator electrode array, spinal, with integrated neurostimulator","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80504","name":"Path clin consltj mod 21-40","description":"Pathology clinical consultation; for a moderately complex clinical problem, with review of patients history and medical records and moderate level of medical decision making when using time for code selection, 21-40 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":32.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0389","name":"Periopic image capture only","description":"Periopic image capture only","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1217","name":"Sys rsn no doc spiro","description":"Documentation of system reason(s) for not documenting and reviewing spirometry results (e.g., spirometry equipment not available at the time of the encounter)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9607","name":"Lutetium lu 177 vipivotide","description":"Lutetium lu 177 vipivotide tetraxetan, therapeutic, 1 millicurie","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3403","name":"Revakinagene, per implant","description":"Revakinagene taroretcel-lwey, per implant","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6073","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (predominantly base metal)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0441U","name":"Nfct ds bct fngl/viral semiq","description":"Nfct ds bct fngl/viral semiq","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4241","name":"Gngvl flap w rootplan 1-3 th","description":"Gingival flap procedure including root planing - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5148","name":"Inj, nyposi 1 mcg","description":"Injection, filgrastim-txid (nypozi), biosimilar, 1 microgram","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2327","name":"Inj risankizumab-rzaa 1 mg","description":"Injection, risankizumab-rzaa, intravenous, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81451","name":"Hl neo gsap 5-50 rna alys","description":"Hematolymphoid neoplasm or disorder, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants, and copy number variants or rearrangements, or isoform expression or mrna expression levels, if performed; rna analysis","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"U0002","name":"Covid-19 lab test non-cdc","description":"2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21461","name":"Optx mndblr fx wo ntrdntl","description":"Open treatment of mandibular fracture; without interdental fixation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":997.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75978","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":843.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98003","name":"Synch audio-video new hi 60","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high medical decision making. when using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1451","name":"Pt dx ppd dur id/pf pd","description":"Patients with an active diagnosis of pervasive developmental disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0714T","name":"Tpla b9 prst8 hyprplsa<50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume less than 50 ml","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32656","name":"Thoracoscopy w/pleurectomy","description":"Thoracoscopy, surgical; with parietal pleurectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1021.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1612","name":"Inj glucagon (gvoke) 0.01 mg","description":"Injection, glucagon (gvoke), 0.01 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0981T","name":"Tcat impl wrls ivc snr","description":"Transcatheter implantation of wireless inferior vena cava sensor for long-term hemodynamic monitoring, including deployment of the sensor, radiological supervision and interpretation, right heart catheterization, and inferior vena cava venography, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91319","name":"Sarscv2 vac 10mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 10 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0567U","name":"Rare ds whl gen seq srs&lrs","description":"Rare ds whl gen seq srs&lrs","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92507","name":"Tx sp lang voice comm indiv","description":"Treatment of speech, language, voice, communication, and/or auditory processing disorder; individual","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4415","name":"Alexiguard st-l per sq cm","description":"Alexiguard sl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21433","name":"Optx cranfcl sep comp mlt","description":"Open treatment of craniofacial separation (lefort iii type); complicated (eg, comminuted or involving cranial nerve foramina), multiple surgical approaches","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1989.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0432U","name":"Klhl11 antb sr/csf asy qual","description":"Klhl11 antb sr/csf asy qual","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1169","name":"Doc med rsn no flu vax","description":"Documentation of medical reason(s) for not administering influenza vaccine (e.g., prior anaphylaxis due to the influenza vaccine)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0610U","name":"Nfct ds antmcr sc phenotypic","description":"Nfct ds antmcr sc phenotypic","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4373","name":"Membrane wrp lt per sq cm","description":"Membrane wrap lite, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0293U","name":"Psyc suicidal idea mrna 54","description":"Psyc suicidal idea mrna 54","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1026","name":"Pt hemo > 3mo","description":"The number of adult patient-months in the denominator who were on maintenance hemodialysis using a catheter continuously for three months or longer under the care of the same practitioner or group partner as of the last hemodialysis session of the reporting month","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1011T","name":"Pbm therapy of oral cavity","description":"Photobiomodulation (pbm) therapy of oral cavity, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63052","name":"Lam facetc/frmt arthrd lum 1","description":"Laminectomy, facetectomy, or foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s] [eg, spinal or lateral recess stenosis]), during posterior interbody arthrodesis, lumbar; single vertebral segment (list separately in addition to code for primary ","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99393","name":"Prev visit est age 5-11","description":"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; late ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":67.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2928","name":"Prefab porc/cer crown perm","description":"Prefab porc/cer crown perm","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0278U","name":"Hem gen thrombosis 12 genes","description":"Hematology (genetic thrombosis), genomic sequence analysis of 12 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5947","name":"Mand implt sup fix","description":"Mand implt sup fix","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86231","name":"Ema each ig class","description":"Endomysial antibody (ema), each immunoglobulin (ig) class","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43290","name":"Egd flx trnsorl dplmnt balo","description":"Esophagogastroduodenoscopy, flexible, transoral; with deployment of intragastric bariatric balloon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":100.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4323","name":"Alloply, per sq cm","description":"Alloply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98007","name":"Synch audio-video est hi 40","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high medical decision making. when using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98979","name":"Rtm tx mgmt 1st 10 min","description":"Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least 1 real-time interactive communication with the patient or caregiver during the calendar month; first 10 minutes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1807","name":"Inj, ethacrynate sod, 1 mg","description":"Injection, ethacrynate sodium, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0546","name":"Phone/internet ehr assess","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty   whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patien","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37289","name":"Revsc evsc tpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80506","name":"Path clin consltj prolng svc","description":"Pathology clinical consultation; prolonged service, each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":26.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1484","name":"No rpt hcv rna perf med rsn","description":"Patients who did not have a repeat hcv rna labs performed for medical reasons documented by clinician (e.g., patient with limited life expectancy, delay in treatment of hcv related to treatment of hiv, hbv, hepatocellular carcinoma, decompensated cirrhosis)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0988T","name":"Opn ins/rplc ins ptn sbq&sbf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0838T","name":"Dgtz gls mcrscp cslt sld els","description":"Digitization of glass microscope slides for consultation and report on referred slides prepared elsewhere (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2039","name":"Innovamatrix fd, per sq cm","description":"Innovamatrix fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0777T","name":"R-t prs sensing edrl gdn sys","description":"Real-time pressure-sensing epidural guidance system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30545","name":"Rpr choanal atresia trsnpltn","description":"Repair choanal atresia; transpalatine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1140.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0850T","name":"Dgtz gls mcrscp ish ea mult","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75993","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":453.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0923T","name":"Rmvl&rplcmt perm ccm-d pg","description":"Removal and replacement of permanent cardiac contractility modulation-defibrillation pulse generator only","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0585U","name":"Tgsap so neo cfdna 521 genes","description":"Tgsap so neo cfdna 521 genes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90382","name":"Rsv monoc antb seasn .7ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose, 0.7 ml, for intramuscular use","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0174","name":"Lecanemab-irmb, for iv inj","description":"Lecanemab-irmb, for intravenous injection, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1195","name":"Rpt wo imp/con mmr/msi","description":"Surgical pathology reports that do not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both, reason not given","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61315","name":"Crnec/crnot ittl ntracereblr","description":"Craniectomy or craniotomy for evacuation of hematoma, infratentorial; intracerebellar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2345.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4287","name":"Disp col sto bag breast milk","description":"Disposable collection and storage bag for breast milk, any size, any type, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0516","name":"Insert drug del implant, >=4","description":"Insertion of non-biodegradable drug delivery implants, 4 or more (services for subdermal rod implant)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":167.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0783T","name":"Tc auriculr neurostimulation","description":"Transcutaneous auricular neurostimulation, set-up, calibration, and patient education on use of equipment","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7521","name":"Tacrolim granules oral susp","description":"Tacrolimus, granules, oral suspension, 0.1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76810","name":"Ob us >/= 14 wks addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9268","name":"Programmer orally ingest cap","description":"Programmer for transient, orally ingested capsule","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0760T","name":"Dgtz gls mcrscp sl imm 1st","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2700","name":"Oxacillin sodium injeciton","description":"Injection, oxacillin sodium, up to 250 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99497","name":"Advncd care plan 30 min","description":"Advance care planning including the explanation and discussion of advance directives such as standard forms (with completion of such forms, when performed), by the physician or other qualified health care professional; first 30 minutes, face-to-face with the patient, family member(s), and/or surroga","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":72.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0550","name":"Phone/inter for dx/treat >5m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a written report to the patients treating/r","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1189","name":"Doc khe pef w/efgr/uacr","description":"Documentation of a kidney health evaluation defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr) performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37735","name":"Lig&div&compl strpg saph vn","description":"Ligation and division and complete stripping of long or short saphenous veins with radical excision of ulcer and skin graft and/or interruption of communicating veins of lower leg, with excision of deep fascia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":786.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2020","name":"Ac5 wound system","description":"Ac5 advanced wound system (ac5)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92502","name":"Ear and throat examination","description":"Otolaryngologic examination under general anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21490","name":"Optx tmprmand dislocation","description":"Open treatment of temporomandibular dislocation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1071.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1576","name":"Inj, panzyga, 500 mg","description":"Injection, immune globulin (panzyga), intravenous, non-lyophilized (e.g., liquid), 500 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9120","name":"Dactinomycin injection","description":"Injection, dactinomycin, 0.5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1228","name":"Pt + hcv aby +vir w/ rx 3 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, has hcv treatment initiated within 3 months of the reactive hcv antibody test","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97804","name":"Medical nutrition group","description":"Medical nutrition therapy; group (2 or more individual(s)), each 30 minutes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":12.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1301","name":"Pt recv tbco cess interv","description":"Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1333","name":"Acute vitreous hemorrhage","description":"Acute vitreous hemorrhage","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50610","name":"Removal of ureter stone","description":"Ureterolithotomy; upper one-third of ureter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1066.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2016","name":"Permeaderm b, per sq cm","description":"Permeaderm b, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1251","name":"Pts proxy cmplt hu surv","description":"Patients for whom a proxy completed the entire hu survey on their behalf for any reason (no patient involvement)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4375","name":"Duograft ac per sq cm","description":"Duograft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1402","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1407","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9913","name":"Admin of neuromod","description":"Admin of neuromod","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4253","name":"Zenith amniotic membrane psc","description":"Zenith amniotic membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0316U","name":"B brgdrferi lyme ds ospa evl","description":"B brgdrferi lyme ds ospa evl","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20680","name":"Removal of implant deep","description":"Removal of implant; deep (eg, buried wire, pin, screw, metal band, nail, rod or plate)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4296","name":"Rebound matrix, per sq cm","description":"Rebound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93584","name":"Vngrph chd anom/persist svc","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; anomalous or persistent superior vena cava when it exists as a second contralateral superior vena cava, with native drainage to heart (list separately in addition to code for pri","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93597","name":"R&l hrt cath chd abnl nt cnj","description":"Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); abnormal native connections","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8541","name":"Oral, hemady, 0.25 mg","description":"Dexamethasone (hemady), oral, 0.25 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0890T","name":"Arhfcmrigtbs 1st tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including target assessment, initial motor threshold determination, neuronavigation, delivery and management, initial treatment day","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0520U","name":"Ther rx mntr 200+ rx/sbsts","description":"Ther rx mntr 200+ rx/sbsts","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1374","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28110","name":"Part removal of metatarsal","description":"Ostectomy, partial excision, fifth metatarsal head (bunionette) (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":354.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33368","name":"Replace aortic valve w/byp","description":"Transcatheter aortic valve replacement (tavr/tavi) with prosthetic valve; cardiopulmonary bypass support with open peripheral arterial and venous cannulation (eg, femoral, iliac, axillary vessels) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4279","name":"Vendaje ac, per sq cm","description":"Vendaje ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37271","name":"Revsc evsc fpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2401","name":"Chloroprocaine hcl injection","description":"Injection, chloroprocaine hydrochloride, per 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"Sup/ext non-ins inf pump syr","description":"Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0500U","name":"Autoinflam ds vexas synd dna","description":"Autoinflam ds vexas synd dna","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0390U","name":"Ob pe kdr eng&rbp4 ia alg","description":"Ob pe kdr eng&rbp4 ia alg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76017","name":"Mr sfty med physics xm cstmz","description":"Mr safety medical physics examination customization, planning and performance monitoring by medical physicist or mr safety expert, with review and analysis by physician or other qualified health care professional to prioritize and select views and imaging sequences, to tailor mr acquisition specific","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5612","name":"Rep resin part dent base max","description":"Rep resin part dent base max","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0491","name":"Oral dv nm mouthpc hw remote","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4298","name":"Amniocore pro, per sq cm","description":"Amniocore pro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0533U","name":"Rx metab advrs gnotyp 16gens","description":"Rx metab advrs gnotyp 16gens","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0308U","name":"Crd cad alys 3 prtn plsm alg","description":"Crd cad alys 3 prtn plsm alg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7939","name":"Indexing for osteotomy","description":"Indexing for osteotomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1015T","name":"Rev/rmv lw esoph sphnc npg/r","description":"Revision or removal, lower esophageal sphincter neurostimulator pulse generator or receiver","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4328","name":"Most, per sq cm","description":"Most, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43453","name":"Dilate esophagus","description":"Dilation of esophagus, over guide wire","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90484","name":"Imm cnsl not admn sm>20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 20 minutes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1396","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0938T","name":"Xtrnl ecg rec>15d<30d rec","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; recording (including connection and initial recording)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0738","name":"Upper extremity rehab","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0900T","name":"N-invas est aqmbf asstv cmr","description":"Noninvasive estimate of absolute quantitation of myocardial blood flow (aqmbf), derived from assistive algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health care profes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43456","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0038","name":"Clin pt no ref","description":"Clinician determines patient does not require referral","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98010","name":"Synch audio-only new mod 45","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection,","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6597","name":"G comp bandage long stretch","description":"Gradient compression bandage roll, elastic long stretch, linear yard, any width, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26121","name":"Release palm contracture","description":"Fasciectomy, palm only, with or without z-plasty, other local tissue rearrangement, or skin grafting (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":714.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5142","name":"Inj adalimumab-ryvk, 1 mg","description":"Injection, adalimumab-ryvk biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99304","name":"1st nf care sf/low mdm 25","description":"Initial nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward or low level of medical decision making. when using total time on the date of the encounter for code selection, 25 minutes mus","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":78.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2394","name":"Post >=4srfc resinbase cmpst","description":"Resin-based composite - four or more surfaces posterior","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0704T","name":"Rem tx amblyopia setup&edu","description":"Remote treatment of amblyopia using an eye tracking device; device supply with initial set-up and patient education on use of equipment","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0299U","name":"Onc pan tum whl gen opt mapg","description":"Onc pan tum whl gen opt mapg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1217","name":"Sys rsn no doc spiro","description":"Documentation of system reason(s) for not documenting and reviewing spirometry results (e.g., spirometry equipment not available at the time of the encounter)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27328","name":"Exc thigh/knee tum deep <5cm","description":"Excision, tumor, soft tissue of thigh or knee area, subfascial (eg, intramuscular); less than 5 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4320","name":"Pellograft, per sq cm","description":"Pellograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9601","name":"Flortaucipir inj 1 millicuri","description":"Flortaucipir f 18 injection, diagnostic, 1 millicurie","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2780","name":"Crown 3/4 cast hi noble met","description":"Crown - 3/4 cast high noble metal","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0755T","name":"Dgtz gls mcrscp sld level vi","description":"Digitization of glass microscope slides for level vi, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1781","name":"Vac admin human pap dose 1","description":"Vac admin human pap dose 1","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"Evoked auditory test limited","description":"Distortion product evoked otoacoustic emissions; limited evaluation (to confirm the presence or absence of hearing disorder, 3-6 frequencies) or transient evoked otoacoustic emissions, with interpretation and report","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98011","name":"Synch audio-only new high 60","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 60 ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1349","name":"No pam inc 3 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 3 points within a 4 to 12 month period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87272","name":"Cryptosporidium ag if","description":"Infectious agent antigen detection by immunofluorescent technique; cryptosporidium","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0029","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0532","name":"Take home supp nasal spray","description":"Take-home supply of nasal nalmefene hydrochloride; one carton of two, 2.7 mg per 0.1 ml nasal sprays (provision of the services by a medicare-enrolled opioid treatment program);( list separately in addition to each primary code)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0596U","name":"Neuro alzds plsm 3dstnct isp","description":"Neuro alzds plsm 3dstnct isp","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16030","name":"Dress/debrid p-thick burn l","description":"Dressings and/or debridement of partial-thickness burns, initial or subsequent; large (eg, more than 1 extremity, or greater than 10% total body surface area)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":248.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83840","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0877","name":"Inj, daptomycin (hospira)","description":"Injection, daptomycin (hospira), not therapeutically equivalent to j0878, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81457","name":"So neo gsap dna mcrstl ins","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis, microsatellite instability","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5941","name":"Resct proth mand part remov","description":"Resct proth mand part remov","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45379","name":"Colonoscopy w/fb removal","description":"Colonoscopy, flexible; with removal of foreign body(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0705","name":"Extra oral post radio image","description":"Extra oral post radio image","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0469U","name":"Rare ds whl gen seq ftl samp","description":"Rare ds whl gen seq ftl samp","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2043","name":"Biobrane, per sq cm","description":"Biobrane, per square centimeter","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0581U","name":"Trnspl med antb nohla 39trgt","description":"Trnspl med antb nohla 39trgt","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1403","name":"Bslne and fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15018","name":"App skn cll ssp f/n/g/hf ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 480 sq cm or part thereof (list separately in addition to code for prima","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49614","name":"Rpr aa hrn rcr < 3 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92120","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4286","name":"Nudyn sl or slw, per sq cm","description":"Nudyn sl or nudyn slw, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63251","name":"Revise spinal cord vsls thrc","description":"Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; thoracic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3407.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0819T","name":"Revj/rmvl ins ptn subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49188","name":"Opn exc/dst ntra-abd 10.1-20","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 10.1 to 20 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1476","name":"Pt dx cog imp or ad","description":"Patients with diagnosis of cognitive impairment or alzheimers disease","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0616","name":"Inj metoprolol tartrate 1 mg","description":"Injection, metoprolol tartrate, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0693T","name":"Compre ful bdy 3d mtn alys","description":"Comprehensive full body computer-based markerless 3d kinematic and kinetic motion analysis and report","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33509","name":"Ndsc hrv uxtr art 1 sgm cab","description":"Harvest of upper extremity artery, 1 segment, for coronary artery bypass procedure, endoscopic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4271","name":"Home lancing/test cartridges","description":"Integrated lancing and blood sample testing cartridges for home blood glucose monitor, per 50 tests","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6596","name":"G comp bandge conform gauze","description":"Gradient compression bandaging supply, conforming gauze, per linear yard, any width, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":0.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38510","name":"Biopsy/removal lymph nodes","description":"Biopsy or excision of lymph node(s); open, deep cervical node(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":474.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1681","name":"Ho bilateral hip abduction","description":"Hip orthosis, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0853T","name":"Dgtz gls mcrscp mphmtrc ea m","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76883","name":"Us nrv&acc strux 1xtr compre","description":"Ultrasound, nerve(s) and accompanying structures throughout their entire anatomic course in one extremity, comprehensive, including real-time cine imaging with image documentation, per extremity","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0815T","name":"Us rems b1 dns hips plvs/spi","description":"Ultrasound-based radiofrequency echographic multi-spectrometry (rems), bone-density study and fracture-risk assessment, 1 or more sites, hips, pelvis, or spine","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4001","name":"Diagnostic rad ss","description":"Diagnostic radiology mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3376","name":"Inj vancomycin (hikma) 10mg","description":"Injection, vancomycin hcl (hikma), not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1395","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0411U","name":"Psyc genom alys pnl 15 gen","description":"Psyc genom alys pnl 15 gen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24516","name":"Tx humrl shaft fx imed implt","description":"Treatment of humeral shaft fracture, with insertion of intramedullary implant, with or without cerclage and/or locking screws","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1038.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21100","name":"Maxillofacial fixation","description":"Application of halo type appliance for maxillofacial fixation, includes removal (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2018","name":"Permeaderm c, per sq cm","description":"Permeaderm c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0736T","name":"Colonic lavage 35+l water","description":"Colonic lavage, 35 or more liters of water, gravity-fed, with induced defecation, including insertion of rectal catheter","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37287","name":"Revsc evasc tpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9697","name":"Inj, magtrace per study dose","description":"Injection, carboxydextran-coated superparamagnetic iron oxide, per study dose","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4369","name":"Amnioplast 3 per sq cm","description":"Amnioplast 3, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1323","name":"Inj, elranatamab-bcmm, 1 mg","description":"Injection, elranatamab-bcmm, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5140","name":"Inj adalimumab-fkjp, 1 mg","description":"Injection, adalimumab-fkjp, biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9245","name":"Admin mod sedation-enteral","description":"Admin mod sedation-enteral","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0824T","name":"Tcat rmv 1chmbr ldls pm ra","description":"Transcatheter removal of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography), when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37270","name":"Revsc evasc fpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9293","name":"Fertility cycl tracking soft","description":"Fertility cycle (contraception & conception) tracking software application, fda cleared, per month, includes accessories (e.g., thermometer)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1286","name":"Bmi doc onl fup not cmpltd","description":"Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1015T","name":"Rev/rmv lw esoph sphnc npg/r","description":"Revision or removal, lower esophageal sphincter neurostimulator pulse generator or receiver","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0396","name":"3d print of 3d surface scan","description":"3d print of 3d surface scan","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0350","name":"Oral/facial photo images","description":"Oral/facial photographic images","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0402","name":"Initial preventive exam","description":"Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":200.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64596","name":"Ins/rplcmt prq eltrd ra pn 1","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; initial electrode array","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6251","name":"Bridge resin base metal","description":"Pontic-resin with predominantly base metal","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4437","name":"Revival ac per sq cm","description":"Revival ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4343","name":"Dermacyte ac matrx per sq cm","description":"Dermacyte ac matrix amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33904","name":"Perq p-art revsc each addl","description":"Percutaneous pulmonary artery revascularization by stent placement, each additional vessel or separate lesion, normal or abnormal connections (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5133","name":"Inj, tofidence, 1 mg","description":"Injection, tocilizumab-bavi (tofidence), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0520U","name":"Ther rx mntr 200+ rx/sbsts","description":"Ther rx mntr 200+ rx/sbsts","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37269","name":"Revsc evasc fpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0343U","name":"Onc prst8 xom aly 442 sncrna","description":"Onc prst8 xom aly 442 sncrna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5146","name":"Inj, hercessi, 10 mg","description":"Injection, trastuzumab-strf (hercessi), biosimilar, 10 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7295","name":"Eth estr and eton monthly","description":"Ethinyl estradiol and etonogestrel 0.015mg, 0.12mg per 24 hours; monthly vaginal ring, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9359","name":"Inj lon tesirin-lpyl 0.075mg","description":"Injection, loncastuximab tesirine-lpyl, 0.075 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61680","name":"Intracranial vessel surgery","description":"Surgery of intracranial arteriovenous malformation; supratentorial, simple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2582.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1170","name":"Pt w/o flu vax 7/1-6/30","description":"Patient did not receive an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94664","name":"Demo&/eval pt use inhaler","description":"Demonstration and/or evaluation of patient utilization of an aerosol generator, nebulizer, metered dose inhaler or ippb device","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69643","name":"Revise middle ear & mastoid","description":"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with intact or reconstructed wall, without ossicular chain reconstruction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1409.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0470U","name":"Onc orop detcj mrd 8 dna hpv","description":"Onc orop detcj mrd 8 dna hpv","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0338U","name":"Onc sld tum crcg tum cl slct","description":"Onc sld tum crcg tum cl slct","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27665","name":"Repair of leg tendon each","description":"Repair, extensor tendon, leg; secondary, with or without graft, each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":514.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0460U","name":"Onc whl bld/bucc rtpcr 24gen","description":"Onc whl bld/bucc rtpcr 24gen","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93976","name":"Vascular study","description":"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0941T","name":"Cysto flx ins&xpns urtl scaf","description":"Cystourethroscopy, flexible; with insertion and expansion of prostatic urethral scaffold using integrated cystoscopic visualization","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63032","name":"Lamot rpr anulr dfct 1 lmbr","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; with repair of annular defect by implantation of bone-anchored annular closure device, including all imaging guidance, 1 interspace, lumbar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29450","name":"Application clubfoot cast","description":"Application of clubfoot cast with molding or manipulation, long or short leg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81001","name":"Urinalysis auto w/scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; automated, with microscopy","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96548","name":"Ntraop hipec px ea add 30min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0547U","name":"Neurflmnt lt chn cleia plsm","description":"Neurflmnt lt chn cleia plsm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0911T","name":"Elec aly nstm sys vgs nrv wo","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; without programming by physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0727T","name":"Rmvl&rplcmt implt vstblr dev","description":"Removal and replacement of implanted vestibular device, unilateral","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1340","name":"Indx whodas 2.0 or sds","description":"Index assessment completed using the 12-item whodas 2.0 or sds during the denominator identification period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2865","name":"Inj sulfameth/trim 5 mg/1 mg","description":"Injection, sulfamethoxazole 5 mg and trimethoprim 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0540","name":"Train for caregiver add 15","description":"Caregiver training in behavior management/modification for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face; each additional 15 minutes","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33900","name":"Perq p-art revsc 1 nm nt uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, unilateral","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3389","name":"Topi adm prad zami per treat","description":"Topical administration, prademagene zamikeracel, per treatment","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2781","name":"Crown 3/4 cast base metal","description":"Crown - 3/4 cast predominantly base metal","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9051","name":"Inj, bortezomib (maia)","description":"Injection, bortezomib (maia), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3471","name":"Surg rep root res anterior","description":"Surg rep root res anterior","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2781","name":"Inj, pegcetacoplan, 1mg","description":"Injection, pegcetacoplan, intravitreal, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0520","name":"New pt-cg dyad dem mod cmplx","description":"Management of new patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1013T","name":"Lap srg imp/rpl eso nea&pg/r","description":"Laparoscopy, surgical, implantation or replacement of lower esophageal sphincter neurostimulator electrode array and neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver, including cruroplasty and/or electronic ","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0225","name":"Inj, vutrisiran, 1 mg","description":"Injection, vutrisiran, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33897","name":"Perq trluml angp nt/recr coa","description":"Percutaneous transluminal angioplasty of native or recurrent coarctation of the aorta","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21199","name":"Reconstr lwr jaw w/advance","description":"Osteotomy, mandible, segmental; with genioglossus advancement","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1175.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2024","name":"Resolve or xenopatch sq cm","description":"Resolve matrix or xenopatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94625","name":"Phy/qhp op pulm rhb w/o mntr","description":"Physician or other qualified health care professional services for outpatient pulmonary rehabilitation; without continuous oximetry monitoring (per session)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96160","name":"Pt-focused hlth risk assmt","description":"Administration of patient-focused health risk assessment instrument (eg, health hazard appraisal) with scoring and documentation, per standardized instrument","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["95","ET"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43237","name":"Endoscopic us exam esoph","description":"Esophagogastroduodenoscopy, flexible, transoral; with endoscopic ultrasound examination limited to the esophagus, stomach or duodenum, and adjacent structures","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3291","name":"Tranexamic acid in sod chlor","description":"Injection, tranexamic acid in sodium chloride, 5 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4322","name":"Caregraft, per sq cm","description":"Caregraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0291U","name":"Psyc mood do mrna 144 genes","description":"Psyc mood do mrna 144 genes","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1227","name":"Eb therapy prescribed","description":"Evidence-based therapy was prescribed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0511U","name":"Onc sol tum 3dmicroenvir 36+","description":"Onc sol tum 3dmicroenvir 36+","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1011T","name":"Pbm therapy of oral cavity","description":"Photobiomodulation (pbm) therapy of oral cavity, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0483","name":"Indirect immunofluorescence","description":"Indirect immunofluorescence","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1426","name":"Injection, casimersen, 10 mg","description":"Injection, casimersen, 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0287U","name":"Onc thyr dna&mrna 112 genes","description":"Onc thyr dna&mrna 112 genes","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","name":"Gait mod systm rhym auditory","description":"Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1356","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0561","name":"Temp tube delivery, unil","description":"Tympanostomy with local or topical anesthesia and insertion of a ventilating tube when performed with tympanostomy tube delivery device, unilateral (list separately in addition to 69433) (do not use in conjunction with 0583t)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1393","name":"Pr no dx rec mlnm","description":"Patients who were not diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0904T","name":"Ecg alg 12 ld rdcd trcg only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; tracing only","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1341","name":"Pt no f/u 30-180 dys","description":"Patients who did not have a follow-up assessment or did not have an assessment within 30 to 180 days after the index assessment during the performance period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6105","name":"Remove implant body","description":"Remove implant body","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1221","name":"Dre w/o rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; without evidence of retinopathy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33267","name":"Excl laa open any method","description":"Exclusion of left atrial appendage, open, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4420","name":"Nuform per sq cm","description":"Nuform, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90624","name":"Menb-4c&menacwy vacc im","description":"Meningococcal pentavalent vaccine, men b-4c recombinant proteins and outer membrane vesicle and conjugated men a, c, w, y-diphtheria toxoid carrier, for intramuscular use","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2246","name":"Inj, micafungin (baxter)","description":"Injection, micafungin in sodium (baxter), not therapeutically equivalent to j2248, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1269","name":"Recd esrd mcp lst day of mo","description":"Receiving esrd mcp dialysis services by the provider on the last day of the reporting month","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83013","name":"H pylori (c-13) breath","description":"Helicobacter pylori; breath test analysis for urease activity, non-radioactive isotope (eg, c-13)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90482","name":"Imm cnsl not admn sm 3<10","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; 3 minutes up to 10 minutes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0547U","name":"Neurflmnt lt chn cleia plsm","description":"Neurflmnt lt chn cleia plsm","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26358","name":"Repair/graft hand tendon","description":"Repair or advancement, flexor tendon, in zone 2 digital flexor tendon sheath (eg, no mans land); secondary, with free graft (includes obtaining graft), each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1257.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41113","name":"Excision of tongue lesion","description":"Excision of lesion of tongue with closure; posterior one-third","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1430","name":"Ret exm ou no retinopthy doc","description":"Retinal exam finding without evidence of retinopathy in both eyes with severity level documented (in measurement year or in the prior year)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83655","name":"Assay of lead","description":"Lead","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6614","name":"Onlay cst nbl mtl 2 surfaces","description":"Onlay - cast noble metal two surfaces","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1222","name":"Glaucoma pln of care not doc","description":"Glaucoma plan of care not documented, reason not otherwise specified","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"Motor &/ sens nrve cndj test","description":"Motor and/or sensory nerve conduction, using preconfigured electrode array(s), amplitude and latency/velocity study, each limb, includes f-wave study when performed, with interpretation and report","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1245","name":"Pt othr thn true person","description":"Patient provided a response other than completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1171","name":"Inj, hydromorphone, 0.1 mg","description":"Injection, hydromorphone, 0.1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9393","name":"Inj, fulvestrant (teva)","description":"Injection, fulvestrant (teva), not therapeutically equivalent to j9395, 25 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0799T","name":"Tcat rmvl 2chmbr ldls pm ra","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right atrial pacemaker component","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5725","name":"Rebase hybrid prosthesis","description":"Rebase hybrid prosthesis","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1326","name":"Inj, zolbetuximab-clzb, 2 mg","description":"Injection, zolbetuximab-clzb, 2 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1153","name":"Pt w/ dx osteo doe","description":"Patient with diagnosis of osteoporosis on date of encounter","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33268","name":"Excl laa opn oth px any meth","description":"Exclusion of left atrial appendage, open, performed at the time of other sternotomy or thoracotomy procedure(s), any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0930T","name":"Ephys eval ccm-d ld 1st impl","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), at time of initial implantation or replacement with testing of cardiac contrac","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42408","name":"Excision of salivary cyst","description":"Excision of sublingual salivary cyst (ranula)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58152","name":"Total hysterectomy","description":"Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s); with colpo-urethrocystopexy (eg, marshall-marchetti-krantz, burch)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1461.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0429U","name":"Hpv orop swab 14 hi-risk typ","description":"Hpv orop swab 14 hi-risk typ","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93588","name":"Vngrph chd vnvn cltrl below","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating below the heart (eg, from the inferior vena cava) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2650","name":"Prednisolone acetate inj","description":"Injection, prednisolone acetate, up to 1 ml","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57265","name":"Cmbn ap colprhy w/ntrcl rpr","description":"Combined anteroposterior colporrhaphy, including cystourethroscopy, when performed; with enterocele repair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":833.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55882","name":"Ablt trurl prst8 tis trnsdcr","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation; with insertion of transurethral ultrasound transducer for delivery of thermal ultrasound, including suprapubic tube placement and placement of ","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87076","name":"Culture anaerobe ident each","description":"Culture, bacterial; anaerobic isolate, additional methods required for definitive identification, each isolate","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9432","name":"Med food non inborn err meta","description":"Medical foods for non-inborn errors of metabolism","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46045","name":"I&d absc tranal under anes","description":"Incision and drainage of intramural, intramuscular, or submucosal abscess, transanal, under anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0718T","name":"Adrc ther prtl rc tear njx","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; injection into supraspinatus tendon including ultrasound guidance, unilateral","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1265","name":"Dopamine injection","description":"Injection, dopamine hcl, 40 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0330U","name":"Iadna vag pthgn panel 27 org","description":"Iadna vag pthgn panel 27 org","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19370","name":"Revj peri-implt capsule brst","description":"Revision of peri-implant capsule, breast, including capsulotomy, capsulorrhaphy, and/or partial capsulectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4296","name":"Rebound matrix, per sq cm","description":"Rebound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0454U","name":"U rare ds id opt genome mapg","description":"U rare ds id opt genome mapg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0602U","name":"Endocrin dm ins gen mthyltn","description":"Endocrin dm ins gen mthyltn","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0622U","name":"Psyc mdd dna alys >20000","description":"Psyc mdd dna alys >20000","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4424","name":"Revive ft per sq cm","description":"Revive ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86606","name":"Aspergillus antibody","description":"Antibody; aspergillus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82776","name":"Galactose transferase test","description":"Galactose-1-phosphate uridyl transferase; screen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4339","name":"Artacent vericlen, per sq cm","description":"Artacent vericlen, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1481","name":"Pt in hosp/pal care who died","description":"Patients receiving hospice or palliative care or who died during the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0520","name":"New pt-cg dyad dem mod cmplx","description":"Management of new patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0431","name":"Diag tst detect mucos abnorm","description":"Adjunctive pre-diagnostic test that aids in detection of mucosal abnormalities including premalignant and malignant lesions not to include cytology or biopsy","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0162","name":"Inj epinephrine (fresenius)","description":"Injection, epinephrine (fresenius), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1165","name":"Pt use hspc dur meas pd","description":"Patients who use hospice services any time during the measurement period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76988","name":"Dx ntrop epcr us chd img acq","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; placement, manipulation of transducer, and image acquisition only","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0037","name":"Pt not able to participate","description":"On date of encounter, patient is not able to participate in assessment or screening, including non-verbal patients, delirious, severely aphasic, severely developmentally delayed, severe visual or hearing impairment and for those patients, no knowledgeable informant available","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1441","name":"Init dx slp apn = 1st enc","description":"Encounter corresponds to initial diagnosis of sleep apnea or first contact with sleep apnea diagnosed patient","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43291","name":"Egd flx trnsorl rmvl balo","description":"Esophagogastroduodenoscopy, flexible, transoral; with removal of intragastric bariatric balloon(s)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98011","name":"Synch audio-only new high 60","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 60 ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0605","name":"Sucroferric oxyhydroxide 5mg","description":"Sucroferric oxyhydroxide, oral, 5 mg (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1277","name":"Colorectal ca screen doc rev","description":"Colorectal cancer screening results documented and reviewed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0526U","name":"Nefro rnl trnspl quan cxcl10","description":"Nefro rnl trnspl quan cxcl10","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99437","name":"Chrnc care mgmt phys ea addl","description":"Chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, or funct","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1747","name":"Inj, spesolimab-sbzo, 1 mg","description":"Injection, spesolimab-sbzo, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0872","name":"Daptomycin (xellia) unrefrig","description":"Injection, daptomycin (xellia), unrefrigerated, not therapeutically equivalent to j0878 or j0873, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0613U","name":"Onc uc dna mthyltn&mut 6bmrk","description":"Onc uc dna mthyltn&mut 6bmrk","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4351","name":"Enclose tl matrix, per sq cm","description":"Enclose tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99406","name":"Behav chng smoking 3-10 min","description":"Smoking and tobacco use cessation counseling visit; intermediate, greater than 3 minutes up to 10 minutes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":11.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4375","name":"Duograft ac per sq cm","description":"Duograft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4033","name":"Skilled nursing facility ss","description":"Skilled nursing facility mips specialty set","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6028","name":"Part hand finger metacar amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s) /thumb, amputation at metacarpal level, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12044","name":"Intmd rpr n-hf/genit7.6-12.5","description":"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 7.6 cm to 12.5 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15778","name":"Impl absrb msh/prsth dly cls","description":"Implantation of absorbable mesh or other prosthesis for delayed closure of defect(s) (ie, external genitalia, perineum, abdominal wall) due to soft tissue infection or trauma","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0030","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9347","name":"Inj, tremelimumab-actl, 1 mg","description":"Injection, tremelimumab-actl, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0561","name":"Temp tube delivery, unil","description":"Tympanostomy with local or topical anesthesia and insertion of a ventilating tube when performed with tympanostomy tube delivery device, unilateral (list separately in addition to 69433) (do not use in conjunction with 0583t)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1343","name":"Pt pam lvl 4 base or srt lin","description":"Patients who are at pam level 4 at baseline or patients who are flagged with extreme straight line response sets on the pam or with excessive missing responses","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67835","name":"Revise eyelashes","description":"Correction of trichiasis; incision of lid margin, with free mucous membrane graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":464.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9988","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0580U","name":"Bbrgdrferi antb detc 24rprtn","description":"Bbrgdrferi antb detc 24rprtn","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0909T","name":"Rplcmt int nstim sys vgs nrv","description":"Replacement of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4304","name":"Grafix plus, per sq cm","description":"Grafix plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1202","name":"Miglustat oral 65 mg","description":"Miglustat, oral, 65 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4432","name":"510(k) skin subs, nos","description":"510(k) skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37267","name":"Revsc evsc fpvt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9247","name":"Mod sedation noniv-sub15min","description":"Mod sedation noniv-sub15min","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0547","name":"Phone/internet svs 11-20 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0858T","name":"Ext trnscranl mag stimj meas","description":"Externally applied transcranial magnetic stimulation with concomitant measurement of evoked cortical potentials with automated report","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0687T","name":"Tx amblyopia dev setup 1st","description":"Treatment of amblyopia using an online digital program; device supply, educational set-up, and initial session","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45390","name":"Colonoscopy w/resection","description":"Colonoscopy, flexible; with endoscopic mucosal resection","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":310.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85004","name":"Automated diff wbc count","description":"Blood count; automated differential wbc count","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0002","name":"Opt care kidney hlth mvp","description":"Optimal care for kidney health mips value pathways","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6610","name":"G com stcking bk 18-30 custm","description":"Gradient compression stocking, below knee, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":226.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82487","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99195","name":"Phlebotomy","description":"Phlebotomy, therapeutic (separate procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0714T","name":"Tpla b9 prst8 hyprplsa<50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume less than 50 ml","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2472","name":"Inj, pantoprazole sodium chl","description":"Injection, pantoprazole sodium in sodium chloride (baxter), 40 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0621U","name":"Nfct ds lb dna alys>10000","description":"Nfct ds lb dna alys>10000","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2012","name":"Suprathel, per sq cm","description":"Suprathel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1612","name":"Inj glucagon (gvoke) 0.01 mg","description":"Injection, glucagon (gvoke), 0.01 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33276","name":"Insj phrnc nrv stim sys","description":"Insertion of phrenic nerve stimulator system (pulse generator and stimulating lead[s]), including vessel catheterization, all imaging guidance, and pulse generator initial analysis with diagnostic mode activation, when performed","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0799","name":"Hiv prep, fda approved, noc","description":"Fda approved prescription drug, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv), not otherwise classified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4438","name":"Pretect per sq cm","description":"Pretect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15854","name":"Removal sutr&stapl xreq anes","description":"Removal of sutures and staples not requiring anesthesia (list separately in addition to e/m code)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83789","name":"Mass spectrometry qual/quan","description":"Mass spectrometry and tandem mass spectrometry (eg, ms, ms/ms, maldi, ms-tof, qtof), non-drug analyte(s) not elsewhere specified, qualitative or quantitative, each specimen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0805T","name":"Tcat s&ivc prstc vl impl prq","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); percutaneous femoral vein approach","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1304","name":"No pneum vax admin 19+","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7771","name":"Alveolus clsd reduc stblz te","description":"Alveolus closed reduction stabilization of teeth","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90593","name":"Chikungunya vacc recomb im","description":"Chikungunya virus vaccine, recombinant, for intramuscular use","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0224","name":"Pemivibart infusion","description":"Intravenous infusion, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppr","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93978","name":"Vascular study","description":"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4275","name":"Esano aca, per sq cm","description":"Esano aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9064","name":"Inj, cabazitaxel (sandoz)","description":"Injection, cabazitaxel (sandoz), not therapeutically equivalent to j9043, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82465","name":"Assay bld/serum cholesterol","description":"Cholesterol, serum or whole blood, total","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9616","name":"Gallium gozellix 1 millicuri","description":"Gallium ga-68 gozetotide (gozellix), diagnostic, 1 millicurie","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86277","name":"Growth hormone antibody","description":"Growth hormone, human (hgh), antibody","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55711","name":"Bx prst8 trct mri-us 1st","description":"Biopsy, prostate, transrectal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4457","name":"Enema tube any type repl","description":"Enema tube, with or without adapter, any type, replacement only, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86906","name":"Bld typing serologic rh phnt","description":"Blood typing, serologic; rh phenotyping, complete","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0124","name":"Screen c/v thin layer by md","description":"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, requiring interpretation by physician","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99315","name":"Nf dschrg mgmt 30 min/less","description":"Nursing facility discharge management; 30 minutes or less total time on the date of the encounter","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":83.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7294","name":"Seg acet and eth estr yearly","description":"Segesterone acetate and ethinyl estradiol 0.15mg, 0.013mg per 24 hours; yearly vaginal system, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26236","name":"Partial removal finger bone","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis); distal phalanx of finger","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":522.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0825T","name":"Tcat rmv&rpl1chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or prog","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0686T","name":"Histotripsy mal hepatcel tis","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant hepatocellular tissue, including image guidance","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0624U","name":"Hep nash dna mthyl alys 5000","description":"Hep nash dna mthyl alys 5000","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33957","name":"Ecmo/ecls repos perph cnula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; reposition peripheral (arterial and/or venous) cannula(e), percutaneous, birth through 5 years of age (includes fluoroscopic guidance, when performed)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"Rec cath any transanal, each","description":"Rectal catheter with or without balloon, for use with any type transanal irrigation system, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62201","name":"Brain cavity shunt w/scope","description":"Ventriculocisternostomy, third ventricle; stereotactic, neuroendoscopic method","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1279.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90473","name":"Immune admin oral/nasal","description":"Immunization administration by intranasal or oral route; 1 vaccine (single or combination vaccine/toxoid)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"Non-adju cgm supply allow","description":"Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0513U","name":"Onc prst8 alg alys msi&hrd","description":"Onc prst8 alg alys msi&hrd","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0268U","name":"Hem ahus gen seq alys 15 gen","description":"Hematology (atypical hemolytic uremic syndrome [ahus]), genomic sequence analysis of 15 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0796T","name":"Tcat ins 2chmbr ldls pm ra","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right atrial pacemaker","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4276","name":"Orion, per sq cm","description":"Orion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53505","name":"Repair of urethra injury","description":"Urethrorrhaphy, suture of urethral wound or injury; penile","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":527.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4016","name":"Neurosurgical ss","description":"Neurosurgical mips specialty set","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7173","name":"Inj. concizumab-mtci, 0.5 mg","description":"Injection, concizumab-mtci, 0.5 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"Adju cgm supply allowance","description":"Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KF"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87075","name":"Cultr bacteria except blood","description":"Culture, bacterial; any source, except blood, anaerobic with isolation and presumptive identification of isolates","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90759","name":"Hep b vac 3ag 10mcg 3 dos im","description":"Hepatitis b vaccine (hepb), 3-antigen (s, pre-s1, pre-s2), 10 mcg dosage, 3 dose schedule, for intramuscular use","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4004","name":"Endocrinology ss","description":"Endocrinology mips specialty set","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0418U","name":"Onc brst aug alg aly whl sl8","description":"Onc brst aug alg aly whl sl8","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1375","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43497","name":"Transorl lwr esophgl myotomy","description":"Lower esophageal myotomy, transoral (ie, peroral endoscopic myotomy [poem])","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74000","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1233","name":"Pt no hcv aby or result","description":"Patient does not receive hcv antibody test or patient does receive hcv antibody test but results not documented, reason not given","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22836","name":"Ant thrc vrt body tethrg <7","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; up to 7 vertebral segments","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7023","name":"Mech allergen parti barrier","description":"Mechanical allergen particle barrier/inhalation filter, cream, nasal, topical","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37261","name":"Revsc evasc ivt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26170","name":"Removal of palm tendon each","description":"Excision of tendon, palm, flexor or extensor, single, each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":475.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0867T","name":"Tpla b9 prst8 hyprplsa>=50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume greater or equal to 50 ml","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15015","name":"App skn cl ssp agrft t/a/l 1","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; first 480 sq cm or less","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1304","name":"Inj tofersen intrathec 1 mg","description":"Injection, tofersen, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1261","name":"Pts on wtlist bef dialysis","description":"Patients that were on the kidney or kidney-pancreas waitlist prior to initiation of dialysis","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0522U","name":"Ca vi psp&sp1 antb cl semiql","description":"Ca vi psp&sp1 antb cl semiql","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11201","name":"Rmvl skin tags ea addl 10","description":"Removal of skin tags, multiple fibrocutaneous tags, any area; each additional 10 lesions, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":14.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":21.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1020T","name":"Raman spectroscopy 1+skn les","description":"Raman spectroscopy of 1 or more skin lesions, with probability score for malignant risk derived by algorithmic analysis of data from each lesion","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2021","name":"Neomatrix per sq cm","description":"Neomatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92137","name":"Cptrz oph img pst sg rta oct","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), posterior segment, with interpretation and report, unilateral or bilateral; retina, including oct angiography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0282U","name":"Rbc dna gntyp 12 bld grp gen","description":"Red blood cell antigen typing, dna, genotyping of 12 blood group system genes to predict 44 red blood cell antigen phenotypes","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1461","name":"Pt dx chron hepc","description":"Patient diagnosis for chronic hepatitis c","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5914","name":"Auricular prosthesis","description":"Auricular prosthesis","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4361","name":"Epixpress, per sq cm","description":"Epixpress, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1180","name":"Pt imm ckpt inhib therapy","description":"Patients on immune checkpoint inhibitor therapy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38225","name":"Car-t hrv bld-drv t lymphcyt","description":"Chimeric antigen receptor t-cell (car-t) therapy; harvesting of blood-derived t lymphocytes for development of genetically modified autologous car-t cells, per day","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1224","name":"Iop dec <20% from base","description":"Intraocular pressure (iop) reduced by a value less than 20% from the pre-intervention level","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0992T","name":"N-invas assmt car rsk w/o ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat without concurrent computed tomography (ct) scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43450","name":"Dilate esophagus 1/mult pass","description":"Dilation of esophagus, by unguided sound or bougie, single or multiple passes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0268U","name":"Hem ahus gen seq alys 15 gen","description":"Hematology (atypical hemolytic uremic syndrome [ahus]), genomic sequence analysis of 15 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1331","name":"Pts eval ini xm 8 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 8 weeks from initial exam","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"Ak 4 bar link hydl swg/stanc","description":"Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97760","name":"Orthotic mgmt&traing 1st enc","description":"Orthotic(s) management and training (including assessment and fitting when not otherwise reported), upper extremity(ies), lower extremity(ies) and/or trunk, initial orthotic(s) encounter, each 15 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33510","name":"Cabg vein single","description":"Coronary artery bypass, vein only; single coronary venous graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2230.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2252","name":"Inj midazolam in 0.8% nacl","description":"Injection, midazolam in 0.8% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64473","name":"Lwr xtr fscl pln blk uni njx","description":"Lower extremity fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1921","name":"Inj labetalol hcl hikma, 5mg","description":"Injection, labetalol hydrochloride (hikma), not therapeutically equivalent to j1920, 5 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1230","name":"Pt hcv rctv aby no f/u tst","description":"Patient has a reactive hcv antibody test and does not have a follow up hcv viral test, or patient has a reactive hcv antibody test and has a follow up hcv viral test that detects hcv viremia and is not referred to a clinician who treats hcv infection within 1 month and does not have hcv treatment in","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0404U","name":"Onc brst semiq meas thym kn","description":"Onc brst semiq meas thym kn","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1941","name":"Inj, furoscix, 20 mg","description":"Injection, furosemide (furoscix), 20 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0372U","name":"Nfct ds gu pthgn arg detcj","description":"Nfct ds gu pthgn arg detcj","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"Ctlso a-p-l control custom","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0268","name":"Removal of impacted wax md","description":"Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1204","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1475","name":"Pt dx huntington","description":"Patients with diagnosis of huntingtons disease","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64598","name":"Revj/rmvl nea pn w/int nstim","description":"Revision or removal of neurostimulator electrode array, peripheral nerve, with integrated neurostimulator","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6073","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (predominantly base metal)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0432U","name":"Klhl11 antb sr/csf asy qual","description":"Klhl11 antb sr/csf asy qual","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0333U","name":"Onc lvr surveilanc hcc cfdna","description":"Onc lvr surveilanc hcc cfdna","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4304","name":"Grafix plus, per sq cm","description":"Grafix plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65860","name":"Severing ads ant sgm laser","description":"Severing adhesions of anterior segment, laser technique (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":274.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9333","name":"Inj rozanolixizum-noli 1 mg","description":"Injection, rozanolixizumab-noli, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33902","name":"Perq p-art revsc 1 abnor uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, unilateral","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1458","name":"Pt died bef end meas pd","description":"Patient died prior to the end of the performance period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1010T","name":"Cptr oph alys monoc eye mvmt","description":"Computerized ophthalmic analysis of monocular eye movements using retinal-based eye-tracking without spatial calibration, including fixation, microsaccades, drift, and horizontal saccades, when performed, unilateral or bilateral, with interpretation and report","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33236","name":"Remove electrode/thoracotomy","description":"Removal of permanent epicardial pacemaker and electrodes by thoracotomy; single lead system, atrial or ventricular","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":974.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1203","name":"No rsn ace-i/arb rx","description":"Ace inhibitor or arb therapy not prescribed during the measurement period, reason not given","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5152","name":"Inj, eculizumab-aeeb, 2 mg","description":"Injection, eculizumab-aeeb (bkemv), biosimilar, 2 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1369","name":"Qualcare mental hlth/sud mvp","description":"Quality care in mental health and substance use disorders mips value pathway","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0496U","name":"Onc clrct cfdna 8/7 genes","description":"Onc clrct cfdna 8/7 genes","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36406","name":"Vnpnxr<3yrs phy/qhp other vn","description":"Venipuncture, younger than age 3 years, necessitating the skill of a physician or other qualified health care professional, not to be used for routine venipuncture; other vein","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":8.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37299","name":"Revsc evsc imvt angio cpx ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0248","name":"Inj, remdesivir, 1 mg","description":"Injection, remdesivir, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2002","name":"Inj, lidocaine in d5w, 1 mg","description":"Injection, lidocaine hcl in 5% dextrose, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1017T","name":"Elec aly npgs esoph sbsq w/o","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2781","name":"Inj, pegcetacoplan, 1mg","description":"Injection, pegcetacoplan, intravitreal, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60660","name":"Abltj 1/+thyr ndul 1lobe prq","description":"Ablation of 1 or more thyroid nodule(s), one lobe or the isthmus, percutaneous, including imaging guidance, radiofrequency","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81001","name":"Urinalysis auto w/scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; automated, with microscopy","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98006","name":"Synch audio-video est mod 30","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15740","name":"Island pedicle flap graft","description":"Flap; island pedicle requiring identification and dissection of an anatomically named axial vessel","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":853.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9334","name":"Inj efgart-alfa 2mg hya-qvfc","description":"Injection, efgartigimod alfa, 2 mg and hyaluronidase-qvfc","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0949T","name":"Rem interrog dev ccm tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4438","name":"Adhesive clip ext ens contr","description":"Adhesive clip applied to the skin to secure external electrical nerve stimulator controller, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1426","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1446","name":"Pt died bef end meas pd","description":"Patients who died any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1469","name":"Hx of hep b, or pos bld test","description":"Patient has a history of hepatitis b illness or received a hepatitis b surface antigen, hepatitis b surface antibody, or total antibody to hepatitis b core antigen test with a positive result any time before or during the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4303","name":"Complete aa, per sq cm","description":"Complete aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86043","name":"Acetylcholn rcptr modlg antb","description":"Acetylcholine receptor (achr); modulating antibody","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76805","name":"Ob us >/= 14 wks sngl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0679T","name":"Laps rmvl lead isdss","description":"Laparoscopic removal of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1026","name":"Pt hemo > 3mo","description":"The number of adult patient-months in the denominator who were on maintenance hemodialysis using a catheter continuously for three months or longer under the care of the same practitioner or group partner as of the last hemodialysis session of the reporting month","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4560","name":"Nmes disposable","description":"Neuromuscular electrical stimulator (nmes), disposable, replacement only","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27254","name":"Treat hip dislocation","description":"Open treatment of hip dislocation, traumatic, with acetabular wall and femoral head fracture, with or without internal or external fixation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1518.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93150","name":"Therapy activation ipnss","description":"Therapy activation of implanted phrenic nerve stimulator system, including all interrogation and programming","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1165","name":"Pt use hspc dur meas pd","description":"Patients who use hospice services any time during the measurement period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0849T","name":"Dgtz gls mcrscp ish ea adl 1","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1356","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93145","name":"Interrog crtd sins bat ip wo","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1461","name":"Pt dx chron hepc","description":"Patient diagnosis for chronic hepatitis c","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0750T","name":"B1 str&fx rsk asmt dxrbmd1vw","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0506U","name":"Gi barretts esophgl cell 89","description":"Gi barretts esophgl cell 89","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27132","name":"Total hip arthroplasty","description":"Conversion of previous hip surgery to total hip arthroplasty, with or without autograft or allograft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1954.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4410","name":"Amchomatrixdl per sq cm","description":"Amchomatrixdl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0398U","name":"Gi baret esph dna mthyln aly","description":"Gi baret esph dna mthyln aly","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1280","name":"Bilat mast/hx bi /unilat mas","description":"Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1496","name":"No doc of fall or poc","description":"Patients that had a fall who did not have a plan of care for falls documented or do not have documentation of being assessed for falls","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1499","name":"Interventional radiology mvp","description":"Interventional radiology mips value pathway","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0396","name":"3d print of 3d surface scan","description":"3d print of 3d surface scan","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1423","name":"Opt care urologic cnd mvp","description":"Optimal care for patients with urologic conditions mips value pathway","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64728","name":"Dcmprn median nrv carpl tunl","description":"Decompression; median nerve at the carpal tunnel, percutaneous, with intracarpal tunnel balloon dilation, including ultrasound guidance","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98011","name":"Synch audio-only new high 60","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 60 ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0327U","name":"Ftl aneuploidy trsmy dna seq","description":"Ftl aneuploidy trsmy dna seq","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4011","name":"Internal medicine ss","description":"Internal medicine mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0316U","name":"B brgdrferi lyme ds ospa evl","description":"B brgdrferi lyme ds ospa evl","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2058","name":"Obecbtge autol up to 400 mil","description":"Obecabtagene autoleucel, 10 up to 400 million cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per infusion","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90955","name":"Esrd srv 2-3 vsts p mo 2-11","description":"End-stage renal disease (esrd) related services monthly, for patients 2-11 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 2-3 face-to-face visits by a physician or other qualified health care professional per mo","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1480","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0758T","name":"Dgtz gls mcrscp sl spc hchem","description":"Digitization of glass microscope slides for special stain, including interpretation and report, histochemical stain on frozen tissue block (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62268","name":"Drain spinal cord cyst","description":"Percutaneous aspiration, spinal cord cyst or syrinx","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":321.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0826T","name":"Prgrmg evl ldls pm 1chmbr ip","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional, leadless pacemaker system in si","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7173","name":"Inj. concizumab-mtci, 0.5 mg","description":"Injection, concizumab-mtci, 0.5 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0371","name":"Sialoendoscopy capt & interp","description":"Sialoendoscopy capt & interp","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82985","name":"Assay of glycated protein","description":"Glycated protein","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76100","name":"X-ray exam of body section","description":"Radiologic examination, single plane body section (eg, tomography), other than with urography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4037","name":"Urology ss","description":"Urology mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3471","name":"Surg rep root res anterior","description":"Surg rep root res anterior","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0694T","name":"3d vol img&rcnstj brst/ax","description":"3-dimensional volumetric imaging and reconstruction of breast or axillary lymph node tissue, each excised specimen, 3-dimensional automatic specimen reorientation, interpretation and report, real-time intraoperative","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27218","name":"Treat pelvic ring fracture","description":"Open treatment of posterior pelvic bone fracture and/or dislocation, for fracture patterns that disrupt the pelvic ring, unilateral, includes internal fixation, when performed (includes ipsilateral ilium, sacroiliac joint and/or sacrum)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1588.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34707","name":"Evasc rpr ilio-iliac ndgft","description":"Endovascular repair of iliac artery by deployment of an ilio-iliac tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, and all endograft extension(s) proximally to the aortic bifurcation ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1226.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2601","name":"Inj, vasopressin (baxter)","description":"Injection, vasopressin (baxter), 1 unit","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31201","name":"Removal of ethmoid sinus","description":"Ethmoidectomy; intranasal, total","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":831.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9002","name":"Intra-vag motion sens biofk","description":"Intra-vaginal motion sensor system, provides biofeedback for pelvic floor muscle rehabilitation device","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37269","name":"Revsc evasc fpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9608","name":"Flotufolastat f18 diag 1 mci","description":"Flotufolastat f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0917T","name":"Insj perm ccm-d sys 1 lead","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; single transvenous lead (pacing or defibrillation) only","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64629","name":"Trml dstrj ios bvn ea addl","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; each additional vertebral body, lumbar or sacral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56632","name":"Vlvctmy rad prtl bi lymphad","description":"Vulvectomy, radical, partial; with bilateral inguinofemoral lymphadenectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1427.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64657","name":"Rmvl bat modulj sys tot sys","description":"Removal of baroreflex activation therapy (bat) modulation system; total system, including lead and pulse generator","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90631","name":"H5 vaccine pandemic im use","description":"Influenza virus vaccine (iiv), h5, pandemic formulation, split virus, adjuvanted, for intramuscular use","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1720","name":"Influenza vacc admin","description":"Influenza vacc admin","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1216","name":"No spiro doc no res doc","description":"No spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and/or no spirometry performed with results documented during the encounter","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1453","name":"Preop vis acu > 20/40","description":"Patients with a pre-operative visual acuity better than 20/40","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0279U","name":"Hem vw factor&clgn iii bndg","description":"Hematology (von willebrand disease [vwd]), von willebrand factor (vwf) and collagen iii binding by enzyme-linked immunosorbent assays (elisa), plasma, report of collagen iii binding","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43193","name":"Esophagoscp rig trnso biopsy","description":"Esophagoscopy, rigid, transoral; with biopsy, single or multiple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8005","name":"Grip glove w microprocessor","description":"Powered, cable driven grip assist glove, hand, finger, includes microprocessor, pressure sensors, all components and accessories, custom fitted","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1411","name":"Inj, hemgenix, per tx dose","description":"Injection, etranacogene dezaparvovec-drlb, per therapeutic dose","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69970","name":"Remove inner ear lesion","description":"Removal of tumor, temporal bone","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2496.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9128","name":"Photobio therpy-first 15 min","description":"Photobio therpy-first 15 min","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0752T","name":"Dgtz gls mcrscp sld lvl iii","description":"Digitization of glass microscope slides for level iii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62331","name":"Dcmprn prq rmv lig flv addl","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; additional interspace(s), lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1323","name":"Inj, elranatamab-bcmm, 1 mg","description":"Injection, elranatamab-bcmm, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25526","name":"Optx rdl shft fx&dstl rad/ul","description":"Open treatment of radial shaft fracture, includes internal fixation, when performed, and open treatment of distal radioulnar joint dislocation (galeazzi fracture/ dislocation), includes internal fixation, when performed, includes repair of triangular fibrocartilage complex","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1312.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50976","name":"Ureter endoscopy & treatment","description":"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without biopsy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":553.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0804T","name":"Prgrmg evl ldls pm 2chmbr ip","description":"Programming device evaluation (in person) with iterative adjustment of implantable device to test the function of device and to select optimal permanent programmed values, with analysis, review, and report, by a physician or other qualified health care professional, leadless pacemaker system in dual","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1021T","name":"Active thrc irrigation spx","description":"Active thoracic irrigation (separate procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9026","name":"Inj, tarlatamab-dlle, 1 mg","description":"Injection, tarlatamab-dlle, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87478","name":"Borrelia miyamotoi amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); borrelia miyamotoi, amplified probe technique","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1251","name":"Pts proxy cmplt hu surv","description":"Patients for whom a proxy completed the entire hu survey on their behalf for any reason (no patient involvement)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6525","name":"G com garm lwrleg/ft ngt cus","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, custom, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0848T","name":"Dgtz gls mcrscp ish 1st","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0568","name":"Int psych care mng, 1 cal mo","description":"Initial psychiatric collaborative care management, in the first calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required elements: outrea","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37272","name":"Revsc evsc fpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0453U","name":"Onc clrct ca cfdna qpcr asy","description":"Onc clrct ca cfdna qpcr asy","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83987","name":"Exhaled breath condensate","description":"Ph; exhaled breath condensate","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92637","name":"Hearing aid pst-fitg f-up ea","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69222","name":"Clean out mastoid cavity","description":"Debridement, mastoidectomy cavity, complex (eg, with anesthesia or more than routine cleaning)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37261","name":"Revsc evasc ivt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4543","name":"Supply trans elec nerve stim","description":"Supplies for transcutaneous electrical nerve stimulator, for nerves in the auricular region, per month","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0799T","name":"Tcat rmvl 2chmbr ldls pm ra","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right atrial pacemaker component","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9954","name":"Fab/del oral appliance thxpy","description":"Fab/del oral appliance thxpy","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0712T","name":"N-nvs artl plaq alys quan","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess atherosclerotic plaque stability","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76019","name":"Mr safety implt pos&/immoblj","description":"Mr safety implant positioning and/or immobilization under supervision of physician or other qualified health care professional, including application of physical protections to secure implanted medical device from mr-induced translational or vibrational forces, magnetically induced functional change","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82043","name":"Ur albumin quantitative","description":"Albumin; urine (eg, microalbumin), quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1267","name":"Pt no act kid transplt wtlst","description":"Patients not observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1255","name":"Pts w/ othr rsn vst,+prg tst","description":"Patients who have another reason for visiting the clinic [not prenatal or postpartum care] and have a positive pregnancy test but have not established the clinic as an ob provider (e.g., plan to terminate the pregnancy or seek prenatal services elsewhere)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88150","name":"Cytopath c/v manual","description":"Cytopathology, slides, cervical or vaginal; manual screening under physician supervision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1430","name":"Ret exm ou no retinopthy doc","description":"Retinal exam finding without evidence of retinopathy in both eyes with severity level documented (in measurement year or in the prior year)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0459U","name":"Abeta42 & ttau eclia csf","description":"Abeta42 & ttau eclia csf","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82234","name":"Beta-amyloid 1-42 (abeta 42)","description":"Beta-amyloid; 1-42 (abeta 42)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2313","name":"Inj, naloxone (zimhi) 0.01mg","description":"Injection, naloxone hydrochloride (zimhi), 0.01 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0892","name":"Argatroban dialysis (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1596","name":"Inj, glycopyrrolate, 0.1 mg","description":"Injection, glycopyrrolate, 0.1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0662","name":"Team remote e/m new pt 30 mn","description":"Team remote e/m new pt 30 mins","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69728","name":"Rmv ntr oi imp sk tc>=100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":329.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87626","name":"Hpv sep hi-rsk typ&pool rslt","description":"Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), separately reported high-risk types (eg, 16, 18, 31, 45, 51, 52) and high-risk pooled result(s)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1152","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81338","name":"Mpl gene common variants","description":"Mpl (mpl proto-oncogene, thrombopoietin receptor) (eg, myeloproliferative disorder) gene analysis; common variants (eg, w515a, w515k, w515l, w515r)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22836","name":"Ant thrc vrt body tethrg <7","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; up to 7 vertebral segments","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1710","name":"Moderna vacc admin 3rd dose","description":"Moderna vacc admin 3rd dose","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64655","name":"Revj/rplcmt bat mod sys lead","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; lead only","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5099","name":"Inj ustekinumab-stba, 1 mg","description":"Injection, ustekinumab-stba (steqeyma), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63042","name":"Laminotomy single lumbar","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; lumbar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1520.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9957","name":"Screening sleep disorders","description":"Screening sleep disorders","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0700T","name":"Molec fluor img sus nev 1st","description":"Molecular fluorescent imaging of suspicious nevus; first lesion","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93574","name":"Njx cath slct pulm vn angrph","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary venous angiography of each distinct pulmonary vein during cardiac catheterization (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64740","name":"Incision of tongue nerve","description":"Transection or avulsion of; lingual nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0312U","name":"Ai ds sle alys 8 igg autoant","description":"Ai ds sle alys 8 igg autoant","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1366","name":"Focus on womens health mvp","description":"Focusing on womens health mips value pathway","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76883","name":"Us nrv&acc strux 1xtr compre","description":"Ultrasound, nerve(s) and accompanying structures throughout their entire anatomic course in one extremity, comprehensive, including real-time cine imaging with image documentation, per extremity","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93225","name":"Xtrnl ecg rec<48 hrs rec","description":"External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage; recording (includes connection, recording, and disconnection)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4291","name":"Lamellas xt, per sq cm","description":"Lamellas xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0423U","name":"Psyc genomic alys pnl 26 gen","description":"Psyc genomic alys pnl 26 gen","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21480","name":"Cltx tmprmand dislc 1st/sbsq","description":"Closed treatment of temporomandibular dislocation; initial or subsequent","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4359","name":"Choriply, per sq cm","description":"Choriply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0942T","name":"Cysto flx rmv&rplc urtl scaf","description":"Cystourethroscopy, flexible; with removal and replacement of prostatic urethral scaffold","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4029","name":"Preventive medicine ss","description":"Preventive medicine mips specialty set","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9947","name":"Sleep apnea appliance","description":"Sleep apnea appliance","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4025","name":"Physical medicine ss","description":"Physical medicine mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0738","name":"Hiv prep, inj, lenacapavir","description":"Injection, lenacapavir, 1 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37283","name":"Rvsc evsc tpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0300U","name":"Onc pan tum whl gen seq&opt","description":"Onc pan tum whl gen seq&opt","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32665","name":"Thoracoscop w/esoph musc exc","description":"Thoracoscopy, surgical; with esophagomyotomy (heller type)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1157.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93584","name":"Vngrph chd anom/persist svc","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; anomalous or persistent superior vena cava when it exists as a second contralateral superior vena cava, with native drainage to heart (list separately in addition to code for pri","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0553U","name":"Repr med pga embry te strux","description":"Repr med pga embry te strux","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3424","name":"Inj hydroxocobalamin iv 25mg","description":"Injection, hydroxocobalamin, intravenous, 25 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64486","name":"Tap block unil by injection","description":"Transversus abdominis plane (tap) block (abdominal plane block, rectus sheath block) unilateral; by injection(s) (includes imaging guidance, when performed)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86825","name":"Hla x-math non-cytotoxic","description":"Human leukocyte antigen (hla) crossmatch, non-cytotoxic (eg, using flow cytometry); first serum sample or dilution","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1210","name":">=2 same meds tbl4 not ord","description":"At least two orders for high-risk medications from the same drug class, (table 4), not ordered","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1343","name":"Pt pam lvl 4 base or srt lin","description":"Patients who are at pam level 4 at baseline or patients who are flagged with extreme straight line response sets on the pam or with excessive missing responses","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6584","name":"Grad com wrap w straps","description":"Gradient compression wrap with adjustable straps, not otherwise specified","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1345","name":"Pt bsln pam, 2nd scr 4-12 mo","description":"Patients who had a baseline pam score and a second score within 4 to 12 month of baseline pam score","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69729","name":"Impl oi implt sk tc esp>=100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside of the mastoid and resulting in removal of greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76883","name":"Us nrv&acc strux 1xtr compre","description":"Ultrasound, nerve(s) and accompanying structures throughout their entire anatomic course in one extremity, comprehensive, including real-time cine imaging with image documentation, per extremity","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0569","name":"Subs psych care mng, subs mo","description":"Subsequent psychiatric collaborative care management, in a subsequent month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required elements: tracking ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1153","name":"Pt w/ dx osteo doe","description":"Patient with diagnosis of osteoporosis on date of encounter","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86808","name":"Cytotoxic antibody screening","description":"Serum screening for cytotoxic percent reactive antibody (pra); quick method","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9601","name":"Inj linvoseltamab-gcpt 1 mg","description":"Injection, linvoseltamab-gcpt, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0092A","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0493U","name":"Trnspl med quan dd-cfdna ngs","description":"Trnspl med quan dd-cfdna ngs","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5657","name":"Add low ext man aut vol any","description":"Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":306.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6604","name":"G com bandge low dn foam flt","description":"Gradient compression bandaging supply, low density flat foam sheet, per 250 square centimeters, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1167","name":"Hspc dur meas pd","description":"In hospice or using hospice services during the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90612","name":"Inf&sarscov2 vacc 31.7/.32im","description":"Influenza virus vaccine, trivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 31.7 mcg/0.32 ml dosage, for intramuscular use","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3244","name":"Inj. tigecycline (accord)","description":"Injection, tigecycline (accord), not therapeutically equivalent to j3243, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7111","name":"Extraction coronal remnants","description":"Extraction coronal remnants - deciduous tooth","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0468U","name":"Hep nash mir34a5p a2m ykl40","description":"Hep nash mir34a5p a2m ykl40","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0577U","name":"Onc ovr serum alys 39 gps","description":"Onc ovr serum alys 39 gps","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6107","name":"Tissue regen non-resorbable","description":"Tissue regen non-resorbable","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"X-ray exam chest 2 views","description":"Radiologic examination, chest; 2 views","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1297","name":"Bmi not doc medrsn ptref","description":"Bmi not documented due to medical reason or patient refusal of height or weight measurement","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37290","name":"Revsc evsc tpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9268","name":"Programmer orally ingest cap","description":"Programmer for transient, orally ingested capsule","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2281","name":"Inj moxifloxacin (fres kabi)","description":"Injection, moxifloxacin (fresenius kabi), not therapeutically equivalent to j2280, 100 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60545","name":"Explore adrenal gland","description":"Adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal (separate procedure); with excision of adjacent retroperitoneal tumor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1348.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0431U","name":"Gly rcptr alpha1 igg srm/csf","description":"Gly rcptr alpha1 igg srm/csf","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6089","name":"Access/retorq implant screw","description":"Access/retorq implant screw","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5611","name":"Rep resin part dent base man","description":"Rep resin part dent base man","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1379","name":"10 yr fu no rec rsn not giv","description":"A 10 year follow-up interval for colonoscopy not recommended, reason not otherwise specified","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1197","name":"Isa reduced >=3 fr ixv","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92622","name":"Dx aly aud oi snd prcsr 1st","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; first 60 minutes","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91319","name":"Sarscv2 vac 10mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 10 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9024","name":"Inj atezolizumb 5mg hya-tqjs","description":"Injection, atezolizumab, 5 mg and hyaluronidase-tqjs","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0919T","name":"Rmvl perm ccm-d sys pg only","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); pulse generator only","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0650","name":"Inj, levothyroxine nos 10mcg","description":"Injection, levothyroxine sodium, not otherwise specified, 10 mcg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59856","name":"Induced ab 1+vag supp d&c","description":"Induced abortion, by 1 or more vaginal suppositories (eg, prostaglandin) with or without cervical dilation (eg, laminaria), including hospital admission and visits, delivery of fetus and secundines; with dilation and curettage and/or evacuation","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":531.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0107","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0687T","name":"Tx amblyopia dev setup 1st","description":"Treatment of amblyopia using an online digital program; device supply, educational set-up, and initial session","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64417","name":"Njx aa&/strd ax nerve img","description":"Injection(s), anesthetic agent(s) and/or steroid; axillary nerve, including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12020","name":"Tx supfc wnd dehsn smpl clsr","description":"Treatment of superficial wound dehiscence; simple closure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":211.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":375.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38225","name":"Car-t hrv bld-drv t lymphcyt","description":"Chimeric antigen receptor t-cell (car-t) therapy; harvesting of blood-derived t lymphocytes for development of genetically modified autologous car-t cells, per day","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49557","name":"Rerepair fem hernia blocked","description":"Repair recurrent femoral hernia; incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":784.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0770T","name":"Vr technology assist therapy","description":"Virtual reality technology to assist therapy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0504U","name":"Nfct ds uti id 17 path orgs","description":"Nfct ds uti id 17 path orgs","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0821T","name":"Mntr psychdlc med 2ndphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; second physician or other qualified health care professional, concurrent with first physician or other qualified health care professional, each hour (list sepa","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86317","name":"Immunoassay infectious agent","description":"Immunoassay for infectious agent antibody, quantitative, not otherwise specified","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11300","name":"Shave skin lesion 0.5 cm/<","description":"Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion diameter 0.5 cm or less","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":92.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64864","name":"Repair of facial nerve","description":"Suture of facial nerve; extracranial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1011.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4300","name":"Acesso tl, per sq cm","description":"Acesso tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0718T","name":"Adrc ther prtl rc tear njx","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; injection into supraspinatus tendon including ultrasound guidance, unilateral","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87075","name":"Cultr bacteria except blood","description":"Culture, bacterial; any source, except blood, anaerobic with isolation and presumptive identification of isolates","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76019","name":"Mr safety implt pos&/immoblj","description":"Mr safety implant positioning and/or immobilization under supervision of physician or other qualified health care professional, including application of physical protections to secure implanted medical device from mr-induced translational or vibrational forces, magnetically induced functional change","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4396","name":"Natalin per sq cm","description":"Natalin, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67560","name":"Revise eye socket implant","description":"Orbital implant (implant outside muscle cone); removal or revision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1010.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85441","name":"Heinz bodies direct","description":"Heinz bodies; direct","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1484","name":"No rpt hcv rna perf med rsn","description":"Patients who did not have a repeat hcv rna labs performed for medical reasons documented by clinician (e.g., patient with limited life expectancy, delay in treatment of hcv related to treatment of hiv, hbv, hepatocellular carcinoma, decompensated cirrhosis)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0283","name":"Inj, amiodarone (nexterone)","description":"Injection, amiodarone hydrochloride (nexterone), 30 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0562U","name":"Onc sol tum tgsa 33gens snvs","description":"Onc sol tum tgsa 33gens snvs","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0554","name":"Add 20 m of monthly tx","description":"Each additional 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing data generated from the","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81418","name":"Rx metab gen seq alys pnl 6","description":"Drug metabolism (eg, pharmacogenomics) genomic sequence analysis panel, must include testing of at least 6 genes, including cyp2c19, cyp2d6, and cyp2d6 duplication/deletion analysis","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28005","name":"Treat foot bone lesion","description":"Incision, bone cortex (eg, osteomyelitis or bone abscess), foot","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":717.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52284","name":"Cysto rx balo cath urtl strx","description":"Cystourethroscopy, with mechanical urethral dilation and urethral therapeutic drug delivery by drug-coated balloon catheter for urethral stricture or stenosis, male, including fluoroscopy, when performed","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84433","name":"Asy thiopurin s-mthyltrnsfrs","description":"Thiopurine s-methyltransferase (tpmt)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0978T","name":"Submucosal cryolysis therapy","description":"Submucosal cryolysis therapy; soft palate, base of tongue, and lingual tonsil","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74019","name":"Radex abdomen 2 views","description":"Radiologic examination, abdomen; 2 views","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87515","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77763","name":"Apply intrcav radiat compl","description":"Intracavitary radiation source application; complex","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1296","name":"Calc bmi norm parameters","description":"Bmi is documented within normal parameters and no follow-up plan is required","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84394","name":"Total tau","description":"Tau, total (ttau)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1330","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7415","name":"Excision malig les complicat","description":"Excision of malignant lesion complicated","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4419","name":"Biolab wrap flw lt per sq cm","description":"Biolab membrane wrap lite flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1485","name":"Neg viro resp hep c/qual rna","description":"Patients who did not achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3921","name":"Decor or submerg erupt tooth","description":"Decor or submerg erupt tooth","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85007","name":"Bl smear w/diff wbc count","description":"Blood count; blood smear, microscopic examination with manual differential wbc count","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1423","name":"Opt care urologic cnd mvp","description":"Optimal care for patients with urologic conditions mips value pathway","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6280","name":"Implt maint procd remv implt","description":"Implt maint procd remv implt","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33802","name":"Division aberrant vessel","description":"Division of aberrant vessel (vascular ring);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1302.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1404","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6594","name":"G comp bandge liner lwr extr","description":"Gradient compression bandaging supply, bandage liner, lower extremity, any size or length, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1198","name":"Isa not red 3pts /no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68841","name":"Insj rx elut implt lac canal","description":"Insertion of drug-eluting implant, including punctal dilation when performed, into lacrimal canaliculus, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0895T","name":"Connj lvr algrft prfu dev 1","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; initial 4 hours of monitoring time, including hourly physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary ","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0854T","name":"Dgtz gls mcrscp bld smr prph","description":"Digitization of glass microscope slides for blood smear, peripheral, interpretation by physician with written report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4418","name":"Biolab wrap flow per sq cm","description":"Biolab membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53454","name":"Tprnl balo cntnc dev adjmt","description":"Periurethral transperineal adjustable balloon continence device; percutaneous adjustment of balloon(s) fluid volume","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4293","name":"Acesso dl, per sq cm","description":"Acesso dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4287","name":"Disp col sto bag breast milk","description":"Disposable collection and storage bag for breast milk, any size, any type, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1353","name":"Pts no cmplt suicd saf pln","description":"Patients who did not have a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1024T","name":"Perq tiss dsplmt soft tissue","description":"Percutaneous tissue displacement, any method, including imaging guidance; soft tissue (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76018","name":"Mr safety implant elec prepj","description":"Mr safety implant electronics preparation under supervision of physician or other qualified health care professional, including mr-specific programming of pulse generator and/or transmitter to verify device integrity, protection of device internal circuitry from mr electromagnetic fields, and protec","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0491","name":"Oral dv nm mouthpc hw remote","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0966T","name":"I&cst prp jw xpn dl arch fxd","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, fixed hinge mechanism","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6600","name":"G com bandge hgh dn foam sht","description":"Gradient compression bandaging supply, high density foam sheet, per 250 square centimeters, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0576U","name":"Trnsplj med lar quan ddcfdna","description":"Trnsplj med lar quan ddcfdna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83080","name":"Assay of b hexosaminidase ea","description":"B-hexosaminidase, each assay","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87811","name":"Sars-cov-2 covid19 w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19])","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87467","name":"Hepatitis b surface ag quan","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; hepatitis b surface antigen (hbsag), quantitative","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3299","name":"Inj xipere 1 mg","description":"Injection, triamcinolone acetonide (xipere), 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"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":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54385","name":"Repair penis","description":"Plastic operation on penis for epispadias distal to external sphincter; with incontinence","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1071.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0296U","name":"Onc orl&/orop ca 20 mlc feat","description":"Onc orl&/orop ca 20 mlc feat","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0273U","name":"Hem gen hyprfibrnlysis 8 gen","description":"Hematology (genetic hyperfibrinolysis, delayed bleeding), genomic sequence analysis of 8 genes (f13a1, f13b, fga, fgb, fgg, serpina1, serpine1, serpinf2, plau) blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J1020","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J0365","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84442","name":"Assay of thyroid activity","description":"Thyroxine binding globulin (tbg)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3373","name":"Inj, vancomycin hcl, 10 mg","description":"Injection, vancomycin hydrochloride, 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37289","name":"Revsc evsc tpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37292","name":"Rvsc evsc tpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93005","name":"Electrocardiogram tracing","description":"Electrocardiogram, routine ecg with at least 12 leads; tracing only, without interpretation and report","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98925","name":"Osteopath manj 1-2 regions","description":"Osteopathic manipulative treatment (omt); 1-2 body regions involved","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":34.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5913","name":"Nasal prosthesis","description":"Nasal prosthesis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9994","name":"Pall serv during meas","description":"Patient is using palliative care services any time during the measurement period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7294","name":"Seg acet and eth estr yearly","description":"Segesterone acetate and ethinyl estradiol 0.15mg, 0.013mg per 24 hours; yearly vaginal system, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99494","name":"1st/sbsq psyc collab care","description":"Initial or subsequent psychiatric collaborative care management, each additional 30 minutes in a calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional (list separa","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":39.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01938","name":"Anes drg/aspir lmbr/sac","description":"Anesthesia for percutaneous image-guided injection, drainage or aspiration procedures on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33253","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2209.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2012","name":"Suprathel, per sq cm","description":"Suprathel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9196","name":"Inj gemcitabine hcl (accord)","description":"Injection, gemcitabine hydrochloride (accord), not therapeutically equivalent to j9201, 200 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4199","name":"Cygnus matrix, per sq cm","description":"Cygnus matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4305","name":"Amer am ac tri-lay per sq cm","description":"American amnion ac tri-layer, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1720","name":"Influenza vacc admin","description":"Influenza vacc admin","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92639","name":"Hearing aid meas verif","description":"Hearing-aid measurement, verification with probe-microphone (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59409","name":"Obstetrical care","description":"Vaginal delivery only (with or without episiotomy and/or forceps);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":887.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":1010.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1279","name":"Pre-htn/htn, no f/u, not gvn","description":"Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96202","name":"Mlt fam grp bhv train 1st 60","description":"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face with multiple sets of paren","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1175","name":"Doc med rsn no hzv","description":"Documentation of medical reason(s) for not administering zoster vaccine (e.g., prior anaphylaxis due to the zoster vaccine)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27095","name":"Injection for hip x-ray","description":"Injection procedure for hip arthrography; with anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1324","name":"Pts intravitreal/pci","description":"Patients who had an intravitreal or periocular corticosteroid injection (e.g., triamcinolone, preservative-free triamcinolone, dexamethasone, dexamethasone intravitreal implant, or fluocinolone intravitreal implant)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1008T","name":"Rem mntr s-scl eeg sys setup","description":"Remote monitoring of sub-scalp implanted continuous bilateral electroencephalography monitoring system, device fitting, initial set-up, and patient education in wearing of system and use of equipment","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49593","name":"Rpr aa hrn 1st 3-10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, reducible","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0609U","name":"Onc prostate ia tot&free psa","description":"Onc prostate ia tot&free psa","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0398U","name":"Gi baret esph dna mthyln aly","description":"Gi baret esph dna mthyln aly","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37279","name":"Iv lithotrp fpvt w/in sm art","description":"Intravascular lithotripsy(ies), femoral and popliteal vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0308U","name":"Crd cad alys 3 prtn plsm alg","description":"Crd cad alys 3 prtn plsm alg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78600","name":"Brain image < 4 views","description":"Brain imaging, less than 4 static views;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68340","name":"Separate eyelid adhesions","description":"Repair of symblepharon; division of symblepharon, with or without insertion of conformer or contact lens","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4276","name":"Orion, per sq cm","description":"Orion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1423","name":"Opt care urologic cnd mvp","description":"Optimal care for patients with urologic conditions mips value pathway","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61333","name":"Expl orbit w/removal lesion","description":"Exploration of orbit (transcranial approach), with removal of lesion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2125.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1499","name":"Interventional radiology mvp","description":"Interventional radiology mips value pathway","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1782","name":"Vac admin human pap dose 2","description":"Vac admin human pap dose 2","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26450","name":"Incision of palm tendon","description":"Tenotomy, flexor, palm, open, each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":537.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2004","name":"Inj, lidocaine w epinephrine","description":"Injection, lidocaine hcl with epinephrine, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D8671","name":"Periodic orth treat w surg","description":"Periodic orth treat w surg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64597","name":"Ins/rplcm prq eltrd ra pn ea","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; each additional electrode array (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4564","name":"Pessary, disposable any type","description":"Pessary, disposable, any type","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1174","name":"Pt w/ 2 hzv 10/2017 - mp","description":"Patient received at least two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85027","name":"Complete cbc automated","description":"Blood count; complete (cbc), automated (hgb, hct, rbc, wbc and platelet count)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59200","name":"Insert cervical dilator","description":"Insertion of cervical dilator (eg, laminaria, prostaglandin) (separate procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":152.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43240","name":"Egd w/transmural drain cyst","description":"Esophagogastroduodenoscopy, flexible, transoral; with transmural drainage of pseudocyst (includes placement of transmural drainage catheter[s]/stent[s], when performed, and endoscopic ultrasound, when performed)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93596","name":"R&l hrt cath chd nml nt cnj","description":"Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); normal native connections","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9947","name":"Sleep apnea appliance","description":"Sleep apnea appliance","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1630","name":"Haloperidol injection","description":"Injection, haloperidol, up to 5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0960T","name":"Rpl s-sclp eltr ra rcvr&tlmt","description":"Replacement of sub-scalp implanted electrode array, receiver, and telemetry unit with tunneling of electrode for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15221","name":"Fth/gft fr s/a/l each addl","description":"Full thickness graft, free, including direct closure of donor site, scalp, arms, and/or legs; each additional 20 sq cm, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1498","name":"Diagnostic radiology mvp","description":"Diagnostic radiology mips value pathway","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99222","name":"1st hosp ip/obs moderate 55","description":"Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 55 minutes ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4377","name":"Trigraft ft per sq cm","description":"Trigraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90826","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4323","name":"Splint extra-coronal","description":"Splint extra-coronal","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1450","name":"Pt hos/pal care dur id/pf pd","description":"Patients who received hospice or palliative care service any time during denominator identification period or the measure assessment period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1427","name":"Doc med rsn bone scn","description":"Documentation of medical reason(s) for performing a bone scan (including documented pain related to prostate cancer, salvage therapy, other medical reasons)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0698T","name":"Quan mr tiss w/mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained with diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, target ","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78492","name":"Myocrd img pet mlt rst&strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); multiple studies at rest and stress (exercise or pharmacologic)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1414.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7299","name":"Intraut copp cont (miudella)","description":"Intrauterine copper contraceptive (miudella)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1279","name":"Pre-htn/htn, no f/u, not gvn","description":"Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76801","name":"Ob us < 14 wks single fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93644","name":"Ep eval subq impl dfb","description":"Electrophysiologic evaluation of subcutaneous implantable defibrillator (includes defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing for arrhythmia termination, and programming or reprogramming of sensing or therapeutic parameters)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93145","name":"Interrog crtd sins bat ip wo","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4322","name":"Caregraft, per sq cm","description":"Caregraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87015","name":"Specimen infect agnt concntj","description":"Concentration (any type), for infectious agents","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29855","name":"Tibial arthroscopy/surgery","description":"Arthroscopically aided treatment of tibial fracture, proximal (plateau); unicondylar, includes internal fixation, when performed (includes arthroscopy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":969.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45381","name":"Colonoscopy submucous njx","description":"Colonoscopy, flexible; with directed submucosal injection(s), any substance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0431","name":"Diag tst detect mucos abnorm","description":"Adjunctive pre-diagnostic test that aids in detection of mucosal abnormalities including premalignant and malignant lesions not to include cytology or biopsy","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33990","name":"Insj perq vad l hrt arterial","description":"Insertion of ventricular assist device, percutaneous, including radiological supervision and interpretation; left heart, arterial access only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":530.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0001","name":"Advancing cancer care mvp","description":"Advancing cancer care mips value pathways","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1310","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4373","name":"Membrane wrp lt per sq cm","description":"Membrane wrap lite, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44408","name":"Colonoscopy w/decompression","description":"Colonoscopy through stoma; with decompression (for pathologic distention) (eg, volvulus, megacolon), including placement of decompression tube, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"Breathing capacity test","description":"Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement(s), with or without maximal voluntary ventilation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98005","name":"Synch audio-video est low 20","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low medical decision making. when using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded.","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0426","name":"Coll, analys of saliva","description":"Coll, analys of saliva","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5141","name":"Inj adalimumab-aaty, 1 mg","description":"Injection, adalimumab-aaty, biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1387","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0671T","name":"Insj ant sgm aq drg dev 1+","description":"Insertion of anterior segment aqueous drainage device into the trabecular meshwork, without external reservoir, and without concomitant cataract removal, one or more","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0174","name":"Lecanemab-irmb, for iv inj","description":"Lecanemab-irmb, for intravenous injection, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69719","name":"Rplcm oi implt sk tc esp<100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2468","name":"Inj, palonosetron (posfrea)","description":"Injection, palonosetron hydrochloride (posfrea), 25 micrograms","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1747","name":"Inj, spesolimab-sbzo, 1 mg","description":"Injection, spesolimab-sbzo, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0586U","name":"Onc mrna gen xprsn 216 genes","description":"Onc mrna gen xprsn 216 genes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99345","name":"Home/res vst new high mdm 75","description":"Home or residence visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 75 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0024","name":"Pin srv add 30 min pr m","description":"Principal illness navigation services, additional 30 minutes per calendar month (list separately in addition to g0023)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1193","name":"Rpts w/ imp/con mmr/msi","description":"Surgical pathology reports that contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0390U","name":"Ob pe kdr eng&rbp4 ia alg","description":"Ob pe kdr eng&rbp4 ia alg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11743.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35121","name":"Repair defect of artery","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, hepatic, celiac, renal, or mesenteric artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2081.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4241","name":"Gngvl flap w rootplan 1-3 th","description":"Gingival flap procedure including root planing - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9595","name":"Piflu f-18, dia 1 millicurie","description":"Piflufolastat f-18, diagnostic, 1 millicurie","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1495","name":"Fall w/ poc, no fall","description":"Patients that reported a fall occurred who had a plan of care for falls documented or patients that did not report a fall","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0885T","name":"Colsc flx 1st tndsc dilat","description":"Colonoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76815","name":"Ob us limited fetus(s)","description":"Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0810T","name":"Subrta njx rx agt w/vtrc","description":"Subretinal injection of a pharmacologic agent, including vitrectomy and 1 or more retinotomies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2508","name":"Pegunigalsidase alfa-iwxj","description":"Injection, pegunigalsidase alfa-iwxj, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6602","name":"G com bandge hgh dn foamroll","description":"Gradient compression bandaging supply, high density foam roll for bandage, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37298","name":"Revsc evsc imvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0767T","name":"Tc mag stimj pn ea addl nrv","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; each additional nerve (list separat","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64896","name":"Nrv grf mltst hnd/foot >4 cm","description":"Nerve graft (includes obtaining graft), multiple strands (cable), hand or foot; more than 4 cm length","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1560.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0905T","name":"Ecg alg 12 ld rdcd i&r only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; interpretation and report only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0491","name":"Oral dv nm mouthpc hw remote","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0390U","name":"Ob pe kdr eng&rbp4 ia alg","description":"Ob pe kdr eng&rbp4 ia alg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68115","name":"Exc les conjunctiva >1 cm","description":"Excision of lesion, conjunctiva; over 1 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1387","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0733T","name":"Rem r-t mtn nrehab ther sply","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; supply and technical support, per 30 days","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0547U","name":"Neurflmnt lt chn cleia plsm","description":"Neurflmnt lt chn cleia plsm","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0576U","name":"Trnsplj med lar quan ddcfdna","description":"Trnsplj med lar quan ddcfdna","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71047","name":"X-ray exam chest 3 views","description":"Radiologic examination, chest; 3 views","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2023","name":"Innovamatrix pd, 1 mg","description":"Innovamatrix pd, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60660","name":"Abltj 1/+thyr ndul 1lobe prq","description":"Ablation of 1 or more thyroid nodule(s), one lobe or the isthmus, percutaneous, including imaging guidance, radiofrequency","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70487","name":"Ct maxillofacial w/dye","description":"Computed tomography, maxillofacial area; with contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1429","name":"Retinopathy in od, os, ou","description":"Retinal exam finding with evidence of retinopathy in left, right or both eyes with severity level documented","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1284","name":"Pt 66+ snp or ltc pos > 90d","description":"Patients age 66 or older in institutional special needs plans (snp) or residing in long term care with pos code 32, 33, 34, 54, or 56 for more than 90 consecutive days during the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0984T","name":"Iv img xtrc cere vsl oct 1st","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1366","name":"Focus on womens health mvp","description":"Focusing on womens health mips value pathway","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1256","name":"Prior history of known cvd","description":"Prior history of known cvd","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5943","name":"Proth mandib implt sup remv","description":"Proth mandib implt sup remv","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2956","name":"Indirect rest remov","description":"Indirect rest remov","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87484","name":"Ehrlicha chaffeensis amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); ehrlichia chaffeensis, amplified probe technique","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5995","name":"Peri medicament w/seal, max","description":"Peri medicament w/seal, max","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7414","name":"Excision malig lesion>1.25cm","description":"Excision of malignant lesion greater than 1.25 cm","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0819T","name":"Revj/rmvl ins ptn subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69716","name":"Impl oi implt sk tc esp<100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or resulting in removal of less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0376U","name":"Onc prst8 ca img alys 128","description":"Onc prst8 ca img alys 128","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96203","name":"Mlt fam grp bhv train ea add","description":"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face with multiple sets of paren","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2779","name":"Inj, susvimo 0.1 mg","description":"Injection, ranibizumab, via intravitreal implant (susvimo), 0.1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1249","name":"Pt resp true imprt to me","description":"Patient responded completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27696","name":"Repair of ankle ligaments","description":"Repair, primary, disrupted ligament, ankle; both collateral ligaments","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":726.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9341","name":"Inj thiotepa (tepylute) 1 mg","description":"Injection, thiotepa (tepylute), 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5942","name":"Proth max implt sup remv","description":"Proth max implt sup remv","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1017T","name":"Elec aly npgs esoph sbsq w/o","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0936T","name":"Photobiomodulation ther rta","description":"Photobiomodulation therapy of retina, single session","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1377","name":"Fu colscop 10 yr doc w/ disc","description":"Recommended follow-up interval for repeat colonoscopy of 10 years documented  in colonoscopy report and communicated with patient","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26255","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0703","name":"2d oral/facial photo image","description":"2d oral/facial photo image","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0741","name":"Inj, cabote rilpivir 2mg 3mg","description":"Injection, cabotegravir and rilpivirine, 2mg/3mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76886","name":"Us exam infant hips static","description":"Ultrasound, infant hips, real time with imaging documentation; limited, static (not requiring physician or other qualified health care professional manipulation)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0782T","name":"Brnchsc rf dstrj plm nrv uni","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; unilateral mainstem bronchus","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0878T","name":"Augmnt alys ch ct ild w/ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained with concurrent ct examination of the same structure","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0554","name":"Add 20 m of monthly tx","description":"Each additional 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing data generated from the","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4269","name":"Surgraft xt per sq cm","description":"Surgraft xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6611","name":"Grad com wrap w strap ak cus","description":"Gradient compression wrap with adjustable straps, above knee, each, custom","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2057","name":"Afamitresgene autoleucel","description":"Afamitresgene autoleucel, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36836","name":"Prq av fstl crtj uxtr 1 acs","description":"Percutaneous arteriovenous fistula creation, upper extremity, single access of both the peripheral artery and peripheral vein, including fistula maturation procedures (eg, transluminal balloon angioplasty, coil embolization) when performed, including all vascular access, imaging guidance and radiolo","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28299","name":"Cor hlx vlgs double osteot","description":"Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with double osteotomy, any method","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":808.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6524","name":"G com garmnt lwr leg/ft nght","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":383.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76003","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64473","name":"Lwr xtr fscl pln blk uni njx","description":"Lower extremity fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81560","name":"Trnsplj pd lvr&bwl cd154+cll","description":"Transplantation medicine (allograft rejection, pediatric liver and small bowel), measurement of donor and third-party-induced cd154+t-cytotoxic memory cells, utilizing whole peripheral blood, algorithm reported as a rejection risk score","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0661","name":"Team remote e/m new pt 20 mn","description":"Team remote e/m new pt 20mins","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1429","name":"Retinopathy in od, os, ou","description":"Retinal exam finding with evidence of retinopathy in left, right or both eyes with severity level documented","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9601","name":"Inj linvoseltamab-gcpt 1 mg","description":"Injection, linvoseltamab-gcpt, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1433","name":"Oral chemo wthn 30 days enc","description":"Patient on oral chemotherapy on or within 30 days before denominator eligible encounter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99460","name":"Init nb em per day hosp","description":"Initial hospital or birthing center care, per day, for evaluation and management of normal newborn infant","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9247","name":"Mod sedation noniv-sub15min","description":"Mod sedation noniv-sub15min","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0286U","name":"Cep72 nudt15&tpmt gene alys","description":"Cep72 nudt15&tpmt gene alys","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85032","name":"Manual cell count each","description":"Blood count; manual cell count (erythrocyte, leukocyte, or platelet) each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0811T","name":"Rem mlt day uroflow setup","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); set-up and patient education on use of equipment","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55874","name":"Tprnl plmt biodegrdabl matrl","description":"Transperineal placement of biodegradable material, peri-prostatic, single or multiple injection(s), including image guidance, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":4369.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45820","name":"Repair rectourethral fistula","description":"Closure of rectourethral fistula;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1214.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1168","name":"Pt recd flu vax 7/1-6/30","description":"Patient received an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92631","name":"Hearing aid slctn svc 1st 30","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76883","name":"Us nrv&acc strux 1xtr compre","description":"Ultrasound, nerve(s) and accompanying structures throughout their entire anatomic course in one extremity, comprehensive, including real-time cine imaging with image documentation, per extremity","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1009T","name":"Rem mntr s-sclp cont eeg sys","description":"Remote monitoring of a sub-scalp implanted continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1008T","name":"Rem mntr s-scl eeg sys setup","description":"Remote monitoring of sub-scalp implanted continuous bilateral electroencephalography monitoring system, device fitting, initial set-up, and patient education in wearing of system and use of equipment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0738T","name":"Tx pln mag fld abltj prst8","description":"Treatment planning for magnetic field induction ablation of malignant prostate tissue, using data from previously performed magnetic resonance imaging (mri) examination","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0889T","name":"Prsnlz trgt dvl arhfcmrigtbs","description":"Personalized target development for accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation derived from a structural and resting-state functional mri, including data preparation and transmission, generation of the target, motor threshold-starting location, neuro","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0379U","name":"Tgsap sl or neo dna523&rna55","description":"Tgsap sl or neo dna523&rna55","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1289","name":"No pt tbco cess interv rng","description":"Patient identified as tobacco user did not receive tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64654","name":"1st opn implt bat modulj sys","description":"Initial open implantation of baroreflex activation therapy (bat) modulation system, including lead placement onto the carotid sinus, lead tunnelling, connection to a pulse generator placed in a distant subcutaneous pocket (ie, total system), and intraoperative interrogation and programming","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27732","name":"Repair of fibula epiphysis","description":"Arrest, epiphyseal (epiphysiodesis), open; distal fibula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99212","name":"Office o/p est sf 10 min","description":"Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 10 minutes must be met o","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":68.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1405","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2029","name":"Mirotract matrix sheet","description":"Mirotract wound matrix sheet, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2998","name":"Inj plasminogen tvmh 1mg","description":"Injection, plasminogen, human-tvmh, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35484","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":686.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76856","name":"Us exam pelvic complete","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4289","name":"Revoshield+ amnio, per sq cm","description":"Revoshield + amniotic barrier, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1283","name":"Pt scrn tbco and id as user","description":"Patient screened for tobacco use and identified as a tobacco user","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51721","name":"Ins trurl ablt trnsdc thr us","description":"Insertion of transurethral ablation transducer for delivery of thermal ultrasound for prostate tissue ablation, including suprapubic tube placement during the same session and placement of an endorectal cooling device, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1312","name":"No pt tbco scrn rng","description":"Patient not screened for tobacco use","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86052","name":"Aquaporin-4 antb cba each","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; cell-based immunofluorescence assay (cba), each","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0870T","name":"Imp subq prtl ascts pmp sys","description":"Implantation of subcutaneous peritoneal ascites pump system, percutaneous, including pump-pocket creation, insertion of tunneled indwelling bladder and peritoneal catheters with pump connections, including all imaging and initial programming, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82271","name":"Occult blood other sources","description":"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; other sources","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4404","name":"Xwrap hydro plus per sq cm","description":"Xwrap hydro plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0833T","name":"Dgtz gls mcrscp cytp oth prp","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; preparation, screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9024","name":"Inj atezolizumb 5mg hya-tqjs","description":"Injection, atezolizumab, 5 mg and hyaluronidase-tqjs","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6604","name":"G com bandge low dn foam flt","description":"Gradient compression bandaging supply, low density flat foam sheet, per 250 square centimeters, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2249","name":"Inj, remimazolam, 1 mg","description":"Injection, remimazolam, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21725","name":"Revision of neck muscle","description":"Division of sternocleidomastoid for torticollis, open operation; with cast application","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":622.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0967T","name":"Tranal ins tmp clrc anst dev","description":"Transanal insertion of endoluminal temporary colorectal anastomosis protection device, including vacuum anchoring component and flexible sheath connected to external vacuum source and monitoring system","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0394U","name":"Pfas 16 pfas compnd lc ms/ms","description":"Pfas 16 pfas compnd lc ms/ms","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9294","name":"Biofeed dig cog behav tx fda","description":"Prescription digital cognitive and/or behavioral therapy, biofeedback, fda cleared, per course of treatment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29044","name":"Appl bdy cst sho to hip 1thi","description":"Application of body cast, shoulder to hips; including 1 thigh","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9609","name":"F18 fdg, 15 millicuries","description":"Fludeoxyglucose f18 up to 15 millicuries","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19340","name":"Insj breast implt sm d mast","description":"Insertion of breast implant on same day of mastectomy (ie, immediate)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":473.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4370","name":"Aeroguard per sq cm","description":"Aeroguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0458U","name":"Onc brst ca s100 a8&a9 elisa","description":"Onc brst ca s100 a8&a9 elisa","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4328","name":"Most, per sq cm","description":"Most, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1307","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37275","name":"Rvsc evsc fpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33015","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":553.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0926T","name":"Prgrmg dev eval ccm-d ip","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, including review and report, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37285","name":"Revsc evasc tpvt st sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1358","name":"Pts no <suicd idea 120 dys","description":"Patients who did not have a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4340","name":"Simpligraft, per sq cm","description":"Simpligraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0955T","name":"Tot impl amei removal","description":"Totally implantable active middle ear hearing implant; removal, including removal of sound processor and all implant components","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86900","name":"Blood typing serologic abo","description":"Blood typing, serologic; abo","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49615","name":"Rpr aa hrn rcr 3-10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, reducible","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0365U","name":"Onc bldr 10 prb bldr ca","description":"Onc bldr 10 prb bldr ca","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87154","name":"Cul typ id bld pthgn 6+ trgt","description":"Culture, typing; identification of blood pathogen and resistance typing, when performed, by nucleic acid (dna or rna) probe, multiplexed amplified probe technique including multiplex reverse transcription, when performed, per culture or isolate, 6 or more targets","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19286","name":"Perq dev breast add us imag","description":"Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; each additional lesion, including ultrasound guidance (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":434.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0522U","name":"Ca vi psp&sp1 antb cl semiql","description":"Ca vi psp&sp1 antb cl semiql","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0926T","name":"Prgrmg dev eval ccm-d ip","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, including review and report, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87150","name":"Dna/rna amplified probe","description":"Culture, typing; identification by nucleic acid (dna or rna) probe, amplified probe technique, per culture or isolate, each organism probed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0464U","name":"Onc clrct scr qrtsa dna mrk","description":"Onc clrct scr qrtsa dna mrk","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21182","name":"Reconstruct cranial bone","description":"Reconstruction of orbital walls, rims, forehead, nasoethmoid complex following intra- and extracranial excision of benign tumor of cranial bone (eg, fibrous dysplasia), with multiple autografts (includes obtaining grafts); total area of bone grafting less than 40 sq cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2399.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31287","name":"Nasal/sinus endoscopy surg","description":"Nasal/sinus endoscopy, surgical, with sphenoidotomy;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89235","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49186","name":"Opn exc/dstr ntra-abd 5 cm/<","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5 cm or less","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0939T","name":"Xtrnl ecg rec>15d<30d scan","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; scanning analysis with report","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0502","name":"Other oral pathology procedu","description":"Other oral pathology procedures by report","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4401","name":"Absolv3 per sq cm","description":"Absolv3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25505","name":"Cltx rdl shft fx w/mnpj","description":"Closed treatment of radial shaft fracture; with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":523.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0676T","name":"Laps insj nw/rpcmt isdss ea","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional lead (list separately in addition to code for primary ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0237","name":"Intrav inf, toci, first dose","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0971T","name":"Ablt mal brst tum pq lsr uni","description":"Ablation, malignant breast tumor(s), percutaneous, laser, including imaging guidance when performed, unilateral","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9988","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6597","name":"G comp bandage long stretch","description":"Gradient compression bandage roll, elastic long stretch, linear yard, any width, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20552","name":"Njx 1/mlt trigger point 1/2","description":"Injection(s); single or multiple trigger point(s), 1 or 2 muscle(s)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":34.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17266","name":"Dstrj mal les t/a/l >4.0 cm","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), trunk, arms or legs; lesion diameter over 4.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87513","name":"H pylri clrthmcn rst amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); helicobacter pylori (h. pylori), clarithromycin resistance, amplified probe technique","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0396","name":"Alcohol/subs interv 15-30mn","description":"Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":32.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1362","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57420","name":"Exam of vagina w/scope","description":"Colposcopy of the entire vagina, with cervix if present;","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":93.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1266","name":"Pts admit snf","description":"Patients admitted to a skilled nursing facility (snf)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4311","name":"Acesso, per sq cm","description":"Acesso, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0405U","name":"Onc pncrtc 59 mthltn blk mrk","description":"Onc pncrtc 59 mthltn blk mrk","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0693T","name":"Compre ful bdy 3d mtn alys","description":"Comprehensive full body computer-based markerless 3d kinematic and kinetic motion analysis and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64912","name":"Nrv rpr w/nrv algrft 1st","description":"Nerve repair; with nerve allograft, each nerve, first strand (cable)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":941.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2291","name":"Inj, nafcillin (baxter) 20mg","description":"Injection, nafcillin sodium (baxter), 20 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1256","name":"Prior history of known cvd","description":"Prior history of known cvd","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0588U","name":"Nfct ds bct/vir 32genes mrna","description":"Nfct ds bct/vir 32genes mrna","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1224","name":"Iop dec <20% from base","description":"Intraocular pressure (iop) reduced by a value less than 20% from the pre-intervention level","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0137","name":"Inj, acetaminophen (hikma)","description":"Injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0310U","name":"Ped vsclts kd alys 3 bmrks","description":"Ped vsclts kd alys 3 bmrks","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0514U","name":"Gi ibd ia quan deter adl lvl","description":"Gi ibd ia quan deter adl lvl","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0012","name":"Injection of hiv prep drug","description":"Injection of pre-exposure prophylaxis (prep) drug for hiv prevention, under skin or into muscle","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92920","name":"Prq trluml c angiop 1art&/br","description":"Percutaneous transluminal coronary angioplasty, single major coronary artery and/or its branch(es)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0895T","name":"Connj lvr algrft prfu dev 1","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; initial 4 hours of monitoring time, including hourly physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary ","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2038","name":"Skill train and dev/diem","description":"Skills training and development, per diem","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0208","name":"Inj, pedmark, 100 mg","description":"Injection, sodium thiosulfate (pedmark), 100 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1302","name":"Scrn mam perf rslts doc","description":"Screening, diagnostic, film digital or digital breast tomosynthesis (3d) mammography results documented and reviewed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1394","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97763","name":"Orthc/prostc mgmt sbsq enc","description":"Orthotic(s)/prosthetic(s) management and/or training, upper extremity(ies), lower extremity(ies), and/or trunk, subsequent orthotic(s)/prosthetic(s) encounter, each 15 minutes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9269","name":"Programable ingest capsule","description":"Programable, transient, orally ingested capsule, for use with external programmer, per month","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86305","name":"Human epididymis protein 4","description":"Human epididymis protein 4 (he4)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63077","name":"Spine disk surgery thorax","description":"Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; thoracic, single interspace","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1724.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1447","name":"Pt dx bd bef end meas pd","description":"Patients with an active diagnosis of bipolar disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1952","name":"Afo spiral prefab ots","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, off-the-shelf","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4300","name":"Acesso tl, per sq cm","description":"Acesso tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9294","name":"Biofeed dig cog behav tx fda","description":"Prescription digital cognitive and/or behavioral therapy, biofeedback, fda cleared, per course of treatment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98976","name":"Rtm dev sply resp sys 16-30d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of respiratory system, 16-30 days in a 30-day period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0319U","name":"Neph rna pretrnspl perph bld","description":"Neph rna pretrnspl perph bld","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4322","name":"Caregraft, per sq cm","description":"Caregraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4338","name":"Artacent velos, per sq cm","description":"Artacent velos, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5145","name":"Inj, abrilada, 1 mg","description":"Injection, adalimumab-afzb (abrilada), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0322U","name":"Neuro asd meas 14 acyl carn","description":"Neuro asd meas 14 acyl carn","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99407","name":"Behav chng smoking > 10 min","description":"Smoking and tobacco use cessation counseling visit; intensive, greater than 10 minutes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":24.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80505","name":"Path clin consltj high 41-60","description":"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patients history and medical records and high level of medical decision making when using time for code selection, 41-60 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52606","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81449","name":"So neo gsap 5-50 rna alys","description":"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; rna analysis","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0043","name":"Pt mech pros ht valv","description":"Patients with mechanical prosthetic heart valve","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9063","name":"Inj, elahere, 1 mg","description":"Injection, mirvetuximab soravtansine-gynx, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4003","name":"Emergency med ss","description":"Emergency medicine mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0258U","name":"Ai psor mrna 50-100 gen alg","description":"Autoimmune (psoriasis), mrna, next-generation sequencing, gene expression profiling of 50-100 genes, skin- surface collection using adhesive patch, algorithm reported as likelihood of response to psoriasis biologics","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0517U","name":"Ther rx mntr 80+ psyactiv rx","description":"Ther rx mntr 80+ psyactiv rx","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36262","name":"Removal of infusion pump","description":"Removal of implanted intra-arterial infusion pump","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87220","name":"Tissue exam for fungi","description":"Tissue examination by koh slide of samples from skin, hair, or nails for fungi or ectoparasite ova or mites (eg, scabies)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0349","name":"Inj, rezafungin, 1 mg","description":"Injection, rezafungin, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49592","name":"Rpr aa hrn 1st < 3 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, incarcerated or strangulated","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86015","name":"Actin antibody each","description":"Actin (smooth muscle) antibody (asma), each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1340","name":"Indx whodas 2.0 or sds","description":"Index assessment completed using the 12-item whodas 2.0 or sds during the denominator identification period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95117","name":"Immunotherapy injections","description":"Professional services for allergen immunotherapy not including provision of allergenic extracts; 2 or more injections","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0837T","name":"Dgtz gls mcrscp fna i&r","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; interpretation and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6602","name":"Cst hgh nble mtl inlay 2 srf","description":"Inlay - cast high noble metal two surfaces","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0924T","name":"Rpos prv ccm-d trnsvns eltrd","description":"Repositioning of previously implanted cardiac contractility modulation-defibrillation transvenous electrode(s)/lead(s), including fluoroscopic guidance and programming of sensing and therapeutic parameters","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1262","name":"Pts transplt bef dialysis","description":"Patients who had a transplant prior to initiation of dialysis","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0556U","name":"Nfct ds p-s dna&rna 12 trgts","description":"Nfct ds p-s dna&rna 12 trgts","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2516","name":"Inj, pentamidine isethionate","description":"Injection, pentamidine isethionate, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0417U","name":"Rare ds alys 335 nuc genes","description":"Rare ds alys 335 nuc genes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1005T","name":"Elec alys s-scl eeg prgr 1st","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, first 15 minutes face-to-face time with physician or other qualified hea","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0779T","name":"Gi myoelectrical actv study","description":"Gastrointestinal myoelectrical activity study, stomach through colon, with interpretation and report","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0665","name":"Inj, bupivacaine, nos, 0.5mg","description":"Injection, bupivicaine, not otherwise specified, 0.5 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55400","name":"Repair of sperm duct","description":"Vasovasostomy, vasovasorrhaphy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":578.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0697T","name":"Quan mr tis wo mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained without diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, targ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4340","name":"Simpligraft, per sq cm","description":"Simpligraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0922T","name":"Rmvl perm ccm-d sys dual ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); dual (pacing and defibrillation) transvenous leads only","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9190","name":"Fluorouracil injection","description":"Injection, fluorouracil, 500 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0283U","name":"Vw factor type 2b eval plsm","description":"Von willebrand factor (vwf), type 2b, platelet-binding evaluation, radioimmunoassay, plasma","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37255","name":"Revsc evasc ivt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":73.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0295U","name":"Onc brst dux carc 7 proteins","description":"Onc brst dux carc 7 proteins","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1713","name":"Pfizer vacc adm ped 1st dose","description":"Pfizer vacc adm ped 1st dose","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9347","name":"Inj, tremelimumab-actl, 1 mg","description":"Injection, tremelimumab-actl, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0845T","name":"Dgtz gls mcrscp imfluor 1st","description":"Digitization of glass microscope slides for immunofluorescence, per specimen; initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4438","name":"Pretect per sq cm","description":"Pretect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93586","name":"Vngrph chd coronary sinus","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; coronary sinus (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43291","name":"Egd flx trnsorl rmvl balo","description":"Esophagogastroduodenoscopy, flexible, transoral; with removal of intragastric bariatric balloon(s)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4457","name":"Enema tube any type repl","description":"Enema tube, with or without adapter, any type, replacement only, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1150","name":"Lvef <=40% or mod/sev l vsf","description":"Current or prior left ventricular ejection fraction (lvef) less than or equal to 40% or documentation of moderately or severely depressed left ventricular systolic function","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0486U","name":"Onc pan sol tum ngs cfctdna","description":"Onc pan sol tum ngs cfctdna","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1025","name":"Pt mnth 1 mcp prov","description":"Patient-months where there are more than one medicare capitated payment (mcp) provider listed for the month","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0672T","name":"Ndovag cryg rf remdl tiss","description":"Endovaginal cryogen-cooled, monopolar radiofrequency remodeling of the tissues surrounding the female bladder neck and proximal urethra for urinary incontinence","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9993","name":"Pall serv during meas","description":"Patient was provided palliative care services any time during the measurement period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1454","name":"New cied","description":"New cied","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27438","name":"Revise kneecap with implant","description":"Arthroplasty, patella; with prosthesis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":990.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28760","name":"Fusion of big toe joint","description":"Arthrodesis, with extensor hallucis longus transfer to first metatarsal neck, great toe, interphalangeal joint (eg, jones type procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":646.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64598","name":"Revj/rmvl nea pn w/int nstim","description":"Revision or removal of neurostimulator electrode array, peripheral nerve, with integrated neurostimulator","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25024","name":"Decompress forearm 2 spaces","description":"Decompression fasciotomy, forearm and/or wrist, flexor and extensor compartment; without debridement of nonviable muscle and/or nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":828.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90963","name":"Esrd home pt serv p mo <2yrs","description":"End-stage renal disease (esrd) related services for home dialysis per full month, for patients younger than 2 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":608.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55882","name":"Ablt trurl prst8 tis trnsdcr","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation; with insertion of transurethral ultrasound transducer for delivery of thermal ultrasound, including suprapubic tube placement and placement of ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87626","name":"Hpv sep hi-rsk typ&pool rslt","description":"Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), separately reported high-risk types (eg, 16, 18, 31, 45, 51, 52) and high-risk pooled result(s)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15011","name":"Hrv skn cll ssp agrft 1st 25","description":"Harvest of skin for skin cell suspension autograft; first 25 sq cm or less","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64913","name":"Nrv rpr w/nrv algrft ea addl","description":"Nerve repair; with nerve allograft, each additional strand (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98004","name":"Synch audio-video est sf 10","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 10 minutes must be met or e","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4327","name":"Duoamnion, per sq cm","description":"Duoamnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1171","name":"Inj, hydromorphone, 0.1 mg","description":"Injection, hydromorphone, 0.1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J1080","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1163","name":"Pt anphx due to hpv bef 13","description":"Patient had anaphylaxis due to the hpv vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81523","name":"Onc brst mrna 70 cnt 31 gene","description":"Oncology (breast), mrna, next-generation sequencing gene expression profiling of 70 content genes and 31 housekeeping genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as index related to risk to distant metastasis","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0898T","name":"N-invas prst8 cancer est map","description":"Noninvasive prostate cancer estimation map, derived from augmentative analysis of image-guided fusion biopsy and pathology, including visualization of margin volume and location, with margin determination and physician interpretation and report","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78492","name":"Myocrd img pet mlt rst&strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); multiple studies at rest and stress (exercise or pharmacologic)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1226.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1257","name":"Cvd risk assess not perf","description":"Cvd risk assessment not performed or incomplete (e.g., cvd risk assessment was not documented), reason not otherwise specified","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87182","name":"Sc std carbapenemase nzm det","description":"Susceptibility studies, antimicrobial agent; carbapenemase enzyme detection (eg, klebsiella pneumoniae carbapenemase [kpc], new delhi metallo-beta-lactamase [ndm], verona integron-encoded metallo-beta-lactamase [vim]), multiplex immunoassay, qualitative, per isolate","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5126","name":"Inj alymsys 10 mg","description":"Injection, bevacizumab-maly, biosimilar, (alymsys), 10 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0892T","name":"Arhfcmrigtbs sbsq per tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent motor threshold redetermination with delivery and management, per treatment day","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90963","name":"Esrd home pt serv p mo <2yrs","description":"End-stage renal disease (esrd) related services for home dialysis per full month, for patients younger than 2 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":699.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1294","name":"Bp scrn perf rec interval","description":"Normal blood pressure reading documented, follow-up not required","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0718T","name":"Adrc ther prtl rc tear njx","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; injection into supraspinatus tendon including ultrasound guidance, unilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43291","name":"Egd flx trnsorl rmvl balo","description":"Esophagogastroduodenoscopy, flexible, transoral; with removal of intragastric bariatric balloon(s)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0684T","name":"Peri-px dev eval isdss ip","description":"Peri-procedural device evaluation (in-person) and programming of device system parameters before or after a surgery, procedure, or test with analysis, review, and report by a physician or other qualified health care professional, permanent implantable synchronized diaphragmatic stimulation system fo","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7214","name":"Altuviiio per factor viii iu","description":"Injection, factor viii/von willebrand factor complex, recombinant (altuviiio), per factor viii i.u.","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55713","name":"Bx prst8 in-bore ct/mri bx 1","description":"Biopsy, prostate, in-bore ct- or mri-guided (ie, sextant), with biopsy of additional targeted lesion(s), first targeted lesion","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1286","name":"Bmi doc onl fup not cmpltd","description":"Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0208","name":"Inj, pedmark, 100 mg","description":"Injection, sodium thiosulfate (pedmark), 100 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0760T","name":"Dgtz gls mcrscp sl imm 1st","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0776T","name":"Ther indctj ntrabrn hypthrm","description":"Therapeutic induction of intra-brain hypothermia, including placement of a mechanical temperature-controlled cooling device to the neck over carotids and head, including monitoring (eg, vital signs and sport concussion assessment tool 5 [scat5]), 30 minutes of treatment","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98979","name":"Rtm tx mgmt 1st 10 min","description":"Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least 1 real-time interactive communication with the patient or caregiver during the calendar month; first 10 minutes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23665","name":"Cltx sho dslc fx gr hmrl tbr","description":"Closed treatment of shoulder dislocation, with fracture of greater humeral tuberosity, with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6594","name":"G comp bandge liner lwr extr","description":"Gradient compression bandaging supply, bandage liner, lower extremity, any size or length, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81459","name":"So neo gsap dna/dna&rna","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants, microsatellite instability, tumor mutation burden, and rearrangements","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83521","name":"Ig light chains free each","description":"Immunoglobulin light chains (ie, kappa, lambda), free, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":17.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0029","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4334","name":"Amnioplast 1, per sq cm","description":"Amnioplast 1, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0933T","name":"Tcat impl wrls l atr prs snr","description":"Transcatheter implantation of wireless left atrial pressure sensor for long-term left atrial pressure monitoring, including sensor calibration and deployment, right heart catheterization, transseptal puncture, imaging guidance, and radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4349","name":"Mantle dl matrix per sq cm","description":"Mantle dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0426U","name":"Genome ultra-rapid seq alys","description":"Genome ultra-rapid seq alys","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93151","name":"Interrog&prgrmg ipnss","description":"Interrogation and programming (minimum one parameter) of implanted phrenic nerve stimulator system","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4028","name":"Podiatry ss","description":"Podiatry mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1177","name":"Pt recd pcv on/aft 19","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0496U","name":"Onc clrct cfdna 8/7 genes","description":"Onc clrct cfdna 8/7 genes","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0707","name":"Intraoral periap radio image","description":"Intraoral periap radio image","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33775","name":"Rpr tga atr bfl rmvl plm bnd","description":"Repair of transposition of the great arteries, atrial baffle procedure (eg, mustard or senning type) with cardiopulmonary bypass; with removal of pulmonary band","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2344.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2151","name":"Inj, mannitol, 250 mg","description":"Injection, mannitol, 250 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32400","name":"Needle biopsy chest lining","description":"Biopsy, pleura, percutaneous needle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0970T","name":"Ablt b9 brst tum perq lsr ea","description":"Ablation, benign breast tumor (eg, fibroadenoma), percutaneous, laser, including imaging guidance when performed, each tumor","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33903","name":"Perq p-art revsc 1 abnor bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, bilateral","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1409","name":"Recd gmln brca1/brca2 couns","description":"Patients who received germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0293U","name":"Psyc suicidal idea mrna 54","description":"Psyc suicidal idea mrna 54","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76017","name":"Mr sfty med physics xm cstmz","description":"Mr safety medical physics examination customization, planning and performance monitoring by medical physicist or mr safety expert, with review and analysis by physician or other qualified health care professional to prioritize and select views and imaging sequences, to tailor mr acquisition specific","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0053","name":"Ht mental health and care","description":"Historical trauma (ht) mental health and clinical care for indigenous persons","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63275","name":"Bx/exc xdrl spine lesn crvl","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, cervical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1989.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37291","name":"Revsc evsc tpvt athr cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0997T","name":"Precuneus mag stimj tx plng","description":"Precuneus magnetic stimulation; treatment planning using magnetic resonance imaging-guided neuronavigation to determine optimal location, dose, and intensity for magnetic stimulation therapy, derived from evoked potentials from single pulses of electromagnetic energy recorded by 64-channel electroen","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0557U","name":"Nfct ds bv dna mrk vag fluid","description":"Nfct ds bv dna mrk vag fluid","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0019","name":"Comm hlth intg svs sdoh 60mn","description":"Community health integration services performed by certified or trained auxiliary personnel, including a community health worker, under the direction of a physician or other practitioner; 60 minutes per calendar month, in the following activities to address social determinants of health (sdoh) need(","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15017","name":"App skn cll ssp f/n/g/hf 1st","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 480 sq cm or less","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22103","name":"Remove extra spine segment","description":"Partial excision of posterior vertebral component (eg, spinous process, lamina or facet) for intrinsic bony lesion, single vertebral segment; each additional segment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38227","name":"Car-t receipt&prepj admn","description":"Chimeric antigen receptor t-cell (car-t) therapy; receipt and preparation of car-t cells for administration","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0424U","name":"Onc prst8 xom alys 53 sncrna","description":"Onc prst8 xom alys 53 sncrna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64610","name":"Injection treatment of nerve","description":"Destruction by neurolytic agent, trigeminal nerve; second and third division branches at foramen ovale under radiologic monitoring","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":565.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0839T","name":"Dgtz gls mcrscp cslt mat prp","description":"Digitization of glass microscope slides for consultation and report on referred material requiring preparation of slides (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1165","name":"Pt use hspc dur meas pd","description":"Patients who use hospice services any time during the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6555","name":"G com stcking bk 40+ custm","description":"Gradient compression stocking, below knee, 40 mmhg or greater, custom, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0018M","name":"Trnsplj rnl meas cd154+cll","description":"Transplantation medicine (allograft rejection, renal), measurement of donor and third-party-induced cd154+t-cytotoxic memory cells, utilizing whole peripheral blood, algorithm reported as a rejection risk score","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27093","name":"Injection for hip x-ray","description":"Injection procedure for hip arthrography; without anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2792","name":"Crown full cast noble metal","description":"Crown-full cast noble metal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2468","name":"Inj, palonosetron (posfrea)","description":"Injection, palonosetron hydrochloride (posfrea), 25 micrograms","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0362U","name":"Onc pap thyr ca rna 82&10","description":"Onc pap thyr ca rna 82&10","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49188","name":"Opn exc/dst ntra-abd 10.1-20","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 10.1 to 20 cm","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9326","name":"Telisotuzumab vedotin-tllv","description":"Injection, telisotuzumab vedotin-tllv, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6700","name":"Ue add ext power myoel","description":"Upper extremity addition, external powered feature, myoelectronic control module, additional emg inputs, pattern-recognition decoding intent movement","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29510.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7472","name":"Removal of torus palatinus","description":"Removal of torus palatinus","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2544","name":"Dental onlay metl 4/more sur","description":"Onlay - metallic - four or more surfaces","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1000T","name":"Autol musc cell therapy admn","description":"Autologous muscle cell therapy, administration of muscle progenitor cells into the urethral sphincter, including cystoscopy and post-void residual ultrasound, when performed","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35905","name":"Excision graft thorax","description":"Excision of infected graft; thorax","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37254","name":"Revsc evasc ivt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81349","name":"Cytog alys chrml abnr lw-ps","description":"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and loss-of-heterozygosity variants, low-pass sequencing analysis","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4422","name":"Ac wrap per sq cm","description":"A/c wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0580U","name":"Bbrgdrferi antb detc 24rprtn","description":"Bbrgdrferi antb detc 24rprtn","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0169","name":"Inj epinephrine (adrenalin)","description":"Injection, epinephrine (adrenalin), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0484U","name":"Nfct ds mgen 23s rrna pt mut","description":"Nfct ds mgen 23s rrna pt mut","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4010","name":"Infectious disease ss","description":"Infectious disease mips specialty set","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4268","name":"Surgraft ft per sq cm","description":"Surgraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85032","name":"Manual cell count each","description":"Blood count; manual cell count (erythrocyte, leukocyte, or platelet) each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1503","name":"Vascular surgery mvp","description":"Vascular surgery mips value pathway","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0621U","name":"Nfct ds lb dna alys>10000","description":"Nfct ds lb dna alys>10000","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9612","name":"Thera par drugs 2 or > admin","description":"Therapeutic parenteral drugs two or more administrations different medications","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3379","name":"Inj, valproate sod, 5 mg","description":"Injection, valproate sodium, 5 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99427","name":"Prin care mgmt staff ea addl","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8502","name":"Inj, aponvie, 1 mg","description":"Injection, aprepitant (aponvie), 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11301","name":"Shave skin lesion 0.6-1.0 cm","description":"Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion diameter 0.6 to 1.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":55.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":136.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1939","name":"Inj, bumetanide, 0.5 mg","description":"Injection, bumetanide, 0.5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6560","name":"G stckng full/chap30-40 cust","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, custom, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6595","name":"G comp bandge liner upr extr","description":"Gradient compression bandaging supply, bandage liner, upper extremity, any size or length, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27602","name":"Decompression of lower leg","description":"Decompression fasciotomy, leg; anterior and/or lateral, and posterior compartment(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":614.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0729T","name":"Dx alys vstblr implt uni sbq","description":"Diagnostic analysis of vestibular implant, unilateral; with subsequent programming","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0044","name":"Pt mitral stenosis","description":"Patients with moderate or severe mitral stenosis","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27161","name":"Incision of neck of femur","description":"Osteotomy, femoral neck (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1444.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59414","name":"Deliver placenta","description":"Delivery of placenta (separate procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87183","name":"Sc std carbapenem resist gen","description":"Susceptibility studies, antimicrobial agent; carbapenem resistance genes (eg, blakpc, blandm, blavim, blaoxa-48, blaimp), amplified probe technique, per isolate","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0919T","name":"Rmvl perm ccm-d sys pg only","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); pulse generator only","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58720","name":"Removal of ovary/tube(s)","description":"Salpingo-oophorectomy, complete or partial, unilateral or bilateral (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":825.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1714","name":"Pfizer vacc adm ped 2nd dose","description":"Pfizer vacc adm ped 2nd dose","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33901","name":"Perq p-art revsc 1 nm nt bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, bilateral","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43205","name":"Esophagus endoscopy/ligation","description":"Esophagoscopy, flexible, transoral; with band ligation of esophageal varices","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4433","name":"361 hct/p skin subs, nos","description":"361 hct/p skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5945","name":"Mand implt sup remv part","description":"Mand implt sup remv part","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93593","name":"R hrt cath chd nml nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; normal native connections","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7354","name":"Cantharidin top, applicator","description":"Cantharidin for topical administration, 0.7%, single unit dose applicator (3.2 mg)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36100","name":"Establish access to artery","description":"Introduction of needle or intracatheter, carotid or vertebral artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6113","name":"Imp/abut rem dent part mand","description":"Imp/abut rem dent part mand","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4004","name":"Endocrinology ss","description":"Endocrinology mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0961T","name":"Shortwave ifr radiation img","description":"Shortwave infrared radiation imaging, surgical pathology specimen, to assist gross examination for lymph node localization in fibroadipose tissue, per specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21045","name":"Extensive jaw surgery","description":"Excision of malignant tumor of mandible; radical resection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1344.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0812T","name":"Rem mlt day uroflow dev sply","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); device supply with automated report generation, up to 10 days","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0956T","name":"Prt crn ch cr&tun elt s-sclp","description":"Partial craniectomy, channel creation, and tunneling of electrode for sub-scalp implantation of an electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0540","name":"Train for caregiver add 15","description":"Caregiver training in behavior management/modification for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face; each additional 15 minutes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4349","name":"Mantle dl matrix per sq cm","description":"Mantle dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63053","name":"Lam factc/frmt arthrd lum ea","description":"Laminectomy, facetectomy, or foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s] [eg, spinal or lateral recess stenosis]), during posterior interbody arthrodesis, lumbar; each additional vertebral segment (list separately in addition to code for","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40650","name":"Rpr lip fth vermilion only","description":"Repair lip, full thickness; vermilion only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62270","name":"Dx lmbr spi pnxr","description":"Spinal puncture, lumbar, diagnostic;","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":156.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0525","name":"Inj cefotetan disodium 10 mg","description":"Injection, cefotetan disodium, 10 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1469","name":"Hx of hep b, or pos bld test","description":"Patient has a history of hepatitis b illness or received a hepatitis b surface antigen, hepatitis b surface antibody, or total antibody to hepatitis b core antigen test with a positive result any time before or during the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0410U","name":"Onc pncrtc dna whl gn seq 5-","description":"Onc pncrtc dna whl gn seq 5-","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4433","name":"361 hct/p skin subs, nos","description":"361 hct/p skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61790","name":"Treat trigeminal nerve","description":"Creation of lesion by stereotactic method, percutaneous, by neurolytic agent (eg, alcohol, thermal, electrical, radiofrequency); gasserian ganglion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76937","name":"Us guide vascular access","description":"Ultrasound guidance for vascular access requiring ultrasound evaluation of potential access sites, documentation of selected vessel patency, concurrent realtime ultrasound visualization of vascular needle entry, with permanent recording and reporting (list separately in addition to code for primary ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6519","name":"Grad com garm noc night use","description":"Gradient compression garment, not otherwise specified, for nighttime use, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1494","name":"Fall rep since last visit","description":"Patients that reported a fall since the last visit","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9056","name":"Inj, vivimusta, 1 mg","description":"Injection, bendamustine hydrochloride (vivimusta), 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57720","name":"Revision of cervix","description":"Trachelorrhaphy, plastic repair of uterine cervix, vaginal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90967","name":"Esrd svc pr day pt <2","description":"End-stage renal disease (esrd) related services for dialysis less than a full month of service, per day; for patients younger than 2 years of age","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60252","name":"Removal of thyroid","description":"Thyroidectomy, total or subtotal for malignancy; with limited neck dissection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1465.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7412","name":"Excision benign lesion compl","description":"Excision of benign lesion complicated","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1361","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5933","name":"Refitting of obturator","description":"Obturator prosthesis modification","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9432","name":"Med food non inborn err meta","description":"Medical foods for non-inborn errors of metabolism","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98016","name":"Brief comunicaj tech-bsd svc","description":"Brief communication technology-based service (eg, virtual check-in) by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related evaluation and management service provided within the p","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0992T","name":"N-invas assmt car rsk w/o ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat without concurrent computed tomography (ct) scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0683T","name":"Prgrmg dev eval isdss ip","description":"Programming device evaluation (in-person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional, permanent implantable synchroni","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1225","name":"Iop dec>=20% from base","description":"Intraocular pressure (iop) reduced by a value of greater than or equal to 20% from the pre-intervention level","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0767T","name":"Tc mag stimj pn ea addl nrv","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; each additional nerve (list separat","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5130","name":"Inj, fylnetra, 0.5 mg","description":"Injection, pegfilgrastim-pbbk (fylnetra), biosimilar, 0.5 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1340","name":"Indx whodas 2.0 or sds","description":"Index assessment completed using the 12-item whodas 2.0 or sds during the denominator identification period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5992","name":"Low prosth foot shell repl","description":"All lower extremity prosthesis, foot shell for modular foot/non-solid ankle cushion heel (sach) replacement only","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64913","name":"Nrv rpr w/nrv algrft ea addl","description":"Nerve repair; with nerve allograft, each additional strand (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32906","name":"Revise & repair chest wall","description":"Thoracoplasty, schede type or extrapleural (all stages); with closure of bronchopleural fistula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1910.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99470","name":"Rpm tx mgmt 1st 10 min","description":"Remote physiologic monitoring treatment management services, clinical staff/physician/other qualified health care professional time in a calendar month requiring 1 real-time interactive communication with the patient/caregiver during the calendar month; first 10 minutes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0322U","name":"Neuro asd meas 14 acyl carn","description":"Neuro asd meas 14 acyl carn","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82030","name":"Assay of adp & amp","description":"Adenosine, 5-monophosphate, cyclic (cyclic amp)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0466U","name":"Crd cad dna gwas 564856 snp","description":"Crd cad dna gwas 564856 snp","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0552U","name":"Repr med pga gdo te bx locus","description":"Repr med pga gdo te bx locus","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0692T","name":"Therapeutic ultrafiltration","description":"Therapeutic ultrafiltration","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85007","name":"Bl smear w/diff wbc count","description":"Blood count; blood smear, microscopic examination with manual differential wbc count","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":3.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1245","name":"Pt othr thn true person","description":"Patient provided a response other than completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64628","name":"Trml dstrj ios bvn 1st 2 l/s","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; first 2 vertebral bodies, lumbar or sacral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5612","name":"Rep resin part dent base max","description":"Rep resin part dent base max","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37270","name":"Revsc evasc fpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4304","name":"Grafix plus, per sq cm","description":"Grafix plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0563U","name":"Nfct ds pthgn-sna 11vir&4bct","description":"Nfct ds pthgn-sna 11vir&4bct","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0641","name":"Lo rig pos pnl l1-l5 pre ots","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64728","name":"Dcmprn median nrv carpl tunl","description":"Decompression; median nerve at the carpal tunnel, percutaneous, with intracarpal tunnel balloon dilation, including ultrasound guidance","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0483","name":"Indirect immunofluorescence","description":"Indirect immunofluorescence","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0599U","name":"Onc pncrtc ca mult ia serum","description":"Onc pncrtc ca mult ia serum","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J1060","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0053","name":"Ht mental health and care","description":"Historical trauma (ht) mental health and clinical care for indigenous persons","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0585U","name":"Tgsap so neo cfdna 521 genes","description":"Tgsap so neo cfdna 521 genes","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2006","name":"Novosorb synpath per sq cm","description":"Novosorb synpath dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0969T","name":"Removal epicranial nstim sys","description":"Removal of epicranial neurostimulator system","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1013T","name":"Lap srg imp/rpl eso nea&pg/r","description":"Laparoscopy, surgical, implantation or replacement of lower esophageal sphincter neurostimulator electrode array and neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver, including cruroplasty and/or electronic ","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86617","name":"Lyme disease antibody","description":"Antibody; borrelia burgdorferi (lyme disease) confirmatory test (eg, western blot or immunoblot)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0966T","name":"I&cst prp jw xpn dl arch fxd","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, fixed hinge mechanism","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92928","name":"Prq tcat plmt ntrac st 1 les","description":"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 1 lesion involving 1 or more coronary segments","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5949","name":"Mand implt sup fix part","description":"Mand implt sup fix part","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33901","name":"Perq p-art revsc 1 nm nt bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, bilateral","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37289","name":"Revsc evsc tpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6038","name":"Multiax rotation attachment","description":"Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52284","name":"Cysto rx balo cath urtl strx","description":"Cystourethroscopy, with mechanical urethral dilation and urethral therapeutic drug delivery by drug-coated balloon catheter for urethral stricture or stenosis, male, including fluoroscopy, when performed","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4375","name":"Duograft ac per sq cm","description":"Duograft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26180","name":"Removal of finger tendon","description":"Excision of tendon, finger, flexor or extensor, each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":520.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0514U","name":"Gi ibd ia quan deter adl lvl","description":"Gi ibd ia quan deter adl lvl","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1019T","name":"Lymphovenous bypass per xtr","description":"Lymphovenous bypass, including robotic assistance, when performed, per extremity","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0329U","name":"Onc neo xome&trns seq alys","description":"Onc neo xome&trns seq alys","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6112","name":"Imp/abut rem dent part max","description":"Imp/abut rem dent part max","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2989","name":"Excavate tooth non-restorabl","description":"Excavate tooth non-restorabl","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4302","name":"Complete aca, per sq cm","description":"Complete aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7972","name":"Surg redct fibrous tuberosit","description":"Surgical reduction of fibrous tuberosity","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1263","name":"Pts hosp dialysis dt","description":"Patients in hospice on their initiation of dialysis date or during the month of evaluation","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2422.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2010","name":"Apis, per square centimeter","description":"Apis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2008","name":"Theragenesis, per sq cm","description":"Theragenesis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1350","name":"Pt w/ suic saf pln init rev","description":"Patients who had a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0962T","name":"Asstv alg alys acous&ecg rec","description":"Assistive algorithmic analysis of acoustic and electrocardiogram recording for detection of cardiac dysfunction (eg, reduced ejection fraction, cardiac murmurs, atrial fibrillation), with review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0736T","name":"Colonic lavage 35+l water","description":"Colonic lavage, 35 or more liters of water, gravity-fed, with induced defecation, including insertion of rectal catheter","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0603U","name":"Rx asy prsmv 77rx/metablt ur","description":"Rx asy prsmv 77rx/metablt ur","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0744T","name":"Insj bioprostc vlv fem vn","description":"Insertion of bioprosthetic valve, open, femoral vein, including duplex ultrasound imaging guidance, when performed, including autogenous or nonautogenous patch graft (eg, polyester, eptfe, bovine pericardium), when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0908T","name":"Opn imp int nstm sys vgs nrv","description":"Open implantation of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9954","name":"Fab/del oral appliance thxpy","description":"Fab/del oral appliance thxpy","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0979T","name":"Sbmcsl crylys ther sft palt","description":"Submucosal cryolysis therapy; soft palate only","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0345U","name":"Psyc genom alys pnl 15 gen","description":"Psyc genom alys pnl 15 gen","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0854T","name":"Dgtz gls mcrscp bld smr prph","description":"Digitization of glass microscope slides for blood smear, peripheral, interpretation by physician with written report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0557","name":"Adv prim care mgmt lvl 2","description":"Advanced primary care management services for a patient with multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, which place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline, provided by c","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0594U","name":"Nfct ds sepsis pncrtc spc","description":"Nfct ds sepsis pncrtc spc","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7972","name":"Surg redct fibrous tuberosit","description":"Surgical reduction of fibrous tuberosity","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0859T","name":"Ncntc ifr spctrsc o/t pad ea","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), other than for screening for peripheral arterial disease, image acquisition, interpretation, and report; each additional anatomic site (list separately in addition to code ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69716","name":"Impl oi implt sk tc esp<100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or resulting in removal of less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93145","name":"Interrog crtd sins bat ip wo","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0688T","name":"Tx amblyopia assmt w/report","description":"Treatment of amblyopia using an online digital program; assessment of patient performance and program data by physician or other qualified health care professional, with report, per calendar month","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2281","name":"Inj moxifloxacin (fres kabi)","description":"Injection, moxifloxacin (fresenius kabi), not therapeutically equivalent to j2280, 100 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6212","name":"Bridge noble metal cast","description":"Pontic-cast noble metal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0462U","name":"Melatonin lvl tst slp std7/9","description":"Melatonin lvl tst slp std7/9","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4024","name":"Pediatrics ss","description":"Pediatrics mips specialty set","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9282","name":"Mitomycin intravesical inst","description":"Mitomycin, intravesical instillation, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0892T","name":"Arhfcmrigtbs sbsq per tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent motor threshold redetermination with delivery and management, per treatment day","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4263","name":"Surgraft tl, per sq cm","description":"Surgraft tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83884","name":"Assay neurflmnt light chain","description":"Neurofilament light chain (nfl)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31300","name":"Removal of larynx lesion","description":"Laryngotomy (thyrotomy, laryngofissure), with removal of tumor or laryngocele, cordectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1371.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76019","name":"Mr safety implt pos&/immoblj","description":"Mr safety implant positioning and/or immobilization under supervision of physician or other qualified health care professional, including application of physical protections to secure implanted medical device from mr-induced translational or vibrational forces, magnetically induced functional change","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5996","name":"Peri medicament w/seal, mand","description":"Peri medicament w/seal, mand","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1347","name":"Pt pam incr 3 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 3 points in a 4 to 12 month period (passing)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1811","name":"Fiasp for insulin pump use","description":"Insulin (fiasp) for administration through dme (i.e., insulin pump) per 50 units","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92546","name":"Sinusoidal rotational test","description":"Sinusoidal vertical axis rotational testing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9912","name":"Pre-visit patient screening","description":"Pre-visit patient screening","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1287","name":"Calc bmi blw low param f/u","description":"Bmi is documented below normal parameters and a follow-up plan is documented","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4371","name":"Neoguard per sq cm","description":"Neoguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86041","name":"Acetylcholn rcptr bndng antb","description":"Acetylcholine receptor (achr); binding antibody","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26841","name":"Fusion of thumb","description":"Arthrodesis, carpometacarpal joint, thumb, with or without internal fixation;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":999.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0875T","name":"Prgrm subq prtl asct pmp sys","description":"Programming of subcutaneously implanted peritoneal ascites pump system by physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0433U","name":"Onc prst8 5 dna reg mrk pcr","description":"Onc prst8 5 dna reg mrk pcr","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9563","name":"Ht inj immuno diem","description":"Home injectable therapy, immunotherapy, 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":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5228","name":"Immed mand part denture","description":"Immed mand part denture","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0706","name":"Intraoral occlus radio image","description":"Intraoral occlus radio image","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0535U","name":"Pfas lc-ms/ms plsm/srm quan","description":"Pfas lc-ms/ms plsm/srm quan","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0818T","name":"Revj/rmvl ins ptn subq","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2022","name":"Innovabrn/innovamatx xl sqcm","description":"Innovaburn or innovamatrix xl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92596","name":"Ear protector evaluation","description":"Ear protector attenuation measurements","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1341","name":"Pt no f/u 30-180 dys","description":"Patients who did not have a follow-up assessment or did not have an assessment within 30 to 180 days after the index assessment during the performance period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7414","name":"Excision malig lesion>1.25cm","description":"Excision of malignant lesion greater than 1.25 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55707","name":"Bx prst8 trct us guided","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57511","name":"Cryocautery of cervix","description":"Cautery of cervix; cryocautery, initial or repeat","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":225.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":156.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4019","name":"Oncology/hema ss","description":"Oncology/hematology mips specialty set","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4432","name":"510(k) skin subs, nos","description":"510(k) skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76815","name":"Ob us limited fetus(s)","description":"Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1364","name":"Ascvd risk >=20pct","description":"Calculated 10-year ascvd risk score of >= 20 percent during the performance period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1356","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0555","name":"Replacment pt electronic sys","description":"Provision of replacement patient electronics system (e.g., system pillow, handheld reader) for home pulmonary artery pressure monitoring","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63053","name":"Lam factc/frmt arthrd lum ea","description":"Laminectomy, facetectomy, or foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s] [eg, spinal or lateral recess stenosis]), during posterior interbody arthrodesis, lumbar; each additional vertebral segment (list separately in addition to code for","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1282","name":"Pt scrn tbco id as non user","description":"Patient screened for tobacco use and identified as a tobacco non-user","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81517","name":"Liver ds alys 3 bmrk srm alg","description":"Liver disease, analysis of 3 biomarkers (hyaluronic acid [ha], procollagen iii amino terminal peptide [piiinp], tissue inhibitor of metalloproteinase 1 [timp-1]), using immunoassays, utilizing serum, prognostic algorithm reported as a risk score and risk of liver fibrosis and liver-related clinical ","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0465","name":"Autolog prp diab wound ulcer","description":"Autologous platelet rich plasma (prp) or other blood-derived product for diabetic chronic wounds/ulcers, using an fda-cleared device for this indication, (includes as applicable administration, dressings, phlebotomy, centrifugation or mixing, and all other preparatory procedures, per treatment)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5134","name":"Inj, tyruko, 1 mg","description":"Injection, natalizumab-sztn (tyruko), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5153","name":"Inj, aflibercept-yszy, 1 mg","description":"Injection, aflibercept-yszy (opuviz), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5909","name":"Max guid prothes w/ flange","description":"Max guid prothes w/ flange","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94662","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0561","name":"Temp tube delivery, unil","description":"Tympanostomy with local or topical anesthesia and insertion of a ventilating tube when performed with tympanostomy tube delivery device, unilateral (list separately in addition to 69433) (do not use in conjunction with 0583t)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4365","name":"Amnio bur dl mem per sq cm","description":"Amnio burgeon dual-layer membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41130","name":"Partial removal of tongue","description":"Glossectomy; hemiglossectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1289.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4391","name":"Amnioplast double per sq cm","description":"Amnioplast double, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0527","name":"Mgt est pt dmentia low cmplx","description":"Management of established patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4199","name":"Cygnus matrix, per sq cm","description":"Cygnus matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J0170","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78492","name":"Myocrd img pet mlt rst&strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); multiple studies at rest and stress (exercise or pharmacologic)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2021","name":"Neomatrix per sq cm","description":"Neomatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0347U","name":"Rx metab/pcx dna 16 gen alys","description":"Rx metab/pcx dna 16 gen alys","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0560U","name":"Onc mrd gsa cfdna baseline","description":"Onc mrd gsa cfdna baseline","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0558","name":"Adv prim care mgmt lvl 3","description":"Advanced primary care management services for a patient that is a qualified medicare beneficiary with multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, which place the patient at significant risk of death, acute exacerbation/decompensat","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0506","name":"Comp asses care plan ccm svc","description":"Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":64.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9610","name":"Xe129 xenon, diagnostic","description":"Xenon xe-129 hyperpolarized gas, diagnostic, per study dose","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27781","name":"Treatment of fibula fracture","description":"Closed treatment of proximal fibula or shaft fracture; with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2312","name":"Inj naloxone hcl nos, 0.01mg","description":"Injection, naloxone hydrochloride, not otherwise specified, 0.01 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1335","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1325","name":"Epoprostenol injection","description":"Injection, epoprostenol, 0.5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2779","name":"Inj, susvimo 0.1 mg","description":"Injection, ranibizumab, via intravitreal implant (susvimo), 0.1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2470","name":"Inj pantoprazole sodium 40mg","description":"Injection, pantoprazole sodium, 40 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27158","name":"Revision of pelvis","description":"Osteotomy, pelvis, bilateral (eg, congenital malformation)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1529.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4426","name":"Dermbnd tl+, tlx per sq cm","description":"Dermabind tl + or dermabind tl x,  per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0539U","name":"Onc sol tumor cfctdna 152gen","description":"Onc sol tumor cfctdna 152gen","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0299U","name":"Onc pan tum whl gen opt mapg","description":"Onc pan tum whl gen opt mapg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0481U","name":"Idh1 idh2&tert promoter ngs","description":"Idh1 idh2&tert promoter ngs","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87593","name":"Orthopoxvirus amp prb each","description":"Infectious agent detection by nucleic acid (dna or rna); orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus), amplified probe technique, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1459","name":"Pt hosp/pal care dur perf pd","description":"Patient was in hospice or receiving palliative care services at any time during the performance period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9064","name":"Inj, cabazitaxel (sandoz)","description":"Injection, cabazitaxel (sandoz), not therapeutically equivalent to j9043, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77092","name":"Tbs i&r fx rsk qhp","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; interpretation and report on fracture-risk only by other qualified health care professional","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1200","name":"Ace-i/arb rx","description":"Ace inhibitor (ace-i) or arb therapy prescribed during the measurement period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1496","name":"No doc of fall or poc","description":"Patients that had a fall who did not have a plan of care for falls documented or do not have documentation of being assessed for falls","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0521U","name":"Rf iga&igm ccp antb sr-a ia","description":"Rf iga&igm ccp antb sr-a ia","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1327","name":"Pts no eval ini xm no 8 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 8 weeks","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1010T","name":"Cptr oph alys monoc eye mvmt","description":"Computerized ophthalmic analysis of monocular eye movements using retinal-based eye-tracking without spatial calibration, including fixation, microsaccades, drift, and horizontal saccades, when performed, unilateral or bilateral, with interpretation and report","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9361","name":"Inj, efbemalenograstim alfa-","description":"Injection, efbemalenograstim alfa-vuxw, 0.5 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5878","name":"Dup of complt dent-mandib","description":"Dup of complt dent-mandib","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0856T","name":"Dgtz gls mcrscp electron mic","description":"Digitization of glass microscope slides for electron microscopy, diagnostic (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1339","name":"Pts f/u 30-180 dys + improv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who demonstrated positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0332U","name":"Onc pan tum gen prflg 8 dna","description":"Onc pan tum gen prflg 8 dna","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S4024","name":"Air polymer foam per study","description":"Air polymer-type a intrauterine foam, per study dose","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98006","name":"Synch audio-video est mod 30","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0607U","name":"Reprdtve med ema rtpcr 31bct","description":"Reprdtve med ema rtpcr 31bct","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76086","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0802","name":"Inj. (ani), up to 40 units","description":"Injection, corticotropin (ani), up to 40 units","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4360","name":"Amchoplast fd per sq cm","description":"Amchoplast fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0953T","name":"Tot impl amei rev/rplc w/o","description":"Totally implantable active middle ear hearing implant; revision or replacement, without mastoidectomy and replacement of sound processor","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0111","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0964T","name":"I&cust prep jaw xpnsj 1arch","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; single arch, without mandibular advancement mechanism","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4365","name":"Amnio bur dl mem per sq cm","description":"Amnio burgeon dual-layer membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92636","name":"Hearing aid post-fitg f-up 1","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64644","name":"Chemodenerv 1 extrem 5/> mus","description":"Chemodenervation of one extremity; 5 or more muscles","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99404","name":"Prev med cnsl indiv apprx 60","description":"Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 60 minutes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":126.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5914","name":"Auricular prosthesis","description":"Auricular prosthesis","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1384","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85007","name":"Bl smear w/diff wbc count","description":"Blood count; blood smear, microscopic examination with manual differential wbc count","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53431","name":"Reconstruct urethra/bladder","description":"Urethroplasty with tubularization of posterior urethra and/or lower bladder for incontinence (eg, tenago, leadbetter procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1282.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93153","name":"Interrog w/o prgrmg ipnss","description":"Interrogation without programming of implanted phrenic nerve stimulator system","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49617","name":"Rpr aa hrn rcr > 10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, reducible","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01942","name":"Anes neuromd/ntrvrt lmbr/sac","description":"Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4260","name":"Signature apatch, per sq cm","description":"Signature apatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4282","name":"Cygnus dual per sq cm","description":"Cygnus dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37255","name":"Revsc evasc ivt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9292","name":"Pres dig visual therapy fda","description":"Prescription digital visual therapy, software-only, fda cleared, per course of treatment","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3921","name":"Decor or submerg erupt tooth","description":"Decor or submerg erupt tooth","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1285","name":"Scrn mam perf rslts not doc","description":"Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed, reason not otherwise specified","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93588","name":"Vngrph chd vnvn cltrl below","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating below the heart (eg, from the inferior vena cava) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":86.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0482U","name":"Ob pe biochem asy sfit1&pigf","description":"Ob pe biochem asy sfit1&pigf","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0816T","name":"Opn insj/rplcmt ins ptn subq","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0801","name":"3d dental scan direct","description":"3d dental scan direct","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0041","name":"Pt/ptn decln referral","description":"Patient and/or care partner decline referral","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4270","name":"Complete sl per sq cm","description":"Complete sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87084","name":"Culture of specimen by kit","description":"Culture, presumptive, pathogenic organisms, screening only; with colony estimation from density chart","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1423","name":"Opt care urologic cnd mvp","description":"Optimal care for patients with urologic conditions mips value pathway","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37296","name":"Revsc evasc imvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37282","name":"Rvsc evsc tpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0388U","name":"Onc nonsm cll lng ca 37 gen","description":"Onc nonsm cll lng ca 37 gen","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0923T","name":"Rmvl&rplcmt perm ccm-d pg","description":"Removal and replacement of permanent cardiac contractility modulation-defibrillation pulse generator only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43320","name":"Fuse esophagus & stomach","description":"Esophagogastrostomy (cardioplasty), with or without vagotomy and pyloroplasty, transabdominal or transthoracic approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1411.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1262","name":"Pts transplt bef dialysis","description":"Patients who had a transplant prior to initiation of dialysis","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1280","name":"Bilat mast/hx bi /unilat mas","description":"Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82550","name":"Assay of ck (cpk)","description":"Creatine kinase (ck), (cpk); total","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43113","name":"Removal of esophagus","description":"Total or near total esophagectomy, with thoracotomy; with colon interposition or small intestine reconstruction, including intestine mobilization, preparation, and anastomosis(es)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2436.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01938","name":"Anes drg/aspir lmbr/sac","description":"Anesthesia for percutaneous image-guided injection, drainage or aspiration procedures on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96380","name":"Admn rsv monoc antb im cnsl","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection, with counseling by physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0538U","name":"Onc sol tum ngts ffpe 600gen","description":"Onc sol tum ngts ffpe 600gen","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0420U","name":"Onc urthl mrna xprsn 6 snp","description":"Onc urthl mrna xprsn 6 snp","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1238","name":"Doc 2nd recom hzv 2-6 mo int","description":"Documentation that administration of second recombinant zoster vaccine could not occur during the performance period due to the recommended 2-6 month interval between doses (i.e, first dose received after october 31)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7514","name":"Mycophenol (myhibbin) 100 mg","description":"Mycophenolate mofetil (myhibbin), oral suspension, 100 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81517","name":"Liver ds alys 3 bmrk srm alg","description":"Liver disease, analysis of 3 biomarkers (hyaluronic acid [ha], procollagen iii amino terminal peptide [piiinp], tissue inhibitor of metalloproteinase 1 [timp-1]), using immunoassays, utilizing serum, prognostic algorithm reported as a risk score and risk of liver fibrosis and liver-related clinical ","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1439","name":"Sig ocu cond imp surg out","description":"Significant ocular conditions that impact the visual outcome of surgery","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4358","name":"Xwrap dual, per sq cm","description":"Xwrap dual, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0825T","name":"Tcat rmv&rpl1chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or prog","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1250","name":"Pt resp true heard","description":"Patient responded as completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0432U","name":"Klhl11 antb sr/csf asy qual","description":"Klhl11 antb sr/csf asy qual","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81459","name":"So neo gsap dna/dna&rna","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants, microsatellite instability, tumor mutation burden, and rearrangements","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0733T","name":"Rem r-t mtn nrehab ther sply","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; supply and technical support, per 30 days","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0481","name":"Electron microscopy diagnost","description":"Electron microscopy - diagnostic","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5422","name":"Dentures adjust part mandbl","description":"Adjust partial denture - mandibular","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9609","name":"F18 fdg, 15 millicuries","description":"Fludeoxyglucose f18 up to 15 millicuries","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90961","name":"Esrd srv 2-3 vsts p mo 20+","description":"End-stage renal disease (esrd) related services monthly, for patients 20 years of age and older; with 2-3 face-to-face visits by a physician or other qualified health care professional per month","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2448.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1274","name":"Pts snf exl mo","description":"Patients who were admitted to a skilled nursing facility (snf) during the month of evaluation were excluded from that month","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2253","name":"Inj midazolam (seizalam)","description":"Injection, midazolam (seizalam), 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0288U","name":"Onc lung mrna quan pcr 11&3","description":"Onc lung mrna quan pcr 11&3","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0680T","name":"Insj/rplcmt pg only isdss","description":"Insertion or replacement of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing lead(s)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9949","name":"Repair sleep apnea appliance","description":"Repair sleep apnea appliance","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0547U","name":"Neurflmnt lt chn cleia plsm","description":"Neurflmnt lt chn cleia plsm","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1098","name":"Articaine ophthalmi 8% 0.4ml","description":"Articaine ophthalmic, 8% solution, 0.4 ml","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1244","name":"Pt othr thn true best int","description":"Patient provided a response other than completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1370","name":"Rehab support msk care mvp","description":"Rehabilitative support for musculoskeletal care mips value pathway","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47350","name":"Repair liver wound","description":"Management of liver hemorrhage; simple suture of liver wound or injury","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1379.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45355","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82240","name":"Bile acids cholylglycine","description":"Bile acids; cholylglycine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0514U","name":"Gi ibd ia quan deter adl lvl","description":"Gi ibd ia quan deter adl lvl","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0597U","name":"Onc breast rna xprsn 329gens","description":"Onc breast rna xprsn 329gens","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64466","name":"Thrc fascial pln blk uni njx","description":"Thoracic fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6612","name":"Onlay cst base mtl 2 surface","description":"Onlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1494","name":"Fall rep since last visit","description":"Patients that reported a fall since the last visit","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0844T","name":"Dgtz gls mcrscp cslt cyt ea","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), each additional site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98009","name":"Synch audio-only new low 30","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 30 m","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0703","name":"2d oral/facial photo image","description":"2d oral/facial photo image","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J9250","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4373","name":"Membrane wrp lt per sq cm","description":"Membrane wrap lite, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56634","name":"Vlvctmy rad comp uni lymphad","description":"Vulvectomy, radical, complete; with unilateral inguinofemoral lymphadenectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1313.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43290","name":"Egd flx trnsorl dplmnt balo","description":"Esophagogastroduodenoscopy, flexible, transoral; with deployment of intragastric bariatric balloon","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35459","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":577.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87428","name":"Sarscov & inf vir a&b ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; severe acute respiratory syndrome coronavirus (eg, sars-cov, s","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1414","name":"Inj, beqvez, per tx dose","description":"Injection, fidanacogene elaparvovec-dzkt, per therapeutic dose","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0701","name":"Pano radio image","description":"Pano radio image","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0917T","name":"Insj perm ccm-d sys 1 lead","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; single transvenous lead (pacing or defibrillation) only","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1383","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82946","name":"Glucagon tolerance test","description":"Glucagon tolerance test","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6594","name":"G comp bandge liner lwr extr","description":"Gradient compression bandaging supply, bandage liner, lower extremity, any size or length, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":35.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25332","name":"Revise wrist joint","description":"Arthroplasty, wrist, with or without interposition, with or without external or internal fixation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44393","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2007","name":"Restrata, per sq cm","description":"Restrata, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90635","name":"H5n1 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n1, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87470","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78013","name":"Thyroid imaging w/blood flow","description":"Thyroid imaging (including vascular flow, when performed);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1317","name":"Pts counsl cpt opt out","description":"Patients who are counseled on connection with a csp and explicitly opt out","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1009T","name":"Rem mntr s-sclp cont eeg sys","description":"Remote monitoring of a sub-scalp implanted continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69730","name":"Rplc oi implt sk tc esp>=100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92930","name":"Prq tcat plmt ntrac st 2+les","description":"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 2 or more distinct coronary lesions with 2 or more coronary stents deployed in 2 or more coronary segments, or a bifurcation lesion requiring ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6553","name":"G com stcking bk 30-40 custm","description":"Gradient compression stocking, below knee, 30-40 mmhg, custom, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84181","name":"Western blot test","description":"Protein; western blot, with interpretation and report, blood or other body fluid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4397","name":"Static or dynami afo pre ots","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated, off-the-shelf","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1311","name":"Aphlx to vax bef enc","description":"Anaphylaxis due to the vaccine on or before the date of the encounter","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0530","name":"Adult daycare center, 8 hr u","description":"Adult day center, 8-hour unit, for use in cmmi model","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0668","name":"Team remote e/m est pt 40 mn","description":"Team remote e/m est. pt 40mins","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27385","name":"Repair of thigh muscle","description":"Suture of quadriceps or hamstring muscle rupture; primary","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":768.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84030","name":"Assay of blood pku","description":"Phenylalanine (pku), blood","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0755T","name":"Dgtz gls mcrscp sld level vi","description":"Digitization of glass microscope slides for level vi, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37259","name":"Revsc evasc ivt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1460","name":"Dx copd, cf, or arf","description":"Diagnosis for chronic obstructive pulmonary disease, emphysema, cystic fibrosis, or acute respiratory failure","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3373","name":"Inj, vancomycin hcl, 10 mg","description":"Injection, vancomycin hydrochloride, 10 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0335U","name":"Rare ds whl gen seq fetal","description":"Rare ds whl gen seq fetal","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0446U","name":"Ai ds sle alys 10 cytokine","description":"Ai ds sle alys 10 cytokine","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0018M","name":"Trnsplj rnl meas cd154+cll","description":"Transplantation medicine (allograft rejection, renal), measurement of donor and third-party-induced cd154+t-cytotoxic memory cells, utilizing whole peripheral blood, algorithm reported as a rejection risk score","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1275","name":"Pts hosp exl","description":"Patients determined to be in hospice were excluded from month of evaluation and the remainder of reporting period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81025","name":"Urine pregnancy test","description":"Urine pregnancy test, by visual color comparison methods","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0424U","name":"Onc prst8 xom alys 53 sncrna","description":"Onc prst8 xom alys 53 sncrna","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6039","name":"Passive custom digit/thumb","description":"Passive prosthetic digit or thumb prosthesis not including hand restoration partial hand, full or partial, custom made, any material, initial or replacement, per single passive prosthetic digit or thumb","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1736","name":"Inj meloxicam (delova) 1mg","description":"Injection, meloxicam (delova), 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5657","name":"Add low ext man aut vol any","description":"Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":306.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1465","name":"F/u > 180 days after rx","description":"Patient follow up more than 180 days after treatment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2040","name":"Microlyte painguard pr sq cm","description":"Microlyte painguard, per square centimeter","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"U0002","name":"Covid-19 lab test non-cdc","description":"2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1226","name":"Iop not doc","description":"Iop measurement not documented, reason not otherwise specified","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01938","name":"Anes drg/aspir lmbr/sac","description":"Anesthesia for percutaneous image-guided injection, drainage or aspiration procedures on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0260U","name":"Rare ds id opt genome mapg","description":"Rare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20553","name":"Njx 1/mlt trigger points 3/>","description":"Injection(s); single or multiple trigger point(s), 3 or more muscles","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":47.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":69.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7299","name":"Rem anchorage device w/flap","description":"Rem anchorage device w/flap","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1552","name":"Inj, alyglo, 500 mg","description":"Injection, immune globulin (alyglo), 500 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0389","name":"Periopic image capture only","description":"Periopic image capture only","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82710","name":"Fats/lipids feces quant","description":"Fat or lipids, feces; quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1290","name":"Pt not eli d/t act dig htn","description":"Patient not eligible due to active diagnosis of hypertension","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99427","name":"Prin care mgmt staff ea addl","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76932","name":"Echo guide for heart biopsy","description":"Ultrasonic guidance for endomyocardial biopsy, imaging supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4035","name":"Thoracic surgery ss","description":"Thoracic surgery mips specialty set","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0290U","name":"Pain mgmt mrna gen xprsn 36","description":"Pain mgmt mrna gen xprsn 36","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0442","name":"Annual alcohol screen 15 min","description":"Annual alcohol misuse screening, 5 to 15 minutes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":17.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0164","name":"Epinephrine in nacl (baxter)","description":"Injection, epinephrine in sodium chloride (baxter), 0.1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0549","name":"Phone/inter for treat>31m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64650","name":"Chemodenerv eccrine glands","description":"Chemodenervation of eccrine glands; both axillae","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2020","name":"Ac5 wound system","description":"Ac5 advanced wound system (ac5)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85025","name":"Complete cbc w/auto diff wbc","description":"Blood count; complete (cbc), automated (hgb, hct, rbc, wbc and platelet count) and automated differential wbc count","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0224","name":"Pemivibart infusion","description":"Intravenous infusion, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppr","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0677T","name":"Laps repos lead isdss 1st ld","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first repositioned lead","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26025","name":"Drainage of palm bursa","description":"Drainage of palmar bursa; single, bursa","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0784T","name":"Ins/rplmt eltrd ra spi nstim","description":"Insertion or replacement of percutaneous electrode array, spinal, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99459","name":"Pelvic examination","description":"Pelvic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7241","name":"Impact tooth rem bony w/comp","description":"Removal of impacted tooth-completely bony with unusual surgical complications","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0567","name":"Screening hep c detect","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis c, screening, amplified probe technique","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28344","name":"Repair extra toe(s)","description":"Reconstruction, toe(s); polydactyly","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93303","name":"Echo transthoracic","description":"Transthoracic echocardiography for congenital cardiac anomalies; complete","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9914","name":"Admin of dermal fill","description":"Admin of dermal fill","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87485","name":"Chlmyd pneum dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); chlamydia pneumoniae, direct probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59851","name":"Induced abortion 1+njx d&c","description":"Induced abortion, by 1 or more intra-amniotic injections (amniocentesis-injections), including hospital admission and visits, delivery of fetus and secundines; with dilation and curettage and/or evacuation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":503.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":477.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61458","name":"Crnec sopl xpl/dcmpr crl nrv","description":"Craniectomy, suboccipital; for exploration or decompression of cranial nerves","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2293.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0454U","name":"U rare ds id opt genome mapg","description":"U rare ds id opt genome mapg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2038","name":"Skill train and dev/diem","description":"Skills training and development, per diem","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42975","name":"Dise eval slp do brth flx dx","description":"Drug-induced sleep endoscopy, with dynamic evaluation of velum, pharynx, tongue base, and larynx for evaluation of sleep-disordered breathing, flexible, diagnostic","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0689","name":"Inj cefazolin sodium, baxter","description":"Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2472","name":"Inj, pantoprazole sodium chl","description":"Injection, pantoprazole sodium in sodium chloride (baxter), 40 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1345","name":"Pt bsln pam, 2nd scr 4-12 mo","description":"Patients who had a baseline pam score and a second score within 4 to 12 month of baseline pam score","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2041","name":"Coord special care encounter","description":"Coordinated specialty care, team-based, for first episode psychosis, per encounter","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93731","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0523U","name":"Onc soltum dna ngs snv 22gen","description":"Onc soltum dna ngs snv 22gen","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81001","name":"Urinalysis auto w/scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; automated, with microscopy","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9953","name":"Reline sleep apnea appliance","description":"Reline sleep apnea appliance","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51840","name":"Attach bladder/urethra","description":"Anterior vesicourethropexy, or urethropexy (eg, marshall-marchetti-krantz, burch); simple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":768.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9697","name":"Inj, magtrace per study dose","description":"Injection, carboxydextran-coated superparamagnetic iron oxide, per study dose","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27703","name":"Reconstruction ankle joint","description":"Arthroplasty, ankle; revision, total ankle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1359.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4409","name":"Amniomatrixf3x per sq cm","description":"Amniomatrixf3x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78804","name":"Rp loclzj tum whbdy 2+d img","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, requiring 2 or more days imaging","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":614.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1782","name":"Vac admin human pap dose 2","description":"Vac admin human pap dose 2","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0973T","name":"Slctv nzmtc dbrdmt t/a/l 1st","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; first 100 sq cm","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45402","name":"Lap proctopexy w/sig resect","description":"Laparoscopy, surgical; proctopexy (for prolapse), with sigmoid resection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1673.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1414","name":"Med rsn no pdl1 bef 1st ther","description":"Documentation of medical reason(s) for not performing the pd-l1 biomarker expression test prior to initiation of first-line immune checkpoint inhibitor therapy (e.g., patient is in an urgent or emergent situation where delay of treatment would jeopardize the patients health status; other medical rea","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55714","name":"Bx prst8 in-bore ct/mri 1","description":"Biopsy, prostate, in-bore ct- or mri-guided targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4321","name":"Renograft, per sq cm","description":"Renograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0703","name":"2d oral/facial photo image","description":"2d oral/facial photo image","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2679","name":"Inj fluphenazine hcl 1.25 mg","description":"Injection, fluphenazine hcl, 1.25 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5159","name":"Inj, denosumab-dssb, 1 mg","description":"Injection, denosumab-dssb (ospomyv/xbryk), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22630","name":"Arthrd pst tq 1ntrspc lum","description":"Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression), single interspace, lumbar;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1798.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26850","name":"Fusion of knuckle","description":"Arthrodesis, metacarpophalangeal joint, with or without internal fixation;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":935.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1747","name":"Inj, spesolimab-sbzo, 1 mg","description":"Injection, spesolimab-sbzo, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0895T","name":"Connj lvr algrft prfu dev 1","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; initial 4 hours of monitoring time, including hourly physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary ","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0018M","name":"Trnsplj rnl meas cd154+cll","description":"Transplantation medicine (allograft rejection, renal), measurement of donor and third-party-induced cd154+t-cytotoxic memory cells, utilizing whole peripheral blood, algorithm reported as a rejection risk score","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4429","name":"Dermbnd chn, chx per sq cm","description":"Dermabind ch n or dermabind ch x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15854","name":"Removal sutr&stapl xreq anes","description":"Removal of sutures and staples not requiring anesthesia (list separately in addition to e/m code)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59812","name":"Treatment of miscarriage","description":"Treatment of incomplete abortion, any trimester, completed surgically","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":330.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0169","name":"Inj epinephrine (adrenalin)","description":"Injection, epinephrine (adrenalin), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2470","name":"Inj pantoprazole sodium 40mg","description":"Injection, pantoprazole sodium, 40 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0697T","name":"Quan mr tis wo mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained without diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, targ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90792","name":"Psych diag eval w/med srvcs","description":"Psychiatric diagnostic evaluation with medical services","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":173.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2028","name":"Micromatrix flex per mg","description":"Micromatrix flex, per mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0881T","name":"Cryotherapy oral cavity","description":"Cryotherapy of the oral cavity using temperature regulated fluid cooling system, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4316","name":"Amchoplast, per sq cm","description":"Amchoplast, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7528","name":"Mycophen mofetil for susp","description":"Mycophenolate mofetil, for suspension, oral, 100 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52214","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) of trigone, bladder neck, prostatic fossa, urethra, or periurethral glands","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1010T","name":"Cptr oph alys monoc eye mvmt","description":"Computerized ophthalmic analysis of monocular eye movements using retinal-based eye-tracking without spatial calibration, including fixation, microsaccades, drift, and horizontal saccades, when performed, unilateral or bilateral, with interpretation and report","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0370","name":"Max ultrasound capt & interp","description":"Max ultrasound capt & interp","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0313U","name":"Onc pncrs dna&mrna seq 74","description":"Onc pncrs dna&mrna seq 74","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55709","name":"Bx prst8 tprnl us guided","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0139","name":"Inj, adalimumab, 1 mg","description":"Injection, adalimumab, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1173","name":"Pt no rec td/tdap 9yrs prior","description":"Patient did not receive at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58558","name":"Hysteroscopy biopsy","description":"Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without d & c","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1472.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":234.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5943","name":"Proth mandib implt sup remv","description":"Proth mandib implt sup remv","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37272","name":"Revsc evsc fpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92557","name":"Comprehensive hearing test","description":"Comprehensive audiometry threshold evaluation and speech recognition (92553 and 92556 combined)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":39.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9286","name":"Inj glofitamab gxbm, 2.5 mg","description":"Injection, glofitamab-gxbm, 2.5 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4304","name":"Grafix plus, per sq cm","description":"Grafix plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48120","name":"Removal of pancreas lesion","description":"Excision of lesion of pancreas (eg, cyst, adenoma)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1103.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99233","name":"Sbsq hosp ip/obs high 50","description":"Subsequent hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 50 minutes m","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":37.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0216","name":"Inj, alfentanil hcl, 500mcg","description":"Injection, alfentanil hydrochloride, 500 micrograms","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86300","name":"Immunoassay tumor ca 15-3","description":"Immunoassay for tumor antigen, quantitative; ca 15-3 (27.29)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0267U","name":"Rare do id opt gen mapg&seq","description":"Rare constitutional and other heritable disorders, identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping and whole-genome sequencing","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0605","name":"Sucroferric oxyhydroxide 5mg","description":"Sucroferric oxyhydroxide, oral, 5 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0400U","name":"Ob xpnd car scr 145 genes","description":"Ob xpnd car scr 145 genes","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64598","name":"Revj/rmvl nea pn w/int nstim","description":"Revision or removal of neurostimulator electrode array, peripheral nerve, with integrated neurostimulator","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24420","name":"Osteoplasty humerus","description":"Osteoplasty, humerus (eg, shortening or lengthening) (excluding 64876)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43291","name":"Egd flx trnsorl rmvl balo","description":"Esophagogastroduodenoscopy, flexible, transoral; with removal of intragastric bariatric balloon(s)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1100","name":"Dexamethasone sodium phos","description":"Injection, dexamethasone sodium phosphate, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0554","name":"Add 20 m of monthly tx","description":"Each additional 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing data generated from the","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1465","name":"F/u > 180 days after rx","description":"Patient follow up more than 180 days after treatment","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1307","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55707","name":"Bx prst8 trct us guided","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1500","name":"Neuropsychology mvp","description":"Neuropsychology mips value pathway","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0699","name":"Inj, cefiderocol, 10 mg","description":"Injection, cefiderocol, 10 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0753T","name":"Dgtz gls mcrscp sld level iv","description":"Digitization of glass microscope slides for level iv, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0283U","name":"Vw factor type 2b eval plsm","description":"Von willebrand factor (vwf), type 2b, platelet-binding evaluation, radioimmunoassay, plasma","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0749T","name":"B1 str&fx rsk assmt dxr-bmd","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72126","name":"Ct neck spine w/dye","description":"Computed tomography, cervical spine; with contrast material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0452U","name":"Onc bldr mthyl penk lte-qmsp","description":"Onc bldr mthyl penk lte-qmsp","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0694T","name":"3d vol img&rcnstj brst/ax","description":"3-dimensional volumetric imaging and reconstruction of breast or axillary lymph node tissue, each excised specimen, 3-dimensional automatic specimen reorientation, interpretation and report, real-time intraoperative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0389","name":"Periopic image capture only","description":"Periopic image capture only","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26735","name":"Treat finger fracture each","description":"Open treatment of phalangeal shaft fracture, proximal or middle phalanx, finger or thumb, includes internal fixation, when performed, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":569.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"U0002","name":"Covid-19 lab test non-cdc","description":"2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0891","name":"Argatroban nonesrd (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1359","name":"Indx suicd idea, no 0 scr","description":"Index assessment during the denominator period when the suicidal ideation and/or behavior symptoms or increased suicide risk by clinician determination occurs and a non-zero c-ssrs score is obtained","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4265","name":"Neostim tl per sq cm","description":"Neostim tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27170","name":"Repair/graft femur head/neck","description":"Bone graft, femoral head, neck, intertrochanteric or subtrochanteric area (includes obtaining bone graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1373.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3374","name":"Inj, vancomycin (mylan) 10mg","description":"Injection, vancomycin hydrochloride (mylan) not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0826T","name":"Prgrmg evl ldls pm 1chmbr ip","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional, leadless pacemaker system in si","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87513","name":"H pylri clrthmcn rst amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); helicobacter pylori (h. pylori), clarithromycin resistance, amplified probe technique","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1223","name":"Glaucoma plan of care doc","description":"Glaucoma plan of care documented","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0915T","name":"Insj perm ccm-d sys pg&eltrd","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator and dual transvenous electrodes/leads (pacing and defibrillation)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37282","name":"Rvsc evsc tpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G3002","name":"Chronic pain mgmt 30 mins","description":"Chronic pain management and treatment, monthly bundle including, diagnosis; assessment and monitoring; administration of a validated pain rating scale or tool; the development, implementation, revision, and/or maintenance of a person-centered care plan that includes strengths, goals, clinical needs,","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99325","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9615","name":"Inj, pegulicianine, 1 mg","description":"Injection, pegulicianine, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0273U","name":"Hem gen hyprfibrnlysis 8 gen","description":"Hematology (genetic hyperfibrinolysis, delayed bleeding), genomic sequence analysis of 8 genes (f13a1, f13b, fga, fgb, fgg, serpina1, serpine1, serpinf2, plau) blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9612","name":"Inj, fluorescein, 1 mg","description":"Injection, fluorescein, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78608","name":"Brain imaging (pet)","description":"Brain imaging, positron emission tomography (pet); metabolic evaluation","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2402","name":"Chloroprocaine (clorotekal)","description":"Injection, chloroprocaine hydrochloride (clorotekal), per 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2003","name":"Inj, lidocaine hcl, 1 mg","description":"Injection, lidocaine hydrochloride, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0789T","name":"Elec aly cpx iins sp/sac nrv","description":"Electronic analysis with complex programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detect","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0735","name":"Clonidine hydrochloride","description":"Injection, clonidine hydrochloride, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9936","name":"Clean occ guard","description":"Clean occ guard","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1197","name":"Isa reduced >=3 fr ixv","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4323","name":"Splint extra-coronal","description":"Splint extra-coronal","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0854T","name":"Dgtz gls mcrscp bld smr prph","description":"Digitization of glass microscope slides for blood smear, peripheral, interpretation by physician with written report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0435U","name":"Onc chemo rx cytox csc 14 rx","description":"Onc chemo rx cytox csc 14 rx","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15853","name":"Removal sutr/stapl xreq anes","description":"Removal of sutures or staples not requiring anesthesia (list separately in addition to e/m code)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74010","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4312","name":"Acesso ac, per sq cm","description":"Acesso ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4259","name":"Celera per sq cm","description":"Celera dual layer or celera dual membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0903T","name":"Ecg alg 12 lead reduced i&r","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; with interpretation and report","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0783T","name":"Tc auriculr neurostimulation","description":"Transcutaneous auricular neurostimulation, set-up, calibration, and patient education on use of equipment","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93597","name":"R&l hrt cath chd abnl nt cnj","description":"Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); abnormal native connections","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1494","name":"Fall rep since last visit","description":"Patients that reported a fall since the last visit","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6049","name":"Scale implt peri-implt inflm","description":"Scale implt peri-implt inflm","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0707T","name":"Njx b1 sub mtrl sbchdrl dfct","description":"Injection(s), bone-substitute material (eg, calcium phosphate) into subchondral bone defect (ie, bone marrow lesion, bone bruise, stress injury, microtrabecular fracture), including imaging guidance and arthroscopic assistance for joint visualization","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1261","name":"Pts on wtlist bef dialysis","description":"Patients that were on the kidney or kidney-pancreas waitlist prior to initiation of dialysis","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0378U","name":"Rfc1 repeat xpnsj vrnt alys","description":"Rfc1 repeat xpnsj vrnt alys","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0730T","name":"Trabeculotomy lsr w/oct gdn","description":"Trabeculotomy by laser, including optical coherence tomography (oct) guidance","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0323U","name":"Iadna cns pthgn next gen seq","description":"Iadna cns pthgn next gen seq","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45170","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":802.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93532","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3105.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92635","name":"Hearing aid fitg svc ea addl","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; each additional 15 minutes (list separately in addition to code","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1307","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1281","name":"Bp scrn no perf at interval","description":"Blood pressure reading not documented, reason not given","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0942T","name":"Cysto flx rmv&rplc urtl scaf","description":"Cystourethroscopy, flexible; with removal and replacement of prostatic urethral scaffold","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0617U","name":"Cv ascvd dna alys >20000","description":"Cv ascvd dna alys >20000","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1643","name":"Inj heparin, pfizer, 1000u","description":"Injection, heparin sodium (pfizer), not therapeutically equivalent to j1644, per 1000 units","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0270U","name":"Hem cgen coagj do 20 genes","description":"Hematology (congenital coagulation disorders), genomic sequence analysis of 20 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0741T","name":"Rem auton alg nsln data coll","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; provision of software, data collection, transmission, and storage, each 30 days","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0700T","name":"Molec fluor img sus nev 1st","description":"Molecular fluorescent imaging of suspicious nevus; first lesion","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0351U","name":"Nfct ds bct/viral trail ip10","description":"Nfct ds bct/viral trail ip10","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0883T","name":"Intraop ther estim pn ue ea","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; each additional nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81025","name":"Urine pregnancy test","description":"Urine pregnancy test, by visual color comparison methods","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43340","name":"Fuse esophagus & intestine","description":"Esophagojejunostomy (without total gastrectomy); abdominal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1382.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0335U","name":"Rare ds whl gen seq fetal","description":"Rare ds whl gen seq fetal","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0569","name":"Subs psych care mng, subs mo","description":"Subsequent psychiatric collaborative care management, in a subsequent month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required elements: tracking ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0630U","name":"Onc brst mrna gen prflg 80","description":"Onc brst mrna gen prflg 80","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0759T","name":"Dgtz gls mcrscp sl sp grpiii","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group iii, for enzyme constituents (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1021T","name":"Active thrc irrigation spx","description":"Active thoracic irrigation (separate procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4294","name":"Amnio quad-core, per sq cm","description":"Amnio quad-core, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0481","name":"Electron microscopy diagnost","description":"Electron microscopy - diagnostic","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0535U","name":"Pfas lc-ms/ms plsm/srm quan","description":"Pfas lc-ms/ms plsm/srm quan","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4273","name":"Esano aaa, per sq cm","description":"Esano aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77316","name":"Brachytx isodose plan simple","description":"Brachytherapy isodose plan; simple (calculation[s] made from 1 to 4 sources, or remote afterloading brachytherapy, 1 channel), includes basic dosimetry calculation(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0444U","name":"Onc sld orgn neo tgsap 361","description":"Onc sld orgn neo tgsap 361","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0224","name":"Pemivibart infusion","description":"Intravenous infusion, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppr","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87075","name":"Cultr bacteria except blood","description":"Culture, bacterial; any source, except blood, anaerobic with isolation and presumptive identification of isolates","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1208","name":"Pt no scrn sdoh","description":"Patient is not screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6093","name":"Recement supp part denture","description":"Recement implant/abutment supported fixed partial denture","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0436U","name":"Onc lng plsm alys 388 prtn","description":"Onc lng plsm alys 388 prtn","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0516U","name":"Rx metab rxgenomic gnotyp 40","description":"Rx metab rxgenomic gnotyp 40","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5930","name":"Max guid prothes w/o flange","description":"Max guid prothes w/o flange","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4023","name":"Pathology ss","description":"Pathology mips specialty set","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"Ctlso a-p-l control custom","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87513","name":"H pylri clrthmcn rst amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); helicobacter pylori (h. pylori), clarithromycin resistance, amplified probe technique","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0371U","name":"Iadna gu pthgn semiq dna16&1","description":"Iadna gu pthgn semiq dna16&1","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0331U","name":"Onc hl neo opt gen mapping","description":"Onc hl neo opt gen mapping","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1189","name":"Doc khe pef w/efgr/uacr","description":"Documentation of a kidney health evaluation defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr) performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62331","name":"Dcmprn prq rmv lig flv addl","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; additional interspace(s), lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0062","name":"Audiology ss","description":"Audiology mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0890T","name":"Arhfcmrigtbs 1st tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including target assessment, initial motor threshold determination, neuronavigation, delivery and management, initial treatment day","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1210","name":">=2 same meds tbl4 not ord","description":"At least two orders for high-risk medications from the same drug class, (table 4), not ordered","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1418","name":"Med rsn not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination because of a medical contraindication documented by clinician","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4290","name":"Membrane wrap hydr per sq cm","description":"Membrane wrap-hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9268","name":"Programmer orally ingest cap","description":"Programmer for transient, orally ingested capsule","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0466","name":"Home vent non-invasive inter","description":"Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell)","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1360.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5421","name":"Dentures adjust part maxill","description":"Adjust partial denture - maxillary","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15135","name":"Drm agrft f/s/n/h/f/g/m 1st","description":"Dermal autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq cm or less, or 1% of body area of infants and children","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":897.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0993T","name":"N-invas assmt car rsk w/ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat with concurrent computed tomography scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional (list s","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0169","name":"Inj epinephrine (adrenalin)","description":"Injection, epinephrine (adrenalin), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5129","name":"Inj, vegzelma, 10 mg","description":"Injection, bevacizumab-adcd (vegzelma), biosimilar, 10 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44312","name":"Revision of ileostomy","description":"Revision of ileostomy; simple (release of superficial scar) (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0600U","name":"Nfct ds wnd infctj 65orgs&30","description":"Nfct ds wnd infctj 65orgs&30","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1289","name":"No pt tbco cess interv rng","description":"Patient identified as tobacco user did not receive tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0765T","name":"Asstv alg ecg rsk asmt prev","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to previously performed electrocardiogram","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15572","name":"Skin pedicle flap arms/legs","description":"Formation of direct or tubed pedicle, with or without transfer; scalp, arms, or legs","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":761.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0410U","name":"Onc pncrtc dna whl gn seq 5-","description":"Onc pncrtc dna whl gn seq 5-","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7300","name":"Rem anchorage dev w/o flap","description":"Rem anchorage dev w/o flap","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43180","name":"Esophagoscopy rigid trnso","description":"Esophagoscopy, rigid, transoral with diverticulectomy of hypopharynx or cervical esophagus (eg, zenkers diverticulum), with cricopharyngeal myotomy, includes use of telescope or operating microscope and repair, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":642.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5133","name":"Inj, tofidence, 1 mg","description":"Injection, tocilizumab-bavi (tofidence), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50961","name":"Ureter endoscopy & treatment","description":"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":374.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1308","name":"Inj, famotidine, 0.25 mg","description":"Injection, famotidine, 0.25 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91113","name":"Gi trc img intral colon i&r","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4298","name":"Amniocore pro, per sq cm","description":"Amniocore pro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72141","name":"Mri neck spine w/o dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":671.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78491","name":"Myocrd img pet 1std rst/strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); single study, at rest or stress (exercise or pharmacologic)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7298","name":"Remove screw retained plate","description":"Remove screw retained plate","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0764T","name":"Asstv alg ecg rsk asmt cncrt","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to concurrently performed electrocardiogram (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83661","name":"L/s ratio fetal lung","description":"Fetal lung maturity assessment; lecithin sphingomyelin (l/s) ratio","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9277","name":"Pembrolizumab 1mg berahyalur","description":"Injection, pembrolizumab, 1 mg and berahyaluronidase alfa-pmph","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0045","name":"Mrs 90 days post stk","description":"Clinical follow-up and mrs score assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1450","name":"Pt hos/pal care dur id/pf pd","description":"Patients who received hospice or palliative care service any time during denominator identification period or the measure assessment period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64473","name":"Lwr xtr fscl pln blk uni njx","description":"Lower extremity fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50525","name":"Close nephrovisceral fistula","description":"Closure of nephrovisceral fistula (eg, renocolic), including visceral repair; abdominal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1447.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81354","name":"Cytog alys chrml abnor ogm","description":"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of structural and copy number variants, optical genome mapping (ogm)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2270","name":"Morphine sulfate injection","description":"Injection, morphine sulfate, up to 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4439","name":"Instagraft per sq cm","description":"Instagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2253","name":"Inj midazolam (seizalam)","description":"Injection, midazolam (seizalam), 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1285","name":"Scrn mam perf rslts not doc","description":"Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed, reason not otherwise specified","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1748","name":"Inj, zymfentra, 10 mg","description":"Injection, infliximab-dyyb (zymfentra), 10 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9342","name":"Inj thiotepa nos 1 mg","description":"Injection, thiotepa, not otherwise specified, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7912","name":"Suture complicate wnd > 5 cm","description":"Complicated suture-greater than 5 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1711","name":"Moderna vacc admin booster","description":"Moderna vacc admin booster","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64596","name":"Ins/rplcmt prq eltrd ra pn 1","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; initial electrode array","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0927T","name":"Interrog dev eval ccm-d ip","description":"Interrogation device evaluation (in person) with analysis, review, and report, including connection, recording, and disconnection, per patient encounter, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64617","name":"Chemodener muscle larynx emg","description":"Chemodenervation of muscle(s); larynx, unilateral, percutaneous (eg, for spasmodic dysphonia), includes guidance by needle electromyography, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98015","name":"Synch audio-only est high 40","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selec","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1783","name":"Vac admin human pap dose 3","description":"Vac admin human pap dose 3","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2023","name":"Innovamatrix pd, 1 mg","description":"Innovamatrix pd, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9332","name":"Inj efgartigimod 2mg","description":"Injection, efgartigimod alfa-fcab, 2mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15012","name":"Hrv skn cll ssp agrft ea add","description":"Harvest of skin for skin cell suspension autograft; each additional 25 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33895","name":"Evasc st rpr thrc/aa x crsg","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; not crossing major side branches","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64487","name":"Tap block uni by infusion","description":"Transversus abdominis plane (tap) block (abdominal plane block, rectus sheath block) unilateral; by continuous infusion(s) (includes imaging guidance, when performed)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35341","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; mesenteric, celiac, or renal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1779.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87493","name":"C diff amplified probe","description":"Infectious agent detection by nucleic acid (dna or rna); clostridium difficile, toxin gene(s), amplified probe technique","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0958T","name":"Rmv s-sclp eltr ra rcvr&tlmt","description":"Removal of sub-scalp implanted electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0864T","name":"Low ntsty eswt corpus cvrnsm","description":"Low-intensity extracorporeal shock wave therapy involving corpus cavernosum, low energy","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27570","name":"Fixation of knee joint","description":"Manipulation of knee joint under general anesthesia (includes application of traction or other fixation devices)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35001","name":"Repair defect of artery","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm and associated occlusive disease, carotid, subclavian artery, by neck incision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37282","name":"Rvsc evsc tpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9506","name":"Tc-99m graphite crucible","description":"Graphite crucible for preparation of technetium tc 99m-labeled carbon aerosol, one crucible","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92288","name":"Scr dark adaptation meas i&r","description":"Screening dark adaptation measurement (eg, rod recovery intercept time), with interpretation and report","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0373","name":"Tomo bitewing image","description":"Tomo bitewing image","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0920T","name":"Rmvl perm ccm-d sys 1 pac ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous pacing lead only","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64657","name":"Rmvl bat modulj sys tot sys","description":"Removal of baroreflex activation therapy (bat) modulation system; total system, including lead and pulse generator","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83026","name":"Hemoglobin copper sulfate","description":"Hemoglobin; by copper sulfate method, non-automated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0478U","name":"Onc nsclc dna&rna dpcr 9 gen","description":"Onc nsclc dna&rna dpcr 9 gen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0532","name":"Take home supp nasal spray","description":"Take-home supply of nasal nalmefene hydrochloride; one carton of two, 2.7 mg per 0.1 ml nasal sprays (provision of the services by a medicare-enrolled opioid treatment program);( list separately in addition to each primary code)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1268","name":"Pt ac stat kid trnsplt wtlst","description":"Patients observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82272","name":"Occult bld feces 1-3 tests","description":"Blood, occult, by peroxidase activity (eg, guaiac), qualitative, feces, 1-3 simultaneous determinations, performed for other than colorectal neoplasm screening","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49187","name":"Opn exc/dstr ntra-abd 5.1-10","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5.1 to 10 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0986T","name":"Iv img icr cere vsl oct 1st","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1952","name":"Afo spiral prefab ots","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, off-the-shelf","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0277U","name":"Hem gen pltlt funcj do 31","description":"Hematology (genetic platelet function disorder), genomic sequence analysis of 31 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0693T","name":"Compre ful bdy 3d mtn alys","description":"Comprehensive full body computer-based markerless 3d kinematic and kinetic motion analysis and report","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0345U","name":"Psyc genom alys pnl 15 gen","description":"Psyc genom alys pnl 15 gen","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70543","name":"Mri orbt/fac/nck w/o &w/dye","description":"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1377.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5158","name":"Inj, denosumab-bnht, 1 mg","description":"Injection, denosumab-bnht (bomyntra/conexxence), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8502","name":"Inj, aponvie, 1 mg","description":"Injection, aprepitant (aponvie), 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41140","name":"Removal of tongue","description":"Glossectomy; complete or total, with or without tracheostomy, without radical neck dissection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2453.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5144","name":"Inj, idacio, 1 mg","description":"Injection, adalimumab-aacf (idacio), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75580","name":"N-invas est c ffr sw aly cta","description":"Noninvasive estimate of coronary fractional flow reserve (ffr) derived from augmentative software analysis of the data set from a coronary computed tomography angiography, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9156","name":"Oral mucoadhesive per 1 ml","description":"Oral mucoadhesive, any type (liquid, gel, paste, etc.), per 1 ml","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85014","name":"Hematocrit","description":"Blood count; hematocrit (hct)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0013","name":"Hiv prep counsel, clin staff","description":"Individual counseling for pre-exposure prophylaxis (prep) by clinical staff to prevent human immunodeficiency virus (hiv), includes: hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93574","name":"Njx cath slct pulm vn angrph","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary venous angiography of each distinct pulmonary vein during cardiac catheterization (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1471","name":"Ffs hep b not covered","description":"Documentation that patient is a medicare fee-for-service beneficiary and without additional supplementary insurance coverage for whom hep b vaccination is not reimbursable under current medicare part b coverage rules","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76812","name":"Ob us detailed addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1352","name":"Suicd c-ssrs assessment, equ","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs or equivalent assessment","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0603","name":"Sevelamer hydrochloride 20mg","description":"Sevelamer hydrochloride (renagel or therapeutically equivalent), oral, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0434U","name":"Rx metab advrs vrnt alys 25","description":"Rx metab advrs vrnt alys 25","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1170","name":"Pt w/o flu vax 7/1-6/30","description":"Patient did not receive an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9184","name":"Inj gemcitabin (avyxa) 200mg","description":"Injection, gemcitabine hydrochloride (avyxa), 200 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4270","name":"Complete sl per sq cm","description":"Complete sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73115","name":"Contrast x-ray of wrist","description":"Radiologic examination, wrist, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0737T","name":"Xenograft impltj artclr surf","description":"Xenograft implantation into the articular surface","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64628","name":"Trml dstrj ios bvn 1st 2 l/s","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; first 2 vertebral bodies, lumbar or sacral","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5945","name":"Mand implt sup remv part","description":"Mand implt sup remv part","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1339","name":"Pts f/u 30-180 dys + improv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who demonstrated positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37264","name":"Revsc evasc fpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0947T","name":"Mrgfus strtctc bl-br disrpj","description":"Magnetic resonance image guided low intensity focused ultrasound (mrgfus), stereotactic blood-brain barrier disruption using microbubble resonators to increase the concentration of blood-based biomarkers of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0047","name":"Ped blunt hd traum","description":"Pediatric patient with minor blunt head trauma and pecarn prediction criteria are not assessed","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23630","name":"Optx gr hmrl tbrs fx int fix","description":"Open treatment of greater humeral tuberosity fracture, includes internal fixation, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1229","name":"Pt w/ +hcv +vir ref win 1 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, is referred within 1 month of the reactive hcv antibody test to a clinician who treats hcv infection","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47760","name":"Fuse bile ducts and bowel","description":"Anastomosis, of extrahepatic biliary ducts and gastrointestinal tract","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1784.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1366","name":"Focus on womens health mvp","description":"Focusing on womens health mips value pathway","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0673T","name":"Abltj b9 thyr ndul perq lasr","description":"Ablation, benign thyroid nodule(s), percutaneous, laser, including imaging guidance","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0446U","name":"Ai ds sle alys 10 cytokine","description":"Ai ds sle alys 10 cytokine","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0921T","name":"Rmvl perm ccm-d sys 1 dfb ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous defibrillation lead only","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23472","name":"Reconstruct shoulder joint","description":"Arthroplasty, glenohumeral joint; total shoulder (glenoid and proximal humeral replacement (eg, total shoulder))","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1780.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85046","name":"Reticyte/hgb concentrate","description":"Blood count; reticulocytes, automated, including 1 or more cellular parameters (eg, reticulocyte hemoglobin content [chr], immature reticulocyte fraction [irf], reticulocyte volume [mrv], rna content), direct measurement","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0136","name":"Adm of pa/n assess 5-15 m","description":"Administration of a standardized, evidence-based assessment of physical activity and nutrition, 5-15 minutes, not more often than every 6 months","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5611","name":"Rep resin part dent base man","description":"Rep resin part dent base man","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93510","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2226.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1000T","name":"Autol musc cell therapy admn","description":"Autologous muscle cell therapy, administration of muscle progenitor cells into the urethral sphincter, including cystoscopy and post-void residual ultrasound, when performed","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33986","name":"Ecmo/ecls rmvl ctr cannula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; removal of central cannula(e) by sternotomy or thoracotomy, 6 years and older","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":789.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54410","name":"Remove/replace penis prosth","description":"Removal and replacement of all component(s) of a multi-component, inflatable penile prosthesis at the same operative session","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1013.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27334","name":"Remove knee joint lining","description":"Arthrotomy, with synovectomy, knee; anterior or posterior","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":805.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49500","name":"Rpr ing hernia init reduce","description":"Repair initial inguinal hernia, age 6 months to younger than 5 years, with or without hydrocelectomy; reducible","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4323","name":"Splint extra-coronal","description":"Splint extra-coronal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3425","name":"Hydroxocobalamin im 10mcg","description":"Injection, hydroxocobalamin, intramuscular, 10 mcg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1358","name":"Pts no <suicd idea 120 dys","description":"Patients who did not have a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2991","name":"App of hydroxyapatite","description":"App of hydroxyapatite","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4022","name":"Otolaryngology ss","description":"Otolaryngology mips specialty set","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97026","name":"Infrared therapy","description":"Application of a modality to 1 or more areas; infrared","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49591","name":"Rpr aa hrn 1st < 3 cm rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, reducible","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2371","name":"Inj phenylephrine hcl 20 mcg","description":"Injection, phenylephrine hydrochloride, 20 micrograms","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0948T","name":"Rem interrog dev ccm phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system with interim analysis, review, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6212","name":"Bridge noble metal cast","description":"Pontic-cast noble metal","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0527","name":"Mgt est pt dmentia low cmplx","description":"Management of established patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88248","name":"Chromosome analysis 50-100","description":"Chromosome analysis for breakage syndromes; baseline breakage, score 50-100 cells, count 20 cells, 2 karyotypes (eg, for ataxia telangiectasia, fanconi anemia, fragile x)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33545","name":"Repair of heart damage","description":"Repair of postinfarction ventricular septal defect, with or without myocardial resection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2571.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0035","name":"Pt ed pos 23","description":"Patient has any emergency department encounter during the performance period with place of service indicator 23","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5827","name":"Endo knee shin single axis","description":"Endoskeletal knee-shin system, single axis, electromechanical swing and stance phase control, with or without shock absorption and stance extension damping","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81347","name":"Sf3b1 gene common variants","description":"Sf3b1 (splicing factor [3b] subunit b1) (eg, myelodysplastic syndrome/acute myeloid leukemia) gene analysis, common variants (eg, a672t, e622d, l833f, r625c, r625l)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9573","name":"Inj, gadopiclenol, 1 ml","description":"Injection, gadopiclenol, 1 ml","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55707","name":"Bx prst8 trct us guided","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82271","name":"Occult blood other sources","description":"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; other sources","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4286","name":"Nudyn sl or slw, per sq cm","description":"Nudyn sl or nudyn slw, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64582","name":"Opn mpltj hpglsl nstm ary pg","description":"Open implantation of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49622","name":"Rpr parastomal hrna ncr/strn","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; incarcerated or strangulated","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5138","name":"Inj, wezlana, iv, 1 mg","description":"Injection, ustekinumab-auub (wezlana), biosimilar, intravenous, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11011","name":"Debride skin musc at fx site","description":"Debridement including removal of foreign material at the site of an open fracture and/or an open dislocation (eg, excisional debridement); skin, subcutaneous tissue, muscle fascia, and muscle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0482U","name":"Ob pe biochem asy sfit1&pigf","description":"Ob pe biochem asy sfit1&pigf","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86701","name":"Hiv-1antibody","description":"Antibody; hiv-1","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2006","name":"Novosorb synpath per sq cm","description":"Novosorb synpath dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9685","name":"Acute nursing facility care","description":"Physician service or other qualified health care professional for the evaluation and management of a beneficiarys acute change in condition in a nursing facility. this service is for a demonstration project","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1399","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2056","name":"Ciltacabtagene car-pos t","description":"Ciltacabtagene autoleucel, up to 100 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7509","name":"Marsupialization odon cyst","description":"Marsupialization odon cyst","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0749T","name":"B1 str&fx rsk assmt dxr-bmd","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4323","name":"Alloply, per sq cm","description":"Alloply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9959","name":"Unspec sleep ap proc","description":"Unspec sleep ap proc","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99406","name":"Behav chng smoking 3-10 min","description":"Smoking and tobacco use cessation counseling visit; intermediate, greater than 3 minutes up to 10 minutes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":14.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1408","name":"Gmln brca bef dx ca","description":"Patients who have germline brca testing completed before diagnosis of epithelial ovarian, fallopian tube, or primary peritoneal cancer","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58740","name":"Adhesiolysis tube ovary","description":"Lysis of adhesions (salpingolysis, ovariolysis)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1016.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96118","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36510","name":"Insertion of catheter vein","description":"Catheterization of umbilical vein for diagnosis or therapy, newborn","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49613","name":"Rpr aa hrn rcr < 3 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, reducible","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1318","name":"Pts no csp doc contact","description":"Patients who did not have documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening or documentation that there was no contact with a csp","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99309","name":"Sbsq nf care moderate mdm 30","description":"Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":32.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":112.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33894","name":"Evasc st rpr thrc/aa acrs br","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; across major side branches","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1478","name":"Psychoactive sub abuse","description":"Psychoactive substance abuse","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23180","name":"Prtl excision bone clavicle","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), clavicle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":871.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3431","name":"Biological materials","description":"Biological materials","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0477U","name":"Rx metab psy 14&cyp2d6 gn-rx","description":"Rx metab psy 14&cyp2d6 gn-rx","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90624","name":"Menb-4c&menacwy vacc im","description":"Meningococcal pentavalent vaccine, men b-4c recombinant proteins and outer membrane vesicle and conjugated men a, c, w, y-diphtheria toxoid carrier, for intramuscular use","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0432U","name":"Klhl11 antb sr/csf asy qual","description":"Klhl11 antb sr/csf asy qual","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83992","name":"Assay for phencyclidine","description":"Phencyclidine (pcp)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49622","name":"Rpr parastomal hrna ncr/strn","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73010","name":"X-ray exam of shoulder blade","description":"Radiologic examination; scapula, complete","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6089","name":"Access/retorq implant screw","description":"Access/retorq implant screw","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6598","name":"G comp bandage med stretch","description":"Gradient compression bandage roll, elastic medium stretch, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21044","name":"Removal of jaw bone lesion","description":"Excision of malignant tumor of mandible;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1002.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2976","name":"Band stabilization per tooth","description":"Band stabilization per tooth","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78608","name":"Brain imaging (pet)","description":"Brain imaging, positron emission tomography (pet); metabolic evaluation","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1599.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1315","name":"Crc no doc no rsn","description":"Colorectal cancer screening results were not documented and reviewed; reason not otherwise specified","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1240","name":"Pt no resp best int","description":"Patient did not respond to the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94617","name":"Exercise tst brncspsm w/ecg","description":"Exercise test for bronchospasm, including pre- and post-spirometry and pulse oximetry; with electrocardiographic recording(s)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1475","name":"Pt dx huntington","description":"Patients with diagnosis of huntingtons disease","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85660","name":"Rbc sickle cell test","description":"Sickling of rbc, reduction","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0855T","name":"Dgtz gls mcrscp b1 marow smr","description":"Digitization of glass microscope slides for bone marrow, smear interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4336","name":"Artecent c, per sq cm","description":"Artacent c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0812T","name":"Rem mlt day uroflow dev sply","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); device supply with automated report generation, up to 10 days","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0866T","name":"Quan mri alys brn w/dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion detection, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transmissio","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0431U","name":"Gly rcptr alpha1 igg srm/csf","description":"Gly rcptr alpha1 igg srm/csf","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1278","name":"Pre-htn or htn doc, f/u indc","description":"Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4361","name":"Epixpress, per sq cm","description":"Epixpress, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0388U","name":"Onc nonsm cll lng ca 37 gen","description":"Onc nonsm cll lng ca 37 gen","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0914T","name":"Prq tcat thr rx ntrc bal sep","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting) performed on a separate target lesion from the target lesion treated with balloon angioplasty, coronary stent placement or coronary atherectomy, including mechanical dilation b","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0818T","name":"Revj/rmvl ins ptn subq","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5912","name":"Facial moulage complete","description":"Facial moulage (complete)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35651","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1736.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5942","name":"Proth max implt sup remv","description":"Proth max implt sup remv","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9601","name":"Flortaucipir inj 1 millicuri","description":"Flortaucipir f 18 injection, diagnostic, 1 millicurie","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2802","name":"Inj, romiplostim 1 microgram","description":"Injection, romiplostim, 1 microgram","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4354","name":"Palingen dl-palingen dl-x","description":"Palingen dual-layer membrane and dual-layer palingen x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88291","name":"Cyto/molecular report","description":"Cytogenetics and molecular cytogenetics, interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0400U","name":"Ob xpnd car scr 145 genes","description":"Ob xpnd car scr 145 genes","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0936T","name":"Photobiomodulation ther rta","description":"Photobiomodulation therapy of retina, single session","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93040","name":"Rhythm ecg with report","description":"Rhythm ecg, 1-3 leads; with interpretation and report","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"14060","name":"Tis trnfr e/n/e/l 10 sq cm/<","description":"Adjacent tissue transfer or rearrangement, eyelids, nose, ears and/or lips; defect 10 sq cm or less","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":743.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0417U","name":"Rare ds alys 335 nuc genes","description":"Rare ds alys 335 nuc genes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5914","name":"Auricular prosthesis","description":"Auricular prosthesis","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0725T","name":"Vestibular dev impltj uni","description":"Vestibular device implantation, unilateral","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7415","name":"Excision malig les complicat","description":"Excision of malignant lesion complicated","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1274","name":"Pts snf exl mo","description":"Patients who were admitted to a skilled nursing facility (snf) during the month of evaluation were excluded from that month","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0255U","name":"Andrology infertility assmt","description":"Andrology (infertility), sperm-capacitation assessment of ganglioside gm1 distribution patterns, fluorescence microscopy, fresh or frozen specimen, reported as percentage of capacitated sperm and probability of generating a pregnancy score","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3362.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0872","name":"Daptomycin (xellia) unrefrig","description":"Injection, daptomycin (xellia), unrefrigerated, not therapeutically equivalent to j0878 or j0873, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37262","name":"Iv lithotrp ivt w/in sm art","description":"Intravascular lithotripsy(ies), iliac vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7972","name":"Surg redct fibrous tuberosit","description":"Surgical reduction of fibrous tuberosity","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1163","name":"Pt anphx due to hpv bef 13","description":"Patient had anaphylaxis due to the hpv vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33268","name":"Excl laa opn oth px any meth","description":"Exclusion of left atrial appendage, open, performed at the time of other sternotomy or thoracotomy procedure(s), any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2372","name":"Inj, biorphen, 20 micrograms","description":"Injection, phenylephrine hydrochloride (biorphen), 20 micrograms","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4327","name":"Duoamnion, per sq cm","description":"Duoamnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5948","name":"Max implt sup fix part","description":"Max implt sup fix part","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36597","name":"Reposition venous catheter","description":"Repositioning of previously placed central venous catheter under fluoroscopic guidance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36479","name":"Endovenous laser vein addon","description":"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, laser; subsequent vein(s) treated in a single extremity, each through separate access sites (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1439","name":"Sig ocu cond imp surg out","description":"Significant ocular conditions that impact the visual outcome of surgery","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4263","name":"Surgraft tl, per sq cm","description":"Surgraft tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1411","name":"1st ln ici no chemo","description":"Currently on first-line immune checkpoint inhibitors without chemotherapy","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0763T","name":"Dgtz gls mcrscp mphmtrc alys","description":"Digitization of glass microscope slides for morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure, manual (list separately in addition to code for primary proced","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0540U","name":"Trnsplj med quan dd-cfdna","description":"Trnsplj med quan dd-cfdna","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47125","name":"Partial removal of liver","description":"Hepatectomy, resection of liver; total left lobectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3326.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33897","name":"Perq trluml angp nt/recr coa","description":"Percutaneous transluminal angioplasty of native or recurrent coarctation of the aorta","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49568","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92287","name":"Ant sgm img ir flrscn angrph","description":"Anterior segment imaging with interpretation and report; with fluorescein angiography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7049","name":"Epap nasal valve","description":"Expiratory positive airway pressure intranasal resistance valve","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86364","name":"Tiss trnsgltmnase ea ig clas","description":"Tissue transglutaminase, each immunoglobulin (ig) class","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0821T","name":"Mntr psychdlc med 2ndphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; second physician or other qualified health care professional, concurrent with first physician or other qualified health care professional, each hour (list sepa","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0541U","name":"Cv ds hdl rct cec lc-ms/ms 5","description":"Cv ds hdl rct cec lc-ms/ms 5","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9954","name":"Fab/del oral appliance thxpy","description":"Fab/del oral appliance thxpy","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7165","name":"Inj, human-lans, per i.u","description":"Injection, prothrombin complex concentrate, human-lans, per i.u. of factor ix activity","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"C9225","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82947","name":"Assay glucose blood quant","description":"Glucose; quantitative, blood (except reagent strip)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9938","name":"Fab removable appliance","description":"Fab removable appliance","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4291","name":"Lamellas xt, per sq cm","description":"Lamellas xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20926","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7259","name":"Nerve dissection","description":"Nerve dissection","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6610","name":"G com stcking bk 18-30 custm","description":"Gradient compression stocking, below knee, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5160","name":"Inj, jobevne, 10 mg","description":"Injection, bevacizumab-nwgd (jobevne), biosimilar, 10 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34051","name":"Removal of artery clot","description":"Embolectomy or thrombectomy, with or without catheter; innominate, subclavian artery, by thoracic incision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1130.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99391","name":"Per pm reeval est pat infant","description":"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; infan","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":117.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":24.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9997","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73590","name":"X-ray exam of lower leg","description":"Radiologic examination; tibia and fibula, 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44141","name":"Partial removal of colon","description":"Colectomy, partial; with skin level cecostomy or colostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1432.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0684","name":"App non-sheet skin sb g addl","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area or part thereof, or each additional 1% o","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0218","name":"Inj olipudase alfa-rpcp 1mg","description":"Injection, olipudase alfa-rpcp, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0896T","name":"Connj lvr algrft prfu dev ea","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; each additional hour, including physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary bicarbonate, lactate ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0031","name":"Pall serv during meas","description":"Palliative care services given to patient any time during the measurement period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28175","name":"Resect phalanx of toe tumor","description":"Radical resection of tumor; phalanx of toe","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2038","name":"Marigen pacto, per sq cm","description":"Marigen pacto, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0797T","name":"Tcat ins 2chmbr ldls pm rv","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ventricular pace","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0921T","name":"Rmvl perm ccm-d sys 1 dfb ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous defibrillation lead only","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7997","name":"Appliance removal","description":"Appliance removal (not by dentist who placed appliance) includes removal of archbar","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1477","name":"Dx delirium","description":"Diagnosis of delirium","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37289","name":"Revsc evsc tpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6516","name":"Grad com wrap w strap foo cu","description":"Gradient compression wrap with adjustable straps, foot, each, custom","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86825","name":"Hla x-math non-cytotoxic","description":"Human leukocyte antigen (hla) crossmatch, non-cytotoxic (eg, using flow cytometry); first serum sample or dilution","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32659","name":"Thoracoscopy w/sac drainage","description":"Thoracoscopy, surgical; with creation of pericardial window or partial resection of pericardial sac for drainage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":931.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1159","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99463","name":"Same day nb discharge","description":"Initial hospital or birthing center care, per day, for evaluation and management of normal newborn infant admitted and discharged on the same date","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0759","name":"Inj, clevidipine, 1 mg","description":"Injection, clevidipine butyrate, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0673T","name":"Abltj b9 thyr ndul perq lasr","description":"Ablation, benign thyroid nodule(s), percutaneous, laser, including imaging guidance","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55882","name":"Ablt trurl prst8 tis trnsdcr","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation; with insertion of transurethral ultrasound transducer for delivery of thermal ultrasound, including suprapubic tube placement and placement of ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1222","name":"Glaucoma pln of care not doc","description":"Glaucoma plan of care not documented, reason not otherwise specified","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64822","name":"Sympathectomy ulnar artery","description":"Sympathectomy; ulnar artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":783.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1298","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0463","name":"Inj atropine (fresenius te)","description":"Injection, atropine sulfate (fresenius and therapeutically equivalent), 0.01 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15017","name":"App skn cll ssp f/n/g/hf 1st","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 480 sq cm or less","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9282","name":"Mitomycin intravesical inst","description":"Mitomycin, intravesical instillation, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0520U","name":"Ther rx mntr 200+ rx/sbsts","description":"Ther rx mntr 200+ rx/sbsts","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9247","name":"Mod sedation noniv-sub15min","description":"Mod sedation noniv-sub15min","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1736","name":"Inj meloxicam (delova) 1mg","description":"Injection, meloxicam (delova), 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1267","name":"Pt no act kid transplt wtlst","description":"Patients not observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5144","name":"Inj, idacio, 1 mg","description":"Injection, adalimumab-aacf (idacio), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0300U","name":"Onc pan tum whl gen seq&opt","description":"Onc pan tum whl gen seq&opt","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0830T","name":"Dgtz gls mcrscp cytp slctv","description":"Digitization of glass microscope slides for cytopathology, selective-cellular enhancement technique with interpretation (eg, liquid-based slide preparation method), except cervical or vaginal (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25635","name":"Cltx carpl fx w/mnpj ea b1","description":"Closed treatment of carpal bone fracture (excluding carpal scaphoid [navicular]); with manipulation, each bone","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91319","name":"Sarscv2 vac 10mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 10 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34813","name":"Femoral endovas graft add-on","description":"Placement of femoral-femoral prosthetic graft during endovascular aortic aneurysm repair (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81560","name":"Trnsplj pd lvr&bwl cd154+cll","description":"Transplantation medicine (allograft rejection, pediatric liver and small bowel), measurement of donor and third-party-induced cd154+t-cytotoxic memory cells, utilizing whole peripheral blood, algorithm reported as a rejection risk score","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9225","name":"Gen anes adv air-sub 15 min","description":"Gen anes adv air-sub 15 min","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85660","name":"Rbc sickle cell test","description":"Sickling of rbc, reduction","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0327","name":"Colon ca scrn;bld-bsd biomrk","description":"Colorectal cancer screening; blood-based biomarker","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86258","name":"Dgp antibody each ig class","description":"Gliadin (deamidated) (dgp) antibody, each immunoglobulin (ig) class","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0994T","name":"Evasc dlvr a-wal stbl rx prq","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; percutaneous","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"Adju cgm supply allowance","description":"Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6112","name":"Imp/abut rem dent part max","description":"Imp/abut rem dent part max","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45347","name":"Sigmoidoscopy w/plcmt stent","description":"Sigmoidoscopy, flexible; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84210","name":"Assay of pyruvate","description":"Pyruvate","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0627U","name":"Psyc scz dna alys >15000","description":"Psyc scz dna alys >15000","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1208","name":"Pt no scrn sdoh","description":"Patient is not screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0517U","name":"Ther rx mntr 80+ psyactiv rx","description":"Ther rx mntr 80+ psyactiv rx","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86710","name":"Influenza virus antibody","description":"Antibody; influenza virus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5912","name":"Facial moulage complete","description":"Facial moulage (complete)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1468","name":"Hep b vaccine received","description":"Patient received recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85032","name":"Manual cell count each","description":"Blood count; manual cell count (erythrocyte, leukocyte, or platelet) each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88185","name":"Flowcytometry/tc add-on","description":"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; each additional marker (list separately in addition to code for first marker)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27120","name":"Reconstruction of hip socket","description":"Acetabuloplasty; (eg, whitman, colonna, haygroves, or cup type)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1491.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1212","name":"Missing gsa not perf","description":"Glycemic status assessment (hba1c or gmi) level is missing, or was not performed during the measurement period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1231","name":"Pt hcv tst no reactive res","description":"Patient receives hcv antibody test with nonreactive result","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0705","name":"Extra oral post radio image","description":"Extra oral post radio image","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0024","name":"Pin srv add 30 min pr m","description":"Principal illness navigation services, additional 30 minutes per calendar month (list separately in addition to g0023)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0707T","name":"Njx b1 sub mtrl sbchdrl dfct","description":"Injection(s), bone-substitute material (eg, calcium phosphate) into subchondral bone defect (ie, bone marrow lesion, bone bruise, stress injury, microtrabecular fracture), including imaging guidance and arthroscopic assistance for joint visualization","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1345","name":"Pt bsln pam, 2nd scr 4-12 mo","description":"Patients who had a baseline pam score and a second score within 4 to 12 month of baseline pam score","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32994","name":"Ablate pulm tumor perq crybl","description":"Ablation therapy for reduction or eradication of 1 or more pulmonary tumor(s) including pleura or chest wall when involved by tumor extension, percutaneous, including imaging guidance when performed, unilateral; cryoablation","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":427.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":5266.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0684","name":"App non-sheet skin sb g addl","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area or part thereof, or each additional 1% o","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1952","name":"Leuprolide inj, camcevi, 1mg","description":"Leuprolide injectable, camcevi, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36870","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0681","name":"Inj ceftobipole medocarl 3mg","description":"Injection, ceftobiprole medocaril sodium, 3 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1225","name":"Iop dec>=20% from base","description":"Intraocular pressure (iop) reduced by a value of greater than or equal to 20% from the pre-intervention level","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4382","name":"Advograft dual per sq cm","description":"Advograft dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15853","name":"Removal sutr/stapl xreq anes","description":"Removal of sutures or staples not requiring anesthesia (list separately in addition to e/m code)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1194","name":"Med rsn no imp/con mmr/msi","description":"Documentation of medical reason(s) surgical pathology reports did not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both tests were not included (e.g., patient will not be treated with checkpoint inhibitor therap","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1363","name":"Pts no f/u 120 dys","description":"Patients who did not have a follow-up assessment within 120 days of the index assessment","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2403","name":"Chloroprocaine opht gel, 1mg","description":"Chloroprocaine hcl ophthalmic, 3% gel, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50547","name":"Laparo removal donor kidney","description":"Laparoscopy, surgical; donor nephrectomy (including cold preservation), from living donor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1740.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1179","name":"No pcv recd","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine, on or after their 19th birthday and before or during measurement period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1427","name":"Doc med rsn bone scn","description":"Documentation of medical reason(s) for performing a bone scan (including documented pain related to prostate cancer, salvage therapy, other medical reasons)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15832","name":"Exc excessive skin thigh","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy); thigh","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61892","name":"Rmv sk-mnt crnl nstm pg/rcvr","description":"Removal of skull-mounted cranial neurostimulator pulse generator or receiver with cranioplasty, when performed","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38241","name":"Transplt autol hct/donor","description":"Hematopoietic progenitor cell (hpc); autologous transplantation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11201","name":"Rmvl skin tags ea addl 10","description":"Removal of skin tags, multiple fibrocutaneous tags, any area; each additional 10 lesions, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":20.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0296U","name":"Onc orl&/orop ca 20 mlc feat","description":"Onc orl&/orop ca 20 mlc feat","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8006","name":"Grip glove replacement only","description":"Powered, cable driven grip assist glove, hand, finger, includes pressure sensors, glove replacement only","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3222","name":"Part pulp for apexogenesis","description":"Partial pulpotomy for apexogenesis - permanent tooth with incomplete root development","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86825","name":"Hla x-math non-cytotoxic","description":"Human leukocyte antigen (hla) crossmatch, non-cytotoxic (eg, using flow cytometry); first serum sample or dilution","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81558","name":"Trnspl rej kdn mrna qpcr 139","description":"Transplantation medicine (allograft rejection, kidney), mrna, gene expression profiling by quantitative polymerase chain reaction (qpcr) of 139 genes, utilizing whole blood, algorithm reported as a binary categorization as transplant excellence, which indicates immune quiescence, or not transplant e","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2804","name":"Inj, rifampin, 1 mg","description":"Injection, rifampin, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9996","name":"Ustekinumab- ttwe sub cu inj","description":"Injection, ustekinumab-ttwe (pyzchiva), subcutaneous, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0184","name":"Inj, amisulpride, 1 mg","description":"Injection, amisulpride, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94015","name":"Patient recorded spirometry","description":"Patient-initiated spirometric recording per 30-day period of time; recording (includes hook-up, reinforced education, data transmission, data capture, trend analysis, and periodic recalibration)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1206","name":"Isa not red 3pts/no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0522","name":"Mgt nw pt dementia low cmplx","description":"Management of a new patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9697","name":"Inj, magtrace per study dose","description":"Injection, carboxydextran-coated superparamagnetic iron oxide, per study dose","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0420U","name":"Onc urthl mrna xprsn 6 snp","description":"Onc urthl mrna xprsn 6 snp","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2991","name":"App of hydroxyapatite","description":"App of hydroxyapatite","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0264U","name":"Rare ds id opt genome mapg","description":"Rare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0481","name":"Electron microscopy diagnost","description":"Electron microscopy - diagnostic","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40490","name":"Biopsy of lip","description":"Biopsy of lip","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0525","name":"Est pt-cg dyad dem mod cmplx","description":"Management of established patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84376","name":"Sugars single qual","description":"Sugars (mono-, di-, and oligosaccharides); single qualitative, each specimen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4026","name":"Phys/occ therapy ss","description":"Physical therapy/occupational therapy mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27329","name":"Resect thigh/knee tum < 5 cm","description":"Radical resection of tumor (eg, sarcoma), soft tissue of thigh or knee area; less than 5 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1141.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0020M","name":"Onc cns alys 30000 dna loci","description":"Oncology (central nervous system), analysis of 30,000 dna methylation loci by methylation array, utilizing dna extracted from tumor tissue, diagnostic algorithm reported as probability of matching a reference tumor subclass","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0440U","name":"Crd chd dna alys 10 snp 6dna","description":"Crd chd dna alys 10 snp 6dna","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7413","name":"Excision malig lesion<=1.25c","description":"Excision of malignant lesion up to 1.25 cm","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0495U","name":"Onc prst8 alys crcg plsm prt","description":"Onc prst8 alys crcg plsm prt","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87913","name":"Nfct agt gntyp alys sarscov2","description":"Infectious agent genotype analysis by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), mutation identification in targeted region(s)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4036","name":"Urgent care ss","description":"Urgent care mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84078","name":"Assay alkaline phosphatase","description":"Phosphatase, alkaline; heat stable (total not included)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4423","name":"Biolab tri wrap fl per sq cm","description":"Biolab tri-membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1279","name":"Pre-htn/htn, no f/u, not gvn","description":"Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0478U","name":"Onc nsclc dna&rna dpcr 9 gen","description":"Onc nsclc dna&rna dpcr 9 gen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0257U","name":"Vlcad leuk nzm actv whl bld","description":"Very long chain acyl- coenzyme a (coa) dehydrogenase (vlcad), leukocyte enzyme activity, whole blood","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1713","name":"Pfizer vacc adm ped 1st dose","description":"Pfizer vacc adm ped 1st dose","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0604U","name":"All&immunology crae 4bk pep","description":"All&immunology crae 4bk pep","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49186","name":"Opn exc/dstr ntra-abd 5 cm/<","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5 cm or less","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1462","name":"Pt clin ind hd image","description":"Patients with clinical indications for imaging of the head","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86430","name":"Rheumatoid factor test qual","description":"Rheumatoid factor; qualitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92137","name":"Cptrz oph img pst sg rta oct","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), posterior segment, with interpretation and report, unilateral or bilateral; retina, including oct angiography","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0525","name":"Inj cefotetan disodium 10 mg","description":"Injection, cefotetan disodium, 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0445","name":"High inten beh couns std 30m","description":"High intensity behavioral counseling to prevent sexually transmitted infection; face-to-face, individual, includes: education, skills training and guidance on how to change sexual behavior; performed semi-annually, 30 minutes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":29.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0802","name":"3d dental scan indirect","description":"3d dental scan indirect","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59020","name":"Fetal contract stress test","description":"Fetal contraction stress test","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1305","name":"Pneum vax admin 19+","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1010T","name":"Cptr oph alys monoc eye mvmt","description":"Computerized ophthalmic analysis of monocular eye movements using retinal-based eye-tracking without spatial calibration, including fixation, microsaccades, drift, and horizontal saccades, when performed, unilateral or bilateral, with interpretation and report","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93573","name":"Njx cath slct p-art angrp bi","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, bilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99465","name":"Nb resuscitation","description":"Delivery/birthing room resuscitation, provision of positive pressure ventilation and/or chest compressions in the presence of acute inadequate ventilation and/or cardiac output","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7912","name":"Suture complicate wnd > 5 cm","description":"Complicated suture-greater than 5 cm","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29580","name":"Strapping unna boot","description":"Strapping; unna boot","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":22.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1304","name":"Inj tofersen intrathec 1 mg","description":"Injection, tofersen, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2020","name":"Ac5 wound system","description":"Ac5 advanced wound system (ac5)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2272","name":"Inj, morphine (fresenius)","description":"Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64466","name":"Thrc fascial pln blk uni njx","description":"Thoracic fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43632","name":"Removal of stomach partial","description":"Gastrectomy, partial, distal; with gastrojejunostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1544.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5227","name":"Immed max part denture","description":"Immed max part denture","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9949","name":"Repair sleep apnea appliance","description":"Repair sleep apnea appliance","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83015","name":"Heavy metal qual any number","description":"Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); qualitative, any number of analytes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96548","name":"Ntraop hipec px ea add 30min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87077","name":"Culture aerobic identify","description":"Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38226","name":"Car-t prep t lymphcyt f/trns","description":"Chimeric antigen receptor t-cell (car-t) therapy; preparation of blood-derived t lymphocytes for transportation (eg, cryopreservation, storage)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37281","name":"Revsc evsc tpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98010","name":"Synch audio-only new mod 45","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection,","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93587","name":"Vngrph chd vnvn cltrl at/abv","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating at or above the heart (eg, from innominate vein) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1286","name":"Bmi doc onl fup not cmpltd","description":"Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49187","name":"Opn exc/dstr ntra-abd 5.1-10","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5.1 to 10 cm","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0901T","name":"Plmt bone marrow smplg port","description":"Placement of bone marrow sampling port, including imaging guidance when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9609","name":"F18 fdg, 15 millicuries","description":"Fludeoxyglucose f18 up to 15 millicuries","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15012","name":"Hrv skn cll ssp agrft ea add","description":"Harvest of skin for skin cell suspension autograft; each additional 25 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91124","name":"Rct snsatn tone&cmplianc std","description":"Rectal sensation, tone, and compliance study (eg, barostat)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9601","name":"Flortaucipir inj 1 millicuri","description":"Flortaucipir f 18 injection, diagnostic, 1 millicurie","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92639","name":"Hearing aid meas verif","description":"Hearing-aid measurement, verification with probe-microphone (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0365U","name":"Onc bldr 10 prb bldr ca","description":"Onc bldr 10 prb bldr ca","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29358","name":"Appl long leg cast brace","description":"Application of long leg cast brace","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0654","name":"Inj, liothyronine, 1 mcg","description":"Injection, liothyronine, 1 mcg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1253","name":"Pts hu surv no amb plltv","description":"Patients who respond on the patient experience hu survey that they did not receive care by the listed ambulatory palliative care provider in the last 60 days (disavowal)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6610","name":"G com stcking bk 18-30 custm","description":"Gradient compression stocking, below knee, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87206","name":"Smear fluorescent/acid stai","description":"Smear, primary source with interpretation; fluorescent and/or acid fast stain for bacteria, fungi, parasites, viruses or cell types","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4402","name":"Xwrap 2.0 per sq cm","description":"Xwrap 2.0, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3392","name":"Inj, exagamglogene autotem","description":"Injection, exagamglogene autotemcel, per treatment","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4037","name":"Urology ss","description":"Urology mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5939","name":"Resct proth mand comp remov","description":"Resct proth mand comp remov","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27391","name":"Incision of thigh tendons","description":"Tenotomy, open, hamstring, knee to hip; multiple tendons, 1 leg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6613","name":"Onlay cst base mtl >=3 surfa","description":"Onlay - cast predominantly base metal three or more surfaces","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46710","name":"Repr per/vag pouch sngl proc","description":"Repair of ileoanal pouch fistula/sinus (eg, perineal or vaginal), pouch advancement; transperineal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1108.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5143","name":"Inj adalimumab-adbm, 1 mg","description":"Injection, adalimumab-adbm, biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93979","name":"Vascular study","description":"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7911","name":"Dental suture wound to 5 cm","description":"Complicated suture-up to 5 cm","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50900","name":"Repair of ureter","description":"Ureterorrhaphy, suture of ureter (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":919.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82380","name":"Assay of carotene","description":"Carotene","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0859T","name":"Ncntc ifr spctrsc o/t pad ea","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), other than for screening for peripheral arterial disease, image acquisition, interpretation, and report; each additional anatomic site (list separately in addition to code ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1279","name":"Pre-htn/htn, no f/u, not gvn","description":"Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77437","name":"Surf radj ther supfc<=150kv","description":"Surface radiation therapy; superficial, delivery, </=150 kv, per fraction (eg, electronic brachytherapy)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1193","name":"Rpts w/ imp/con mmr/msi","description":"Surgical pathology reports that contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33276","name":"Insj phrnc nrv stim sys","description":"Insertion of phrenic nerve stimulator system (pulse generator and stimulating lead[s]), including vessel catheterization, all imaging guidance, and pulse generator initial analysis with diagnostic mode activation, when performed","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84302","name":"Assay of sweat sodium","description":"Sodium; other source","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9128","name":"Photobio therpy-first 15 min","description":"Photobio therpy-first 15 min","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0030","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1397","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2033","name":"Myriad morcells, 4 mg","description":"Myriad morcells, 4 milligrams","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6561","name":"G stockng full/chap 40+ cust","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, custom, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11046","name":"Dbrdmt musc&/fsca ea addl","description":"Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); each additional 20 sq cm, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":14.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":56.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9054","name":"Inj bortezomib boruzu 0.1 mg","description":"Injection, bortezomib (boruzu), 0.1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90631","name":"H5 vaccine pandemic im use","description":"Influenza virus vaccine (iiv), h5, pandemic formulation, split virus, adjuvanted, for intramuscular use","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0884T","name":"Esphgsc flx 1st tndsc dilat","description":"Esophagoscopy, flexible, transoral, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for esophageal stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0681","name":"App of non-sheet skin sub","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; first 25 sq cm or less of wound surface area","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0521","name":"Supply fee hiv prep fda appr","description":"Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92930","name":"Prq tcat plmt ntrac st 2+les","description":"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 2 or more distinct coronary lesions with 2 or more coronary stents deployed in 2 or more coronary segments, or a bifurcation lesion requiring ","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1354","name":"Int caries med app per tooth","description":"Interim caries med app","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83014","name":"H pylori drug admin","description":"Helicobacter pylori; drug administration","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37287","name":"Revsc evasc tpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15015","name":"App skn cl ssp agrft t/a/l 1","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; first 480 sq cm or less","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78491","name":"Myocrd img pet 1std rst/strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); single study, at rest or stress (exercise or pharmacologic)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3244","name":"Inj. tigecycline (accord)","description":"Injection, tigecycline (accord), not therapeutically equivalent to j3243, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2011","name":"Supra sdrm, per sq cm","description":"Supra sdrm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0668","name":"Team remote e/m est pt 40 mn","description":"Team remote e/m est. pt 40mins","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90481","name":"Admn sarscov2 vac ea add cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; each additional component administered (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85705","name":"Thromboplastin inhibition","description":"Thromboplastin inhibition, tissue","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0052","name":"Mmip mental health and care","description":"Missing and murdered indigenous persons (mmip) mental health and clinical care","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41135","name":"Tongue and neck surgery","description":"Glossectomy; partial, with unilateral radical neck dissection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2173.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2991","name":"App of hydroxyapatite","description":"App of hydroxyapatite","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5148","name":"Inj, nyposi 1 mcg","description":"Injection, filgrastim-txid (nypozi), biosimilar, 1 microgram","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1597","name":"Inj glycopyrrolate, glyrx-pf","description":"Injection, glycopyrrolate (glyrx-pf), 0.1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2780","name":"Crown 3/4 cast hi noble met","description":"Crown - 3/4 cast high noble metal","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0310U","name":"Ped vsclts kd alys 3 bmrks","description":"Ped vsclts kd alys 3 bmrks","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0469U","name":"Rare ds whl gen seq ftl samp","description":"Rare ds whl gen seq ftl samp","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0812T","name":"Rem mlt day uroflow dev sply","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); device supply with automated report generation, up to 10 days","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90631","name":"H5 vaccine pandemic im use","description":"Influenza virus vaccine (iiv), h5, pandemic formulation, split virus, adjuvanted, for intramuscular use","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0317U","name":"Onc lung ca 4-prb fish assay","description":"Onc lung ca 4-prb fish assay","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0556","name":"Adv prim care mgmt lvl 1","description":"Advanced primary care management services for a patient with one chronic condition [expected to last at least 12 months, or until the death of the patient, which place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline], or fewer, provided by clinical ","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60540","name":"Explore adrenal gland","description":"Adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal (separate procedure);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1165.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83655","name":"Assay of lead","description":"Lead","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0528","name":"Mgt est pt dem mod-hi cmplx","description":"Management of established patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87594","name":"Pneumcysts jirovecii amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); pneumocystis jirovecii, amplified probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33895","name":"Evasc st rpr thrc/aa x crsg","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; not crossing major side branches","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36513","name":"Apheresis platelets","description":"Therapeutic apheresis; for platelets","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76989","name":"Dx intraop epcar us chd i&r","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; interpretation and report only","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67445","name":"Explr/decompress eye socket","description":"Orbitotomy with bone flap or window, lateral approach (eg, kroenlein); with removal of bone for decompression","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1308.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1159","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51860","name":"Repair of bladder wound","description":"Cystorrhaphy, suture of bladder wound, injury or rupture; simple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":836.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0250","name":"Adm tocilizu covid-19 2nd","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87850","name":"N. gonorrhoeae assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; neisseria gonorrhoeae","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1485","name":"Neg viro resp hep c/qual rna","description":"Patients who did not achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0137","name":"Inten outpt svs,min 9 pr 7 d","description":"Intensive outpatient services; weekly bundle, minimum of 9 services over a 7 contiguous day period, which can include individual and group therapy with physicians or psychologists (or other mental health professionals to the extent authorized under state law); occupational therapy requiring the skil","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1476","name":"Pt dx cog imp or ad","description":"Patients with diagnosis of cognitive impairment or alzheimers disease","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89136","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9060","name":"Cisplatin 10 mg injection","description":"Injection, cisplatin, powder or solution, 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0020M","name":"Onc cns alys 30000 dna loci","description":"Oncology (central nervous system), analysis of 30,000 dna methylation loci by methylation array, utilizing dna extracted from tumor tissue, diagnostic algorithm reported as probability of matching a reference tumor subclass","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6191","name":"Semi precision abutment","description":"Semi precision abutment","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36476","name":"Endovenous rf vein add-on","description":"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; subsequent vein(s) treated in a single extremity, each through separate access sites (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95822","name":"Eeg coma or sleep only","description":"Electroencephalogram (eeg); recording in coma or sleep only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9025","name":"Plasma cryo redu path each","description":"Plasma, cryoprecipitate reduced, pathogen reduced, each unit","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1353","name":"Sealant repair per tooth","description":"Sealant repair per tooth","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9272","name":"Inj, dostarlimab-gxly, 10 mg","description":"Injection, dostarlimab-gxly, 10 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2428","name":"Inj, erzofri, 1 mg","description":"Injection, paliperidone palmitate extended release (erzofri), 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0841T","name":"Dgtz gls mcrscp pth cslt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; first tissue block, with frozen section(s), single specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4364","name":"Am bur xp mem xpl hy p sq cm","description":"Amnio burgeon xplus membrane and xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75992","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":844.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0339U","name":"Onc prst8 mrna hoxc6 & dlx1","description":"Onc prst8 mrna hoxc6 & dlx1","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0453U","name":"Onc clrct ca cfdna qpcr asy","description":"Onc clrct ca cfdna qpcr asy","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9282","name":"Mitomycin intravesical inst","description":"Mitomycin, intravesical instillation, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0542","name":"No pt prsnt train add 15","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0414U","name":"Onc lng aug alg aly whl sld8","description":"Onc lng aug alg aly whl sld8","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0392U","name":"Rx metab genrx ia 16 genes","description":"Rx metab genrx ia 16 genes","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1323","name":"Pts 7wk inj, scrn iop >25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop >25 mm hg and a plan of care was documented","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25900","name":"Amputation of forearm","description":"Amputation, forearm, through radius and ulna;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1050.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1446","name":"Pt died bef end meas pd","description":"Patients who died any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52443","name":"Cysto 1st trurl prst8 comis","description":"Cystourethroscopy with initial transurethral anterior prostate commissurotomy with a nondrug-coated balloon catheter followed by therapeutic drug delivery into the prostate by a drug-coated balloon catheter, including transrectal ultrasound and fluoroscopy, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1357","name":"Pt w/red suic idea 120 days","description":"Patients who had a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1230","name":"Pt hcv rctv aby no f/u tst","description":"Patient has a reactive hcv antibody test and does not have a follow up hcv viral test, or patient has a reactive hcv antibody test and has a follow up hcv viral test that detects hcv viremia and is not referred to a clinician who treats hcv infection within 1 month and does not have hcv treatment in","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32095","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":671.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37269","name":"Revsc evasc fpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0682T","name":"Removal pulse gen only isdss","description":"Removal of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0590U","name":"Nfct ds bct&fngl dna 44 orgs","description":"Nfct ds bct&fngl dna 44 orgs","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7972","name":"Surg redct fibrous tuberosit","description":"Surgical reduction of fibrous tuberosity","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0297U","name":"Onc pan tum whl gen seq dna","description":"Onc pan tum whl gen seq dna","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9269","name":"Programable ingest capsule","description":"Programable, transient, orally ingested capsule, for use with external programmer, per month","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87627","name":"Jt spc pthgn&rx rsist gen26+","description":"Infectious agent detection by nucleic acid (dna or rna); joint space pathogens and drug resistance genes, multiplex amplified probe technique, 26 or more targets","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9607","name":"Lutetium lu 177 vipivotide","description":"Lutetium lu 177 vipivotide tetraxetan, therapeutic, 1 millicurie","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2058","name":"Obecbtge autol up to 400 mil","description":"Obecabtagene autoleucel, 10 up to 400 million cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per infusion","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0372","name":"Md service required for pmd","description":"Physician service required to establish and document the need for a power mobility device","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9432","name":"Med food non inborn err meta","description":"Medical foods for non-inborn errors of metabolism","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78460","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1714","name":"Pfizer vacc adm ped 2nd dose","description":"Pfizer vacc adm ped 2nd dose","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4479","name":"Transanal irrigation, electr","description":"Electronic transanal irrigation system, includes electronic pump, water reservoir, tubing, and accessories, without catheter, any type","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1302","name":"Scrn mam perf rslts doc","description":"Screening, diagnostic, film digital or digital breast tomosynthesis (3d) mammography results documented and reviewed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0903T","name":"Ecg alg 12 lead reduced i&r","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; with interpretation and report","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86153","name":"Cell enumeration phys interp","description":"Cell enumeration using immunologic selection and identification in fluid specimen (eg, circulating tumor cells in blood); physician interpretation and report, when required","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37251","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50557","name":"Kidney endoscopy & treatment","description":"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without biopsy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1404","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3373","name":"Inj, vancomycin hcl, 10 mg","description":"Injection, vancomycin hydrochloride, 10 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9994","name":"Pall serv during meas","description":"Patient is using palliative care services any time during the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80503","name":"Path clin consltj sf 5-20","description":"Pathology clinical consultation; for a clinical problem, with limited review of patients history and medical records and straightforward medical decision making when using time for code selection, 5-20 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33822","name":"Repair pda div<18 years","description":"Repair of patent ductus arteriosus; by division, younger than 18 years","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1303.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37287","name":"Revsc evasc tpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90631","name":"H5 vaccine pandemic im use","description":"Influenza virus vaccine (iiv), h5, pandemic formulation, split virus, adjuvanted, for intramuscular use","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1708","name":"Pfizer vacc admin 3rd dose","description":"Pfizer vacc admin 3rd dose","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0518U","name":"Ther rx mntr 90+ pn&mtl hlth","description":"Ther rx mntr 90+ pn&mtl hlth","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33465","name":"Replace tricuspid valve","description":"Replacement, tricuspid valve, with cardiopulmonary bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2059.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76930","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1265","name":"Cms 2728 completed","description":"Cms medical evidence form 2728 for dialysis patients: initial form completed","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0578","name":"Inj brixadi, more than 7 day","description":"Injection, buprenorphine extended release (brixadi), greater than 7 days and up to 28 days of therapy","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1305","name":"Pneum vax admin 19+","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0328U","name":"Drug assay 120+ rx&metablt","description":"Drug assay 120+ rx&metablt","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46210","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5911","name":"Facial moulage sectional","description":"Facial moulage (sectional)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98985","name":"Rtm dev sply mscsk sys 2-15d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of musculoskeletal system, 2-15 days in a 30-day period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6253","name":"Provisional pontic","description":"Provisional pontic","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4357","name":"Xwrap plus, per sq cm","description":"Xwrap plus, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15012","name":"Hrv skn cll ssp agrft ea add","description":"Harvest of skin for skin cell suspension autograft; each additional 25 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54000","name":"Slitting of prepuce","description":"Slitting of prepuce, dorsal or lateral (separate procedure); newborn","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90624","name":"Menb-4c&menacwy vacc im","description":"Meningococcal pentavalent vaccine, men b-4c recombinant proteins and outer membrane vesicle and conjugated men a, c, w, y-diphtheria toxoid carrier, for intramuscular use","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1814","name":"Inj. insulin (lyumjev)","description":"Insulin (lyumjev), per 5 units","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86015","name":"Actin antibody each","description":"Actin (smooth muscle) antibody (asma), each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52330","name":"Cystoscopy and treatment","description":"Cystourethroscopy (including ureteral catheterization); with manipulation, without removal of ureteral calculus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":310.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9886","name":"In-person attendance g code","description":"Behavioral counseling for diabetes prevention, in-person, group, 60 minutes","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0673T","name":"Abltj b9 thyr ndul perq lasr","description":"Ablation, benign thyroid nodule(s), percutaneous, laser, including imaging guidance","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2006","name":"Novosorb synpath per sq cm","description":"Novosorb synpath dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28108","name":"Removal of toe lesions","description":"Excision or curettage of bone cyst or benign tumor, phalanges of foot","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1355","name":"Caries med app per tooth","description":"Caries med app per tooth","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2056","name":"Ciltacabtagene car-pos t","description":"Ciltacabtagene autoleucel, up to 100 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7519","name":"Inj. mycophenolate mofetil","description":"Injection, mycophenolate mofetil, 10 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1401","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76810","name":"Ob us >/= 14 wks addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5227","name":"Immed max part denture","description":"Immed max part denture","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1308","name":"Flu immunize no admin","description":"Influenza immunization was not administered, reason not given","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0747T","name":"Car ablt rad arrhyt dlvr rad","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; delivery of radiation therapy, arrhythmia","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92930","name":"Prq tcat plmt ntrac st 2+les","description":"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 2 or more distinct coronary lesions with 2 or more coronary stents deployed in 2 or more coronary segments, or a bifurcation lesion requiring ","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5932","name":"Postsurgical obturator","description":"Obturator prosthesis definitive","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5933","name":"Refitting of obturator","description":"Obturator prosthesis modification","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63046","name":"Lam facetec & foramot thrc","description":"Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; thoracic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1357.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5142","name":"Inj adalimumab-ryvk, 1 mg","description":"Injection, adalimumab-ryvk biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0627U","name":"Psyc scz dna alys >15000","description":"Psyc scz dna alys >15000","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1163","name":"Pt anphx due to hpv bef 13","description":"Patient had anaphylaxis due to the hpv vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0498U","name":"Onc clrct ngs mut detc 43gen","description":"Onc clrct ngs mut detc 43gen","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93585","name":"Vngrph chd azygs/hemiazygs","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; azygos/hemiazygos venous system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":45.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98005","name":"Synch audio-video est low 20","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low medical decision making. when using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63032","name":"Lamot rpr anulr dfct 1 lmbr","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; with repair of annular defect by implantation of bone-anchored annular closure device, including all imaging guidance, 1 interspace, lumbar","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33895","name":"Evasc st rpr thrc/aa x crsg","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; not crossing major side branches","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6112","name":"Imp/abut rem dent part max","description":"Imp/abut rem dent part max","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1376","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4426","name":"Dermbnd tl+, tlx per sq cm","description":"Dermabind tl + or dermabind tl x,  per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55874","name":"Tprnl plmt biodegrdabl matrl","description":"Transperineal placement of biodegradable material, peri-prostatic, single or multiple injection(s), including image guidance, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3521.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":137.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77081","name":"Dxa bone density appendiculr","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0520","name":"New pt-cg dyad dem mod cmplx","description":"Management of new patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95829","name":"Surgery electrocorticogram","description":"Electrocorticogram at surgery (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1770.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0269U","name":"Hem aut dm cgen trmbctpna 14","description":"Hematology (autosomal dominant congenital thrombocytopenia), genomic sequence analysis of 14 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93561","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0901T","name":"Plmt bone marrow smplg port","description":"Placement of bone marrow sampling port, including imaging guidance when performed","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1288","name":"Doc rsn no hbp scrn or f/u","description":"Documented reason for not screening or recommending a follow-up for high blood pressure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36570","name":"Insert picvad cath","description":"Insertion of peripherally inserted central venous access device, with subcutaneous port; younger than 5 years of age","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99470","name":"Rpm tx mgmt 1st 10 min","description":"Remote physiologic monitoring treatment management services, clinical staff/physician/other qualified health care professional time in a calendar month requiring 1 real-time interactive communication with the patient/caregiver during the calendar month; first 10 minutes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35102","name":"Repair defect of artery","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, abdominal aorta involving iliac vessels (common, hypogastric, external)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2123.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45339","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0732T","name":"Immntx admn electroporatn im","description":"Immunotherapy administration with electroporation, intramuscular","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69209","name":"Remove impacted ear wax uni","description":"Removal impacted cerumen using irrigation/lavage, unilateral","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0495U","name":"Onc prst8 alys crcg plsm prt","description":"Onc prst8 alys crcg plsm prt","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6611","name":"Onlay cst hgh nbl mtl >=3srf","description":"Onlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0709","name":"Intraoral cmplt radio images","description":"Intraoral cmplt radio images","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37282","name":"Rvsc evsc tpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":302.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"Basic vestibular evaluation","description":"Basic vestibular evaluation, includes spontaneous nystagmus test with eccentric gaze fixation nystagmus, with recording, positional nystagmus test, minimum of 4 positions, with recording, optokinetic nystagmus test, bidirectional foveal and peripheral stimulation, with recording, and oscillating tra","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4384","name":"Axolotl dual ult per sq cm","description":"Axolotl dualgraft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20526","name":"Ther injection carp tunnel","description":"Injection, therapeutic (eg, local anesthetic, corticosteroid), carpal tunnel","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54312","name":"Reconstruction of urethra","description":"Urethroplasty for second stage hypospadias repair (including urinary diversion); greater than 3 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":962.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0941T","name":"Cysto flx ins&xpns urtl scaf","description":"Cystourethroscopy, flexible; with insertion and expansion of prostatic urethral scaffold using integrated cystoscopic visualization","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1323","name":"Inj, elranatamab-bcmm, 1 mg","description":"Injection, elranatamab-bcmm, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4397","name":"Summit aaa per sq cm","description":"Summit aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0535","name":"Pt navigat svs direct/ref","description":"Patient navigational services, provided directly or by referral; including helping the patient to navigate health systems and identify care providers and supportive services, to build patient self-advocacy and communication skills with care providers, and to promote patient-driven action plans and g","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2791","name":"Crown full cast base metal","description":"Crown-full cast predominantly base metal","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93744","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0534","name":"Coordinated care/or referral","description":"Coordinated care and/or referral services, such as to adequate and accessible community resources to address unmet health-related social needs, including harm reduction interventions and recovery support services a patient needs and wishes to pursue, which significantly limit the ability to diagnose","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0437U","name":"Psyc anxiety do mrna 15 bmrk","description":"Psyc anxiety do mrna 15 bmrk","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1021T","name":"Active thrc irrigation spx","description":"Active thoracic irrigation (separate procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81025","name":"Urine pregnancy test","description":"Urine pregnancy test, by visual color comparison methods","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9601","name":"Inj linvoseltamab-gcpt 1 mg","description":"Injection, linvoseltamab-gcpt, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4270","name":"Complete sl per sq cm","description":"Complete sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33206","name":"Insert heart pm atrial","description":"Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); atrial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1393","name":"Pr no dx rec mlnm","description":"Patients who were not diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1396","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9026","name":"Cryo fib comp path redu each","description":"Cryoprecipitated fibrinogen complex, pathogen reduced, each unit","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7355","name":"Inj travoprost intra impl","description":"Injection, travoprost, intracameral implant, 1 microgram","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1473","name":"Pt func cap not allow impr","description":"Patient situations, at any point during the denominator identification period, where the patients functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools, such as delirium, dementia, intellectual disabilities, and pervasive and specific de","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4417","name":"Alexiguard dl-t per sq cm","description":"Alexiguard dl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6089","name":"Access/retorq implant screw","description":"Access/retorq implant screw","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33278","name":"Rmvl phrnc nrv stim sys","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; system, including pulse generator and lead(s)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33287","name":"Rmv&rplcmt phrnc nrv stim pg","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46601","name":"Diagnostic anoscopy","description":"Anoscopy; diagnostic, with high-resolution magnification (hra) (eg, colposcope, operating microscope) and chemical agent enhancement, including collection of specimen(s) by brushing or washing, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":91.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99222","name":"1st hosp ip/obs moderate 55","description":"Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 55 minutes ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1279","name":"Pre-htn/htn, no f/u, not gvn","description":"Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1452","name":"Pt dx dementia ever","description":"Patient ever had a diagnosis of dementia","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1017T","name":"Elec aly npgs esoph sbsq w/o","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9887","name":"Distance learning attendance","description":"Behavioral counseling for diabetes prevention, distance learning, 60 minutes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0309U","name":"Crd cv ds aly 4 prtn plm alg","description":"Crd cv ds aly 4 prtn plm alg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19001","name":"Puncture aspir cyst brst ea","description":"Puncture aspiration of cyst of breast; each additional cyst (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9276","name":"Inj zanidatamab-hrii, 2 mg","description":"Injection, zanidatamab-hrii, 2 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98980","name":"Rtm tx mgmt 1st 20 min","description":"Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least 1 real-time interactive communication with the patient or caregiver during the calendar month; first 20 minutes","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0566","name":"3d bn img algor drvd fr mri","description":"3d radiodensity-value bone imaging, algorithm derived, from previous magnetic resonance examination of the same anatomy","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0613","name":"Calcium glucon (wg critical)","description":"Injection, calcium gluconate (wg critical care), not therapeutically equivalent to j0612, 10 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2561","name":"Inj, sezaby, 1 mg","description":"Injection, phenobarbital sodium (sezaby), 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0490U","name":"Onc cutan/uveal mlnma cd146","description":"Onc cutan/uveal mlnma cd146","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0901T","name":"Plmt bone marrow smplg port","description":"Placement of bone marrow sampling port, including imaging guidance when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1720","name":"Influenza vacc admin","description":"Influenza vacc admin","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37286","name":"Revsc evasc tpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4281","name":"Barrera slor dl per sq cm","description":"Barrera sl or barrera dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74320","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1387","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99426","name":"Prin care mgmt staff 1st 30","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30115","name":"Removal of nose polyp(s)","description":"Excision, nasal polyp(s), extensive","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":478.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0844T","name":"Dgtz gls mcrscp cslt cyt ea","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), each additional site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2039","name":"Innovamatrix fd, per sq cm","description":"Innovamatrix fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9953","name":"Reline sleep apnea appliance","description":"Reline sleep apnea appliance","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9914","name":"Admin of dermal fill","description":"Admin of dermal fill","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0385U","name":"Neph ckd alg rsk dbtc kdn ds","description":"Neph ckd alg rsk dbtc kdn ds","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4316","name":"Amchoplast, per sq cm","description":"Amchoplast, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50561","name":"Kidney endoscopy & treatment","description":"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":467.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0974T","name":"Slctv nzmtc dbrdmt t/a/l ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; each additional 100 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2596","name":"Vasopressin (long grove) 1 u","description":"Injection, vasopressin (long grove), not therapeutically equivalent to j2598, 1 unit","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0681","name":"App of non-sheet skin sub","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; first 25 sq cm or less of wound surface area","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7342","name":"Ciprofloxacin otic susp 6 mg","description":"Instillation, ciprofloxacin otic suspension, 6 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1370","name":"Inj, esomeprazole sod, 1 mg","description":"Injection, esomeprazole sodium, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4315","name":"Regenelink amniotic mem allo","description":"Regenelink amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81449","name":"So neo gsap 5-50 rna alys","description":"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; rna analysis","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15017","name":"App skn cll ssp f/n/g/hf 1st","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 480 sq cm or less","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9888","name":"5% wl maintnd from bsline wt","description":"Maintenance 5% wl from baseline weight in months 7-12","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0169","name":"Inj epinephrine (adrenalin)","description":"Injection, epinephrine (adrenalin), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1277","name":"Colorectal ca screen doc rev","description":"Colorectal cancer screening results documented and reviewed","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37277","name":"Rvsc evsc fpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6517","name":"Grad com wrap w strap bn cus","description":"Gradient compression wrap with adjustable straps, below knee, each, custom","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1469","name":"Hx of hep b, or pos bld test","description":"Patient has a history of hepatitis b illness or received a hepatitis b surface antigen, hepatitis b surface antibody, or total antibody to hepatitis b core antigen test with a positive result any time before or during the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33897","name":"Perq trluml angp nt/recr coa","description":"Percutaneous transluminal angioplasty of native or recurrent coarctation of the aorta","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81441","name":"Ibmfs seq alys pnl 30 genes","description":"Inherited bone marrow failure syndromes (ibmfs) (eg, fanconi anemia, dyskeratosis congenita, diamond-blackfan anemia, shwachman-diamond syndrome, gata2 deficiency syndrome, congenital amegakaryocytic thrombocytopenia) sequence analysis panel, must include sequencing of at least 30 genes, including b","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2679","name":"Inj fluphenazine hcl 1.25 mg","description":"Injection, fluphenazine hcl, 1.25 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87153","name":"Dna/rna sequencing","description":"Culture, typing; identification by nucleic acid sequencing method, each isolate (eg, sequencing of the 16s rrna gene)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37276","name":"Rvsc evsc fpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92945","name":"Prq trl rvs ch occ ant&rtrgr","description":"Percutaneous transluminal revascularization of chronic total occlusion, single coronary artery, coronary artery branch, or coronary artery bypass graft, and/or subtended major coronary artery branches of the bypass graft, any combination of intracoronary stent, atherectomy and angioplasty; combined ","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0043","name":"Pt mech pros ht valv","description":"Patients with mechanical prosthetic heart valve","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1313","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4300","name":"Acesso tl, per sq cm","description":"Acesso tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0875T","name":"Prgrm subq prtl asct pmp sys","description":"Programming of subcutaneously implanted peritoneal ascites pump system by physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0290U","name":"Pain mgmt mrna gen xprsn 36","description":"Pain mgmt mrna gen xprsn 36","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15823","name":"Blepharp upr eyelid xcsv skn","description":"Blepharoplasty, upper eyelid; with excessive skin weighting down lid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":625.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43290","name":"Egd flx trnsorl dplmnt balo","description":"Esophagogastroduodenoscopy, flexible, transoral; with deployment of intragastric bariatric balloon","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1284","name":"Pt 66+ snp or ltc pos > 90d","description":"Patients age 66 or older in institutional special needs plans (snp) or residing in long term care with pos code 32, 33, 34, 54, or 56 for more than 90 consecutive days during the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0973T","name":"Slctv nzmtc dbrdmt t/a/l 1st","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; first 100 sq cm","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16025","name":"Dress/debrid p-thick burn m","description":"Dressings and/or debridement of partial-thickness burns, initial or subsequent; medium (eg, whole face or whole extremity, or 5% to 10% total body surface area)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":158.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1411","name":"Inj, hemgenix, per tx dose","description":"Injection, etranacogene dezaparvovec-drlb, per therapeutic dose","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0951T","name":"Tot impl amei 1st plmt","description":"Totally implantable active middle ear hearing implant; initial placement, including mastoidectomy, placement of and attachment to sound processor","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1242","name":"Pt no resp imprt to me","description":"Patient did not respond to the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0459U","name":"Abeta42 & ttau eclia csf","description":"Abeta42 & ttau eclia csf","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0666","name":"Team remote e/m est pt 15 mn","description":"Team remote e/m est. pt 15mins","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59515","name":"Cesarean delivery","description":"Cesarean delivery only; including postpartum care","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1141.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1239","name":"Pt no resp heard","description":"Patient did not respond to the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6527","name":"G garmt full leg/ft nght cus","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, custom, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61715","name":"Mrgfus strtctc ablt trgt icr","description":"Magnetic resonance image guided high intensity focused ultrasound (mrgfus), stereotactic ablation of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87899","name":"Agent nos assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; not otherwise specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7060","name":"5% dextrose/water","description":"5% dextrose/water (500 ml = 1 unit)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2004","name":"Inj, lidocaine w epinephrine","description":"Injection, lidocaine hcl with epinephrine, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2247","name":"Inj, micafungin (par pharm)","description":"Injection, micafungin sodium (par pharm) not thereapeutically equivalent to j2248, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78268","name":"Urea breath test c-14 alys","description":"Urea breath test, c-14 (isotopic); analysis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1242","name":"Pt no resp imprt to me","description":"Patient did not respond to the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2183","name":"Inj meropenem (wg crit care)","description":"Injection, meropenem (wg critical care), not therapeutically equivalent to j2185, 100 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15130","name":"Drm agrft t/a/l 1st 100 sqcm","description":"Dermal autograft, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":653.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7912","name":"Suture complicate wnd > 5 cm","description":"Complicated suture-greater than 5 cm","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33370","name":"Tcat plmt&rmvl cepd perq","description":"Transcatheter placement and subsequent removal of cerebral embolic protection device(s), including arterial access, catheterization, imaging, and radiological supervision and interpretation, percutaneous (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1443","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01940","name":"Anes nulyt agt lmbr/sac","description":"Anesthesia for percutaneous image-guided destruction procedures by neurolytic agent on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4295","name":"Amnio tri-core, per sq cm","description":"Amnio tri-core amniotic, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54150","name":"Circumcision w/regionl block","description":"Circumcision, using clamp or other device with regional dorsal penile or ring block","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":173.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0873","name":"Inj daptomycin (xellia)","description":"Injection, daptomycin (xellia), not therapeutically equivalent to j0878 or j0872, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59620","name":"Attempted vbac delivery only","description":"Cesarean delivery only, following attempted vaginal delivery after previous cesarean delivery;","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":988.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34510","name":"Transposition of vein valve","description":"Venous valve transposition, any vein donor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1365.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49594","name":"Rpr aa hrn 1st 3-10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82000","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4299","name":"Amniocore pro+, per sq cm","description":"Amniocore pro+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1426","name":"Injection, casimersen, 10 mg","description":"Injection, casimersen, 10 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78492","name":"Myocrd img pet mlt rst&strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); multiple studies at rest and stress (exercise or pharmacologic)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4391","name":"Amnioplast double per sq cm","description":"Amnioplast double, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11403","name":"Exc tr-ext b9+marg 2.1-3cm","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 2.1 to 3.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83915","name":"Assay of nucleotidase","description":"Nucleotidase 5-","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15015","name":"App skn cl ssp agrft t/a/l 1","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; first 480 sq cm or less","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1162","name":"Pt enceph due to dtp bef 13","description":"Patient had encephalitis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0686T","name":"Histotripsy mal hepatcel tis","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant hepatocellular tissue, including image guidance","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33508","name":"Endoscopic vein harvest","description":"Endoscopy, surgical, including video-assisted harvest of vein(s) for coronary artery bypass procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0591U","name":"Onc prst8 ca 3prtns plsm srm","description":"Onc prst8 ca 3prtns plsm srm","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1407","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98928","name":"Osteopath manj 7-8 regions","description":"Osteopathic manipulative treatment (omt); 7-8 body regions involved","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":82.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92523","name":"Speech sound lang comprehen","description":"Evaluation of speech sound production (eg, articulation, phonological process, apraxia, dysarthria); with evaluation of language comprehension and expression (eg, receptive and expressive language)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90836","name":"Psytx w pt w e/m 45 min","description":"Psychotherapy, 45 minutes with patient when performed with an evaluation and management service (list separately in addition to the code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":114.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0283","name":"Inj, amiodarone (nexterone)","description":"Injection, amiodarone hydrochloride (nexterone), 30 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98984","name":"Rtm dev sply resp sys 2-15 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of respiratory system, 2-15 days in a 30-day period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86036","name":"Anca screen each antibody","description":"Antineutrophil cytoplasmic antibody (anca); screen, each antibody","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92635","name":"Hearing aid fitg svc ea addl","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; each additional 15 minutes (list separately in addition to code","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01937","name":"Anes drg/aspir crv/thrc","description":"Anesthesia for percutaneous image-guided injection, drainage or aspiration procedures on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1254","name":"Pts deceased prior hu surv","description":"Patients who were deceased when the hu survey reached them","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1459","name":"Pt hosp/pal care dur perf pd","description":"Patient was in hospice or receiving palliative care services at any time during the performance period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0473U","name":"Onc sld tum bld/slv 648 gene","description":"Onc sld tum bld/slv 648 gene","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59410","name":"Obstetrical care","description":"Vaginal delivery only (with or without episiotomy and/or forceps); including postpartum care","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":914.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33894","name":"Evasc st rpr thrc/aa acrs br","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; across major side branches","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":559.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5128","name":"Inj, cimerli, 0.1 mg","description":"Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0008","name":"Admin influenza virus vac","description":"Administration of influenza virus vaccine","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0694T","name":"3d vol img&rcnstj brst/ax","description":"3-dimensional volumetric imaging and reconstruction of breast or axillary lymph node tissue, each excised specimen, 3-dimensional automatic specimen reorientation, interpretation and report, real-time intraoperative","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0506U","name":"Gi barretts esophgl cell 89","description":"Gi barretts esophgl cell 89","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25111","name":"Remove wrist tendon lesion","description":"Excision of ganglion, wrist (dorsal or volar); primary","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64721","name":"Carpal tunnel surgery","description":"Neuroplasty and/or transposition; median nerve at carpal tunnel","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":477.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95930","name":"Visual ep test cns w/i&r","description":"Visual evoked potential (vep) checkerboard or flash testing, central nervous system except glaucoma, with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9225","name":"Gen anes adv air-sub 15 min","description":"Gen anes adv air-sub 15 min","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0592U","name":"Onc hl neo dna tgs 417 genes","description":"Onc hl neo dna tgs 417 genes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4398","name":"Summit ac per sq cm","description":"Summit ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64598","name":"Revj/rmvl nea pn w/int nstim","description":"Revision or removal of neurostimulator electrode array, peripheral nerve, with integrated neurostimulator","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0029","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77280","name":"Ther rad simulaj field smpl","description":"Therapeutic radiology simulation-aided field setting; simple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":220.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1335","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27713","name":"Osteot tibia imed lngth dev","description":"Osteotomy(ies), tibia, including fibula when performed, unilateral, with insertion of an externally controlled intramedullary lengthening device, including imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11042","name":"Dbrdmt subq tis 1st 20sqcm/<","description":"Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":53.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92311","name":"Contact lens fitg aphakia 1","description":"Prescription of optical and physical characteristics of and fitting of contact lens, with medical supervision of adaptation; corneal lens for aphakia, 1 eye","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1150","name":"Lvef <=40% or mod/sev l vsf","description":"Current or prior left ventricular ejection fraction (lvef) less than or equal to 40% or documentation of moderately or severely depressed left ventricular systolic function","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46262","name":"Remove in/ex hem grps w/fist","description":"Hemorrhoidectomy, internal and external, 2 or more columns/groups; with fistulectomy, including fissurectomy, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1411","name":"Inj, hemgenix, per tx dose","description":"Injection, etranacogene dezaparvovec-drlb, per therapeutic dose","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0525","name":"Inj cefotetan disodium 10 mg","description":"Injection, cefotetan disodium, 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33478","name":"Revision of heart chamber","description":"Outflow tract augmentation (gusset), with or without commissurotomy or infundibular resection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1959.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37262","name":"Iv lithotrp ivt w/in sm art","description":"Intravascular lithotripsy(ies), iliac vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55709","name":"Bx prst8 tprnl us guided","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37294","name":"Rvsc evsc tpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33901","name":"Perq p-art revsc 1 nm nt bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, bilateral","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9003","name":"Leupro inj, camcevi etm, 1mg","description":"Leuprolide injectable (camcevi etm), 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6559","name":"G stckng full/chap18-30 cust","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5931","name":"Surgical obturator","description":"Obturator prosthesis surgical","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37284","name":"Revsc evasc tpvt st sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38225","name":"Car-t hrv bld-drv t lymphcyt","description":"Chimeric antigen receptor t-cell (car-t) therapy; harvesting of blood-derived t lymphocytes for development of genetically modified autologous car-t cells, per day","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4313","name":"Dermabind fm, per sq cm","description":"Dermabind fm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83013","name":"H pylori (c-13) breath","description":"Helicobacter pylori; breath test analysis for urease activity, non-radioactive isotope (eg, c-13)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7353","name":"Anacaulase-bcdb 8.8% gel 1 g","description":"Anacaulase-bcdb, 8.8% gel, 1 gram","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0484U","name":"Nfct ds mgen 23s rrna pt mut","description":"Nfct ds mgen 23s rrna pt mut","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0689T","name":"Quan us tis charac w/o dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained without diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93569","name":"Njx cth slct p-art angrp uni","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7165","name":"Inj, human-lans, per i.u","description":"Injection, prothrombin complex concentrate, human-lans, per i.u. of factor ix activity","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0342U","name":"Onc pncrtc ca mult ia eclia","description":"Onc pncrtc ca mult ia eclia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5125","name":"Inj, releuko 1 mcg","description":"Injection, filgrastim-ayow, biosimilar, (releuko), 1 microgram","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86317","name":"Immunoassay infectious agent","description":"Immunoassay for infectious agent antibody, quantitative, not otherwise specified","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0313U","name":"Onc pncrs dna&mrna seq 74","description":"Onc pncrs dna&mrna seq 74","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54522","name":"Orchiectomy partial","description":"Orchiectomy, partial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":674.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0373","name":"Tomo bitewing image","description":"Tomo bitewing image","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57455","name":"Biopsy of cervix w/scope","description":"Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":110.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15401","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9274","name":"Inj, tebentafusp-tebn, 1 mcg","description":"Injection, tebentafusp-tebn, 1 microgram","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1224","name":"Iop dec <20% from base","description":"Intraocular pressure (iop) reduced by a value less than 20% from the pre-intervention level","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1425","name":"Surgical care mvp","description":"Surgical care mips value pathway","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90958","name":"Esrd srv 2-3 vsts p mo 12-19","description":"End-stage renal disease (esrd) related services monthly, for patients 12-19 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 2-3 face-to-face visits by a physician or other qualified health care professional per m","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":579.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76019","name":"Mr safety implt pos&/immoblj","description":"Mr safety implant positioning and/or immobilization under supervision of physician or other qualified health care professional, including application of physical protections to secure implanted medical device from mr-induced translational or vibrational forces, magnetically induced functional change","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33903","name":"Perq p-art revsc 1 abnor bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, bilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":477.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64912","name":"Nrv rpr w/nrv algrft 1st","description":"Nerve repair; with nerve allograft, each nerve, first strand (cable)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98986","name":"Rtm dev sply cbt 2-15 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of cognitive behavioral therapy, 2-15 days in a 30-day period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37293","name":"Rvsc evsc tpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0903T","name":"Ecg alg 12 lead reduced i&r","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; with interpretation and report","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11470","name":"Exc skn h/p/p/u smpl/ntrm","description":"Excision of skin and subcutaneous tissue for hidradenitis, perianal, perineal, or umbilical; with simple or intermediate repair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4300","name":"Acesso tl, per sq cm","description":"Acesso tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0563","name":"Sbrt w/positron emission del","description":"Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance and real-time positron emissions-based delivery adjustments to 1 or more lesions, entire course not to exceed 5 fractions","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9156","name":"Oral mucoadhesive per 1 ml","description":"Oral mucoadhesive, any type (liquid, gel, paste, etc.), per 1 ml","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94617","name":"Exercise tst brncspsm w/ecg","description":"Exercise test for bronchospasm, including pre- and post-spirometry and pulse oximetry; with electrocardiographic recording(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97551","name":"Caregiver traing ea addl 15","description":"Caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patie","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17003","name":"Destruct premalg les 2-14","description":"Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (eg, actinic keratoses); second through 14 lesions, each (list separately in addition to code for first lesion)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":6.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1357","name":"Pt w/red suic idea 120 days","description":"Patients who had a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0791T","name":"Motr cog vr gait train ea 15","description":"Motor-cognitive, semi-immersive virtual reality-facilitated gait training, each 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0418U","name":"Onc brst aug alg aly whl sl8","description":"Onc brst aug alg aly whl sl8","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0874T","name":"Rmvl pertl ascites pmp sys","description":"Removal of a peritoneal ascites pump system, including implanted peritoneal ascites pump and indwelling bladder and peritoneal catheters","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1344","name":"No bsln/2nd pam score 4-12mo","description":"Patients who did not have a baseline pam score and/or a second score within 4 to 12 months of baseline pam score","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0762T","name":"Dgtz gls mcrscp sl imm ea m","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, each multiplex antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4000","name":"Dermatology ss","description":"Dermatology mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0958T","name":"Rmv s-sclp eltr ra rcvr&tlmt","description":"Removal of sub-scalp implanted electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0941T","name":"Cysto flx ins&xpns urtl scaf","description":"Cystourethroscopy, flexible; with insertion and expansion of prostatic urethral scaffold using integrated cystoscopic visualization","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1422","name":"Gastroenterology care mvp","description":"Gastroenterology care mips value pathway","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0023","name":"Pin service 60m per month","description":"Principal illness navigation services by certified or trained auxiliary personnel under the direction of a physician or other practitioner, including a patient navigator; 60 minutes per calendar month, in the following activities:  person-centered assessment, performed to better understand the indiv","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3911","name":"Intraorifice barrier","description":"Intraorifice barrier","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0928T","name":"Rem interrog dev ccm-d phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system with interim analysis and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4419","name":"Biolab wrap flw lt per sq cm","description":"Biolab membrane wrap lite flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4000","name":"Dermatology ss","description":"Dermatology mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76987","name":"Dx intraop epicar car us chd","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; including placement and manipulation of transducer, image acquisition, interpretation and report","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0799","name":"Hiv prep, fda approved, noc","description":"Fda approved prescription drug, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv), not otherwise classified","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3244","name":"Inj. tigecycline (accord)","description":"Injection, tigecycline (accord), not therapeutically equivalent to j3243, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0101","name":"Ca screen;pelvic/breast exam","description":"Cervical or vaginal cancer screening; pelvic and clinical breast examination","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":28.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0861T","name":"Rmvl pg wcs lv both compnt","description":"Removal of pulse generator for wireless cardiac stimulator for left ventricular pacing; both components (battery and transmitter)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87184","name":"Sc std disk method per plate","description":"Susceptibility studies, antimicrobial agent; disk method, per plate (12 or fewer agents)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98014","name":"Synch audio-only est mod 30","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code s","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0946T","name":"Ortho impl mvmt alys pair ct","description":"Orthopedic implant movement analysis using paired computed tomography (ct) examination of the target structure, including data acquisition, data preparation and transmission, interpretation and report (including ct scan of the joint or extremity performed with paired views)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0786T","name":"Insj/rplcmt prq ra sac nstim","description":"Insertion or replacement of percutaneous electrode array, sacral, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6037","name":"Postop dsg cast chg handfing","description":"Immediate post-surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, partial hand including fingers","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0558U","name":"Onc clrct elisa bf7 ag serum","description":"Onc clrct elisa bf7 ag serum","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1359","name":"Indx suicd idea, no 0 scr","description":"Index assessment during the denominator period when the suicidal ideation and/or behavior symptoms or increased suicide risk by clinician determination occurs and a non-zero c-ssrs score is obtained","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0785T","name":"Revj/rmvl nea spi w/nstim","description":"Revision or removal of neurostimulator electrode array, spinal, with integrated neurostimulator","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81354","name":"Cytog alys chrml abnor ogm","description":"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of structural and copy number variants, optical genome mapping (ogm)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9603","name":"Inj, pafolacianine, 0.1 mg","description":"Injection, pafolacianine, 0.1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0539","name":"Initial care training 30 m","description":"Caregiver training in behavior management/modification for caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face; initial 30 minutes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0166","name":"Inj epinephrine (bpi)","description":"Injection, epinephrine (bpi), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0792T","name":"Appl slvr diamn fluoride 38%","description":"Application of silver diamine fluoride 38%, by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82784","name":"Assay iga/igd/igg/igm each","description":"Gammaglobulin (immunoglobulin); iga, igd, igg, igm, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83529","name":"Asay of interleukin-6 (il-6)","description":"Interleukin-6 (il-6)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0853T","name":"Dgtz gls mcrscp mphmtrc ea m","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37269","name":"Revsc evasc fpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6564","name":"G com stckng waist 40+ cust","description":"Gradient compression stocking, waist length, 40 mmhg or greater, custom, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":1093.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0047","name":"Ped blunt hd traum","description":"Pediatric patient with minor blunt head trauma and pecarn prediction criteria are not assessed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1180","name":"Pt imm ckpt inhib therapy","description":"Patients on immune checkpoint inhibitor therapy","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59841","name":"Induced abortion dilat&evac","description":"Induced abortion, by dilation and evacuation","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":494.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":391.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0874T","name":"Rmvl pertl ascites pmp sys","description":"Removal of a peritoneal ascites pump system, including implanted peritoneal ascites pump and indwelling bladder and peritoneal catheters","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8501","name":"Oral aprepitant","description":"Aprepitant, oral, 5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6564","name":"G com stckng waist 40+ cust","description":"Gradient compression stocking, waist length, 40 mmhg or greater, custom, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1471","name":"Ffs hep b not covered","description":"Documentation that patient is a medicare fee-for-service beneficiary and without additional supplementary insurance coverage for whom hep b vaccination is not reimbursable under current medicare part b coverage rules","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76815","name":"Ob us limited fetus(s)","description":"Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51721","name":"Ins trurl ablt trnsdc thr us","description":"Insertion of transurethral ablation transducer for delivery of thermal ultrasound for prostate tissue ablation, including suprapubic tube placement during the same session and placement of an endorectal cooling device, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33281","name":"Reposg phrnc nrv stim trnsvn","description":"Repositioning of phrenic nerve stimulator transvenous lead(s)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4283","name":"Biovance tri or 3l, sq cm","description":"Biovance tri-layer or biovance 3l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0887T","name":"End-tidal ctrl inhaled anes","description":"End-tidal control of inhaled anesthetic agents and oxygen to assist anesthesia care delivery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0543U","name":"Onc sol tum ngs dna 517 gens","description":"Onc sol tum ngs dna 517 gens","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0679T","name":"Laps rmvl lead isdss","description":"Laparoscopic removal of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9997","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21123","name":"Geniop sldg augmentation","description":"Genioplasty; sliding, augmentation with interpositional bone grafts (includes obtaining autografts)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99215","name":"Office o/p est hi 40 min","description":"Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 40 minutes must be met or ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":122.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9268","name":"Programmer orally ingest cap","description":"Programmer for transient, orally ingested capsule","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0940T","name":"Xtrnl ecg rec>15d<30d r&i","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87469","name":"Babesia microti amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); babesia microti, amplified probe technique","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0019M","name":"Cv ds plasma alys prtn bmrk","description":"Cardiovascular disease, plasma, analysis of protein biomarkers by aptamer-based microarray and algorithm reported as 4-year likelihood of coronary event in high-risk populations","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0681T","name":"Rlcj pulse gen only isdss","description":"Relocation of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing dual leads","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4017","name":"Nutrition/dietician ss","description":"Nutrition/dietician mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54520","name":"Removal of testis","description":"Orchiectomy, simple (including subcapsular), with or without testicular prosthesis, scrotal or inguinal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76018","name":"Mr safety implant elec prepj","description":"Mr safety implant electronics preparation under supervision of physician or other qualified health care professional, including mr-specific programming of pulse generator and/or transmitter to verify device integrity, protection of device internal circuitry from mr electromagnetic fields, and protec","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1396","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9888","name":"5% wl maintnd from bsline wt","description":"Maintenance 5% wl from baseline weight in months 7-12","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4402","name":"Xwrap 2.0 per sq cm","description":"Xwrap 2.0, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61889","name":"Ins sk-mnt crnl nstm pg/rcvr","description":"Insertion of skull-mounted cranial neurostimulator pulse generator or receiver, including craniectomy or craniotomy, when performed, with direct or inductive coupling, with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1365","name":"Hosp+pall care spec code 17","description":"Patient encounter during the performance period with hospice and palliative care specialty code 17","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0582","name":"Bivalirudin (endo) 1 mg","description":"Injection, bivalirudin (endo), not therapeutically equivalent to j0583, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22112","name":"Remove part thorax vertebra","description":"Partial excision of vertebral body, for intrinsic bony lesion, without decompression of spinal cord or nerve root(s), single vertebral segment; thoracic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1123.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4339","name":"Artacent vericlen, per sq cm","description":"Artacent vericlen, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0808T","name":"Pulm tiss vntj alys w/ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with computed tomography (ct) images taken for the purpose of pulmonary tissue ventilation analysis, including data preparation and transmission, quantificati","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0838T","name":"Dgtz gls mcrscp cslt sld els","description":"Digitization of glass microscope slides for consultation and report on referred slides prepared elsewhere (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1098","name":"Articaine ophthalmi 8% 0.4ml","description":"Articaine ophthalmic, 8% solution, 0.4 ml","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0402U","name":"Nfct agt sti mult amp prb tq","description":"Nfct agt sti mult amp prb tq","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67923","name":"Repair eyelid defect","description":"Repair of entropion; excision tarsal wedge","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":495.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2030","name":"Miro3d fibers, per mg","description":"Miro3d fibers, per milligram","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0257U","name":"Vlcad leuk nzm actv whl bld","description":"Very long chain acyl- coenzyme a (coa) dehydrogenase (vlcad), leukocyte enzyme activity, whole blood","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29883","name":"Arthrs kne srg mnisc rpr m&l","description":"Arthroscopy, knee, surgical; with meniscus repair (medial and lateral)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1005.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59820","name":"Care of miscarriage","description":"Treatment of missed abortion, completed surgically; first trimester","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":414.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1441","name":"Init dx slp apn = 1st enc","description":"Encounter corresponds to initial diagnosis of sleep apnea or first contact with sleep apnea diagnosed patient","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0514U","name":"Gi ibd ia quan deter adl lvl","description":"Gi ibd ia quan deter adl lvl","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5228","name":"Immed mand part denture","description":"Immed mand part denture","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85041","name":"Automated rbc count","description":"Blood count; red blood cell (rbc), automated","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1420","name":"Complete ophthalmologic mvp","description":"Complete ophthalmologic care mips value pathway","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95782","name":"Polysom <6 yrs 4/> paramtrs","description":"Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1183.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0534U","name":"Onc prst8 mirna snp 32 vrnt","description":"Onc prst8 mirna snp 32 vrnt","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0493U","name":"Trnspl med quan dd-cfdna ngs","description":"Trnspl med quan dd-cfdna ngs","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2044","name":"Biobrane glove, each","description":"Biobrane glove, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80505","name":"Path clin consltj high 41-60","description":"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patients history and medical records and high level of medical decision making when using time for code selection, 41-60 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0689T","name":"Quan us tis charac w/o dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained without diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38790","name":"Inject for lymphatic x-ray","description":"Injection procedure; lymphangiography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4311","name":"Acesso, per sq cm","description":"Acesso, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37274","name":"Rvsc evsc fpvt athrc cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5933","name":"Refitting of obturator","description":"Obturator prosthesis modification","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71048","name":"X-ray exam chest 4+ views","description":"Radiologic examination, chest; 4 or more views","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3055","name":"Inj talquetamab-tgvs 0.25 mg","description":"Injection, talquetamab-tgvs, 0.25 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1426","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6525","name":"G com garm lwrleg/ft ngt cus","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, custom, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0954T","name":"Tot impl amei rplc snd proc","description":"Totally implantable active middle ear hearing implant; replacement of sound processor only, with attachment to existing transducers","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1423","name":"Opt care urologic cnd mvp","description":"Optimal care for patients with urologic conditions mips value pathway","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1709","name":"Pfizer vaccine admin booster","description":"Pfizer vaccine admin booster","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93573","name":"Njx cath slct p-art angrp bi","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, bilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49592","name":"Rpr aa hrn 1st < 3 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9024","name":"Inj atezolizumb 5mg hya-tqjs","description":"Injection, atezolizumab, 5 mg and hyaluronidase-tqjs","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0759T","name":"Dgtz gls mcrscp sl sp grpiii","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group iii, for enzyme constituents (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9289","name":"Inj nivolumab 2 mg hyaluron","description":"Injection, nivolumab, 2 mg and hyaluronidase-nvhy","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99418","name":"Prolng ip/obs e/m ea 15 min","description":"Prolonged inpatient or observation evaluation and management service(s) time with or without direct patient contact beyond the required time of the primary service when the primary service level has been selected using total time, each 15 minutes of total time (list separately in addition to the cod","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37275","name":"Rvsc evsc fpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23405","name":"Incision of tendon & muscle","description":"Tenotomy, shoulder area; single tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":763.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0582","name":"Bivalirudin (endo) 1 mg","description":"Injection, bivalirudin (endo), not therapeutically equivalent to j0583, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8510","name":"Oral busulfan","description":"Busulfan; oral, 2 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33920","name":"Repair pulmonary atresia","description":"Repair of pulmonary atresia with ventricular septal defect, by construction or replacement of conduit from right or left ventricle to pulmonary artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2238.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0047","name":"Ped blunt hd traum","description":"Pediatric patient with minor blunt head trauma and pecarn prediction criteria are not assessed","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9041","name":"Albumin (human),5%, 50ml","description":"Infusion, albumin (human), 5%, 50 ml","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82666","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90964","name":"Esrd home pt serv p mo 2-11","description":"End-stage renal disease (esrd) related services for home dialysis per full month, for patients 2-11 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1354","name":"Int caries med app per tooth","description":"Interim caries med app","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1013","name":"Sign lang/oral interpreter","description":"Sign language or oral interpretive services, per 15 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2542","name":"Dental onlay metallic 2 surf","description":"Onlay-metallic-two surfaces","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0784T","name":"Ins/rplmt eltrd ra spi nstim","description":"Insertion or replacement of percutaneous electrode array, spinal, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4431","name":"Pma skin substitute, nos","description":"Pma skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0520U","name":"Ther rx mntr 200+ rx/sbsts","description":"Ther rx mntr 200+ rx/sbsts","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0667","name":"Team remote e/m est pt 25 mn","description":"Team remote e/m est. pt 25mins","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0819T","name":"Revj/rmvl ins ptn subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0681","name":"Inj ceftobipole medocarl 3mg","description":"Injection, ceftobiprole medocaril sodium, 3 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15820","name":"Blepharoplasty lower eyelid","description":"Blepharoplasty, lower eyelid;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1325","name":"Doc med rsn not seen","description":"Patients who were not seen for reasons documented by clinician for patient or medical reasons (e.g., inadequate time for follow-up, patients who received a prior intravitreal or periocular steroid injection within the last six (6) months and had a subsequent iop evaluation with iop <25mm hg within s","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2327","name":"Inj risankizumab-rzaa 1 mg","description":"Injection, risankizumab-rzaa, intravenous, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4417","name":"Alexiguard dl-t per sq cm","description":"Alexiguard dl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9913","name":"Admin of neuromod","description":"Admin of neuromod","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2956","name":"Indirect rest remov","description":"Indirect rest remov","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0660","name":"Team remote e/m new pt 10 mn","description":"Team remote e/m new pt 10mins","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4379","name":"Amniodefend ft per sq cm","description":"Amniodefend ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4385","name":"Apollo ft per sq cm","description":"Apollo ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0528","name":"Mgt est pt dem mod-hi cmplx","description":"Management of established patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47383","name":"Perq abltj lvr cryoablation","description":"Ablation, 1 or more liver tumor(s), percutaneous, cryoablation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9033.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87798","name":"Detect agent nos dna amp","description":"Infectious agent detection by nucleic acid (dna or rna), not otherwise specified; amplified probe technique, each organism","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7682","name":"Tobramycin non-comp unit","description":"Tobramycin, inhalation solution, fda-approved final product, non-compounded, unit dose form, administered through dme, per 300 milligrams","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0364U","name":"Onc hl neo gen seq alys alg","description":"Onc hl neo gen seq alys alg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0534","name":"Coordinated care/or referral","description":"Coordinated care and/or referral services, such as to adequate and accessible community resources to address unmet health-related social needs, including harm reduction interventions and recovery support services a patient needs and wishes to pursue, which significantly limit the ability to diagnose","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0549","name":"Phone/inter for treat>31m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1321","name":"Pts no 7wk inj,no iop,iop>25","description":"Patients who were not seen within 7 weeks following the date of injection for follow up or who did not have a documented iop or no plan of care documented if the iop was >25 mm hg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0549","name":"Phone/inter for treat>31m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1365","name":"Hosp+pall care spec code 17","description":"Patient encounter during the performance period with hospice and palliative care specialty code 17","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4317","name":"Vitograft, per sq cm","description":"Vitograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53452","name":"Tprnl balo cntnc dev uni","description":"Periurethral transperineal adjustable balloon continence device; unilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37273","name":"Revsc evsc fpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0817T","name":"Opn insj/rplcmt ins ptn subf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3404","name":"Inj zopapogene per ther dose","description":"Injection, zopapogene imadenovec-drba suspension, per therapeutic dose","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0461U","name":"Onc rxgenom alys rtpcr 24gen","description":"Onc rxgenom alys rtpcr 24gen","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0013","name":"Hiv prep counsel, clin staff","description":"Individual counseling for pre-exposure prophylaxis (prep) by clinical staff to prevent human immunodeficiency virus (hiv), includes: hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0491U","name":"Onc sol tum ctc slct er prtn","description":"Onc sol tum ctc slct er prtn","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37296","name":"Revsc evasc imvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1150","name":"Lvef <=40% or mod/sev l vsf","description":"Current or prior left ventricular ejection fraction (lvef) less than or equal to 40% or documentation of moderately or severely depressed left ventricular systolic function","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0892T","name":"Arhfcmrigtbs sbsq per tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent motor threshold redetermination with delivery and management, per treatment day","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0045","name":"Mrs 90 days post stk","description":"Clinical follow-up and mrs score assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72192","name":"Ct pelvis w/o dye","description":"Computed tomography, pelvis; without contrast material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5931","name":"Surgical obturator","description":"Obturator prosthesis surgical","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0136","name":"Adm of pa/n assess 5-15 m","description":"Administration of a standardized, evidence-based assessment of physical activity and nutrition, 5-15 minutes, not more often than every 6 months","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49613","name":"Rpr aa hrn rcr < 3 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, reducible","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88142","name":"Cytopath c/v thin layer","description":"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; manual screening under physician supervision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44955","name":"Appendectomy add-on","description":"Appendectomy; when done for indicated purpose at time of other major procedure (not as separate procedure) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33268","name":"Excl laa opn oth px any meth","description":"Exclusion of left atrial appendage, open, performed at the time of other sternotomy or thoracotomy procedure(s), any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4396","name":"Natalin per sq cm","description":"Natalin, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45337","name":"Sigmoidoscopy & decompress","description":"Sigmoidoscopy, flexible; with decompression (for pathologic distention) (eg, volvulus, megacolon), including placement of decompression tube, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6517","name":"Grad com wrap w strap bn cus","description":"Gradient compression wrap with adjustable straps, below knee, each, custom","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1483.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0368","name":"Cone beam ct interprete tmj","description":"Cone beam ct interprete tmj","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0743T","name":"B1 str & fx rsk vrt fx assmt","description":"Bone strength and fracture risk using finite element analysis of functional data and bone mineral density (bmd), with concurrent vertebral fracture assessment, utilizing data from a computed tomography scan, retrieval and transmission of the scan data, measurement of bone strength and bmd and classi","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0062","name":"Audiology ss","description":"Audiology mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1153","name":"Pt w/ dx osteo doe","description":"Patient with diagnosis of osteoporosis on date of encounter","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0561","name":"Temp tube delivery, unil","description":"Tympanostomy with local or topical anesthesia and insertion of a ventilating tube when performed with tympanostomy tube delivery device, unilateral (list separately in addition to 69433) (do not use in conjunction with 0583t)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98012","name":"Synch audio-only est sf 10","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75580","name":"N-invas est c ffr sw aly cta","description":"Noninvasive estimate of coronary fractional flow reserve (ffr) derived from augmentative software analysis of the data set from a coronary computed tomography angiography, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0970T","name":"Ablt b9 brst tum perq lsr ea","description":"Ablation, benign breast tumor (eg, fibroadenoma), percutaneous, laser, including imaging guidance when performed, each tumor","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64897","name":"Nrv grf mltst arm/leg <4 cm","description":"Nerve graft (includes obtaining graft), multiple strands (cable), arm or leg; up to 4 cm length","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1414.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6524","name":"G com garmnt lwr leg/ft nght","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":383.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69209","name":"Remove impacted ear wax uni","description":"Removal impacted cerumen using irrigation/lavage, unilateral","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0313U","name":"Onc pncrs dna&mrna seq 74","description":"Onc pncrs dna&mrna seq 74","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87086","name":"Urine culture/colony count","description":"Culture, bacterial; quantitative colony count, urine","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9887","name":"Distance learning attendance","description":"Behavioral counseling for diabetes prevention, distance learning, 60 minutes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5137","name":"Inj, wezlana, sub cu, 1 mg","description":"Injection, ustekinumab-auub (wezlana), biosimilar, subcutaneous, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93793","name":"Anticoag mgmt pt warfarin","description":"Anticoagulant management for a patient taking warfarin, must include review and interpretation of a new home, office, or lab international normalized ratio (inr) test result, patient instructions, dosage adjustment (as needed), and scheduling of additional test(s), when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4348","name":"Sentry sl matrix per sq cm","description":"Sentry sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11000","name":"Dbrdmt ecz/infected skin<10%","description":"Debridement of extensive eczematous or infected skin; up to 10% of body surface","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":67.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2371","name":"Inj phenylephrine hcl 20 mcg","description":"Injection, phenylephrine hydrochloride, 20 micrograms","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0890T","name":"Arhfcmrigtbs 1st tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including target assessment, initial motor threshold determination, neuronavigation, delivery and management, initial treatment day","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3475","name":"Inj magnesium sulfate","description":"Injection, magnesium sulfate, per 500 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2009","name":"Symphony, per sq cm","description":"Symphony, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"Motor &/ sens nrve cndj test","description":"Motor and/or sensory nerve conduction, using preconfigured electrode array(s), amplitude and latency/velocity study, each limb, includes f-wave study when performed, with interpretation and report","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0895","name":"Deferoxamine mesylate inj","description":"Injection, deferoxamine mesylate, 500 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0430U","name":"Gi malabs aat calpro pncrtc","description":"Gi malabs aat calpro pncrtc","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4367","name":"Amniocore sl, per sq cm","description":"Amniocore sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2390","name":"Ant resin-based cmpst crown","description":"Resin-based composite crown anterior","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31382","name":"Partial removal of larynx","description":"Partial laryngectomy (hemilaryngectomy); antero-latero-vertical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1975.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0446","name":"Intens behave ther cardio dx","description":"Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":29.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K1007","name":"Bil hkaf pc s/d micro sensor","description":"Bilateral hip, knee, ankle, foot device, powered, includes pelvic component, single or double upright(s), knee joints any type, with or without ankle joints any type, includes all components and accessories, motors, microprocessors, sensors","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95081.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1350","name":"Pt w/ suic saf pln init rev","description":"Patients who had a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64728","name":"Dcmprn median nrv carpl tunl","description":"Decompression; median nerve at the carpal tunnel, percutaneous, with intracarpal tunnel balloon dilation, including ultrasound guidance","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55714","name":"Bx prst8 in-bore ct/mri 1","description":"Biopsy, prostate, in-bore ct- or mri-guided targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75889","name":"Vein x-ray liver w/hemodynam","description":"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93584","name":"Vngrph chd anom/persist svc","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; anomalous or persistent superior vena cava when it exists as a second contralateral superior vena cava, with native drainage to heart (list separately in addition to code for pri","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0804T","name":"Prgrmg evl ldls pm 2chmbr ip","description":"Programming device evaluation (in person) with iterative adjustment of implantable device to test the function of device and to select optimal permanent programmed values, with analysis, review, and report, by a physician or other qualified health care professional, leadless pacemaker system in dual","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76819","name":"Fetal biophys profil w/o nst","description":"Fetal biophysical profile; without non-stress testing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D8091","name":"Compre ortho treat w surg","description":"Compre ortho treat w surg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1302","name":"Scrn mam perf rslts doc","description":"Screening, diagnostic, film digital or digital breast tomosynthesis (3d) mammography results documented and reviewed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1226","name":"Iop not doc","description":"Iop measurement not documented, reason not otherwise specified","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2057","name":"Afamitresgene autoleucel","description":"Afamitresgene autoleucel, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82948","name":"Reagent strip/blood glucose","description":"Glucose; blood, reagent strip","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5158","name":"Inj, denosumab-bnht, 1 mg","description":"Injection, denosumab-bnht (bomyntra/conexxence), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33897","name":"Perq trluml angp nt/recr coa","description":"Percutaneous transluminal angioplasty of native or recurrent coarctation of the aorta","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0224","name":"Pemivibart infusion","description":"Intravenous infusion, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppr","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0392U","name":"Rx metab genrx ia 16 genes","description":"Rx metab genrx ia 16 genes","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9296","name":"Inj pemetrexed (accord) 10mg","description":"Injection, pemetrexed (accord), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9938","name":"Fab removable appliance","description":"Fab removable appliance","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1480","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0367U","name":"Onc bldr 10 flwg trurl rescj","description":"Onc bldr 10 flwg trurl rescj","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0739","name":"Hiv prep, inj, cabotegravir","description":"Injection, cabotegravir, 1mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33903","name":"Perq p-art revsc 1 abnor bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, bilateral","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D8671","name":"Periodic orth treat w surg","description":"Periodic orth treat w surg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0395U","name":"Onc lng multiomics plsm alg","description":"Onc lng multiomics plsm alg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11620","name":"Exc h-f-nk-sp mal+marg 0.5/<","description":"Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 0.5 cm or less","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"Add upp ext mec limb vol lam","description":"Addition to upper extremity prosthesis, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0844T","name":"Dgtz gls mcrscp cslt cyt ea","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), each additional site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71023","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93896","name":"Vsrctv std tcd icr art compl","description":"Vasoreactivity study performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1215","name":"Med rsn for no doc spiro","description":"Documentation of medical reason(s) for not documenting and reviewing spirometry results (e.g., patients with dementia or tracheostomy)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1443","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0665","name":"Team remote e/m est pt 10 mn","description":"Team remote e/m est. pt 10mins","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0971T","name":"Ablt mal brst tum pq lsr uni","description":"Ablation, malignant breast tumor(s), percutaneous, laser, including imaging guidance when performed, unilateral","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4361","name":"Epixpress, per sq cm","description":"Epixpress, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1238","name":"Doc 2nd recom hzv 2-6 mo int","description":"Documentation that administration of second recombinant zoster vaccine could not occur during the performance period due to the recommended 2-6 month interval between doses (i.e, first dose received after october 31)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90695","name":"H5n8 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n8, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1336","name":"Pts eval ini xm 2 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 2 weeks","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0063","name":"Cardiology ss","description":"Cardiology mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4148","name":"Enteral feed elastomer daily","description":"Enteral feeding supply kit; elastomeric control fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0922T","name":"Rmvl perm ccm-d sys dual ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); dual (pacing and defibrillation) transvenous leads only","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1272","name":"Pts kid transplt wtlst","description":"Patients observed on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4398","name":"Summit ac per sq cm","description":"Summit ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37265","name":"Revsc evsc fpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9432","name":"Med food non inborn err meta","description":"Medical foods for non-inborn errors of metabolism","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7997","name":"Appliance removal","description":"Appliance removal (not by dentist who placed appliance) includes removal of archbar","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0836T","name":"Dgtz gls mcrscp fna ea addl","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0651","name":"Lso sag-co shell pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1105.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0995T","name":"Evasc dlvr a-wal stbl rx opn","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; open","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0326U","name":"Trgt gen seq alys pnl 83+","description":"Trgt gen seq alys pnl 83+","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0429U","name":"Hpv orop swab 14 hi-risk typ","description":"Hpv orop swab 14 hi-risk typ","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7997","name":"Appliance removal","description":"Appliance removal (not by dentist who placed appliance) includes removal of archbar","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87046","name":"Stool cultr aerobic bact ea","description":"Culture, bacterial; stool, aerobic, additional pathogens, isolation and presumptive identification of isolates, each plate","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37269","name":"Revsc evasc fpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87627","name":"Jt spc pthgn&rx rsist gen26+","description":"Infectious agent detection by nucleic acid (dna or rna); joint space pathogens and drug resistance genes, multiplex amplified probe technique, 26 or more targets","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0917T","name":"Insj perm ccm-d sys 1 lead","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; single transvenous lead (pacing or defibrillation) only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0356U","name":"Onc orop 17 dna ddpcr alg","description":"Onc orop 17 dna ddpcr alg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93146","name":"Interrog crtd sins bat ip w/","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35372","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; deep (profunda) femoral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1282.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53865","name":"Cysto insj dev ischmc rmdlg","description":"Cystourethroscopy with insertion of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7284","name":"Exc biopsy of saliv glands","description":"Exc biopsy of saliv glands","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0690T","name":"Quan us tis charac w/dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained with diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89310","name":"Semen analysis w/count","description":"Semen analysis; motility and count (not including huhner test)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2642","name":"Dental onlay porcelin 2 surf","description":"Onlay - porcelain/ceramic - two surfaces","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93584","name":"Vngrph chd anom/persist svc","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; anomalous or persistent superior vena cava when it exists as a second contralateral superior vena cava, with native drainage to heart (list separately in addition to code for pri","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1260","name":"Pt not doc <= 1 yr dialysis","description":"Patient status not documented within the first year of initiating dialysis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81517","name":"Liver ds alys 3 bmrk srm alg","description":"Liver disease, analysis of 3 biomarkers (hyaluronic acid [ha], procollagen iii amino terminal peptide [piiinp], tissue inhibitor of metalloproteinase 1 [timp-1]), using immunoassays, utilizing serum, prognostic algorithm reported as a risk score and risk of liver fibrosis and liver-related clinical ","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2865","name":"Inj sulfameth/trim 5 mg/1 mg","description":"Injection, sulfamethoxazole 5 mg and trimethoprim 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0167","name":"Inj epinephrine (hospira)","description":"Injection, epinephrine (hospira), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0037","name":"Pt not able to participate","description":"On date of encounter, patient is not able to participate in assessment or screening, including non-verbal patients, delirious, severely aphasic, severely developmentally delayed, severe visual or hearing impairment and for those patients, no knowledgeable informant available","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9063","name":"Inj, elahere, 1 mg","description":"Injection, mirvetuximab soravtansine-gynx, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4362","name":"Cygnus disk, per sq cm","description":"Cygnus disk, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69020","name":"Drg xtrnl aud canal abscess","description":"Drainage external auditory canal, abscess","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1364","name":"Ascvd risk >=20pct","description":"Calculated 10-year ascvd risk score of >= 20 percent during the performance period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1362","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0865T","name":"Quan mri alys brn w/o dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion identification, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transm","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90759","name":"Hep b vac 3ag 10mcg 3 dos im","description":"Hepatitis b vaccine (hepb), 3-antigen (s, pre-s1, pre-s2), 10 mcg dosage, 3 dose schedule, for intramuscular use","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61140","name":"Burr hole/treph bx brain/les","description":"Burr hole(s) or trephine; with biopsy of brain or intracranial lesion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1384.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0870T","name":"Imp subq prtl ascts pmp sys","description":"Implantation of subcutaneous peritoneal ascites pump system, percutaneous, including pump-pocket creation, insertion of tunneled indwelling bladder and peritoneal catheters with pump connections, including all imaging and initial programming, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0525","name":"Inj cefotetan disodium 10 mg","description":"Injection, cefotetan disodium, 10 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1221","name":"Dre w/o rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; without evidence of retinopathy","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0817T","name":"Opn insj/rplcmt ins ptn subf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94617","name":"Exercise tst brncspsm w/ecg","description":"Exercise test for bronchospasm, including pre- and post-spirometry and pulse oximetry; with electrocardiographic recording(s)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64886","name":"Nerve graft head/neck >4 cm","description":"Nerve graft (includes obtaining graft), head or neck; more than 4 cm length","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1624.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4405","name":"Xwrap fenestra plus sq cm","description":"Xwrap fenestra plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33901","name":"Perq p-art revsc 1 nm nt bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, bilateral","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4319","name":"Sanograft, per sq cm","description":"Sanograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0467U","name":"Onc bldr dna ngs 60gen&aneup","description":"Onc bldr dna ngs 60gen&aneup","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64474","name":"Lwr xtr fscl pln blk uni nfs","description":"Lower extremity fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J0395","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5150","name":"Inj, aflibercept-mrbb, 1 mg","description":"Injection, aflibercept-mrbb (ahzantive), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4298","name":"Amniocore pro, per sq cm","description":"Amniocore pro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6251","name":"Bridge resin base metal","description":"Pontic-resin with predominantly base metal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44207","name":"L colectomy/coloproctostomy","description":"Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1999.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1098","name":"Articaine ophthalmi 8% 0.4ml","description":"Articaine ophthalmic, 8% solution, 0.4 ml","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24586","name":"Optx partclr fx&/dislc elbow","description":"Open treatment of periarticular fracture and/or dislocation of the elbow (fracture distal humerus and proximal ulna and/or proximal radius);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1323.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0911T","name":"Elec aly nstm sys vgs nrv wo","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; without programming by physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7521","name":"Incision/drain abscess extra","description":"Incision and drainage of abscess - extraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1188","name":"Pt w/ ckd stg 5","description":"Patients with a diagnosis of chronic kidney disease (ckd) stage 5","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0877T","name":"Augmnt alys ch ct ild w/o ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0523","name":"Mgt nw pt dem mod-high cmplx","description":"Management of a new patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0483U","name":"Nfct ds ng gyra s91f pt mut","description":"Nfct ds ng gyra s91f pt mut","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4327","name":"Duoamnion, per sq cm","description":"Duoamnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0029","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34490","name":"Removal of vein clot","description":"Thrombectomy, direct or with catheter; axillary and subclavian vein, by arm incision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":745.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1301","name":"Immunization counseling","description":"Immunization counseling","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98009","name":"Synch audio-only new low 30","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 30 m","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2998","name":"Inj plasminogen tvmh 1mg","description":"Injection, plasminogen, human-tvmh, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49596","name":"Rpr aa hrn 1st > 10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0961T","name":"Shortwave ifr radiation img","description":"Shortwave infrared radiation imaging, surgical pathology specimen, to assist gross examination for lymph node localization in fibroadipose tissue, per specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80503","name":"Path clin consltj sf 5-20","description":"Pathology clinical consultation; for a clinical problem, with limited review of patients history and medical records and straightforward medical decision making when using time for code selection, 5-20 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72265","name":"Myelography l-s spine","description":"Myelography, lumbosacral, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4296","name":"Rebound matrix, per sq cm","description":"Rebound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1171","name":"Pt recd 1 td/tdap 9yrs prior","description":"Patient received at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31590","name":"Reinnervate larynx","description":"Laryngeal reinnervation by neuromuscular pedicle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1078.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0013","name":"Esketamine, nasal spray","description":"Esketamine, nasal spray, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0569","name":"Subs psych care mng, subs mo","description":"Subsequent psychiatric collaborative care management, in a subsequent month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required elements: tracking ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86701","name":"Hiv-1antibody","description":"Antibody; hiv-1","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1466","name":"Pt disc/lam proc same day","description":"Patient had a lumbar fusion on the same date as the discectomy/laminectomy procedure","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51710","name":"Change of bladder tube","description":"Change of cystostomy tube; complicated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0813T","name":"Egd vol adjmt bariatric balo","description":"Esophagogastroduodenoscopy, flexible, transoral, with volume adjustment of intragastric bariatric balloon","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6089","name":"Access/retorq implant screw","description":"Access/retorq implant screw","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0901T","name":"Plmt bone marrow smplg port","description":"Placement of bone marrow sampling port, including imaging guidance when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45346","name":"Sigmoidoscopy w/ablation","description":"Sigmoidoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2369.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":137.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75553","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":693.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43231","name":"Esophagoscop ultrasound exam","description":"Esophagoscopy, flexible, transoral; with endoscopic ultrasound examination","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4271","name":"Complete ft per sq cm","description":"Complete ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0586U","name":"Onc mrna gen xprsn 216 genes","description":"Onc mrna gen xprsn 216 genes","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63287","name":"Bx/exc idrl imed lesn thrlmb","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, thoracolumbar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3047.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2406","name":"Injection, oritavancin 10 mg","description":"Injection, oritavancin (kimyrsa), 10 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4416","name":"Alexiguard tl-t per sq cm","description":"Alexiguard tl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1227","name":"Eb therapy prescribed","description":"Evidence-based therapy was prescribed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4278","name":"Epieffect, per sq cm","description":"Epieffect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1258","name":"Cvd risk assess perf","description":"Cvd risk assessment performed, have a documented calculated risk score","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0975T","name":"Slctv nzmtc dbrdmt s/n/hf 1","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; first 100 sq cm","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0447U","name":"Ai ds sle alys 11 cytokine","description":"Ai ds sle alys 11 cytokine","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0937T","name":"Xtrnl ecg rec>15d<30d","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; including recording, scanning analysis with report, review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44346","name":"Revision of colostomy","description":"Revision of colostomy; with repair of paracolostomy hernia (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1176.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0717T","name":"Adrc ther prtl rc tear","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; adipose tissue harvesting, isolation and preparation of harvested cells, including incubation with cell dissociation enzymes, filtration, washing, and concentration of adrcs","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0502","name":"Other oral pathology procedu","description":"Other oral pathology procedures by report","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1309","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3421","name":"Root surgery bicuspid","description":"Apicoectomy/periradicular surgery-bicuspid (first root)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4399","name":"Summit fx per sq cm","description":"Summit fx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2401","name":"Chloroprocaine hcl injection","description":"Injection, chloroprocaine hydrochloride, per 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3471","name":"Surg rep root res anterior","description":"Surg rep root res anterior","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J3365","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1424","name":"Pulmonology care mvp","description":"Pulmonology care mips value pathway","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1182","name":"Not elg pre ex ibd/uc/crohn","description":"Patients not eligible due to pre-existing inflammatory bowel disease (ibd) (e.g., ulcerative colitis, crohns disease)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55707","name":"Bx prst8 trct us guided","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11770","name":"Exc pilonidal cyst simple","description":"Excision of pilonidal cyst or sinus; simple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1312","name":"No pt tbco scrn rng","description":"Patient not screened for tobacco use","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1378","name":"Med rsn no 10 yr fu colscope","description":"Documentation of medical reason(s) for not recommending a 10 year follow-up interval (e.g., inadequate prep, familial or personal history of colonic polyps, patient had no adenoma and age is >= 66 years old, or life expectancy < 10 years, other medical reasons)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0752T","name":"Dgtz gls mcrscp sld lvl iii","description":"Digitization of glass microscope slides for level iii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84431","name":"Thromboxane urine","description":"Thromboxane metabolite(s), including thromboxane if performed, urine","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93587","name":"Vngrph chd vnvn cltrl at/abv","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating at or above the heart (eg, from innominate vein) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"Evoked auditory test limited","description":"Distortion product evoked otoacoustic emissions; limited evaluation (to confirm the presence or absence of hearing disorder, 3-6 frequencies) or transient evoked otoacoustic emissions, with interpretation and report","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57530","name":"Removal of cervix","description":"Trachelectomy (cervicectomy), amputation of cervix (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":393.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4323","name":"Splint extra-coronal","description":"Splint extra-coronal","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1252","name":"Pts no cmplt hu survey","description":"Patients who did not complete at least one of the four patient experience hu survey items and return the hu survey within 60 days of the ambulatory palliative care visit","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4260","name":"Signature apatch, per sq cm","description":"Signature apatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0796T","name":"Tcat ins 2chmbr ldls pm ra","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right atrial pacemaker","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27230","name":"Treat thigh fracture","description":"Closed treatment of femoral fracture, proximal end, neck; without manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":526.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67010","name":"Partial removal of eye fluid","description":"Removal of vitreous, anterior approach (open sky technique or limbal incision); subtotal removal with mechanical vitrectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":558.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4360","name":"Amchoplast fd per sq cm","description":"Amchoplast fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1402","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1173","name":"Pt no rec td/tdap 9yrs prior","description":"Patient did not receive at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0504U","name":"Nfct ds uti id 17 path orgs","description":"Nfct ds uti id 17 path orgs","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2029","name":"Mirotract matrix sheet","description":"Mirotract wound matrix sheet, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1120","name":"Acetazolamid sodium injectio","description":"Injection, acetazolamide sodium, up to 500 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0787T","name":"Revj/rmvl nea sac w/nstim","description":"Revision or removal of neurostimulator electrode array, sacral, with integrated neurostimulator","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0716T","name":"Car acous wavfrm rec cad rsk","description":"Cardiac acoustic waveform recording with automated analysis and generation of coronary artery disease risk score","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0722T","name":"Quan ct tiss charac w/ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained with concurrent ct examination of any structure contained in the concurrently acquired diagnostic imaging dataset (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6251","name":"Bridge resin base metal","description":"Pontic-resin with predominantly base metal","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6035","name":"Prosthetic digit mechanical","description":"Single prosthetic digit, mechanical, can include metacarpophalangeal (mcp), proximal interphalangeal (pip), and/or distal interphalangeal (dip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1167","name":"Hspc dur meas pd","description":"In hospice or using hospice services during the measurement period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41825","name":"Excision of gum lesion","description":"Excision of lesion or tumor (except listed above), dentoalveolar structures; without repair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85175","name":"Blood clot lysis time","description":"Clot lysis time, whole blood dilution","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0296","name":"Visit to determ ldct elig","description":"Counseling visit to discuss need for lung cancer screening using low dose ct scan (ldct) (service is for eligibility determination and shared decision making)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":32.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2013","name":"Innovamatrix fs, per sq cm","description":"Innovamatrix fs, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0902T","name":"Qtc ntrvl augmnt alg aly ecg","description":"Qtc interval derived by augmentative algorithmic analysis of input from an external, patient-activated mobile ecg device","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45346","name":"Sigmoidoscopy w/ablation","description":"Sigmoidoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2959.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":166.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0114","name":"Fern test","description":"Fern test","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0994T","name":"Evasc dlvr a-wal stbl rx prq","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; percutaneous","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0549U","name":"Onc urthl dna mthyltd rt pcr","description":"Onc urthl dna mthyltd rt pcr","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84153","name":"Assay of psa total","description":"Prostate specific antigen (psa); total","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0552","name":"Supply of digital device","description":"Supply of digital mental health treatment device and initial education and onboarding, per course of treatment that augments a behavioral therapy plan","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2038","name":"Skill train and dev/diem","description":"Skills training and development, per diem","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4412","name":"Choriofix per sq cm","description":"Choriofix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84485","name":"Assay duodenal fluid trypsin","description":"Trypsin; duodenal fluid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88164","name":"Cytopath tbs c/v manual","description":"Cytopathology, slides, cervical or vaginal (the bethesda system); manual screening under physician supervision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7997","name":"Appliance removal","description":"Appliance removal (not by dentist who placed appliance) includes removal of archbar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0737T","name":"Xenograft impltj artclr surf","description":"Xenograft implantation into the articular surface","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0526","name":"Est pt-cg dyad dem hig cmplx","description":"Management of established patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9393","name":"Inj, fulvestrant (teva)","description":"Injection, fulvestrant (teva), not therapeutically equivalent to j9395, 25 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0404","name":"Ekg tracing for initial prev","description":"Electrocardiogram, routine ecg with 12 leads; tracing only, without interpretation and report, performed as a screening for the initial preventive physical examination","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0525","name":"Inj cefotetan disodium 10 mg","description":"Injection, cefotetan disodium, 10 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27396","name":"Transplant of thigh tendon","description":"Transplant or transfer (with muscle redirection or rerouting), thigh (eg, extensor to flexor); single tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":740.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2390","name":"Ant resin-based cmpst crown","description":"Resin-based composite crown anterior","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4319","name":"Sanograft, per sq cm","description":"Sanograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53410","name":"Reconstruction of urethra","description":"Urethroplasty, 1-stage reconstruction of male anterior urethra","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1078.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0683","name":"App of non-sheet skin sub g","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6111","name":"Implnt/abut remov dent mand","description":"Implnt/abut remov dent mand","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1165","name":"Pt use hspc dur meas pd","description":"Patients who use hospice services any time during the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28740","name":"Fusion of foot bones","description":"Arthrodesis, midtarsal or tarsometatarsal, single joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":714.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0036","name":"Pt/ptn decln assess","description":"Patient or care partner decline assessment","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9601","name":"Flortaucipir inj 1 millicuri","description":"Flortaucipir f 18 injection, diagnostic, 1 millicurie","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0036","name":"Pt/ptn decln assess","description":"Patient or care partner decline assessment","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1388","name":"Pt doc exm rec melmn","description":"Patients with documentation of an exam performed for recurrence of melanoma","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69711","name":"Remove/repair hearing aid","description":"Removal or repair of electromagnetic bone conduction hearing device in temporal bone","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":992.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37269","name":"Revsc evasc fpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0703","name":"2d oral/facial photo image","description":"2d oral/facial photo image","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0607U","name":"Reprdtve med ema rtpcr 31bct","description":"Reprdtve med ema rtpcr 31bct","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0537U","name":"Onc clrct ca cfdna >2500 dmr","description":"Onc clrct ca cfdna >2500 dmr","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0606U","name":"Hem red cll memb do rbc oge","description":"Hem red cll memb do rbc oge","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86381","name":"Mitochondrial antibody each","description":"Mitochondrial antibody (eg, m2), each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1807","name":"Inj, ethacrynate sod, 1 mg","description":"Injection, ethacrynate sodium, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92632","name":"Hearing aid slctn svc ea add","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86317","name":"Immunoassay infectious agent","description":"Immunoassay for infectious agent antibody, quantitative, not otherwise specified","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2014","name":"Omeza collag compl 100 mg","description":"Omeza collagen matrix or omeza complete matrix, per 100 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6518","name":"Grad com wrap w strap arm cu","description":"Gradient compression wrap with adjustable straps, arm, each, custom","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1033","name":"Sv doula brth wrk per diem","description":"Services performed by a doula birth worker, per diem","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0036","name":"Pt/ptn decln assess","description":"Patient or care partner decline assessment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6192","name":"Semi precision attachment","description":"Semi precision attachment","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8611","name":"Oral methotrexate (jylamvo)","description":"Methotrexate (jylamvo), oral, 2.5 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1502","name":"Podiatry mvp","description":"Podiatry mips value pathway","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1461","name":"Pt dx chron hepc","description":"Patient diagnosis for chronic hepatitis c","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34706","name":"Evasc rpr a-biiliac rpt","description":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-bi-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2347.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4029","name":"Preventive medicine ss","description":"Preventive medicine mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0607U","name":"Reprdtve med ema rtpcr 31bct","description":"Reprdtve med ema rtpcr 31bct","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1499","name":"Interventional radiology mvp","description":"Interventional radiology mips value pathway","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1381","name":"Pt sec strk wthin 5 days","description":"Patients with secondary stroke (e.g., a subsequent stroke that may occur with vasospasm in the setting of subarachnoid hemorrhage) within 5 days of the initial procedure","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38226","name":"Car-t prep t lymphcyt f/trns","description":"Chimeric antigen receptor t-cell (car-t) therapy; preparation of blood-derived t lymphocytes for transportation (eg, cryopreservation, storage)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45330","name":"Diagnostic sigmoidoscopy","description":"Sigmoidoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":57.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0544","name":"Post d/c phone follow up","description":"Post discharge telephonic follow-up contacts performed in conjunction with a discharge from the emergency department for behavioral health or other crisis encounter, 4 calls per calendar month","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0387","name":"Comp image capture only","description":"Comp image capture only","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"Ak 4 bar link hydl swg/stanc","description":"Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0587U","name":"Ther rx mntr 60-150rx&metabl","description":"Ther rx mntr 60-150rx&metabl","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0924T","name":"Rpos prv ccm-d trnsvns eltrd","description":"Repositioning of previously implanted cardiac contractility modulation-defibrillation transvenous electrode(s)/lead(s), including fluoroscopic guidance and programming of sensing and therapeutic parameters","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52450","name":"Transurethral inc prostate","description":"Transurethral incision of prostate","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5136","name":"Inj. denosumab-bbdz, 1 mg","description":"Injection, denosumab-bbdz (jubbonti/wyost), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96161","name":"Caregiver health risk assmt","description":"Administration of caregiver-focused health risk assessment instrument (eg, depression inventory) for the benefit of the patient, with scoring and documentation, per standardized instrument","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76015","name":"Mr sfty mplt&/fb asmt stf ea","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2030","name":"Miro3d fibers, per mg","description":"Miro3d fibers, per milligram","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64567","name":"Perq elec nrv field stimj cn","description":"Percutaneous electrical nerve field stimulation, cranial nerves, without implantation","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6601","name":"Porc/ceram inlay >= 3 surfac","description":"Inlay - porcelain/ceramic three or more surfaces","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1271","name":"Pts dem any time/dur mo","description":"Patients with dementia at any time prior to or during the month","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4292","name":"Lamellas, per sq cm","description":"Lamellas, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93575","name":"Njx cath slct p angrph mapca","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary angiography of major aortopulmonary collateral arteries (mapcas) arising off the aorta or its systemic branches, during cardiac catheterization for congenital heart d","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0908T","name":"Opn imp int nstm sys vgs nrv","description":"Open implantation of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1481","name":"Pt in hosp/pal care who died","description":"Patients receiving hospice or palliative care or who died during the measurement period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0851T","name":"Dgtz gls mcrscp mphmtrc 1st","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5161","name":"Inj, denosumab-kyqq, 1 mg","description":"Injection, denosumab-kyqq (aukelso/bosaya), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0042","name":"Ref to therapy","description":"Referral to physical, occupational, speech, or recreational therapy","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93923","name":"Upr/lxtr art stdy 3+ lvls","description":"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus segmental blood pressure measurements with bidirectional doppler wave","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2794","name":"Crown-titanium","description":"Crown-titanium","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1340","name":"Indx whodas 2.0 or sds","description":"Index assessment completed using the 12-item whodas 2.0 or sds during the denominator identification period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0597U","name":"Onc breast rna xprsn 329gens","description":"Onc breast rna xprsn 329gens","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0849T","name":"Dgtz gls mcrscp ish ea adl 1","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83805","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87070","name":"Culture othr specimn aerobic","description":"Culture, bacterial; any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0139","name":"Inj, adalimumab, 1 mg","description":"Injection, adalimumab, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"Ctlso a-p-l control custom","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37285","name":"Revsc evasc tpvt st sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0946T","name":"Ortho impl mvmt alys pair ct","description":"Orthopedic implant movement analysis using paired computed tomography (ct) examination of the target structure, including data acquisition, data preparation and transmission, interpretation and report (including ct scan of the joint or extremity performed with paired views)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0752T","name":"Dgtz gls mcrscp sld lvl iii","description":"Digitization of glass microscope slides for level iii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1273","name":"Pts snf 1 yr dialysis","description":"Patients who were admitted to a skilled nursing facility (snf) within one year of dialysis initiation according to the cms-2728 form","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1286","name":"Bmi doc onl fup not cmpltd","description":"Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0825T","name":"Tcat rmv&rpl1chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or prog","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0815T","name":"Us rems b1 dns hips plvs/spi","description":"Ultrasound-based radiofrequency echographic multi-spectrometry (rems), bone-density study and fracture-risk assessment, 1 or more sites, hips, pelvis, or spine","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0616","name":"Inj metoprolol tartrate 1 mg","description":"Injection, metoprolol tartrate, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0822T","name":"Mntr psychdlc med cln staff","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; clinical staff under the direction of a physician or other qualified health care professional, concurrent with first physician or other qualified health care p","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0570U","name":"Neurol tbi alys gfap&uch-l1","description":"Neurol tbi alys gfap&uch-l1","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53451","name":"Tprnl balo cntnc dev bi","description":"Periurethral transperineal adjustable balloon continence device; bilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9381","name":"Inj teplizumab mzwv 5 mcg","description":"Injection, teplizumab-mzwv, 5 mcg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3393","name":"Inj, betibeglogene autotemce","description":"Injection, betibeglogene autotemcel, per treatment","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1193","name":"Rpts w/ imp/con mmr/msi","description":"Surgical pathology reports that contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0787T","name":"Revj/rmvl nea sac w/nstim","description":"Revision or removal of neurostimulator electrode array, sacral, with integrated neurostimulator","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99303","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0518U","name":"Ther rx mntr 90+ pn&mtl hlth","description":"Ther rx mntr 90+ pn&mtl hlth","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93616","name":"Esophageal recording w/pacg","description":"Esophageal recording of atrial electrogram with or without ventricular electrogram(s); with pacing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0333U","name":"Onc lvr surveilanc hcc cfdna","description":"Onc lvr surveilanc hcc cfdna","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0934T","name":"Rem mntr wrls l atr prs snr","description":"Remote monitoring of a wireless left atrial pressure sensor for up to 30 days, including data from daily uploads of left atrial pressure recordings, interpretation(s) and trend analysis, with adjustments to the diuretics plan, treatment paradigm thresholds, medications or lifestyle modifications, wh","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50290","name":"Excision perinephric cyst","description":"Excision of perinephric cyst","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":994.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1378","name":"Med rsn no 10 yr fu colscope","description":"Documentation of medical reason(s) for not recommending a 10 year follow-up interval (e.g., inadequate prep, familial or personal history of colonic polyps, patient had no adenoma and age is >= 66 years old, or life expectancy < 10 years, other medical reasons)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70549","name":"Mr angiograph neck w/o&w/dye","description":"Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1221.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1811","name":"Fiasp for insulin pump use","description":"Insulin (fiasp) for administration through dme (i.e., insulin pump) per 50 units","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0441U","name":"Nfct ds bct fngl/viral semiq","description":"Nfct ds bct fngl/viral semiq","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6253","name":"Provisional pontic","description":"Provisional pontic","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6614","name":"Onlay cst nbl mtl 2 surfaces","description":"Onlay - cast noble metal two surfaces","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0134","name":"Inj acetaminophen -fresenius","description":"Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4264","name":"Cocoon membrane, per sq cm","description":"Cocoon membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0529U","name":"Hem vte snp f2&f5 gen leiden","description":"Hem vte snp f2&f5 gen leiden","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0138","name":"Inj acetaminoph 10mg/ibu 3mg","description":"Injection, acetaminophen 10 mg and ibuprofen 3 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0896T","name":"Connj lvr algrft prfu dev ea","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; each additional hour, including physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary bicarbonate, lactate ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58950","name":"Resect ovarian malignancy","description":"Resection (initial) of ovarian, tubal or primary peritoneal malignancy with bilateral salpingo-oophorectomy and omentectomy;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1217.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0526","name":"Est pt-cg dyad dem hig cmplx","description":"Management of established patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61750","name":"Incise skull/brain biopsy","description":"Stereotactic biopsy, aspiration, or excision, including burr hole(s), for intracranial lesion;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1543.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1393","name":"Pr no dx rec mlnm","description":"Patients who were not diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27720","name":"Repair of tibia","description":"Repair of nonunion or malunion, tibia; without graft, (eg, compression technique)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1059.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4294","name":"Amnio quad-core, per sq cm","description":"Amnio quad-core, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0658","name":"Seg pneum comp 2 arm chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6112","name":"Imp/abut rem dent part max","description":"Imp/abut rem dent part max","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19101","name":"Biopsy of breast open","description":"Biopsy of breast; open, incisional","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99221","name":"1st hosp ip/obs sf/low 40","description":"Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward or low level medical decision making. when using total time on the date of the encounter for code selection, ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0894T","name":"Cannulation liver allograft","description":"Cannulation of the liver allograft in preparation for connection to the normothermic perfusion device and decannulation of the liver allograft following normothermic perfusion","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11601","name":"Exc tr-ext mal+marg 0.6-1 cm","description":"Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 0.6 to 1.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7961","name":"Buccal/labial frenectomy","description":"Buccal/labial frenectomy","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98000","name":"Synch audio-video new sf 15","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 15 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4349","name":"Mantle dl matrix per sq cm","description":"Mantle dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87088","name":"Urine bacteria culture","description":"Culture, bacterial; with isolation and presumptive identification of each isolate, urine","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0404U","name":"Onc brst semiq meas thym kn","description":"Onc brst semiq meas thym kn","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1748","name":"Inj, zymfentra, 10 mg","description":"Injection, infliximab-dyyb (zymfentra), 10 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92583","name":"Select picture audiometry","description":"Select picture audiometry","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0413U","name":"Onc hl neo opt gen mapg dna","description":"Onc hl neo opt gen mapg dna","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1932","name":"Inj, lanreotide, (cipla) 1mg","description":"Injection, lanreotide, (cipla), 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0981T","name":"Tcat impl wrls ivc snr","description":"Transcatheter implantation of wireless inferior vena cava sensor for long-term hemodynamic monitoring, including deployment of the sensor, radiological supervision and interpretation, right heart catheterization, and inferior vena cava venography, when performed","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12011","name":"Rpr f/e/e/n/l/m 2.5 cm/<","description":"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":162.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0302U","name":"Iadna brtnla ddpcr flwg liq","description":"Iadna brtnla ddpcr flwg liq","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98007","name":"Synch audio-video est hi 40","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high medical decision making. when using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded.","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77423","name":"Neutron beam tx complex","description":"High energy neutron radiation treatment delivery, 1 or more isocenter(s) with coplanar or non-coplanar geometry with blocking and/or wedge, and/or compensator(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0872T","name":"Rplcmt ndwllg bldr&prtl cath","description":"Replacement of indwelling bladder and peritoneal catheters, including tunneling of catheter(s) and connection with previously implanted peritoneal ascites pump, including imaging and programming, when performed","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1396","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59350","name":"Repair of uterus","description":"Hysterorrhaphy of ruptured uterus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":306.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29730","name":"Windowing of cast","description":"Windowing of cast","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81558","name":"Trnspl rej kdn mrna qpcr 139","description":"Transplantation medicine (allograft rejection, kidney), mrna, gene expression profiling by quantitative polymerase chain reaction (qpcr) of 139 genes, utilizing whole blood, algorithm reported as a binary categorization as transplant excellence, which indicates immune quiescence, or not transplant e","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86343","name":"Leukocyte histamine release","description":"Leukocyte histamine release test (lhr)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4007","name":"General surgery ss","description":"General surgery mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92634","name":"Hearing aid fitg svc 1st 60","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; first 60 minutes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1004T","name":"Elec alys s-scl eeg wo prgrm","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; without programming","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0703","name":"2d oral/facial photo image","description":"2d oral/facial photo image","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76015","name":"Mr sfty mplt&/fb asmt stf ea","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77326","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65710","name":"Corneal transplant","description":"Keratoplasty (corneal transplant); anterior lamellar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59425","name":"Antepartum care only","description":"Antepartum care only; 4-6 visits","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":358.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":483.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0431","name":"Diag tst detect mucos abnorm","description":"Adjunctive pre-diagnostic test that aids in detection of mucosal abnormalities including premalignant and malignant lesions not to include cytology or biopsy","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5992","name":"Low prosth foot shell repl","description":"All lower extremity prosthesis, foot shell for modular foot/non-solid ankle cushion heel (sach) replacement only","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22812","name":"Arthrd ant dfrm 8+ vrt sgm","description":"Arthrodesis, anterior, for spinal deformity, with or without cast; 8 or more vertebral segments","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2629.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0238","name":"Inj, tocilizumab-aazg, hospi","description":"Injection, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4435","name":"Renati membrane per sq cm","description":"Renati membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0933T","name":"Tcat impl wrls l atr prs snr","description":"Transcatheter implantation of wireless left atrial pressure sensor for long-term left atrial pressure monitoring, including sensor calibration and deployment, right heart catheterization, transseptal puncture, imaging guidance, and radiological supervision and interpretation","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0937T","name":"Xtrnl ecg rec>15d<30d","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; including recording, scanning analysis with report, review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7511","name":"Incision/drain abscess intra","description":"Incision and drainage of abscess - intraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37271","name":"Revsc evsc fpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9993","name":"Pall serv during meas","description":"Patient was provided palliative care services any time during the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q0224","name":"Inj, pemivibart, 4500 mg","description":"Injection, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, and who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppressive ","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5142","name":"Inj adalimumab-ryvk, 1 mg","description":"Injection, adalimumab-ryvk biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0562","name":"Complex simulation w/pet-ct","description":"Therapeutic radiology simulation-aided field setting; complex, including acquisition of pet and ct imaging data required for radiopharmaceutical-directed radiation therapy treatment planning (i.e., modeling)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86160","name":"Complement antigen","description":"Complement; antigen, each component","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6280","name":"Implt maint procd remv implt","description":"Implt maint procd remv implt","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37260","name":"Revsc evasc ivt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0818T","name":"Revj/rmvl ins ptn subq","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7021","name":"Suppl and access lung expan","description":"Supplies and accessories for lung expansion airway clearance, continuous high frequency oscillation, and nebulization device (e.g., handset, nebulizer kit, biofilter)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1442","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85660","name":"Rbc sickle cell test","description":"Sickling of rbc, reduction","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95925","name":"Somatosensory testing","description":"Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in upper limbs","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1236","name":"Baseline mrs > 2","description":"Baseline mrs > 2","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0316U","name":"B brgdrferi lyme ds ospa evl","description":"B brgdrferi lyme ds ospa evl","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0525U","name":"Onc sphrd cell cul 11-rx pnl","description":"Onc sphrd cell cul 11-rx pnl","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1305","name":"Inj, evinacumab-dgnb, 5mg","description":"Injection, evinacumab-dgnb, 5mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0714T","name":"Tpla b9 prst8 hyprplsa<50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume less than 50 ml","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8541","name":"Oral, hemady, 0.25 mg","description":"Dexamethasone (hemady), oral, 0.25 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0559","name":"Unrelat prac follow up visit","description":"Post-operative follow-up visit complexity inherent to evaluation and management services addressing surgical procedure(s), provided by a physician or qualified health care professional who is not the practitioner who performed the procedure (or in the same group practice) and is of the same or of a ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61737","name":"Litt icr mlt trj mlt/cplx ls","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; multiple trajectories for multiple or complex lesion(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0568","name":"Int psych care mng, 1 cal mo","description":"Initial psychiatric collaborative care management, in the first calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required elements: outrea","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0730T","name":"Trabeculotomy lsr w/oct gdn","description":"Trabeculotomy by laser, including optical coherence tomography (oct) guidance","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0936T","name":"Photobiomodulation ther rta","description":"Photobiomodulation therapy of retina, single session","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0879T","name":"Augmnt alys ch ct ild prep","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; radiological data preparation and transmission","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0789T","name":"Elec aly cpx iins sp/sac nrv","description":"Electronic analysis with complex programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detect","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2246","name":"Inj, micafungin (baxter)","description":"Injection, micafungin in sodium (baxter), not therapeutically equivalent to j2248, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0529U","name":"Hem vte snp f2&f5 gen leiden","description":"Hem vte snp f2&f5 gen leiden","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0400U","name":"Ob xpnd car scr 145 genes","description":"Ob xpnd car scr 145 genes","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58555","name":"Hysteroscopy dx sep proc","description":"Hysteroscopy, diagnostic (separate procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":356.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27091","name":"Removal of hip prosthesis","description":"Removal of hip prosthesis; complicated, including total hip prosthesis, methylmethacrylate with or without insertion of spacer","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1815.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0741","name":"Inj, cabote rilpivir 2mg 3mg","description":"Injection, cabotegravir and rilpivirine, 2mg/3mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4148","name":"Enteral feed elastomer daily","description":"Enteral feeding supply kit; elastomeric control fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J7317","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0332U","name":"Onc pan tum gen prflg 8 dna","description":"Onc pan tum gen prflg 8 dna","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4394","name":"Surgraft aca per sq cm","description":"Surgraft aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1073","name":"Testosterone pellet 75 mg","description":"Testosterone pellet, implant, 75 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2058","name":"Obecbtge autol up to 400 mil","description":"Obecabtagene autoleucel, 10 up to 400 million cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per infusion","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90965","name":"Esrd home pt serv p mo 12-19","description":"End-stage renal disease (esrd) related services for home dialysis per full month, for patients 12-19 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85337","name":"Thrombomodulin","description":"Thrombomodulin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4009","name":"Hospitalists ss","description":"Hospitalists mips specialty set","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0957T","name":"Rev s-sclp eltr ra rcvr&tlmt","description":"Revision of sub-scalp implanted electrode array, receiver, and telemetry unit for electrode, when required, including imaging guidance","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63082","name":"Remove vertebral body add-on","description":"Vertebral corpectomy (vertebral body resection), partial or complete, anterior approach with decompression of spinal cord and/or nerve root(s); cervical, each additional segment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9609","name":"F18 fdg, 15 millicuries","description":"Fludeoxyglucose f18 up to 15 millicuries","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6193","name":"Replace implnt screw","description":"Replace implnt screw","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1322","name":"Pts 7wk inj, scrn iop =<25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop =<25 mm hg for injected eye","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64623","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0520U","name":"Ther rx mntr 200+ rx/sbsts","description":"Ther rx mntr 200+ rx/sbsts","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0664","name":"Team remote e/m new pt 60 mn","description":"Team remote e/m new pt 60mins","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0359U","name":"Onc prst8 ca alys all psa","description":"Onc prst8 ca alys all psa","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4432","name":"510(k) skin subs, nos","description":"510(k) skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33280","name":"Rmvl phrnc nrv stim pg only","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator only","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2013","name":"Innovamatrix fs, per sq cm","description":"Innovamatrix fs, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97550","name":"Caregiver traing 1st 30 min","description":"Caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patie","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9603","name":"Inj, pafolacianine, 0.1 mg","description":"Injection, pafolacianine, 0.1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4431","name":"Pma skin substitute, nos","description":"Pma skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2007","name":"Restrata, per sq cm","description":"Restrata, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1009T","name":"Rem mntr s-sclp cont eeg sys","description":"Remote monitoring of a sub-scalp implanted continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28313","name":"Repair deformity of toe","description":"Reconstruction, angular deformity of toe, soft tissue procedures only (eg, overlapping second toe, fifth toe, curly toes)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":481.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2253","name":"Inj midazolam (seizalam)","description":"Injection, midazolam (seizalam), 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31520","name":"Dx laryngoscopy newborn","description":"Laryngoscopy direct, with or without tracheoscopy; diagnostic, newborn","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0935T","name":"Cysto w/rnl pel symp dnrvtj","description":"Cystourethroscopy with renal pelvic sympathetic denervation, radiofrequency ablation, retrograde ureteral approach, including insertion of guide wire, selective placement of ureteral sheath(s) and multiple conformable electrodes, contrast injection(s), and fluoroscopy, bilateral","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0845T","name":"Dgtz gls mcrscp imfluor 1st","description":"Digitization of glass microscope slides for immunofluorescence, per specimen; initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1425","name":"Surgical care mvp","description":"Surgical care mips value pathway","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31587","name":"Laryngoplasty cricoid split","description":"Laryngoplasty, cricoid split, without graft placement","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":994.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76857","name":"Us exam pelvic limited","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4361","name":"Epixpress, per sq cm","description":"Epixpress, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51880","name":"Repair of bladder opening","description":"Closure of cystostomy (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":545.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0441U","name":"Nfct ds bct fngl/viral semiq","description":"Nfct ds bct fngl/viral semiq","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49189","name":"Opn exc/dst ntra-abd 20.1-30","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 20.1 to 30 cm","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77092","name":"Tbs i&r fx rsk qhp","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; interpretation and report on fracture-risk only by other qualified health care professional","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87880","name":"Strep a assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; streptococcus, group a","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93732","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1105","name":"Dexmedetomidine film, 1 mcg","description":"Dexmedetomidine, oral, 1 mcg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1173","name":"Pt no rec td/tdap 9yrs prior","description":"Patient did not receive at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4364","name":"Am bur xp mem xpl hy p sq cm","description":"Amnio burgeon xplus membrane and xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0291U","name":"Psyc mood do mrna 144 genes","description":"Psyc mood do mrna 144 genes","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33891","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1319.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88184","name":"Flowcytometry/ tc 1 marker","description":"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; first marker","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5942","name":"Proth max implt sup remv","description":"Proth max implt sup remv","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0038","name":"Clin pt no ref","description":"Clinician determines patient does not require referral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0531","name":"Fclty-based respite, 24 hr u","description":"Facility-based respite, 24-hour unit, for use in cmmi model","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5141","name":"Inj adalimumab-aaty, 1 mg","description":"Injection, adalimumab-aaty, biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92632","name":"Hearing aid slctn svc ea add","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1005T","name":"Elec alys s-scl eeg prgr 1st","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, first 15 minutes face-to-face time with physician or other qualified hea","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0556","name":"Adv prim care mgmt lvl 1","description":"Advanced primary care management services for a patient with one chronic condition [expected to last at least 12 months, or until the death of the patient, which place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline], or fewer, provided by clinical ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1307","name":"Inj, crovalimab-akkz, 10 mg","description":"Injection, crovalimab-akkz, 10 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4330","name":"Total, per sq cm","description":"Total, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0863T","name":"Rlcj pg wcs lv trnsmtr only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; transmitter component only","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1150","name":"Lvef <=40% or mod/sev l vsf","description":"Current or prior left ventricular ejection fraction (lvef) less than or equal to 40% or documentation of moderately or severely depressed left ventricular systolic function","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4420","name":"Nuform per sq cm","description":"Nuform, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5128","name":"Inj, cimerli, 0.1 mg","description":"Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0307U","name":"Onc mrd nxt-gnrj alys sbsq","description":"Onc mrd nxt-gnrj alys sbsq","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0423U","name":"Psyc genomic alys pnl 26 gen","description":"Psyc genomic alys pnl 26 gen","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26010","name":"Drainage of finger abscess","description":"Drainage of finger abscess; simple","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":137.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1317","name":"Pts counsl cpt opt out","description":"Patients who are counseled on connection with a csp and explicitly opt out","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87467","name":"Hepatitis b surface ag quan","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; hepatitis b surface antigen (hbsag), quantitative","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1462","name":"Pt clin ind hd image","description":"Patients with clinical indications for imaging of the head","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37278","name":"Rvsc evsc fpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0349","name":"Inj, rezafungin, 1 mg","description":"Injection, rezafungin, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27709","name":"Osteotomy tibia & fibula","description":"Osteotomy; tibia and fibula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":903.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5913","name":"Nasal prosthesis","description":"Nasal prosthesis","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93898","name":"Ven-artl shunt det mbubb njx","description":"Venous-arterial shunt detection with intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49593","name":"Rpr aa hrn 1st 3-10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, reducible","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0018M","name":"Trnsplj rnl meas cd154+cll","description":"Transplantation medicine (allograft rejection, renal), measurement of donor and third-party-induced cd154+t-cytotoxic memory cells, utilizing whole peripheral blood, algorithm reported as a rejection risk score","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70170","name":"X-ray exam of tear duct","description":"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1458","name":"Pt died bef end meas pd","description":"Patient died prior to the end of the performance period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19030","name":"Njx px only mam ducto/glcto","description":"Injection procedure only for mammary ductogram or galactogram","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4410","name":"Amchomatrixdl per sq cm","description":"Amchomatrixdl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5159","name":"Inj, denosumab-dssb, 1 mg","description":"Injection, denosumab-dssb (ospomyv/xbryk), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37277","name":"Rvsc evsc fpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1178","name":"Doc med rsn no pcv","description":"Documentation of medical reason(s) for not administering pneumococcal vaccine (e.g., prior anaphylaxis due to the pneumococcal vaccine)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58300","name":"Insert intrauterine device","description":"Insertion of intrauterine device (iud)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":121.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64483","name":"Njx aa&/strd tfrm epi l/s 1","description":"Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or ct), lumbar or sacral, single level","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10040","name":"Extraction","description":"Extraction (eg, marsupialization, opening or removal of multiple milia, comedones, cysts, pustules)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33853","name":"Rpr hypopl a-arch w/byp","description":"Repair of hypoplastic or interrupted aortic arch using autogenous or prosthetic material; with cardiopulmonary bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2282.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0716T","name":"Car acous wavfrm rec cad rsk","description":"Cardiac acoustic waveform recording with automated analysis and generation of coronary artery disease risk score","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15012","name":"Hrv skn cll ssp agrft ea add","description":"Harvest of skin for skin cell suspension autograft; each additional 25 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98005","name":"Synch audio-video est low 20","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low medical decision making. when using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0683","name":"App of non-sheet skin sub g","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4378","name":"Renew ft matrix per sq cm","description":"Renew ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4287","name":"Disp col sto bag breast milk","description":"Disposable collection and storage bag for breast milk, any size, any type, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93896","name":"Vsrctv std tcd icr art compl","description":"Vasoreactivity study performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0484","name":"Consult slides prep elsewher","description":"Consultation on slides prepared elsewhere","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0859T","name":"Ncntc ifr spctrsc o/t pad ea","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), other than for screening for peripheral arterial disease, image acquisition, interpretation, and report; each additional anatomic site (list separately in addition to code ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1305","name":"Pneum vax admin 19+","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91113","name":"Gi trc img intral colon i&r","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65426","name":"Removal of eye lesion","description":"Excision or transposition of pterygium; with graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":464.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69729","name":"Impl oi implt sk tc esp>=100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside of the mastoid and resulting in removal of greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0695T","name":"Bdy srf mpg pm/cvdfb tm impl","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of implant or replacement","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0022","name":"Comm hlth intg svs add 30 m","description":"Community health integration services, each additional 30 minutes per calendar month (list separately in addition to g0019)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9612","name":"Inj, fluorescein, 1 mg","description":"Injection, fluorescein, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1180","name":"Pt imm ckpt inhib therapy","description":"Patients on immune checkpoint inhibitor therapy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36830","name":"Artery-vein nonautograft","description":"Creation of arteriovenous fistula by other than direct arteriovenous anastomosis (separate procedure); nonautogenous graft (eg, biological collagen, thermoplastic graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":843.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2025","name":"Miro3d per cubic cm","description":"Miro3d, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64837","name":"Repair nerve add-on","description":"Suture of each additional nerve, hand or foot (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0549","name":"Phone/inter for treat>31m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4224","name":"Hhf10-p per sq cm","description":"Human health factor 10 amniotic patch (hhf10-p), per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1397","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0982T","name":"Rem mntr impl ivc snr set-up","description":"Remote monitoring of implantable inferior vena cava sensor, physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate), initial set-up and patient education on use of equipment","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26551","name":"Great toe-hand transfer","description":"Transfer, toe-to-hand with microvascular anastomosis; great toe wrap-around with bone graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3960.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74021","name":"Radex abdomen 3+ views","description":"Radiologic examination, abdomen; 3 or more views","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9959","name":"Unspec sleep ap proc","description":"Unspec sleep ap proc","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28606","name":"Treat foot dislocation","description":"Percutaneous skeletal fixation of tarsometatarsal joint dislocation, with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":476.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0847T","name":"Dgtz gls mcrscp xm arch tiss","description":"Digitization of glass microscope slides for examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, kras mutational analysis) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1257","name":"Cvd risk assess not perf","description":"Cvd risk assessment not performed or incomplete (e.g., cvd risk assessment was not documented), reason not otherwise specified","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0531","name":"Fclty-based respite, 24 hr u","description":"Facility-based respite, 24-hour unit, for use in cmmi model","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0168","name":"Epinephrine (intl med sys)","description":"Injection, epinephrine (international medication systems), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4297","name":"Emerge matrix, per sq cm","description":"Emerge matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0591U","name":"Onc prst8 ca 3prtns plsm srm","description":"Onc prst8 ca 3prtns plsm srm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4385","name":"Apollo ft per sq cm","description":"Apollo ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76810","name":"Ob us >/= 14 wks addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91125","name":"Anrct mano rct snsatn&balo","description":"Anorectal manometry, with rectal sensation and rectal balloon expulsion test, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33509","name":"Ndsc hrv uxtr art 1 sgm cab","description":"Harvest of upper extremity artery, 1 segment, for coronary artery bypass procedure, endoscopic","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92631","name":"Hearing aid slctn svc 1st 30","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6197","name":"Replace material prosthesis","description":"Replace material prosthesis","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1201","name":"Med rsn no ace-i/arb rx","description":"Documentation of medical reason(s) for not prescribing ace inhibitor (ace-i) or arb therapy during the measurement period (e.g., pregnancy, history of angioedema to ace-i, other allergy to ace-i and arb, hyperkalemia or history of hyperkalemia while on ace-i or arb therapy, acute kidney injury due t","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0763T","name":"Dgtz gls mcrscp mphmtrc alys","description":"Digitization of glass microscope slides for morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure, manual (list separately in addition to code for primary proced","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1260","name":"Pt not doc <= 1 yr dialysis","description":"Patient status not documented within the first year of initiating dialysis","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9129","name":"Photobio therpy-sub 15 mins","description":"Photobio therpy-sub 15 mins","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74450","name":"X-ray urethra/bladder","description":"Urethrocystography, retrograde, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0912T","name":"Elec alys nstim sys vgs smpl","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; with simple programming by physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1710","name":"Moderna vacc admin 3rd dose","description":"Moderna vacc admin 3rd dose","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6253","name":"Provisional pontic","description":"Provisional pontic","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37285","name":"Revsc evasc tpvt st sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96202","name":"Mlt fam grp bhv train 1st 60","description":"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face with multiple sets of paren","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1185","name":"Imm ckpt inhib not hld no rx","description":"Documentation of immune checkpoint inhibitor therapy not held and/or corticosteroids or immunosuppressants prescribed or administered was not performed, reason not given","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1411","name":"1st ln ici no chemo","description":"Currently on first-line immune checkpoint inhibitors without chemotherapy","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28001","name":"Drainage of bursa of foot","description":"Incision and drainage, bursa, foot","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95810","name":"Polysom 6/> yrs 4/> param","description":"Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, attended by a technologist","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1020.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97037","name":"Appl modality 1+lllt po pain","description":"Application of a modality to 1 or more areas; low-level laser therapy (ie, nonthermal and non-ablative) for post-operative pain reduction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87913","name":"Nfct agt gntyp alys sarscov2","description":"Infectious agent genotype analysis by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), mutation identification in targeted region(s)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37282","name":"Rvsc evsc tpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1207","name":"Pt scrn sdoh","description":"Patient is screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0962T","name":"Asstv alg alys acous&ecg rec","description":"Assistive algorithmic analysis of acoustic and electrocardiogram recording for detection of cardiac dysfunction (eg, reduced ejection fraction, cardiac murmurs, atrial fibrillation), with review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7957","name":"Tiss regen edent nonresorb","description":"Tiss regen edent nonresorb","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0177","name":"Inj, aflibercept hd, 1 mg","description":"Injection, aflibercept hd, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0046","name":"No mrs 90 days post stk","description":"Clinical follow-up and mrs score not assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27151","name":"Incision of hip bones","description":"Osteotomy, iliac, acetabular or innominate bone; with femoral osteotomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1546.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2009","name":"Symphony, per sq cm","description":"Symphony, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59412","name":"Antepartum manipulation","description":"External cephalic version, with or without tocolysis","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64629","name":"Trml dstrj ios bvn ea addl","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; each additional vertebral body, lumbar or sacral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33496","name":"Repair prosth valve clot","description":"Repair of non-structural prosthetic valve dysfunction with cardiopulmonary bypass (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1975.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0969T","name":"Removal epicranial nstim sys","description":"Removal of epicranial neurostimulator system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1807","name":"Inj, ethacrynate sod, 1 mg","description":"Injection, ethacrynate sodium, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74018","name":"Radex abdomen 1 view","description":"Radiologic examination, abdomen; 1 view","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92632","name":"Hearing aid slctn svc ea add","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0699T","name":"Njx pst chmbr eye medication","description":"Injection, posterior chamber of eye, medication","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93651","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86590","name":"Streptokinase antibody","description":"Streptokinase, antibody","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1483","name":"Neg quan hep c or qual rna","description":"Patients who achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6611","name":"Onlay cst hgh nbl mtl >=3srf","description":"Onlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99203","name":"Office o/p new low 30 min","description":"Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":80.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0576U","name":"Trnsplj med lar quan ddcfdna","description":"Trnsplj med lar quan ddcfdna","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6037","name":"Postop dsg cast chg handfing","description":"Immediate post-surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, partial hand including fingers","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":1695.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0402","name":"Initial preventive exam","description":"Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":187.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7049","name":"Epap nasal valve","description":"Expiratory positive airway pressure intranasal resistance valve","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5098","name":"Inj ustekinumab-srlf, 1 mg","description":"Injection, ustekinumab-srlf (imuldosa), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0821T","name":"Mntr psychdlc med 2ndphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; second physician or other qualified health care professional, concurrent with first physician or other qualified health care professional, each hour (list sepa","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0806T","name":"Tcat s&ivc prstc vl impl opn","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); open femoral vein approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8006","name":"Grip glove replacement only","description":"Powered, cable driven grip assist glove, hand, finger, includes pressure sensors, glove replacement only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1476","name":"Pt dx cog imp or ad","description":"Patients with diagnosis of cognitive impairment or alzheimers disease","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0588U","name":"Nfct ds bct/vir 32genes mrna","description":"Nfct ds bct/vir 32genes mrna","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92631","name":"Hearing aid slctn svc 1st 30","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7049","name":"Epap nasal valve","description":"Expiratory positive airway pressure intranasal resistance valve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0698T","name":"Quan mr tiss w/mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained with diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, target ","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27060","name":"Removal of ischial bursa","description":"Excision; ischial bursa","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":480.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92330","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36836","name":"Prq av fstl crtj uxtr 1 acs","description":"Percutaneous arteriovenous fistula creation, upper extremity, single access of both the peripheral artery and peripheral vein, including fistula maturation procedures (eg, transluminal balloon angioplasty, coil embolization) when performed, including all vascular access, imaging guidance and radiolo","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28200","name":"Repair of foot tendon","description":"Repair, tendon, flexor, foot; primary or secondary, without free graft, each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":395.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37280","name":"Revsc evsc tpvt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1354","name":"Int caries med app per tooth","description":"Interim caries med app","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8694","name":"Aoi transducer/actuator repl","description":"Auditory osseointegrated device, transducer/actuator, replacement only, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1134.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0421U","name":"Onc clrct scr sgl amp 8 rna","description":"Onc clrct scr sgl amp 8 rna","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1174","name":"Pt w/ 2 hzv 10/2017 - mp","description":"Patient received at least two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1397","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93597","name":"R&l hrt cath chd abnl nt cnj","description":"Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); abnormal native connections","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55713","name":"Bx prst8 in-bore ct/mri bx 1","description":"Biopsy, prostate, in-bore ct- or mri-guided (ie, sextant), with biopsy of additional targeted lesion(s), first targeted lesion","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1439","name":"Sig ocu cond imp surg out","description":"Significant ocular conditions that impact the visual outcome of surgery","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1837","name":"Inj, posaconazole, 1 mg","description":"Injection, posaconazole, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1341","name":"Pt no f/u 30-180 dys","description":"Patients who did not have a follow-up assessment or did not have an assessment within 30 to 180 days after the index assessment during the performance period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63052","name":"Lam facetc/frmt arthrd lum 1","description":"Laminectomy, facetectomy, or foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s] [eg, spinal or lateral recess stenosis]), during posterior interbody arthrodesis, lumbar; single vertebral segment (list separately in addition to code for primary ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":153.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2037","name":"G4derm plus/suprello, pr ml","description":"G4derm plus/suprello, per milliliter","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4358","name":"Xwrap dual, per sq cm","description":"Xwrap dual, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64567","name":"Perq elec nrv field stimj cn","description":"Percutaneous electrical nerve field stimulation, cranial nerves, without implantation","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4324","name":"Amniotx, per sq cm","description":"Amniotx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4424","name":"Revive ft per sq cm","description":"Revive ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6607","name":"G com bandage tub protct lyr","description":"Gradient compression bandaging supply, tubular protective absorption layer, per linear yard, any width, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2003","name":"Inj, lidocaine hcl, 1 mg","description":"Injection, lidocaine hydrochloride, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1166","name":"Path rpt tis spec wle/reexc","description":"Pathology report for tissue specimens produced from wide local excisions or re-excisions","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0318U","name":"Ped whl gen mthyltn alys 50+","description":"Ped whl gen mthyltn alys 50+","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93596","name":"R&l hrt cath chd nml nt cnj","description":"Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); normal native connections","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9249","name":"Inj, melphalan (apotex) 1 mg","description":"Injection, melphalan (apotex), 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24200","name":"Rmvl fb upper arm/elbw subq","description":"Removal of foreign body, upper arm or elbow area; subcutaneous","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50200","name":"Renal biopsy perq","description":"Renal biopsy; percutaneous, by trocar or needle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49617","name":"Rpr aa hrn rcr > 10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, reducible","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":495.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1355","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98985","name":"Rtm dev sply mscsk sys 2-15d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of musculoskeletal system, 2-15 days in a 30-day period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99424","name":"Prin care mgmt phys 1st 30","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2039","name":"Innovamatrix fd, per sq cm","description":"Innovamatrix fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46735","name":"Construction of absent anus","description":"Repair of high imperforate anus without fistula; combined transabdominal and sacroperineal approaches","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2155.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0620","name":"Calcium glycer & lact/10 ml","description":"Injection, calcium glycerophosphate and calcium lactate, per 10 ml","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80503","name":"Path clin consltj sf 5-20","description":"Pathology clinical consultation; for a clinical problem, with limited review of patients history and medical records and straightforward medical decision making when using time for code selection, 5-20 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1228","name":"Pt + hcv aby +vir w/ rx 3 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, has hcv treatment initiated within 3 months of the reactive hcv antibody test","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1426","name":"Injection, casimersen, 10 mg","description":"Injection, casimersen, 10 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84510","name":"Assay of tyrosine","description":"Tyrosine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1020T","name":"Raman spectroscopy 1+skn les","description":"Raman spectroscopy of 1 or more skin lesions, with probability score for malignant risk derived by algorithmic analysis of data from each lesion","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28290","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":508.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0823T","name":"Tcat ins 1chmbr ldls pm ra","description":"Transcatheter insertion of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or programming), when","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D8091","name":"Compre ortho treat w surg","description":"Compre ortho treat w surg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1007T","name":"Eeg impl s-sclp eeg w/o vid","description":"Electroencephalogram from implanted sub-scalp continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0904T","name":"Ecg alg 12 ld rdcd trcg only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; tracing only","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33904","name":"Perq p-art revsc each addl","description":"Percutaneous pulmonary artery revascularization by stent placement, each additional vessel or separate lesion, normal or abnormal connections (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9225","name":"Gen anes adv air-sub 15 min","description":"Gen anes adv air-sub 15 min","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1961","name":"Inj lenacapavir (hiv tx) 1mg","description":"Injection, lenacapavir (only for use as hiv treatment), 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90461","name":"Im admin each addl component","description":"Immunization administration through 18 years of age via any route of administration, with counseling by physician or other qualified health care professional; each additional vaccine or toxoid component administered (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0063","name":"Cardiology ss","description":"Cardiology mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9061","name":"Inj, amivantamab-vmjw","description":"Injection, amivantamab-vmjw, 2 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23412","name":"Repair rotator cuff chronic","description":"Repair of ruptured musculotendinous cuff (eg, rotator cuff) open; chronic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1161.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0034","name":"Pall serv during meas","description":"Patients receiving palliative care during the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0857T","name":"Opto-acoustic img breast uni","description":"Opto-acoustic imaging, breast, unilateral, including axilla when performed, real-time with image documentation, augmentative analysis and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0708T","name":"Id ca immntx prep & 1st njx","description":"Intradermal cancer immunotherapy; preparation and initial injection","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0840T","name":"Dgtz gls mcrscp cslt compre","description":"Digitization of glass microscope slides for consultation, comprehensive, with review of records and specimens, with report on referred material (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0235","name":"Intrav inf, mon anti, fir do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4379","name":"Amniodefend ft per sq cm","description":"Amniodefend ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7472","name":"Removal of torus palatinus","description":"Removal of torus palatinus","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29845","name":"Wrist arthroscopy/surgery","description":"Arthroscopy, wrist, surgical; synovectomy, complete","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2291","name":"Inj, nafcillin (baxter) 20mg","description":"Injection, nafcillin sodium (baxter), 20 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80504","name":"Path clin consltj mod 21-40","description":"Pathology clinical consultation; for a moderately complex clinical problem, with review of patients history and medical records and moderate level of medical decision making when using time for code selection, 21-40 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76870","name":"Us exam scrotum","description":"Ultrasound, scrotum and contents","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0699","name":"Inj, cefiderocol, 10 mg","description":"Injection, cefiderocol, 10 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0882T","name":"Intraop ther estim pn ue 1st","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; initial nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49605","name":"Repair umbilical lesion","description":"Repair of large omphalocele or gastroschisis; with or without prosthesis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5044.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0879","name":"Difelikefalin, esrd on dialy","description":"Injection, difelikefalin, 0.1 microgram, (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3471","name":"Surg rep root res anterior","description":"Surg rep root res anterior","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0840T","name":"Dgtz gls mcrscp cslt compre","description":"Digitization of glass microscope slides for consultation, comprehensive, with review of records and specimens, with report on referred material (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0992T","name":"N-invas assmt car rsk w/o ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat without concurrent computed tomography (ct) scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0883T","name":"Intraop ther estim pn ue ea","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; each additional nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8502","name":"Inj, aponvie, 1 mg","description":"Injection, aprepitant (aponvie), 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0461U","name":"Onc rxgenom alys rtpcr 24gen","description":"Onc rxgenom alys rtpcr 24gen","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0778T","name":"Smmg cncrnt appl imu snr","description":"Surface mechanomyography (smmg) with concurrent application of inertial measurement unit (imu) sensors for measurement of multi-joint range of motion, posture, gait, and muscle function","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9998","name":"Doc med rsn <3 colon","description":"Documentation of medical reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., last colonoscopy incomplete, last colonoscopy had inadequate prep, piecemeal removal of adenomas, or sessile serrated polyps >= 20 mm in size, last colonoscopy found greater than 10 adenomas, lo","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4006","name":"Gastroenterology ss","description":"Gastro-enterology mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53454","name":"Tprnl balo cntnc dev adjmt","description":"Periurethral transperineal adjustable balloon continence device; percutaneous adjustment of balloon(s) fluid volume","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0814T","name":"Prq njx biod osteo matrl fem","description":"Percutaneous injection of calcium-based biodegradable osteoconductive material, proximal femur, including imaging guidance, unilateral","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34701","name":"Evasc rpr a-ao ndgft","description":"Endovascular repair of infrarenal aorta by deployment of an aorto-aortic tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the aorta from the level ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1359.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86052","name":"Aquaporin-4 antb cba each","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; cell-based immunofluorescence assay (cba), each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95907","name":"Nvr cndj tst 1-2 studies","description":"Nerve conduction studies; 1-2 studies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27360","name":"Partial removal leg bone(s)","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone, femur, proximal tibia and/or fibula (eg, osteomyelitis or bone abscess)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":997.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5422","name":"Dentures adjust part mandbl","description":"Adjust partial denture - mandibular","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0405U","name":"Onc pncrtc 59 mthltn blk mrk","description":"Onc pncrtc 59 mthltn blk mrk","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6600","name":"G com bandge hgh dn foam sht","description":"Gradient compression bandaging supply, high density foam sheet, per 250 square centimeters, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59020","name":"Fetal contract stress test","description":"Fetal contraction stress test","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1221","name":"Dre w/o rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; without evidence of retinopathy","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0237","name":"Intrav inf, toci, first dose","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99394","name":"Prev visit est age 12-17","description":"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; adole","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":115.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98929","name":"Osteopath manj 9-10 regions","description":"Osteopathic manipulative treatment (omt); 9-10 body regions involved","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":97.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":66.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87428","name":"Sarscov & inf vir a&b ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; severe acute respiratory syndrome coronavirus (eg, sars-cov, s","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94016","name":"Review patient spirometry","description":"Patient-initiated spirometric recording per 30-day period of time; review and interpretation only by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1447","name":"Pt dx bd bef end meas pd","description":"Patients with an active diagnosis of bipolar disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4303","name":"Complete aa, per sq cm","description":"Complete aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7111","name":"Extraction coronal remnants","description":"Extraction coronal remnants - deciduous tooth","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2643","name":"Dental onlay porcelin 3 surf","description":"Onlay - porcelain/ceramic - three surfaces","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4320","name":"Pellograft, per sq cm","description":"Pellograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0136","name":"Adm of pa/n assess 5-15 m","description":"Administration of a standardized, evidence-based assessment of physical activity and nutrition, 5-15 minutes, not more often than every 6 months","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1176","name":"No 2 hzv 10/2017-meas pd","description":"Patient did not receive two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0488U","name":"Ob fetal ag nipt cfdna alys","description":"Ob fetal ag nipt cfdna alys","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0555U","name":"Repr med pga embryonic te qc","description":"Repr med pga embryonic te qc","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0466U","name":"Crd cad dna gwas 564856 snp","description":"Crd cad dna gwas 564856 snp","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2679","name":"Inj fluphenazine hcl 1.25 mg","description":"Injection, fluphenazine hcl, 1.25 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20553","name":"Njx 1/mlt trigger points 3/>","description":"Injection(s); single or multiple trigger point(s), 3 or more muscles","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":39.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4396","name":"Natalin per sq cm","description":"Natalin, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76984","name":"Dx intraop thoracic aorta us","description":"Ultrasound, intraoperative thoracic aorta (eg, epiaortic), diagnostic","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1336","name":"Pts eval ini xm 2 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 2 weeks","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0485U","name":"Onc sol tum cfdna&rna ngs gm","description":"Onc sol tum cfdna&rna ngs gm","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0454U","name":"U rare ds id opt genome mapg","description":"U rare ds id opt genome mapg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78216","name":"Lvr&spleen img w/vasc flow","description":"Liver and spleen imaging; with vascular flow","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0929T","name":"Rem interrog dev ccm-d tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2711","name":"Inj neostigmin/glycopyrrolat","description":"Injection, neostigmine methylsulfate 0.1 mg and glycopyrrolate 0.02 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0965T","name":"I&cst prp jw xpn dl arch non","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, non-fixed hinge mechanism","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90460","name":"Im admin 1st/only component","description":"Immunization administration through 18 years of age via any route of administration, with counseling by physician or other qualified health care professional; first or only component of each vaccine or toxoid administered","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4543","name":"Supply trans elec nerve stim","description":"Supplies for transcutaneous electrical nerve stimulator, for nerves in the auricular region, per month","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6180","name":"Implnt maint proced","description":"Implnt maint proced","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64858","name":"Repair sciatic nerve","description":"Suture of sciatic nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1401.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4011","name":"Internal medicine ss","description":"Internal medicine mips specialty set","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1260","name":"Pt not doc <= 1 yr dialysis","description":"Patient status not documented within the first year of initiating dialysis","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9051","name":"Inj, bortezomib (maia)","description":"Injection, bortezomib (maia), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1813","name":"Lyumjev for insulin pump use","description":"Insulin (lyumjev) for administration through dme (i.e., insulin pump) per 50 units","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0533U","name":"Rx metab advrs gnotyp 16gens","description":"Rx metab advrs gnotyp 16gens","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55867","name":"Laps surg prst8ect smpl stot","description":"Laparoscopy, surgical prostatectomy, simple subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy), includes robotic assistance, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1189","name":"Doc khe pef w/efgr/uacr","description":"Documentation of a kidney health evaluation defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr) performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0388","name":"Bitewing image capture only","description":"Bitewing image capture only","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1413","name":"Pos pdl1 bef init ici tx","description":"Patients who had a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0234","name":"Intra inf, toci, second dos","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2777","name":"Inj, faricimab-svoa, 0.1mg","description":"Injection, faricimab-svoa, 0.1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90382","name":"Rsv monoc antb seasn .7ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose, 0.7 ml, for intramuscular use","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21270","name":"Augmentation cheek bone","description":"Malar augmentation, prosthetic material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":806.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9996","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2291","name":"Inj, nafcillin (baxter) 20mg","description":"Injection, nafcillin sodium (baxter), 20 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59622","name":"Attempted vbac after care","description":"Cesarean delivery only, following attempted vaginal delivery after previous cesarean delivery; including postpartum care","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1571.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86850","name":"Rbc antibody screen","description":"Antibody screen, rbc, each serum technique","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1447","name":"Pt dx bd bef end meas pd","description":"Patients with an active diagnosis of bipolar disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60212","name":"Partial thyroid excision","description":"Partial thyroid lobectomy, unilateral; with contralateral subtotal lobectomy, including isthmusectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1141.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96372","name":"Ther/proph/diag inj sc/im","description":"Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0841T","name":"Dgtz gls mcrscp pth cslt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; first tissue block, with frozen section(s), single specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5157","name":"Inj, denosumab-bmwo, 1 mg","description":"Injection, denosumab-bmwo (stoboclo/osenvelt), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9294","name":"Biofeed dig cog behav tx fda","description":"Prescription digital cognitive and/or behavioral therapy, biofeedback, fda cleared, per course of treatment","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86052","name":"Aquaporin-4 antb cba each","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; cell-based immunofluorescence assay (cba), each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2006","name":"Novosorb synpath per sq cm","description":"Novosorb synpath dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2765","name":"Metoclopramide hcl injection","description":"Injection, metoclopramide hcl, up to 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01938","name":"Anes drg/aspir lmbr/sac","description":"Anesthesia for percutaneous image-guided injection, drainage or aspiration procedures on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0588U","name":"Nfct ds bct/vir 32genes mrna","description":"Nfct ds bct/vir 32genes mrna","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1468","name":"Hep b vaccine received","description":"Patient received recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0037","name":"Pt not able to participate","description":"On date of encounter, patient is not able to participate in assessment or screening, including non-verbal patients, delirious, severely aphasic, severely developmentally delayed, severe visual or hearing impairment and for those patients, no knowledgeable informant available","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0771T","name":"Vr px dissoc svc sm phy 1st","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0388U","name":"Onc nonsm cll lng ca 37 gen","description":"Onc nonsm cll lng ca 37 gen","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0225","name":"Inj, vutrisiran, 1 mg","description":"Injection, vutrisiran, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0618","name":"Inj, calcium chloride, 2 mg","description":"Injection, calcium chloride, 2 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1358","name":"Pts no <suicd idea 120 dys","description":"Patients who did not have a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0950T","name":"Abltj b9 prst8 tissue hifu","description":"Ablation of benign prostate tissue, transrectal, with high intensity-focused ultrasound (hifu), including ultrasound guidance","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0503U","name":"Neuro alz ds bamyl&tau prtn","description":"Neuro alz ds bamyl&tau prtn","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0938T","name":"Xtrnl ecg rec>15d<30d rec","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; recording (including connection and initial recording)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1552","name":"Inj, alyglo, 500 mg","description":"Injection, immune globulin (alyglo), 500 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76989","name":"Dx intraop epcar us chd i&r","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; interpretation and report only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49622","name":"Rpr parastomal hrna ncr/strn","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J3100","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2040.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0920T","name":"Rmvl perm ccm-d sys 1 pac ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous pacing lead only","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9998","name":"Inj ustekinumab-aekn, 1 mg","description":"Injection, ustekinumab-aekn (selarsdi), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1017T","name":"Elec aly npgs esoph sbsq w/o","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1782","name":"Vac admin human pap dose 2","description":"Vac admin human pap dose 2","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0582","name":"Bivalirudin (endo) 1 mg","description":"Injection, bivalirudin (endo), not therapeutically equivalent to j0583, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1403","name":"Bslne and fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78608","name":"Brain imaging (pet)","description":"Brain imaging, positron emission tomography (pet); metabolic evaluation","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86366","name":"Muscle-specific kinase antb","description":"Muscle-specific kinase (musk) antibody","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0047","name":"Ped blunt hd traum","description":"Pediatric patient with minor blunt head trauma and pecarn prediction criteria are not assessed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32503","name":"Resect apical lung tumor","description":"Resection of apical lung tumor (eg, pancoast tumor), including chest wall resection, rib(s) resection(s), neurovascular dissection, when performed; without chest wall reconstruction(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2224.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7021","name":"Suppl and access lung expan","description":"Supplies and accessories for lung expansion airway clearance, continuous high frequency oscillation, and nebulization device (e.g., handset, nebulizer kit, biofilter)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37268","name":"Revsc evasc fpvt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0383U","name":"Tyrosinemia typ i mntr quan","description":"Tyrosinemia typ i mntr quan","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0726T","name":"Rmvl implt vstibular dev uni","description":"Removal of implanted vestibular device, unilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0681","name":"Inj ceftobipole medocarl 3mg","description":"Injection, ceftobiprole medocaril sodium, 3 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0496U","name":"Onc clrct cfdna 8/7 genes","description":"Onc clrct cfdna 8/7 genes","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28126","name":"Partial removal of toe","description":"Resection, partial or complete, phalangeal base, each toe","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0522","name":"Mgt nw pt dementia low cmplx","description":"Management of a new patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7912","name":"Suture complicate wnd > 5 cm","description":"Complicated suture-greater than 5 cm","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4420","name":"Nuform per sq cm","description":"Nuform, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0342U","name":"Onc pncrtc ca mult ia eclia","description":"Onc pncrtc ca mult ia eclia","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0770T","name":"Vr technology assist therapy","description":"Virtual reality technology to assist therapy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0915T","name":"Insj perm ccm-d sys pg&eltrd","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator and dual transvenous electrodes/leads (pacing and defibrillation)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36405","name":"Vnpnxr<3yrs phy/qhp scalp vn","description":"Venipuncture, younger than age 3 years, necessitating the skill of a physician or other qualified health care professional, not to be used for routine venipuncture; scalp vein","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":27.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85004","name":"Automated diff wbc count","description":"Blood count; automated differential wbc count","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0485U","name":"Onc sol tum cfdna&rna ngs gm","description":"Onc sol tum cfdna&rna ngs gm","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15017","name":"App skn cll ssp f/n/g/hf 1st","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 480 sq cm or less","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1259","name":"Pt stat doc <= 1 yr dialysis","description":"Patient status documented within the first year of initiating dialysis","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1222","name":"Glaucoma pln of care not doc","description":"Glaucoma plan of care not documented, reason not otherwise specified","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5933","name":"Refitting of obturator","description":"Obturator prosthesis modification","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0801T","name":"Tcat rmv&rpl 2chmbr ldls pm","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; dual-cha","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0395U","name":"Onc lng multiomics plsm alg","description":"Onc lng multiomics plsm alg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0689T","name":"Quan us tis charac w/o dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained without diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9996","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1260","name":"Pt not doc <= 1 yr dialysis","description":"Patient status not documented within the first year of initiating dialysis","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6604","name":"G com bandge low dn foam flt","description":"Gradient compression bandaging supply, low density flat foam sheet, per 250 square centimeters, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1424","name":"Pulmonology care mvp","description":"Pulmonology care mips value pathway","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0821T","name":"Mntr psychdlc med 2ndphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; second physician or other qualified health care professional, concurrent with first physician or other qualified health care professional, each hour (list sepa","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1020T","name":"Raman spectroscopy 1+skn les","description":"Raman spectroscopy of 1 or more skin lesions, with probability score for malignant risk derived by algorithmic analysis of data from each lesion","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38230","name":"Bone marrow harvest allogen","description":"Bone marrow harvesting for transplantation; allogeneic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37266","name":"Rvsc evsc fpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0045","name":"Mrs 90 days post stk","description":"Clinical follow-up and mrs score assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92641","name":"Hearing dev verif eacous aly","description":"Hearing device verification, electroacoustic analysis","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4392","name":"Grafix duo per sq cm","description":"Grafix duo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1709","name":"Pfizer vaccine admin booster","description":"Pfizer vaccine admin booster","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93542","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0905T","name":"Ecg alg 12 ld rdcd i&r only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; interpretation and report only","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37263","name":"Revsc evasc fpvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64584","name":"Rmvl hpglsl nstim ary pg","description":"Removal of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2928","name":"Prefab porc/cer crown perm","description":"Prefab porc/cer crown perm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29876","name":"Arthrs knee surg synvct maj","description":"Arthroscopy, knee, surgical; synovectomy, major, 2 or more compartments (eg, medial or lateral)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":746.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1308","name":"Inj, famotidine, 0.25 mg","description":"Injection, famotidine, 0.25 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61868","name":"Implant neuroelectrde addl","description":"Twist drill, burr hole, craniotomy, or craniectomy with stereotactic implantation of neurostimulator electrode array in subcortical site (eg, thalamus, globus pallidus, subthalamic nucleus, periventricular, periaqueductal gray), with use of intraoperative microelectrode recording; each additional ar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":862.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7473","name":"Remove torus mandibularis","description":"Removal of torus mandibularis","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7415","name":"Excision malig les complicat","description":"Excision of malignant lesion complicated","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9382","name":"Inj zenocutuzumab-zbco 1 mg","description":"Injection, zenocutuzumab-zbco, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5158","name":"Inj, denosumab-bnht, 1 mg","description":"Injection, denosumab-bnht (bomyntra/conexxence), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2050","name":"Financial mgt waiver/diem","description":"Financial management, self-directed, waiver; per diem","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1327","name":"Pts no eval ini xm no 8 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 8 weeks","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0811T","name":"Rem mlt day uroflow setup","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); set-up and patient education on use of equipment","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64597","name":"Ins/rplcm prq eltrd ra pn ea","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; each additional electrode array (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0579U","name":"Nfro dbtc ckd elisa apoa4","description":"Nfro dbtc ckd elisa apoa4","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26390","name":"Revise hand/finger tendon","description":"Excision flexor tendon, with implantation of synthetic rod for delayed tendon graft, hand or finger, each rod","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1099.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0735T","name":"Prep tum cav iort prim crnot","description":"Preparation of tumor cavity, with placement of a radiation therapy applicator for intraoperative radiation therapy (iort) concurrent with primary craniotomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0351U","name":"Nfct ds bct/viral trail ip10","description":"Nfct ds bct/viral trail ip10","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35602","name":"Bpg crtd-clat crtd","description":"Bypass graft, with other than vein; carotid-contralateral carotid","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2184","name":"Inj, meropenem (b. braun)","description":"Injection, meropenem (b. braun), not therapeutically equivalent to j2185, 100 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21121","name":"Geniop sldg osteot 1","description":"Genioplasty; sliding osteotomy, single piece","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44376","name":"Small bowel endoscopy","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, including ileum; diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2644","name":"Dental onlay porc 4/more sur","description":"Onlay - porcelain/ceramic - four or more surfaces","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5811","name":"Denture interm cmplt mandbl","description":"Interim complete denture (mandibular)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2044","name":"Biobrane glove, each","description":"Biobrane glove, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90482","name":"Imm cnsl not admn sm 3<10","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; 3 minutes up to 10 minutes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1404","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"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":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7972","name":"Surg redct fibrous tuberosit","description":"Surgical reduction of fibrous tuberosity","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0535","name":"Pt navigat svs direct/ref","description":"Patient navigational services, provided directly or by referral; including helping the patient to navigate health systems and identify care providers and supportive services, to build patient self-advocacy and communication skills with care providers, and to promote patient-driven action plans and g","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1468","name":"Hep b vaccine received","description":"Patient received recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9220","name":"Indigotindisulfonate sod 1mg","description":"Injection, indigotindisulfonate sodium, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4320","name":"Pellograft, per sq cm","description":"Pellograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9381","name":"Inj teplizumab mzwv 5 mcg","description":"Injection, teplizumab-mzwv, 5 mcg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2313","name":"Inj, naloxone (zimhi) 0.01mg","description":"Injection, naloxone hydrochloride (zimhi), 0.01 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4401","name":"Absolv3 per sq cm","description":"Absolv3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87086","name":"Urine culture/colony count","description":"Culture, bacterial; quantitative colony count, urine","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32701","name":"Thorax stereo rad targetw/tx","description":"Thoracic target(s) delineation for stereotactic body radiation therapy (srs/sbrt), (photon or particle beam), entire course of treatment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0250","name":"Md inr test revie inter mgmt","description":"Physician review, interpretation, and patient management of home inr testing for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria; testing not occurring more frequently than once a week; billing units of servic","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2802","name":"Inj, romiplostim 1 microgram","description":"Injection, romiplostim, 1 microgram","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1005T","name":"Elec alys s-scl eeg prgr 1st","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, first 15 minutes face-to-face time with physician or other qualified hea","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0528","name":"Mgt est pt dem mod-hi cmplx","description":"Management of established patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0475U","name":"Hered prst8 ca gsap 23 genes","description":"Hered prst8 ca gsap 23 genes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1008T","name":"Rem mntr s-scl eeg sys setup","description":"Remote monitoring of sub-scalp implanted continuous bilateral electroencephalography monitoring system, device fitting, initial set-up, and patient education in wearing of system and use of equipment","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0731T","name":"Augmnt ai-based fcl phnt a/r","description":"Augmentative ai-based facial phenotype analysis with report","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0916T","name":"Insj perm ccm-d sys pg only","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6611","name":"Onlay cst hgh nbl mtl >=3srf","description":"Onlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0998T","name":"Precuneus mag stimj tx dlvr","description":"Precuneus magnetic stimulation; personalized treatment delivery of magnetic stimulation therapy to a prespecified target area derived from analysis of evoked potentials within the precuneus, utilizing magnetic resonance imaging-based neuronavigation, with management, per day","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15014","name":"Prepj skn cll ssp agrft ea","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; each additional 25 sq cm of harvested skin or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37263","name":"Revsc evasc fpvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0315U","name":"Onc cutan sq cll ca mrna 40","description":"Onc cutan sq cll ca mrna 40","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1422","name":"Gastroenterology care mvp","description":"Gastroenterology care mips value pathway","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78492","name":"Myocrd img pet mlt rst&strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); multiple studies at rest and stress (exercise or pharmacologic)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1461","name":"Pt dx chron hepc","description":"Patient diagnosis for chronic hepatitis c","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4380","name":"Advograft one per sq cm","description":"Advograft one, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60661","name":"Abltj 1/+thyr ndul addl prq","description":"Ablation of 1 or more thyroid nodule(s), additional lobe, percutaneous, including imaging guidance, radiofrequency (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99426","name":"Prin care mgmt staff 1st 30","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2777","name":"Inj, faricimab-svoa, 0.1mg","description":"Injection, faricimab-svoa, 0.1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4318","name":"Fem urinary cup w/wo attch","description":"Female external urinary collection cup, with or without ring attachment, per day","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4417","name":"Alexiguard dl-t per sq cm","description":"Alexiguard dl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4379","name":"Amniodefend ft per sq cm","description":"Amniodefend ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0300U","name":"Onc pan tum whl gen seq&opt","description":"Onc pan tum whl gen seq&opt","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43290","name":"Egd flx trnsorl dplmnt balo","description":"Esophagogastroduodenoscopy, flexible, transoral; with deployment of intragastric bariatric balloon","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15854","name":"Removal sutr&stapl xreq anes","description":"Removal of sutures and staples not requiring anesthesia (list separately in addition to e/m code)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0236","name":"Intrav inf, mon anti, sec do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93153","name":"Interrog w/o prgrmg ipnss","description":"Interrogation without programming of implanted phrenic nerve stimulator system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61889","name":"Ins sk-mnt crnl nstm pg/rcvr","description":"Insertion of skull-mounted cranial neurostimulator pulse generator or receiver, including craniectomy or craniotomy, when performed, with direct or inductive coupling, with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0813T","name":"Egd vol adjmt bariatric balo","description":"Esophagogastroduodenoscopy, flexible, transoral, with volume adjustment of intragastric bariatric balloon","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1449","name":"Inj eflapegrastim-xnst 0.1mg","description":"Injection, eflapegrastim-xnst, 0.1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58100","name":"Biopsy of uterus lining","description":"Endometrial sampling (biopsy) with or without endocervical sampling (biopsy), without cervical dilation, any method (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0522","name":"Mgt nw pt dementia low cmplx","description":"Management of a new patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78800","name":"Rp loclzj tum 1 area 1 d img","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, single area (eg, head, neck, chest, pelvis), single day imaging","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5228","name":"Immed mand part denture","description":"Immed mand part denture","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1385","name":"Pt rsn not seen 2nd pam","description":"Documentation of patient reasons for patients who were not seen for the second pam survey (e.g., less than four months between baseline pam assessment and follow-up","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33901","name":"Perq p-art revsc 1 nm nt bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, bilateral","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4386","name":"Acesso trifaca per sq cm","description":"Acesso trifaca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9029","name":"Instill adstiladrin, tx dose","description":"Intravesical instillation, nadofaragene firadenovec-vncg, per therapeutic dose","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82234","name":"Beta-amyloid 1-42 (abeta 42)","description":"Beta-amyloid; 1-42 (abeta 42)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37266","name":"Rvsc evsc fpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0739T","name":"Abltj mal prst8 mag fld ndct","description":"Ablation of malignant prostate tissue by magnetic field induction, including all intraprocedural, transperineal needle/catheter placement for nanoparticle installation and intraprocedural temperature monitoring, thermal dosimetry, bladder irrigation, and magnetic field nanoparticle activation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0417U","name":"Rare ds alys 335 nuc genes","description":"Rare ds alys 335 nuc genes","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4361","name":"Epixpress, per sq cm","description":"Epixpress, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93925","name":"Lower extremity study","description":"Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":374.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0876T","name":"Duplex scan hemo fstl lmtd","description":"Duplex scan of hemodialysis fistula, computer-aided, limited (volume flow, diameter, and depth, including only body of fistula)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0896T","name":"Connj lvr algrft prfu dev ea","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; each additional hour, including physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary bicarbonate, lactate ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76988","name":"Dx ntrop epcr us chd img acq","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; placement, manipulation of transducer, and image acquisition only","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1005T","name":"Elec alys s-scl eeg prgr 1st","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, first 15 minutes face-to-face time with physician or other qualified hea","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45305","name":"Proctosigmoidoscopy w/bx","description":"Proctosigmoidoscopy, rigid; with biopsy, single or multiple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0488U","name":"Ob fetal ag nipt cfdna alys","description":"Ob fetal ag nipt cfdna alys","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85651","name":"Rbc sed rate nonautomated","description":"Sedimentation rate, erythrocyte; non-automated","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4291","name":"Lamellas xt, per sq cm","description":"Lamellas xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4322","name":"Caregraft, per sq cm","description":"Caregraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90675","name":"Rabies vaccine im","description":"Rabies vaccine, for intramuscular use","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0480U","name":"Nfct ds csf metag ngs alys","description":"Nfct ds csf metag ngs alys","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73080","name":"X-ray exam of elbow","description":"Radiologic examination, elbow; complete, minimum of 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0987T","name":"Iv img icr cere vsl oct ea","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0891T","name":"Arhfcmrigtbs sbsq tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent treatment day","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5941","name":"Resct proth mand part remov","description":"Resct proth mand part remov","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q0171","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4275","name":"Esano aca, per sq cm","description":"Esano aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1277","name":"Colorectal ca screen doc rev","description":"Colorectal cancer screening results documented and reviewed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0465","name":"Home vent invasive interface","description":"Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1360.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4412","name":"Choriofix per sq cm","description":"Choriofix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37286","name":"Revsc evasc tpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0527","name":"Mgt est pt dmentia low cmplx","description":"Management of established patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27458","name":"Osteot femur imed lngth dev","description":"Osteotomy(ies), femur, unilateral, with insertion of an externally controlled intramedullary lengthening device, including iliotibial band release when performed, imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":935.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1491","name":"Recd esrd mcp dur perf pd","description":"Receiving esrd mcp dialysis services by the provider during the performance period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0320U","name":"Neph rna psttrnspl perph bld","description":"Neph rna psttrnspl perph bld","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1451","name":"Pt dx ppd dur id/pf pd","description":"Patients with an active diagnosis of pervasive developmental disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1291","name":"Pt 66+ frailty and med dem","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0446U","name":"Ai ds sle alys 10 cytokine","description":"Ai ds sle alys 10 cytokine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0401U","name":"Crd c hrt ds 9 gen 12 vrnts","description":"Crd c hrt ds 9 gen 12 vrnts","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0569","name":"Subs psych care mng, subs mo","description":"Subsequent psychiatric collaborative care management, in a subsequent month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required elements: tracking ","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0525","name":"Inj cefotetan disodium 10 mg","description":"Injection, cefotetan disodium, 10 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15011","name":"Hrv skn cll ssp agrft 1st 25","description":"Harvest of skin for skin cell suspension autograft; first 25 sq cm or less","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1098","name":"Articaine ophthalmi 8% 0.4ml","description":"Articaine ophthalmic, 8% solution, 0.4 ml","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50810","name":"Fusion of ureter & bowel","description":"Ureterosigmoidostomy, with creation of sigmoid bladder and establishment of abdominal or perineal colostomy, including intestine anastomosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1395.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9611","name":"Flurpiridaz f18, diag, 1 mci","description":"Flurpiridaz f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2471","name":"Inj pantoprazole(hikma) 40mg","description":"Injection, pantoprazole (hikma), not therapeutically equivalent to j2470, 40 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2782","name":"Inj avacincaptad pegol 0.1mg","description":"Injection, avacincaptad pegol, 0.1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0803T","name":"Tcat rmv&rpl2chmb ldls pm rv","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40525","name":"Reconstruct lip with flap","description":"Excision of lip; full thickness, reconstruction with local flap (eg, estlander or fan)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":662.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4403","name":"Xwrap dual plus per sq cm","description":"Xwrap dual plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55711","name":"Bx prst8 trct mri-us 1st","description":"Biopsy, prostate, transrectal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87086","name":"Urine culture/colony count","description":"Culture, bacterial; quantitative colony count, urine","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99211","name":"Off/op est may x req phy/qhp","description":"Office or other outpatient visit for the evaluation and management of an established patient that may not require the presence of a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":8.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0529U","name":"Hem vte snp f2&f5 gen leiden","description":"Hem vte snp f2&f5 gen leiden","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2043","name":"Biobrane, per sq cm","description":"Biobrane, per square centimeter","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1316","name":"Tobacco non-user","description":"Current tobacco non-user","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26676","name":"Pin hand dislocation","description":"Percutaneous skeletal fixation of carpometacarpal dislocation, other than thumb, with manipulation, each joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1284","name":"Pt 66+ snp or ltc pos > 90d","description":"Patients age 66 or older in institutional special needs plans (snp) or residing in long term care with pos code 32, 33, 34, 54, or 56 for more than 90 consecutive days during the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4287","name":"Dermabind dl, per sq cm","description":"Dermabind dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2991","name":"App of hydroxyapatite","description":"App of hydroxyapatite","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1812","name":"Inj. insulin (fiasp)","description":"Insulin (fiasp), per 5 units","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1346","name":"No pam inc 6 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 6 points within a 4 to 12 month period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90471","name":"Immunization admin","description":"Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); 1 vaccine (single or combination vaccine/toxoid)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45342","name":"Sigmoidoscopy w/us guide bx","description":"Sigmoidoscopy, flexible; with transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87812","name":"Sarscov2&inf typ a&b w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) and influenza virus types a and b","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1278","name":"Pre-htn or htn doc, f/u indc","description":"Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98011","name":"Synch audio-only new high 60","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 60 ","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2021","name":"Neomatrix per sq cm","description":"Neomatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1170","name":"Pt w/o flu vax 7/1-6/30","description":"Patient did not receive an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9953","name":"Reline sleep apnea appliance","description":"Reline sleep apnea appliance","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0019","name":"Comm hlth intg svs sdoh 60mn","description":"Community health integration services performed by certified or trained auxiliary personnel, including a community health worker, under the direction of a physician or other practitioner; 60 minutes per calendar month, in the following activities to address social determinants of health (sdoh) need(","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4295","name":"Amnio tri-core, per sq cm","description":"Amnio tri-core amniotic, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0389","name":"Periopic image capture only","description":"Periopic image capture only","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1282","name":"Pt scrn tbco id as non user","description":"Patient screened for tobacco use and identified as a tobacco non-user","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4000","name":"Dermatology ss","description":"Dermatology mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31578","name":"Largsc w/removal lesion","description":"Laryngoscopy, flexible; with removal of lesion(s), non-laser","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1202","name":"Miglustat oral 65 mg","description":"Miglustat, oral, 65 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28415","name":"Optx calcaneal fracture","description":"Open treatment of calcaneal fracture, includes internal fixation, when performed;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1455.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0845T","name":"Dgtz gls mcrscp imfluor 1st","description":"Digitization of glass microscope slides for immunofluorescence, per specimen; initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1006T","name":"Elec alys s-scl eeg prgrm ea","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, each additional 15 minutes face-to-face time with physician or other qua","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4336","name":"Artecent c, per sq cm","description":"Artacent c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0418U","name":"Onc brst aug alg aly whl sl8","description":"Onc brst aug alg aly whl sl8","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0307U","name":"Onc mrd nxt-gnrj alys sbsq","description":"Onc mrd nxt-gnrj alys sbsq","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75577","name":"Quan&char c athrosclrtc plaq","description":"Quantification and characterization of coronary atherosclerotic plaque to assess severity of coronary disease, derived from augmentative software analysis of the data set from a coronary computed tomographic angiography, with interpretation and report by a physician or other qualified health care pr","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87336","name":"Entamoeb hist dispr ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; entamoeba histolytica dispar group","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1352","name":"Suicd c-ssrs assessment, equ","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs or equivalent assessment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1291","name":"Pt 66+ frailty and med dem","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11954","name":"Subq njx fil matrl>10.0 cc","description":"Subcutaneous injection of filling material (eg, collagen); over 10.0 cc","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4344","name":"Tri membrane wrap, per sq cm","description":"Tri-membrane wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3425","name":"Hydroxocobalamin im 10mcg","description":"Injection, hydroxocobalamin, intramuscular, 10 mcg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1238","name":"Doc 2nd recom hzv 2-6 mo int","description":"Documentation that administration of second recombinant zoster vaccine could not occur during the performance period due to the recommended 2-6 month interval between doses (i.e, first dose received after october 31)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2021","name":"Inj, linezolid (hospira)","description":"Injection, linezolid (hospira), not therapeutically equivalent to j2020, 200 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0454U","name":"U rare ds id opt genome mapg","description":"U rare ds id opt genome mapg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59618","name":"Attempted vbac delivery","description":"Routine obstetric care including antepartum care, cesarean delivery, and postpartum care, following attempted vaginal delivery after previous cesarean delivery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3097.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2041","name":"Foundation drs+ duo pr sq cm","description":"Foundation drs+ duo, per square centimeter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1417","name":"Pt up to date cov","description":"Patients who are up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5911","name":"Facial moulage sectional","description":"Facial moulage (sectional)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7354","name":"Cantharidin top, applicator","description":"Cantharidin for topical administration, 0.7%, single unit dose applicator (3.2 mg)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0949T","name":"Rem interrog dev ccm tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9609","name":"F18 fdg, 15 millicuries","description":"Fludeoxyglucose f18 up to 15 millicuries","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51721","name":"Ins trurl ablt trnsdc thr us","description":"Insertion of transurethral ablation transducer for delivery of thermal ultrasound for prostate tissue ablation, including suprapubic tube placement during the same session and placement of an endorectal cooling device, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0369","name":"Max mri capture & interprete","description":"Max mri capture & interprete","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1207","name":"Pt scrn sdoh","description":"Patient is screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6555","name":"G com stcking bk 40+ custm","description":"Gradient compression stocking, below knee, 40 mmhg or greater, custom, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0372U","name":"Nfct ds gu pthgn arg detcj","description":"Nfct ds gu pthgn arg detcj","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0233","name":"Intra inf, toci, first dose","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76977","name":"Us bone density measure","description":"Ultrasound bone density measurement and interpretation, peripheral site(s), any method","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4034","name":"Speech language path ss","description":"Speech language pathology mips specialty set","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1257","name":"Cvd risk assess not perf","description":"Cvd risk assessment not performed or incomplete (e.g., cvd risk assessment was not documented), reason not otherwise specified","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52630","name":"Remove prostate regrowth","description":"Transurethral resection; residual or regrowth of obstructive prostate tissue including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy are included)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":478.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44720","name":"Prep donor intestine/venous","description":"Backbench reconstruction of cadaver or living donor intestine allograft prior to transplantation; venous anastomosis, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5421","name":"Dentures adjust part maxill","description":"Adjust partial denture - maxillary","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0371U","name":"Iadna gu pthgn semiq dna16&1","description":"Iadna gu pthgn semiq dna16&1","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9276","name":"Inj zanidatamab-hrii, 2 mg","description":"Injection, zanidatamab-hrii, 2 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0802T","name":"Tcat rmv&rpl2chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right at","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6196","name":"Remv of ind rest on implt","description":"Remv of ind rest on implt","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4317","name":"Vitograft, per sq cm","description":"Vitograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0817T","name":"Opn insj/rplcmt ins ptn subf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87150","name":"Dna/rna amplified probe","description":"Culture, typing; identification by nucleic acid (dna or rna) probe, amplified probe technique, per culture or isolate, each organism probed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31628","name":"Bronchoscopy/lung bx each","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial lung biopsy(s), single lobe","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51865","name":"Repair of bladder wound","description":"Cystorrhaphy, suture of bladder wound, injury or rupture; complicated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1008.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0817T","name":"Opn insj/rplcmt ins ptn subf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4265","name":"Neostim tl per sq cm","description":"Neostim tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5228","name":"Immed mand part denture","description":"Immed mand part denture","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2313","name":"Inj, naloxone (zimhi) 0.01mg","description":"Injection, naloxone hydrochloride (zimhi), 0.01 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64628","name":"Trml dstrj ios bvn 1st 2 l/s","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; first 2 vertebral bodies, lumbar or sacral","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49593","name":"Rpr aa hrn 1st 3-10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, reducible","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4346","name":"Shelter dm matrix per sq cm","description":"Shelter dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"Evoked auditory test limited","description":"Distortion product evoked otoacoustic emissions; limited evaluation (to confirm the presence or absence of hearing disorder, 3-6 frequencies) or transient evoked otoacoustic emissions, with interpretation and report","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1033","name":"Sv doula brth wrk per diem","description":"Services performed by a doula birth worker, per diem","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0549","name":"Phone/inter for treat>31m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0911T","name":"Elec aly nstm sys vgs nrv wo","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; without programming by physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1783","name":"Vac admin human pap dose 3","description":"Vac admin human pap dose 3","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0532","name":"Take home supp nasal spray","description":"Take-home supply of nasal nalmefene hydrochloride; one carton of two, 2.7 mg per 0.1 ml nasal sprays (provision of the services by a medicare-enrolled opioid treatment program);( list separately in addition to each primary code)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7962","name":"Lingual frenectomy","description":"Lingual frenectomy","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87088","name":"Urine bacteria culture","description":"Culture, bacterial; with isolation and presumptive identification of each isolate, urine","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69801","name":"Incise inner ear","description":"Labyrinthotomy, with perfusion of vestibuloactive drug(s), transcanal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":844.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1197","name":"Isa reduced >=3 fr ixv","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28322","name":"Repair of metatarsals","description":"Repair, nonunion or malunion; metatarsal, with or without bone graft (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":723.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0039","name":"Pt no ref, rn spec","description":"Patient not referred, reason not otherwise specified","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1433","name":"Oral chemo wthn 30 days enc","description":"Patient on oral chemotherapy on or within 30 days before denominator eligible encounter","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1463","name":"2 f/u wthn 180 day rx atmp","description":"Documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1453","name":"Preop vis acu > 20/40","description":"Patients with a pre-operative visual acuity better than 20/40","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5160","name":"Inj, jobevne, 10 mg","description":"Injection, bevacizumab-nwgd (jobevne), biosimilar, 10 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0048","name":"Pall serv during meas","description":"Patients who receive palliative care services any time during the intake period through the end of the measurement year","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4425","name":"Revive tl per sq cm","description":"Revive tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0103","name":"Psa screening","description":"Prostate cancer screening; prostate specific antigen test (psa)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0950T","name":"Abltj b9 prst8 tissue hifu","description":"Ablation of benign prostate tissue, transrectal, with high intensity-focused ultrasound (hifu), including ultrasound guidance","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1160","name":"Pt anphx due to mengb bef 13","description":"Patient had anaphylaxis due to the meningococcal vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0819T","name":"Revj/rmvl ins ptn subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0807T","name":"Pulm tiss vntj alys prev ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with previously acquired computed tomography (ct) images, including data preparation and transmission, quantification of pulmonary tissue ventilation, data re","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0608","name":"Lanthanum carbonate pwdr 5mg","description":"Lanthanum carbonate, oral, powder, 5 mg, not therapeutically equivalent to j0607 (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59025","name":"Fetal non-stress test","description":"Fetal non-stress test","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5942","name":"Proth max implt sup remv","description":"Proth max implt sup remv","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28400","name":"Cltx calcaneal fx w/o mnpj","description":"Closed treatment of calcaneal fracture; without manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90482","name":"Imm cnsl not admn sm 3<10","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; 3 minutes up to 10 minutes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2956","name":"Indirect rest remov","description":"Indirect rest remov","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0803T","name":"Tcat rmv&rpl2chmb ldls pm rv","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ve","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78315","name":"Bone imaging 3 phase","description":"Bone and/or joint imaging; 3 phase study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2033","name":"Myriad morcells, 4 mg","description":"Myriad morcells, 4 milligrams","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33370","name":"Tcat plmt&rmvl cepd perq","description":"Transcatheter placement and subsequent removal of cerebral embolic protection device(s), including arterial access, catheterization, imaging, and radiological supervision and interpretation, percutaneous (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93574","name":"Njx cath slct pulm vn angrph","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary venous angiography of each distinct pulmonary vein during cardiac catheterization (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93584","name":"Vngrph chd anom/persist svc","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; anomalous or persistent superior vena cava when it exists as a second contralateral superior vena cava, with native drainage to heart (list separately in addition to code for pri","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59510","name":"Cesarean delivery","description":"Routine obstetric care including antepartum care, cesarean delivery, and postpartum care","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2923.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1287","name":"Calc bmi blw low param f/u","description":"Bmi is documented below normal parameters and a follow-up plan is documented","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0298U","name":"Onc pan tum whl trns seq rna","description":"Onc pan tum whl trns seq rna","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1369","name":"Qualcare mental hlth/sud mvp","description":"Quality care in mental health and substance use disorders mips value pathway","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0779T","name":"Gi myoelectrical actv study","description":"Gastrointestinal myoelectrical activity study, stomach through colon, with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1486","name":"Pt admitted to snf dur eval","description":"Patients admitted to a skilled nursing facility (snf) during the period of evaluation","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1003T","name":"Arthrp 1st crp/mtcrpl prostc","description":"Arthroplasty, first carpometacarpal joint, with distal trapezial and proximal first metacarpal prosthetic replacement (eg, first carpometacarpal total joint)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90637","name":"Vacc qirv mrna 30mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 30 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"Rec cath any transanal, each","description":"Rectal catheter with or without balloon, for use with any type transanal irrigation system, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0407U","name":"Neph dbtc ckd mult eclia alg","description":"Neph dbtc ckd mult eclia alg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17004","name":"Destroy premal lesions 15/>","description":"Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (eg, actinic keratoses), 15 or more lesions","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":176.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5611","name":"Rep resin part dent base man","description":"Rep resin part dent base man","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0432U","name":"Klhl11 antb sr/csf asy qual","description":"Klhl11 antb sr/csf asy qual","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0741T","name":"Rem auton alg nsln data coll","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; provision of software, data collection, transmission, and storage, each 30 days","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0777T","name":"R-t prs sensing edrl gdn sys","description":"Real-time pressure-sensing epidural guidance system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0640","name":"Leucovorin calcium injection","description":"Injection, leucovorin calcium, per 50 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1710","name":"Moderna vacc admin 3rd dose","description":"Moderna vacc admin 3rd dose","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7165","name":"Inj, human-lans, per i.u","description":"Injection, prothrombin complex concentrate, human-lans, per i.u. of factor ix activity","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4299","name":"Amniocore pro+, per sq cm","description":"Amniocore pro+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2010","name":"Apis, per square centimeter","description":"Apis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0063","name":"Cardiology ss","description":"Cardiology mips specialty set","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37296","name":"Revsc evasc imvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0823T","name":"Tcat ins 1chmbr ldls pm ra","description":"Transcatheter insertion of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or programming), when","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70110","name":"X-ray exam of jaw 4/> views","description":"Radiologic examination, mandible; complete, minimum of 4 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77437","name":"Surf radj ther supfc<=150kv","description":"Surface radiation therapy; superficial, delivery, </=150 kv, per fraction (eg, electronic brachytherapy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0717T","name":"Adrc ther prtl rc tear","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; adipose tissue harvesting, isolation and preparation of harvested cells, including incubation with cell dissociation enzymes, filtration, washing, and concentration of adrcs","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0036","name":"Pt/ptn decln assess","description":"Patient or care partner decline assessment","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9246","name":"Mod sedation noniv-15 min","description":"Mod sedation noniv-15 min","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7912","name":"Suture complicate wnd > 5 cm","description":"Complicated suture-greater than 5 cm","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4024","name":"Pediatrics ss","description":"Pediatrics mips specialty set","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0256U","name":"Tma/tmao prfl ms/ms ur alg","description":"Trimethylamine/trimethylamine n-oxide (tma/tmao) profile, tandem mass spectrometry (ms/ms), urine, with algorithmic analysis and interpretive report","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29126","name":"Appl short arm splint dyn","description":"Application of short arm splint (forearm to hand); dynamic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4286","name":"Remove non-resorb barrier","description":"Remove non-resorb barrier","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66500","name":"Incision of iris","description":"Iridotomy by stab incision (separate procedure); except transfixion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0524U","name":"Ob pe sflt-1/plgf ia srm/pls","description":"Ob pe sflt-1/plgf ia srm/pls","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6596","name":"G comp bandge conform gauze","description":"Gradient compression bandaging supply, conforming gauze, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1168","name":"Pt recd flu vax 7/1-6/30","description":"Patient received an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87154","name":"Cul typ id bld pthgn 6+ trgt","description":"Culture, typing; identification of blood pathogen and resistance typing, when performed, by nucleic acid (dna or rna) probe, multiplexed amplified probe technique including multiplex reverse transcription, when performed, per culture or isolate, 6 or more targets","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0839T","name":"Dgtz gls mcrscp cslt mat prp","description":"Digitization of glass microscope slides for consultation and report on referred material requiring preparation of slides (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22860","name":"Tot disc arthrp 2ntrspc lmbr","description":"Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression); second interspace, lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0545","name":"Inherent visit to inpt","description":"Visit complexity inherent to hospital inpatient or observation care associated with a confirmed or suspected infectious disease by an infectious diseases specialist, including disease transmission risk assessment and mitigation, public health investigation, analysis, and testing, and complex antimic","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0017","name":"Crisis psychotherapy 60m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); first 60 minutes","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1334","name":"Pts act pvd 2 wks 2 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 2 weeks after initial acute pvd encounter","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0266U","name":"Unxpl cnst hrtbl do gn xprsn","description":"Unexplained constitutional or other heritable disorders or syndromes, tissue-specific gene expression by whole-transcriptome and next-generation sequencing, blood, formalin-fixed paraffin-embedded (ffpe) tissue or fresh frozen tissue, reported as presence or absence of splicing or expression changes","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1626","name":"Granisetron hcl injection","description":"Injection, granisetron hydrochloride, 100 mcg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1479","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64716","name":"Revision of cranial nerve","description":"Neuroplasty and/or transposition; cranial nerve (specify)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":583.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9611","name":"Flurpiridaz f18, diag, 1 mci","description":"Flurpiridaz f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0399U","name":"Neuro cere folate defncy srm","description":"Neuro cere folate defncy srm","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7299","name":"Intraut copp cont (miudella)","description":"Intrauterine copper contraceptive (miudella)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35111","name":"Repair defect of artery","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, splenic artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1731.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0301U","name":"Iadna bartonella ddpcr","description":"Iadna bartonella ddpcr","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99232","name":"Sbsq hosp ip/obs moderate 35","description":"Subsequent hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 35 minut","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50081","name":"Perq nl/pl lithotrp cplx>2cm","description":"Percutaneous nephrolithotomy or pyelolithotomy, lithotripsy, stone extraction, antegrade ureteroscopy, antegrade stent placement and nephrostomy tube placement, when performed, including imaging guidance; complex (eg, stone[s] > 2 cm, branching stones, stones in multiple locations, ureter stones, co","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1398.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1280","name":"Bilat mast/hx bi /unilat mas","description":"Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34830","name":"Open aortic tube prosth repr","description":"Open repair of infrarenal aortic aneurysm or dissection, plus repair of associated arterial trauma, following unsuccessful endovascular repair; tube prosthesis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2269.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0688T","name":"Tx amblyopia assmt w/report","description":"Treatment of amblyopia using an online digital program; assessment of patient performance and program data by physician or other qualified health care professional, with report, per calendar month","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4027","name":"Plastic surgery ss","description":"Plastic surgery mips specialty set","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6037","name":"Postop dsg cast chg handfing","description":"Immediate post-surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, partial hand including fingers","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0372U","name":"Nfct ds gu pthgn arg detcj","description":"Nfct ds gu pthgn arg detcj","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0530","name":"Adult daycare center, 8 hr u","description":"Adult day center, 8-hour unit, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0862T","name":"Rlcj pg wcs lv battery only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; battery component only","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86701","name":"Hiv-1antibody","description":"Antibody; hiv-1","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5948","name":"Max implt sup fix part","description":"Max implt sup fix part","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1378","name":"Med rsn no 10 yr fu colscope","description":"Documentation of medical reason(s) for not recommending a 10 year follow-up interval (e.g., inadequate prep, familial or personal history of colonic polyps, patient had no adenoma and age is >= 66 years old, or life expectancy < 10 years, other medical reasons)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0700T","name":"Molec fluor img sus nev 1st","description":"Molecular fluorescent imaging of suspicious nevus; first lesion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1814","name":"Inj. insulin (lyumjev)","description":"Insulin (lyumjev), per 5 units","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4289","name":"Revoshield+ amnio, per sq cm","description":"Revoshield + amniotic barrier, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4397","name":"Summit aaa per sq cm","description":"Summit aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1212","name":"Missing gsa not perf","description":"Glycemic status assessment (hba1c or gmi) level is missing, or was not performed during the measurement period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0013","name":"Hiv prep counsel, clin staff","description":"Individual counseling for pre-exposure prophylaxis (prep) by clinical staff to prevent human immunodeficiency virus (hiv), includes: hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8522","name":"Capecitabine, oral, 50 mg","description":"Capecitabine, oral, 50 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1311","name":"Aphlx to vax bef enc","description":"Anaphylaxis due to the vaccine on or before the date of the encounter","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92920","name":"Prq trluml c angiop 1art&/br","description":"Percutaneous transluminal coronary angioplasty, single major coronary artery and/or its branch(es)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3403","name":"Revakinagene, per implant","description":"Revakinagene taroretcel-lwey, per implant","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4332","name":"Axolotl dualgraft, per sq cm","description":"Axolotl dualgraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37273","name":"Revsc evsc fpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44153","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2154.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1331","name":"Pts eval ini xm 8 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 8 weeks from initial exam","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1411","name":"Inj, hemgenix, per tx dose","description":"Injection, etranacogene dezaparvovec-drlb, per therapeutic dose","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87880","name":"Strep a assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; streptococcus, group a","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1201","name":"Med rsn no ace-i/arb rx","description":"Documentation of medical reason(s) for not prescribing ace inhibitor (ace-i) or arb therapy during the measurement period (e.g., pregnancy, history of angioedema to ace-i, other allergy to ace-i and arb, hyperkalemia or history of hyperkalemia while on ace-i or arb therapy, acute kidney injury due t","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1237","name":"Pt rsn no scrn","description":"Patient reason for not screening for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety (e.g., patient declined or other patient reasons)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92235","name":"Fluorescein angrph mltiframe","description":"Fluorescein angiography (includes multiframe imaging) with interpretation and report, unilateral or bilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":175.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20240","name":"Bone biopsy open superficial","description":"Biopsy, bone, open; superficial (eg, sternum, spinous process, rib, patella, olecranon process, calcaneus, tarsal, metatarsal, carpal, metacarpal, phalanx)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0560","name":"Safety plan interven","description":"Safety planning interventions, each 20 minutes personally performed by the billing practitioner, including assisting the patient in the identification of the following personalized elements of a safety plan: recognizing warning signs of an impending suicidal or substance use-related crisis; employin","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1402","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33370","name":"Tcat plmt&rmvl cepd perq","description":"Transcatheter placement and subsequent removal of cerebral embolic protection device(s), including arterial access, catheterization, imaging, and radiological supervision and interpretation, percutaneous (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5932","name":"Postsurgical obturator","description":"Obturator prosthesis definitive","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0138","name":"Inj acetaminoph 10mg/ibu 3mg","description":"Injection, acetaminophen 10 mg and ibuprofen 3 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0866T","name":"Quan mri alys brn w/dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion detection, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transmissio","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0761T","name":"Dgtz gls mcrscp sl imm ea 1","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97552","name":"Group caregiver training","description":"Group caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21206","name":"Reconstruct upper jaw bone","description":"Osteotomy, maxilla, segmental (eg, wassmund or schuchard)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1260.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4011","name":"Internal medicine ss","description":"Internal medicine mips specialty set","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0983T","name":"Rem mntr impl ivc snr phys","description":"Remote monitoring of an implanted inferior vena cava sensor for up to 30 days, including at least weekly downloads of inferior vena cava area recordings, interpretation(s), trend analysis, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0393U","name":"Neu prksn msfl a-syncln prtn","description":"Neu prksn msfl a-syncln prtn","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0877","name":"Inj, daptomycin (hospira)","description":"Injection, daptomycin (hospira), not therapeutically equivalent to j0878, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0952T","name":"Tot impl amei rev/rplc mstdc","description":"Totally implantable active middle ear hearing implant; revision or replacement, with mastoidectomy and replacement of sound processor","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77439","name":"Surf rad thr img gdn us plmt","description":"Surface radiation therapy; superficial or orthovoltage, image guidance, ultrasound for placement of radiation therapy fields for treatment of cutaneous tumors, per course of treatment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1471","name":"Ffs hep b not covered","description":"Documentation that patient is a medicare fee-for-service beneficiary and without additional supplementary insurance coverage for whom hep b vaccination is not reimbursable under current medicare part b coverage rules","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61550","name":"Release of skull seams","description":"Craniectomy for craniosynostosis; single cranial suture","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2022","name":"Innovabrn/innovamatx xl sqcm","description":"Innovaburn or innovamatrix xl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37291","name":"Revsc evsc tpvt athr cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26490","name":"Revise thumb tendon","description":"Opponensplasty; superficialis tendon transfer type, each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1033.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25805","name":"Arthrd wrist w/sliding graft","description":"Arthrodesis, wrist; with sliding graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1064.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2791","name":"Crown full cast base metal","description":"Crown-full cast predominantly base metal","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99239","name":"Hosp ip/obs dschrg mgmt >30","description":"Hospital inpatient or observation discharge day management; more than 30 minutes on the date of the encounter","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4389","name":"Neothelium 4l+ per sq cm","description":"Neothelium 4l+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1406","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0389U","name":"Ped fbrl kd ifi27&mcemp1 rna","description":"Ped fbrl kd ifi27&mcemp1 rna","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0848T","name":"Dgtz gls mcrscp ish 1st","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85651","name":"Rbc sed rate nonautomated","description":"Sedimentation rate, erythrocyte; non-automated","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","name":"Scoliosis orth sag/ cor","description":"Scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla to trochanter, includes all accessory pads, straps and interface, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0525U","name":"Onc sphrd cell cul 11-rx pnl","description":"Onc sphrd cell cul 11-rx pnl","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4034","name":"Speech language path ss","description":"Speech language pathology mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0023","name":"Pin service 60m per month","description":"Principal illness navigation services by certified or trained auxiliary personnel under the direction of a physician or other practitioner, including a patient navigator; 60 minutes per calendar month, in the following activities:  person-centered assessment, performed to better understand the indiv","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9997","name":"Ustekinumab-ttwe iv inj 1 mg","description":"Injection, ustekinumab-ttwe (pyzchiva), intravenous, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85610","name":"Prothrombin time","description":"Prothrombin time;","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6081","name":"Scale & debride, single imp","description":"Scale & debride, single imp","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0760T","name":"Dgtz gls mcrscp sl imm 1st","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0969T","name":"Removal epicranial nstim sys","description":"Removal of epicranial neurostimulator system","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62311","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1226","name":"Iop not doc","description":"Iop measurement not documented, reason not otherwise specified","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2810","name":"Inj theophylline per 40 mg","description":"Injection, theophylline, per 40 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37271","name":"Revsc evsc fpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78491","name":"Myocrd img pet 1std rst/strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); single study, at rest or stress (exercise or pharmacologic)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1474.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4294","name":"Amnio quad-core, per sq cm","description":"Amnio quad-core, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43229","name":"Esophagoscopy lesion ablate","description":"Esophagoscopy, flexible, transoral; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":805.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0423","name":"Genetic test spec analysis","description":"Genetic test spec analysis","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9128","name":"Photobio therpy-first 15 min","description":"Photobio therpy-first 15 min","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3425","name":"Hydroxocobalamin im 10mcg","description":"Injection, hydroxocobalamin, intramuscular, 10 mcg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7956","name":"Tiss regen edent resorb","description":"Tiss regen edent resorb","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88272","name":"Cytogenetics 3-5","description":"Molecular cytogenetics; chromosomal in situ hybridization, analyze 3-5 cells (eg, for derivatives and markers)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0904T","name":"Ecg alg 12 ld rdcd trcg only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; tracing only","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6111","name":"Implnt/abut remov dent mand","description":"Implnt/abut remov dent mand","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0799T","name":"Tcat rmvl 2chmbr ldls pm ra","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right atrial pacemaker component","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9608","name":"Flotufolastat f18 diag 1 mci","description":"Flotufolastat f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0859T","name":"Ncntc ifr spctrsc o/t pad ea","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), other than for screening for peripheral arterial disease, image acquisition, interpretation, and report; each additional anatomic site (list separately in addition to code ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0359U","name":"Onc prst8 ca alys all psa","description":"Onc prst8 ca alys all psa","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1401","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64629","name":"Trml dstrj ios bvn ea addl","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; each additional vertebral body, lumbar or sacral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97140","name":"Manual therapy 1/> regions","description":"Manual therapy techniques (eg, mobilization/ manipulation, manual lymphatic drainage, manual traction), 1 or more regions, each 15 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1189","name":"Doc khe pef w/efgr/uacr","description":"Documentation of a kidney health evaluation defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr) performed","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7295","name":"Eth estr and eton monthly","description":"Ethinyl estradiol and etonogestrel 0.015mg, 0.12mg per 24 hours; monthly vaginal ring, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71048","name":"X-ray exam chest 4+ views","description":"Radiologic examination, chest; 4 or more views","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7411","name":"Excision benign lesion>1.25c","description":"Excision of benign lesion greater than 1.25 cm","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33894","name":"Evasc st rpr thrc/aa acrs br","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; across major side branches","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2004","name":"Inj, lidocaine w epinephrine","description":"Injection, lidocaine hcl with epinephrine, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0757T","name":"Dgtz gls mcrscp sl spc grpii","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group ii, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistochemistry (list separately in addition to code for primary","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0343U","name":"Onc prst8 xom aly 442 sncrna","description":"Onc prst8 xom aly 442 sncrna","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9318","name":"Inj romidepsin non-lyo 0.1mg","description":"Injection, romidepsin, non-lyophilized, 0.1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0273U","name":"Hem gen hyprfibrnlysis 8 gen","description":"Hematology (genetic hyperfibrinolysis, delayed bleeding), genomic sequence analysis of 8 genes (f13a1, f13b, fga, fgb, fgg, serpina1, serpine1, serpinf2, plau) blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"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":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9247","name":"Mod sedation noniv-sub15min","description":"Mod sedation noniv-sub15min","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86381","name":"Mitochondrial antibody each","description":"Mitochondrial antibody (eg, m2), each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77436","name":"Surf radj ther tx planning","description":"Surface radiation therapy; superficial or orthovoltage, treatment planning and simulation-aided field setting","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52597","name":"Trurl rbtc wtrjt rescj prst8","description":"Transurethral robotic-assisted waterjet resection of prostate, including intraoperative planning, ultrasound guidance, control of postoperative bleeding, complete, including vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy, when performed","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63746","name":"Removal of spinal shunt","description":"Removal of entire lumbosubarachnoid shunt system without replacement","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1357","name":"Pt w/red suic idea 120 days","description":"Patients who had a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1205","name":"Isa reduced >=3","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1834","name":"Inj, isoniazid, 1 mg","description":"Injection, isoniazid, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43865","name":"Revj gstr/jj anast w/vgtmy","description":"Revision of gastrojejunal anastomosis (gastrojejunostomy) with reconstruction, with or without partial gastrectomy or intestine resection; with vagotomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49081","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5150","name":"Inj, aflibercept-mrbb, 1 mg","description":"Injection, aflibercept-mrbb (ahzantive), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55868","name":"Lap srg prst8ct lymph nod bx","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with lymph node biopsy(ies) (limited pelvic lymphadenectomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":593.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0263U","name":"Neuro asd meas 16 c metblt","description":"Neurology (autism spectrum disorder [asd]), quantitative measurements of 16 central carbon metabolites (ie, a-ketoglutarate, alanine, lactate, phenylalanine, pyruvate, succinate, carnitine, citrate, fumarate, hypoxanthine, inosine, malate, s-sulfocysteine, taurine, urate, and xanthine), liquid chrom","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4011","name":"Internal medicine ss","description":"Internal medicine mips specialty set","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1022T","name":"Prq tis dsplmt ntra-abdl/pel","description":"Percutaneous tissue displacement, any method, including imaging guidance; intra-abdominal/pelvic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1167","name":"Hspc dur meas pd","description":"In hospice or using hospice services during the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2037","name":"G4derm plus/suprello, pr ml","description":"G4derm plus/suprello, per milliliter","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0590U","name":"Nfct ds bct&fngl dna 44 orgs","description":"Nfct ds bct&fngl dna 44 orgs","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4428","name":"Dermbnd sln sl+ slx sq cm","description":"Dermabind sl n or dermabind sl + or dermabind sl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0805T","name":"Tcat s&ivc prstc vl impl prq","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); percutaneous femoral vein approach","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0738","name":"Upper extremity rehab","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2039.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0485U","name":"Onc sol tum cfdna&rna ngs gm","description":"Onc sol tum cfdna&rna ngs gm","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0951T","name":"Tot impl amei 1st plmt","description":"Totally implantable active middle ear hearing implant; initial placement, including mastoidectomy, placement of and attachment to sound processor","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86336","name":"Inhibin a","description":"Inhibin a","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19112","name":"Excise breast duct fistula","description":"Excision of lactiferous duct fistula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51721","name":"Ins trurl ablt trnsdc thr us","description":"Insertion of transurethral ablation transducer for delivery of thermal ultrasound for prostate tissue ablation, including suprapubic tube placement during the same session and placement of an endorectal cooling device, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1169","name":"Doc med rsn no flu vax","description":"Documentation of medical reason(s) for not administering influenza vaccine (e.g., prior anaphylaxis due to the influenza vaccine)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7295","name":"Eth estr and eton monthly","description":"Ethinyl estradiol and etonogestrel 0.015mg, 0.12mg per 24 hours; monthly vaginal ring, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31770","name":"Repair/graft of bronchus","description":"Bronchoplasty; graft repair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1583.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0546","name":"Phone/internet ehr assess","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty   whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patien","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0957T","name":"Rev s-sclp eltr ra rcvr&tlmt","description":"Revision of sub-scalp implanted electrode array, receiver, and telemetry unit for electrode, when required, including imaging guidance","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3431","name":"Biological materials","description":"Biological materials","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5421","name":"Dentures adjust part maxill","description":"Adjust partial denture - maxillary","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0288U","name":"Onc lung mrna quan pcr 11&3","description":"Onc lung mrna quan pcr 11&3","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73202","name":"Ct uppr extremity w/o&w/dye","description":"Computed tomography, upper extremity; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4033","name":"Skilled nursing facility ss","description":"Skilled nursing facility mips specialty set","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83715","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0235","name":"Intrav inf, mon anti, fir do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0497U","name":"Onc prst8 mrna rt-pcr 6 gene","description":"Onc prst8 mrna rt-pcr 6 gene","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4419","name":"Biolab wrap flw lt per sq cm","description":"Biolab membrane wrap lite flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59074","name":"Fetal fluid drainage w/us","description":"Fetal fluid drainage (eg, vesicocentesis, thoracocentesis, paracentesis), including ultrasound guidance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0541U","name":"Cv ds hdl rct cec lc-ms/ms 5","description":"Cv ds hdl rct cec lc-ms/ms 5","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81523","name":"Onc brst mrna 70 cnt 31 gene","description":"Oncology (breast), mrna, next-generation sequencing gene expression profiling of 70 content genes and 31 housekeeping genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as index related to risk to distant metastasis","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79005","name":"Nuclear rx oral admin","description":"Radiopharmaceutical therapy, by oral administration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1412","name":"Inj roctavian ml 2x10^13vc g","description":"Injection, valoctocogene roxaparvovec-rvox, per ml, containing nominal 2 x 10^13 vector genomes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0691T","name":"Auto alys xst ct std vrt fx","description":"Automated analysis of an existing computed tomography study for vertebral fracture(s), including assessment of bone density when performed, data preparation, interpretation, and report","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0757T","name":"Dgtz gls mcrscp sl spc grpii","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group ii, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistochemistry (list separately in addition to code for primary","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1281","name":"Bp scrn no perf at interval","description":"Blood pressure reading not documented, reason not given","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9323","name":"Inj pemetrexed ditromethamin","description":"Injection, pemetrexed ditromethamine, 10 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2253","name":"Inj midazolam (seizalam)","description":"Injection, midazolam (seizalam), 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1317","name":"Pts counsl cpt opt out","description":"Patients who are counseled on connection with a csp and explicitly opt out","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1812","name":"Inj. insulin (fiasp)","description":"Insulin (fiasp), per 5 units","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15013","name":"Prepj skn cll ssp agrft 1st","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; first 25 sq cm or less of harvested skin","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0758T","name":"Dgtz gls mcrscp sl spc hchem","description":"Digitization of glass microscope slides for special stain, including interpretation and report, histochemical stain on frozen tissue block (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4281","name":"Barrera slor dl per sq cm","description":"Barrera sl or barrera dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0748T","name":"Njx stm cl prdct anl sft tis","description":"Injections of stem cell product into perianal perifistular soft tissue, including fistula preparation (eg, removal of setons, fistula curettage, closure of internal openings)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83521","name":"Ig light chains free each","description":"Immunoglobulin light chains (ie, kappa, lambda), free, each","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0368","name":"Cone beam ct interprete tmj","description":"Cone beam ct interprete tmj","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0049","name":"Main hemo in-cntr","description":"With maintenance hemodialysis (in-center and home hd) for the complete reporting month","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4298","name":"Amniocore pro, per sq cm","description":"Amniocore pro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61715","name":"Mrgfus strtctc ablt trgt icr","description":"Magnetic resonance image guided high intensity focused ultrasound (mrgfus), stereotactic ablation of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4411","name":"Amniomatrixf4x per sq cm","description":"Amniomatrixf4x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0182","name":"Hospice care supervision","description":"Physician supervision of a patient under a medicare-approved hospice (patient not present) requiring complex and multidisciplinary care modalities involving regular physician development and/or revision of care plans, review of subsequent reports of patient status, review of laboratory and other stu","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90832","name":"Psytx w pt 30 minutes","description":"Psychotherapy, 30 minutes with patient","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":74.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1250","name":"Pt resp true heard","description":"Patient responded as completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4313","name":"Dermabind fm, per sq cm","description":"Dermabind fm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0403U","name":"Onc prst8 mrna 18 gen dre ur","description":"Onc prst8 mrna 18 gen dre ur","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4285","name":"Nudyn dl or dl mesh pr sq cm","description":"Nudyn dl or nudyn dl mesh, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0779T","name":"Gi myoelectrical actv study","description":"Gastrointestinal myoelectrical activity study, stomach through colon, with interpretation and report","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0723T","name":"Qmrcp w/o dx mri sm anat ses","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained without diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) during the same session","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57455","name":"Biopsy of cervix w/scope","description":"Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":137.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":191.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1414","name":"Inj, beqvez, per tx dose","description":"Injection, fidanacogene elaparvovec-dzkt, per therapeutic dose","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0704T","name":"Rem tx amblyopia setup&edu","description":"Remote treatment of amblyopia using an eye tracking device; device supply with initial set-up and patient education on use of equipment","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0865T","name":"Quan mri alys brn w/o dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion identification, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transm","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0524U","name":"Ob pe sflt-1/plgf ia srm/pls","description":"Ob pe sflt-1/plgf ia srm/pls","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4416","name":"Alexiguard tl-t per sq cm","description":"Alexiguard tl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4307","name":"American amnion, per sq cm","description":"American amnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0935T","name":"Cysto w/rnl pel symp dnrvtj","description":"Cystourethroscopy with renal pelvic sympathetic denervation, radiofrequency ablation, retrograde ureteral approach, including insertion of guide wire, selective placement of ureteral sheath(s) and multiple conformable electrodes, contrast injection(s), and fluoroscopy, bilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0942T","name":"Cysto flx rmv&rplc urtl scaf","description":"Cystourethroscopy, flexible; with removal and replacement of prostatic urethral scaffold","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0689","name":"Inj cefazolin sodium, baxter","description":"Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83970","name":"Assay of parathormone","description":"Parathormone (parathyroid hormone)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1209","name":">=2 same hi-rsk med w/o diag","description":"At least two orders for high-risk medications from the same drug class, (table 4), without appropriate diagnoses","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1460","name":"Dx copd, cf, or arf","description":"Diagnosis for chronic obstructive pulmonary disease, emphysema, cystic fibrosis, or acute respiratory failure","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0931T","name":"Ephys eval ccm-d ld separate","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), separate from initial implantation or replacement with testing of cardiac cont","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1216","name":"No spiro doc no res doc","description":"No spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and/or no spirometry performed with results documented during the encounter","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1357","name":"Pt w/red suic idea 120 days","description":"Patients who had a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0837T","name":"Dgtz gls mcrscp fna i&r","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; interpretation and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33288","name":"Rmv&rplcmt phrnc nrv stim ld","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87494","name":"Chlmy trch&neisra gonor mult","description":"Infectious agent detection by nucleic acid (dna or rna); chlamydia trachomatis and neisseria gonorrhoeae, multiplex amplified probe technique","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1552","name":"Inj, alyglo, 500 mg","description":"Injection, immune globulin (alyglo), 500 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0759","name":"Inj, clevidipine, 1 mg","description":"Injection, clevidipine butyrate, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5137","name":"Inj, wezlana, sub cu, 1 mg","description":"Injection, ustekinumab-auub (wezlana), biosimilar, subcutaneous, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9292","name":"Pres dig visual therapy fda","description":"Prescription digital visual therapy, software-only, fda cleared, per course of treatment","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37297","name":"Revsc evasc imvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4269","name":"Surgraft xt per sq cm","description":"Surgraft xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0805T","name":"Tcat s&ivc prstc vl impl prq","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); percutaneous femoral vein approach","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87182","name":"Sc std carbapenemase nzm det","description":"Susceptibility studies, antimicrobial agent; carbapenemase enzyme detection (eg, klebsiella pneumoniae carbapenemase [kpc], new delhi metallo-beta-lactamase [ndm], verona integron-encoded metallo-beta-lactamase [vim]), multiplex immunoassay, qualitative, per isolate","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0121A","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76856","name":"Us exam pelvic complete","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1681","name":"Ho bilateral hip abduction","description":"Hip orthosis, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2795.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2783","name":"Rasburicase","description":"Injection, rasburicase, 0.5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2221","name":"Ank mcrop plant & dorsi flex","description":"Addition to lower extremity orthosis, ankle system, microprocessor-controlled feature plantarflexion and/or dorsiflexion, includes power source","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0752","name":"Hiv prep, oral lenacapavir","description":"Oral, lenacapavir, 300 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22837","name":"Ant thrc vrt body tethrg 8+","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; 8 or more vertebral segments","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86592","name":"Syphilis test non-trep qual","description":"Syphilis test, non-treponemal antibody; qualitative (eg, vdrl, rpr, art)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30150","name":"Rhinectomy partial","description":"Rhinectomy; partial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":955.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76818","name":"Fetal biophys profile w/nst","description":"Fetal biophysical profile; with non-stress testing","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0237","name":"Intrav inf, toci, first dose","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1431","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6561","name":"G stockng full/chap 40+ cust","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, custom, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76016","name":"Mr safety deter phys/qhp","description":"Mr safety determination by a physician or other qualified health care professional responsible for the safety of the mr procedure, including review of implant mr conditions for indicated mr examination, analysis of risk vs clinical benefit of performing mr examination, and determination of mr equipm","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0017","name":"Crisis psychotherapy 60m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); first 60 minutes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0523","name":"Mgt nw pt dem mod-high cmplx","description":"Management of a new patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0860T","name":"Ncntc ifr spctrsc scr pad","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), for screening for peripheral arterial disease, including provocative maneuvers, image acquisition, interpretation, and report, one or both lower extremities","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1178","name":"Doc med rsn no pcv","description":"Documentation of medical reason(s) for not administering pneumococcal vaccine (e.g., prior anaphylaxis due to the pneumococcal vaccine)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49618","name":"Rpr aa hrn rcr > 10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, incarcerated or strangulate","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0773T","name":"Vr px dissoc svc oth phy 1st","description":"Virtual reality (vr) procedural dissociation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports; initial 15 min","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9273","name":"Inj tisotu vedotin-tftv, 1mg","description":"Injection, tisotumab vedotin-tftv, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":310.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0564U","name":"Nfct ds pthgn-sna 10vir&4bct","description":"Nfct ds pthgn-sna 10vir&4bct","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99462","name":"Sbsq nb em per day hosp","description":"Subsequent hospital care, per day, for evaluation and management of normal newborn","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1807","name":"Inj, ethacrynate sod, 1 mg","description":"Injection, ethacrynate sodium, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9601","name":"Flortaucipir inj 1 millicuri","description":"Flortaucipir f 18 injection, diagnostic, 1 millicurie","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1006T","name":"Elec alys s-scl eeg prgrm ea","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, each additional 15 minutes face-to-face time with physician or other qua","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52290","name":"Cystoscopy and treatment","description":"Cystourethroscopy; with ureteral meatotomy, unilateral or bilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":284.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4379","name":"Amniodefend ft per sq cm","description":"Amniodefend ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0847T","name":"Dgtz gls mcrscp xm arch tiss","description":"Digitization of glass microscope slides for examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, kras mutational analysis) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0983T","name":"Rem mntr impl ivc snr phys","description":"Remote monitoring of an implanted inferior vena cava sensor for up to 30 days, including at least weekly downloads of inferior vena cava area recordings, interpretation(s), trend analysis, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5938","name":"Resct proth max comp remov","description":"Resct proth max comp remov","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1414","name":"Inj, beqvez, per tx dose","description":"Injection, fidanacogene elaparvovec-dzkt, per therapeutic dose","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5126","name":"Inj alymsys 10 mg","description":"Injection, bevacizumab-maly, biosimilar, (alymsys), 10 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0574U","name":"Mtb cfp-10 serum/plsm lc-ms","description":"Mtb cfp-10 serum/plsm lc-ms","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25270","name":"Repair forearm tendon/muscle","description":"Repair, tendon or muscle, extensor, forearm and/or wrist; primary, single, each tendon or muscle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":880.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92972","name":"Perq trluml coronry lithotrp","description":"Percutaneous transluminal coronary lithotripsy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33863","name":"Ascending aortic graft","description":"Ascending aorta graft, with cardiopulmonary bypass, with aortic root replacement using valved conduit and coronary reconstruction (eg, bentall)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3139.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98979","name":"Rtm tx mgmt 1st 10 min","description":"Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least 1 real-time interactive communication with the patient or caregiver during the calendar month; first 10 minutes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0535","name":"Pt navigat svs direct/ref","description":"Patient navigational services, provided directly or by referral; including helping the patient to navigate health systems and identify care providers and supportive services, to build patient self-advocacy and communication skills with care providers, and to promote patient-driven action plans and g","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99253","name":"Ip/obs cnsltj new/est low 45","description":"Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 45 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1386","name":"Exc sx melmn or mlnm is","description":"Patients with an excisional surgery for melanoma or melanoma in situ in the past 5 years with an initial ajcc staging of 0, i, or ii at the start of the performance period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0138","name":"Iv cipaglucosidase alfa-atga","description":"Intravenous infusion of cipaglucosidase alfa-atga, including provider/supplier acquisition and clinical supervision of oral administration of miglustat in preparation of receipt of cipaglucosidase alfa-atga","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0860T","name":"Ncntc ifr spctrsc scr pad","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), for screening for peripheral arterial disease, including provocative maneuvers, image acquisition, interpretation, and report, one or both lower extremities","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99384","name":"Prev visit new age 12-17","description":"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; adolescent (age ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":157.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0472","name":"Gross exam prep & report","description":"Accession of tissue gross examination preparation and transmission of written report","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4279","name":"Vendaje ac, per sq cm","description":"Vendaje ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0004","name":"Qual care neurologic cnd mvp","description":"Quality care for patients with neurological conditions mips value pathway","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1252","name":"Pts no cmplt hu survey","description":"Patients who did not complete at least one of the four patient experience hu survey items and return the hu survey within 60 days of the ambulatory palliative care visit","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33281","name":"Reposg phrnc nrv stim trnsvn","description":"Repositioning of phrenic nerve stimulator transvenous lead(s)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0925T","name":"Rlcj skin pocket ccm-d pg","description":"Relocation of skin pocket for implanted cardiac contractility modulation-defibrillation pulse generator","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82948","name":"Reagent strip/blood glucose","description":"Glucose; blood, reagent strip","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0389U","name":"Ped fbrl kd ifi27&mcemp1 rna","description":"Ped fbrl kd ifi27&mcemp1 rna","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01939","name":"Anes nulyt agt crv/thrc","description":"Anesthesia for percutaneous image-guided destruction procedures by neurolytic agent on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92632","name":"Hearing aid slctn svc ea add","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9992","name":"Pall serv during meas","description":"Palliative care services used by patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0901","name":"Vadadustat oral 1mg for esrd","description":"Vadadustat, oral, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6607","name":"G com bandage tub protct lyr","description":"Gradient compression bandaging supply, tubular protective absorption layer, per linear yard, any width, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55715","name":"Bx prst8 ea add mri-us/ct/mr","description":"Biopsy, prostate, each additional, mri-ultrasound fusion or in-bore ct- or mri-guided targeted lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83521","name":"Ig light chains free each","description":"Immunoglobulin light chains (ie, kappa, lambda), free, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9026","name":"Cryo fib comp path redu each","description":"Cryoprecipitated fibrinogen complex, pathogen reduced, each unit","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98981","name":"Rtm tx mgmt ea addl 20 min","description":"Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least 1 real-time interactive communication with the patient or caregiver during the calendar month; each additional 20 minutes (list separately in","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J1785","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61737","name":"Litt icr mlt trj mlt/cplx ls","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; multiple trajectories for multiple or complex lesion(s)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25448","name":"Arthrp ntrcrpl/crp/mtcrp ssp","description":"Arthroplasty, intercarpal or carpometacarpal joints; suspension, including transfer or transplant of tendon, with interposition, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4011","name":"Internal medicine ss","description":"Internal medicine mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0845T","name":"Dgtz gls mcrscp imfluor 1st","description":"Digitization of glass microscope slides for immunofluorescence, per specimen; initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0461","name":"Testing for cracked tooth","description":"Testing for cracked tooth","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0689T","name":"Quan us tis charac w/o dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained without diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1032","name":"Sv doula brth wrk per 15 min","description":"Services performed by a doula birth worker, per 15 minutes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37295","name":"Rvsc evsc tpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0414","name":"Lab process microbial spec","description":"Lab process microbial spec","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76017","name":"Mr sfty med physics xm cstmz","description":"Mr safety medical physics examination customization, planning and performance monitoring by medical physicist or mr safety expert, with review and analysis by physician or other qualified health care professional to prioritize and select views and imaging sequences, to tailor mr acquisition specific","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0562U","name":"Onc sol tum tgsa 33gens snvs","description":"Onc sol tum tgsa 33gens snvs","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2027","name":"Matriderm per sq cm","description":"Matriderm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4274","name":"Esano ac, per sq cm","description":"Esano ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95924","name":"Ans parasymp & symp w/tilt","description":"Testing of autonomic nervous system function; combined parasympathetic and sympathetic adrenergic function testing with at least 5 minutes of passive tilt","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0436U","name":"Onc lng plsm alys 388 prtn","description":"Onc lng plsm alys 388 prtn","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86051","name":"Aquaporin-4 antb elisa","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; enzyme-linked immunosorbent immunoassay (elisa)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2679","name":"Inj fluphenazine hcl 1.25 mg","description":"Injection, fluphenazine hcl, 1.25 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4431","name":"Pma skin substitute, nos","description":"Pma skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77437","name":"Surf radj ther supfc<=150kv","description":"Surface radiation therapy; superficial, delivery, </=150 kv, per fraction (eg, electronic brachytherapy)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1834","name":"Inj, isoniazid, 1 mg","description":"Injection, isoniazid, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1408","name":"Gmln brca bef dx ca","description":"Patients who have germline brca testing completed before diagnosis of epithelial ovarian, fallopian tube, or primary peritoneal cancer","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4382","name":"Advograft dual per sq cm","description":"Advograft dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4404","name":"Xwrap hydro plus per sq cm","description":"Xwrap hydro plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0044","name":"Pt mitral stenosis","description":"Patients with moderate or severe mitral stenosis","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93271","name":"Ecg/monitoring and analysis","description":"External patient and, when performed, auto activated electrocardiographic rhythm derived event recording with symptom-related memory loop with remote download capability up to 30 days, 24-hour attended monitoring; transmission and analysis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87428","name":"Sarscov & inf vir a&b ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; severe acute respiratory syndrome coronavirus (eg, sars-cov, s","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20005","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":274.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9994","name":"Pall serv during meas","description":"Patient is using palliative care services any time during the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76016","name":"Mr safety deter phys/qhp","description":"Mr safety determination by a physician or other qualified health care professional responsible for the safety of the mr procedure, including review of implant mr conditions for indicated mr examination, analysis of risk vs clinical benefit of performing mr examination, and determination of mr equipm","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86825","name":"Hla x-math non-cytotoxic","description":"Human leukocyte antigen (hla) crossmatch, non-cytotoxic (eg, using flow cytometry); first serum sample or dilution","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0651","name":"Inj, levothyroxine, freskabi","description":"Injection, levothyroxine sodium (fresenius kabi), not therapeutically equivalent to j0650, 10 mcg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2989","name":"Excavate tooth non-restorabl","description":"Excavate tooth non-restorabl","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9274","name":"Inj, tebentafusp-tebn, 1 mcg","description":"Injection, tebentafusp-tebn, 1 microgram","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9998","name":"Inj ustekinumab-aekn, 1 mg","description":"Injection, ustekinumab-aekn (selarsdi), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0462","name":"Atropine sulf, nte, 0.01 mg","description":"Injection, atropine sulfate, not therapeutically equivalent to j0461, 0.01 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28320","name":"Repair of foot bones","description":"Repair, nonunion or malunion; tarsal bones","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":786.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1199","name":"Pt recg rrt","description":"Patients receiving rrt","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0551","name":"Phn/intr svs fr dx treat 30m","description":"Interprofessional telephone/internet/electronic health record referral service(s) provided by a treating/requesting practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, 30 minutes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4298","name":"Amniocore pro, per sq cm","description":"Amniocore pro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4258","name":"Enverse, per sq cm","description":"Enverse, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36582","name":"Replace tunneled cv cath","description":"Replacement, complete, of a tunneled centrally inserted central venous access device, with subcutaneous port, through same venous access","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1499","name":"Interventional radiology mvp","description":"Interventional radiology mips value pathway","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37257","name":"Revsc evsc ivt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0268","name":"Removal of impacted wax md","description":"Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":37.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0706T","name":"Rem tx amblyopia i&r phy/qhp","description":"Remote treatment of amblyopia using an eye tracking device; interpretation and report by physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0709T","name":"Id ca immntx each addl njx","description":"Intradermal cancer immunotherapy; each additional injection (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68841","name":"Insj rx elut implt lac canal","description":"Insertion of drug-eluting implant, including punctal dilation when performed, into lacrimal canaliculus, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1197","name":"Isa reduced >=3 fr ixv","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1297","name":"Bmi not doc medrsn ptref","description":"Bmi not documented due to medical reason or patient refusal of height or weight measurement","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6180","name":"Implnt maint proced","description":"Implnt maint proced","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2919","name":"Inj, methylpred sod succ 5mg","description":"Injection, methylprednisolone sodium succinate, 5 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6039","name":"Passive custom digit/thumb","description":"Passive prosthetic digit or thumb prosthesis not including hand restoration partial hand, full or partial, custom made, any material, initial or replacement, per single passive prosthetic digit or thumb","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5125","name":"Inj, releuko 1 mcg","description":"Injection, filgrastim-ayow, biosimilar, (releuko), 1 microgram","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91322","name":"Sarscov2 vac 50 mcg/0.5ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 50 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1024T","name":"Perq tiss dsplmt soft tissue","description":"Percutaneous tissue displacement, any method, including imaging guidance; soft tissue (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55881","name":"Ablt trurl prst8 tis thrm us","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation;","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84431","name":"Thromboxane urine","description":"Thromboxane metabolite(s), including thromboxane if performed, urine","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34701","name":"Evasc rpr a-ao ndgft","description":"Endovascular repair of infrarenal aorta by deployment of an aorto-aortic tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the aorta from the level ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1302.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6211","name":"Bridge base metal cast","description":"Pontic-cast predominantly base metal","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90472","name":"Immunization admin each add","description":"Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); each additional vaccine (single or combination vaccine/toxoid) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0694T","name":"3d vol img&rcnstj brst/ax","description":"3-dimensional volumetric imaging and reconstruction of breast or axillary lymph node tissue, each excised specimen, 3-dimensional automatic specimen reorientation, interpretation and report, real-time intraoperative","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9956","name":"Admin home sleep apnea test","description":"Admin home sleep apnea test","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35602","name":"Bpg crtd-clat crtd","description":"Bypass graft, with other than vein; carotid-contralateral carotid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5144","name":"Inj, idacio, 1 mg","description":"Injection, adalimumab-aacf (idacio), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33895","name":"Evasc st rpr thrc/aa x crsg","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; not crossing major side branches","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49190","name":"Opn exc/dstr ntra-abd >30 cm","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); greater than 30 cm","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83529","name":"Asay of interleukin-6 (il-6)","description":"Interleukin-6 (il-6)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82360","name":"Calculus assay quant","description":"Calculus; quantitative analysis, chemical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0759T","name":"Dgtz gls mcrscp sl sp grpiii","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group iii, for enzyme constituents (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0896T","name":"Connj lvr algrft prfu dev ea","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; each additional hour, including physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary bicarbonate, lactate ","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0916T","name":"Insj perm ccm-d sys pg only","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator only","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4315","name":"Regenelink amniotic mem allo","description":"Regenelink amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0697T","name":"Quan mr tis wo mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained without diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, targ","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4001","name":"Diagnostic rad ss","description":"Diagnostic radiology mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1349","name":"No pam inc 3 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 3 points within a 4 to 12 month period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32650","name":"Thoracoscopy w/pleurodesis","description":"Thoracoscopy, surgical; with pleurodesis (eg, mechanical or chemical)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":856.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0572U","name":"Onc prst8 httl qfish whl bld","description":"Onc prst8 httl qfish whl bld","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J0200","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0545","name":"Inherent visit to inpt","description":"Visit complexity inherent to hospital inpatient or observation care associated with a confirmed or suspected infectious disease by an infectious diseases specialist, including disease transmission risk assessment and mitigation, public health investigation, analysis, and testing, and complex antimic","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1185","name":"Imm ckpt inhib not hld no rx","description":"Documentation of immune checkpoint inhibitor therapy not held and/or corticosteroids or immunosuppressants prescribed or administered was not performed, reason not given","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49621","name":"Rpr parastomal hernia rdc","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; reducible","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1207","name":"Pt scrn sdoh","description":"Patient is screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1020T","name":"Raman spectroscopy 1+skn les","description":"Raman spectroscopy of 1 or more skin lesions, with probability score for malignant risk derived by algorithmic analysis of data from each lesion","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93598","name":"Car outp meas drg cath chd","description":"Cardiac output measurement(s), thermodilution or other indicator dilution method, performed during cardiac catheterization for the evaluation of congenital heart defects (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0630U","name":"Onc brst mrna gen prflg 80","description":"Onc brst mrna gen prflg 80","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0405U","name":"Onc pncrtc 59 mthltn blk mrk","description":"Onc pncrtc 59 mthltn blk mrk","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9052","name":"Inj, carmustine (accord)","description":"Injection, carmustine (accord), not therapeutically equivalent to j9050, 100 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0899","name":"Argatroban dialysis, auromed","description":"Injection, argatroban (auromedics), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9278","name":"Inj, carboplatin (avyxa)","description":"Injection, carboplatin (avyxa), 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4397","name":"Summit aaa per sq cm","description":"Summit aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0847T","name":"Dgtz gls mcrscp xm arch tiss","description":"Digitization of glass microscope slides for examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, kras mutational analysis) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6584","name":"Grad com wrap w straps","description":"Gradient compression wrap with adjustable straps, not otherwise specified","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1354","name":"Pt no suicd saf pln 120dy","description":"Patients who did not have a suicide safety plan initiated, reviewed, or updated or reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0874T","name":"Rmvl pertl ascites pmp sys","description":"Removal of a peritoneal ascites pump system, including implanted peritoneal ascites pump and indwelling bladder and peritoneal catheters","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1032","name":"Sv doula brth wrk per 15 min","description":"Services performed by a doula birth worker, per 15 minutes","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33530","name":"Coronary artery bypass/reop","description":"Reoperation, coronary artery bypass procedure or valve procedure, more than 1 month after original operation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2801","name":"Inj, rykindo, 0.5 mg","description":"Injection, risperidone (rykindo), 0.5 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1380","name":"2 rx in perf pd any com meds","description":"Filled at least two prescriptions during the performance period for any combination of the qualifying oral antipsychotic medications listed under denominator note or the long-acting injectable antipsychotic medications listed under denominator note","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96380","name":"Admn rsv monoc antb im cnsl","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection, with counseling by physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0481U","name":"Idh1 idh2&tert promoter ngs","description":"Idh1 idh2&tert promoter ngs","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61531","name":"Implant brain electrodes","description":"Subdural implantation of strip electrodes through 1 or more burr or trephine hole(s) for long-term seizure monitoring","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1275.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4354","name":"Palingen dl-palingen dl-x","description":"Palingen dual-layer membrane and dual-layer palingen x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0747T","name":"Car ablt rad arrhyt dlvr rad","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; delivery of radiation therapy, arrhythmia","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0948T","name":"Rem interrog dev ccm phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system with interim analysis, review, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5933","name":"Refitting of obturator","description":"Obturator prosthesis modification","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0552","name":"Supply of digital device","description":"Supply of digital mental health treatment device and initial education and onboarding, per course of treatment that augments a behavioral therapy plan","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1195","name":"Rpt wo imp/con mmr/msi","description":"Surgical pathology reports that do not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both, reason not given","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84393","name":"Tau phosphorylated ea","description":"Tau, phosphorylated (eg, ptau 181, ptau 217), each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1495","name":"Fall w/ poc, no fall","description":"Patients that reported a fall occurred who had a plan of care for falls documented or patients that did not report a fall","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88364","name":"Insitu hybridization (fish)","description":"In situ hybridization (eg, fish), per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5612","name":"Rep resin part dent base max","description":"Rep resin part dent base max","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0412U","name":"Beta amyloid ab42/40 imprcip","description":"Beta amyloid ab42/40 imprcip","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50065","name":"Nl sec surg operj calculus","description":"Nephrolithotomy; secondary surgical operation for calculus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1232.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2035","name":"Corpl p therac p allac p mg","description":"Corplex p or theracor p or allacor p, per milligram","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1001T","name":"Autol musc cell therapy njx","description":"Autologous muscle cell therapy, injection of muscle progenitor cells into the external anal sphincter, including ultrasound guidance, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85635","name":"Reptilase test","description":"Reptilase test","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4272","name":"Esano a, per sq cm","description":"Esano a, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4377","name":"Trigraft ft per sq cm","description":"Trigraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92555","name":"Speech threshold audiometry","description":"Speech audiometry threshold;","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0307U","name":"Onc mrd nxt-gnrj alys sbsq","description":"Onc mrd nxt-gnrj alys sbsq","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0949T","name":"Rem interrog dev ccm tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37284","name":"Revsc evasc tpvt st sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76017","name":"Mr sfty med physics xm cstmz","description":"Mr safety medical physics examination customization, planning and performance monitoring by medical physicist or mr safety expert, with review and analysis by physician or other qualified health care professional to prioritize and select views and imaging sequences, to tailor mr acquisition specific","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0996T","name":"Ins&sclr fix caps bag prosth","description":"Insertion and scleral fixation of a capsular bag prosthesis containing an intraocular lens prosthesis, with vitrectomy, including removal of crystalline lens or dislocated intraocular lens prosthesis, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0286U","name":"Cep72 nudt15&tpmt gene alys","description":"Cep72 nudt15&tpmt gene alys","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1837","name":"Inj, posaconazole, 1 mg","description":"Injection, posaconazole, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27110","name":"Transfer of iliopsoas muscle","description":"Transfer iliopsoas; to greater trochanter of femur","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1109.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1551","name":"Inj cutaquig 100 mg","description":"Injection, immune globulin (cutaquig), 100 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0376U","name":"Onc prst8 ca img alys 128","description":"Onc prst8 ca img alys 128","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27511","name":"Treatment of thigh fracture","description":"Open treatment of femoral supracondylar or transcondylar fracture without intercondylar extension, includes internal fixation, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1242.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69728","name":"Rmv ntr oi imp sk tc>=100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2247","name":"Inj, micafungin (par pharm)","description":"Injection, micafungin sodium (par pharm) not thereapeutically equivalent to j2248, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4261","name":"Tag, per square centimeter","description":"Tag, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1436","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29740","name":"Wedging of cast","description":"Wedging of cast (except clubfoot casts)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0605","name":"Antibody test pub hlth path","description":"Antibody test pub hlth path","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0512U","name":"Onc prst8 alys dgtz img msi","description":"Onc prst8 alys dgtz img msi","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0424U","name":"Onc prst8 xom alys 53 sncrna","description":"Onc prst8 xom alys 53 sncrna","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1448","name":"Injection, trilaciclib, 1mg","description":"Injection, trilaciclib, 1mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0741T","name":"Rem auton alg nsln data coll","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; provision of software, data collection, transmission, and storage, each 30 days","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84315","name":"Body fluid specific gravity","description":"Specific gravity (except urine)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53240","name":"Surgery for urethra pouch","description":"Marsupialization of urethral diverticulum, male or female","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"Endoskel posit rotat unit","description":"Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0566U","name":"Onc lng qpcr-bsd alys 13dmrs","description":"Onc lng qpcr-bsd alys 13dmrs","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4440","name":"Curamatrix per sq cm","description":"Curamatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80506","name":"Path clin consltj prolng svc","description":"Pathology clinical consultation; prolonged service, each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0521U","name":"Rf iga&igm ccp antb sr-a ia","description":"Rf iga&igm ccp antb sr-a ia","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15778","name":"Impl absrb msh/prsth dly cls","description":"Implantation of absorbable mesh or other prosthesis for delayed closure of defect(s) (ie, external genitalia, perineum, abdominal wall) due to soft tissue infection or trauma","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9888","name":"5% wl maintnd from bsline wt","description":"Maintenance 5% wl from baseline weight in months 7-12","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1212","name":"Missing gsa not perf","description":"Glycemic status assessment (hba1c or gmi) level is missing, or was not performed during the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0808T","name":"Pulm tiss vntj alys w/ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with computed tomography (ct) images taken for the purpose of pulmonary tissue ventilation analysis, including data preparation and transmission, quantificati","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6596","name":"G comp bandge conform gauze","description":"Gradient compression bandaging supply, conforming gauze, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90961","name":"Esrd srv 2-3 vsts p mo 20+","description":"End-stage renal disease (esrd) related services monthly, for patients 20 years of age and older; with 2-3 face-to-face visits by a physician or other qualified health care professional per month","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0525","name":"Est pt-cg dyad dem mod cmplx","description":"Management of established patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1401","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0350","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93319","name":"3d echo img cgen car anomal","description":"3d echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac structure(s) (eg, cardiac chambers and valves, left atrial appendage, interatrial septum, interventricular","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0313U","name":"Onc pncrs dna&mrna seq 74","description":"Onc pncrs dna&mrna seq 74","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0892T","name":"Arhfcmrigtbs sbsq per tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent motor threshold redetermination with delivery and management, per treatment day","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99459","name":"Pelvic examination","description":"Pelvic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1169","name":"Doc med rsn no flu vax","description":"Documentation of medical reason(s) for not administering influenza vaccine (e.g., prior anaphylaxis due to the influenza vaccine)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4421","name":"Biolab wrap solo per sq cm","description":"Biolab membrane wrap solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0786T","name":"Insj/rplcmt prq ra sac nstim","description":"Insertion or replacement of percutaneous electrode array, sacral, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0277U","name":"Hem gen pltlt funcj do 31","description":"Hematology (genetic platelet function disorder), genomic sequence analysis of 31 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33894","name":"Evasc st rpr thrc/aa acrs br","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; across major side branches","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1204","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98986","name":"Rtm dev sply cbt 2-15 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of cognitive behavioral therapy, 2-15 days in a 30-day period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2020","name":"Ac5 wound system","description":"Ac5 advanced wound system (ac5)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1468","name":"Hep b vaccine received","description":"Patient received recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31511","name":"Remove foreign body larynx","description":"Laryngoscopy, indirect; with removal of foreign body","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4311","name":"Acesso, per sq cm","description":"Acesso, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99411","name":"Preventive counseling group","description":"Preventive medicine counseling and/or risk factor reduction intervention(s) provided to individuals in a group setting (separate procedure); approximately 30 minutes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":6.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0878T","name":"Augmnt alys ch ct ild w/ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained with concurrent ct examination of the same structure","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4003","name":"Emergency med ss","description":"Emergency medicine mips specialty set","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0523","name":"Mgt nw pt dem mod-high cmplx","description":"Management of a new patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76016","name":"Mr safety deter phys/qhp","description":"Mr safety determination by a physician or other qualified health care professional responsible for the safety of the mr procedure, including review of implant mr conditions for indicated mr examination, analysis of risk vs clinical benefit of performing mr examination, and determination of mr equipm","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2184","name":"Inj, meropenem (b. braun)","description":"Injection, meropenem (b. braun), not therapeutically equivalent to j2185, 100 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0916T","name":"Insj perm ccm-d sys pg only","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator only","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0526U","name":"Nefro rnl trnspl quan cxcl10","description":"Nefro rnl trnspl quan cxcl10","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9506","name":"Tc-99m graphite crucible","description":"Graphite crucible for preparation of technetium tc 99m-labeled carbon aerosol, one crucible","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98009","name":"Synch audio-only new low 30","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 30 m","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2543","name":"Dental onlay metallic 3 surf","description":"Onlay - metallic - three surfaces","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0827T","name":"Dgtz gls mcrscp cytp smears","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; smears with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0678T","name":"Laps repos lead isdss ea add","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional repositioned lead (list separately in addition to code for primary proce","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37290","name":"Revsc evsc tpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27228","name":"Treat hip fracture(s)","description":"Open treatment of acetabular fracture(s) involving anterior and posterior (two) columns, includes t-fracture and both column fracture with complete articular detachment, or single column or transverse fracture with associated acetabular wall fracture, with internal fixation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2246.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2038","name":"Skill train and dev/diem","description":"Skills training and development, per diem","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49618","name":"Rpr aa hrn rcr > 10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, incarcerated or strangulate","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1348","name":"Pam incr 6 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 6-points in a 4 to 12 month period (excellent)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0264U","name":"Rare ds id opt genome mapg","description":"Rare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1483","name":"Neg quan hep c or qual rna","description":"Patients who achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1204","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1164","name":"Inj diltiazem in 0.72% nacl","description":"Injection, diltiazem hydrochloride in 0.72% sodium chloride, 0.5 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4388","name":"Neothelium 4l per sq cm","description":"Neothelium 4l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99426","name":"Prin care mgmt staff 1st 30","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0528","name":"Mgt est pt dem mod-hi cmplx","description":"Management of established patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93598","name":"Car outp meas drg cath chd","description":"Cardiac output measurement(s), thermodilution or other indicator dilution method, performed during cardiac catheterization for the evaluation of congenital heart defects (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4002","name":"Ep cardio ss","description":"Electrophysiology cardiac specialist mips specialty set","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1347","name":"Pt pam incr 3 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 3 points in a 4 to 12 month period (passing)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0563","name":"Sbrt w/positron emission del","description":"Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance and real-time positron emissions-based delivery adjustments to 1 or more lesions, entire course not to exceed 5 fractions","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86305","name":"Human epididymis protein 4","description":"Human epididymis protein 4 (he4)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1307","name":"Inj, crovalimab-akkz, 10 mg","description":"Injection, crovalimab-akkz, 10 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3389","name":"Topi adm prad zami per treat","description":"Topical administration, prademagene zamikeracel, per treatment","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76988","name":"Dx ntrop epcr us chd img acq","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; placement, manipulation of transducer, and image acquisition only","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9334","name":"Inj efgart-alfa 2mg hya-qvfc","description":"Injection, efgartigimod alfa, 2 mg and hyaluronidase-qvfc","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4251","name":"Vim, per square centimeter","description":"Vim, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43774","name":"Lap rmvl gastr adj all parts","description":"Laparoscopy, surgical, gastric restrictive procedure; removal of adjustable gastric restrictive device and subcutaneous port components","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1041.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4341","name":"Simplimax, per sq cm","description":"Simplimax, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0746T","name":"Car ablt rad arr cnv loc map","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; conversion of arrhythmia localization and mapping of arrhythmia site (nidus) into a multidimensional radiation treatment plan","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0553U","name":"Repr med pga embry te strux","description":"Repr med pga embry te strux","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2390","name":"Ant resin-based cmpst crown","description":"Resin-based composite crown anterior","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6091","name":"Repl semi/precision attach","description":"Replacement of semi-precision or precision attachment (male or female component) of implant/abutment supported prosthesis per attachment","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6214","name":"Pontic titanium","description":"Pontic - titanium","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0218","name":"Inj olipudase alfa-rpcp 1mg","description":"Injection, olipudase alfa-rpcp, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1241","name":"Pt no resp seen as person","description":"Patient did not respond to the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1361","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4257","name":"Relese, per sq cm","description":"Relese, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57110","name":"Vagnc compl rmvl vag wall","description":"Vaginectomy, complete removal of vaginal wall;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2329","name":"Inj ublituximab-xiiy, 1 mg","description":"Injection, ublituximab-xiiy, 1mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15366","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4323","name":"Alloply, per sq cm","description":"Alloply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6555","name":"G com stcking bk 40+ custm","description":"Gradient compression stocking, below knee, 40 mmhg or greater, custom, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1177","name":"Pt recd pcv on/aft 19","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92622","name":"Dx aly aud oi snd prcsr 1st","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; first 60 minutes","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0052","name":"Mmip mental health and care","description":"Missing and murdered indigenous persons (mmip) mental health and clinical care","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9206","name":"Irinotecan injection","description":"Injection, irinotecan, 20 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4426","name":"Dermbnd tl+, tlx per sq cm","description":"Dermabind tl + or dermabind tl x,  per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86701","name":"Hiv-1antibody","description":"Antibody; hiv-1","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2056","name":"Ciltacabtagene car-pos t","description":"Ciltacabtagene autoleucel, up to 100 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0899T","name":"N-invas deter aqmbf aug cmr","description":"Noninvasive determination of absolute quantitation of myocardial blood flow (aqmbf), derived from augmentative algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health car","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1288","name":"Doc rsn no hbp scrn or f/u","description":"Documented reason for not screening or recommending a follow-up for high blood pressure","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1239","name":"Pt no resp heard","description":"Patient did not respond to the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0437U","name":"Psyc anxiety do mrna 15 bmrk","description":"Psyc anxiety do mrna 15 bmrk","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0359U","name":"Onc prst8 ca alys all psa","description":"Onc prst8 ca alys all psa","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9224","name":"Gen anes adv air-15 min","description":"Gen anes adv air-15 min","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43497","name":"Transorl lwr esophgl myotomy","description":"Lower esophageal myotomy, transoral (ie, peroral endoscopic myotomy [poem])","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95872","name":"Ndl emg single fiber eltrd","description":"Needle electromyography using single fiber electrode, with quantitative measurement of jitter, blocking and/or fiber density, any/all sites of each muscle studied","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5995","name":"Peri medicament w/seal, max","description":"Peri medicament w/seal, max","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93598","name":"Car outp meas drg cath chd","description":"Cardiac output measurement(s), thermodilution or other indicator dilution method, performed during cardiac catheterization for the evaluation of congenital heart defects (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0927T","name":"Interrog dev eval ccm-d ip","description":"Interrogation device evaluation (in person) with analysis, review, and report, including connection, recording, and disconnection, per patient encounter, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5914","name":"Auricular prosthesis","description":"Auricular prosthesis","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29700","name":"Rmvl/bivlv gauntlet boot/cst","description":"Removal or bivalving; gauntlet, boot or body cast","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1006T","name":"Elec alys s-scl eeg prgrm ea","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, each additional 15 minutes face-to-face time with physician or other qua","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0901","name":"Vadadustat oral 1mg for esrd","description":"Vadadustat, oral, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2252","name":"Inj midazolam in 0.8% nacl","description":"Injection, midazolam in 0.8% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6598","name":"G comp bandage med stretch","description":"Gradient compression bandage roll, elastic medium stretch, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2221","name":"Ank mcrop plant & dorsi flex","description":"Addition to lower extremity orthosis, ankle system, microprocessor-controlled feature plantarflexion and/or dorsiflexion, includes power source","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0483","name":"Indirect immunofluorescence","description":"Indirect immunofluorescence","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1301","name":"Immunization counseling","description":"Immunization counseling","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1232","name":"Pt hcv tst reactive result","description":"Patient receives hcv antibody test with reactive result","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94617","name":"Exercise tst brncspsm w/ecg","description":"Exercise test for bronchospasm, including pre- and post-spirometry and pulse oximetry; with electrocardiographic recording(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1337","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99214","name":"Office o/p est mod 30 min","description":"Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":130.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1415","name":"No pos pdl1 bef ici ther","description":"Patients who did not have a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86231","name":"Ema each ig class","description":"Endomysial antibody (ema), each immunoglobulin (ig) class","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1427","name":"Doc med rsn bone scn","description":"Documentation of medical reason(s) for performing a bone scan (including documented pain related to prostate cancer, salvage therapy, other medical reasons)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0605","name":"Antibody test pub hlth path","description":"Antibody test pub hlth path","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15015","name":"App skn cl ssp agrft t/a/l 1","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; first 480 sq cm or less","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4251","name":"Vim, per square centimeter","description":"Vim, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83884","name":"Assay neurflmnt light chain","description":"Neurofilament light chain (nfl)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1284","name":"Pt 66+ snp or ltc pos > 90d","description":"Patients age 66 or older in institutional special needs plans (snp) or residing in long term care with pos code 32, 33, 34, 54, or 56 for more than 90 consecutive days during the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0823T","name":"Tcat ins 1chmbr ldls pm ra","description":"Transcatheter insertion of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or programming), when","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0255U","name":"Andrology infertility assmt","description":"Andrology (infertility), sperm-capacitation assessment of ganglioside gm1 distribution patterns, fluorescence microscopy, fresh or frozen specimen, reported as percentage of capacitated sperm and probability of generating a pregnancy score","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4348","name":"Sentry sl matrix per sq cm","description":"Sentry sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1708","name":"Pfizer vacc admin 3rd dose","description":"Pfizer vacc admin 3rd dose","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4261","name":"Tag, per square centimeter","description":"Tag, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5827","name":"Endo knee shin single axis","description":"Endoskeletal knee-shin system, single axis, electromechanical swing and stance phase control, with or without shock absorption and stance extension damping","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22849","name":"Reinsert spinal fixation","description":"Reinsertion of spinal fixation device","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1562.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83050","name":"Hgb methemoglobin quan","description":"Hemoglobin; methemoglobin, quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93556","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":559.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5942","name":"Proth max implt sup remv","description":"Proth max implt sup remv","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78185","name":"Spleen imaging","description":"Spleen imaging only, with or without vascular flow","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16035","name":"Escharotomy 1st incision","description":"Escharotomy; initial incision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4401","name":"Absolv3 per sq cm","description":"Absolv3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9996","name":"Ustekinumab- ttwe sub cu inj","description":"Injection, ustekinumab-ttwe (pyzchiva), subcutaneous, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2001","name":"Suct pum ext mgmt sys","description":"Suction pump, home model, portable or stationary, electric, any type, for use with external urine and/or fecal management system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":652.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0165","name":"Inj epinephrine nos 0.1 mg","description":"Injection, epinephrine, not otherwise specified, 0.1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6211","name":"Bridge base metal cast","description":"Pontic-cast predominantly base metal","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0911T","name":"Elec aly nstm sys vgs nrv wo","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; without programming by physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9993","name":"Pall serv during meas","description":"Patient was provided palliative care services any time during the measurement period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0599U","name":"Onc pncrtc ca mult ia serum","description":"Onc pncrtc ca mult ia serum","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92635","name":"Hearing aid fitg svc ea addl","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; each additional 15 minutes (list separately in addition to code","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29515","name":"Application short leg splint","description":"Application of short leg splint (calf to foot)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0891T","name":"Arhfcmrigtbs sbsq tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent treatment day","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8541","name":"Oral, hemady, 0.25 mg","description":"Dexamethasone (hemady), oral, 0.25 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99403","name":"Prev med cnsl indiv apprx 45","description":"Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 45 minutes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":85.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86344","name":"Leukocyte phagocytosis","description":"Leukocyte phagocytosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0592U","name":"Onc hl neo dna tgs 417 genes","description":"Onc hl neo dna tgs 417 genes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0378U","name":"Rfc1 repeat xpnsj vrnt alys","description":"Rfc1 repeat xpnsj vrnt alys","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2009","name":"Symphony, per sq cm","description":"Symphony, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"Rec cath any transanal, each","description":"Rectal catheter with or without balloon, for use with any type transanal irrigation system, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98977","name":"Rtm dev sply mscskl 16-30 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of musculoskeletal system, 16-30 days in a 30-day period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4335","name":"Amnioplast 2, per sq cm","description":"Amnioplast 2, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91112","name":"Gi wireless capsule measure","description":"Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3432","name":"Guided tissue regeneration","description":"Guided tissue regeneration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0904T","name":"Ecg alg 12 ld rdcd trcg only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; tracing only","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0709","name":"Intraoral cmplt radio images","description":"Intraoral cmplt radio images","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9046","name":"Inj, bortezomib, dr. reddys","description":"Injection, bortezomib (dr. reddys), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1351","name":"Pt cmplt suicd saf pln 120dy","description":"Patients who had a suicide safety plan initiated, reviewed, or updated and reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93720","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87635","name":"Sars-cov-2 covid-19 amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55867","name":"Laps surg prst8ect smpl stot","description":"Laparoscopy, surgical prostatectomy, simple subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy), includes robotic assistance, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4367","name":"Amniocore sl, per sq cm","description":"Amniocore sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81000","name":"Urinalysis nonauto w/scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; non-automated, with microscopy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0933T","name":"Tcat impl wrls l atr prs snr","description":"Transcatheter implantation of wireless left atrial pressure sensor for long-term left atrial pressure monitoring, including sensor calibration and deployment, right heart catheterization, transseptal puncture, imaging guidance, and radiological supervision and interpretation","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64728","name":"Dcmprn median nrv carpl tunl","description":"Decompression; median nerve at the carpal tunnel, percutaneous, with intracarpal tunnel balloon dilation, including ultrasound guidance","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1175","name":"Doc med rsn no hzv","description":"Documentation of medical reason(s) for not administering zoster vaccine (e.g., prior anaphylaxis due to the zoster vaccine)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1202","name":"Pt rsn no ace-i/arb rx","description":"Documentation of patient reason(s) for not prescribing ace inhibitor or arb therapy during the measurement period, (e.g., patient declined, other patient reasons)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5938","name":"Resct proth max comp remov","description":"Resct proth max comp remov","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1289","name":"No pt tbco cess interv rng","description":"Patient identified as tobacco user did not receive tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0709T","name":"Id ca immntx each addl njx","description":"Intradermal cancer immunotherapy; each additional injection (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1749","name":"Inj, iloprost, 0.1 mcg","description":"Injection, iloprost, 0.1 mcg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82951","name":"Glucose tolerance test (gtt)","description":"Glucose; tolerance test (gtt), 3 specimens (includes glucose)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4343","name":"Dermacyte ac matrx per sq cm","description":"Dermacyte ac matrix amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32484","name":"Segmentectomy","description":"Removal of lung, other than pneumonectomy; single segment (segmentectomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1574.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36483","name":"Endoven ther chem adhes sbsq","description":"Endovenous ablation therapy of incompetent vein, extremity, by transcatheter delivery of a chemical adhesive (eg, cyanoacrylate) remote from the access site, inclusive of all imaging guidance and monitoring, percutaneous; subsequent vein(s) treated in a single extremity, each through separate access","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":164.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53454","name":"Tprnl balo cntnc dev adjmt","description":"Periurethral transperineal adjustable balloon continence device; percutaneous adjustment of balloon(s) fluid volume","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0292U","name":"Psyc strs do mrna 72 genes","description":"Psyc strs do mrna 72 genes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0419U","name":"Nrpsyc gen seq vrnt aly 13","description":"Nrpsyc gen seq vrnt aly 13","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0899","name":"Argatroban dialysis, auromed","description":"Injection, argatroban (auromedics), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1434","name":"Orl chemo wthn 30 d post enc","description":"Patient on oral chemotherapy on or within 30 days after denominator eligible encounter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52265","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with dilation of bladder for interstitial cystitis; local anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1419","name":"Pt not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5157","name":"Inj, denosumab-bmwo, 1 mg","description":"Injection, denosumab-bmwo (stoboclo/osenvelt), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76830","name":"Transvaginal us non-ob","description":"Ultrasound, transvaginal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2356","name":"Inj tezepelumab-ekko, 1mg","description":"Injection, tezepelumab-ekko, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67801","name":"Remove eyelid lesions","description":"Excision of chalazion; multiple, same lid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0560","name":"Safety plan interven","description":"Safety planning interventions, each 20 minutes personally performed by the billing practitioner, including assisting the patient in the identification of the following personalized elements of a safety plan: recognizing warning signs of an impending suicidal or substance use-related crisis; employin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0772T","name":"Vr px dissoc svc sm phy ea","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1417","name":"Pt up to date cov","description":"Patients who are up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4390","name":"Ascendion per sq cm","description":"Ascendion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0515U","name":"Gi ibd ia quan deter ifx lvl","description":"Gi ibd ia quan deter ifx lvl","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1216","name":"No spiro doc no res doc","description":"No spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and/or no spirometry performed with results documented during the encounter","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35002","name":"Repair artery rupture neck","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, carotid, subclavian artery, by neck incision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1510.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0407","name":"Inpt/tele follow up 25","description":"Follow-up inpatient consultation, intermediate, physicians typically spend 25 minutes communicating with the patient via telehealth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0531U","name":"Nfct ds afb&inv fng 673orgs","description":"Nfct ds afb&inv fng 673orgs","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0629U","name":"Nfct ds tb dna aly 1trgt pcr","description":"Nfct ds tb dna aly 1trgt pcr","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0528","name":"Mgt est pt dem mod-hi cmplx","description":"Management of established patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40652","name":"Rpr lip fth<half ver height","description":"Repair lip, full thickness; up to half vertical height","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":408.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9291","name":"Pres dig cog behav thera fda","description":"Prescription digital cognitive and/or behavioral therapy, fda cleared, per course of treatment","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58956","name":"Bso omentectomy w/tah","description":"Bilateral salpingo-oophorectomy with total omentectomy, total abdominal hysterectomy for malignancy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1598.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1351","name":"Pt cmplt suicd saf pln 120dy","description":"Patients who had a suicide safety plan initiated, reviewed, or updated and reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0764T","name":"Asstv alg ecg rsk asmt cncrt","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to concurrently performed electrocardiogram (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50120","name":"Pyelotomy w/exploration","description":"Pyelotomy; with exploration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1045.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0036","name":"Pt/ptn decln assess","description":"Patient or care partner decline assessment","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9595","name":"Piflu f-18, dia 1 millicurie","description":"Piflufolastat f-18, diagnostic, 1 millicurie","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0680","name":"Cr art clc art vlv clc w rpt","description":"Detection and quantification of coronary artery calcium and/or aortic valve calcification from algorithmic analysis of computed tomography of the chest with report","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0829T","name":"Dgtz gls mcrscp cytp conctrj","description":"Digitization of glass microscope slides for cytopathology, concentration technique, smears, and interpretation (eg, saccomanno technique) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1422","name":"Gastroenterology care mvp","description":"Gastroenterology care mips value pathway","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1497","name":"No doc fall med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0545U","name":"Achr antb id imfluor livecll","description":"Achr antb id imfluor livecll","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0350","name":"Oral/facial photo images","description":"Oral/facial photographic images","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11301","name":"Shave skin lesion 0.6-1.0 cm","description":"Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion diameter 0.6 to 1.0 cm","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":111.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7972","name":"Surg redct fibrous tuberosit","description":"Surgical reduction of fibrous tuberosity","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23334","name":"Shoulder prosthesis removal","description":"Removal of prosthesis, includes debridement and synovectomy when performed; humeral or glenoid component","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1172.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98014","name":"Synch audio-only est mod 30","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code s","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0959T","name":"Rmv/rplc magnet coil assem","description":"Removal or replacement of magnet from coil assembly that is connected to continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5949","name":"Mand implt sup fix part","description":"Mand implt sup fix part","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80416","name":"Renin stimulation panel","description":"Renal vein renin stimulation panel (eg, captopril) this panel must include the following: renin (84244 x 6)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23532","name":"Optx strclv dslc aq/chrn grf","description":"Open treatment of sternoclavicular dislocation, acute or chronic; with fascial graft (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64468","name":"Thrc fascial pln blk bi njx","description":"Thoracic fascial plane block, bilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2351","name":"Inj ocrelizumab 1mg hya-ocsq","description":"Injection, ocrelizumab, 1 mg and hyaluronidase-ocsq","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4395","name":"Acelagraft per sq cm","description":"Acelagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6113","name":"Imp/abut rem dent part mand","description":"Imp/abut rem dent part mand","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36596","name":"Mech remov tunneled cv cath","description":"Mechanical removal of intraluminal (intracatheter) obstructive material from central venous device through device lumen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2792","name":"Crown full cast noble metal","description":"Crown-full cast noble metal","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0695T","name":"Bdy srf mpg pm/cvdfb tm impl","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of implant or replacement","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36568","name":"Insj picc <5 yr w/o imaging","description":"Insertion of peripherally inserted central venous catheter (picc), without subcutaneous port or pump, without imaging guidance; younger than 5 years of age","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64466","name":"Thrc fascial pln blk uni njx","description":"Thoracic fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2249","name":"Inj, remimazolam, 1 mg","description":"Injection, remimazolam, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37267","name":"Revsc evsc fpvt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":215.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87088","name":"Urine bacteria culture","description":"Culture, bacterial; with isolation and presumptive identification of each isolate, urine","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67971","name":"Reconstruction of eyelid","description":"Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; up to two-thirds of eyelid, 1 stage or first stage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":778.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D8091","name":"Compre ortho treat w surg","description":"Compre ortho treat w surg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55713","name":"Bx prst8 in-bore ct/mri bx 1","description":"Biopsy, prostate, in-bore ct- or mri-guided (ie, sextant), with biopsy of additional targeted lesion(s), first targeted lesion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1402","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9954","name":"Oral mr contrast, 100 ml","description":"Oral magnetic resonance contrast agent, per 100 ml","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0811T","name":"Rem mlt day uroflow setup","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); set-up and patient education on use of equipment","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23525","name":"Cltx strnclav dislc w/mnpj","description":"Closed treatment of sternoclavicular dislocation; with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76010","name":"X-ray nose to rectum","description":"Radiologic examination from nose to rectum for foreign body, single view, child","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0911T","name":"Elec aly nstm sys vgs nrv wo","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; without programming by physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7356","name":"Inj foscarb/foslevodopa 5 mg","description":"Injection, foscarbidopa 0.25 mg/foslevodopa 5 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0777T","name":"R-t prs sensing edrl gdn sys","description":"Real-time pressure-sensing epidural guidance system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9183","name":"Gemcitabine intravesical sys","description":"Gemcitabine intravesical system, 225 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0506U","name":"Gi barretts esophgl cell 89","description":"Gi barretts esophgl cell 89","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0711T","name":"N-nvs artl plaq alys dat prp","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data preparation and transmission","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1812","name":"Inj. insulin (fiasp)","description":"Insulin (fiasp), per 5 units","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0856T","name":"Dgtz gls mcrscp electron mic","description":"Digitization of glass microscope slides for electron microscopy, diagnostic (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0695T","name":"Bdy srf mpg pm/cvdfb tm impl","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of implant or replacement","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82646","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83002","name":"Assay of gonadotropin (lh)","description":"Gonadotropin; luteinizing hormone (lh)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77437","name":"Surf radj ther supfc<=150kv","description":"Surface radiation therapy; superficial, delivery, </=150 kv, per fraction (eg, electronic brachytherapy)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80166","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4365","name":"Amnio bur dl mem per sq cm","description":"Amnio burgeon dual-layer membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20550","name":"Njx 1 tendon sheath/ligament","description":"Injection(s); single tendon sheath, or ligament, aponeurosis (eg, plantar fascia)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":37.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":310.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0566","name":"3d bn img algor drvd fr mri","description":"3d radiodensity-value bone imaging, algorithm derived, from previous magnetic resonance examination of the same anatomy","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31084","name":"Removal of frontal sinus","description":"Sinusotomy frontal; obliterative, with osteoplastic flap, brow incision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1274.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7355","name":"Inj travoprost intra impl","description":"Injection, travoprost, intracameral implant, 1 microgram","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34708","name":"Evasc rpr ilio-iliac rpt","description":"Endovascular repair of iliac artery by deployment of an ilio-iliac tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, and all endograft extension(s) proximally to the aortic bifurcation ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2015.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99315","name":"Nf dschrg mgmt 30 min/less","description":"Nursing facility discharge management; 30 minutes or less total time on the date of the encounter","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":91.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66989","name":"Xcpsl ctrc rmvl cplx insj 1+","description":"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification), complex, requiring devices or techniques not generally used in routine cataract surgery (eg, iris expansion device,","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4415","name":"Alexiguard st-l per sq cm","description":"Alexiguard sl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1424","name":"Pulmonology care mvp","description":"Pulmonology care mips value pathway","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42409","name":"Drainage of salivary cyst","description":"Marsupialization of sublingual salivary cyst (ranula)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0144","name":"Scr c/v cyto,thinlayer,rescr","description":"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system, under physician supervision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44407","name":"Colonoscopy w/ndl aspir/bx","description":"Colonoscopy through stoma; with transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy(s), includes endoscopic ultrasound examination limited to the sigmoid, descending, transverse, or ascending colon and cecum and adjacent structures","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0752","name":"Hiv prep, oral lenacapavir","description":"Oral, lenacapavir, 300 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25120","name":"Removal of forearm lesion","description":"Excision or curettage of bone cyst or benign tumor of radius or ulna (excluding head or neck of radius and olecranon process);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":890.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0780T","name":"Instlj fecal microbiota ssp","description":"Instillation of fecal microbiota suspension via rectal enema into lower gastrointestinal tract","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0466U","name":"Crd cad dna gwas 564856 snp","description":"Crd cad dna gwas 564856 snp","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1187","name":"Pt w/ esrd","description":"Patients with a diagnosis of end stage renal disease (esrd)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4417","name":"Alexiguard dl-t per sq cm","description":"Alexiguard dl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7509","name":"Marsupialization odon cyst","description":"Marsupialization odon cyst","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9294","name":"Inj pemetrexed, hospira 10mg","description":"Injection, pemetrexed (hospira), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2404","name":"Inj, nicardipine 0.1 mg","description":"Injection, nicardipine, 0.1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"Sup/ext non-ins inf pump syr","description":"Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6559","name":"G stckng full/chap18-30 cust","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99425","name":"Prin care mgmt phys ea addl","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1005T","name":"Elec alys s-scl eeg prgr 1st","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, first 15 minutes face-to-face time with physician or other qualified hea","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9697","name":"Inj, magtrace per study dose","description":"Injection, carboxydextran-coated superparamagnetic iron oxide, per study dose","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44227","name":"Lap close enterostomy","description":"Laparoscopy, surgical, closure of enterostomy, large or small intestine, with resection and anastomosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1801.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4003","name":"Emergency med ss","description":"Emergency medicine mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92137","name":"Cptrz oph img pst sg rta oct","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), posterior segment, with interpretation and report, unilateral or bilateral; retina, including oct angiography","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1346","name":"No pam inc 6 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 6 points within a 4 to 12 month period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29881","name":"Arthrs kne srg mnisectmy m/l","description":"Arthroscopy, knee, surgical; with meniscectomy (medial or lateral, including any meniscal shaving) including debridement/shaving of articular cartilage (chondroplasty), same or separate compartment(s), when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":735.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2247","name":"Inj, micafungin (par pharm)","description":"Injection, micafungin sodium (par pharm) not thereapeutically equivalent to j2248, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1821","name":"Ko elas w/ condyle pads otf","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, off the shelf","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94626","name":"Phy/qhp op pulm rhb w/mntr","description":"Physician or other qualified health care professional services for outpatient pulmonary rehabilitation; with continuous oximetry monitoring (per session)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0693T","name":"Compre ful bdy 3d mtn alys","description":"Comprehensive full body computer-based markerless 3d kinematic and kinetic motion analysis and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0233","name":"Intra inf, toci, first dose","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1224","name":"Iop dec <20% from base","description":"Intraocular pressure (iop) reduced by a value less than 20% from the pre-intervention level","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80506","name":"Path clin consltj prolng svc","description":"Pathology clinical consultation; prolonged service, each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99437","name":"Chrnc care mgmt phys ea addl","description":"Chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, or funct","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0611U","name":"Onc lvr alys >1000 mr cfdna","description":"Onc lvr alys >1000 mr cfdna","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98985","name":"Rtm dev sply mscsk sys 2-15d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of musculoskeletal system, 2-15 days in a 30-day period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0328U","name":"Drug assay 120+ rx&metablt","description":"Drug assay 120+ rx&metablt","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65175","name":"Removal of ocular implant","description":"Removal of ocular implant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0947T","name":"Mrgfus strtctc bl-br disrpj","description":"Magnetic resonance image guided low intensity focused ultrasound (mrgfus), stereotactic blood-brain barrier disruption using microbubble resonators to increase the concentration of blood-based biomarkers of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0730T","name":"Trabeculotomy lsr w/oct gdn","description":"Trabeculotomy by laser, including optical coherence tomography (oct) guidance","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37266","name":"Rvsc evsc fpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49621","name":"Rpr parastomal hernia rdc","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; reducible","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21195","name":"Reconst lwr jaw w/o fixation","description":"Reconstruction of mandibular rami and/or body, sagittal split; without internal rigid fixation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1511.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83896","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0605","name":"Sucroferric oxyhydroxide 5mg","description":"Sucroferric oxyhydroxide, oral, 5 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0850T","name":"Dgtz gls mcrscp ish ea mult","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61892","name":"Rmv sk-mnt crnl nstm pg/rcvr","description":"Removal of skull-mounted cranial neurostimulator pulse generator or receiver with cranioplasty, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49595","name":"Rpr aa hrn 1st > 10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, reducible","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1415","name":"No pos pdl1 bef ici ther","description":"Patients who did not have a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1415","name":"No pos pdl1 bef ici ther","description":"Patients who did not have a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87467","name":"Hepatitis b surface ag quan","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; hepatitis b surface antigen (hbsag), quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G3003","name":"Chronic pain mgmt addl 15m","description":"Each additional 15 minutes of chronic pain management and treatment by a physician or other qualified health care professional, per calendar month. (list separately in addition to code for g3002. when using g3003, 15 minutes must be met or exceeded.)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0864T","name":"Low ntsty eswt corpus cvrnsm","description":"Low-intensity extracorporeal shock wave therapy involving corpus cavernosum, low energy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0422","name":"Collect & prep genetic samp","description":"Collect & prep genetic samp","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9128","name":"Photobio therpy-first 15 min","description":"Photobio therpy-first 15 min","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2033","name":"Myriad morcells, 4 mg","description":"Myriad morcells, 4 milligrams","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35656","name":"Bpg femoral-popliteal","description":"Bypass graft, with other than vein; femoral-popliteal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1380.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59150","name":"Treat ectopic pregnancy","description":"Laparoscopic treatment of ectopic pregnancy; without salpingectomy and/or oophorectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":941.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97028","name":"Ultraviolet therapy","description":"Application of a modality to 1 or more areas; ultraviolet","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6517","name":"Grad com wrap w strap bn cus","description":"Gradient compression wrap with adjustable straps, below knee, each, custom","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1213","name":"No hx spiro prs spiro>=70%","description":"No history of spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) and present spirometry is >= 70%","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24356","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":644.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0309U","name":"Crd cv ds aly 4 prtn plm alg","description":"Crd cv ds aly 4 prtn plm alg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1961","name":"Inj lenacapavir (hiv tx) 1mg","description":"Injection, lenacapavir (only for use as hiv treatment), 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0825T","name":"Tcat rmv&rpl1chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or prog","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99391","name":"Per pm reeval est pat infant","description":"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; infan","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":110.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4006","name":"Gastroenterology ss","description":"Gastro-enterology mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64629","name":"Trml dstrj ios bvn ea addl","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; each additional vertebral body, lumbar or sacral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0737T","name":"Xenograft impltj artclr surf","description":"Xenograft implantation into the articular surface","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0931T","name":"Ephys eval ccm-d ld separate","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), separate from initial implantation or replacement with testing of cardiac cont","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0783T","name":"Tc auriculr neurostimulation","description":"Transcutaneous auricular neurostimulation, set-up, calibration, and patient education on use of equipment","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73201","name":"Ct upper extremity w/dye","description":"Computed tomography, upper extremity; with contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q2011","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1411","name":"Inj, hemgenix, per tx dose","description":"Injection, etranacogene dezaparvovec-drlb, per therapeutic dose","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1489","name":"Pt status doc","description":"Patient status documented","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0714T","name":"Tpla b9 prst8 hyprplsa<50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume less than 50 ml","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1338","name":"Pt f/u 30-180 dys no + imprv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who did not demonstrate positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7295","name":"Eth estr and eton monthly","description":"Ethinyl estradiol and etonogestrel 0.015mg, 0.12mg per 24 hours; monthly vaginal ring, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5228","name":"Immed mand part denture","description":"Immed mand part denture","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43245","name":"Egd dilate stricture","description":"Esophagogastroduodenoscopy, flexible, transoral; with dilation of gastric/duodenal stricture(s) (eg, balloon, bougie)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0696T","name":"Bdy surf mapg pm/cvdfb f/up","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of follow-up interrogation or programming device evaluatio","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9914","name":"Admin of dermal fill","description":"Admin of dermal fill","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33330","name":"Insert major vessel graft","description":"Insertion of graft, aorta or great vessels; without shunt, or cardiopulmonary bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1536.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4293","name":"Acesso dl, per sq cm","description":"Acesso dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9255","name":"Inj, methotrexate (accord)","description":"Injection, methotrexate (accord), not therapeutically equivalent to j9260, 50 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6093","name":"Recement supp part denture","description":"Recement implant/abutment supported fixed partial denture","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-06-05","zip":"10985","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86366","name":"Muscle-specific kinase antb","description":"Muscle-specific kinase (musk) antibody","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0864T","name":"Low ntsty eswt corpus cvrnsm","description":"Low-intensity extracorporeal shock wave therapy involving corpus cavernosum, low energy","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4306","name":"Americ amnion ac per sq cm","description":"American amnion ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7021","name":"Suppl and access lung expan","description":"Supplies and accessories for lung expansion airway clearance, continuous high frequency oscillation, and nebulization device (e.g., handset, nebulizer kit, biofilter)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99498","name":"Advncd care plan addl 30 min","description":"Advance care planning including the explanation and discussion of advance directives such as standard forms (with completion of such forms, when performed), by the physician or other qualified health care professional; each additional 30 minutes (list separately in addition to code for primary proce","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":67.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0978T","name":"Submucosal cryolysis therapy","description":"Submucosal cryolysis therapy; soft palate, base of tongue, and lingual tonsil","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1294","name":"Bp scrn perf rec interval","description":"Normal blood pressure reading documented, follow-up not required","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0415U","name":"Cv ds acs bld alg 5 yr score","description":"Cv ds acs bld alg 5 yr score","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21240","name":"Reconstruction of jaw joint","description":"Arthroplasty, temporomandibular joint, with or without autograft (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1292.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0700T","name":"Molec fluor img sus nev 1st","description":"Molecular fluorescent imaging of suspicious nevus; first lesion","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0666","name":"Team remote e/m est pt 15 mn","description":"Team remote e/m est. pt 15mins","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0426","name":"Coll, analys of saliva","description":"Coll, analys of saliva","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0408U","name":"Iaad blk ac wv bsnsr sarscv2","description":"Iaad blk ac wv bsnsr sarscv2","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1418","name":"Med rsn not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination because of a medical contraindication documented by clinician","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9887","name":"Distance learning attendance","description":"Behavioral counseling for diabetes prevention, distance learning, 60 minutes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1246","name":"Pt othr thn true imprt to me","description":"Patient provided a response other than completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67911","name":"Revise eyelid defect","description":"Correction of lid retraction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0614U","name":"Iem pmd alys 4 nzm cplx page","description":"Iem pmd alys 4 nzm cplx page","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82465","name":"Assay bld/serum cholesterol","description":"Cholesterol, serum or whole blood, total","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0047","name":"Ped blunt hd traum","description":"Pediatric patient with minor blunt head trauma and pecarn prediction criteria are not assessed","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0973T","name":"Slctv nzmtc dbrdmt t/a/l 1st","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; first 100 sq cm","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2028","name":"Micromatrix flex per mg","description":"Micromatrix flex, per mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1357","name":"Pt w/red suic idea 120 days","description":"Patients who had a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93145","name":"Interrog crtd sins bat ip wo","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1014T","name":"Lap rv/rmv eso sph nstm eltr","description":"Laparoscopic revision or removal, lower esophageal sphincter neurostimulator electrodes","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J1070","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2998","name":"Inj plasminogen tvmh 1mg","description":"Injection, plasminogen, human-tvmh, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9129","name":"Photobio therpy-sub 15 mins","description":"Photobio therpy-sub 15 mins","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15013","name":"Prepj skn cll ssp agrft 1st","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; first 25 sq cm or less of harvested skin","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0506U","name":"Gi barretts esophgl cell 89","description":"Gi barretts esophgl cell 89","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62273","name":"Inject epidural patch","description":"Injection, epidural, of blood or clot patch","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24655","name":"Cltx rdl head/nck fx w/mnpj","description":"Closed treatment of radial head or neck fracture; with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2792","name":"Crown full cast noble metal","description":"Crown-full cast noble metal","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64466","name":"Thrc fascial pln blk uni njx","description":"Thoracic fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92928","name":"Prq tcat plmt ntrac st 1 les","description":"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 1 lesion involving 1 or more coronary segments","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90474","name":"Immune admin oral/nasal addl","description":"Immunization administration by intranasal or oral route; each additional vaccine (single or combination vaccine/toxoid) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0184","name":"Inj, amisulpride, 1 mg","description":"Injection, amisulpride, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64657","name":"Rmvl bat modulj sys tot sys","description":"Removal of baroreflex activation therapy (bat) modulation system; total system, including lead and pulse generator","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9602","name":"Fluorodopa f-18 diag per mci","description":"Fluorodopa f-18, diagnostic, per millicurie","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27407","name":"Repair of knee ligament","description":"Repair, primary, torn ligament and/or capsule, knee; cruciate","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32994","name":"Ablate pulm tumor perq crybl","description":"Ablation therapy for reduction or eradication of 1 or more pulmonary tumor(s) including pleura or chest wall when involved by tumor extension, percutaneous, including imaging guidance when performed, unilateral; cryoablation","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4965.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":406.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0546U","name":"Ldns lrp4 antb imflr livecll","description":"Ldns lrp4 antb imflr livecll","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J9212","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1174","name":"Pt w/ 2 hzv 10/2017 - mp","description":"Patient received at least two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0801","name":"3d dental scan direct","description":"3d dental scan direct","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55680","name":"Remove sperm pouch lesion","description":"Excision of mullerian duct cyst","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0722T","name":"Quan ct tiss charac w/ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained with concurrent ct examination of any structure contained in the concurrently acquired diagnostic imaging dataset (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33512","name":"Cabg vein three","description":"Coronary artery bypass, vein only; 3 coronary venous grafts","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2430.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1247","name":"Pt resp true best int","description":"Patient responded completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55708","name":"Bx prst8 trct us w/mri fus 1","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant) with mri-fusion-guidance, first targeted lesion","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86850","name":"Rbc antibody screen","description":"Antibody screen, rbc, each serum technique","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0306U","name":"Onc mrd nxt-gnrj alys 1st","description":"Onc mrd nxt-gnrj alys 1st","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0581U","name":"Trnspl med antb nohla 39trgt","description":"Trnspl med antb nohla 39trgt","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78608","name":"Brain imaging (pet)","description":"Brain imaging, positron emission tomography (pet); metabolic evaluation","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1670.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6091","name":"Repl semi/precision attach","description":"Replacement of semi-precision or precision attachment (male or female component) of implant/abutment supported prosthesis per attachment","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4364","name":"Am bur xp mem xpl hy p sq cm","description":"Amnio burgeon xplus membrane and xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0052","name":"Mmip mental health and care","description":"Missing and murdered indigenous persons (mmip) mental health and clinical care","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74246","name":"X-ray xm upr gi trc 2cntrst","description":"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study, including glucagon, when administered","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0468U","name":"Hep nash mir34a5p a2m ykl40","description":"Hep nash mir34a5p a2m ykl40","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0480","name":"Drug test def 1-7 classes","description":"Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding i","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0617U","name":"Cv ascvd dna alys >20000","description":"Cv ascvd dna alys >20000","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4000","name":"Dermatology ss","description":"Dermatology mips specialty set","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4370","name":"Aeroguard per sq cm","description":"Aeroguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33900","name":"Perq p-art revsc 1 nm nt uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, unilateral","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0886T","name":"Sgmdsc flx 1st tndsc dilat","description":"Sigmoidoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1371","name":"Mst rec gsa<7","description":"Most recent glycemic status assessment (hba1c or gmi) level < 7.0%","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4408","name":"Xwrap hydro per sq cm","description":"Xwrap hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33901","name":"Perq p-art revsc 1 nm nt bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, bilateral","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1242","name":"Pt no resp imprt to me","description":"Patient did not respond to the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1358","name":"Pts no <suicd idea 120 dys","description":"Patients who did not have a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6594","name":"G comp bandge liner lwr extr","description":"Gradient compression bandaging supply, bandage liner, lower extremity, any size or length, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1305","name":"Pneum vax admin 19+","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4331","name":"Axolotl graft, per sq cm","description":"Axolotl graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1241","name":"Pt no resp seen as person","description":"Patient did not respond to the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0373","name":"Tomo bitewing image","description":"Tomo bitewing image","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99315","name":"Nf dschrg mgmt 30 min/less","description":"Nursing facility discharge management; 30 minutes or less total time on the date of the encounter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":97.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":82.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0931T","name":"Ephys eval ccm-d ld separate","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), separate from initial implantation or replacement with testing of cardiac cont","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93880","name":"Extracranial bilat study","description":"Duplex scan of extracranial arteries; complete bilateral study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0854T","name":"Dgtz gls mcrscp bld smr prph","description":"Digitization of glass microscope slides for blood smear, peripheral, interpretation by physician with written report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4016","name":"Neurosurgical ss","description":"Neurosurgical mips specialty set","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4288","name":"Replacement breastpump valve","description":"Valve for breast pump, replacement","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20552","name":"Njx 1/mlt trigger point 1/2","description":"Injection(s); single or multiple trigger point(s), 1 or 2 muscle(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":18.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":41.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0716T","name":"Car acous wavfrm rec cad rsk","description":"Cardiac acoustic waveform recording with automated analysis and generation of coronary artery disease risk score","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4038","name":"Vascular surgery ss","description":"Vascular surgery mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1282","name":"Pt scrn tbco id as non user","description":"Patient screened for tobacco use and identified as a tobacco non-user","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99484","name":"Care mgmt svc bhvl hlth cond","description":"Care management services for behavioral health conditions, at least 20 minutes of clinical staff time, directed by a physician or other qualified health care professional, per calendar month, with the following required elements: initial assessment or follow-up monitoring, including the use of appli","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":64.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45398","name":"Colonoscopy w/band ligation","description":"Colonoscopy, flexible; with band ligation(s) (eg, hemorrhoids)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":859.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9004","name":"Va whole health partner serv","description":"Department of veterans affairs whole health partner services","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4329","name":"Singlay, per sq cm","description":"Singlay, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2327","name":"Inj risankizumab-rzaa 1 mg","description":"Injection, risankizumab-rzaa, intravenous, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4385","name":"Apollo ft per sq cm","description":"Apollo ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62330","name":"Dcmprn prq rmv lig flv 1lmbr","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; one interspace, lumbar","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0367U","name":"Onc bldr 10 flwg trurl rescj","description":"Onc bldr 10 flwg trurl rescj","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0449U","name":"Car scr sev inh cond 5 genes","description":"Car scr sev inh cond 5 genes","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9048","name":"Inj, bortezomib freseniuskab","description":"Injection, bortezomib (fresenius kabi), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0609U","name":"Onc prostate ia tot&free psa","description":"Onc prostate ia tot&free psa","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90840","name":"Psytx crisis ea addl 30 min","description":"Psychotherapy for crisis; each additional 30 minutes (list separately in addition to code for primary service)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":67.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57520","name":"Conization of cervix","description":"Conization of cervix, with or without fulguration, with or without dilation and curettage, with or without repair; cold knife or laser","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1200","name":"Ace-i/arb rx","description":"Ace inhibitor (ace-i) or arb therapy prescribed during the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11603","name":"Exc tr-ext mal+marg 2.1-3 cm","description":"Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 2.1 to 3.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9607","name":"Lutetium lu 177 vipivotide","description":"Lutetium lu 177 vipivotide tetraxetan, therapeutic, 1 millicurie","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2794","name":"Crown-titanium","description":"Crown-titanium","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0688T","name":"Tx amblyopia assmt w/report","description":"Treatment of amblyopia using an online digital program; assessment of patient performance and program data by physician or other qualified health care professional, with report, per calendar month","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1004T","name":"Elec alys s-scl eeg wo prgrm","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; without programming","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1316","name":"Tobacco non-user","description":"Current tobacco non-user","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9957","name":"Screening sleep disorders","description":"Screening sleep disorders","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1105","name":"Dexmedetomidine film, 1 mcg","description":"Dexmedetomidine, oral, 1 mcg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0101","name":"Ca screen;pelvic/breast exam","description":"Cervical or vaginal cancer screening; pelvic and clinical breast examination","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":46.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15014","name":"Prepj skn cll ssp agrft ea","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; each additional 25 sq cm of harvested skin or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59525","name":"Remove uterus after cesarean","description":"Subtotal or total hysterectomy after cesarean delivery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51792","name":"Urinary reflex study","description":"Stimulus evoked response (eg, measurement of bulbocavernosus reflex latency time)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":345.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0491","name":"Inj anifrolumab-fnia 1mg","description":"Injection, anifrolumab-fnia, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0459U","name":"Abeta42 & ttau eclia csf","description":"Abeta42 & ttau eclia csf","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1167","name":"Hspc dur meas pd","description":"In hospice or using hospice services during the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1202","name":"Pt rsn no ace-i/arb rx","description":"Documentation of patient reason(s) for not prescribing ace inhibitor or arb therapy during the measurement period, (e.g., patient declined, other patient reasons)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4000","name":"Dermatology ss","description":"Dermatology mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1952","name":"Afo spiral prefab ots","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, off-the-shelf","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1011T","name":"Pbm therapy of oral cavity","description":"Photobiomodulation (pbm) therapy of oral cavity, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59850","name":"Induced abortion 1+ njx","description":"Induced abortion, by 1 or more intra-amniotic injections (amniocentesis-injections), including hospital admission and visits, delivery of fetus and secundines;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":438.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1163","name":"Inj, diltiazem hcl, 0.5 mg","description":"Injection, diltiazem hydrochloride, 0.5 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6091","name":"Repl semi/precision attach","description":"Replacement of semi-precision or precision attachment (male or female component) of implant/abutment supported prosthesis per attachment","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0883T","name":"Intraop ther estim pn ue ea","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; each additional nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0554","name":"Add 20 m of monthly tx","description":"Each additional 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing data generated from the","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0870","name":"Injection, imetelstat, 1 mg","description":"Injection, imetelstat, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1307","name":"Inj, crovalimab-akkz, 10 mg","description":"Injection, crovalimab-akkz, 10 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1072","name":"Inj, testosterone, azmiro","description":"Injection, testosterone cypionate (azmiro), 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37277","name":"Rvsc evsc fpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4310","name":"Procenta, per 100 mg","description":"Procenta, per 100 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1714","name":"Pfizer vacc adm ped 2nd dose","description":"Pfizer vacc adm ped 2nd dose","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0248","name":"Inj, remdesivir, 1 mg","description":"Injection, remdesivir, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2355","name":"Oprelvekin injection","description":"Injection, oprelvekin, 5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73719","name":"Mri lower extremity w/dye","description":"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":771.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61055","name":"Injection into brain canal","description":"Cisternal or lateral cervical (c1-c2) puncture; with injection of medication or other substance for diagnosis or treatment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61557","name":"Incise skull/sutures","description":"Craniotomy for craniosynostosis; bifrontal bone flap","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1939.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63700","name":"Repair of spinal herniation","description":"Repair of meningocele; less than 5 cm diameter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1388.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4031","name":"Radiation oncology ss","description":"Radiation oncology mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78272","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49621","name":"Rpr parastomal hernia rdc","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; reducible","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90631","name":"H5 vaccine pandemic im use","description":"Influenza virus vaccine (iiv), h5, pandemic formulation, split virus, adjuvanted, for intramuscular use","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1298","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86403","name":"Particle agglut antbdy scrn","description":"Particle agglutination; screen, each antibody","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1239","name":"Pt no resp heard","description":"Patient did not respond to the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63306","name":"Remov vert idrl bdy thrclmbr","description":"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, thoracic by thoracolumbar approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2704.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0218","name":"Inj olipudase alfa-rpcp 1mg","description":"Injection, olipudase alfa-rpcp, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4389","name":"Neothelium 4l+ per sq cm","description":"Neothelium 4l+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64473","name":"Lwr xtr fscl pln blk uni njx","description":"Lower extremity fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3415","name":"Pyridoxine hcl 100 mg","description":"Injection, pyridoxine hcl, 100 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4323","name":"Splint extra-coronal","description":"Splint extra-coronal","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0953T","name":"Tot impl amei rev/rplc w/o","description":"Totally implantable active middle ear hearing implant; revision or replacement, without mastoidectomy and replacement of sound processor","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4322","name":"Splint intra-coronal","description":"Splint intra-coronal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58210","name":"Extensive hysterectomy","description":"Radical abdominal hysterectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy), with or without removal of tube(s), with or without removal of ovary(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2013.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83655","name":"Assay of lead","description":"Lead","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93981","name":"Penile vascular study","description":"Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1001T","name":"Autol musc cell therapy njx","description":"Autologous muscle cell therapy, injection of muscle progenitor cells into the external anal sphincter, including ultrasound guidance, when performed","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88314","name":"Histochemical stains add-on","description":"Special stain including interpretation and report; histochemical stain on frozen tissue block (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93569","name":"Njx cth slct p-art angrp uni","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":20.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98000","name":"Synch audio-video new sf 15","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 15 minutes must be met or exceeded.","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5060.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98004","name":"Synch audio-video est sf 10","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 10 minutes must be met or e","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9025","name":"Plasma cryo redu path each","description":"Plasma, cryoprecipitate reduced, pathogen reduced, each unit","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0886T","name":"Sgmdsc flx 1st tndsc dilat","description":"Sigmoidoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33020","name":"Incision of heart sac","description":"Pericardiotomy for removal of clot or foreign body (primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":948.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61539","name":"Removal of brain tissue","description":"Craniotomy with elevation of bone flap; for lobectomy, other than temporal lobe, partial or total, with electrocorticography during surgery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2694.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99396","name":"Prev visit est age 40-64","description":"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 40-64","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":89.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24430","name":"Rpr non/mal humerus wo graft","description":"Repair of nonunion or malunion, humerus; without graft (eg, compression technique)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0824T","name":"Tcat rmv 1chmbr ldls pm ra","description":"Transcatheter removal of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography), when performed","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1261","name":"Pts on wtlist bef dialysis","description":"Patients that were on the kidney or kidney-pancreas waitlist prior to initiation of dialysis","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0402","name":"Initial preventive exam","description":"Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":168.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4346","name":"Shelter dm matrix per sq cm","description":"Shelter dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6252","name":"Bridge resin w/noble metal","description":"Pontic-resin with noble metal","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5159","name":"Inj, denosumab-dssb, 1 mg","description":"Injection, denosumab-dssb (ospomyv/xbryk), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93593","name":"R hrt cath chd nml nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; normal native connections","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2013","name":"Innovamatrix fs, per sq cm","description":"Innovamatrix fs, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1227","name":"Eb therapy prescribed","description":"Evidence-based therapy was prescribed","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0332U","name":"Onc pan tum gen prflg 8 dna","description":"Onc pan tum gen prflg 8 dna","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5945","name":"Mand implt sup remv part","description":"Mand implt sup remv part","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60660","name":"Abltj 1/+thyr ndul 1lobe prq","description":"Ablation of 1 or more thyroid nodule(s), one lobe or the isthmus, percutaneous, including imaging guidance, radiofrequency","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4349","name":"Mantle dl matrix per sq cm","description":"Mantle dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0873T","name":"Revj subq prtl asct pmp sys","description":"Revision of a subcutaneously implanted peritoneal ascites pump system, any component (ascites pump, associated peritoneal catheter, associated bladder catheter), including imaging and programming, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1152","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21060","name":"Remove jaw joint cartilage","description":"Meniscectomy, partial or complete, temporomandibular joint (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":916.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0461U","name":"Onc rxgenom alys rtpcr 24gen","description":"Onc rxgenom alys rtpcr 24gen","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4030","name":"Pulmonology ss","description":"Pulmonology mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9298","name":"Inj nivol relatlimab 3mg/1mg","description":"Injection, nivolumab and relatlimab-rmbw, 3 mg/1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0497U","name":"Onc prst8 mrna rt-pcr 6 gene","description":"Onc prst8 mrna rt-pcr 6 gene","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96203","name":"Mlt fam grp bhv train ea add","description":"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face with multiple sets of paren","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0462U","name":"Melatonin lvl tst slp std7/9","description":"Melatonin lvl tst slp std7/9","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4387","name":"Neothelium ft per sq cm","description":"Neothelium ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7521","name":"Tacrolim granules oral susp","description":"Tacrolimus, granules, oral suspension, 0.1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1493","name":"No fall doc med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32522","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1773.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1388","name":"Pt doc exm rec melmn","description":"Patients with documentation of an exam performed for recurrence of melanoma","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5133","name":"Inj, tofidence, 1 mg","description":"Injection, tocilizumab-bavi (tofidence), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6600","name":"G com bandge hgh dn foam sht","description":"Gradient compression bandaging supply, high density foam sheet, per 250 square centimeters, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0591U","name":"Onc prst8 ca 3prtns plsm srm","description":"Onc prst8 ca 3prtns plsm srm","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2642","name":"Dental onlay porcelin 2 surf","description":"Onlay - porcelain/ceramic - two surfaces","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7415","name":"Excision malig les complicat","description":"Excision of malignant lesion complicated","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37287","name":"Revsc evasc tpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1172","name":"Doc med rsn no td/tdap","description":"Documentation of medical reason(s) for not administering td or tdap vaccine (e.g., prior anaphylaxis due to the td or tdap vaccine or history of encephalopathy within seven days after a previous dose of a td-containing vaccine)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0730T","name":"Trabeculotomy lsr w/oct gdn","description":"Trabeculotomy by laser, including optical coherence tomography (oct) guidance","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0883T","name":"Intraop ther estim pn ue ea","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; each additional nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0333U","name":"Onc lvr surveilanc hcc cfdna","description":"Onc lvr surveilanc hcc cfdna","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0249","name":"Tocilizumab for covid-19","description":"Injection, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0887T","name":"End-tidal ctrl inhaled anes","description":"End-tidal control of inhaled anesthetic agents and oxygen to assist anesthesia care delivery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1276","name":"Calc bmi out nrm param nof/u","description":"Bmi documented outside normal parameters, no follow-up plan documented, no reason given","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0770T","name":"Vr technology assist therapy","description":"Virtual reality technology to assist therapy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0898T","name":"N-invas prst8 cancer est map","description":"Noninvasive prostate cancer estimation map, derived from augmentative analysis of image-guided fusion biopsy and pathology, including visualization of margin volume and location, with margin determination and physician interpretation and report","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"Home vent dual fnct incl all","description":"Home ventilator, dual-function respiratory device, also performs additional function of cough stimulation, includes all accessories, components and supplies for all functions","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4007","name":"General surgery ss","description":"General surgery mips specialty set","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1352","name":"Suicd c-ssrs assessment, equ","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs or equivalent assessment","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0333U","name":"Onc lvr surveilanc hcc cfdna","description":"Onc lvr surveilanc hcc cfdna","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45111","name":"Partial removal of rectum","description":"Proctectomy; partial resection of rectum, transabdominal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1142.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0527U","name":"Hsv 1&2 vzv amp prb tq pthgn","description":"Hsv 1&2 vzv amp prb tq pthgn","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80220","name":"Drug asy hydroxychloroquine","description":"Hydroxychloroquine","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9046","name":"Inj, bortezomib, dr. reddys","description":"Injection, bortezomib (dr. reddys), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0680T","name":"Insj/rplcmt pg only isdss","description":"Insertion or replacement of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing lead(s)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98012","name":"Synch audio-only est sf 10","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1337","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2038","name":"Marigen pacto, per sq cm","description":"Marigen pacto, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0568U","name":"Neurol dementia bamyl ptau","description":"Neurol dementia bamyl ptau","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37279","name":"Iv lithotrp fpvt w/in sm art","description":"Intravascular lithotripsy(ies), femoral and popliteal vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1182","name":"Not elg pre ex ibd/uc/crohn","description":"Patients not eligible due to pre-existing inflammatory bowel disease (ibd) (e.g., ulcerative colitis, crohns disease)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1315","name":"Crc no doc no rsn","description":"Colorectal cancer screening results were not documented and reviewed; reason not otherwise specified","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15014","name":"Prepj skn cll ssp agrft ea","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; each additional 25 sq cm of harvested skin or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2976","name":"Band stabilization per tooth","description":"Band stabilization per tooth","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99291","name":"Critical care first hour","description":"Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":223.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1098","name":"Articaine ophthalmi 8% 0.4ml","description":"Articaine ophthalmic, 8% solution, 0.4 ml","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99427","name":"Prin care mgmt staff ea addl","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1461","name":"Pt dx chron hepc","description":"Patient diagnosis for chronic hepatitis c","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0472U","name":"Ca vi psp&sp1 antb sjogren","description":"Ca vi psp&sp1 antb sjogren","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9246","name":"Mod sedation noniv-15 min","description":"Mod sedation noniv-15 min","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0424U","name":"Onc prst8 xom alys 53 sncrna","description":"Onc prst8 xom alys 53 sncrna","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81195","name":"Cytog genom-wid alys hem mal","description":"Cytogenomic (genome-wide) analysis, hematologic malignancy, structural variants and copy number variants, optical genome mapping (ogm)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4436","name":"Renati ac membrane per sq cm","description":"Renati ac membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92570","name":"Acoustic immitance testing","description":"Acoustic immittance testing, includes tympanometry (impedance testing), acoustic reflex threshold testing, and acoustic reflex decay testing","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":34.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54406","name":"Remove muti-comp penis pros","description":"Removal of all components of a multi-component, inflatable penile prosthesis without replacement of prosthesis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":803.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7514","name":"Mycophenol (myhibbin) 100 mg","description":"Mycophenolate mofetil (myhibbin), oral suspension, 100 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1287","name":"Calc bmi blw low param f/u","description":"Bmi is documented below normal parameters and a follow-up plan is documented","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21632","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1433.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30560","name":"Lysis intranasal synechia","description":"Lysis intranasal synechia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1921","name":"Inj labetalol hcl hikma, 5mg","description":"Injection, labetalol hydrochloride (hikma), not therapeutically equivalent to j1920, 5 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0881T","name":"Cryotherapy oral cavity","description":"Cryotherapy of the oral cavity using temperature regulated fluid cooling system, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J3120","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85292","name":"Clot factor fletcher fact","description":"Clotting; prekallikrein assay (fletcher factor assay)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1450","name":"Pt hos/pal care dur id/pf pd","description":"Patients who received hospice or palliative care service any time during denominator identification period or the measure assessment period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0833T","name":"Dgtz gls mcrscp cytp oth prp","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; preparation, screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69727","name":"Rmv ntr oi imp sk tc esp<100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9329","name":"Inj, tislelizumab-jsgr","description":"Injection, tislelizumab-jsgr, 1mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1448","name":"Pt dx pd bef end meas pd","description":"Patients with an active diagnosis of personality disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26130","name":"Remove wrist joint lining","description":"Synovectomy, carpometacarpal joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":537.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9997","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9332","name":"Inj efgartigimod 2mg","description":"Injection, efgartigimod alfa-fcab, 2mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0544","name":"Post d/c phone follow up","description":"Post discharge telephonic follow-up contacts performed in conjunction with a discharge from the emergency department for behavioral health or other crisis encounter, 4 calls per calendar month","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0665","name":"Team remote e/m est pt 10 mn","description":"Team remote e/m est. pt 10mins","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1426","name":"Injection, casimersen, 10 mg","description":"Injection, casimersen, 10 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1161","name":"Pt anphx due to dtp bef 13","description":"Patient had anaphylaxis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1341","name":"Pt no f/u 30-180 dys","description":"Patients who did not have a follow-up assessment or did not have an assessment within 30 to 180 days after the index assessment during the performance period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2013","name":"Innovamatrix fs, per sq cm","description":"Innovamatrix fs, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0879T","name":"Augmnt alys ch ct ild prep","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; radiological data preparation and transmission","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0966T","name":"I&cst prp jw xpn dl arch fxd","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, fixed hinge mechanism","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92628","name":"Eval hearing aid cand 1st 30","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4327","name":"Duoamnion, per sq cm","description":"Duoamnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0359U","name":"Onc prst8 ca alys all psa","description":"Onc prst8 ca alys all psa","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0568U","name":"Neurol dementia bamyl ptau","description":"Neurol dementia bamyl ptau","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0924T","name":"Rpos prv ccm-d trnsvns eltrd","description":"Repositioning of previously implanted cardiac contractility modulation-defibrillation transvenous electrode(s)/lead(s), including fluoroscopic guidance and programming of sensing and therapeutic parameters","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1235","name":"Doc pt hcv aby rna tst","description":"Documentation or patient report of hcv antibody test or hcv rna test which occurred prior to the performance period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2041","name":"Foundation drs+ duo pr sq cm","description":"Foundation drs+ duo, per square centimeter","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17107","name":"Dstr cut vsc prlf les10-50sq","description":"Destruction of cutaneous vascular proliferative lesions (eg, laser technique); 10.0 to 50.0 sq cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22836","name":"Ant thrc vrt body tethrg <7","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; up to 7 vertebral segments","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0687T","name":"Tx amblyopia dev setup 1st","description":"Treatment of amblyopia using an online digital program; device supply, educational set-up, and initial session","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1390","name":"Pt no doc exm for rec","description":"Patients who do not have a documented exam performed for recurrence of melanoma or no documentation within the performance period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0331U","name":"Onc hl neo opt gen mapping","description":"Onc hl neo opt gen mapping","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2799","name":"Inj, uzedy, 1 mg","description":"Injection, risperidone (uzedy), 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99221","name":"1st hosp ip/obs sf/low 40","description":"Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward or low level medical decision making. when using total time on the date of the encounter for code selection, ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":35.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9342","name":"Inj thiotepa nos 1 mg","description":"Injection, thiotepa, not otherwise specified, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61715","name":"Mrgfus strtctc ablt trgt icr","description":"Magnetic resonance image guided high intensity focused ultrasound (mrgfus), stereotactic ablation of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86403","name":"Particle agglut antbdy scrn","description":"Particle agglutination; screen, each antibody","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2183","name":"Inj meropenem (wg crit care)","description":"Injection, meropenem (wg critical care), not therapeutically equivalent to j2185, 100 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1294","name":"Bp scrn perf rec interval","description":"Normal blood pressure reading documented, follow-up not required","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0738","name":"Upper extremity rehab","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6599","name":"G comp bandage short stretch","description":"Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9612","name":"Thera par drugs 2 or > admin","description":"Therapeutic parenteral drugs two or more administrations different medications","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93619","name":"Comprehensive ep evaluation","description":"Comprehensive electrophysiologic evaluation with right atrial pacing and recording, right ventricular pacing and recording, his bundle recording, including insertion and repositioning of multiple electrode catheters, without induction or attempted induction of arrhythmia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":863.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88172","name":"Cytp dx eval fna 1st ea site","description":"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1188","name":"Pt w/ ckd stg 5","description":"Patients with a diagnosis of chronic kidney disease (ckd) stage 5","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0554","name":"Add 20 m of monthly tx","description":"Each additional 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing data generated from the","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78492","name":"Myocrd img pet mlt rst&strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); multiple studies at rest and stress (exercise or pharmacologic)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1468.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61470","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2104.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4315","name":"Regenelink amniotic mem allo","description":"Regenelink amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0790T","name":"Revj rplcmt/rmvl vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracolumbar or lumbar vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2543","name":"Dental onlay metallic 3 surf","description":"Onlay - metallic - three surfaces","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0308U","name":"Crd cad alys 3 prtn plsm alg","description":"Crd cad alys 3 prtn plsm alg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86741","name":"Neisseria meningitidis","description":"Antibody; neisseria meningitidis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9021","name":"Inj, aspara, rylaze, 0.1 mg","description":"Injection, asparaginase, recombinant, (rylaze), 0.1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2599","name":"Inj vasopressin (am reg) 1 u","description":"Injection, vasopressin (american regent), not therapeutically equivalent to j2598, 1 unit","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49594","name":"Rpr aa hrn 1st 3-10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75996","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":453.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7473","name":"Remove torus mandibularis","description":"Removal of torus mandibularis","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0455U","name":"Nfct agt sti mult amp prb ur","description":"Nfct agt sti mult amp prb ur","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0581U","name":"Trnspl med antb nohla 39trgt","description":"Trnspl med antb nohla 39trgt","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0578","name":"Inj brixadi, more than 7 day","description":"Injection, buprenorphine extended release (brixadi), greater than 7 days and up to 28 days of therapy","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95145","name":"Antigen therapy services","description":"Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy (specify number of doses); single stinging insect venom","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01938","name":"Anes drg/aspir lmbr/sac","description":"Anesthesia for percutaneous image-guided injection, drainage or aspiration procedures on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9999","name":"Inj ustekinumab-aauz 1 mg","description":"Injection, ustekinumab-aauz (otulfi), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1463","name":"2 f/u wthn 180 day rx atmp","description":"Documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87220","name":"Tissue exam for fungi","description":"Tissue examination by koh slide of samples from skin, hair, or nails for fungi or ectoparasite ova or mites (eg, scabies)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99310","name":"Sbsq nf care high mdm 45","description":"Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 45 minutes must be met or exc","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":156.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0418U","name":"Onc brst aug alg aly whl sl8","description":"Onc brst aug alg aly whl sl8","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44146","name":"Partial removal of colon","description":"Colectomy, partial; with coloproctostomy (low pelvic anastomosis), with colostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1949.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94375","name":"Respiratory flow volume loop","description":"Respiratory flow volume loop","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0519U","name":"Ther rx mntr meds p/d/a 110+","description":"Ther rx mntr meds p/d/a 110+","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1382","name":"Enc dur perf pd pos 11","description":"Patient encounter during the performance period with place of service code 11","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0759T","name":"Dgtz gls mcrscp sl sp grpiii","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group iii, for enzyme constituents (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95863","name":"Needle emg 3 extremities","description":"Needle electromyography; 3 extremities with or without related paraspinal areas","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1497","name":"No doc fall med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99424","name":"Prin care mgmt phys 1st 30","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30210","name":"Nasal sinus therapy","description":"Displacement therapy (proetz type)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37268","name":"Revsc evasc fpvt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6192","name":"Semi precision attachment","description":"Semi precision attachment","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0033","name":"2+ benzo seiz","description":"Two or more benzodiazepine prescriptions ordered for patients who had a diagnosis of seizure disorders, rapid eye movement sleep behavior disorder, benzodiazepine withdrawal, ethanol withdrawal, or severe generalized anxiety disorder on or between january 1 of the year prior to the measurement perio","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46050","name":"I&d perianal abscess supfc","description":"Incision and drainage, perianal abscess, superficial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1653","name":"Ho abduction static ots","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, off the shelf","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1183","name":"Doc imm ckpt inhib hld","description":"Documentation of immune checkpoint inhibitor therapy held and corticosteroids or immunosuppressants prescribed or administered","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91323","name":"Sarscov2 vac 10 mcg/0.2ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 10 mcg/0.2 ml dosage, for intramuscular use","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8611","name":"Oral methotrexate (jylamvo)","description":"Methotrexate (jylamvo), oral, 2.5 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19290","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1372","name":"Mst rec gsa >=7 and<8","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 7.0% and < 8.0%","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7502","name":"Cyclosporine oral 100 mg","description":"Cyclosporine, oral, 100 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58770","name":"Create new tubal opening","description":"Salpingostomy (salpingoneostomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1007.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91321","name":"Sarscov2 vac 25 mcg/.25ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 25 mcg/0.25 ml dosage, for intramuscular use","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49593","name":"Rpr aa hrn 1st 3-10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, reducible","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86015","name":"Actin antibody each","description":"Actin (smooth muscle) antibody (asma), each","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9342","name":"Inj thiotepa nos 1 mg","description":"Injection, thiotepa, not otherwise specified, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0420U","name":"Onc urthl mrna xprsn 6 snp","description":"Onc urthl mrna xprsn 6 snp","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4353","name":"Xceed tl matrix per sq cm","description":"Xceed tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5914","name":"Auricular prosthesis","description":"Auricular prosthesis","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0991T","name":"Cysto lo-nrg lithtrp&mcrsphr","description":"Cystourethroscopy, with low-energy lithotripsy and acoustically actuated microspheres, including imaging","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0556U","name":"Nfct ds p-s dna&rna 12 trgts","description":"Nfct ds p-s dna&rna 12 trgts","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6092","name":"Recement supp crown","description":"Recement implant/abutment supported crown","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0011","name":"Hiv prep counsel, md 15-30m","description":"Individual counseling for pre-exposure prophylaxis (prep) by physician or qualified health care professional (qhp) to prevent human immunodeficiency virus (hiv), includes hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence, 15-30 minutes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4212","name":"Gingivectomy/plasty rest","description":"Gingivectomy/plasty rest","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0387","name":"Comp image capture only","description":"Comp image capture only","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8005","name":"Grip glove w microprocessor","description":"Powered, cable driven grip assist glove, hand, finger, includes microprocessor, pressure sensors, all components and accessories, custom fitted","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0544","name":"Post d/c phone follow up","description":"Post discharge telephonic follow-up contacts performed in conjunction with a discharge from the emergency department for behavioral health or other crisis encounter, 4 calls per calendar month","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4012","name":"Interventional rad ss","description":"Interventional radiology mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75887","name":"Vein x-ray liver w/o hemodyn","description":"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1229","name":"Pt w/ +hcv +vir ref win 1 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, is referred within 1 month of the reactive hcv antibody test to a clinician who treats hcv infection","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90637","name":"Vacc qirv mrna 30mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 30 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0590U","name":"Nfct ds bct&fngl dna 44 orgs","description":"Nfct ds bct&fngl dna 44 orgs","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87267","name":"Enterovirus antibody dfa","description":"Infectious agent antigen detection by immunofluorescent technique; enterovirus, direct fluorescent antibody (dfa)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0425U","name":"Genom rpd seq alys ea cmprtr","description":"Genom rpd seq alys ea cmprtr","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64467","name":"Thrc fascial pln blk uni nfs","description":"Thoracic fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86780","name":"Treponema pallidum","description":"Antibody; treponema pallidum","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98006","name":"Synch audio-video est mod 30","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0701","name":"Inj. cefepime hcl (baxter)","description":"Injection, cefepime hydrochloride (baxter), not therapeutically equivalent to maxipime, 500 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49616","name":"Rpr aa hrn rcr 3-10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0364U","name":"Onc hl neo gen seq alys alg","description":"Onc hl neo gen seq alys alg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0865T","name":"Quan mri alys brn w/o dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion identification, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transm","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1166","name":"Path rpt tis spec wle/reexc","description":"Pathology report for tissue specimens produced from wide local excisions or re-excisions","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6611","name":"Onlay cst hgh nbl mtl >=3srf","description":"Onlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6560","name":"G stckng full/chap30-40 cust","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, custom, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15853","name":"Removal sutr/stapl xreq anes","description":"Removal of sutures or staples not requiring anesthesia (list separately in addition to e/m code)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0606U","name":"Hem red cll memb do rbc oge","description":"Hem red cll memb do rbc oge","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53454","name":"Tprnl balo cntnc dev adjmt","description":"Periurethral transperineal adjustable balloon continence device; percutaneous adjustment of balloon(s) fluid volume","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0546","name":"Phone/internet ehr assess","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty   whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patien","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0175","name":"Inj, donanemab-azbt, 2 mg","description":"Injection, donanemab-azbt, 2 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"13122","name":"Cmplx rpr s/a/l addl 5 cm/>","description":"Repair, complex, scalp, arms, and/or legs; each additional 5 cm or less (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87513","name":"H pylri clrthmcn rst amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); helicobacter pylori (h. pylori), clarithromycin resistance, amplified probe technique","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1269","name":"Recd esrd mcp lst day of mo","description":"Receiving esrd mcp dialysis services by the provider on the last day of the reporting month","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0472U","name":"Ca vi psp&sp1 antb sjogren","description":"Ca vi psp&sp1 antb sjogren","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7172","name":"Inj marstacim-hncq, 0.5 mg","description":"Injection, marstacimab-hncq, 0.5 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0406U","name":"Onc lung flow cytmtry 5 mrk","description":"Onc lung flow cytmtry 5 mrk","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2272","name":"Inj, morphine (fresenius)","description":"Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0786T","name":"Insj/rplcmt prq ra sac nstim","description":"Insertion or replacement of percutaneous electrode array, sacral, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1322","name":"Pts 7wk inj, scrn iop =<25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop =<25 mm hg for injected eye","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0924T","name":"Rpos prv ccm-d trnsvns eltrd","description":"Repositioning of previously implanted cardiac contractility modulation-defibrillation transvenous electrode(s)/lead(s), including fluoroscopic guidance and programming of sensing and therapeutic parameters","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0533","name":"Buprenorphone inj weekly","description":"Medication assisted treatment, buprenorphine (injectable) administered on a weekly basis; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid tre","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4402","name":"Xwrap 2.0 per sq cm","description":"Xwrap 2.0, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59812","name":"Treatment of miscarriage","description":"Treatment of incomplete abortion, any trimester, completed surgically","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":337.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0898T","name":"N-invas prst8 cancer est map","description":"Noninvasive prostate cancer estimation map, derived from augmentative analysis of image-guided fusion biopsy and pathology, including visualization of margin volume and location, with margin determination and physician interpretation and report","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0925T","name":"Rlcj skin pocket ccm-d pg","description":"Relocation of skin pocket for implanted cardiac contractility modulation-defibrillation pulse generator","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87478","name":"Borrelia miyamotoi amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); borrelia miyamotoi, amplified probe technique","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1293","name":"Calc bmi abv up param f/u","description":"Bmi is documented above normal parameters and a follow-up plan is documented","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0616U","name":"Neurol dementia alys >30000","description":"Neurol dementia alys >30000","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5725","name":"Rebase hybrid prosthesis","description":"Rebase hybrid prosthesis","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4432","name":"510(k) skin subs, nos","description":"510(k) skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0914T","name":"Prq tcat thr rx ntrc bal sep","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting) performed on a separate target lesion from the target lesion treated with balloon angioplasty, coronary stent placement or coronary atherectomy, including mechanical dilation b","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64656","name":"Revj/rplcmt bat mod sys pg","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; pulse generator only","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6561","name":"G stockng full/chap 40+ cust","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, custom, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56720","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1022T","name":"Prq tis dsplmt ntra-abdl/pel","description":"Percutaneous tissue displacement, any method, including imaging guidance; intra-abdominal/pelvic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78701","name":"Kidney imaging with flow","description":"Kidney imaging morphology; with vascular flow","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92937","name":"Prq trluml revsc cab grf 1","description":"Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of intracoronary stent, atherectomy and angioplasty, including distal protection when performed, single major coronary artery and/or its branches","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":728.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1325","name":"Doc med rsn not seen","description":"Patients who were not seen for reasons documented by clinician for patient or medical reasons (e.g., inadequate time for follow-up, patients who received a prior intravitreal or periocular steroid injection within the last six (6) months and had a subsequent iop evaluation with iop <25mm hg within s","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49615","name":"Rpr aa hrn rcr 3-10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, reducible","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74445","name":"X-ray exam of penis","description":"Corpora cavernosography, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5939","name":"Resct proth mand comp remov","description":"Resct proth mand comp remov","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0919T","name":"Rmvl perm ccm-d sys pg only","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); pulse generator only","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55709","name":"Bx prst8 tprnl us guided","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":87.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76830","name":"Transvaginal us non-ob","description":"Ultrasound, transvaginal","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0919T","name":"Rmvl perm ccm-d sys pg only","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); pulse generator only","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59430","name":"Care after delivery","description":"Postpartum care only (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":199.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":317.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9998","name":"Doc med rsn <3 colon","description":"Documentation of medical reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., last colonoscopy incomplete, last colonoscopy had inadequate prep, piecemeal removal of adenomas, or sessile serrated polyps >= 20 mm in size, last colonoscopy found greater than 10 adenomas, lo","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9002","name":"Intra-vag motion sens biofk","description":"Intra-vaginal motion sensor system, provides biofeedback for pelvic floor muscle rehabilitation device","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0296U","name":"Onc orl&/orop ca 20 mlc feat","description":"Onc orl&/orop ca 20 mlc feat","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49618","name":"Rpr aa hrn rcr > 10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, incarcerated or strangulate","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1427","name":"Doc med rsn bone scn","description":"Documentation of medical reason(s) for performing a bone scan (including documented pain related to prostate cancer, salvage therapy, other medical reasons)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35236","name":"Repair blvsl vn grf uxtr","description":"Repair blood vessel with vein graft; upper extremity","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1226.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0235","name":"Inj, monoclon antibody, 1 mg","description":"Injection, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extraco","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0800T","name":"Tcat rmvl 2chmbr ldls pm rv","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right ventricular pacemaker component (when part of a dual-chamber leadless pacem","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36836","name":"Prq av fstl crtj uxtr 1 acs","description":"Percutaneous arteriovenous fistula creation, upper extremity, single access of both the peripheral artery and peripheral vein, including fistula maturation procedures (eg, transluminal balloon angioplasty, coil embolization) when performed, including all vascular access, imaging guidance and radiolo","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84433","name":"Asy thiopurin s-mthyltrnsfrs","description":"Thiopurine s-methyltransferase (tpmt)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6600","name":"G com bandge hgh dn foam sht","description":"Gradient compression bandaging supply, high density foam sheet, per 250 square centimeters, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9324","name":"Inj, pemrydi rtu, 10 mg","description":"Injection, pemetrexed (pemrydi rtu), 10 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"14001","name":"Tis trnfr trunk 10.1-30sqcm","description":"Adjacent tissue transfer or rearrangement, trunk; defect 10.1 sq cm to 30.0 sq cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":735.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37294","name":"Rvsc evsc tpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1933","name":"Afo rig ant tib tcf/= ots","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, off-the-shelf","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0957T","name":"Rev s-sclp eltr ra rcvr&tlmt","description":"Revision of sub-scalp implanted electrode array, receiver, and telemetry unit for electrode, when required, including imaging guidance","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5154","name":"Inj, omlyclo, 5 mg","description":"Injection, omalizumab-igec (omlyclo), biosimilar, 5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0263U","name":"Neuro asd meas 16 c metblt","description":"Neurology (autism spectrum disorder [asd]), quantitative measurements of 16 central carbon metabolites (ie, a-ketoglutarate, alanine, lactate, phenylalanine, pyruvate, succinate, carnitine, citrate, fumarate, hypoxanthine, inosine, malate, s-sulfocysteine, taurine, urate, and xanthine), liquid chrom","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4396","name":"Natalin per sq cm","description":"Natalin, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38530","name":"Biopsy/removal lymph nodes","description":"Biopsy or excision of lymph node(s); open, internal mammary node(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92641","name":"Hearing dev verif eacous aly","description":"Hearing device verification, electroacoustic analysis","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7353","name":"Anacaulase-bcdb 8.8% gel 1 g","description":"Anacaulase-bcdb, 8.8% gel, 1 gram","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0705T","name":"Rem tx amblyopia tech sprt","description":"Remote treatment of amblyopia using an eye tracking device; surveillance center technical support including data transmission with analysis, with a minimum of 18 training hours, each 30 days","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9615","name":"Inj, pegulicianine, 1 mg","description":"Injection, pegulicianine, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28035","name":"Decompression of tibia nerve","description":"Release, tarsal tunnel (posterior tibial nerve decompression)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0532U","name":"Rare ds whlgen&mitochdrl dna","description":"Rare ds whlgen&mitochdrl dna","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28173","name":"Resect metatarsal tumor","description":"Radical resection of tumor; metatarsal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98007","name":"Synch audio-video est hi 40","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high medical decision making. when using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0681T","name":"Rlcj pulse gen only isdss","description":"Relocation of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing dual leads","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4371","name":"Neoguard per sq cm","description":"Neoguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27005","name":"Tenotomy hip flexor open","description":"Tenotomy, hip flexor(s), open (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":875.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5942","name":"Proth max implt sup remv","description":"Proth max implt sup remv","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0976T","name":"Slctv nzmtc dbrdmt s/n/hf ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; each additional 100 sq cm (list separately in addition to code for p","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5943","name":"Proth mandib implt sup remv","description":"Proth mandib implt sup remv","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1430","name":"Ret exm ou no retinopthy doc","description":"Retinal exam finding without evidence of retinopathy in both eyes with severity level documented (in measurement year or in the prior year)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43275","name":"Ercp remove forgn body duct","description":"Endoscopic retrograde cholangiopancreatography (ercp); with removal of foreign body(s) or stent(s) from biliary/pancreatic duct(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":433.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0699T","name":"Njx pst chmbr eye medication","description":"Injection, posterior chamber of eye, medication","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1198","name":"Isa not red 3pts /no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1184","name":"Doc med rsn no cst/ist rx","description":"Documentation of medical reason(s) for not prescribing or administering corticosteroid or immunosuppressant treatment (e.g., allergy, intolerance, infectious etiology, pancreatic insufficiency, hyperthyroidism, prior bowel surgical interventions, celiac disease, receiving other medication, awaiting ","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1681","name":"Ho bilateral hip abduction","description":"Hip orthosis, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0398U","name":"Gi baret esph dna mthyln aly","description":"Gi baret esph dna mthyln aly","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0738","name":"Hiv prep, inj, lenacapavir","description":"Injection, lenacapavir, 1 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7213","name":"Inj, ixinity, 1 i.u.","description":"Injection, coagulation factor ix (recombinant), ixinity, 1 i.u.","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4334","name":"Amnioplast 1, per sq cm","description":"Amnioplast 1, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93896","name":"Vsrctv std tcd icr art compl","description":"Vasoreactivity study performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37284","name":"Revsc evasc tpvt st sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0819T","name":"Revj/rmvl ins ptn subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0532U","name":"Rare ds whlgen&mitochdrl dna","description":"Rare ds whlgen&mitochdrl dna","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1310","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2542","name":"Dental onlay metallic 2 surf","description":"Onlay-metallic-two surfaces","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0891T","name":"Arhfcmrigtbs sbsq tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent treatment day","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47480","name":"Incision of gallbladder","description":"Cholecystotomy or cholecystostomy, open, with exploration, drainage, or removal of calculus (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":810.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82274","name":"Assay test for blood fecal","description":"Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0751T","name":"Dgtz gls mcrscp sld level ii","description":"Digitization of glass microscope slides for level ii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87636","name":"Sarscov2 & inf a&b amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) and influenza virus types a and b, multiplex amplified probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82525","name":"Assay of copper","description":"Copper","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0001","name":"Advancing cancer care mvp","description":"Advancing cancer care mips value pathways","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1295","name":"Pt hx tot col or colon ca","description":"Patients with a diagnosis or past history of total colectomy or colorectal cancer","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15360","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0455U","name":"Nfct agt sti mult amp prb ur","description":"Nfct agt sti mult amp prb ur","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0894T","name":"Cannulation liver allograft","description":"Cannulation of the liver allograft in preparation for connection to the normothermic perfusion device and decannulation of the liver allograft following normothermic perfusion","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93594","name":"R hrt cath chd abnl nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; abnormal native connections","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9996","name":"Ustekinumab- ttwe sub cu inj","description":"Injection, ustekinumab-ttwe (pyzchiva), subcutaneous, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12011","name":"Rpr f/e/e/n/l/m 2.5 cm/<","description":"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":62.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47564","name":"Laparo cholecystectomy/explr","description":"Laparoscopy, surgical; cholecystectomy with exploration of common duct","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":981.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81195","name":"Cytog genom-wid alys hem mal","description":"Cytogenomic (genome-wide) analysis, hematologic malignancy, structural variants and copy number variants, optical genome mapping (ogm)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4368","name":"Amchothick per sq cm","description":"Amchothick, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4256","name":"Mlg complet, per sq cm","description":"Mlg-complete, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67882","name":"Revision of eyelid","description":"Construction of intermarginal adhesions, median tarsorrhaphy, or canthorrhaphy; with transposition of tarsal plate","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99427","name":"Prin care mgmt staff ea addl","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27111","name":"Transfer of iliopsoas muscle","description":"Transfer iliopsoas; to femoral neck","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1055.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0311","name":"Immunize counsel 16-30 mins","description":"Immunization counseling by a physician or other qualified health care professional when the vaccine(s) is not administered on the same date of service,  16-30 mins time (this code is used for medicaid billing purposes)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1023T","name":"Prq tis dsplmt intrathoracic","description":"Percutaneous tissue displacement, any method, including imaging guidance; intrathoracic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0491U","name":"Onc sol tum ctc slct er prtn","description":"Onc sol tum ctc slct er prtn","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2251","name":"Inj midazolam in 0.9% nacl","description":"Injection, midazolam in 0.9% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q2002","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4394","name":"Surgraft aca per sq cm","description":"Surgraft aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94760","name":"N-invas ear/pls oximetry 1","description":"Noninvasive ear or pulse oximetry for oxygen saturation; single determination","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4424","name":"Revive ft per sq cm","description":"Revive ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9506","name":"Tc-99m graphite crucible","description":"Graphite crucible for preparation of technetium tc 99m-labeled carbon aerosol, one crucible","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99406","name":"Behav chng smoking 3-10 min","description":"Smoking and tobacco use cessation counseling visit; intermediate, greater than 3 minutes up to 10 minutes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":17.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2675","name":"Inj progesterone per 50 mg","description":"Injection, progesterone, per 50 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87110","name":"Chlamydia culture","description":"Culture, chlamydia, any source","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68020","name":"Incise/drain eyelid lining","description":"Incision of conjunctiva, drainage of cyst","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1197","name":"Isa reduced >=3 fr ixv","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1151","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0528U","name":"Lrt iad 18bct/8vir&7arg rna","description":"Lrt iad 18bct/8vir&7arg rna","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9294","name":"Biofeed dig cog behav tx fda","description":"Prescription digital cognitive and/or behavioral therapy, biofeedback, fda cleared, per course of treatment","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0827T","name":"Dgtz gls mcrscp cytp smears","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; smears with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0721T","name":"Quan ct tiss charac w/o ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4285","name":"Nudyn dl or dl mesh pr sq cm","description":"Nudyn dl or nudyn dl mesh, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57456","name":"Endocerv curettage w/scope","description":"Colposcopy of the cervix including upper/adjacent vagina; with endocervical curettage","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":101.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7511","name":"Incision/drain abscess intra","description":"Incision and drainage of abscess - intraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0523","name":"Mgt nw pt dem mod-high cmplx","description":"Management of a new patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1021T","name":"Active thrc irrigation spx","description":"Active thoracic irrigation (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51705","name":"Change of bladder tube","description":"Change of cystostomy tube; simple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64681","name":"Injection treatment of nerve","description":"Destruction by neurolytic agent, with or without radiologic monitoring; superior hypogastric plexus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":259.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0937T","name":"Xtrnl ecg rec>15d<30d","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; including recording, scanning analysis with report, review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0748T","name":"Njx stm cl prdct anl sft tis","description":"Injections of stem cell product into perianal perifistular soft tissue, including fistula preparation (eg, removal of setons, fistula curettage, closure of internal openings)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1301","name":"Immunization counseling","description":"Immunization counseling","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37250","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94011","name":"Spirometry up to 2 yrs old","description":"Measurement of spirometric forced expiratory flows in an infant or child through 2 years of age","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3432","name":"Guided tissue regeneration","description":"Guided tissue regeneration","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1190","name":"Doc khe not pef w/efgr/uacr","description":"Documentation of a kidney health evaluation was not performed or defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1737","name":"Inj meloxicam (azurity) 1mg","description":"Injection, meloxicam (azurity), 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9800","name":"Gallium locametz 1 millicuri","description":"Gallium ga-68 gozetotide, diagnostic, (locametz), 1 millicurie","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0619U","name":"Pulm copd dna alys >18000","description":"Pulm copd dna alys >18000","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27524","name":"Treat kneecap fracture","description":"Open treatment of patellar fracture, with internal fixation and/or partial or complete patellectomy and soft tissue repair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0563","name":"Sbrt w/positron emission del","description":"Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance and real-time positron emissions-based delivery adjustments to 1 or more lesions, entire course not to exceed 5 fractions","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77063","name":"Breast tomosynthesis bi","description":"Screening digital breast tomosynthesis, bilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1304","name":"No pneum vax admin 19+","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33370","name":"Tcat plmt&rmvl cepd perq","description":"Transcatheter placement and subsequent removal of cerebral embolic protection device(s), including arterial access, catheterization, imaging, and radiological supervision and interpretation, percutaneous (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1397","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0595U","name":"Nfct ds tfp vctrbrn&zoonotic","description":"Nfct ds tfp vctrbrn&zoonotic","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1373","name":"Mst rec gsa >=8 and <=9","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 8.0% and <= 9.0%","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90833","name":"Psytx w pt w e/m 30 min","description":"Psychotherapy, 30 minutes with patient when performed with an evaluation and management service (list separately in addition to the code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":72.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":91.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1430","name":"Ret exm ou no retinopthy doc","description":"Retinal exam finding without evidence of retinopathy in both eyes with severity level documented (in measurement year or in the prior year)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4285","name":"Nudyn dl or dl mesh pr sq cm","description":"Nudyn dl or nudyn dl mesh, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2390","name":"Ant resin-based cmpst crown","description":"Resin-based composite crown anterior","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0521U","name":"Rf iga&igm ccp antb sr-a ia","description":"Rf iga&igm ccp antb sr-a ia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92636","name":"Hearing aid post-fitg f-up 1","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9986","name":"Missed appointment","description":"Missed appointment","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4004","name":"Endocrinology ss","description":"Endocrinology mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0309U","name":"Crd cv ds aly 4 prtn plm alg","description":"Crd cv ds aly 4 prtn plm alg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1197","name":"Isa reduced >=3 fr ixv","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0902T","name":"Qtc ntrvl augmnt alg aly ecg","description":"Qtc interval derived by augmentative algorithmic analysis of input from an external, patient-activated mobile ecg device","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0411","name":"Hba1c in office testing","description":"Hba1c in office testing","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2291","name":"Inj, nafcillin (baxter) 20mg","description":"Injection, nafcillin sodium (baxter), 20 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1643","name":"Inj heparin, pfizer, 1000u","description":"Injection, heparin sodium (pfizer), not therapeutically equivalent to j1644, per 1000 units","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6111","name":"Implnt/abut remov dent mand","description":"Implnt/abut remov dent mand","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4294","name":"Amnio quad-core, per sq cm","description":"Amnio quad-core, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99273","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2360","name":"Orphenadrine injection","description":"Injection, orphenadrine citrate, up to 60 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1330","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52277","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with resection of external sphincter (sphincterotomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87070","name":"Culture othr specimn aerobic","description":"Culture, bacterial; any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0687","name":"Inj cefazolin (wg crit care)","description":"Injection, cefazolin sodium (wg critical care), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0136","name":"Adm of pa/n assess 5-15 m","description":"Administration of a standardized, evidence-based assessment of physical activity and nutrition, 5-15 minutes, not more often than every 6 months","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1192","name":"Pt w/ dx sq cell ca of esoph","description":"Patients with an existing diagnosis of squamous cell carcinoma of the esophagus","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0563U","name":"Nfct ds pthgn-sna 11vir&4bct","description":"Nfct ds pthgn-sna 11vir&4bct","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0284U","name":"Vw factor type 2n eval plsm","description":"Von willebrand factor (vwd), type 2n, factor viii and vwf binding evaluation, enzyme-linked immunosorbent assays (elisa), plasma","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6584","name":"Grad com wrap w straps","description":"Gradient compression wrap with adjustable straps, not otherwise specified","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0884T","name":"Esphgsc flx 1st tndsc dilat","description":"Esophagoscopy, flexible, transoral, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for esophageal stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1474","name":"Pt dx dementia","description":"Patients with diagnosis of dementia","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0903T","name":"Ecg alg 12 lead reduced i&r","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; with interpretation and report","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35602","name":"Bpg crtd-clat crtd","description":"Bypass graft, with other than vein; carotid-contralateral carotid","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31512","name":"Removal of larynx lesion","description":"Laryngoscopy, indirect; with removal of lesion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1162","name":"Pt enceph due to dtp bef 13","description":"Patient had encephalitis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0778T","name":"Smmg cncrnt appl imu snr","description":"Surface mechanomyography (smmg) with concurrent application of inertial measurement unit (imu) sensors for measurement of multi-joint range of motion, posture, gait, and muscle function","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83987","name":"Exhaled breath condensate","description":"Ph; exhaled breath condensate","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":310.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6111","name":"Implnt/abut remov dent mand","description":"Implnt/abut remov dent mand","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99477","name":"Init day hosp neonate care","description":"Initial hospital care, per day, for the evaluation and management of the neonate, 28 days of age or younger, who requires intensive observation, frequent interventions, and other intensive care services","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8607","name":"Inj vocal cord bulking agent","description":"Injectable bulking agent for vocal cord medialization, 0.1 ml, includes shipping and necessary supplies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89300","name":"Semen analysis w/huhner","description":"Semen analysis; presence and/or motility of sperm including huhner test (post coital)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6280","name":"Implt maint procd remv implt","description":"Implt maint procd remv implt","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5128","name":"Inj, cimerli, 0.1 mg","description":"Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25920","name":"Amputate hand at wrist","description":"Disarticulation through wrist;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":815.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2327","name":"Inj risankizumab-rzaa 1 mg","description":"Injection, risankizumab-rzaa, intravenous, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0546U","name":"Ldns lrp4 antb imflr livecll","description":"Ldns lrp4 antb imflr livecll","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0981T","name":"Tcat impl wrls ivc snr","description":"Transcatheter implantation of wireless inferior vena cava sensor for long-term hemodynamic monitoring, including deployment of the sensor, radiological supervision and interpretation, right heart catheterization, and inferior vena cava venography, when performed","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3375","name":"Inj, vanco (tyzavan) 10mg","description":"Injection, vancomycin hydrochloride (tyzavan), not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0411U","name":"Psyc genom alys pnl 15 gen","description":"Psyc genom alys pnl 15 gen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15201","name":"Fth/gft fr trnk each addl","description":"Full thickness graft, free, including direct closure of donor site, trunk; each additional 20 sq cm, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1200","name":"Ace-i/arb rx","description":"Ace inhibitor (ace-i) or arb therapy prescribed during the measurement period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0491","name":"Oral dv nm mouthpc hw remote","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4263","name":"Surgraft tl, per sq cm","description":"Surgraft tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0912T","name":"Elec alys nstim sys vgs smpl","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; with simple programming by physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0559","name":"Unrelat prac follow up visit","description":"Post-operative follow-up visit complexity inherent to evaluation and management services addressing surgical procedure(s), provided by a physician or qualified health care professional who is not the practitioner who performed the procedure (or in the same group practice) and is of the same or of a ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1467","name":"Pt dx lynch syn","description":"Patients with an existing diagnosis of lynch syndrome","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3222","name":"Part pulp for apexogenesis","description":"Partial pulpotomy for apexogenesis - permanent tooth with incomplete root development","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86668","name":"Francisella tularensis","description":"Antibody; francisella tularensis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0341U","name":"Ftl aneup dna seq cmpr alys","description":"Ftl aneup dna seq cmpr alys","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5161","name":"Inj, denosumab-kyqq, 1 mg","description":"Injection, denosumab-kyqq (aukelso/bosaya), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2781","name":"Inj, pegcetacoplan, 1mg","description":"Injection, pegcetacoplan, intravitreal, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6073","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (predominantly base metal)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87181","name":"Sc std agar dilution per agt","description":"Susceptibility studies, antimicrobial agent; agar dilution method, per agent (eg, antibiotic gradient strip)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91124","name":"Rct snsatn tone&cmplianc std","description":"Rectal sensation, tone, and compliance study (eg, barostat)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93595","name":"L hrt cath chd nm/abn nt cnj","description":"Left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone, normal or abnormal native connections","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1448","name":"Pt dx pd bef end meas pd","description":"Patients with an active diagnosis of personality disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69110","name":"Remove external ear partial","description":"Excision external ear; partial, simple repair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98000","name":"Synch audio-video new sf 15","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 15 minutes must be met or exceeded.","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2359","name":"Inj. olanzapine, 0.5mg","description":"Injection, olanzapine, 0.5 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9596","name":"Gallium illuccix 1 millicure","description":"Gallium ga-68 gozetotide, diagnostic, (illuccix), 1 millicurie","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33288","name":"Rmv&rplcmt phrnc nrv stim ld","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4439","name":"Instagraft per sq cm","description":"Instagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0483U","name":"Nfct ds ng gyra s91f pt mut","description":"Nfct ds ng gyra s91f pt mut","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2011","name":"Supra sdrm, per sq cm","description":"Supra sdrm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47140","name":"Partial removal donor liver","description":"Donor hepatectomy (including cold preservation), from living donor; left lateral segment only (segments ii and iii)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3621.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49593","name":"Rpr aa hrn 1st 3-10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, reducible","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":320.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97607","name":"Neg prs wnd thr ndme<=50sqcm","description":"Negative pressure wound therapy, (eg, vacuum assisted drainage collection), utilizing disposable, non-durable medical equipment including provision of exudate management collection system, topical application(s), wound assessment, and instructions for ongoing care, per session; total wound(s) surfac","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":433.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0394U","name":"Pfas 16 pfas compnd lc ms/ms","description":"Pfas 16 pfas compnd lc ms/ms","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58540","name":"Revision of uterus","description":"Hysteroplasty, repair of uterine anomaly (strassman type)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1039.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4018","name":"Ob/gyn ss","description":"Obstetrics/gynecology mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6516","name":"Grad com wrap w strap foo cu","description":"Gradient compression wrap with adjustable straps, foot, each, custom","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4542","name":"Supp ext up limb tremor stim","description":"Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0175","name":"Inj, donanemab-azbt, 2 mg","description":"Injection, donanemab-azbt, 2 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37618","name":"Ligation major artery xtr","description":"Ligation, major artery (eg, post-traumatic, rupture); extremity","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77090","name":"Tbs techl prep&transmis data","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90695","name":"H5n8 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n8, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4338","name":"Artacent velos, per sq cm","description":"Artacent velos, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0867T","name":"Tpla b9 prst8 hyprplsa>=50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume greater or equal to 50 ml","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1255","name":"Pts w/ othr rsn vst,+prg tst","description":"Patients who have another reason for visiting the clinic [not prenatal or postpartum care] and have a positive pregnancy test but have not established the clinic as an ob provider (e.g., plan to terminate the pregnancy or seek prenatal services elsewhere)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1173","name":"Pt no rec td/tdap 9yrs prior","description":"Patient did not receive at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30430","name":"Revision of nose","description":"Rhinoplasty, secondary; minor revision (small amount of nasal tip work)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1109.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0422","name":"Collect & prep genetic samp","description":"Collect & prep genetic samp","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1285","name":"Scrn mam perf rslts not doc","description":"Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed, reason not otherwise specified","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95991","name":"Spin/brain pump refil & main","description":"Refilling and maintenance of implantable pump or reservoir for drug delivery, spinal (intrathecal, epidural) or brain (intraventricular), includes electronic analysis of pump, when performed; requiring skill of a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57452","name":"Exam of cervix w/scope","description":"Colposcopy of the cervix including upper/adjacent vagina;","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":94.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27468","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1574.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0524","name":"Est pt-cg dyad dem low cmplx","description":"Management of established patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99484","name":"Care mgmt svc bhvl hlth cond","description":"Care management services for behavioral health conditions, at least 20 minutes of clinical staff time, directed by a physician or other qualified health care professional, per calendar month, with the following required elements: initial assessment or follow-up monitoring, including the use of appli","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":55.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6590","name":"Urinary cath disp suc pump","description":"External urinary catheters; disposable, with wicking material, for use with suction pump, per month","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1270","name":"Injection, doxercalciferol","description":"Injection, doxercalciferol, 1 mcg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0530","name":"Adult daycare center, 8 hr u","description":"Adult day center, 8-hour unit, for use in cmmi model","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1497","name":"No doc fall med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49616","name":"Rpr aa hrn rcr 3-10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, incarcerated or strangulated","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0871T","name":"Rplcmt subq prtl ascites pmp","description":"Replacement of a subcutaneous peritoneal ascites pump, including reconnection between pump and indwelling bladder and peritoneal catheters, including initial programming and imaging, when performed","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0520U","name":"Ther rx mntr 200+ rx/sbsts","description":"Ther rx mntr 200+ rx/sbsts","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0952T","name":"Tot impl amei rev/rplc mstdc","description":"Totally implantable active middle ear hearing implant; revision or replacement, with mastoidectomy and replacement of sound processor","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92928","name":"Prq tcat plmt ntrac st 1 les","description":"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 1 lesion involving 1 or more coronary segments","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0822T","name":"Mntr psychdlc med cln staff","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; clinical staff under the direction of a physician or other qualified health care professional, concurrent with first physician or other qualified health care p","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38520","name":"Biopsy/removal lymph nodes","description":"Biopsy or excision of lymph node(s); open, deep cervical node(s) with excision scalene fat pad","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":518.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91322","name":"Sarscov2 vac 50 mcg/0.5ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 50 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1232","name":"Pt hcv tst reactive result","description":"Patient receives hcv antibody test with reactive result","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1017T","name":"Elec aly npgs esoph sbsq w/o","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0813T","name":"Egd vol adjmt bariatric balo","description":"Esophagogastroduodenoscopy, flexible, transoral, with volume adjustment of intragastric bariatric balloon","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6624","name":"Inlay titanium","description":"Inlay - titanium","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82962","name":"Glucose blood test","description":"Glucose, blood by glucose monitoring device(s) cleared by the fda specifically for home use","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0370","name":"Max ultrasound capt & interp","description":"Max ultrasound capt & interp","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1181","name":"Gr 2 or> dia or gr2 or> col","description":"Grade 2 or above diarrhea and/or grade 2 or above colitis","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1258","name":"Cvd risk assess perf","description":"Cvd risk assessment performed, have a documented calculated risk score","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0032","name":"2+ antipsy schiz","description":"Two or more antipsychotic prescriptions ordered for patients who had a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder on or between january 1 of the year prior to the measurement period and the index prescription start date (ipsd) for antipsychotics","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0777T","name":"R-t prs sensing edrl gdn sys","description":"Real-time pressure-sensing epidural guidance system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59320","name":"Revision of cervix","description":"Cerclage of cervix, during pregnancy; vaginal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2003","name":"Inj, lidocaine hcl, 1 mg","description":"Injection, lidocaine hydrochloride, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93587","name":"Vngrph chd vnvn cltrl at/abv","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating at or above the heart (eg, from innominate vein) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44127","name":"Enterectomy w/taper cong","description":"Enterectomy, resection of small intestine for congenital atresia, single resection and anastomosis of proximal segment of intestine; with tapering","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2783.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0300U","name":"Onc pan tum whl gen seq&opt","description":"Onc pan tum whl gen seq&opt","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4004","name":"Endocrinology ss","description":"Endocrinology mips specialty set","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4325","name":"Acapatch, per sq cm","description":"Acapatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69145","name":"Remove ear canal lesion(s)","description":"Excision soft tissue lesion, external auditory canal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1306","name":"Pt anphx due to pneum","description":"Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6609","name":"G compression bandaging","description":"Gradient compression bandaging supply, not otherwise specified","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2403","name":"Chloroprocaine opht gel, 1mg","description":"Chloroprocaine hcl ophthalmic, 3% gel, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0438U","name":"Rx metab advrs vrnt alys 33","description":"Rx metab advrs vrnt alys 33","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31755","name":"Trachplsty trchphryngl fstlj","description":"Tracheoplasty; tracheopharyngeal fistulization, each stage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1904.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2041","name":"Foundation drs+ duo pr sq cm","description":"Foundation drs+ duo, per square centimeter","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6611","name":"Onlay cst hgh nbl mtl >=3srf","description":"Onlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0236","name":"Intrav inf, mon anti, sec do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4289","name":"Revoshield+ amnio, per sq cm","description":"Revoshield + amniotic barrier, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0986T","name":"Iv img icr cere vsl oct 1st","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1710","name":"Moderna vacc admin 3rd dose","description":"Moderna vacc admin 3rd dose","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0169","name":"Inj epinephrine (adrenalin)","description":"Injection, epinephrine (adrenalin), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2402","name":"Chloroprocaine (clorotekal)","description":"Injection, chloroprocaine hydrochloride (clorotekal), per 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1200","name":"Ace-i/arb rx","description":"Ace inhibitor (ace-i) or arb therapy prescribed during the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4259","name":"Celera per sq cm","description":"Celera dual layer or celera dual membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0790T","name":"Revj rplcmt/rmvl vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracolumbar or lumbar vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1302","name":"Inj, sutimlimab-jome, 10 mg","description":"Injection, sutimlimab-jome, 10 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1262","name":"Pts transplt bef dialysis","description":"Patients who had a transplant prior to initiation of dialysis","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4251","name":"Vim, per square centimeter","description":"Vim, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0501U","name":"Onc clrc bld quan meas cfdna","description":"Onc clrc bld quan meas cfdna","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27659","name":"Repair of leg tendon each","description":"Repair, flexor tendon, leg; secondary, with or without graft, each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":616.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99205","name":"Office o/p new hi 60 min","description":"Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":254.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0280","name":"Aminophyllin 250 mg inj","description":"Injection, aminophyllin, up to 250 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70360","name":"X-ray exam of neck","description":"Radiologic examination; neck, soft tissue","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1437","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1263","name":"Pts hosp dialysis dt","description":"Patients in hospice on their initiation of dialysis date or during the month of evaluation","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2011","name":"Supra sdrm, per sq cm","description":"Supra sdrm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0944T","name":"3d cntr simula trgt lvr les","description":"3d contour simulation of target liver lesion(s) and margin(s) for image-guided percutaneous microwave ablation","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63195","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1612.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61737","name":"Litt icr mlt trj mlt/cplx ls","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; multiple trajectories for multiple or complex lesion(s)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58800","name":"Drainage of ovarian cyst(s)","description":"Drainage of ovarian cyst(s), unilateral or bilateral (separate procedure); vaginal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59851","name":"Induced abortion 1+njx d&c","description":"Induced abortion, by 1 or more intra-amniotic injections (amniocentesis-injections), including hospital admission and visits, delivery of fetus and secundines; with dilation and curettage and/or evacuation","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1236","name":"Baseline mrs > 2","description":"Baseline mrs > 2","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99496","name":"Transj care mgmt high f2f 7d","description":"Transitional care management services with the following required elements: communication (direct contact, telephone, electronic) with the patient and/or caregiver within 2 business days of discharge high level of medical decision making during the service period face-to-face visit, within 7 calenda","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":187.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0045","name":"Mrs 90 days post stk","description":"Clinical follow-up and mrs score assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45560","name":"Repair of rectocele","description":"Repair of rectocele (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73660","name":"X-ray exam of toe(s)","description":"Radiologic examination; toe(s), minimum of 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9255","name":"Inj, methotrexate (accord)","description":"Injection, methotrexate (accord), not therapeutically equivalent to j9260, 50 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0767T","name":"Tc mag stimj pn ea addl nrv","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; each additional nerve (list separat","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1309","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0405","name":"Ekg interpret & report preve","description":"Electrocardiogram, routine ecg with 12 leads; interpretation and report only, performed as a screening for the initial preventive physical examination","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4422","name":"Ac wrap per sq cm","description":"A/c wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2017","name":"Permeaderm glove, each","description":"Permeaderm glove, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9245","name":"Admin mod sedation-enteral","description":"Admin mod sedation-enteral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4029","name":"Preventive medicine ss","description":"Preventive medicine mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82300","name":"Assay of cadmium","description":"Cadmium","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0313U","name":"Onc pncrs dna&mrna seq 74","description":"Onc pncrs dna&mrna seq 74","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0713T","name":"N-nvs artl plaq alys rvw i&r","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data review, interpretation and report","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4439","name":"Instagraft per sq cm","description":"Instagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15011","name":"Hrv skn cll ssp agrft 1st 25","description":"Harvest of skin for skin cell suspension autograft; first 25 sq cm or less","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92928","name":"Prq tcat plmt ntrac st 1 les","description":"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 1 lesion involving 1 or more coronary segments","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2928","name":"Prefab porc/cer crown perm","description":"Prefab porc/cer crown perm","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0467","name":"Home vent multi-function","description":"Home ventilator, multi-function respiratory device, also performs any or all of the additional functions of oxygen concentration, drug nebulization, aspiration, and cough stimulation, includes all accessories, components and supplies for all functions","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1578.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1172","name":"Doc med rsn no td/tdap","description":"Documentation of medical reason(s) for not administering td or tdap vaccine (e.g., prior anaphylaxis due to the td or tdap vaccine or history of encephalopathy within seven days after a previous dose of a td-containing vaccine)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4316","name":"Amchoplast, per sq cm","description":"Amchoplast, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0778T","name":"Smmg cncrnt appl imu snr","description":"Surface mechanomyography (smmg) with concurrent application of inertial measurement unit (imu) sensors for measurement of multi-joint range of motion, posture, gait, and muscle function","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9955","name":"Oral app thxpy titration vis","description":"Oral app thxpy titration vis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6608","name":"G com bandage tub protct pad","description":"Gradient compression bandaging supply, tubular protective absorption padded layer, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"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":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87084","name":"Culture of specimen by kit","description":"Culture, presumptive, pathogenic organisms, screening only; with colony estimation from density chart","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0183","name":"Software meas of cardiac vol","description":"Quantitative software measurements of cardiac volume, cardiac chambers volumes and left ventricular wall mass derived from ct scan(s) data of the chest/heart (with or without contrast)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57023","name":"I&d vaginal hematoma non-ob","description":"Incision and drainage of vaginal hematoma; non-obstetrical (eg, post-trauma, spontaneous bleeding)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4304","name":"Grafix plus, per sq cm","description":"Grafix plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0570","name":"Care manage serv, pr cal mo","description":"Care management services for behavioral health conditions, directed by a physician or other qualified health care professional, per calendar month, with the following required elements: initial assessment or follow-up monitoring, including the use of applicable validated rating scales, behavioral he","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0877T","name":"Augmnt alys ch ct ild w/o ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98008","name":"Synch audio-only new sf 15","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code sel","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99487","name":"Cplx chrnc care 1st 60 min","description":"Complex chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":77.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2393","name":"Post 3 srfc resinbased cmpst","description":"Resin-based composite - three surfaces posterior","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1358","name":"Pts no <suicd idea 120 dys","description":"Patients who did not have a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0877T","name":"Augmnt alys ch ct ild w/o ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84431","name":"Thromboxane urine","description":"Thromboxane metabolite(s), including thromboxane if performed, urine","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1461","name":"Pt dx chron hepc","description":"Patient diagnosis for chronic hepatitis c","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45327","name":"Proctosigmoidoscopy w/stent","description":"Proctosigmoidoscopy, rigid; with transendoscopic stent placement (includes predilation)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0918T","name":"Insj perm ccm-d sys dual ld","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; dual transvenous leads (pacing and defibrillation) only","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2003","name":"Inj, lidocaine hcl, 1 mg","description":"Injection, lidocaine hydrochloride, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54344","name":"Rrp hypspad comp moblj&urtp","description":"Repair of hypospadias complication(s) (ie, fistula, stricture, diverticula); requiring mobilization of skin flaps and urethroplasty with flap or patch graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1114.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1464","name":"No record of f/u by 180 days","description":"No documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0422","name":"Collect & prep genetic samp","description":"Collect & prep genetic samp","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1429","name":"Retinopathy in od, os, ou","description":"Retinal exam finding with evidence of retinopathy in left, right or both eyes with severity level documented","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2040","name":"Coord specialty care, month","description":"Coordinated specialty care, team-based, for first episode psychosis, per month","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87150","name":"Dna/rna amplified probe","description":"Culture, typing; identification by nucleic acid (dna or rna) probe, amplified probe technique, per culture or isolate, each organism probed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6214","name":"Pontic titanium","description":"Pontic - titanium","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1421","name":"Dermatological care mvp","description":"Dermatological care mips value pathway","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0780T","name":"Instlj fecal microbiota ssp","description":"Instillation of fecal microbiota suspension via rectal enema into lower gastrointestinal tract","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2040","name":"Microlyte painguard pr sq cm","description":"Microlyte painguard, per square centimeter","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99425","name":"Prin care mgmt phys ea addl","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15176","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5942","name":"Proth max implt sup remv","description":"Proth max implt sup remv","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0138","name":"Iv cipaglucosidase alfa-atga","description":"Intravenous infusion of cipaglucosidase alfa-atga, including provider/supplier acquisition and clinical supervision of oral administration of miglustat in preparation of receipt of cipaglucosidase alfa-atga","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99234","name":"Hosp ip/obs sm dt sf/low 45","description":"Hospital inpatient or observation care, for the evaluation and management of a patient including admission and discharge on the same date, which requires a medically appropriate history and/or examination and straightforward or low level of medical decision making. when using total time on the date ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0402","name":"Inj, abilify asimtufii, 1 mg","description":"Injection, aripiprazole (abilify asimtufii), 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7023","name":"Mech allergen parti barrier","description":"Mechanical allergen particle barrier/inhalation filter, cream, nasal, topical","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1289","name":"No pt tbco cess interv rng","description":"Patient identified as tobacco user did not receive tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31255","name":"Nsl/sins ndsc w/tot ethmdct","description":"Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3291","name":"Tranexamic acid in sod chlor","description":"Injection, tranexamic acid in sodium chloride, 5 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37298","name":"Revsc evsc imvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92920","name":"Prq trluml c angiop 1art&/br","description":"Percutaneous transluminal coronary angioplasty, single major coronary artery and/or its branch(es)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3473","name":"Surg rep root res molar","description":"Surg rep root res molar","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1301","name":"Pt recv tbco cess interv","description":"Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0825T","name":"Tcat rmv&rpl1chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or prog","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1023T","name":"Prq tis dsplmt intrathoracic","description":"Percutaneous tissue displacement, any method, including imaging guidance; intrathoracic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4338","name":"Artacent velos, per sq cm","description":"Artacent velos, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5160","name":"Inj, jobevne, 10 mg","description":"Injection, bevacizumab-nwgd (jobevne), biosimilar, 10 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53451","name":"Tprnl balo cntnc dev bi","description":"Periurethral transperineal adjustable balloon continence device; bilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9871","name":"Bhv couns dm prev, onln 60 m","description":"Behavioral counseling for diabetes prevention, online, 60 minutes","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5128","name":"Inj, cimerli, 0.1 mg","description":"Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2021","name":"Inj, linezolid (hospira)","description":"Injection, linezolid (hospira), not therapeutically equivalent to j2020, 200 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15012","name":"Hrv skn cll ssp agrft ea add","description":"Harvest of skin for skin cell suspension autograft; each additional 25 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2004","name":"Inj, lidocaine w epinephrine","description":"Injection, lidocaine hcl with epinephrine, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80210","name":"Drug assay rufinamide","description":"Rufinamide","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91125","name":"Anrct mano rct snsatn&balo","description":"Anorectal manometry, with rectal sensation and rectal balloon expulsion test, when performed","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4382","name":"Advograft dual per sq cm","description":"Advograft dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2019","name":"Kerecis marigen shld sq cm","description":"Kerecis omega3 marigen shield, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76015","name":"Mr sfty mplt&/fb asmt stf ea","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55867","name":"Laps surg prst8ect smpl stot","description":"Laparoscopy, surgical prostatectomy, simple subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy), includes robotic assistance, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0747T","name":"Car ablt rad arrhyt dlvr rad","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; delivery of radiation therapy, arrhythmia","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1314","name":"Bmi not calculated","description":"Bmi not documented and no reason is given","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37140","name":"Revision of circulation","description":"Venous anastomosis, open; portocaval","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1583.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":20.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0871T","name":"Rplcmt subq prtl ascites pmp","description":"Replacement of a subcutaneous peritoneal ascites pump, including reconnection between pump and indwelling bladder and peritoneal catheters, including initial programming and imaging, when performed","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0888T","name":"Histotripsy mal renal tissue","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant renal tissue, including imaging guidance","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26460","name":"Incise hand/finger tendon","description":"Tenotomy, extensor, hand or finger, open, each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":517.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6597","name":"G comp bandage long stretch","description":"Gradient compression bandage roll, elastic long stretch, linear yard, any width, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3424","name":"Inj hydroxocobalamin iv 25mg","description":"Injection, hydroxocobalamin, intravenous, 25 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86317","name":"Immunoassay infectious agent","description":"Immunoassay for infectious agent antibody, quantitative, not otherwise specified","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6113","name":"Imp/abut rem dent part mand","description":"Imp/abut rem dent part mand","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26607","name":"Treat metacarpal fracture","description":"Closed treatment of metacarpal fracture, with manipulation, with external fixation, each bone","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":573.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1251","name":"Pts proxy cmplt hu surv","description":"Patients for whom a proxy completed the entire hu survey on their behalf for any reason (no patient involvement)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1221","name":"Dre w/o rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; without evidence of retinopathy","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0522","name":"Mgt nw pt dementia low cmplx","description":"Management of a new patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82948","name":"Reagent strip/blood glucose","description":"Glucose; blood, reagent strip","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7300","name":"Rem anchorage dev w/o flap","description":"Rem anchorage dev w/o flap","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76815","name":"Ob us limited fetus(s)","description":"Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0738","name":"Upper extremity rehab","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1327","name":"Pts no eval ini xm no 8 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 8 weeks","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9992","name":"Pall serv during meas","description":"Palliative care services used by patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0312U","name":"Ai ds sle alys 8 igg autoant","description":"Ai ds sle alys 8 igg autoant","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37259","name":"Revsc evasc ivt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1354","name":"Pt no suicd saf pln 120dy","description":"Patients who did not have a suicide safety plan initiated, reviewed, or updated or reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1225","name":"Iop dec>=20% from base","description":"Intraocular pressure (iop) reduced by a value of greater than or equal to 20% from the pre-intervention level","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0023","name":"Pin service 60m per month","description":"Principal illness navigation services by certified or trained auxiliary personnel under the direction of a physician or other practitioner, including a patient navigator; 60 minutes per calendar month, in the following activities:  person-centered assessment, performed to better understand the indiv","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0801T","name":"Tcat rmv&rpl 2chmbr ldls pm","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; dual-cha","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0250","name":"Adm tocilizu covid-19 2nd","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0902T","name":"Qtc ntrvl augmnt alg aly ecg","description":"Qtc interval derived by augmentative algorithmic analysis of input from an external, patient-activated mobile ecg device","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0732T","name":"Immntx admn electroporatn im","description":"Immunotherapy administration with electroporation, intramuscular","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0679T","name":"Laps rmvl lead isdss","description":"Laparoscopic removal of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2025","name":"Miro3d per cubic cm","description":"Miro3d, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0738","name":"Hiv prep, inj, lenacapavir","description":"Injection, lenacapavir, 1 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1465","name":"F/u > 180 days after rx","description":"Patient follow up more than 180 days after treatment","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38573","name":"Laps pelvic lymphadec","description":"Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy and peri-aortic lymph node sampling, peritoneal washings, peritoneal biopsy(ies), omentectomy, and diaphragmatic washings, including diaphragmatic and other serosal biopsy(ies), when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1167.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86581","name":"Strptcs pneum antb serot ia","description":"Streptococcus pneumoniae antibody (igg), serotypes, multiplex immunoassay, quantitative","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9038","name":"Inj axatilimab-csfr 0.1 mg","description":"Injection, axatilimab-csfr, 0.1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15014","name":"Prepj skn cll ssp agrft ea","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; each additional 25 sq cm of harvested skin or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4231","name":"Ana crown exp 1-3 per quad","description":"Anatomical crown exposure - one to three teeth per quadrant","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5125","name":"Inj, releuko 1 mcg","description":"Injection, filgrastim-ayow, biosimilar, (releuko), 1 microgram","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1653","name":"Ho abduction static ots","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, off the shelf","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4332","name":"Axolotl dualgraft, per sq cm","description":"Axolotl dualgraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9537","name":"Tc99m mebrofenin","description":"Technetium tc-99m mebrofenin, diagnostic, per study dose, up to 15 millicuries","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4432","name":"510(k) skin subs, nos","description":"510(k) skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28505","name":"Treat big toe fracture","description":"Open treatment of fracture, great toe, phalanx or phalanges, includes internal fixation, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93235","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80176","name":"Assay of lidocaine","description":"Lidocaine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1190","name":"Doc khe not pef w/efgr/uacr","description":"Documentation of a kidney health evaluation was not performed or defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0471U","name":"Onc clrc ca 35 vrn kras&nras","description":"Onc clrc ca 35 vrn kras&nras","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3921","name":"Decor or submerg erupt tooth","description":"Decor or submerg erupt tooth","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90635","name":"H5n1 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n1, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76988","name":"Dx ntrop epcr us chd img acq","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; placement, manipulation of transducer, and image acquisition only","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0806T","name":"Tcat s&ivc prstc vl impl opn","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); open femoral vein approach","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76817","name":"Transvaginal us obstetric","description":"Ultrasound, pregnant uterus, real time with image documentation, transvaginal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1185","name":"Imm ckpt inhib not hld no rx","description":"Documentation of immune checkpoint inhibitor therapy not held and/or corticosteroids or immunosuppressants prescribed or administered was not performed, reason not given","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4421","name":"Biolab wrap solo per sq cm","description":"Biolab membrane wrap solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0738T","name":"Tx pln mag fld abltj prst8","description":"Treatment planning for magnetic field induction ablation of malignant prostate tissue, using data from previously performed magnetic resonance imaging (mri) examination","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0956T","name":"Prt crn ch cr&tun elt s-sclp","description":"Partial craniectomy, channel creation, and tunneling of electrode for sub-scalp implantation of an electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6602","name":"Cst hgh nble mtl inlay 2 srf","description":"Inlay - cast high noble metal two surfaces","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6192","name":"Semi precision attachment","description":"Semi precision attachment","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0726T","name":"Rmvl implt vstibular dev uni","description":"Removal of implanted vestibular device, unilateral","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1386","name":"Exc sx melmn or mlnm is","description":"Patients with an excisional surgery for melanoma or melanoma in situ in the past 5 years with an initial ajcc staging of 0, i, or ii at the start of the performance period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1392","name":"Pt rsn no exm or lst to fu","description":"Documentation of patient reasons for no examination, i.e., refusal of examination or lost to follow-up (documentation must include information that the clinician was unable to reach the patient by phone, mail or secure electronic mail - at least one method must be documented)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1441","name":"Init dx slp apn = 1st enc","description":"Encounter corresponds to initial diagnosis of sleep apnea or first contact with sleep apnea diagnosed patient","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90484","name":"Imm cnsl not admn sm>20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 20 minutes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90695","name":"H5n8 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n8, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0875T","name":"Prgrm subq prtl asct pmp sys","description":"Programming of subcutaneously implanted peritoneal ascites pump system by physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3394","name":"Inj, lovotibeglogene autotem","description":"Injection, lovotibeglogene autotemcel, per treatment","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0433U","name":"Onc prst8 5 dna reg mrk pcr","description":"Onc prst8 5 dna reg mrk pcr","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99356","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0878T","name":"Augmnt alys ch ct ild w/ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained with concurrent ct examination of the same structure","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82272","name":"Occult bld feces 1-3 tests","description":"Blood, occult, by peroxidase activity (eg, guaiac), qualitative, feces, 1-3 simultaneous determinations, performed for other than colorectal neoplasm screening","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4422","name":"Ac wrap per sq cm","description":"A/c wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0953T","name":"Tot impl amei rev/rplc w/o","description":"Totally implantable active middle ear hearing implant; revision or replacement, without mastoidectomy and replacement of sound processor","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0740T","name":"Rem auton alg nsln cal setup","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; initial set-up and patient education","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99402","name":"Prev med cnsl indiv apprx 30","description":"Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 30 minutes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":46.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76810","name":"Ob us >/= 14 wks addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94617","name":"Exercise tst brncspsm w/ecg","description":"Exercise test for bronchospasm, including pre- and post-spirometry and pulse oximetry; with electrocardiographic recording(s)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1267","name":"Pt no act kid transplt wtlst","description":"Patients not observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1282","name":"Pt scrn tbco id as non user","description":"Patient screened for tobacco use and identified as a tobacco non-user","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1238","name":"Doc 2nd recom hzv 2-6 mo int","description":"Documentation that administration of second recombinant zoster vaccine could not occur during the performance period due to the recommended 2-6 month interval between doses (i.e, first dose received after october 31)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86361","name":"T cell absolute count","description":"T cells; absolute cd4 count","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1324","name":"Pts intravitreal/pci","description":"Patients who had an intravitreal or periocular corticosteroid injection (e.g., triamcinolone, preservative-free triamcinolone, dexamethasone, dexamethasone intravitreal implant, or fluocinolone intravitreal implant)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33279","name":"Rmvl phrnc nrv stim transvns","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s) only","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0424U","name":"Onc prst8 xom alys 53 sncrna","description":"Onc prst8 xom alys 53 sncrna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0793T","name":"Prq tcat thrm ablt nrv p-art","description":"Percutaneous transcatheter thermal ablation of nerves innervating the pulmonary arteries, including right heart catheterization, pulmonary artery angiography, and all imaging guidance","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87076","name":"Culture anaerobe ident each","description":"Culture, bacterial; anaerobic isolate, additional methods required for definitive identification, each isolate","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0967T","name":"Tranal ins tmp clrc anst dev","description":"Transanal insertion of endoluminal temporary colorectal anastomosis protection device, including vacuum anchoring component and flexible sheath connected to external vacuum source and monitoring system","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4336","name":"Artecent c, per sq cm","description":"Artacent c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0682T","name":"Removal pulse gen only isdss","description":"Removal of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1192","name":"Pt w/ dx sq cell ca of esoph","description":"Patients with an existing diagnosis of squamous cell carcinoma of the esophagus","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5946","name":"Max implt sup fix","description":"Max implt sup fix","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9999","name":"Doc sys rsn <3 colon","description":"Documentation of system reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., unable to locate previous colonoscopy report, patient cannot provide precise date or details from previous colonoscopy, previous colonoscopy report was incomplete)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0736","name":"Inj, clindamycin phosp 300mg","description":"Injection, clindamycin phosphate, 300 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7771","name":"Alveolus clsd reduc stblz te","description":"Alveolus closed reduction stabilization of teeth","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94626","name":"Phy/qhp op pulm rhb w/mntr","description":"Physician or other qualified health care professional services for outpatient pulmonary rehabilitation; with continuous oximetry monitoring (per session)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1025","name":"Pt mnth 1 mcp prov","description":"Patient-months where there are more than one medicare capitated payment (mcp) provider listed for the month","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2027","name":"Matriderm per sq cm","description":"Matriderm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1165","name":"Pt use hspc dur meas pd","description":"Patients who use hospice services any time during the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0137","name":"Inten outpt svs,min 9 pr 7 d","description":"Intensive outpatient services; weekly bundle, minimum of 9 services over a 7 contiguous day period, which can include individual and group therapy with physicians or psychologists (or other mental health professionals to the extent authorized under state law); occupational therapy requiring the skil","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1433","name":"Oral chemo wthn 30 days enc","description":"Patient on oral chemotherapy on or within 30 days before denominator eligible encounter","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22837","name":"Ant thrc vrt body tethrg 8+","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; 8 or more vertebral segments","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59350","name":"Repair of uterus","description":"Hysterorrhaphy of ruptured uterus","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":267.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4231","name":"Ana crown exp 1-3 per quad","description":"Anatomical crown exposure - one to three teeth per quadrant","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92973","name":"Prq trluml c mchn asp thrmbc","description":"Percutaneous transluminal coronary mechanical aspiration thrombectomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0538U","name":"Onc sol tum ngts ffpe 600gen","description":"Onc sol tum ngts ffpe 600gen","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2543","name":"Dental onlay metallic 3 surf","description":"Onlay - metallic - three surfaces","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0951T","name":"Tot impl amei 1st plmt","description":"Totally implantable active middle ear hearing implant; initial placement, including mastoidectomy, placement of and attachment to sound processor","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0994T","name":"Evasc dlvr a-wal stbl rx prq","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; percutaneous","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0944T","name":"3d cntr simula trgt lvr les","description":"3d contour simulation of target liver lesion(s) and margin(s) for image-guided percutaneous microwave ablation","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0470U","name":"Onc orop detcj mrd 8 dna hpv","description":"Onc orop detcj mrd 8 dna hpv","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5145","name":"Inj, abrilada, 1 mg","description":"Injection, adalimumab-afzb (abrilada), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0950T","name":"Abltj b9 prst8 tissue hifu","description":"Ablation of benign prostate tissue, transrectal, with high intensity-focused ultrasound (hifu), including ultrasound guidance","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1395","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55867","name":"Laps surg prst8ect smpl stot","description":"Laparoscopy, surgical prostatectomy, simple subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy), includes robotic assistance, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0857T","name":"Opto-acoustic img breast uni","description":"Opto-acoustic imaging, breast, unilateral, including axilla when performed, real-time with image documentation, augmentative analysis and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31600","name":"Planned tracheostomy","description":"Tracheostomy, planned (separate procedure);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":495.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0429U","name":"Hpv orop swab 14 hi-risk typ","description":"Hpv orop swab 14 hi-risk typ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4266","name":"Neostim per sq cm","description":"Neostim membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3401","name":"Vyjuvek 5x10^9pfu/ml, 0.1 ml","description":"Beremagene geperpavec-svdt for topical administration, containing nominal 5 x 10^9 pfu/ml vector genomes, per 0.1 ml","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0420U","name":"Onc urthl mrna xprsn 6 snp","description":"Onc urthl mrna xprsn 6 snp","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93151","name":"Interrog&prgrmg ipnss","description":"Interrogation and programming (minimum one parameter) of implanted phrenic nerve stimulator system","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12035","name":"Intmd rpr s/a/t/ext 12.6-20","description":"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 12.6 cm to 20.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2011","name":"Supra sdrm, per sq cm","description":"Supra sdrm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2643","name":"Dental onlay porcelin 3 surf","description":"Onlay - porcelain/ceramic - three surfaces","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3244","name":"Inj. tigecycline (accord)","description":"Injection, tigecycline (accord), not therapeutically equivalent to j3243, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0018M","name":"Trnsplj rnl meas cd154+cll","description":"Transplantation medicine (allograft rejection, renal), measurement of donor and third-party-induced cd154+t-cytotoxic memory cells, utilizing whole peripheral blood, algorithm reported as a rejection risk score","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76017","name":"Mr sfty med physics xm cstmz","description":"Mr safety medical physics examination customization, planning and performance monitoring by medical physicist or mr safety expert, with review and analysis by physician or other qualified health care professional to prioritize and select views and imaging sequences, to tailor mr acquisition specific","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9603","name":"Inj, pafolacianine, 0.1 mg","description":"Injection, pafolacianine, 0.1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0560","name":"Safety plan interven","description":"Safety planning interventions, each 20 minutes personally performed by the billing practitioner, including assisting the patient in the identification of the following personalized elements of a safety plan: recognizing warning signs of an impending suicidal or substance use-related crisis; employin","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1286","name":"Bmi doc onl fup not cmpltd","description":"Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1025","name":"Pt mnth 1 mcp prov","description":"Patient-months where there are more than one medicare capitated payment (mcp) provider listed for the month","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33900","name":"Perq p-art revsc 1 nm nt uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, unilateral","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0988T","name":"Opn ins/rplc ins ptn sbq&sbf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2004","name":"Inj, lidocaine w epinephrine","description":"Injection, lidocaine hcl with epinephrine, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3374","name":"Inj, vancomycin (mylan) 10mg","description":"Injection, vancomycin hydrochloride (mylan) not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0754T","name":"Dgtz gls mcrscp sld level v","description":"Digitization of glass microscope slides for level v, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0681","name":"Inj ceftobipole medocarl 3mg","description":"Injection, ceftobiprole medocaril sodium, 3 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92930","name":"Prq tcat plmt ntrac st 2+les","description":"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 2 or more distinct coronary lesions with 2 or more coronary stents deployed in 2 or more coronary segments, or a bifurcation lesion requiring ","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K1007","name":"Bil hkaf pc s/d micro sensor","description":"Bilateral hip, knee, ankle, foot device, powered, includes pelvic component, single or double upright(s), knee joints any type, with or without ankle joints any type, includes all components and accessories, motors, microprocessors, sensors","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95081.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0482U","name":"Ob pe biochem asy sfit1&pigf","description":"Ob pe biochem asy sfit1&pigf","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92928","name":"Prq tcat plmt ntrac st 1 les","description":"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 1 lesion involving 1 or more coronary segments","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0674T","name":"Laps insj nw/rpcmt prm isdss","description":"Laparoscopic insertion of new or replacement of permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including an implantable pulse generator and diaphragmatic lead(s)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60271","name":"Removal of thyroid","description":"Thyroidectomy, including substernal thyroid; cervical approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1207.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1378","name":"Med rsn no 10 yr fu colscope","description":"Documentation of medical reason(s) for not recommending a 10 year follow-up interval (e.g., inadequate prep, familial or personal history of colonic polyps, patient had no adenoma and age is >= 66 years old, or life expectancy < 10 years, other medical reasons)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0552","name":"Supply of digital device","description":"Supply of digital mental health treatment device and initial education and onboarding, per course of treatment that augments a behavioral therapy plan","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4304","name":"Grafix plus, per sq cm","description":"Grafix plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0953T","name":"Tot impl amei rev/rplc w/o","description":"Totally implantable active middle ear hearing implant; revision or replacement, without mastoidectomy and replacement of sound processor","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6527","name":"G garmt full leg/ft nght cus","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, custom, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2031","name":"Mirodry, per sq cm","description":"Mirodry wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2791","name":"Crown full cast base metal","description":"Crown-full cast predominantly base metal","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0891","name":"Argatroban nonesrd (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80162","name":"Assay of digoxin total","description":"Digoxin; total","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0865T","name":"Quan mri alys brn w/o dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion identification, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transm","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1261","name":"Pts on wtlist bef dialysis","description":"Patients that were on the kidney or kidney-pancreas waitlist prior to initiation of dialysis","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99238","name":"Hosp ip/obs dschrg mgmt 30/<","description":"Hospital inpatient or observation discharge day management; 30 minutes or less on the date of the encounter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":85.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4000","name":"Dermatology ss","description":"Dermatology mips specialty set","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1012T","name":"Mtrz ab ntrno trph scl/tr mw","description":"Motorized ab interno trephination of sclera (sclerostomy), or trabecular meshwork (trabeculostomy), 1 or more, including injection of antifibrotic agents, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1151","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0402U","name":"Nfct agt sti mult amp prb tq","description":"Nfct agt sti mult amp prb tq","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4350","name":"Palisade dm matrix per sq cm","description":"Palisade dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0815T","name":"Us rems b1 dns hips plvs/spi","description":"Ultrasound-based radiofrequency echographic multi-spectrometry (rems), bone-density study and fracture-risk assessment, 1 or more sites, hips, pelvis, or spine","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1501","name":"Pathology mvp","description":"Pathology mips value pathway","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0963T","name":"Anosc sbmcsl njx bulking agt","description":"Anoscopy with directed submucosal injection of bulking agent into anal canal","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4315","name":"Regenelink amniotic mem allo","description":"Regenelink amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0046","name":"No mrs 90 days post stk","description":"Clinical follow-up and mrs score not assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1428","name":"Bilateral absence of eyes","description":"Patients who have bilateral absence of eyes any time during the patients history through the end of the measurement period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1498","name":"Diagnostic radiology mvp","description":"Diagnostic radiology mips value pathway","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1433","name":"Oral chemo wthn 30 days enc","description":"Patient on oral chemotherapy on or within 30 days before denominator eligible encounter","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81007","name":"Urine screen for bacteria","description":"Urinalysis; bacteriuria screen, except by culture or dipstick","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5133","name":"Inj, tofidence, 1 mg","description":"Injection, tocilizumab-bavi (tofidence), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66770","name":"Removal of inner eye lesion","description":"Destruction of cyst or lesion iris or ciliary body (nonexcisional procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19160","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":457.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0750T","name":"B1 str&fx rsk asmt dxrbmd1vw","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20605","name":"Drain/inj joint/bursa w/o us","description":"Arthrocentesis, aspiration and/or injection, intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa); without ultrasound guidance","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":61.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9244","name":"Office min sed drug enteral","description":"Office min sed drug enteral","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81005","name":"Urinalysis","description":"Urinalysis; qualitative or semiquantitative, except immunoassays","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0962T","name":"Asstv alg alys acous&ecg rec","description":"Assistive algorithmic analysis of acoustic and electrocardiogram recording for detection of cardiac dysfunction (eg, reduced ejection fraction, cardiac murmurs, atrial fibrillation), with review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1190","name":"Doc khe not pef w/efgr/uacr","description":"Documentation of a kidney health evaluation was not performed or defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33277","name":"Insj phrnc nrv stim transvns","description":"Insertion of phrenic nerve stimulator transvenous sensing lead (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0371U","name":"Iadna gu pthgn semiq dna16&1","description":"Iadna gu pthgn semiq dna16&1","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6634","name":"Onlay titanium","description":"Onlay - titanium","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37258","name":"Revsc evasc ivt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57454","name":"Bx/curett of cervix w/scope","description":"Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix and endocervical curettage","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":127.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69730","name":"Rplc oi implt sk tc esp>=100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0892","name":"Argatroban dialysis (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0004","name":"Qual care neurologic cnd mvp","description":"Quality care for patients with neurological conditions mips value pathway","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6597","name":"G comp bandage long stretch","description":"Gradient compression bandage roll, elastic long stretch, linear yard, any width, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1246","name":"Pt othr thn true imprt to me","description":"Patient provided a response other than completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0475U","name":"Hered prst8 ca gsap 23 genes","description":"Hered prst8 ca gsap 23 genes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57287","name":"Revise/remove sling repair","description":"Removal or revision of sling for stress incontinence (eg, fascia or synthetic)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":753.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0421U","name":"Onc clrct scr sgl amp 8 rna","description":"Onc clrct scr sgl amp 8 rna","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37272","name":"Revsc evsc fpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6519","name":"Grad com garm noc night use","description":"Gradient compression garment, not otherwise specified, for nighttime use, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7298","name":"Remove screw retained plate","description":"Remove screw retained plate","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99386","name":"Prev visit new age 40-64","description":"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; 40-64 years","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":175.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3373","name":"Inj, vancomycin hcl, 10 mg","description":"Injection, vancomycin hydrochloride, 10 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4336","name":"Artecent c, per sq cm","description":"Artacent c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1198","name":"Isa not red 3pts /no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91322","name":"Sarscov2 vac 50 mcg/0.5ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 50 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0062","name":"Audiology ss","description":"Audiology mips specialty set","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0572U","name":"Onc prst8 httl qfish whl bld","description":"Onc prst8 httl qfish whl bld","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87075","name":"Cultr bacteria except blood","description":"Culture, bacterial; any source, except blood, anaerobic with isolation and presumptive identification of isolates","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31780","name":"Reconstruct windpipe","description":"Excision tracheal stenosis and anastomosis; cervical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1352.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J7310","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4240.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J7350","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1430","name":"Ret exm ou no retinopthy doc","description":"Retinal exam finding without evidence of retinopathy in both eyes with severity level documented (in measurement year or in the prior year)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7972","name":"Surg redct fibrous tuberosit","description":"Surgical reduction of fibrous tuberosity","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80503","name":"Path clin consltj sf 5-20","description":"Pathology clinical consultation; for a clinical problem, with limited review of patients history and medical records and straightforward medical decision making when using time for code selection, 5-20 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2035","name":"Corpl p therac p allac p mg","description":"Corplex p or theracor p or allacor p, per milligram","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0738","name":"Upper extremity rehab","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87207","name":"Smear special stain","description":"Smear, primary source with interpretation; special stain for inclusion bodies or parasites (eg, malaria, coccidia, microsporidia, trypanosomes, herpes viruses)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9321","name":"Inj epcoritamab-bysp 0.16 mg","description":"Injection, epcoritamab-bysp, 0.16 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1472","name":"Hep b vaccine not received","description":"Patient did not receive recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63277","name":"Bx/exc xdrl spine lesn lmbr","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, lumbar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1764.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51080","name":"Drainage of bladder abscess","description":"Drainage of perivesical or prevesical space abscess","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0101","name":"Ca screen;pelvic/breast exam","description":"Cervical or vaginal cancer screening; pelvic and clinical breast examination","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":37.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35472","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0366U","name":"Onc bldr 10 prb recr bldr ca","description":"Onc bldr 10 prb recr bldr ca","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0690T","name":"Quan us tis charac w/dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained with diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83003","name":"Assay growth hormone (hgh)","description":"Growth hormone, human (hgh) (somatotropin)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":442.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0439U","name":"Crd chd dna alys 5 snp 3 dna","description":"Crd chd dna alys 5 snp 3 dna","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26117","name":"Rad resect hand tumor < 3 cm","description":"Radical resection of tumor (eg, sarcoma), soft tissue of hand or finger; less than 3 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":765.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0945T","name":"Intraop assmt abnl tum tiss","description":"Intraoperative assessment for abnormal (tumor) tissue, in-vivo, following partial mastectomy (eg, lumpectomy) using computer-aided fluorescence imaging (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0562","name":"Complex simulation w/pet-ct","description":"Therapeutic radiology simulation-aided field setting; complex, including acquisition of pet and ct imaging data required for radiopharmaceutical-directed radiation therapy treatment planning (i.e., modeling)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5135","name":"Inj, tyenne, 1 mg","description":"Injection, tocilizumab-aazg (tyenne), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4359","name":"Choriply, per sq cm","description":"Choriply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1355","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"Motor &/ sens nrve cndj test","description":"Motor and/or sensory nerve conduction, using preconfigured electrode array(s), amplitude and latency/velocity study, each limb, includes f-wave study when performed, with interpretation and report","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15860","name":"Iv njx tst vasc flo flap/grf","description":"Intravenous injection of agent (eg, fluorescein) to test vascular flow in flap or graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0928T","name":"Rem interrog dev ccm-d phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system with interim analysis and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76018","name":"Mr safety implant elec prepj","description":"Mr safety implant electronics preparation under supervision of physician or other qualified health care professional, including mr-specific programming of pulse generator and/or transmitter to verify device integrity, protection of device internal circuitry from mr electromagnetic fields, and protec","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5878","name":"Dup of complt dent-mandib","description":"Dup of complt dent-mandib","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69727","name":"Rmv ntr oi imp sk tc esp<100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0274U","name":"Hem gen pltlt do 43 genes","description":"Hematology (genetic platelet disorders), genomic sequence analysis of 43 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0743","name":"Cilastatin sodium injection","description":"Injection, cilastatin sodium; imipenem, per 250 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33917","name":"Repair pulmonary artery","description":"Repair of pulmonary artery stenosis by reconstruction with patch or graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1814.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7261","name":"Primary closure sinus perf","description":"Primary closure of a sinus perforation","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4419","name":"Biolab wrap flw lt per sq cm","description":"Biolab membrane wrap lite flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1234","name":"Pt hcv rctv aby f/u neg","description":"Patient has a reactive hcv antibody test, and has a follow up hcv viral test that does not detect hcv viremia","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0738T","name":"Tx pln mag fld abltj prst8","description":"Treatment planning for magnetic field induction ablation of malignant prostate tissue, using data from previously performed magnetic resonance imaging (mri) examination","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0619U","name":"Pulm copd dna alys >18000","description":"Pulm copd dna alys >18000","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4283","name":"Biovance tri or 3l, sq cm","description":"Biovance tri-layer or biovance 3l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3055","name":"Inj talquetamab-tgvs 0.25 mg","description":"Injection, talquetamab-tgvs, 0.25 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2643","name":"Dental onlay porcelin 3 surf","description":"Onlay - porcelain/ceramic - three surfaces","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9225","name":"Gen anes adv air-sub 15 min","description":"Gen anes adv air-sub 15 min","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52270","name":"Cystoscopy & revise urethra","description":"Cystourethroscopy, with internal urethrotomy; female","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4318","name":"Fem urinary cup w/wo attch","description":"Female external urinary collection cup, with or without ring attachment, per day","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0761T","name":"Dgtz gls mcrscp sl imm ea 1","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52342","name":"Cysto w/up stricture tx","description":"Cystourethroscopy; with treatment of ureteropelvic junction stricture (eg, balloon dilation, laser, electrocautery, and incision)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20939","name":"Bone marrow aspir bone grfg","description":"Bone marrow aspiration for bone grafting, spine surgery only, through separate skin or fascial incision (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15778","name":"Impl absrb msh/prsth dly cls","description":"Implantation of absorbable mesh or other prosthesis for delayed closure of defect(s) (ie, external genitalia, perineum, abdominal wall) due to soft tissue infection or trauma","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37277","name":"Rvsc evsc fpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0728T","name":"Dx alys vstblr implt uni 1st","description":"Diagnostic analysis of vestibular implant, unilateral; with initial programming","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81524","name":"Onc cns tum dna mthyl 10,000","description":"Oncology (central nervous system tumor), dna methylation analysis of at least 10,000 methylation sites, utilizing dna extracted from formalin-fixed tumor tissue, algorithm(s) reported as probability of matching a reference tumor family and class, and mgmt (o-6-methylguanine-dna methyltransferase) pr","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1356","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0668","name":"Team remote e/m est pt 40 mn","description":"Team remote e/m est. pt 40mins","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1182","name":"Not elg pre ex ibd/uc/crohn","description":"Patients not eligible due to pre-existing inflammatory bowel disease (ibd) (e.g., ulcerative colitis, crohns disease)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4358","name":"Xwrap dual, per sq cm","description":"Xwrap dual, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0499U","name":"Onc clrct&lng dna ngs 8gene","description":"Onc clrct&lng dna ngs 8gene","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21194","name":"Reconst lwr jaw w/graft","description":"Reconstruction of mandibular rami, horizontal, vertical, c, or l osteotomy; with bone graft (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1590.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21385","name":"Opn tx orbit fx transantral","description":"Open treatment of orbital floor blowout fracture; transantral approach (caldwell-luc type operation)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":829.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0755T","name":"Dgtz gls mcrscp sld level vi","description":"Digitization of glass microscope slides for level vi, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38227","name":"Car-t receipt&prepj admn","description":"Chimeric antigen receptor t-cell (car-t) therapy; receipt and preparation of car-t cells for administration","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70492","name":"Ct sft tsue nck w/o & w/dye","description":"Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44408","name":"Colonoscopy w/decompression","description":"Colonoscopy through stoma; with decompression (for pathologic distention) (eg, volvulus, megacolon), including placement of decompression tube, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1445","name":"Pp care visit by 12 weeks","description":"Postpartum care visit before or at 12 weeks of giving birth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15011","name":"Hrv skn cll ssp agrft 1st 25","description":"Harvest of skin for skin cell suspension autograft; first 25 sq cm or less","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15730","name":"Mdfc flap w/prsrv vasc pedcl","description":"Midface flap (ie, zygomaticofacial flap) with preservation of vascular pedicle(s)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1651.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":887.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0549U","name":"Onc urthl dna mthyltd rt pcr","description":"Onc urthl dna mthyltd rt pcr","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0504U","name":"Nfct ds uti id 17 path orgs","description":"Nfct ds uti id 17 path orgs","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49623","name":"Rmvl ninfct mesh hernia rpr","description":"Removal of total or near total non-infected mesh or other prosthesis at the time of initial or recurrent anterior abdominal hernia repair or parastomal hernia repair, any approach (ie, open, laparoscopic, robotic) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9273","name":"Inj tisotu vedotin-tftv, 1mg","description":"Injection, tisotumab vedotin-tftv, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0863T","name":"Rlcj pg wcs lv trnsmtr only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; transmitter component only","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99431","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99236","name":"Hosp ip/obs same date hi 85","description":"Hospital inpatient or observation care, for the evaluation and management of a patient including admission and discharge on the same date, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter f","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4418","name":"Biolab wrap flow per sq cm","description":"Biolab membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0310U","name":"Ped vsclts kd alys 3 bmrks","description":"Ped vsclts kd alys 3 bmrks","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29840","name":"Wrist arthroscopy","description":"Arthroscopy, wrist, diagnostic, with or without synovial biopsy (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9992","name":"Pall serv during meas","description":"Palliative care services used by patient any time during the measurement period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0430U","name":"Gi malabs aat calpro pncrtc","description":"Gi malabs aat calpro pncrtc","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24640","name":"Cltx rdl head sublxtj nrsemd","description":"Closed treatment of radial head subluxation in child, nursemaid elbow, with manipulation","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":80.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1334","name":"Pts act pvd 2 wks 2 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 2 weeks after initial acute pvd encounter","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2021","name":"Neomatrix per sq cm","description":"Neomatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93575","name":"Njx cath slct p angrph mapca","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary angiography of major aortopulmonary collateral arteries (mapcas) arising off the aorta or its systemic branches, during cardiac catheterization for congenital heart d","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33288","name":"Rmv&rplcmt phrnc nrv stim ld","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96380","name":"Admn rsv monoc antb im cnsl","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection, with counseling by physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0680","name":"Cr art clc art vlv clc w rpt","description":"Detection and quantification of coronary artery calcium and/or aortic valve calcification from algorithmic analysis of computed tomography of the chest with report","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63052","name":"Lam facetc/frmt arthrd lum 1","description":"Laminectomy, facetectomy, or foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s] [eg, spinal or lateral recess stenosis]), during posterior interbody arthrodesis, lumbar; single vertebral segment (list separately in addition to code for primary ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0542","name":"No pt prsnt train add 15","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1022T","name":"Prq tis dsplmt ntra-abdl/pel","description":"Percutaneous tissue displacement, any method, including imaging guidance; intra-abdominal/pelvic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43638","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1987.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99498","name":"Advncd care plan addl 30 min","description":"Advance care planning including the explanation and discussion of advance directives such as standard forms (with completion of such forms, when performed), by the physician or other qualified health care professional; each additional 30 minutes (list separately in addition to code for primary proce","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":75.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1293","name":"Calc bmi abv up param f/u","description":"Bmi is documented above normal parameters and a follow-up plan is documented","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0968T","name":"Insj/rplcmt epcrnl nstim sys","description":"Insertion or replacement of epicranial neurostimulator system, including electrode array and pulse generator, with connection to electrode array","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0560U","name":"Onc mrd gsa cfdna baseline","description":"Onc mrd gsa cfdna baseline","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37286","name":"Revsc evasc tpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1249","name":"Pt resp true imprt to me","description":"Patient responded completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1436","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0754T","name":"Dgtz gls mcrscp sld level v","description":"Digitization of glass microscope slides for level v, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0804T","name":"Prgrmg evl ldls pm 2chmbr ip","description":"Programming device evaluation (in person) with iterative adjustment of implantable device to test the function of device and to select optimal permanent programmed values, with analysis, review, and report, by a physician or other qualified health care professional, leadless pacemaker system in dual","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9986","name":"Missed appointment","description":"Missed appointment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0742T","name":"Aqmbf spect xers/strs & rest","description":"Absolute quantitation of myocardial blood flow (aqmbf), single-photon emission computed tomography (spect), with exercise or pharmacologic stress, and at rest, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0724T","name":"Qmrcp w/dx mri same anatomy","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained with diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in additio","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6094","name":"Abut support crown titanium","description":"Abutment supported crown - (titanium)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83883","name":"Assay nephelometry not spec","description":"Nephelometry, each analyte not elsewhere specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98010","name":"Synch audio-only new mod 45","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection,","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1503","name":"Vascular surgery mvp","description":"Vascular surgery mips value pathway","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26685","name":"Treat hand dislocation","description":"Open treatment of carpometacarpal dislocation, other than thumb; includes internal fixation, when performed, each joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":646.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93586","name":"Vngrph chd coronary sinus","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; coronary sinus (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1276","name":"Calc bmi out nrm param nof/u","description":"Bmi documented outside normal parameters, no follow-up plan documented, no reason given","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0710T","name":"N-invas artl plaq alys","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; including data preparation and transmission, quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess a","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67550","name":"Insert eye socket implant","description":"Orbital implant (implant outside muscle cone); insertion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1000.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0582U","name":"Rare ds rpd whlgen dna vrnts","description":"Rare ds rpd whlgen dna vrnts","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6049","name":"Scale implt peri-implt inflm","description":"Scale implt peri-implt inflm","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0935T","name":"Cysto w/rnl pel symp dnrvtj","description":"Cystourethroscopy with renal pelvic sympathetic denervation, radiofrequency ablation, retrograde ureteral approach, including insertion of guide wire, selective placement of ureteral sheath(s) and multiple conformable electrodes, contrast injection(s), and fluoroscopy, bilateral","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3247","name":"Inj secukinumab intrav 1mg","description":"Injection, secukinumab, intravenous, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1278","name":"Pre-htn or htn doc, f/u indc","description":"Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1301","name":"Pt recv tbco cess interv","description":"Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1377","name":"Fu colscop 10 yr doc w/ disc","description":"Recommended follow-up interval for repeat colonoscopy of 10 years documented  in colonoscopy report and communicated with patient","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0528","name":"Mgt est pt dem mod-hi cmplx","description":"Management of established patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0813T","name":"Egd vol adjmt bariatric balo","description":"Esophagogastroduodenoscopy, flexible, transoral, with volume adjustment of intragastric bariatric balloon","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78013","name":"Thyroid imaging w/blood flow","description":"Thyroid imaging (including vascular flow, when performed);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55712","name":"Bx prst8 tprnl mri-us 1st","description":"Biopsy, prostate, transperineal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83719","name":"Assay of blood lipoprotein","description":"Lipoprotein, direct measurement; vldl cholesterol","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93597","name":"R&l hrt cath chd abnl nt cnj","description":"Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); abnormal native connections","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4334","name":"Amnioplast 1, per sq cm","description":"Amnioplast 1, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0688T","name":"Tx amblyopia assmt w/report","description":"Treatment of amblyopia using an online digital program; assessment of patient performance and program data by physician or other qualified health care professional, with report, per calendar month","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0289U","name":"Neuro alzheimer mrna 24 gen","description":"Neuro alzheimer mrna 24 gen","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87522","name":"Hepatitis c revrs trnscrpj","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis c, quantification, includes reverse transcription when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1194","name":"Med rsn no imp/con mmr/msi","description":"Documentation of medical reason(s) surgical pathology reports did not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both tests were not included (e.g., patient will not be treated with checkpoint inhibitor therap","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1182","name":"Not elg pre ex ibd/uc/crohn","description":"Patients not eligible due to pre-existing inflammatory bowel disease (ibd) (e.g., ulcerative colitis, crohns disease)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0710T","name":"N-invas artl plaq alys","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; including data preparation and transmission, quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess a","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93586","name":"Vngrph chd coronary sinus","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; coronary sinus (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0777T","name":"R-t prs sensing edrl gdn sys","description":"Real-time pressure-sensing epidural guidance system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0614","name":"Inj, treosulfan, 50 mg","description":"Injection, treosulfan, 50 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9249","name":"Inj, melphalan (apotex) 1 mg","description":"Injection, melphalan (apotex), 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2356","name":"Inj tezepelumab-ekko, 1mg","description":"Injection, tezepelumab-ekko, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5153","name":"Inj, aflibercept-yszy, 1 mg","description":"Injection, aflibercept-yszy (opuviz), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2404","name":"Inj, nicardipine 0.1 mg","description":"Injection, nicardipine, 0.1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J1056","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24370","name":"Revise reconst elbow joint","description":"Revision of total elbow arthroplasty, including allograft when performed; humeral or ulnar component","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1883.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1431","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1427","name":"Doc med rsn bone scn","description":"Documentation of medical reason(s) for performing a bone scan (including documented pain related to prostate cancer, salvage therapy, other medical reasons)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0882","name":"Darbepoetin alfa, esrd use","description":"Injection, darbepoetin alfa, 1 microgram (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6034","name":"Part hand finger distal amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s)/thumb, amputation at distal to metacarpal joint, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l669","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6608","name":"G com bandage tub protct pad","description":"Gradient compression bandaging supply, tubular protective absorption padded layer, per linear yard, any width, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57511","name":"Cryocautery of cervix","description":"Cautery of cervix; cryocautery, initial or repeat","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":142.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9914","name":"Admin of dermal fill","description":"Admin of dermal fill","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0651","name":"Inj, levothyroxine, freskabi","description":"Injection, levothyroxine sodium (fresenius kabi), not therapeutically equivalent to j0650, 10 mcg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0018","name":"Crisis psychotherapy add 30m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); each additional 30 minutes (list separately in addition to code for primary service)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0736T","name":"Colonic lavage 35+l water","description":"Colonic lavage, 35 or more liters of water, gravity-fed, with induced defecation, including insertion of rectal catheter","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9610","name":"Xe129 xenon, diagnostic","description":"Xenon xe-129 hyperpolarized gas, diagnostic, per study dose","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81354","name":"Cytog alys chrml abnor ogm","description":"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of structural and copy number variants, optical genome mapping (ogm)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1271","name":"Pts dem any time/dur mo","description":"Patients with dementia at any time prior to or during the month","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36410","name":"Vnpnxr 3yr/> phy/qhp dx/ther","description":"Venipuncture, age 3 years or older, necessitating the skill of a physician or other qualified health care professional (separate procedure), for diagnostic or therapeutic purposes (not to be used for routine venipuncture)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":22.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0206","name":"Inj allopurinol sodium 1 mg","description":"Injection, allopurinol sodium, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85041","name":"Automated rbc count","description":"Blood count; red blood cell (rbc), automated","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30802","name":"Ablate inf turbinate submuc","description":"Ablation, soft tissue of inferior turbinates, unilateral or bilateral, any method (eg, electrocautery, radiofrequency ablation, or tissue volume reduction); intramural (ie, submucosal)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0208","name":"Inj, pedmark, 100 mg","description":"Injection, sodium thiosulfate (pedmark), 100 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28022","name":"Exploration of foot joint","description":"Arthrotomy, including exploration, drainage, or removal of loose or foreign body; metatarsophalangeal joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP19","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0317U","name":"Onc lung ca 4-prb fish assay","description":"Onc lung ca 4-prb fish assay","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0710T","name":"N-invas artl plaq alys","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; including data preparation and transmission, quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess a","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59430","name":"Care after delivery","description":"Postpartum care only (separate procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":245.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15011","name":"Hrv skn cll ssp agrft 1st 25","description":"Harvest of skin for skin cell suspension autograft; first 25 sq cm or less","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0403","name":"Ekg for initial prevent exam","description":"Electrocardiogram, routine ecg with 12 leads; performed as a screening for the initial preventive physical examination with interpretation and report","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0411","name":"Hba1c in office testing","description":"Hba1c in office testing","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37299","name":"Revsc evsc imvt angio cpx ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5944","name":"Max implt sup remv part","description":"Max implt sup remv part","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1238","name":"Doc 2nd recom hzv 2-6 mo int","description":"Documentation that administration of second recombinant zoster vaccine could not occur during the performance period due to the recommended 2-6 month interval between doses (i.e, first dose received after october 31)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93527","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2937.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0211","name":"Inj, nithiodote, 3mg / 125mg","description":"Injection, sodium nitrite 3 mg and sodium thiosulfate 125 mg (nithiodote)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1223","name":"Glaucoma plan of care doc","description":"Glaucoma plan of care documented","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1493","name":"No fall doc med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4267","name":"Neostim dl per sq cm","description":"Neostim dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0502","name":"Other oral pathology procedu","description":"Other oral pathology procedures by report","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9359","name":"Inj lon tesirin-lpyl 0.075mg","description":"Injection, loncastuximab tesirine-lpyl, 0.075 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77437","name":"Surf radj ther supfc<=150kv","description":"Surface radiation therapy; superficial, delivery, </=150 kv, per fraction (eg, electronic brachytherapy)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99213","name":"Office o/p est low 20 min","description":"Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 20 minutes must be met or e","date_of_service":"2026-06-05","other_properties":[{"name":"BillingTaxonomy","value":["207V00000X","207VB0002X","207VE0102X","207VF0040X","207VG0400X","207VM0101X","207VX0000X","207VX0201X","363LX0001X"]},{"name":"RenderingTaxonomy","value":["207V00000X","207VB0002X","207VE0102X","207VF0040X","207VG0400X","207VM0101X","207VX0000X","207VX0201X","363LX0001X"]},{"name":"ClaimSpecialtyCode","value":["904","905","907","AMGY","APNOB","COLP","FPEM","GYNE","GYON","GYSU","MAFE","NPAG","NPGY","NPOB","OBEM","OBGY","OBHR","OBST","REND","URGY"]},{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TH"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49622","name":"Rpr parastomal hrna ncr/strn","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; incarcerated or strangulated","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0983T","name":"Rem mntr impl ivc snr phys","description":"Remote monitoring of an implanted inferior vena cava sensor for up to 30 days, including at least weekly downloads of inferior vena cava area recordings, interpretation(s), trend analysis, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4440","name":"Curamatrix per sq cm","description":"Curamatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0847T","name":"Dgtz gls mcrscp xm arch tiss","description":"Digitization of glass microscope slides for examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, kras mutational analysis) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84145","name":"Procalcitonin (pct)","description":"Procalcitonin (pct)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4427","name":"Dermbnd dln dl+ dlx sq cm","description":"Dermabind dl n or dermabind dl + or dermabind dl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3392","name":"Inj, exagamglogene autotem","description":"Injection, exagamglogene autotemcel, per treatment","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49614","name":"Rpr aa hrn rcr < 3 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1322","name":"Pts 7wk inj, scrn iop =<25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop =<25 mm hg for injected eye","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0315U","name":"Onc cutan sq cll ca mrna 40","description":"Onc cutan sq cll ca mrna 40","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81354","name":"Cytog alys chrml abnor ogm","description":"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of structural and copy number variants, optical genome mapping (ogm)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6106","name":"Tissue regen resorbable","description":"Tissue regen resorbable","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0549U","name":"Onc urthl dna mthyltd rt pcr","description":"Onc urthl dna mthyltd rt pcr","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0959T","name":"Rmv/rplc magnet coil assem","description":"Removal or replacement of magnet from coil assembly that is connected to continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4037","name":"Urology ss","description":"Urology mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":189.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9331","name":"Inj sirolimus prot part 1 mg","description":"Injection, sirolimus protein-bound particles, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1404","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1295","name":"Pt hx tot col or colon ca","description":"Patients with a diagnosis or past history of total colectomy or colorectal cancer","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55725","name":"Drainage of prostate abscess","description":"Prostatotomy, external drainage of prostatic abscess, any approach; complicated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":610.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0902T","name":"Qtc ntrvl augmnt alg aly ecg","description":"Qtc interval derived by augmentative algorithmic analysis of input from an external, patient-activated mobile ecg device","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7962","name":"Lingual frenectomy","description":"Lingual frenectomy","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0410U","name":"Onc pncrtc dna whl gn seq 5-","description":"Onc pncrtc dna whl gn seq 5-","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88262","name":"Chromosome analysis 15-20","description":"Chromosome analysis; count 15-20 cells, 2 karyotypes, with banding","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0702","name":"2d cephal radio image","description":"2d cephal radio image","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0761T","name":"Dgtz gls mcrscp sl imm ea 1","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3403","name":"Revakinagene, per implant","description":"Revakinagene taroretcel-lwey, per implant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1551","name":"Inj cutaquig 100 mg","description":"Injection, immune globulin (cutaquig), 100 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7514","name":"Mycophenol (myhibbin) 100 mg","description":"Mycophenolate mofetil (myhibbin), oral suspension, 100 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3421","name":"Root surgery bicuspid","description":"Apicoectomy/periradicular surgery-bicuspid (first root)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19084","name":"Bx breast add lesion us imag","description":"Biopsy, breast, with placement of breast localization device(s) (eg, clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; each additional lesion, including ultrasound guidance (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0918T","name":"Insj perm ccm-d sys dual ld","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; dual transvenous leads (pacing and defibrillation) only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77317","name":"Brachytx isodose intermed","description":"Brachytherapy isodose plan; intermediate (calculation[s] made from 5 to 10 sources, or remote afterloading brachytherapy, 2-12 channels), includes basic dosimetry calculation(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15012","name":"Hrv skn cll ssp agrft ea add","description":"Harvest of skin for skin cell suspension autograft; each additional 25 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0331U","name":"Onc hl neo opt gen mapping","description":"Onc hl neo opt gen mapping","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1255","name":"Pts w/ othr rsn vst,+prg tst","description":"Patients who have another reason for visiting the clinic [not prenatal or postpartum care] and have a positive pregnancy test but have not established the clinic as an ob provider (e.g., plan to terminate the pregnancy or seek prenatal services elsewhere)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76091","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6604","name":"Cst bse mtl inlay 2 surfaces","description":"Inlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0378U","name":"Rfc1 repeat xpnsj vrnt alys","description":"Rfc1 repeat xpnsj vrnt alys","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1431","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83521","name":"Ig light chains free each","description":"Immunoglobulin light chains (ie, kappa, lambda), free, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46762","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":857.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85660","name":"Rbc sickle cell test","description":"Sickling of rbc, reduction","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1495","name":"Fall w/ poc, no fall","description":"Patients that reported a fall occurred who had a plan of care for falls documented or patients that did not report a fall","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4366","name":"Dl amnio bur x-mem per sq cm","description":"Dual layer amnio burgeon x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33370","name":"Tcat plmt&rmvl cepd perq","description":"Transcatheter placement and subsequent removal of cerebral embolic protection device(s), including arterial access, catheterization, imaging, and radiological supervision and interpretation, percutaneous (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0168","name":"Epinephrine (intl med sys)","description":"Injection, epinephrine (international medication systems), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97551","name":"Caregiver traing ea addl 15","description":"Caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patie","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86355","name":"B cells total count","description":"B cells, total count","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0438U","name":"Rx metab advrs vrnt alys 33","description":"Rx metab advrs vrnt alys 33","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4280","name":"Xcell amnio matrix per sq cm","description":"Xcell amnio matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0233","name":"Intra inf, toci, first dose","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4361","name":"Epixpress, per sq cm","description":"Epixpress, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74018","name":"Radex abdomen 1 view","description":"Radiologic examination, abdomen; 1 view","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7771","name":"Alveolus clsd reduc stblz te","description":"Alveolus closed reduction stabilization of teeth","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28341","name":"Resect enlarged toe","description":"Reconstruction, toe, macrodactyly; requiring bone resection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37296","name":"Revsc evasc imvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44660","name":"Repair bowel-bladder fistula","description":"Closure of enterovesical fistula; without intestinal or bladder resection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1400.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49190","name":"Opn exc/dstr ntra-abd >30 cm","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); greater than 30 cm","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0703","name":"2d oral/facial photo image","description":"2d oral/facial photo image","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2956","name":"Indirect rest remov","description":"Indirect rest remov","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0904T","name":"Ecg alg 12 ld rdcd trcg only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; tracing only","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2782","name":"Inj avacincaptad pegol 0.1mg","description":"Injection, avacincaptad pegol, 0.1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76000","name":"Fluoroscopy <1 hr phys/qhp","description":"Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01937","name":"Anes drg/aspir crv/thrc","description":"Anesthesia for percutaneous image-guided injection, drainage or aspiration procedures on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0062","name":"Audiology ss","description":"Audiology mips specialty set","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38226","name":"Car-t prep t lymphcyt f/trns","description":"Chimeric antigen receptor t-cell (car-t) therapy; preparation of blood-derived t lymphocytes for transportation (eg, cryopreservation, storage)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7021","name":"Suppl and access lung expan","description":"Supplies and accessories for lung expansion airway clearance, continuous high frequency oscillation, and nebulization device (e.g., handset, nebulizer kit, biofilter)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4358","name":"Xwrap dual, per sq cm","description":"Xwrap dual, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90839","name":"Psytx crisis initial 60 min","description":"Psychotherapy for crisis; first 60 minutes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":175.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0598U","name":"Gi ibs igg antb 18food items","description":"Gi ibs igg antb 18food items","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0979T","name":"Sbmcsl crylys ther sft palt","description":"Submucosal cryolysis therapy; soft palate only","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4035","name":"Thoracic surgery ss","description":"Thoracic surgery mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87086","name":"Urine culture/colony count","description":"Culture, bacterial; quantitative colony count, urine","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0474U","name":"Hered pan ca gsap 88gene ngs","description":"Hered pan ca gsap 88gene ngs","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85611","name":"Prothrombin test","description":"Prothrombin time; substitution, plasma fractions, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5911","name":"Facial moulage sectional","description":"Facial moulage (sectional)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9986","name":"Missed appointment","description":"Missed appointment","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87484","name":"Ehrlicha chaffeensis amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); ehrlichia chaffeensis, amplified probe technique","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":617.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1455","name":"Rep/rev cied","description":"Replaced or revised cied","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1263","name":"Pts hosp dialysis dt","description":"Patients in hospice on their initiation of dialysis date or during the month of evaluation","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2427","name":"Inj, invega hafyera/trinza","description":"Injection, paliperidone palmitate extended release (invega hafyera, or invega trinza), 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1322","name":"Pts 7wk inj, scrn iop =<25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop =<25 mm hg for injected eye","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5125","name":"Inj, releuko 1 mcg","description":"Injection, filgrastim-ayow, biosimilar, (releuko), 1 microgram","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6518","name":"Grad com wrap w strap arm cu","description":"Gradient compression wrap with adjustable straps, arm, each, custom","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6038","name":"Multiax rotation attachment","description":"Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1425","name":"Surgical care mvp","description":"Surgical care mips value pathway","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0563U","name":"Nfct ds pthgn-sna 11vir&4bct","description":"Nfct ds pthgn-sna 11vir&4bct","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1259","name":"Pt stat doc <= 1 yr dialysis","description":"Patient status documented within the first year of initiating dialysis","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64654","name":"1st opn implt bat modulj sys","description":"Initial open implantation of baroreflex activation therapy (bat) modulation system, including lead placement onto the carotid sinus, lead tunnelling, connection to a pulse generator placed in a distant subcutaneous pocket (ie, total system), and intraoperative interrogation and programming","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3431","name":"Biological materials","description":"Biological materials","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73220","name":"Mri uppr extremity w/o&w/dye","description":"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1377.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5143","name":"Inj adalimumab-adbm, 1 mg","description":"Injection, adalimumab-adbm, biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92628","name":"Eval hearing aid cand 1st 30","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9052","name":"Inj, carmustine (accord)","description":"Injection, carmustine (accord), not therapeutically equivalent to j9050, 100 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59410","name":"Obstetrical care","description":"Vaginal delivery only (with or without episiotomy and/or forceps); including postpartum care","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1201.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0561U","name":"Onc mrd gsa cfdna subsequent","description":"Onc mrd gsa cfdna subsequent","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1465","name":"F/u > 180 days after rx","description":"Patient follow up more than 180 days after treatment","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4323","name":"Alloply, per sq cm","description":"Alloply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2055","name":"Idecabtagene vicleucel car","description":"Idecabtagene vicleucel, up to 510 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4253","name":"Zenith amniotic membrane psc","description":"Zenith amniotic membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98003","name":"Synch audio-video new hi 60","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high medical decision making. when using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37290","name":"Revsc evsc tpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0483U","name":"Nfct ds ng gyra s91f pt mut","description":"Nfct ds ng gyra s91f pt mut","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0966T","name":"I&cst prp jw xpn dl arch fxd","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, fixed hinge mechanism","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99492","name":"1st psyc collab care mgmt","description":"Initial psychiatric collaborative care management, first 70 minutes in the first calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":185.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0379U","name":"Tgsap sl or neo dna523&rna55","description":"Tgsap sl or neo dna523&rna55","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90638","name":"Vacc qirv mrna 60mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 60 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0795T","name":"Tcat ins 2chmbr ldls pm cmpl","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; complete system (ie, r","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82495","name":"Assay of chromium","description":"Chromium","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38243","name":"Transplj hematopoietic boost","description":"Hematopoietic progenitor cell (hpc); hpc boost","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2919","name":"Inj, methylpred sod succ 5mg","description":"Injection, methylprednisolone sodium succinate, 5 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0802T","name":"Tcat rmv&rpl2chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right at","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0036","name":"Pt/ptn decln assess","description":"Patient or care partner decline assessment","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0550","name":"Phone/inter for dx/treat >5m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a written report to the patients treating/r","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36837","name":"Prq av fstl crt uxtr sep acs","description":"Percutaneous arteriovenous fistula creation, upper extremity, separate access sites of the peripheral artery and peripheral vein, including fistula maturation procedures (eg, transluminal balloon angioplasty, coil embolization) when performed, including all vascular access, imaging guidance and radi","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85348","name":"Coagulation time otr method","description":"Coagulation time; other methods","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4409","name":"Amniomatrixf3x per sq cm","description":"Amniomatrixf3x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7354","name":"Cantharidin top, applicator","description":"Cantharidin for topical administration, 0.7%, single unit dose applicator (3.2 mg)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57455","name":"Biopsy of cervix w/scope","description":"Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":103.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43497","name":"Transorl lwr esophgl myotomy","description":"Lower esophageal myotomy, transoral (ie, peroral endoscopic myotomy [poem])","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0367U","name":"Onc bldr 10 flwg trurl rescj","description":"Onc bldr 10 flwg trurl rescj","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0473U","name":"Onc sld tum bld/slv 648 gene","description":"Onc sld tum bld/slv 648 gene","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0137","name":"Inten outpt svs,min 9 pr 7 d","description":"Intensive outpatient services; weekly bundle, minimum of 9 services over a 7 contiguous day period, which can include individual and group therapy with physicians or psychologists (or other mental health professionals to the extent authorized under state law); occupational therapy requiring the skil","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0494U","name":"Rbc ag ftl rhd gene alys ngs","description":"Rbc ag ftl rhd gene alys ngs","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98005","name":"Synch audio-video est low 20","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low medical decision making. when using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0770T","name":"Vr technology assist therapy","description":"Virtual reality technology to assist therapy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76016","name":"Mr safety deter phys/qhp","description":"Mr safety determination by a physician or other qualified health care professional responsible for the safety of the mr procedure, including review of implant mr conditions for indicated mr examination, analysis of risk vs clinical benefit of performing mr examination, and determination of mr equipm","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1231","name":"Pt hcv tst no reactive res","description":"Patient receives hcv antibody test with nonreactive result","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0848T","name":"Dgtz gls mcrscp ish 1st","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82136","name":"Amino acids quant 2-5","description":"Amino acids, 2 to 5 amino acids, quantitative, each specimen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5155","name":"Inj, aflibercept-jbvf, 1 mg","description":"Injection, aflibercept-jbvf (yesafili), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0683T","name":"Prgrmg dev eval isdss ip","description":"Programming device evaluation (in-person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional, permanent implantable synchroni","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0952T","name":"Tot impl amei rev/rplc mstdc","description":"Totally implantable active middle ear hearing implant; revision or replacement, with mastoidectomy and replacement of sound processor","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4291","name":"Lamellas xt, per sq cm","description":"Lamellas xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78162","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9128","name":"Photobio therpy-first 15 min","description":"Photobio therpy-first 15 min","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0834T","name":"Dgtz gls mcrscp cytp oth xtn","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27825","name":"Treat lower leg fracture","description":"Closed treatment of fracture of weight bearing articular portion of distal tibia (eg, pilon or tibial plafond), with or without anesthesia; with skeletal traction and/or requiring manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":574.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0660","name":"Team remote e/m new pt 10 mn","description":"Team remote e/m new pt 10mins","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9025","name":"Plasma cryo redu path each","description":"Plasma, cryoprecipitate reduced, pathogen reduced, each unit","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0385U","name":"Neph ckd alg rsk dbtc kdn ds","description":"Neph ckd alg rsk dbtc kdn ds","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6211","name":"Bridge base metal cast","description":"Pontic-cast predominantly base metal","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7111","name":"Extraction coronal remnants","description":"Extraction coronal remnants - deciduous tooth","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2045","name":"Novashield/novogen pr sq cm","description":"Novashield or novogen wound matrix, per square centimeter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0417U","name":"Rare ds alys 335 nuc genes","description":"Rare ds alys 335 nuc genes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4300","name":"Acesso tl, per sq cm","description":"Acesso tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"Home vent dual fnct incl all","description":"Home ventilator, dual-function respiratory device, also performs additional function of cough stimulation, includes all accessories, components and supplies for all functions","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":916.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0626U","name":"Neurol pd dna alys >20000","description":"Neurol pd dna alys >20000","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0433U","name":"Onc prst8 5 dna reg mrk pcr","description":"Onc prst8 5 dna reg mrk pcr","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98004","name":"Synch audio-video est sf 10","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 10 minutes must be met or e","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1414","name":"Med rsn no pdl1 bef 1st ther","description":"Documentation of medical reason(s) for not performing the pd-l1 biomarker expression test prior to initiation of first-line immune checkpoint inhibitor therapy (e.g., patient is in an urgent or emergent situation where delay of treatment would jeopardize the patients health status; other medical rea","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1234","name":"Pt hcv rctv aby f/u neg","description":"Patient has a reactive hcv antibody test, and has a follow up hcv viral test that does not detect hcv viremia","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0454U","name":"U rare ds id opt genome mapg","description":"U rare ds id opt genome mapg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0966T","name":"I&cst prp jw xpn dl arch fxd","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, fixed hinge mechanism","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80503","name":"Path clin consltj sf 5-20","description":"Pathology clinical consultation; for a clinical problem, with limited review of patients history and medical records and straightforward medical decision making when using time for code selection, 5-20 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9047","name":"Albumin (human), 25%, 50ml","description":"Infusion, albumin (human), 25%, 50 ml","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7241","name":"Impact tooth rem bony w/comp","description":"Removal of impacted tooth-completely bony with unusual surgical complications","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7972","name":"Surg redct fibrous tuberosit","description":"Surgical reduction of fibrous tuberosity","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64467","name":"Thrc fascial pln blk uni nfs","description":"Thoracic fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0751T","name":"Dgtz gls mcrscp sld level ii","description":"Digitization of glass microscope slides for level ii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4411","name":"Amniomatrixf4x per sq cm","description":"Amniomatrixf4x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92567","name":"Tympanometry","description":"Tympanometry (impedance testing)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":9.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59857","name":"Induced ab 1+vag supp hyst","description":"Induced abortion, by 1 or more vaginal suppositories (eg, prostaglandin) with or without cervical dilation (eg, laminaria), including hospital admission and visits, delivery of fetus and secundines; with hysterotomy (failed medical evacuation)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55867","name":"Laps surg prst8ect smpl stot","description":"Laparoscopy, surgical prostatectomy, simple subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy), includes robotic assistance, when performed","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3421","name":"Root surgery bicuspid","description":"Apicoectomy/periradicular surgery-bicuspid (first root)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4428","name":"Dermbnd sln sl+ slx sq cm","description":"Dermabind sl n or dermabind sl + or dermabind sl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2792","name":"Rho(d) immune globulin h, sd","description":"Injection, rho d immune globulin, intravenous, human, solvent detergent, 100 iu","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0935T","name":"Cysto w/rnl pel symp dnrvtj","description":"Cystourethroscopy with renal pelvic sympathetic denervation, radiofrequency ablation, retrograde ureteral approach, including insertion of guide wire, selective placement of ureteral sheath(s) and multiple conformable electrodes, contrast injection(s), and fluoroscopy, bilateral","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7213","name":"Inj, ixinity, 1 i.u.","description":"Injection, coagulation factor ix (recombinant), ixinity, 1 i.u.","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0275U","name":"Hem heprn nduc trmbctpna srm","description":"Hematology (heparin-induced thrombocytopenia) platelet antibody reactivity by flow cytometry, serum","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82365","name":"Calculus spectroscopy","description":"Calculus; infrared spectroscopy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3373","name":"Inj, vancomycin hcl, 10 mg","description":"Injection, vancomycin hydrochloride, 10 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90484","name":"Imm cnsl not admn sm>20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 20 minutes","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1196","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5612","name":"Rep resin part dent base max","description":"Rep resin part dent base max","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1346","name":"No pam inc 6 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 6 points within a 4 to 12 month period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0804T","name":"Prgrmg evl ldls pm 2chmbr ip","description":"Programming device evaluation (in person) with iterative adjustment of implantable device to test the function of device and to select optimal permanent programmed values, with analysis, review, and report, by a physician or other qualified health care professional, leadless pacemaker system in dual","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64466","name":"Thrc fascial pln blk uni njx","description":"Thoracic fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65220","name":"Remove foreign body from eye","description":"Removal of foreign body, external eye; corneal, without slit lamp","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4431","name":"Pma skin substitute, nos","description":"Pma skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4019","name":"Oncology/hema ss","description":"Oncology/hematology mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10060","name":"I&d abscess simple/single","description":"Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); simple or single","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":114.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0961T","name":"Shortwave ifr radiation img","description":"Shortwave infrared radiation imaging, surgical pathology specimen, to assist gross examination for lymph node localization in fibroadipose tissue, per specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58900","name":"Biopsy of ovary(s)","description":"Biopsy of ovary, unilateral or bilateral (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":457.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87110","name":"Chlamydia culture","description":"Culture, chlamydia, any source","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76802","name":"Ob us < 14 wks addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0710T","name":"N-invas artl plaq alys","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; including data preparation and transmission, quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess a","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0830T","name":"Dgtz gls mcrscp cytp slctv","description":"Digitization of glass microscope slides for cytopathology, selective-cellular enhancement technique with interpretation (eg, liquid-based slide preparation method), except cervical or vaginal (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0432U","name":"Klhl11 antb sr/csf asy qual","description":"Klhl11 antb sr/csf asy qual","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74021","name":"Radex abdomen 3+ views","description":"Radiologic examination, abdomen; 3 or more views","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6515","name":"Grad com wrap w str fu le cu","description":"Gradient compression wrap with adjustable straps, full leg, each, custom","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1208","name":"Pt no scrn sdoh","description":"Patient is not screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98016","name":"Brief comunicaj tech-bsd svc","description":"Brief communication technology-based service (eg, virtual check-in) by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related evaluation and management service provided within the p","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0936T","name":"Photobiomodulation ther rta","description":"Photobiomodulation therapy of retina, single session","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37255","name":"Revsc evasc ivt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1253","name":"Pts hu surv no amb plltv","description":"Patients who respond on the patient experience hu survey that they did not receive care by the listed ambulatory palliative care provider in the last 60 days (disavowal)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98979","name":"Rtm tx mgmt 1st 10 min","description":"Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least 1 real-time interactive communication with the patient or caregiver during the calendar month; first 10 minutes","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01940","name":"Anes nulyt agt lmbr/sac","description":"Anesthesia for percutaneous image-guided destruction procedures by neurolytic agent on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98006","name":"Synch audio-video est mod 30","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1151","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0862T","name":"Rlcj pg wcs lv battery only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; battery component only","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0676T","name":"Laps insj nw/rpcmt isdss ea","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional lead (list separately in addition to code for primary ","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40654","name":"Rpr lip fth>1half ver ht/cpx","description":"Repair lip, full thickness; over one-half vertical height, or complex","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":490.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1024T","name":"Perq tiss dsplmt soft tissue","description":"Percutaneous tissue displacement, any method, including imaging guidance; soft tissue (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1331","name":"Pts eval ini xm 8 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 8 weeks from initial exam","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62190","name":"Establish brain cavity shunt","description":"Creation of shunt; subarachnoid/subdural-atrial, -jugular, -auricular","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6072","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (high noble metal)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0911T","name":"Elec aly nstm sys vgs nrv wo","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; without programming by physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0688T","name":"Tx amblyopia assmt w/report","description":"Treatment of amblyopia using an online digital program; assessment of patient performance and program data by physician or other qualified health care professional, with report, per calendar month","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4315","name":"Regenelink amniotic mem allo","description":"Regenelink amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93573","name":"Njx cath slct p-art angrp bi","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, bilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0499U","name":"Onc clrct&lng dna ngs 8gene","description":"Onc clrct&lng dna ngs 8gene","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0293U","name":"Psyc suicidal idea mrna 54","description":"Psyc suicidal idea mrna 54","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81002","name":"Urinalysis nonauto w/o scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; non-automated, without microscopy","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0557","name":"Adv prim care mgmt lvl 2","description":"Advanced primary care management services for a patient with multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, which place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline, provided by c","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81002","name":"Urinalysis nonauto w/o scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; non-automated, without microscopy","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0709","name":"Intraoral cmplt radio images","description":"Intraoral cmplt radio images","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0017","name":"Crisis psychotherapy 60m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); first 60 minutes","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0937T","name":"Xtrnl ecg rec>15d<30d","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; including recording, scanning analysis with report, review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85549","name":"Muramidase","description":"Muramidase","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4301","name":"Activate matrix, per sq cm","description":"Activate matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92623","name":"Dx aly aud oi snd prcsr each","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; each additional 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5149","name":"Inj, aflibercept-abzv, 1 mg","description":"Injection, aflibercept-abzv (enzeevu), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90382","name":"Rsv monoc antb seasn .7ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose, 0.7 ml, for intramuscular use","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1374","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67516","name":"Sprchoroidal spc njx rx agt","description":"Suprachoroidal space injection of pharmacologic agent (separate procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0532","name":"Take home supp nasal spray","description":"Take-home supply of nasal nalmefene hydrochloride; one carton of two, 2.7 mg per 0.1 ml nasal sprays (provision of the services by a medicare-enrolled opioid treatment program);( list separately in addition to each primary code)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0696T","name":"Bdy surf mapg pm/cvdfb f/up","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of follow-up interrogation or programming device evaluatio","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9999","name":"Doc sys rsn <3 colon","description":"Documentation of system reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., unable to locate previous colonoscopy report, patient cannot provide precise date or details from previous colonoscopy, previous colonoscopy report was incomplete)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44140","name":"Partial removal of colon","description":"Colectomy, partial; with anastomosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1437.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0730T","name":"Trabeculotomy lsr w/oct gdn","description":"Trabeculotomy by laser, including optical coherence tomography (oct) guidance","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7295","name":"Eth estr and eton monthly","description":"Ethinyl estradiol and etonogestrel 0.015mg, 0.12mg per 24 hours; monthly vaginal ring, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0345U","name":"Psyc genom alys pnl 15 gen","description":"Psyc genom alys pnl 15 gen","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0777T","name":"R-t prs sensing edrl gdn sys","description":"Real-time pressure-sensing epidural guidance system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52275","name":"Cystoscopy & revise urethra","description":"Cystourethroscopy, with internal urethrotomy; male","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0878T","name":"Augmnt alys ch ct ild w/ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained with concurrent ct examination of the same structure","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0174","name":"Lecanemab-irmb, for iv inj","description":"Lecanemab-irmb, for intravenous injection, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0013","name":"Hiv prep counsel, clin staff","description":"Individual counseling for pre-exposure prophylaxis (prep) by clinical staff to prevent human immunodeficiency virus (hiv), includes: hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0479U","name":"Tau phosphorylated ptau217","description":"Tau phosphorylated ptau217","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33281","name":"Reposg phrnc nrv stim trnsvn","description":"Repositioning of phrenic nerve stimulator transvenous lead(s)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64598","name":"Revj/rmvl nea pn w/int nstim","description":"Revision or removal of neurostimulator electrode array, peripheral nerve, with integrated neurostimulator","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27278","name":"Arthrd si jt plmt iartic dev","description":"Arthrodesis, sacroiliac joint, percutaneous or minimally invasive, with image guidance, includes obtaining bone graft when performed, unilateral; placement of intra-articular device(s), without cortical piercing","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0465","name":"Autolog prp diab wound ulcer","description":"Autologous platelet rich plasma (prp) or other blood-derived product for diabetic chronic wounds/ulcers, using an fda-cleared device for this indication, (includes as applicable administration, dressings, phlebotomy, centrifugation or mixing, and all other preparatory procedures, per treatment)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0568U","name":"Neurol dementia bamyl ptau","description":"Neurol dementia bamyl ptau","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0427U","name":"Monocyte dstrbj wdth whl bld","description":"Monocyte dstrbj wdth whl bld","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1812","name":"Inj. insulin (fiasp)","description":"Insulin (fiasp), per 5 units","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9359","name":"Inj lon tesirin-lpyl 0.075mg","description":"Injection, loncastuximab tesirine-lpyl, 0.075 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98016","name":"Brief comunicaj tech-bsd svc","description":"Brief communication technology-based service (eg, virtual check-in) by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related evaluation and management service provided within the p","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86759","name":"Rotavirus antibody","description":"Antibody; rotavirus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4398","name":"Summit ac per sq cm","description":"Summit ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90834","name":"Psytx w pt 45 minutes","description":"Psychotherapy, 45 minutes with patient","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":98.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0292U","name":"Psyc strs do mrna 72 genes","description":"Psyc strs do mrna 72 genes","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93319","name":"3d echo img cgen car anomal","description":"3d echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac structure(s) (eg, cardiac chambers and valves, left atrial appendage, interatrial septum, interventricular","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4231","name":"Ana crown exp 1-3 per quad","description":"Anatomical crown exposure - one to three teeth per quadrant","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0739","name":"Rehab sys active assist rt","description":"Rehabilitation system with interactive interface providing active assistance in rehabilitation therapy, includes all components and accessories, motors, microprocessors, sensors","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1438","name":"Lst knwn well <=210 min","description":"Time last known well to hospital arrival less than or equal to 3.5 hours (<= 210 minutes)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0558U","name":"Onc clrct elisa bf7 ag serum","description":"Onc clrct elisa bf7 ag serum","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9217","name":"Leuprolide acetate suspnsion","description":"Leuprolide acetate (for depot suspension), 7.5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0558U","name":"Onc clrct elisa bf7 ag serum","description":"Onc clrct elisa bf7 ag serum","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76536","name":"Us exam of head and neck","description":"Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0515U","name":"Gi ibd ia quan deter ifx lvl","description":"Gi ibd ia quan deter ifx lvl","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83150","name":"Assay of homovanillic acid","description":"Homovanillic acid (hva)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9939","name":"Placemnt removable appliance","description":"Placemnt removable appliance","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1229","name":"Pt w/ +hcv +vir ref win 1 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, is referred within 1 month of the reactive hcv antibody test to a clinician who treats hcv infection","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9608","name":"Flotufolastat f18 diag 1 mci","description":"Flotufolastat f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82785","name":"Assay of ige","description":"Gammaglobulin (immunoglobulin); ige","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0435U","name":"Onc chemo rx cytox csc 14 rx","description":"Onc chemo rx cytox csc 14 rx","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15936","name":"Exc sac pr ulc prep mus flap","description":"Excision, sacral pressure ulcer, in preparation for muscle or myocutaneous flap or skin graft closure;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1007.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38382","name":"Thoracic duct procedure","description":"Suture and/or ligation of thoracic duct; abdominal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":772.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70473","name":"Ct cere prfu aly c+wo ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed without concurrent ct or ct angiography of the same anatomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86043","name":"Acetylcholn rcptr modlg antb","description":"Acetylcholine receptor (achr); modulating antibody","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0299U","name":"Onc pan tum whl gen opt mapg","description":"Onc pan tum whl gen opt mapg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9201","name":"In gemcitabine hcl nos 200mg","description":"Injection, gemcitabine hydrochloride, not otherwise specified, 200 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28307","name":"Incision of metatarsal","description":"Osteotomy, with or without lengthening, shortening or angular correction, metatarsal; first metatarsal with autograft (other than first toe)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6614","name":"Onlay cst nbl mtl 2 surfaces","description":"Onlay - cast noble metal two surfaces","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4009","name":"Hospitalists ss","description":"Hospitalists mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1193","name":"Rpts w/ imp/con mmr/msi","description":"Surgical pathology reports that contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9326","name":"Telisotuzumab vedotin-tllv","description":"Injection, telisotuzumab vedotin-tllv, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99427","name":"Prin care mgmt staff ea addl","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9615","name":"Inj, pegulicianine, 1 mg","description":"Injection, pegulicianine, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4431","name":"Pma skin substitute, nos","description":"Pma skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6602","name":"G com bandge hgh dn foamroll","description":"Gradient compression bandaging supply, high density foam roll for bandage, per linear yard, any width, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0551","name":"Phn/intr svs fr dx treat 30m","description":"Interprofessional telephone/internet/electronic health record referral service(s) provided by a treating/requesting practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, 30 minutes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4008","name":"Geriatrics ss","description":"Geriatrics mips specialty set","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9376","name":"Inj pozelimab-bbfg, 1 mg","description":"Injection, pozelimab-bbfg, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98976","name":"Rtm dev sply resp sys 16-30d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of respiratory system, 16-30 days in a 30-day period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0675","name":"Inj, carboprost, 0.1 mg","description":"Injection, carboprost tromethamine, 0.1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1251","name":"Pts proxy cmplt hu surv","description":"Patients for whom a proxy completed the entire hu survey on their behalf for any reason (no patient involvement)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97007","name":"Mchnl sclp cool meas fitg","description":"Mechanical scalp cooling, including individual cap supply with head measurement, fitting, and patient education","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9936","name":"Clean occ guard","description":"Clean occ guard","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2596","name":"Vasopressin (long grove) 1 u","description":"Injection, vasopressin (long grove), not therapeutically equivalent to j2598, 1 unit","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4335","name":"Amnioplast 2, per sq cm","description":"Amnioplast 2, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45349","name":"Sigmoidoscopy w/resection","description":"Sigmoidoscopy, flexible; with endoscopic mucosal resection","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1007T","name":"Eeg impl s-sclp eeg w/o vid","description":"Electroencephalogram from implanted sub-scalp continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27690","name":"Revise lower leg tendon","description":"Transfer or transplant of single tendon (with muscle redirection or rerouting); superficial (eg, anterior tibial extensors into midfoot)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":743.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11400","name":"Exc tr-ext b9+marg 0.5 cm<","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 0.5 cm or less","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":150.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":89.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24410","name":"Mlt osteot rlgnm imed rd hum","description":"Multiple osteotomies with realignment on intramedullary rod, humeral shaft (sofield type procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1261.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0967T","name":"Tranal ins tmp clrc anst dev","description":"Transanal insertion of endoluminal temporary colorectal anastomosis protection device, including vacuum anchoring component and flexible sheath connected to external vacuum source and monitoring system","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36836","name":"Prq av fstl crtj uxtr 1 acs","description":"Percutaneous arteriovenous fistula creation, upper extremity, single access of both the peripheral artery and peripheral vein, including fistula maturation procedures (eg, transluminal balloon angioplasty, coil embolization) when performed, including all vascular access, imaging guidance and radiolo","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0837T","name":"Dgtz gls mcrscp fna i&r","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; interpretation and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0652","name":"Inj, levothyroxine, hikma","description":"Injection, levothyroxine sodium (hikma), not therapeutically equivalent to j0650, 10 mcg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0263U","name":"Neuro asd meas 16 c metblt","description":"Neurology (autism spectrum disorder [asd]), quantitative measurements of 16 central carbon metabolites (ie, a-ketoglutarate, alanine, lactate, phenylalanine, pyruvate, succinate, carnitine, citrate, fumarate, hypoxanthine, inosine, malate, s-sulfocysteine, taurine, urate, and xanthine), liquid chrom","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4415","name":"Alexiguard st-l per sq cm","description":"Alexiguard sl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0791T","name":"Motr cog vr gait train ea 15","description":"Motor-cognitive, semi-immersive virtual reality-facilitated gait training, each 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0526","name":"Est pt-cg dyad dem hig cmplx","description":"Management of established patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0595U","name":"Nfct ds tfp vctrbrn&zoonotic","description":"Nfct ds tfp vctrbrn&zoonotic","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0384U","name":"Neph ckd rsk hi stg kdn ds","description":"Neph ckd rsk hi stg kdn ds","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0276U","name":"Hem inh thrombocytopenia 23","description":"Hematology (inherited thrombocytopenia), genomic sequence analysis of 23 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11951","name":"Subq njx fil matrl 1.1-5.0cc","description":"Subcutaneous injection of filling material (eg, collagen); 1.1 to 5.0 cc","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0165","name":"Inj epinephrine nos 0.1 mg","description":"Injection, epinephrine, not otherwise specified, 0.1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27477","name":"Surgery to stop leg growth","description":"Arrest, epiphyseal, any method (eg, epiphysiodesis); tibia and fibula, proximal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":881.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92563","name":"Tone decay hearing test","description":"Tone decay test","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q0224","name":"Inj, pemivibart, 4500 mg","description":"Injection, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, and who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppressive ","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9506","name":"Tc-99m graphite crucible","description":"Graphite crucible for preparation of technetium tc 99m-labeled carbon aerosol, one crucible","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99475","name":"Ped crit care age 2-5 init","description":"Initial inpatient pediatric critical care, per day, for the evaluation and management of a critically ill infant or young child, 2 through 5 years of age","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33902","name":"Perq p-art revsc 1 abnor uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, unilateral","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0461","name":"Testing for cracked tooth","description":"Testing for cracked tooth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9051","name":"Inj, bortezomib (maia)","description":"Injection, bortezomib (maia), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0539","name":"Initial care training 30 m","description":"Caregiver training in behavior management/modification for caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face; initial 30 minutes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0795T","name":"Tcat ins 2chmbr ldls pm cmpl","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; complete system (ie, r","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37281","name":"Revsc evsc tpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86041","name":"Acetylcholn rcptr bndng antb","description":"Acetylcholine receptor (achr); binding antibody","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6519","name":"Grad com garm noc night use","description":"Gradient compression garment, not otherwise specified, for nighttime use, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82166","name":"Assay anti-mullerian horm","description":"Anti-mullerian hormone (amh)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0998T","name":"Precuneus mag stimj tx dlvr","description":"Precuneus magnetic stimulation; personalized treatment delivery of magnetic stimulation therapy to a prespecified target area derived from analysis of evoked potentials within the precuneus, utilizing magnetic resonance imaging-based neuronavigation, with management, per day","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0311U","name":"Nfct ds bct quan antmcrb sc","description":"Nfct ds bct quan antmcrb sc","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0911","name":"Inst tauro 1.35mg/hep 100u","description":"Instillation, taurolidine 1.35 mg and heparin sodium 100 units (central venous catheter lock for adult patients receiving chronic hemodialysis)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76970","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0136","name":"Inj, acetaminophen (b braun)","description":"Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4017","name":"Nutrition/dietician ss","description":"Nutrition/dietician mips specialty set","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9028","name":"Inj, nogapendekin pmln, 1mcg","description":"Injection, nogapendekin alfa inbakicept-pmln, for intravesical use, 1 microgram","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0611U","name":"Onc lvr alys >1000 mr cfdna","description":"Onc lvr alys >1000 mr cfdna","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1437","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77783","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1265.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0002","name":"Opt care kidney hlth mvp","description":"Optimal care for kidney health mips value pathways","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42507","name":"Parotid duct diversion","description":"Parotid duct diversion, bilateral (wilke type procedure);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2221","name":"Ank mcrop plant & dorsi flex","description":"Addition to lower extremity orthosis, ankle system, microprocessor-controlled feature plantarflexion and/or dorsiflexion, includes power source","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1887.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0274U","name":"Hem gen pltlt do 43 genes","description":"Hematology (genetic platelet disorders), genomic sequence analysis of 43 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64654","name":"1st opn implt bat modulj sys","description":"Initial open implantation of baroreflex activation therapy (bat) modulation system, including lead placement onto the carotid sinus, lead tunnelling, connection to a pulse generator placed in a distant subcutaneous pocket (ie, total system), and intraoperative interrogation and programming","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76017","name":"Mr sfty med physics xm cstmz","description":"Mr safety medical physics examination customization, planning and performance monitoring by medical physicist or mr safety expert, with review and analysis by physician or other qualified health care professional to prioritize and select views and imaging sequences, to tailor mr acquisition specific","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1468","name":"Hep b vaccine received","description":"Patient received recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6600","name":"G com bandge hgh dn foam sht","description":"Gradient compression bandaging supply, high density foam sheet, per 250 square centimeters, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4359","name":"Choriply, per sq cm","description":"Choriply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2043","name":"Biobrane, per sq cm","description":"Biobrane, per square centimeter","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3374","name":"Inj, vancomycin (mylan) 10mg","description":"Injection, vancomycin hydrochloride (mylan) not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22860","name":"Tot disc arthrp 2ntrspc lmbr","description":"Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression); second interspace, lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92920","name":"Prq trluml c angiop 1art&/br","description":"Percutaneous transluminal coronary angioplasty, single major coronary artery and/or its branch(es)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4468","name":"Exsuff belt incl all sup acc","description":"Exsufflation belt, includes all supplies and accessories","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9321","name":"Inj epcoritamab-bysp 0.16 mg","description":"Injection, epcoritamab-bysp, 0.16 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38102","name":"Removal of spleen total","description":"Splenectomy; total, en bloc for extensive disease, in conjunction with other procedure (list in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33268","name":"Excl laa opn oth px any meth","description":"Exclusion of left atrial appendage, open, performed at the time of other sternotomy or thoracotomy procedure(s), any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1422","name":"Gastroenterology care mvp","description":"Gastroenterology care mips value pathway","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9224","name":"Gen anes adv air-15 min","description":"Gen anes adv air-15 min","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0589","name":"Inj daxibotulinumtoxina-lanm","description":"Injection, daxibotulinumtoxina-lanm, 1 unit","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43268","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2373","name":"Inj, immphentiv, 20 mcg","description":"Injection, phenylephrine hydrochloride (immphentiv), 20 micrograms","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0693T","name":"Compre ful bdy 3d mtn alys","description":"Comprehensive full body computer-based markerless 3d kinematic and kinetic motion analysis and report","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1414","name":"Med rsn no pdl1 bef 1st ther","description":"Documentation of medical reason(s) for not performing the pd-l1 biomarker expression test prior to initiation of first-line immune checkpoint inhibitor therapy (e.g., patient is in an urgent or emergent situation where delay of treatment would jeopardize the patients health status; other medical rea","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4001","name":"Diagnostic rad ss","description":"Diagnostic radiology mips specialty set","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1394","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22512","name":"Vertebroplasty addl inject","description":"Percutaneous vertebroplasty (bone biopsy included when performed), 1 vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance; each additional cervicothoracic or lumbosacral vertebral body (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1123.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2544","name":"Dental onlay metl 4/more sur","description":"Onlay - metallic - four or more surfaces","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J9182","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1388","name":"Pt doc exm rec melmn","description":"Patients with documentation of an exam performed for recurrence of melanoma","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0304U","name":"Hem rbc ads whl bld normoxic","description":"Hem rbc ads whl bld normoxic","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96573","name":"Pdt dstr prmlg les phys/qhp","description":"Photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosensitizing drug(s) provided by a physician or other qualified health care professional, per day","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6081","name":"Scale & debride, single imp","description":"Scale & debride, single imp","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99394","name":"Prev visit est age 12-17","description":"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; adole","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":135.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87626","name":"Hpv sep hi-rsk typ&pool rslt","description":"Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), separately reported high-risk types (eg, 16, 18, 31, 45, 51, 52) and high-risk pooled result(s)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0334U","name":"Onc sld orgn tgsa dna 84/+","description":"Onc sld orgn tgsa dna 84/+","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1353","name":"Pts no cmplt suicd saf pln","description":"Patients who did not have a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7521","name":"Tacrolim granules oral susp","description":"Tacrolimus, granules, oral suspension, 0.1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":126.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0403U","name":"Onc prst8 mrna 18 gen dre ur","description":"Onc prst8 mrna 18 gen dre ur","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0032","name":"2+ antipsy schiz","description":"Two or more antipsychotic prescriptions ordered for patients who had a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder on or between january 1 of the year prior to the measurement period and the index prescription start date (ipsd) for antipsychotics","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5144","name":"Inj, idacio, 1 mg","description":"Injection, adalimumab-aacf (idacio), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0424U","name":"Onc prst8 xom alys 53 sncrna","description":"Onc prst8 xom alys 53 sncrna","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60661","name":"Abltj 1/+thyr ndul addl prq","description":"Ablation of 1 or more thyroid nodule(s), additional lobe, percutaneous, including imaging guidance, radiofrequency (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":115.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99424","name":"Prin care mgmt phys 1st 30","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93000","name":"Electrocardiogram complete","description":"Electrocardiogram, routine ecg with at least 12 leads; with interpretation and report","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9172","name":"Docetaxel (docivyx), 1 mg","description":"Injection, docetaxel (docivyx), 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82373","name":"Assay c-d transfer measure","description":"Carbohydrate deficient transferrin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33305","name":"Repair of heart wound","description":"Repair of cardiac wound; with cardiopulmonary bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1576.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15734","name":"Muscle-skin graft trunk","description":"Muscle, myocutaneous, or fasciocutaneous flap; trunk","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1478.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73560","name":"X-ray exam of knee 1 or 2","description":"Radiologic examination, knee; 1 or 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6252","name":"Bridge resin w/noble metal","description":"Pontic-resin with noble metal","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37291","name":"Revsc evsc tpvt athr cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0802","name":"Inj. (ani), up to 40 units","description":"Injection, corticotropin (ani), up to 40 units","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85366","name":"Fibrinogen test","description":"Fibrin(ogen) degradation (split) products (fdp) (fsp); paracoagulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4400","name":"Polygon3 per sq cm","description":"Polygon3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0519U","name":"Ther rx mntr meds p/d/a 110+","description":"Ther rx mntr meds p/d/a 110+","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50700","name":"Revision of ureter","description":"Ureteroplasty, plastic operation on ureter (eg, stricture)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1037.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33895","name":"Evasc st rpr thrc/aa x crsg","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; not crossing major side branches","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92945","name":"Prq trl rvs ch occ ant&rtrgr","description":"Percutaneous transluminal revascularization of chronic total occlusion, single coronary artery, coronary artery branch, or coronary artery bypass graft, and/or subtended major coronary artery branches of the bypass graft, any combination of intracoronary stent, atherectomy and angioplasty; combined ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1344","name":"No bsln/2nd pam score 4-12mo","description":"Patients who did not have a baseline pam score and/or a second score within 4 to 12 months of baseline pam score","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4287","name":"Dermabind dl, per sq cm","description":"Dermabind dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0559","name":"Unrelat prac follow up visit","description":"Post-operative follow-up visit complexity inherent to evaluation and management services addressing surgical procedure(s), provided by a physician or qualified health care professional who is not the practitioner who performed the procedure (or in the same group practice) and is of the same or of a ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4395","name":"Acelagraft per sq cm","description":"Acelagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0469U","name":"Rare ds whl gen seq ftl samp","description":"Rare ds whl gen seq ftl samp","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9224","name":"Gen anes adv air-15 min","description":"Gen anes adv air-15 min","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0852T","name":"Dgtz gls mcrscp mphmtrc ea 1","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0968T","name":"Insj/rplcmt epcrnl nstim sys","description":"Insertion or replacement of epicranial neurostimulator system, including electrode array and pulse generator, with connection to electrode array","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59020","name":"Fetal contract stress test","description":"Fetal contraction stress test","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4035","name":"Thoracic surgery ss","description":"Thoracic surgery mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46080","name":"Sphnctrotmy anal div sphnctr","description":"Sphincterotomy, anal, division of sphincter (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0930T","name":"Ephys eval ccm-d ld 1st impl","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), at time of initial implantation or replacement with testing of cardiac contrac","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4281","name":"Barrera slor dl per sq cm","description":"Barrera sl or barrera dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1173","name":"Pt no rec td/tdap 9yrs prior","description":"Patient did not receive at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27049","name":"Resect hip/pelv tum < 5 cm","description":"Radical resection of tumor (eg, sarcoma), soft tissue of pelvis and hip area; less than 5 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1086.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0285U","name":"Onc rsps radj cll fr dna tox","description":"Onc rsps radj cll fr dna tox","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93575","name":"Njx cath slct p angrph mapca","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary angiography of major aortopulmonary collateral arteries (mapcas) arising off the aorta or its systemic branches, during cardiac catheterization for congenital heart d","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0556U","name":"Nfct ds p-s dna&rna 12 trgts","description":"Nfct ds p-s dna&rna 12 trgts","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1396","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2036","name":"Cohealyx col dml mx pr sq cm","description":"Cohealyx collagen dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0678T","name":"Laps repos lead isdss ea add","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional repositioned lead (list separately in addition to code for primary proce","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9697","name":"Inj, magtrace per study dose","description":"Injection, carboxydextran-coated superparamagnetic iron oxide, per study dose","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0829T","name":"Dgtz gls mcrscp cytp conctrj","description":"Digitization of glass microscope slides for cytopathology, concentration technique, smears, and interpretation (eg, saccomanno technique) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4212","name":"Gingivectomy/plasty rest","description":"Gingivectomy/plasty rest","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0897T","name":"N-invas augmnt arrhyt alys","description":"Noninvasive augmentative arrhythmia analysis derived from quantitative computational cardiac arrhythmia simulations, based on selected intervals of interest from 12-lead electrocardiogram and uploaded clinical parameters, including uploading clinical parameters with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4387","name":"Neothelium ft per sq cm","description":"Neothelium ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0053","name":"Ht mental health and care","description":"Historical trauma (ht) mental health and clinical care for indigenous persons","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1812","name":"Inj. insulin (fiasp)","description":"Insulin (fiasp), per 5 units","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6092","name":"Recement supp crown","description":"Recement implant/abutment supported crown","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4030","name":"Pulmonology ss","description":"Pulmonology mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0446U","name":"Ai ds sle alys 10 cytokine","description":"Ai ds sle alys 10 cytokine","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0652","name":"Inj, levothyroxine, hikma","description":"Injection, levothyroxine sodium (hikma), not therapeutically equivalent to j0650, 10 mcg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31614","name":"Tracheostoma revj complex","description":"Tracheostoma revision; complex, with flap rotation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":745.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2601","name":"Inj, vasopressin (baxter)","description":"Injection, vasopressin (baxter), 1 unit","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0174","name":"Lecanemab-irmb, for iv inj","description":"Lecanemab-irmb, for intravenous injection, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99211","name":"Off/op est may x req phy/qhp","description":"Office or other outpatient visit for the evaluation and management of an established patient that may not require the presence of a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":27.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9886","name":"In-person attendance g code","description":"Behavioral counseling for diabetes prevention, in-person, group, 60 minutes","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0799","name":"Hiv prep, fda approved, noc","description":"Fda approved prescription drug, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv), not otherwise classified","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92637","name":"Hearing aid pst-fitg f-up ea","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0692T","name":"Therapeutic ultrafiltration","description":"Therapeutic ultrafiltration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61892","name":"Rmv sk-mnt crnl nstm pg/rcvr","description":"Removal of skull-mounted cranial neurostimulator pulse generator or receiver with cranioplasty, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4329","name":"Singlay, per sq cm","description":"Singlay, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0783T","name":"Tc auriculr neurostimulation","description":"Transcutaneous auricular neurostimulation, set-up, calibration, and patient education on use of equipment","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0754T","name":"Dgtz gls mcrscp sld level v","description":"Digitization of glass microscope slides for level v, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0968T","name":"Insj/rplcmt epcrnl nstim sys","description":"Insertion or replacement of epicranial neurostimulator system, including electrode array and pulse generator, with connection to electrode array","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64468","name":"Thrc fascial pln blk bi njx","description":"Thoracic fascial plane block, bilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0888T","name":"Histotripsy mal renal tissue","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant renal tissue, including imaging guidance","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5135","name":"Inj, tyenne, 1 mg","description":"Injection, tocilizumab-aazg (tyenne), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0235","name":"Inj, monoclon antibody, 1 mg","description":"Injection, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extraco","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4260","name":"Signature apatch, per sq cm","description":"Signature apatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33271","name":"Insj subq impltbl dfb elctrd","description":"Insertion of subcutaneous implantable defibrillator electrode","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":579.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93897","name":"Emboli detcj wo iv mbubb njx","description":"Emboli detection without intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53454","name":"Tprnl balo cntnc dev adjmt","description":"Periurethral transperineal adjustable balloon continence device; percutaneous adjustment of balloon(s) fluid volume","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64628","name":"Trml dstrj ios bvn 1st 2 l/s","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; first 2 vertebral bodies, lumbar or sacral","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0291U","name":"Psyc mood do mrna 144 genes","description":"Psyc mood do mrna 144 genes","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9071","name":"Inj cyclophosphamd auromedic","description":"Injection, cyclophosphamide (auromedics), 5 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1023T","name":"Prq tis dsplmt intrathoracic","description":"Percutaneous tissue displacement, any method, including imaging guidance; intrathoracic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0596U","name":"Neuro alzds plsm 3dstnct isp","description":"Neuro alzds plsm 3dstnct isp","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4276","name":"Orion, per sq cm","description":"Orion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69730","name":"Rplc oi implt sk tc esp>=100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35355","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; iliofemoral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1307.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94625","name":"Phy/qhp op pulm rhb w/o mntr","description":"Physician or other qualified health care professional services for outpatient pulmonary rehabilitation; without continuous oximetry monitoring (per session)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":10.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49190","name":"Opn exc/dstr ntra-abd >30 cm","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); greater than 30 cm","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2014","name":"Omeza collag compl 100 mg","description":"Omeza collagen matrix or omeza complete matrix, per 100 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37260","name":"Revsc evasc ivt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33281","name":"Reposg phrnc nrv stim trnsvn","description":"Repositioning of phrenic nerve stimulator transvenous lead(s)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2956","name":"Indirect rest remov","description":"Indirect rest remov","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81002","name":"Urinalysis nonauto w/o scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; non-automated, without microscopy","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1392","name":"Pt rsn no exm or lst to fu","description":"Documentation of patient reasons for no examination, i.e., refusal of examination or lost to follow-up (documentation must include information that the clinician was unable to reach the patient by phone, mail or secure electronic mail - at least one method must be documented)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1430","name":"Ethanolamine oleate 100 mg","description":"Injection, ethanolamine oleate, 100 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0605","name":"Sucroferric oxyhydroxide 5mg","description":"Sucroferric oxyhydroxide, oral, 5 mg (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0285U","name":"Onc rsps radj cll fr dna tox","description":"Onc rsps radj cll fr dna tox","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2281","name":"Inj moxifloxacin (fres kabi)","description":"Injection, moxifloxacin (fresenius kabi), not therapeutically equivalent to j2280, 100 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0270U","name":"Hem cgen coagj do 20 genes","description":"Hematology (congenital coagulation disorders), genomic sequence analysis of 20 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97703","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11402","name":"Exc tr-ext b9+marg 1.1-2 cm","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 1.1 to 2.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92317","name":"C-lens fitg tech corneosclrl","description":"Prescription of optical and physical characteristics of contact lens, with medical supervision of adaptation and direction of fitting by independent technician; corneoscleral lens","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86807","name":"Cytotoxic antibody screening","description":"Serum screening for cytotoxic percent reactive antibody (pra); standard method","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4297","name":"Emerge matrix, per sq cm","description":"Emerge matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0372","name":"Tomo comp series images","description":"Tomo comp series images","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0680","name":"Cr art clc art vlv clc w rpt","description":"Detection and quantification of coronary artery calcium and/or aortic valve calcification from algorithmic analysis of computed tomography of the chest with report","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6602","name":"G com bandge hgh dn foamroll","description":"Gradient compression bandaging supply, high density foam roll for bandage, per linear yard, any width, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":5.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0309U","name":"Crd cv ds aly 4 prtn plm alg","description":"Crd cv ds aly 4 prtn plm alg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61612","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0528","name":"Mgt est pt dem mod-hi cmplx","description":"Management of established patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4340","name":"Simpligraft, per sq cm","description":"Simpligraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0613U","name":"Onc uc dna mthyltn&mut 6bmrk","description":"Onc uc dna mthyltn&mut 6bmrk","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38228","name":"Car-t admn autologous","description":"Chimeric antigen receptor t-cell (car-t) therapy; car-t cell administration, autologous","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5144","name":"Inj, idacio, 1 mg","description":"Injection, adalimumab-aacf (idacio), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0522U","name":"Ca vi psp&sp1 antb cl semiql","description":"Ca vi psp&sp1 antb cl semiql","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0319U","name":"Neph rna pretrnspl perph bld","description":"Neph rna pretrnspl perph bld","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1440","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81451","name":"Hl neo gsap 5-50 rna alys","description":"Hematolymphoid neoplasm or disorder, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants, and copy number variants or rearrangements, or isoform expression or mrna expression levels, if performed; rna analysis","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38120","name":"Laparoscopy splenectomy","description":"Laparoscopy, surgical, splenectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1185.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0831T","name":"Dgtz gls mcrscp cytp c/v","description":"Digitization of glass microscope slides for cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4031","name":"Radiation oncology ss","description":"Radiation oncology mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92930","name":"Prq tcat plmt ntrac st 2+les","description":"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 2 or more distinct coronary lesions with 2 or more coronary stents deployed in 2 or more coronary segments, or a bifurcation lesion requiring ","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3302","name":"Triamcinolone diacetate inj","description":"Injection, triamcinolone diacetate, per 5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87803","name":"Clostridium toxin a w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; clostridium difficile toxin a","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1268","name":"Pt ac stat kid trnsplt wtlst","description":"Patients observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1343","name":"Pt pam lvl 4 base or srt lin","description":"Patients who are at pam level 4 at baseline or patients who are flagged with extreme straight line response sets on the pam or with excessive missing responses","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81463","name":"So gsap cl fr cpy nmbr&mcrst","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis, copy number variants, and microsatellite instability","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75577","name":"Quan&char c athrosclrtc plaq","description":"Quantification and characterization of coronary atherosclerotic plaque to assess severity of coronary disease, derived from augmentative software analysis of the data set from a coronary computed tomographic angiography, with interpretation and report by a physician or other qualified health care pr","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9612","name":"Inj, fluorescein, 1 mg","description":"Injection, fluorescein, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4278","name":"Epieffect, per sq cm","description":"Epieffect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33534","name":"Cabg arterial two","description":"Coronary artery bypass, using arterial graft(s); 2 coronary arterial grafts","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2447.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7413","name":"Excision malig lesion<=1.25c","description":"Excision of malignant lesion up to 1.25 cm","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1334","name":"Pts act pvd 2 wks 2 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 2 weeks after initial acute pvd encounter","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4292","name":"Lamellas, per sq cm","description":"Lamellas, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67414","name":"Explr/decompress eye socket","description":"Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of bone for decompression","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1068.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0671T","name":"Insj ant sgm aq drg dev 1+","description":"Insertion of anterior segment aqueous drainage device into the trabecular meshwork, without external reservoir, and without concomitant cataract removal, one or more","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75825","name":"Vein x-ray trunk","description":"Venography, caval, inferior, with serialography, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1449","name":"Inj eflapegrastim-xnst 0.1mg","description":"Injection, eflapegrastim-xnst, 0.1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37258","name":"Revsc evasc ivt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2036","name":"Cohealyx col dml mx pr sq cm","description":"Cohealyx collagen dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0765T","name":"Asstv alg ecg rsk asmt prev","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to previously performed electrocardiogram","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0503U","name":"Neuro alz ds bamyl&tau prtn","description":"Neuro alz ds bamyl&tau prtn","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15131","name":"Drm agrft t/a/l ea addl","description":"Dermal autograft, trunk, arms, legs; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12001","name":"Rpr s/n/ax/gen/trnk 2.5cm/<","description":"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 2.5 cm or less","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":124.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9564","name":"P32 chromic phosphate","description":"Chromic phosphate p-32 suspension, therapeutic, per millicurie","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6634","name":"Onlay titanium","description":"Onlay - titanium","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22838","name":"Rev rplc/rmv thrc vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracic vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37269","name":"Revsc evasc fpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1184","name":"Doc med rsn no cst/ist rx","description":"Documentation of medical reason(s) for not prescribing or administering corticosteroid or immunosuppressant treatment (e.g., allergy, intolerance, infectious etiology, pancreatic insufficiency, hyperthyroidism, prior bowel surgical interventions, celiac disease, receiving other medication, awaiting ","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89050","name":"Body fluid cell count","description":"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0761T","name":"Dgtz gls mcrscp sl imm ea 1","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64627","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1359","name":"Indx suicd idea, no 0 scr","description":"Index assessment during the denominator period when the suicidal ideation and/or behavior symptoms or increased suicide risk by clinician determination occurs and a non-zero c-ssrs score is obtained","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0597U","name":"Onc breast rna xprsn 329gens","description":"Onc breast rna xprsn 329gens","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1205","name":"Isa reduced >=3","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5946","name":"Max implt sup fix","description":"Max implt sup fix","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0531","name":"Fclty-based respite, 24 hr u","description":"Facility-based respite, 24-hour unit, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0839T","name":"Dgtz gls mcrscp cslt mat prp","description":"Digitization of glass microscope slides for consultation and report on referred material requiring preparation of slides (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2221","name":"Ank mcrop plant & dorsi flex","description":"Addition to lower extremity orthosis, ankle system, microprocessor-controlled feature plantarflexion and/or dorsiflexion, includes power source","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0455U","name":"Nfct agt sti mult amp prb ur","description":"Nfct agt sti mult amp prb ur","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0425U","name":"Genom rpd seq alys ea cmprtr","description":"Genom rpd seq alys ea cmprtr","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0844T","name":"Dgtz gls mcrscp cslt cyt ea","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), each additional site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37257","name":"Revsc evsc ivt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90759","name":"Hep b vac 3ag 10mcg 3 dos im","description":"Hepatitis b vaccine (hepb), 3-antigen (s, pre-s1, pre-s2), 10 mcg dosage, 3 dose schedule, for intramuscular use","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0425U","name":"Genom rpd seq alys ea cmprtr","description":"Genom rpd seq alys ea cmprtr","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0672T","name":"Ndovag cryg rf remdl tiss","description":"Endovaginal cryogen-cooled, monopolar radiofrequency remodeling of the tissues surrounding the female bladder neck and proximal urethra for urinary incontinence","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9294","name":"Inj pemetrexed, hospira 10mg","description":"Injection, pemetrexed (hospira), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93596","name":"R&l hrt cath chd nml nt cnj","description":"Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); normal native connections","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0296","name":"Visit to determ ldct elig","description":"Counseling visit to discuss need for lung cancer screening using low dose ct scan (ldct) (service is for eligibility determination and shared decision making)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":24.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1320","name":"Pts scrn + hrsn","description":"Patients who screened positive for at least 1 of the 5 hrsns","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38226","name":"Car-t prep t lymphcyt f/trns","description":"Chimeric antigen receptor t-cell (car-t) therapy; preparation of blood-derived t lymphocytes for transportation (eg, cryopreservation, storage)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0833T","name":"Dgtz gls mcrscp cytp oth prp","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; preparation, screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82962","name":"Glucose blood test","description":"Glucose, blood by glucose monitoring device(s) cleared by the fda specifically for home use","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6609","name":"G compression bandaging","description":"Gradient compression bandaging supply, not otherwise specified","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6197","name":"Replace material prosthesis","description":"Replace material prosthesis","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69641","name":"Revise middle ear & mastoid","description":"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); without ossicular chain reconstruction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1193.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76015","name":"Mr sfty mplt&/fb asmt stf ea","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0211","name":"Inj, nithiodote, 3mg / 125mg","description":"Injection, sodium nitrite 3 mg and sodium thiosulfate 125 mg (nithiodote)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0784T","name":"Ins/rplmt eltrd ra spi nstim","description":"Insertion or replacement of percutaneous electrode array, spinal, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4440","name":"Curamatrix per sq cm","description":"Curamatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0697T","name":"Quan mr tis wo mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained without diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, targ","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0279U","name":"Hem vw factor&clgn iii bndg","description":"Hematology (von willebrand disease [vwd]), von willebrand factor (vwf) and collagen iii binding by enzyme-linked immunosorbent assays (elisa), plasma, report of collagen iii binding","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0862T","name":"Rlcj pg wcs lv battery only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; battery component only","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1302","name":"Scrn mam perf rslts doc","description":"Screening, diagnostic, film digital or digital breast tomosynthesis (3d) mammography results documented and reviewed","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0708T","name":"Id ca immntx prep & 1st njx","description":"Intradermal cancer immunotherapy; preparation and initial injection","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4262","name":"Dual layer impax, per sq cm","description":"Dual layer impax membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7415","name":"Excision malig les complicat","description":"Excision of malignant lesion complicated","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9025","name":"Plasma cryo redu path each","description":"Plasma, cryoprecipitate reduced, pathogen reduced, each unit","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0866T","name":"Quan mri alys brn w/dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion detection, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transmissio","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37294","name":"Rvsc evsc tpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4329","name":"Singlay, per sq cm","description":"Singlay, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28113","name":"Part removal of metatarsal","description":"Ostectomy, complete excision; fifth metatarsal head","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0555","name":"Replacment pt electronic sys","description":"Provision of replacement patient electronics system (e.g., system pillow, handheld reader) for home pulmonary artery pressure monitoring","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4332","name":"Axolotl dualgraft, per sq cm","description":"Axolotl dualgraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6560","name":"G stckng full/chap30-40 cust","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, custom, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1021T","name":"Active thrc irrigation spx","description":"Active thoracic irrigation (separate procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0201","name":"Pne flu hepb cov home admin","description":"Administration of pneumococcal, influenza, hepatitis b, and/or covid-19 vaccine inside a patients home; reported only once per individual home per date of service when such vaccine administration(s) are performed at the patients home","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1553","name":"Inj yimmugo 100 mg","description":"Injection, immune globulin (yimmugo), 100 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1173","name":"Pt no rec td/tdap 9yrs prior","description":"Patient did not receive at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86826","name":"Hla x-match noncytotoxc addl","description":"Human leukocyte antigen (hla) crossmatch, non-cytotoxic (eg, using flow cytometry); each additional serum sample or sample dilution (list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0217","name":"Inj velmanase alfa-tycv 1 mg","description":"Injection, velmanase alfa-tycv, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1386","name":"Exc sx melmn or mlnm is","description":"Patients with an excisional surgery for melanoma or melanoma in situ in the past 5 years with an initial ajcc staging of 0, i, or ii at the start of the performance period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1933","name":"Afo rig ant tib tcf/= ots","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, off-the-shelf","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4252","name":"Vendaje, per square centimet","description":"Vendaje, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84087","name":"Assay phosphohexose enzymes","description":"Phosphohexose isomerase","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0550","name":"Phone/inter for dx/treat >5m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a written report to the patients treating/r","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1304","name":"No pneum vax admin 19+","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26030","name":"Drainage of palm bursas","description":"Drainage of palmar bursa; multiple bursa","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":573.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92557","name":"Comprehensive hearing test","description":"Comprehensive audiometry threshold evaluation and speech recognition (92553 and 92556 combined)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":27.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1748","name":"Inj, zymfentra, 10 mg","description":"Injection, infliximab-dyyb (zymfentra), 10 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4264","name":"Cocoon membrane, per sq cm","description":"Cocoon membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0538","name":"Ascvd rsk mng clin stf pr mo","description":"Atherosclerotic cardiovascular disease (ascvd) risk management services; clinical staff time; per calendar month","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94760","name":"N-invas ear/pls oximetry 1","description":"Noninvasive ear or pulse oximetry for oxygen saturation; single determination","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1026","name":"Pt hemo > 3mo","description":"The number of adult patient-months in the denominator who were on maintenance hemodialysis using a catheter continuously for three months or longer under the care of the same practitioner or group partner as of the last hemodialysis session of the reporting month","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4438","name":"Pretect per sq cm","description":"Pretect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0589","name":"Inj daxibotulinumtoxina-lanm","description":"Injection, daxibotulinumtoxina-lanm, 1 unit","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0414U","name":"Onc lng aug alg aly whl sld8","description":"Onc lng aug alg aly whl sld8","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2029","name":"Mirotract matrix sheet","description":"Mirotract wound matrix sheet, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0806T","name":"Tcat s&ivc prstc vl impl opn","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); open femoral vein approach","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0282U","name":"Rbc dna gntyp 12 bld grp gen","description":"Red blood cell antigen typing, dna, genotyping of 12 blood group system genes to predict 44 red blood cell antigen phenotypes","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0488U","name":"Ob fetal ag nipt cfdna alys","description":"Ob fetal ag nipt cfdna alys","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0576U","name":"Trnsplj med lar quan ddcfdna","description":"Trnsplj med lar quan ddcfdna","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86318","name":"Ia infectious agent antibody","description":"Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip);","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0314U","name":"Onc cutan mlnma mrna 35 gene","description":"Onc cutan mlnma mrna 35 gene","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4325","name":"Acapatch, per sq cm","description":"Acapatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5149","name":"Inj, aflibercept-abzv, 1 mg","description":"Injection, aflibercept-abzv (enzeevu), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3401","name":"Vyjuvek 5x10^9pfu/ml, 0.1 ml","description":"Beremagene geperpavec-svdt for topical administration, containing nominal 5 x 10^9 pfu/ml vector genomes, per 0.1 ml","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1162","name":"Pt enceph due to dtp bef 13","description":"Patient had encephalitis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25350","name":"Revision of radius","description":"Osteotomy, radius; distal third","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1119.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7299","name":"Intraut copp cont (miudella)","description":"Intrauterine copper contraceptive (miudella)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0238","name":"Inj, tocilizumab-aazg, hospi","description":"Injection, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0453U","name":"Onc clrct ca cfdna qpcr asy","description":"Onc clrct ca cfdna qpcr asy","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4305","name":"Amer am ac tri-lay per sq cm","description":"American amnion ac tri-layer, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77437","name":"Surf radj ther supfc<=150kv","description":"Surface radiation therapy; superficial, delivery, </=150 kv, per fraction (eg, electronic brachytherapy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0890T","name":"Arhfcmrigtbs 1st tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including target assessment, initial motor threshold determination, neuronavigation, delivery and management, initial treatment day","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0884T","name":"Esphgsc flx 1st tndsc dilat","description":"Esophagoscopy, flexible, transoral, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for esophageal stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5939","name":"Resct proth mand comp remov","description":"Resct proth mand comp remov","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0063","name":"Cardiology ss","description":"Cardiology mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0739","name":"Rehab sys active assist rt","description":"Rehabilitation system with interactive interface providing active assistance in rehabilitation therapy, includes all components and accessories, motors, microprocessors, sensors","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0258U","name":"Ai psor mrna 50-100 gen alg","description":"Autoimmune (psoriasis), mrna, next-generation sequencing, gene expression profiling of 50-100 genes, skin- surface collection using adhesive patch, algorithm reported as likelihood of response to psoriasis biologics","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7299","name":"Rem anchorage device w/flap","description":"Rem anchorage device w/flap","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34715","name":"Opn ax/subcla art expos","description":"Open axillary/subclavian artery exposure for delivery of endovascular prosthesis by infraclavicular or supraclavicular incision, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6555","name":"G com stcking bk 40+ custm","description":"Gradient compression stocking, below knee, 40 mmhg or greater, custom, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1251","name":"Pts proxy cmplt hu surv","description":"Patients for whom a proxy completed the entire hu survey on their behalf for any reason (no patient involvement)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96041","name":"Genetic counseling svc ea 30","description":"Medical genetics and genetic counseling services, each 30 minutes of total time provided by the genetic counselor on the date of the encounter","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6553","name":"G com stcking bk 30-40 custm","description":"Gradient compression stocking, below knee, 30-40 mmhg, custom, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71045","name":"X-ray exam chest 1 view","description":"Radiologic examination, chest; single view","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2508","name":"Pegunigalsidase alfa-iwxj","description":"Injection, pegunigalsidase alfa-iwxj, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45800","name":"Repair rect/bladder fistula","description":"Closure of rectovesical fistula;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1192.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92622","name":"Dx aly aud oi snd prcsr 1st","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; first 60 minutes","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97007","name":"Mchnl sclp cool meas fitg","description":"Mechanical scalp cooling, including individual cap supply with head measurement, fitting, and patient education","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0540","name":"Train for caregiver add 15","description":"Caregiver training in behavior management/modification for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face; each additional 15 minutes","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0472","name":"Gross exam prep & report","description":"Accession of tissue gross examination preparation and transmission of written report","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59855","name":"Induced abortion 1+vag supp","description":"Induced abortion, by 1 or more vaginal suppositories (eg, prostaglandin) with or without cervical dilation (eg, laminaria), including hospital admission and visits, delivery of fetus and secundines;","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":419.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0518","name":"Remove w insert drug implant","description":"Removal with reinsertion, non-biodegradable drug delivery implants, 4 or more (services for subdermal implants)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":366.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93597","name":"R&l hrt cath chd abnl nt cnj","description":"Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); abnormal native connections","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1708","name":"Pfizer vacc admin 3rd dose","description":"Pfizer vacc admin 3rd dose","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1367","name":"Qual care ent disorder mvp","description":"Quality care for the treatment of ear, nose, and throat disorders mips value pathway","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6594","name":"G comp bandge liner lwr extr","description":"Gradient compression bandaging supply, bandage liner, lower extremity, any size or length, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9323","name":"Inj pemetrexed ditromethamin","description":"Injection, pemetrexed ditromethamine, 10 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1251","name":"Pts proxy cmplt hu surv","description":"Patients for whom a proxy completed the entire hu survey on their behalf for any reason (no patient involvement)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1229","name":"Pt w/ +hcv +vir ref win 1 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, is referred within 1 month of the reactive hcv antibody test to a clinician who treats hcv infection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0348U","name":"Rx metab/pcx dna 25 gen alys","description":"Rx metab/pcx dna 25 gen alys","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0684T","name":"Peri-px dev eval isdss ip","description":"Peri-procedural device evaluation (in-person) and programming of device system parameters before or after a surgery, procedure, or test with analysis, review, and report by a physician or other qualified health care professional, permanent implantable synchronized diaphragmatic stimulation system fo","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1460","name":"Dx copd, cf, or arf","description":"Diagnosis for chronic obstructive pulmonary disease, emphysema, cystic fibrosis, or acute respiratory failure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0985T","name":"Iv img xtrc cere vsl oct ea","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37181","name":"Splice spleen/kidney veins","description":"Venous anastomosis, open; splenorenal, distal (selective decompression of esophagogastric varices, any technique)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1825.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0683T","name":"Prgrmg dev eval isdss ip","description":"Programming device evaluation (in-person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional, permanent implantable synchroni","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0995T","name":"Evasc dlvr a-wal stbl rx opn","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; open","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7472","name":"Removal of torus palatinus","description":"Removal of torus palatinus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0837T","name":"Dgtz gls mcrscp fna i&r","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; interpretation and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7173","name":"Inj. concizumab-mtci, 0.5 mg","description":"Injection, concizumab-mtci, 0.5 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62163","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1366.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2013","name":"Innovamatrix fs, per sq cm","description":"Innovamatrix fs, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27415","name":"Osteochondral knee allograft","description":"Osteochondral allograft, knee, open","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1637.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64732","name":"Incision of brow nerve","description":"Transection or avulsion of; supraorbital nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":408.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4287","name":"Dermabind dl, per sq cm","description":"Dermabind dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0908T","name":"Opn imp int nstm sys vgs nrv","description":"Open implantation of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1266","name":"Pts admit snf","description":"Patients admitted to a skilled nursing facility (snf)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4035","name":"Thoracic surgery ss","description":"Thoracic surgery mips specialty set","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9949","name":"Repair sleep apnea appliance","description":"Repair sleep apnea appliance","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0018","name":"Crisis psychotherapy add 30m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); each additional 30 minutes (list separately in addition to code for primary service)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7501","name":"Azathioprine parenteral","description":"Azathioprine, parenteral, 100 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1230","name":"Pt hcv rctv aby no f/u tst","description":"Patient has a reactive hcv antibody test and does not have a follow up hcv viral test, or patient has a reactive hcv antibody test and has a follow up hcv viral test that detects hcv viremia and is not referred to a clinician who treats hcv infection within 1 month and does not have hcv treatment in","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2034","name":"Found drs solo, per sq cm","description":"Foundation drs solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0877T","name":"Augmnt alys ch ct ild w/o ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4252","name":"Vendaje, per square centimet","description":"Vendaje, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42260","name":"Repair nose to lip fistula","description":"Repair of nasolabial fistula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":816.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0906T","name":"Coms ther 1st appl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; first application, total wound(s) surface area less than or equal to 50 sq cm","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1186","name":"Pt w/ rx for hspc/plltv care","description":"Patients who have an order for or are receiving hospice or palliative care","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0896T","name":"Connj lvr algrft prfu dev ea","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; each additional hour, including physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary bicarbonate, lactate ","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0804","name":"3d facial scan indirect","description":"3d facial scan indirect","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1375","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99459","name":"Pelvic examination","description":"Pelvic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86696","name":"Herpes simplex type 2 test","description":"Antibody; herpes simplex, type 2","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0846T","name":"Dgtz gls mcrscp imfluor ea","description":"Digitization of glass microscope slides for immunofluorescence, per specimen; each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4385","name":"Apollo ft per sq cm","description":"Apollo ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0538U","name":"Onc sol tum ngts ffpe 600gen","description":"Onc sol tum ngts ffpe 600gen","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1018T","name":"Elec alys npgs esoph sbsq w/","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6595","name":"G comp bandge liner upr extr","description":"Gradient compression bandaging supply, bandage liner, upper extremity, any size or length, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75555","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":682.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0521","name":"New pt-cg dyad dem hig cmplx","description":"Management of new patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4422","name":"Ac wrap per sq cm","description":"A/c wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60660","name":"Abltj 1/+thyr ndul 1lobe prq","description":"Ablation of 1 or more thyroid nodule(s), one lobe or the isthmus, percutaneous, including imaging guidance, radiofrequency","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0248","name":"Inj, remdesivir, 1 mg","description":"Injection, remdesivir, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"Add upp ext mec limb vol lam","description":"Addition to upper extremity prosthesis, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1268","name":"Pt ac stat kid trnsplt wtlst","description":"Patients observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1346","name":"No pam inc 6 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 6 points within a 4 to 12 month period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21348","name":"Opn tx nasomax fx w/graft","description":"Open treatment of nasomaxillary complex fracture (lefort ii type); with bone grafting (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1369.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99221","name":"1st hosp ip/obs sf/low 40","description":"Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward or low level medical decision making. when using total time on the date of the encounter for code selection, ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0337U","name":"Onc plsm cell do&myeloma id","description":"Onc plsm cell do&myeloma id","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91113","name":"Gi trc img intral colon i&r","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31631","name":"Bronchoscopy dilate w/stent","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with placement of tracheal stent(s) (includes tracheal/bronchial dilation as required)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1427","name":"Doc med rsn bone scn","description":"Documentation of medical reason(s) for performing a bone scan (including documented pain related to prostate cancer, salvage therapy, other medical reasons)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98927","name":"Osteopath manj 5-6 regions","description":"Osteopathic manipulative treatment (omt); 5-6 body regions involved","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":58.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1204","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86255","name":"Fluorescent antibody screen","description":"Fluorescent noninfectious agent antibody; screen, each antibody","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1600","name":"Gold sodium thiomaleate inj","description":"Injection, gold sodium thiomalate, up to 50 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1163","name":"Pt anphx due to hpv bef 13","description":"Patient had anaphylaxis due to the hpv vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0602U","name":"Endocrin dm ins gen mthyltn","description":"Endocrin dm ins gen mthyltn","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1355","name":"Caries med app per tooth","description":"Caries med app per tooth","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99477","name":"Init day hosp neonate care","description":"Initial hospital care, per day, for the evaluation and management of the neonate, 28 days of age or younger, who requires intensive observation, frequent interventions, and other intensive care services","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0447U","name":"Ai ds sle alys 11 cytokine","description":"Ai ds sle alys 11 cytokine","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96405","name":"Chemo intralesional up to 7","description":"Chemotherapy administration; intralesional, up to and including 7 lesions","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0045","name":"Mrs 90 days post stk","description":"Clinical follow-up and mrs score assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1297","name":"Bmi not doc medrsn ptref","description":"Bmi not documented due to medical reason or patient refusal of height or weight measurement","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4403","name":"Xwrap dual plus per sq cm","description":"Xwrap dual plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0988T","name":"Opn ins/rplc ins ptn sbq&sbf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1708","name":"Pfizer vacc admin 3rd dose","description":"Pfizer vacc admin 3rd dose","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22212","name":"Incis 1 vertebral seg thorac","description":"Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; thoracic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1667.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5940","name":"Resct proth max part remov","description":"Resct proth max part remov","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0421U","name":"Onc clrct scr sgl amp 8 rna","description":"Onc clrct scr sgl amp 8 rna","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77285","name":"Ther rad simulaj field intrm","description":"Therapeutic radiology simulation-aided field setting; intermediate","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0457U","name":"Pfas 9 cmpnd lcms/ms pls/sr","description":"Pfas 9 cmpnd lcms/ms pls/sr","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7294","name":"Seg acet and eth estr yearly","description":"Segesterone acetate and ethinyl estradiol 0.15mg, 0.013mg per 24 hours; yearly vaginal system, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4337","name":"Artecent trident, per sq cm","description":"Artacent trident, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0259U","name":"Neph ckd nuc mrs meas gfr","description":"Nephrology (chronic kidney disease), nuclear magnetic resonance spectroscopy measurement of myo-inositol, valine, and creatinine, algorithmically combined with cystatin c (by immunoassay) and demographic data to determine estimated glomerular filtration rate (gfr), serum, quantitative","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11302","name":"Shave skin lesion 1.1-2.0 cm","description":"Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion diameter 1.1 to 2.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0029","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37270","name":"Revsc evasc fpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24000","name":"Arthrt elbw expl drg/rmvl fb","description":"Arthrotomy, elbow, including exploration, drainage, or removal of foreign body","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":557.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81195","name":"Cytog genom-wid alys hem mal","description":"Cytogenomic (genome-wide) analysis, hematologic malignancy, structural variants and copy number variants, optical genome mapping (ogm)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2010","name":"Apis, per square centimeter","description":"Apis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0436U","name":"Onc lng plsm alys 388 prtn","description":"Onc lng plsm alys 388 prtn","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9075","name":"Inj, cyclophosphamide, nos","description":"Injection, cyclophosphamide, not otherwise specified, 5 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4328","name":"Most, per sq cm","description":"Most, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4543","name":"Supply trans elec nerve stim","description":"Supplies for transcutaneous electrical nerve stimulator, for nerves in the auricular region, per month","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1481","name":"Pt in hosp/pal care who died","description":"Patients receiving hospice or palliative care or who died during the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0801","name":"Inj. acthar gel to 40 units","description":"Injection, corticotropin (acthar gel), up to 40 units","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1412","name":"Inj roctavian ml 2x10^13vc g","description":"Injection, valoctocogene roxaparvovec-rvox, per ml, containing nominal 2 x 10^13 vector genomes","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1476","name":"Pt dx cog imp or ad","description":"Patients with diagnosis of cognitive impairment or alzheimers disease","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5827","name":"Endo knee shin single axis","description":"Endoskeletal knee-shin system, single axis, electromechanical swing and stance phase control, with or without shock absorption and stance extension damping","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":7671.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1271","name":"Inj doxycycline hyclate 1 mg","description":"Injection, doxycycline hyclate, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0666","name":"Inj, bupivacaine liposome","description":"Injection, bupivacaine liposome, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1501","name":"Pathology mvp","description":"Pathology mips value pathway","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97813","name":"Acup 1/> w/estim 1st 15 min","description":"Acupuncture, 1 or more needles; with electrical stimulation, initial 15 minutes of personal one-on-one contact with the patient","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":54.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1941","name":"Inj, furoscix, 20 mg","description":"Injection, furosemide (furoscix), 20 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0449U","name":"Car scr sev inh cond 5 genes","description":"Car scr sev inh cond 5 genes","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21355","name":"Perq tx malar fracture","description":"Percutaneous treatment of fracture of malar area, including zygomatic arch and malar tripod, with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37260","name":"Revsc evasc ivt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1374","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42180","name":"Repair lac palate<2 cm","description":"Repair, laceration of palate; up to 2 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2596","name":"Vasopressin (long grove) 1 u","description":"Injection, vasopressin (long grove), not therapeutically equivalent to j2598, 1 unit","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0723T","name":"Qmrcp w/o dx mri sm anat ses","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained without diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) during the same session","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33269","name":"Excl laa thrscp any method","description":"Exclusion of left atrial appendage, thoracoscopic, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":481.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4014","name":"Nephrology ss","description":"Nephrology mips specialty set","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1422","name":"Gastroenterology care mvp","description":"Gastroenterology care mips value pathway","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7284","name":"Exc biopsy of saliv glands","description":"Exc biopsy of saliv glands","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0019","name":"Comm hlth intg svs sdoh 60mn","description":"Community health integration services performed by certified or trained auxiliary personnel, including a community health worker, under the direction of a physician or other practitioner; 60 minutes per calendar month, in the following activities to address social determinants of health (sdoh) need(","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0829T","name":"Dgtz gls mcrscp cytp conctrj","description":"Digitization of glass microscope slides for cytopathology, concentration technique, smears, and interpretation (eg, saccomanno technique) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4283","name":"Biovance tri or 3l, sq cm","description":"Biovance tri-layer or biovance 3l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4020","name":"Ophthalmology/optometry ss","description":"Ophthalmology/optometry mips specialty set","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0892T","name":"Arhfcmrigtbs sbsq per tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent motor threshold redetermination with delivery and management, per treatment day","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3911","name":"Intraorifice barrier","description":"Intraorifice barrier","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4272","name":"Esano a, per sq cm","description":"Esano a, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":834.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2026","name":"Restrata minimatrix, 5 mg","description":"Restrata minimatrix, 5 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1163","name":"Pt anphx due to hpv bef 13","description":"Patient had anaphylaxis due to the hpv vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5147","name":"Inj, aflibercept-ayyh, 1 mg","description":"Injection, aflibercept-ayyh (pavblu), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99305","name":"1st nf care moderate mdm 35","description":"Initial nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 35 minutes must be met or ex","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":158.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0913T","name":"Prq tcat ther rx ntrac balo1","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting), including mechanical dilation by nondrug-delivery balloon angioplasty, endoluminal imaging using intravascular ultrasound (ivus) or optical coherence tomography (oct) when per","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0880T","name":"Augmnt alys ch ct ild i&r","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98016","name":"Brief comunicaj tech-bsd svc","description":"Brief communication technology-based service (eg, virtual check-in) by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related evaluation and management service provided within the p","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0832T","name":"Dgtz gls mcrscp cytp oth scr","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0268","name":"Removal of impacted wax md","description":"Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0626U","name":"Neurol pd dna alys >20000","description":"Neurol pd dna alys >20000","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0963T","name":"Anosc sbmcsl njx bulking agt","description":"Anoscopy with directed submucosal injection of bulking agent into anal canal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68841","name":"Insj rx elut implt lac canal","description":"Insertion of drug-eluting implant, including punctal dilation when performed, into lacrimal canaliculus, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1372","name":"Mst rec gsa >=7 and<8","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 7.0% and < 8.0%","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0685T","name":"Interrog dev eval isdss ip","description":"Interrogation device evaluation (in-person) with analysis, review and report by a physician or other qualified health care professional, including connection, recording and disconnection per patient encounter, permanent implantable synchronized diaphragmatic stimulation system for augmentation of ca","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2643","name":"Dental onlay porcelin 3 surf","description":"Onlay - porcelain/ceramic - three surfaces","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5811","name":"Denture interm cmplt mandbl","description":"Interim complete denture (mandibular)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69728","name":"Rmv ntr oi imp sk tc>=100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0140","name":"Nav srv peer sup 60 min pr m","description":"Principal illness navigation - peer support by certified or trained auxiliary personnel under the direction of a physician or other practitioner, including a certified peer specialist; 60 minutes per calendar month, in the following activities:  person-centered interview, performed to better underst","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38745","name":"Remove armpit lymph nodes","description":"Axillary lymphadenectomy; complete","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27742","name":"Repair of leg epiphyses","description":"Arrest, epiphyseal (epiphysiodesis), any method, combined, proximal and distal tibia and fibula; and distal femur","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1498","name":"Diagnostic radiology mvp","description":"Diagnostic radiology mips value pathway","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2002","name":"Inj, lidocaine in d5w, 1 mg","description":"Injection, lidocaine hcl in 5% dextrose, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4100","name":"Nosht skin sub fda clrd nos","description":"Non-sheet form skin substitute, fda cleared as a device, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86328","name":"Ia nfct ab sarscov2 covid19","description":"Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19])","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27823","name":"Treatment of ankle fracture","description":"Open treatment of trimalleolar ankle fracture, includes internal fixation, when performed, medial and/or lateral malleolus; with fixation of posterior lip","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1221.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52443","name":"Cysto 1st trurl prst8 comis","description":"Cystourethroscopy with initial transurethral anterior prostate commissurotomy with a nondrug-coated balloon catheter followed by therapeutic drug delivery into the prostate by a drug-coated balloon catheter, including transrectal ultrasound and fluoroscopy, when performed","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27256","name":"Treat hip dislocation","description":"Treatment of spontaneous hip dislocation (developmental, including congenital or pathological), by abduction, splint or traction; without anesthesia, without manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1208","name":"Pt no scrn sdoh","description":"Patient is not screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56620","name":"Vulvectomy simple partial","description":"Vulvectomy simple; partial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4283","name":"Biovance tri or 3l, sq cm","description":"Biovance tri-layer or biovance 3l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7165","name":"Inj, human-lans, per i.u","description":"Injection, prothrombin complex concentrate, human-lans, per i.u. of factor ix activity","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99381","name":"Init pm e/m new pat infant","description":"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; infant (age youn","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":70.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4017","name":"Nutrition/dietician ss","description":"Nutrition/dietician mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59000","name":"Amniocentesis diagnostic","description":"Amniocentesis; diagnostic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0729T","name":"Dx alys vstblr implt uni sbq","description":"Diagnostic analysis of vestibular implant, unilateral; with subsequent programming","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9172","name":"Docetaxel (docivyx), 1 mg","description":"Injection, docetaxel (docivyx), 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01941","name":"Anes neuromd/ntrvrt crv/thrc","description":"Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1261","name":"Pts on wtlist bef dialysis","description":"Patients that were on the kidney or kidney-pancreas waitlist prior to initiation of dialysis","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25448","name":"Arthrp ntrcrpl/crp/mtcrp ssp","description":"Arthroplasty, intercarpal or carpometacarpal joints; suspension, including transfer or transplant of tendon, with interposition, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0951T","name":"Tot impl amei 1st plmt","description":"Totally implantable active middle ear hearing implant; initial placement, including mastoidectomy, placement of and attachment to sound processor","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1307","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61795","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2590","name":"Oxytocin injection","description":"Injection, oxytocin, up to 10 units","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1382","name":"Enc dur perf pd pos 11","description":"Patient encounter during the performance period with place of service code 11","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0506U","name":"Gi barretts esophgl cell 89","description":"Gi barretts esophgl cell 89","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0362U","name":"Onc pap thyr ca rna 82&10","description":"Onc pap thyr ca rna 82&10","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96415","name":"Chemo iv infusion addl hr","description":"Chemotherapy administration, intravenous infusion technique; each additional hour (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49501","name":"Rpr ing hernia init blocked","description":"Repair initial inguinal hernia, age 6 months to younger than 5 years, with or without hydrocelectomy; incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":630.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0729T","name":"Dx alys vstblr implt uni sbq","description":"Diagnostic analysis of vestibular implant, unilateral; with subsequent programming","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61597","name":"Transcondylar approach/skull","description":"Transcondylar (far lateral) approach to posterior cranial fossa, jugular foramen or midline skull base, including occipital condylectomy, mastoidectomy, resection of c1-c3 vertebral body(s), decompression of vertebral artery, with or without mobilization","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3187.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9128","name":"Photobio therpy-first 15 min","description":"Photobio therpy-first 15 min","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0726T","name":"Rmvl implt vstibular dev uni","description":"Removal of implanted vestibular device, unilateral","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33370","name":"Tcat plmt&rmvl cepd perq","description":"Transcatheter placement and subsequent removal of cerebral embolic protection device(s), including arterial access, catheterization, imaging, and radiological supervision and interpretation, percutaneous (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0557","name":"Adv prim care mgmt lvl 2","description":"Advanced primary care management services for a patient with multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, which place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline, provided by c","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76989","name":"Dx intraop epcar us chd i&r","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; interpretation and report only","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90612","name":"Inf&sarscov2 vacc 31.7/.32im","description":"Influenza virus vaccine, trivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 31.7 mcg/0.32 ml dosage, for intramuscular use","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4286","name":"Remove non-resorb barrier","description":"Remove non-resorb barrier","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J1441","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1497","name":"No doc fall med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37211","name":"Thrombolytic art therapy","description":"Transcatheter therapy, arterial infusion for thrombolysis other than coronary or intracranial, any method, including radiological supervision and interpretation, initial treatment day","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":488.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90474","name":"Immune admin oral/nasal addl","description":"Immunization administration by intranasal or oral route; each additional vaccine (single or combination vaccine/toxoid) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J1563","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69210","name":"Remove impacted ear wax uni","description":"Removal impacted cerumen requiring instrumentation, unilateral","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0332U","name":"Onc pan tum gen prflg 8 dna","description":"Onc pan tum gen prflg 8 dna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95834","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0843T","name":"Dgtz gls mcrscp cslt cyt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), initial site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6093","name":"Recement supp part denture","description":"Recement implant/abutment supported fixed partial denture","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0965T","name":"I&cst prp jw xpn dl arch non","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, non-fixed hinge mechanism","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21142","name":"Rcnstj midface lefort i 2pcs","description":"Reconstruction midface, lefort i; 2 pieces, segment movement in any direction, without bone graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1529.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15845","name":"Skin and muscle repair face","description":"Graft for facial nerve paralysis; regional muscle transfer","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1004.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6610","name":"G com stcking bk 18-30 custm","description":"Gradient compression stocking, below knee, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":226.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3404","name":"Inj zopapogene per ther dose","description":"Injection, zopapogene imadenovec-drba suspension, per therapeutic dose","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0378U","name":"Rfc1 repeat xpnsj vrnt alys","description":"Rfc1 repeat xpnsj vrnt alys","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86043","name":"Acetylcholn rcptr modlg antb","description":"Acetylcholine receptor (achr); modulating antibody","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93586","name":"Vngrph chd coronary sinus","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; coronary sinus (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33366","name":"Trcath replace aortic valve","description":"Transcatheter aortic valve replacement (tavr/tavi) with prosthetic valve; transapical exposure (eg, left thoracotomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2110.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35131","name":"Repair defect of artery","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, iliac artery (common, hypogastric, external)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1768.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92636","name":"Hearing aid post-fitg f-up 1","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90624","name":"Menb-4c&menacwy vacc im","description":"Meningococcal pentavalent vaccine, men b-4c recombinant proteins and outer membrane vesicle and conjugated men a, c, w, y-diphtheria toxoid carrier, for intramuscular use","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0309U","name":"Crd cv ds aly 4 prtn plm alg","description":"Crd cv ds aly 4 prtn plm alg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9046","name":"Inj, bortezomib, dr. reddys","description":"Injection, bortezomib (dr. reddys), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2221","name":"Ank mcrop plant & dorsi flex","description":"Addition to lower extremity orthosis, ankle system, microprocessor-controlled feature plantarflexion and/or dorsiflexion, includes power source","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85027","name":"Complete cbc automated","description":"Blood count; complete (cbc), automated (hgb, hct, rbc, wbc and platelet count)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9871","name":"Bhv couns dm prev, onln 60 m","description":"Behavioral counseling for diabetes prevention, online, 60 minutes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1013T","name":"Lap srg imp/rpl eso nea&pg/r","description":"Laparoscopy, surgical, implantation or replacement of lower esophageal sphincter neurostimulator electrode array and neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver, including cruroplasty and/or electronic ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4346","name":"Shelter dm matrix per sq cm","description":"Shelter dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4356","name":"Abio mem abio hyd per sq cm","description":"Abiomend membrane and abiomend hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0614","name":"Inj, treosulfan, 50 mg","description":"Injection, treosulfan, 50 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0827T","name":"Dgtz gls mcrscp cytp smears","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; smears with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1310","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0308U","name":"Crd cad alys 3 prtn plsm alg","description":"Crd cad alys 3 prtn plsm alg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76017","name":"Mr sfty med physics xm cstmz","description":"Mr safety medical physics examination customization, planning and performance monitoring by medical physicist or mr safety expert, with review and analysis by physician or other qualified health care professional to prioritize and select views and imaging sequences, to tailor mr acquisition specific","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1454","name":"New cied","description":"New cied","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50340","name":"Recipient nephrectomy","description":"Recipient nephrectomy (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0979T","name":"Sbmcsl crylys ther sft palt","description":"Submucosal cryolysis therapy; soft palate only","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9615","name":"Inj, pegulicianine, 1 mg","description":"Injection, pegulicianine, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2044","name":"Biobrane glove, each","description":"Biobrane glove, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9244","name":"Office min sed drug enteral","description":"Office min sed drug enteral","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1241","name":"Pt no resp seen as person","description":"Patient did not respond to the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27071","name":"Part removal hip bone deep","description":"Partial excision, wing of ilium, symphysis pubis, or greater trochanter of femur, (craterization, saucerization) (eg, osteomyelitis or bone abscess); deep (subfascial or intramuscular)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1072.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64474","name":"Lwr xtr fscl pln blk uni nfs","description":"Lower extremity fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0733T","name":"Rem r-t mtn nrehab ther sply","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; supply and technical support, per 30 days","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0391","name":"Inj, artesunate, 1mg","description":"Injection, artesunate, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69727","name":"Rmv ntr oi imp sk tc esp<100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0403U","name":"Onc prst8 mrna 18 gen dre ur","description":"Onc prst8 mrna 18 gen dre ur","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0038","name":"Clin pt no ref","description":"Clinician determines patient does not require referral","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4003","name":"Emergency med ss","description":"Emergency medicine mips specialty set","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0456","name":"Azithromycin","description":"Injection, azithromycin, 500 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44391","name":"Colonoscopy for bleeding","description":"Colonoscopy through stoma; with control of bleeding, any method","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87084","name":"Culture of specimen by kit","description":"Culture, presumptive, pathogenic organisms, screening only; with colony estimation from density chart","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61892","name":"Rmv sk-mnt crnl nstm pg/rcvr","description":"Removal of skull-mounted cranial neurostimulator pulse generator or receiver with cranioplasty, when performed","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1005T","name":"Elec alys s-scl eeg prgr 1st","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, first 15 minutes face-to-face time with physician or other qualified hea","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1418","name":"Med rsn not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination because of a medical contraindication documented by clinician","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5228","name":"Immed mand part denture","description":"Immed mand part denture","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0824T","name":"Tcat rmv 1chmbr ldls pm ra","description":"Transcatheter removal of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography), when performed","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0985T","name":"Iv img xtrc cere vsl oct ea","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0602","name":"Sevelamer carbonate pdr 20mg","description":"Sevelamer carbonate (renvela or therapeutically equivalent), oral, powder, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0997T","name":"Precuneus mag stimj tx plng","description":"Precuneus magnetic stimulation; treatment planning using magnetic resonance imaging-guided neuronavigation to determine optimal location, dose, and intensity for magnetic stimulation therapy, derived from evoked potentials from single pulses of electromagnetic energy recorded by 64-channel electroen","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85613","name":"Russell viper venom diluted","description":"Russell viper venom time (includes venom); diluted","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9334","name":"Inj efgart-alfa 2mg hya-qvfc","description":"Injection, efgartigimod alfa, 2 mg and hyaluronidase-qvfc","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0894T","name":"Cannulation liver allograft","description":"Cannulation of the liver allograft in preparation for connection to the normothermic perfusion device and decannulation of the liver allograft following normothermic perfusion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9051","name":"Inj, bortezomib (maia)","description":"Injection, bortezomib (maia), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0618U","name":"Psyc bd dna mthyl alys>10000","description":"Psyc bd dna mthyl alys>10000","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33278","name":"Rmvl phrnc nrv stim sys","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; system, including pulse generator and lead(s)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33902","name":"Perq p-art revsc 1 abnor uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, unilateral","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42808","name":"Excise pharynx lesion","description":"Excision or destruction of lesion of pharynx, any method","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5098","name":"Inj ustekinumab-srlf, 1 mg","description":"Injection, ustekinumab-srlf (imuldosa), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0678T","name":"Laps repos lead isdss ea add","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional repositioned lead (list separately in addition to code for primary proce","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37271","name":"Revsc evsc fpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9988","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1021T","name":"Active thrc irrigation spx","description":"Active thoracic irrigation (separate procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92635","name":"Hearing aid fitg svc ea addl","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; each additional 15 minutes (list separately in addition to code","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0757T","name":"Dgtz gls mcrscp sl spc grpii","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group ii, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistochemistry (list separately in addition to code for primary","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1352","name":"Suicd c-ssrs assessment, equ","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs or equivalent assessment","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87210","name":"Smear wet mount saline/ink","description":"Smear, primary source with interpretation; wet mount for infectious agents (eg, saline, india ink, koh preps)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86037","name":"Anca titer each antibody","description":"Antineutrophil cytoplasmic antibody (anca); titer, each antibody","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0586U","name":"Onc mrna gen xprsn 216 genes","description":"Onc mrna gen xprsn 216 genes","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0045","name":"Mrs 90 days post stk","description":"Clinical follow-up and mrs score assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76778","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4306","name":"Americ amnion ac per sq cm","description":"American amnion ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51520","name":"Removal of bladder lesion","description":"Cystotomy; for simple excision of vesical neck (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":643.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1302","name":"Inj, sutimlimab-jome, 10 mg","description":"Injection, sutimlimab-jome, 10 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1324","name":"Pts intravitreal/pci","description":"Patients who had an intravitreal or periocular corticosteroid injection (e.g., triamcinolone, preservative-free triamcinolone, dexamethasone, dexamethasone intravitreal implant, or fluocinolone intravitreal implant)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53250","name":"Removal of urethra gland","description":"Excision of bulbourethral gland (cowpers gland)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":427.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1402","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15016","name":"App skn cl ssp agrf t/a/l ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; each additional 480 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J3487","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0814T","name":"Prq njx biod osteo matrl fem","description":"Percutaneous injection of calcium-based biodegradable osteoconductive material, proximal femur, including imaging guidance, unilateral","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2151","name":"Inj, mannitol, 250 mg","description":"Injection, mannitol, 250 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4326","name":"Woundplus, per sq cm","description":"Woundplus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96372","name":"Ther/proph/diag inj sc/im","description":"Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1961","name":"Inj lenacapavir (hiv tx) 1mg","description":"Injection, lenacapavir (only for use as hiv treatment), 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70544","name":"Mr angiography head w/o dye","description":"Magnetic resonance angiography, head; without contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":648.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93585","name":"Vngrph chd azygs/hemiazygs","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; azygos/hemiazygos venous system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0724T","name":"Qmrcp w/dx mri same anatomy","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained with diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in additio","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10121","name":"Inc&rmvl fb subq tiss comp","description":"Incision and removal of foreign body, subcutaneous tissues; complicated","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":196.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0889T","name":"Prsnlz trgt dvl arhfcmrigtbs","description":"Personalized target development for accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation derived from a structural and resting-state functional mri, including data preparation and transmission, generation of the target, motor threshold-starting location, neuro","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5140","name":"Inj adalimumab-fkjp, 1 mg","description":"Injection, adalimumab-fkjp, biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92020","name":"Gonioscopy","description":"Gonioscopy (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9072","name":"Inj cyclophos frindovyx 5 mg","description":"Injection, cyclophosphamide (frindovyx), 5 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9382","name":"Inj zenocutuzumab-zbco 1 mg","description":"Injection, zenocutuzumab-zbco, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23474","name":"Revis reconst shoulder joint","description":"Revision of total shoulder arthroplasty, including allograft when performed; humeral and glenoid component","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2153.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77439","name":"Surf rad thr img gdn us plmt","description":"Surface radiation therapy; superficial or orthovoltage, image guidance, ultrasound for placement of radiation therapy fields for treatment of cutaneous tumors, per course of treatment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1266","name":"Pts admit snf","description":"Patients admitted to a skilled nursing facility (snf)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1495","name":"Fall w/ poc, no fall","description":"Patients that reported a fall occurred who had a plan of care for falls documented or patients that did not report a fall","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83519","name":"Ria nonantibody","description":"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, by radioimmunoassay (eg, ria)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35840","name":"Explore abdominal vessels","description":"Exploration for postoperative hemorrhage, thrombosis or infection; abdomen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0691T","name":"Auto alys xst ct std vrt fx","description":"Automated analysis of an existing computed tomography study for vertebral fracture(s), including assessment of bone density when performed, data preparation, interpretation, and report","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7485","name":"Surg reduct osseoustuberosit","description":"Surgical reduction of osseous tuberosity","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46922","name":"Excision of anal lesion(s)","description":"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; surgical excision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31730","name":"Intro windpipe wire/tube","description":"Transtracheal (percutaneous) introduction of needle wire dilator/stent or indwelling tube for oxygen therapy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0832T","name":"Dgtz gls mcrscp cytp oth scr","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76818","name":"Fetal biophys profile w/nst","description":"Fetal biophysical profile; with non-stress testing","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93642","name":"Ep evl 1/2chmb trnsvns cvdfb","description":"Electrophysiologic evaluation of single or dual chamber transvenous pacing cardioverter-defibrillator (includes defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing and pacing for arrhythmia termination, and programming or reprogramming of sensing or therapeutic parame","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":685.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4264","name":"Cocoon membrane, per sq cm","description":"Cocoon membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0536","name":"Peer recover support svs","description":"Peer recovery support services, provided directly or by referral; including leveraging knowledge of the condition or lived experience to provide support, mentorship, or inspiration to meet oud treatment and recovery goals; conducting a person-centered interview to understand the patients life story,","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45384","name":"Colonoscopy w/lesion removal","description":"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0802T","name":"Tcat rmv&rpl2chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right at","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1885","name":"Ketorolac tromethamine inj","description":"Injection, ketorolac tromethamine, per 15 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4421","name":"Biolab wrap solo per sq cm","description":"Biolab membrane wrap solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0743T","name":"B1 str & fx rsk vrt fx assmt","description":"Bone strength and fracture risk using finite element analysis of functional data and bone mineral density (bmd), with concurrent vertebral fracture assessment, utilizing data from a computed tomography scan, retrieval and transmission of the scan data, measurement of bone strength and bmd and classi","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98985","name":"Rtm dev sply mscsk sys 2-15d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of musculoskeletal system, 2-15 days in a 30-day period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"Breathing capacity test","description":"Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement(s), with or without maximal voluntary ventilation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0666","name":"Team remote e/m est pt 15 mn","description":"Team remote e/m est. pt 15mins","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6031","name":"Rep interface handfng molded","description":"Replacement socket/interface, partial hand including fingers, molded to patient model, for use with or without external power","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97009","name":"Mchnl sclp cool after chemo","description":"Mechanical scalp cooling; provided after discontinuation of chemotherapy, each 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86658","name":"Enterovirus antibody","description":"Antibody; enterovirus (eg, coxsackie, echo, polio)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0708","name":"Intraoral bite radio image","description":"Intraoral bite radio image","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15013","name":"Prepj skn cll ssp agrft 1st","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; first 25 sq cm or less of harvested skin","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3473","name":"Surg rep root res molar","description":"Surg rep root res molar","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0663","name":"Team remote e/m new pt 45 mn","description":"Team remote e/m new pt 45mins","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23145","name":"Removal of bone lesion","description":"Excision or curettage of bone cyst or benign tumor of clavicle or scapula; with autograft (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":822.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96160","name":"Pt-focused hlth risk assmt","description":"Administration of patient-focused health risk assessment instrument (eg, health hazard appraisal) with scoring and documentation, per standardized instrument","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93875","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95928","name":"C motor evoked uppr limbs","description":"Central motor evoked potential study (transcranial motor stimulation); upper limbs","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33901","name":"Perq p-art revsc 1 nm nt bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, bilateral","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1643","name":"Inj heparin, pfizer, 1000u","description":"Injection, heparin sodium (pfizer), not therapeutically equivalent to j1644, per 1000 units","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0024","name":"Pin srv add 30 min pr m","description":"Principal illness navigation services, additional 30 minutes per calendar month (list separately in addition to g0023)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0742T","name":"Aqmbf spect xers/strs & rest","description":"Absolute quantitation of myocardial blood flow (aqmbf), single-photon emission computed tomography (spect), with exercise or pharmacologic stress, and at rest, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87255","name":"Genet virus isolate hsv","description":"Virus isolation; including identification by non-immunologic method, other than by cytopathic effect (eg, virus specific enzymatic activity)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0422U","name":"Onc pan solid tum alys dna","description":"Onc pan solid tum alys dna","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0754T","name":"Dgtz gls mcrscp sld level v","description":"Digitization of glass microscope slides for level v, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4302","name":"Complete aca, per sq cm","description":"Complete aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0267U","name":"Rare do id opt gen mapg&seq","description":"Rare constitutional and other heritable disorders, identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping and whole-genome sequencing","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87472","name":"Bartonella dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); bartonella henselae and bartonella quintana, quantification","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1252","name":"Pts no cmplt hu survey","description":"Patients who did not complete at least one of the four patient experience hu survey items and return the hu survey within 60 days of the ambulatory palliative care visit","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4029","name":"Preventive medicine ss","description":"Preventive medicine mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0919T","name":"Rmvl perm ccm-d sys pg only","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); pulse generator only","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4274","name":"Esano ac, per sq cm","description":"Esano ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0385U","name":"Neph ckd alg rsk dbtc kdn ds","description":"Neph ckd alg rsk dbtc kdn ds","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1268","name":"Pt ac stat kid trnsplt wtlst","description":"Patients observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1019T","name":"Lymphovenous bypass per xtr","description":"Lymphovenous bypass, including robotic assistance, when performed, per extremity","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0495U","name":"Onc prst8 alys crcg plsm prt","description":"Onc prst8 alys crcg plsm prt","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76987","name":"Dx intraop epicar car us chd","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; including placement and manipulation of transducer, image acquisition, interpretation and report","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9275","name":"Inj cosibelimab-ipdl, 2 mg","description":"Injection, cosibelimab-ipdl, 2 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0662","name":"Team remote e/m new pt 30 mn","description":"Team remote e/m new pt 30 mins","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24331","name":"Flexor-plasty elbw w/advmnt","description":"Flexor-plasty, elbow (eg, steindler type advancement); with extensor advancement","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":962.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64659","name":"Rmvl bat modulj sys pg only","description":"Removal of baroreflex activation therapy (bat) modulation system; pulse generator only","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1395","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0345U","name":"Psyc genom alys pnl 15 gen","description":"Psyc genom alys pnl 15 gen","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0407U","name":"Neph dbtc ckd mult eclia alg","description":"Neph dbtc ckd mult eclia alg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84466","name":"Assay of transferrin","description":"Transferrin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1233","name":"Pt no hcv aby or result","description":"Patient does not receive hcv antibody test or patient does receive hcv antibody test but results not documented, reason not given","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0436U","name":"Onc lng plsm alys 388 prtn","description":"Onc lng plsm alys 388 prtn","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2779","name":"Inj, susvimo 0.1 mg","description":"Injection, ranibizumab, via intravitreal implant (susvimo), 0.1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60660","name":"Abltj 1/+thyr ndul 1lobe prq","description":"Ablation of 1 or more thyroid nodule(s), one lobe or the isthmus, percutaneous, including imaging guidance, radiofrequency","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4355","name":"Abio xpl abio xpl hy p sq cm","description":"Abiomend xplus membrane and abiomend xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57425","name":"Laparoscopy surg colpopexy","description":"Laparoscopy, surgical, colpopexy (suspension of vaginal apex)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1067.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0816T","name":"Opn insj/rplcmt ins ptn subq","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0469U","name":"Rare ds whl gen seq ftl samp","description":"Rare ds whl gen seq ftl samp","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0292U","name":"Psyc strs do mrna 72 genes","description":"Psyc strs do mrna 72 genes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0691T","name":"Auto alys xst ct std vrt fx","description":"Automated analysis of an existing computed tomography study for vertebral fracture(s), including assessment of bone density when performed, data preparation, interpretation, and report","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1191","name":"Hspc svc any time in meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1378","name":"Med rsn no 10 yr fu colscope","description":"Documentation of medical reason(s) for not recommending a 10 year follow-up interval (e.g., inadequate prep, familial or personal history of colonic polyps, patient had no adenoma and age is >= 66 years old, or life expectancy < 10 years, other medical reasons)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4564","name":"Pessary, disposable any type","description":"Pessary, disposable, any type","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0675T","name":"Laps insj nw/rpcmt isdss 1ld","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first lead","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0249","name":"Adm tocilizu covid-19 1st","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2020","name":"Ac5 wound system","description":"Ac5 advanced wound system (ac5)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01942","name":"Anes neuromd/ntrvrt lmbr/sac","description":"Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2012","name":"Suprathel, per sq cm","description":"Suprathel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0899T","name":"N-invas deter aqmbf aug cmr","description":"Noninvasive determination of absolute quantitation of myocardial blood flow (aqmbf), derived from augmentative algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health car","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98014","name":"Synch audio-only est mod 30","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code s","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37208","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96423","name":"Chemo ia infuse each addl hr","description":"Chemotherapy administration, intra-arterial; infusion technique, each additional hour (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9172","name":"Docetaxel (docivyx), 1 mg","description":"Injection, docetaxel (docivyx), 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0257U","name":"Vlcad leuk nzm actv whl bld","description":"Very long chain acyl- coenzyme a (coa) dehydrogenase (vlcad), leukocyte enzyme activity, whole blood","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0318U","name":"Ped whl gen mthyltn alys 50+","description":"Ped whl gen mthyltn alys 50+","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94681","name":"O2 uptk co2 outp % o2 xtrc","description":"Oxygen uptake, expired gas analysis; including co2 output, percentage oxygen extracted","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0484","name":"Consult slides prep elsewher","description":"Consultation on slides prepared elsewhere","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0822T","name":"Mntr psychdlc med cln staff","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; clinical staff under the direction of a physician or other qualified health care professional, concurrent with first physician or other qualified health care p","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0470U","name":"Onc orop detcj mrd 8 dna hpv","description":"Onc orop detcj mrd 8 dna hpv","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0744T","name":"Insj bioprostc vlv fem vn","description":"Insertion of bioprosthetic valve, open, femoral vein, including duplex ultrasound imaging guidance, when performed, including autogenous or nonautogenous patch graft (eg, polyester, eptfe, bovine pericardium), when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5995","name":"Peri medicament w/seal, max","description":"Peri medicament w/seal, max","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77416","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0030","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0507U","name":"Onc ovr dna whole gen w/5hmc","description":"Onc ovr dna whole gen w/5hmc","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0461","name":"Testing for cracked tooth","description":"Testing for cracked tooth","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1306","name":"Pt anphx due to pneum","description":"Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4389","name":"Neothelium 4l+ per sq cm","description":"Neothelium 4l+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0945T","name":"Intraop assmt abnl tum tiss","description":"Intraoperative assessment for abnormal (tumor) tissue, in-vivo, following partial mastectomy (eg, lumpectomy) using computer-aided fluorescence imaging (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0297U","name":"Onc pan tum whl gen seq dna","description":"Onc pan tum whl gen seq dna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0839T","name":"Dgtz gls mcrscp cslt mat prp","description":"Digitization of glass microscope slides for consultation and report on referred material requiring preparation of slides (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1711","name":"Moderna vacc admin booster","description":"Moderna vacc admin booster","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0681","name":"App of non-sheet skin sub","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; first 25 sq cm or less of wound surface area","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1390","name":"Pt no doc exm for rec","description":"Patients who do not have a documented exam performed for recurrence of melanoma or no documentation within the performance period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30118","name":"Removal of intranasal lesion","description":"Excision or destruction (eg, laser), intranasal lesion; external approach (lateral rhinotomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0563","name":"Sbrt w/positron emission del","description":"Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance and real-time positron emissions-based delivery adjustments to 1 or more lesions, entire course not to exceed 5 fractions","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0608U","name":"Reprdtve med ema rtpcr 10bct","description":"Reprdtve med ema rtpcr 10bct","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54130","name":"Remove penis & nodes","description":"Amputation of penis, radical; with bilateral inguinofemoral lymphadenectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1301.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69716","name":"Impl oi implt sk tc esp<100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or resulting in removal of less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":341.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49422","name":"Remove tunneled ip cath","description":"Removal of tunneled intraperitoneal catheter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6035","name":"Prosthetic digit mechanical","description":"Single prosthetic digit, mechanical, can include metacarpophalangeal (mcp), proximal interphalangeal (pip), and/or distal interphalangeal (dip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6211","name":"Bridge base metal cast","description":"Pontic-cast predominantly base metal","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60600","name":"Remove carotid body lesion","description":"Excision of carotid body tumor; without excision of carotid artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1393.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0872T","name":"Rplcmt ndwllg bldr&prtl cath","description":"Replacement of indwelling bladder and peritoneal catheters, including tunneling of catheter(s) and connection with previously implanted peritoneal ascites pump, including imaging and programming, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11308","name":"Shave skin lesion >2.0 cm","description":"Shaving of epidermal or dermal lesion, single lesion, scalp, neck, hands, feet, genitalia; lesion diameter over 2.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0941T","name":"Cysto flx ins&xpns urtl scaf","description":"Cystourethroscopy, flexible; with insertion and expansion of prostatic urethral scaffold using integrated cystoscopic visualization","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93595","name":"L hrt cath chd nm/abn nt cnj","description":"Left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone, normal or abnormal native connections","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4324","name":"Amniotx, per sq cm","description":"Amniotx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0053","name":"Ht mental health and care","description":"Historical trauma (ht) mental health and clinical care for indigenous persons","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33278","name":"Rmvl phrnc nrv stim sys","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; system, including pulse generator and lead(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61440","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2211.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0582U","name":"Rare ds rpd whlgen dna vrnts","description":"Rare ds rpd whlgen dna vrnts","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0776T","name":"Ther indctj ntrabrn hypthrm","description":"Therapeutic induction of intra-brain hypothermia, including placement of a mechanical temperature-controlled cooling device to the neck over carotids and head, including monitoring (eg, vital signs and sport concussion assessment tool 5 [scat5]), 30 minutes of treatment","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1305","name":"Inj, evinacumab-dgnb, 5mg","description":"Injection, evinacumab-dgnb, 5mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3391","name":"Inj, atidarsagene autotemcel","description":"Injection, atidarsagene autotemcel, per treatment","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81441","name":"Ibmfs seq alys pnl 30 genes","description":"Inherited bone marrow failure syndromes (ibmfs) (eg, fanconi anemia, dyskeratosis congenita, diamond-blackfan anemia, shwachman-diamond syndrome, gata2 deficiency syndrome, congenital amegakaryocytic thrombocytopenia) sequence analysis panel, must include sequencing of at least 30 genes, including b","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36261","name":"Revision of infusion pump","description":"Revision of implanted intra-arterial infusion pump","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5227","name":"Immed max part denture","description":"Immed max part denture","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0322U","name":"Neuro asd meas 14 acyl carn","description":"Neuro asd meas 14 acyl carn","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9992","name":"Pall serv during meas","description":"Palliative care services used by patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0815T","name":"Us rems b1 dns hips plvs/spi","description":"Ultrasound-based radiofrequency echographic multi-spectrometry (rems), bone-density study and fracture-risk assessment, 1 or more sites, hips, pelvis, or spine","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0401U","name":"Crd c hrt ds 9 gen 12 vrnts","description":"Crd c hrt ds 9 gen 12 vrnts","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3244","name":"Inj. tigecycline (accord)","description":"Injection, tigecycline (accord), not therapeutically equivalent to j3243, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0283U","name":"Vw factor type 2b eval plsm","description":"Von willebrand factor (vwf), type 2b, platelet-binding evaluation, radioimmunoassay, plasma","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0622U","name":"Psyc mdd dna alys >20000","description":"Psyc mdd dna alys >20000","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0396","name":"3d print of 3d surface scan","description":"3d print of 3d surface scan","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9003","name":"Leupro inj, camcevi etm, 1mg","description":"Leuprolide injectable (camcevi etm), 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2051","name":"Support broker waiver/diem","description":"Supports brokerage, self-directed, waiver; per diem","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1344","name":"No bsln/2nd pam score 4-12mo","description":"Patients who did not have a baseline pam score and/or a second score within 4 to 12 months of baseline pam score","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6527","name":"G garmt full leg/ft nght cus","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, custom, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86258","name":"Dgp antibody each ig class","description":"Gliadin (deamidated) (dgp) antibody, each immunoglobulin (ig) class","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":12.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93742","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93146","name":"Interrog crtd sins bat ip w/","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0492U","name":"Onc sol tum ctc slctn pd-l1","description":"Onc sol tum ctc slctn pd-l1","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55714","name":"Bx prst8 in-bore ct/mri 1","description":"Biopsy, prostate, in-bore ct- or mri-guided targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93586","name":"Vngrph chd coronary sinus","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; coronary sinus (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6252","name":"Bridge resin w/noble metal","description":"Pontic-resin with noble metal","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0928T","name":"Rem interrog dev ccm-d phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system with interim analysis and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4241","name":"Gngvl flap w rootplan 1-3 th","description":"Gingival flap procedure including root planing - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4036","name":"Urgent care ss","description":"Urgent care mips specialty set","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0472","name":"Gross exam prep & report","description":"Accession of tissue gross examination preparation and transmission of written report","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3055","name":"Inj talquetamab-tgvs 0.25 mg","description":"Injection, talquetamab-tgvs, 0.25 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96547","name":"Intraop hipec px 1st 60 min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; first 60 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":645.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61313","name":"Crnec/crnot sttl icere","description":"Craniectomy or craniotomy for evacuation of hematoma, supratentorial; intracerebral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2133.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34704","name":"Evasc rpr a-unilac ndgft rpt","description":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-uni-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in th","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2468.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0570","name":"Care manage serv, pr cal mo","description":"Care management services for behavioral health conditions, directed by a physician or other qualified health care professional, per calendar month, with the following required elements: initial assessment or follow-up monitoring, including the use of applicable validated rating scales, behavioral he","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2801","name":"Inj, rykindo, 0.5 mg","description":"Injection, risperidone (rykindo), 0.5 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99392","name":"Prev visit est age 1-4","description":"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; early","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":124.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98012","name":"Synch audio-only est sf 10","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3402","name":"Inj. remestemcel-l-rknd/ td","description":"Injection, remestemcel-l-rknd, per therapeutic dose","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0063","name":"Cardiology ss","description":"Cardiology mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80504","name":"Path clin consltj mod 21-40","description":"Pathology clinical consultation; for a moderately complex clinical problem, with review of patients history and medical records and moderate level of medical decision making when using time for code selection, 21-40 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4330","name":"Total, per sq cm","description":"Total, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4011","name":"Internal medicine ss","description":"Internal medicine mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0388U","name":"Onc nonsm cll lng ca 37 gen","description":"Onc nonsm cll lng ca 37 gen","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0753T","name":"Dgtz gls mcrscp sld level iv","description":"Digitization of glass microscope slides for level iv, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31241","name":"Nsl/sns ndsc lig sphnptn art","description":"Nasal/sinus endoscopy, surgical; with ligation of sphenopalatine artery","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99275","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7300","name":"Rem anchorage dev w/o flap","description":"Rem anchorage dev w/o flap","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0802","name":"3d dental scan indirect","description":"3d dental scan indirect","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5939","name":"Resct proth mand comp remov","description":"Resct proth mand comp remov","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33900","name":"Perq p-art revsc 1 nm nt uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, unilateral","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3387","name":"Inj elivaldogene autotemecel","description":"Injection, elivaldogene autotemcel, per treatment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6602","name":"Cst hgh nble mtl inlay 2 srf","description":"Inlay - cast high noble metal two surfaces","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0989T","name":"Revj/rmvl ins ptn subq&subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9256","name":"Inj, nipocalimab-aahu, 3 mg","description":"Injection, nipocalimab-aahu, 3 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0668","name":"Instill, bupivac and meloxic","description":"Instillation, bupivacaine and meloxicam, 1 mg/0.03 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1287","name":"Calc bmi blw low param f/u","description":"Bmi is documented below normal parameters and a follow-up plan is documented","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2353","name":"Octreotide injection, depot","description":"Injection, octreotide, depot form for intramuscular injection, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4289","name":"Revoshield+ amnio, per sq cm","description":"Revoshield + amniotic barrier, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9246","name":"Mod sedation noniv-15 min","description":"Mod sedation noniv-15 min","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80061","name":"Lipid panel","description":"Lipid panel this panel must include the following: cholesterol, serum, total (82465) lipoprotein, direct measurement, high density cholesterol (hdl cholesterol) (83718) triglycerides (84478)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62331","name":"Dcmprn prq rmv lig flv addl","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; additional interspace(s), lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":100.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77439","name":"Surf rad thr img gdn us plmt","description":"Surface radiation therapy; superficial or orthovoltage, image guidance, ultrasound for placement of radiation therapy fields for treatment of cutaneous tumors, per course of treatment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1398","name":"Bslne and  fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0573U","name":"Onc pancreas 3bmrk pclf alg","description":"Onc pancreas 3bmrk pclf alg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0992T","name":"N-invas assmt car rsk w/o ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat without concurrent computed tomography (ct) scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"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":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4392","name":"Grafix duo per sq cm","description":"Grafix duo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6191","name":"Semi precision abutment","description":"Semi precision abutment","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q2007","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90484","name":"Imm cnsl not admn sm>20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 20 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4395","name":"Acelagraft per sq cm","description":"Acelagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1474","name":"Pt dx dementia","description":"Patients with diagnosis of dementia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4331","name":"Axolotl graft, per sq cm","description":"Axolotl graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6191","name":"Semi precision abutment","description":"Semi precision abutment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4334","name":"Amnioplast 1, per sq cm","description":"Amnioplast 1, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0306U","name":"Onc mrd nxt-gnrj alys 1st","description":"Onc mrd nxt-gnrj alys 1st","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90593","name":"Chikungunya vacc recomb im","description":"Chikungunya virus vaccine, recombinant, for intramuscular use","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87812","name":"Sarscov2&inf typ a&b w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) and influenza virus types a and b","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0818T","name":"Revj/rmvl ins ptn subq","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1488","name":"Dx dementia in msr timeframe","description":"Patients with a diagnosis for dementia in the year before or during the period of evaluation","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9225","name":"Gen anes adv air-sub 15 min","description":"Gen anes adv air-sub 15 min","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4292","name":"Lamellas, per sq cm","description":"Lamellas, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0598U","name":"Gi ibs igg antb 18food items","description":"Gi ibs igg antb 18food items","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76604","name":"Us exam chest","description":"Ultrasound, chest (includes mediastinum), real time with image documentation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1239","name":"Pt no resp heard","description":"Patient did not respond to the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44151","name":"Removal of colon/ileostomy","description":"Colectomy, total, abdominal, without proctectomy; with continent ileostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1953.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4367","name":"Amniocore sl, per sq cm","description":"Amniocore sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0951T","name":"Tot impl amei 1st plmt","description":"Totally implantable active middle ear hearing implant; initial placement, including mastoidectomy, placement of and attachment to sound processor","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3471","name":"Surg rep root res anterior","description":"Surg rep root res anterior","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1276","name":"Calc bmi out nrm param nof/u","description":"Bmi documented outside normal parameters, no follow-up plan documented, no reason given","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1383","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0484","name":"Consult slides prep elsewher","description":"Consultation on slides prepared elsewhere","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1184","name":"Doc med rsn no cst/ist rx","description":"Documentation of medical reason(s) for not prescribing or administering corticosteroid or immunosuppressant treatment (e.g., allergy, intolerance, infectious etiology, pancreatic insufficiency, hyperthyroidism, prior bowel surgical interventions, celiac disease, receiving other medication, awaiting ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1230","name":"Pt hcv rctv aby no f/u tst","description":"Patient has a reactive hcv antibody test and does not have a follow up hcv viral test, or patient has a reactive hcv antibody test and has a follow up hcv viral test that detects hcv viremia and is not referred to a clinician who treats hcv infection within 1 month and does not have hcv treatment in","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37268","name":"Revsc evasc fpvt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1194","name":"Med rsn no imp/con mmr/msi","description":"Documentation of medical reason(s) surgical pathology reports did not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both tests were not included (e.g., patient will not be treated with checkpoint inhibitor therap","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1354","name":"Int caries med app per tooth","description":"Interim caries med app","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4343","name":"Dermacyte ac matrx per sq cm","description":"Dermacyte ac matrix amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90966","name":"Esrd home pt serv p mo 20+","description":"End-stage renal disease (esrd) related services for home dialysis per full month, for patients 20 years of age and older","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87903","name":"Phenotype dna hiv w/culture","description":"Infectious agent phenotype analysis by nucleic acid (dna or rna) with drug resistance tissue culture analysis, hiv 1; first through 10 drugs tested","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":682.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0555U","name":"Repr med pga embryonic te qc","description":"Repr med pga embryonic te qc","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92137","name":"Cptrz oph img pst sg rta oct","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), posterior segment, with interpretation and report, unilateral or bilateral; retina, including oct angiography","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0765T","name":"Asstv alg ecg rsk asmt prev","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to previously performed electrocardiogram","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1501","name":"Pathology mvp","description":"Pathology mips value pathway","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0777T","name":"R-t prs sensing edrl gdn sys","description":"Real-time pressure-sensing epidural guidance system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55713","name":"Bx prst8 in-bore ct/mri bx 1","description":"Biopsy, prostate, in-bore ct- or mri-guided (ie, sextant), with biopsy of additional targeted lesion(s), first targeted lesion","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0538","name":"Ascvd rsk mng clin stf pr mo","description":"Atherosclerotic cardiovascular disease (ascvd) risk management services; clinical staff time; per calendar month","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10060","name":"I&d abscess simple/single","description":"Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); simple or single","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":43.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":117.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98012","name":"Synch audio-only est sf 10","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83655","name":"Assay of lead","description":"Lead","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10121","name":"Inc&rmvl fb subq tiss comp","description":"Incision and removal of foreign body, subcutaneous tissues; complicated","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":184.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66720","name":"Destruction ciliary body","description":"Ciliary body destruction; cryotherapy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78491","name":"Myocrd img pet 1std rst/strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); single study, at rest or stress (exercise or pharmacologic)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1475","name":"Pt dx huntington","description":"Patients with diagnosis of huntingtons disease","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97551","name":"Caregiver traing ea addl 15","description":"Caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patie","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0784T","name":"Ins/rplmt eltrd ra spi nstim","description":"Insertion or replacement of percutaneous electrode array, spinal, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0556","name":"Adv prim care mgmt lvl 1","description":"Advanced primary care management services for a patient with one chronic condition [expected to last at least 12 months, or until the death of the patient, which place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline], or fewer, provided by clinical ","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0563U","name":"Nfct ds pthgn-sna 11vir&4bct","description":"Nfct ds pthgn-sna 11vir&4bct","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27704","name":"Removal of ankle implant","description":"Removal of ankle implant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":659.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77091","name":"Tbs techl calculation only","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical calculation only","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1289","name":"No pt tbco cess interv rng","description":"Patient identified as tobacco user did not receive tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0684","name":"App non-sheet skin sb g addl","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area or part thereof, or each additional 1% o","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3375","name":"Inj, vanco (tyzavan) 10mg","description":"Injection, vancomycin hydrochloride (tyzavan), not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1489","name":"Pt status doc","description":"Patient status documented","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3501","name":"Surg exp root surf anterior","description":"Surg exp root surf anterior","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0873T","name":"Revj subq prtl asct pmp sys","description":"Revision of a subcutaneously implanted peritoneal ascites pump system, any component (ascites pump, associated peritoneal catheter, associated bladder catheter), including imaging and programming, when performed","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99418","name":"Prolng ip/obs e/m ea 15 min","description":"Prolonged inpatient or observation evaluation and management service(s) time with or without direct patient contact beyond the required time of the primary service when the primary service level has been selected using total time, each 15 minutes of total time (list separately in addition to the cod","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0483","name":"Indirect immunofluorescence","description":"Indirect immunofluorescence","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0398U","name":"Gi baret esph dna mthyln aly","description":"Gi baret esph dna mthyln aly","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4009","name":"Hospitalists ss","description":"Hospitalists mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1952","name":"Afo spiral prefab ots","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, off-the-shelf","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0534","name":"Coordinated care/or referral","description":"Coordinated care and/or referral services, such as to adequate and accessible community resources to address unmet health-related social needs, including harm reduction interventions and recovery support services a patient needs and wishes to pursue, which significantly limit the ability to diagnose","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0525U","name":"Onc sphrd cell cul 11-rx pnl","description":"Onc sphrd cell cul 11-rx pnl","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92641","name":"Hearing dev verif eacous aly","description":"Hearing device verification, electroacoustic analysis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0458U","name":"Onc brst ca s100 a8&a9 elisa","description":"Onc brst ca s100 a8&a9 elisa","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","name":"Scoliosis orth sag/ cor","description":"Scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla to trochanter, includes all accessory pads, straps and interface, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2004","name":"Inj, lidocaine w epinephrine","description":"Injection, lidocaine hcl with epinephrine, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0004","name":"Qual care neurologic cnd mvp","description":"Quality care for patients with neurological conditions mips value pathway","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0890T","name":"Arhfcmrigtbs 1st tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including target assessment, initial motor threshold determination, neuronavigation, delivery and management, initial treatment day","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7519","name":"Inj. mycophenolate mofetil","description":"Injection, mycophenolate mofetil, 10 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51555","name":"Partial removal of bladder","description":"Cystectomy, partial; complicated (eg, postradiation, previous surgery, difficult location)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1383.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0871T","name":"Rplcmt subq prtl ascites pmp","description":"Replacement of a subcutaneous peritoneal ascites pump, including reconnection between pump and indwelling bladder and peritoneal catheters, including initial programming and imaging, when performed","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0683","name":"App of non-sheet skin sub g","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9331","name":"Inj sirolimus prot part 1 mg","description":"Injection, sirolimus protein-bound particles, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8522","name":"Capecitabine, oral, 50 mg","description":"Capecitabine, oral, 50 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5148","name":"Inj, nyposi 1 mcg","description":"Injection, filgrastim-txid (nypozi), biosimilar, 1 microgram","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0838T","name":"Dgtz gls mcrscp cslt sld els","description":"Digitization of glass microscope slides for consultation and report on referred slides prepared elsewhere (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49591","name":"Rpr aa hrn 1st < 3 cm rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, reducible","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47141","name":"Partial removal donor liver","description":"Donor hepatectomy (including cold preservation), from living donor; total left lobectomy (segments ii, iii and iv)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4345.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0678T","name":"Laps repos lead isdss ea add","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional repositioned lead (list separately in addition to code for primary proce","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87564","name":"Mtb rifampin rst amp prb tq","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacterium tuberculosis, rifampin resistance, amplified probe technique","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1357","name":"Pt w/red suic idea 120 days","description":"Patients who had a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4321","name":"Renograft, per sq cm","description":"Renograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0708","name":"Intraoral bite radio image","description":"Intraoral bite radio image","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3503","name":"Surg exp root surf molar","description":"Surg exp root surf molar","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4002","name":"Ep cardio ss","description":"Electrophysiology cardiac specialist mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92550","name":"Tympanometry & reflex thresh","description":"Tympanometry and reflex threshold measurements","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0402","name":"Inj, abilify asimtufii, 1 mg","description":"Injection, aripiprazole (abilify asimtufii), 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4252","name":"Vendaje, per square centimet","description":"Vendaje, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1434","name":"Orl chemo wthn 30 d post enc","description":"Patient on oral chemotherapy on or within 30 days after denominator eligible encounter","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1301","name":"Pt recv tbco cess interv","description":"Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0272U","name":"Hem genetic bld do 51 genes","description":"Hematology (genetic bleeding disorders), genomic sequence analysis of 51 genes, blood, buccal swab, or amniotic fluid, comprehensive","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4377","name":"Trigraft ft per sq cm","description":"Trigraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20650","name":"Insert and remove bone pin","description":"Insertion of wire or pin with application of skeletal traction, including removal (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0385U","name":"Neph ckd alg rsk dbtc kdn ds","description":"Neph ckd alg rsk dbtc kdn ds","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86480","name":"Tb test cell immun measure","description":"Tuberculosis test, cell mediated immunity antigen response measurement; gamma interferon","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42975","name":"Dise eval slp do brth flx dx","description":"Drug-induced sleep endoscopy, with dynamic evaluation of velum, pharynx, tongue base, and larynx for evaluation of sleep-disordered breathing, flexible, diagnostic","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27372","name":"Removal of foreign body","description":"Removal of foreign body, deep, thigh region or knee area","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":481.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"Adju cgm supply allowance","description":"Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4034","name":"Speech language path ss","description":"Speech language pathology mips specialty set","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55881","name":"Ablt trurl prst8 tis thrm us","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation;","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0144A","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0985T","name":"Iv img xtrc cere vsl oct ea","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0393U","name":"Neu prksn msfl a-syncln prtn","description":"Neu prksn msfl a-syncln prtn","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0889T","name":"Prsnlz trgt dvl arhfcmrigtbs","description":"Personalized target development for accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation derived from a structural and resting-state functional mri, including data preparation and transmission, generation of the target, motor threshold-starting location, neuro","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4468","name":"Exsuff belt incl all sup acc","description":"Exsufflation belt, includes all supplies and accessories","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0479U","name":"Tau phosphorylated ptau217","description":"Tau phosphorylated ptau217","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0711T","name":"N-nvs artl plaq alys dat prp","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data preparation and transmission","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86258","name":"Dgp antibody each ig class","description":"Gliadin (deamidated) (dgp) antibody, each immunoglobulin (ig) class","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1344","name":"No bsln/2nd pam score 4-12mo","description":"Patients who did not have a baseline pam score and/or a second score within 4 to 12 months of baseline pam score","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6112","name":"Imp/abut rem dent part max","description":"Imp/abut rem dent part max","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0249","name":"Adm tocilizu covid-19 1st","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2782","name":"Crown 3/4 cast noble metal","description":"Crown - 3/4 cast noble metal","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1502","name":"Podiatry mvp","description":"Podiatry mips value pathway","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33897","name":"Perq trluml angp nt/recr coa","description":"Percutaneous transluminal angioplasty of native or recurrent coarctation of the aorta","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55711","name":"Bx prst8 trct mri-us 1st","description":"Biopsy, prostate, transrectal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0935T","name":"Cysto w/rnl pel symp dnrvtj","description":"Cystourethroscopy with renal pelvic sympathetic denervation, radiofrequency ablation, retrograde ureteral approach, including insertion of guide wire, selective placement of ureteral sheath(s) and multiple conformable electrodes, contrast injection(s), and fluoroscopy, bilateral","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5153","name":"Inj, aflibercept-yszy, 1 mg","description":"Injection, aflibercept-yszy (opuviz), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0871T","name":"Rplcmt subq prtl ascites pmp","description":"Replacement of a subcutaneous peritoneal ascites pump, including reconnection between pump and indwelling bladder and peritoneal catheters, including initial programming and imaging, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0502","name":"Other oral pathology procedu","description":"Other oral pathology procedures by report","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82274","name":"Assay test for blood fecal","description":"Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0734T","name":"Rem r-t mtn nrehab tx mgmt","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; treatment management services by a physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69644","name":"Revise middle ear & mastoid","description":"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with intact or reconstructed canal wall, with ossicular chain reconstruction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1751.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9321","name":"Inj epcoritamab-bysp 0.16 mg","description":"Injection, epcoritamab-bysp, 0.16 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9957","name":"Screening sleep disorders","description":"Screening sleep disorders","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5657","name":"Add low ext man aut vol any","description":"Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0751T","name":"Dgtz gls mcrscp sld level ii","description":"Digitization of glass microscope slides for level ii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0519","name":"New pt-cg dyad dem low cmplx","description":"Management of new patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35022","name":"Repair artery rupture chest","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, innominate, subclavian artery, by thoracic incision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1614.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1462","name":"Pt clin ind hd image","description":"Patients with clinical indications for imaging of the head","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0334U","name":"Onc sld orgn tgsa dna 84/+","description":"Onc sld orgn tgsa dna 84/+","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93015","name":"Cv stress test supvj i&r","description":"Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; with supervision, interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0584U","name":"Neuro csf prion prtn qual","description":"Neuro csf prion prtn qual","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11043","name":"Dbrdmt musc&/fsca 1st 20/<","description":"Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); first 20 sq cm or less","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":259.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":148.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1263","name":"Pts hosp dialysis dt","description":"Patients in hospice on their initiation of dialysis date or during the month of evaluation","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0368U","name":"Onc clrct ca mut&mthyltn mrk","description":"Onc clrct ca mut&mthyltn mrk","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6094","name":"Abut support crown titanium","description":"Abutment supported crown - (titanium)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0209","name":"Inj, sod thiosulfate (hope)","description":"Injection, sodium thiosulfate (hope), 100 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0426","name":"Coll, analys of saliva","description":"Coll, analys of saliva","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1939","name":"Inj, bumetanide, 0.5 mg","description":"Injection, bumetanide, 0.5 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1474","name":"Pt dx dementia","description":"Patients with diagnosis of dementia","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0817T","name":"Opn insj/rplcmt ins ptn subf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73206","name":"Ct angio upr extrm w/o&w/dye","description":"Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":658.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0893T","name":"N-invas assmt bld oxygnation","description":"Noninvasive assessment of blood oxygenation, gas exchange efficiency, and cardiorespiratory status, with physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6212","name":"Bridge noble metal cast","description":"Pontic-cast noble metal","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1164","name":"Pt w/ dementia any time","description":"Patients with dementia any time during the patients history through the end of the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1484","name":"No rpt hcv rna perf med rsn","description":"Patients who did not have a repeat hcv rna labs performed for medical reasons documented by clinician (e.g., patient with limited life expectancy, delay in treatment of hcv related to treatment of hiv, hbv, hepatocellular carcinoma, decompensated cirrhosis)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0636","name":"Inj calcitriol per 0.1 mcg","description":"Injection, calcitriol, 0.1 mcg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0598U","name":"Gi ibs igg antb 18food items","description":"Gi ibs igg antb 18food items","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33519","name":"Cabg artery-vein three","description":"Coronary artery bypass, using venous graft(s) and arterial graft(s); 3 venous grafts (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61889","name":"Ins sk-mnt crnl nstm pg/rcvr","description":"Insertion of skull-mounted cranial neurostimulator pulse generator or receiver, including craniectomy or craniotomy, when performed, with direct or inductive coupling, with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37288","name":"Revsc evsc tpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43287","name":"Esphg dstl 2/3 w/laps moblj","description":"Esophagectomy, distal two-thirds, with laparoscopic mobilization of the abdominal and lower mediastinal esophagus and proximal gastrectomy, with laparoscopic pyloric drainage procedure if performed, with separate thoracoscopic mobilization of the middle and upper mediastinal esophagus and thoracic e","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3103.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5147","name":"Inj, aflibercept-ayyh, 1 mg","description":"Injection, aflibercept-ayyh (pavblu), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0739T","name":"Abltj mal prst8 mag fld ndct","description":"Ablation of malignant prostate tissue by magnetic field induction, including all intraprocedural, transperineal needle/catheter placement for nanoparticle installation and intraprocedural temperature monitoring, thermal dosimetry, bladder irrigation, and magnetic field nanoparticle activation","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69717","name":"Rplcmt oi implt skl prq esp","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with percutaneous attachment to external speech processor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1356.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90612","name":"Inf&sarscov2 vacc 31.7/.32im","description":"Influenza virus vaccine, trivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 31.7 mcg/0.32 ml dosage, for intramuscular use","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0924T","name":"Rpos prv ccm-d trnsvns eltrd","description":"Repositioning of previously implanted cardiac contractility modulation-defibrillation transvenous electrode(s)/lead(s), including fluoroscopic guidance and programming of sensing and therapeutic parameters","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0519","name":"New pt-cg dyad dem low cmplx","description":"Management of new patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1426","name":"Injection, casimersen, 10 mg","description":"Injection, casimersen, 10 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6039","name":"Passive custom digit/thumb","description":"Passive prosthetic digit or thumb prosthesis not including hand restoration partial hand, full or partial, custom made, any material, initial or replacement, per single passive prosthetic digit or thumb","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0497U","name":"Onc prst8 mrna rt-pcr 6 gene","description":"Onc prst8 mrna rt-pcr 6 gene","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0555U","name":"Repr med pga embryonic te qc","description":"Repr med pga embryonic te qc","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7601","name":"Ensifentrine inh 3 mg","description":"Ensifentrine, inhalation suspension, fda approved final product, non-compounded, administered through dme, unit dose form, 3 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2020","name":"Ac5 wound system","description":"Ac5 advanced wound system (ac5)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6607","name":"G com bandage tub protct lyr","description":"Gradient compression bandaging supply, tubular protective absorption layer, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0546U","name":"Ldns lrp4 antb imflr livecll","description":"Ldns lrp4 antb imflr livecll","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9269","name":"Programable ingest capsule","description":"Programable, transient, orally ingested capsule, for use with external programmer, per month","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4355","name":"Abio xpl abio xpl hy p sq cm","description":"Abiomend xplus membrane and abiomend xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9342","name":"Inj thiotepa nos 1 mg","description":"Injection, thiotepa, not otherwise specified, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0370","name":"Max ultrasound capt & interp","description":"Max ultrasound capt & interp","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33277","name":"Insj phrnc nrv stim transvns","description":"Insertion of phrenic nerve stimulator transvenous sensing lead (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0893T","name":"N-invas assmt bld oxygnation","description":"Noninvasive assessment of blood oxygenation, gas exchange efficiency, and cardiorespiratory status, with physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1381","name":"Pt sec strk wthin 5 days","description":"Patients with secondary stroke (e.g., a subsequent stroke that may occur with vasospasm in the setting of subarachnoid hemorrhage) within 5 days of the initial procedure","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2044","name":"Biobrane glove, each","description":"Biobrane glove, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9292","name":"Pres dig visual therapy fda","description":"Prescription digital visual therapy, software-only, fda cleared, per course of treatment","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0137","name":"Inj, acetaminophen (hikma)","description":"Injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0010","name":"Eom meos payment","description":"Enhancing oncology model (eom) monthly enhanced oncology services (meos) payment for eom enhanced services","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78261","name":"Gastric mucosa imaging","description":"Gastric mucosa imaging","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0505U","name":"Nfct ds vag infctj id 32orgs","description":"Nfct ds vag infctj id 32orgs","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69729","name":"Impl oi implt sk tc esp>=100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside of the mastoid and resulting in removal of greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7261","name":"Primary closure sinus perf","description":"Primary closure of a sinus perforation","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0854T","name":"Dgtz gls mcrscp bld smr prph","description":"Digitization of glass microscope slides for blood smear, peripheral, interpretation by physician with written report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0977T","name":"Upr gi bld detcj snr capsule","description":"Upper gastrointestinal blood detection, sensor capsule, with interpretation and report","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0167","name":"Inj epinephrine (hospira)","description":"Injection, epinephrine (hospira), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0039","name":"Pt no ref, rn spec","description":"Patient not referred, reason not otherwise specified","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0554","name":"Add 20 m of monthly tx","description":"Each additional 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing data generated from the","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0980T","name":"Sbmcsl crylys ther tng&tnsl","description":"Submucosal cryolysis therapy; base of tongue and lingual tonsil only","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4271","name":"Complete ft per sq cm","description":"Complete ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9341","name":"Inj thiotepa (tepylute) 1 mg","description":"Injection, thiotepa (tepylute), 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1448","name":"Pt dx pd bef end meas pd","description":"Patients with an active diagnosis of personality disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0894T","name":"Cannulation liver allograft","description":"Cannulation of the liver allograft in preparation for connection to the normothermic perfusion device and decannulation of the liver allograft following normothermic perfusion","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0832T","name":"Dgtz gls mcrscp cytp oth scr","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76514","name":"Echo exam of eye thickness","description":"Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92573","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q0165","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82759","name":"Assay of rbc galactokinase","description":"Galactokinase, rbc","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82653","name":"El-1 fecal quantitative","description":"Elastase, pancreatic (el-1), fecal; quantitative","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58301","name":"Remove intrauterine device","description":"Removal of intrauterine device (iud)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":55.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92629","name":"Eval hearing aid cand ea add","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86037","name":"Anca titer each antibody","description":"Antineutrophil cytoplasmic antibody (anca); titer, each antibody","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1456","name":"Inj, fosaprepitant (teva)","description":"Injection, fosaprepitant (teva), not therapeutically equivalent to j1453, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1257","name":"Cvd risk assess not perf","description":"Cvd risk assessment not performed or incomplete (e.g., cvd risk assessment was not documented), reason not otherwise specified","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0841T","name":"Dgtz gls mcrscp pth cslt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; first tissue block, with frozen section(s), single specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6613","name":"Onlay cst base mtl >=3 surfa","description":"Onlay - cast predominantly base metal three or more surfaces","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33404","name":"Prepare heart-aorta conduit","description":"Construction of apical-aortic conduit","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2132.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52443","name":"Cysto 1st trurl prst8 comis","description":"Cystourethroscopy with initial transurethral anterior prostate commissurotomy with a nondrug-coated balloon catheter followed by therapeutic drug delivery into the prostate by a drug-coated balloon catheter, including transrectal ultrasound and fluoroscopy, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3233.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6555","name":"G com stcking bk 40+ custm","description":"Gradient compression stocking, below knee, 40 mmhg or greater, custom, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0502U","name":"Hpv e6/e7 mrk hi-rsk typ crv","description":"Hpv e6/e7 mrk hi-rsk typ crv","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0587U","name":"Ther rx mntr 60-150rx&metabl","description":"Ther rx mntr 60-150rx&metabl","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0010","name":"Eom meos payment","description":"Enhancing oncology model (eom) monthly enhanced oncology services (meos) payment for eom enhanced services","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99425","name":"Prin care mgmt phys ea addl","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36420","name":"Venipuncture cutdown < 1 yr","description":"Venipuncture, cutdown; younger than age 1 year","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9887","name":"Distance learning attendance","description":"Behavioral counseling for diabetes prevention, distance learning, 60 minutes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0443","name":"Brief alcohol misuse counsel","description":"Brief face-to-face behavioral counseling for alcohol misuse, 15 minutes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":38.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93152","name":"Interrog&prgrmg ipnss polysm","description":"Interrogation and programming of implanted phrenic nerve stimulator system during polysomnography","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1471","name":"Ffs hep b not covered","description":"Documentation that patient is a medicare fee-for-service beneficiary and without additional supplementary insurance coverage for whom hep b vaccination is not reimbursable under current medicare part b coverage rules","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30020","name":"Drainage of nose lesion","description":"Drainage abscess or hematoma, nasal septum","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4287","name":"Disp col sto bag breast milk","description":"Disposable collection and storage bag for breast milk, any size, any type, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0327U","name":"Ftl aneuploidy trsmy dna seq","description":"Ftl aneuploidy trsmy dna seq","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6564","name":"G com stckng waist 40+ cust","description":"Gradient compression stocking, waist length, 40 mmhg or greater, custom, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1323","name":"Pts 7wk inj, scrn iop >25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop >25 mm hg and a plan of care was documented","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74018","name":"Radex abdomen 1 view","description":"Radiologic examination, abdomen; 1 view","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0652","name":"Inj, levothyroxine, hikma","description":"Injection, levothyroxine sodium (hikma), not therapeutically equivalent to j0650, 10 mcg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88274","name":"Cytogenetics 25-99","description":"Molecular cytogenetics; interphase in situ hybridization, analyze 25-99 cells","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93151","name":"Interrog&prgrmg ipnss","description":"Interrogation and programming (minimum one parameter) of implanted phrenic nerve stimulator system","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80220","name":"Drug asy hydroxychloroquine","description":"Hydroxychloroquine","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9601","name":"Inj linvoseltamab-gcpt 1 mg","description":"Injection, linvoseltamab-gcpt, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0802T","name":"Tcat rmv&rpl2chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right at","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9293","name":"Fertility cycl tracking soft","description":"Fertility cycle (contraception & conception) tracking software application, fda cleared, per month, includes accessories (e.g., thermometer)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8005","name":"Grip glove w microprocessor","description":"Powered, cable driven grip assist glove, hand, finger, includes microprocessor, pressure sensors, all components and accessories, custom fitted","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6180","name":"Implnt maint proced","description":"Implnt maint proced","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9184","name":"Inj gemcitabin (avyxa) 200mg","description":"Injection, gemcitabine hydrochloride (avyxa), 200 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87260","name":"Adenovirus ag if","description":"Infectious agent antigen detection by immunofluorescent technique; adenovirus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2019","name":"Kerecis marigen shld sq cm","description":"Kerecis omega3 marigen shield, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44401","name":"Colonoscopy with ablation","description":"Colonoscopy through stoma; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre-and post-dilation and guide wire passage, when performed)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2992.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":240.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26020","name":"Drain hand tendon sheath","description":"Drainage of tendon sheath, digit and/or palm, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":492.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55710","name":"Bx prst8 tprn us w/mri fus 1","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant) with mri-fusion-guidance biopsy, first targeted lesion","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4018","name":"Ob/gyn ss","description":"Obstetrics/gynecology mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0710T","name":"N-invas artl plaq alys","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; including data preparation and transmission, quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess a","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1392","name":"Pt rsn no exm or lst to fu","description":"Documentation of patient reasons for no examination, i.e., refusal of examination or lost to follow-up (documentation must include information that the clinician was unable to reach the patient by phone, mail or secure electronic mail - at least one method must be documented)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33268","name":"Excl laa opn oth px any meth","description":"Exclusion of left atrial appendage, open, performed at the time of other sternotomy or thoracotomy procedure(s), any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86363","name":"Mog-igg1 antb flo cytmtry ea","description":"Myelin oligodendrocyte glycoprotein (mog-igg1) antibody; flow cytometry (ie, fluorescence-activated cell sorting [facs]), each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90483","name":"Imm cnsl not admn sm>10<20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 10 minutes up to 20 minutes","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76984","name":"Dx intraop thoracic aorta us","description":"Ultrasound, intraoperative thoracic aorta (eg, epiaortic), diagnostic","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30125","name":"Removal of nose lesion","description":"Excision dermoid cyst, nose; complex, under bone or cartilage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":730.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0893T","name":"N-invas assmt bld oxygnation","description":"Noninvasive assessment of blood oxygenation, gas exchange efficiency, and cardiorespiratory status, with physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4356","name":"Abio mem abio hyd per sq cm","description":"Abiomend membrane and abiomend hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42320","name":"Drainage of salivary gland","description":"Drainage of abscess; submaxillary, external","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0898T","name":"N-invas prst8 cancer est map","description":"Noninvasive prostate cancer estimation map, derived from augmentative analysis of image-guided fusion biopsy and pathology, including visualization of margin volume and location, with margin determination and physician interpretation and report","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83890","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63053","name":"Lam factc/frmt arthrd lum ea","description":"Laminectomy, facetectomy, or foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s] [eg, spinal or lateral recess stenosis]), during posterior interbody arthrodesis, lumbar; each additional vertebral segment (list separately in addition to code for","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":114.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6594","name":"G comp bandge liner lwr extr","description":"Gradient compression bandaging supply, bandage liner, lower extremity, any size or length, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82247","name":"Bilirubin total","description":"Bilirubin; total","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2045","name":"Novashield/novogen pr sq cm","description":"Novashield or novogen wound matrix, per square centimeter","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0408U","name":"Iaad blk ac wv bsnsr sarscv2","description":"Iaad blk ac wv bsnsr sarscv2","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1277","name":"Colorectal ca screen doc rev","description":"Colorectal cancer screening results documented and reviewed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27722","name":"Repair/graft of tibia","description":"Repair of nonunion or malunion, tibia; with sliding graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1047.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4225","name":"Amnio or derma tl, per sq cm","description":"Amniobind or dermabind tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0950T","name":"Abltj b9 prst8 tissue hifu","description":"Ablation of benign prostate tissue, transrectal, with high intensity-focused ultrasound (hifu), including ultrasound guidance","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0265U","name":"Rar do whl gn&mtcdrl dna als","description":"Rare constitutional and other heritable disorders, whole- genome and mitochondrial dna sequence analysis, blood, frozen and formalin-fixed paraffin-embedded (ffpe) tissue, saliva, buccal swabs or cell lines, identification of single nucleotide and copy number variants","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90613","name":"Inf&sarscov2 vacc 40/0.4 im","description":"Influenza virus vaccine, quadrivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 40 mcg/0.4 ml dosage, for intramuscular use","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1188","name":"Pt w/ ckd stg 5","description":"Patients with a diagnosis of chronic kidney disease (ckd) stage 5","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0539","name":"Initial care training 30 m","description":"Caregiver training in behavior management/modification for caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face; initial 30 minutes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92623","name":"Dx aly aud oi snd prcsr each","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; each additional 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9294","name":"Inj pemetrexed, hospira 10mg","description":"Injection, pemetrexed (hospira), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0825T","name":"Tcat rmv&rpl1chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or prog","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0835T","name":"Dgtz gls mcrscp fna 1st ea","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0597U","name":"Onc breast rna xprsn 329gens","description":"Onc breast rna xprsn 329gens","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1419","name":"Pt not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4278","name":"Epieffect, per sq cm","description":"Epieffect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43497","name":"Transorl lwr esophgl myotomy","description":"Lower esophageal myotomy, transoral (ie, peroral endoscopic myotomy [poem])","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0519","name":"New pt-cg dyad dem low cmplx","description":"Management of new patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81002","name":"Urinalysis nonauto w/o scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; non-automated, without microscopy","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0010","name":"Admin hepatitis b vaccine","description":"Administration of hepatitis b vaccine","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95926","name":"Somatosensory testing","description":"Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in lower limbs","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9913","name":"Admin of neuromod","description":"Admin of neuromod","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3392","name":"Inj, exagamglogene autotem","description":"Injection, exagamglogene autotemcel, per treatment","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9292","name":"Inj, pemetrexed dipotassium","description":"Injection, pemetrexed dipotassium, 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0004","name":"Qual care neurologic cnd mvp","description":"Quality care for patients with neurological conditions mips value pathway","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95146","name":"Antigen therapy services","description":"Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy (specify number of doses); 2 single stinging insect venoms","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27814","name":"Treatment of ankle fracture","description":"Open treatment of bimalleolar ankle fracture (eg, lateral and medial malleoli, or lateral and posterior malleoli, or medial and posterior malleoli), includes internal fixation, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":962.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4285","name":"Nudyn dl or dl mesh pr sq cm","description":"Nudyn dl or nudyn dl mesh, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1720","name":"Influenza vacc admin","description":"Influenza vacc admin","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55720","name":"Drainage of prostate abscess","description":"Prostatotomy, external drainage of prostatic abscess, any approach; simple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6516","name":"Grad com wrap w strap foo cu","description":"Gradient compression wrap with adjustable straps, foot, each, custom","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93575","name":"Njx cath slct p angrph mapca","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary angiography of major aortopulmonary collateral arteries (mapcas) arising off the aorta or its systemic branches, during cardiac catheterization for congenital heart d","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54415","name":"Remove self-contd penis pros","description":"Removal of non-inflatable (semi-rigid) or inflatable (self-contained) penile prosthesis, without replacement of prosthesis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":569.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63270","name":"Excise intrspinl lesion crvl","description":"Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; cervical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2260.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21825","name":"Treat sternum fracture","description":"Open treatment of sternum fracture with or without skeletal fixation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":676.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0553","name":"Monthly tx for dmht 20mins","description":"First 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing information related to the use of","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0967T","name":"Tranal ins tmp clrc anst dev","description":"Transanal insertion of endoluminal temporary colorectal anastomosis protection device, including vacuum anchoring component and flexible sheath connected to external vacuum source and monitoring system","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2642","name":"Dental onlay porcelin 2 surf","description":"Onlay - porcelain/ceramic - two surfaces","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4007","name":"General surgery ss","description":"General surgery mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49187","name":"Opn exc/dstr ntra-abd 5.1-10","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5.1 to 10 cm","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9334","name":"Inj efgart-alfa 2mg hya-qvfc","description":"Injection, efgartigimod alfa, 2 mg and hyaluronidase-qvfc","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4008","name":"Geriatrics ss","description":"Geriatrics mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7473","name":"Remove torus mandibularis","description":"Removal of torus mandibularis","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1361","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24560","name":"Cltx hum epcndylr fx wo mnpj","description":"Closed treatment of humeral epicondylar fracture, medial or lateral; without manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0582","name":"Bivalirudin (endo) 1 mg","description":"Injection, bivalirudin (endo), not therapeutically equivalent to j0583, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25574","name":"Optx rdl&uln shft fx rds/uln","description":"Open treatment of radial and ulnar shaft fractures, with internal fixation, when performed; of radius or ulna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":707.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9949","name":"Repair sleep apnea appliance","description":"Repair sleep apnea appliance","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99334","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9359","name":"Inj lon tesirin-lpyl 0.075mg","description":"Injection, loncastuximab tesirine-lpyl, 0.075 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1032","name":"Sv doula brth wrk per 15 min","description":"Services performed by a doula birth worker, per 15 minutes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33430","name":"Replacement of mitral valve","description":"Replacement, mitral valve, with cardiopulmonary bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2501.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4026","name":"Phys/occ therapy ss","description":"Physical therapy/occupational therapy mips specialty set","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61542","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2636.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94618","name":"Pulmonary stress testing","description":"Pulmonary stress testing (eg, 6-minute walk test), including measurement of heart rate, oximetry, and oxygen titration, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62330","name":"Dcmprn prq rmv lig flv 1lmbr","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; one interspace, lumbar","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0650","name":"Inj, levothyroxine nos 10mcg","description":"Injection, levothyroxine sodium, not otherwise specified, 10 mcg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9913","name":"Admin of neuromod","description":"Admin of neuromod","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61736","name":"Litt icr 1 traj 1 smpl les","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; single trajectory for 1 simple lesion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0518U","name":"Ther rx mntr 90+ pn&mtl hlth","description":"Ther rx mntr 90+ pn&mtl hlth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31595","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":887.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64469","name":"Thrc fascial pln blk bi nfs","description":"Thoracic fascial plane block, bilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33287","name":"Rmv&rplcmt phrnc nrv stim pg","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90631","name":"H5 vaccine pandemic im use","description":"Influenza virus vaccine (iiv), h5, pandemic formulation, split virus, adjuvanted, for intramuscular use","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D8091","name":"Compre ortho treat w surg","description":"Compre ortho treat w surg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0338U","name":"Onc sld tum crcg tum cl slct","description":"Onc sld tum crcg tum cl slct","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1366","name":"Focus on womens health mvp","description":"Focusing on womens health mips value pathway","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0833T","name":"Dgtz gls mcrscp cytp oth prp","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; preparation, screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0692T","name":"Therapeutic ultrafiltration","description":"Therapeutic ultrafiltration","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0797T","name":"Tcat ins 2chmbr ldls pm rv","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ventricular pace","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0580U","name":"Bbrgdrferi antb detc 24rprtn","description":"Bbrgdrferi antb detc 24rprtn","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1196","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0553","name":"Monthly tx for dmht 20mins","description":"First 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing information related to the use of","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33927","name":"Impltj tot rplcmt hrt sys","description":"Implantation of a total replacement heart system (artificial heart) with recipient cardiectomy","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2702.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1345","name":"Pt bsln pam, 2nd scr 4-12 mo","description":"Patients who had a baseline pam score and a second score within 4 to 12 month of baseline pam score","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4275","name":"Esano aca, per sq cm","description":"Esano aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90836","name":"Psytx w pt w e/m 45 min","description":"Psychotherapy, 45 minutes with patient when performed with an evaluation and management service (list separately in addition to the code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":81.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4013","name":"Mntal/behav/psych hlth ss","description":"Mental/behavioral and psychiatry mips specialty set","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0569","name":"Subs psych care mng, subs mo","description":"Subsequent psychiatric collaborative care management, in a subsequent month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required elements: tracking ","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90483","name":"Imm cnsl not admn sm>10<20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 10 minutes up to 20 minutes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5934","name":"Mandibular flange prosthesis","description":"Mandibular resection prosthesis with guide flange","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93573","name":"Njx cath slct p-art angrp bi","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, bilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7111","name":"Extraction coronal remnants","description":"Extraction coronal remnants - deciduous tooth","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93588","name":"Vngrph chd vnvn cltrl below","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating below the heart (eg, from the inferior vena cava) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7411","name":"Excision benign lesion>1.25c","description":"Excision of benign lesion greater than 1.25 cm","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4425","name":"Revive tl per sq cm","description":"Revive tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61850","name":"Implant neuroelectrodes","description":"Twist drill or burr hole(s) for implantation of neurostimulator electrodes, cortical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1080.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1501","name":"Pathology mvp","description":"Pathology mips value pathway","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0259U","name":"Neph ckd nuc mrs meas gfr","description":"Nephrology (chronic kidney disease), nuclear magnetic resonance spectroscopy measurement of myo-inositol, valine, and creatinine, algorithmically combined with cystatin c (by immunoassay) and demographic data to determine estimated glomerular filtration rate (gfr), serum, quantitative","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4000","name":"Dermatology ss","description":"Dermatology mips specialty set","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9955","name":"Oral app thxpy titration vis","description":"Oral app thxpy titration vis","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93573","name":"Njx cath slct p-art angrp bi","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, bilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77438","name":"Surf rad thr orthvlt>150-500","description":"Surface radiation therapy; orthovoltage, delivery, >150-500 kv, per fraction","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95144","name":"Antigen therapy services","description":"Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, single dose vial(s) (specify number of vials)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50715","name":"Release of ureter","description":"Ureterolysis, with or without repositioning of ureter for retroperitoneal fibrosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1319.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23900","name":"Interthoracoscplr amputation","description":"Interthoracoscapular amputation (forequarter)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1563.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82340","name":"Assay of calcium in urine","description":"Calcium; urine quantitative, timed specimen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4034","name":"Speech language path ss","description":"Speech language pathology mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0733T","name":"Rem r-t mtn nrehab ther sply","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; supply and technical support, per 30 days","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"3078F","name":"Diast bp <80 mm hg","description":"Most recent diastolic blood pressure less than 80 mm hg (htn, ckd, cad) (dm)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1237","name":"Pt rsn no scrn","description":"Patient reason for not screening for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety (e.g., patient declined or other patient reasons)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4428","name":"Dermbnd sln sl+ slx sq cm","description":"Dermabind sl n or dermabind sl + or dermabind sl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5152","name":"Inj, eculizumab-aeeb, 2 mg","description":"Injection, eculizumab-aeeb (bkemv), biosimilar, 2 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78704","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39520","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1180.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0738T","name":"Tx pln mag fld abltj prst8","description":"Treatment planning for magnetic field induction ablation of malignant prostate tissue, using data from previously performed magnetic resonance imaging (mri) examination","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83631","name":"Lactoferrin fecal (quant)","description":"Lactoferrin, fecal; quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6593","name":"Grad com accessory gmt_wrap","description":"Accessory for gradient compression garment or wrap with adjustable straps, not-otherwise specified","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0830T","name":"Dgtz gls mcrscp cytp slctv","description":"Digitization of glass microscope slides for cytopathology, selective-cellular enhancement technique with interpretation (eg, liquid-based slide preparation method), except cervical or vaginal (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4356","name":"Abio mem abio hyd per sq cm","description":"Abiomend membrane and abiomend hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0788T","name":"Elec aly smp iins sp/sac nrv","description":"Electronic analysis with simple programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detecti","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0747T","name":"Car ablt rad arrhyt dlvr rad","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; delivery of radiation therapy, arrhythmia","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63290","name":"Bx/exc xdrl/idrl lsn any lvl","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; combined extradural-intradural lesion, any level","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3077.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0309U","name":"Crd cv ds aly 4 prtn plm alg","description":"Crd cv ds aly 4 prtn plm alg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22326","name":"Treat neck spine fracture","description":"Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; cervical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1682.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1412","name":"Met nsclc w/ egfr alk oth ab","description":"Patients with metastatic nsclc with epidermal growth factor receptor (egfr) mutations, alk genomic tumor aberrations, or other targetable genomic abnormalities with approved first-line targeted therapy, such as nsclc with ros1 rearrangement, braf v600e mutation, ntrk 1/2/3 gene fusion, met ex14 skip","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0301U","name":"Iadna bartonella ddpcr","description":"Iadna bartonella ddpcr","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0256U","name":"Tma/tmao prfl ms/ms ur alg","description":"Trimethylamine/trimethylamine n-oxide (tma/tmao) profile, tandem mass spectrometry (ms/ms), urine, with algorithmic analysis and interpretive report","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1373","name":"Mst rec gsa >=8 and <=9","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 8.0% and <= 9.0%","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4012","name":"Interventional rad ss","description":"Interventional radiology mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9394","name":"Inj, fulvestrant (fresenius)","description":"Injection, fulvestrant (fresenius kabi) not therapeutically equivalent to j9395, 25 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0623U","name":"Ai ms dna mthyl alys >5000","description":"Ai ms dna mthyl alys >5000","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0604U","name":"All&immunology crae 4bk pep","description":"All&immunology crae 4bk pep","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1217","name":"Sys rsn no doc spiro","description":"Documentation of system reason(s) for not documenting and reviewing spirometry results (e.g., spirometry equipment not available at the time of the encounter)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72133","name":"Ct lumbar spine w/o & w/dye","description":"Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":530.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0388","name":"Bitewing image capture only","description":"Bitewing image capture only","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0414","name":"Lab process microbial spec","description":"Lab process microbial spec","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81441","name":"Ibmfs seq alys pnl 30 genes","description":"Inherited bone marrow failure syndromes (ibmfs) (eg, fanconi anemia, dyskeratosis congenita, diamond-blackfan anemia, shwachman-diamond syndrome, gata2 deficiency syndrome, congenital amegakaryocytic thrombocytopenia) sequence analysis panel, must include sequencing of at least 30 genes, including b","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5914","name":"Auricular prosthesis","description":"Auricular prosthesis","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1253","name":"Pts hu surv no amb plltv","description":"Patients who respond on the patient experience hu survey that they did not receive care by the listed ambulatory palliative care provider in the last 60 days (disavowal)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47711","name":"Excision of bile duct tumor","description":"Excision of bile duct tumor, with or without primary repair of bile duct; extrahepatic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1603.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0830T","name":"Dgtz gls mcrscp cytp slctv","description":"Digitization of glass microscope slides for cytopathology, selective-cellular enhancement technique with interpretation (eg, liquid-based slide preparation method), except cervical or vaginal (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51841","name":"Attach bladder/urethra","description":"Anterior vesicourethropexy, or urethropexy (eg, marshall-marchetti-krantz, burch); complicated (eg, secondary repair)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":913.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0303U","name":"Hem rbc ads whl bld hypoxic","description":"Hem rbc ads whl bld hypoxic","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1574","name":"Inj, ganciclovir (exela)","description":"Injection, ganciclovir sodium (exela), not therapeutically equivalent to j1570, 500 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0739","name":"Rehab sys active assist rt","description":"Rehabilitation system with interactive interface providing active assistance in rehabilitation therapy, includes all components and accessories, motors, microprocessors, sensors","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77328","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0520U","name":"Ther rx mntr 200+ rx/sbsts","description":"Ther rx mntr 200+ rx/sbsts","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43842","name":"Gstr rstcv px v-banded gstp","description":"Gastric restrictive procedure, without gastric bypass, for morbid obesity; vertical-banded gastroplasty","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85013","name":"Spun microhematocrit","description":"Blood count; spun microhematocrit","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87812","name":"Sarscov2&inf typ a&b w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) and influenza virus types a and b","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82150","name":"Assay of amylase","description":"Amylase","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0249","name":"Tocilizumab for covid-19","description":"Injection, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1166","name":"Path rpt tis spec wle/reexc","description":"Pathology report for tissue specimens produced from wide local excisions or re-excisions","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34707","name":"Evasc rpr ilio-iliac ndgft","description":"Endovascular repair of iliac artery by deployment of an ilio-iliac tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, and all endograft extension(s) proximally to the aortic bifurcation ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1135.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22836","name":"Ant thrc vrt body tethrg <7","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; up to 7 vertebral segments","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92552","name":"Pure tone audiometry air","description":"Pure tone audiometry (threshold); air only","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1463","name":"2 f/u wthn 180 day rx atmp","description":"Documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0999T","name":"Autol musc cell therapy hrvg","description":"Autologous muscle cell therapy, harvesting of muscle progenitor cells, including ultrasound guidance, when performed","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0441U","name":"Nfct ds bct fngl/viral semiq","description":"Nfct ds bct fngl/viral semiq","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33509","name":"Ndsc hrv uxtr art 1 sgm cab","description":"Harvest of upper extremity artery, 1 segment, for coronary artery bypass procedure, endoscopic","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0458U","name":"Onc brst ca s100 a8&a9 elisa","description":"Onc brst ca s100 a8&a9 elisa","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0687T","name":"Tx amblyopia dev setup 1st","description":"Treatment of amblyopia using an online digital program; device supply, educational set-up, and initial session","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0990T","name":"Trncrv inst biod hydrgl mtrl","description":"Transcervical instillation of biodegradable hydrogel materials, intrauterine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0678T","name":"Laps repos lead isdss ea add","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional repositioned lead (list separately in addition to code for primary proce","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1334","name":"Pts act pvd 2 wks 2 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 2 weeks after initial acute pvd encounter","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1461","name":"Pt dx chron hepc","description":"Patient diagnosis for chronic hepatitis c","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9997","name":"Ustekinumab-ttwe iv inj 1 mg","description":"Injection, ustekinumab-ttwe (pyzchiva), intravenous, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0551","name":"Phn/intr svs fr dx treat 30m","description":"Interprofessional telephone/internet/electronic health record referral service(s) provided by a treating/requesting practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, 30 minutes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":800.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1807","name":"Inj, ethacrynate sod, 1 mg","description":"Injection, ethacrynate sodium, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3761","name":"Eo, adj lock joint prefab ot","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, off-the-shelf","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":545.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0868T","name":"Hi-res gastric ep mapping","description":"High-resolution gastric electrophysiology mapping with simultaneous patient-symptom profiling, with interpretation and report","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0588U","name":"Nfct ds bct/vir 32genes mrna","description":"Nfct ds bct/vir 32genes mrna","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83036","name":"Hemoglobin glycosylated a1c","description":"Hemoglobin; glycosylated (a1c)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1297","name":"Bmi not doc medrsn ptref","description":"Bmi not documented due to medical reason or patient refusal of height or weight measurement","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0292U","name":"Psyc strs do mrna 72 genes","description":"Psyc strs do mrna 72 genes","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0421U","name":"Onc clrct scr sgl amp 8 rna","description":"Onc clrct scr sgl amp 8 rna","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0868T","name":"Hi-res gastric ep mapping","description":"High-resolution gastric electrophysiology mapping with simultaneous patient-symptom profiling, with interpretation and report","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0540U","name":"Trnsplj med quan dd-cfdna","description":"Trnsplj med quan dd-cfdna","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1414","name":"Inj, beqvez, per tx dose","description":"Injection, fidanacogene elaparvovec-dzkt, per therapeutic dose","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0271U","name":"Hem cgen neutropenia 23 gen","description":"Hematology (congenital neutropenia), genomic sequence analysis of 23 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9064","name":"Inj, cabazitaxel (sandoz)","description":"Injection, cabazitaxel (sandoz), not therapeutically equivalent to j9043, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0562U","name":"Onc sol tum tgsa 33gens snvs","description":"Onc sol tum tgsa 33gens snvs","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1399","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4298","name":"Amniocore pro, per sq cm","description":"Amniocore pro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7415","name":"Excision malig les complicat","description":"Excision of malignant lesion complicated","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0654","name":"Inj, liothyronine, 1 mcg","description":"Injection, liothyronine, 1 mcg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01940","name":"Anes nulyt agt lmbr/sac","description":"Anesthesia for percutaneous image-guided destruction procedures by neurolytic agent on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85651","name":"Rbc sed rate nonautomated","description":"Sedimentation rate, erythrocyte; non-automated","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4380","name":"Advograft one per sq cm","description":"Advograft one, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97552","name":"Group caregiver training","description":"Group caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24800","name":"Arthrodesis elbw joint local","description":"Arthrodesis, elbow joint; local","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":978.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0861T","name":"Rmvl pg wcs lv both compnt","description":"Removal of pulse generator for wireless cardiac stimulator for left ventricular pacing; both components (battery and transmitter)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4276","name":"Orion, per sq cm","description":"Orion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0924T","name":"Rpos prv ccm-d trnsvns eltrd","description":"Repositioning of previously implanted cardiac contractility modulation-defibrillation transvenous electrode(s)/lead(s), including fluoroscopic guidance and programming of sensing and therapeutic parameters","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1298","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1256","name":"Prior history of known cvd","description":"Prior history of known cvd","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64643","name":"Chemodenerv 1 extrem 1-4 ea","description":"Chemodenervation of one extremity; each additional extremity, 1-4 muscle(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0683T","name":"Prgrmg dev eval isdss ip","description":"Programming device evaluation (in-person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional, permanent implantable synchroni","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0738T","name":"Tx pln mag fld abltj prst8","description":"Treatment planning for magnetic field induction ablation of malignant prostate tissue, using data from previously performed magnetic resonance imaging (mri) examination","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0880T","name":"Augmnt alys ch ct ild i&r","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7912","name":"Suture complicate wnd > 5 cm","description":"Complicated suture-greater than 5 cm","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3389","name":"Topi adm prad zami per treat","description":"Topical administration, prademagene zamikeracel, per treatment","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1202","name":"Miglustat oral 65 mg","description":"Miglustat, oral, 65 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1235","name":"Doc pt hcv aby rna tst","description":"Documentation or patient report of hcv antibody test or hcv rna test which occurred prior to the performance period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0030","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1251","name":"Pts proxy cmplt hu surv","description":"Patients for whom a proxy completed the entire hu survey on their behalf for any reason (no patient involvement)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2015","name":"Phoenix wnd mtrx, per sq cm","description":"Phoenix wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01938","name":"Anes drg/aspir lmbr/sac","description":"Anesthesia for percutaneous image-guided injection, drainage or aspiration procedures on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1290","name":"Pt not eli d/t act dig htn","description":"Patient not eligible due to active diagnosis of hypertension","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61891","name":"Rev/rplcmt sk-mnt crnl nstm","description":"Revision or replacement of skull-mounted cranial neurostimulator pulse generator or receiver with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4360","name":"Amchoplast fd per sq cm","description":"Amchoplast fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4385","name":"Apollo ft per sq cm","description":"Apollo ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4030","name":"Pulmonology ss","description":"Pulmonology mips specialty set","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44200","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1001.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1198","name":"Isa not red 3pts /no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31230","name":"Removal of upper jaw","description":"Maxillectomy; with orbital exenteration (en bloc)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1931.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68135","name":"Destruction les conjunctiva","description":"Destruction of lesion, conjunctiva","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76017","name":"Mr sfty med physics xm cstmz","description":"Mr safety medical physics examination customization, planning and performance monitoring by medical physicist or mr safety expert, with review and analysis by physician or other qualified health care professional to prioritize and select views and imaging sequences, to tailor mr acquisition specific","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0691T","name":"Auto alys xst ct std vrt fx","description":"Automated analysis of an existing computed tomography study for vertebral fracture(s), including assessment of bone density when performed, data preparation, interpretation, and report","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4001","name":"Diagnostic rad ss","description":"Diagnostic radiology mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0420U","name":"Onc urthl mrna xprsn 6 snp","description":"Onc urthl mrna xprsn 6 snp","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6106","name":"Tissue regen resorbable","description":"Tissue regen resorbable","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0870","name":"Injection, imetelstat, 1 mg","description":"Injection, imetelstat, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0853T","name":"Dgtz gls mcrscp mphmtrc ea m","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27647","name":"Resect talus/calcaneus tum","description":"Radical resection of tumor; talus or calcaneus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0372","name":"Tomo comp series images","description":"Tomo comp series images","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1553","name":"Inj yimmugo 100 mg","description":"Injection, immune globulin (yimmugo), 100 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0532U","name":"Rare ds whlgen&mitochdrl dna","description":"Rare ds whlgen&mitochdrl dna","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38100","name":"Removal of spleen total","description":"Splenectomy; total (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1004.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49491","name":"Rpr hern preemie reduc","description":"Repair, initial inguinal hernia, preterm infant (younger than 37 weeks gestation at birth), performed from birth up to 50 weeks postconception age, with or without hydrocelectomy; reducible","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":783.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1450","name":"Pt hos/pal care dur id/pf pd","description":"Patients who received hospice or palliative care service any time during denominator identification period or the measure assessment period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19125","name":"Excision breast lesion","description":"Excision of breast lesion identified by preoperative placement of radiological marker, open; single lesion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":453.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7939","name":"Indexing for osteotomy","description":"Indexing for osteotomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64870","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1147.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37282","name":"Rvsc evsc tpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6037","name":"Postop dsg cast chg handfing","description":"Immediate post-surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, partial hand including fingers","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1254","name":"Pts deceased prior hu surv","description":"Patients who were deceased when the hu survey reached them","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4423","name":"Biolab tri wrap fl per sq cm","description":"Biolab tri-membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J9265","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22838","name":"Rev rplc/rmv thrc vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracic vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9595","name":"Piflu f-18, dia 1 millicurie","description":"Piflufolastat f-18, diagnostic, 1 millicurie","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0465","name":"Autolog prp diab wound ulcer","description":"Autologous platelet rich plasma (prp) or other blood-derived product for diabetic chronic wounds/ulcers, using an fda-cleared device for this indication, (includes as applicable administration, dressings, phlebotomy, centrifugation or mixing, and all other preparatory procedures, per treatment)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23044","name":"Arthrt ac sc jt exp/rmvl fb","description":"Arthrotomy, acromioclavicular, sternoclavicular joint, including exploration, drainage, or removal of foreign body","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":675.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2002","name":"Inj, lidocaine in d5w, 1 mg","description":"Injection, lidocaine hcl in 5% dextrose, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23430","name":"Repair biceps tendon","description":"Tenodesis of long tendon of biceps","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":904.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4367","name":"Amniocore sl, per sq cm","description":"Amniocore sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31588","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1250.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1218","name":"Pt copd symptoms","description":"Patient has copd symptoms (e.g., dyspnea, cough/sputum, wheezing)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0714T","name":"Tpla b9 prst8 hyprplsa<50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume less than 50 ml","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1179","name":"No pcv recd","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine, on or after their 19th birthday and before or during measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87528","name":"Hsv dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); herpes simplex virus, direct probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6112","name":"Imp/abut rem dent part max","description":"Imp/abut rem dent part max","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1354","name":"Pt no suicd saf pln 120dy","description":"Patients who did not have a suicide safety plan initiated, reviewed, or updated or reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7353","name":"Anacaulase-bcdb 8.8% gel 1 g","description":"Anacaulase-bcdb, 8.8% gel, 1 gram","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0755T","name":"Dgtz gls mcrscp sld level vi","description":"Digitization of glass microscope slides for level vi, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78071","name":"Parathyrd planar w/wo subtrj","description":"Parathyroid planar imaging (including subtraction, when performed); with tomographic (spect)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":453.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1310","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6081","name":"Scale & debride, single imp","description":"Scale & debride, single imp","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0341U","name":"Ftl aneup dna seq cmpr alys","description":"Ftl aneup dna seq cmpr alys","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1402","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28545","name":"Treat foot dislocation","description":"Closed treatment of tarsal bone dislocation, other than talotarsal; requiring anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63650","name":"Implant neuroelectrodes","description":"Percutaneous implantation of neurostimulator electrode array, epidural","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0665","name":"Team remote e/m est pt 10 mn","description":"Team remote e/m est. pt 10mins","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0472U","name":"Ca vi psp&sp1 antb sjogren","description":"Ca vi psp&sp1 antb sjogren","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98981","name":"Rtm tx mgmt ea addl 20 min","description":"Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least 1 real-time interactive communication with the patient or caregiver during the calendar month; each additional 20 minutes (list separately in","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0051","name":"Traditional healing service","description":"Traditional healing service","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4312","name":"Acesso ac, per sq cm","description":"Acesso ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47765","name":"Fuse liver ducts & bowel","description":"Anastomosis, of intrahepatic ducts and gastrointestinal tract","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1734.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83987","name":"Exhaled breath condensate","description":"Ph; exhaled breath condensate","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0503U","name":"Neuro alz ds bamyl&tau prtn","description":"Neuro alz ds bamyl&tau prtn","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1277","name":"Colorectal ca screen doc rev","description":"Colorectal cancer screening results documented and reviewed","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1479","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25800","name":"Arthrd wrist complete wo grf","description":"Arthrodesis, wrist; complete, without bone graft (includes radiocarpal and/or intercarpal and/or carpometacarpal joints)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":931.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38550","name":"Removal neck/armpit lesion","description":"Excision of cystic hygroma, axillary or cervical; without deep neurovascular dissection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":524.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67901","name":"Repair eyelid defect","description":"Repair of blepharoptosis; frontalis muscle technique with suture or other material (eg, banked fascia)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":573.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1354","name":"Int caries med app per tooth","description":"Interim caries med app","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28114","name":"Removal of metatarsal heads","description":"Ostectomy, complete excision; all metatarsal heads, with partial proximal phalangectomy, excluding first metatarsal (eg, clayton type procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":891.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9999","name":"Doc sys rsn <3 colon","description":"Documentation of system reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., unable to locate previous colonoscopy report, patient cannot provide precise date or details from previous colonoscopy, previous colonoscopy report was incomplete)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0325","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0954T","name":"Tot impl amei rplc snd proc","description":"Totally implantable active middle ear hearing implant; replacement of sound processor only, with attachment to existing transducers","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10060","name":"I&d abscess simple/single","description":"Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); simple or single","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":115.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0368U","name":"Onc clrct ca mut&mthyltn mrk","description":"Onc clrct ca mut&mthyltn mrk","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54620","name":"Suspension of testis","description":"Fixation of contralateral testis (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":338.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0836T","name":"Dgtz gls mcrscp fna ea addl","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1183","name":"Doc imm ckpt inhib hld","description":"Documentation of immune checkpoint inhibitor therapy held and corticosteroids or immunosuppressants prescribed or administered","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98975","name":"Rtm 1st set-up&pt educaj eqp","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); initial set-up and patient education on use of equipment","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0110","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1164","name":"Pt w/ dementia any time","description":"Patients with dementia any time during the patients history through the end of the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93573","name":"Njx cath slct p-art angrp bi","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, bilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5657","name":"Add low ext man aut vol any","description":"Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1344","name":"No bsln/2nd pam score 4-12mo","description":"Patients who did not have a baseline pam score and/or a second score within 4 to 12 months of baseline pam score","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92637","name":"Hearing aid pst-fitg f-up ea","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4241","name":"Gngvl flap w rootplan 1-3 th","description":"Gingival flap procedure including root planing - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1781","name":"Vac admin human pap dose 1","description":"Vac admin human pap dose 1","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85009","name":"Manual diff wbc count b-coat","description":"Blood count; manual differential wbc count, buffy coat","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4367","name":"Amniocore sl, per sq cm","description":"Amniocore sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0781T","name":"Brnchsc rf dstrj pulm nrv bi","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; bilateral mainstem bronchi","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0468U","name":"Hep nash mir34a5p a2m ykl40","description":"Hep nash mir34a5p a2m ykl40","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0555U","name":"Repr med pga embryonic te qc","description":"Repr med pga embryonic te qc","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85025","name":"Complete cbc w/auto diff wbc","description":"Blood count; complete (cbc), automated (hgb, hct, rbc, wbc and platelet count) and automated differential wbc count","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0559U","name":"Onc brs quan elisa bf9ag srm","description":"Onc brs quan elisa bf9ag srm","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1271","name":"Inj doxycycline hyclate 1 mg","description":"Injection, doxycycline hyclate, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4292","name":"Lamellas, per sq cm","description":"Lamellas, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37270","name":"Revsc evasc fpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4278","name":"Epieffect, per sq cm","description":"Epieffect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11441","name":"Exc face-mm b9+marg 0.6-1 cm","description":"Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 0.6 to 1.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0688T","name":"Tx amblyopia assmt w/report","description":"Treatment of amblyopia using an online digital program; assessment of patient performance and program data by physician or other qualified health care professional, with report, per calendar month","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1434","name":"Orl chemo wthn 30 d post enc","description":"Patient on oral chemotherapy on or within 30 days after denominator eligible encounter","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1018T","name":"Elec alys npgs esoph sbsq w/","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0938T","name":"Xtrnl ecg rec>15d<30d rec","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; recording (including connection and initial recording)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1418","name":"Med rsn not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination because of a medical contraindication documented by clinician","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9996","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1184","name":"Doc med rsn no cst/ist rx","description":"Documentation of medical reason(s) for not prescribing or administering corticosteroid or immunosuppressant treatment (e.g., allergy, intolerance, infectious etiology, pancreatic insufficiency, hyperthyroidism, prior bowel surgical interventions, celiac disease, receiving other medication, awaiting ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93319","name":"3d echo img cgen car anomal","description":"3d echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac structure(s) (eg, cardiac chambers and valves, left atrial appendage, interatrial septum, interventricular","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0873","name":"Inj daptomycin (xellia)","description":"Injection, daptomycin (xellia), not therapeutically equivalent to j0878 or j0872, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0788T","name":"Elec aly smp iins sp/sac nrv","description":"Electronic analysis with simple programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detecti","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28406","name":"Prq skel fix clcnl fx w/mnpj","description":"Percutaneous skeletal fixation of calcaneal fracture, with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":652.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77080","name":"Dxa bone density axial","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1710","name":"Moderna vacc admin 3rd dose","description":"Moderna vacc admin 3rd dose","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9886","name":"In-person attendance g code","description":"Behavioral counseling for diabetes prevention, in-person, group, 60 minutes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11424","name":"Exc h-f-nk-sp b9+marg 3.1-4","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 3.1 to 4.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98013","name":"Synch audio-only est low 20","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code select","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5811","name":"Denture interm cmplt mandbl","description":"Interim complete denture (mandibular)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4313","name":"Dermabind fm, per sq cm","description":"Dermabind fm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0350","name":"Oral/facial photo images","description":"Oral/facial photographic images","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9616","name":"Gallium gozellix 1 millicuri","description":"Gallium ga-68 gozetotide (gozellix), diagnostic, 1 millicurie","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37299","name":"Revsc evsc imvt angio cpx ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45334","name":"Sigmoidoscopy for bleeding","description":"Sigmoidoscopy, flexible; with control of bleeding, any method","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76984","name":"Dx intraop thoracic aorta us","description":"Ultrasound, intraoperative thoracic aorta (eg, epiaortic), diagnostic","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6560","name":"G stckng full/chap30-40 cust","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, custom, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0700T","name":"Molec fluor img sus nev 1st","description":"Molecular fluorescent imaging of suspicious nevus; first lesion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":949.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0560","name":"Safety plan interven","description":"Safety planning interventions, each 20 minutes personally performed by the billing practitioner, including assisting the patient in the identification of the following personalized elements of a safety plan: recognizing warning signs of an impending suicidal or substance use-related crisis; employin","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1933","name":"Afo rig ant tib tcf/= ots","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, off-the-shelf","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0431U","name":"Gly rcptr alpha1 igg srm/csf","description":"Gly rcptr alpha1 igg srm/csf","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26215","name":"Remove/graft finger lesion","description":"Excision or curettage of bone cyst or benign tumor of proximal, middle, or distal phalanx of finger; with autograft (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":653.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1497","name":"No doc fall med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4257","name":"Relese, per sq cm","description":"Relese, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1408","name":"Gmln brca bef dx ca","description":"Patients who have germline brca testing completed before diagnosis of epithelial ovarian, fallopian tube, or primary peritoneal cancer","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75685","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":726.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0411U","name":"Psyc genom alys pnl 15 gen","description":"Psyc genom alys pnl 15 gen","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0558","name":"Adv prim care mgmt lvl 3","description":"Advanced primary care management services for a patient that is a qualified medicare beneficiary with multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, which place the patient at significant risk of death, acute exacerbation/decompensat","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6038","name":"Multiax rotation attachment","description":"Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1341","name":"Pt no f/u 30-180 dys","description":"Patients who did not have a follow-up assessment or did not have an assessment within 30 to 180 days after the index assessment during the performance period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0302U","name":"Iadna brtnla ddpcr flwg liq","description":"Iadna brtnla ddpcr flwg liq","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3393","name":"Inj, betibeglogene autotemce","description":"Injection, betibeglogene autotemcel, per treatment","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0811T","name":"Rem mlt day uroflow setup","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); set-up and patient education on use of equipment","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1808","name":"Inj, folic acid, 0.1 mg","description":"Injection, folic acid, 0.1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62331","name":"Dcmprn prq rmv lig flv addl","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; additional interspace(s), lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1173","name":"Pt no rec td/tdap 9yrs prior","description":"Patient did not receive at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37283","name":"Rvsc evsc tpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37287","name":"Revsc evasc tpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64659","name":"Rmvl bat modulj sys pg only","description":"Removal of baroreflex activation therapy (bat) modulation system; pulse generator only","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0616U","name":"Neurol dementia alys >30000","description":"Neurol dementia alys >30000","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9048","name":"Inj, bortezomib freseniuskab","description":"Injection, bortezomib (fresenius kabi), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86052","name":"Aquaporin-4 antb cba each","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; cell-based immunofluorescence assay (cba), each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36561","name":"Insert tunneled cv cath","description":"Insertion of tunneled centrally inserted central venous access device, with subcutaneous port; age 5 years or older","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23800","name":"Arthrodesis glenohumeral jt","description":"Arthrodesis, glenohumeral joint;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1219.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4020","name":"Ophthalmology/optometry ss","description":"Ophthalmology/optometry mips specialty set","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1210","name":">=2 same meds tbl4 not ord","description":"At least two orders for high-risk medications from the same drug class, (table 4), not ordered","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"A9535","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15016","name":"App skn cl ssp agrf t/a/l ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; each additional 480 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6211","name":"Bridge base metal cast","description":"Pontic-cast predominantly base metal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4328","name":"Most, per sq cm","description":"Most, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1318","name":"Pts no csp doc contact","description":"Patients who did not have documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening or documentation that there was no contact with a csp","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4324","name":"Amniotx, per sq cm","description":"Amniotx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85014","name":"Hematocrit","description":"Blood count; hematocrit (hct)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0426U","name":"Genome ultra-rapid seq alys","description":"Genome ultra-rapid seq alys","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4290","name":"Membrane wrap hydr per sq cm","description":"Membrane wrap-hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"Motor &/ sens nrve cndj test","description":"Motor and/or sensory nerve conduction, using preconfigured electrode array(s), amplitude and latency/velocity study, each limb, includes f-wave study when performed, with interpretation and report","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2041","name":"Foundation drs+ duo pr sq cm","description":"Foundation drs+ duo, per square centimeter","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71045","name":"X-ray exam chest 1 view","description":"Radiologic examination, chest; single view","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0278U","name":"Hem gen thrombosis 12 genes","description":"Hematology (genetic thrombosis), genomic sequence analysis of 12 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0624U","name":"Hep nash dna mthyl alys 5000","description":"Hep nash dna mthyl alys 5000","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1781","name":"Vac admin human pap dose 1","description":"Vac admin human pap dose 1","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0780T","name":"Instlj fecal microbiota ssp","description":"Instillation of fecal microbiota suspension via rectal enema into lower gastrointestinal tract","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0136","name":"Inj, acetaminophen (b braun)","description":"Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1245","name":"Pt othr thn true person","description":"Patient provided a response other than completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4369","name":"Amnioplast 3 per sq cm","description":"Amnioplast 3, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0897T","name":"N-invas augmnt arrhyt alys","description":"Noninvasive augmentative arrhythmia analysis derived from quantitative computational cardiac arrhythmia simulations, based on selected intervals of interest from 12-lead electrocardiogram and uploaded clinical parameters, including uploading clinical parameters with interpretation and report","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0022","name":"Comm hlth intg svs add 30 m","description":"Community health integration services, each additional 30 minutes per calendar month (list separately in addition to g0019)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2002","name":"Inj, lidocaine in d5w, 1 mg","description":"Injection, lidocaine hcl in 5% dextrose, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0427U","name":"Monocyte dstrbj wdth whl bld","description":"Monocyte dstrbj wdth whl bld","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0799","name":"Hiv prep, fda approved, noc","description":"Fda approved prescription drug, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv), not otherwise classified","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0974T","name":"Slctv nzmtc dbrdmt t/a/l ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; each additional 100 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4004","name":"Endocrinology ss","description":"Endocrinology mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0629U","name":"Nfct ds tb dna aly 1trgt pcr","description":"Nfct ds tb dna aly 1trgt pcr","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0401U","name":"Crd c hrt ds 9 gen 12 vrnts","description":"Crd c hrt ds 9 gen 12 vrnts","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5150","name":"Inj, aflibercept-mrbb, 1 mg","description":"Injection, aflibercept-mrbb (ahzantive), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0873T","name":"Revj subq prtl asct pmp sys","description":"Revision of a subcutaneously implanted peritoneal ascites pump system, any component (ascites pump, associated peritoneal catheter, associated bladder catheter), including imaging and programming, when performed","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1808","name":"Inj, folic acid, 0.1 mg","description":"Injection, folic acid, 0.1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32160","name":"Open chest heart massage","description":"Thoracotomy; with cardiac massage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82533","name":"Total cortisol","description":"Cortisol; total","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4378","name":"Renew ft matrix per sq cm","description":"Renew ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9026","name":"Cryo fib comp path redu each","description":"Cryoprecipitated fibrinogen complex, pathogen reduced, each unit","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5940","name":"Resct proth max part remov","description":"Resct proth max part remov","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4417","name":"Alexiguard dl-t per sq cm","description":"Alexiguard dl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"Home vent dual fnct incl all","description":"Home ventilator, dual-function respiratory device, also performs additional function of cough stimulation, includes all accessories, components and supplies for all functions","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6089","name":"Access/retorq implant screw","description":"Access/retorq implant screw","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1010T","name":"Cptr oph alys monoc eye mvmt","description":"Computerized ophthalmic analysis of monocular eye movements using retinal-based eye-tracking without spatial calibration, including fixation, microsaccades, drift, and horizontal saccades, when performed, unilateral or bilateral, with interpretation and report","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2599","name":"Inj vasopressin (am reg) 1 u","description":"Injection, vasopressin (american regent), not therapeutically equivalent to j2598, 1 unit","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96523","name":"Irrig drug delivery device","description":"Irrigation of implanted venous access device for drug delivery systems","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1370","name":"Rehab support msk care mvp","description":"Rehabilitative support for musculoskeletal care mips value pathway","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4408","name":"Xwrap hydro per sq cm","description":"Xwrap hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0394U","name":"Pfas 16 pfas compnd lc ms/ms","description":"Pfas 16 pfas compnd lc ms/ms","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82947","name":"Assay glucose blood quant","description":"Glucose; quantitative, blood (except reagent strip)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0521U","name":"Rf iga&igm ccp antb sr-a ia","description":"Rf iga&igm ccp antb sr-a ia","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6049","name":"Scale implt peri-implt inflm","description":"Scale implt peri-implt inflm","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9322","name":"Inj pemetrexed (bluepoint)","description":"Injection, pemetrexed (bluepoint), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1326","name":"Pts dx hypotony","description":"Patients with a diagnosis of hypotony","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1247","name":"Pt resp true best int","description":"Patient responded completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0037","name":"Pt not able to participate","description":"On date of encounter, patient is not able to participate in assessment or screening, including non-verbal patients, delirious, severely aphasic, severely developmentally delayed, severe visual or hearing impairment and for those patients, no knowledgeable informant available","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43287","name":"Esphg dstl 2/3 w/laps moblj","description":"Esophagectomy, distal two-thirds, with laparoscopic mobilization of the abdominal and lower mediastinal esophagus and proximal gastrectomy, with laparoscopic pyloric drainage procedure if performed, with separate thoracoscopic mobilization of the middle and upper mediastinal esophagus and thoracic e","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3564.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9322","name":"Inj pemetrexed (bluepoint)","description":"Injection, pemetrexed (bluepoint), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0948T","name":"Rem interrog dev ccm phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system with interim analysis, review, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3379","name":"Inj, valproate sod, 5 mg","description":"Injection, valproate sodium, 5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9381","name":"Inj teplizumab mzwv 5 mcg","description":"Injection, teplizumab-mzwv, 5 mcg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55715","name":"Bx prst8 ea add mri-us/ct/mr","description":"Biopsy, prostate, each additional, mri-ultrasound fusion or in-bore ct- or mri-guided targeted lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1220","name":"Dre wth interp rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; with evidence of retinopathy","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26554","name":"Double transfer toe-hand","description":"Transfer, toe-to-hand with microvascular anastomosis; other than great toe, double","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4638.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0437U","name":"Psyc anxiety do mrna 15 bmrk","description":"Psyc anxiety do mrna 15 bmrk","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2006","name":"Novosorb synpath per sq cm","description":"Novosorb synpath dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78596","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33736","name":"Revision of heart chamber","description":"Atrial septectomy or septostomy; open heart with cardiopulmonary bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1718.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73221","name":"Mri joint upr extrem w/o dye","description":"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":643.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80220","name":"Drug asy hydroxychloroquine","description":"Hydroxychloroquine","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0441U","name":"Nfct ds bct fngl/viral semiq","description":"Nfct ds bct fngl/viral semiq","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9246","name":"Mod sedation noniv-15 min","description":"Mod sedation noniv-15 min","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0529U","name":"Hem vte snp f2&f5 gen leiden","description":"Hem vte snp f2&f5 gen leiden","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0673T","name":"Abltj b9 thyr ndul perq lasr","description":"Ablation, benign thyroid nodule(s), percutaneous, laser, including imaging guidance","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0504U","name":"Nfct ds uti id 17 path orgs","description":"Nfct ds uti id 17 path orgs","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33617","name":"Repair single ventricle","description":"Repair of complex cardiac anomalies (eg, single ventricle) by modified fontan procedure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2629.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37257","name":"Revsc evsc ivt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0863T","name":"Rlcj pg wcs lv trnsmtr only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; transmitter component only","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30906","name":"Repeat control of nosebleed","description":"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; subsequent","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64856","name":"Repair/transpose nerve","description":"Suture of major peripheral nerve, arm or leg, except sciatic; including transposition","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1134.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0013","name":"Hiv prep counsel, clin staff","description":"Individual counseling for pre-exposure prophylaxis (prep) by clinical staff to prevent human immunodeficiency virus (hiv), includes: hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99397","name":"Per pm reeval est pat 65+ yr","description":"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 65 ye","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":41.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":95.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0522U","name":"Ca vi psp&sp1 antb cl semiql","description":"Ca vi psp&sp1 antb cl semiql","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61343","name":"Crnec sopl crv lam dcmprn","description":"Craniectomy, suboccipital with cervical laminectomy for decompression of medulla and spinal cord, with or without dural graft (eg, arnold-chiari malformation)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2500.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4323","name":"Alloply, per sq cm","description":"Alloply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4008","name":"Geriatrics ss","description":"Geriatrics mips specialty set","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0551","name":"Phn/intr svs fr dx treat 30m","description":"Interprofessional telephone/internet/electronic health record referral service(s) provided by a treating/requesting practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, 30 minutes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31610","name":"Tracheostomy fenest skin flp","description":"Tracheostomy, fenestration procedure with skin flaps","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49621","name":"Rpr parastomal hernia rdc","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; reducible","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":413.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1448","name":"Injection, trilaciclib, 1mg","description":"Injection, trilaciclib, 1mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64467","name":"Thrc fascial pln blk uni nfs","description":"Thoracic fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":39.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1420","name":"Complete ophthalmologic mvp","description":"Complete ophthalmologic care mips value pathway","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0217","name":"Inj velmanase alfa-tycv 1 mg","description":"Injection, velmanase alfa-tycv, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0535U","name":"Pfas lc-ms/ms plsm/srm quan","description":"Pfas lc-ms/ms plsm/srm quan","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64584","name":"Rmvl hpglsl nstim ary pg","description":"Removal of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2791","name":"Crown full cast base metal","description":"Crown-full cast predominantly base metal","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43254","name":"Egd endo mucosal resection","description":"Esophagogastroduodenoscopy, flexible, transoral; with endoscopic mucosal resection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0960T","name":"Rpl s-sclp eltr ra rcvr&tlmt","description":"Replacement of sub-scalp implanted electrode array, receiver, and telemetry unit with tunneling of electrode for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21750","name":"Repair of sternum separation","description":"Closure of median sternotomy separation with or without debridement (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":829.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0687","name":"Inj cefazolin (wg crit care)","description":"Injection, cefazolin sodium (wg critical care), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1285","name":"Scrn mam perf rslts not doc","description":"Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed, reason not otherwise specified","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1498","name":"Diagnostic radiology mvp","description":"Diagnostic radiology mips value pathway","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85347","name":"Coagulation time activated","description":"Coagulation time; activated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0726T","name":"Rmvl implt vstibular dev uni","description":"Removal of implanted vestibular device, unilateral","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76830","name":"Transvaginal us non-ob","description":"Ultrasound, transvaginal","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50957","name":"Ureter endoscopy & treatment","description":"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without biopsy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":419.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0425U","name":"Genom rpd seq alys ea cmprtr","description":"Genom rpd seq alys ea cmprtr","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36245","name":"Ins cath abd/l-ext art 1st","description":"Selective catheter placement, arterial system; each first order abdominal, pelvic, or lower extremity artery branch, within a vascular family","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S4024","name":"Air polymer foam per study","description":"Air polymer-type a intrauterine foam, per study dose","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0791T","name":"Motr cog vr gait train ea 15","description":"Motor-cognitive, semi-immersive virtual reality-facilitated gait training, each 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37259","name":"Revsc evasc ivt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0872","name":"Daptomycin (xellia) unrefrig","description":"Injection, daptomycin (xellia), unrefrigerated, not therapeutically equivalent to j0878 or j0873, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0911T","name":"Elec aly nstm sys vgs nrv wo","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; without programming by physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0307U","name":"Onc mrd nxt-gnrj alys sbsq","description":"Onc mrd nxt-gnrj alys sbsq","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4284","name":"Dermabind sl, per sq cm","description":"Dermabind sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37254","name":"Revsc evasc ivt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":189.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0300U","name":"Onc pan tum whl gen seq&opt","description":"Onc pan tum whl gen seq&opt","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0301U","name":"Iadna bartonella ddpcr","description":"Iadna bartonella ddpcr","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7511","name":"Incision/drain abscess intra","description":"Incision and drainage of abscess - intraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0270","name":"Mnt subs tx for change dx","description":"Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face to face with the patient, each 15 minutes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":30.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3375","name":"Inj, vanco (tyzavan) 10mg","description":"Injection, vancomycin hydrochloride (tyzavan), not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97008","name":"Mchnl sclp cool prep plmt","description":"Mechanical scalp cooling; including hair preparation, individual cap placement, therapy initiation, and precooling period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76810","name":"Ob us >/= 14 wks addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1181","name":"Gr 2 or> dia or gr2 or> col","description":"Grade 2 or above diarrhea and/or grade 2 or above colitis","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0711T","name":"N-nvs artl plaq alys dat prp","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data preparation and transmission","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80504","name":"Path clin consltj mod 21-40","description":"Pathology clinical consultation; for a moderately complex clinical problem, with review of patients history and medical records and moderate level of medical decision making when using time for code selection, 21-40 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0601U","name":"Nfct ds pji alys 11 bmrks ia","description":"Nfct ds pji alys 11 bmrks ia","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0840T","name":"Dgtz gls mcrscp cslt compre","description":"Digitization of glass microscope slides for consultation, comprehensive, with review of records and specimens, with report on referred material (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27792","name":"Treatment of ankle fracture","description":"Open treatment of distal fibular fracture (lateral malleolus), includes internal fixation, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0832T","name":"Dgtz gls mcrscp cytp oth scr","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0506U","name":"Gi barretts esophgl cell 89","description":"Gi barretts esophgl cell 89","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93588","name":"Vngrph chd vnvn cltrl below","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating below the heart (eg, from the inferior vena cava) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66630","name":"Removal of iris","description":"Iridectomy, with corneoscleral or corneal section; sector for glaucoma (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4348","name":"Sentry sl matrix per sq cm","description":"Sentry sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0534","name":"Coordinated care/or referral","description":"Coordinated care and/or referral services, such as to adequate and accessible community resources to address unmet health-related social needs, including harm reduction interventions and recovery support services a patient needs and wishes to pursue, which significantly limit the ability to diagnose","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2016","name":"Permeaderm b, per sq cm","description":"Permeaderm b, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1289","name":"No pt tbco cess interv rng","description":"Patient identified as tobacco user did not receive tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2018","name":"Permeaderm c, per sq cm","description":"Permeaderm c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4368","name":"Amchothick per sq cm","description":"Amchothick, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7299","name":"Intraut copp cont (miudella)","description":"Intrauterine copper contraceptive (miudella)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9697","name":"Inj, magtrace per study dose","description":"Injection, carboxydextran-coated superparamagnetic iron oxide, per study dose","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0876T","name":"Duplex scan hemo fstl lmtd","description":"Duplex scan of hemodialysis fistula, computer-aided, limited (volume flow, diameter, and depth, including only body of fistula)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1385","name":"Pt rsn not seen 2nd pam","description":"Documentation of patient reasons for patients who were not seen for the second pam survey (e.g., less than four months between baseline pam assessment and follow-up","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2249","name":"Inj, remimazolam, 1 mg","description":"Injection, remimazolam, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69646","name":"Revise middle ear & mastoid","description":"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); radical or complete, with ossicular chain reconstruction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1816.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32005","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0616","name":"Inj metoprolol tartrate 1 mg","description":"Injection, metoprolol tartrate, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28116","name":"Revision of foot","description":"Ostectomy, excision of tarsal coalition","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":629.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61736","name":"Litt icr 1 traj 1 smpl les","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; single trajectory for 1 simple lesion","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69716","name":"Impl oi implt sk tc esp<100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or resulting in removal of less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49186","name":"Opn exc/dstr ntra-abd 5 cm/<","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5 cm or less","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64567","name":"Perq elec nrv field stimj cn","description":"Percutaneous electrical nerve field stimulation, cranial nerves, without implantation","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1938","name":"Inj, furosemide, 1 mg","description":"Injection, furosemide, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9955","name":"Oral app thxpy titration vis","description":"Oral app thxpy titration vis","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0804","name":"3d facial scan indirect","description":"3d facial scan indirect","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0108","name":"Diab manage trn  per indiv","description":"Diabetes outpatient self-management training services, individual, per 30 minutes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3921","name":"Decor or submerg erupt tooth","description":"Decor or submerg erupt tooth","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0689T","name":"Quan us tis charac w/o dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained without diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1212","name":"Missing gsa not perf","description":"Glycemic status assessment (hba1c or gmi) level is missing, or was not performed during the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0750T","name":"B1 str&fx rsk asmt dxrbmd1vw","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4288","name":"Replacement breastpump valve","description":"Valve for breast pump, replacement","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0602U","name":"Endocrin dm ins gen mthyltn","description":"Endocrin dm ins gen mthyltn","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0936T","name":"Photobiomodulation ther rta","description":"Photobiomodulation therapy of retina, single session","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92981","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7299","name":"Intraut copp cont (miudella)","description":"Intrauterine copper contraceptive (miudella)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4560","name":"Nmes disposable","description":"Neuromuscular electrical stimulator (nmes), disposable, replacement only","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6031","name":"Rep interface handfng molded","description":"Replacement socket/interface, partial hand including fingers, molded to patient model, for use with or without external power","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0436U","name":"Onc lng plsm alys 388 prtn","description":"Onc lng plsm alys 388 prtn","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4298","name":"Amniocore pro, per sq cm","description":"Amniocore pro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95912","name":"Nrv cndj test 11-12 studies","description":"Nerve conduction studies; 11-12 studies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61334","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1359.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30310","name":"Remove nasal foreign body","description":"Removal foreign body, intranasal; requiring general anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4318","name":"E-graft, per sq cm","description":"E-graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0249","name":"Adm tocilizu covid-19 1st","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55710","name":"Bx prst8 tprn us w/mri fus 1","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant) with mri-fusion-guidance biopsy, first targeted lesion","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0745T","name":"Car ablt rad arr n-invas loc","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; noninvasive arrhythmia localization and mapping of arrhythmia site (nidus), derived from anatomical image data (eg, ct, mri, or myocardial perfusion scan) and electrical data (eg, 12-lead ecg data), and identification of areas of avo","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0709T","name":"Id ca immntx each addl njx","description":"Intradermal cancer immunotherapy; each additional injection (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43123","name":"Partial removal of esophagus","description":"Partial esophagectomy, thoracoabdominal or abdominal approach, with or without proximal gastrectomy; with colon interposition or small intestine reconstruction, including intestine mobilization, preparation, and anastomosis(es)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2289.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0484","name":"Consult slides prep elsewher","description":"Consultation on slides prepared elsewhere","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33897","name":"Perq trluml angp nt/recr coa","description":"Percutaneous transluminal angioplasty of native or recurrent coarctation of the aorta","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86041","name":"Acetylcholn rcptr bndng antb","description":"Acetylcholine receptor (achr); binding antibody","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4433","name":"361 hct/p skin subs, nos","description":"361 hct/p skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0553","name":"Monthly tx for dmht 20mins","description":"First 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing information related to the use of","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1332","name":"Pts no eval ini xm no 2 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 2 weeks","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0290U","name":"Pain mgmt mrna gen xprsn 36","description":"Pain mgmt mrna gen xprsn 36","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9986","name":"Missed appointment","description":"Missed appointment","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1323","name":"Pts 7wk inj, scrn iop >25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop >25 mm hg and a plan of care was documented","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1344","name":"No bsln/2nd pam score 4-12mo","description":"Patients who did not have a baseline pam score and/or a second score within 4 to 12 months of baseline pam score","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4431","name":"Pma skin substitute, nos","description":"Pma skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0389U","name":"Ped fbrl kd ifi27&mcemp1 rna","description":"Ped fbrl kd ifi27&mcemp1 rna","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1418","name":"Med rsn not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination because of a medical contraindication documented by clinician","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2249","name":"Inj, remimazolam, 1 mg","description":"Injection, remimazolam, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0728T","name":"Dx alys vstblr implt uni 1st","description":"Diagnostic analysis of vestibular implant, unilateral; with initial programming","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4262","name":"Dual layer impax, per sq cm","description":"Dual layer impax membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0914T","name":"Prq tcat thr rx ntrc bal sep","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting) performed on a separate target lesion from the target lesion treated with balloon angioplasty, coronary stent placement or coronary atherectomy, including mechanical dilation b","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93641","name":"Ep evl 1/2chmb pac cvdfb tst","description":"Electrophysiologic evaluation of single or dual chamber pacing cardioverter-defibrillator leads including defibrillation threshold evaluation (induction of arrhythmia, evaluation of sensing and pacing for arrhythmia termination) at time of initial implantation or replacement; with testing of single ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1385","name":"Pt rsn not seen 2nd pam","description":"Documentation of patient reasons for patients who were not seen for the second pam survey (e.g., less than four months between baseline pam assessment and follow-up","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0180","name":"Md certification hha patient","description":"Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initial ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0504U","name":"Nfct ds uti id 17 path orgs","description":"Nfct ds uti id 17 path orgs","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0449U","name":"Car scr sev inh cond 5 genes","description":"Car scr sev inh cond 5 genes","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0525U","name":"Onc sphrd cell cul 11-rx pnl","description":"Onc sphrd cell cul 11-rx pnl","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1402","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0680","name":"Cr art clc art vlv clc w rpt","description":"Detection and quantification of coronary artery calcium and/or aortic valve calcification from algorithmic analysis of computed tomography of the chest with report","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97112","name":"Neuromuscular reeducation","description":"Therapeutic procedure, 1 or more areas, each 15 minutes; neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing activities","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1163","name":"Inj, diltiazem hcl, 0.5 mg","description":"Injection, diltiazem hydrochloride, 0.5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0737T","name":"Xenograft impltj artclr surf","description":"Xenograft implantation into the articular surface","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76989","name":"Dx intraop epcar us chd i&r","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; interpretation and report only","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76883","name":"Us nrv&acc strux 1xtr compre","description":"Ultrasound, nerve(s) and accompanying structures throughout their entire anatomic course in one extremity, comprehensive, including real-time cine imaging with image documentation, per extremity","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49187","name":"Opn exc/dstr ntra-abd 5.1-10","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5.1 to 10 cm","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0969T","name":"Removal epicranial nstim sys","description":"Removal of epicranial neurostimulator system","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4457","name":"Enema tube any type repl","description":"Enema tube, with or without adapter, any type, replacement only, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4297","name":"Emerge matrix, per sq cm","description":"Emerge matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7471","name":"Rem exostosis any site","description":"Removal of lateral exostosis (maxilla or mandible)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9332","name":"Inj efgartigimod 2mg","description":"Injection, efgartigimod alfa-fcab, 2mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99445","name":"Rem mntr physiol param 2-15","description":"Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate); device(s) supply with daily recording(s) or programmed alert(s) transmission, 2-15 days in a 30-day period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0292U","name":"Psyc strs do mrna 72 genes","description":"Psyc strs do mrna 72 genes","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6519","name":"Grad com garm noc night use","description":"Gradient compression garment, not otherwise specified, for nighttime use, each","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0582U","name":"Rare ds rpd whlgen dna vrnts","description":"Rare ds rpd whlgen dna vrnts","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9247","name":"Mod sedation noniv-sub15min","description":"Mod sedation noniv-sub15min","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50545","name":"Laparo radical nephrectomy","description":"Laparoscopy, surgical; radical nephrectomy (includes removal of gerotas fascia and surrounding fatty tissue, removal of regional lymph nodes, and adrenalectomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1520.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"Endoskel posit rotat unit","description":"Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93012","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0439U","name":"Crd chd dna alys 5 snp 3 dna","description":"Crd chd dna alys 5 snp 3 dna","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4007","name":"General surgery ss","description":"General surgery mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61737","name":"Litt icr mlt trj mlt/cplx ls","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; multiple trajectories for multiple or complex lesion(s)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99496","name":"Transj care mgmt high f2f 7d","description":"Transitional care management services with the following required elements: communication (direct contact, telephone, electronic) with the patient and/or caregiver within 2 business days of discharge high level of medical decision making during the service period face-to-face visit, within 7 calenda","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":321.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":176.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1306","name":"Pt anphx due to pneum","description":"Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50725","name":"Release/revise ureter","description":"Ureterolysis for retrocaval ureter, with reanastomosis of upper urinary tract or vena cava","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1229.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0662","name":"Team remote e/m new pt 30 mn","description":"Team remote e/m new pt 30 mins","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1446","name":"Pt died bef end meas pd","description":"Patients who died any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70473","name":"Ct cere prfu aly c+wo ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed without concurrent ct or ct angiography of the same anatomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0237","name":"Inj, tocilizumab-anoh, hospi","description":"Injection, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84394","name":"Total tau","description":"Tau, total (ttau)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0799","name":"Hiv prep, fda approved, noc","description":"Fda approved prescription drug, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv), not otherwise classified","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52443","name":"Cysto 1st trurl prst8 comis","description":"Cystourethroscopy with initial transurethral anterior prostate commissurotomy with a nondrug-coated balloon catheter followed by therapeutic drug delivery into the prostate by a drug-coated balloon catheter, including transrectal ultrasound and fluoroscopy, when performed","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37280","name":"Revsc evsc tpvt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33901","name":"Perq p-art revsc 1 nm nt bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, bilateral","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7471","name":"Rem exostosis any site","description":"Removal of lateral exostosis (maxilla or mandible)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1426","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0238","name":"Inj, tocilizumab-aazg, hospi","description":"Injection, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1356","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0472","name":"Gross exam prep & report","description":"Accession of tissue gross examination preparation and transmission of written report","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0039","name":"Pt no ref, rn spec","description":"Patient not referred, reason not otherwise specified","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5142","name":"Inj adalimumab-ryvk, 1 mg","description":"Injection, adalimumab-ryvk biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1467","name":"Pt dx lynch syn","description":"Patients with an existing diagnosis of lynch syndrome","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63704","name":"Repair of spinal herniation","description":"Repair of myelomeningocele; less than 5 cm diameter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1776.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1228","name":"Pt + hcv aby +vir w/ rx 3 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, has hcv treatment initiated within 3 months of the reactive hcv antibody test","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75726","name":"Artery x-rays abdomen","description":"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0567","name":"Screening hep c detect","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis c, screening, amplified probe technique","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65820","name":"Goniotomy","description":"Goniotomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81007","name":"Urine screen for bacteria","description":"Urinalysis; bacteriuria screen, except by culture or dipstick","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1178","name":"Doc med rsn no pcv","description":"Documentation of medical reason(s) for not administering pneumococcal vaccine (e.g., prior anaphylaxis due to the pneumococcal vaccine)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0282U","name":"Rbc dna gntyp 12 bld grp gen","description":"Red blood cell antigen typing, dna, genotyping of 12 blood group system genes to predict 44 red blood cell antigen phenotypes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99466","name":"Ped crit care transport","description":"Critical care face-to-face services, during an interfacility transport of critically ill or critically injured pediatric patient, 24 months of age or younger; first 30-74 minutes of hands-on care during transport","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6597","name":"G comp bandage long stretch","description":"Gradient compression bandage roll, elastic long stretch, linear yard, any width, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62319","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98008","name":"Synch audio-only new sf 15","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code sel","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78455","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87341","name":"Hep b surface ag neutrlzj ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; hepatitis b surface antigen (hbsag) neutralization","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2561","name":"Inj, sezaby, 1 mg","description":"Injection, phenobarbital sodium (sezaby), 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0039","name":"Pt no ref, rn spec","description":"Patient not referred, reason not otherwise specified","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9293","name":"Fertility cycl tracking soft","description":"Fertility cycle (contraception & conception) tracking software application, fda cleared, per month, includes accessories (e.g., thermometer)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0073A","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0986T","name":"Iv img icr cere vsl oct 1st","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4148","name":"Enteral feed elastomer daily","description":"Enteral feeding supply kit; elastomeric control fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30901","name":"Control of nosebleed","description":"Control nasal hemorrhage, anterior, simple (limited cautery and/or packing) any method","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":193.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0273U","name":"Hem gen hyprfibrnlysis 8 gen","description":"Hematology (genetic hyperfibrinolysis, delayed bleeding), genomic sequence analysis of 8 genes (f13a1, f13b, fga, fgb, fgg, serpina1, serpine1, serpinf2, plau) blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1426","name":"Injection, casimersen, 10 mg","description":"Injection, casimersen, 10 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0031","name":"Pall serv during meas","description":"Palliative care services given to patient any time during the measurement period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0525U","name":"Onc sphrd cell cul 11-rx pnl","description":"Onc sphrd cell cul 11-rx pnl","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63091","name":"Remove vertebral body add-on","description":"Vertebral corpectomy (vertebral body resection), partial or complete, transperitoneal or retroperitoneal approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic, lumbar, or sacral; each additional segment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0613","name":"Calcium glucon (wg critical)","description":"Injection, calcium gluconate (wg critical care), not therapeutically equivalent to j0612, 10 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9293","name":"Mitoxantrone hydrochl / 5 mg","description":"Injection, mitoxantrone hydrochloride, per 5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":321.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0570U","name":"Neurol tbi alys gfap&uch-l1","description":"Neurol tbi alys gfap&uch-l1","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1416","name":"Pt rec hosp","description":"Patient received hospice services any time during the performance period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2030","name":"Miro3d fibers, per mg","description":"Miro3d fibers, per milligram","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1434","name":"Inj, focinvez, 1mg","description":"Injection, fosaprepitant (focinvez), 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8679","name":"Imp neurosti pls gn any type","description":"Implantable neurostimulator, pulse generator, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10028.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0033","name":"2+ benzo seiz","description":"Two or more benzodiazepine prescriptions ordered for patients who had a diagnosis of seizure disorders, rapid eye movement sleep behavior disorder, benzodiazepine withdrawal, ethanol withdrawal, or severe generalized anxiety disorder on or between january 1 of the year prior to the measurement perio","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1187","name":"Pt w/ esrd","description":"Patients with a diagnosis of end stage renal disease (esrd)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0967T","name":"Tranal ins tmp clrc anst dev","description":"Transanal insertion of endoluminal temporary colorectal anastomosis protection device, including vacuum anchoring component and flexible sheath connected to external vacuum source and monitoring system","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44361","name":"Small bowel endoscopy/biopsy","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with biopsy, single or multiple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99470","name":"Rpm tx mgmt 1st 10 min","description":"Remote physiologic monitoring treatment management services, clinical staff/physician/other qualified health care professional time in a calendar month requiring 1 real-time interactive communication with the patient/caregiver during the calendar month; first 10 minutes","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1294","name":"Bp scrn perf rec interval","description":"Normal blood pressure reading documented, follow-up not required","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0625U","name":"Endocrinol op dna alys>5000","description":"Endocrinol op dna alys>5000","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1356","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1234","name":"Pt hcv rctv aby f/u neg","description":"Patient has a reactive hcv antibody test, and has a follow up hcv viral test that does not detect hcv viremia","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0314U","name":"Onc cutan mlnma mrna 35 gene","description":"Onc cutan mlnma mrna 35 gene","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90759","name":"Hep b vac 3ag 10mcg 3 dos im","description":"Hepatitis b vaccine (hepb), 3-antigen (s, pre-s1, pre-s2), 10 mcg dosage, 3 dose schedule, for intramuscular use","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20931","name":"Sp bone algrft struct add-on","description":"Allograft, structural, for spine surgery only (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0649","name":"Lso sc r pos/lat pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0703","name":"Inj, cefepime hcl (b braun)","description":"Injection, cefepime hydrochloride (b braun), not therapeutically equivalent to maxipime, 500 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2004","name":"Inj, lidocaine w epinephrine","description":"Injection, lidocaine hcl with epinephrine, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98978","name":"Rtm dev sply cbt 16-30 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of cognitive behavioral therapy, 16-30 days in a 30-day period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0917T","name":"Insj perm ccm-d sys 1 lead","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; single transvenous lead (pacing or defibrillation) only","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0880T","name":"Augmnt alys ch ct ild i&r","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31651","name":"Bronchial valve addl insert","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with balloon occlusion, when performed, assessment of air leak, airway sizing, and insertion of bronchial valve(s), each additional lobe (list separately in addition to code for primary procedure[s])","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81517","name":"Liver ds alys 3 bmrk srm alg","description":"Liver disease, analysis of 3 biomarkers (hyaluronic acid [ha], procollagen iii amino terminal peptide [piiinp], tissue inhibitor of metalloproteinase 1 [timp-1]), using immunoassays, utilizing serum, prognostic algorithm reported as a risk score and risk of liver fibrosis and liver-related clinical ","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61736","name":"Litt icr 1 traj 1 smpl les","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; single trajectory for 1 simple lesion","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9329","name":"Inj, tislelizumab-jsgr","description":"Injection, tislelizumab-jsgr, 1mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0528","name":"Mgt est pt dem mod-hi cmplx","description":"Management of established patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0738","name":"Hiv prep, inj, lenacapavir","description":"Injection, lenacapavir, 1 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1551","name":"Inj cutaquig 100 mg","description":"Injection, immune globulin (cutaquig), 100 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1193","name":"Rpts w/ imp/con mmr/msi","description":"Surgical pathology reports that contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5930","name":"Max guid prothes w/o flange","description":"Max guid prothes w/o flange","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1305","name":"Inj, evinacumab-dgnb, 5mg","description":"Injection, evinacumab-dgnb, 5mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86480","name":"Tb test cell immun measure","description":"Tuberculosis test, cell mediated immunity antigen response measurement; gamma interferon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2038","name":"Skill train and dev/diem","description":"Skills training and development, per diem","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27756","name":"Treatment of tibia fracture","description":"Percutaneous skeletal fixation of tibial shaft fracture (with or without fibular fracture) (eg, pins or screws)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":659.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92634","name":"Hearing aid fitg svc 1st 60","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; first 60 minutes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1072","name":"Inj, testosterone, azmiro","description":"Injection, testosterone cypionate (azmiro), 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0540","name":"Train for caregiver add 15","description":"Caregiver training in behavior management/modification for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face; each additional 15 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1432","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64467","name":"Thrc fascial pln blk uni nfs","description":"Thoracic fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9947","name":"Sleep apnea appliance","description":"Sleep apnea appliance","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1010T","name":"Cptr oph alys monoc eye mvmt","description":"Computerized ophthalmic analysis of monocular eye movements using retinal-based eye-tracking without spatial calibration, including fixation, microsaccades, drift, and horizontal saccades, when performed, unilateral or bilateral, with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0671T","name":"Insj ant sgm aq drg dev 1+","description":"Insertion of anterior segment aqueous drainage device into the trabecular meshwork, without external reservoir, and without concomitant cataract removal, one or more","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90838","name":"Psytx w pt w e/m 60 min","description":"Psychotherapy, 60 minutes with patient when performed with an evaluation and management service (list separately in addition to the code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":116.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6093","name":"Recement supp part denture","description":"Recement implant/abutment supported fixed partial denture","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9048","name":"Inj, bortezomib freseniuskab","description":"Injection, bortezomib (fresenius kabi), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86301","name":"Immunoassay tumor ca 19-9","description":"Immunoassay for tumor antigen, quantitative; ca 19-9","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90684","name":"Pcv21 vaccine im","description":"Pneumococcal conjugate vaccine, 21 valent (pcv21), for intramuscular use","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6604","name":"Cst bse mtl inlay 2 surfaces","description":"Inlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0063","name":"Cardiology ss","description":"Cardiology mips specialty set","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27052","name":"Biopsy of hip joint","description":"Arthrotomy, with biopsy; hip joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31395","name":"Reconstruct larynx & pharynx","description":"Pharyngolaryngectomy, with radical neck dissection; with reconstruction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2775.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0675","name":"Inj, carboprost, 0.1 mg","description":"Injection, carboprost tromethamine, 0.1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0944T","name":"3d cntr simula trgt lvr les","description":"3d contour simulation of target liver lesion(s) and margin(s) for image-guided percutaneous microwave ablation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1474","name":"Pt dx dementia","description":"Patients with diagnosis of dementia","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67220","name":"Treatment of choroid lesion","description":"Destruction of localized lesion of choroid (eg, choroidal neovascularization); photocoagulation (eg, laser), 1 or more sessions","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1002.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1166","name":"Path rpt tis spec wle/reexc","description":"Pathology report for tissue specimens produced from wide local excisions or re-excisions","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92634","name":"Hearing aid fitg svc 1st 60","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; first 60 minutes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5930","name":"Max guid prothes w/o flange","description":"Max guid prothes w/o flange","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0303U","name":"Hem rbc ads whl bld hypoxic","description":"Hem rbc ads whl bld hypoxic","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0613","name":"Calcium glucon (wg critical)","description":"Injection, calcium gluconate (wg critical care), not therapeutically equivalent to j0612, 10 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85396","name":"Clotting assay whole blood","description":"Coagulation/fibrinolysis assay, whole blood (eg, viscoelastic clot assessment), including use of any pharmacologic additive(s), as indicated, including interpretation and written report, per day","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6603","name":"Cst hgh nble mtl inlay >=3sr","description":"Inlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29887","name":"Arthrs knee srg drlg od fixj","description":"Arthroscopy, knee, surgical; drilling for intact osteochondritis dissecans lesion with internal fixation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8611","name":"Oral methotrexate (jylamvo)","description":"Methotrexate (jylamvo), oral, 2.5 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3392","name":"Inj, exagamglogene autotem","description":"Injection, exagamglogene autotemcel, per treatment","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0224","name":"Pemivibart infusion","description":"Intravenous infusion, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppr","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1503","name":"Vascular surgery mvp","description":"Vascular surgery mips value pathway","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0625U","name":"Endocrinol op dna alys>5000","description":"Endocrinol op dna alys>5000","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93595","name":"L hrt cath chd nm/abn nt cnj","description":"Left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone, normal or abnormal native connections","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0689T","name":"Quan us tis charac w/o dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained without diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0581U","name":"Trnspl med antb nohla 39trgt","description":"Trnspl med antb nohla 39trgt","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99464","name":"Attendance at delivery","description":"Attendance at delivery (when requested by the delivering physician or other qualified health care professional) and initial stabilization of newborn","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1249","name":"Pt resp true imprt to me","description":"Patient responded completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90954","name":"Esrd serv 4 vsts p mo 2-11","description":"End-stage renal disease (esrd) related services monthly, for patients 2-11 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 4 or more face-to-face visits by a physician or other qualified health care professional ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1248","name":"Pt resp true seen as person","description":"Patient responded completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0482","name":"Direct immunofluorescence","description":"Direct immunofluorescence","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0339U","name":"Onc prst8 mrna hoxc6 & dlx1","description":"Onc prst8 mrna hoxc6 & dlx1","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4312","name":"Acesso ac, per sq cm","description":"Acesso ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5153","name":"Inj, aflibercept-yszy, 1 mg","description":"Injection, aflibercept-yszy (opuviz), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1481","name":"Pt in hosp/pal care who died","description":"Patients receiving hospice or palliative care or who died during the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23700","name":"Mnpj anes sho jt fixj aprats","description":"Manipulation under anesthesia, shoulder joint, including application of fixation apparatus (dislocation excluded)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0019","name":"Comm hlth intg svs sdoh 60mn","description":"Community health integration services performed by certified or trained auxiliary personnel, including a community health worker, under the direction of a physician or other practitioner; 60 minutes per calendar month, in the following activities to address social determinants of health (sdoh) need(","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0865T","name":"Quan mri alys brn w/o dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion identification, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transm","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1270","name":"Pts no kid transplt wtlst","description":"Patients not on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4033","name":"Skilled nursing facility ss","description":"Skilled nursing facility mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0864T","name":"Low ntsty eswt corpus cvrnsm","description":"Low-intensity extracorporeal shock wave therapy involving corpus cavernosum, low energy","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91122","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2404","name":"Inj, nicardipine 0.1 mg","description":"Injection, nicardipine, 0.1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45398","name":"Colonoscopy w/band ligation","description":"Colonoscopy, flexible; with band ligation(s) (eg, hemorrhoids)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":1043.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0312U","name":"Ai ds sle alys 8 igg autoant","description":"Ai ds sle alys 8 igg autoant","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1382","name":"Enc dur perf pd pos 11","description":"Patient encounter during the performance period with place of service code 11","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3420","name":"Vitamin b12 injection","description":"Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7771","name":"Alveolus clsd reduc stblz te","description":"Alveolus closed reduction stabilization of teeth","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4351","name":"Enclose tl matrix, per sq cm","description":"Enclose tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5153","name":"Inj, aflibercept-yszy, 1 mg","description":"Injection, aflibercept-yszy (opuviz), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1197","name":"Isa reduced >=3 fr ixv","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28420","name":"Optx calcaneal fx w/bone grf","description":"Open treatment of calcaneal fracture, includes internal fixation, when performed; with primary iliac or other autogenous bone graft (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1473.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4435","name":"Renati membrane per sq cm","description":"Renati membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92629","name":"Eval hearing aid cand ea add","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0146","name":"Nav srv peer sup add 30 pr m","description":"Principal illness navigation - peer support, additional 30 minutes per calendar month (list separately in addition to g0140)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1010","name":"Inj, methylpred acetate 1 mg","description":"Injection, methylprednisolone acetate, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5156","name":"Inj, tocilizumab-anoh, 1 mg","description":"Injection, tocilizumab-anoh (avtozma), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29131","name":"Appl finger splint dynamic","description":"Application of finger splint; dynamic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":36.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4328","name":"Most, per sq cm","description":"Most, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76820","name":"Umbilical artery echo","description":"Doppler velocimetry, fetal; umbilical artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1500","name":"Neuropsychology mvp","description":"Neuropsychology mips value pathway","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1737","name":"Inj meloxicam (azurity) 1mg","description":"Injection, meloxicam (azurity), 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1419","name":"Pt not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9003","name":"Leupro inj, camcevi etm, 1mg","description":"Leuprolide injectable (camcevi etm), 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0870T","name":"Imp subq prtl ascts pmp sys","description":"Implantation of subcutaneous peritoneal ascites pump system, percutaneous, including pump-pocket creation, insertion of tunneled indwelling bladder and peritoneal catheters with pump connections, including all imaging and initial programming, when performed","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2018","name":"Permeaderm c, per sq cm","description":"Permeaderm c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98000","name":"Synch audio-video new sf 15","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 15 minutes must be met or exceeded.","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94626","name":"Phy/qhp op pulm rhb w/mntr","description":"Physician or other qualified health care professional services for outpatient pulmonary rehabilitation; with continuous oximetry monitoring (per session)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6191","name":"Semi precision abutment","description":"Semi precision abutment","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0040","name":"Pt phys/occ therapy","description":"Patient already receiving physical/occupational/speech/recreational therapy during the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4362","name":"Cygnus disk, per sq cm","description":"Cygnus disk, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0872T","name":"Rplcmt ndwllg bldr&prtl cath","description":"Replacement of indwelling bladder and peritoneal catheters, including tunneling of catheter(s) and connection with previously implanted peritoneal ascites pump, including imaging and programming, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10060","name":"I&d abscess simple/single","description":"Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); simple or single","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":108.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58952","name":"Resect ovarian malignancy","description":"Resection (initial) of ovarian, tubal or primary peritoneal malignancy with bilateral salpingo-oophorectomy and omentectomy; with radical dissection for debulking (ie, radical excision or destruction, intra-abdominal or retroperitoneal tumors)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1767.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0522","name":"Mgt nw pt dementia low cmplx","description":"Management of a new patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2004","name":"Inj, lidocaine w epinephrine","description":"Injection, lidocaine hcl with epinephrine, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76815","name":"Ob us limited fetus(s)","description":"Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0539U","name":"Onc sol tumor cfctdna 152gen","description":"Onc sol tumor cfctdna 152gen","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45350","name":"Sgmdsc w/band ligation","description":"Sigmoidoscopy, flexible; with band ligation(s) (eg, hemorrhoids)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":881.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86826","name":"Hla x-match noncytotoxc addl","description":"Human leukocyte antigen (hla) crossmatch, non-cytotoxic (eg, using flow cytometry); each additional serum sample or sample dilution (list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"Endoskel posit rotat unit","description":"Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37290","name":"Revsc evsc tpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1323","name":"Pts 7wk inj, scrn iop >25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop >25 mm hg and a plan of care was documented","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1354","name":"Int caries med app per tooth","description":"Interim caries med app","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33267","name":"Excl laa open any method","description":"Exclusion of left atrial appendage, open, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":609.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1439","name":"Sig ocu cond imp surg out","description":"Significant ocular conditions that impact the visual outcome of surgery","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1164","name":"Pt w/ dementia any time","description":"Patients with dementia any time during the patients history through the end of the measurement period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7911","name":"Dental suture wound to 5 cm","description":"Complicated suture-up to 5 cm","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2506","name":"Inj pegfilgrast ex bio 0.5mg","description":"Injection, pegfilgrastim, excludes biosimilar, 0.5 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0360U","name":"Onc lung elisa 7 autoant alg","description":"Onc lung elisa 7 autoant alg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2041","name":"Coord special care encounter","description":"Coordinated specialty care, team-based, for first episode psychosis, per encounter","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82272","name":"Occult bld feces 1-3 tests","description":"Blood, occult, by peroxidase activity (eg, guaiac), qualitative, feces, 1-3 simultaneous determinations, performed for other than colorectal neoplasm screening","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1269","name":"Recd esrd mcp lst day of mo","description":"Receiving esrd mcp dialysis services by the provider on the last day of the reporting month","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1225","name":"Iop dec>=20% from base","description":"Intraocular pressure (iop) reduced by a value of greater than or equal to 20% from the pre-intervention level","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0789T","name":"Elec aly cpx iins sp/sac nrv","description":"Electronic analysis with complex programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detect","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7961","name":"Buccal/labial frenectomy","description":"Buccal/labial frenectomy","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5913","name":"Nasal prosthesis","description":"Nasal prosthesis","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0919T","name":"Rmvl perm ccm-d sys pg only","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); pulse generator only","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1451","name":"Pt dx ppd dur id/pf pd","description":"Patients with an active diagnosis of pervasive developmental disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47525","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1439","name":"Sig ocu cond imp surg out","description":"Significant ocular conditions that impact the visual outcome of surgery","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64597","name":"Ins/rplcm prq eltrd ra pn ea","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; each additional electrode array (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9912","name":"Pre-visit patient screening","description":"Pre-visit patient screening","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64654","name":"1st opn implt bat modulj sys","description":"Initial open implantation of baroreflex activation therapy (bat) modulation system, including lead placement onto the carotid sinus, lead tunnelling, connection to a pulse generator placed in a distant subcutaneous pocket (ie, total system), and intraoperative interrogation and programming","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4253","name":"Zenith amniotic membrane psc","description":"Zenith amniotic membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6609","name":"G compression bandaging","description":"Gradient compression bandaging supply, not otherwise specified","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0487U","name":"Onc sol tum cfcdna tgsap 84","description":"Onc sol tum cfcdna tgsap 84","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80408","name":"Aldosterone suppression eval","description":"Aldosterone suppression evaluation panel (eg, saline infusion) this panel must include the following: aldosterone (82088 x 2) renin (84244 x 2)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0843T","name":"Dgtz gls mcrscp cslt cyt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), initial site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4301","name":"Activate matrix, per sq cm","description":"Activate matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1653","name":"Ho abduction static ots","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, off the shelf","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20662","name":"Application halo pelvic","description":"Application of halo, including removal; pelvic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0767T","name":"Tc mag stimj pn ea addl nrv","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; each additional nerve (list separat","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81524","name":"Onc cns tum dna mthyl 10,000","description":"Oncology (central nervous system tumor), dna methylation analysis of at least 10,000 methylation sites, utilizing dna extracted from formalin-fixed tumor tissue, algorithm(s) reported as probability of matching a reference tumor family and class, and mgmt (o-6-methylguanine-dna methyltransferase) pr","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1013T","name":"Lap srg imp/rpl eso nea&pg/r","description":"Laparoscopy, surgical, implantation or replacement of lower esophageal sphincter neurostimulator electrode array and neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver, including cruroplasty and/or electronic ","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0841T","name":"Dgtz gls mcrscp pth cslt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; first tissue block, with frozen section(s), single specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33288","name":"Rmv&rplcmt phrnc nrv stim ld","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2470","name":"Inj pantoprazole sodium 40mg","description":"Injection, pantoprazole sodium, 40 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99382","name":"Init pm e/m new pat 1-4 yrs","description":"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; early childhood ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":75.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0328U","name":"Drug assay 120+ rx&metablt","description":"Drug assay 120+ rx&metablt","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0750T","name":"B1 str&fx rsk asmt dxrbmd1vw","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4286","name":"Nudyn sl or slw, per sq cm","description":"Nudyn sl or nudyn slw, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0863T","name":"Rlcj pg wcs lv trnsmtr only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; transmitter component only","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1215","name":"Med rsn for no doc spiro","description":"Documentation of medical reason(s) for not documenting and reviewing spirometry results (e.g., patients with dementia or tracheostomy)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15018","name":"App skn cll ssp f/n/g/hf ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 480 sq cm or part thereof (list separately in addition to code for prima","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1834","name":"Inj, isoniazid, 1 mg","description":"Injection, isoniazid, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78608","name":"Brain imaging (pet)","description":"Brain imaging, positron emission tomography (pet); metabolic evaluation","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1357","name":"Pt w/red suic idea 120 days","description":"Patients who had a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0273U","name":"Hem gen hyprfibrnlysis 8 gen","description":"Hematology (genetic hyperfibrinolysis, delayed bleeding), genomic sequence analysis of 8 genes (f13a1, f13b, fga, fgb, fgg, serpina1, serpine1, serpinf2, plau) blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0549U","name":"Onc urthl dna mthyltd rt pcr","description":"Onc urthl dna mthyltd rt pcr","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1249","name":"Pt resp true imprt to me","description":"Patient responded completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0891T","name":"Arhfcmrigtbs sbsq tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent treatment day","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64766","name":"Incise hip/thigh nerve","description":"Transection or avulsion of obturator nerve, intrapelvic, with or without adductor tenotomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":671.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1708","name":"Pfizer vacc admin 3rd dose","description":"Pfizer vacc admin 3rd dose","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3222","name":"Part pulp for apexogenesis","description":"Partial pulpotomy for apexogenesis - permanent tooth with incomplete root development","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0270U","name":"Hem cgen coagj do 20 genes","description":"Hematology (congenital coagulation disorders), genomic sequence analysis of 20 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99349","name":"Home/res vst est mod mdm 40","description":"Home or residence visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 40 minutes must be met or excee","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57240","name":"Anterior colporrhaphy","description":"Anterior colporrhaphy, repair of cystocele with or without repair of urethrocele, including cystourethroscopy, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0794T","name":"Pt spec alg rx-onc tx option","description":"Patient-specific, assistive, rules-based algorithm for ranking pharmaco-oncologic treatment options based on the patients tumor-specific cancer marker information obtained from prior molecular pathology, immunohistochemical, or other pathology results which have been previously interpreted and repor","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64474","name":"Lwr xtr fscl pln blk uni nfs","description":"Lower extremity fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6604","name":"G com bandge low dn foam flt","description":"Gradient compression bandaging supply, low density flat foam sheet, per 250 square centimeters, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0425U","name":"Genom rpd seq alys ea cmprtr","description":"Genom rpd seq alys ea cmprtr","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1921","name":"Inj labetalol hcl hikma, 5mg","description":"Injection, labetalol hydrochloride (hikma), not therapeutically equivalent to j1920, 5 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1349","name":"No pam inc 3 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 3 points within a 4 to 12 month period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2026","name":"Restrata minimatrix, 5 mg","description":"Restrata minimatrix, 5 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0053","name":"Ht mental health and care","description":"Historical trauma (ht) mental health and clinical care for indigenous persons","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59618","name":"Attempted vbac delivery","description":"Routine obstetric care including antepartum care, cesarean delivery, and postpartum care, following attempted vaginal delivery after previous cesarean delivery","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2719.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15732","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1434.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1399","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"Sup/ext non-ins inf pump syr","description":"Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0266U","name":"Unxpl cnst hrtbl do gn xprsn","description":"Unexplained constitutional or other heritable disorders or syndromes, tissue-specific gene expression by whole-transcriptome and next-generation sequencing, blood, formalin-fixed paraffin-embedded (ffpe) tissue or fresh frozen tissue, reported as presence or absence of splicing or expression changes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0275U","name":"Hem heprn nduc trmbctpna srm","description":"Hematology (heparin-induced thrombocytopenia) platelet antibody reactivity by flow cytometry, serum","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1279","name":"Pre-htn/htn, no f/u, not gvn","description":"Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4411","name":"Amniomatrixf4x per sq cm","description":"Amniomatrixf4x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0970T","name":"Ablt b9 brst tum perq lsr ea","description":"Ablation, benign breast tumor (eg, fibroadenoma), percutaneous, laser, including imaging guidance when performed, each tumor","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1378","name":"Med rsn no 10 yr fu colscope","description":"Documentation of medical reason(s) for not recommending a 10 year follow-up interval (e.g., inadequate prep, familial or personal history of colonic polyps, patient had no adenoma and age is >= 66 years old, or life expectancy < 10 years, other medical reasons)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75957","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":391.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2976","name":"Band stabilization per tooth","description":"Band stabilization per tooth","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4405","name":"Xwrap fenestra plus sq cm","description":"Xwrap fenestra plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93897","name":"Emboli detcj wo iv mbubb njx","description":"Emboli detection without intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1812","name":"Inj. insulin (fiasp)","description":"Insulin (fiasp), per 5 units","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98975","name":"Rtm 1st set-up&pt educaj eqp","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); initial set-up and patient education on use of equipment","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0610U","name":"Nfct ds antmcr sc phenotypic","description":"Nfct ds antmcr sc phenotypic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38573","name":"Laps pelvic lymphadec","description":"Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy and peri-aortic lymph node sampling, peritoneal washings, peritoneal biopsy(ies), omentectomy, and diaphragmatic washings, including diaphragmatic and other serosal biopsy(ies), when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1237.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1171","name":"Pt recd 1 td/tdap 9yrs prior","description":"Patient received at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92629","name":"Eval hearing aid cand ea add","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0820T","name":"Mntr psychdlc med 1stphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; first physician or other qualified health care professional, each hour","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9011","name":"Datopotamab deruxtecan, 1 mg","description":"Injection, datopotamab deruxtecan-dlnk, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4384","name":"Axolotl dual ult per sq cm","description":"Axolotl dualgraft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7471","name":"Rem exostosis any site","description":"Removal of lateral exostosis (maxilla or mandible)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0800T","name":"Tcat rmvl 2chmbr ldls pm rv","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right ventricular pacemaker component (when part of a dual-chamber leadless pacem","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96116","name":"Nubhvl xm phys/qhp 1st hr","description":"Neurobehavioral status exam (clinical assessment of thinking, reasoning and judgment, [eg, acquired knowledge, attention, language, memory, planning and problem solving, and visual spatial abilities]), by physician or other qualified health care professional, both face-to-face time with the patient ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":71.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0545U","name":"Achr antb id imfluor livecll","description":"Achr antb id imfluor livecll","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84479","name":"Assay of thyroid (t3 or t4)","description":"Thyroid hormone (t3 or t4) uptake or thyroid hormone binding ratio (thbr)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4428","name":"Dermbnd sln sl+ slx sq cm","description":"Dermabind sl n or dermabind sl + or dermabind sl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0461","name":"Testing for cracked tooth","description":"Testing for cracked tooth","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81515","name":"Nfct ds bv&vaginitis dna alg","description":"Infectious disease, bacterial vaginosis and vaginitis, real-time pcr amplification of dna markers for atopobium vaginae, atopobium species, megasphaera type 1, and bacterial vaginosis associated bacteria-2 (bvab-2), utilizing vaginal-fluid specimens, algorithm reported as positive or negative for hi","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15012","name":"Hrv skn cll ssp agrft ea add","description":"Harvest of skin for skin cell suspension autograft; each additional 25 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6037","name":"Postop dsg cast chg handfing","description":"Immediate post-surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, partial hand including fingers","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1337","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98006","name":"Synch audio-video est mod 30","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11305","name":"Shave skin lesion 0.5 cm/<","description":"Shaving of epidermal or dermal lesion, single lesion, scalp, neck, hands, feet, genitalia; lesion diameter 0.5 cm or less","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":36.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37265","name":"Revsc evsc fpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2021","name":"Inj, linezolid (hospira)","description":"Injection, linezolid (hospira), not therapeutically equivalent to j2020, 200 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23615","name":"Optx prox humrl fx w/int fix","description":"Open treatment of proximal humeral (surgical or anatomical neck) fracture, includes internal fixation, when performed, includes repair of tuberosity(s), when performed;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":907.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57260","name":"Cmbn ant pst colprhy","description":"Combined anteroposterior colporrhaphy, including cystourethroscopy, when performed;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":629.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5100","name":"Inj ustekinumab-kfce, 1 mg","description":"Injection, ustekinumab-kfce (yesintek), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0289U","name":"Neuro alzheimer mrna 24 gen","description":"Neuro alzheimer mrna 24 gen","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2017","name":"Permeaderm glove, each","description":"Permeaderm glove, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2989","name":"Excavate tooth non-restorabl","description":"Excavate tooth non-restorabl","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93575","name":"Njx cath slct p angrph mapca","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary angiography of major aortopulmonary collateral arteries (mapcas) arising off the aorta or its systemic branches, during cardiac catheterization for congenital heart d","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52353","name":"Cystouretero w/lithotripsy","description":"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy (ureteral catheterization is included)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":495.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0764T","name":"Asstv alg ecg rsk asmt cncrt","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to concurrently performed electrocardiogram (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1275","name":"Pts hosp exl","description":"Patients determined to be in hospice were excluded from month of evaluation and the remainder of reporting period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33927","name":"Impltj tot rplcmt hrt sys","description":"Implantation of a total replacement heart system (artificial heart) with recipient cardiectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2820.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0048","name":"Pall serv during meas","description":"Patients who receive palliative care services any time during the intake period through the end of the measurement year","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1449","name":"Pt dx scz/pys bef end msr pd","description":"Patients with an active diagnosis of schizophrenia or psychotic disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87478","name":"Borrelia miyamotoi amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); borrelia miyamotoi, amplified probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0893","name":"Inj, decitabine (sun pharma)","description":"Injection, decitabine (sun pharma), not therapeutically equivalent to j0894, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76082","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2312","name":"Inj naloxone hcl nos, 0.01mg","description":"Injection, naloxone hydrochloride, not otherwise specified, 0.01 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6028","name":"Part hand finger metacar amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s) /thumb, amputation at metacarpal level, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2351","name":"Inj ocrelizumab 1mg hya-ocsq","description":"Injection, ocrelizumab, 1 mg and hyaluronidase-ocsq","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15778","name":"Impl absrb msh/prsth dly cls","description":"Implantation of absorbable mesh or other prosthesis for delayed closure of defect(s) (ie, external genitalia, perineum, abdominal wall) due to soft tissue infection or trauma","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90963","name":"Esrd home pt serv p mo <2yrs","description":"End-stage renal disease (esrd) related services for home dialysis per full month, for patients younger than 2 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":281.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1171","name":"Pt recd 1 td/tdap 9yrs prior","description":"Patient received at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0870T","name":"Imp subq prtl ascts pmp sys","description":"Implantation of subcutaneous peritoneal ascites pump system, percutaneous, including pump-pocket creation, insertion of tunneled indwelling bladder and peritoneal catheters with pump connections, including all imaging and initial programming, when performed","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9997","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6094","name":"Abut support crown titanium","description":"Abutment supported crown - (titanium)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2472","name":"Inj, pantoprazole sodium chl","description":"Injection, pantoprazole sodium in sodium chloride (baxter), 40 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87183","name":"Sc std carbapenem resist gen","description":"Susceptibility studies, antimicrobial agent; carbapenem resistance genes (eg, blakpc, blandm, blavim, blaoxa-48, blaimp), amplified probe technique, per isolate","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37277","name":"Rvsc evsc fpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21032","name":"Remove exostosis maxilla","description":"Excision of maxillary torus palatinus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84431","name":"Thromboxane urine","description":"Thromboxane metabolite(s), including thromboxane if performed, urine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61545","name":"Excision of brain tumor","description":"Craniotomy with elevation of bone flap; for excision of craniopharyngioma","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3589.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0485U","name":"Onc sol tum cfdna&rna ngs gm","description":"Onc sol tum cfdna&rna ngs gm","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9268","name":"Programmer orally ingest cap","description":"Programmer for transient, orally ingested capsule","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0391","name":"Inj, artesunate, 1mg","description":"Injection, artesunate, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33900","name":"Perq p-art revsc 1 nm nt uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, unilateral","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1938","name":"Inj, furosemide, 1 mg","description":"Injection, furosemide, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3291","name":"Tranexamic acid in sod chlor","description":"Injection, tranexamic acid in sodium chloride, 5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92140","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0044","name":"Pt mitral stenosis","description":"Patients with moderate or severe mitral stenosis","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0147","name":"Scr c/v cyto, automated sys","description":"Screening cytopathology smears, cervical or vaginal, performed by automated system under physician supervision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1362","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1245","name":"Pt othr thn true person","description":"Patient provided a response other than completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50396","name":"Measure kidney pressure","description":"Manometric studies through nephrostomy or pyelostomy tube, or indwelling ureteral catheter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0800T","name":"Tcat rmvl 2chmbr ldls pm rv","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right ventricular pacemaker component (when part of a dual-chamber leadless pacem","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0493U","name":"Trnspl med quan dd-cfdna ngs","description":"Trnspl med quan dd-cfdna ngs","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95816","name":"Eeg awake and drowsy","description":"Electroencephalogram (eeg); including recording awake and drowsy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0389","name":"Periopic image capture only","description":"Periopic image capture only","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67332","name":"Rerevise eye muscles add-on","description":"Strabismus surgery on patient with scarring of extraocular muscles (eg, prior ocular injury, strabismus or retinal detachment surgery) or restrictive myopathy (eg, dysthyroid ophthalmopathy) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93146","name":"Interrog crtd sins bat ip w/","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6112","name":"Imp/abut rem dent part max","description":"Imp/abut rem dent part max","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0829T","name":"Dgtz gls mcrscp cytp conctrj","description":"Digitization of glass microscope slides for cytopathology, concentration technique, smears, and interpretation (eg, saccomanno technique) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42100","name":"Biopsy roof of mouth","description":"Biopsy of palate, uvula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0317U","name":"Onc lung ca 4-prb fish assay","description":"Onc lung ca 4-prb fish assay","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0709T","name":"Id ca immntx each addl njx","description":"Intradermal cancer immunotherapy; each additional injection (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0708T","name":"Id ca immntx prep & 1st njx","description":"Intradermal cancer immunotherapy; preparation and initial injection","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01941","name":"Anes neuromd/ntrvrt crv/thrc","description":"Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9342","name":"Inj thiotepa nos 1 mg","description":"Injection, thiotepa, not otherwise specified, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0443U","name":"Neurflmnt lt chn ultrsens ia","description":"Neurflmnt lt chn ultrsens ia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4376","name":"Duograft aa per sq cm","description":"Duograft aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77307","name":"Telethx isodose plan cplx","description":"Teletherapy isodose plan; complex (multiple treatment areas, tangential ports, the use of wedges, blocking, rotational beam, or special beam considerations), includes basic dosimetry calculation(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4309","name":"Via matrix, per sq cm","description":"Via matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60661","name":"Abltj 1/+thyr ndul addl prq","description":"Ablation of 1 or more thyroid nodule(s), additional lobe, percutaneous, including imaging guidance, radiofrequency (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1023T","name":"Prq tis dsplmt intrathoracic","description":"Percutaneous tissue displacement, any method, including imaging guidance; intrathoracic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61715","name":"Mrgfus strtctc ablt trgt icr","description":"Magnetic resonance image guided high intensity focused ultrasound (mrgfus), stereotactic ablation of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27458","name":"Osteot femur imed lngth dev","description":"Osteotomy(ies), femur, unilateral, with insertion of an externally controlled intramedullary lengthening device, including iliotibial band release when performed, imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1011T","name":"Pbm therapy of oral cavity","description":"Photobiomodulation (pbm) therapy of oral cavity, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2277","name":"Inj, motixafortide, 0.25 mg","description":"Injection, motixafortide, 0.25 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6039","name":"Passive custom digit/thumb","description":"Passive prosthetic digit or thumb prosthesis not including hand restoration partial hand, full or partial, custom made, any material, initial or replacement, per single passive prosthetic digit or thumb","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1205","name":"Isa reduced >=3","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0739","name":"Hiv prep, inj, cabotegravir","description":"Injection, cabotegravir, 1mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1307","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43248","name":"Egd guide wire insertion","description":"Esophagogastroduodenoscopy, flexible, transoral; with insertion of guide wire followed by passage of dilator(s) through esophagus over guide wire","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23480","name":"Revision of collar bone","description":"Osteotomy, clavicle, with or without internal fixation;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":998.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0411U","name":"Psyc genom alys pnl 15 gen","description":"Psyc genom alys pnl 15 gen","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9245","name":"Admin mod sedation-enteral","description":"Admin mod sedation-enteral","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82657","name":"Enzyme cell activity","description":"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; nonradioactive substrate, each specimen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51000","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0851T","name":"Dgtz gls mcrscp mphmtrc 1st","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0958T","name":"Rmv s-sclp eltr ra rcvr&tlmt","description":"Removal of sub-scalp implanted electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0549","name":"Phone/inter for treat>31m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4100","name":"Nosht skin sub fda clrd nos","description":"Non-sheet form skin substitute, fda cleared as a device, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4327","name":"Duoamnion, per sq cm","description":"Duoamnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0729T","name":"Dx alys vstblr implt uni sbq","description":"Diagnostic analysis of vestibular implant, unilateral; with subsequent programming","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4253","name":"Zenith amniotic membrane psc","description":"Zenith amniotic membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82397","name":"Chemiluminescent assay","description":"Chemiluminescent assay","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93587","name":"Vngrph chd vnvn cltrl at/abv","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating at or above the heart (eg, from innominate vein) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5411","name":"Dentures adjust cmplt mand","description":"Adjust complete denture - mandibular","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90838","name":"Psytx w pt w e/m 60 min","description":"Psychotherapy, 60 minutes with patient when performed with an evaluation and management service (list separately in addition to the code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":55.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":121.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31360","name":"Removal of larynx","description":"Laryngectomy; total, without radical neck dissection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1581.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4032","name":"Rheumatology ss","description":"Rheumatology mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1737","name":"Inj meloxicam (azurity) 1mg","description":"Injection, meloxicam (azurity), 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0289U","name":"Neuro alzheimer mrna 24 gen","description":"Neuro alzheimer mrna 24 gen","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98928","name":"Osteopath manj 7-8 regions","description":"Osteopathic manipulative treatment (omt); 7-8 body regions involved","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":71.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54336","name":"Revise penis/urethra","description":"1-stage perineal hypospadias repair requiring extensive dissection to correct chordee and urethroplasty by use of skin graft tube and/or island flap","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1445.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57335","name":"Repair vagina","description":"Vaginoplasty for intersex state","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1311.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92635","name":"Hearing aid fitg svc ea addl","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; each additional 15 minutes (list separately in addition to code","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0676T","name":"Laps insj nw/rpcmt isdss ea","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional lead (list separately in addition to code for primary ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81451","name":"Hl neo gsap 5-50 rna alys","description":"Hematolymphoid neoplasm or disorder, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants, and copy number variants or rearrangements, or isoform expression or mrna expression levels, if performed; rna analysis","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0030","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1233","name":"Pt no hcv aby or result","description":"Patient does not receive hcv antibody test or patient does receive hcv antibody test but results not documented, reason not given","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0945T","name":"Intraop assmt abnl tum tiss","description":"Intraoperative assessment for abnormal (tumor) tissue, in-vivo, following partial mastectomy (eg, lumpectomy) using computer-aided fluorescence imaging (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4212","name":"Gingivectomy/plasty rest","description":"Gingivectomy/plasty rest","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2272","name":"Inj, morphine (fresenius)","description":"Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0276U","name":"Hem inh thrombocytopenia 23","description":"Hematology (inherited thrombocytopenia), genomic sequence analysis of 23 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1300","name":"Flu imm no admin doc rea","description":"Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4266","name":"Neostim per sq cm","description":"Neostim membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1026","name":"Pt hemo > 3mo","description":"The number of adult patient-months in the denominator who were on maintenance hemodialysis using a catheter continuously for three months or longer under the care of the same practitioner or group partner as of the last hemodialysis session of the reporting month","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99350","name":"Home/res vst est high mdm 60","description":"Home or residence visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90483","name":"Imm cnsl not admn sm>10<20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 10 minutes up to 20 minutes","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93597","name":"R&l hrt cath chd abnl nt cnj","description":"Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); abnormal native connections","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4355","name":"Abio xpl abio xpl hy p sq cm","description":"Abiomend xplus membrane and abiomend xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86036","name":"Anca screen each antibody","description":"Antineutrophil cytoplasmic antibody (anca); screen, each antibody","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0918T","name":"Insj perm ccm-d sys dual ld","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; dual transvenous leads (pacing and defibrillation) only","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54304","name":"Revision of penis","description":"Plastic operation on penis for correction of chordee or for first stage hypospadias repair with or without transplantation of prepuce and/or skin flaps","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":863.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1237","name":"Pt rsn no scrn","description":"Patient reason for not screening for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety (e.g., patient declined or other patient reasons)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1022T","name":"Prq tis dsplmt ntra-abdl/pel","description":"Percutaneous tissue displacement, any method, including imaging guidance; intra-abdominal/pelvic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28086","name":"Excise foot tendon sheath","description":"Synovectomy, tendon sheath, foot; flexor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1319","name":"Pts csp doc contact","description":"Patients who had documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6598","name":"G comp bandage med stretch","description":"Gradient compression bandage roll, elastic medium stretch, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81464","name":"So gsap cll fr mcrstl ins","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants, microsatellite instability, tumor mutation burden, and rearrangements","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98975","name":"Rtm 1st set-up&pt educaj eqp","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); initial set-up and patient education on use of equipment","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0146","name":"Nav srv peer sup add 30 pr m","description":"Principal illness navigation - peer support, additional 30 minutes per calendar month (list separately in addition to g0140)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0841T","name":"Dgtz gls mcrscp pth cslt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; first tissue block, with frozen section(s), single specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9994","name":"Pall serv during meas","description":"Patient is using palliative care services any time during the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38228","name":"Car-t admn autologous","description":"Chimeric antigen receptor t-cell (car-t) therapy; car-t cell administration, autologous","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":91.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83908","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35475","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0511U","name":"Onc sol tum 3dmicroenvir 36+","description":"Onc sol tum 3dmicroenvir 36+","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0406U","name":"Onc lung flow cytmtry 5 mrk","description":"Onc lung flow cytmtry 5 mrk","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0591U","name":"Onc prst8 ca 3prtns plsm srm","description":"Onc prst8 ca 3prtns plsm srm","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0567","name":"Screening hep c detect","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis c, screening, amplified probe technique","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1449","name":"Pt dx scz/pys bef end msr pd","description":"Patients with an active diagnosis of schizophrenia or psychotic disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0705T","name":"Rem tx amblyopia tech sprt","description":"Remote treatment of amblyopia using an eye tracking device; surveillance center technical support including data transmission with analysis, with a minimum of 18 training hours, each 30 days","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0062","name":"Audiology ss","description":"Audiology mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0012","name":"Injection of hiv prep drug","description":"Injection of pre-exposure prophylaxis (prep) drug for hiv prevention, under skin or into muscle","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9394","name":"Inj, fulvestrant (fresenius)","description":"Injection, fulvestrant (fresenius kabi) not therapeutically equivalent to j9395, 25 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60660","name":"Abltj 1/+thyr ndul 1lobe prq","description":"Ablation of 1 or more thyroid nodule(s), one lobe or the isthmus, percutaneous, including imaging guidance, radiofrequency","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"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":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4284","name":"Dermabind sl, per sq cm","description":"Dermabind sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0886T","name":"Sgmdsc flx 1st tndsc dilat","description":"Sigmoidoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75580","name":"N-invas est c ffr sw aly cta","description":"Noninvasive estimate of coronary fractional flow reserve (ffr) derived from augmentative software analysis of the data set from a coronary computed tomography angiography, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4253","name":"Zenith amniotic membrane psc","description":"Zenith amniotic membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3425","name":"Hydroxocobalamin im 10mcg","description":"Injection, hydroxocobalamin, intramuscular, 10 mcg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4361","name":"Epixpress, per sq cm","description":"Epixpress, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55715","name":"Bx prst8 ea add mri-us/ct/mr","description":"Biopsy, prostate, each additional, mri-ultrasound fusion or in-bore ct- or mri-guided targeted lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0770T","name":"Vr technology assist therapy","description":"Virtual reality technology to assist therapy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9278","name":"Inj, carboplatin (avyxa)","description":"Injection, carboplatin (avyxa), 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3430","name":"Vitamin k phytonadione inj","description":"Injection, phytonadione (vitamin k), per 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0002","name":"Opt care kidney hlth mvp","description":"Optimal care for kidney health mips value pathways","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0019M","name":"Cv ds plasma alys prtn bmrk","description":"Cardiovascular disease, plasma, analysis of protein biomarkers by aptamer-based microarray and algorithm reported as 4-year likelihood of coronary event in high-risk populations","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0896T","name":"Connj lvr algrft prfu dev ea","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; each additional hour, including physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary bicarbonate, lactate ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27646","name":"Resect fibula tumor","description":"Radical resection of tumor; fibula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1172.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4322","name":"Caregraft, per sq cm","description":"Caregraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0857T","name":"Opto-acoustic img breast uni","description":"Opto-acoustic imaging, breast, unilateral, including axilla when performed, real-time with image documentation, augmentative analysis and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76815","name":"Ob us limited fetus(s)","description":"Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72149","name":"Mri lumbar spine w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; with contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":797.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74021","name":"Radex abdomen 3+ views","description":"Radiologic examination, abdomen; 3 or more views","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2543","name":"Dental onlay metallic 3 surf","description":"Onlay - metallic - three surfaces","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86042","name":"Acetylcholn rcptr blckg antb","description":"Acetylcholine receptor (achr); blocking antibody","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0218","name":"Inj olipudase alfa-rpcp 1mg","description":"Injection, olipudase alfa-rpcp, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4314","name":"Reeva, per sq cm","description":"Reeva ft, per square cenitmeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27280","name":"Arthr si jt opn b1grf instrm","description":"Arthrodesis, sacroiliac joint, open, includes obtaining bone graft, including instrumentation, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96521","name":"Refill/maint portable pump","description":"Refilling and maintenance of portable pump","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32658","name":"Thoracoscopy w/sac fb remove","description":"Thoracoscopy, surgical; with removal of clot or foreign body from pericardial sac","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":928.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01937","name":"Anes drg/aspir crv/thrc","description":"Anesthesia for percutaneous image-guided injection, drainage or aspiration procedures on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6614","name":"Onlay cst nbl mtl 2 surfaces","description":"Onlay - cast noble metal two surfaces","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3403","name":"Revakinagene, per implant","description":"Revakinagene taroretcel-lwey, per implant","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36406","name":"Vnpnxr<3yrs phy/qhp other vn","description":"Venipuncture, younger than age 3 years, necessitating the skill of a physician or other qualified health care professional, not to be used for routine venipuncture; other vein","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":19.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33882","name":"Evasc rpr ta dplmt mltpc sys","description":"Endovascular repair of the thoracic aorta by deployment of a branched endograft multipiece system involving an aorto-aortic tube device with a fenestration for the left subclavian artery stent graft(s) and all aortic tube endograft extension(s) placed from the level of the left common carotid artery","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6107","name":"Tissue regen non-resorbable","description":"Tissue regen non-resorbable","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1374","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1179","name":"No pcv recd","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine, on or after their 19th birthday and before or during measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47700","name":"Exploration of bile ducts","description":"Exploration for congenital atresia of bile ducts, without repair, with or without liver biopsy, with or without cholangiography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1118.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1483","name":"Neg quan hep c or qual rna","description":"Patients who achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0971T","name":"Ablt mal brst tum pq lsr uni","description":"Ablation, malignant breast tumor(s), percutaneous, laser, including imaging guidance when performed, unilateral","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9959","name":"Unspec sleep ap proc","description":"Unspec sleep ap proc","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6602","name":"G com bandge hgh dn foamroll","description":"Gradient compression bandaging supply, high density foam roll for bandage, per linear yard, any width, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24140","name":"Partial exc bone humerus","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), humerus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":906.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91304","name":"Sarscov2 vac 5mcg/0.5ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, 5 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2253","name":"Inj midazolam (seizalam)","description":"Injection, midazolam (seizalam), 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1354","name":"Pt no suicd saf pln 120dy","description":"Patients who did not have a suicide safety plan initiated, reviewed, or updated or reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0660","name":"Team remote e/m new pt 10 mn","description":"Team remote e/m new pt 10mins","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0410U","name":"Onc pncrtc dna whl gn seq 5-","description":"Onc pncrtc dna whl gn seq 5-","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6612","name":"Onlay cst base mtl 2 surface","description":"Onlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4341","name":"Simplimax, per sq cm","description":"Simplimax, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90637","name":"Vacc qirv mrna 30mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 30 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91113","name":"Gi trc img intral colon i&r","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1485","name":"Neg viro resp hep c/qual rna","description":"Patients who did not achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0022","name":"Comm hlth intg svs add 30 m","description":"Community health integration services, each additional 30 minutes per calendar month (list separately in addition to g0019)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0686T","name":"Histotripsy mal hepatcel tis","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant hepatocellular tissue, including image guidance","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0700T","name":"Molec fluor img sus nev 1st","description":"Molecular fluorescent imaging of suspicious nevus; first lesion","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81003","name":"Urinalysis auto w/o scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; automated, without microscopy","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2598","name":"Inj, vasopressin, 1 unit","description":"Injection, vasopressin, 1 unit","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6072","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (high noble metal)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92617","name":"Fees w/laryngeal sense i&r","description":"Flexible endoscopic evaluation of swallowing and laryngeal sensory testing by cine or video recording; interpretation and report only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0294U","name":"Lngvty&mrtlty rsk mrna 18gen","description":"Lngvty&mrtlty rsk mrna 18gen","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0394U","name":"Pfas 16 pfas compnd lc ms/ms","description":"Pfas 16 pfas compnd lc ms/ms","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15340","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27278","name":"Arthrd si jt plmt iartic dev","description":"Arthrodesis, sacroiliac joint, percutaneous or minimally invasive, with image guidance, includes obtaining bone graft when performed, unilateral; placement of intra-articular device(s), without cortical piercing","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0709","name":"Intraoral cmplt radio images","description":"Intraoral cmplt radio images","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0542U","name":"Nefro renal trnspl ur nmr 84","description":"Nefro renal trnspl ur nmr 84","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0994T","name":"Evasc dlvr a-wal stbl rx prq","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; percutaneous","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2792","name":"Crown full cast noble metal","description":"Crown-full cast noble metal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1933","name":"Afo rig ant tib tcf/= ots","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, off-the-shelf","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44405","name":"Colonoscopy w/dilation","description":"Colonoscopy through stoma; with transendoscopic balloon dilation","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":669.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":174.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0281","name":"Inj aminocaproic acid 1 gram","description":"Injection, aminocaproic acid, 1 gram","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5137","name":"Inj, wezlana, sub cu, 1 mg","description":"Injection, ustekinumab-auub (wezlana), biosimilar, subcutaneous, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1713","name":"Pfizer vacc adm ped 1st dose","description":"Pfizer vacc adm ped 1st dose","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7168.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37290","name":"Revsc evsc tpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96381","name":"Admn rsv monoc antb im njx","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0592U","name":"Onc hl neo dna tgs 417 genes","description":"Onc hl neo dna tgs 417 genes","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9156","name":"Oral mucoadhesive per 1 ml","description":"Oral mucoadhesive, any type (liquid, gel, paste, etc.), per 1 ml","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0591U","name":"Onc prst8 ca 3prtns plsm srm","description":"Onc prst8 ca 3prtns plsm srm","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9800","name":"Gallium locametz 1 millicuri","description":"Gallium ga-68 gozetotide, diagnostic, (locametz), 1 millicurie","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1261","name":"Pts on wtlist bef dialysis","description":"Patients that were on the kidney or kidney-pancreas waitlist prior to initiation of dialysis","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0985T","name":"Iv img xtrc cere vsl oct ea","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0292U","name":"Psyc strs do mrna 72 genes","description":"Psyc strs do mrna 72 genes","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0249","name":"Tocilizumab for covid-19","description":"Injection, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0480U","name":"Nfct ds csf metag ngs alys","description":"Nfct ds csf metag ngs alys","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0987T","name":"Iv img icr cere vsl oct ea","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0281","name":"Inj aminocaproic acid 1 gram","description":"Injection, aminocaproic acid, 1 gram","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81449","name":"So neo gsap 5-50 rna alys","description":"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; rna analysis","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0183","name":"Software meas of cardiac vol","description":"Quantitative software measurements of cardiac volume, cardiac chambers volumes and left ventricular wall mass derived from ct scan(s) data of the chest/heart (with or without contrast)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1406","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1491","name":"Recd esrd mcp dur perf pd","description":"Receiving esrd mcp dialysis services by the provider during the performance period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0372","name":"Tomo comp series images","description":"Tomo comp series images","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1363","name":"Pts no f/u 120 dys","description":"Patients who did not have a follow-up assessment within 120 days of the index assessment","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4350","name":"Palisade dm matrix per sq cm","description":"Palisade dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0882T","name":"Intraop ther estim pn ue 1st","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; initial nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4347","name":"Rampart dl matrix per sq cm","description":"Rampart dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0719T","name":"Pst vrt jt rplcmt lmbr 1 sgm","description":"Posterior vertebral joint replacement, including bilateral facetectomy, laminectomy, and radical discectomy, including imaging guidance, lumbar spine, single segment","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64517","name":"N block inj hypogas plxs","description":"Injection, anesthetic agent; superior hypogastric plexus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1211","name":"Gsa level>9.0%","description":"Most recent glycemic status assessment (hba1c or gmi) level > 9.0%","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0167","name":"Inj epinephrine (hospira)","description":"Injection, epinephrine (hospira), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37297","name":"Revsc evasc imvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"Add upp ext mec limb vol lam","description":"Addition to upper extremity prosthesis, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4542","name":"Supp ext up limb tremor stim","description":"Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0980T","name":"Sbmcsl crylys ther tng&tnsl","description":"Submucosal cryolysis therapy; base of tongue and lingual tonsil only","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0462U","name":"Melatonin lvl tst slp std7/9","description":"Melatonin lvl tst slp std7/9","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1435","name":"Oral chemo in perf pd","description":"Patient on oral chemotherapy during the performance period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0944T","name":"3d cntr simula trgt lvr les","description":"3d contour simulation of target liver lesion(s) and margin(s) for image-guided percutaneous microwave ablation","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1598","name":"Inj glycopyrrolate fres kabi","description":"Injection, glycopyrrolate (fresenius kabi), not therapeutically equivalent to j1596, 0.1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27246","name":"Treat thigh fracture","description":"Closed treatment of greater trochanteric fracture, without manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4273","name":"Esano aaa, per sq cm","description":"Esano aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0535U","name":"Pfas lc-ms/ms plsm/srm quan","description":"Pfas lc-ms/ms plsm/srm quan","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1326","name":"Pts dx hypotony","description":"Patients with a diagnosis of hypotony","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0022","name":"Comm hlth intg svs add 30 m","description":"Community health integration services, each additional 30 minutes per calendar month (list separately in addition to g0019)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4411","name":"Amniomatrixf4x per sq cm","description":"Amniomatrixf4x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89320","name":"Semen anal vol/count/mot","description":"Semen analysis; volume, count, motility, and differential","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2036","name":"Cohealyx col dml mx pr sq cm","description":"Cohealyx collagen dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0731T","name":"Augmnt ai-based fcl phnt a/r","description":"Augmentative ai-based facial phenotype analysis with report","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87812","name":"Sarscov2&inf typ a&b w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) and influenza virus types a and b","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71045","name":"X-ray exam chest 1 view","description":"Radiologic examination, chest; single view","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98005","name":"Synch audio-video est low 20","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low medical decision making. when using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0537U","name":"Onc clrct ca cfdna >2500 dmr","description":"Onc clrct ca cfdna >2500 dmr","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0372U","name":"Nfct ds gu pthgn arg detcj","description":"Nfct ds gu pthgn arg detcj","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1348","name":"Pam incr 6 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 6-points in a 4 to 12 month period (excellent)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1229","name":"Pt w/ +hcv +vir ref win 1 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, is referred within 1 month of the reactive hcv antibody test to a clinician who treats hcv infection","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0874T","name":"Rmvl pertl ascites pmp sys","description":"Removal of a peritoneal ascites pump system, including implanted peritoneal ascites pump and indwelling bladder and peritoneal catheters","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84433","name":"Asy thiopurin s-mthyltrnsfrs","description":"Thiopurine s-methyltransferase (tpmt)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6604","name":"G com bandge low dn foam flt","description":"Gradient compression bandaging supply, low density flat foam sheet, per 250 square centimeters, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0371","name":"Sialoendoscopy capt & interp","description":"Sialoendoscopy capt & interp","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44626","name":"Repair bowel opening","description":"Closure of enterostomy, large or small intestine; with resection and colorectal anastomosis (eg, closure of hartmann type procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76856","name":"Us exam pelvic complete","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2919","name":"Inj, methylpred sod succ 5mg","description":"Injection, methylprednisolone sodium succinate, 5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0962T","name":"Asstv alg alys acous&ecg rec","description":"Assistive algorithmic analysis of acoustic and electrocardiogram recording for detection of cardiac dysfunction (eg, reduced ejection fraction, cardiac murmurs, atrial fibrillation), with review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27458","name":"Osteot femur imed lngth dev","description":"Osteotomy(ies), femur, unilateral, with insertion of an externally controlled intramedullary lengthening device, including iliotibial band release when performed, imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68841","name":"Insj rx elut implt lac canal","description":"Insertion of drug-eluting implant, including punctal dilation when performed, into lacrimal canaliculus, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0545U","name":"Achr antb id imfluor livecll","description":"Achr antb id imfluor livecll","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84145","name":"Procalcitonin (pct)","description":"Procalcitonin (pct)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2001","name":"Suct pum ext mgmt sys","description":"Suction pump, home model, portable or stationary, electric, any type, for use with external urine and/or fecal management system","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1351","name":"Pt cmplt suicd saf pln 120dy","description":"Patients who had a suicide safety plan initiated, reviewed, or updated and reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9936","name":"Clean occ guard","description":"Clean occ guard","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":310.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61860","name":"Implant neuroelectrodes","description":"Craniectomy or craniotomy for implantation of neurostimulator electrodes, cerebral, cortical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1747.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0801","name":"Inj. acthar gel to 40 units","description":"Injection, corticotropin (acthar gel), up to 40 units","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0607U","name":"Reprdtve med ema rtpcr 31bct","description":"Reprdtve med ema rtpcr 31bct","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0534U","name":"Onc prst8 mirna snp 32 vrnt","description":"Onc prst8 mirna snp 32 vrnt","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77091","name":"Tbs techl calculation only","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical calculation only","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2017","name":"Permeaderm glove, each","description":"Permeaderm glove, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0978T","name":"Submucosal cryolysis therapy","description":"Submucosal cryolysis therapy; soft palate, base of tongue, and lingual tonsil","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4417","name":"Alexiguard dl-t per sq cm","description":"Alexiguard dl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98976","name":"Rtm dev sply resp sys 16-30d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of respiratory system, 16-30 days in a 30-day period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1218","name":"Pt copd symptoms","description":"Patient has copd symptoms (e.g., dyspnea, cough/sputum, wheezing)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0344U","name":"Hep nafld semiq evl 28 lipid","description":"Hep nafld semiq evl 28 lipid","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0895T","name":"Connj lvr algrft prfu dev 1","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; initial 4 hours of monitoring time, including hourly physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0700T","name":"Molec fluor img sus nev 1st","description":"Molecular fluorescent imaging of suspicious nevus; first lesion","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55881","name":"Ablt trurl prst8 tis thrm us","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation;","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64583","name":"Rev/rplct hpglsl nstm ary pg","description":"Revision or replacement of hypoglossal nerve neurostimulator array and distal respiratory sensor electrode or electrode array, including connection to existing pulse generator","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2393","name":"Post 3 srfc resinbased cmpst","description":"Resin-based composite - three surfaces posterior","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1274","name":"Pts snf exl mo","description":"Patients who were admitted to a skilled nursing facility (snf) during the month of evaluation were excluded from that month","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1305","name":"Pneum vax admin 19+","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0707T","name":"Njx b1 sub mtrl sbchdrl dfct","description":"Injection(s), bone-substitute material (eg, calcium phosphate) into subchondral bone defect (ie, bone marrow lesion, bone bruise, stress injury, microtrabecular fracture), including imaging guidance and arthroscopic assistance for joint visualization","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1166","name":"Path rpt tis spec wle/reexc","description":"Pathology report for tissue specimens produced from wide local excisions or re-excisions","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11719","name":"Trim nail(s) any number","description":"Trimming of nondystrophic nails, any number","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1339","name":"Pts f/u 30-180 dys + improv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who demonstrated positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23450","name":"Repair shoulder capsule","description":"Capsulorrhaphy, anterior; putti-platt procedure or magnuson type operation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1164.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0281","name":"Elec stim unattend for press","description":"Electrical stimulation, (unattended), to one or more areas, for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care, as part of a therapy plan of care","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0314U","name":"Onc cutan mlnma mrna 35 gene","description":"Onc cutan mlnma mrna 35 gene","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44206","name":"Lap part colectomy w/stoma","description":"Laparoscopy, surgical; colectomy, partial, with end colostomy and closure of distal segment (hartmann type procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1853.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95874","name":"Guide nerv destr needle emg","description":"Needle electromyography for guidance in conjunction with chemodenervation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20553","name":"Njx 1/mlt trigger points 3/>","description":"Injection(s); single or multiple trigger point(s), 3 or more muscles","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":64.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72275","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1411","name":"1st ln ici no chemo","description":"Currently on first-line immune checkpoint inhibitors without chemotherapy","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90957","name":"Esrd srv 4 vsts p mo 12-19","description":"End-stage renal disease (esrd) related services monthly, for patients 12-19 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 4 or more face-to-face visits by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":774.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93152","name":"Interrog&prgrmg ipnss polysm","description":"Interrogation and programming of implanted phrenic nerve stimulator system during polysomnography","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J2310","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1297","name":"Bmi not doc medrsn ptref","description":"Bmi not documented due to medical reason or patient refusal of height or weight measurement","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93597","name":"R&l hrt cath chd abnl nt cnj","description":"Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); abnormal native connections","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0617U","name":"Cv ascvd dna alys >20000","description":"Cv ascvd dna alys >20000","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86155","name":"Chemotaxis assay","description":"Chemotaxis assay, specify method","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0566U","name":"Onc lng qpcr-bsd alys 13dmrs","description":"Onc lng qpcr-bsd alys 13dmrs","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0101","name":"Ca screen;pelvic/breast exam","description":"Cervical or vaginal cancer screening; pelvic and clinical breast examination","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":45.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0932T","name":"N-invs det hrt fail aug echo","description":"Noninvasive detection of heart failure derived from augmentative analysis of an echocardiogram that demonstrated preserved ejection fraction, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59851","name":"Induced abortion 1+njx d&c","description":"Induced abortion, by 1 or more intra-amniotic injections (amniocentesis-injections), including hospital admission and visits, delivery of fetus and secundines; with dilation and curettage and/or evacuation","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":456.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9076","name":"Inj, cyclophos (baxter) 5mg","description":"Injection, cyclophosphamide (baxter), 5 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1257","name":"Cvd risk assess not perf","description":"Cvd risk assessment not performed or incomplete (e.g., cvd risk assessment was not documented), reason not otherwise specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9596","name":"Gallium illuccix 1 millicure","description":"Gallium ga-68 gozetotide, diagnostic, (illuccix), 1 millicurie","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6081","name":"Scale & debride, single imp","description":"Scale & debride, single imp","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0892T","name":"Arhfcmrigtbs sbsq per tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent motor threshold redetermination with delivery and management, per treatment day","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8005","name":"Grip glove w microprocessor","description":"Powered, cable driven grip assist glove, hand, finger, includes microprocessor, pressure sensors, all components and accessories, custom fitted","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0687T","name":"Tx amblyopia dev setup 1st","description":"Treatment of amblyopia using an online digital program; device supply, educational set-up, and initial session","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15941","name":"Exc isch pr ulc prm sut ostc","description":"Excision, ischial pressure ulcer, with primary suture; with ostectomy (ischiectomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1022.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1306","name":"Pt anphx due to pneum","description":"Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84375","name":"Chromatogram assay sugars","description":"Sugars, chromatographic, tlc or paper chromatography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97810","name":"Acup 1/> wo estim 1st 15 min","description":"Acupuncture, 1 or more needles; without electrical stimulation, initial 15 minutes of personal one-on-one contact with the patient","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":30.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4340","name":"Simpligraft, per sq cm","description":"Simpligraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75803","name":"Lymph vessel x-ray arms/legs","description":"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2022","name":"Innovabrn/innovamatx xl sqcm","description":"Innovaburn or innovamatrix xl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78635","name":"Csf ventriculography","description":"Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0492U","name":"Onc sol tum ctc slctn pd-l1","description":"Onc sol tum ctc slctn pd-l1","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6251","name":"Bridge resin base metal","description":"Pontic-resin with predominantly base metal","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90783","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0490U","name":"Onc cutan/uveal mlnma cd146","description":"Onc cutan/uveal mlnma cd146","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38227","name":"Car-t receipt&prepj admn","description":"Chimeric antigen receptor t-cell (car-t) therapy; receipt and preparation of car-t cells for administration","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93594","name":"R hrt cath chd abnl nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; abnormal native connections","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0235","name":"Intrav inf, mon anti, fir do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0412U","name":"Beta amyloid ab42/40 imprcip","description":"Beta amyloid ab42/40 imprcip","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1366","name":"Focus on womens health mvp","description":"Focusing on womens health mips value pathway","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0476U","name":"Rx metab psyc 14gen&cyp2d6","description":"Rx metab psyc 14gen&cyp2d6","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1938","name":"Inj, furosemide, 1 mg","description":"Injection, furosemide, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0802","name":"3d dental scan indirect","description":"3d dental scan indirect","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76016","name":"Mr safety deter phys/qhp","description":"Mr safety determination by a physician or other qualified health care professional responsible for the safety of the mr procedure, including review of implant mr conditions for indicated mr examination, analysis of risk vs clinical benefit of performing mr examination, and determination of mr equipm","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35661","name":"Bpg femoral-femoral","description":"Bypass graft, with other than vein; femoral-femoral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1369.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2356","name":"Inj tezepelumab-ekko, 1mg","description":"Injection, tezepelumab-ekko, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42975","name":"Dise eval slp do brth flx dx","description":"Drug-induced sleep endoscopy, with dynamic evaluation of velum, pharynx, tongue base, and larynx for evaluation of sleep-disordered breathing, flexible, diagnostic","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47556","name":"Biliary endoscopy thru skin","description":"Biliary endoscopy, percutaneous via t-tube or other tract; with dilation of biliary duct stricture(s) with stent","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0422","name":"Collect & prep genetic samp","description":"Collect & prep genetic samp","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0216","name":"Inj, alfentanil hcl, 500mcg","description":"Injection, alfentanil hydrochloride, 500 micrograms","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0888T","name":"Histotripsy mal renal tissue","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant renal tissue, including imaging guidance","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92623","name":"Dx aly aud oi snd prcsr each","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; each additional 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2012","name":"Suprathel, per sq cm","description":"Suprathel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68841","name":"Insj rx elut implt lac canal","description":"Insertion of drug-eluting implant, including punctal dilation when performed, into lacrimal canaliculus, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6603","name":"Cst hgh nble mtl inlay >=3sr","description":"Inlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2221","name":"Ank mcrop plant & dorsi flex","description":"Addition to lower extremity orthosis, ankle system, microprocessor-controlled feature plantarflexion and/or dorsiflexion, includes power source","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1392","name":"Pt rsn no exm or lst to fu","description":"Documentation of patient reasons for no examination, i.e., refusal of examination or lost to follow-up (documentation must include information that the clinician was unable to reach the patient by phone, mail or secure electronic mail - at least one method must be documented)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33288","name":"Rmv&rplcmt phrnc nrv stim ld","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81560","name":"Trnsplj pd lvr&bwl cd154+cll","description":"Transplantation medicine (allograft rejection, pediatric liver and small bowel), measurement of donor and third-party-induced cd154+t-cytotoxic memory cells, utilizing whole peripheral blood, algorithm reported as a rejection risk score","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6031","name":"Rep interface handfng molded","description":"Replacement socket/interface, partial hand including fingers, molded to patient model, for use with or without external power","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1602.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63265","name":"Excise intraspinl lesion crv","description":"Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; cervical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1834.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0898","name":"Argatroban nonesrd (auromed)","description":"Injection, argatroban (auromedics), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2038","name":"Skill train and dev/diem","description":"Skills training and development, per diem","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4370","name":"Aeroguard per sq cm","description":"Aeroguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0712T","name":"N-nvs artl plaq alys quan","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess atherosclerotic plaque stability","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0710T","name":"N-invas artl plaq alys","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; including data preparation and transmission, quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess a","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0792T","name":"Appl slvr diamn fluoride 38%","description":"Application of silver diamine fluoride 38%, by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11200","name":"Rmvl skin tags up to&inc 15","description":"Removal of skin tags, multiple fibrocutaneous tags, any area; up to and including 15 lesions","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":99.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0371","name":"Sialoendoscopy capt & interp","description":"Sialoendoscopy capt & interp","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0568","name":"Int psych care mng, 1 cal mo","description":"Initial psychiatric collaborative care management, in the first calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required elements: outrea","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6560","name":"G stckng full/chap30-40 cust","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, custom, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1175","name":"Doc med rsn no hzv","description":"Documentation of medical reason(s) for not administering zoster vaccine (e.g., prior anaphylaxis due to the zoster vaccine)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4262","name":"Dual layer impax, per sq cm","description":"Dual layer impax membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98014","name":"Synch audio-only est mod 30","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code s","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5942","name":"Proth max implt sup remv","description":"Proth max implt sup remv","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53265","name":"Treatment of urethra lesion","description":"Excision or fulguration; urethral caruncle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0886T","name":"Sgmdsc flx 1st tndsc dilat","description":"Sigmoidoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0233","name":"Intra inf, toci, first dose","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6111","name":"Implnt/abut remov dent mand","description":"Implnt/abut remov dent mand","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15013","name":"Prepj skn cll ssp agrft 1st","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; first 25 sq cm or less of harvested skin","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99282","name":"Emergency dept visit sf mdm","description":"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward medical decision making","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1244","name":"Pt othr thn true best int","description":"Patient provided a response other than completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93595","name":"L hrt cath chd nm/abn nt cnj","description":"Left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone, normal or abnormal native connections","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38227","name":"Car-t receipt&prepj admn","description":"Chimeric antigen receptor t-cell (car-t) therapy; receipt and preparation of car-t cells for administration","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0391U","name":"Onc sld tum dna&rna 437 gen","description":"Onc sld tum dna&rna 437 gen","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81449","name":"So neo gsap 5-50 rna alys","description":"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; rna analysis","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6032","name":"Part handfng ultralite tcf/=","description":"Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0488U","name":"Ob fetal ag nipt cfdna alys","description":"Ob fetal ag nipt cfdna alys","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21406","name":"Opn tx orbit fx w/o implant","description":"Open treatment of fracture of orbit, except blowout; without implant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":621.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1325","name":"Doc med rsn not seen","description":"Patients who were not seen for reasons documented by clinician for patient or medical reasons (e.g., inadequate time for follow-up, patients who received a prior intravitreal or periocular steroid injection within the last six (6) months and had a subsequent iop evaluation with iop <25mm hg within s","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4409","name":"Amniomatrixf3x per sq cm","description":"Amniomatrixf3x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4411","name":"Amniomatrixf4x per sq cm","description":"Amniomatrixf4x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0504U","name":"Nfct ds uti id 17 path orgs","description":"Nfct ds uti id 17 path orgs","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1321","name":"Pts no 7wk inj,no iop,iop>25","description":"Patients who were not seen within 7 weeks following the date of injection for follow up or who did not have a documented iop or no plan of care documented if the iop was >25 mm hg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0832T","name":"Dgtz gls mcrscp cytp oth scr","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98002","name":"Synch audio-video new mod 45","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate medical decision making. when using total time on the date of the encounter for code selection, 45 minutes must be met or exceeded.","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4383","name":"Axolotl graft ult per sq cm","description":"Axolotl graft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1411","name":"1st ln ici no chemo","description":"Currently on first-line immune checkpoint inhibitors without chemotherapy","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23066","name":"Biopsy shoulder tissues","description":"Biopsy, soft tissue of shoulder area; deep","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":398.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0962T","name":"Asstv alg alys acous&ecg rec","description":"Assistive algorithmic analysis of acoustic and electrocardiogram recording for detection of cardiac dysfunction (eg, reduced ejection fraction, cardiac murmurs, atrial fibrillation), with review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4369","name":"Amnioplast 3 per sq cm","description":"Amnioplast 3, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0579U","name":"Nfro dbtc ckd elisa apoa4","description":"Nfro dbtc ckd elisa apoa4","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88263","name":"Chromosome analysis 45","description":"Chromosome analysis; count 45 cells for mosaicism, 2 karyotypes, with banding","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36515","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37283","name":"Rvsc evsc tpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99253","name":"Ip/obs cnsltj new/est low 45","description":"Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 45 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2799","name":"Inj, uzedy, 1 mg","description":"Injection, risperidone (uzedy), 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24935","name":"Revision of amputation","description":"Stump elongation, upper extremity","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1152.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0476U","name":"Rx metab psyc 14gen&cyp2d6","description":"Rx metab psyc 14gen&cyp2d6","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6211","name":"Bridge base metal cast","description":"Pontic-cast predominantly base metal","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27244","name":"Treat thigh fracture","description":"Treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; with plate/screw type implant, with or without cerclage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1365.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48510","name":"Drain pancreatic pseudocyst","description":"External drainage, pseudocyst of pancreas, open","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1050.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69990","name":"Microsurgery add-on","description":"Microsurgical techniques, requiring use of operating microscope (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0591U","name":"Onc prst8 ca 3prtns plsm srm","description":"Onc prst8 ca 3prtns plsm srm","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64597","name":"Ins/rplcm prq eltrd ra pn ea","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; each additional electrode array (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0032","name":"2+ antipsy schiz","description":"Two or more antipsychotic prescriptions ordered for patients who had a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder on or between january 1 of the year prior to the measurement period and the index prescription start date (ipsd) for antipsychotics","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7514","name":"Mycophenol (myhibbin) 100 mg","description":"Mycophenolate mofetil (myhibbin), oral suspension, 100 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1002T","name":"Air displacmnt plethysmograp","description":"Air displacement plethysmography, whole-body composition assessment, with interpretation and report","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85360","name":"Euglobulin lysis","description":"Euglobulin lysis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1574","name":"Inj, ganciclovir (exela)","description":"Injection, ganciclovir sodium (exela), not therapeutically equivalent to j1570, 500 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92637","name":"Hearing aid pst-fitg f-up ea","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37255","name":"Revsc evasc ivt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94360","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7528","name":"Mycophen mofetil for susp","description":"Mycophenolate mofetil, for suspension, oral, 100 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0484U","name":"Nfct ds mgen 23s rrna pt mut","description":"Nfct ds mgen 23s rrna pt mut","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0557U","name":"Nfct ds bv dna mrk vag fluid","description":"Nfct ds bv dna mrk vag fluid","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0485U","name":"Onc sol tum cfdna&rna ngs gm","description":"Onc sol tum cfdna&rna ngs gm","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0500U","name":"Autoinflam ds vexas synd dna","description":"Autoinflam ds vexas synd dna","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93640","name":"Ep eval 1/2chmbr pacg cvdfb","description":"Electrophysiologic evaluation of single or dual chamber pacing cardioverter-defibrillator leads including defibrillation threshold evaluation (induction of arrhythmia, evaluation of sensing and pacing for arrhythmia termination) at time of initial implantation or replacement;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":586.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0799T","name":"Tcat rmvl 2chmbr ldls pm ra","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right atrial pacemaker component","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1816.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0044","name":"Pt mitral stenosis","description":"Patients with moderate or severe mitral stenosis","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0139","name":"Inj, adalimumab, 1 mg","description":"Injection, adalimumab, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1323","name":"Inj, elranatamab-bcmm, 1 mg","description":"Injection, elranatamab-bcmm, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0331U","name":"Onc hl neo opt gen mapping","description":"Onc hl neo opt gen mapping","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83045","name":"Hgb methemoglobin qual","description":"Hemoglobin; methemoglobin, qualitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93600","name":"Bundle of his recording","description":"Bundle of his recording","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0930T","name":"Ephys eval ccm-d ld 1st impl","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), at time of initial implantation or replacement with testing of cardiac contrac","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6112","name":"Imp/abut rem dent part max","description":"Imp/abut rem dent part max","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0792T","name":"Appl slvr diamn fluoride 38%","description":"Application of silver diamine fluoride 38%, by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97007","name":"Mchnl sclp cool meas fitg","description":"Mechanical scalp cooling, including individual cap supply with head measurement, fitting, and patient education","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3402","name":"Inj. remestemcel-l-rknd/ td","description":"Injection, remestemcel-l-rknd, per therapeutic dose","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7214","name":"Altuviiio per factor viii iu","description":"Injection, factor viii/von willebrand factor complex, recombinant (altuviiio), per factor viii i.u.","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1836","name":"Inj, metronidazole, 10 mg","description":"Injection, metronidazole, 10 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35184","name":"Rpr cgen av fistula xtr","description":"Repair, congenital arteriovenous fistula; extremities","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1288.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47460","name":"Incise bile duct sphincter","description":"Transduodenal sphincterotomy or sphincteroplasty, with or without transduodenal extraction of calculus (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1266.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4415","name":"Alexiguard st-l per sq cm","description":"Alexiguard sl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0505U","name":"Nfct ds vag infctj id 32orgs","description":"Nfct ds vag infctj id 32orgs","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52285","name":"Cystoscopy and treatment","description":"Cystourethroscopy for treatment of the female urethral syndrome with any or all of the following: urethral meatotomy, urethral dilation, internal urethrotomy, lysis of urethrovaginal septal fibrosis, lateral incisions of the bladder neck, and fulguration of polyp(s) of urethra, bladder neck, and/or ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1283","name":"Pt scrn tbco and id as user","description":"Patient screened for tobacco use and identified as a tobacco user","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29835","name":"Elbow arthroscopy/surgery","description":"Arthroscopy, elbow, surgical; synovectomy, partial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":617.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0530","name":"Adult daycare center, 8 hr u","description":"Adult day center, 8-hour unit, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0535U","name":"Pfas lc-ms/ms plsm/srm quan","description":"Pfas lc-ms/ms plsm/srm quan","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7412","name":"Excision benign lesion compl","description":"Excision of benign lesion complicated","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46615","name":"Anoscopy","description":"Anoscopy; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1477","name":"Dx delirium","description":"Diagnosis of delirium","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90631","name":"H5 vaccine pandemic im use","description":"Influenza virus vaccine (iiv), h5, pandemic formulation, split virus, adjuvanted, for intramuscular use","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22610","name":"Arthrd pst tq 1ntrspc thrc","description":"Arthrodesis, posterior or posterolateral technique, single interspace; thoracic (with lateral transverse technique, when performed)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1422.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0412U","name":"Beta amyloid ab42/40 imprcip","description":"Beta amyloid ab42/40 imprcip","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7171","name":"Inj, adzynma, 10 iu","description":"Injection, adamts13, recombinant-krhn, 10 iu","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93588","name":"Vngrph chd vnvn cltrl below","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating below the heart (eg, from the inferior vena cava) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1381","name":"Pt sec strk wthin 5 days","description":"Patients with secondary stroke (e.g., a subsequent stroke that may occur with vasospasm in the setting of subarachnoid hemorrhage) within 5 days of the initial procedure","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99308","name":"Sbsq nf care low mdm 20","description":"Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 20 minutes must be met or exce","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":76.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0349U","name":"Rx metab/pcx dna 27gen rx ia","description":"Rx metab/pcx dna 27gen rx ia","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4231","name":"Ana crown exp 1-3 per quad","description":"Anatomical crown exposure - one to three teeth per quadrant","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1403","name":"Bslne and fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64584","name":"Rmvl hpglsl nstim ary pg","description":"Removal of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0281U","name":"Hem vwd propeptide ag lvl","description":"Hematology (von willebrand disease [vwd]), von willebrand propeptide, enzyme-linked immunosorbent assays (elisa), plasma, diagnostic report of von willebrand factor (vwf) propeptide antigen level","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37271","name":"Revsc evsc fpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5930","name":"Max guid prothes w/o flange","description":"Max guid prothes w/o flange","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0391U","name":"Onc sld tum dna&rna 437 gen","description":"Onc sld tum dna&rna 437 gen","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64655","name":"Revj/rplcmt bat mod sys lead","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; lead only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1395","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92550","name":"Tympanometry & reflex thresh","description":"Tympanometry and reflex threshold measurements","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0811T","name":"Rem mlt day uroflow setup","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); set-up and patient education on use of equipment","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77263","name":"Ther radiology tx plng cplx","description":"Therapeutic radiology treatment planning; complex","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2050","name":"Financial mgt waiver/diem","description":"Financial management, self-directed, waiver; per diem","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1410","name":"Inj estrogen conjugate 25 mg","description":"Injection, estrogen conjugated, per 25 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48511","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0837T","name":"Dgtz gls mcrscp fna i&r","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; interpretation and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0870","name":"Injection, imetelstat, 1 mg","description":"Injection, imetelstat, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5098","name":"Inj ustekinumab-srlf, 1 mg","description":"Injection, ustekinumab-srlf (imuldosa), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0804T","name":"Prgrmg evl ldls pm 2chmbr ip","description":"Programming device evaluation (in person) with iterative adjustment of implantable device to test the function of device and to select optimal permanent programmed values, with analysis, review, and report, by a physician or other qualified health care professional, leadless pacemaker system in dual","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87084","name":"Culture of specimen by kit","description":"Culture, presumptive, pathogenic organisms, screening only; with colony estimation from density chart","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4358","name":"Xwrap dual, per sq cm","description":"Xwrap dual, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1197","name":"Isa reduced >=3 fr ixv","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4363","name":"Am bur mem hydro per sq cm","description":"Amnio burgeon membrane and hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29827","name":"Sho arthrs srg rt8tr cuf rpr","description":"Arthroscopy, shoulder, surgical; with rotator cuff repair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1347.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9341","name":"Inj thiotepa (tepylute) 1 mg","description":"Injection, thiotepa (tepylute), 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73562","name":"X-ray exam of knee 3","description":"Radiologic examination, knee; 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0238","name":"Inj, tocilizumab-aazg, hospi","description":"Injection, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0291U","name":"Psyc mood do mrna 144 genes","description":"Psyc mood do mrna 144 genes","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19283","name":"Perq dev breast 1st strtctc","description":"Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; first lesion, including stereotactic guidance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7241","name":"Impact tooth rem bony w/comp","description":"Removal of impacted tooth-completely bony with unusual surgical complications","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0746T","name":"Car ablt rad arr cnv loc map","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; conversion of arrhythmia localization and mapping of arrhythmia site (nidus) into a multidimensional radiation treatment plan","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2373","name":"Inj, immphentiv, 20 mcg","description":"Injection, phenylephrine hydrochloride (immphentiv), 20 micrograms","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1269","name":"Recd esrd mcp lst day of mo","description":"Receiving esrd mcp dialysis services by the provider on the last day of the reporting month","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21395","name":"Opn tx orbit periorbt w/grft","description":"Open treatment of orbital floor blowout fracture; periorbital approach with bone graft (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1040.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77080","name":"Dxa bone density axial","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77090","name":"Tbs techl prep&transmis data","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86334","name":"Immunofix e-phoresis serum","description":"Immunofixation electrophoresis; serum","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0742T","name":"Aqmbf spect xers/strs & rest","description":"Absolute quantitation of myocardial blood flow (aqmbf), single-photon emission computed tomography (spect), with exercise or pharmacologic stress, and at rest, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1339","name":"Pts f/u 30-180 dys + improv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who demonstrated positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1211","name":"Gsa level>9.0%","description":"Most recent glycemic status assessment (hba1c or gmi) level > 9.0%","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1265","name":"Cms 2728 completed","description":"Cms medical evidence form 2728 for dialysis patients: initial form completed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49617","name":"Rpr aa hrn rcr > 10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, reducible","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94618","name":"Pulmonary stress testing","description":"Pulmonary stress testing (eg, 6-minute walk test), including measurement of heart rate, oximetry, and oxygen titration, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70488","name":"Ct maxillofacial w/o & w/dye","description":"Computed tomography, maxillofacial area; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9128","name":"Photobio therpy-first 15 min","description":"Photobio therpy-first 15 min","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81000","name":"Urinalysis nonauto w/scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; non-automated, with microscopy","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0914T","name":"Prq tcat thr rx ntrc bal sep","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting) performed on a separate target lesion from the target lesion treated with balloon angioplasty, coronary stent placement or coronary atherectomy, including mechanical dilation b","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47362","name":"Repair liver wound","description":"Management of liver hemorrhage; re-exploration of hepatic wound for removal of packing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1321.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0303U","name":"Hem rbc ads whl bld hypoxic","description":"Hem rbc ads whl bld hypoxic","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34710","name":"Dlyd plmt xtn prosth 1st vsl","description":"Delayed placement of distal or proximal extension prosthesis for endovascular repair of infrarenal abdominal aortic or iliac aneurysm, false aneurysm, dissection, endoleak, or endograft migration, including pre-procedure sizing and device selection, all nonselective catheterization(s), all associate","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":879.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6192","name":"Semi precision attachment","description":"Semi precision attachment","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0053","name":"Ht mental health and care","description":"Historical trauma (ht) mental health and clinical care for indigenous persons","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4370","name":"Aeroguard per sq cm","description":"Aeroguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3425","name":"Hydroxocobalamin im 10mcg","description":"Injection, hydroxocobalamin, intramuscular, 10 mcg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4022","name":"Otolaryngology ss","description":"Otolaryngology mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0350U","name":"Rx metab/pcx dna 27 gen alys","description":"Rx metab/pcx dna 27 gen alys","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1164","name":"Inj diltiazem in 0.72% nacl","description":"Injection, diltiazem hydrochloride in 0.72% sodium chloride, 0.5 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9596","name":"Gallium illuccix 1 millicure","description":"Gallium ga-68 gozetotide, diagnostic, (illuccix), 1 millicurie","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1324","name":"Pts intravitreal/pci","description":"Patients who had an intravitreal or periocular corticosteroid injection (e.g., triamcinolone, preservative-free triamcinolone, dexamethasone, dexamethasone intravitreal implant, or fluocinolone intravitreal implant)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6525","name":"G com garm lwrleg/ft ngt cus","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, custom, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0794T","name":"Pt spec alg rx-onc tx option","description":"Patient-specific, assistive, rules-based algorithm for ranking pharmaco-oncologic treatment options based on the patients tumor-specific cancer marker information obtained from prior molecular pathology, immunohistochemical, or other pathology results which have been previously interpreted and repor","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87071","name":"Culture aerobic quant other","description":"Culture, bacterial; quantitative, aerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1181","name":"Gr 2 or> dia or gr2 or> col","description":"Grade 2 or above diarrhea and/or grade 2 or above colitis","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15946","name":"Exc isch pr ulc prep mus flp","description":"Excision, ischial pressure ulcer, with ostectomy, in preparation for muscle or myocutaneous flap or skin graft closure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1764.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76015","name":"Mr sfty mplt&/fb asmt stf ea","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22010","name":"I&d p-spine c/t/cerv-thor","description":"Incision and drainage, open, of deep abscess (subfascial), posterior spine; cervical, thoracic, or cervicothoracic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0867T","name":"Tpla b9 prst8 hyprplsa>=50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume greater or equal to 50 ml","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0468U","name":"Hep nash mir34a5p a2m ykl40","description":"Hep nash mir34a5p a2m ykl40","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64598","name":"Revj/rmvl nea pn w/int nstim","description":"Revision or removal of neurostimulator electrode array, peripheral nerve, with integrated neurostimulator","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9248","name":"Inj melphalan (hepzato) 1 mg","description":"Injection, melphalan (hepzato), 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27395","name":"Lengthening of thigh tendons","description":"Lengthening of hamstring tendon; multiple tendons, bilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1054.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1222","name":"Glaucoma pln of care not doc","description":"Glaucoma plan of care not documented, reason not otherwise specified","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37269","name":"Revsc evasc fpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0787T","name":"Revj/rmvl nea sac w/nstim","description":"Revision or removal of neurostimulator electrode array, sacral, with integrated neurostimulator","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29874","name":"Arthrs knee surg rmv loos/fb","description":"Arthroscopy, knee, surgical; for removal of loose body or foreign body (eg, osteochondritis dissecans fragmentation, chondral fragmentation)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":646.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15944","name":"Exc isch pr ulc skn flp clsr","description":"Excision, ischial pressure ulcer, with skin flap closure;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":982.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1392","name":"Pt rsn no exm or lst to fu","description":"Documentation of patient reasons for no examination, i.e., refusal of examination or lost to follow-up (documentation must include information that the clinician was unable to reach the patient by phone, mail or secure electronic mail - at least one method must be documented)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0482","name":"Direct immunofluorescence","description":"Direct immunofluorescence","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4308","name":"Sanopellis, per sq cm","description":"Sanopellis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5421","name":"Dentures adjust part maxill","description":"Adjust partial denture - maxillary","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44128","name":"Enterectomy cong add-on","description":"Enterectomy, resection of small intestine for congenital atresia, single resection and anastomosis of proximal segment of intestine; each additional resection and anastomosis (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22858","name":"Tot disc arthrp 2nd lvl crv","description":"Total disc arthroplasty (artificial disc), anterior approach, including discectomy with end plate preparation (includes osteophytectomy for nerve root or spinal cord decompression and microdissection); second level, cervical (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":896.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7241","name":"Impact tooth rem bony w/comp","description":"Removal of impacted tooth-completely bony with unusual surgical complications","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81352","name":"Tp53 gene trgt sequence alys","description":"Tp53 (tumor protein 53) (eg, li-fraumeni syndrome) gene analysis; targeted sequence analysis (eg, 4 oncology)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2034","name":"Found drs solo, per sq cm","description":"Foundation drs solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0457U","name":"Pfas 9 cmpnd lcms/ms pls/sr","description":"Pfas 9 cmpnd lcms/ms pls/sr","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1225","name":"Iop dec>=20% from base","description":"Intraocular pressure (iop) reduced by a value of greater than or equal to 20% from the pre-intervention level","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85379","name":"Fibrin degradation quant","description":"Fibrin degradation products, d-dimer; quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85445","name":"Heinz bodies induced","description":"Heinz bodies; induced, acetyl phenylhydrazine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1450","name":"Pt hos/pal care dur id/pf pd","description":"Patients who received hospice or palliative care service any time during denominator identification period or the measure assessment period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1421","name":"Dermatological care mvp","description":"Dermatological care mips value pathway","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0238","name":"Inj, tocilizumab-aazg, hospi","description":"Injection, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0359","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26740","name":"Treat finger fracture each","description":"Closed treatment of articular fracture, involving metacarpophalangeal or interphalangeal joint; without manipulation, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46946","name":"Int hrhc lig 2+hroid w/o img","description":"Hemorrhoidectomy, internal, by ligation other than rubber band; 2 or more hemorrhoid columns/groups, without imaging guidance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0772T","name":"Vr px dissoc svc sm phy ea","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86366","name":"Muscle-specific kinase antb","description":"Muscle-specific kinase (musk) antibody","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0817T","name":"Opn insj/rplcmt ins ptn subf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1215","name":"Med rsn for no doc spiro","description":"Documentation of medical reason(s) for not documenting and reviewing spirometry results (e.g., patients with dementia or tracheostomy)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85555","name":"Rbc osmotic fragility","description":"Osmotic fragility, rbc; unincubated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1339","name":"Pts f/u 30-180 dys + improv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who demonstrated positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33897","name":"Perq trluml angp nt/recr coa","description":"Percutaneous transluminal angioplasty of native or recurrent coarctation of the aorta","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0980T","name":"Sbmcsl crylys ther tng&tnsl","description":"Submucosal cryolysis therapy; base of tongue and lingual tonsil only","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0388","name":"Bitewing image capture only","description":"Bitewing image capture only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4408","name":"Xwrap hydro per sq cm","description":"Xwrap hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0532U","name":"Rare ds whlgen&mitochdrl dna","description":"Rare ds whlgen&mitochdrl dna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0997T","name":"Precuneus mag stimj tx plng","description":"Precuneus magnetic stimulation; treatment planning using magnetic resonance imaging-guided neuronavigation to determine optimal location, dose, and intensity for magnetic stimulation therapy, derived from evoked potentials from single pulses of electromagnetic energy recorded by 64-channel electroen","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0225","name":"Inj, vutrisiran, 1 mg","description":"Injection, vutrisiran, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0019M","name":"Cv ds plasma alys prtn bmrk","description":"Cardiovascular disease, plasma, analysis of protein biomarkers by aptamer-based microarray and algorithm reported as 4-year likelihood of coronary event in high-risk populations","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0628U","name":"Nfro kdn ds genetic cond 449","description":"Nfro kdn ds genetic cond 449","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1952","name":"Afo spiral prefab ots","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, off-the-shelf","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1356","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87913","name":"Nfct agt gntyp alys sarscov2","description":"Infectious agent genotype analysis by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), mutation identification in targeted region(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33471","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1587.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0622U","name":"Psyc mdd dna alys >20000","description":"Psyc mdd dna alys >20000","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1236","name":"Baseline mrs > 2","description":"Baseline mrs > 2","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64795","name":"Biopsy of nerve","description":"Biopsy of nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5913","name":"Nasal prosthesis","description":"Nasal prosthesis","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33233","name":"Removal of pm generator","description":"Removal of permanent pacemaker pulse generator only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":304.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85009","name":"Manual diff wbc count b-coat","description":"Blood count; manual differential wbc count, buffy coat","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7956","name":"Tiss regen edent resorb","description":"Tiss regen edent resorb","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64628","name":"Trml dstrj ios bvn 1st 2 l/s","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; first 2 vertebral bodies, lumbar or sacral","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73140","name":"X-ray exam of finger(s)","description":"Radiologic examination, finger(s), minimum of 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76061","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0449U","name":"Car scr sev inh cond 5 genes","description":"Car scr sev inh cond 5 genes","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4287","name":"Disp col sto bag breast milk","description":"Disposable collection and storage bag for breast milk, any size, any type, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4349","name":"Mantle dl matrix per sq cm","description":"Mantle dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37292","name":"Rvsc evsc tpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":365.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6034","name":"Part hand finger distal amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s)/thumb, amputation at distal to metacarpal joint, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l669","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54861","name":"Removal of epididymis","description":"Epididymectomy; bilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1417","name":"Pt up to date cov","description":"Patients who are up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9609","name":"F18 fdg, 15 millicuries","description":"Fludeoxyglucose f18 up to 15 millicuries","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0948T","name":"Rem interrog dev ccm phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system with interim analysis, review, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91320","name":"Sarscv2 vac 30mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 30 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1323","name":"Inj, elranatamab-bcmm, 1 mg","description":"Injection, elranatamab-bcmm, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4345","name":"Matrix hd allogrft per sq cm","description":"Matrix hd allograft dermis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17004","name":"Destroy premal lesions 15/>","description":"Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (eg, actinic keratoses), 15 or more lesions","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":187.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6049","name":"Scale implt peri-implt inflm","description":"Scale implt peri-implt inflm","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0332U","name":"Onc pan tum gen prflg 8 dna","description":"Onc pan tum gen prflg 8 dna","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0722T","name":"Quan ct tiss charac w/ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained with concurrent ct examination of any structure contained in the concurrently acquired diagnostic imaging dataset (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90969","name":"Esrd svc pr day pt 12-19","description":"End-stage renal disease (esrd) related services for dialysis less than a full month of service, per day; for patients 12-19 years of age","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33735","name":"Revision of heart chamber","description":"Atrial septectomy or septostomy; closed heart (blalock-hanlon type operation)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1415.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0437U","name":"Psyc anxiety do mrna 15 bmrk","description":"Psyc anxiety do mrna 15 bmrk","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1228","name":"Pt + hcv aby +vir w/ rx 3 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, has hcv treatment initiated within 3 months of the reactive hcv antibody test","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0680T","name":"Insj/rplcmt pg only isdss","description":"Insertion or replacement of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing lead(s)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0422","name":"Collect & prep genetic samp","description":"Collect & prep genetic samp","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0801T","name":"Tcat rmv&rpl 2chmbr ldls pm","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; dual-cha","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71047","name":"X-ray exam chest 3 views","description":"Radiologic examination, chest; 3 views","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0916T","name":"Insj perm ccm-d sys pg only","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator only","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0250","name":"Adm tocilizu covid-19 2nd","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5141","name":"Inj adalimumab-aaty, 1 mg","description":"Injection, adalimumab-aaty, biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0710T","name":"N-invas artl plaq alys","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; including data preparation and transmission, quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess a","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98980","name":"Rtm tx mgmt 1st 20 min","description":"Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least 1 real-time interactive communication with the patient or caregiver during the calendar month; first 20 minutes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8006","name":"Grip glove replacement only","description":"Powered, cable driven grip assist glove, hand, finger, includes pressure sensors, glove replacement only","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33279","name":"Rmvl phrnc nrv stim transvns","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s) only","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0529U","name":"Hem vte snp f2&f5 gen leiden","description":"Hem vte snp f2&f5 gen leiden","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26442","name":"Release palm & finger tendon","description":"Tenolysis, flexor tendon; palm and finger, each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1171.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0260U","name":"Rare ds id opt genome mapg","description":"Rare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0689T","name":"Quan us tis charac w/o dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained without diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24566","name":"Prq skel fix epcndylr hum fx","description":"Percutaneous skeletal fixation of humeral epicondylar fracture, medial or lateral, with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":791.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0411","name":"Hba1c in office testing","description":"Hba1c in office testing","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25444","name":"Arthrp w/prostc lunate","description":"Arthroplasty with prosthetic replacement; lunate","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":994.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1218","name":"Pt copd symptoms","description":"Patient has copd symptoms (e.g., dyspnea, cough/sputum, wheezing)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0787T","name":"Revj/rmvl nea sac w/nstim","description":"Revision or removal of neurostimulator electrode array, sacral, with integrated neurostimulator","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3394","name":"Inj, lovotibeglogene autotem","description":"Injection, lovotibeglogene autotemcel, per treatment","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0427U","name":"Monocyte dstrbj wdth whl bld","description":"Monocyte dstrbj wdth whl bld","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43460","name":"Pressure treatment esophagus","description":"Esophagogastric tamponade, with balloon (sengstaken type)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98979","name":"Rtm tx mgmt 1st 10 min","description":"Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least 1 real-time interactive communication with the patient or caregiver during the calendar month; first 10 minutes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4264","name":"Cocoon membrane, per sq cm","description":"Cocoon membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0550","name":"Phone/inter for dx/treat >5m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a written report to the patients treating/r","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1552","name":"Inj, alyglo, 500 mg","description":"Injection, immune globulin (alyglo), 500 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"Endoskel posit rotat unit","description":"Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1165","name":"Pt use hspc dur meas pd","description":"Patients who use hospice services any time during the measurement period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70473","name":"Ct cere prfu aly c+wo ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed without concurrent ct or ct angiography of the same anatomy","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0827T","name":"Dgtz gls mcrscp cytp smears","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; smears with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0748T","name":"Njx stm cl prdct anl sft tis","description":"Injections of stem cell product into perianal perifistular soft tissue, including fistula preparation (eg, removal of setons, fistula curettage, closure of internal openings)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67040","name":"Laser treatment of retina","description":"Vitrectomy, mechanical, pars plana approach; with endolaser panretinal photocoagulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1404.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4253","name":"Zenith amniotic membrane psc","description":"Zenith amniotic membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49594","name":"Rpr aa hrn 1st 3-10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0844T","name":"Dgtz gls mcrscp cslt cyt ea","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), each additional site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43773","name":"Lap replace gastr adj device","description":"Laparoscopy, surgical, gastric restrictive procedure; removal and replacement of adjustable gastric restrictive device component only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1367.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1023T","name":"Prq tis dsplmt intrathoracic","description":"Percutaneous tissue displacement, any method, including imaging guidance; intrathoracic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1429","name":"Retinopathy in od, os, ou","description":"Retinal exam finding with evidence of retinopathy in left, right or both eyes with severity level documented","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0431","name":"Diag tst detect mucos abnorm","description":"Adjunctive pre-diagnostic test that aids in detection of mucosal abnormalities including premalignant and malignant lesions not to include cytology or biopsy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0877","name":"Inj, daptomycin (hospira)","description":"Injection, daptomycin (hospira), not therapeutically equivalent to j0878, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"Rec cath any transanal, each","description":"Rectal catheter with or without balloon, for use with any type transanal irrigation system, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4356","name":"Abio mem abio hyd per sq cm","description":"Abiomend membrane and abiomend hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0929T","name":"Rem interrog dev ccm-d tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1018T","name":"Elec alys npgs esoph sbsq w/","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69716","name":"Impl oi implt sk tc esp<100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or resulting in removal of less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96450","name":"Chemotherapy into cns","description":"Chemotherapy administration, into cns (eg, intrathecal), requiring and including spinal puncture","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0804","name":"3d facial scan indirect","description":"3d facial scan indirect","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74330","name":"X-ray bile/panc endoscopy","description":"Combined endoscopic catheterization of the biliary and pancreatic ductal systems, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1280","name":"Bilat mast/hx bi /unilat mas","description":"Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1430","name":"Ret exm ou no retinopthy doc","description":"Retinal exam finding without evidence of retinopathy in both eyes with severity level documented (in measurement year or in the prior year)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4376","name":"Duograft aa per sq cm","description":"Duograft aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0689","name":"Inj cefazolin sodium, baxter","description":"Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0738","name":"Upper extremity rehab","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3055","name":"Inj talquetamab-tgvs 0.25 mg","description":"Injection, talquetamab-tgvs, 0.25 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0480U","name":"Nfct ds csf metag ngs alys","description":"Nfct ds csf metag ngs alys","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1335","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81458","name":"So gsap dna cpy nmbr&mcrstl","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis, copy number variants and microsatellite instability","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4251","name":"Vim, per square centimeter","description":"Vim, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0315U","name":"Onc cutan sq cll ca mrna 40","description":"Onc cutan sq cll ca mrna 40","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1413","name":"Inj delandistrogene mox rokl","description":"Injection, delandistrogene moxeparvovec-rokl, per therapeutic dose","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0801","name":"Inj. acthar gel to 40 units","description":"Injection, corticotropin (acthar gel), up to 40 units","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25023","name":"Decompress forearm 1 space","description":"Decompression fasciotomy, forearm and/or wrist, flexor or extensor compartment; with debridement of nonviable muscle and/or nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1369.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87494","name":"Chlmy trch&neisra gonor mult","description":"Infectious agent detection by nucleic acid (dna or rna); chlamydia trachomatis and neisseria gonorrhoeae, multiplex amplified probe technique","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0413U","name":"Onc hl neo opt gen mapg dna","description":"Onc hl neo opt gen mapg dna","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7412","name":"Excision benign lesion compl","description":"Excision of benign lesion complicated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0569","name":"Subs psych care mng, subs mo","description":"Subsequent psychiatric collaborative care management, in a subsequent month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required elements: tracking ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0017","name":"Crisis psychotherapy 60m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); first 60 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0824T","name":"Tcat rmv 1chmbr ldls pm ra","description":"Transcatheter removal of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography), when performed","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1267","name":"Pt no act kid transplt wtlst","description":"Patients not observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0115","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0273U","name":"Hem gen hyprfibrnlysis 8 gen","description":"Hematology (genetic hyperfibrinolysis, delayed bleeding), genomic sequence analysis of 8 genes (f13a1, f13b, fga, fgb, fgg, serpina1, serpine1, serpinf2, plau) blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1025","name":"Pt mnth 1 mcp prov","description":"Patient-months where there are more than one medicare capitated payment (mcp) provider listed for the month","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1344","name":"No bsln/2nd pam score 4-12mo","description":"Patients who did not have a baseline pam score and/or a second score within 4 to 12 months of baseline pam score","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55709","name":"Bx prst8 tprnl us guided","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9432","name":"Med food non inborn err meta","description":"Medical foods for non-inborn errors of metabolism","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33268","name":"Excl laa opn oth px any meth","description":"Exclusion of left atrial appendage, open, performed at the time of other sternotomy or thoracotomy procedure(s), any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0457","name":"Injection, aztreonam, 100 mg","description":"Injection, aztreonam, 100 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0491","name":"Inj anifrolumab-fnia 1mg","description":"Injection, anifrolumab-fnia, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0358U","name":"Neuro alys b-amyl 1-42&1-40","description":"Neuro alys b-amyl 1-42&1-40","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98978","name":"Rtm dev sply cbt 16-30 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of cognitive behavioral therapy, 16-30 days in a 30-day period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0435U","name":"Onc chemo rx cytox csc 14 rx","description":"Onc chemo rx cytox csc 14 rx","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1201","name":"Med rsn no ace-i/arb rx","description":"Documentation of medical reason(s) for not prescribing ace inhibitor (ace-i) or arb therapy during the measurement period (e.g., pregnancy, history of angioedema to ace-i, other allergy to ace-i and arb, hyperkalemia or history of hyperkalemia while on ace-i or arb therapy, acute kidney injury due t","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95117","name":"Immunotherapy injections","description":"Professional services for allergen immunotherapy not including provision of allergenic extracts; 2 or more injections","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4435","name":"Renati membrane per sq cm","description":"Renati membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74170","name":"Ct abd wo cntrst flwd cntrst","description":"Computed tomography, abdomen; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":518.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4387","name":"Neothelium ft per sq cm","description":"Neothelium ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85004","name":"Automated diff wbc count","description":"Blood count; automated differential wbc count","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0877T","name":"Augmnt alys ch ct ild w/o ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64658","name":"Rmvl bat modul sys lead only","description":"Removal of baroreflex activation therapy (bat) modulation system; lead only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5932","name":"Postsurgical obturator","description":"Obturator prosthesis definitive","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0507U","name":"Onc ovr dna whole gen w/5hmc","description":"Onc ovr dna whole gen w/5hmc","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0689","name":"Inj cefazolin sodium, baxter","description":"Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0042","name":"Ref to therapy","description":"Referral to physical, occupational, speech, or recreational therapy","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4008","name":"Geriatrics ss","description":"Geriatrics mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0532U","name":"Rare ds whlgen&mitochdrl dna","description":"Rare ds whlgen&mitochdrl dna","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1489","name":"Pt status doc","description":"Patient status documented","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0692T","name":"Therapeutic ultrafiltration","description":"Therapeutic ultrafiltration","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4034","name":"Speech language path ss","description":"Speech language pathology mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0290U","name":"Pain mgmt mrna gen xprsn 36","description":"Pain mgmt mrna gen xprsn 36","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1434","name":"Orl chemo wthn 30 d post enc","description":"Patient on oral chemotherapy on or within 30 days after denominator eligible encounter","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0994T","name":"Evasc dlvr a-wal stbl rx prq","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; percutaneous","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1355","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52284","name":"Cysto rx balo cath urtl strx","description":"Cystourethroscopy, with mechanical urethral dilation and urethral therapeutic drug delivery by drug-coated balloon catheter for urethral stricture or stenosis, male, including fluoroscopy, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0960T","name":"Rpl s-sclp eltr ra rcvr&tlmt","description":"Replacement of sub-scalp implanted electrode array, receiver, and telemetry unit with tunneling of electrode for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4311","name":"Acesso, per sq cm","description":"Acesso, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0705","name":"Extra oral post radio image","description":"Extra oral post radio image","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0529","name":"In home respite care, 4 hr u","description":"In-home respite care, 4-hour unit, for use in cmmi model","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64629","name":"Trml dstrj ios bvn ea addl","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; each additional vertebral body, lumbar or sacral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3424","name":"Inj hydroxocobalamin iv 25mg","description":"Injection, hydroxocobalamin, intravenous, 25 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0799T","name":"Tcat rmvl 2chmbr ldls pm ra","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right atrial pacemaker component","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0264U","name":"Rare ds id opt genome mapg","description":"Rare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0219","name":"Inj aval alfa-nqpt 4mg","description":"Injection, avalglucosidase alfa-ngpt, 4 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45330","name":"Diagnostic sigmoidoscopy","description":"Sigmoidoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":61.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0136","name":"Inj, acetaminophen (b braun)","description":"Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0846T","name":"Dgtz gls mcrscp imfluor ea","description":"Digitization of glass microscope slides for immunofluorescence, per specimen; each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0833T","name":"Dgtz gls mcrscp cytp oth prp","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; preparation, screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4435","name":"1pc ost pch drain hgh output","description":"Ostomy pouch, drainable, high output, with extended wear barrier (one-piece system), with or without filter, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0045","name":"Mrs 90 days post stk","description":"Clinical follow-up and mrs score assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26123","name":"Release palm contracture","description":"Fasciectomy, partial palmar with release of single digit including proximal interphalangeal joint, with or without z-plasty, other local tissue rearrangement, or skin grafting (includes obtaining graft);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":893.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9184","name":"Inj gemcitabin (avyxa) 200mg","description":"Injection, gemcitabine hydrochloride (avyxa), 200 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33764","name":"Shunt central w/prostc graft","description":"Shunt; central, with prosthetic graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1565.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7528","name":"Mycophen mofetil for susp","description":"Mycophenolate mofetil, for suspension, oral, 100 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9697","name":"Inj, magtrace per study dose","description":"Injection, carboxydextran-coated superparamagnetic iron oxide, per study dose","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0947T","name":"Mrgfus strtctc bl-br disrpj","description":"Magnetic resonance image guided low intensity focused ultrasound (mrgfus), stereotactic blood-brain barrier disruption using microbubble resonators to increase the concentration of blood-based biomarkers of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4317","name":"Vitograft, per sq cm","description":"Vitograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51940","name":"Correction of bladder defect","description":"Closure, exstrophy of bladder","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1862.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0310U","name":"Ped vsclts kd alys 3 bmrks","description":"Ped vsclts kd alys 3 bmrks","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0801T","name":"Tcat rmv&rpl 2chmbr ldls pm","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; dual-cha","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25450","name":"Epiphysl arrst dstl rds/ulna","description":"Epiphyseal arrest by epiphysiodesis or stapling; distal radius or ulna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":895.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1160","name":"Pt anphx due to mengb bef 13","description":"Patient had anaphylaxis due to the meningococcal vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0552","name":"Supply of digital device","description":"Supply of digital mental health treatment device and initial education and onboarding, per course of treatment that augments a behavioral therapy plan","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1413","name":"Inj delandistrogene mox rokl","description":"Injection, delandistrogene moxeparvovec-rokl, per therapeutic dose","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86318","name":"Ia infectious agent antibody","description":"Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip);","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0716T","name":"Car acous wavfrm rec cad rsk","description":"Cardiac acoustic waveform recording with automated analysis and generation of coronary artery disease risk score","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25500","name":"Cltx rdl shft fx w/o mnpj","description":"Closed treatment of radial shaft fracture; without manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6028","name":"Part hand finger metacar amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s) /thumb, amputation at metacarpal level, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4410","name":"Amchomatrixdl per sq cm","description":"Amchomatrixdl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38228","name":"Car-t admn autologous","description":"Chimeric antigen receptor t-cell (car-t) therapy; car-t cell administration, autologous","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0828T","name":"Dgtz gls mcrscp cytp smpl fl","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; simple filter method with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9612","name":"Inj, fluorescein, 1 mg","description":"Injection, fluorescein, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5933","name":"Refitting of obturator","description":"Obturator prosthesis modification","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0572U","name":"Onc prst8 httl qfish whl bld","description":"Onc prst8 httl qfish whl bld","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5129","name":"Inj, vegzelma, 10 mg","description":"Injection, bevacizumab-adcd (vegzelma), biosimilar, 10 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77293","name":"Respirator motion mgmt simul","description":"Respiratory motion management simulation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9027","name":"Clofarabine injection","description":"Injection, clofarabine, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99321","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7956","name":"Tiss regen edent resorb","description":"Tiss regen edent resorb","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81003","name":"Urinalysis auto w/o scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; automated, without microscopy","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9294","name":"Biofeed dig cog behav tx fda","description":"Prescription digital cognitive and/or behavioral therapy, biofeedback, fda cleared, per course of treatment","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0843T","name":"Dgtz gls mcrscp cslt cyt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), initial site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0571U","name":"Onc sol tum dna80&rna10g ngs","description":"Onc sol tum dna80&rna10g ngs","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84394","name":"Total tau","description":"Tau, total (ttau)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0294U","name":"Lngvty&mrtlty rsk mrna 18gen","description":"Lngvty&mrtlty rsk mrna 18gen","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82653","name":"El-1 fecal quantitative","description":"Elastase, pancreatic (el-1), fecal; quantitative","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87593","name":"Orthopoxvirus amp prb each","description":"Infectious agent detection by nucleic acid (dna or rna); orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus), amplified probe technique, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93145","name":"Interrog crtd sins bat ip wo","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0399U","name":"Neuro cere folate defncy srm","description":"Neuro cere folate defncy srm","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4408","name":"Xwrap hydro per sq cm","description":"Xwrap hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86596","name":"Voltage-gtd ca chnl antb ea","description":"Voltage-gated calcium channel antibody, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92928","name":"Prq tcat plmt ntrac st 1 les","description":"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 1 lesion involving 1 or more coronary segments","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0849T","name":"Dgtz gls mcrscp ish ea adl 1","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9957","name":"Screening sleep disorders","description":"Screening sleep disorders","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0660","name":"Team remote e/m new pt 10 mn","description":"Team remote e/m new pt 10mins","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6049","name":"Scale implt peri-implt inflm","description":"Scale implt peri-implt inflm","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51720","name":"Treatment of bladder lesion","description":"Bladder instillation of anticarcinogenic agent (including retention time)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49186","name":"Opn exc/dstr ntra-abd 5 cm/<","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5 cm or less","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0707","name":"Intraoral periap radio image","description":"Intraoral periap radio image","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5143","name":"Inj adalimumab-adbm, 1 mg","description":"Injection, adalimumab-adbm, biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4416","name":"Alexiguard tl-t per sq cm","description":"Alexiguard tl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86051","name":"Aquaporin-4 antb elisa","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; enzyme-linked immunosorbent immunoassay (elisa)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44407","name":"Colonoscopy w/ndl aspir/bx","description":"Colonoscopy through stoma; with transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy(s), includes endoscopic ultrasound examination limited to the sigmoid, descending, transverse, or ascending colon and cecum and adjacent structures","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0042","name":"Ref to therapy","description":"Referral to physical, occupational, speech, or recreational therapy","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63052","name":"Lam facetc/frmt arthrd lum 1","description":"Laminectomy, facetectomy, or foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s] [eg, spinal or lateral recess stenosis]), during posterior interbody arthrodesis, lumbar; single vertebral segment (list separately in addition to code for primary ","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0556","name":"Adv prim care mgmt lvl 1","description":"Advanced primary care management services for a patient with one chronic condition [expected to last at least 12 months, or until the death of the patient, which place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline], or fewer, provided by clinical ","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1171","name":"Pt recd 1 td/tdap 9yrs prior","description":"Patient received at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25645","name":"Optx crpl fx oth/thn scph ea","description":"Open treatment of carpal bone fracture (other than carpal scaphoid [navicular]), each bone","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":689.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4004","name":"Endocrinology ss","description":"Endocrinology mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37216","name":"Transcath stent cca w/o eps","description":"Transcatheter placement of intravascular stent(s), cervical carotid artery, open or percutaneous, including angioplasty, when performed, and radiological supervision and interpretation; without distal embolic protection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1215.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1747","name":"Inj, spesolimab-sbzo, 1 mg","description":"Injection, spesolimab-sbzo, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0628U","name":"Nfro kdn ds genetic cond 449","description":"Nfro kdn ds genetic cond 449","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0735T","name":"Prep tum cav iort prim crnot","description":"Preparation of tumor cavity, with placement of a radiation therapy applicator for intraoperative radiation therapy (iort) concurrent with primary craniotomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4371","name":"Neoguard per sq cm","description":"Neoguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1374","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0824T","name":"Tcat rmv 1chmbr ldls pm ra","description":"Transcatheter removal of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography), when performed","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67028","name":"Injection eye drug","description":"Intravitreal injection of a pharmacologic agent (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49622","name":"Rpr parastomal hrna ncr/strn","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; incarcerated or strangulated","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0140","name":"Nav srv peer sup 60 min pr m","description":"Principal illness navigation - peer support by certified or trained auxiliary personnel under the direction of a physician or other practitioner, including a certified peer specialist; 60 minutes per calendar month, in the following activities:  person-centered interview, performed to better underst","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0918T","name":"Insj perm ccm-d sys dual ld","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; dual transvenous leads (pacing and defibrillation) only","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1352","name":"Suicd c-ssrs assessment, equ","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs or equivalent assessment","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0545U","name":"Achr antb id imfluor livecll","description":"Achr antb id imfluor livecll","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5912","name":"Facial moulage complete","description":"Facial moulage (complete)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37294","name":"Rvsc evsc tpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9025","name":"Plasma cryo redu path each","description":"Plasma, cryoprecipitate reduced, pathogen reduced, each unit","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"Sup/ext non-ins inf pump syr","description":"Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0268U","name":"Hem ahus gen seq alys 15 gen","description":"Hematology (atypical hemolytic uremic syndrome [ahus]), genomic sequence analysis of 15 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81003","name":"Urinalysis auto w/o scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; automated, without microscopy","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92628","name":"Eval hearing aid cand 1st 30","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86850","name":"Rbc antibody screen","description":"Antibody screen, rbc, each serum technique","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4029","name":"Preventive medicine ss","description":"Preventive medicine mips specialty set","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61891","name":"Rev/rplcmt sk-mnt crnl nstm","description":"Revision or replacement of skull-mounted cranial neurostimulator pulse generator or receiver with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9871","name":"Bhv couns dm prev, onln 60 m","description":"Behavioral counseling for diabetes prevention, online, 60 minutes","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2312","name":"Inj naloxone hcl nos, 0.01mg","description":"Injection, naloxone hydrochloride, not otherwise specified, 0.01 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93644","name":"Ep eval subq impl dfb","description":"Electrophysiologic evaluation of subcutaneous implantable defibrillator (includes defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing for arrhythmia termination, and programming or reprogramming of sensing or therapeutic parameters)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0724T","name":"Qmrcp w/dx mri same anatomy","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained with diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in additio","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0904T","name":"Ecg alg 12 ld rdcd trcg only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; tracing only","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9914","name":"Admin of dermal fill","description":"Admin of dermal fill","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49618","name":"Rpr aa hrn rcr > 10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, incarcerated or strangulate","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0838T","name":"Dgtz gls mcrscp cslt sld els","description":"Digitization of glass microscope slides for consultation and report on referred slides prepared elsewhere (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1462","name":"Pt clin ind hd image","description":"Patients with clinical indications for imaging of the head","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66185","name":"Revise aqueous shunt eye","description":"Revision of aqueous shunt to extraocular equatorial plate reservoir; with graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":707.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1245","name":"Pt othr thn true person","description":"Patient provided a response other than completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4333","name":"Ardeograft, per sq cm","description":"Ardeograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4288","name":"Dermabind ch, per sq cm","description":"Dermabind ch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1432","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4287","name":"Dermabind dl, per sq cm","description":"Dermabind dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99459","name":"Pelvic examination","description":"Pelvic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0371","name":"Sialoendoscopy capt & interp","description":"Sialoendoscopy capt & interp","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81000","name":"Urinalysis nonauto w/scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; non-automated, with microscopy","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93018","name":"Cv stress test i&r only","description":"Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; interpretation and report only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15730","name":"Mdfc flap w/prsrv vasc pedcl","description":"Midface flap (ie, zygomaticofacial flap) with preservation of vascular pedicle(s)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1378.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":752.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2470","name":"Inj pantoprazole sodium 40mg","description":"Injection, pantoprazole sodium, 40 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2017","name":"Permeaderm glove, each","description":"Permeaderm glove, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36584","name":"Compl rplcmt picc rs&i","description":"Replacement, complete, of a peripherally inserted central venous catheter (picc), without subcutaneous port or pump, through same venous access, including all imaging guidance, image documentation, and all associated radiological supervision and interpretation required to perform the replacement","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95973","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81463","name":"So gsap cl fr cpy nmbr&mcrst","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis, copy number variants, and microsatellite instability","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96416","name":"Chemo prolong infuse w/pump","description":"Chemotherapy administration, intravenous infusion technique; initiation of prolonged chemotherapy infusion (more than 8 hours), requiring use of a portable or implantable pump","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0913T","name":"Prq tcat ther rx ntrac balo1","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting), including mechanical dilation by nondrug-delivery balloon angioplasty, endoluminal imaging using intravascular ultrasound (ivus) or optical coherence tomography (oct) when per","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4392","name":"Grafix duo per sq cm","description":"Grafix duo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0810T","name":"Subrta njx rx agt w/vtrc","description":"Subretinal injection of a pharmacologic agent, including vitrectomy and 1 or more retinotomies","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0010","name":"Eom meos payment","description":"Enhancing oncology model (eom) monthly enhanced oncology services (meos) payment for eom enhanced services","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0140","name":"Nav srv peer sup 60 min pr m","description":"Principal illness navigation - peer support by certified or trained auxiliary personnel under the direction of a physician or other practitioner, including a certified peer specialist; 60 minutes per calendar month, in the following activities:  person-centered interview, performed to better underst","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1229","name":"Pt w/ +hcv +vir ref win 1 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, is referred within 1 month of the reactive hcv antibody test to a clinician who treats hcv infection","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69728","name":"Rmv ntr oi imp sk tc>=100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0520U","name":"Ther rx mntr 200+ rx/sbsts","description":"Ther rx mntr 200+ rx/sbsts","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31528","name":"Laryngoscopy and dilation","description":"Laryngoscopy direct, with or without tracheoscopy; with dilation, initial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6193","name":"Replace implnt screw","description":"Replace implnt screw","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82252","name":"Fecal bilirubin test","description":"Bilirubin; feces, qualitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98006","name":"Synch audio-video est mod 30","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"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":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1424","name":"Pulmonology care mvp","description":"Pulmonology care mips value pathway","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36011","name":"Place catheter in vein","description":"Selective catheter placement, venous system; first order branch (eg, renal vein, jugular vein)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9986","name":"Missed appointment","description":"Missed appointment","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7997","name":"Appliance removal","description":"Appliance removal (not by dentist who placed appliance) includes removal of archbar","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9026","name":"Inj, tarlatamab-dlle, 1 mg","description":"Injection, tarlatamab-dlle, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2221","name":"Ank mcrop plant & dorsi flex","description":"Addition to lower extremity orthosis, ankle system, microprocessor-controlled feature plantarflexion and/or dorsiflexion, includes power source","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61736","name":"Litt icr 1 traj 1 smpl les","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; single trajectory for 1 simple lesion","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1236","name":"Baseline mrs > 2","description":"Baseline mrs > 2","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1333","name":"Acute vitreous hemorrhage","description":"Acute vitreous hemorrhage","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86780","name":"Treponema pallidum","description":"Antibody; treponema pallidum","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81349","name":"Cytog alys chrml abnr lw-ps","description":"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and loss-of-heterozygosity variants, low-pass sequencing analysis","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4404","name":"Xwrap hydro plus per sq cm","description":"Xwrap hydro plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0320U","name":"Neph rna psttrnspl perph bld","description":"Neph rna psttrnspl perph bld","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1178","name":"Doc med rsn no pcv","description":"Documentation of medical reason(s) for not administering pneumococcal vaccine (e.g., prior anaphylaxis due to the pneumococcal vaccine)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0522U","name":"Ca vi psp&sp1 antb cl semiql","description":"Ca vi psp&sp1 antb cl semiql","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0444","name":"Depression screen annual","description":"Annual depression screening, 5 to 15 minutes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":8.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1301","name":"Immunization counseling","description":"Immunization counseling","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J1565","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0249","name":"Adm tocilizu covid-19 1st","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0431U","name":"Gly rcptr alpha1 igg srm/csf","description":"Gly rcptr alpha1 igg srm/csf","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9595","name":"Piflu f-18, dia 1 millicurie","description":"Piflufolastat f-18, diagnostic, 1 millicurie","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4286","name":"Remove non-resorb barrier","description":"Remove non-resorb barrier","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0287U","name":"Onc thyr dna&mrna 112 genes","description":"Onc thyr dna&mrna 112 genes","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0738","name":"Hiv prep, inj, lenacapavir","description":"Injection, lenacapavir, 1 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90967","name":"Esrd svc pr day pt <2","description":"End-stage renal disease (esrd) related services for dialysis less than a full month of service, per day; for patients younger than 2 years of age","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67904","name":"Repair eyelid defect","description":"Repair of blepharoptosis; (tarso) levator resection or advancement, external approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":529.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49613","name":"Rpr aa hrn rcr < 3 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, reducible","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97020","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0519","name":"New pt-cg dyad dem low cmplx","description":"Management of new patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0739","name":"Rehab sys active assist rt","description":"Rehabilitation system with interactive interface providing active assistance in rehabilitation therapy, includes all components and accessories, motors, microprocessors, sensors","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1612","name":"Inj glucagon (gvoke) 0.01 mg","description":"Injection, glucagon (gvoke), 0.01 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3389","name":"Topi adm prad zami per treat","description":"Topical administration, prademagene zamikeracel, per treatment","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0311U","name":"Nfct ds bct quan antmcrb sc","description":"Nfct ds bct quan antmcrb sc","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0749T","name":"B1 str&fx rsk assmt dxr-bmd","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9601","name":"Flortaucipir inj 1 millicuri","description":"Flortaucipir f 18 injection, diagnostic, 1 millicurie","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0729T","name":"Dx alys vstblr implt uni sbq","description":"Diagnostic analysis of vestibular implant, unilateral; with subsequent programming","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0595U","name":"Nfct ds tfp vctrbrn&zoonotic","description":"Nfct ds tfp vctrbrn&zoonotic","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86362","name":"Mog-igg1 antb cba each","description":"Myelin oligodendrocyte glycoprotein (mog-igg1) antibody; cell-based immunofluorescence assay (cba), each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0483","name":"Indirect immunofluorescence","description":"Indirect immunofluorescence","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9220","name":"Indigotindisulfonate sod 1mg","description":"Injection, indigotindisulfonate sodium, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1468","name":"Hep b vaccine received","description":"Patient received recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97532","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37279","name":"Iv lithotrp fpvt w/in sm art","description":"Intravascular lithotripsy(ies), femoral and popliteal vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55882","name":"Ablt trurl prst8 tis trnsdcr","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation; with insertion of transurethral ultrasound transducer for delivery of thermal ultrasound, including suprapubic tube placement and placement of ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92928","name":"Prq tcat plmt ntrac st 1 les","description":"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 1 lesion involving 1 or more coronary segments","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0740T","name":"Rem auton alg nsln cal setup","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; initial set-up and patient education","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5943","name":"Proth mandib implt sup remv","description":"Proth mandib implt sup remv","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1283","name":"Pt scrn tbco and id as user","description":"Patient screened for tobacco use and identified as a tobacco user","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"Adju cgm supply allowance","description":"Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5911","name":"Facial moulage sectional","description":"Facial moulage (sectional)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0664","name":"Team remote e/m new pt 60 mn","description":"Team remote e/m new pt 60mins","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4280","name":"Xcell amnio matrix per sq cm","description":"Xcell amnio matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1449","name":"Inj eflapegrastim-xnst 0.1mg","description":"Injection, eflapegrastim-xnst, 0.1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0387","name":"Comp image capture only","description":"Comp image capture only","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5945","name":"Mand implt sup remv part","description":"Mand implt sup remv part","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6601","name":"G com bandge hgh dn foam pad","description":"Gradient compression bandaging supply, high density foam pad, any size or shape, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7354","name":"Cantharidin top, applicator","description":"Cantharidin for topical administration, 0.7%, single unit dose applicator (3.2 mg)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0746T","name":"Car ablt rad arr cnv loc map","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; conversion of arrhythmia localization and mapping of arrhythmia site (nidus) into a multidimensional radiation treatment plan","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1028","name":"Take home supply 8mg per 0.1","description":"Take-home supply of nasal naloxone; 2-pack of 8mg per 0.1 ml nasal spray (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0580U","name":"Bbrgdrferi antb detc 24rprtn","description":"Bbrgdrferi antb detc 24rprtn","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70473","name":"Ct cere prfu aly c+wo ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed without concurrent ct or ct angiography of the same anatomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76987","name":"Dx intraop epicar car us chd","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; including placement and manipulation of transducer, image acquisition, interpretation and report","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0358U","name":"Neuro alys b-amyl 1-42&1-40","description":"Neuro alys b-amyl 1-42&1-40","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1017T","name":"Elec aly npgs esoph sbsq w/o","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93655","name":"Icar cath abltj dscrt arrhyt","description":"Intracardiac catheter ablation of a discrete mechanism of arrhythmia which is distinct from the primary ablated mechanism, including repeat diagnostic maneuvers, to treat a spontaneous or induced arrhythmia (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4260","name":"Signature apatch, per sq cm","description":"Signature apatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1361","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0701","name":"Pano radio image","description":"Pano radio image","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7528","name":"Mycophen mofetil for susp","description":"Mycophenolate mofetil, for suspension, oral, 100 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0521","name":"Supply fee hiv prep fda appr","description":"Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37284","name":"Revsc evasc tpvt st sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90960","name":"Esrd srv 4 visits p mo 20+","description":"End-stage renal disease (esrd) related services monthly, for patients 20 years of age and older; with 4 or more face-to-face visits by a physician or other qualified health care professional per month","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2427","name":"Inj, invega hafyera/trinza","description":"Injection, paliperidone palmitate extended release (invega hafyera, or invega trinza), 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76016","name":"Mr safety deter phys/qhp","description":"Mr safety determination by a physician or other qualified health care professional responsible for the safety of the mr procedure, including review of implant mr conditions for indicated mr examination, analysis of risk vs clinical benefit of performing mr examination, and determination of mr equipm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0700T","name":"Molec fluor img sus nev 1st","description":"Molecular fluorescent imaging of suspicious nevus; first lesion","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97007","name":"Mchnl sclp cool meas fitg","description":"Mechanical scalp cooling, including individual cap supply with head measurement, fitting, and patient education","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28312","name":"Revision of toe","description":"Osteotomy, shortening, angular or rotational correction; other phalanges, any toe","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99384","name":"Prev visit new age 12-17","description":"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; adolescent (age ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":83.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80193","name":"Drug assay leflunomide","description":"Leflunomide","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15730","name":"Mdfc flap w/prsrv vasc pedcl","description":"Midface flap (ie, zygomaticofacial flap) with preservation of vascular pedicle(s)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":1663.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1952","name":"Leuprolide inj, camcevi, 1mg","description":"Leuprolide injectable, camcevi, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0574U","name":"Mtb cfp-10 serum/plsm lc-ms","description":"Mtb cfp-10 serum/plsm lc-ms","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0881T","name":"Cryotherapy oral cavity","description":"Cryotherapy of the oral cavity using temperature regulated fluid cooling system, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96203","name":"Mlt fam grp bhv train ea add","description":"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face with multiple sets of paren","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44404","name":"Colonoscopy w/injection","description":"Colonoscopy through stoma; with directed submucosal injection(s), any substance","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":444.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37293","name":"Rvsc evsc tpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7241","name":"Impact tooth rem bony w/comp","description":"Removal of impacted tooth-completely bony with unusual surgical complications","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1322","name":"Pts 7wk inj, scrn iop =<25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop =<25 mm hg for injected eye","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0578U","name":"Onc cutan mln rna qpcr 10gen","description":"Onc cutan mln rna qpcr 10gen","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0751T","name":"Dgtz gls mcrscp sld level ii","description":"Digitization of glass microscope slides for level ii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1500","name":"Neuropsychology mvp","description":"Neuropsychology mips value pathway","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1390","name":"Pt no doc exm for rec","description":"Patients who do not have a documented exam performed for recurrence of melanoma or no documentation within the performance period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7259","name":"Nerve dissection","description":"Nerve dissection","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9432","name":"Med food non inborn err meta","description":"Medical foods for non-inborn errors of metabolism","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4148","name":"Enteral feed elastomer daily","description":"Enteral feeding supply kit; elastomeric control fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4355","name":"Abio xpl abio xpl hy p sq cm","description":"Abiomend xplus membrane and abiomend xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4367","name":"Amniocore sl, per sq cm","description":"Amniocore sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0935T","name":"Cysto w/rnl pel symp dnrvtj","description":"Cystourethroscopy with renal pelvic sympathetic denervation, radiofrequency ablation, retrograde ureteral approach, including insertion of guide wire, selective placement of ureteral sheath(s) and multiple conformable electrodes, contrast injection(s), and fluoroscopy, bilateral","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3389","name":"Topi adm prad zami per treat","description":"Topical administration, prademagene zamikeracel, per treatment","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5099","name":"Inj ustekinumab-stba, 1 mg","description":"Injection, ustekinumab-stba (steqeyma), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80505","name":"Path clin consltj high 41-60","description":"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patients history and medical records and high level of medical decision making when using time for code selection, 41-60 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4264","name":"Cocoon membrane, per sq cm","description":"Cocoon membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0995T","name":"Evasc dlvr a-wal stbl rx opn","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; open","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7298","name":"Remove screw retained plate","description":"Remove screw retained plate","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0743T","name":"B1 str & fx rsk vrt fx assmt","description":"Bone strength and fracture risk using finite element analysis of functional data and bone mineral density (bmd), with concurrent vertebral fracture assessment, utilizing data from a computed tomography scan, retrieval and transmission of the scan data, measurement of bone strength and bmd and classi","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51980","name":"Construct bladder opening","description":"Cutaneous vesicostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":771.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85013","name":"Spun microhematocrit","description":"Blood count; spun microhematocrit","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51721","name":"Ins trurl ablt trnsdc thr us","description":"Insertion of transurethral ablation transducer for delivery of thermal ultrasound for prostate tissue ablation, including suprapubic tube placement during the same session and placement of an endorectal cooling device, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78003","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1333","name":"Acute vitreous hemorrhage","description":"Acute vitreous hemorrhage","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4257","name":"Relese, per sq cm","description":"Relese, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6107","name":"Tissue regen non-resorbable","description":"Tissue regen non-resorbable","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92637","name":"Hearing aid pst-fitg f-up ea","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98926","name":"Osteopath manj 3-4 regions","description":"Osteopathic manipulative treatment (omt); 3-4 body regions involved","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":32.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23155","name":"Removal of humerus lesion","description":"Excision or curettage of bone cyst or benign tumor of proximal humerus; with autograft (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":935.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44388","name":"Colonoscopy thru stoma spx","description":"Colonoscopy through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4033","name":"Skilled nursing facility ss","description":"Skilled nursing facility mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99418","name":"Prolng ip/obs e/m ea 15 min","description":"Prolonged inpatient or observation evaluation and management service(s) time with or without direct patient contact beyond the required time of the primary service when the primary service level has been selected using total time, each 15 minutes of total time (list separately in addition to the cod","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0547","name":"Phone/internet svs 11-20 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0728T","name":"Dx alys vstblr implt uni 1st","description":"Diagnostic analysis of vestibular implant, unilateral; with initial programming","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58943","name":"Removal of ovary(s)","description":"Oophorectomy, partial or total, unilateral or bilateral; for ovarian, tubal or primary peritoneal malignancy, with para-aortic and pelvic lymph node biopsies, peritoneal washings, peritoneal biopsies, diaphragmatic assessments, with or without salpingectomy(s), with or without omentectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1302.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1216","name":"No spiro doc no res doc","description":"No spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and/or no spirometry performed with results documented during the encounter","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0442U","name":"Nfct ds respir nfctj mxa&crp","description":"Nfct ds respir nfctj mxa&crp","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2033","name":"Myriad morcells, 4 mg","description":"Myriad morcells, 4 milligrams","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2956","name":"Indirect rest remov","description":"Indirect rest remov","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D8671","name":"Periodic orth treat w surg","description":"Periodic orth treat w surg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0836T","name":"Dgtz gls mcrscp fna ea addl","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6516","name":"Grad com wrap w strap foo cu","description":"Gradient compression wrap with adjustable straps, foot, each, custom","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1496","name":"No doc of fall or poc","description":"Patients that had a fall who did not have a plan of care for falls documented or do not have documentation of being assessed for falls","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9611","name":"Flurpiridaz f18, diag, 1 mci","description":"Flurpiridaz f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46935","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1026","name":"Pt hemo > 3mo","description":"The number of adult patient-months in the denominator who were on maintenance hemodialysis using a catheter continuously for three months or longer under the care of the same practitioner or group partner as of the last hemodialysis session of the reporting month","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1259","name":"Pt stat doc <= 1 yr dialysis","description":"Patient status documented within the first year of initiating dialysis","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1184","name":"Doc med rsn no cst/ist rx","description":"Documentation of medical reason(s) for not prescribing or administering corticosteroid or immunosuppressant treatment (e.g., allergy, intolerance, infectious etiology, pancreatic insufficiency, hyperthyroidism, prior bowel surgical interventions, celiac disease, receiving other medication, awaiting ","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0345U","name":"Psyc genom alys pnl 15 gen","description":"Psyc genom alys pnl 15 gen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98976","name":"Rtm dev sply resp sys 16-30d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of respiratory system, 16-30 days in a 30-day period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32320","name":"Free/remove chest lining","description":"Decortication and parietal pleurectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1774.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92615","name":"Laryngoscopic sensory i&r","description":"Flexible endoscopic evaluation, laryngeal sensory testing by cine or video recording; interpretation and report only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0302U","name":"Iadna brtnla ddpcr flwg liq","description":"Iadna brtnla ddpcr flwg liq","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90635","name":"H5n1 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n1, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99235","name":"Hosp ip/obs same date mod 70","description":"Hospital inpatient or observation care, for the evaluation and management of a patient including admission and discharge on the same date, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encount","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2781","name":"Crown 3/4 cast base metal","description":"Crown - 3/4 cast predominantly base metal","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0748T","name":"Njx stm cl prdct anl sft tis","description":"Injections of stem cell product into perianal perifistular soft tissue, including fistula preparation (eg, removal of setons, fistula curettage, closure of internal openings)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0529U","name":"Hem vte snp f2&f5 gen leiden","description":"Hem vte snp f2&f5 gen leiden","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2601","name":"Inj, vasopressin (baxter)","description":"Injection, vasopressin (baxter), 1 unit","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1260","name":"Pt not doc <= 1 yr dialysis","description":"Patient status not documented within the first year of initiating dialysis","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4333","name":"Ardeograft, per sq cm","description":"Ardeograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1003T","name":"Arthrp 1st crp/mtcrpl prostc","description":"Arthroplasty, first carpometacarpal joint, with distal trapezial and proximal first metacarpal prosthetic replacement (eg, first carpometacarpal total joint)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26340","name":"Manipulate finger w/anesth","description":"Manipulation, finger joint, under anesthesia, each joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93584","name":"Vngrph chd anom/persist svc","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; anomalous or persistent superior vena cava when it exists as a second contralateral superior vena cava, with native drainage to heart (list separately in addition to code for pri","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0786T","name":"Insj/rplcmt prq ra sac nstim","description":"Insertion or replacement of percutaneous electrode array, sacral, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0713T","name":"N-nvs artl plaq alys rvw i&r","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data review, interpretation and report","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2601","name":"Inj, vasopressin (baxter)","description":"Injection, vasopressin (baxter), 1 unit","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82947","name":"Assay glucose blood quant","description":"Glucose; quantitative, blood (except reagent strip)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q2019","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1476.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86645","name":"Cmv antibody igm","description":"Antibody; cytomegalovirus (cmv), igm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4260","name":"Signature apatch, per sq cm","description":"Signature apatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0519","name":"New pt-cg dyad dem low cmplx","description":"Management of new patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0614","name":"Inj, treosulfan, 50 mg","description":"Injection, treosulfan, 50 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6601","name":"Porc/ceram inlay >= 3 surfac","description":"Inlay - porcelain/ceramic three or more surfaces","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0260U","name":"Rare ds id opt genome mapg","description":"Rare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90638","name":"Vacc qirv mrna 60mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 60 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0699","name":"Inj, cefiderocol, 10 mg","description":"Injection, cefiderocol, 10 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4439","name":"Instagraft per sq cm","description":"Instagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9319","name":"Inj romidepsin lyophil 0.1mg","description":"Injection, romidepsin, lyophilized, 0.1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64595","name":"Rev/rmv prph sac/gstr npg/r","description":"Revision or removal of peripheral, sacral, or gastric neurostimulator pulse generator or receiver, with detachable connection to electrode array","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91125","name":"Anrct mano rct snsatn&balo","description":"Anorectal manometry, with rectal sensation and rectal balloon expulsion test, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2804","name":"Inj, rifampin, 1 mg","description":"Injection, rifampin, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4410","name":"Amchomatrixdl per sq cm","description":"Amchomatrixdl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91321","name":"Sarscov2 vac 25 mcg/.25ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 25 mcg/0.25 ml dosage, for intramuscular use","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1256","name":"Prior history of known cvd","description":"Prior history of known cvd","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0868T","name":"Hi-res gastric ep mapping","description":"High-resolution gastric electrophysiology mapping with simultaneous patient-symptom profiling, with interpretation and report","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99445","name":"Rem mntr physiol param 2-15","description":"Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate); device(s) supply with daily recording(s) or programmed alert(s) transmission, 2-15 days in a 30-day period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71120","name":"X-ray exam breastbone 2/>vws","description":"Radiologic examination; sternum, minimum of 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4307","name":"American amnion, per sq cm","description":"American amnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1452","name":"Pt dx dementia ever","description":"Patient ever had a diagnosis of dementia","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92642","name":"Hearing asstv dev fitg svc","description":"Hearing assistive device, supplemental technology fitting services (eg, personal frequency modulation [fm]/digital modulation [dm] system, remote microphone, alerting devices)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4343","name":"Dermacyte ac matrx per sq cm","description":"Dermacyte ac matrix amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1245","name":"Pt othr thn true person","description":"Patient provided a response other than completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0923T","name":"Rmvl&rplcmt perm ccm-d pg","description":"Removal and replacement of permanent cardiac contractility modulation-defibrillation pulse generator only","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0753T","name":"Dgtz gls mcrscp sld level iv","description":"Digitization of glass microscope slides for level iv, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97024","name":"Diathermy eg microwave","description":"Application of a modality to 1 or more areas; diathermy (eg, microwave)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7415","name":"Excision malig les complicat","description":"Excision of malignant lesion complicated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81005","name":"Urinalysis","description":"Urinalysis; qualitative or semiquantitative, except immunoassays","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44625","name":"Repair bowel opening","description":"Closure of enterostomy, large or small intestine; with resection and anastomosis other than colorectal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90958","name":"Esrd srv 2-3 vsts p mo 12-19","description":"End-stage renal disease (esrd) related services monthly, for patients 12-19 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 2-3 face-to-face visits by a physician or other qualified health care professional per m","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":553.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4028","name":"Podiatry ss","description":"Podiatry mips specialty set","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2351","name":"Inj ocrelizumab 1mg hya-ocsq","description":"Injection, ocrelizumab, 1 mg and hyaluronidase-ocsq","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15853","name":"Removal sutr/stapl xreq anes","description":"Removal of sutures or staples not requiring anesthesia (list separately in addition to e/m code)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0853T","name":"Dgtz gls mcrscp mphmtrc ea m","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0973T","name":"Slctv nzmtc dbrdmt t/a/l 1st","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; first 100 sq cm","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83950","name":"Oncoprotein her-2/neu","description":"Oncoprotein; her-2/neu","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1476","name":"Pt dx cog imp or ad","description":"Patients with diagnosis of cognitive impairment or alzheimers disease","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2680","name":"Fluphenazine decanoate 25 mg","description":"Injection, fluphenazine decanoate, up to 25 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1437","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0850","name":"Cytomegalovirus imm iv /vial","description":"Injection, cytomegalovirus immune globulin intravenous (human), per vial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":672.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2976","name":"Band stabilization per tooth","description":"Band stabilization per tooth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1249","name":"Pt resp true imprt to me","description":"Patient responded completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15840","name":"Nerve palsy fascial graft","description":"Graft for facial nerve paralysis; free fascia graft (including obtaining fascia)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0585U","name":"Tgsap so neo cfdna 521 genes","description":"Tgsap so neo cfdna 521 genes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4273","name":"Esano aaa, per sq cm","description":"Esano aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49594","name":"Rpr aa hrn 1st 3-10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6590","name":"Urinary cath disp suc pump","description":"External urinary catheters; disposable, with wicking material, for use with suction pump, per month","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0376U","name":"Onc prst8 ca img alys 128","description":"Onc prst8 ca img alys 128","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1394","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77437","name":"Surf radj ther supfc<=150kv","description":"Surface radiation therapy; superficial, delivery, </=150 kv, per fraction (eg, electronic brachytherapy)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83013","name":"H pylori (c-13) breath","description":"Helicobacter pylori; breath test analysis for urease activity, non-radioactive isotope (eg, c-13)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74290","name":"Contrast x-ray gallbladder","description":"Cholecystography, oral contrast","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0140","name":"Nav srv peer sup 60 min pr m","description":"Principal illness navigation - peer support by certified or trained auxiliary personnel under the direction of a physician or other practitioner, including a certified peer specialist; 60 minutes per calendar month, in the following activities:  person-centered interview, performed to better underst","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7911","name":"Dental suture wound to 5 cm","description":"Complicated suture-up to 5 cm","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93042","name":"Rhythm ecg report","description":"Rhythm ecg, 1-3 leads; interpretation and report only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64761","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4409","name":"Amniomatrixf3x per sq cm","description":"Amniomatrixf3x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1226","name":"Iop not doc","description":"Iop measurement not documented, reason not otherwise specified","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0907T","name":"Coms ther ea addl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; each additional application, total wound(s) surface area less than or equal to 50 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1302","name":"Inj, sutimlimab-jome, 10 mg","description":"Injection, sutimlimab-jome, 10 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6518","name":"Grad com wrap w strap arm cu","description":"Gradient compression wrap with adjustable straps, arm, each, custom","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4330","name":"Total, per sq cm","description":"Total, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0835T","name":"Dgtz gls mcrscp fna 1st ea","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4336","name":"Artecent c, per sq cm","description":"Artacent c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q0137","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0462U","name":"Melatonin lvl tst slp std7/9","description":"Melatonin lvl tst slp std7/9","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2550","name":"Promethazine hcl injection","description":"Injection, promethazine hcl, up to 50 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4386","name":"Acesso trifaca per sq cm","description":"Acesso trifaca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1251","name":"Pts proxy cmplt hu surv","description":"Patients for whom a proxy completed the entire hu survey on their behalf for any reason (no patient involvement)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0600U","name":"Nfct ds wnd infctj 65orgs&30","description":"Nfct ds wnd infctj 65orgs&30","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35531","name":"Art byp grft aorcel/aormesen","description":"Bypass graft, with vein; aortoceliac or aortomesenteric","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2486.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0730T","name":"Trabeculotomy lsr w/oct gdn","description":"Trabeculotomy by laser, including optical coherence tomography (oct) guidance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0625U","name":"Endocrinol op dna alys>5000","description":"Endocrinol op dna alys>5000","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0553","name":"Monthly tx for dmht 20mins","description":"First 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing information related to the use of","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0238","name":"Inj, tocilizumab-aazg, hospi","description":"Injection, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26540","name":"Repair hand joint","description":"Repair of collateral ligament, metacarpophalangeal or interphalangeal joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":893.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46030","name":"Removal anal seton oth mrk","description":"Removal of anal seton, other marker","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1596","name":"Inj, glycopyrrolate, 0.1 mg","description":"Injection, glycopyrrolate, 0.1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4276","name":"Orion, per sq cm","description":"Orion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1196","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0608","name":"Lanthanum carbonate pwdr 5mg","description":"Lanthanum carbonate, oral, powder, 5 mg, not therapeutically equivalent to j0607 (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"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":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4268","name":"Surgraft ft per sq cm","description":"Surgraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0514","name":"Prolong prev svcs, addl 30m","description":"Prolonged preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient contact beyond the usual service; each additional 30 minutes (list separately in addition to code g0513 for additional 30 minutes of preventi","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":72.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1004T","name":"Elec alys s-scl eeg wo prgrm","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; without programming","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0989T","name":"Revj/rmvl ins ptn subq&subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9334","name":"Inj efgart-alfa 2mg hya-qvfc","description":"Injection, efgartigimod alfa, 2 mg and hyaluronidase-qvfc","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1232","name":"Pt hcv tst reactive result","description":"Patient receives hcv antibody test with reactive result","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9333","name":"Inj rozanolixizum-noli 1 mg","description":"Injection, rozanolixizumab-noli, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0881T","name":"Cryotherapy oral cavity","description":"Cryotherapy of the oral cavity using temperature regulated fluid cooling system, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0712T","name":"N-nvs artl plaq alys quan","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess atherosclerotic plaque stability","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99395","name":"Prev visit est age 18-39","description":"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 18-39","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":137.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7997","name":"Appliance removal","description":"Appliance removal (not by dentist who placed appliance) includes removal of archbar","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0607","name":"Lanthanum carbonate oral 5mg","description":"Lanthanum carbonate, oral, 5 mg (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4258","name":"Enverse, per sq cm","description":"Enverse, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75671","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":747.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76805","name":"Ob us >/= 14 wks sngl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0452U","name":"Onc bldr mthyl penk lte-qmsp","description":"Onc bldr mthyl penk lte-qmsp","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35013","name":"Repair artery rupture arm","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, axillary-brachial artery, by arm incision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1552.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9291","name":"Pres dig cog behav thera fda","description":"Prescription digital cognitive and/or behavioral therapy, fda cleared, per course of treatment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0721T","name":"Quan ct tiss charac w/o ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9029","name":"Instill adstiladrin, tx dose","description":"Intravesical instillation, nadofaragene firadenovec-vncg, per therapeutic dose","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0685T","name":"Interrog dev eval isdss ip","description":"Interrogation device evaluation (in-person) with analysis, review and report by a physician or other qualified health care professional, including connection, recording and disconnection per patient encounter, permanent implantable synchronized diaphragmatic stimulation system for augmentation of ca","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6595","name":"G comp bandge liner upr extr","description":"Gradient compression bandaging supply, bandage liner, upper extremity, any size or length, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9045","name":"Carboplatin injection","description":"Injection, carboplatin, 50 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47384","name":"Abltj ire liver 1+ tum perq","description":"Ablation, irreversible electroporation, liver, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0155","name":"Dronabinol (syndros) 0.1 mg","description":"Dronabinol (syndros), 0.1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0807T","name":"Pulm tiss vntj alys prev ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with previously acquired computed tomography (ct) images, including data preparation and transmission, quantification of pulmonary tissue ventilation, data re","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9361","name":"Inj, efbemalenograstim alfa-","description":"Injection, efbemalenograstim alfa-vuxw, 0.5 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2183","name":"Inj meropenem (wg crit care)","description":"Injection, meropenem (wg critical care), not therapeutically equivalent to j2185, 100 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0999T","name":"Autol musc cell therapy hrvg","description":"Autologous muscle cell therapy, harvesting of muscle progenitor cells, including ultrasound guidance, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1033","name":"Sv doula brth wrk per diem","description":"Services performed by a doula birth worker, per diem","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1387","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4393","name":"Surgraft ac per sq cm","description":"Surgraft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36425","name":"Venipuncture cutdown 1 yr/>","description":"Venipuncture, cutdown; age 1 or over","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2252","name":"Inj midazolam in 0.8% nacl","description":"Injection, midazolam in 0.8% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1309","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37258","name":"Revsc evasc ivt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4100","name":"Nosht skin sub fda clrd nos","description":"Non-sheet form skin substitute, fda cleared as a device, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0272U","name":"Hem genetic bld do 51 genes","description":"Hematology (genetic bleeding disorders), genomic sequence analysis of 51 genes, blood, buccal swab, or amniotic fluid, comprehensive","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0319U","name":"Neph rna pretrnspl perph bld","description":"Neph rna pretrnspl perph bld","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0387U","name":"Onc mlnma ambra1&amlo","description":"Onc mlnma ambra1&amlo","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1151","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82554","name":"Creatine isoforms","description":"Creatine kinase (ck), (cpk); isoforms","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0808T","name":"Pulm tiss vntj alys w/ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with computed tomography (ct) images taken for the purpose of pulmonary tissue ventilation analysis, including data preparation and transmission, quantificati","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35363","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; combined aortoiliofemoral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2103.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1252","name":"Pts no cmplt hu survey","description":"Patients who did not complete at least one of the four patient experience hu survey items and return the hu survey within 60 days of the ambulatory palliative care visit","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63198","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1855.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0862T","name":"Rlcj pg wcs lv battery only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; battery component only","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9292","name":"Pres dig visual therapy fda","description":"Prescription digital visual therapy, software-only, fda cleared, per course of treatment","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1805","name":"Inj, esmolol hcl, 10mg","description":"Injection, esmolol hydrochloride, 10 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0897T","name":"N-invas augmnt arrhyt alys","description":"Noninvasive augmentative arrhythmia analysis derived from quantitative computational cardiac arrhythmia simulations, based on selected intervals of interest from 12-lead electrocardiogram and uploaded clinical parameters, including uploading clinical parameters with interpretation and report","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0608U","name":"Reprdtve med ema rtpcr 10bct","description":"Reprdtve med ema rtpcr 10bct","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4312","name":"Acesso ac, per sq cm","description":"Acesso ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99310","name":"Sbsq nf care high mdm 45","description":"Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 45 minutes must be met or exc","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":149.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53605","name":"Dilate urethra stricture","description":"Dilation of urethral stricture or vesical neck by passage of sound or urethral dilator, male, general or conduction (spinal) anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1409","name":"Recd gmln brca1/brca2 couns","description":"Patients who received germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0179","name":"Md recertification hha pt","description":"Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initi","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9011","name":"Datopotamab deruxtecan, 1 mg","description":"Injection, datopotamab deruxtecan-dlnk, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0507U","name":"Onc ovr dna whole gen w/5hmc","description":"Onc ovr dna whole gen w/5hmc","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0683","name":"App of non-sheet skin sub g","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0852T","name":"Dgtz gls mcrscp mphmtrc ea 1","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0418U","name":"Onc brst aug alg aly whl sl8","description":"Onc brst aug alg aly whl sl8","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3376","name":"Inj vancomycin (hikma) 10mg","description":"Injection, vancomycin hcl (hikma), not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2781","name":"Crown 3/4 cast base metal","description":"Crown - 3/4 cast predominantly base metal","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92136","name":"Ophthalmic biometry","description":"Ophthalmic biometry by partial coherence interferometry with intraocular lens power calculation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80506","name":"Path clin consltj prolng svc","description":"Pathology clinical consultation; prolonged service, each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4351","name":"Enclose tl matrix, per sq cm","description":"Enclose tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87154","name":"Cul typ id bld pthgn 6+ trgt","description":"Culture, typing; identification of blood pathogen and resistance typing, when performed, by nucleic acid (dna or rna) probe, multiplexed amplified probe technique including multiplex reverse transcription, when performed, per culture or isolate, 6 or more targets","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1296","name":"Calc bmi norm parameters","description":"Bmi is documented within normal parameters and no follow-up plan is required","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1325","name":"Doc med rsn not seen","description":"Patients who were not seen for reasons documented by clinician for patient or medical reasons (e.g., inadequate time for follow-up, patients who received a prior intravitreal or periocular steroid injection within the last six (6) months and had a subsequent iop evaluation with iop <25mm hg within s","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0249","name":"Adm tocilizu covid-19 1st","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1811","name":"Fiasp for insulin pump use","description":"Insulin (fiasp) for administration through dme (i.e., insulin pump) per 50 units","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4407","name":"Xwrap tribus per sq cm","description":"Xwrap tribus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4560","name":"Nmes disposable","description":"Neuromuscular electrical stimulator (nmes), disposable, replacement only","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0765T","name":"Asstv alg ecg rsk asmt prev","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to previously performed electrocardiogram","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0834T","name":"Dgtz gls mcrscp cytp oth xtn","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1809","name":"Inj, fosdenopterin, 0.1mg","description":"Injection, fosdenopterin, 0.1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4287","name":"Dermabind dl, per sq cm","description":"Dermabind dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88153","name":"Cytopath c/v redo","description":"Cytopathology, slides, cervical or vaginal; with manual screening and rescreening under physician supervision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1349","name":"No pam inc 3 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 3 points within a 4 to 12 month period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"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":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4225","name":"Amnio or derma tl, per sq cm","description":"Amniobind or dermabind tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3263","name":"Inj, toripalimab-tpzi, 1 mg","description":"Injection, toripalimab-tpzi, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2644","name":"Dental onlay porc 4/more sur","description":"Onlay - porcelain/ceramic - four or more surfaces","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1017T","name":"Elec aly npgs esoph sbsq w/o","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0002","name":"Opt care kidney hlth mvp","description":"Optimal care for kidney health mips value pathways","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1560","name":"Gamma globulin > 10 cc inj","description":"Injection, gamma globulin, intramuscular, over 10 cc","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26045","name":"Release palm contracture","description":"Fasciotomy, palmar (eg, dupuytrens contracture); open, partial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4297","name":"Emerge matrix, per sq cm","description":"Emerge matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27445","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1507.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26546","name":"Repair nonunion hand","description":"Repair non-union, metacarpal or phalanx (includes obtaining bone graft with or without external or internal fixation)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1175.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0043","name":"Pt mech pros ht valv","description":"Patients with mechanical prosthetic heart valve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63282","name":"Bx/exc idrl spine lesn lmbr","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, lumbar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2226.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1782","name":"Vac admin human pap dose 2","description":"Vac admin human pap dose 2","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0271U","name":"Hem cgen neutropenia 23 gen","description":"Hematology (congenital neutropenia), genomic sequence analysis of 23 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0949T","name":"Rem interrog dev ccm tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1369","name":"Qualcare mental hlth/sud mvp","description":"Quality care in mental health and substance use disorders mips value pathway","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69726","name":"Rmv ntr oi implt skl prq esp","description":"Removal, entire osseointegrated implant, skull; with percutaneous attachment to external speech processor","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4393","name":"Surgraft ac per sq cm","description":"Surgraft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87482","name":"Candida dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); candida species, quantification","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5946","name":"Max implt sup fix","description":"Max implt sup fix","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1343.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1353","name":"Sealant repair per tooth","description":"Sealant repair per tooth","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1837","name":"Inj, posaconazole, 1 mg","description":"Injection, posaconazole, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85018","name":"Hemoglobin","description":"Blood count; hemoglobin (hgb)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69209","name":"Remove impacted ear wax uni","description":"Removal impacted cerumen using irrigation/lavage, unilateral","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22836","name":"Ant thrc vrt body tethrg <7","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; up to 7 vertebral segments","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4329","name":"Singlay, per sq cm","description":"Singlay, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37283","name":"Rvsc evsc tpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0903T","name":"Ecg alg 12 lead reduced i&r","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; with interpretation and report","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0001A","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0700T","name":"Molec fluor img sus nev 1st","description":"Molecular fluorescent imaging of suspicious nevus; first lesion","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1640","name":"Hemin, 1 mg","description":"Injection, hemin, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0052","name":"Mmip mental health and care","description":"Missing and murdered indigenous persons (mmip) mental health and clinical care","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99445","name":"Rem mntr physiol param 2-15","description":"Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate); device(s) supply with daily recording(s) or programmed alert(s) transmission, 2-15 days in a 30-day period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0485U","name":"Onc sol tum cfdna&rna ngs gm","description":"Onc sol tum cfdna&rna ngs gm","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1497","name":"No doc fall med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27062","name":"Remove femur lesion/bursa","description":"Excision; trochanteric bursa or calcification","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":526.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0169","name":"Inj epinephrine (adrenalin)","description":"Injection, epinephrine (adrenalin), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5939","name":"Resct proth mand comp remov","description":"Resct proth mand comp remov","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0807T","name":"Pulm tiss vntj alys prev ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with previously acquired computed tomography (ct) images, including data preparation and transmission, quantification of pulmonary tissue ventilation, data re","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0606U","name":"Hem red cll memb do rbc oge","description":"Hem red cll memb do rbc oge","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1339","name":"Pts f/u 30-180 dys + improv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who demonstrated positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75577","name":"Quan&char c athrosclrtc plaq","description":"Quantification and characterization of coronary atherosclerotic plaque to assess severity of coronary disease, derived from augmentative software analysis of the data set from a coronary computed tomographic angiography, with interpretation and report by a physician or other qualified health care pr","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52250","name":"Cystoscopy and radiotracer","description":"Cystourethroscopy with insertion of radioactive substance, with or without biopsy or fulguration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0708","name":"Intraoral bite radio image","description":"Intraoral bite radio image","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2359","name":"Inj. olanzapine, 0.5mg","description":"Injection, olanzapine, 0.5 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4402","name":"Xwrap 2.0 per sq cm","description":"Xwrap 2.0, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33776","name":"Rpr tga atr bfl clsr vsd","description":"Repair of transposition of the great arteries, atrial baffle procedure (eg, mustard or senning type) with cardiopulmonary bypass; with closure of ventricular septal defect","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2463.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98925","name":"Osteopath manj 1-2 regions","description":"Osteopathic manipulative treatment (omt); 1-2 body regions involved","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":36.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0688T","name":"Tx amblyopia assmt w/report","description":"Treatment of amblyopia using an online digital program; assessment of patient performance and program data by physician or other qualified health care professional, with report, per calendar month","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9161","name":"Inj denileuk difti-cxdl 1mcg","description":"Injection, denileukin diftitox-cxdl, 1 mcg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1477","name":"Dx delirium","description":"Diagnosis of delirium","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98003","name":"Synch audio-video new hi 60","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high medical decision making. when using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9800","name":"Gallium locametz 1 millicuri","description":"Gallium ga-68 gozetotide, diagnostic, (locametz), 1 millicurie","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0487U","name":"Onc sol tum cfcdna tgsap 84","description":"Onc sol tum cfcdna tgsap 84","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1402","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5152","name":"Inj, eculizumab-aeeb, 2 mg","description":"Injection, eculizumab-aeeb (bkemv), biosimilar, 2 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0502U","name":"Hpv e6/e7 mrk hi-rsk typ crv","description":"Hpv e6/e7 mrk hi-rsk typ crv","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1302","name":"Inj, sutimlimab-jome, 10 mg","description":"Injection, sutimlimab-jome, 10 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0948T","name":"Rem interrog dev ccm phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system with interim analysis, review, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0560U","name":"Onc mrd gsa cfdna baseline","description":"Onc mrd gsa cfdna baseline","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1806","name":"Inj esmolol hcl wg crit care","description":"Injection, esmolol hydrochloride (wg critical care), not therapeutically equivalent to j1805, 10 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2642","name":"Dental onlay porcelin 2 surf","description":"Onlay - porcelain/ceramic - two surfaces","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86880","name":"Coombs test direct","description":"Antihuman globulin test (coombs test); direct, each antiserum","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0486U","name":"Onc pan sol tum ngs cfctdna","description":"Onc pan sol tum ngs cfctdna","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4408","name":"Xwrap hydro per sq cm","description":"Xwrap hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93585","name":"Vngrph chd azygs/hemiazygs","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; azygos/hemiazygos venous system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0162","name":"Inj epinephrine (fresenius)","description":"Injection, epinephrine (fresenius), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37299","name":"Revsc evsc imvt angio cpx ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6624","name":"Inlay titanium","description":"Inlay - titanium","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0723T","name":"Qmrcp w/o dx mri sm anat ses","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained without diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) during the same session","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1405","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1210","name":">=2 same meds tbl4 not ord","description":"At least two orders for high-risk medications from the same drug class, (table 4), not ordered","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2011","name":"Supra sdrm, per sq cm","description":"Supra sdrm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0464U","name":"Onc clrct scr qrtsa dna mrk","description":"Onc clrct scr qrtsa dna mrk","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4301","name":"Activate matrix, per sq cm","description":"Activate matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86381","name":"Mitochondrial antibody each","description":"Mitochondrial antibody (eg, m2), each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":25.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1442","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37296","name":"Revsc evasc imvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62331","name":"Dcmprn prq rmv lig flv addl","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; additional interspace(s), lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95010","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11442","name":"Exc face-mm b9+marg 1.1-2 cm","description":"Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 1.1 to 2.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0043","name":"Pt mech pros ht valv","description":"Patients with mechanical prosthetic heart valve","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0914T","name":"Prq tcat thr rx ntrc bal sep","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting) performed on a separate target lesion from the target lesion treated with balloon angioplasty, coronary stent placement or coronary atherectomy, including mechanical dilation b","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1351","name":"Dental sealant per tooth","description":"Sealant-per tooth","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0985T","name":"Iv img xtrc cere vsl oct ea","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0274U","name":"Hem gen pltlt do 43 genes","description":"Hematology (genetic platelet disorders), genomic sequence analysis of 43 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81354","name":"Cytog alys chrml abnor ogm","description":"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of structural and copy number variants, optical genome mapping (ogm)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0355U","name":"Apol1 risk variants","description":"Apol1 risk variants","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0942T","name":"Cysto flx rmv&rplc urtl scaf","description":"Cystourethroscopy, flexible; with removal and replacement of prostatic urethral scaffold","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0260U","name":"Rare ds id opt genome mapg","description":"Rare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2994.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44680","name":"Surgical revision intestine","description":"Intestinal plication (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1054.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2782","name":"Inj avacincaptad pegol 0.1mg","description":"Injection, avacincaptad pegol, 0.1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9611","name":"Flurpiridaz f18, diag, 1 mci","description":"Flurpiridaz f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1611","name":"Inj glucagon hcl, fresenius","description":"Injection, glucagon hydrochloride (fresenius kabi), not therapeutically equivalent to j1610, per 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71045","name":"X-ray exam chest 1 view","description":"Radiologic examination, chest; single view","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4345","name":"Matrix hd allogrft per sq cm","description":"Matrix hd allograft dermis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5153","name":"Inj, aflibercept-yszy, 1 mg","description":"Injection, aflibercept-yszy (opuviz), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37295","name":"Rvsc evsc tpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9506","name":"Tc-99m graphite crucible","description":"Graphite crucible for preparation of technetium tc 99m-labeled carbon aerosol, one crucible","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36420","name":"Venipuncture cutdown < 1 yr","description":"Venipuncture, cutdown; younger than age 1 year","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":815.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92974","name":"Cath place cardio brachytx","description":"Transcatheter placement of radiation delivery device for subsequent coronary intravascular brachytherapy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0411U","name":"Psyc genom alys pnl 15 gen","description":"Psyc genom alys pnl 15 gen","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2919","name":"Inj, methylpred sod succ 5mg","description":"Injection, methylprednisolone sodium succinate, 5 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0929T","name":"Rem interrog dev ccm-d tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0849T","name":"Dgtz gls mcrscp ish ea adl 1","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7165","name":"Inj, human-lans, per i.u","description":"Injection, prothrombin complex concentrate, human-lans, per i.u. of factor ix activity","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93152","name":"Interrog&prgrmg ipnss polysm","description":"Interrogation and programming of implanted phrenic nerve stimulator system during polysomnography","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90624","name":"Menb-4c&menacwy vacc im","description":"Meningococcal pentavalent vaccine, men b-4c recombinant proteins and outer membrane vesicle and conjugated men a, c, w, y-diphtheria toxoid carrier, for intramuscular use","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52325","name":"Cystoscopy stone removal","description":"Cystourethroscopy (including ureteral catheterization); with fragmentation of ureteral calculus (eg, ultrasonic or electro-hydraulic technique)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27257","name":"Treat hip dislocation","description":"Treatment of spontaneous hip dislocation (developmental, including congenital or pathological), by abduction, splint or traction; with manipulation, requiring anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":390.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36516","name":"Apheresis immunoads slctv","description":"Therapeutic apheresis; with extracorporeal immunoadsorption, selective adsorption or selective filtration and plasma reinfusion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1212","name":"Missing gsa not perf","description":"Glycemic status assessment (hba1c or gmi) level is missing, or was not performed during the measurement period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0994T","name":"Evasc dlvr a-wal stbl rx prq","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; percutaneous","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2030","name":"Miro3d fibers, per mg","description":"Miro3d fibers, per milligram","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27788","name":"Treatment of ankle fracture","description":"Closed treatment of distal fibular fracture (lateral malleolus); with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1073","name":"Testosterone pellet 75 mg","description":"Testosterone pellet, implant, 75 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2021","name":"Inj, linezolid (hospira)","description":"Injection, linezolid (hospira), not therapeutically equivalent to j2020, 200 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1377","name":"Fu colscop 10 yr doc w/ disc","description":"Recommended follow-up interval for repeat colonoscopy of 10 years documented  in colonoscopy report and communicated with patient","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1350","name":"Pt w/ suic saf pln init rev","description":"Patients who had a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0466","name":"Home vent non-invasive inter","description":"Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1360.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2516","name":"Inj, pentamidine isethionate","description":"Injection, pentamidine isethionate, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0600U","name":"Nfct ds wnd infctj 65orgs&30","description":"Nfct ds wnd infctj 65orgs&30","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1271","name":"Pts dem any time/dur mo","description":"Patients with dementia at any time prior to or during the month","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9275","name":"Inj cosibelimab-ipdl, 2 mg","description":"Injection, cosibelimab-ipdl, 2 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31243","name":"Nsl/sinus ndsc cryoabltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by cryoablation, posterior nasal nerve","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85018","name":"Hemoglobin","description":"Blood count; hemoglobin (hgb)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0738T","name":"Tx pln mag fld abltj prst8","description":"Treatment planning for magnetic field induction ablation of malignant prostate tissue, using data from previously performed magnetic resonance imaging (mri) examination","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53453","name":"Tprnl balo cntnc dev rmvl ea","description":"Periurethral transperineal adjustable balloon continence device; removal, each balloon","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3471","name":"Surg rep root res anterior","description":"Surg rep root res anterior","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1419","name":"Pt not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0909T","name":"Rplcmt int nstim sys vgs nrv","description":"Replacement of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6515","name":"Grad com wrap w str fu le cu","description":"Gradient compression wrap with adjustable straps, full leg, each, custom","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64584","name":"Rmvl hpglsl nstim ary pg","description":"Removal of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0608","name":"Lanthanum carbonate pwdr 5mg","description":"Lanthanum carbonate, oral, powder, 5 mg, not therapeutically equivalent to j0607 (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0783T","name":"Tc auriculr neurostimulation","description":"Transcutaneous auricular neurostimulation, set-up, calibration, and patient education on use of equipment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1339","name":"Pts f/u 30-180 dys + improv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who demonstrated positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0982T","name":"Rem mntr impl ivc snr set-up","description":"Remote monitoring of implantable inferior vena cava sensor, physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate), initial set-up and patient education on use of equipment","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37274","name":"Rvsc evsc fpvt athrc cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1170","name":"Pt w/o flu vax 7/1-6/30","description":"Patient did not receive an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0894T","name":"Cannulation liver allograft","description":"Cannulation of the liver allograft in preparation for connection to the normothermic perfusion device and decannulation of the liver allograft following normothermic perfusion","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0234","name":"Intra inf, toci, second dos","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53454","name":"Tprnl balo cntnc dev adjmt","description":"Periurethral transperineal adjustable balloon continence device; percutaneous adjustment of balloon(s) fluid volume","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9986","name":"Missed appointment","description":"Missed appointment","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1430","name":"Ret exm ou no retinopthy doc","description":"Retinal exam finding without evidence of retinopathy in both eyes with severity level documented (in measurement year or in the prior year)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4282","name":"Cygnus dual per sq cm","description":"Cygnus dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51726","name":"Complex cystometrogram","description":"Complex cystometrogram (ie, calibrated electronic equipment);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":440.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77331","name":"Special radiation dosimetry","description":"Special dosimetry (eg, tld, microdosimetry) (specify), only when prescribed by the treating physician","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0393U","name":"Neu prksn msfl a-syncln prtn","description":"Neu prksn msfl a-syncln prtn","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4016","name":"Neurosurgical ss","description":"Neurosurgical mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0596U","name":"Neuro alzds plsm 3dstnct isp","description":"Neuro alzds plsm 3dstnct isp","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0540U","name":"Trnsplj med quan dd-cfdna","description":"Trnsplj med quan dd-cfdna","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0889T","name":"Prsnlz trgt dvl arhfcmrigtbs","description":"Personalized target development for accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation derived from a structural and resting-state functional mri, including data preparation and transmission, generation of the target, motor threshold-starting location, neuro","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24344","name":"Reconstruct elbow lat ligmnt","description":"Reconstruction lateral collateral ligament, elbow, with tendon graft (includes harvesting of graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1271.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1200","name":"Ace-i/arb rx","description":"Ace inhibitor (ace-i) or arb therapy prescribed during the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0552U","name":"Repr med pga gdo te bx locus","description":"Repr med pga gdo te bx locus","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4380","name":"Advograft one per sq cm","description":"Advograft one, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1379","name":"10 yr fu no rec rsn not giv","description":"A 10 year follow-up interval for colonoscopy not recommended, reason not otherwise specified","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0780T","name":"Instlj fecal microbiota ssp","description":"Instillation of fecal microbiota suspension via rectal enema into lower gastrointestinal tract","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86778","name":"Toxoplasma antibody igm","description":"Antibody; toxoplasma, igm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49021","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26434","name":"Repair/graft finger tendon","description":"Repair of extensor tendon, distal insertion, primary or secondary; with free graft (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":860.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10022","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0462","name":"Atropine sulf, nte, 0.01 mg","description":"Injection, atropine sulfate, not therapeutically equivalent to j0461, 0.01 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83529","name":"Asay of interleukin-6 (il-6)","description":"Interleukin-6 (il-6)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0969T","name":"Removal epicranial nstim sys","description":"Removal of epicranial neurostimulator system","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0749T","name":"B1 str&fx rsk assmt dxr-bmd","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95911","name":"Nrv cndj test 9-10 studies","description":"Nerve conduction studies; 9-10 studies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0287","name":"Amphotericin b lipid complex","description":"Injection, amphotericin b lipid complex, 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1289","name":"No pt tbco cess interv rng","description":"Patient identified as tobacco user did not receive tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0998T","name":"Precuneus mag stimj tx dlvr","description":"Precuneus magnetic stimulation; personalized treatment delivery of magnetic stimulation therapy to a prespecified target area derived from analysis of evoked potentials within the precuneus, utilizing magnetic resonance imaging-based neuronavigation, with management, per day","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97008","name":"Mchnl sclp cool prep plmt","description":"Mechanical scalp cooling; including hair preparation, individual cap placement, therapy initiation, and precooling period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4267","name":"Neostim dl per sq cm","description":"Neostim dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87220","name":"Tissue exam for fungi","description":"Tissue examination by koh slide of samples from skin, hair, or nails for fungi or ectoparasite ova or mites (eg, scabies)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4038","name":"Vascular surgery ss","description":"Vascular surgery mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1313","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11045","name":"Dbrdmt subq tiss each addl","description":"Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); each additional 20 sq cm, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":48.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2008","name":"Theragenesis, per sq cm","description":"Theragenesis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0269U","name":"Hem aut dm cgen trmbctpna 14","description":"Hematology (autosomal dominant congenital thrombocytopenia), genomic sequence analysis of 14 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9596","name":"Gallium illuccix 1 millicure","description":"Gallium ga-68 gozetotide, diagnostic, (illuccix), 1 millicurie","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1436","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31243","name":"Nsl/sinus ndsc cryoabltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by cryoablation, posterior nasal nerve","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31603","name":"Emer tracheostomy ttrach","description":"Tracheostomy, emergency procedure; transtracheal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4369","name":"Amnioplast 3 per sq cm","description":"Amnioplast 3, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1401","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4265","name":"Neostim tl per sq cm","description":"Neostim tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33278","name":"Rmvl phrnc nrv stim sys","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; system, including pulse generator and lead(s)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0317","name":"Prolong nursin fac eval 15m","description":"Prolonged nursing facility evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the date of the primary service); each additional 15 minutes by the physician or qualified healthcare professional, with or without ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0041","name":"Pt/ptn decln referral","description":"Patient and/or care partner decline referral","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0677T","name":"Laps repos lead isdss 1st ld","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first repositioned lead","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0736T","name":"Colonic lavage 35+l water","description":"Colonic lavage, 35 or more liters of water, gravity-fed, with induced defecation, including insertion of rectal catheter","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0949T","name":"Rem interrog dev ccm tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7912","name":"Suture complicate wnd > 5 cm","description":"Complicated suture-greater than 5 cm","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0888T","name":"Histotripsy mal renal tissue","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant renal tissue, including imaging guidance","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81000","name":"Urinalysis nonauto w/scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; non-automated, with microscopy","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1961","name":"Inj lenacapavir (hiv tx) 1mg","description":"Injection, lenacapavir (only for use as hiv treatment), 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92145","name":"Corneal hysteresis deter","description":"Corneal hysteresis determination, by air impulse stimulation, unilateral or bilateral, with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0921T","name":"Rmvl perm ccm-d sys 1 dfb ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous defibrillation lead only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2030","name":"Miro3d fibers, per mg","description":"Miro3d fibers, per milligram","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0577","name":"Inj, brixadi, 7 days or less","description":"Injection, buprenorphine extended-release (brixadi), less than or equal to 7 days of therapy","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2781","name":"Crown 3/4 cast base metal","description":"Crown - 3/4 cast predominantly base metal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6519","name":"Grad com garm noc night use","description":"Gradient compression garment, not otherwise specified, for nighttime use, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0986T","name":"Iv img icr cere vsl oct 1st","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50100","name":"Trnsxj/repos abrrnt rnl vsls","description":"Transection or repositioning of aberrant renal vessels (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1155.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0139","name":"Inj, adalimumab, 1 mg","description":"Injection, adalimumab, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53866","name":"Cathj rmvl dev ischmc rmdlg","description":"Catheterization with removal of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1151","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5147","name":"Inj, aflibercept-ayyh, 1 mg","description":"Injection, aflibercept-ayyh (pavblu), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0977T","name":"Upr gi bld detcj snr capsule","description":"Upper gastrointestinal blood detection, sensor capsule, with interpretation and report","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0919T","name":"Rmvl perm ccm-d sys pg only","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); pulse generator only","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86037","name":"Anca titer each antibody","description":"Antineutrophil cytoplasmic antibody (anca); titer, each antibody","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60661","name":"Abltj 1/+thyr ndul addl prq","description":"Ablation of 1 or more thyroid nodule(s), additional lobe, percutaneous, including imaging guidance, radiofrequency (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0717T","name":"Adrc ther prtl rc tear","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; adipose tissue harvesting, isolation and preparation of harvested cells, including incubation with cell dissociation enzymes, filtration, washing, and concentration of adrcs","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15012","name":"Hrv skn cll ssp agrft ea add","description":"Harvest of skin for skin cell suspension autograft; each additional 25 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64820","name":"Sympathectomy digital artery","description":"Sympathectomy; digital arteries, each digit","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":857.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1426","name":"Injection, casimersen, 10 mg","description":"Injection, casimersen, 10 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1203","name":"No rsn ace-i/arb rx","description":"Ace inhibitor or arb therapy not prescribed during the measurement period, reason not given","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62367","name":"Analyze spine infus pump","description":"Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); without reprogramming or refill","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1395","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1409","name":"Recd gmln brca1/brca2 couns","description":"Patients who received germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55869","name":"Lap srg prst8ct bi pl lmphad","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G3003","name":"Chronic pain mgmt addl 15m","description":"Each additional 15 minutes of chronic pain management and treatment by a physician or other qualified health care professional, per calendar month. (list separately in addition to code for g3002. when using g3003, 15 minutes must be met or exceeded.)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99465","name":"Nb resuscitation","description":"Delivery/birthing room resuscitation, provision of positive pressure ventilation and/or chest compressions in the presence of acute inadequate ventilation and/or cardiac output","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0561U","name":"Onc mrd gsa cfdna subsequent","description":"Onc mrd gsa cfdna subsequent","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99467","name":"Ped crit care transport addl","description":"Critical care face-to-face services, during an interfacility transport of critically ill or critically injured pediatric patient, 24 months of age or younger; each additional 30 minutes (list separately in addition to code for primary service)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4285","name":"Nudyn dl or dl mesh pr sq cm","description":"Nudyn dl or nudyn dl mesh, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1260","name":"Pt not doc <= 1 yr dialysis","description":"Patient status not documented within the first year of initiating dialysis","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0724T","name":"Qmrcp w/dx mri same anatomy","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained with diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in additio","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0484","name":"Consult slides prep elsewher","description":"Consultation on slides prepared elsewhere","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1259","name":"Pt stat doc <= 1 yr dialysis","description":"Patient status documented within the first year of initiating dialysis","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62220","name":"Establish brain cavity shunt","description":"Creation of shunt; ventriculo-atrial, -jugular, -auricular","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1111.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5725","name":"Rebase hybrid prosthesis","description":"Rebase hybrid prosthesis","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50947","name":"Laparo new ureter/bladder","description":"Laparoscopy, surgical; ureteroneocystostomy with cystoscopy and ureteral stent placement","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1591.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0489U","name":"Ob sgnipt cfdna seq alys 1+","description":"Ob sgnipt cfdna seq alys 1+","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9506","name":"Tc-99m graphite crucible","description":"Graphite crucible for preparation of technetium tc 99m-labeled carbon aerosol, one crucible","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1098","name":"Articaine ophthalmi 8% 0.4ml","description":"Articaine ophthalmic, 8% solution, 0.4 ml","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0337U","name":"Onc plsm cell do&myeloma id","description":"Onc plsm cell do&myeloma id","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0839T","name":"Dgtz gls mcrscp cslt mat prp","description":"Digitization of glass microscope slides for consultation and report on referred material requiring preparation of slides (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64755","name":"Incision of stomach nerves","description":"Transection or avulsion of; vagus nerves limited to proximal stomach (selective proximal vagotomy, proximal gastric vagotomy, parietal cell vagotomy, supra- or highly selective vagotomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":934.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9289","name":"Inj nivolumab 2 mg hyaluron","description":"Injection, nivolumab, 2 mg and hyaluronidase-nvhy","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1349","name":"No pam inc 3 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 3 points within a 4 to 12 month period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1398","name":"Bslne and  fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1265","name":"Cms 2728 completed","description":"Cms medical evidence form 2728 for dialysis patients: initial form completed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66991","name":"Xcapsl ctrc rmvl insj 1+","description":"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); with insertion of intraocular (eg, trabecular meshwork, supraciliary, suprachoroidal) anterior segment aqueous drai","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70471","name":"Cta h&n c+ w/noncontrast img","description":"Computed tomographic angiography (cta), head and neck, with contrast material(s), including noncontrast images, when performed, and image postprocessing","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"Evaluation of wheezing","description":"Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1306","name":"Injection, inclisiran, 1 mg","description":"Injection, inclisiran, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98009","name":"Synch audio-only new low 30","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 30 m","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4323","name":"Splint extra-coronal","description":"Splint extra-coronal","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0601","name":"Sevelamer carbonate 20 mg","description":"Sevelamer carbonate (renvela or therapeutically equivalent), oral, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0832T","name":"Dgtz gls mcrscp cytp oth scr","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6036","name":"Prosthetic thumb mechanical","description":"Prosthetic thumb, mechanical, can include metacarpophalangeal (mcp), interphalangeal (ip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87480","name":"Candida dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); candida species, direct probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0762T","name":"Dgtz gls mcrscp sl imm ea m","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, each multiplex antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81463","name":"So gsap cl fr cpy nmbr&mcrst","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis, copy number variants, and microsatellite instability","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88344","name":"Imhchem/imcytchm ea mlt antb","description":"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1161","name":"Pt anphx due to dtp bef 13","description":"Patient had anaphylaxis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1214","name":"Spiro results wth obs doc","description":"Spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and reviewed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0034","name":"Pall serv during meas","description":"Patients receiving palliative care during the measurement period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1436","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0537","name":"Risk ascvd tst once pr 12 mo","description":"Administration of a standardized, evidence-based atherosclerotic cardiovascular disease (ascvd) risk assessment, 5-15 minutes, not more often than every 12 months","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76989","name":"Dx intraop epcar us chd i&r","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; interpretation and report only","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1457","name":"Dx asth dur crnt/prv perf pd","description":"Patient had a diagnosis of asthma with any contact during the current or prior performance period or had asthma present on an active problem list any time during the performance period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0442U","name":"Nfct ds respir nfctj mxa&crp","description":"Nfct ds respir nfctj mxa&crp","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1375","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1339","name":"Pts f/u 30-180 dys + improv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who demonstrated positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0773T","name":"Vr px dissoc svc oth phy 1st","description":"Virtual reality (vr) procedural dissociation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports; initial 15 min","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86362","name":"Mog-igg1 antb cba each","description":"Myelin oligodendrocyte glycoprotein (mog-igg1) antibody; cell-based immunofluorescence assay (cba), each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9072","name":"Inj cyclophos frindovyx 5 mg","description":"Injection, cyclophosphamide (frindovyx), 5 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36465","name":"Njx noncmpnd sclrsnt 1 vein","description":"Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate, inclusive of all imaging guidance and monitoring; single incompetent extremity truncal vein (eg, great saphenous vein, accessory saphenous vein)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":121.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86305","name":"Human epididymis protein 4","description":"Human epididymis protein 4 (he4)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0356U","name":"Onc orop 17 dna ddpcr alg","description":"Onc orop 17 dna ddpcr alg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0544","name":"Post d/c phone follow up","description":"Post discharge telephonic follow-up contacts performed in conjunction with a discharge from the emergency department for behavioral health or other crisis encounter, 4 calls per calendar month","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1007T","name":"Eeg impl s-sclp eeg w/o vid","description":"Electroencephalogram from implanted sub-scalp continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7771","name":"Alveolus clsd reduc stblz te","description":"Alveolus closed reduction stabilization of teeth","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90460","name":"Im admin 1st/only component","description":"Immunization administration through 18 years of age via any route of administration, with counseling by physician or other qualified health care professional; first or only component of each vaccine or toxoid administered","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1478","name":"Psychoactive sub abuse","description":"Psychoactive substance abuse","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85004","name":"Automated diff wbc count","description":"Blood count; automated differential wbc count","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0146","name":"Nav srv peer sup add 30 pr m","description":"Principal illness navigation - peer support, additional 30 minutes per calendar month (list separately in addition to g0140)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0686T","name":"Histotripsy mal hepatcel tis","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant hepatocellular tissue, including image guidance","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47136","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4613.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0665","name":"Team remote e/m est pt 10 mn","description":"Team remote e/m est. pt 10mins","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37182","name":"Insert hepatic shunt (tips)","description":"Insertion of transvenous intrahepatic portosystemic shunt(s) (tips) (includes venous access, hepatic and portal vein catheterization, portography with hemodynamic evaluation, intrahepatic tract formation/dilatation, stent placement and all associated imaging guidance and documentation)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1040.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1279","name":"Pre-htn/htn, no f/u, not gvn","description":"Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0420U","name":"Onc urthl mrna xprsn 6 snp","description":"Onc urthl mrna xprsn 6 snp","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0459","name":"Telehealth inpt pharm mgmt","description":"Inpatient telehealth pharmacologic management, including prescription, use, and review of medication with no more than minimal medical psychotherapy","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1174","name":"Pt w/ 2 hzv 10/2017 - mp","description":"Patient received at least two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9616","name":"Gallium gozellix 1 millicuri","description":"Gallium ga-68 gozetotide (gozellix), diagnostic, 1 millicurie","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1491","name":"Recd esrd mcp dur perf pd","description":"Receiving esrd mcp dialysis services by the provider during the performance period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1015T","name":"Rev/rmv lw esoph sphnc npg/r","description":"Revision or removal, lower esophageal sphincter neurostimulator pulse generator or receiver","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27179","name":"Revise head/neck of femur","description":"Open treatment of slipped femoral epiphysis; osteoplasty of femoral neck (heyman type procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1150.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55868","name":"Lap srg prst8ct lymph nod bx","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with lymph node biopsy(ies) (limited pelvic lymphadenectomy)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5612","name":"Rep resin part dent base max","description":"Rep resin part dent base max","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4393","name":"Surgraft ac per sq cm","description":"Surgraft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4007","name":"General surgery ss","description":"General surgery mips specialty set","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0366U","name":"Onc bldr 10 prb recr bldr ca","description":"Onc bldr 10 prb recr bldr ca","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0869T","name":"Njx b1 sub mtrl hw fixj aug","description":"Injection(s), bone-substitute material for bone and/or soft tissue hardware fixation augmentation, including intraoperative imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1262","name":"Pts transplt bef dialysis","description":"Patients who had a transplant prior to initiation of dialysis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69730","name":"Rplc oi implt sk tc esp>=100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64680","name":"Injection treatment of nerve","description":"Destruction by neurolytic agent, with or without radiologic monitoring; celiac plexus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2016","name":"Permeaderm b, per sq cm","description":"Permeaderm b, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0426U","name":"Genome ultra-rapid seq alys","description":"Genome ultra-rapid seq alys","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9954","name":"Fab/del oral appliance thxpy","description":"Fab/del oral appliance thxpy","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0436U","name":"Onc lng plsm alys 388 prtn","description":"Onc lng plsm alys 388 prtn","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63016","name":"Remove spine lamina >2 thrc","description":"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), more than 2 vertebral segments; thoracic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93598","name":"Car outp meas drg cath chd","description":"Cardiac output measurement(s), thermodilution or other indicator dilution method, performed during cardiac catheterization for the evaluation of congenital heart defects (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92930","name":"Prq tcat plmt ntrac st 2+les","description":"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 2 or more distinct coronary lesions with 2 or more coronary stents deployed in 2 or more coronary segments, or a bifurcation lesion requiring ","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0718T","name":"Adrc ther prtl rc tear njx","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; injection into supraspinatus tendon including ultrasound guidance, unilateral","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1186","name":"Pt w/ rx for hspc/plltv care","description":"Patients who have an order for or are receiving hospice or palliative care","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1204","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1315","name":"Crc no doc no rsn","description":"Colorectal cancer screening results were not documented and reviewed; reason not otherwise specified","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25116","name":"Remove wrist/forearm lesion","description":"Radical excision of bursa, synovia of wrist, or forearm tendon sheaths (eg, tenosynovitis, fungus, tbc, or other granulomas, rheumatoid arthritis); extensors, with or without transposition of dorsal retinaculum","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":990.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1457","name":"Dx asth dur crnt/prv perf pd","description":"Patient had a diagnosis of asthma with any contact during the current or prior performance period or had asthma present on an active problem list any time during the performance period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1024T","name":"Perq tiss dsplmt soft tissue","description":"Percutaneous tissue displacement, any method, including imaging guidance; soft tissue (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2359","name":"Inj. olanzapine, 0.5mg","description":"Injection, olanzapine, 0.5 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99445","name":"Rem mntr physiol param 2-15","description":"Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate); device(s) supply with daily recording(s) or programmed alert(s) transmission, 2-15 days in a 30-day period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0571","name":"Intraop nerve cryoablation","description":"Intraoperative nerve(s) cryoablation for post-surgical pain relief (list separately in addition to code for primary service)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1360","name":"Suicd c-ssrs assessment","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0445U","name":"Abeta42 & ptau181 eclia csf","description":"Abeta42 & ptau181 eclia csf","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43290","name":"Egd flx trnsorl dplmnt balo","description":"Esophagogastroduodenoscopy, flexible, transoral; with deployment of intragastric bariatric balloon","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98007","name":"Synch audio-video est hi 40","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high medical decision making. when using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded.","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5153","name":"Inj, aflibercept-yszy, 1 mg","description":"Injection, aflibercept-yszy (opuviz), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87338","name":"Hpylori stool ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; helicobacter pylori, stool","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1248","name":"Pt resp true seen as person","description":"Patient responded completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1412","name":"Met nsclc w/ egfr alk oth ab","description":"Patients with metastatic nsclc with epidermal growth factor receptor (egfr) mutations, alk genomic tumor aberrations, or other targetable genomic abnormalities with approved first-line targeted therapy, such as nsclc with ros1 rearrangement, braf v600e mutation, ntrk 1/2/3 gene fusion, met ex14 skip","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1353","name":"Pts no cmplt suicd saf pln","description":"Patients who did not have a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1812","name":"Inj. insulin (fiasp)","description":"Insulin (fiasp), per 5 units","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0270","name":"Mnt subs tx for change dx","description":"Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face to face with the patient, each 15 minutes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":24.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1281","name":"Bp scrn no perf at interval","description":"Blood pressure reading not documented, reason not given","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63032","name":"Lamot rpr anulr dfct 1 lmbr","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; with repair of annular defect by implantation of bone-anchored annular closure device, including all imaging guidance, 1 interspace, lumbar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1271","name":"Inj doxycycline hyclate 1 mg","description":"Injection, doxycycline hyclate, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0258U","name":"Ai psor mrna 50-100 gen alg","description":"Autoimmune (psoriasis), mrna, next-generation sequencing, gene expression profiling of 50-100 genes, skin- surface collection using adhesive patch, algorithm reported as likelihood of response to psoriasis biologics","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1439","name":"Sig ocu cond imp surg out","description":"Significant ocular conditions that impact the visual outcome of surgery","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4280","name":"Xcell amnio matrix per sq cm","description":"Xcell amnio matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4468","name":"Exsuff belt incl all sup acc","description":"Exsufflation belt, includes all supplies and accessories","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33361","name":"Replace aortic valve perq","description":"Transcatheter aortic valve replacement (tavr/tavi) with prosthetic valve; percutaneous femoral artery approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1632.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0001","name":"Advancing cancer care mvp","description":"Advancing cancer care mips value pathways","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0409U","name":"Onc sld tum dna 80 & rna 36","description":"Onc sld tum dna 80 & rna 36","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87467","name":"Hepatitis b surface ag quan","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; hepatitis b surface antigen (hbsag), quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0350","name":"Oral/facial photo images","description":"Oral/facial photographic images","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2038","name":"Skill train and dev/diem","description":"Skills training and development, per diem","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3376","name":"Inj vancomycin (hikma) 10mg","description":"Injection, vancomycin hcl (hikma), not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83529","name":"Asay of interleukin-6 (il-6)","description":"Interleukin-6 (il-6)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66250","name":"Follow-up surgery of eye","description":"Revision or repair of operative wound of anterior segment, any type, early or late, major or minor procedure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":523.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4231","name":"Ana crown exp 1-3 per quad","description":"Anatomical crown exposure - one to three teeth per quadrant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81524","name":"Onc cns tum dna mthyl 10,000","description":"Oncology (central nervous system tumor), dna methylation analysis of at least 10,000 methylation sites, utilizing dna extracted from formalin-fixed tumor tissue, algorithm(s) reported as probability of matching a reference tumor family and class, and mgmt (o-6-methylguanine-dna methyltransferase) pr","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3401","name":"Vyjuvek 5x10^9pfu/ml, 0.1 ml","description":"Beremagene geperpavec-svdt for topical administration, containing nominal 5 x 10^9 pfu/ml vector genomes, per 0.1 ml","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0462U","name":"Melatonin lvl tst slp std7/9","description":"Melatonin lvl tst slp std7/9","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0506","name":"Comp asses care plan ccm svc","description":"Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":40.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1222","name":"Glaucoma pln of care not doc","description":"Glaucoma plan of care not documented, reason not otherwise specified","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6584","name":"Grad com wrap w straps","description":"Gradient compression wrap with adjustable straps, not otherwise specified","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1495","name":"Fall w/ poc, no fall","description":"Patients that reported a fall occurred who had a plan of care for falls documented or patients that did not report a fall","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0561U","name":"Onc mrd gsa cfdna subsequent","description":"Onc mrd gsa cfdna subsequent","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17250","name":"Chem caut of granltj tissue","description":"Chemical cauterization of granulation tissue (ie, proud flesh)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":98.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33902","name":"Perq p-art revsc 1 abnor uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, unilateral","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9996","name":"Ustekinumab- ttwe sub cu inj","description":"Injection, ustekinumab-ttwe (pyzchiva), subcutaneous, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92642","name":"Hearing asstv dev fitg svc","description":"Hearing assistive device, supplemental technology fitting services (eg, personal frequency modulation [fm]/digital modulation [dm] system, remote microphone, alerting devices)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87880","name":"Strep a assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; streptococcus, group a","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0484U","name":"Nfct ds mgen 23s rrna pt mut","description":"Nfct ds mgen 23s rrna pt mut","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0689","name":"Inj cefazolin sodium, baxter","description":"Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0899T","name":"N-invas deter aqmbf aug cmr","description":"Noninvasive determination of absolute quantitation of myocardial blood flow (aqmbf), derived from augmentative algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health car","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2015","name":"Phoenix wnd mtrx, per sq cm","description":"Phoenix wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2281","name":"Inj moxifloxacin (fres kabi)","description":"Injection, moxifloxacin (fresenius kabi), not therapeutically equivalent to j2280, 100 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88161","name":"Cytopath smear other source","description":"Cytopathology, smears, any other source; preparation, screening and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6611","name":"Grad com wrap w strap ak cus","description":"Gradient compression wrap with adjustable straps, above knee, each, custom","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1271","name":"Inj doxycycline hyclate 1 mg","description":"Injection, doxycycline hyclate, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1276","name":"Calc bmi out nrm param nof/u","description":"Bmi documented outside normal parameters, no follow-up plan documented, no reason given","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4318","name":"E-graft, per sq cm","description":"E-graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92920","name":"Prq trluml c angiop 1art&/br","description":"Percutaneous transluminal coronary angioplasty, single major coronary artery and/or its branch(es)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70473","name":"Ct cere prfu aly c+wo ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed without concurrent ct or ct angiography of the same anatomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4241","name":"Gngvl flap w rootplan 1-3 th","description":"Gingival flap procedure including root planing - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60661","name":"Abltj 1/+thyr ndul addl prq","description":"Ablation of 1 or more thyroid nodule(s), additional lobe, percutaneous, including imaging guidance, radiofrequency (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95919","name":"Quan puplmtry phy/qhp uni/bi","description":"Quantitative pupillometry with physician or other qualified health care professional interpretation and report, unilateral or bilateral","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0423U","name":"Psyc genomic alys pnl 26 gen","description":"Psyc genomic alys pnl 26 gen","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4418","name":"Biolab wrap flow per sq cm","description":"Biolab membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1244","name":"Pt othr thn true best int","description":"Patient provided a response other than completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7972","name":"Surg redct fibrous tuberosit","description":"Surgical reduction of fibrous tuberosity","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0378U","name":"Rfc1 repeat xpnsj vrnt alys","description":"Rfc1 repeat xpnsj vrnt alys","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0017","name":"Crisis psychotherapy 60m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); first 60 minutes","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0734T","name":"Rem r-t mtn nrehab tx mgmt","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; treatment management services by a physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0654","name":"Inj, liothyronine, 1 mcg","description":"Injection, liothyronine, 1 mcg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82653","name":"El-1 fecal quantitative","description":"Elastase, pancreatic (el-1), fecal; quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1002T","name":"Air displacmnt plethysmograp","description":"Air displacement plethysmography, whole-body composition assessment, with interpretation and report","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83884","name":"Assay neurflmnt light chain","description":"Neurofilament light chain (nfl)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3911","name":"Intraorifice barrier","description":"Intraorifice barrier","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37262","name":"Iv lithotrp ivt w/in sm art","description":"Intravascular lithotripsy(ies), iliac vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0274U","name":"Hem gen pltlt do 43 genes","description":"Hematology (genetic platelet disorders), genomic sequence analysis of 43 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0482U","name":"Ob pe biochem asy sfit1&pigf","description":"Ob pe biochem asy sfit1&pigf","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0595U","name":"Nfct ds tfp vctrbrn&zoonotic","description":"Nfct ds tfp vctrbrn&zoonotic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9278","name":"Inj, carboplatin (avyxa)","description":"Injection, carboplatin (avyxa), 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9602","name":"Fluorodopa f-18 diag per mci","description":"Fluorodopa f-18, diagnostic, per millicurie","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44015","name":"Insert needle cath bowel","description":"Tube or needle catheter jejunostomy for enteral alimentation, intraoperative, any method (list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0997T","name":"Precuneus mag stimj tx plng","description":"Precuneus magnetic stimulation; treatment planning using magnetic resonance imaging-guided neuronavigation to determine optimal location, dose, and intensity for magnetic stimulation therapy, derived from evoked potentials from single pulses of electromagnetic energy recorded by 64-channel electroen","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68841","name":"Insj rx elut implt lac canal","description":"Insertion of drug-eluting implant, including punctal dilation when performed, into lacrimal canaliculus, each","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80503","name":"Path clin consltj sf 5-20","description":"Pathology clinical consultation; for a clinical problem, with limited review of patients history and medical records and straightforward medical decision making when using time for code selection, 5-20 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91125","name":"Anrct mano rct snsatn&balo","description":"Anorectal manometry, with rectal sensation and rectal balloon expulsion test, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50940","name":"Release of ureter","description":"Deligation of ureter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67015","name":"Release of eye fluid","description":"Aspiration or release of vitreous, subretinal or choroidal fluid, pars plana approach (posterior sclerotomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":610.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55714","name":"Bx prst8 in-bore ct/mri 1","description":"Biopsy, prostate, in-bore ct- or mri-guided targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93587","name":"Vngrph chd vnvn cltrl at/abv","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating at or above the heart (eg, from innominate vein) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43265","name":"Ercp lithotripsy calculi","description":"Endoscopic retrograde cholangiopancreatography (ercp); with destruction of calculi, any method (eg, mechanical, electrohydraulic, lithotripsy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":628.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0872T","name":"Rplcmt ndwllg bldr&prtl cath","description":"Replacement of indwelling bladder and peritoneal catheters, including tunneling of catheter(s) and connection with previously implanted peritoneal ascites pump, including imaging and programming, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1427","name":"Doc med rsn bone scn","description":"Documentation of medical reason(s) for performing a bone scan (including documented pain related to prostate cancer, salvage therapy, other medical reasons)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2032","name":"Myriad matrix, per sq cm","description":"Myriad matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4318","name":"E-graft, per sq cm","description":"E-graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43640","name":"Vagotomy & pylorus repair","description":"Vagotomy including pyloroplasty, with or without gastrostomy; truncal or selective","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1180.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93593","name":"R hrt cath chd nml nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; normal native connections","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1416","name":"Pt rec hosp","description":"Patient received hospice services any time during the performance period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84394","name":"Total tau","description":"Tau, total (ttau)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97009","name":"Mchnl sclp cool after chemo","description":"Mechanical scalp cooling; provided after discontinuation of chemotherapy, each 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2041","name":"Coord special care encounter","description":"Coordinated specialty care, team-based, for first episode psychosis, per encounter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0308U","name":"Crd cad alys 3 prtn plsm alg","description":"Crd cad alys 3 prtn plsm alg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0784T","name":"Ins/rplmt eltrd ra spi nstim","description":"Insertion or replacement of percutaneous electrode array, spinal, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21263","name":"Revise eye sockets","description":"Periorbital osteotomies for orbital hypertelorism, with bone grafts; with forehead advancement","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2231.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2021","name":"Neomatrix per sq cm","description":"Neomatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0945T","name":"Intraop assmt abnl tum tiss","description":"Intraoperative assessment for abnormal (tumor) tissue, in-vivo, following partial mastectomy (eg, lumpectomy) using computer-aided fluorescence imaging (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9322","name":"Inj pemetrexed (bluepoint)","description":"Injection, pemetrexed (bluepoint), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1463","name":"2 f/u wthn 180 day rx atmp","description":"Documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0562","name":"Complex simulation w/pet-ct","description":"Therapeutic radiology simulation-aided field setting; complex, including acquisition of pet and ct imaging data required for radiopharmaceutical-directed radiation therapy treatment planning (i.e., modeling)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1378","name":"Med rsn no 10 yr fu colscope","description":"Documentation of medical reason(s) for not recommending a 10 year follow-up interval (e.g., inadequate prep, familial or personal history of colonic polyps, patient had no adenoma and age is >= 66 years old, or life expectancy < 10 years, other medical reasons)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2012","name":"Suprathel, per sq cm","description":"Suprathel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7172","name":"Inj marstacim-hncq, 0.5 mg","description":"Injection, marstacimab-hncq, 0.5 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29861","name":"Hip arthro w/fb removal","description":"Arthroscopy, hip, surgical; with removal of loose body or foreign body","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":824.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0236","name":"Intrav inf, mon anti, sec do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4310","name":"Procenta, per 100 mg","description":"Procenta, per 100 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96111","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98014","name":"Synch audio-only est mod 30","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code s","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98007","name":"Synch audio-video est hi 40","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high medical decision making. when using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded.","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1470","name":"Hep b vac not recd med rsn","description":"Documentation of medical reason(s) for not administering hepatitis b vaccine (e.g., prior anaphylaxis due to the hepatitis b vaccine)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4260","name":"Signature apatch, per sq cm","description":"Signature apatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37256","name":"Revsc evasc ivt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98015","name":"Synch audio-only est high 40","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selec","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37285","name":"Revsc evasc tpvt st sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81558","name":"Trnspl rej kdn mrna qpcr 139","description":"Transplantation medicine (allograft rejection, kidney), mrna, gene expression profiling by quantitative polymerase chain reaction (qpcr) of 139 genes, utilizing whole blood, algorithm reported as a binary categorization as transplant excellence, which indicates immune quiescence, or not transplant e","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0562","name":"Complex simulation w/pet-ct","description":"Therapeutic radiology simulation-aided field setting; complex, including acquisition of pet and ct imaging data required for radiopharmaceutical-directed radiation therapy treatment planning (i.e., modeling)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3373","name":"Inj, vancomycin hcl, 10 mg","description":"Injection, vancomycin hydrochloride, 10 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0052","name":"Mmip mental health and care","description":"Missing and murdered indigenous persons (mmip) mental health and clinical care","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49613","name":"Rpr aa hrn rcr < 3 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, reducible","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"Home vent dual fnct incl all","description":"Home ventilator, dual-function respiratory device, also performs additional function of cough stimulation, includes all accessories, components and supplies for all functions","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49594","name":"Rpr aa hrn 1st 3-10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9955","name":"Oral app thxpy titration vis","description":"Oral app thxpy titration vis","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1553","name":"Inj yimmugo 100 mg","description":"Injection, immune globulin (yimmugo), 100 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0433U","name":"Onc prst8 5 dna reg mrk pcr","description":"Onc prst8 5 dna reg mrk pcr","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0892T","name":"Arhfcmrigtbs sbsq per tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent motor threshold redetermination with delivery and management, per treatment day","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0257U","name":"Vlcad leuk nzm actv whl bld","description":"Very long chain acyl- coenzyme a (coa) dehydrogenase (vlcad), leukocyte enzyme activity, whole blood","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1416","name":"Pt rec hosp","description":"Patient received hospice services any time during the performance period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4419","name":"Biolab wrap flw lt per sq cm","description":"Biolab membrane wrap lite flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2001","name":"Suct pum ext mgmt sys","description":"Suction pump, home model, portable or stationary, electric, any type, for use with external urine and/or fecal management system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4378","name":"Renew ft matrix per sq cm","description":"Renew ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0024","name":"Pin srv add 30 min pr m","description":"Principal illness navigation services, additional 30 minutes per calendar month (list separately in addition to g0023)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7295","name":"Eth estr and eton monthly","description":"Ethinyl estradiol and etonogestrel 0.015mg, 0.12mg per 24 hours; monthly vaginal ring, each","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0830T","name":"Dgtz gls mcrscp cytp slctv","description":"Digitization of glass microscope slides for cytopathology, selective-cellular enhancement technique with interpretation (eg, liquid-based slide preparation method), except cervical or vaginal (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96381","name":"Admn rsv monoc antb im njx","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1326","name":"Inj, zolbetuximab-clzb, 2 mg","description":"Injection, zolbetuximab-clzb, 2 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0526U","name":"Nefro rnl trnspl quan cxcl10","description":"Nefro rnl trnspl quan cxcl10","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57452","name":"Exam of cervix w/scope","description":"Colposcopy of the cervix including upper/adjacent vagina;","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":144.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82271","name":"Occult blood other sources","description":"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; other sources","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0268","name":"Removal of impacted wax md","description":"Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0572U","name":"Onc prst8 httl qfish whl bld","description":"Onc prst8 httl qfish whl bld","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1434","name":"Inj, focinvez, 1mg","description":"Injection, fosaprepitant (focinvez), 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76988","name":"Dx ntrop epcr us chd img acq","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; placement, manipulation of transducer, and image acquisition only","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50365","name":"Rnl altrnsplj w/rcp nfrct","description":"Renal allotransplantation, implantation of graft; with recipient nephrectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2645.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33370","name":"Tcat plmt&rmvl cepd perq","description":"Transcatheter placement and subsequent removal of cerebral embolic protection device(s), including arterial access, catheterization, imaging, and radiological supervision and interpretation, percutaneous (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44144","name":"Partial removal of colon","description":"Colectomy, partial; with resection, with colostomy or ileostomy and creation of mucofistula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1512.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69210","name":"Remove impacted ear wax uni","description":"Removal impacted cerumen requiring instrumentation, unilateral","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":30.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76016","name":"Mr safety deter phys/qhp","description":"Mr safety determination by a physician or other qualified health care professional responsible for the safety of the mr procedure, including review of implant mr conditions for indicated mr examination, analysis of risk vs clinical benefit of performing mr examination, and determination of mr equipm","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33947","name":"Ecmo/ecls initiation artery","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; initiation, veno-arterial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4307","name":"American amnion, per sq cm","description":"American amnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0013","name":"Hiv prep counsel, clin staff","description":"Individual counseling for pre-exposure prophylaxis (prep) by clinical staff to prevent human immunodeficiency virus (hiv), includes: hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1308","name":"Flu immunize no admin","description":"Influenza immunization was not administered, reason not given","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0896T","name":"Connj lvr algrft prfu dev ea","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; each additional hour, including physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary bicarbonate, lactate ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4400","name":"Polygon3 per sq cm","description":"Polygon3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1438","name":"Lst knwn well <=210 min","description":"Time last known well to hospital arrival less than or equal to 3.5 hours (<= 210 minutes)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0885T","name":"Colsc flx 1st tndsc dilat","description":"Colonoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9955","name":"Oral app thxpy titration vis","description":"Oral app thxpy titration vis","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74021","name":"Radex abdomen 3+ views","description":"Radiologic examination, abdomen; 3 or more views","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1296","name":"Calc bmi norm parameters","description":"Bmi is documented within normal parameters and no follow-up plan is required","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90969","name":"Esrd svc pr day pt 12-19","description":"End-stage renal disease (esrd) related services for dialysis less than a full month of service, per day; for patients 12-19 years of age","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":7.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59350","name":"Repair of uterus","description":"Hysterorrhaphy of ruptured uterus","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0759","name":"Inj, clevidipine, 1 mg","description":"Injection, clevidipine butyrate, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0599U","name":"Onc pncrtc ca mult ia serum","description":"Onc pncrtc ca mult ia serum","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0285U","name":"Onc rsps radj cll fr dna tox","description":"Onc rsps radj cll fr dna tox","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99476","name":"Ped crit care age 2-5 subsq","description":"Subsequent inpatient pediatric critical care, per day, for the evaluation and management of a critically ill infant or young child, 2 through 5 years of age","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":348.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64445","name":"Njx aa&/strd sciatic nrv img","description":"Injection(s), anesthetic agent(s) and/or steroid; sciatic nerve, including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2022","name":"Innovabrn/innovamatx xl sqcm","description":"Innovaburn or innovamatrix xl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1921","name":"Inj labetalol hcl hikma, 5mg","description":"Injection, labetalol hydrochloride (hikma), not therapeutically equivalent to j1920, 5 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59841","name":"Induced abortion dilat&evac","description":"Induced abortion, by dilation and evacuation","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":365.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0281","name":"Inj aminocaproic acid 1 gram","description":"Injection, aminocaproic acid, 1 gram","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2026","name":"Restrata minimatrix, 5 mg","description":"Restrata minimatrix, 5 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3374","name":"Inj, vancomycin (mylan) 10mg","description":"Injection, vancomycin hydrochloride (mylan) not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9052","name":"Inj, carmustine (accord)","description":"Injection, carmustine (accord), not therapeutically equivalent to j9050, 100 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0535U","name":"Pfas lc-ms/ms plsm/srm quan","description":"Pfas lc-ms/ms plsm/srm quan","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0295U","name":"Onc brst dux carc 7 proteins","description":"Onc brst dux carc 7 proteins","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2393","name":"Post 3 srfc resinbased cmpst","description":"Resin-based composite - three surfaces posterior","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0960T","name":"Rpl s-sclp eltr ra rcvr&tlmt","description":"Replacement of sub-scalp implanted electrode array, receiver, and telemetry unit with tunneling of electrode for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4025","name":"Physical medicine ss","description":"Physical medicine mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1961","name":"Inj lenacapavir (hiv tx) 1mg","description":"Injection, lenacapavir (only for use as hiv treatment), 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0554U","name":"Repr med pga 24chrm te bx qc","description":"Repr med pga 24chrm te bx qc","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53452","name":"Tprnl balo cntnc dev uni","description":"Periurethral transperineal adjustable balloon continence device; unilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26498","name":"Finger tendon transfer","description":"Transfer of tendon to restore intrinsic function; all 4 fingers","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1478.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0778T","name":"Smmg cncrnt appl imu snr","description":"Surface mechanomyography (smmg) with concurrent application of inertial measurement unit (imu) sensors for measurement of multi-joint range of motion, posture, gait, and muscle function","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33882","name":"Evasc rpr ta dplmt mltpc sys","description":"Endovascular repair of the thoracic aorta by deployment of a branched endograft multipiece system involving an aorto-aortic tube device with a fenestration for the left subclavian artery stent graft(s) and all aortic tube endograft extension(s) placed from the level of the left common carotid artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87517","name":"Hepatitis b dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis b virus, quantification","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92639","name":"Hearing aid meas verif","description":"Hearing-aid measurement, verification with probe-microphone (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1246","name":"Pt othr thn true imprt to me","description":"Patient provided a response other than completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37267","name":"Revsc evsc fpvt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7174","name":"Injection fitusiran 0.04 mg","description":"Injection, fitusiran, 0.04 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6032","name":"Part handfng ultralite tcf/=","description":"Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0701","name":"Pano radio image","description":"Pano radio image","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9004","name":"Va whole health partner serv","description":"Department of veterans affairs whole health partner services","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1681","name":"Ho bilateral hip abduction","description":"Hip orthosis, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5150","name":"Inj, aflibercept-mrbb, 1 mg","description":"Injection, aflibercept-mrbb (ahzantive), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0314U","name":"Onc cutan mlnma mrna 35 gene","description":"Onc cutan mlnma mrna 35 gene","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87086","name":"Urine culture/colony count","description":"Culture, bacterial; quantitative colony count, urine","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1012T","name":"Mtrz ab ntrno trph scl/tr mw","description":"Motorized ab interno trephination of sclera (sclerostomy), or trabecular meshwork (trabeculostomy), 1 or more, including injection of antifibrotic agents, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1468","name":"Hep b vaccine received","description":"Patient received recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0911T","name":"Elec aly nstm sys vgs nrv wo","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; without programming by physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33287","name":"Rmv&rplcmt phrnc nrv stim pg","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1319","name":"Pts csp doc contact","description":"Patients who had documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76830","name":"Transvaginal us non-ob","description":"Ultrasound, transvaginal","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0667","name":"Team remote e/m est pt 25 mn","description":"Team remote e/m est. pt 25mins","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2782","name":"Crown 3/4 cast noble metal","description":"Crown - 3/4 cast noble metal","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0322U","name":"Neuro asd meas 14 acyl carn","description":"Neuro asd meas 14 acyl carn","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9245","name":"Admin mod sedation-enteral","description":"Admin mod sedation-enteral","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0870T","name":"Imp subq prtl ascts pmp sys","description":"Implantation of subcutaneous peritoneal ascites pump system, percutaneous, including pump-pocket creation, insertion of tunneled indwelling bladder and peritoneal catheters with pump connections, including all imaging and initial programming, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76019","name":"Mr safety implt pos&/immoblj","description":"Mr safety implant positioning and/or immobilization under supervision of physician or other qualified health care professional, including application of physical protections to secure implanted medical device from mr-induced translational or vibrational forces, magnetically induced functional change","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2372","name":"Inj, biorphen, 20 micrograms","description":"Injection, phenylephrine hydrochloride (biorphen), 20 micrograms","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21125","name":"Augmentation mndblr prostc","description":"Augmentation, mandibular body or angle; prosthetic material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":877.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4362","name":"Cygnus disk, per sq cm","description":"Cygnus disk, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74240","name":"X-ray xm upr gi trc 1cntrst","description":"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2281","name":"Inj moxifloxacin (fres kabi)","description":"Injection, moxifloxacin (fresenius kabi), not therapeutically equivalent to j2280, 100 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0030","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4436","name":"Renati ac membrane per sq cm","description":"Renati ac membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0042","name":"Ref to therapy","description":"Referral to physical, occupational, speech, or recreational therapy","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37292","name":"Rvsc evsc tpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33895","name":"Evasc st rpr thrc/aa x crsg","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; not crossing major side branches","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1479","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0940T","name":"Xtrnl ecg rec>15d<30d r&i","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33268","name":"Excl laa opn oth px any meth","description":"Exclusion of left atrial appendage, open, performed at the time of other sternotomy or thoracotomy procedure(s), any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0541","name":"No pt prsnt train initial 30","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0480U","name":"Nfct ds csf metag ngs alys","description":"Nfct ds csf metag ngs alys","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1415","name":"No pos pdl1 bef ici ther","description":"Patients who did not have a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87913","name":"Nfct agt gntyp alys sarscov2","description":"Infectious agent genotype analysis by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), mutation identification in targeted region(s)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0219","name":"Inj aval alfa-nqpt 4mg","description":"Injection, avalglucosidase alfa-ngpt, 4 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0469U","name":"Rare ds whl gen seq ftl samp","description":"Rare ds whl gen seq ftl samp","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0336U","name":"Rare ds whl gen seq bld/slv","description":"Rare ds whl gen seq bld/slv","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1393","name":"Pr no dx rec mlnm","description":"Patients who were not diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49616","name":"Rpr aa hrn rcr 3-10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":481.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6559","name":"G stckng full/chap18-30 cust","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0557U","name":"Nfct ds bv dna mrk vag fluid","description":"Nfct ds bv dna mrk vag fluid","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0579U","name":"Nfro dbtc ckd elisa apoa4","description":"Nfro dbtc ckd elisa apoa4","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2526","name":"Cntct lens blue violet","description":"Contact lens, hydrophilic, with blue-violet filter, per lens","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51900","name":"Repair bladder/vagina lesion","description":"Closure of vesicovaginal fistula, abdominal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0013","name":"Hiv prep counsel, clin staff","description":"Individual counseling for pre-exposure prophylaxis (prep) by clinical staff to prevent human immunodeficiency virus (hiv), includes: hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33509","name":"Ndsc hrv uxtr art 1 sgm cab","description":"Harvest of upper extremity artery, 1 segment, for coronary artery bypass procedure, endoscopic","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9996","name":"Ustekinumab- ttwe sub cu inj","description":"Injection, ustekinumab-ttwe (pyzchiva), subcutaneous, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65270","name":"Repair of eye wound","description":"Repair of laceration; conjunctiva, with or without nonperforating laceration sclera, direct closure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0947T","name":"Mrgfus strtctc bl-br disrpj","description":"Magnetic resonance image guided low intensity focused ultrasound (mrgfus), stereotactic blood-brain barrier disruption using microbubble resonators to increase the concentration of blood-based biomarkers of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0505U","name":"Nfct ds vag infctj id 32orgs","description":"Nfct ds vag infctj id 32orgs","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0308","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":949.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99214","name":"Office o/p est mod 30 min","description":"Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":93.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7911","name":"Dental suture wound to 5 cm","description":"Complicated suture-up to 5 cm","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0485U","name":"Onc sol tum cfdna&rna ngs gm","description":"Onc sol tum cfdna&rna ngs gm","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4335","name":"Amnioplast 2, per sq cm","description":"Amnioplast 2, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1226","name":"Iop not doc","description":"Iop measurement not documented, reason not otherwise specified","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0726T","name":"Rmvl implt vstibular dev uni","description":"Removal of implanted vestibular device, unilateral","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1323","name":"Pts 7wk inj, scrn iop >25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop >25 mm hg and a plan of care was documented","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9154","name":"Artificial saliva, 1 ml","description":"Artificial saliva, 1 ml","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4412","name":"Choriofix per sq cm","description":"Choriofix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0309U","name":"Crd cv ds aly 4 prtn plm alg","description":"Crd cv ds aly 4 prtn plm alg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11921","name":"Correct skn color 6.1-20.0cm","description":"Tattooing, intradermal introduction of insoluble opaque pigments to correct color defects of skin, including micropigmentation; 6.1 to 20.0 sq cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83775","name":"Assay malate dehydrogenase","description":"Malate dehydrogenase","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6597","name":"G comp bandage long stretch","description":"Gradient compression bandage roll, elastic long stretch, linear yard, any width, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6603","name":"G com bandge low dn foamchnl","description":"Gradient compression bandaging supply, low density channel foam sheet, per 250 square centimeters, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4271","name":"Complete ft per sq cm","description":"Complete ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0271U","name":"Hem cgen neutropenia 23 gen","description":"Hematology (congenital neutropenia), genomic sequence analysis of 23 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4003","name":"Emergency med ss","description":"Emergency medicine mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0384U","name":"Neph ckd rsk hi stg kdn ds","description":"Neph ckd rsk hi stg kdn ds","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64583","name":"Rev/rplct hpglsl nstm ary pg","description":"Revision or replacement of hypoglossal nerve neurostimulator array and distal respiratory sensor electrode or electrode array, including connection to existing pulse generator","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0372","name":"Tomo comp series images","description":"Tomo comp series images","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0544","name":"Post d/c phone follow up","description":"Post discharge telephonic follow-up contacts performed in conjunction with a discharge from the emergency department for behavioral health or other crisis encounter, 4 calls per calendar month","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52442","name":"Cysto ins trnsprstc implt ea","description":"Cystourethroscopy, with insertion of permanent adjustable transprostatic implant; each additional permanent adjustable transprostatic implant (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4359","name":"Choriply, per sq cm","description":"Choriply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0689T","name":"Quan us tis charac w/o dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained without diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0676T","name":"Laps insj nw/rpcmt isdss ea","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional lead (list separately in addition to code for primary ","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0873","name":"Inj daptomycin (xellia)","description":"Injection, daptomycin (xellia), not therapeutically equivalent to j0878 or j0872, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55881","name":"Ablt trurl prst8 tis thrm us","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation;","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43520","name":"Incision of pyloric muscle","description":"Pyloromyotomy, cutting of pyloric muscle (fredet-ramstedt type operation)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0559U","name":"Onc brs quan elisa bf9ag srm","description":"Onc brs quan elisa bf9ag srm","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99472","name":"Ped critical care subsq","description":"Subsequent inpatient pediatric critical care, per day, for the evaluation and management of a critically ill infant or young child, 29 days through 24 months of age","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2777","name":"Inj, faricimab-svoa, 0.1mg","description":"Injection, faricimab-svoa, 0.1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49594","name":"Rpr aa hrn 1st 3-10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, incarcerated or strangulated","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86352","name":"Cell function assay w/stim","description":"Cellular function assay involving stimulation (eg, mitogen or antigen) and detection of biomarker (eg, atp)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2711","name":"Inj neostigmin/glycopyrrolat","description":"Injection, neostigmine methylsulfate 0.1 mg and glycopyrrolate 0.02 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77086","name":"Vrt fracture assmt via dxa","description":"Vertebral fracture assessment via dual-energy x-ray absorptiometry (dxa)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0274U","name":"Hem gen pltlt do 43 genes","description":"Hematology (genetic platelet disorders), genomic sequence analysis of 43 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0603","name":"Sevelamer hydrochloride 20mg","description":"Sevelamer hydrochloride (renagel or therapeutically equivalent), oral, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0886T","name":"Sgmdsc flx 1st tndsc dilat","description":"Sigmoidoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0807T","name":"Pulm tiss vntj alys prev ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with previously acquired computed tomography (ct) images, including data preparation and transmission, quantification of pulmonary tissue ventilation, data re","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1323","name":"Inj, elranatamab-bcmm, 1 mg","description":"Injection, elranatamab-bcmm, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37292","name":"Rvsc evsc tpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0725T","name":"Vestibular dev impltj uni","description":"Vestibular device implantation, unilateral","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87428","name":"Sarscov & inf vir a&b ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; severe acute respiratory syndrome coronavirus (eg, sars-cov, s","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5137","name":"Inj, wezlana, sub cu, 1 mg","description":"Injection, ustekinumab-auub (wezlana), biosimilar, subcutaneous, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0753T","name":"Dgtz gls mcrscp sld level iv","description":"Digitization of glass microscope slides for level iv, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49187","name":"Opn exc/dstr ntra-abd 5.1-10","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5.1 to 10 cm","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1214","name":"Spiro results wth obs doc","description":"Spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and reviewed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1019T","name":"Lymphovenous bypass per xtr","description":"Lymphovenous bypass, including robotic assistance, when performed, per extremity","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94680","name":"O2 uptk rst&xers dir simple","description":"Oxygen uptake, expired gas analysis; rest and exercise, direct, simple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64469","name":"Thrc fascial pln blk bi nfs","description":"Thoracic fascial plane block, bilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0972T","name":"Asstv alg clsfctn burn hlg","description":"Assistive algorithmic classification of burn healing (ie, healing or nonhealing) by noninvasive multispectral imaging, including system set-up and acquisition, selection, and transmission of images, with automated generation of report","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70471","name":"Cta h&n c+ w/noncontrast img","description":"Computed tomographic angiography (cta), head and neck, with contrast material(s), including noncontrast images, when performed, and image postprocessing","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0805T","name":"Tcat s&ivc prstc vl impl prq","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); percutaneous femoral vein approach","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2642","name":"Dental onlay porcelin 2 surf","description":"Onlay - porcelain/ceramic - two surfaces","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27846","name":"Treat ankle dislocation","description":"Open treatment of ankle dislocation, with or without percutaneous skeletal fixation; without repair or internal fixation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":883.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65865","name":"Incise inner eye adhesions","description":"Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); goniosynechiae","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":513.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17306","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0871T","name":"Rplcmt subq prtl ascites pmp","description":"Replacement of a subcutaneous peritoneal ascites pump, including reconnection between pump and indwelling bladder and peritoneal catheters, including initial programming and imaging, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0310U","name":"Ped vsclts kd alys 3 bmrks","description":"Ped vsclts kd alys 3 bmrks","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84433","name":"Asy thiopurin s-mthyltrnsfrs","description":"Thiopurine s-methyltransferase (tpmt)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0674T","name":"Laps insj nw/rpcmt prm isdss","description":"Laparoscopic insertion of new or replacement of permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including an implantable pulse generator and diaphragmatic lead(s)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0823T","name":"Tcat ins 1chmbr ldls pm ra","description":"Transcatheter insertion of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or programming), when","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5944","name":"Max implt sup remv part","description":"Max implt sup remv part","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3379","name":"Inj, valproate sod, 5 mg","description":"Injection, valproate sodium, 5 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0698T","name":"Quan mr tiss w/mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained with diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, target ","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0873","name":"Inj daptomycin (xellia)","description":"Injection, daptomycin (xellia), not therapeutically equivalent to j0878 or j0872, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0802T","name":"Tcat rmv&rpl2chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right at","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31298","name":"Nsl/sins ndsc surg frnt&sphn","description":"Nasal/sinus endoscopy, surgical, with dilation (eg, balloon dilation); frontal and sphenoid sinus ostia","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3493.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":243.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1448","name":"Injection, trilaciclib, 1mg","description":"Injection, trilaciclib, 1mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51702","name":"Insert temp bladder cath","description":"Insertion of temporary indwelling bladder catheter; simple (eg, foley)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4349","name":"Mantle dl matrix per sq cm","description":"Mantle dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0886T","name":"Sgmdsc flx 1st tndsc dilat","description":"Sigmoidoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15121","name":"Splt agrft f/s/n/h/f/g/m ea","description":"Split-thickness autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90957","name":"Esrd srv 4 vsts p mo 12-19","description":"End-stage renal disease (esrd) related services monthly, for patients 12-19 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 4 or more face-to-face visits by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":889.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3921","name":"Decor or submerg erupt tooth","description":"Decor or submerg erupt tooth","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0062","name":"Audiology ss","description":"Audiology mips specialty set","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0457U","name":"Pfas 9 cmpnd lcms/ms pls/sr","description":"Pfas 9 cmpnd lcms/ms pls/sr","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98985","name":"Rtm dev sply mscsk sys 2-15d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of musculoskeletal system, 2-15 days in a 30-day period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0169","name":"Inj epinephrine (adrenalin)","description":"Injection, epinephrine (adrenalin), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0850T","name":"Dgtz gls mcrscp ish ea mult","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0851T","name":"Dgtz gls mcrscp mphmtrc 1st","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0695T","name":"Bdy srf mpg pm/cvdfb tm impl","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of implant or replacement","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0404","name":"Ekg tracing for initial prev","description":"Electrocardiogram, routine ecg with 12 leads; tracing only, without interpretation and report, performed as a screening for the initial preventive physical examination","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82465","name":"Assay bld/serum cholesterol","description":"Cholesterol, serum or whole blood, total","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44111","name":"Excision of bowel lesion(s)","description":"Excision of 1 or more lesions of small or large intestine not requiring anastomosis, exteriorization, or fistulization; multiple enterotomies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38226","name":"Car-t prep t lymphcyt f/trns","description":"Chimeric antigen receptor t-cell (car-t) therapy; preparation of blood-derived t lymphocytes for transportation (eg, cryopreservation, storage)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9272","name":"Inj, dostarlimab-gxly, 10 mg","description":"Injection, dostarlimab-gxly, 10 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0533U","name":"Rx metab advrs gnotyp 16gens","description":"Rx metab advrs gnotyp 16gens","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10061","name":"I&d abscess comp/multiple","description":"Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); complicated or multiple","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":252.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2012","name":"Suprathel, per sq cm","description":"Suprathel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3473","name":"Surg rep root res molar","description":"Surg rep root res molar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4359","name":"Choriply, per sq cm","description":"Choriply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34705","name":"Evac rpr a-biiliac ndgft","description":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-bi-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1675.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0723T","name":"Qmrcp w/o dx mri sm anat ses","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained without diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) during the same session","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1373","name":"Mst rec gsa >=8 and <=9","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 8.0% and <= 9.0%","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0446U","name":"Ai ds sle alys 10 cytokine","description":"Ai ds sle alys 10 cytokine","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1354","name":"Pt no suicd saf pln 120dy","description":"Patients who did not have a suicide safety plan initiated, reviewed, or updated or reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0583U","name":"Rare ds rpd whlgen cmptr dna","description":"Rare ds rpd whlgen cmptr dna","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1263","name":"Pts hosp dialysis dt","description":"Patients in hospice on their initiation of dialysis date or during the month of evaluation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4432","name":"510(k) skin subs, nos","description":"510(k) skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77316","name":"Brachytx isodose plan simple","description":"Brachytherapy isodose plan; simple (calculation[s] made from 1 to 4 sources, or remote afterloading brachytherapy, 1 channel), includes basic dosimetry calculation(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1370","name":"Rehab support msk care mvp","description":"Rehabilitative support for musculoskeletal care mips value pathway","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22838","name":"Rev rplc/rmv thrc vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracic vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37294","name":"Rvsc evsc tpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0402","name":"Inj, abilify asimtufii, 1 mg","description":"Injection, aripiprazole (abilify asimtufii), 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1172","name":"Doc med rsn no td/tdap","description":"Documentation of medical reason(s) for not administering td or tdap vaccine (e.g., prior anaphylaxis due to the td or tdap vaccine or history of encephalopathy within seven days after a previous dose of a td-containing vaccine)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33895","name":"Evasc st rpr thrc/aa x crsg","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; not crossing major side branches","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1256","name":"Prior history of known cvd","description":"Prior history of known cvd","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0019M","name":"Cv ds plasma alys prtn bmrk","description":"Cardiovascular disease, plasma, analysis of protein biomarkers by aptamer-based microarray and algorithm reported as 4-year likelihood of coronary event in high-risk populations","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4023","name":"Pathology ss","description":"Pathology mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0836T","name":"Dgtz gls mcrscp fna ea addl","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0967T","name":"Tranal ins tmp clrc anst dev","description":"Transanal insertion of endoluminal temporary colorectal anastomosis protection device, including vacuum anchoring component and flexible sheath connected to external vacuum source and monitoring system","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82017","name":"Acylcarnitines quant","description":"Acylcarnitines; quantitative, each specimen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9052","name":"Inj, carmustine (accord)","description":"Injection, carmustine (accord), not therapeutically equivalent to j9050, 100 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0899T","name":"N-invas deter aqmbf aug cmr","description":"Noninvasive determination of absolute quantitation of myocardial blood flow (aqmbf), derived from augmentative algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health car","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69728","name":"Rmv ntr oi imp sk tc>=100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15240","name":"Fth/gft f/c/c/m/n/ax/g/h/f20","description":"Full thickness graft, free, including direct closure of donor site, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet; 20 sq cm or less","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":807.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q9948","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58615","name":"Occlude fallopian tube(s)","description":"Occlusion of fallopian tube(s) by device (eg, band, clip, falope ring) vaginal or suprapubic approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61892","name":"Rmv sk-mnt crnl nstm pg/rcvr","description":"Removal of skull-mounted cranial neurostimulator pulse generator or receiver with cranioplasty, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9247","name":"Mod sedation noniv-sub15min","description":"Mod sedation noniv-sub15min","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1471","name":"Ffs hep b not covered","description":"Documentation that patient is a medicare fee-for-service beneficiary and without additional supplementary insurance coverage for whom hep b vaccination is not reimbursable under current medicare part b coverage rules","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85475","name":"Hemolysin acid","description":"Hemolysin, acid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0850T","name":"Dgtz gls mcrscp ish ea mult","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1224","name":"Iop dec <20% from base","description":"Intraocular pressure (iop) reduced by a value less than 20% from the pre-intervention level","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0294U","name":"Lngvty&mrtlty rsk mrna 18gen","description":"Lngvty&mrtlty rsk mrna 18gen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86039","name":"Antinuclear antibodies (ana)","description":"Antinuclear antibodies (ana); titer","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4265","name":"Neostim tl per sq cm","description":"Neostim tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1497","name":"No doc fall med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9949","name":"Repair sleep apnea appliance","description":"Repair sleep apnea appliance","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0322U","name":"Neuro asd meas 14 acyl carn","description":"Neuro asd meas 14 acyl carn","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33665","name":"Repair of heart defects","description":"Repair of intermediate or transitional atrioventricular canal, with or without atrioventricular valve repair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2078.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2019","name":"Kerecis marigen shld sq cm","description":"Kerecis omega3 marigen shield, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9612","name":"Inj, fluorescein, 1 mg","description":"Injection, fluorescein, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0443U","name":"Neurflmnt lt chn ultrsens ia","description":"Neurflmnt lt chn ultrsens ia","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0601U","name":"Nfct ds pji alys 11 bmrks ia","description":"Nfct ds pji alys 11 bmrks ia","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53865","name":"Cysto insj dev ischmc rmdlg","description":"Cystourethroscopy with insertion of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0238","name":"Intrav inf, toci, second dos","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1316","name":"Tobacco non-user","description":"Current tobacco non-user","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1007T","name":"Eeg impl s-sclp eeg w/o vid","description":"Electroencephalogram from implanted sub-scalp continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0570","name":"Care manage serv, pr cal mo","description":"Care management services for behavioral health conditions, directed by a physician or other qualified health care professional, per calendar month, with the following required elements: initial assessment or follow-up monitoring, including the use of applicable validated rating scales, behavioral he","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4269","name":"Surgraft xt per sq cm","description":"Surgraft xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4281","name":"Barrera slor dl per sq cm","description":"Barrera sl or barrera dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0743T","name":"B1 str & fx rsk vrt fx assmt","description":"Bone strength and fracture risk using finite element analysis of functional data and bone mineral density (bmd), with concurrent vertebral fracture assessment, utilizing data from a computed tomography scan, retrieval and transmission of the scan data, measurement of bone strength and bmd and classi","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58353","name":"Endometr ablate thermal","description":"Endometrial ablation, thermal, without hysteroscopic guidance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6561","name":"G stockng full/chap 40+ cust","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, custom, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96202","name":"Mlt fam grp bhv train 1st 60","description":"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face with multiple sets of paren","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2031","name":"Mirodry, per sq cm","description":"Mirodry wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0271U","name":"Hem cgen neutropenia 23 gen","description":"Hematology (congenital neutropenia), genomic sequence analysis of 23 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90695","name":"H5n8 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n8, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78491","name":"Myocrd img pet 1std rst/strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); single study, at rest or stress (exercise or pharmacologic)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0688T","name":"Tx amblyopia assmt w/report","description":"Treatment of amblyopia using an online digital program; assessment of patient performance and program data by physician or other qualified health care professional, with report, per calendar month","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1489","name":"Pt status doc","description":"Patient status documented","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4388","name":"Neothelium 4l per sq cm","description":"Neothelium 4l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0906T","name":"Coms ther 1st appl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; first application, total wound(s) surface area less than or equal to 50 sq cm","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77089","name":"Tbs dxa cal w/i&r fx risk","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; using dual x-ray absorptiometry (dxa) or other imaging data on gray-scale variogram, calculation, with interpretation and report on fracture-risk","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0375U","name":"Onc ovrn bchm asy 7 prtn alg","description":"Onc ovrn bchm asy 7 prtn alg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33277","name":"Insj phrnc nrv stim transvns","description":"Insertion of phrenic nerve stimulator transvenous sensing lead (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1180","name":"Pt imm ckpt inhib therapy","description":"Patients on immune checkpoint inhibitor therapy","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22318","name":"Treat odontoid fx w/o graft","description":"Open treatment and/or reduction of odontoid fracture(s) and or dislocation(s) (including os odontoideum), anterior approach, including placement of internal fixation; without grafting","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1852.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4348","name":"Sentry sl matrix per sq cm","description":"Sentry sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4305","name":"Amer am ac tri-lay per sq cm","description":"American amnion ac tri-layer, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42806","name":"Biopsy of upper nose/throat","description":"Biopsy; nasopharynx, survey for unknown primary lesion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5877","name":"Dup of complt dent-maxill","description":"Dup of complt dent-maxill","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93990","name":"Doppler flow testing","description":"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9321","name":"Inj epcoritamab-bysp 0.16 mg","description":"Injection, epcoritamab-bysp, 0.16 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43191","name":"Esophagoscopy rigid trnso dx","description":"Esophagoscopy, rigid, transoral; diagnostic, including collection of specimen(s) by brushing or washing when performed (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4030","name":"Pulmonology ss","description":"Pulmonology mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1410","name":"No gmln brca1/brca2 couns","description":"Patients who did not have germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4323","name":"Alloply, per sq cm","description":"Alloply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1611","name":"Inj glucagon hcl, fresenius","description":"Injection, glucagon hydrochloride (fresenius kabi), not therapeutically equivalent to j1610, per 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46288","name":"Repair anal fistula","description":"Closure of anal fistula with rectal advancement flap","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1424","name":"Pulmonology care mvp","description":"Pulmonology care mips value pathway","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5159","name":"Inj, denosumab-dssb, 1 mg","description":"Injection, denosumab-dssb (ospomyv/xbryk), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0411","name":"Hba1c in office testing","description":"Hba1c in office testing","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0628U","name":"Nfro kdn ds genetic cond 449","description":"Nfro kdn ds genetic cond 449","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0594U","name":"Nfct ds sepsis pncrtc spc","description":"Nfct ds sepsis pncrtc spc","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0802","name":"3d dental scan indirect","description":"3d dental scan indirect","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0948T","name":"Rem interrog dev ccm phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system with interim analysis, review, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0574U","name":"Mtb cfp-10 serum/plsm lc-ms","description":"Mtb cfp-10 serum/plsm lc-ms","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1190","name":"Doc khe not pef w/efgr/uacr","description":"Documentation of a kidney health evaluation was not performed or defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9997","name":"Ustekinumab-ttwe iv inj 1 mg","description":"Injection, ustekinumab-ttwe (pyzchiva), intravenous, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0306U","name":"Onc mrd nxt-gnrj alys 1st","description":"Onc mrd nxt-gnrj alys 1st","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0433U","name":"Onc prst8 5 dna reg mrk pcr","description":"Onc prst8 5 dna reg mrk pcr","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1332","name":"Pts no eval ini xm no 2 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 2 weeks","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"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":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60660","name":"Abltj 1/+thyr ndul 1lobe prq","description":"Ablation of 1 or more thyroid nodule(s), one lobe or the isthmus, percutaneous, including imaging guidance, radiofrequency","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89325","name":"Sperm antibody test","description":"Sperm antibodies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0217","name":"Inj velmanase alfa-tycv 1 mg","description":"Injection, velmanase alfa-tycv, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4479","name":"Transanal irrigation, electr","description":"Electronic transanal irrigation system, includes electronic pump, water reservoir, tubing, and accessories, without catheter, any type","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90473","name":"Immune admin oral/nasal","description":"Immunization administration by intranasal or oral route; 1 vaccine (single or combination vaccine/toxoid)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0859T","name":"Ncntc ifr spctrsc o/t pad ea","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), other than for screening for peripheral arterial disease, image acquisition, interpretation, and report; each additional anatomic site (list separately in addition to code ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4457","name":"Enema tube any type repl","description":"Enema tube, with or without adapter, any type, replacement only, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33315","name":"Exploratory heart surgery","description":"Cardiotomy, exploratory (includes removal of foreign body, atrial or ventricular thrombus); with cardiopulmonary bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1637.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90810","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0709T","name":"Id ca immntx each addl njx","description":"Intradermal cancer immunotherapy; each additional injection (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92638","name":"Bhvl verif of amplification","description":"Behavioral verification of amplification including aided thresholds, functional gain, speech-in-noise, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4333","name":"Ardeograft, per sq cm","description":"Ardeograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1009T","name":"Rem mntr s-sclp cont eeg sys","description":"Remote monitoring of a sub-scalp implanted continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36837","name":"Prq av fstl crt uxtr sep acs","description":"Percutaneous arteriovenous fistula creation, upper extremity, separate access sites of the peripheral artery and peripheral vein, including fistula maturation procedures (eg, transluminal balloon angioplasty, coil embolization) when performed, including all vascular access, imaging guidance and radi","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77610","name":"Hyperthermia ntrstl prb 5/<","description":"Hyperthermia generated by interstitial probe(s); 5 or fewer interstitial applicators","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3501","name":"Surg exp root surf anterior","description":"Surg exp root surf anterior","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4421","name":"Biolab wrap solo per sq cm","description":"Biolab membrane wrap solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37255","name":"Revsc evasc ivt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47425","name":"Incision of bile duct","description":"Choledochotomy or choledochostomy with exploration, drainage, or removal of calculus, with or without cholecystotomy; with transduodenal sphincterotomy or sphincteroplasty","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1391.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42975","name":"Dise eval slp do brth flx dx","description":"Drug-induced sleep endoscopy, with dynamic evaluation of velum, pharynx, tongue base, and larynx for evaluation of sleep-disordered breathing, flexible, diagnostic","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7519","name":"Inj. mycophenolate mofetil","description":"Injection, mycophenolate mofetil, 10 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0524","name":"Est pt-cg dyad dem low cmplx","description":"Management of established patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42972","name":"Control nose/throat bleeding","description":"Control of nasopharyngeal hemorrhage, primary or secondary (eg, postadenoidectomy); with secondary surgical intervention","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":604.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1495","name":"Fall w/ poc, no fall","description":"Patients that reported a fall occurred who had a plan of care for falls documented or patients that did not report a fall","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01939","name":"Anes nulyt agt crv/thrc","description":"Anesthesia for percutaneous image-guided destruction procedures by neurolytic agent on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86318","name":"Ia infectious agent antibody","description":"Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip);","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0350","name":"Oral/facial photo images","description":"Oral/facial photographic images","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9003","name":"Leupro inj, camcevi etm, 1mg","description":"Leuprolide injectable (camcevi etm), 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0146","name":"Nav srv peer sup add 30 pr m","description":"Principal illness navigation - peer support, additional 30 minutes per calendar month (list separately in addition to g0140)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98008","name":"Synch audio-only new sf 15","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code sel","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5878","name":"Dup of complt dent-mandib","description":"Dup of complt dent-mandib","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4375","name":"Duograft ac per sq cm","description":"Duograft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0615","name":"Calcium acetate, oral, 23 mg","description":"Calcium acetate, oral, 23 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6092","name":"Recement supp crown","description":"Recement implant/abutment supported crown","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0268U","name":"Hem ahus gen seq alys 15 gen","description":"Hematology (atypical hemolytic uremic syndrome [ahus]), genomic sequence analysis of 15 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1714","name":"Pfizer vacc adm ped 2nd dose","description":"Pfizer vacc adm ped 2nd dose","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64473","name":"Lwr xtr fscl pln blk uni njx","description":"Lower extremity fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0698T","name":"Quan mr tiss w/mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained with diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, target ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0138","name":"Iv cipaglucosidase alfa-atga","description":"Intravenous infusion of cipaglucosidase alfa-atga, including provider/supplier acquisition and clinical supervision of oral administration of miglustat in preparation of receipt of cipaglucosidase alfa-atga","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0946T","name":"Ortho impl mvmt alys pair ct","description":"Orthopedic implant movement analysis using paired computed tomography (ct) examination of the target structure, including data acquisition, data preparation and transmission, interpretation and report (including ct scan of the joint or extremity performed with paired views)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2472","name":"Inj, pantoprazole sodium chl","description":"Injection, pantoprazole sodium in sodium chloride (baxter), 40 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97763","name":"Orthc/prostc mgmt sbsq enc","description":"Orthotic(s)/prosthetic(s) management and/or training, upper extremity(ies), lower extremity(ies), and/or trunk, subsequent orthotic(s)/prosthetic(s) encounter, each 15 minutes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86581","name":"Strptcs pneum antb serot ia","description":"Streptococcus pneumoniae antibody (igg), serotypes, multiplex immunoassay, quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98010","name":"Synch audio-only new mod 45","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection,","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1489","name":"Pt status doc","description":"Patient status documented","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63045","name":"Lam facetec & foramot crv","description":"Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; cervical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1421.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0552","name":"Supply of digital device","description":"Supply of digital mental health treatment device and initial education and onboarding, per course of treatment that augments a behavioral therapy plan","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43405","name":"Ligate/staple esophagus","description":"Ligation or stapling at gastroesophageal junction for pre-existing esophageal perforation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1448.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1384","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1475","name":"Pt dx huntington","description":"Patients with diagnosis of huntingtons disease","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1382","name":"Enc dur perf pd pos 11","description":"Patient encounter during the performance period with place of service code 11","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99467","name":"Ped crit care transport addl","description":"Critical care face-to-face services, during an interfacility transport of critically ill or critically injured pediatric patient, 24 months of age or younger; each additional 30 minutes (list separately in addition to code for primary service)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":113.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1170","name":"Pt w/o flu vax 7/1-6/30","description":"Patient did not receive an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1354","name":"Pt no suicd saf pln 120dy","description":"Patients who did not have a suicide safety plan initiated, reviewed, or updated or reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1196","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1250","name":"Pt resp true heard","description":"Patient responded as completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82747","name":"Assay of folic acid rbc","description":"Folic acid; rbc","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87110","name":"Chlamydia culture","description":"Culture, chlamydia, any source","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4282","name":"Cygnus dual per sq cm","description":"Cygnus dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"Home vent dual fnct incl all","description":"Home ventilator, dual-function respiratory device, also performs additional function of cough stimulation, includes all accessories, components and supplies for all functions","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G3003","name":"Chronic pain mgmt addl 15m","description":"Each additional 15 minutes of chronic pain management and treatment by a physician or other qualified health care professional, per calendar month. (list separately in addition to code for g3002. when using g3003, 15 minutes must be met or exceeded.)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57135","name":"Excision vaginal cyst/tumor","description":"Excision of vaginal cyst or tumor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82653","name":"El-1 fecal quantitative","description":"Elastase, pancreatic (el-1), fecal; quantitative","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"Limited visual field xm","description":"Visual field examination, unilateral or bilateral, with interpretation and report; limited examination (eg, tangent screen, autoplot, arc perimeter, or single stimulus level automated test, such as octopus 3 or 7 equivalent)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86826","name":"Hla x-match noncytotoxc addl","description":"Human leukocyte antigen (hla) crossmatch, non-cytotoxic (eg, using flow cytometry); each additional serum sample or sample dilution (list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4293","name":"Acesso dl, per sq cm","description":"Acesso dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27105","name":"Transfer of spinal muscle","description":"Transfer paraspinal muscle to hip (includes fascial or tendon extension graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1026.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0431","name":"Diag tst detect mucos abnorm","description":"Adjunctive pre-diagnostic test that aids in detection of mucosal abnormalities including premalignant and malignant lesions not to include cytology or biopsy","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86364","name":"Tiss trnsgltmnase ea ig clas","description":"Tissue transglutaminase, each immunoglobulin (ig) class","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93151","name":"Interrog&prgrmg ipnss","description":"Interrogation and programming (minimum one parameter) of implanted phrenic nerve stimulator system","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1447","name":"Pt dx bd bef end meas pd","description":"Patients with an active diagnosis of bipolar disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0981T","name":"Tcat impl wrls ivc snr","description":"Transcatheter implantation of wireless inferior vena cava sensor for long-term hemodynamic monitoring, including deployment of the sensor, radiological supervision and interpretation, right heart catheterization, and inferior vena cava venography, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0762T","name":"Dgtz gls mcrscp sl imm ea m","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, each multiplex antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0544","name":"Post d/c phone follow up","description":"Post discharge telephonic follow-up contacts performed in conjunction with a discharge from the emergency department for behavioral health or other crisis encounter, 4 calls per calendar month","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4339","name":"Artacent vericlen, per sq cm","description":"Artacent vericlen, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0928T","name":"Rem interrog dev ccm-d phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system with interim analysis and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0063","name":"Cardiology ss","description":"Cardiology mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4263","name":"Surgraft tl, per sq cm","description":"Surgraft tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31242","name":"Nsl/sinus ndsc rf abltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by radiofrequency ablation, posterior nasal nerve","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0401U","name":"Crd c hrt ds 9 gen 12 vrnts","description":"Crd c hrt ds 9 gen 12 vrnts","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0515U","name":"Gi ibd ia quan deter ifx lvl","description":"Gi ibd ia quan deter ifx lvl","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64596","name":"Ins/rplcmt prq eltrd ra pn 1","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; initial electrode array","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0875T","name":"Prgrm subq prtl asct pmp sys","description":"Programming of subcutaneously implanted peritoneal ascites pump system by physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35241","name":"Rpr blvsl vn grf ntrthrc w/b","description":"Repair blood vessel with vein graft; intrathoracic, with bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1695.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3394","name":"Inj, lovotibeglogene autotem","description":"Injection, lovotibeglogene autotemcel, per treatment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35470","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0858T","name":"Ext trnscranl mag stimj meas","description":"Externally applied transcranial magnetic stimulation with concomitant measurement of evoked cortical potentials with automated report","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74160","name":"Ct abdomen w/contrast","description":"Computed tomography, abdomen; with contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":427.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7320","name":"Genvisc 850, inj, 1mg","description":"Hyaluronan or derivitive, genvisc 850, for intra-articular injection, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"Ak 4 bar link hydl swg/stanc","description":"Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37275","name":"Rvsc evsc fpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1295","name":"Pt hx tot col or colon ca","description":"Patients with a diagnosis or past history of total colectomy or colorectal cancer","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33278","name":"Rmvl phrnc nrv stim sys","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; system, including pulse generator and lead(s)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98000","name":"Synch audio-video new sf 15","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 15 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4327","name":"Duoamnion, per sq cm","description":"Duoamnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0263U","name":"Neuro asd meas 16 c metblt","description":"Neurology (autism spectrum disorder [asd]), quantitative measurements of 16 central carbon metabolites (ie, a-ketoglutarate, alanine, lactate, phenylalanine, pyruvate, succinate, carnitine, citrate, fumarate, hypoxanthine, inosine, malate, s-sulfocysteine, taurine, urate, and xanthine), liquid chrom","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1366","name":"Focus on womens health mvp","description":"Focusing on womens health mips value pathway","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0033","name":"2+ benzo seiz","description":"Two or more benzodiazepine prescriptions ordered for patients who had a diagnosis of seizure disorders, rapid eye movement sleep behavior disorder, benzodiazepine withdrawal, ethanol withdrawal, or severe generalized anxiety disorder on or between january 1 of the year prior to the measurement perio","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90965","name":"Esrd home pt serv p mo 12-19","description":"End-stage renal disease (esrd) related services for home dialysis per full month, for patients 12-19 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0550","name":"Phone/inter for dx/treat >5m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a written report to the patients treating/r","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1287","name":"Calc bmi blw low param f/u","description":"Bmi is documented below normal parameters and a follow-up plan is documented","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4380","name":"Advograft one per sq cm","description":"Advograft one, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0316U","name":"B brgdrferi lyme ds ospa evl","description":"B brgdrferi lyme ds ospa evl","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61892","name":"Rmv sk-mnt crnl nstm pg/rcvr","description":"Removal of skull-mounted cranial neurostimulator pulse generator or receiver with cranioplasty, when performed","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2009","name":"Symphony, per sq cm","description":"Symphony, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6605","name":"G com bandage padded foam","description":"Gradient compression bandaging supply, padded foam, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0936T","name":"Photobiomodulation ther rta","description":"Photobiomodulation therapy of retina, single session","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1397","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9563","name":"Ht inj immuno diem","description":"Home injectable therapy, immunotherapy, 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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1232","name":"Pt hcv tst reactive result","description":"Patient receives hcv antibody test with reactive result","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33926","name":"Repr pul art unifocal w/cpb","description":"Repair of pulmonary artery arborization anomalies by unifocalization; with cardiopulmonary bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2953.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2305","name":"Inj, nitroglycerin, 5 mg","description":"Injection, nitroglycerin, 5 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1643","name":"Inj heparin, pfizer, 1000u","description":"Injection, heparin sodium (pfizer), not therapeutically equivalent to j1644, per 1000 units","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1713","name":"Pfizer vacc adm ped 1st dose","description":"Pfizer vacc adm ped 1st dose","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4350","name":"Palisade dm matrix per sq cm","description":"Palisade dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87467","name":"Hepatitis b surface ag quan","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; hepatitis b surface antigen (hbsag), quantitative","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2928","name":"Prefab porc/cer crown perm","description":"Prefab porc/cer crown perm","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5995","name":"Peri medicament w/seal, max","description":"Peri medicament w/seal, max","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1285","name":"Scrn mam perf rslts not doc","description":"Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed, reason not otherwise specified","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64629","name":"Trml dstrj ios bvn ea addl","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; each additional vertebral body, lumbar or sacral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4399","name":"Summit fx per sq cm","description":"Summit fx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0860T","name":"Ncntc ifr spctrsc scr pad","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), for screening for peripheral arterial disease, including provocative maneuvers, image acquisition, interpretation, and report, one or both lower extremities","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0521U","name":"Rf iga&igm ccp antb sr-a ia","description":"Rf iga&igm ccp antb sr-a ia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1308","name":"Flu immunize no admin","description":"Influenza immunization was not administered, reason not given","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46260","name":"Remove in/ex hem groups 2+","description":"Hemorrhoidectomy, internal and external, 2 or more columns/groups;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99205","name":"Office o/p new hi 60 min","description":"Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":178.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87593","name":"Orthopoxvirus amp prb each","description":"Infectious agent detection by nucleic acid (dna or rna); orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus), amplified probe technique, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0561","name":"Temp tube delivery, unil","description":"Tympanostomy with local or topical anesthesia and insertion of a ventilating tube when performed with tympanostomy tube delivery device, unilateral (list separately in addition to 69433) (do not use in conjunction with 0583t)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0971T","name":"Ablt mal brst tum pq lsr uni","description":"Ablation, malignant breast tumor(s), percutaneous, laser, including imaging guidance when performed, unilateral","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72158","name":"Mri lumbar spine w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; lumbar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1421.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1368","name":"Prev trt inf d/o hiv/hep mvp","description":"Prevention and treatment of infectious disorders including hepatitis c and hiv mips value pathway","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35221","name":"Rpr bld vsl dir intra-abdl","description":"Repair blood vessel, direct; intra-abdominal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1675.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81457","name":"So neo gsap dna mcrstl ins","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis, microsatellite instability","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9000","name":"Doxorubicin hcl injection","description":"Injection, doxorubicin hydrochloride, 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83036","name":"Hemoglobin glycosylated a1c","description":"Hemoglobin; glycosylated (a1c)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1756","name":"Iron sucrose injection","description":"Injection, iron sucrose, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4014","name":"Nephrology ss","description":"Nephrology mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43272","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":467.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86317","name":"Immunoassay infectious agent","description":"Immunoassay for infectious agent antibody, quantitative, not otherwise specified","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67343","name":"Release eye tissue","description":"Release of extensive scar tissue without detaching extraocular muscle (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":632.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4331","name":"Axolotl graft, per sq cm","description":"Axolotl graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0423","name":"Genetic test spec analysis","description":"Genetic test spec analysis","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0181","name":"Home health care supervision","description":"Physician or allowed practitioner supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplinary care modalities involving regular physician or allowed practitioner development and/or revision ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0932T","name":"N-invs det hrt fail aug echo","description":"Noninvasive detection of heart failure derived from augmentative analysis of an echocardiogram that demonstrated preserved ejection fraction, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55877","name":"Abltj ire prst8 1+ tum perq","description":"Ablation, irreversible electroporation, prostate, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1230","name":"Pt hcv rctv aby no f/u tst","description":"Patient has a reactive hcv antibody test and does not have a follow up hcv viral test, or patient has a reactive hcv antibody test and has a follow up hcv viral test that detects hcv viremia and is not referred to a clinician who treats hcv infection within 1 month and does not have hcv treatment in","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49613","name":"Rpr aa hrn rcr < 3 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, reducible","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1434","name":"Orl chemo wthn 30 d post enc","description":"Patient on oral chemotherapy on or within 30 days after denominator eligible encounter","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1164","name":"Pt w/ dementia any time","description":"Patients with dementia any time during the patients history through the end of the measurement period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0651","name":"Inj, levothyroxine, freskabi","description":"Injection, levothyroxine sodium (fresenius kabi), not therapeutically equivalent to j0650, 10 mcg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0452U","name":"Onc bldr mthyl penk lte-qmsp","description":"Onc bldr mthyl penk lte-qmsp","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87880","name":"Strep a assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; streptococcus, group a","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7252","name":"Part extract for implant","description":"Part extract for implant","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21310","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90970","name":"Esrd svc pr day pt 20+","description":"End-stage renal disease (esrd) related services for dialysis less than a full month of service, per day; for patients 20 years of age and older","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":11.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1244","name":"Pt othr thn true best int","description":"Patient provided a response other than completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5946","name":"Max implt sup fix","description":"Max implt sup fix","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11008","name":"Rmv prstc mtrl/mesh abd wall","description":"Removal of prosthetic material or mesh, abdominal wall for infection (eg, for chronic or recurrent mesh infection or necrotizing soft tissue infection) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0588U","name":"Nfct ds bct/vir 32genes mrna","description":"Nfct ds bct/vir 32genes mrna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80061","name":"Lipid panel","description":"Lipid panel this panel must include the following: cholesterol, serum, total (82465) lipoprotein, direct measurement, high density cholesterol (hdl cholesterol) (83718) triglycerides (84478)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9054","name":"Inj bortezomib boruzu 0.1 mg","description":"Injection, bortezomib (boruzu), 0.1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0434U","name":"Rx metab advrs vrnt alys 25","description":"Rx metab advrs vrnt alys 25","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70471","name":"Cta h&n c+ w/noncontrast img","description":"Computed tomographic angiography (cta), head and neck, with contrast material(s), including noncontrast images, when performed, and image postprocessing","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1415","name":"No pos pdl1 bef ici ther","description":"Patients who did not have a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4408","name":"Xwrap hydro per sq cm","description":"Xwrap hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0266U","name":"Unxpl cnst hrtbl do gn xprsn","description":"Unexplained constitutional or other heritable disorders or syndromes, tissue-specific gene expression by whole-transcriptome and next-generation sequencing, blood, formalin-fixed paraffin-embedded (ffpe) tissue or fresh frozen tissue, reported as presence or absence of splicing or expression changes","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99492","name":"1st psyc collab care mgmt","description":"Initial psychiatric collaborative care management, first 70 minutes in the first calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":90.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86156","name":"Cold agglutinin screen","description":"Cold agglutinin; screen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1486","name":"Pt admitted to snf dur eval","description":"Patients admitted to a skilled nursing facility (snf) during the period of evaluation","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0706","name":"Intraoral occlus radio image","description":"Intraoral occlus radio image","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0850T","name":"Dgtz gls mcrscp ish ea mult","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64582","name":"Opn mpltj hpglsl nstm ary pg","description":"Open implantation of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69210","name":"Remove impacted ear wax uni","description":"Removal impacted cerumen requiring instrumentation, unilateral","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":54.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6105","name":"Remove implant body","description":"Remove implant body","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1429","name":"Retinopathy in od, os, ou","description":"Retinal exam finding with evidence of retinopathy in left, right or both eyes with severity level documented","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1681","name":"Ho bilateral hip abduction","description":"Hip orthosis, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1320","name":"Pts scrn + hrsn","description":"Patients who screened positive for at least 1 of the 5 hrsns","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9800","name":"Gallium locametz 1 millicuri","description":"Gallium ga-68 gozetotide, diagnostic, (locametz), 1 millicurie","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4256","name":"Mlg complet, per sq cm","description":"Mlg-complete, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61000","name":"Remove cranial cavity fluid","description":"Subdural tap through fontanelle, or suture, infant, unilateral or bilateral; initial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96377","name":"Applicaton on-body injector","description":"Application of on-body injector (includes cannula insertion) for timed subcutaneous injection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1939","name":"Inj, bumetanide, 0.5 mg","description":"Injection, bumetanide, 0.5 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9071","name":"Inj cyclophosphamd auromedic","description":"Injection, cyclophosphamide (auromedics), 5 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7214","name":"Altuviiio per factor viii iu","description":"Injection, factor viii/von willebrand factor complex, recombinant (altuviiio), per factor viii i.u.","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0399U","name":"Neuro cere folate defncy srm","description":"Neuro cere folate defncy srm","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0285U","name":"Onc rsps radj cll fr dna tox","description":"Onc rsps radj cll fr dna tox","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J2995","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29000","name":"Appl halo type body cast","description":"Application of halo type body cast (see 20661-20663 for insertion)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99293","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":943.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2782","name":"Inj avacincaptad pegol 0.1mg","description":"Injection, avacincaptad pegol, 0.1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9395","name":"Injection, fulvestrant","description":"Injection, fulvestrant, 25 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1298","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99292","name":"Critical care addl 30 min","description":"Critical care, evaluation and management of the critically ill or critically injured patient; each additional 30 minutes (list separately in addition to code for primary service)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":112.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1220","name":"Dre wth interp rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; with evidence of retinopathy","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1165","name":"Pt use hspc dur meas pd","description":"Patients who use hospice services any time during the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0459U","name":"Abeta42 & ttau eclia csf","description":"Abeta42 & ttau eclia csf","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80436","name":"Metyrapone panel","description":"Metyrapone panel this panel must include the following: cortisol (82533 x 2) 11 deoxycortisol (82634 x 2)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2042","name":"Foundation drs+ solo, sq cm","description":"Foundation drs+ solo, per square centimeter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2989","name":"Excavate tooth non-restorabl","description":"Excavate tooth non-restorabl","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70100","name":"X-ray exam of jaw <4views","description":"Radiologic examination, mandible; partial, less than 4 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93150","name":"Therapy activation ipnss","description":"Therapy activation of implanted phrenic nerve stimulator system, including all interrogation and programming","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69714","name":"Impl oi implt skull perq esp","description":"Implantation, osseointegrated implant, skull; with percutaneous attachment to external speech processor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1245.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1339","name":"Pts f/u 30-180 dys + improv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who demonstrated positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0490U","name":"Onc cutan/uveal mlnma cd146","description":"Onc cutan/uveal mlnma cd146","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0507U","name":"Onc ovr dna whole gen w/5hmc","description":"Onc ovr dna whole gen w/5hmc","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45400","name":"Laparoscopic proc","description":"Laparoscopy, surgical; proctopexy (for prolapse)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1237.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9800","name":"Gallium locametz 1 millicuri","description":"Gallium ga-68 gozetotide, diagnostic, (locametz), 1 millicurie","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1444","name":"Del < 39 weeks gest","description":"Delivery at < 39 weeks of gestation","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":672.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9685","name":"Acute nursing facility care","description":"Physician service or other qualified health care professional for the evaluation and management of a beneficiarys acute change in condition in a nursing facility. this service is for a demonstration project","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1241","name":"Pt no resp seen as person","description":"Patient did not respond to the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77439","name":"Surf rad thr img gdn us plmt","description":"Surface radiation therapy; superficial or orthovoltage, image guidance, ultrasound for placement of radiation therapy fields for treatment of cutaneous tumors, per course of treatment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4295","name":"Amnio tri-core, per sq cm","description":"Amnio tri-core amniotic, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0903T","name":"Ecg alg 12 lead reduced i&r","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; with interpretation and report","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"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":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9993","name":"Pall serv during meas","description":"Patient was provided palliative care services any time during the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0382U","name":"Hyprphenylalninmia mntr quan","description":"Hyprphenylalninmia mntr quan","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0502U","name":"Hpv e6/e7 mrk hi-rsk typ crv","description":"Hpv e6/e7 mrk hi-rsk typ crv","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33276","name":"Insj phrnc nrv stim sys","description":"Insertion of phrenic nerve stimulator system (pulse generator and stimulating lead[s]), including vessel catheterization, all imaging guidance, and pulse generator initial analysis with diagnostic mode activation, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4260","name":"Signature apatch, per sq cm","description":"Signature apatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15837","name":"Exc excsv skin forearm/hand","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy); forearm or hand","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":771.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99385","name":"Prev visit new age 18-39","description":"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; 18-39 years","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":87.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6555","name":"G com stcking bk 40+ custm","description":"Gradient compression stocking, below knee, 40 mmhg or greater, custom, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":226.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1357","name":"Pt w/red suic idea 120 days","description":"Patients who had a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0891T","name":"Arhfcmrigtbs sbsq tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent treatment day","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93595","name":"L hrt cath chd nm/abn nt cnj","description":"Left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone, normal or abnormal native connections","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2017","name":"Permeaderm glove, each","description":"Permeaderm glove, each","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88367","name":"Insitu hybridization auto","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; initial single probe stain procedure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3503","name":"Surg exp root surf molar","description":"Surg exp root surf molar","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1351","name":"Dental sealant per tooth","description":"Sealant-per tooth","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1443","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5811","name":"Denture interm cmplt mandbl","description":"Interim complete denture (mandibular)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0235","name":"Intrav inf, mon anti, fir do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90631","name":"H5 vaccine pandemic im use","description":"Influenza virus vaccine (iiv), h5, pandemic formulation, split virus, adjuvanted, for intramuscular use","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67314","name":"Revise eye muscle","description":"Strabismus surgery, recession or resection procedure; 1 vertical muscle (excluding superior oblique)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":642.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81354","name":"Cytog alys chrml abnor ogm","description":"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of structural and copy number variants, optical genome mapping (ogm)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0811T","name":"Rem mlt day uroflow setup","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); set-up and patient education on use of equipment","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0804","name":"3d facial scan indirect","description":"3d facial scan indirect","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0512U","name":"Onc prst8 alys dgtz img msi","description":"Onc prst8 alys dgtz img msi","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0876T","name":"Duplex scan hemo fstl lmtd","description":"Duplex scan of hemodialysis fistula, computer-aided, limited (volume flow, diameter, and depth, including only body of fistula)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82101","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25110","name":"Remove wrist tendon lesion","description":"Excision, lesion of tendon sheath, forearm and/or wrist","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92552","name":"Pure tone audiometry air","description":"Pure tone audiometry (threshold); air only","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81462","name":"So gsap cll fr dna/dna&rna","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants and rearrangements","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4342","name":"Theramend, per sq cm","description":"Theramend, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43250","name":"Egd cautery tumor polyp","description":"Esophagogastroduodenoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1480","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83788","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9612","name":"Inj, fluorescein, 1 mg","description":"Injection, fluorescein, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4439","name":"Instagraft per sq cm","description":"Instagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5946","name":"Max implt sup fix","description":"Max implt sup fix","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53454","name":"Tprnl balo cntnc dev adjmt","description":"Periurethral transperineal adjustable balloon continence device; percutaneous adjustment of balloon(s) fluid volume","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9071","name":"Inj cyclophosphamd auromedic","description":"Injection, cyclophosphamide (auromedics), 5 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0744T","name":"Insj bioprostc vlv fem vn","description":"Insertion of bioprosthetic valve, open, femoral vein, including duplex ultrasound imaging guidance, when performed, including autogenous or nonautogenous patch graft (eg, polyester, eptfe, bovine pericardium), when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0414U","name":"Onc lng aug alg aly whl sld8","description":"Onc lng aug alg aly whl sld8","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33902","name":"Perq p-art revsc 1 abnor uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, unilateral","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0350","name":"Oral/facial photo images","description":"Oral/facial photographic images","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0816T","name":"Opn insj/rplcmt ins ptn subq","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1439","name":"Sig ocu cond imp surg out","description":"Significant ocular conditions that impact the visual outcome of surgery","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0208","name":"Inj, pedmark, 100 mg","description":"Injection, sodium thiosulfate (pedmark), 100 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52601","name":"Prostatectomy (turp)","description":"Transurethral electrosurgical resection of prostate, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy are included)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92551","name":"Pure tone hearing test air","description":"Screening test, pure tone, air only","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1190","name":"Doc khe not pef w/efgr/uacr","description":"Documentation of a kidney health evaluation was not performed or defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86708","name":"Hepatitis a antibody","description":"Hepatitis a antibody (haab)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0987T","name":"Iv img icr cere vsl oct ea","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4294","name":"Amnio quad-core, per sq cm","description":"Amnio quad-core, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6584","name":"Grad com wrap w straps","description":"Gradient compression wrap with adjustable straps, not otherwise specified","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0748T","name":"Njx stm cl prdct anl sft tis","description":"Injections of stem cell product into perianal perifistular soft tissue, including fistula preparation (eg, removal of setons, fistula curettage, closure of internal openings)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70336","name":"Magnetic image jaw joint","description":"Magnetic resonance (eg, proton) imaging, temporomandibular joint(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":664.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2249","name":"Inj, remimazolam, 1 mg","description":"Injection, remimazolam, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1477","name":"Dx delirium","description":"Diagnosis of delirium","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4288","name":"Dermabind ch, per sq cm","description":"Dermabind ch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0381U","name":"Maple syrup ur ds mntr quan","description":"Maple syrup ur ds mntr quan","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65290","name":"Repair of eye socket wound","description":"Repair of wound, extraocular muscle, tendon and/or tenons capsule","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":465.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0301U","name":"Iadna bartonella ddpcr","description":"Iadna bartonella ddpcr","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0549","name":"Phone/inter for treat>31m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98941","name":"Chiropract manj 3-4 regions","description":"Chiropractic manipulative treatment (cmt); spinal, 3-4 regions","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5946","name":"Max implt sup fix","description":"Max implt sup fix","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63196","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1923.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76018","name":"Mr safety implant elec prepj","description":"Mr safety implant electronics preparation under supervision of physician or other qualified health care professional, including mr-specific programming of pulse generator and/or transmitter to verify device integrity, protection of device internal circuitry from mr electromagnetic fields, and protec","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0482U","name":"Ob pe biochem asy sfit1&pigf","description":"Ob pe biochem asy sfit1&pigf","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1720","name":"Influenza vacc admin","description":"Influenza vacc admin","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0988T","name":"Opn ins/rplc ins ptn sbq&sbf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1016T","name":"Elec alys npgs esoph intraop","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98975","name":"Rtm 1st set-up&pt educaj eqp","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); initial set-up and patient education on use of equipment","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0233","name":"Intra inf, toci, first dose","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1343","name":"Pt pam lvl 4 base or srt lin","description":"Patients who are at pam level 4 at baseline or patients who are flagged with extreme straight line response sets on the pam or with excessive missing responses","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2019","name":"Kerecis marigen shld sq cm","description":"Kerecis omega3 marigen shield, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0615U","name":"Bbrgdrferi ld antb detcj 26","description":"Bbrgdrferi ld antb detcj 26","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1312","name":"No pt tbco scrn rng","description":"Patient not screened for tobacco use","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0524","name":"Est pt-cg dyad dem low cmplx","description":"Management of established patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52351","name":"Cystouretero & or pyeloscope","description":"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; diagnostic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":366.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2039","name":"Innovamatrix fd, per sq cm","description":"Innovamatrix fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0415U","name":"Cv ds acs bld alg 5 yr score","description":"Cv ds acs bld alg 5 yr score","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0892","name":"Argatroban dialysis (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0904T","name":"Ecg alg 12 ld rdcd trcg only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; tracing only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0351U","name":"Nfct ds bct/viral trail ip10","description":"Nfct ds bct/viral trail ip10","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27193","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":530.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38225","name":"Car-t hrv bld-drv t lymphcyt","description":"Chimeric antigen receptor t-cell (car-t) therapy; harvesting of blood-derived t lymphocytes for development of genetically modified autologous car-t cells, per day","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2802","name":"Inj, romiplostim 1 microgram","description":"Injection, romiplostim, 1 microgram","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33288","name":"Rmv&rplcmt phrnc nrv stim ld","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0234","name":"Intra inf, toci, second dos","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0723T","name":"Qmrcp w/o dx mri sm anat ses","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained without diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) during the same session","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88125","name":"Forensic cytopathology","description":"Cytopathology, forensic (eg, sperm)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4294","name":"Amnio quad-core, per sq cm","description":"Amnio quad-core, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0351","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5142","name":"Inj adalimumab-ryvk, 1 mg","description":"Injection, adalimumab-ryvk biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0958T","name":"Rmv s-sclp eltr ra rcvr&tlmt","description":"Removal of sub-scalp implanted electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99468","name":"Neonate crit care initial","description":"Initial inpatient neonatal critical care, per day, for the evaluation and management of a critically ill neonate, 28 days of age or younger","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":860.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0477U","name":"Rx metab psy 14&cyp2d6 gn-rx","description":"Rx metab psy 14&cyp2d6 gn-rx","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49616","name":"Rpr aa hrn rcr 3-10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0682T","name":"Removal pulse gen only isdss","description":"Removal of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0885T","name":"Colsc flx 1st tndsc dilat","description":"Colonoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0947T","name":"Mrgfus strtctc bl-br disrpj","description":"Magnetic resonance image guided low intensity focused ultrasound (mrgfus), stereotactic blood-brain barrier disruption using microbubble resonators to increase the concentration of blood-based biomarkers of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9296","name":"Inj pemetrexed (accord) 10mg","description":"Injection, pemetrexed (accord), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7415","name":"Excision malig les complicat","description":"Excision of malignant lesion complicated","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93721","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82105","name":"Alpha-fetoprotein serum","description":"Alpha-fetoprotein (afp); serum","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0605U","name":"All&immunology hat tpsab1","description":"All&immunology hat tpsab1","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4545","name":"Suppl accessor tibial stim","description":"Supplies and accessories for external tibial nerve stimulator (e.g., socks, gel pads, electrodes, etc.), needed for one month","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0359U","name":"Onc prst8 ca alys all psa","description":"Onc prst8 ca alys all psa","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0743T","name":"B1 str & fx rsk vrt fx assmt","description":"Bone strength and fracture risk using finite element analysis of functional data and bone mineral density (bmd), with concurrent vertebral fracture assessment, utilizing data from a computed tomography scan, retrieval and transmission of the scan data, measurement of bone strength and bmd and classi","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20605","name":"Drain/inj joint/bursa w/o us","description":"Arthrocentesis, aspiration and/or injection, intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa); without ultrasound guidance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":20.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":37.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93040","name":"Rhythm ecg with report","description":"Rhythm ecg, 1-3 leads; with interpretation and report","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0318U","name":"Ped whl gen mthyltn alys 50+","description":"Ped whl gen mthyltn alys 50+","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4012","name":"Interventional rad ss","description":"Interventional radiology mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4293","name":"Acesso dl, per sq cm","description":"Acesso dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1371","name":"Mst rec gsa<7","description":"Most recent glycemic status assessment (hba1c or gmi) level < 7.0%","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0402","name":"Inj, abilify asimtufii, 1 mg","description":"Injection, aripiprazole (abilify asimtufii), 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33280","name":"Rmvl phrnc nrv stim pg only","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator only","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99315","name":"Nf dschrg mgmt 30 min/less","description":"Nursing facility discharge management; 30 minutes or less total time on the date of the encounter","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":81.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0047","name":"Ped blunt hd traum","description":"Pediatric patient with minor blunt head trauma and pecarn prediction criteria are not assessed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88333","name":"Path consltj surg cyto xm 1","description":"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), initial site","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25515","name":"Optx radial shaft fracture","description":"Open treatment of radial shaft fracture, includes internal fixation, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":831.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0265U","name":"Rar do whl gn&mtcdrl dna als","description":"Rare constitutional and other heritable disorders, whole- genome and mitochondrial dna sequence analysis, blood, frozen and formalin-fixed paraffin-embedded (ffpe) tissue, saliva, buccal swabs or cell lines, identification of single nucleotide and copy number variants","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98984","name":"Rtm dev sply resp sys 2-15 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of respiratory system, 2-15 days in a 30-day period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51703","name":"Insert bladder cath complex","description":"Insertion of temporary indwelling bladder catheter; complicated (eg, altered anatomy, fractured catheter/balloon)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2524","name":"Cntct lens hydrophil photoch","description":"Contact lens, hydrophilic, spherical, photochromic additive, per lens","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57267","name":"Insert mesh/pelvic flr addon","description":"Insertion of mesh or other prosthesis for repair of pelvic floor defect, each site (anterior, posterior compartment), vaginal approach (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93741","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55868","name":"Lap srg prst8ct lymph nod bx","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with lymph node biopsy(ies) (limited pelvic lymphadenectomy)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2019","name":"Kerecis marigen shld sq cm","description":"Kerecis omega3 marigen shield, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88364","name":"Insitu hybridization (fish)","description":"In situ hybridization (eg, fish), per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93624","name":"Ep f-up study pacg&rec","description":"Electrophysiologic follow-up study with pacing and recording to test effectiveness of therapy, including induction or attempted induction of arrhythmia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37283","name":"Rvsc evsc tpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1412","name":"Inj roctavian ml 2x10^13vc g","description":"Injection, valoctocogene roxaparvovec-rvox, per ml, containing nominal 2 x 10^13 vector genomes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5931","name":"Surgical obturator","description":"Obturator prosthesis surgical","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0032","name":"2+ antipsy schiz","description":"Two or more antipsychotic prescriptions ordered for patients who had a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder on or between january 1 of the year prior to the measurement period and the index prescription start date (ipsd) for antipsychotics","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0578U","name":"Onc cutan mln rna qpcr 10gen","description":"Onc cutan mln rna qpcr 10gen","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37197","name":"Remove intrvas foreign body","description":"Transcatheter retrieval, percutaneous, of intravascular foreign body (eg, fractured venous or arterial catheter), includes radiological supervision and interpretation, and imaging guidance (ultrasound or fluoroscopy), when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2113.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82139","name":"Amino acids quan 6 or more","description":"Amino acids, 6 or more amino acids, quantitative, each specimen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0419U","name":"Nrpsyc gen seq vrnt aly 13","description":"Nrpsyc gen seq vrnt aly 13","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1370","name":"Inj, esomeprazole sod, 1 mg","description":"Injection, esomeprazole sodium, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99385","name":"Prev visit new age 18-39","description":"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; 18-39 years","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":130.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71048","name":"X-ray exam chest 4+ views","description":"Radiologic examination, chest; 4 or more views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64783","name":"Limb nerve surgery add-on","description":"Excision of neuroma; hand or foot, each additional nerve, except same digit (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3393","name":"Inj, betibeglogene autotemce","description":"Injection, betibeglogene autotemcel, per treatment","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0010","name":"Admin hepatitis b vaccine","description":"Administration of hepatitis b vaccine","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0369","name":"Max mri capture & interprete","description":"Max mri capture & interprete","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","name":"Gait mod systm rhym auditory","description":"Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11786.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1814","name":"Inj. insulin (lyumjev)","description":"Insulin (lyumjev), per 5 units","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0987T","name":"Iv img icr cere vsl oct ea","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20551","name":"Njx 1 tendon origin/insj","description":"Injection(s); single tendon origin/insertion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":38.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":70.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1468","name":"Hep b vaccine received","description":"Patient received recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6515","name":"Grad com wrap w str fu le cu","description":"Gradient compression wrap with adjustable straps, full leg, each, custom","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0860T","name":"Ncntc ifr spctrsc scr pad","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), for screening for peripheral arterial disease, including provocative maneuvers, image acquisition, interpretation, and report, one or both lower extremities","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75893","name":"Venous sampling by catheter","description":"Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":680.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3404","name":"Inj zopapogene per ther dose","description":"Injection, zopapogene imadenovec-drba suspension, per therapeutic dose","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0734T","name":"Rem r-t mtn nrehab tx mgmt","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; treatment management services by a physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0616U","name":"Neurol dementia alys >30000","description":"Neurol dementia alys >30000","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31243","name":"Nsl/sinus ndsc cryoabltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by cryoablation, posterior nasal nerve","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4023","name":"Pathology ss","description":"Pathology mips specialty set","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1483","name":"Neg quan hep c or qual rna","description":"Patients who achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93890","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1006T","name":"Elec alys s-scl eeg prgrm ea","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, each additional 15 minutes face-to-face time with physician or other qua","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65430","name":"Corneal smear","description":"Scraping of cornea, diagnostic, for smear and/or culture","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0523","name":"Mgt nw pt dem mod-high cmplx","description":"Management of a new patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4413","name":"Cygnus solo per sq cm","description":"Cygnus solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0491","name":"Oral dv nm mouthpc hw remote","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":105.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96380","name":"Admn rsv monoc antb im cnsl","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection, with counseling by physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9913","name":"Admin of neuromod","description":"Admin of neuromod","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1380","name":"2 rx in perf pd any com meds","description":"Filled at least two prescriptions during the performance period for any combination of the qualifying oral antipsychotic medications listed under denominator note or the long-acting injectable antipsychotic medications listed under denominator note","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0459","name":"Telehealth inpt pharm mgmt","description":"Inpatient telehealth pharmacologic management, including prescription, use, and review of medication with no more than minimal medical psychotherapy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":31.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24670","name":"Cltx ulnar fx prox w/o mnpj","description":"Closed treatment of ulnar fracture, proximal end (eg, olecranon or coronoid process[es]); without manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1482","name":"Pos quan hep c or qual rna","description":"Positive/detectable hepatitis c virus quantitative or qualitative rna test result during the denominator identification period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42425","name":"Excise parotid gland/lesion","description":"Excision of parotid tumor or parotid gland; total, en bloc removal with sacrifice of facial nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1011.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73510","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99487","name":"Cplx chrnc care 1st 60 min","description":"Complex chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":89.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99292","name":"Critical care addl 30 min","description":"Critical care, evaluation and management of the critically ill or critically injured patient; each additional 30 minutes (list separately in addition to code for primary service)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":154.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":114.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1204","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98006","name":"Synch audio-video est mod 30","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6614","name":"Onlay cst nbl mtl 2 surfaces","description":"Onlay - cast noble metal two surfaces","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38225","name":"Car-t hrv bld-drv t lymphcyt","description":"Chimeric antigen receptor t-cell (car-t) therapy; harvesting of blood-derived t lymphocytes for development of genetically modified autologous car-t cells, per day","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1938","name":"Inj, furosemide, 1 mg","description":"Injection, furosemide, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1015T","name":"Rev/rmv lw esoph sphnc npg/r","description":"Revision or removal, lower esophageal sphincter neurostimulator pulse generator or receiver","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0513U","name":"Onc prst8 alg alys msi&hrd","description":"Onc prst8 alg alys msi&hrd","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0534U","name":"Onc prst8 mirna snp 32 vrnt","description":"Onc prst8 mirna snp 32 vrnt","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2782","name":"Inj avacincaptad pegol 0.1mg","description":"Injection, avacincaptad pegol, 0.1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9244","name":"Office min sed drug enteral","description":"Office min sed drug enteral","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9563","name":"Ht inj immuno diem","description":"Home injectable therapy, immunotherapy, 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":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0570U","name":"Neurol tbi alys gfap&uch-l1","description":"Neurol tbi alys gfap&uch-l1","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0876T","name":"Duplex scan hemo fstl lmtd","description":"Duplex scan of hemodialysis fistula, computer-aided, limited (volume flow, diameter, and depth, including only body of fistula)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3502","name":"Surg exp root surf premolar","description":"Surg exp root surf premolar","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1553","name":"Inj yimmugo 100 mg","description":"Injection, immune globulin (yimmugo), 100 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76818","name":"Fetal biophys profile w/nst","description":"Fetal biophysical profile; with non-stress testing","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9294","name":"Biofeed dig cog behav tx fda","description":"Prescription digital cognitive and/or behavioral therapy, biofeedback, fda cleared, per course of treatment","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6198","name":"Remove interim implant","description":"Remove interim implant","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85049","name":"Automated platelet count","description":"Blood count; platelet, automated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46220","name":"Excise anal ext tag/papilla","description":"Excision of single external papilla or tag, anus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1326","name":"Inj, zolbetuximab-clzb, 2 mg","description":"Injection, zolbetuximab-clzb, 2 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52614","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":467.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90954","name":"Esrd serv 4 vsts p mo 2-11","description":"End-stage renal disease (esrd) related services monthly, for patients 2-11 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 4 or more face-to-face visits by a physician or other qualified health care professional ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1152.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1710","name":"Moderna vacc admin 3rd dose","description":"Moderna vacc admin 3rd dose","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1710","name":"Moderna vacc admin 3rd dose","description":"Moderna vacc admin 3rd dose","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9046","name":"Inj, bortezomib, dr. reddys","description":"Injection, bortezomib (dr. reddys), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33237","name":"Remove electrode/thoracotomy","description":"Removal of permanent epicardial pacemaker and electrodes by thoracotomy; dual lead system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1028.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0438","name":"Ppps, initial visit","description":"Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83586","name":"Assay 17- ketosteroids","description":"Ketosteroids, 17- (17-ks); total","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0365U","name":"Onc bldr 10 prb bldr ca","description":"Onc bldr 10 prb bldr ca","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99445","name":"Rem mntr physiol param 2-15","description":"Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate); device(s) supply with daily recording(s) or programmed alert(s) transmission, 2-15 days in a 30-day period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1205","name":"Isa reduced >=3","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25390","name":"Shorten radius or ulna","description":"Osteoplasty, radius or ulna; shortening","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1226.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0737T","name":"Xenograft impltj artclr surf","description":"Xenograft implantation into the articular surface","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33780","name":"Rpr tga rcnstj clsr vsd","description":"Repair of transposition of the great arteries, aortic pulmonary artery reconstruction (eg, jatene type); with closure of ventricular septal defect","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2836.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0533U","name":"Rx metab advrs gnotyp 16gens","description":"Rx metab advrs gnotyp 16gens","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35492","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0513U","name":"Onc prst8 alg alys msi&hrd","description":"Onc prst8 alg alys msi&hrd","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0800T","name":"Tcat rmvl 2chmbr ldls pm rv","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right ventricular pacemaker component (when part of a dual-chamber leadless pacem","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9183","name":"Gemcitabine intravesical sys","description":"Gemcitabine intravesical system, 225 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0020M","name":"Onc cns alys 30000 dna loci","description":"Oncology (central nervous system), analysis of 30,000 dna methylation loci by methylation array, utilizing dna extracted from tumor tissue, diagnostic algorithm reported as probability of matching a reference tumor subclass","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70471","name":"Cta h&n c+ w/noncontrast img","description":"Computed tomographic angiography (cta), head and neck, with contrast material(s), including noncontrast images, when performed, and image postprocessing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64473","name":"Lwr xtr fscl pln blk uni njx","description":"Lower extremity fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20200","name":"Muscle biopsy superficial","description":"Biopsy, muscle; superficial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98009","name":"Synch audio-only new low 30","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 30 m","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1491","name":"Recd esrd mcp dur perf pd","description":"Receiving esrd mcp dialysis services by the provider during the performance period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1073","name":"Testosterone pellet 75 mg","description":"Testosterone pellet, implant, 75 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1466","name":"Pt disc/lam proc same day","description":"Patient had a lumbar fusion on the same date as the discectomy/laminectomy procedure","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0899T","name":"N-invas deter aqmbf aug cmr","description":"Noninvasive determination of absolute quantitation of myocardial blood flow (aqmbf), derived from augmentative algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health car","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1215","name":"Med rsn for no doc spiro","description":"Documentation of medical reason(s) for not documenting and reviewing spirometry results (e.g., patients with dementia or tracheostomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0956T","name":"Prt crn ch cr&tun elt s-sclp","description":"Partial craniectomy, channel creation, and tunneling of electrode for sub-scalp implantation of an electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86051","name":"Aquaporin-4 antb elisa","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; enzyme-linked immunosorbent immunoassay (elisa)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86363","name":"Mog-igg1 antb flo cytmtry ea","description":"Myelin oligodendrocyte glycoprotein (mog-igg1) antibody; flow cytometry (ie, fluorescence-activated cell sorting [facs]), each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4432","name":"510(k) skin subs, nos","description":"510(k) skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15120","name":"Splt agrft f/s/n/h/f/g/m 1st","description":"Split-thickness autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq cm or less, or 1% of body area of infants and children (except 15050)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":845.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0574U","name":"Mtb cfp-10 serum/plsm lc-ms","description":"Mtb cfp-10 serum/plsm lc-ms","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0745T","name":"Car ablt rad arr n-invas loc","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; noninvasive arrhythmia localization and mapping of arrhythmia site (nidus), derived from anatomical image data (eg, ct, mri, or myocardial perfusion scan) and electrical data (eg, 12-lead ecg data), and identification of areas of avo","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1390","name":"Pt no doc exm for rec","description":"Patients who do not have a documented exam performed for recurrence of melanoma or no documentation within the performance period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0870T","name":"Imp subq prtl ascts pmp sys","description":"Implantation of subcutaneous peritoneal ascites pump system, percutaneous, including pump-pocket creation, insertion of tunneled indwelling bladder and peritoneal catheters with pump connections, including all imaging and initial programming, when performed","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80506","name":"Path clin consltj prolng svc","description":"Pathology clinical consultation; prolonged service, each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0666","name":"Inj, bupivacaine liposome","description":"Injection, bupivacaine liposome, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1296","name":"Calc bmi norm parameters","description":"Bmi is documented within normal parameters and no follow-up plan is required","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1385","name":"Pt rsn not seen 2nd pam","description":"Documentation of patient reasons for patients who were not seen for the second pam survey (e.g., less than four months between baseline pam assessment and follow-up","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42975","name":"Dise eval slp do brth flx dx","description":"Drug-induced sleep endoscopy, with dynamic evaluation of velum, pharynx, tongue base, and larynx for evaluation of sleep-disordered breathing, flexible, diagnostic","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87627","name":"Jt spc pthgn&rx rsist gen26+","description":"Infectious agent detection by nucleic acid (dna or rna); joint space pathogens and drug resistance genes, multiplex amplified probe technique, 26 or more targets","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99310","name":"Sbsq nf care high mdm 45","description":"Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 45 minutes must be met or exc","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":187.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":47.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0494U","name":"Rbc ag ftl rhd gene alys ngs","description":"Rbc ag ftl rhd gene alys ngs","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99426","name":"Prin care mgmt staff 1st 30","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8515","name":"Cabergoline, oral 0.25mg","description":"Cabergoline, oral, 0.25 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0184","name":"Inj, amisulpride, 1 mg","description":"Injection, amisulpride, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0616","name":"Inj metoprolol tartrate 1 mg","description":"Injection, metoprolol tartrate, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92642","name":"Hearing asstv dev fitg svc","description":"Hearing assistive device, supplemental technology fitting services (eg, personal frequency modulation [fm]/digital modulation [dm] system, remote microphone, alerting devices)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0831T","name":"Dgtz gls mcrscp cytp c/v","description":"Digitization of glass microscope slides for cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G3003","name":"Chronic pain mgmt addl 15m","description":"Each additional 15 minutes of chronic pain management and treatment by a physician or other qualified health care professional, per calendar month. (list separately in addition to code for g3002. when using g3003, 15 minutes must be met or exceeded.)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0516U","name":"Rx metab rxgenomic gnotyp 40","description":"Rx metab rxgenomic gnotyp 40","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5912","name":"Facial moulage complete","description":"Facial moulage (complete)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0211","name":"Inj, nithiodote, 3mg / 125mg","description":"Injection, sodium nitrite 3 mg and sodium thiosulfate 125 mg (nithiodote)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4319","name":"Sanograft, per sq cm","description":"Sanograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81195","name":"Cytog genom-wid alys hem mal","description":"Cytogenomic (genome-wide) analysis, hematologic malignancy, structural variants and copy number variants, optical genome mapping (ogm)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0177","name":"Inj, aflibercept hd, 1 mg","description":"Injection, aflibercept hd, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2040","name":"Microlyte painguard pr sq cm","description":"Microlyte painguard, per square centimeter","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0753T","name":"Dgtz gls mcrscp sld level iv","description":"Digitization of glass microscope slides for level iv, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4468","name":"Exsuff belt incl all sup acc","description":"Exsufflation belt, includes all supplies and accessories","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82274","name":"Assay test for blood fecal","description":"Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9326","name":"Telisotuzumab vedotin-tllv","description":"Injection, telisotuzumab vedotin-tllv, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77439","name":"Surf rad thr img gdn us plmt","description":"Surface radiation therapy; superficial or orthovoltage, image guidance, ultrasound for placement of radiation therapy fields for treatment of cutaneous tumors, per course of treatment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0848T","name":"Dgtz gls mcrscp ish 1st","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0854T","name":"Dgtz gls mcrscp bld smr prph","description":"Digitization of glass microscope slides for blood smear, peripheral, interpretation by physician with written report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4212","name":"Gingivectomy/plasty rest","description":"Gingivectomy/plasty rest","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55707","name":"Bx prst8 trct us guided","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":53.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99234","name":"Hosp ip/obs sm dt sf/low 45","description":"Hospital inpatient or observation care, for the evaluation and management of a patient including admission and discharge on the same date, which requires a medically appropriate history and/or examination and straightforward or low level of medical decision making. when using total time on the date ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8006","name":"Grip glove replacement only","description":"Powered, cable driven grip assist glove, hand, finger, includes pressure sensors, glove replacement only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0130","name":"Single energy x-ray study","description":"Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76805","name":"Ob us >/= 14 wks sngl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"Basic vestibular evaluation","description":"Basic vestibular evaluation, includes spontaneous nystagmus test with eccentric gaze fixation nystagmus, with recording, positional nystagmus test, minimum of 4 positions, with recording, optokinetic nystagmus test, bidirectional foveal and peripheral stimulation, with recording, and oscillating tra","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0911T","name":"Elec aly nstm sys vgs nrv wo","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; without programming by physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37257","name":"Revsc evsc ivt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2058","name":"Obecbtge autol up to 400 mil","description":"Obecabtagene autoleucel, 10 up to 400 million cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per infusion","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84285","name":"Assay of silica","description":"Silica","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37264","name":"Revsc evasc fpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0546","name":"Phone/internet ehr assess","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty   whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patien","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1011T","name":"Pbm therapy of oral cavity","description":"Photobiomodulation (pbm) therapy of oral cavity, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6253","name":"Provisional pontic","description":"Provisional pontic","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98010","name":"Synch audio-only new mod 45","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection,","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0701T","name":"Molec fluor img sus nev ea","description":"Molecular fluorescent imaging of suspicious nevus; each additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87494","name":"Chlmy trch&neisra gonor mult","description":"Infectious agent detection by nucleic acid (dna or rna); chlamydia trachomatis and neisseria gonorrhoeae, multiplex amplified probe technique","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0920T","name":"Rmvl perm ccm-d sys 1 pac ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous pacing lead only","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86480","name":"Tb test cell immun measure","description":"Tuberculosis test, cell mediated immunity antigen response measurement; gamma interferon","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37298","name":"Revsc evsc imvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7241","name":"Impact tooth rem bony w/comp","description":"Removal of impacted tooth-completely bony with unusual surgical complications","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0686T","name":"Histotripsy mal hepatcel tis","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant hepatocellular tissue, including image guidance","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0219","name":"Inj aval alfa-nqpt 4mg","description":"Injection, avalglucosidase alfa-ngpt, 4 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0807T","name":"Pulm tiss vntj alys prev ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with previously acquired computed tomography (ct) images, including data preparation and transmission, quantification of pulmonary tissue ventilation, data re","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4032","name":"Rheumatology ss","description":"Rheumatology mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38225","name":"Car-t hrv bld-drv t lymphcyt","description":"Chimeric antigen receptor t-cell (car-t) therapy; harvesting of blood-derived t lymphocytes for development of genetically modified autologous car-t cells, per day","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98002","name":"Synch audio-video new mod 45","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate medical decision making. when using total time on the date of the encounter for code selection, 45 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2042","name":"Foundation drs+ solo, sq cm","description":"Foundation drs+ solo, per square centimeter","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52284","name":"Cysto rx balo cath urtl strx","description":"Cystourethroscopy, with mechanical urethral dilation and urethral therapeutic drug delivery by drug-coated balloon catheter for urethral stricture or stenosis, male, including fluoroscopy, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":137.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99220","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0919T","name":"Rmvl perm ccm-d sys pg only","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); pulse generator only","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22838","name":"Rev rplc/rmv thrc vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracic vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":1619.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83491","name":"Asy hydroxycorticosteroids17","description":"Hydroxycorticosteroids, 17- (17-ohcs)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0042","name":"Ref to therapy","description":"Referral to physical, occupational, speech, or recreational therapy","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37257","name":"Revsc evsc ivt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5098","name":"Inj ustekinumab-srlf, 1 mg","description":"Injection, ustekinumab-srlf (imuldosa), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84152","name":"Assay of psa complexed","description":"Prostate specific antigen (psa); complexed (direct measurement)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90839","name":"Psytx crisis initial 60 min","description":"Psychotherapy for crisis; first 60 minutes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":158.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96548","name":"Ntraop hipec px ea add 30min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4320","name":"Pellograft, per sq cm","description":"Pellograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0390U","name":"Ob pe kdr eng&rbp4 ia alg","description":"Ob pe kdr eng&rbp4 ia alg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29806","name":"Sho arthrs srg capsulorraphy","description":"Arthroscopy, shoulder, surgical; capsulorrhaphy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1277.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0891","name":"Argatroban nonesrd (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21146","name":"Rcnstj mdfc lefort i 2 w/grf","description":"Reconstruction midface, lefort i; 2 pieces, segment movement in any direction, requiring bone grafts (includes obtaining autografts) (eg, ungrafted unilateral alveolar cleft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1773.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54230","name":"Njx corpora cavernosograpy","description":"Injection procedure for corpora cavernosography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1244","name":"Pt othr thn true best int","description":"Patient provided a response other than completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2794","name":"Crown-titanium","description":"Crown-titanium","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90481","name":"Admn sarscov2 vac ea add cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; each additional component administered (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1552","name":"Inj, alyglo, 500 mg","description":"Injection, immune globulin (alyglo), 500 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1208","name":"Pt no scrn sdoh","description":"Patient is not screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37254","name":"Revsc evasc ivt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0339U","name":"Onc prst8 mrna hoxc6 & dlx1","description":"Onc prst8 mrna hoxc6 & dlx1","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0477U","name":"Rx metab psy 14&cyp2d6 gn-rx","description":"Rx metab psy 14&cyp2d6 gn-rx","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9027","name":"Rbc o2 co2 reduced","description":"Red blood cells, leukocytes reduced, oxygen/ carbon dioxide reduced, each unit","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4433","name":"361 hct/p skin subs, nos","description":"361 hct/p skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0803T","name":"Tcat rmv&rpl2chmb ldls pm rv","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ve","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20600","name":"Drain/inj joint/bursa w/o us","description":"Arthrocentesis, aspiration and/or injection, small joint or bursa (eg, fingers, toes); without ultrasound guidance","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":64.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0559","name":"Unrelat prac follow up visit","description":"Post-operative follow-up visit complexity inherent to evaluation and management services addressing surgical procedure(s), provided by a physician or qualified health care professional who is not the practitioner who performed the procedure (or in the same group practice) and is of the same or of a ","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2679","name":"Inj fluphenazine hcl 1.25 mg","description":"Injection, fluphenazine hcl, 1.25 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0564U","name":"Nfct ds pthgn-sna 10vir&4bct","description":"Nfct ds pthgn-sna 10vir&4bct","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22226","name":"Osteot dsc ant 1vrt sgm ea","description":"Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; each additional vertebral segment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":473.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9685","name":"Acute nursing facility care","description":"Physician service or other qualified health care professional for the evaluation and management of a beneficiarys acute change in condition in a nursing facility. this service is for a demonstration project","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1272","name":"Pts kid transplt wtlst","description":"Patients observed on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80418","name":"Pituitary evaluation panel","description":"Combined rapid anterior pituitary evaluation panel this panel must include the following: adrenocorticotropic hormone (acth) (82024 x 4) luteinizing hormone (lh) (83002 x 4) follicle stimulating hormone (fsh) (83001 x 4) prolactin (84146 x 4) human growth hormone (hgh) (83003 x 4) cortisol (82533 x ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":809.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23220","name":"Radical rescj tumor prox hum","description":"Radical resection of tumor, proximal humerus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1267.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4275","name":"Esano aca, per sq cm","description":"Esano aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93586","name":"Vngrph chd coronary sinus","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; coronary sinus (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5877","name":"Dup of complt dent-maxill","description":"Dup of complt dent-maxill","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37254","name":"Revsc evasc ivt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1464","name":"No record of f/u by 180 days","description":"No documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76001","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0793T","name":"Prq tcat thrm ablt nrv p-art","description":"Percutaneous transcatheter thermal ablation of nerves innervating the pulmonary arteries, including right heart catheterization, pulmonary artery angiography, and all imaging guidance","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0268","name":"Removal of impacted wax md","description":"Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3247","name":"Inj secukinumab intrav 1mg","description":"Injection, secukinumab, intravenous, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1321","name":"Couns for high risk sub use","description":"Couns for high risk sub use","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37730","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":566.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0717T","name":"Adrc ther prtl rc tear","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; adipose tissue harvesting, isolation and preparation of harvested cells, including incubation with cell dissociation enzymes, filtration, washing, and concentration of adrcs","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0378U","name":"Rfc1 repeat xpnsj vrnt alys","description":"Rfc1 repeat xpnsj vrnt alys","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1461","name":"Pt dx chron hepc","description":"Patient diagnosis for chronic hepatitis c","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81354","name":"Cytog alys chrml abnor ogm","description":"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of structural and copy number variants, optical genome mapping (ogm)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96440","name":"Chmotx admn plrl cav thrcnts","description":"Chemotherapy administration into pleural cavity, requiring and including thoracentesis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4336","name":"Artecent c, per sq cm","description":"Artacent c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0797T","name":"Tcat ins 2chmbr ldls pm rv","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ventricular pace","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0701T","name":"Molec fluor img sus nev ea","description":"Molecular fluorescent imaging of suspicious nevus; each additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0682T","name":"Removal pulse gen only isdss","description":"Removal of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81463","name":"So gsap cl fr cpy nmbr&mcrst","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis, copy number variants, and microsatellite instability","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4004","name":"Endocrinology ss","description":"Endocrinology mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73030","name":"X-ray exam of shoulder","description":"Radiologic examination, shoulder; complete, minimum of 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5913","name":"Nasal prosthesis","description":"Nasal prosthesis","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":160.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55175","name":"Revision of scrotum","description":"Scrotoplasty; simple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92634","name":"Hearing aid fitg svc 1st 60","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; first 60 minutes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1281","name":"Bp scrn no perf at interval","description":"Blood pressure reading not documented, reason not given","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0497U","name":"Onc prst8 mrna rt-pcr 6 gene","description":"Onc prst8 mrna rt-pcr 6 gene","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0746T","name":"Car ablt rad arr cnv loc map","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; conversion of arrhythmia localization and mapping of arrhythmia site (nidus) into a multidimensional radiation treatment plan","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0980T","name":"Sbmcsl crylys ther tng&tnsl","description":"Submucosal cryolysis therapy; base of tongue and lingual tonsil only","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0886T","name":"Sgmdsc flx 1st tndsc dilat","description":"Sigmoidoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0603","name":"Sevelamer hydrochloride 20mg","description":"Sevelamer hydrochloride (renagel or therapeutically equivalent), oral, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6604","name":"Cst bse mtl inlay 2 surfaces","description":"Inlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9359","name":"Inj lon tesirin-lpyl 0.075mg","description":"Injection, loncastuximab tesirine-lpyl, 0.075 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0004","name":"Qual care neurologic cnd mvp","description":"Quality care for patients with neurological conditions mips value pathway","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1408","name":"Gmln brca bef dx ca","description":"Patients who have germline brca testing completed before diagnosis of epithelial ovarian, fallopian tube, or primary peritoneal cancer","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99203","name":"Office o/p new low 30 min","description":"Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.","date_of_service":"2026-06-05","other_properties":[{"name":"BillingTaxonomy","value":["207V00000X","207VB0002X","207VE0102X","207VF0040X","207VG0400X","207VM0101X","207VX0000X","207VX0201X","363LX0001X"]},{"name":"RenderingTaxonomy","value":["207V00000X","207VB0002X","207VE0102X","207VF0040X","207VG0400X","207VM0101X","207VX0000X","207VX0201X","363LX0001X"]},{"name":"ClaimSpecialtyCode","value":["904","905","907","AMGY","APNOB","COLP","FPEM","GYNE","GYON","GYSU","MAFE","NPAG","NPGY","NPOB","OBEM","OBGY","OBHR","OBST","REND","URGY"]},{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TH"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TH"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0554","name":"Add 20 m of monthly tx","description":"Each additional 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing data generated from the","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9296","name":"Inj pemetrexed (accord) 10mg","description":"Injection, pemetrexed (accord), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0306","name":"Cbc/diffwbc w/o platelet","description":"Complete cbc, automated (hgb, hct, rbc, wbc, without platelet count) and automated wbc differential count","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0425U","name":"Genom rpd seq alys ea cmprtr","description":"Genom rpd seq alys ea cmprtr","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92642","name":"Hearing asstv dev fitg svc","description":"Hearing assistive device, supplemental technology fitting services (eg, personal frequency modulation [fm]/digital modulation [dm] system, remote microphone, alerting devices)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0895T","name":"Connj lvr algrft prfu dev 1","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; initial 4 hours of monitoring time, including hourly physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary ","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4308","name":"Sanopellis, per sq cm","description":"Sanopellis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70472","name":"Ct cere prfu alys c+w/ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed with concurrent ct or ct angiography of the same anatomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0520","name":"New pt-cg dyad dem mod cmplx","description":"Management of new patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42892","name":"Revision of pharyngeal walls","description":"Resection of lateral pharyngeal wall or pyriform sinus, direct closure by advancement of lateral and posterior pharyngeal walls","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1550.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0940T","name":"Xtrnl ecg rec>15d<30d r&i","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84433","name":"Asy thiopurin s-mthyltrnsfrs","description":"Thiopurine s-methyltransferase (tpmt)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2050","name":"Financial mgt waiver/diem","description":"Financial management, self-directed, waiver; per diem","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0552U","name":"Repr med pga gdo te bx locus","description":"Repr med pga gdo te bx locus","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9888","name":"5% wl maintnd from bsline wt","description":"Maintenance 5% wl from baseline weight in months 7-12","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0946T","name":"Ortho impl mvmt alys pair ct","description":"Orthopedic implant movement analysis using paired computed tomography (ct) examination of the target structure, including data acquisition, data preparation and transmission, interpretation and report (including ct scan of the joint or extremity performed with paired views)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0707T","name":"Njx b1 sub mtrl sbchdrl dfct","description":"Injection(s), bone-substitute material (eg, calcium phosphate) into subchondral bone defect (ie, bone marrow lesion, bone bruise, stress injury, microtrabecular fracture), including imaging guidance and arthroscopic assistance for joint visualization","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9376","name":"Inj pozelimab-bbfg, 1 mg","description":"Injection, pozelimab-bbfg, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0614U","name":"Iem pmd alys 4 nzm cplx page","description":"Iem pmd alys 4 nzm cplx page","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5765","name":"Liner compl/partial rem dent","description":"Liner compl/partial rem dent","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74021","name":"Radex abdomen 3+ views","description":"Radiologic examination, abdomen; 3 or more views","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37286","name":"Revsc evasc tpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2404","name":"Inj, nicardipine 0.1 mg","description":"Injection, nicardipine, 0.1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33955","name":"Ecmo/ecls insj ctr cannula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; insertion of central cannula(e) by sternotomy or thoracotomy, birth through 5 years of age","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1094.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0524U","name":"Ob pe sflt-1/plgf ia srm/pls","description":"Ob pe sflt-1/plgf ia srm/pls","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36578","name":"Replace tunneled cv cath","description":"Replacement, catheter only, of central venous access device, with subcutaneous port or pump, central or peripheral insertion site","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5140","name":"Inj adalimumab-fkjp, 1 mg","description":"Injection, adalimumab-fkjp, biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1434","name":"Inj, focinvez, 1mg","description":"Injection, fosaprepitant (focinvez), 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0010","name":"Eom meos payment","description":"Enhancing oncology model (eom) monthly enhanced oncology services (meos) payment for eom enhanced services","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70300","name":"X-ray exam of teeth","description":"Radiologic examination, teeth; single view","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0561U","name":"Onc mrd gsa cfdna subsequent","description":"Onc mrd gsa cfdna subsequent","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4002","name":"Ep cardio ss","description":"Electrophysiology cardiac specialist mips specialty set","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4231","name":"Ana crown exp 1-3 per quad","description":"Anatomical crown exposure - one to three teeth per quadrant","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0522","name":"Mgt nw pt dementia low cmplx","description":"Management of a new patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94015","name":"Patient recorded spirometry","description":"Patient-initiated spirometric recording per 30-day period of time; recording (includes hook-up, reinforced education, data transmission, data capture, trend analysis, and periodic recalibration)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":41.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4270","name":"Complete sl per sq cm","description":"Complete sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97813","name":"Acup 1/> w/estim 1st 15 min","description":"Acupuncture, 1 or more needles; with electrical stimulation, initial 15 minutes of personal one-on-one contact with the patient","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":60.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4003","name":"Emergency med ss","description":"Emergency medicine mips specialty set","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0782T","name":"Brnchsc rf dstrj plm nrv uni","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; unilateral mainstem bronchus","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44384","name":"Small bowel endoscopy","description":"Ileoscopy, through stoma; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4306","name":"Americ amnion ac per sq cm","description":"American amnion ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77784","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1376.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78202","name":"Liver imaging with vasc flow","description":"Liver imaging; with vascular flow","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4420","name":"Nuform per sq cm","description":"Nuform, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46020","name":"Placement of seton","description":"Placement of seton","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0759","name":"Inj, clevidipine, 1 mg","description":"Injection, clevidipine butyrate, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0624U","name":"Hep nash dna mthyl alys 5000","description":"Hep nash dna mthyl alys 5000","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26852","name":"Fusion of knuckle with graft","description":"Arthrodesis, metacarpophalangeal joint, with or without internal fixation; with autograft (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1039.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4427","name":"Dermbnd dln dl+ dlx sq cm","description":"Dermabind dl n or dermabind dl + or dermabind dl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0371","name":"Sialoendoscopy capt & interp","description":"Sialoendoscopy capt & interp","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0345U","name":"Psyc genom alys pnl 15 gen","description":"Psyc genom alys pnl 15 gen","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1836.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0525","name":"Est pt-cg dyad dem mod cmplx","description":"Management of established patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1263","name":"Pts hosp dialysis dt","description":"Patients in hospice on their initiation of dialysis date or during the month of evaluation","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4211","name":"Gingivectomy/plasty per toot","description":"Gingivectomy or gingivoplasty - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86720","name":"Leptospira antibody","description":"Antibody; leptospira","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4212","name":"Gingivectomy/plasty rest","description":"Gingivectomy/plasty rest","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43830","name":"Gstrst open wo constj tube","description":"Gastrostomy, open; without construction of gastric tube (eg, stamm procedure) (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":695.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0146","name":"Nav srv peer sup add 30 pr m","description":"Principal illness navigation - peer support, additional 30 minutes per calendar month (list separately in addition to g0140)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33902","name":"Perq p-art revsc 1 abnor uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, unilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0786T","name":"Insj/rplcmt prq ra sac nstim","description":"Insertion or replacement of percutaneous electrode array, sacral, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9871","name":"Bhv couns dm prev, onln 60 m","description":"Behavioral counseling for diabetes prevention, online, 60 minutes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4271","name":"Complete ft per sq cm","description":"Complete ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9028","name":"Inj, nogapendekin pmln, 1mcg","description":"Injection, nogapendekin alfa inbakicept-pmln, for intravesical use, 1 microgram","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92930","name":"Prq tcat plmt ntrac st 2+les","description":"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 2 or more distinct coronary lesions with 2 or more coronary stents deployed in 2 or more coronary segments, or a bifurcation lesion requiring ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5411","name":"Dentures adjust cmplt mand","description":"Adjust complete denture - mandibular","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0893","name":"Inj, decitabine (sun pharma)","description":"Injection, decitabine (sun pharma), not therapeutically equivalent to j0894, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1345","name":"Pt bsln pam, 2nd scr 4-12 mo","description":"Patients who had a baseline pam score and a second score within 4 to 12 month of baseline pam score","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1642","name":"Inj heparin sodium per 10 u","description":"Injection, heparin sodium, (heparin lock flush), per 10 units","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1346","name":"No pam inc 6 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 6 points within a 4 to 12 month period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9256","name":"Inj, nipocalimab-aahu, 3 mg","description":"Injection, nipocalimab-aahu, 3 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98014","name":"Synch audio-only est mod 30","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code s","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0991T","name":"Cysto lo-nrg lithtrp&mcrsphr","description":"Cystourethroscopy, with low-energy lithotripsy and acoustically actuated microspheres, including imaging","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0439","name":"Ppps, subseq visit","description":"Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9003","name":"Leupro inj, camcevi etm, 1mg","description":"Leuprolide injectable (camcevi etm), 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5943","name":"Proth mandib implt sup remv","description":"Proth mandib implt sup remv","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93319","name":"3d echo img cgen car anomal","description":"3d echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac structure(s) (eg, cardiac chambers and valves, left atrial appendage, interatrial septum, interventricular","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":13.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97550","name":"Caregiver traing 1st 30 min","description":"Caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patie","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36837","name":"Prq av fstl crt uxtr sep acs","description":"Percutaneous arteriovenous fistula creation, upper extremity, separate access sites of the peripheral artery and peripheral vein, including fistula maturation procedures (eg, transluminal balloon angioplasty, coil embolization) when performed, including all vascular access, imaging guidance and radi","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72170","name":"X-ray exam of pelvis","description":"Radiologic examination, pelvis; 1 or 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31647","name":"Bronchial valve init insert","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with balloon occlusion, when performed, assessment of air leak, airway sizing, and insertion of bronchial valve(s), initial lobe","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0431","name":"Diag tst detect mucos abnorm","description":"Adjunctive pre-diagnostic test that aids in detection of mucosal abnormalities including premalignant and malignant lesions not to include cytology or biopsy","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4323","name":"Splint extra-coronal","description":"Splint extra-coronal","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1455","name":"Rep/rev cied","description":"Replaced or revised cied","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2018","name":"Permeaderm c, per sq cm","description":"Permeaderm c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1436","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1437","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0762T","name":"Dgtz gls mcrscp sl imm ea m","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, each multiplex antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1214","name":"Spiro results wth obs doc","description":"Spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and reviewed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1263","name":"Pts hosp dialysis dt","description":"Patients in hospice on their initiation of dialysis date or during the month of evaluation","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2021","name":"Neomatrix per sq cm","description":"Neomatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1921","name":"Inj labetalol hcl hikma, 5mg","description":"Injection, labetalol hydrochloride (hikma), not therapeutically equivalent to j1920, 5 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57310","name":"Repair urethrovaginal lesion","description":"Closure of urethrovaginal fistula;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":492.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0892","name":"Argatroban dialysis (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1000T","name":"Autol musc cell therapy admn","description":"Autologous muscle cell therapy, administration of muscle progenitor cells into the urethral sphincter, including cystoscopy and post-void residual ultrasound, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0920T","name":"Rmvl perm ccm-d sys 1 pac ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous pacing lead only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83036","name":"Hemoglobin glycosylated a1c","description":"Hemoglobin; glycosylated (a1c)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2373","name":"Inj, immphentiv, 20 mcg","description":"Injection, phenylephrine hydrochloride (immphentiv), 20 micrograms","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87593","name":"Orthopoxvirus amp prb each","description":"Infectious agent detection by nucleic acid (dna or rna); orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus), amplified probe technique, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0348","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0368","name":"Cone beam ct interprete tmj","description":"Cone beam ct interprete tmj","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0182","name":"Hospice care supervision","description":"Physician supervision of a patient under a medicare-approved hospice (patient not present) requiring complex and multidisciplinary care modalities involving regular physician development and/or revision of care plans, review of subsequent reports of patient status, review of laboratory and other stu","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4333","name":"Ardeograft, per sq cm","description":"Ardeograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31242","name":"Nsl/sinus ndsc rf abltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by radiofrequency ablation, posterior nasal nerve","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99487","name":"Cplx chrnc care 1st 60 min","description":"Complex chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":164.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4362","name":"Cygnus disk, per sq cm","description":"Cygnus disk, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5137","name":"Inj, wezlana, sub cu, 1 mg","description":"Injection, ustekinumab-auub (wezlana), biosimilar, subcutaneous, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49521","name":"Rerepair ing hernia blocked","description":"Repair recurrent inguinal hernia, any age; incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":836.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6515","name":"Grad com wrap w str fu le cu","description":"Gradient compression wrap with adjustable straps, full leg, each, custom","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59612","name":"Vbac delivery only","description":"Vaginal delivery only, after previous cesarean delivery (with or without episiotomy and/or forceps);","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":976.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37270","name":"Revsc evasc fpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75962","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":844.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1611","name":"Inj glucagon hcl, fresenius","description":"Injection, glucagon hydrochloride (fresenius kabi), not therapeutically equivalent to j1610, per 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0045","name":"Mrs 90 days post stk","description":"Clinical follow-up and mrs score assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0495U","name":"Onc prst8 alys crcg plsm prt","description":"Onc prst8 alys crcg plsm prt","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6251","name":"Bridge resin base metal","description":"Pontic-resin with predominantly base metal","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48102","name":"Needle biopsy pancreas","description":"Biopsy of pancreas, percutaneous needle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0726T","name":"Rmvl implt vstibular dev uni","description":"Removal of implanted vestibular device, unilateral","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4564","name":"Pessary, disposable any type","description":"Pessary, disposable, any type","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87084","name":"Culture of specimen by kit","description":"Culture, presumptive, pathogenic organisms, screening only; with colony estimation from density chart","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72070","name":"X-ray exam thorac spine 2vws","description":"Radiologic examination, spine; thoracic, 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99243","name":"Off/op cnsltj new/est low 30","description":"Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":97.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1231","name":"Pt hcv tst no reactive res","description":"Patient receives hcv antibody test with nonreactive result","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0955T","name":"Tot impl amei removal","description":"Totally implantable active middle ear hearing implant; removal, including removal of sound processor and all implant components","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84431","name":"Thromboxane urine","description":"Thromboxane metabolite(s), including thromboxane if performed, urine","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76815","name":"Ob us limited fetus(s)","description":"Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0772T","name":"Vr px dissoc svc sm phy ea","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94626","name":"Phy/qhp op pulm rhb w/mntr","description":"Physician or other qualified health care professional services for outpatient pulmonary rehabilitation; with continuous oximetry monitoring (per session)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0706T","name":"Rem tx amblyopia i&r phy/qhp","description":"Remote treatment of amblyopia using an eye tracking device; interpretation and report by physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0525","name":"Est pt-cg dyad dem mod cmplx","description":"Management of established patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64590","name":"Ins/rpl prph sac/gstr npg/r","description":"Insertion or replacement of peripheral, sacral, or gastric neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":220.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4020","name":"Ophthalmology/optometry ss","description":"Ophthalmology/optometry mips specialty set","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0442U","name":"Nfct ds respir nfctj mxa&crp","description":"Nfct ds respir nfctj mxa&crp","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2034","name":"Found drs solo, per sq cm","description":"Foundation drs solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1279","name":"Pre-htn/htn, no f/u, not gvn","description":"Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86015","name":"Actin antibody each","description":"Actin (smooth muscle) antibody (asma), each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1192","name":"Pt w/ dx sq cell ca of esoph","description":"Patients with an existing diagnosis of squamous cell carcinoma of the esophagus","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2928","name":"Prefab porc/cer crown perm","description":"Prefab porc/cer crown perm","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0763T","name":"Dgtz gls mcrscp mphmtrc alys","description":"Digitization of glass microscope slides for morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure, manual (list separately in addition to code for primary proced","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75577","name":"Quan&char c athrosclrtc plaq","description":"Quantification and characterization of coronary atherosclerotic plaque to assess severity of coronary disease, derived from augmentative software analysis of the data set from a coronary computed tomographic angiography, with interpretation and report by a physician or other qualified health care pr","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0897T","name":"N-invas augmnt arrhyt alys","description":"Noninvasive augmentative arrhythmia analysis derived from quantitative computational cardiac arrhythmia simulations, based on selected intervals of interest from 12-lead electrocardiogram and uploaded clinical parameters, including uploading clinical parameters with interpretation and report","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0749T","name":"B1 str&fx rsk assmt dxr-bmd","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","name":"Gait mod systm rhym auditory","description":"Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0519","name":"New pt-cg dyad dem low cmplx","description":"Management of new patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22818","name":"Kyphectomy 1-2 segments","description":"Kyphectomy, circumferential exposure of spine and resection of vertebral segment(s) (including body and posterior elements); single or 2 segments","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2607.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82270","name":"Occult blood feces","description":"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (ie, patient was provided 3 cards or single triple card for consecutive collection)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37272","name":"Revsc evsc fpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1151","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0484U","name":"Nfct ds mgen 23s rrna pt mut","description":"Nfct ds mgen 23s rrna pt mut","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0303U","name":"Hem rbc ads whl bld hypoxic","description":"Hem rbc ads whl bld hypoxic","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0415U","name":"Cv ds acs bld alg 5 yr score","description":"Cv ds acs bld alg 5 yr score","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1254","name":"Pts deceased prior hu surv","description":"Patients who were deceased when the hu survey reached them","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9051","name":"Inj, bortezomib (maia)","description":"Injection, bortezomib (maia), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37294","name":"Rvsc evsc tpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1350","name":"Pt w/ suic saf pln init rev","description":"Patients who had a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30630","name":"Repair nasal septum defect","description":"Repair nasal septal perforations","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":708.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1747","name":"Inj, spesolimab-sbzo, 1 mg","description":"Injection, spesolimab-sbzo, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0920T","name":"Rmvl perm ccm-d sys 1 pac ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous pacing lead only","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90792","name":"Psych diag eval w/med srvcs","description":"Psychiatric diagnostic evaluation with medical services","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":168.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0516U","name":"Rx metab rxgenomic gnotyp 40","description":"Rx metab rxgenomic gnotyp 40","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73592","name":"X-ray exam of leg infant","description":"Radiologic examination; lower extremity, infant, minimum of 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1188","name":"Pt w/ ckd stg 5","description":"Patients with a diagnosis of chronic kidney disease (ckd) stage 5","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1335","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4022","name":"Otolaryngology ss","description":"Otolaryngology mips specialty set","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0511U","name":"Onc sol tum 3dmicroenvir 36+","description":"Onc sol tum 3dmicroenvir 36+","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27824","name":"Treat lower leg fracture","description":"Closed treatment of fracture of weight bearing articular portion of distal tibia (eg, pilon or tibial plafond), with or without anesthesia; without manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76819","name":"Fetal biophys profil w/o nst","description":"Fetal biophysical profile; without non-stress testing","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9322","name":"Inj pemetrexed (bluepoint)","description":"Injection, pemetrexed (bluepoint), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1334","name":"Pts act pvd 2 wks 2 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 2 weeks after initial acute pvd encounter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9248","name":"Inj melphalan (hepzato) 1 mg","description":"Injection, melphalan (hepzato), 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53275","name":"Repair of urethra defect","description":"Excision or fulguration; urethral prolapse","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90834","name":"Psytx w pt 45 minutes","description":"Psychotherapy, 45 minutes with patient","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":98.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98016","name":"Brief comunicaj tech-bsd svc","description":"Brief communication technology-based service (eg, virtual check-in) by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related evaluation and management service provided within the p","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1208","name":"Pt no scrn sdoh","description":"Patient is not screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1211","name":"Gsa level>9.0%","description":"Most recent glycemic status assessment (hba1c or gmi) level > 9.0%","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37271","name":"Revsc evsc fpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60661","name":"Abltj 1/+thyr ndul addl prq","description":"Ablation of 1 or more thyroid nodule(s), additional lobe, percutaneous, including imaging guidance, radiofrequency (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0537U","name":"Onc clrct ca cfdna >2500 dmr","description":"Onc clrct ca cfdna >2500 dmr","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0139","name":"Inj, adalimumab, 1 mg","description":"Injection, adalimumab, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5992","name":"Low prosth foot shell repl","description":"All lower extremity prosthesis, foot shell for modular foot/non-solid ankle cushion heel (sach) replacement only","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4420","name":"Nuform per sq cm","description":"Nuform, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86304","name":"Immunoassay tumor ca 125","description":"Immunoassay for tumor antigen, quantitative; ca 125","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0687","name":"Inj cefazolin (wg crit care)","description":"Injection, cefazolin sodium (wg critical care), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33278","name":"Rmvl phrnc nrv stim sys","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; system, including pulse generator and lead(s)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4388","name":"Neothelium 4l per sq cm","description":"Neothelium 4l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6559","name":"G stckng full/chap18-30 cust","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34471","name":"Removal of vein clot","description":"Thrombectomy, direct or with catheter; subclavian vein, by neck incision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44605","name":"Repair of bowel lesion","description":"Suture of large intestine (colorrhaphy) for perforated ulcer, diverticulum, wound, injury or rupture (single or multiple perforations); with colostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1353.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15015","name":"App skn cl ssp agrft t/a/l 1","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; first 480 sq cm or less","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0355U","name":"Apol1 risk variants","description":"Apol1 risk variants","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22836","name":"Ant thrc vrt body tethrg <7","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; up to 7 vertebral segments","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9615","name":"Inj, pegulicianine, 1 mg","description":"Injection, pegulicianine, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1007T","name":"Eeg impl s-sclp eeg w/o vid","description":"Electroencephalogram from implanted sub-scalp continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2021","name":"Neomatrix per sq cm","description":"Neomatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0677T","name":"Laps repos lead isdss 1st ld","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first repositioned lead","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0602U","name":"Endocrin dm ins gen mthyltn","description":"Endocrin dm ins gen mthyltn","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96574","name":"Dbrdmt prmlg les w/pdt","description":"Debridement of premalignant hyperkeratotic lesion(s) (ie, targeted curettage, abrasion) followed with photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosensitizing drug(s) provide","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9323","name":"Inj pemetrexed ditromethamin","description":"Injection, pemetrexed ditromethamine, 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0491","name":"Inj anifrolumab-fnia 1mg","description":"Injection, anifrolumab-fnia, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2020","name":"Ac5 wound system","description":"Ac5 advanced wound system (ac5)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1246","name":"Pt othr thn true imprt to me","description":"Patient provided a response other than completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0882T","name":"Intraop ther estim pn ue 1st","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; initial nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27513","name":"Treatment of thigh fracture","description":"Open treatment of femoral supracondylar or transcondylar fracture with intercondylar extension, includes internal fixation, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1592.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0473","name":"Micro exam prep & report","description":"Accession of tissue gross and microscopic examination preparation and transmission of written report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0550","name":"Phone/inter for dx/treat >5m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a written report to the patients treating/r","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1317","name":"Pts counsl cpt opt out","description":"Patients who are counseled on connection with a csp and explicitly opt out","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76019","name":"Mr safety implt pos&/immoblj","description":"Mr safety implant positioning and/or immobilization under supervision of physician or other qualified health care professional, including application of physical protections to secure implanted medical device from mr-induced translational or vibrational forces, magnetically induced functional change","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2956","name":"Indirect rest remov","description":"Indirect rest remov","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4281","name":"Barrera slor dl per sq cm","description":"Barrera sl or barrera dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87077","name":"Culture aerobic identify","description":"Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0404","name":"Ekg tracing for initial prev","description":"Electrocardiogram, routine ecg with 12 leads; tracing only, without interpretation and report, performed as a screening for the initial preventive physical examination","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0856T","name":"Dgtz gls mcrscp electron mic","description":"Digitization of glass microscope slides for electron microscopy, diagnostic (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0685T","name":"Interrog dev eval isdss ip","description":"Interrogation device evaluation (in-person) with analysis, review and report by a physician or other qualified health care professional, including connection, recording and disconnection per patient encounter, permanent implantable synchronized diaphragmatic stimulation system for augmentation of ca","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0427U","name":"Monocyte dstrbj wdth whl bld","description":"Monocyte dstrbj wdth whl bld","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0725T","name":"Vestibular dev impltj uni","description":"Vestibular device implantation, unilateral","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37259","name":"Revsc evasc ivt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49596","name":"Rpr aa hrn 1st > 10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1277","name":"Colorectal ca screen doc rev","description":"Colorectal cancer screening results documented and reviewed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0281U","name":"Hem vwd propeptide ag lvl","description":"Hematology (von willebrand disease [vwd]), von willebrand propeptide, enzyme-linked immunosorbent assays (elisa), plasma, diagnostic report of von willebrand factor (vwf) propeptide antigen level","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0872T","name":"Rplcmt ndwllg bldr&prtl cath","description":"Replacement of indwelling bladder and peritoneal catheters, including tunneling of catheter(s) and connection with previously implanted peritoneal ascites pump, including imaging and programming, when performed","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1098","name":"Articaine ophthalmi 8% 0.4ml","description":"Articaine ophthalmic, 8% solution, 0.4 ml","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83529","name":"Asay of interleukin-6 (il-6)","description":"Interleukin-6 (il-6)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1215","name":"Med rsn for no doc spiro","description":"Documentation of medical reason(s) for not documenting and reviewing spirometry results (e.g., patients with dementia or tracheostomy)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92995","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0684","name":"App non-sheet skin sb g addl","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area or part thereof, or each additional 1% o","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37264","name":"Revsc evasc fpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15018","name":"App skn cll ssp f/n/g/hf ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 480 sq cm or part thereof (list separately in addition to code for prima","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7473","name":"Remove torus mandibularis","description":"Removal of torus mandibularis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21356","name":"Opn tx dprsd zygomatic arch","description":"Open treatment of depressed zygomatic arch fracture (eg, gillies approach)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":415.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1316","name":"Tobacco non-user","description":"Current tobacco non-user","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9988","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1324","name":"Pts intravitreal/pci","description":"Patients who had an intravitreal or periocular corticosteroid injection (e.g., triamcinolone, preservative-free triamcinolone, dexamethasone, dexamethasone intravitreal implant, or fluocinolone intravitreal implant)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83020","name":"Hemoglobin electrophoresis","description":"Hemoglobin fractionation and quantitation; electrophoresis (eg, a2, s, c, and/or f)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0476U","name":"Rx metab psyc 14gen&cyp2d6","description":"Rx metab psyc 14gen&cyp2d6","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0845T","name":"Dgtz gls mcrscp imfluor 1st","description":"Digitization of glass microscope slides for immunofluorescence, per specimen; initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84132","name":"Assay of serum potassium","description":"Potassium; serum, plasma or whole blood","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0886T","name":"Sgmdsc flx 1st tndsc dilat","description":"Sigmoidoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22614","name":"Arthrd pst tq 1ntrspc ea add","description":"Arthrodesis, posterior or posterolateral technique, single interspace; each additional interspace (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6252","name":"Bridge resin w/noble metal","description":"Pontic-resin with noble metal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0558","name":"Adv prim care mgmt lvl 3","description":"Advanced primary care management services for a patient that is a qualified medicare beneficiary with multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, which place the patient at significant risk of death, acute exacerbation/decompensat","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0445U","name":"Abeta42 & ptau181 eclia csf","description":"Abeta42 & ptau181 eclia csf","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0411","name":"Hba1c in office testing","description":"Hba1c in office testing","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0478U","name":"Onc nsclc dna&rna dpcr 9 gen","description":"Onc nsclc dna&rna dpcr 9 gen","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0556","name":"Adv prim care mgmt lvl 1","description":"Advanced primary care management services for a patient with one chronic condition [expected to last at least 12 months, or until the death of the patient, which place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline], or fewer, provided by clinical ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0628U","name":"Nfro kdn ds genetic cond 449","description":"Nfro kdn ds genetic cond 449","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3379","name":"Inj, valproate sod, 5 mg","description":"Injection, valproate sodium, 5 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77092","name":"Tbs i&r fx rsk qhp","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; interpretation and report on fracture-risk only by other qualified health care professional","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4385","name":"Apollo ft per sq cm","description":"Apollo ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99407","name":"Behav chng smoking > 10 min","description":"Smoking and tobacco use cessation counseling visit; intensive, greater than 10 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":22.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":33.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"Rec cath any transanal, each","description":"Rectal catheter with or without balloon, for use with any type transanal irrigation system, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81349","name":"Cytog alys chrml abnr lw-ps","description":"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and loss-of-heterozygosity variants, low-pass sequencing analysis","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"Ak 4 bar link hydl swg/stanc","description":"Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85014","name":"Hematocrit","description":"Blood count; hematocrit (hct)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77091","name":"Tbs techl calculation only","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical calculation only","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1492","name":"No reported fall","description":"Patients who did not report a fall","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0626U","name":"Neurol pd dna alys >20000","description":"Neurol pd dna alys >20000","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59622","name":"Attempted vbac after care","description":"Cesarean delivery only, following attempted vaginal delivery after previous cesarean delivery; including postpartum care","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1177.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59514","name":"Cesarean delivery only","description":"Cesarean delivery only;","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":768.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9986","name":"Missed appointment","description":"Missed appointment","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34802","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1544.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5946","name":"Max implt sup fix","description":"Max implt sup fix","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4318","name":"Fem urinary cup w/wo attch","description":"Female external urinary collection cup, with or without ring attachment, per day","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1805","name":"Inj, esmolol hcl, 10mg","description":"Injection, esmolol hydrochloride, 10 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0542U","name":"Nefro renal trnspl ur nmr 84","description":"Nefro renal trnspl ur nmr 84","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1501","name":"Pathology mvp","description":"Pathology mips value pathway","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1254","name":"Pts deceased prior hu surv","description":"Patients who were deceased when the hu survey reached them","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33502","name":"Coronary artery correction","description":"Repair of anomalous coronary artery from pulmonary artery origin; by ligation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6191","name":"Semi precision abutment","description":"Semi precision abutment","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64804","name":"Sympathectomy cervicothorac","description":"Sympathectomy, cervicothoracic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1072.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49614","name":"Rpr aa hrn rcr < 3 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, incarcerated or strangulated","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3387","name":"Inj elivaldogene autotemecel","description":"Injection, elivaldogene autotemcel, per treatment","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41120","name":"Partial removal of tongue","description":"Glossectomy; less than one-half tongue","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1182.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0355U","name":"Apol1 risk variants","description":"Apol1 risk variants","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15341","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4421","name":"Biolab wrap solo per sq cm","description":"Biolab membrane wrap solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4036","name":"Urgent care ss","description":"Urgent care mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4395","name":"Acelagraft per sq cm","description":"Acelagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0867T","name":"Tpla b9 prst8 hyprplsa>=50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume greater or equal to 50 ml","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6074","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (noble metal)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0626U","name":"Neurol pd dna alys >20000","description":"Neurol pd dna alys >20000","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0278U","name":"Hem gen thrombosis 12 genes","description":"Hematology (genetic thrombosis), genomic sequence analysis of 12 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0661","name":"Team remote e/m new pt 20 mn","description":"Team remote e/m new pt 20mins","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92945","name":"Prq trl rvs ch occ ant&rtrgr","description":"Percutaneous transluminal revascularization of chronic total occlusion, single coronary artery, coronary artery branch, or coronary artery bypass graft, and/or subtended major coronary artery branches of the bypass graft, any combination of intracoronary stent, atherectomy and angioplasty; combined ","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86363","name":"Mog-igg1 antb flo cytmtry ea","description":"Myelin oligodendrocyte glycoprotein (mog-igg1) antibody; flow cytometry (ie, fluorescence-activated cell sorting [facs]), each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4292","name":"Lamellas, per sq cm","description":"Lamellas, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2470","name":"Inj pantoprazole sodium 40mg","description":"Injection, pantoprazole sodium, 40 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0297U","name":"Onc pan tum whl gen seq dna","description":"Onc pan tum whl gen seq dna","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85610","name":"Prothrombin time","description":"Prothrombin time;","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91323","name":"Sarscov2 vac 10 mcg/0.2ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 10 mcg/0.2 ml dosage, for intramuscular use","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33904","name":"Perq p-art revsc each addl","description":"Percutaneous pulmonary artery revascularization by stent placement, each additional vessel or separate lesion, normal or abnormal connections (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99471","name":"Ped critical care initial","description":"Initial inpatient pediatric critical care, per day, for the evaluation and management of a critically ill infant or young child, 29 days through 24 months of age","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":659.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1321","name":"Pts no 7wk inj,no iop,iop>25","description":"Patients who were not seen within 7 weeks following the date of injection for follow up or who did not have a documented iop or no plan of care documented if the iop was >25 mm hg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38505","name":"Needle biopsy lymph nodes","description":"Biopsy or excision of lymph node(s); by needle, superficial (eg, cervical, inguinal, axillary)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0219","name":"Inj aval alfa-nqpt 4mg","description":"Injection, avalglucosidase alfa-ngpt, 4 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0712T","name":"N-nvs artl plaq alys quan","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess atherosclerotic plaque stability","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87467","name":"Hepatitis b surface ag quan","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; hepatitis b surface antigen (hbsag), quantitative","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0439U","name":"Crd chd dna alys 5 snp 3 dna","description":"Crd chd dna alys 5 snp 3 dna","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4316","name":"Amchoplast, per sq cm","description":"Amchoplast, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0609","name":"Ferric citrate orl 3 mg iron","description":"Ferric citrate, oral, 3 mg ferric iron, (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1254","name":"Pts deceased prior hu surv","description":"Patients who were deceased when the hu survey reached them","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0928T","name":"Rem interrog dev ccm-d phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system with interim analysis and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6039","name":"Passive custom digit/thumb","description":"Passive prosthetic digit or thumb prosthesis not including hand restoration partial hand, full or partial, custom made, any material, initial or replacement, per single passive prosthetic digit or thumb","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1300","name":"Flu imm no admin doc rea","description":"Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57000","name":"Colpotomy w/exploration","description":"Colpotomy; with exploration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0237","name":"Intrav inf, toci, first dose","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9996","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30901","name":"Control of nosebleed","description":"Control nasal hemorrhage, anterior, simple (limited cautery and/or packing) any method","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":191.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0721T","name":"Quan ct tiss charac w/o ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1576","name":"Inj, panzyga, 500 mg","description":"Injection, immune globulin (panzyga), intravenous, non-lyophilized (e.g., liquid), 500 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1237","name":"Pt rsn no scrn","description":"Patient reason for not screening for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety (e.g., patient declined or other patient reasons)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0545","name":"Inherent visit to inpt","description":"Visit complexity inherent to hospital inpatient or observation care associated with a confirmed or suspected infectious disease by an infectious diseases specialist, including disease transmission risk assessment and mitigation, public health investigation, analysis, and testing, and complex antimic","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7294","name":"Seg acet and eth estr yearly","description":"Segesterone acetate and ethinyl estradiol 0.15mg, 0.013mg per 24 hours; yearly vaginal system, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9432","name":"Med food non inborn err meta","description":"Medical foods for non-inborn errors of metabolism","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43331","name":"Esophagomyotomy thoracic","description":"Esophagomyotomy (heller type); thoracic approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1468.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1395","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1495","name":"Fall w/ poc, no fall","description":"Patients that reported a fall occurred who had a plan of care for falls documented or patients that did not report a fall","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88311","name":"Decalcify tissue","description":"Decalcification procedure (list separately in addition to code for surgical pathology examination)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1313","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0163","name":"Epinephrine in nacl (endo)","description":"Injection, epinephrine in sodium chloride (endo), 0.1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1369","name":"Qualcare mental hlth/sud mvp","description":"Quality care in mental health and substance use disorders mips value pathway","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0406U","name":"Onc lung flow cytmtry 5 mrk","description":"Onc lung flow cytmtry 5 mrk","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94375","name":"Respiratory flow volume loop","description":"Respiratory flow volume loop","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1168","name":"Pt recd flu vax 7/1-6/30","description":"Patient received an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63250","name":"Revise spinal cord vsls crvl","description":"Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; cervical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3194.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99385","name":"Prev visit new age 18-39","description":"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; 18-39 years","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":151.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93596","name":"R&l hrt cath chd nml nt cnj","description":"Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); normal native connections","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28225","name":"Release of foot tendon","description":"Tenolysis, extensor, foot; single tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0403U","name":"Onc prst8 mrna 18 gen dre ur","description":"Onc prst8 mrna 18 gen dre ur","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44390","name":"Colonoscopy for foreign body","description":"Colonoscopy through stoma; with removal of foreign body(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0776T","name":"Ther indctj ntrabrn hypthrm","description":"Therapeutic induction of intra-brain hypothermia, including placement of a mechanical temperature-controlled cooling device to the neck over carotids and head, including monitoring (eg, vital signs and sport concussion assessment tool 5 [scat5]), 30 minutes of treatment","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1354","name":"Int caries med app per tooth","description":"Interim caries med app","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4013","name":"Mntal/behav/psych hlth ss","description":"Mental/behavioral and psychiatry mips specialty set","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0430U","name":"Gi malabs aat calpro pncrtc","description":"Gi malabs aat calpro pncrtc","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1185","name":"Imm ckpt inhib not hld no rx","description":"Documentation of immune checkpoint inhibitor therapy not held and/or corticosteroids or immunosuppressants prescribed or administered was not performed, reason not given","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2034","name":"Found drs solo, per sq cm","description":"Foundation drs solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0274U","name":"Hem gen pltlt do 43 genes","description":"Hematology (genetic platelet disorders), genomic sequence analysis of 43 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0803","name":"3d facial scan direct","description":"3d facial scan direct","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0438U","name":"Rx metab advrs vrnt alys 33","description":"Rx metab advrs vrnt alys 33","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D8671","name":"Periodic orth treat w surg","description":"Periodic orth treat w surg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31290","name":"Nasal/sinus endoscopy surg","description":"Nasal/sinus endoscopy, surgical, with repair of cerebrospinal fluid leak; ethmoid region","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1370.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1354","name":"Pt no suicd saf pln 120dy","description":"Patients who did not have a suicide safety plan initiated, reviewed, or updated or reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92642","name":"Hearing asstv dev fitg svc","description":"Hearing assistive device, supplemental technology fitting services (eg, personal frequency modulation [fm]/digital modulation [dm] system, remote microphone, alerting devices)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1224","name":"Iop dec <20% from base","description":"Intraocular pressure (iop) reduced by a value less than 20% from the pre-intervention level","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37256","name":"Revsc evasc ivt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0491","name":"Inj anifrolumab-fnia 1mg","description":"Injection, anifrolumab-fnia, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49606","name":"Repair umbilical lesion","description":"Repair of large omphalocele or gastroschisis; with removal of prosthesis, final reduction and closure, in operating room","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2024","name":"Resolve or xenopatch sq cm","description":"Resolve matrix or xenopatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83716","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49190","name":"Opn exc/dstr ntra-abd >30 cm","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); greater than 30 cm","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27713","name":"Osteot tibia imed lngth dev","description":"Osteotomy(ies), tibia, including fibula when performed, unilateral, with insertion of an externally controlled intramedullary lengthening device, including imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1392","name":"Pt rsn no exm or lst to fu","description":"Documentation of patient reasons for no examination, i.e., refusal of examination or lost to follow-up (documentation must include information that the clinician was unable to reach the patient by phone, mail or secure electronic mail - at least one method must be documented)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4347","name":"Rampart dl matrix per sq cm","description":"Rampart dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96547","name":"Intraop hipec px 1st 60 min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; first 60 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99223","name":"1st hosp ip/obs high 75","description":"Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 75 minutes must","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":177.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85009","name":"Manual diff wbc count b-coat","description":"Blood count; manual differential wbc count, buffy coat","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9004","name":"Va whole health partner serv","description":"Department of veterans affairs whole health partner services","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6034","name":"Part hand finger distal amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s)/thumb, amputation at distal to metacarpal joint, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l669","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9286","name":"Inj glofitamab gxbm, 2.5 mg","description":"Injection, glofitamab-gxbm, 2.5 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0010","name":"Eom meos payment","description":"Enhancing oncology model (eom) monthly enhanced oncology services (meos) payment for eom enhanced services","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1391","name":"All pt dx w/ rec mlnm","description":"All patients who were diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4428","name":"Dermbnd sln sl+ slx sq cm","description":"Dermabind sl n or dermabind sl + or dermabind sl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0846T","name":"Dgtz gls mcrscp imfluor ea","description":"Digitization of glass microscope slides for immunofluorescence, per specimen; each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86332","name":"Immune complex assay","description":"Immune complex assay","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76015","name":"Mr sfty mplt&/fb asmt stf ea","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64560","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4360","name":"Amchoplast fd per sq cm","description":"Amchoplast fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24330","name":"Flexor-plasty elbow","description":"Flexor-plasty, elbow (eg, steindler type advancement);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":870.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1072","name":"Inj, testosterone, azmiro","description":"Injection, testosterone cypionate (azmiro), 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9347","name":"Inj, tremelimumab-actl, 1 mg","description":"Injection, tremelimumab-actl, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1259","name":"Pt stat doc <= 1 yr dialysis","description":"Patient status documented within the first year of initiating dialysis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58555","name":"Hysteroscopy dx sep proc","description":"Hysteroscopy, diagnostic (separate procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":379.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01941","name":"Anes neuromd/ntrvrt crv/thrc","description":"Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0738","name":"Upper extremity rehab","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3393","name":"Inj, betibeglogene autotemce","description":"Injection, betibeglogene autotemcel, per treatment","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44408","name":"Colonoscopy w/decompression","description":"Colonoscopy through stoma; with decompression (for pathologic distention) (eg, volvulus, megacolon), including placement of decompression tube, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2027","name":"Matriderm per sq cm","description":"Matriderm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0908T","name":"Opn imp int nstm sys vgs nrv","description":"Open implantation of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0358U","name":"Neuro alys b-amyl 1-42&1-40","description":"Neuro alys b-amyl 1-42&1-40","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0558","name":"Adv prim care mgmt lvl 3","description":"Advanced primary care management services for a patient that is a qualified medicare beneficiary with multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, which place the patient at significant risk of death, acute exacerbation/decompensat","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55709","name":"Bx prst8 tprnl us guided","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4335","name":"Amnioplast 2, per sq cm","description":"Amnioplast 2, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60660","name":"Abltj 1/+thyr ndul 1lobe prq","description":"Ablation of 1 or more thyroid nodule(s), one lobe or the isthmus, percutaneous, including imaging guidance, radiofrequency","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15956","name":"Exc trchntr pr ulc prep flap","description":"Excision, trochanteric pressure ulcer, in preparation for muscle or myocutaneous flap or skin graft closure;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1285.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37242","name":"Vasc embolize/occlude artery","description":"Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; arterial, other than hemorrhage or tumor (eg, congenital or acquired arterial malformations, arteriovenous malfo","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8584.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90961","name":"Esrd srv 2-3 vsts p mo 20+","description":"End-stage renal disease (esrd) related services monthly, for patients 20 years of age and older; with 2-3 face-to-face visits by a physician or other qualified health care professional per month","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76015","name":"Mr sfty mplt&/fb asmt stf ea","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80506","name":"Path clin consltj prolng svc","description":"Pathology clinical consultation; prolonged service, each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1010","name":"Inj, methylpred acetate 1 mg","description":"Injection, methylprednisolone acetate, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1806","name":"Inj esmolol hcl wg crit care","description":"Injection, esmolol hydrochloride (wg critical care), not therapeutically equivalent to j1805, 10 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4366","name":"Dl amnio bur x-mem per sq cm","description":"Dual layer amnio burgeon x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0340U","name":"Onc pan ca alys mrd plasma","description":"Onc pan ca alys mrd plasma","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4310","name":"Procenta, per 100 mg","description":"Procenta, per 100 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0350U","name":"Rx metab/pcx dna 27 gen alys","description":"Rx metab/pcx dna 27 gen alys","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0683","name":"App of non-sheet skin sub g","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4433","name":"361 hct/p skin subs, nos","description":"361 hct/p skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1175","name":"Doc med rsn no hzv","description":"Documentation of medical reason(s) for not administering zoster vaccine (e.g., prior anaphylaxis due to the zoster vaccine)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4398","name":"Summit ac per sq cm","description":"Summit ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1502","name":"Podiatry mvp","description":"Podiatry mips value pathway","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4402","name":"Xwrap 2.0 per sq cm","description":"Xwrap 2.0, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1287","name":"Calc bmi blw low param f/u","description":"Bmi is documented below normal parameters and a follow-up plan is documented","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1954","name":"Inj leu acet lutr dpt 7.5 mg","description":"Injection, leuprolide acetate for depot suspension (lutrate depot), 7.5 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83872","name":"Assay synovial fluid mucin","description":"Mucin, synovial fluid (ropes test)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0312U","name":"Ai ds sle alys 8 igg autoant","description":"Ai ds sle alys 8 igg autoant","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92642","name":"Hearing asstv dev fitg svc","description":"Hearing assistive device, supplemental technology fitting services (eg, personal frequency modulation [fm]/digital modulation [dm] system, remote microphone, alerting devices)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1458","name":"Pt died bef end meas pd","description":"Patient died prior to the end of the performance period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5765","name":"Liner compl/partial rem dent","description":"Liner compl/partial rem dent","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0010","name":"Admin hepatitis b vaccine","description":"Administration of hepatitis b vaccine","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1165","name":"Pt use hspc dur meas pd","description":"Patients who use hospice services any time during the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98015","name":"Synch audio-only est high 40","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selec","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9048","name":"Inj, bortezomib freseniuskab","description":"Injection, bortezomib (fresenius kabi), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75946","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82962","name":"Glucose blood test","description":"Glucose, blood by glucose monitoring device(s) cleared by the fda specifically for home use","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90382","name":"Rsv monoc antb seasn .7ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose, 0.7 ml, for intramuscular use","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0405","name":"Ekg interpret & report preve","description":"Electrocardiogram, routine ecg with 12 leads; interpretation and report only, performed as a screening for the initial preventive physical examination","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0387U","name":"Onc mlnma ambra1&amlo","description":"Onc mlnma ambra1&amlo","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":6.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0392U","name":"Rx metab genrx ia 16 genes","description":"Rx metab genrx ia 16 genes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76984","name":"Dx intraop thoracic aorta us","description":"Ultrasound, intraoperative thoracic aorta (eg, epiaortic), diagnostic","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0038","name":"Clin pt no ref","description":"Clinician determines patient does not require referral","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2794","name":"Crown-titanium","description":"Crown-titanium","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9562","name":"Tc99m mertiatide","description":"Technetium tc-99m mertiatide, diagnostic, per study dose, up to 15 millicuries","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4005","name":"Family medicine ss","description":"Family medicine mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4352","name":"Overlay sl matrix, per sq cm","description":"Overlay sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0524","name":"Est pt-cg dyad dem low cmplx","description":"Management of established patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0237","name":"Inj, tocilizumab-anoh, hospi","description":"Injection, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1836","name":"Inj, metronidazole, 10 mg","description":"Injection, metronidazole, 10 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9056","name":"Inj, vivimusta, 1 mg","description":"Injection, bendamustine hydrochloride (vivimusta), 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1479","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0407U","name":"Neph dbtc ckd mult eclia alg","description":"Neph dbtc ckd mult eclia alg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1218","name":"Pt copd symptoms","description":"Patient has copd symptoms (e.g., dyspnea, cough/sputum, wheezing)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0249","name":"Tocilizumab for covid-19","description":"Injection, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1224","name":"Iop dec <20% from base","description":"Intraocular pressure (iop) reduced by a value less than 20% from the pre-intervention level","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87812","name":"Sarscov2&inf typ a&b w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) and influenza virus types a and b","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64582","name":"Opn mpltj hpglsl nstm ary pg","description":"Open implantation of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98013","name":"Synch audio-only est low 20","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code select","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64467","name":"Thrc fascial pln blk uni nfs","description":"Thoracic fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0039","name":"Pt no ref, rn spec","description":"Patient not referred, reason not otherwise specified","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77370","name":"Radiation physics consult","description":"Special medical radiation physics consultation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99445","name":"Rem mntr physiol param 2-15","description":"Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate); device(s) supply with daily recording(s) or programmed alert(s) transmission, 2-15 days in a 30-day period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9268","name":"Programmer orally ingest cap","description":"Programmer for transient, orally ingested capsule","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9949","name":"Repair sleep apnea appliance","description":"Repair sleep apnea appliance","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87116","name":"Mycobacteria culture","description":"Culture, tubercle or other acid-fast bacilli (eg, tb, afb, mycobacteria) any source, with isolation and presumptive identification of isolates","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98014","name":"Synch audio-only est mod 30","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code s","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0540","name":"Train for caregiver add 15","description":"Caregiver training in behavior management/modification for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face; each additional 15 minutes","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4032","name":"Rheumatology ss","description":"Rheumatology mips specialty set","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1932","name":"Inj, lanreotide, (cipla) 1mg","description":"Injection, lanreotide, (cipla), 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0302U","name":"Iadna brtnla ddpcr flwg liq","description":"Iadna brtnla ddpcr flwg liq","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0341U","name":"Ftl aneup dna seq cmpr alys","description":"Ftl aneup dna seq cmpr alys","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0956T","name":"Prt crn ch cr&tun elt s-sclp","description":"Partial craniectomy, channel creation, and tunneling of electrode for sub-scalp implantation of an electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01940","name":"Anes nulyt agt lmbr/sac","description":"Anesthesia for percutaneous image-guided destruction procedures by neurolytic agent on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1576","name":"Inj, panzyga, 500 mg","description":"Injection, immune globulin (panzyga), intravenous, non-lyophilized (e.g., liquid), 500 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2020","name":"Ac5 wound system","description":"Ac5 advanced wound system (ac5)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92972","name":"Perq trluml coronry lithotrp","description":"Percutaneous transluminal coronary lithotripsy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44055","name":"Correct malrotation of bowel","description":"Correction of malrotation by lysis of duodenal bands and/or reduction of midgut volvulus (eg, ladd procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1491.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90484","name":"Imm cnsl not admn sm>20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 20 minutes","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2305","name":"Inj, nitroglycerin, 5 mg","description":"Injection, nitroglycerin, 5 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1010T","name":"Cptr oph alys monoc eye mvmt","description":"Computerized ophthalmic analysis of monocular eye movements using retinal-based eye-tracking without spatial calibration, including fixation, microsaccades, drift, and horizontal saccades, when performed, unilateral or bilateral, with interpretation and report","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1368","name":"Prev trt inf d/o hiv/hep mvp","description":"Prevention and treatment of infectious disorders including hepatitis c and hiv mips value pathway","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0728T","name":"Dx alys vstblr implt uni 1st","description":"Diagnostic analysis of vestibular implant, unilateral; with initial programming","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0878T","name":"Augmnt alys ch ct ild w/ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained with concurrent ct examination of the same structure","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5943","name":"Proth mandib implt sup remv","description":"Proth mandib implt sup remv","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86043","name":"Acetylcholn rcptr modlg antb","description":"Acetylcholine receptor (achr); modulating antibody","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9291","name":"Pres dig cog behav thera fda","description":"Prescription digital cognitive and/or behavioral therapy, fda cleared, per course of treatment","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15778","name":"Impl absrb msh/prsth dly cls","description":"Implantation of absorbable mesh or other prosthesis for delayed closure of defect(s) (ie, external genitalia, perineum, abdominal wall) due to soft tissue infection or trauma","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1456","name":"Pt had htx","description":"Patient had a heart transplant","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77090","name":"Tbs techl prep&transmis data","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0914T","name":"Prq tcat thr rx ntrc bal sep","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting) performed on a separate target lesion from the target lesion treated with balloon angioplasty, coronary stent placement or coronary atherectomy, including mechanical dilation b","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1105","name":"Dexmedetomidine film, 1 mcg","description":"Dexmedetomidine, oral, 1 mcg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52310","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from urethra or bladder (separate procedure); simple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64469","name":"Thrc fascial pln blk bi nfs","description":"Thoracic fascial plane block, bilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0373","name":"Tomo bitewing image","description":"Tomo bitewing image","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61736","name":"Litt icr 1 traj 1 smpl les","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; single trajectory for 1 simple lesion","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86825","name":"Hla x-math non-cytotoxic","description":"Human leukocyte antigen (hla) crossmatch, non-cytotoxic (eg, using flow cytometry); first serum sample or dilution","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0801","name":"3d dental scan direct","description":"3d dental scan direct","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6604","name":"G com bandge low dn foam flt","description":"Gradient compression bandaging supply, low density flat foam sheet, per 250 square centimeters, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37291","name":"Revsc evsc tpvt athr cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0676T","name":"Laps insj nw/rpcmt isdss ea","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional lead (list separately in addition to code for primary ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6106","name":"Tissue regen resorbable","description":"Tissue regen resorbable","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0703","name":"2d oral/facial photo image","description":"2d oral/facial photo image","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0928T","name":"Rem interrog dev ccm-d phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system with interim analysis and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0994T","name":"Evasc dlvr a-wal stbl rx prq","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; percutaneous","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5137","name":"Inj, wezlana, sub cu, 1 mg","description":"Injection, ustekinumab-auub (wezlana), biosimilar, subcutaneous, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0737T","name":"Xenograft impltj artclr surf","description":"Xenograft implantation into the articular surface","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2050","name":"Financial mgt waiver/diem","description":"Financial management, self-directed, waiver; per diem","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0797T","name":"Tcat ins 2chmbr ldls pm rv","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ventricular pace","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43497","name":"Transorl lwr esophgl myotomy","description":"Lower esophageal myotomy, transoral (ie, peroral endoscopic myotomy [poem])","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94014","name":"Patient recorded spirometry","description":"Patient-initiated spirometric recording per 30-day period of time; includes reinforced education, transmission of spirometric tracing, data capture, analysis of transmitted data, periodic recalibration and review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0970T","name":"Ablt b9 brst tum perq lsr ea","description":"Ablation, benign breast tumor (eg, fibroadenoma), percutaneous, laser, including imaging guidance when performed, each tumor","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92571","name":"Filtered speech test","description":"Filtered speech test","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1500","name":"Neuropsychology mvp","description":"Neuropsychology mips value pathway","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37264","name":"Revsc evasc fpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1024T","name":"Perq tiss dsplmt soft tissue","description":"Percutaneous tissue displacement, any method, including imaging guidance; soft tissue (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1025","name":"Pt mnth 1 mcp prov","description":"Patient-months where there are more than one medicare capitated payment (mcp) provider listed for the month","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1304","name":"No pneum vax admin 19+","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0388","name":"Bitewing image capture only","description":"Bitewing image capture only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1218","name":"Pt copd symptoms","description":"Patient has copd symptoms (e.g., dyspnea, cough/sputum, wheezing)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1422","name":"Gastroenterology care mvp","description":"Gastroenterology care mips value pathway","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0374","name":"Tomo periapical image","description":"Tomo periapical image","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0550","name":"Phone/inter for dx/treat >5m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a written report to the patients treating/r","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1023T","name":"Prq tis dsplmt intrathoracic","description":"Percutaneous tissue displacement, any method, including imaging guidance; intrathoracic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1479","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0700T","name":"Molec fluor img sus nev 1st","description":"Molecular fluorescent imaging of suspicious nevus; first lesion","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0792T","name":"Appl slvr diamn fluoride 38%","description":"Application of silver diamine fluoride 38%, by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0529U","name":"Hem vte snp f2&f5 gen leiden","description":"Hem vte snp f2&f5 gen leiden","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1226","name":"Iop not doc","description":"Iop measurement not documented, reason not otherwise specified","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86366","name":"Muscle-specific kinase antb","description":"Muscle-specific kinase (musk) antibody","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85027","name":"Complete cbc automated","description":"Blood count; complete (cbc), automated (hgb, hct, rbc, wbc and platelet count)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93145","name":"Interrog crtd sins bat ip wo","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72127","name":"Ct neck spine w/o & w/dye","description":"Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":530.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1341","name":"Pt no f/u 30-180 dys","description":"Patients who did not have a follow-up assessment or did not have an assessment within 30 to 180 days after the index assessment during the performance period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0206","name":"Inj allopurinol sodium 1 mg","description":"Injection, allopurinol sodium, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0281U","name":"Hem vwd propeptide ag lvl","description":"Hematology (von willebrand disease [vwd]), von willebrand propeptide, enzyme-linked immunosorbent assays (elisa), plasma, diagnostic report of von willebrand factor (vwf) propeptide antigen level","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25393","name":"Lengthen radius & ulna","description":"Osteoplasty, radius and ulna; lengthening with autograft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1664.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2402","name":"Chloroprocaine (clorotekal)","description":"Injection, chloroprocaine hydrochloride (clorotekal), per 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0584U","name":"Neuro csf prion prtn qual","description":"Neuro csf prion prtn qual","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2542","name":"Dental onlay metallic 2 surf","description":"Onlay-metallic-two surfaces","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37256","name":"Revsc evasc ivt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0971T","name":"Ablt mal brst tum pq lsr uni","description":"Ablation, malignant breast tumor(s), percutaneous, laser, including imaging guidance when performed, unilateral","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70540","name":"Mri orbit/face/neck w/o dye","description":"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":643.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8611","name":"Oral methotrexate (jylamvo)","description":"Methotrexate (jylamvo), oral, 2.5 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4322","name":"Caregraft, per sq cm","description":"Caregraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51845","name":"Repair bladder neck","description":"Abdomino-vaginal vesical neck suspension, with or without endoscopic control (eg, stamey, raz, modified pereyra)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":672.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4345","name":"Matrix hd allogrft per sq cm","description":"Matrix hd allograft dermis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87188","name":"Sc std macrobroth dil meth","description":"Susceptibility studies, antimicrobial agent; macrobroth dilution method, each agent","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0955T","name":"Tot impl amei removal","description":"Totally implantable active middle ear hearing implant; removal, including removal of sound processor and all implant components","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10061","name":"I&d abscess comp/multiple","description":"Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); complicated or multiple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":77.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":259.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0445","name":"High inten beh couns std 30m","description":"High intensity behavioral counseling to prevent sexually transmitted infection; face-to-face, individual, includes: education, skills training and guidance on how to change sexual behavior; performed semi-annually, 30 minutes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":29.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1270","name":"Pts no kid transplt wtlst","description":"Patients not on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1202","name":"Pt rsn no ace-i/arb rx","description":"Documentation of patient reason(s) for not prescribing ace inhibitor or arb therapy during the measurement period, (e.g., patient declined, other patient reasons)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1365","name":"Hosp+pall care spec code 17","description":"Patient encounter during the performance period with hospice and palliative care specialty code 17","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0926T","name":"Prgrmg dev eval ccm-d ip","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, including review and report, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36470","name":"Njx sclrsnt 1 incmptnt vein","description":"Injection of sclerosant; single incompetent vein (other than telangiectasia)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0607U","name":"Reprdtve med ema rtpcr 31bct","description":"Reprdtve med ema rtpcr 31bct","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0010","name":"Eom meos payment","description":"Enhancing oncology model (eom) monthly enhanced oncology services (meos) payment for eom enhanced services","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33762","name":"Shunt desc aorta to pulm art","description":"Shunt; descending aorta to pulmonary artery (potts-smith type operation)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1570.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21345","name":"Closed tx nose/jaw fx","description":"Closed treatment of nasomaxillary complex fracture (lefort ii type), with interdental wire fixation or fixation of denture or splint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":733.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64655","name":"Revj/rplcmt bat mod sys lead","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; lead only","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0806T","name":"Tcat s&ivc prstc vl impl opn","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); open femoral vein approach","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0960T","name":"Rpl s-sclp eltr ra rcvr&tlmt","description":"Replacement of sub-scalp implanted electrode array, receiver, and telemetry unit with tunneling of electrode for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0474","name":"Micro w exam of surg margins","description":"Accession of tissue gross and microscopic examination including assessment of surgical margins for presence of disease preparation and transmission of writte","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54360","name":"Penis plastic surgery","description":"Plastic operation on penis to correct angulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":824.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94618","name":"Pulmonary stress testing","description":"Pulmonary stress testing (eg, 6-minute walk test), including measurement of heart rate, oximetry, and oxygen titration, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4341","name":"Simplimax, per sq cm","description":"Simplimax, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1295","name":"Pt hx tot col or colon ca","description":"Patients with a diagnosis or past history of total colectomy or colorectal cancer","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92632","name":"Hearing aid slctn svc ea add","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4331","name":"Axolotl graft, per sq cm","description":"Axolotl graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99412","name":"Preventive counseling group","description":"Preventive medicine counseling and/or risk factor reduction intervention(s) provided to individuals in a group setting (separate procedure); approximately 60 minutes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":28.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1314","name":"Bmi not calculated","description":"Bmi not documented and no reason is given","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1339","name":"Pts f/u 30-180 dys + improv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who demonstrated positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1105","name":"Dexmedetomidine film, 1 mcg","description":"Dexmedetomidine, oral, 1 mcg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37272","name":"Revsc evsc fpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9276","name":"Inj zanidatamab-hrii, 2 mg","description":"Injection, zanidatamab-hrii, 2 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4404","name":"Xwrap hydro plus per sq cm","description":"Xwrap hydro plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0781T","name":"Brnchsc rf dstrj pulm nrv bi","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; bilateral mainstem bronchi","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2003","name":"Inj, lidocaine hcl, 1 mg","description":"Injection, lidocaine hydrochloride, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68815","name":"Probe nasolacrimal duct","description":"Probing of nasolacrimal duct, with or without irrigation; with insertion of tube or stent","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0483","name":"Indirect immunofluorescence","description":"Indirect immunofluorescence","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1353","name":"Pts no cmplt suicd saf pln","description":"Patients who did not have a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98005","name":"Synch audio-video est low 20","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low medical decision making. when using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97037","name":"Appl modality 1+lllt po pain","description":"Application of a modality to 1 or more areas; low-level laser therapy (ie, nonthermal and non-ablative) for post-operative pain reduction","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76810","name":"Ob us >/= 14 wks addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0600U","name":"Nfct ds wnd infctj 65orgs&30","description":"Nfct ds wnd infctj 65orgs&30","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1711","name":"Moderna vacc admin booster","description":"Moderna vacc admin booster","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82960","name":"Test for g6pd enzyme","description":"Glucose-6-phosphate dehydrogenase (g6pd); screen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0225","name":"Inj, vutrisiran, 1 mg","description":"Injection, vutrisiran, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7414","name":"Excision malig lesion>1.25cm","description":"Excision of malignant lesion greater than 1.25 cm","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9273","name":"Inj tisotu vedotin-tftv, 1mg","description":"Injection, tisotumab vedotin-tftv, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0548","name":"Phone/inter svs 21-30 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8607","name":"Inj vocal cord bulking agent","description":"Injectable bulking agent for vocal cord medialization, 0.1 ml, includes shipping and necessary supplies","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90484","name":"Imm cnsl not admn sm>20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 20 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0615","name":"Calcium acetate, oral, 23 mg","description":"Calcium acetate, oral, 23 mg (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1404","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36482","name":"Endoven ther chem adhes 1st","description":"Endovenous ablation therapy of incompetent vein, extremity, by transcatheter delivery of a chemical adhesive (eg, cyanoacrylate) remote from the access site, inclusive of all imaging guidance and monitoring, percutaneous; first vein treated","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1573.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":150.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0681","name":"App of non-sheet skin sub","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; first 25 sq cm or less of wound surface area","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27724","name":"Repair/graft of tibia","description":"Repair of nonunion or malunion, tibia; with iliac or other autograft (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1533.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0512U","name":"Onc prst8 alys dgtz img msi","description":"Onc prst8 alys dgtz img msi","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0742T","name":"Aqmbf spect xers/strs & rest","description":"Absolute quantitation of myocardial blood flow (aqmbf), single-photon emission computed tomography (spect), with exercise or pharmacologic stress, and at rest, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1939","name":"Inj, bumetanide, 0.5 mg","description":"Injection, bumetanide, 0.5 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0761T","name":"Dgtz gls mcrscp sl imm ea 1","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0911","name":"Inst tauro 1.35mg/hep 100u","description":"Instillation, taurolidine 1.35 mg and heparin sodium 100 units (central venous catheter lock for adult patients receiving chronic hemodialysis)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33894","name":"Evasc st rpr thrc/aa acrs br","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; across major side branches","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1424","name":"Pulmonology care mvp","description":"Pulmonology care mips value pathway","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98979","name":"Rtm tx mgmt 1st 10 min","description":"Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least 1 real-time interactive communication with the patient or caregiver during the calendar month; first 10 minutes","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4271","name":"Home lancing/test cartridges","description":"Integrated lancing and blood sample testing cartridges for home blood glucose monitor, per 50 tests","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0474U","name":"Hered pan ca gsap 88gene ngs","description":"Hered pan ca gsap 88gene ngs","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69636","name":"Rebuild eardrum structures","description":"Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic membrane repair); with ossicular chain reconstruction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1620.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4018","name":"Ob/gyn ss","description":"Obstetrics/gynecology mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4278","name":"Epieffect, per sq cm","description":"Epieffect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33688","name":"Clsr 1vsd w/wo ptch rmvl bnd","description":"Closure of single ventricular septal defect, with or without patch; with removal of pulmonary artery band, with or without gusset","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2047.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37298","name":"Revsc evsc imvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4359","name":"Choriply, per sq cm","description":"Choriply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0862T","name":"Rlcj pg wcs lv battery only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; battery component only","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1283","name":"Pt scrn tbco and id as user","description":"Patient screened for tobacco use and identified as a tobacco user","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52510","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":451.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4283","name":"Biovance tri or 3l, sq cm","description":"Biovance tri-layer or biovance 3l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1355","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4417","name":"Alexiguard dl-t per sq cm","description":"Alexiguard dl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4264","name":"Cocoon membrane, per sq cm","description":"Cocoon membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4399","name":"Summit fx per sq cm","description":"Summit fx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37273","name":"Revsc evsc fpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15853","name":"Removal sutr/stapl xreq anes","description":"Removal of sutures or staples not requiring anesthesia (list separately in addition to e/m code)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2026","name":"Restrata minimatrix, 5 mg","description":"Restrata minimatrix, 5 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1153","name":"Pt w/ dx osteo doe","description":"Patient with diagnosis of osteoporosis on date of encounter","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01940","name":"Anes nulyt agt lmbr/sac","description":"Anesthesia for percutaneous image-guided destruction procedures by neurolytic agent on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0334U","name":"Onc sld orgn tgsa dna 84/+","description":"Onc sld orgn tgsa dna 84/+","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9051","name":"Inj, bortezomib (maia)","description":"Injection, bortezomib (maia), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0987T","name":"Iv img icr cere vsl oct ea","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59400","name":"Obstetrical care","description":"Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2713.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4359","name":"Choriply, per sq cm","description":"Choriply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9596","name":"Gallium illuccix 1 millicure","description":"Gallium ga-68 gozetotide, diagnostic, (illuccix), 1 millicurie","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1195","name":"Rpt wo imp/con mmr/msi","description":"Surgical pathology reports that do not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both, reason not given","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0208","name":"Inj, pedmark, 100 mg","description":"Injection, sodium thiosulfate (pedmark), 100 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9938","name":"Fab removable appliance","description":"Fab removable appliance","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4268","name":"Surgraft ft per sq cm","description":"Surgraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6089","name":"Access/retorq implant screw","description":"Access/retorq implant screw","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0762T","name":"Dgtz gls mcrscp sl imm ea m","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, each multiplex antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4295","name":"Amnio tri-core, per sq cm","description":"Amnio tri-core amniotic, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1190","name":"Doc khe not pef w/efgr/uacr","description":"Documentation of a kidney health evaluation was not performed or defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0507U","name":"Onc ovr dna whole gen w/5hmc","description":"Onc ovr dna whole gen w/5hmc","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1176","name":"No 2 hzv 10/2017-meas pd","description":"Patient did not receive two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77090","name":"Tbs techl prep&transmis data","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1150","name":"Lvef <=40% or mod/sev l vsf","description":"Current or prior left ventricular ejection fraction (lvef) less than or equal to 40% or documentation of moderately or severely depressed left ventricular systolic function","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1388","name":"Pt doc exm rec melmn","description":"Patients with documentation of an exam performed for recurrence of melanoma","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86363","name":"Mog-igg1 antb flo cytmtry ea","description":"Myelin oligodendrocyte glycoprotein (mog-igg1) antibody; flow cytometry (ie, fluorescence-activated cell sorting [facs]), each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1333","name":"Acute vitreous hemorrhage","description":"Acute vitreous hemorrhage","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1385","name":"Pt rsn not seen 2nd pam","description":"Documentation of patient reasons for patients who were not seen for the second pam survey (e.g., less than four months between baseline pam assessment and follow-up","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4299","name":"Amniocore pro+, per sq cm","description":"Amniocore pro+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0329U","name":"Onc neo xome&trns seq alys","description":"Onc neo xome&trns seq alys","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1333","name":"Acute vitreous hemorrhage","description":"Acute vitreous hemorrhage","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64646","name":"Chemodenerv trunk musc 1-5","description":"Chemodenervation of trunk muscle(s); 1-5 muscle(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75630","name":"X-ray aorta leg arteries","description":"Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":785.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0547","name":"Phone/internet svs 11-20 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1345","name":"Pt bsln pam, 2nd scr 4-12 mo","description":"Patients who had a baseline pam score and a second score within 4 to 12 month of baseline pam score","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0541U","name":"Cv ds hdl rct cec lc-ms/ms 5","description":"Cv ds hdl rct cec lc-ms/ms 5","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0277U","name":"Hem gen pltlt funcj do 31","description":"Hematology (genetic platelet function disorder), genomic sequence analysis of 31 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0481U","name":"Idh1 idh2&tert promoter ngs","description":"Idh1 idh2&tert promoter ngs","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99424","name":"Prin care mgmt phys 1st 30","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0552","name":"Supply of digital device","description":"Supply of digital mental health treatment device and initial education and onboarding, per course of treatment that augments a behavioral therapy plan","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36012","name":"Place catheter in vein","description":"Selective catheter placement, venous system; second order, or more selective, branch (eg, left adrenal vein, petrosal sinus)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94618","name":"Pulmonary stress testing","description":"Pulmonary stress testing (eg, 6-minute walk test), including measurement of heart rate, oximetry, and oxygen titration, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0853T","name":"Dgtz gls mcrscp mphmtrc ea m","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86310","name":"Heterophile antibody absrbj","description":"Heterophile antibodies; titers after absorption with beef cells and guinea pig kidney","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1189","name":"Doc khe pef w/efgr/uacr","description":"Documentation of a kidney health evaluation defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr) performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1574","name":"Inj, ganciclovir (exela)","description":"Injection, ganciclovir sodium (exela), not therapeutically equivalent to j1570, 500 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1366","name":"Focus on womens health mvp","description":"Focusing on womens health mips value pathway","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0396","name":"3d print of 3d surface scan","description":"3d print of 3d surface scan","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1191","name":"Hspc svc any time in meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0992T","name":"N-invas assmt car rsk w/o ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat without concurrent computed tomography (ct) scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4413","name":"Cygnus solo per sq cm","description":"Cygnus solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0925T","name":"Rlcj skin pocket ccm-d pg","description":"Relocation of skin pocket for implanted cardiac contractility modulation-defibrillation pulse generator","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37283","name":"Rvsc evsc tpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6561","name":"G stockng full/chap 40+ cust","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, custom, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0729T","name":"Dx alys vstblr implt uni sbq","description":"Diagnostic analysis of vestibular implant, unilateral; with subsequent programming","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0861T","name":"Rmvl pg wcs lv both compnt","description":"Removal of pulse generator for wireless cardiac stimulator for left ventricular pacing; both components (battery and transmitter)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4326","name":"Woundplus, per sq cm","description":"Woundplus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75731","name":"Artery x-rays adrenal gland","description":"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55707","name":"Bx prst8 trct us guided","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4540","name":"Trans elec nerv periph nerv","description":"Distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74019","name":"Radex abdomen 2 views","description":"Radiologic examination, abdomen; 2 views","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0746T","name":"Car ablt rad arr cnv loc map","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; conversion of arrhythmia localization and mapping of arrhythmia site (nidus) into a multidimensional radiation treatment plan","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7415","name":"Excision malig les complicat","description":"Excision of malignant lesion complicated","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9269","name":"Programable ingest capsule","description":"Programable, transient, orally ingested capsule, for use with external programmer, per month","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0280U","name":"Hem vw factor&clgn iv bndg","description":"Hematology (von willebrand disease [vwd]), von willebrand factor (vwf) and collagen iv binding by enzyme-linked immunosorbent assays (elisa), plasma, report of collagen iv binding","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20611","name":"Drain/inj joint/bursa w/us","description":"Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, subacromial bursa); with ultrasound guidance, with permanent recording and reporting","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0994T","name":"Evasc dlvr a-wal stbl rx prq","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; percutaneous","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0630U","name":"Onc brst mrna gen prflg 80","description":"Onc brst mrna gen prflg 80","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0395U","name":"Onc lng multiomics plsm alg","description":"Onc lng multiomics plsm alg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81003","name":"Urinalysis auto w/o scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; automated, without microscopy","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4468","name":"Exsuff belt incl all sup acc","description":"Exsufflation belt, includes all supplies and accessories","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87110","name":"Chlamydia culture","description":"Culture, chlamydia, any source","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2043","name":"Biobrane, per sq cm","description":"Biobrane, per square centimeter","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0737T","name":"Xenograft impltj artclr surf","description":"Xenograft implantation into the articular surface","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1207","name":"Pt scrn sdoh","description":"Patient is screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2406","name":"Injection, oritavancin 10 mg","description":"Injection, oritavancin (kimyrsa), 10 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0690T","name":"Quan us tis charac w/dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained with diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0665","name":"Team remote e/m est pt 10 mn","description":"Team remote e/m est. pt 10mins","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0812T","name":"Rem mlt day uroflow dev sply","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); device supply with automated report generation, up to 10 days","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96377","name":"Applicaton on-body injector","description":"Application of on-body injector (includes cannula insertion) for timed subcutaneous injection","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1290","name":"Pt not eli d/t act dig htn","description":"Patient not eligible due to active diagnosis of hypertension","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90593","name":"Chikungunya vacc recomb im","description":"Chikungunya virus vaccine, recombinant, for intramuscular use","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42804","name":"Biopsy of upper nose/throat","description":"Biopsy; nasopharynx, visible lesion, simple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6527","name":"G garmt full leg/ft nght cus","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, custom, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":1274.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":27.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1348","name":"Pam incr 6 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 6-points in a 4 to 12 month period (excellent)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0320U","name":"Neph rna psttrnspl perph bld","description":"Neph rna psttrnspl perph bld","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9046","name":"Inj, bortezomib, dr. reddys","description":"Injection, bortezomib (dr. reddys), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55868","name":"Lap srg prst8ct lymph nod bx","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with lymph node biopsy(ies) (limited pelvic lymphadenectomy)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9292","name":"Inj, pemetrexed dipotassium","description":"Injection, pemetrexed dipotassium, 10 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0523","name":"Mgt nw pt dem mod-high cmplx","description":"Management of a new patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0662","name":"Team remote e/m new pt 30 mn","description":"Team remote e/m new pt 30 mins","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97009","name":"Mchnl sclp cool after chemo","description":"Mechanical scalp cooling; provided after discontinuation of chemotherapy, each 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0913T","name":"Prq tcat ther rx ntrac balo1","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting), including mechanical dilation by nondrug-delivery balloon angioplasty, endoluminal imaging using intravascular ultrasound (ivus) or optical coherence tomography (oct) when per","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6525","name":"G com garm lwrleg/ft ngt cus","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, custom, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0759T","name":"Dgtz gls mcrscp sl sp grpiii","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group iii, for enzyme constituents (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4387","name":"Neothelium ft per sq cm","description":"Neothelium ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98008","name":"Synch audio-only new sf 15","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code sel","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0804","name":"3d facial scan indirect","description":"3d facial scan indirect","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0483U","name":"Nfct ds ng gyra s91f pt mut","description":"Nfct ds ng gyra s91f pt mut","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86480","name":"Tb test cell immun measure","description":"Tuberculosis test, cell mediated immunity antigen response measurement; gamma interferon","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56821","name":"Colposcopy vulva w/biopsy","description":"Colposcopy of the vulva; with biopsy(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9999","name":"Doc sys rsn <3 colon","description":"Documentation of system reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., unable to locate previous colonoscopy report, patient cannot provide precise date or details from previous colonoscopy, previous colonoscopy report was incomplete)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2151","name":"Inj, mannitol, 250 mg","description":"Injection, mannitol, 250 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1197","name":"Isa reduced >=3 fr ixv","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2991","name":"App of hydroxyapatite","description":"App of hydroxyapatite","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9268","name":"Programmer orally ingest cap","description":"Programmer for transient, orally ingested capsule","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1320","name":"Pts scrn + hrsn","description":"Patients who screened positive for at least 1 of the 5 hrsns","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0602","name":"Sevelamer carbonate pdr 20mg","description":"Sevelamer carbonate (renvela or therapeutically equivalent), oral, powder, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01937","name":"Anes drg/aspir crv/thrc","description":"Anesthesia for percutaneous image-guided injection, drainage or aspiration procedures on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90845","name":"Psychoanalysis","description":"Psychoanalysis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":95.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92082","name":"Intermediate visual field xm","description":"Visual field examination, unilateral or bilateral, with interpretation and report; intermediate examination (eg, at least 2 isopters on goldmann perimeter, or semiquantitative, automated suprathreshold screening program, humphrey suprathreshold automatic diagnostic test, octopus program 33)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0794T","name":"Pt spec alg rx-onc tx option","description":"Patient-specific, assistive, rules-based algorithm for ranking pharmaco-oncologic treatment options based on the patients tumor-specific cancer marker information obtained from prior molecular pathology, immunohistochemical, or other pathology results which have been previously interpreted and repor","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49594","name":"Rpr aa hrn 1st 3-10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0584U","name":"Neuro csf prion prtn qual","description":"Neuro csf prion prtn qual","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01942","name":"Anes neuromd/ntrvrt lmbr/sac","description":"Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86036","name":"Anca screen each antibody","description":"Antineutrophil cytoplasmic antibody (anca); screen, each antibody","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0860T","name":"Ncntc ifr spctrsc scr pad","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), for screening for peripheral arterial disease, including provocative maneuvers, image acquisition, interpretation, and report, one or both lower extremities","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4037","name":"Urology ss","description":"Urology mips specialty set","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0603U","name":"Rx asy prsmv 77rx/metablt ur","description":"Rx asy prsmv 77rx/metablt ur","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6601","name":"G com bandge hgh dn foam pad","description":"Gradient compression bandaging supply, high density foam pad, any size or shape, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9333","name":"Inj rozanolixizum-noli 1 mg","description":"Injection, rozanolixizumab-noli, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1252","name":"Pts no cmplt hu survey","description":"Patients who did not complete at least one of the four patient experience hu survey items and return the hu survey within 60 days of the ambulatory palliative care visit","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5144","name":"Inj, idacio, 1 mg","description":"Injection, adalimumab-aacf (idacio), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0695T","name":"Bdy srf mpg pm/cvdfb tm impl","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of implant or replacement","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0042A","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2221","name":"Ank mcrop plant & dorsi flex","description":"Addition to lower extremity orthosis, ankle system, microprocessor-controlled feature plantarflexion and/or dorsiflexion, includes power source","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47122","name":"Extensive removal of liver","description":"Hepatectomy, resection of liver; trisegmentectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3720.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6604","name":"G com bandge low dn foam flt","description":"Gradient compression bandaging supply, low density flat foam sheet, per 250 square centimeters, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35510","name":"Art byp grft carotid-brchial","description":"Bypass graft, with vein; carotid-brachial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1552.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17003","name":"Destruct premalg les 2-14","description":"Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (eg, actinic keratoses); second through 14 lesions, each (list separately in addition to code for first lesion)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":7.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38573","name":"Laps pelvic lymphadec","description":"Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy and peri-aortic lymph node sampling, peritoneal washings, peritoneal biopsy(ies), omentectomy, and diaphragmatic washings, including diaphragmatic and other serosal biopsy(ies), when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1251.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94617","name":"Exercise tst brncspsm w/ecg","description":"Exercise test for bronchospasm, including pre- and post-spirometry and pulse oximetry; with electrocardiographic recording(s)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9076","name":"Inj, cyclophos (baxter) 5mg","description":"Injection, cyclophosphamide (baxter), 5 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2021","name":"Neomatrix per sq cm","description":"Neomatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33960","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1187.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99343","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3403","name":"Revakinagene, per implant","description":"Revakinagene taroretcel-lwey, per implant","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0748T","name":"Njx stm cl prdct anl sft tis","description":"Injections of stem cell product into perianal perifistular soft tissue, including fistula preparation (eg, removal of setons, fistula curettage, closure of internal openings)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98013","name":"Synch audio-only est low 20","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code select","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0423U","name":"Psyc genomic alys pnl 26 gen","description":"Psyc genomic alys pnl 26 gen","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55711","name":"Bx prst8 trct mri-us 1st","description":"Biopsy, prostate, transrectal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":72.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6073","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (predominantly base metal)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94760","name":"N-invas ear/pls oximetry 1","description":"Noninvasive ear or pulse oximetry for oxygen saturation; single determination","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0532U","name":"Rare ds whlgen&mitochdrl dna","description":"Rare ds whlgen&mitochdrl dna","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0583U","name":"Rare ds rpd whlgen cmptr dna","description":"Rare ds rpd whlgen cmptr dna","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37256","name":"Revsc evasc ivt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1371","name":"Mst rec gsa<7","description":"Most recent glycemic status assessment (hba1c or gmi) level < 7.0%","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86317","name":"Immunoassay infectious agent","description":"Immunoassay for infectious agent antibody, quantitative, not otherwise specified","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2427","name":"Inj, invega hafyera/trinza","description":"Injection, paliperidone palmitate extended release (invega hafyera, or invega trinza), 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6516","name":"Grad com wrap w strap foo cu","description":"Gradient compression wrap with adjustable straps, foot, each, custom","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0599U","name":"Onc pncrtc ca mult ia serum","description":"Onc pncrtc ca mult ia serum","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4404","name":"Xwrap hydro plus per sq cm","description":"Xwrap hydro plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1270","name":"Pts no kid transplt wtlst","description":"Patients not on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1418","name":"Med rsn not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination because of a medical contraindication documented by clinician","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82234","name":"Beta-amyloid 1-42 (abeta 42)","description":"Beta-amyloid; 1-42 (abeta 42)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4564","name":"Pessary, disposable any type","description":"Pessary, disposable, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0322U","name":"Neuro asd meas 14 acyl carn","description":"Neuro asd meas 14 acyl carn","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1328","name":"Pts dx acute vitreous hem","description":"Patients with a diagnosis of acute vitreous hemorrhage","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36835","name":"Insertion thomas shunt","description":"Insertion of thomas shunt (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7519","name":"Inj. mycophenolate mofetil","description":"Injection, mycophenolate mofetil, 10 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4212","name":"Gingivectomy/plasty rest","description":"Gingivectomy/plasty rest","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9248","name":"Inj melphalan (hepzato) 1 mg","description":"Injection, melphalan (hepzato), 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55715","name":"Bx prst8 ea add mri-us/ct/mr","description":"Biopsy, prostate, each additional, mri-ultrasound fusion or in-bore ct- or mri-guided targeted lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0039","name":"Pt no ref, rn spec","description":"Patient not referred, reason not otherwise specified","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1205","name":"Isa reduced >=3","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0959T","name":"Rmv/rplc magnet coil assem","description":"Removal or replacement of magnet from coil assembly that is connected to continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5159","name":"Inj, denosumab-dssb, 1 mg","description":"Injection, denosumab-dssb (ospomyv/xbryk), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0255U","name":"Andrology infertility assmt","description":"Andrology (infertility), sperm-capacitation assessment of ganglioside gm1 distribution patterns, fluorescence microscopy, fresh or frozen specimen, reported as percentage of capacitated sperm and probability of generating a pregnancy score","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0687","name":"Inj cefazolin (wg crit care)","description":"Injection, cefazolin sodium (wg critical care), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0407U","name":"Neph dbtc ckd mult eclia alg","description":"Neph dbtc ckd mult eclia alg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28310","name":"Revision of big toe","description":"Osteotomy, shortening, angular or rotational correction; proximal phalanx, first toe (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31242","name":"Nsl/sinus ndsc rf abltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by radiofrequency ablation, posterior nasal nerve","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93146","name":"Interrog crtd sins bat ip w/","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90637","name":"Vacc qirv mrna 30mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 30 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6193","name":"Replace implnt screw","description":"Replace implnt screw","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0568","name":"Int psych care mng, 1 cal mo","description":"Initial psychiatric collaborative care management, in the first calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required elements: outrea","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86352","name":"Cell function assay w/stim","description":"Cellular function assay involving stimulation (eg, mitogen or antigen) and detection of biomarker (eg, atp)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0521","name":"Supply fee hiv prep fda appr","description":"Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0274U","name":"Hem gen pltlt do 43 genes","description":"Hematology (genetic platelet disorders), genomic sequence analysis of 43 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35646","name":"Bpg aortobifemoral","description":"Bypass graft, with other than vein; aortobifemoral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2166.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82595","name":"Assay of cryoglobulin","description":"Cryoglobulin, qualitative or semi-quantitative (eg, cryocrit)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5145","name":"Inj, abrilada, 1 mg","description":"Injection, adalimumab-afzb (abrilada), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0894T","name":"Cannulation liver allograft","description":"Cannulation of the liver allograft in preparation for connection to the normothermic perfusion device and decannulation of the liver allograft following normothermic perfusion","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1018T","name":"Elec alys npgs esoph sbsq w/","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46947","name":"Hemorrhoidopexy by stapling","description":"Hemorrhoidopexy (eg, for prolapsing internal hemorrhoids) by stapling","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":389.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J1655","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4199","name":"Cygnus matrix, per sq cm","description":"Cygnus matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1426","name":"Injection, casimersen, 10 mg","description":"Injection, casimersen, 10 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33901","name":"Perq p-art revsc 1 nm nt bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, bilateral","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0617U","name":"Cv ascvd dna alys >20000","description":"Cv ascvd dna alys >20000","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98008","name":"Synch audio-only new sf 15","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code sel","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0542","name":"No pt prsnt train add 15","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1369","name":"Qualcare mental hlth/sud mvp","description":"Quality care in mental health and substance use disorders mips value pathway","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90631","name":"H5 vaccine pandemic im use","description":"Influenza virus vaccine (iiv), h5, pandemic formulation, split virus, adjuvanted, for intramuscular use","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4290","name":"Membrane wrap hydr per sq cm","description":"Membrane wrap-hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4379","name":"Amniodefend ft per sq cm","description":"Amniodefend ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76987","name":"Dx intraop epicar car us chd","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; including placement and manipulation of transducer, image acquisition, interpretation and report","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1168","name":"Pt recd flu vax 7/1-6/30","description":"Patient received an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0387","name":"Comp image capture only","description":"Comp image capture only","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0394U","name":"Pfas 16 pfas compnd lc ms/ms","description":"Pfas 16 pfas compnd lc ms/ms","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1493","name":"No fall doc med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4212","name":"Gingivectomy/plasty rest","description":"Gingivectomy/plasty rest","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7110","name":"Dextran 75 infusion","description":"Infusion, dextran 75, 500 ml","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4425","name":"Revive tl per sq cm","description":"Revive tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44381","name":"Small bowel endoscopy br/wa","description":"Ileoscopy, through stoma; with transendoscopic balloon dilation","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1167.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":83.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33268","name":"Excl laa opn oth px any meth","description":"Exclusion of left atrial appendage, open, performed at the time of other sternotomy or thoracotomy procedure(s), any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1431","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2277","name":"Inj, motixafortide, 0.25 mg","description":"Injection, motixafortide, 0.25 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0677T","name":"Laps repos lead isdss 1st ld","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first repositioned lead","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4543","name":"Supply trans elec nerve stim","description":"Supplies for transcutaneous electrical nerve stimulator, for nerves in the auricular region, per month","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0699T","name":"Njx pst chmbr eye medication","description":"Injection, posterior chamber of eye, medication","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66130","name":"Remove eye lesion","description":"Excision of lesion, sclera","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5996","name":"Peri medicament w/seal, mand","description":"Peri medicament w/seal, mand","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9333","name":"Inj rozanolixizum-noli 1 mg","description":"Injection, rozanolixizumab-noli, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0052","name":"Mmip mental health and care","description":"Missing and murdered indigenous persons (mmip) mental health and clinical care","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0167","name":"Inj epinephrine (hospira)","description":"Injection, epinephrine (hospira), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0306U","name":"Onc mrd nxt-gnrj alys 1st","description":"Onc mrd nxt-gnrj alys 1st","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26160","name":"Remove tendon sheath lesion","description":"Excision of lesion of tendon sheath or joint capsule (eg, cyst, mucous cyst, or ganglion), hand or finger","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6624","name":"Inlay titanium","description":"Inlay - titanium","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75833","name":"Vein x-ray kidneys","description":"Venography, renal, bilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":737.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0901","name":"Vadadustat oral 1mg for esrd","description":"Vadadustat, oral, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0621U","name":"Nfct ds lb dna alys>10000","description":"Nfct ds lb dna alys>10000","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9156","name":"Oral mucoadhesive per 1 ml","description":"Oral mucoadhesive, any type (liquid, gel, paste, etc.), per 1 ml","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98016","name":"Brief comunicaj tech-bsd svc","description":"Brief communication technology-based service (eg, virtual check-in) by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related evaluation and management service provided within the p","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98004","name":"Synch audio-video est sf 10","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 10 minutes must be met or e","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6613","name":"Onlay cst base mtl >=3 surfa","description":"Onlay - cast predominantly base metal three or more surfaces","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0681T","name":"Rlcj pulse gen only isdss","description":"Relocation of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing dual leads","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87469","name":"Babesia microti amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); babesia microti, amplified probe technique","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1072","name":"Inj, testosterone, azmiro","description":"Injection, testosterone cypionate (azmiro), 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9129","name":"Photobio therpy-sub 15 mins","description":"Photobio therpy-sub 15 mins","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1337","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0434U","name":"Rx metab advrs vrnt alys 25","description":"Rx metab advrs vrnt alys 25","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27315","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35256","name":"Repair blvsl vn grf lxtr","description":"Repair blood vessel with vein graft; lower extremity","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1312.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0389","name":"Periopic image capture only","description":"Periopic image capture only","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1737","name":"Inj meloxicam (azurity) 1mg","description":"Injection, meloxicam (azurity), 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2058","name":"Obecbtge autol up to 400 mil","description":"Obecabtagene autoleucel, 10 up to 400 million cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per infusion","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4325","name":"Acapatch, per sq cm","description":"Acapatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"Non-adju cgm supply allow","description":"Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KF"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0273U","name":"Hem gen hyprfibrnlysis 8 gen","description":"Hematology (genetic hyperfibrinolysis, delayed bleeding), genomic sequence analysis of 8 genes (f13a1, f13b, fga, fgb, fgg, serpina1, serpine1, serpinf2, plau) blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53454","name":"Tprnl balo cntnc dev adjmt","description":"Periurethral transperineal adjustable balloon continence device; percutaneous adjustment of balloon(s) fluid volume","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1164","name":"Inj diltiazem in 0.72% nacl","description":"Injection, diltiazem hydrochloride in 0.72% sodium chloride, 0.5 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4014","name":"Nephrology ss","description":"Nephrology mips specialty set","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0618U","name":"Psyc bd dna mthyl alys>10000","description":"Psyc bd dna mthyl alys>10000","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0334U","name":"Onc sld orgn tgsa dna 84/+","description":"Onc sld orgn tgsa dna 84/+","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0531","name":"Fclty-based respite, 24 hr u","description":"Facility-based respite, 24-hour unit, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0470U","name":"Onc orop detcj mrd 8 dna hpv","description":"Onc orop detcj mrd 8 dna hpv","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59871","name":"Remove cerclage suture","description":"Removal of cerclage suture under anesthesia (other than local)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0280U","name":"Hem vw factor&clgn iv bndg","description":"Hematology (von willebrand disease [vwd]), von willebrand factor (vwf) and collagen iv binding by enzyme-linked immunosorbent assays (elisa), plasma, report of collagen iv binding","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0857T","name":"Opto-acoustic img breast uni","description":"Opto-acoustic imaging, breast, unilateral, including axilla when performed, real-time with image documentation, augmentative analysis and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27100","name":"Transfer of abdominal muscle","description":"Transfer external oblique muscle to greater trochanter including fascial or tendon extension (graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":980.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2045","name":"Novashield/novogen pr sq cm","description":"Novashield or novogen wound matrix, per square centimeter","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0018","name":"Crisis psychotherapy add 30m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); each additional 30 minutes (list separately in addition to code for primary service)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9996","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6028","name":"Part hand finger metacar amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s) /thumb, amputation at metacarpal level, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9028","name":"Inj, nogapendekin pmln, 1mcg","description":"Injection, nogapendekin alfa inbakicept-pmln, for intravesical use, 1 microgram","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82607","name":"Vitamin b-12","description":"Cyanocobalamin (vitamin b-12);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33272","name":"Rmvl of subq defibrillator","description":"Removal of subcutaneous implantable defibrillator electrode","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0665","name":"Inj, bupivacaine, nos, 0.5mg","description":"Injection, bupivicaine, not otherwise specified, 0.5 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4264","name":"Cocoon membrane, per sq cm","description":"Cocoon membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73702","name":"Ct lwr extremity w/o&w/dye","description":"Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":453.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1650","name":"Inj enoxaparin sodium","description":"Injection, enoxaparin sodium, 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53452","name":"Tprnl balo cntnc dev uni","description":"Periurethral transperineal adjustable balloon continence device; unilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1008T","name":"Rem mntr s-scl eeg sys setup","description":"Remote monitoring of sub-scalp implanted continuous bilateral electroencephalography monitoring system, device fitting, initial set-up, and patient education in wearing of system and use of equipment","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0914T","name":"Prq tcat thr rx ntrc bal sep","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting) performed on a separate target lesion from the target lesion treated with balloon angioplasty, coronary stent placement or coronary atherectomy, including mechanical dilation b","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9071","name":"Inj cyclophosphamd auromedic","description":"Injection, cyclophosphamide (auromedics), 5 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0780T","name":"Instlj fecal microbiota ssp","description":"Instillation of fecal microbiota suspension via rectal enema into lower gastrointestinal tract","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92623","name":"Dx aly aud oi snd prcsr each","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; each additional 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98981","name":"Rtm tx mgmt ea addl 20 min","description":"Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least 1 real-time interactive communication with the patient or caregiver during the calendar month; each additional 20 minutes (list separately in","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5161","name":"Inj, denosumab-kyqq, 1 mg","description":"Injection, denosumab-kyqq (aukelso/bosaya), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0864T","name":"Low ntsty eswt corpus cvrnsm","description":"Low-intensity extracorporeal shock wave therapy involving corpus cavernosum, low energy","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9049","name":"Inj, bortezomib, hospira","description":"Injection, bortezomib (hospira), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1230","name":"Pt hcv rctv aby no f/u tst","description":"Patient has a reactive hcv antibody test and does not have a follow up hcv viral test, or patient has a reactive hcv antibody test and has a follow up hcv viral test that detects hcv viremia and is not referred to a clinician who treats hcv infection within 1 month and does not have hcv treatment in","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9871","name":"Bhv couns dm prev, onln 60 m","description":"Behavioral counseling for diabetes prevention, online, 60 minutes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1290","name":"Pt not eli d/t act dig htn","description":"Patient not eligible due to active diagnosis of hypertension","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0719T","name":"Pst vrt jt rplcmt lmbr 1 sgm","description":"Posterior vertebral joint replacement, including bilateral facetectomy, laminectomy, and radical discectomy, including imaging guidance, lumbar spine, single segment","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1461","name":"Pt dx chron hepc","description":"Patient diagnosis for chronic hepatitis c","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86146","name":"Beta-2 glycoprotein antibody","description":"Beta 2 glycoprotein i antibody, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35602","name":"Bpg crtd-clat crtd","description":"Bypass graft, with other than vein; carotid-contralateral carotid","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6089","name":"Access/retorq implant screw","description":"Access/retorq implant screw","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0329U","name":"Onc neo xome&trns seq alys","description":"Onc neo xome&trns seq alys","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87181","name":"Sc std agar dilution per agt","description":"Susceptibility studies, antimicrobial agent; agar dilution method, per agent (eg, antibiotic gradient strip)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0381U","name":"Maple syrup ur ds mntr quan","description":"Maple syrup ur ds mntr quan","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2956","name":"Indirect rest remov","description":"Indirect rest remov","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1385","name":"Pt rsn not seen 2nd pam","description":"Documentation of patient reasons for patients who were not seen for the second pam survey (e.g., less than four months between baseline pam assessment and follow-up","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5932","name":"Postsurgical obturator","description":"Obturator prosthesis definitive","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34702","name":"Evasc rpr a-ao ndgft rpt","description":"Endovascular repair of infrarenal aorta by deployment of an aorto-aortic tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the aorta from the level ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1530.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2036","name":"Cohealyx col dml mx pr sq cm","description":"Cohealyx collagen dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0249","name":"Adm tocilizu covid-19 1st","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0701T","name":"Molec fluor img sus nev ea","description":"Molecular fluorescent imaging of suspicious nevus; each additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37258","name":"Revsc evasc ivt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1151","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1169","name":"Doc med rsn no flu vax","description":"Documentation of medical reason(s) for not administering influenza vaccine (e.g., prior anaphylaxis due to the influenza vaccine)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66991","name":"Xcapsl ctrc rmvl insj 1+","description":"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); with insertion of intraocular (eg, trabecular meshwork, supraciliary, suprachoroidal) anterior segment aqueous drai","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0739","name":"Rehab sys active assist rt","description":"Rehabilitation system with interactive interface providing active assistance in rehabilitation therapy, includes all components and accessories, motors, microprocessors, sensors","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98927","name":"Osteopath manj 5-6 regions","description":"Osteopathic manipulative treatment (omt); 5-6 body regions involved","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":68.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2040","name":"Coord specialty care, month","description":"Coordinated specialty care, team-based, for first episode psychosis, per month","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"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":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1361","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37259","name":"Revsc evasc ivt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87564","name":"Mtb rifampin rst amp prb tq","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacterium tuberculosis, rifampin resistance, amplified probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15778","name":"Impl absrb msh/prsth dly cls","description":"Implantation of absorbable mesh or other prosthesis for delayed closure of defect(s) (ie, external genitalia, perineum, abdominal wall) due to soft tissue infection or trauma","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0820T","name":"Mntr psychdlc med 1stphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; first physician or other qualified health care professional, each hour","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78013","name":"Thyroid imaging w/blood flow","description":"Thyroid imaging (including vascular flow, when performed);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0308U","name":"Crd cad alys 3 prtn plsm alg","description":"Crd cad alys 3 prtn plsm alg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86352","name":"Cell function assay w/stim","description":"Cellular function assay involving stimulation (eg, mitogen or antigen) and detection of biomarker (eg, atp)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4339","name":"Artacent vericlen, per sq cm","description":"Artacent vericlen, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1220","name":"Dre wth interp rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; with evidence of retinopathy","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9573","name":"Inj, gadopiclenol, 1 ml","description":"Injection, gadopiclenol, 1 ml","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0436U","name":"Onc lng plsm alys 388 prtn","description":"Onc lng plsm alys 388 prtn","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0998T","name":"Precuneus mag stimj tx dlvr","description":"Precuneus magnetic stimulation; personalized treatment delivery of magnetic stimulation therapy to a prespecified target area derived from analysis of evoked potentials within the precuneus, utilizing magnetic resonance imaging-based neuronavigation, with management, per day","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82486","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1400","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0282U","name":"Rbc dna gntyp 12 bld grp gen","description":"Red blood cell antigen typing, dna, genotyping of 12 blood group system genes to predict 44 red blood cell antigen phenotypes","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9611","name":"Flurpiridaz f18, diag, 1 mci","description":"Flurpiridaz f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0697T","name":"Quan mr tis wo mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained without diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, targ","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1500","name":"Neuropsychology mvp","description":"Neuropsychology mips value pathway","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0835T","name":"Dgtz gls mcrscp fna 1st ea","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0614U","name":"Iem pmd alys 4 nzm cplx page","description":"Iem pmd alys 4 nzm cplx page","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2247","name":"Inj, micafungin (par pharm)","description":"Injection, micafungin sodium (par pharm) not thereapeutically equivalent to j2248, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1263","name":"Pts hosp dialysis dt","description":"Patients in hospice on their initiation of dialysis date or during the month of evaluation","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0737T","name":"Xenograft impltj artclr surf","description":"Xenograft implantation into the articular surface","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33897","name":"Perq trluml angp nt/recr coa","description":"Percutaneous transluminal angioplasty of native or recurrent coarctation of the aorta","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0767T","name":"Tc mag stimj pn ea addl nrv","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; each additional nerve (list separat","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0798T","name":"Tcat rmv 2chmbr ldls pm cmpl","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; complete system (ie, right atrial and right ventricular pacemaker components)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84127","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1321","name":"Pts no 7wk inj,no iop,iop>25","description":"Patients who were not seen within 7 weeks following the date of injection for follow up or who did not have a documented iop or no plan of care documented if the iop was >25 mm hg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33226","name":"Reposition l ventric lead","description":"Repositioning of previously implanted cardiac venous system (left ventricular) electrode (including removal, insertion and/or replacement of existing generator)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":573.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61156","name":"Burr hol aspir hmtm/cst icer","description":"Burr hole(s); with aspiration of hematoma or cyst, intracerebral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1400.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77089","name":"Tbs dxa cal w/i&r fx risk","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; using dual x-ray absorptiometry (dxa) or other imaging data on gray-scale variogram, calculation, with interpretation and report on fracture-risk","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98928","name":"Osteopath manj 7-8 regions","description":"Osteopathic manipulative treatment (omt); 7-8 body regions involved","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":84.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":56.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89100","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2372","name":"Inj, biorphen, 20 micrograms","description":"Injection, phenylephrine hydrochloride (biorphen), 20 micrograms","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0971T","name":"Ablt mal brst tum pq lsr uni","description":"Ablation, malignant breast tumor(s), percutaneous, laser, including imaging guidance when performed, unilateral","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36410","name":"Vnpnxr 3yr/> phy/qhp dx/ther","description":"Venipuncture, age 3 years or older, necessitating the skill of a physician or other qualified health care professional (separate procedure), for diagnostic or therapeutic purposes (not to be used for routine venipuncture)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":8.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20610","name":"Drain/inj joint/bursa w/o us","description":"Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, subacromial bursa); without ultrasound guidance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":24.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":46.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0486U","name":"Onc pan sol tum ngs cfctdna","description":"Onc pan sol tum ngs cfctdna","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0033","name":"2+ benzo seiz","description":"Two or more benzodiazepine prescriptions ordered for patients who had a diagnosis of seizure disorders, rapid eye movement sleep behavior disorder, benzodiazepine withdrawal, ethanol withdrawal, or severe generalized anxiety disorder on or between january 1 of the year prior to the measurement perio","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0737","name":"Inj, clindamycin (baxter)","description":"Injection, clindamycin phosphate (baxter), not therapeutically equivalent to j0736, 300 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1230","name":"Pt hcv rctv aby no f/u tst","description":"Patient has a reactive hcv antibody test and does not have a follow up hcv viral test, or patient has a reactive hcv antibody test and has a follow up hcv viral test that detects hcv viremia and is not referred to a clinician who treats hcv infection within 1 month and does not have hcv treatment in","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0741","name":"Inj, cabote rilpivir 2mg 3mg","description":"Injection, cabotegravir and rilpivirine, 2mg/3mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1406","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4318","name":"E-graft, per sq cm","description":"E-graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6601","name":"G com bandge hgh dn foam pad","description":"Gradient compression bandaging supply, high density foam pad, any size or shape, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4199","name":"Cygnus matrix, per sq cm","description":"Cygnus matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0712T","name":"N-nvs artl plaq alys quan","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess atherosclerotic plaque stability","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92004","name":"Compre oph exam new pt 1/>","description":"Ophthalmological services: medical examination and evaluation with initiation of diagnostic and treatment program; comprehensive, new patient, 1 or more visits","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0630U","name":"Onc brst mrna gen prflg 80","description":"Onc brst mrna gen prflg 80","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55711","name":"Bx prst8 trct mri-us 1st","description":"Biopsy, prostate, transrectal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1454","name":"New cied","description":"New cied","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88182","name":"Cell marker study","description":"Flow cytometry, cell cycle or dna analysis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67975","name":"Reconstruction of eyelid","description":"Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; second stage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":733.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5146","name":"Inj, hercessi, 10 mg","description":"Injection, trastuzumab-strf (hercessi), biosimilar, 10 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1394","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83033","name":"Hemoglobin ftl f assay qual","description":"Hemoglobin; f (fetal), qualitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0766","name":"Elec stim cancer treatment","description":"Electrical stimulation device used for cancer treatment, includes all accessories, any type","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16384.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76018","name":"Mr safety implant elec prepj","description":"Mr safety implant electronics preparation under supervision of physician or other qualified health care professional, including mr-specific programming of pulse generator and/or transmitter to verify device integrity, protection of device internal circuitry from mr electromagnetic fields, and protec","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1261","name":"Pts on wtlist bef dialysis","description":"Patients that were on the kidney or kidney-pancreas waitlist prior to initiation of dialysis","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5098","name":"Inj ustekinumab-srlf, 1 mg","description":"Injection, ustekinumab-srlf (imuldosa), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31420","name":"Epiglottidectomy","description":"Epiglottidectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":924.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58580","name":"Transcrv abltj utrn fibrd rf","description":"Transcervical ablation of uterine fibroid(s), including intraoperative ultrasound guidance and monitoring, radiofrequency","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93573","name":"Njx cath slct p-art angrp bi","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, bilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77318","name":"Brachytx isodose complex","description":"Brachytherapy isodose plan; complex (calculation[s] made from over 10 sources, or remote afterloading brachytherapy, over 12 channels), includes basic dosimetry calculation(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64656","name":"Revj/rplcmt bat mod sys pg","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; pulse generator only","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4267","name":"Neostim dl per sq cm","description":"Neostim dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0167","name":"Inj epinephrine (hospira)","description":"Injection, epinephrine (hospira), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1201","name":"Med rsn no ace-i/arb rx","description":"Documentation of medical reason(s) for not prescribing ace inhibitor (ace-i) or arb therapy during the measurement period (e.g., pregnancy, history of angioedema to ace-i, other allergy to ace-i and arb, hyperkalemia or history of hyperkalemia while on ace-i or arb therapy, acute kidney injury due t","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9292","name":"Pres dig visual therapy fda","description":"Prescription digital visual therapy, software-only, fda cleared, per course of treatment","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4479","name":"Transanal irrigation, electr","description":"Electronic transanal irrigation system, includes electronic pump, water reservoir, tubing, and accessories, without catheter, any type","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0817T","name":"Opn insj/rplcmt ins ptn subf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5995","name":"Peri medicament w/seal, max","description":"Peri medicament w/seal, max","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21010","name":"Incision of jaw joint","description":"Arthrotomy, temporomandibular joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":817.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1453","name":"Preop vis acu > 20/40","description":"Patients with a pre-operative visual acuity better than 20/40","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32225","name":"Partial release of lung","description":"Decortication, pulmonary (separate procedure); partial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85027","name":"Complete cbc automated","description":"Blood count; complete (cbc), automated (hgb, hct, rbc, wbc and platelet count)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0999T","name":"Autol musc cell therapy hrvg","description":"Autologous muscle cell therapy, harvesting of muscle progenitor cells, including ultrasound guidance, when performed","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15012","name":"Hrv skn cll ssp agrft ea add","description":"Harvest of skin for skin cell suspension autograft; each additional 25 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1356","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26135","name":"Revise finger joint each","description":"Synovectomy, metacarpophalangeal joint including intrinsic release and extensor hood reconstruction, each digit","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":660.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0915T","name":"Insj perm ccm-d sys pg&eltrd","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator and dual transvenous electrodes/leads (pacing and defibrillation)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52007","name":"Cysto urtrl cathj brush bx","description":"Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with brush biopsy of ureter and/or renal pelvis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86053","name":"Aqaprn-4 antb flo cytmtry ea","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; flow cytometry (ie, fluorescence-activated cell sorting [facs]), each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":37.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1395","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30600","name":"Repair mouth/nose fistula","description":"Repair fistula; oronasal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":528.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94015","name":"Patient recorded spirometry","description":"Patient-initiated spirometric recording per 30-day period of time; recording (includes hook-up, reinforced education, data transmission, data capture, trend analysis, and periodic recalibration)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49421","name":"Ins tun ip cath for dial opn","description":"Insertion of tunneled intraperitoneal catheter for dialysis, open","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5134","name":"Inj, tyruko, 1 mg","description":"Injection, natalizumab-sztn (tyruko), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1377","name":"Fu colscop 10 yr doc w/ disc","description":"Recommended follow-up interval for repeat colonoscopy of 10 years documented  in colonoscopy report and communicated with patient","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90593","name":"Chikungunya vacc recomb im","description":"Chikungunya virus vaccine, recombinant, for intramuscular use","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9601","name":"Flortaucipir inj 1 millicuri","description":"Flortaucipir f 18 injection, diagnostic, 1 millicurie","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1263","name":"Pts hosp dialysis dt","description":"Patients in hospice on their initiation of dialysis date or during the month of evaluation","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01942","name":"Anes neuromd/ntrvrt lmbr/sac","description":"Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1228","name":"Pt + hcv aby +vir w/ rx 3 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, has hcv treatment initiated within 3 months of the reactive hcv antibody test","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9998","name":"Inj ustekinumab-aekn, 1 mg","description":"Injection, ustekinumab-aekn (selarsdi), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0767T","name":"Tc mag stimj pn ea addl nrv","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; each additional nerve (list separat","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61891","name":"Rev/rplcmt sk-mnt crnl nstm","description":"Revision or replacement of skull-mounted cranial neurostimulator pulse generator or receiver with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4296","name":"Rebound matrix, per sq cm","description":"Rebound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1374","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0294U","name":"Lngvty&mrtlty rsk mrna 18gen","description":"Lngvty&mrtlty rsk mrna 18gen","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90837","name":"Psytx w pt 60 minutes","description":"Psychotherapy, 60 minutes with patient","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":145.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1473","name":"Pt func cap not allow impr","description":"Patient situations, at any point during the denominator identification period, where the patients functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools, such as delirium, dementia, intellectual disabilities, and pervasive and specific de","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86231","name":"Ema each ig class","description":"Endomysial antibody (ema), each immunoglobulin (ig) class","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2804","name":"Inj, rifampin, 1 mg","description":"Injection, rifampin, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97814","name":"Acup 1/> w/estim ea addl 15","description":"Acupuncture, 1 or more needles; with electrical stimulation, each additional 15 minutes of personal one-on-one contact with the patient, with insertion of needle(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":23.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5422","name":"Dentures adjust part mandbl","description":"Adjust partial denture - mandibular","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53452","name":"Tprnl balo cntnc dev uni","description":"Periurethral transperineal adjustable balloon continence device; unilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96567","name":"Pdt dstr prmlg les skn","description":"Photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosensitive drug(s), per day","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35493","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82760","name":"Assay of galactose","description":"Galactose","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11000","name":"Dbrdmt ecz/infected skin<10%","description":"Debridement of extensive eczematous or infected skin; up to 10% of body surface","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":25.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0709T","name":"Id ca immntx each addl njx","description":"Intradermal cancer immunotherapy; each additional injection (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1307","name":"Inj, crovalimab-akkz, 10 mg","description":"Injection, crovalimab-akkz, 10 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0406U","name":"Onc lung flow cytmtry 5 mrk","description":"Onc lung flow cytmtry 5 mrk","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4010","name":"Infectious disease ss","description":"Infectious disease mips specialty set","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1288","name":"Doc rsn no hbp scrn or f/u","description":"Documented reason for not screening or recommending a follow-up for high blood pressure","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1292","name":"Pt 66+ frail inpt adv ill","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and an advanced illness diagnosis during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4408","name":"Xwrap hydro per sq cm","description":"Xwrap hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0718T","name":"Adrc ther prtl rc tear njx","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; injection into supraspinatus tendon including ultrasound guidance, unilateral","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98986","name":"Rtm dev sply cbt 2-15 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of cognitive behavioral therapy, 2-15 days in a 30-day period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1316","name":"Tobacco non-user","description":"Current tobacco non-user","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33281","name":"Reposg phrnc nrv stim trnsvn","description":"Repositioning of phrenic nerve stimulator transvenous lead(s)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1304","name":"No pneum vax admin 19+","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44401","name":"Colonoscopy with ablation","description":"Colonoscopy through stoma; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre-and post-dilation and guide wire passage, when performed)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":2455.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83014","name":"H pylori drug admin","description":"Helicobacter pylori; drug administration","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1255","name":"Pts w/ othr rsn vst,+prg tst","description":"Patients who have another reason for visiting the clinic [not prenatal or postpartum care] and have a positive pregnancy test but have not established the clinic as an ob provider (e.g., plan to terminate the pregnancy or seek prenatal services elsewhere)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1269","name":"Recd esrd mcp lst day of mo","description":"Receiving esrd mcp dialysis services by the provider on the last day of the reporting month","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1257","name":"Cvd risk assess not perf","description":"Cvd risk assessment not performed or incomplete (e.g., cvd risk assessment was not documented), reason not otherwise specified","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29550","name":"Strapping of toes","description":"Strapping; toes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":10.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4288","name":"Dermabind ch, per sq cm","description":"Dermabind ch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"X-ray exam chest 2 views","description":"Radiologic examination, chest; 2 views","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5155","name":"Inj, aflibercept-jbvf, 1 mg","description":"Injection, aflibercept-jbvf (yesafili), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4564","name":"Pessary, disposable any type","description":"Pessary, disposable, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78609","name":"Brain imaging (pet)","description":"Brain imaging, positron emission tomography (pet); perfusion evaluation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0044","name":"Pt mitral stenosis","description":"Patients with moderate or severe mitral stenosis","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36558","name":"Insert tunneled cv cath","description":"Insertion of tunneled centrally inserted central venous catheter, without subcutaneous port or pump; age 5 years or older","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98001","name":"Synch audio-video new low 30","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0445U","name":"Abeta42 & ptau181 eclia csf","description":"Abeta42 & ptau181 eclia csf","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3410","name":"Hydroxyzine hcl injection","description":"Injection, hydroxyzine hcl, up to 25 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25448","name":"Arthrp ntrcrpl/crp/mtcrp ssp","description":"Arthroplasty, intercarpal or carpometacarpal joints; suspension, including transfer or transplant of tendon, with interposition, when performed","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0609","name":"Ferric citrate orl 3 mg iron","description":"Ferric citrate, oral, 3 mg ferric iron, (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0556","name":"Adv prim care mgmt lvl 1","description":"Advanced primary care management services for a patient with one chronic condition [expected to last at least 12 months, or until the death of the patient, which place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline], or fewer, provided by clinical ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0332U","name":"Onc pan tum gen prflg 8 dna","description":"Onc pan tum gen prflg 8 dna","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4389","name":"Neothelium 4l+ per sq cm","description":"Neothelium 4l+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55709","name":"Bx prst8 tprnl us guided","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0216","name":"Inj, alfentanil hcl, 500mcg","description":"Injection, alfentanil hydrochloride, 500 micrograms","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4014","name":"Nephrology ss","description":"Nephrology mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0297U","name":"Onc pan tum whl gen seq dna","description":"Onc pan tum whl gen seq dna","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91319","name":"Sarscv2 vac 10mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 10 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1552","name":"Inj, alyglo, 500 mg","description":"Injection, immune globulin (alyglo), 500 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23605","name":"Cltx prx hmrl fx mnpj+-tract","description":"Closed treatment of proximal humeral (surgical or anatomical neck) fracture; with manipulation, with or without skeletal traction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":494.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0888T","name":"Histotripsy mal renal tissue","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant renal tissue, including imaging guidance","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J1390","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58575","name":"Laps tot hyst resj mal","description":"Laparoscopy, surgical, total hysterectomy for resection of malignancy (tumor debulking), with omentectomy including salpingo-oophorectomy, unilateral or bilateral, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2032.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0954T","name":"Tot impl amei rplc snd proc","description":"Totally implantable active middle ear hearing implant; replacement of sound processor only, with attachment to existing transducers","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82664","name":"Electrophoretic test","description":"Electrophoretic technique, not elsewhere specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0426U","name":"Genome ultra-rapid seq alys","description":"Genome ultra-rapid seq alys","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74251","name":"X-ray xm sm int 2cntrst std","description":"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) study, including glucagon, when administered","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0756T","name":"Dgtz gls mcrscp sld spc grpi","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group i, for microorganisms (eg, acid fast, methenamine silver) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37294","name":"Rvsc evsc tpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98015","name":"Synch audio-only est high 40","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selec","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0570","name":"Care manage serv, pr cal mo","description":"Care management services for behavioral health conditions, directed by a physician or other qualified health care professional, per calendar month, with the following required elements: initial assessment or follow-up monitoring, including the use of applicable validated rating scales, behavioral he","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2050","name":"Financial mgt waiver/diem","description":"Financial management, self-directed, waiver; per diem","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98013","name":"Synch audio-only est low 20","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code select","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82963","name":"Assay of glucosidase","description":"Glucosidase, beta","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1271","name":"Pts dem any time/dur mo","description":"Patients with dementia at any time prior to or during the month","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97009","name":"Mchnl sclp cool after chemo","description":"Mechanical scalp cooling; provided after discontinuation of chemotherapy, each 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0236","name":"Intrav inf, mon anti, sec do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98013","name":"Synch audio-only est low 20","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code select","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2051","name":"Support broker waiver/diem","description":"Supports brokerage, self-directed, waiver; per diem","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86042","name":"Acetylcholn rcptr blckg antb","description":"Acetylcholine receptor (achr); blocking antibody","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9294","name":"Biofeed dig cog behav tx fda","description":"Prescription digital cognitive and/or behavioral therapy, biofeedback, fda cleared, per course of treatment","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0577U","name":"Onc ovr serum alys 39 gps","description":"Onc ovr serum alys 39 gps","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75605","name":"Contrast exam thoracic aorta","description":"Aortography, thoracic, by serialography, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59855","name":"Induced abortion 1+vag supp","description":"Induced abortion, by 1 or more vaginal suppositories (eg, prostaglandin) with or without cervical dilation (eg, laminaria), including hospital admission and visits, delivery of fetus and secundines;","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35602","name":"Bpg crtd-clat crtd","description":"Bypass graft, with other than vein; carotid-contralateral carotid","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4409","name":"Amniomatrixf3x per sq cm","description":"Amniomatrixf3x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0491U","name":"Onc sol tum ctc slct er prtn","description":"Onc sol tum ctc slct er prtn","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23545","name":"Cltx acromclav dislc w/mnpj","description":"Closed treatment of acromioclavicular dislocation; with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99437","name":"Chrnc care mgmt phys ea addl","description":"Chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, or funct","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24125","name":"Exc/crtg b1 cst/tum rds agrf","description":"Excision or curettage of bone cyst or benign tumor of head or neck of radius or olecranon process; with autograft (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":683.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0883T","name":"Intraop ther estim pn ue ea","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; each additional nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92641","name":"Hearing dev verif eacous aly","description":"Hearing device verification, electroacoustic analysis","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3291","name":"Tranexamic acid in sod chlor","description":"Injection, tranexamic acid in sodium chloride, 5 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0680","name":"Cr art clc art vlv clc w rpt","description":"Detection and quantification of coronary artery calcium and/or aortic valve calcification from algorithmic analysis of computed tomography of the chest with report","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0012","name":"Injection of hiv prep drug","description":"Injection of pre-exposure prophylaxis (prep) drug for hiv prevention, under skin or into muscle","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1709","name":"Pfizer vaccine admin booster","description":"Pfizer vaccine admin booster","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1453","name":"Preop vis acu > 20/40","description":"Patients with a pre-operative visual acuity better than 20/40","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4366","name":"Dl amnio bur x-mem per sq cm","description":"Dual layer amnio burgeon x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2044","name":"Biobrane glove, each","description":"Biobrane glove, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0367U","name":"Onc bldr 10 flwg trurl rescj","description":"Onc bldr 10 flwg trurl rescj","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0772T","name":"Vr px dissoc svc sm phy ea","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72194","name":"Ct pelvis w/o & w/dye","description":"Computed tomography, pelvis; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":508.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55708","name":"Bx prst8 trct us w/mri fus 1","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant) with mri-fusion-guidance, first targeted lesion","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0303U","name":"Hem rbc ads whl bld hypoxic","description":"Hem rbc ads whl bld hypoxic","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"Rec cath any transanal, each","description":"Rectal catheter with or without balloon, for use with any type transanal irrigation system, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1821","name":"Ko elas w/ condyle pads otf","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, off the shelf","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1333","name":"Acute vitreous hemorrhage","description":"Acute vitreous hemorrhage","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98001","name":"Synch audio-video new low 30","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6601","name":"G com bandge hgh dn foam pad","description":"Gradient compression bandaging supply, high density foam pad, any size or shape, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1367","name":"Qual care ent disorder mvp","description":"Quality care for the treatment of ear, nose, and throat disorders mips value pathway","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2042","name":"Foundation drs+ solo, sq cm","description":"Foundation drs+ solo, per square centimeter","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4309","name":"Via matrix, per sq cm","description":"Via matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44900","name":"I&d appendix abscess open","description":"Incision and drainage of appendiceal abscess, open","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1480","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9996","name":"Ustekinumab- ttwe sub cu inj","description":"Injection, ustekinumab-ttwe (pyzchiva), subcutaneous, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0287U","name":"Onc thyr dna&mrna 112 genes","description":"Onc thyr dna&mrna 112 genes","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6091","name":"Repl semi/precision attach","description":"Replacement of semi-precision or precision attachment (male or female component) of implant/abutment supported prosthesis per attachment","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2799","name":"Inj, uzedy, 1 mg","description":"Injection, risperidone (uzedy), 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1174","name":"Pt w/ 2 hzv 10/2017 - mp","description":"Patient received at least two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5934","name":"Mandibular flange prosthesis","description":"Mandibular resection prosthesis with guide flange","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0494U","name":"Rbc ag ftl rhd gene alys ngs","description":"Rbc ag ftl rhd gene alys ngs","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86362","name":"Mog-igg1 antb cba each","description":"Myelin oligodendrocyte glycoprotein (mog-igg1) antibody; cell-based immunofluorescence assay (cba), each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6603","name":"G com bandge low dn foamchnl","description":"Gradient compression bandaging supply, low density channel foam sheet, per 250 square centimeters, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11765","name":"Wedge excision skn nail fold","description":"Wedge excision of skin of nail fold (eg, for ingrown toenail)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2012","name":"Suprathel, per sq cm","description":"Suprathel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q9949","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90970","name":"Esrd svc pr day pt 20+","description":"End-stage renal disease (esrd) related services for dialysis less than a full month of service, per day; for patients 20 years of age and older","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32445","name":"Removal of lung extrapleural","description":"Removal of lung, pneumonectomy; extrapleural","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1925.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6601","name":"G com bandge hgh dn foam pad","description":"Gradient compression bandaging supply, high density foam pad, any size or shape, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0295U","name":"Onc brst dux carc 7 proteins","description":"Onc brst dux carc 7 proteins","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4427","name":"Dermbnd dln dl+ dlx sq cm","description":"Dermabind dl n or dermabind dl + or dermabind dl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0534U","name":"Onc prst8 mirna snp 32 vrnt","description":"Onc prst8 mirna snp 32 vrnt","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"Ctlso a-p-l control custom","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0262U","name":"Onc sld tum rt-pcr 7 gen","description":"Oncology (solid tumor), gene expression profiling by real-time rt-pcr of 7 gene pathways (er, ar, pi3k, mapk, hh, tgfb, notch), formalin-fixed paraffin-embedded (ffpe), algorithm reported as gene pathway activity score","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0892","name":"Argatroban dialysis (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76040","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86826","name":"Hla x-match noncytotoxc addl","description":"Human leukocyte antigen (hla) crossmatch, non-cytotoxic (eg, using flow cytometry); each additional serum sample or sample dilution (list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58110","name":"Bx done w/colposcopy add-on","description":"Endometrial sampling (biopsy) performed in conjunction with colposcopy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3431","name":"Biological materials","description":"Biological materials","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0465U","name":"Onc urthl carc dna qmsp 2gen","description":"Onc urthl carc dna qmsp 2gen","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0914T","name":"Prq tcat thr rx ntrc bal sep","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting) performed on a separate target lesion from the target lesion treated with balloon angioplasty, coronary stent placement or coronary atherectomy, including mechanical dilation b","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5152","name":"Inj, eculizumab-aeeb, 2 mg","description":"Injection, eculizumab-aeeb (bkemv), biosimilar, 2 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1006T","name":"Elec alys s-scl eeg prgrm ea","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, each additional 15 minutes face-to-face time with physician or other qua","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84446","name":"Assay of vitamin e","description":"Tocopherol alpha (vitamin e)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0362U","name":"Onc pap thyr ca rna 82&10","description":"Onc pap thyr ca rna 82&10","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2054","name":"Lisocabtagene mara car pos t","description":"Lisocabtagene maraleucel, up to 110 million autologous anti-cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28122","name":"Partial removal of foot bone","description":"Partial excision (craterization, saucerization, sequestrectomy, or diaphysectomy) bone (eg, osteomyelitis or bossing); tarsal or metatarsal bone, except talus or calcaneus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":611.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0333U","name":"Onc lvr surveilanc hcc cfdna","description":"Onc lvr surveilanc hcc cfdna","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82154","name":"Androstanediol glucuronide","description":"Androstanediol glucuronide","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1194","name":"Med rsn no imp/con mmr/msi","description":"Documentation of medical reason(s) surgical pathology reports did not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both tests were not included (e.g., patient will not be treated with checkpoint inhibitor therap","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0874T","name":"Rmvl pertl ascites pmp sys","description":"Removal of a peritoneal ascites pump system, including implanted peritoneal ascites pump and indwelling bladder and peritoneal catheters","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1258","name":"Cvd risk assess perf","description":"Cvd risk assessment performed, have a documented calculated risk score","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0915T","name":"Insj perm ccm-d sys pg&eltrd","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator and dual transvenous electrodes/leads (pacing and defibrillation)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0691T","name":"Auto alys xst ct std vrt fx","description":"Automated analysis of an existing computed tomography study for vertebral fracture(s), including assessment of bone density when performed, data preparation, interpretation, and report","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0873","name":"Inj daptomycin (xellia)","description":"Injection, daptomycin (xellia), not therapeutically equivalent to j0878 or j0872, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0961T","name":"Shortwave ifr radiation img","description":"Shortwave infrared radiation imaging, surgical pathology specimen, to assist gross examination for lymph node localization in fibroadipose tissue, per specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24565","name":"Cltx hum epcndylr fx w/mnpj","description":"Closed treatment of humeral epicondylar fracture, medial or lateral; with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44404","name":"Colonoscopy w/injection","description":"Colonoscopy through stoma; with directed submucosal injection(s), any substance","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":542.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0543","name":"Group train w/o patient","description":"Group caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient pre","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0858T","name":"Ext trnscranl mag stimj meas","description":"Externally applied transcranial magnetic stimulation with concomitant measurement of evoked cortical potentials with automated report","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77081","name":"Dxa bone density appendiculr","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1444","name":"Del < 39 weeks gest","description":"Delivery at < 39 weeks of gestation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3473","name":"Surg rep root res molar","description":"Surg rep root res molar","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5142","name":"Inj adalimumab-ryvk, 1 mg","description":"Injection, adalimumab-ryvk biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0880T","name":"Augmnt alys ch ct ild i&r","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4231","name":"Ana crown exp 1-3 per quad","description":"Anatomical crown exposure - one to three teeth per quadrant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0002A","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6612","name":"Onlay cst base mtl 2 surface","description":"Onlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0765T","name":"Asstv alg ecg rsk asmt prev","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to previously performed electrocardiogram","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0010","name":"Eom meos payment","description":"Enhancing oncology model (eom) monthly enhanced oncology services (meos) payment for eom enhanced services","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59618","name":"Attempted vbac delivery","description":"Routine obstetric care including antepartum care, cesarean delivery, and postpartum care, following attempted vaginal delivery after previous cesarean delivery","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2334.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0615U","name":"Bbrgdrferi ld antb detcj 26","description":"Bbrgdrferi ld antb detcj 26","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1032","name":"Sv doula brth wrk per 15 min","description":"Services performed by a doula birth worker, per 15 minutes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1174","name":"Pt w/ 2 hzv 10/2017 - mp","description":"Patient received at least two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46730","name":"Construction of absent anus","description":"Repair of high imperforate anus without fistula; perineal or sacroperineal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1815.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86403","name":"Particle agglut antbdy scrn","description":"Particle agglutination; screen, each antibody","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91320","name":"Sarscv2 vac 30mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 30 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4302","name":"Complete aca, per sq cm","description":"Complete aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94617","name":"Exercise tst brncspsm w/ecg","description":"Exercise test for bronchospasm, including pre- and post-spirometry and pulse oximetry; with electrocardiographic recording(s)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2045","name":"Novashield/novogen pr sq cm","description":"Novashield or novogen wound matrix, per square centimeter","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0543","name":"Group train w/o patient","description":"Group caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient pre","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0349","name":"Inj, rezafungin, 1 mg","description":"Injection, rezafungin, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":666.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3389","name":"Topi adm prad zami per treat","description":"Topical administration, prademagene zamikeracel, per treatment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0425U","name":"Genom rpd seq alys ea cmprtr","description":"Genom rpd seq alys ea cmprtr","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97814","name":"Acup 1/> w/estim ea addl 15","description":"Acupuncture, 1 or more needles; with electrical stimulation, each additional 15 minutes of personal one-on-one contact with the patient, with insertion of needle(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":27.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0275U","name":"Hem heprn nduc trmbctpna srm","description":"Hematology (heparin-induced thrombocytopenia) platelet antibody reactivity by flow cytometry, serum","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0744T","name":"Insj bioprostc vlv fem vn","description":"Insertion of bioprosthetic valve, open, femoral vein, including duplex ultrasound imaging guidance, when performed, including autogenous or nonautogenous patch graft (eg, polyester, eptfe, bovine pericardium), when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80503","name":"Path clin consltj sf 5-20","description":"Pathology clinical consultation; for a clinical problem, with limited review of patients history and medical records and straightforward medical decision making when using time for code selection, 5-20 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2252","name":"Inj midazolam in 0.8% nacl","description":"Injection, midazolam in 0.8% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93146","name":"Interrog crtd sins bat ip w/","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33927","name":"Impltj tot rplcmt hrt sys","description":"Implantation of a total replacement heart system (artificial heart) with recipient cardiectomy","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2650.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4352","name":"Overlay sl matrix, per sq cm","description":"Overlay sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5156","name":"Inj, tocilizumab-anoh, 1 mg","description":"Injection, tocilizumab-anoh (avtozma), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36565","name":"Insert tunneled cv cath","description":"Insertion of tunneled centrally inserted central venous access device, requiring 2 catheters via 2 separate venous access sites; without subcutaneous port or pump (eg, tesio type catheter)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4413","name":"Cygnus solo per sq cm","description":"Cygnus solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94640","name":"Airway inhalation treatment","description":"Pressurized or nonpressurized inhalation treatment for acute airway obstruction for therapeutic purposes and/or for diagnostic purposes such as sputum induction with an aerosol generator, nebulizer, metered dose inhaler or intermittent positive pressure breathing (ippb) device","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":10.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3502","name":"Surg exp root surf premolar","description":"Surg exp root surf premolar","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0266U","name":"Unxpl cnst hrtbl do gn xprsn","description":"Unexplained constitutional or other heritable disorders or syndromes, tissue-specific gene expression by whole-transcriptome and next-generation sequencing, blood, formalin-fixed paraffin-embedded (ffpe) tissue or fresh frozen tissue, reported as presence or absence of splicing or expression changes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33417","name":"Repair of aortic valve","description":"Aortoplasty (gusset) for supravalvular stenosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2071.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4542","name":"Supp ext up limb tremor stim","description":"Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":526.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45330","name":"Diagnostic sigmoidoscopy","description":"Sigmoidoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":248.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80504","name":"Path clin consltj mod 21-40","description":"Pathology clinical consultation; for a moderately complex clinical problem, with review of patients history and medical records and moderate level of medical decision making when using time for code selection, 21-40 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2305","name":"Inj, nitroglycerin, 5 mg","description":"Injection, nitroglycerin, 5 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0288U","name":"Onc lung mrna quan pcr 11&3","description":"Onc lung mrna quan pcr 11&3","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1222","name":"Glaucoma pln of care not doc","description":"Glaucoma plan of care not documented, reason not otherwise specified","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52284","name":"Cysto rx balo cath urtl strx","description":"Cystourethroscopy, with mechanical urethral dilation and urethral therapeutic drug delivery by drug-coated balloon catheter for urethral stricture or stenosis, male, including fluoroscopy, when performed","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1190","name":"Doc khe not pef w/efgr/uacr","description":"Documentation of a kidney health evaluation was not performed or defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0654","name":"Inj, liothyronine, 1 mcg","description":"Injection, liothyronine, 1 mcg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1159","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0789T","name":"Elec aly cpx iins sp/sac nrv","description":"Electronic analysis with complex programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detect","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4370","name":"Aeroguard per sq cm","description":"Aeroguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4424","name":"Revive ft per sq cm","description":"Revive ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0524U","name":"Ob pe sflt-1/plgf ia srm/pls","description":"Ob pe sflt-1/plgf ia srm/pls","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4024","name":"Pediatrics ss","description":"Pediatrics mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15012","name":"Hrv skn cll ssp agrft ea add","description":"Harvest of skin for skin cell suspension autograft; each additional 25 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0910T","name":"Rmvl int nstim sys vagus nrv","description":"Removal of integrated neurostimulation system, vagus nerve","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58292","name":"Vag hyst t/o & repair compl","description":"Vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s), with repair of enterocele","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1563.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0628U","name":"Nfro kdn ds genetic cond 449","description":"Nfro kdn ds genetic cond 449","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37290","name":"Revsc evsc tpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0704T","name":"Rem tx amblyopia setup&edu","description":"Remote treatment of amblyopia using an eye tracking device; device supply with initial set-up and patient education on use of equipment","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31633","name":"Bronchoscopy/needle bx addl","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial needle aspiration biopsy(s), each additional lobe (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0261U","name":"Onc clrct ca img alys w/ai","description":"Oncology (colorectal cancer), image analysis with artificial intelligence assessment of 4 histologic and immunohistochemical features (cd3 and cd8 within tumor-stroma border and tumor core), tissue, reported as immune response and recurrence-risk score","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0727T","name":"Rmvl&rplcmt implt vstblr dev","description":"Removal and replacement of implanted vestibular device, unilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1300","name":"Flu imm no admin doc rea","description":"Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2525","name":"Cl, hydrophilic, dual focus","description":"Contact lens, hydrophilic, dual focus, per lens","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59430","name":"Care after delivery","description":"Postpartum care only (separate procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":304.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":186.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1938","name":"Inj, furosemide, 1 mg","description":"Injection, furosemide, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15011","name":"Hrv skn cll ssp agrft 1st 25","description":"Harvest of skin for skin cell suspension autograft; first 25 sq cm or less","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15574","name":"Pedcle fh/ch/ch/m/n/ax/g/h/f","description":"Formation of direct or tubed pedicle, with or without transfer; forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands or feet","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":850.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33509","name":"Ndsc hrv uxtr art 1 sgm cab","description":"Harvest of upper extremity artery, 1 segment, for coronary artery bypass procedure, endoscopic","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64466","name":"Thrc fascial pln blk uni njx","description":"Thoracic fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0319U","name":"Neph rna pretrnspl perph bld","description":"Neph rna pretrnspl perph bld","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51721","name":"Ins trurl ablt trnsdc thr us","description":"Insertion of transurethral ablation transducer for delivery of thermal ultrasound for prostate tissue ablation, including suprapubic tube placement during the same session and placement of an endorectal cooling device, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42330","name":"Removal of salivary stone","description":"Sialolithotomy; submandibular (submaxillary), sublingual or parotid, uncomplicated, intraoral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60661","name":"Abltj 1/+thyr ndul addl prq","description":"Ablation of 1 or more thyroid nodule(s), additional lobe, percutaneous, including imaging guidance, radiofrequency (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0899T","name":"N-invas deter aqmbf aug cmr","description":"Noninvasive determination of absolute quantitation of myocardial blood flow (aqmbf), derived from augmentative algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health car","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0534U","name":"Onc prst8 mirna snp 32 vrnt","description":"Onc prst8 mirna snp 32 vrnt","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0689T","name":"Quan us tis charac w/o dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained without diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27458","name":"Osteot femur imed lngth dev","description":"Osteotomy(ies), femur, unilateral, with insertion of an externally controlled intramedullary lengthening device, including iliotibial band release when performed, imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4275","name":"Esano aca, per sq cm","description":"Esano aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28296","name":"Cor hlx vlgs dstl mtar osteo","description":"Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with distal metatarsal osteotomy, any method","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9947","name":"Sleep apnea appliance","description":"Sleep apnea appliance","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64582","name":"Opn mpltj hpglsl nstm ary pg","description":"Open implantation of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0040","name":"Pt phys/occ therapy","description":"Patient already receiving physical/occupational/speech/recreational therapy during the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0404U","name":"Onc brst semiq meas thym kn","description":"Onc brst semiq meas thym kn","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0788T","name":"Elec aly smp iins sp/sac nrv","description":"Electronic analysis with simple programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detecti","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1018T","name":"Elec alys npgs esoph sbsq w/","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4564","name":"Pessary, disposable any type","description":"Pessary, disposable, any type","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0739","name":"Hiv prep, inj, cabotegravir","description":"Injection, cabotegravir, 1mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0594U","name":"Nfct ds sepsis pncrtc spc","description":"Nfct ds sepsis pncrtc spc","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0790T","name":"Revj rplcmt/rmvl vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracolumbar or lumbar vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9247","name":"Mod sedation noniv-sub15min","description":"Mod sedation noniv-sub15min","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93896","name":"Vsrctv std tcd icr art compl","description":"Vasoreactivity study performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0924T","name":"Rpos prv ccm-d trnsvns eltrd","description":"Repositioning of previously implanted cardiac contractility modulation-defibrillation transvenous electrode(s)/lead(s), including fluoroscopic guidance and programming of sensing and therapeutic parameters","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94375","name":"Respiratory flow volume loop","description":"Respiratory flow volume loop","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]},{"negotiated_type":"negotiated","negotiated_rate":16.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6599","name":"G comp bandage short stretch","description":"Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98000","name":"Synch audio-video new sf 15","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 15 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0961T","name":"Shortwave ifr radiation img","description":"Shortwave infrared radiation imaging, surgical pathology specimen, to assist gross examination for lymph node localization in fibroadipose tissue, per specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2007","name":"Restrata, per sq cm","description":"Restrata, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33277","name":"Insj phrnc nrv stim transvns","description":"Insertion of phrenic nerve stimulator transvenous sensing lead (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0445U","name":"Abeta42 & ptau181 eclia csf","description":"Abeta42 & ptau181 eclia csf","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1748","name":"Inj, zymfentra, 10 mg","description":"Injection, infliximab-dyyb (zymfentra), 10 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1455","name":"Rep/rev cied","description":"Replaced or revised cied","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0940T","name":"Xtrnl ecg rec>15d<30d r&i","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0843T","name":"Dgtz gls mcrscp cslt cyt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), initial site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47605","name":"Cholecystectomy w/cholang","description":"Cholecystectomy; with cholangiography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87172","name":"Pinworm exam","description":"Pinworm exam (eg, cellophane tape prep)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7412","name":"Excision benign lesion compl","description":"Excision of benign lesion complicated","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0520U","name":"Ther rx mntr 200+ rx/sbsts","description":"Ther rx mntr 200+ rx/sbsts","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0047","name":"Ped blunt hd traum","description":"Pediatric patient with minor blunt head trauma and pecarn prediction criteria are not assessed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0549","name":"Phone/inter for treat>31m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0923T","name":"Rmvl&rplcmt perm ccm-d pg","description":"Removal and replacement of permanent cardiac contractility modulation-defibrillation pulse generator only","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0379U","name":"Tgsap sl or neo dna523&rna55","description":"Tgsap sl or neo dna523&rna55","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37260","name":"Revsc evasc ivt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6196","name":"Remv of ind rest on implt","description":"Remv of ind rest on implt","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0175","name":"Inj, donanemab-azbt, 2 mg","description":"Injection, donanemab-azbt, 2 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4303","name":"Complete aa, per sq cm","description":"Complete aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1414","name":"Med rsn no pdl1 bef 1st ther","description":"Documentation of medical reason(s) for not performing the pd-l1 biomarker expression test prior to initiation of first-line immune checkpoint inhibitor therapy (e.g., patient is in an urgent or emergent situation where delay of treatment would jeopardize the patients health status; other medical rea","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9393","name":"Inj, fulvestrant (teva)","description":"Injection, fulvestrant (teva), not therapeutically equivalent to j9395, 25 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0573U","name":"Onc pancreas 3bmrk pclf alg","description":"Onc pancreas 3bmrk pclf alg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4457","name":"Enema tube any type repl","description":"Enema tube, with or without adapter, any type, replacement only, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2040","name":"Coord specialty care, month","description":"Coordinated specialty care, team-based, for first episode psychosis, per month","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1329","name":"Pts act pvd 2 wks 8 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 8 weeks after initial acute pvd encounter","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61737","name":"Litt icr mlt trj mlt/cplx ls","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; multiple trajectories for multiple or complex lesion(s)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9318","name":"Inj romidepsin non-lyo 0.1mg","description":"Injection, romidepsin, non-lyophilized, 0.1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86580","name":"Tb intradermal test","description":"Skin test; tuberculosis, intradermal","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43290","name":"Egd flx trnsorl dplmnt balo","description":"Esophagogastroduodenoscopy, flexible, transoral; with deployment of intragastric bariatric balloon","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84393","name":"Tau phosphorylated ea","description":"Tau, phosphorylated (eg, ptau 181, ptau 217), each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47600","name":"Cholecystectomy","description":"Cholecystectomy;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":958.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0795T","name":"Tcat ins 2chmbr ldls pm cmpl","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; complete system (ie, r","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1498","name":"Diagnostic radiology mvp","description":"Diagnostic radiology mips value pathway","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81459","name":"So neo gsap dna/dna&rna","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants, microsatellite instability, tumor mutation burden, and rearrangements","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62331","name":"Dcmprn prq rmv lig flv addl","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; additional interspace(s), lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97008","name":"Mchnl sclp cool prep plmt","description":"Mechanical scalp cooling; including hair preparation, individual cap placement, therapy initiation, and precooling period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86362","name":"Mog-igg1 antb cba each","description":"Myelin oligodendrocyte glycoprotein (mog-igg1) antibody; cell-based immunofluorescence assay (cba), each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1234","name":"Pt hcv rctv aby f/u neg","description":"Patient has a reactive hcv antibody test, and has a follow up hcv viral test that does not detect hcv viremia","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38225","name":"Car-t hrv bld-drv t lymphcyt","description":"Chimeric antigen receptor t-cell (car-t) therapy; harvesting of blood-derived t lymphocytes for development of genetically modified autologous car-t cells, per day","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1214","name":"Spiro results wth obs doc","description":"Spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and reviewed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0825T","name":"Tcat rmv&rpl1chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or prog","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9269","name":"Programable ingest capsule","description":"Programable, transient, orally ingested capsule, for use with external programmer, per month","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1434","name":"Orl chemo wthn 30 d post enc","description":"Patient on oral chemotherapy on or within 30 days after denominator eligible encounter","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0778T","name":"Smmg cncrnt appl imu snr","description":"Surface mechanomyography (smmg) with concurrent application of inertial measurement unit (imu) sensors for measurement of multi-joint range of motion, posture, gait, and muscle function","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1390","name":"Pt no doc exm for rec","description":"Patients who do not have a documented exam performed for recurrence of melanoma or no documentation within the performance period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0684T","name":"Peri-px dev eval isdss ip","description":"Peri-procedural device evaluation (in-person) and programming of device system parameters before or after a surgery, procedure, or test with analysis, review, and report by a physician or other qualified health care professional, permanent implantable synchronized diaphragmatic stimulation system fo","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91323","name":"Sarscov2 vac 10 mcg/0.2ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 10 mcg/0.2 ml dosage, for intramuscular use","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0939T","name":"Xtrnl ecg rec>15d<30d scan","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; scanning analysis with report","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4324","name":"Amniotx, per sq cm","description":"Amniotx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90821","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1472","name":"Hep b vaccine not received","description":"Patient did not receive recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34702","name":"Evasc rpr a-ao ndgft rpt","description":"Endovascular repair of infrarenal aorta by deployment of an aorto-aortic tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the aorta from the level ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1903.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0036","name":"Pt/ptn decln assess","description":"Patient or care partner decline assessment","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1224","name":"Iop dec <20% from base","description":"Intraocular pressure (iop) reduced by a value less than 20% from the pre-intervention level","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0675","name":"Inj, carboprost, 0.1 mg","description":"Injection, carboprost tromethamine, 0.1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27278","name":"Arthrd si jt plmt iartic dev","description":"Arthrodesis, sacroiliac joint, percutaneous or minimally invasive, with image guidance, includes obtaining bone graft when performed, unilateral; placement of intra-articular device(s), without cortical piercing","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86258","name":"Dgp antibody each ig class","description":"Gliadin (deamidated) (dgp) antibody, each immunoglobulin (ig) class","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9998","name":"Doc med rsn <3 colon","description":"Documentation of medical reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., last colonoscopy incomplete, last colonoscopy had inadequate prep, piecemeal removal of adenomas, or sessile serrated polyps >= 20 mm in size, last colonoscopy found greater than 10 adenomas, lo","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57531","name":"Removal of cervix radical","description":"Radical trachelectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling biopsy, with or without removal of tube(s), with or without removal of ovary(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1978.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9277","name":"Pembrolizumab 1mg berahyalur","description":"Injection, pembrolizumab, 1 mg and berahyaluronidase alfa-pmph","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0609","name":"Ferric citrate orl 3 mg iron","description":"Ferric citrate, oral, 3 mg ferric iron, (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33200","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":941.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5160","name":"Inj, jobevne, 10 mg","description":"Injection, bevacizumab-nwgd (jobevne), biosimilar, 10 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53866","name":"Cathj rmvl dev ischmc rmdlg","description":"Catheterization with removal of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4333","name":"Ardeograft, per sq cm","description":"Ardeograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62116","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1996.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64818","name":"Sympathectomy lumbar","description":"Sympathectomy, lumbar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":755.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36002","name":"Pseudoaneurysm injection trt","description":"Injection procedures (eg, thrombin) for percutaneous treatment of extremity pseudoaneurysm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9291","name":"Pres dig cog behav thera fda","description":"Prescription digital cognitive and/or behavioral therapy, fda cleared, per course of treatment","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2035","name":"Corpl p therac p allac p mg","description":"Corplex p or theracor p or allacor p, per milligram","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4337","name":"Artecent trident, per sq cm","description":"Artacent trident, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4276","name":"Orion, per sq cm","description":"Orion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84482","name":"T3 reverse","description":"Triiodothyronine t3; reverse","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1399","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0512U","name":"Onc prst8 alys dgtz img msi","description":"Onc prst8 alys dgtz img msi","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1653","name":"Ho abduction static ots","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, off the shelf","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0561U","name":"Onc mrd gsa cfdna subsequent","description":"Onc mrd gsa cfdna subsequent","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68745","name":"Create tear duct drain","description":"Conjunctivorhinostomy (fistulization of conjunctiva to nasal cavity); without tube","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0524","name":"Est pt-cg dyad dem low cmplx","description":"Management of established patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1432","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32501","name":"Repair bronchus add-on","description":"Resection and repair of portion of bronchus (bronchoplasty) when performed at time of lobectomy or segmentectomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01940","name":"Anes nulyt agt lmbr/sac","description":"Anesthesia for percutaneous image-guided destruction procedures by neurolytic agent on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93231","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0538U","name":"Onc sol tum ngts ffpe 600gen","description":"Onc sol tum ngts ffpe 600gen","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0245","name":"Initial foot exam pt lops","description":"Initial physician evaluation and management of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) which must include: (1) the diagnosis of lops, (2) a patient history, (3) a physical examination that consists of at least the following elements: (a)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5913","name":"Nasal prosthesis","description":"Nasal prosthesis","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4349","name":"Mantle dl matrix per sq cm","description":"Mantle dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1323","name":"Inj, elranatamab-bcmm, 1 mg","description":"Injection, elranatamab-bcmm, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1711","name":"Moderna vacc admin booster","description":"Moderna vacc admin booster","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26715","name":"Treat knuckle dislocation","description":"Open treatment of metacarpophalangeal dislocation, single, includes internal fixation, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":556.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2001","name":"Suct pum ext mgmt sys","description":"Suction pump, home model, portable or stationary, electric, any type, for use with external urine and/or fecal management system","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":652.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0048","name":"Pall serv during meas","description":"Patients who receive palliative care services any time during the intake period through the end of the measurement year","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37288","name":"Revsc evsc tpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43846","name":"Gstr rstcv px shrt roux-en-y","description":"Gastric restrictive procedure, with gastric bypass for morbid obesity; with short limb (150 cm or less) roux-en-y gastroenterostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1656.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6038","name":"Multiax rotation attachment","description":"Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0907T","name":"Coms ther ea addl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; each additional application, total wound(s) surface area less than or equal to 50 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1188","name":"Pt w/ ckd stg 5","description":"Patients with a diagnosis of chronic kidney disease (ckd) stage 5","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9248","name":"Inj melphalan (hepzato) 1 mg","description":"Injection, melphalan (hepzato), 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9573","name":"Inj, gadopiclenol, 1 ml","description":"Injection, gadopiclenol, 1 ml","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4431","name":"Pma skin substitute, nos","description":"Pma skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4252","name":"Vendaje, per square centimet","description":"Vendaje, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0392U","name":"Rx metab genrx ia 16 genes","description":"Rx metab genrx ia 16 genes","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87593","name":"Orthopoxvirus amp prb each","description":"Infectious agent detection by nucleic acid (dna or rna); orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus), amplified probe technique, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0712T","name":"N-nvs artl plaq alys quan","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess atherosclerotic plaque stability","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15853","name":"Removal sutr/stapl xreq anes","description":"Removal of sutures or staples not requiring anesthesia (list separately in addition to e/m code)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0616U","name":"Neurol dementia alys >30000","description":"Neurol dementia alys >30000","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4417","name":"Alexiguard dl-t per sq cm","description":"Alexiguard dl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7111","name":"Extraction coronal remnants","description":"Extraction coronal remnants - deciduous tooth","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76801","name":"Ob us < 14 wks single fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34711","name":"Dlyd plmt xtn prosth ea addl","description":"Delayed placement of distal or proximal extension prosthesis for endovascular repair of infrarenal abdominal aortic or iliac aneurysm, false aneurysm, dissection, endoleak, or endograft migration, including pre-procedure sizing and device selection, all nonselective catheterization(s), all associate","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5909","name":"Max guid prothes w/ flange","description":"Max guid prothes w/ flange","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82570","name":"Assay of urine creatinine","description":"Creatinine; other source","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0736","name":"Inj, clindamycin phosp 300mg","description":"Injection, clindamycin phosphate, 300 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99307","name":"Sbsq nf care sf mdm 10","description":"Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 10 minutes must be met or e","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":39.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2359","name":"Inj. olanzapine, 0.5mg","description":"Injection, olanzapine, 0.5 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7023","name":"Mech allergen parti barrier","description":"Mechanical allergen particle barrier/inhalation filter, cream, nasal, topical","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83540","name":"Assay of iron","description":"Iron","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1396","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0530","name":"Adult daycare center, 8 hr u","description":"Adult day center, 8-hour unit, for use in cmmi model","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58575","name":"Laps tot hyst resj mal","description":"Laparoscopy, surgical, total hysterectomy for resection of malignancy (tumor debulking), with omentectomy including salpingo-oophorectomy, unilateral or bilateral, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2056.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82544","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1412","name":"Inj roctavian ml 2x10^13vc g","description":"Injection, valoctocogene roxaparvovec-rvox, per ml, containing nominal 2 x 10^13 vector genomes","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1414","name":"Med rsn no pdl1 bef 1st ther","description":"Documentation of medical reason(s) for not performing the pd-l1 biomarker expression test prior to initiation of first-line immune checkpoint inhibitor therapy (e.g., patient is in an urgent or emergent situation where delay of treatment would jeopardize the patients health status; other medical rea","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86036","name":"Anca screen each antibody","description":"Antineutrophil cytoplasmic antibody (anca); screen, each antibody","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2042","name":"Foundation drs+ solo, sq cm","description":"Foundation drs+ solo, per square centimeter","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0225","name":"Inj, vutrisiran, 1 mg","description":"Injection, vutrisiran, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78608","name":"Brain imaging (pet)","description":"Brain imaging, positron emission tomography (pet); metabolic evaluation","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0688T","name":"Tx amblyopia assmt w/report","description":"Treatment of amblyopia using an online digital program; assessment of patient performance and program data by physician or other qualified health care professional, with report, per calendar month","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94626","name":"Phy/qhp op pulm rhb w/mntr","description":"Physician or other qualified health care professional services for outpatient pulmonary rehabilitation; with continuous oximetry monitoring (per session)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9052","name":"Inj, carmustine (accord)","description":"Injection, carmustine (accord), not therapeutically equivalent to j9050, 100 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0438","name":"Ppps, initial visit","description":"Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9051","name":"Inj, bortezomib (maia)","description":"Injection, bortezomib (maia), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0921T","name":"Rmvl perm ccm-d sys 1 dfb ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous defibrillation lead only","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1711","name":"Moderna vacc admin booster","description":"Moderna vacc admin booster","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61736","name":"Litt icr 1 traj 1 smpl les","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; single trajectory for 1 simple lesion","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0624U","name":"Hep nash dna mthyl alys 5000","description":"Hep nash dna mthyl alys 5000","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4009","name":"Hospitalists ss","description":"Hospitalists mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0749T","name":"B1 str&fx rsk assmt dxr-bmd","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0697T","name":"Quan mr tis wo mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained without diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, targ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2865","name":"Inj sulfameth/trim 5 mg/1 mg","description":"Injection, sulfamethoxazole 5 mg and trimethoprim 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0727T","name":"Rmvl&rplcmt implt vstblr dev","description":"Removal and replacement of implanted vestibular device, unilateral","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85018","name":"Hemoglobin","description":"Blood count; hemoglobin (hgb)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1165","name":"Pt use hspc dur meas pd","description":"Patients who use hospice services any time during the measurement period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1407","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11045","name":"Dbrdmt subq tiss each addl","description":"Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); each additional 20 sq cm, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98926","name":"Osteopath manj 3-4 regions","description":"Osteopathic manipulative treatment (omt); 3-4 body regions involved","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":49.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1173","name":"Pt no rec td/tdap 9yrs prior","description":"Patient did not receive at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9156","name":"Oral mucoadhesive per 1 ml","description":"Oral mucoadhesive, any type (liquid, gel, paste, etc.), per 1 ml","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93145","name":"Interrog crtd sins bat ip wo","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6634","name":"Onlay titanium","description":"Onlay - titanium","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98015","name":"Synch audio-only est high 40","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selec","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62331","name":"Dcmprn prq rmv lig flv addl","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; additional interspace(s), lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90624","name":"Menb-4c&menacwy vacc im","description":"Meningococcal pentavalent vaccine, men b-4c recombinant proteins and outer membrane vesicle and conjugated men a, c, w, y-diphtheria toxoid carrier, for intramuscular use","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98981","name":"Rtm tx mgmt ea addl 20 min","description":"Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least 1 real-time interactive communication with the patient or caregiver during the calendar month; each additional 20 minutes (list separately in","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0338U","name":"Onc sld tum crcg tum cl slct","description":"Onc sld tum crcg tum cl slct","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65135","name":"Insert ocular implant","description":"Insertion of ocular implant secondary; after enucleation, muscles not attached to implant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":766.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3394","name":"Inj, lovotibeglogene autotem","description":"Injection, lovotibeglogene autotemcel, per treatment","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6611","name":"Grad com wrap w strap ak cus","description":"Gradient compression wrap with adjustable straps, above knee, each, custom","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2991","name":"App of hydroxyapatite","description":"App of hydroxyapatite","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0843T","name":"Dgtz gls mcrscp cslt cyt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), initial site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9954","name":"Fab/del oral appliance thxpy","description":"Fab/del oral appliance thxpy","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28890","name":"Hi enrgy eswt plantar fascia","description":"Extracorporeal shock wave, high energy, performed by a physician or other qualified health care professional, requiring anesthesia other than local, including ultrasound guidance, involving the plantar fascia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0920T","name":"Rmvl perm ccm-d sys 1 pac ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous pacing lead only","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93151","name":"Interrog&prgrmg ipnss","description":"Interrogation and programming (minimum one parameter) of implanted phrenic nerve stimulator system","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0893","name":"Inj, decitabine (sun pharma)","description":"Injection, decitabine (sun pharma), not therapeutically equivalent to j0894, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4316","name":"Amchoplast, per sq cm","description":"Amchoplast, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"Motor &/ sens nrve cndj test","description":"Motor and/or sensory nerve conduction, using preconfigured electrode array(s), amplitude and latency/velocity study, each limb, includes f-wave study when performed, with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0502","name":"Other oral pathology procedu","description":"Other oral pathology procedures by report","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45119","name":"Remove rectum w/reservoir","description":"Proctectomy, combined abdominoperineal pull-through procedure (eg, colo-anal anastomosis), with creation of colonic reservoir (eg, j-pouch), with diverting enterostomy when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2058.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2051","name":"Support broker waiver/diem","description":"Supports brokerage, self-directed, waiver; per diem","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9185","name":"Fludarabine phosphate inj","description":"Injection, fludarabine phosphate, 50 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":415.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0761T","name":"Dgtz gls mcrscp sl imm ea 1","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64469","name":"Thrc fascial pln blk bi nfs","description":"Thoracic fascial plane block, bilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":41.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6560","name":"G stckng full/chap30-40 cust","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, custom, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0980T","name":"Sbmcsl crylys ther tng&tnsl","description":"Submucosal cryolysis therapy; base of tongue and lingual tonsil only","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0898","name":"Argatroban nonesrd (auromed)","description":"Injection, argatroban (auromedics), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27266","name":"Treat hip dislocation","description":"Closed treatment of post hip arthroplasty dislocation; requiring regional or general anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":690.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4390","name":"Ascendion per sq cm","description":"Ascendion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9029","name":"Instill adstiladrin, tx dose","description":"Intravesical instillation, nadofaragene firadenovec-vncg, per therapeutic dose","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0040","name":"Pt phys/occ therapy","description":"Patient already receiving physical/occupational/speech/recreational therapy during the measurement period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0216","name":"Inj, alfentanil hcl, 500mcg","description":"Injection, alfentanil hydrochloride, 500 micrograms","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0993T","name":"N-invas assmt car rsk w/ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat with concurrent computed tomography scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional (list s","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4365","name":"Amnio bur dl mem per sq cm","description":"Amnio burgeon dual-layer membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1477","name":"Dx delirium","description":"Diagnosis of delirium","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85410","name":"Fibrinolytic antiplasmin","description":"Fibrinolytic factors and inhibitors; alpha-2 antiplasmin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0720","name":"Chloramphenicol sodium injec","description":"Injection, chloramphenicol sodium succinate, up to 1 gm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0301U","name":"Iadna bartonella ddpcr","description":"Iadna bartonella ddpcr","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23620","name":"Cltx gr hmrl tbrs fx wo mnpj","description":"Closed treatment of greater humeral tuberosity fracture; without manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4279","name":"Vendaje ac, per sq cm","description":"Vendaje ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31242","name":"Nsl/sinus ndsc rf abltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by radiofrequency ablation, posterior nasal nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98006","name":"Synch audio-video est mod 30","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1012T","name":"Mtrz ab ntrno trph scl/tr mw","description":"Motorized ab interno trephination of sclera (sclerostomy), or trabecular meshwork (trabeculostomy), 1 or more, including injection of antifibrotic agents, when performed","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92930","name":"Prq tcat plmt ntrac st 2+les","description":"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 2 or more distinct coronary lesions with 2 or more coronary stents deployed in 2 or more coronary segments, or a bifurcation lesion requiring ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65600","name":"Revision of cornea","description":"Multiple punctures of anterior cornea (eg, for corneal erosion, tattoo)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0575U","name":"Trnsplj med lar rtpcr 4genes","description":"Trnsplj med lar rtpcr 4genes","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90792","name":"Psych diag eval w/med srvcs","description":"Psychiatric diagnostic evaluation with medical services","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":197.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1167","name":"Hspc dur meas pd","description":"In hospice or using hospice services during the measurement period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37272","name":"Revsc evsc fpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2037","name":"G4derm plus/suprello, pr ml","description":"G4derm plus/suprello, per milliliter","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0032","name":"2+ antipsy schiz","description":"Two or more antipsychotic prescriptions ordered for patients who had a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder on or between january 1 of the year prior to the measurement period and the index prescription start date (ipsd) for antipsychotics","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1214","name":"Spiro results wth obs doc","description":"Spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and reviewed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85013","name":"Spun microhematocrit","description":"Blood count; spun microhematocrit","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1005T","name":"Elec alys s-scl eeg prgr 1st","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, first 15 minutes face-to-face time with physician or other qualified hea","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84597","name":"Assay of vitamin k","description":"Vitamin k","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37257","name":"Revsc evsc ivt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1025T","name":"Alt elec fld dos&dlv sim mdl","description":"Alternating electric fields dosimetry and delivery-simulation modeling, creation and selection of patient-specific array layouts, and placement verification","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7172","name":"Inj marstacim-hncq, 0.5 mg","description":"Injection, marstacimab-hncq, 0.5 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0990T","name":"Trncrv inst biod hydrgl mtrl","description":"Transcervical instillation of biodegradable hydrogel materials, intrauterine","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7414","name":"Excision malig lesion>1.25cm","description":"Excision of malignant lesion greater than 1.25 cm","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85025","name":"Complete cbc w/auto diff wbc","description":"Blood count; complete (cbc), automated (hgb, hct, rbc, wbc and platelet count) and automated differential wbc count","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0713T","name":"N-nvs artl plaq alys rvw i&r","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data review, interpretation and report","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28103","name":"Remove/graft foot lesion","description":"Excision or curettage of bone cyst or benign tumor, talus or calcaneus; with allograft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":543.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4266","name":"Neostim per sq cm","description":"Neostim membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0545","name":"Inherent visit to inpt","description":"Visit complexity inherent to hospital inpatient or observation care associated with a confirmed or suspected infectious disease by an infectious diseases specialist, including disease transmission risk assessment and mitigation, public health investigation, analysis, and testing, and complex antimic","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1220","name":"Dre wth interp rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; with evidence of retinopathy","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0233","name":"Intra inf, toci, first dose","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0806T","name":"Tcat s&ivc prstc vl impl opn","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); open femoral vein approach","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0049","name":"Main hemo in-cntr","description":"With maintenance hemodialysis (in-center and home hd) for the complete reporting month","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37257","name":"Revsc evsc ivt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1414","name":"Med rsn no pdl1 bef 1st ther","description":"Documentation of medical reason(s) for not performing the pd-l1 biomarker expression test prior to initiation of first-line immune checkpoint inhibitor therapy (e.g., patient is in an urgent or emergent situation where delay of treatment would jeopardize the patients health status; other medical rea","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15012","name":"Hrv skn cll ssp agrft ea add","description":"Harvest of skin for skin cell suspension autograft; each additional 25 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0013","name":"Esketamine, nasal spray","description":"Esketamine, nasal spray, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1342","name":"Pts died perf per","description":"Patients who died during the performance period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0473U","name":"Onc sld tum bld/slv 648 gene","description":"Onc sld tum bld/slv 648 gene","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0561","name":"Temp tube delivery, unil","description":"Tympanostomy with local or topical anesthesia and insertion of a ventilating tube when performed with tympanostomy tube delivery device, unilateral (list separately in addition to 69433) (do not use in conjunction with 0583t)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0682","name":"App non-sheet skin sub add","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (list separately in addition to code for pri","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4293","name":"Acesso dl, per sq cm","description":"Acesso dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0411","name":"Hba1c in office testing","description":"Hba1c in office testing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0024","name":"Pin srv add 30 min pr m","description":"Principal illness navigation services, additional 30 minutes per calendar month (list separately in addition to g0023)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1073","name":"Testosterone pellet 75 mg","description":"Testosterone pellet, implant, 75 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0752T","name":"Dgtz gls mcrscp sld lvl iii","description":"Digitization of glass microscope slides for level iii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1299","name":"Flu immunize order/admin","description":"Influenza immunization administered or previously received","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0559U","name":"Onc brs quan elisa bf9ag srm","description":"Onc brs quan elisa bf9ag srm","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50205","name":"Renal bx surg exposure kdn","description":"Renal biopsy; by surgical exposure of kidney","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4262","name":"Dual layer impax, per sq cm","description":"Dual layer impax membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31380","name":"Partial removal of larynx","description":"Partial laryngectomy (hemilaryngectomy); anterovertical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1913.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9596","name":"Gallium illuccix 1 millicure","description":"Gallium ga-68 gozetotide, diagnostic, (illuccix), 1 millicurie","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4368","name":"Amchothick per sq cm","description":"Amchothick, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0167","name":"Inj epinephrine (hospira)","description":"Injection, epinephrine (hospira), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47384","name":"Abltj ire liver 1+ tum perq","description":"Ablation, irreversible electroporation, liver, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0618","name":"Inj, calcium chloride, 2 mg","description":"Injection, calcium chloride, 2 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4304","name":"Grafix plus, per sq cm","description":"Grafix plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4375","name":"Duograft ac per sq cm","description":"Duograft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1201","name":"Med rsn no ace-i/arb rx","description":"Documentation of medical reason(s) for not prescribing ace inhibitor (ace-i) or arb therapy during the measurement period (e.g., pregnancy, history of angioedema to ace-i, other allergy to ace-i and arb, hyperkalemia or history of hyperkalemia while on ace-i or arb therapy, acute kidney injury due t","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95919","name":"Quan puplmtry phy/qhp uni/bi","description":"Quantitative pupillometry with physician or other qualified health care professional interpretation and report, unilateral or bilateral","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28304","name":"Incision of midfoot bones","description":"Osteotomy, tarsal bones, other than calcaneus or talus;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":728.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0507U","name":"Onc ovr dna whole gen w/5hmc","description":"Onc ovr dna whole gen w/5hmc","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64656","name":"Revj/rplcmt bat mod sys pg","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; pulse generator only","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2183","name":"Inj meropenem (wg crit care)","description":"Injection, meropenem (wg critical care), not therapeutically equivalent to j2185, 100 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1171","name":"Pt recd 1 td/tdap 9yrs prior","description":"Patient received at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6193","name":"Replace implnt screw","description":"Replace implnt screw","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82485","name":"Assay chondroitin sulfate","description":"Chondroitin b sulfate, quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86317","name":"Immunoassay infectious agent","description":"Immunoassay for infectious agent antibody, quantitative, not otherwise specified","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4016","name":"Neurosurgical ss","description":"Neurosurgical mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S4024","name":"Air polymer foam per study","description":"Air polymer-type a intrauterine foam, per study dose","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2002","name":"Inj, lidocaine in d5w, 1 mg","description":"Injection, lidocaine hcl in 5% dextrose, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98009","name":"Synch audio-only new low 30","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 30 m","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22836","name":"Ant thrc vrt body tethrg <7","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; up to 7 vertebral segments","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45550","name":"Repair rectum/remove sigmoid","description":"Proctopexy (eg, for prolapse); with sigmoid resection, abdominal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1539.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1492","name":"No reported fall","description":"Patients who did not report a fall","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64774","name":"Remove skin nerve lesion","description":"Excision of neuroma; cutaneous nerve, surgically identifiable","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2033","name":"Myriad morcells, 4 mg","description":"Myriad morcells, 4 milligrams","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0532","name":"Take home supp nasal spray","description":"Take-home supply of nasal nalmefene hydrochloride; one carton of two, 2.7 mg per 0.1 ml nasal sprays (provision of the services by a medicare-enrolled opioid treatment program);( list separately in addition to each primary code)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0697T","name":"Quan mr tis wo mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained without diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, targ","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1434","name":"Orl chemo wthn 30 d post enc","description":"Patient on oral chemotherapy on or within 30 days after denominator eligible encounter","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35903","name":"Excision graft extremity","description":"Excision of infected graft; extremity","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":759.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0979T","name":"Sbmcsl crylys ther sft palt","description":"Submucosal cryolysis therapy; soft palate only","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4285","name":"Nudyn dl or dl mesh pr sq cm","description":"Nudyn dl or nudyn dl mesh, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0618","name":"Inj, calcium chloride, 2 mg","description":"Injection, calcium chloride, 2 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6212","name":"Bridge noble metal cast","description":"Pontic-cast noble metal","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0901","name":"Vadadustat oral 1mg for esrd","description":"Vadadustat, oral, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23174","name":"Sqstrctmy humrl head srg nck","description":"Sequestrectomy (eg, for osteomyelitis or bone abscess), humeral head to surgical neck","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42955","name":"Surgical opening of throat","description":"Pharyngostomy (fistulization of pharynx, external for feeding)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":862.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82541","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0421U","name":"Onc clrct scr sgl amp 8 rna","description":"Onc clrct scr sgl amp 8 rna","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4425","name":"Revive tl per sq cm","description":"Revive tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1367","name":"Qual care ent disorder mvp","description":"Quality care for the treatment of ear, nose, and throat disorders mips value pathway","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55715","name":"Bx prst8 ea add mri-us/ct/mr","description":"Biopsy, prostate, each additional, mri-ultrasound fusion or in-bore ct- or mri-guided targeted lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0729T","name":"Dx alys vstblr implt uni sbq","description":"Diagnostic analysis of vestibular implant, unilateral; with subsequent programming","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4323","name":"Alloply, per sq cm","description":"Alloply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1346","name":"No pam inc 6 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 6 points within a 4 to 12 month period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4269","name":"Surgraft xt per sq cm","description":"Surgraft xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4342","name":"Theramend, per sq cm","description":"Theramend, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9046","name":"Inj, bortezomib, dr. reddys","description":"Injection, bortezomib (dr. reddys), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0815T","name":"Us rems b1 dns hips plvs/spi","description":"Ultrasound-based radiofrequency echographic multi-spectrometry (rems), bone-density study and fracture-risk assessment, 1 or more sites, hips, pelvis, or spine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5129","name":"Inj, vegzelma, 10 mg","description":"Injection, bevacizumab-adcd (vegzelma), biosimilar, 10 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7411","name":"Excision benign lesion>1.25c","description":"Excision of benign lesion greater than 1.25 cm","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19325","name":"Breast augmentation w/implt","description":"Breast augmentation with implant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5161","name":"Inj, denosumab-kyqq, 1 mg","description":"Injection, denosumab-kyqq (aukelso/bosaya), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64629","name":"Trml dstrj ios bvn ea addl","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; each additional vertebral body, lumbar or sacral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6516","name":"Grad com wrap w strap foo cu","description":"Gradient compression wrap with adjustable straps, foot, each, custom","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7299","name":"Intraut copp cont (miudella)","description":"Intrauterine copper contraceptive (miudella)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4251","name":"Vim, per square centimeter","description":"Vim, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49190","name":"Opn exc/dstr ntra-abd >30 cm","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); greater than 30 cm","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2950","name":"Promazine hcl injection","description":"Injection, promazine hcl, up to 25 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23935","name":"Inc dp opn b1 crtx hum/elbw","description":"Incision, deep, with opening of bone cortex (eg, for osteomyelitis or bone abscess), humerus or elbow","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36583","name":"Replace tunneled cv cath","description":"Replacement, complete, of a tunneled centrally inserted central venous access device, with subcutaneous pump, through same venous access","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q0224","name":"Inj, pemivibart, 4500 mg","description":"Injection, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, and who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppressive ","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28715","name":"Arthrodesis triple","description":"Arthrodesis; triple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1137.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85041","name":"Automated rbc count","description":"Blood count; red blood cell (rbc), automated","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85014","name":"Hematocrit","description":"Blood count; hematocrit (hct)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71045","name":"X-ray exam chest 1 view","description":"Radiologic examination, chest; single view","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9393","name":"Inj, fulvestrant (teva)","description":"Injection, fulvestrant (teva), not therapeutically equivalent to j9395, 25 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0139","name":"Inj, adalimumab, 1 mg","description":"Injection, adalimumab, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86674","name":"Giardia lamblia antibody","description":"Antibody; giardia lamblia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0542","name":"No pt prsnt train add 15","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2013","name":"Innovamatrix fs, per sq cm","description":"Innovamatrix fs, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0974T","name":"Slctv nzmtc dbrdmt t/a/l ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; each additional 100 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85009","name":"Manual diff wbc count b-coat","description":"Blood count; manual differential wbc count, buffy coat","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33536","name":"Cabg arterial four or more","description":"Coronary artery bypass, using arterial graft(s); 4 or more coronary arterial grafts","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2738.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81279","name":"Jak2 gene trgt sequence alys","description":"Jak2 (janus kinase 2) (eg, myeloproliferative disorder) targeted sequence analysis (eg, exons 12 and 13)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6747.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1551","name":"Inj cutaquig 100 mg","description":"Injection, immune globulin (cutaquig), 100 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1386","name":"Exc sx melmn or mlnm is","description":"Patients with an excisional surgery for melanoma or melanoma in situ in the past 5 years with an initial ajcc staging of 0, i, or ii at the start of the performance period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1369","name":"Qualcare mental hlth/sud mvp","description":"Quality care in mental health and substance use disorders mips value pathway","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0900T","name":"N-invas est aqmbf asstv cmr","description":"Noninvasive estimate of absolute quantitation of myocardial blood flow (aqmbf), derived from assistive algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health care profes","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82715","name":"Assay of fecal fat","description":"Fat differential, feces, quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"Basic vestibular evaluation","description":"Basic vestibular evaluation, includes spontaneous nystagmus test with eccentric gaze fixation nystagmus, with recording, positional nystagmus test, minimum of 4 positions, with recording, optokinetic nystagmus test, bidirectional foveal and peripheral stimulation, with recording, and oscillating tra","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0481","name":"Electron microscopy diagnost","description":"Electron microscopy - diagnostic","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52597","name":"Trurl rbtc wtrjt rescj prst8","description":"Transurethral robotic-assisted waterjet resection of prostate, including intraoperative planning, ultrasound guidance, control of postoperative bleeding, complete, including vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59325","name":"Revision of cervix","description":"Cerclage of cervix, during pregnancy; abdominal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1791.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0051","name":"Traditional healing service","description":"Traditional healing service","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9602","name":"Fluorodopa f-18 diag per mci","description":"Fluorodopa f-18, diagnostic, per millicurie","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0897T","name":"N-invas augmnt arrhyt alys","description":"Noninvasive augmentative arrhythmia analysis derived from quantitative computational cardiac arrhythmia simulations, based on selected intervals of interest from 12-lead electrocardiogram and uploaded clinical parameters, including uploading clinical parameters with interpretation and report","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2928","name":"Prefab porc/cer crown perm","description":"Prefab porc/cer crown perm","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4426","name":"Dermbnd tl+, tlx per sq cm","description":"Dermabind tl + or dermabind tl x,  per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1306","name":"Pt anphx due to pneum","description":"Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1378","name":"Med rsn no 10 yr fu colscope","description":"Documentation of medical reason(s) for not recommending a 10 year follow-up interval (e.g., inadequate prep, familial or personal history of colonic polyps, patient had no adenoma and age is >= 66 years old, or life expectancy < 10 years, other medical reasons)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0498U","name":"Onc clrct ngs mut detc 43gen","description":"Onc clrct ngs mut detc 43gen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38240","name":"Transplt allo hct/donor","description":"Hematopoietic progenitor cell (hpc); allogeneic transplantation per donor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1385","name":"Pt rsn not seen 2nd pam","description":"Documentation of patient reasons for patients who were not seen for the second pam survey (e.g., less than four months between baseline pam assessment and follow-up","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0933T","name":"Tcat impl wrls l atr prs snr","description":"Transcatheter implantation of wireless left atrial pressure sensor for long-term left atrial pressure monitoring, including sensor calibration and deployment, right heart catheterization, transseptal puncture, imaging guidance, and radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0716T","name":"Car acous wavfrm rec cad rsk","description":"Cardiac acoustic waveform recording with automated analysis and generation of coronary artery disease risk score","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0411","name":"Hba1c in office testing","description":"Hba1c in office testing","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0707","name":"Intraoral periap radio image","description":"Intraoral periap radio image","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37291","name":"Revsc evsc tpvt athr cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37256","name":"Revsc evasc ivt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":265.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6106","name":"Tissue regen resorbable","description":"Tissue regen resorbable","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9003","name":"Leupro inj, camcevi etm, 1mg","description":"Leuprolide injectable (camcevi etm), 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4317","name":"Vitograft, per sq cm","description":"Vitograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0524","name":"Est pt-cg dyad dem low cmplx","description":"Management of established patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6559","name":"G stckng full/chap18-30 cust","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D8671","name":"Periodic orth treat w surg","description":"Periodic orth treat w surg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1000T","name":"Autol musc cell therapy admn","description":"Autologous muscle cell therapy, administration of muscle progenitor cells into the urethral sphincter, including cystoscopy and post-void residual ultrasound, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2251","name":"Inj midazolam in 0.9% nacl","description":"Injection, midazolam in 0.9% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0270U","name":"Hem cgen coagj do 20 genes","description":"Hematology (congenital coagulation disorders), genomic sequence analysis of 20 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8006","name":"Grip glove replacement only","description":"Powered, cable driven grip assist glove, hand, finger, includes pressure sensors, glove replacement only","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1000T","name":"Autol musc cell therapy admn","description":"Autologous muscle cell therapy, administration of muscle progenitor cells into the urethral sphincter, including cystoscopy and post-void residual ultrasound, when performed","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27278","name":"Arthrd si jt plmt iartic dev","description":"Arthrodesis, sacroiliac joint, percutaneous or minimally invasive, with image guidance, includes obtaining bone graft when performed, unilateral; placement of intra-articular device(s), without cortical piercing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1359","name":"Indx suicd idea, no 0 scr","description":"Index assessment during the denominator period when the suicidal ideation and/or behavior symptoms or increased suicide risk by clinician determination occurs and a non-zero c-ssrs score is obtained","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4415","name":"Alexiguard st-l per sq cm","description":"Alexiguard sl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0917T","name":"Insj perm ccm-d sys 1 lead","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; single transvenous lead (pacing or defibrillation) only","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7521","name":"Incision/drain abscess extra","description":"Incision and drainage of abscess - extraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35458","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":630.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1428","name":"Bilateral absence of eyes","description":"Patients who have bilateral absence of eyes any time during the patients history through the end of the measurement period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0536","name":"Peer recover support svs","description":"Peer recovery support services, provided directly or by referral; including leveraging knowledge of the condition or lived experience to provide support, mentorship, or inspiration to meet oud treatment and recovery goals; conducting a person-centered interview to understand the patients life story,","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7213","name":"Inj, ixinity, 1 i.u.","description":"Injection, coagulation factor ix (recombinant), ixinity, 1 i.u.","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37277","name":"Rvsc evsc fpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6111","name":"Implnt/abut remov dent mand","description":"Implnt/abut remov dent mand","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9249","name":"Inj, melphalan (apotex) 1 mg","description":"Injection, melphalan (apotex), 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0741T","name":"Rem auton alg nsln data coll","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; provision of software, data collection, transmission, and storage, each 30 days","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43200","name":"Esophagoscopy flexible brush","description":"Esophagoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3392","name":"Inj, exagamglogene autotem","description":"Injection, exagamglogene autotemcel, per treatment","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7261","name":"Primary closure sinus perf","description":"Primary closure of a sinus perforation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0660","name":"Team remote e/m new pt 10 mn","description":"Team remote e/m new pt 10mins","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4322","name":"Splint intra-coronal","description":"Splint intra-coronal","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92628","name":"Eval hearing aid cand 1st 30","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9293","name":"Fertility cycl tracking soft","description":"Fertility cycle (contraception & conception) tracking software application, fda cleared, per month, includes accessories (e.g., thermometer)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2054","name":"Lisocabtagene mara car pos t","description":"Lisocabtagene maraleucel, up to 110 million autologous anti-cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0979T","name":"Sbmcsl crylys ther sft palt","description":"Submucosal cryolysis therapy; soft palate only","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4358","name":"Xwrap dual, per sq cm","description":"Xwrap dual, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33416","name":"Revise ventricle muscle","description":"Ventriculomyotomy (-myectomy) for idiopathic hypertrophic subaortic stenosis (eg, asymmetric septal hypertrophy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2166.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1014T","name":"Lap rv/rmv eso sph nstm eltr","description":"Laparoscopic revision or removal, lower esophageal sphincter neurostimulator electrodes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33427","name":"Repair of mitral valve","description":"Valvuloplasty, mitral valve, with cardiopulmonary bypass; radical reconstruction, with or without ring","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2927.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4405","name":"Xwrap fenestra plus sq cm","description":"Xwrap fenestra plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0764T","name":"Asstv alg ecg rsk asmt cncrt","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to concurrently performed electrocardiogram (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6196","name":"Remv of ind rest on implt","description":"Remv of ind rest on implt","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31205","name":"Removal of ethmoid sinus","description":"Ethmoidectomy; extranasal, total","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1026.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4038","name":"Vascular surgery ss","description":"Vascular surgery mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0552U","name":"Repr med pga gdo te bx locus","description":"Repr med pga gdo te bx locus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"Breathing capacity test","description":"Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement(s), with or without maximal voluntary ventilation","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1228","name":"Pt + hcv aby +vir w/ rx 3 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, has hcv treatment initiated within 3 months of the reactive hcv antibody test","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0349","name":"Inj, rezafungin, 1 mg","description":"Injection, rezafungin, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1415","name":"No pos pdl1 bef ici ther","description":"Patients who did not have a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0966T","name":"I&cst prp jw xpn dl arch fxd","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, fixed hinge mechanism","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0108","name":"Diab manage trn  per indiv","description":"Diabetes outpatient self-management training services, individual, per 30 minutes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26700","name":"Treat knuckle dislocation","description":"Closed treatment of metacarpophalangeal dislocation, single, with manipulation; without anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91012","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0734T","name":"Rem r-t mtn nrehab tx mgmt","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; treatment management services by a physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35480","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":724.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93588","name":"Vngrph chd vnvn cltrl below","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating below the heart (eg, from the inferior vena cava) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7639","name":"Dornase alfa non-comp unit","description":"Dornase alfa, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0305U","name":"Hem rbc fnclty&dfrm shr strs","description":"Hem rbc fnclty&dfrm shr strs","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0971T","name":"Ablt mal brst tum pq lsr uni","description":"Ablation, malignant breast tumor(s), percutaneous, laser, including imaging guidance when performed, unilateral","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84393","name":"Tau phosphorylated ea","description":"Tau, phosphorylated (eg, ptau 181, ptau 217), each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1381","name":"Pt sec strk wthin 5 days","description":"Patients with secondary stroke (e.g., a subsequent stroke that may occur with vasospasm in the setting of subarachnoid hemorrhage) within 5 days of the initial procedure","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0013","name":"Hiv prep counsel, clin staff","description":"Individual counseling for pre-exposure prophylaxis (prep) by clinical staff to prevent human immunodeficiency virus (hiv), includes: hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0615","name":"Calcium acetate, oral, 23 mg","description":"Calcium acetate, oral, 23 mg (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26776","name":"Pin finger dislocation","description":"Percutaneous skeletal fixation of interphalangeal joint dislocation, single, with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":531.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0989T","name":"Revj/rmvl ins ptn subq&subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4413","name":"Cygnus solo per sq cm","description":"Cygnus solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2928","name":"Prefab porc/cer crown perm","description":"Prefab porc/cer crown perm","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6555","name":"G com stcking bk 40+ custm","description":"Gradient compression stocking, below knee, 40 mmhg or greater, custom, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28292","name":"Cor hlx vlgs rsc prx phlx bs","description":"Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with resection of proximal phalanx base, when performed, any method","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":609.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77092","name":"Tbs i&r fx rsk qhp","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; interpretation and report on fracture-risk only by other qualified health care professional","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0678T","name":"Laps repos lead isdss ea add","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional repositioned lead (list separately in addition to code for primary proce","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58580","name":"Transcrv abltj utrn fibrd rf","description":"Transcervical ablation of uterine fibroid(s), including intraoperative ultrasound guidance and monitoring, radiofrequency","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10160","name":"Pnxr aspir absc hmtma bulla","description":"Puncture aspiration of abscess, hematoma, bulla, or cyst","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1315","name":"Crc no doc no rsn","description":"Colorectal cancer screening results were not documented and reviewed; reason not otherwise specified","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1448","name":"Injection, trilaciclib, 1mg","description":"Injection, trilaciclib, 1mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0998T","name":"Precuneus mag stimj tx dlvr","description":"Precuneus magnetic stimulation; personalized treatment delivery of magnetic stimulation therapy to a prespecified target area derived from analysis of evoked potentials within the precuneus, utilizing magnetic resonance imaging-based neuronavigation, with management, per day","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59414","name":"Deliver placenta","description":"Delivery of placenta (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":121.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6114","name":"Implnt/abut fixed dent max","description":"Implnt/abut fixed dent max","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4346","name":"Shelter dm matrix per sq cm","description":"Shelter dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80220","name":"Drug asy hydroxychloroquine","description":"Hydroxychloroquine","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98014","name":"Synch audio-only est mod 30","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code s","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1420","name":"Complete ophthalmologic mvp","description":"Complete ophthalmologic care mips value pathway","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0554U","name":"Repr med pga 24chrm te bx qc","description":"Repr med pga 24chrm te bx qc","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63088","name":"Remove vertebral body add-on","description":"Vertebral corpectomy (vertebral body resection), partial or complete, combined thoracolumbar approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic or lumbar; each additional segment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91323","name":"Sarscov2 vac 10 mcg/0.2ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 10 mcg/0.2 ml dosage, for intramuscular use","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5827","name":"Endo knee shin single axis","description":"Endoskeletal knee-shin system, single axis, electromechanical swing and stance phase control, with or without shock absorption and stance extension damping","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0520","name":"New pt-cg dyad dem mod cmplx","description":"Management of new patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0748T","name":"Njx stm cl prdct anl sft tis","description":"Injections of stem cell product into perianal perifistular soft tissue, including fistula preparation (eg, removal of setons, fistula curettage, closure of internal openings)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1341","name":"Pt no f/u 30-180 dys","description":"Patients who did not have a follow-up assessment or did not have an assessment within 30 to 180 days after the index assessment during the performance period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1330","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4280","name":"Xcell amnio matrix per sq cm","description":"Xcell amnio matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0989T","name":"Revj/rmvl ins ptn subq&subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87086","name":"Urine culture/colony count","description":"Culture, bacterial; quantitative colony count, urine","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4349","name":"Mantle dl matrix per sq cm","description":"Mantle dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0022","name":"Comm hlth intg svs add 30 m","description":"Community health integration services, each additional 30 minutes per calendar month (list separately in addition to g0019)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96360","name":"Hydration iv infusion init","description":"Intravenous infusion, hydration; initial, 31 minutes to 1 hour","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66683","name":"Implantation iris prosthesis","description":"Implantation of iris prosthesis, including suture fixation and repair or removal of iris, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7939","name":"Indexing for osteotomy","description":"Indexing for osteotomy","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0040","name":"Pt phys/occ therapy","description":"Patient already receiving physical/occupational/speech/recreational therapy during the measurement period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6515","name":"Grad com wrap w str fu le cu","description":"Gradient compression wrap with adjustable straps, full leg, each, custom","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6605","name":"G com bandage padded foam","description":"Gradient compression bandaging supply, padded foam, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1347","name":"Pt pam incr 3 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 3 points in a 4 to 12 month period (passing)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70328","name":"X-ray exam of jaw joint","description":"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0896T","name":"Connj lvr algrft prfu dev ea","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; each additional hour, including physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary bicarbonate, lactate ","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1262","name":"Pts transplt bef dialysis","description":"Patients who had a transplant prior to initiation of dialysis","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4363","name":"Am bur mem hydro per sq cm","description":"Amnio burgeon membrane and hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0371U","name":"Iadna gu pthgn semiq dna16&1","description":"Iadna gu pthgn semiq dna16&1","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1346","name":"No pam inc 6 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 6 points within a 4 to 12 month period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4282","name":"Cygnus dual per sq cm","description":"Cygnus dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15778","name":"Impl absrb msh/prsth dly cls","description":"Implantation of absorbable mesh or other prosthesis for delayed closure of defect(s) (ie, external genitalia, perineum, abdominal wall) due to soft tissue infection or trauma","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0592U","name":"Onc hl neo dna tgs 417 genes","description":"Onc hl neo dna tgs 417 genes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1298","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7411","name":"Excision benign lesion>1.25c","description":"Excision of benign lesion greater than 1.25 cm","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0447","name":"Port o2 cont, liq over 4 lpm","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit, prescribed amount at rest or nighttime exceeds 4 liters per minute (lpm)","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1612","name":"Inj glucagon (gvoke) 0.01 mg","description":"Injection, glucagon (gvoke), 0.01 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15151","name":"Tis cltr skn agrft t/a/l add","description":"Tissue cultured skin autograft, trunk, arms, legs; additional 1 sq cm to 75 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0712T","name":"N-nvs artl plaq alys quan","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess atherosclerotic plaque stability","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1224","name":"Iop dec <20% from base","description":"Intraocular pressure (iop) reduced by a value less than 20% from the pre-intervention level","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4301","name":"Activate matrix, per sq cm","description":"Activate matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77081","name":"Dxa bone density appendiculr","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0503U","name":"Neuro alz ds bamyl&tau prtn","description":"Neuro alz ds bamyl&tau prtn","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98984","name":"Rtm dev sply resp sys 2-15 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of respiratory system, 2-15 days in a 30-day period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1180","name":"Pt imm ckpt inhib therapy","description":"Patients on immune checkpoint inhibitor therapy","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0316U","name":"B brgdrferi lyme ds ospa evl","description":"B brgdrferi lyme ds ospa evl","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28090","name":"Removal of foot lesion","description":"Excision of lesion, tendon, tendon sheath, or capsule (including synovectomy) (eg, cyst or ganglion); foot","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81025","name":"Urine pregnancy test","description":"Urine pregnancy test, by visual color comparison methods","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9072","name":"Inj cyclophos frindovyx 5 mg","description":"Injection, cyclophosphamide (frindovyx), 5 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87183","name":"Sc std carbapenem resist gen","description":"Susceptibility studies, antimicrobial agent; carbapenem resistance genes (eg, blakpc, blandm, blavim, blaoxa-48, blaimp), amplified probe technique, per isolate","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93153","name":"Interrog w/o prgrmg ipnss","description":"Interrogation without programming of implanted phrenic nerve stimulator system","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9038","name":"Inj axatilimab-csfr 0.1 mg","description":"Injection, axatilimab-csfr, 0.1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81524","name":"Onc cns tum dna mthyl 10,000","description":"Oncology (central nervous system tumor), dna methylation analysis of at least 10,000 methylation sites, utilizing dna extracted from formalin-fixed tumor tissue, algorithm(s) reported as probability of matching a reference tumor family and class, and mgmt (o-6-methylguanine-dna methyltransferase) pr","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1440","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0018M","name":"Trnsplj rnl meas cd154+cll","description":"Transplantation medicine (allograft rejection, renal), measurement of donor and third-party-induced cd154+t-cytotoxic memory cells, utilizing whole peripheral blood, algorithm reported as a rejection risk score","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54125","name":"Removal of penis","description":"Amputation of penis; complete","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":888.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92288","name":"Scr dark adaptation meas i&r","description":"Screening dark adaptation measurement (eg, rod recovery intercept time), with interpretation and report","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77306","name":"Telethx isodose plan simple","description":"Teletherapy isodose plan; simple (1 or 2 unmodified ports directed to a single area of interest), includes basic dosimetry calculation(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37267","name":"Revsc evsc fpvt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88341","name":"Imhchem/imcytchm ea add antb","description":"Immunohistochemistry or immunocytochemistry, per specimen; each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0690T","name":"Quan us tis charac w/dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained with diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98977","name":"Rtm dev sply mscskl 16-30 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of musculoskeletal system, 16-30 days in a 30-day period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9612","name":"Thera par drugs 2 or > admin","description":"Therapeutic parenteral drugs two or more administrations different medications","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1482","name":"Pos quan hep c or qual rna","description":"Positive/detectable hepatitis c virus quantitative or qualitative rna test result during the denominator identification period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1247","name":"Pt resp true best int","description":"Patient responded completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0602U","name":"Endocrin dm ins gen mthyltn","description":"Endocrin dm ins gen mthyltn","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87594","name":"Pneumcysts jirovecii amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); pneumocystis jirovecii, amplified probe technique","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1359","name":"Indx suicd idea, no 0 scr","description":"Index assessment during the denominator period when the suicidal ideation and/or behavior symptoms or increased suicide risk by clinician determination occurs and a non-zero c-ssrs score is obtained","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92638","name":"Bhvl verif of amplification","description":"Behavioral verification of amplification including aided thresholds, functional gain, speech-in-noise, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0666","name":"Team remote e/m est pt 15 mn","description":"Team remote e/m est. pt 15mins","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0734T","name":"Rem r-t mtn nrehab tx mgmt","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; treatment management services by a physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5878","name":"Dup of complt dent-mandib","description":"Dup of complt dent-mandib","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9609","name":"F18 fdg, 15 millicuries","description":"Fludeoxyglucose f18 up to 15 millicuries","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2251","name":"Inj midazolam in 0.9% nacl","description":"Injection, midazolam in 0.9% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92990","name":"Revision of pulmonary valve","description":"Percutaneous balloon valvuloplasty; pulmonary valve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1218.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1469","name":"Hx of hep b, or pos bld test","description":"Patient has a history of hepatitis b illness or received a hepatitis b surface antigen, hepatitis b surface antibody, or total antibody to hepatitis b core antigen test with a positive result any time before or during the measurement period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99344","name":"Home/res vst new mod mdm 60","description":"Home or residence visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7252","name":"Part extract for implant","description":"Part extract for implant","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0589","name":"Inj daxibotulinumtoxina-lanm","description":"Injection, daxibotulinumtoxina-lanm, 1 unit","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5914","name":"Auricular prosthesis","description":"Auricular prosthesis","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5153","name":"Inj, aflibercept-yszy, 1 mg","description":"Injection, aflibercept-yszy (opuviz), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78492","name":"Myocrd img pet mlt rst&strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); multiple studies at rest and stress (exercise or pharmacologic)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0882T","name":"Intraop ther estim pn ue 1st","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; initial nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1426","name":"Injection, casimersen, 10 mg","description":"Injection, casimersen, 10 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0956T","name":"Prt crn ch cr&tun elt s-sclp","description":"Partial craniectomy, channel creation, and tunneling of electrode for sub-scalp implantation of an electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26205","name":"Remove/graft bone lesion","description":"Excision or curettage of bone cyst or benign tumor of metacarpal; with autograft (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":719.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1407","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70473","name":"Ct cere prfu aly c+wo ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed without concurrent ct or ct angiography of the same anatomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0681","name":"Inj ceftobipole medocarl 3mg","description":"Injection, ceftobiprole medocaril sodium, 3 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64598","name":"Revj/rmvl nea pn w/int nstim","description":"Revision or removal of neurostimulator electrode array, peripheral nerve, with integrated neurostimulator","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43651","name":"Laparoscopy vagus nerve","description":"Laparoscopy, surgical; transection of vagus nerves, truncal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":725.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0862T","name":"Rlcj pg wcs lv battery only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; battery component only","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0536U","name":"Rbcag ftl rhd pcr alys exon4","description":"Rbcag ftl rhd pcr alys exon4","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94625","name":"Phy/qhp op pulm rhb w/o mntr","description":"Physician or other qualified health care professional services for outpatient pulmonary rehabilitation; without continuous oximetry monitoring (per session)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16025","name":"Dress/debrid p-thick burn m","description":"Dressings and/or debridement of partial-thickness burns, initial or subsequent; medium (eg, whole face or whole extremity, or 5% to 10% total body surface area)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":179.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4261","name":"Tag, per square centimeter","description":"Tag, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38225","name":"Car-t hrv bld-drv t lymphcyt","description":"Chimeric antigen receptor t-cell (car-t) therapy; harvesting of blood-derived t lymphocytes for development of genetically modified autologous car-t cells, per day","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0513U","name":"Onc prst8 alg alys msi&hrd","description":"Onc prst8 alg alys msi&hrd","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9393","name":"Inj, fulvestrant (teva)","description":"Injection, fulvestrant (teva), not therapeutically equivalent to j9395, 25 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0694T","name":"3d vol img&rcnstj brst/ax","description":"3-dimensional volumetric imaging and reconstruction of breast or axillary lymph node tissue, each excised specimen, 3-dimensional automatic specimen reorientation, interpretation and report, real-time intraoperative","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0238","name":"Intrav inf, toci, second dos","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0803","name":"3d facial scan direct","description":"3d facial scan direct","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6527","name":"G garmt full leg/ft nght cus","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, custom, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3299","name":"Inj xipere 1 mg","description":"Injection, triamcinolone acetonide (xipere), 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4281","name":"Barrera slor dl per sq cm","description":"Barrera sl or barrera dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1160","name":"Pt anphx due to mengb bef 13","description":"Patient had anaphylaxis due to the meningococcal vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0350","name":"Oral/facial photo images","description":"Oral/facial photographic images","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2644","name":"Dental onlay porc 4/more sur","description":"Onlay - porcelain/ceramic - four or more surfaces","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0564U","name":"Nfct ds pthgn-sna 10vir&4bct","description":"Nfct ds pthgn-sna 10vir&4bct","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1273","name":"Pts snf 1 yr dialysis","description":"Patients who were admitted to a skilled nursing facility (snf) within one year of dialysis initiation according to the cms-2728 form","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27630","name":"Removal of tendon lesion","description":"Excision of lesion of tendon sheath or capsule (eg, cyst or ganglion), leg and/or ankle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":451.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0430U","name":"Gi malabs aat calpro pncrtc","description":"Gi malabs aat calpro pncrtc","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0209","name":"Inj, sod thiosulfate (hope)","description":"Injection, sodium thiosulfate (hope), 100 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97802","name":"Medical nutrition indiv in","description":"Medical nutrition therapy; initial assessment and intervention, individual, face-to-face with the patient, each 15 minutes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":35.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0568","name":"Int psych care mng, 1 cal mo","description":"Initial psychiatric collaborative care management, in the first calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required elements: outrea","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2393","name":"Post 3 srfc resinbased cmpst","description":"Resin-based composite - three surfaces posterior","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74245","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0573U","name":"Onc pancreas 3bmrk pclf alg","description":"Onc pancreas 3bmrk pclf alg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2472","name":"Inj, pantoprazole sodium chl","description":"Injection, pantoprazole sodium in sodium chloride (baxter), 40 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0788T","name":"Elec aly smp iins sp/sac nrv","description":"Electronic analysis with simple programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detecti","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54692","name":"Laparoscopy orchiopexy","description":"Laparoscopy, surgical; orchiopexy for intra-abdominal testis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":864.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0739","name":"Rehab sys active assist rt","description":"Rehabilitation system with interactive interface providing active assistance in rehabilitation therapy, includes all components and accessories, motors, microprocessors, sensors","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0683T","name":"Prgrmg dev eval isdss ip","description":"Programming device evaluation (in-person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional, permanent implantable synchroni","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31241","name":"Nsl/sns ndsc lig sphnptn art","description":"Nasal/sinus endoscopy, surgical; with ligation of sphenopalatine artery","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0013","name":"Esketamine, nasal spray","description":"Esketamine, nasal spray, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82310","name":"Assay of calcium","description":"Calcium; total","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36425","name":"Venipuncture cutdown 1 yr/>","description":"Venipuncture, cutdown; age 1 or over","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1230","name":"Pt hcv rctv aby no f/u tst","description":"Patient has a reactive hcv antibody test and does not have a follow up hcv viral test, or patient has a reactive hcv antibody test and has a follow up hcv viral test that detects hcv viremia and is not referred to a clinician who treats hcv infection within 1 month and does not have hcv treatment in","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1309","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4334","name":"Amnioplast 1, per sq cm","description":"Amnioplast 1, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0727T","name":"Rmvl&rplcmt implt vstblr dev","description":"Removal and replacement of implanted vestibular device, unilateral","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0004","name":"Qual care neurologic cnd mvp","description":"Quality care for patients with neurological conditions mips value pathway","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95044","name":"Patch/application tests","description":"Patch or application test(s) (specify number of tests)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0217","name":"Inj velmanase alfa-tycv 1 mg","description":"Injection, velmanase alfa-tycv, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2291","name":"Inj, nafcillin (baxter) 20mg","description":"Injection, nafcillin sodium (baxter), 20 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0537U","name":"Onc clrct ca cfdna >2500 dmr","description":"Onc clrct ca cfdna >2500 dmr","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2021","name":"Inj, linezolid (hospira)","description":"Injection, linezolid (hospira), not therapeutically equivalent to j2020, 200 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0561U","name":"Onc mrd gsa cfdna subsequent","description":"Onc mrd gsa cfdna subsequent","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0049","name":"Main hemo in-cntr","description":"With maintenance hemodialysis (in-center and home hd) for the complete reporting month","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37282","name":"Rvsc evsc tpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9294","name":"Biofeed dig cog behav tx fda","description":"Prescription digital cognitive and/or behavioral therapy, biofeedback, fda cleared, per course of treatment","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4385","name":"Apollo ft per sq cm","description":"Apollo ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5943","name":"Proth mandib implt sup remv","description":"Proth mandib implt sup remv","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4307","name":"American amnion, per sq cm","description":"American amnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4373","name":"Membrane wrp lt per sq cm","description":"Membrane wrap lite, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57420","name":"Exam of vagina w/scope","description":"Colposcopy of the entire vagina, with cervix if present;","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":149.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1196","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4360","name":"Amchoplast fd per sq cm","description":"Amchoplast fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4270","name":"Complete sl per sq cm","description":"Complete sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6111","name":"Implnt/abut remov dent mand","description":"Implnt/abut remov dent mand","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0726T","name":"Rmvl implt vstibular dev uni","description":"Removal of implanted vestibular device, unilateral","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37279","name":"Iv lithotrp fpvt w/in sm art","description":"Intravascular lithotripsy(ies), femoral and popliteal vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6192","name":"Semi precision attachment","description":"Semi precision attachment","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21141","name":"Rcnstj midface lefort i 1pc","description":"Reconstruction midface, lefort i; single piece, segment movement in any direction (eg, for long face syndrome), without bone graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1538.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57120","name":"Colpocleisis le fort type","description":"Colpocleisis (le fort type)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0780T","name":"Instlj fecal microbiota ssp","description":"Instillation of fecal microbiota suspension via rectal enema into lower gastrointestinal tract","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55881","name":"Ablt trurl prst8 tis thrm us","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0739","name":"Rehab sys active assist rt","description":"Rehabilitation system with interactive interface providing active assistance in rehabilitation therapy, includes all components and accessories, motors, microprocessors, sensors","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0371U","name":"Iadna gu pthgn semiq dna16&1","description":"Iadna gu pthgn semiq dna16&1","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82948","name":"Reagent strip/blood glucose","description":"Glucose; blood, reagent strip","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0407U","name":"Neph dbtc ckd mult eclia alg","description":"Neph dbtc ckd mult eclia alg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0877","name":"Inj, daptomycin (hospira)","description":"Injection, daptomycin (hospira), not therapeutically equivalent to j0878, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0721T","name":"Quan ct tiss charac w/o ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93594","name":"R hrt cath chd abnl nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; abnormal native connections","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0471U","name":"Onc clrc ca 35 vrn kras&nras","description":"Onc clrc ca 35 vrn kras&nras","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37267","name":"Revsc evsc fpvt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9025","name":"Plasma cryo redu path each","description":"Plasma, cryoprecipitate reduced, pathogen reduced, each unit","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q2021","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0989T","name":"Revj/rmvl ins ptn subq&subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2471","name":"Inj pantoprazole(hikma) 40mg","description":"Injection, pantoprazole (hikma), not therapeutically equivalent to j2470, 40 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0434U","name":"Rx metab advrs vrnt alys 25","description":"Rx metab advrs vrnt alys 25","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0699T","name":"Njx pst chmbr eye medication","description":"Injection, posterior chamber of eye, medication","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76810","name":"Ob us >/= 14 wks addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0754T","name":"Dgtz gls mcrscp sld level v","description":"Digitization of glass microscope slides for level v, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1474","name":"Pt dx dementia","description":"Patients with diagnosis of dementia","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0612","name":"Inj, calcium gluconate, nos","description":"Injection, calcium gluconate, not otherwise specified, 10 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4299","name":"Amniocore pro+, per sq cm","description":"Amniocore pro+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0334U","name":"Onc sld orgn tgsa dna 84/+","description":"Onc sld orgn tgsa dna 84/+","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0517U","name":"Ther rx mntr 80+ psyactiv rx","description":"Ther rx mntr 80+ psyactiv rx","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0756T","name":"Dgtz gls mcrscp sld spc grpi","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group i, for microorganisms (eg, acid fast, methenamine silver) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1012T","name":"Mtrz ab ntrno trph scl/tr mw","description":"Motorized ab interno trephination of sclera (sclerostomy), or trabecular meshwork (trabeculostomy), 1 or more, including injection of antifibrotic agents, when performed","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0474","name":"Micro w exam of surg margins","description":"Accession of tissue gross and microscopic examination including assessment of surgical margins for presence of disease preparation and transmission of writte","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1481","name":"Pt in hosp/pal care who died","description":"Patients receiving hospice or palliative care or who died during the measurement period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0249","name":"Adm tocilizu covid-19 1st","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0606U","name":"Hem red cll memb do rbc oge","description":"Hem red cll memb do rbc oge","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43291","name":"Egd flx trnsorl rmvl balo","description":"Esophagogastroduodenoscopy, flexible, transoral; with removal of intragastric bariatric balloon(s)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7194","name":"Factor ix complex","description":"Factor ix, complex, per i.u.","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70472","name":"Ct cere prfu alys c+w/ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed with concurrent ct or ct angiography of the same anatomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6525","name":"G com garm lwrleg/ft ngt cus","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, custom, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64468","name":"Thrc fascial pln blk bi njx","description":"Thoracic fascial plane block, bilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1228","name":"Pt + hcv aby +vir w/ rx 3 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, has hcv treatment initiated within 3 months of the reactive hcv antibody test","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31576","name":"Laryngoscopy with biopsy","description":"Laryngoscopy, flexible; with biopsy(ies)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1028","name":"Take home supply 8mg per 0.1","description":"Take-home supply of nasal naloxone; 2-pack of 8mg per 0.1 ml nasal spray (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1216","name":"No spiro doc no res doc","description":"No spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and/or no spirometry performed with results documented during the encounter","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":9.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0658","name":"Seg pneum comp 2 arm chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1393","name":"Pr no dx rec mlnm","description":"Patients who were not diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5149","name":"Inj, aflibercept-abzv, 1 mg","description":"Injection, aflibercept-abzv (enzeevu), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95970","name":"Alys npgt w/o prgrmg","description":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg, contact group[s], interleaving, amplitude, pulse width, frequency [hz], on/off cycling, burst, magnet mode, dose lockout, patient selectable parameters, responsive neurostimulation, detection algorithms, closed loop pa","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0708T","name":"Id ca immntx prep & 1st njx","description":"Intradermal cancer immunotherapy; preparation and initial injection","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33269","name":"Excl laa thrscp any method","description":"Exclusion of left atrial appendage, thoracoscopic, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90966","name":"Esrd home pt serv p mo 20+","description":"End-stage renal disease (esrd) related services for home dialysis per full month, for patients 20 years of age and older","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0233","name":"Intra inf, toci, first dose","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1436","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24546","name":"Optx hum fx w/ntrcndylr xtn","description":"Open treatment of humeral supracondylar or transcondylar fracture, includes internal fixation, when performed; with intercondylar extension","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1353.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0269U","name":"Hem aut dm cgen trmbctpna 14","description":"Hematology (autosomal dominant congenital thrombocytopenia), genomic sequence analysis of 14 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86611","name":"Bartonella antibody","description":"Antibody; bartonella","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7511","name":"Antithymocyte globuln rabbit","description":"Lymphocyte immune globulin, antithymocyte globulin, rabbit, parenteral, 25 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0798T","name":"Tcat rmv 2chmbr ldls pm cmpl","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; complete system (ie, right atrial and right ventricular pacemaker components)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43291","name":"Egd flx trnsorl rmvl balo","description":"Esophagogastroduodenoscopy, flexible, transoral; with removal of intragastric bariatric balloon(s)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0736T","name":"Colonic lavage 35+l water","description":"Colonic lavage, 35 or more liters of water, gravity-fed, with induced defecation, including insertion of rectal catheter","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4423","name":"Biolab tri wrap fl per sq cm","description":"Biolab tri-membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0981T","name":"Tcat impl wrls ivc snr","description":"Transcatheter implantation of wireless inferior vena cava sensor for long-term hemodynamic monitoring, including deployment of the sensor, radiological supervision and interpretation, right heart catheterization, and inferior vena cava venography, when performed","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0344U","name":"Hep nafld semiq evl 28 lipid","description":"Hep nafld semiq evl 28 lipid","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0691T","name":"Auto alys xst ct std vrt fx","description":"Automated analysis of an existing computed tomography study for vertebral fracture(s), including assessment of bone density when performed, data preparation, interpretation, and report","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93597","name":"R&l hrt cath chd abnl nt cnj","description":"Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); abnormal native connections","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7511","name":"Incision/drain abscess intra","description":"Incision and drainage of abscess - intraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1164","name":"Pt w/ dementia any time","description":"Patients with dementia any time during the patients history through the end of the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44310","name":"Ileostomy/jejunostomy","description":"Ileostomy or jejunostomy, non-tube","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1092.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4422","name":"Ac wrap per sq cm","description":"A/c wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37183","name":"Revision tips","description":"Revision of transvenous intrahepatic portosystemic shunt(s) (tips) (includes venous access, hepatic and portal vein catheterization, portography with hemodynamic evaluation, intrahepatic tract recannulization/dilatation, stent placement and all associated imaging guidance and documentation)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":497.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0935T","name":"Cysto w/rnl pel symp dnrvtj","description":"Cystourethroscopy with renal pelvic sympathetic denervation, radiofrequency ablation, retrograde ureteral approach, including insertion of guide wire, selective placement of ureteral sheath(s) and multiple conformable electrodes, contrast injection(s), and fluoroscopy, bilateral","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0728T","name":"Dx alys vstblr implt uni 1st","description":"Diagnostic analysis of vestibular implant, unilateral; with initial programming","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37720","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":457.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1817","name":"Insulin for insulin pump use","description":"Insulin for administration through dme (i.e., insulin pump) per 50 units","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0570","name":"Care manage serv, pr cal mo","description":"Care management services for behavioral health conditions, directed by a physician or other qualified health care professional, per calendar month, with the following required elements: initial assessment or follow-up monitoring, including the use of applicable validated rating scales, behavioral he","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1209","name":">=2 same hi-rsk med w/o diag","description":"At least two orders for high-risk medications from the same drug class, (table 4), without appropriate diagnoses","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7957","name":"Tiss regen edent nonresorb","description":"Tiss regen edent nonresorb","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91113","name":"Gi trc img intral colon i&r","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45389","name":"Colonoscopy w/stent plcmt","description":"Colonoscopy, flexible; with endoscopic stent placement (includes pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37259","name":"Revsc evasc ivt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0850T","name":"Dgtz gls mcrscp ish ea mult","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4414","name":"Simplichor per sq cm","description":"Simplichor, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0356U","name":"Onc orop 17 dna ddpcr alg","description":"Onc orop 17 dna ddpcr alg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11401","name":"Exc tr-ext b9+marg 0.6-1 cm","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 0.6 to 1.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":45.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":110.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78104","name":"Bone marrow imaging body","description":"Bone marrow imaging; whole body","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17360","name":"Chemical exfoliation acne","description":"Chemical exfoliation for acne (eg, acne paste, acid)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75900","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1110.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0139","name":"Inj, adalimumab, 1 mg","description":"Injection, adalimumab, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64582","name":"Opn mpltj hpglsl nstm ary pg","description":"Open implantation of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1271","name":"Pts dem any time/dur mo","description":"Patients with dementia at any time prior to or during the month","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1162","name":"Pt enceph due to dtp bef 13","description":"Patient had encephalitis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1710","name":"Moderna vacc admin 3rd dose","description":"Moderna vacc admin 3rd dose","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44401","name":"Colonoscopy with ablation","description":"Colonoscopy through stoma; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre-and post-dilation and guide wire passage, when performed)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3061.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":246.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1273","name":"Pts snf 1 yr dialysis","description":"Patients who were admitted to a skilled nursing facility (snf) within one year of dialysis initiation according to the cms-2728 form","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0548","name":"Phone/inter svs 21-30 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87153","name":"Dna/rna sequencing","description":"Culture, typing; identification by nucleic acid sequencing method, each isolate (eg, sequencing of the 16s rrna gene)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97551","name":"Caregiver traing ea addl 15","description":"Caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patie","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1709","name":"Pfizer vaccine admin booster","description":"Pfizer vaccine admin booster","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1430","name":"Ret exm ou no retinopthy doc","description":"Retinal exam finding without evidence of retinopathy in both eyes with severity level documented (in measurement year or in the prior year)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0137","name":"Inj, acetaminophen (hikma)","description":"Injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0462U","name":"Melatonin lvl tst slp std7/9","description":"Melatonin lvl tst slp std7/9","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3391","name":"Inj, atidarsagene autotemcel","description":"Injection, atidarsagene autotemcel, per treatment","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4301","name":"Activate matrix, per sq cm","description":"Activate matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9294","name":"Inj pemetrexed, hospira 10mg","description":"Injection, pemetrexed (hospira), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80503","name":"Path clin consltj sf 5-20","description":"Pathology clinical consultation; for a clinical problem, with limited review of patients history and medical records and straightforward medical decision making when using time for code selection, 5-20 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9249","name":"Inj, melphalan (apotex) 1 mg","description":"Injection, melphalan (apotex), 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1265","name":"Cms 2728 completed","description":"Cms medical evidence form 2728 for dialysis patients: initial form completed","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0884T","name":"Esphgsc flx 1st tndsc dilat","description":"Esophagoscopy, flexible, transoral, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for esophageal stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0349U","name":"Rx metab/pcx dna 27gen rx ia","description":"Rx metab/pcx dna 27gen rx ia","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0936T","name":"Photobiomodulation ther rta","description":"Photobiomodulation therapy of retina, single session","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1184","name":"Doc med rsn no cst/ist rx","description":"Documentation of medical reason(s) for not prescribing or administering corticosteroid or immunosuppressant treatment (e.g., allergy, intolerance, infectious etiology, pancreatic insufficiency, hyperthyroidism, prior bowel surgical interventions, celiac disease, receiving other medication, awaiting ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82438","name":"Assay other fluid chlorides","description":"Chloride; other source","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1611","name":"Inj glucagon hcl, fresenius","description":"Injection, glucagon hydrochloride (fresenius kabi), not therapeutically equivalent to j1610, per 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74350","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80504","name":"Path clin consltj mod 21-40","description":"Pathology clinical consultation; for a moderately complex clinical problem, with review of patients history and medical records and moderate level of medical decision making when using time for code selection, 21-40 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99323","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1374","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5149","name":"Inj, aflibercept-abzv, 1 mg","description":"Injection, aflibercept-abzv (enzeevu), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64898","name":"Nrv grf mltst arm/leg >4 cm","description":"Nerve graft (includes obtaining graft), multiple strands (cable), arm or leg; more than 4 cm length","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1533.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2039","name":"Innovamatrix fd, per sq cm","description":"Innovamatrix fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1352","name":"Suicd c-ssrs assessment, equ","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs or equivalent assessment","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4100","name":"Nosht skin sub fda clrd nos","description":"Non-sheet form skin substitute, fda cleared as a device, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0403U","name":"Onc prst8 mrna 18 gen dre ur","description":"Onc prst8 mrna 18 gen dre ur","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4320","name":"Pellograft, per sq cm","description":"Pellograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26568","name":"Lengthen metacarpal/finger","description":"Osteoplasty, lengthening, metacarpal or phalanx","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1205.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0974T","name":"Slctv nzmtc dbrdmt t/a/l ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; each additional 100 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1019T","name":"Lymphovenous bypass per xtr","description":"Lymphovenous bypass, including robotic assistance, when performed, per extremity","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11010","name":"Debride skin at fx site","description":"Debridement including removal of foreign material at the site of an open fracture and/or an open dislocation (eg, excisional debridement); skin and subcutaneous tissues","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55710","name":"Bx prst8 tprn us w/mri fus 1","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant) with mri-fusion-guidance biopsy, first targeted lesion","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0735T","name":"Prep tum cav iort prim crnot","description":"Preparation of tumor cavity, with placement of a radiation therapy applicator for intraoperative radiation therapy (iort) concurrent with primary craniotomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77089","name":"Tbs dxa cal w/i&r fx risk","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; using dual x-ray absorptiometry (dxa) or other imaging data on gray-scale variogram, calculation, with interpretation and report on fracture-risk","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4372","name":"Amchoplast excl per sq cm","description":"Amchoplast excel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0722T","name":"Quan ct tiss charac w/ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained with concurrent ct examination of any structure contained in the concurrently acquired diagnostic imaging dataset (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0664","name":"Team remote e/m new pt 60 mn","description":"Team remote e/m new pt 60mins","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1486","name":"Pt admitted to snf dur eval","description":"Patients admitted to a skilled nursing facility (snf) during the period of evaluation","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37238","name":"Open/perq place stent same","description":"Transcatheter placement of an intravascular stent(s), open or percutaneous, including radiological supervision and interpretation and including angioplasty within the same vessel, when performed; initial vein","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4602.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01941","name":"Anes neuromd/ntrvrt crv/thrc","description":"Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98001","name":"Synch audio-video new low 30","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4397","name":"Summit aaa per sq cm","description":"Summit aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1025","name":"Pt mnth 1 mcp prov","description":"Patient-months where there are more than one medicare capitated payment (mcp) provider listed for the month","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2406","name":"Injection, oritavancin 10 mg","description":"Injection, oritavancin (kimyrsa), 10 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1299","name":"Flu immunize order/admin","description":"Influenza immunization administered or previously received","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1353","name":"Pts no cmplt suicd saf pln","description":"Patients who did not have a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1182","name":"Not elg pre ex ibd/uc/crohn","description":"Patients not eligible due to pre-existing inflammatory bowel disease (ibd) (e.g., ulcerative colitis, crohns disease)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37279","name":"Iv lithotrp fpvt w/in sm art","description":"Intravascular lithotripsy(ies), femoral and popliteal vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0373","name":"Tomo bitewing image","description":"Tomo bitewing image","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6600","name":"G com bandge hgh dn foam sht","description":"Gradient compression bandaging supply, high density foam sheet, per 250 square centimeters, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1468","name":"Hep b vaccine received","description":"Patient received recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6039","name":"Passive custom digit/thumb","description":"Passive prosthetic digit or thumb prosthesis not including hand restoration partial hand, full or partial, custom made, any material, initial or replacement, per single passive prosthetic digit or thumb","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98006","name":"Synch audio-video est mod 30","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1326","name":"Pts dx hypotony","description":"Patients with a diagnosis of hypotony","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6035","name":"Prosthetic digit mechanical","description":"Single prosthetic digit, mechanical, can include metacarpophalangeal (mcp), proximal interphalangeal (pip), and/or distal interphalangeal (dip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0896T","name":"Connj lvr algrft prfu dev ea","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; each additional hour, including physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary bicarbonate, lactate ","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4291","name":"Lamellas xt, per sq cm","description":"Lamellas xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0842T","name":"Dgtz gls mcrscp pth cslt ea","description":"Digitization of glass microscope slides for pathology consultation during surgery; each additional tissue block with frozen section(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87426","name":"Sarscov coronavirus ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; severe acute respiratory syndrome coronavirus (eg, sars-cov, s","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1181","name":"Gr 2 or> dia or gr2 or> col","description":"Grade 2 or above diarrhea and/or grade 2 or above colitis","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3387","name":"Inj elivaldogene autotemecel","description":"Injection, elivaldogene autotemcel, per treatment","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26415","name":"Excision hand/finger tendon","description":"Excision of extensor tendon, with implantation of synthetic rod for delayed tendon graft, hand or finger, each rod","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":965.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0463U","name":"Onc crvx mrna genxprsn 14bmk","description":"Onc crvx mrna genxprsn 14bmk","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1008T","name":"Rem mntr s-scl eeg sys setup","description":"Remote monitoring of sub-scalp implanted continuous bilateral electroencephalography monitoring system, device fitting, initial set-up, and patient education in wearing of system and use of equipment","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4351","name":"Enclose tl matrix, per sq cm","description":"Enclose tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1243","name":"Pt othr thn true heard","description":"Patient provided a response other than completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0465","name":"Autolog prp diab wound ulcer","description":"Autologous platelet rich plasma (prp) or other blood-derived product for diabetic chronic wounds/ulcers, using an fda-cleared device for this indication, (includes as applicable administration, dressings, phlebotomy, centrifugation or mixing, and all other preparatory procedures, per treatment)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82233","name":"Beta-amyloid 1-40 (abeta 40)","description":"Beta-amyloid; 1-40 (abeta 40)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0538U","name":"Onc sol tum ngts ffpe 600gen","description":"Onc sol tum ngts ffpe 600gen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0824T","name":"Tcat rmv 1chmbr ldls pm ra","description":"Transcatheter removal of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography), when performed","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81418","name":"Rx metab gen seq alys pnl 6","description":"Drug metabolism (eg, pharmacogenomics) genomic sequence analysis panel, must include testing of at least 6 genes, including cyp2c19, cyp2d6, and cyp2d6 duplication/deletion analysis","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59412","name":"Antepartum manipulation","description":"External cephalic version, with or without tocolysis","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7485","name":"Surg reduct osseoustuberosit","description":"Surgical reduction of osseous tuberosity","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15261","name":"Fth/gft fr n/e/e/l each addl","description":"Full thickness graft, free, including direct closure of donor site, nose, ears, eyelids, and/or lips; each additional 20 sq cm, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36460","name":"Intrauterine transfusion ftl","description":"Transfusion, intrauterine, fetal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":425.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47135","name":"Transplantation of liver","description":"Liver allotransplantation, orthotopic, partial or whole, from cadaver or living donor, any age","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5434.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93573","name":"Njx cath slct p-art angrp bi","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, bilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9998","name":"Doc med rsn <3 colon","description":"Documentation of medical reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., last colonoscopy incomplete, last colonoscopy had inadequate prep, piecemeal removal of adenomas, or sessile serrated polyps >= 20 mm in size, last colonoscopy found greater than 10 adenomas, lo","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64640","name":"Injection treatment of nerve","description":"Destruction by neurolytic agent; other peripheral nerve or branch","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1274","name":"Pts snf exl mo","description":"Patients who were admitted to a skilled nursing facility (snf) during the month of evaluation were excluded from that month","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15934","name":"Exc sacral pr ulc skn flap","description":"Excision, sacral pressure ulcer, with skin flap closure;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1013.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52597","name":"Trurl rbtc wtrjt rescj prst8","description":"Transurethral robotic-assisted waterjet resection of prostate, including intraoperative planning, ultrasound guidance, control of postoperative bleeding, complete, including vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0983T","name":"Rem mntr impl ivc snr phys","description":"Remote monitoring of an implanted inferior vena cava sensor for up to 30 days, including at least weekly downloads of inferior vena cava area recordings, interpretation(s), trend analysis, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38562","name":"Removal pelvic lymph nodes","description":"Limited lymphadenectomy for staging (separate procedure); pelvic and para-aortic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":779.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4386","name":"Acesso trifaca per sq cm","description":"Acesso trifaca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9957","name":"Screening sleep disorders","description":"Screening sleep disorders","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11001","name":"Dbrdmt ecz/infct skn ea addl","description":"Debridement of extensive eczematous or infected skin; each additional 10% of the body surface, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1182","name":"Not elg pre ex ibd/uc/crohn","description":"Patients not eligible due to pre-existing inflammatory bowel disease (ibd) (e.g., ulcerative colitis, crohns disease)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1210","name":">=2 same meds tbl4 not ord","description":"At least two orders for high-risk medications from the same drug class, (table 4), not ordered","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7049","name":"Epap nasal valve","description":"Expiratory positive airway pressure intranasal resistance valve","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0666","name":"Inj, bupivacaine liposome","description":"Injection, bupivacaine liposome, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3394","name":"Inj, lovotibeglogene autotem","description":"Injection, lovotibeglogene autotemcel, per treatment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82272","name":"Occult bld feces 1-3 tests","description":"Blood, occult, by peroxidase activity (eg, guaiac), qualitative, feces, 1-3 simultaneous determinations, performed for other than colorectal neoplasm screening","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9697","name":"Inj, magtrace per study dose","description":"Injection, carboxydextran-coated superparamagnetic iron oxide, per study dose","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1349","name":"No pam inc 3 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 3 points within a 4 to 12 month period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4361","name":"Epixpress, per sq cm","description":"Epixpress, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0317U","name":"Onc lung ca 4-prb fish assay","description":"Onc lung ca 4-prb fish assay","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1436","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0422U","name":"Onc pan solid tum alys dna","description":"Onc pan solid tum alys dna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0407U","name":"Neph dbtc ckd mult eclia alg","description":"Neph dbtc ckd mult eclia alg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90965","name":"Esrd home pt serv p mo 12-19","description":"End-stage renal disease (esrd) related services for home dialysis per full month, for patients 12-19 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0731T","name":"Augmnt ai-based fcl phnt a/r","description":"Augmentative ai-based facial phenotype analysis with report","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0468U","name":"Hep nash mir34a5p a2m ykl40","description":"Hep nash mir34a5p a2m ykl40","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2013","name":"Innovamatrix fs, per sq cm","description":"Innovamatrix fs, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4033","name":"Skilled nursing facility ss","description":"Skilled nursing facility mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15854","name":"Removal sutr&stapl xreq anes","description":"Removal of sutures and staples not requiring anesthesia (list separately in addition to e/m code)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1373","name":"Mst rec gsa >=8 and <=9","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 8.0% and <= 9.0%","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85670","name":"Thrombin time plasma","description":"Thrombin time; plasma","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9297","name":"Inj pemetrexed (sandoz) 10mg","description":"Injection, pemetrexed (sandoz), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0682","name":"App non-sheet skin sub add","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (list separately in addition to code for pri","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7214","name":"Altuviiio per factor viii iu","description":"Injection, factor viii/von willebrand factor complex, recombinant (altuviiio), per factor viii i.u.","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0985T","name":"Iv img xtrc cere vsl oct ea","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93596","name":"R&l hrt cath chd nml nt cnj","description":"Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); normal native connections","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93931","name":"Upper extremity study","description":"Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1476","name":"Pt dx cog imp or ad","description":"Patients with diagnosis of cognitive impairment or alzheimers disease","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0302U","name":"Iadna brtnla ddpcr flwg liq","description":"Iadna brtnla ddpcr flwg liq","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69210","name":"Remove impacted ear wax uni","description":"Removal impacted cerumen requiring instrumentation, unilateral","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84550","name":"Assay of blood/uric acid","description":"Uric acid; blood","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0019","name":"Comm hlth intg svs sdoh 60mn","description":"Community health integration services performed by certified or trained auxiliary personnel, including a community health worker, under the direction of a physician or other practitioner; 60 minutes per calendar month, in the following activities to address social determinants of health (sdoh) need(","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0689","name":"Inj cefazolin sodium, baxter","description":"Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9225","name":"Gen anes adv air-sub 15 min","description":"Gen anes adv air-sub 15 min","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0521","name":"New pt-cg dyad dem hig cmplx","description":"Management of new patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1327","name":"Pts no eval ini xm no 8 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 8 weeks","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5878","name":"Dup of complt dent-mandib","description":"Dup of complt dent-mandib","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1299","name":"Flu immunize order/admin","description":"Influenza immunization administered or previously received","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0569U","name":"Onc sol tum ngs tmm>20000dmr","description":"Onc sol tum ngs tmm>20000dmr","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1308","name":"Flu immunize no admin","description":"Influenza immunization was not administered, reason not given","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5100","name":"Inj ustekinumab-kfce, 1 mg","description":"Injection, ustekinumab-kfce (yesintek), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55877","name":"Abltj ire prst8 1+ tum perq","description":"Ablation, irreversible electroporation, prostate, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85307","name":"Assay activated protein c","description":"Activated protein c (apc) resistance assay","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1025","name":"Pt mnth 1 mcp prov","description":"Patient-months where there are more than one medicare capitated payment (mcp) provider listed for the month","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9046","name":"Inj, bortezomib, dr. reddys","description":"Injection, bortezomib (dr. reddys), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21034","name":"Excise max/zygoma mal tumor","description":"Excision of malignant tumor of maxilla or zygoma","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1370.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29075","name":"Appl cst elbw fngr short arm","description":"Application, cast; elbow to finger (short arm)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4265","name":"Neostim tl per sq cm","description":"Neostim tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0792T","name":"Appl slvr diamn fluoride 38%","description":"Application of silver diamine fluoride 38%, by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6106","name":"Tissue regen resorbable","description":"Tissue regen resorbable","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99404","name":"Prev med cnsl indiv apprx 60","description":"Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 60 minutes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":121.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0802","name":"3d dental scan indirect","description":"3d dental scan indirect","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67413","name":"Explore/treat eye socket","description":"Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of foreign body","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":954.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99492","name":"1st psyc collab care mgmt","description":"Initial psychiatric collaborative care management, first 70 minutes in the first calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":172.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92636","name":"Hearing aid post-fitg f-up 1","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9268","name":"Programmer orally ingest cap","description":"Programmer for transient, orally ingested capsule","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4293","name":"Acesso dl, per sq cm","description":"Acesso dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36014","name":"Place catheter in artery","description":"Selective catheter placement, left or right pulmonary artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4338","name":"Artacent velos, per sq cm","description":"Artacent velos, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0965T","name":"I&cst prp jw xpn dl arch non","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, non-fixed hinge mechanism","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1305","name":"Pneum vax admin 19+","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0273U","name":"Hem gen hyprfibrnlysis 8 gen","description":"Hematology (genetic hyperfibrinolysis, delayed bleeding), genomic sequence analysis of 8 genes (f13a1, f13b, fga, fgb, fgg, serpina1, serpine1, serpinf2, plau) blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0901T","name":"Plmt bone marrow smplg port","description":"Placement of bone marrow sampling port, including imaging guidance when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0467","name":"Home vent multi-function","description":"Home ventilator, multi-function respiratory device, also performs any or all of the additional functions of oxygen concentration, drug nebulization, aspiration, and cough stimulation, includes all accessories, components and supplies for all functions","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1605.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86619","name":"Borrelia antibody","description":"Antibody; borrelia (relapsing fever)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1435","name":"Oral chemo in perf pd","description":"Patient on oral chemotherapy during the performance period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95919","name":"Quan puplmtry phy/qhp uni/bi","description":"Quantitative pupillometry with physician or other qualified health care professional interpretation and report, unilateral or bilateral","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D8671","name":"Periodic orth treat w surg","description":"Periodic orth treat w surg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0565U","name":"Onc hcc ngs detc 6626epigalt","description":"Onc hcc ngs detc 6626epigalt","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1435","name":"Oral chemo in perf pd","description":"Patient on oral chemotherapy during the performance period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0707T","name":"Njx b1 sub mtrl sbchdrl dfct","description":"Injection(s), bone-substitute material (eg, calcium phosphate) into subchondral bone defect (ie, bone marrow lesion, bone bruise, stress injury, microtrabecular fracture), including imaging guidance and arthroscopic assistance for joint visualization","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1173","name":"Pt no rec td/tdap 9yrs prior","description":"Patient did not receive at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0256U","name":"Tma/tmao prfl ms/ms ur alg","description":"Trimethylamine/trimethylamine n-oxide (tma/tmao) profile, tandem mass spectrometry (ms/ms), urine, with algorithmic analysis and interpretive report","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4301","name":"Activate matrix, per sq cm","description":"Activate matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9953","name":"Reline sleep apnea appliance","description":"Reline sleep apnea appliance","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4320","name":"Pellograft, per sq cm","description":"Pellograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85032","name":"Manual cell count each","description":"Blood count; manual cell count (erythrocyte, leukocyte, or platelet) each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4382","name":"Advograft dual per sq cm","description":"Advograft dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4023","name":"Pathology ss","description":"Pathology mips specialty set","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0884T","name":"Esphgsc flx 1st tndsc dilat","description":"Esophagoscopy, flexible, transoral, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for esophageal stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0458U","name":"Onc brst ca s100 a8&a9 elisa","description":"Onc brst ca s100 a8&a9 elisa","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82653","name":"El-1 fecal quantitative","description":"Elastase, pancreatic (el-1), fecal; quantitative","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4037","name":"Urology ss","description":"Urology mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65260","name":"Remove foreign body from eye","description":"Removal of foreign body, intraocular; from posterior segment, magnetic extraction, anterior or posterior route","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":941.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0868T","name":"Hi-res gastric ep mapping","description":"High-resolution gastric electrophysiology mapping with simultaneous patient-symptom profiling, with interpretation and report","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84255","name":"Assay of selenium","description":"Selenium","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92631","name":"Hearing aid slctn svc 1st 30","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0691T","name":"Auto alys xst ct std vrt fx","description":"Automated analysis of an existing computed tomography study for vertebral fracture(s), including assessment of bone density when performed, data preparation, interpretation, and report","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2040","name":"Microlyte painguard pr sq cm","description":"Microlyte painguard, per square centimeter","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7354","name":"Cantharidin top, applicator","description":"Cantharidin for topical administration, 0.7%, single unit dose applicator (3.2 mg)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0531","name":"Fclty-based respite, 24 hr u","description":"Facility-based respite, 24-hour unit, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2252","name":"Inj midazolam in 0.8% nacl","description":"Injection, midazolam in 0.8% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1408","name":"Gmln brca bef dx ca","description":"Patients who have germline brca testing completed before diagnosis of epithelial ovarian, fallopian tube, or primary peritoneal cancer","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7190","name":"Factor viii","description":"Factor viii (antihemophilic factor, human) per i.u.","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55882","name":"Ablt trurl prst8 tis trnsdcr","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation; with insertion of transurethral ultrasound transducer for delivery of thermal ultrasound, including suprapubic tube placement and placement of ","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86042","name":"Acetylcholn rcptr blckg antb","description":"Acetylcholine receptor (achr); blocking antibody","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0879T","name":"Augmnt alys ch ct ild prep","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; radiological data preparation and transmission","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9293","name":"Fertility cycl tracking soft","description":"Fertility cycle (contraception & conception) tracking software application, fda cleared, per month, includes accessories (e.g., thermometer)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0163","name":"Epinephrine in nacl (endo)","description":"Injection, epinephrine in sodium chloride (endo), 0.1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97804","name":"Medical nutrition group","description":"Medical nutrition therapy; group (2 or more individual(s)), each 30 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":13.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":14.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0799","name":"Hiv prep, fda approved, noc","description":"Fda approved prescription drug, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv), not otherwise classified","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0682","name":"App non-sheet skin sub add","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (list separately in addition to code for pri","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6515","name":"Grad com wrap w str fu le cu","description":"Gradient compression wrap with adjustable straps, full leg, each, custom","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4298","name":"Amniocore pro, per sq cm","description":"Amniocore pro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1415","name":"No pos pdl1 bef ici ther","description":"Patients who did not have a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7299","name":"Rem anchorage device w/flap","description":"Rem anchorage device w/flap","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1200","name":"Ace-i/arb rx","description":"Ace inhibitor (ace-i) or arb therapy prescribed during the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1428","name":"Bilateral absence of eyes","description":"Patients who have bilateral absence of eyes any time during the patients history through the end of the measurement period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J9098","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98001","name":"Synch audio-video new low 30","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28092","name":"Removal of toe lesions","description":"Excision of lesion, tendon, tendon sheath, or capsule (including synovectomy) (eg, cyst or ganglion); toe(s), each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3263","name":"Inj, toripalimab-tpzi, 1 mg","description":"Injection, toripalimab-tpzi, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1211","name":"Gsa level>9.0%","description":"Most recent glycemic status assessment (hba1c or gmi) level > 9.0%","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22515","name":"Perq vertebral augmentation","description":"Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (eg, kyphoplasty), 1 vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; each additional thoracic or lumbar vertebra","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1289","name":"No pt tbco cess interv rng","description":"Patient identified as tobacco user did not receive tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1098","name":"Articaine ophthalmi 8% 0.4ml","description":"Articaine ophthalmic, 8% solution, 0.4 ml","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0455U","name":"Nfct agt sti mult amp prb ur","description":"Nfct agt sti mult amp prb ur","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49190","name":"Opn exc/dstr ntra-abd >30 cm","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); greater than 30 cm","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0012","name":"Injection of hiv prep drug","description":"Injection of pre-exposure prophylaxis (prep) drug for hiv prevention, under skin or into muscle","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4372","name":"Amchoplast excl per sq cm","description":"Amchoplast excel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1412","name":"Inj roctavian ml 2x10^13vc g","description":"Injection, valoctocogene roxaparvovec-rvox, per ml, containing nominal 2 x 10^13 vector genomes","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0619U","name":"Pulm copd dna alys >18000","description":"Pulm copd dna alys >18000","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0899T","name":"N-invas deter aqmbf aug cmr","description":"Noninvasive determination of absolute quantitation of myocardial blood flow (aqmbf), derived from augmentative algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health car","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0839T","name":"Dgtz gls mcrscp cslt mat prp","description":"Digitization of glass microscope slides for consultation and report on referred material requiring preparation of slides (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0987T","name":"Iv img icr cere vsl oct ea","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99397","name":"Per pm reeval est pat 65+ yr","description":"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 65 ye","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":134.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1814","name":"Inj. insulin (lyumjev)","description":"Insulin (lyumjev), per 5 units","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1365","name":"Hosp+pall care spec code 17","description":"Patient encounter during the performance period with hospice and palliative care specialty code 17","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63005","name":"Remove spine lamina 1/2 lmbr","description":"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), 1 or 2 vertebral segments; lumbar, except for spondylolisthesis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1298.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0664","name":"Team remote e/m new pt 60 mn","description":"Team remote e/m new pt 60mins","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64597","name":"Ins/rplcm prq eltrd ra pn ea","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; each additional electrode array (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0473","name":"Micro exam prep & report","description":"Accession of tissue gross and microscopic examination preparation and transmission of written report","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66821","name":"After cataract laser surgery","description":"Discission of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid); laser surgery (eg, yag laser) (1 or more stages)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87523","name":"Hepatitis d quantification","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis d (delta), quantification, including reverse transcription, when performed","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1413","name":"Pos pdl1 bef init ici tx","description":"Patients who had a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0368U","name":"Onc clrct ca mut&mthyltn mrk","description":"Onc clrct ca mut&mthyltn mrk","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6602","name":"Cst hgh nble mtl inlay 2 srf","description":"Inlay - cast high noble metal two surfaces","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9245","name":"Admin mod sedation-enteral","description":"Admin mod sedation-enteral","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99442","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1490","name":"Pt status not doc","description":"Patient status not documented","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1246","name":"Pt othr thn true imprt to me","description":"Patient provided a response other than completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6106","name":"Tissue regen resorbable","description":"Tissue regen resorbable","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25126","name":"Remove/graft forearm lesion","description":"Excision or curettage of bone cyst or benign tumor of radius or ulna (excluding head or neck of radius and olecranon process); with allograft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1013.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0667","name":"Team remote e/m est pt 25 mn","description":"Team remote e/m est. pt 25mins","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1251","name":"Pts proxy cmplt hu surv","description":"Patients for whom a proxy completed the entire hu survey on their behalf for any reason (no patient involvement)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0136","name":"Adm of pa/n assess 5-15 m","description":"Administration of a standardized, evidence-based assessment of physical activity and nutrition, 5-15 minutes, not more often than every 6 months","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80220","name":"Drug asy hydroxychloroquine","description":"Hydroxychloroquine","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65210","name":"Remove foreign body from eye","description":"Removal of foreign body, external eye; conjunctival embedded (includes concretions), subconjunctival, or scleral nonperforating","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36005","name":"Injection ext venography","description":"Injection procedure for extremity venography (including introduction of needle or intracatheter)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1257","name":"Cvd risk assess not perf","description":"Cvd risk assessment not performed or incomplete (e.g., cvd risk assessment was not documented), reason not otherwise specified","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1174","name":"Pt w/ 2 hzv 10/2017 - mp","description":"Patient received at least two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43232","name":"Esophagoscopy w/us needle bx","description":"Esophagoscopy, flexible, transoral; with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":289.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0822T","name":"Mntr psychdlc med cln staff","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; clinical staff under the direction of a physician or other qualified health care professional, concurrent with first physician or other qualified health care p","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50387","name":"Change nephroureteral cath","description":"Removal and replacement of externally accessible nephroureteral catheter (eg, external/internal stent) requiring fluoroscopic guidance, including radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99464","name":"Attendance at delivery","description":"Attendance at delivery (when requested by the delivering physician or other qualified health care professional) and initial stabilization of newborn","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93975","name":"Vascular study","description":"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":476.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0383U","name":"Tyrosinemia typ i mntr quan","description":"Tyrosinemia typ i mntr quan","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55711","name":"Bx prst8 trct mri-us 1st","description":"Biopsy, prostate, transrectal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0586U","name":"Onc mrna gen xprsn 216 genes","description":"Onc mrna gen xprsn 216 genes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25392","name":"Shorten radius & ulna","description":"Osteoplasty, radius and ulna; shortening (excluding 64876)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1466.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9025","name":"Plasma cryo redu path each","description":"Plasma, cryoprecipitate reduced, pathogen reduced, each unit","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1307","name":"Inj, crovalimab-akkz, 10 mg","description":"Injection, crovalimab-akkz, 10 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"Non-adju cgm supply allow","description":"Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KF"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0843T","name":"Dgtz gls mcrscp cslt cyt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), initial site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2989","name":"Excavate tooth non-restorabl","description":"Excavate tooth non-restorabl","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59614","name":"Vbac care after delivery","description":"Vaginal delivery only, after previous cesarean delivery (with or without episiotomy and/or forceps); including postpartum care","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":993.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0583U","name":"Rare ds rpd whlgen cmptr dna","description":"Rare ds rpd whlgen cmptr dna","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2804","name":"Inj, rifampin, 1 mg","description":"Injection, rifampin, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4030","name":"Pulmonology ss","description":"Pulmonology mips specialty set","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J8521","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64654","name":"1st opn implt bat modulj sys","description":"Initial open implantation of baroreflex activation therapy (bat) modulation system, including lead placement onto the carotid sinus, lead tunnelling, connection to a pulse generator placed in a distant subcutaneous pocket (ie, total system), and intraoperative interrogation and programming","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5913","name":"Nasal prosthesis","description":"Nasal prosthesis","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1248","name":"Pt resp true seen as person","description":"Patient responded completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0248","name":"Inj, remdesivir, 1 mg","description":"Injection, remdesivir, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19396","name":"Design custom breast implant","description":"Preparation of moulage for custom breast implant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4265","name":"Neostim tl per sq cm","description":"Neostim tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4379","name":"Amniodefend ft per sq cm","description":"Amniodefend ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D8671","name":"Periodic orth treat w surg","description":"Periodic orth treat w surg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4393","name":"Surgraft ac per sq cm","description":"Surgraft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95861","name":"Needle emg 2 extremities","description":"Needle electromyography; 2 extremities with or without related paraspinal areas","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34805","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1474.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92629","name":"Eval hearing aid cand ea add","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99234","name":"Hosp ip/obs sm dt sf/low 45","description":"Hospital inpatient or observation care, for the evaluation and management of a patient including admission and discharge on the same date, which requires a medically appropriate history and/or examination and straightforward or low level of medical decision making. when using total time on the date ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":50.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1426","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15200","name":"Fth/gft fr trnk 20 sq cm/<","description":"Full thickness graft, free, including direct closure of donor site, trunk; 20 sq cm or less","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":685.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33279","name":"Rmvl phrnc nrv stim transvns","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s) only","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64655","name":"Revj/rplcmt bat mod sys lead","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; lead only","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33897","name":"Perq trluml angp nt/recr coa","description":"Percutaneous transluminal angioplasty of native or recurrent coarctation of the aorta","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3421","name":"Root surgery bicuspid","description":"Apicoectomy/periradicular surgery-bicuspid (first root)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81458","name":"So gsap dna cpy nmbr&mcrstl","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis, copy number variants and microsatellite instability","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0677T","name":"Laps repos lead isdss 1st ld","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first repositioned lead","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4286","name":"Remove non-resorb barrier","description":"Remove non-resorb barrier","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33542","name":"Removal of heart lesion","description":"Myocardial resection (eg, ventricular aneurysmectomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2063.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0805T","name":"Tcat s&ivc prstc vl impl prq","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); percutaneous femoral vein approach","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9248","name":"Inj melphalan (hepzato) 1 mg","description":"Injection, melphalan (hepzato), 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0011","name":"Hiv prep counsel, md 15-30m","description":"Individual counseling for pre-exposure prophylaxis (prep) by physician or qualified health care professional (qhp) to prevent human immunodeficiency virus (hiv), includes hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence, 15-30 minutes","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9610","name":"Xe129 xenon, diagnostic","description":"Xenon xe-129 hyperpolarized gas, diagnostic, per study dose","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2247","name":"Inj, micafungin (par pharm)","description":"Injection, micafungin sodium (par pharm) not thereapeutically equivalent to j2248, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90474","name":"Immune admin oral/nasal addl","description":"Immunization administration by intranasal or oral route; each additional vaccine (single or combination vaccine/toxoid) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37273","name":"Revsc evsc fpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0255U","name":"Andrology infertility assmt","description":"Andrology (infertility), sperm-capacitation assessment of ganglioside gm1 distribution patterns, fluorescence microscopy, fresh or frozen specimen, reported as percentage of capacitated sperm and probability of generating a pregnancy score","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2252","name":"Inj midazolam in 0.8% nacl","description":"Injection, midazolam in 0.8% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1403","name":"Bslne and fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1442","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5160","name":"Inj, jobevne, 10 mg","description":"Injection, bevacizumab-nwgd (jobevne), biosimilar, 10 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1388","name":"Pt doc exm rec melmn","description":"Patients with documentation of an exam performed for recurrence of melanoma","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64659","name":"Rmvl bat modulj sys pg only","description":"Removal of baroreflex activation therapy (bat) modulation system; pulse generator only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6091","name":"Repl semi/precision attach","description":"Replacement of semi-precision or precision attachment (male or female component) of implant/abutment supported prosthesis per attachment","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3393","name":"Inj, betibeglogene autotemce","description":"Injection, betibeglogene autotemcel, per treatment","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9332","name":"Inj efgartigimod 2mg","description":"Injection, efgartigimod alfa-fcab, 2mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0541","name":"No pt prsnt train initial 30","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1303","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1318","name":"Pts no csp doc contact","description":"Patients who did not have documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening or documentation that there was no contact with a csp","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4009","name":"Hospitalists ss","description":"Hospitalists mips specialty set","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5877","name":"Dup of complt dent-maxill","description":"Dup of complt dent-maxill","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0879","name":"Difelikefalin, esrd on dialy","description":"Injection, difelikefalin, 0.1 microgram, (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42821","name":"Remove tonsils and adenoids","description":"Tonsillectomy and adenoidectomy; age 12 or over","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49614","name":"Rpr aa hrn rcr < 3 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, incarcerated or strangulated","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9953","name":"Reline sleep apnea appliance","description":"Reline sleep apnea appliance","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7972","name":"Surg redct fibrous tuberosit","description":"Surgical reduction of fibrous tuberosity","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1351","name":"Pt cmplt suicd saf pln 120dy","description":"Patients who had a suicide safety plan initiated, reviewed, or updated and reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37257","name":"Revsc evsc ivt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99475","name":"Ped crit care age 2-5 init","description":"Initial inpatient pediatric critical care, per day, for the evaluation and management of a critically ill infant or young child, 2 through 5 years of age","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":523.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1182","name":"Not elg pre ex ibd/uc/crohn","description":"Patients not eligible due to pre-existing inflammatory bowel disease (ibd) (e.g., ulcerative colitis, crohns disease)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0062","name":"Audiology ss","description":"Audiology mips specialty set","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1161","name":"Pt anphx due to dtp bef 13","description":"Patient had anaphylaxis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1200","name":"Ace-i/arb rx","description":"Ace inhibitor (ace-i) or arb therapy prescribed during the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0855T","name":"Dgtz gls mcrscp b1 marow smr","description":"Digitization of glass microscope slides for bone marrow, smear interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0605","name":"Antibody test pub hlth path","description":"Antibody test pub hlth path","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71101","name":"X-ray exam unilat ribs/chest","description":"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7173","name":"Inj. concizumab-mtci, 0.5 mg","description":"Injection, concizumab-mtci, 0.5 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1271","name":"Pts dem any time/dur mo","description":"Patients with dementia at any time prior to or during the month","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2050","name":"Financial mgt waiver/diem","description":"Financial management, self-directed, waiver; per diem","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0445U","name":"Abeta42 & ptau181 eclia csf","description":"Abeta42 & ptau181 eclia csf","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24582","name":"Prq skel fix humrl cndylr fx","description":"Percutaneous skeletal fixation of humeral condylar fracture, medial or lateral, with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":879.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76989","name":"Dx intraop epcar us chd i&r","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; interpretation and report only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28106","name":"Remove/graft foot lesion","description":"Excision or curettage of bone cyst or benign tumor, tarsal or metatarsal, except talus or calcaneus; with iliac or other autograft (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":565.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73520","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93569","name":"Njx cth slct p-art angrp uni","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0388U","name":"Onc nonsm cll lng ca 37 gen","description":"Onc nonsm cll lng ca 37 gen","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2247","name":"Inj, micafungin (par pharm)","description":"Injection, micafungin sodium (par pharm) not thereapeutically equivalent to j2248, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37255","name":"Revsc evasc ivt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37297","name":"Revsc evasc imvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1274","name":"Pts snf exl mo","description":"Patients who were admitted to a skilled nursing facility (snf) during the month of evaluation were excluded from that month","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77089","name":"Tbs dxa cal w/i&r fx risk","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; using dual x-ray absorptiometry (dxa) or other imaging data on gray-scale variogram, calculation, with interpretation and report on fracture-risk","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93150","name":"Therapy activation ipnss","description":"Therapy activation of implanted phrenic nerve stimulator system, including all interrogation and programming","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0175","name":"Inj, donanemab-azbt, 2 mg","description":"Injection, donanemab-azbt, 2 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1401","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0385U","name":"Neph ckd alg rsk dbtc kdn ds","description":"Neph ckd alg rsk dbtc kdn ds","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0540","name":"Train for caregiver add 15","description":"Caregiver training in behavior management/modification for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face; each additional 15 minutes","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0789T","name":"Elec aly cpx iins sp/sac nrv","description":"Electronic analysis with complex programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detect","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34712","name":"Tcat dlvr enhncd fixj dev","description":"Transcatheter delivery of enhanced fixation device(s) to the endograft (eg, anchor, screw, tack) and all associated radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":641.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0489U","name":"Ob sgnipt cfdna seq alys 1+","description":"Ob sgnipt cfdna seq alys 1+","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0935T","name":"Cysto w/rnl pel symp dnrvtj","description":"Cystourethroscopy with renal pelvic sympathetic denervation, radiofrequency ablation, retrograde ureteral approach, including insertion of guide wire, selective placement of ureteral sheath(s) and multiple conformable electrodes, contrast injection(s), and fluoroscopy, bilateral","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0169","name":"Inj epinephrine (adrenalin)","description":"Injection, epinephrine (adrenalin), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0668","name":"Instill, bupivac and meloxic","description":"Instillation, bupivacaine and meloxicam, 1 mg/0.03 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0842T","name":"Dgtz gls mcrscp pth cslt ea","description":"Digitization of glass microscope slides for pathology consultation during surgery; each additional tissue block with frozen section(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0665","name":"Team remote e/m est pt 10 mn","description":"Team remote e/m est. pt 10mins","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1308","name":"Flu immunize no admin","description":"Influenza immunization was not administered, reason not given","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15953","name":"Exc trchntr pr ulc flp ostc","description":"Excision, trochanteric pressure ulcer, with skin flap closure; with ostectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1058.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1003T","name":"Arthrp 1st crp/mtcrpl prostc","description":"Arthroplasty, first carpometacarpal joint, with distal trapezial and proximal first metacarpal prosthetic replacement (eg, first carpometacarpal total joint)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37266","name":"Rvsc evsc fpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90840","name":"Psytx crisis ea addl 30 min","description":"Psychotherapy for crisis; each additional 30 minutes (list separately in addition to code for primary service)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":75.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1424","name":"Pulmonology care mvp","description":"Pulmonology care mips value pathway","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59856","name":"Induced ab 1+vag supp d&c","description":"Induced abortion, by 1 or more vaginal suppositories (eg, prostaglandin) with or without cervical dilation (eg, laminaria), including hospital admission and visits, delivery of fetus and secundines; with dilation and curettage and/or evacuation","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":419.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83914","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93005","name":"Electrocardiogram tracing","description":"Electrocardiogram, routine ecg with at least 12 leads; tracing only, without interpretation and report","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99426","name":"Prin care mgmt staff 1st 30","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61891","name":"Rev/rplcmt sk-mnt crnl nstm","description":"Revision or replacement of skull-mounted cranial neurostimulator pulse generator or receiver with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49616","name":"Rpr aa hrn rcr 3-10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1783","name":"Vac admin human pap dose 3","description":"Vac admin human pap dose 3","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38305","name":"Drainage lymph node lesion","description":"Drainage of lymph node abscess or lymphadenitis; extensive","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0388U","name":"Onc nonsm cll lng ca 37 gen","description":"Onc nonsm cll lng ca 37 gen","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4008","name":"Geriatrics ss","description":"Geriatrics mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4432","name":"510(k) skin subs, nos","description":"510(k) skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2041","name":"Foundation drs+ duo pr sq cm","description":"Foundation drs+ duo, per square centimeter","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99350","name":"Home/res vst est high mdm 60","description":"Home or residence visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":219.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1406","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1172","name":"Doc med rsn no td/tdap","description":"Documentation of medical reason(s) for not administering td or tdap vaccine (e.g., prior anaphylaxis due to the td or tdap vaccine or history of encephalopathy within seven days after a previous dose of a td-containing vaccine)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81515","name":"Nfct ds bv&vaginitis dna alg","description":"Infectious disease, bacterial vaginosis and vaginitis, real-time pcr amplification of dna markers for atopobium vaginae, atopobium species, megasphaera type 1, and bacterial vaginosis associated bacteria-2 (bvab-2), utilizing vaginal-fluid specimens, algorithm reported as positive or negative for hi","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91113","name":"Gi trc img intral colon i&r","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99284","name":"Emergency dept visit mod mdm","description":"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1159","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37277","name":"Rvsc evsc fpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4420","name":"Nuform per sq cm","description":"Nuform, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2042","name":"Foundation drs+ solo, sq cm","description":"Foundation drs+ solo, per square centimeter","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37279","name":"Iv lithotrp fpvt w/in sm art","description":"Intravascular lithotripsy(ies), femoral and popliteal vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0774T","name":"Vr px dissoc svc oth phy ea","description":"Virtual reality (vr) procedural dissociation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports; each additiona","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0658","name":"Seg pneum comp 2 arm chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95148","name":"Antigen therapy services","description":"Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy (specify number of doses); 4 single stinging insect venoms","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32900","name":"Removal of rib(s)","description":"Resection of ribs, extrapleural, all stages","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1482.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86362","name":"Mog-igg1 antb cba each","description":"Myelin oligodendrocyte glycoprotein (mog-igg1) antibody; cell-based immunofluorescence assay (cba), each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33235","name":"Removal pacemaker electrode","description":"Removal of transvenous pacemaker electrode(s); dual lead system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":754.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0839T","name":"Dgtz gls mcrscp cslt mat prp","description":"Digitization of glass microscope slides for consultation and report on referred material requiring preparation of slides (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43832","name":"Gstrst open w/constj tube","description":"Gastrostomy, open; with construction of gastric tube (eg, janeway procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1084.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0705","name":"Extra oral post radio image","description":"Extra oral post radio image","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0041","name":"Pt/ptn decln referral","description":"Patient and/or care partner decline referral","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1194","name":"Med rsn no imp/con mmr/msi","description":"Documentation of medical reason(s) surgical pathology reports did not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both tests were not included (e.g., patient will not be treated with checkpoint inhibitor therap","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1481","name":"Pt in hosp/pal care who died","description":"Patients receiving hospice or palliative care or who died during the measurement period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78231","name":"Salivary glnd img serial img","description":"Salivary gland imaging; with serial images","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3921","name":"Decor or submerg erupt tooth","description":"Decor or submerg erupt tooth","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0630U","name":"Onc brst mrna gen prflg 80","description":"Onc brst mrna gen prflg 80","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0731T","name":"Augmnt ai-based fcl phnt a/r","description":"Augmentative ai-based facial phenotype analysis with report","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15420","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":398.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20664","name":"Appl halo cranial 6+pins","description":"Application of halo, including removal, cranial, 6 or more pins placed, for thin skull osteology (eg, pediatric patients, hydrocephalus, osteogenesis imperfecta)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":774.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0926T","name":"Prgrmg dev eval ccm-d ip","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, including review and report, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3394","name":"Inj, lovotibeglogene autotem","description":"Injection, lovotibeglogene autotemcel, per treatment","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0034","name":"Pall serv during meas","description":"Patients receiving palliative care during the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4326","name":"Woundplus, per sq cm","description":"Woundplus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2024","name":"Resolve or xenopatch sq cm","description":"Resolve matrix or xenopatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7259","name":"Nerve dissection","description":"Nerve dissection","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69535","name":"Remove part of temporal bone","description":"Resection temporal bone, external approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3176.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3473","name":"Surg rep root res molar","description":"Surg rep root res molar","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5411","name":"Dentures adjust cmplt mand","description":"Adjust complete denture - mandibular","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1283","name":"Pt scrn tbco and id as user","description":"Patient screened for tobacco use and identified as a tobacco user","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4224","name":"Hhf10-p per sq cm","description":"Human health factor 10 amniotic patch (hhf10-p), per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1242","name":"Pt no resp imprt to me","description":"Patient did not respond to the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4278","name":"Epieffect, per sq cm","description":"Epieffect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0375U","name":"Onc ovrn bchm asy 7 prtn alg","description":"Onc ovrn bchm asy 7 prtn alg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34812","name":"Opn fem art expos","description":"Open femoral artery exposure for delivery of endovascular prosthesis, by groin incision, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0606U","name":"Hem red cll memb do rbc oge","description":"Hem red cll memb do rbc oge","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1005T","name":"Elec alys s-scl eeg prgr 1st","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, first 15 minutes face-to-face time with physician or other qualified hea","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75580","name":"N-invas est c ffr sw aly cta","description":"Noninvasive estimate of coronary fractional flow reserve (ffr) derived from augmentative software analysis of the data set from a coronary computed tomography angiography, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0030","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22837","name":"Ant thrc vrt body tethrg 8+","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; 8 or more vertebral segments","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4276","name":"Orion, per sq cm","description":"Orion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97804","name":"Medical nutrition group","description":"Medical nutrition therapy; group (2 or more individual(s)), each 30 minutes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":13.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1386","name":"Exc sx melmn or mlnm is","description":"Patients with an excisional surgery for melanoma or melanoma in situ in the past 5 years with an initial ajcc staging of 0, i, or ii at the start of the performance period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0339U","name":"Onc prst8 mrna hoxc6 & dlx1","description":"Onc prst8 mrna hoxc6 & dlx1","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0686T","name":"Histotripsy mal hepatcel tis","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant hepatocellular tissue, including image guidance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1369","name":"Qualcare mental hlth/sud mvp","description":"Quality care in mental health and substance use disorders mips value pathway","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64597","name":"Ins/rplcm prq eltrd ra pn ea","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; each additional electrode array (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0262U","name":"Onc sld tum rt-pcr 7 gen","description":"Oncology (solid tumor), gene expression profiling by real-time rt-pcr of 7 gene pathways (er, ar, pi3k, mapk, hh, tgfb, notch), formalin-fixed paraffin-embedded (ffpe), algorithm reported as gene pathway activity score","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88189","name":"Flowcytometry/read 16 & >","description":"Flow cytometry, interpretation; 16 or more markers","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6584","name":"Grad com wrap w straps","description":"Gradient compression wrap with adjustable straps, not otherwise specified","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4338","name":"Artacent velos, per sq cm","description":"Artacent velos, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1488","name":"Dx dementia in msr timeframe","description":"Patients with a diagnosis for dementia in the year before or during the period of evaluation","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0706T","name":"Rem tx amblyopia i&r phy/qhp","description":"Remote treatment of amblyopia using an eye tracking device; interpretation and report by physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4027","name":"Plastic surgery ss","description":"Plastic surgery mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3471","name":"Ovine, up to 999 usp units","description":"Injection, hyaluronidase, ovine, preservative free, per 1 usp unit (up to 999 usp units)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":405.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4394","name":"Surgraft aca per sq cm","description":"Surgraft aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6212","name":"Bridge noble metal cast","description":"Pontic-cast noble metal","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33768","name":"Anast cavopulm sec sup v/c","description":"Anastomosis, cavopulmonary, second superior vena cava (list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":528.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33901","name":"Perq p-art revsc 1 nm nt bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, bilateral","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0826T","name":"Prgrmg evl ldls pm 1chmbr ip","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional, leadless pacemaker system in si","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99392","name":"Prev visit est age 1-4","description":"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; early","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":70.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0411","name":"Hba1c in office testing","description":"Hba1c in office testing","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53040","name":"Drainage of urethra abscess","description":"Drainage of deep periurethral abscess","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":453.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2267","name":"Inj, mirikizumab-mrkz, 1 mg","description":"Injection, mirikizumab-mrkz, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55708","name":"Bx prst8 trct us w/mri fus 1","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant) with mri-fusion-guidance, first targeted lesion","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99203","name":"Office o/p new low 30 min","description":"Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":81.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":136.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"Ak 4 bar link hydl swg/stanc","description":"Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49428","name":"Ligation of shunt","description":"Ligation of peritoneal-venous shunt","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":485.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2468","name":"Inj, palonosetron (posfrea)","description":"Injection, palonosetron hydrochloride (posfrea), 25 micrograms","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5996","name":"Peri medicament w/seal, mand","description":"Peri medicament w/seal, mand","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2013","name":"Innovamatrix fs, per sq cm","description":"Innovamatrix fs, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0369","name":"Max mri capture & interprete","description":"Max mri capture & interprete","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63200","name":"Release spinal cord lumbar","description":"Laminectomy, with release of tethered spinal cord, lumbar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1630.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69210","name":"Remove impacted ear wax uni","description":"Removal impacted cerumen requiring instrumentation, unilateral","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48153","name":"Pancreatectomy","description":"Pancreatectomy, proximal subtotal with near-total duodenectomy, choledochoenterostomy and duodenojejunostomy (pylorus-sparing, whipple-type procedure); with pancreatojejunostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3281.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9992","name":"Pall serv during meas","description":"Palliative care services used by patient any time during the measurement period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0560","name":"Safety plan interven","description":"Safety planning interventions, each 20 minutes personally performed by the billing practitioner, including assisting the patient in the identification of the following personalized elements of a safety plan: recognizing warning signs of an impending suicidal or substance use-related crisis; employin","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67840","name":"Remove eyelid lesion","description":"Excision of lesion of eyelid (except chalazion) without closure or with simple direct closure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0516U","name":"Rx metab rxgenomic gnotyp 40","description":"Rx metab rxgenomic gnotyp 40","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75958","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43118","name":"Partial removal of esophagus","description":"Partial esophagectomy, distal two-thirds, with thoracotomy and separate abdominal incision, with or without proximal gastrectomy; with colon interposition or small intestine reconstruction, including intestine mobilization, preparation, and anastomosis(es)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2268.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4036","name":"Urgent care ss","description":"Urgent care mips specialty set","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9999","name":"Inj ustekinumab-aauz 1 mg","description":"Injection, ustekinumab-aauz (otulfi), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33279","name":"Rmvl phrnc nrv stim transvns","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s) only","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53451","name":"Tprnl balo cntnc dev bi","description":"Periurethral transperineal adjustable balloon continence device; bilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82308","name":"Assay of calcitonin","description":"Calcitonin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3501","name":"Surg exp root surf anterior","description":"Surg exp root surf anterior","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1438","name":"Etanercept injection","description":"Injection, etanercept, 25 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4268","name":"Surgraft ft per sq cm","description":"Surgraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85660","name":"Rbc sickle cell test","description":"Sickling of rbc, reduction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69728","name":"Rmv ntr oi imp sk tc>=100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33882","name":"Evasc rpr ta dplmt mltpc sys","description":"Endovascular repair of the thoracic aorta by deployment of a branched endograft multipiece system involving an aorto-aortic tube device with a fenestration for the left subclavian artery stent graft(s) and all aortic tube endograft extension(s) placed from the level of the left common carotid artery","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0532U","name":"Rare ds whlgen&mitochdrl dna","description":"Rare ds whlgen&mitochdrl dna","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1016T","name":"Elec alys npgs esoph intraop","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1245","name":"Pt othr thn true person","description":"Patient provided a response other than completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69666","name":"Repair middle ear structures","description":"Repair oval window fistula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":923.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2020","name":"Ac5 wound system","description":"Ac5 advanced wound system (ac5)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55881","name":"Ablt trurl prst8 tis thrm us","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation;","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9914","name":"Admin of dermal fill","description":"Admin of dermal fill","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94375","name":"Respiratory flow volume loop","description":"Respiratory flow volume loop","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0841T","name":"Dgtz gls mcrscp pth cslt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; first tissue block, with frozen section(s), single specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90613","name":"Inf&sarscov2 vacc 40/0.4 im","description":"Influenza virus vaccine, quadrivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 40 mcg/0.4 ml dosage, for intramuscular use","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83884","name":"Assay neurflmnt light chain","description":"Neurofilament light chain (nfl)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0567U","name":"Rare ds whl gen seq srs&lrs","description":"Rare ds whl gen seq srs&lrs","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2038","name":"Marigen pacto, per sq cm","description":"Marigen pacto, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4336","name":"Artecent c, per sq cm","description":"Artacent c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9871","name":"Bhv couns dm prev, onln 60 m","description":"Behavioral counseling for diabetes prevention, online, 60 minutes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0575U","name":"Trnsplj med lar rtpcr 4genes","description":"Trnsplj med lar rtpcr 4genes","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0709T","name":"Id ca immntx each addl njx","description":"Intradermal cancer immunotherapy; each additional injection (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0745T","name":"Car ablt rad arr n-invas loc","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; noninvasive arrhythmia localization and mapping of arrhythmia site (nidus), derived from anatomical image data (eg, ct, mri, or myocardial perfusion scan) and electrical data (eg, 12-lead ecg data), and identification of areas of avo","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0844T","name":"Dgtz gls mcrscp cslt cyt ea","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), each additional site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0732T","name":"Immntx admn electroporatn im","description":"Immunotherapy administration with electroporation, intramuscular","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2561","name":"Inj, sezaby, 1 mg","description":"Injection, phenobarbital sodium (sezaby), 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0235","name":"Inj, monoclon antibody, 1 mg","description":"Injection, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extraco","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0870T","name":"Imp subq prtl ascts pmp sys","description":"Implantation of subcutaneous peritoneal ascites pump system, percutaneous, including pump-pocket creation, insertion of tunneled indwelling bladder and peritoneal catheters with pump connections, including all imaging and initial programming, when performed","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4312","name":"Acesso ac, per sq cm","description":"Acesso ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82370","name":"X-ray assay calculus","description":"Calculus; x-ray diffraction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1496","name":"No doc of fall or poc","description":"Patients that had a fall who did not have a plan of care for falls documented or do not have documentation of being assessed for falls","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2561","name":"Inj, sezaby, 1 mg","description":"Injection, phenobarbital sodium (sezaby), 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1952","name":"Leuprolide inj, camcevi, 1mg","description":"Leuprolide injectable, camcevi, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6590","name":"Urinary cath disp suc pump","description":"External urinary catheters; disposable, with wicking material, for use with suction pump, per month","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87040","name":"Blood culture for bacteria","description":"Culture, bacterial; blood, aerobic, with isolation and presumptive identification of isolates (includes anaerobic culture, if appropriate)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0792T","name":"Appl slvr diamn fluoride 38%","description":"Application of silver diamine fluoride 38%, by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88312","name":"Special stains group 1","description":"Special stain including interpretation and report; group i for microorganisms (eg, acid fast, methenamine silver)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1304","name":"Inj tofersen intrathec 1 mg","description":"Injection, tofersen, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76819","name":"Fetal biophys profil w/o nst","description":"Fetal biophysical profile; without non-stress testing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0385U","name":"Neph ckd alg rsk dbtc kdn ds","description":"Neph ckd alg rsk dbtc kdn ds","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2777","name":"Inj, faricimab-svoa, 0.1mg","description":"Injection, faricimab-svoa, 0.1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1256","name":"Prior history of known cvd","description":"Prior history of known cvd","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0613U","name":"Onc uc dna mthyltn&mut 6bmrk","description":"Onc uc dna mthyltn&mut 6bmrk","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0735T","name":"Prep tum cav iort prim crnot","description":"Preparation of tumor cavity, with placement of a radiation therapy applicator for intraoperative radiation therapy (iort) concurrent with primary craniotomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9954","name":"Fab/del oral appliance thxpy","description":"Fab/del oral appliance thxpy","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45321","name":"Proctosigmoidoscopy volvul","description":"Proctosigmoidoscopy, rigid; with decompression of volvulus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70471","name":"Cta h&n c+ w/noncontrast img","description":"Computed tomographic angiography (cta), head and neck, with contrast material(s), including noncontrast images, when performed, and image postprocessing","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1357","name":"Pt w/red suic idea 120 days","description":"Patients who had a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0829T","name":"Dgtz gls mcrscp cytp conctrj","description":"Digitization of glass microscope slides for cytopathology, concentration technique, smears, and interpretation (eg, saccomanno technique) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99403","name":"Prev med cnsl indiv apprx 45","description":"Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 45 minutes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":68.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1806","name":"Inj esmolol hcl wg crit care","description":"Injection, esmolol hydrochloride (wg critical care), not therapeutically equivalent to j1805, 10 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0443U","name":"Neurflmnt lt chn ultrsens ia","description":"Neurflmnt lt chn ultrsens ia","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99272","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99411","name":"Preventive counseling group","description":"Preventive medicine counseling and/or risk factor reduction intervention(s) provided to individuals in a group setting (separate procedure); approximately 30 minutes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":7.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1226","name":"Iop not doc","description":"Iop measurement not documented, reason not otherwise specified","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0681","name":"App of non-sheet skin sub","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; first 25 sq cm or less of wound surface area","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74220","name":"X-ray xm esophagus 1cntrst","description":"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3421","name":"Root surgery bicuspid","description":"Apicoectomy/periradicular surgery-bicuspid (first root)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1502","name":"Podiatry mvp","description":"Podiatry mips value pathway","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0915T","name":"Insj perm ccm-d sys pg&eltrd","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator and dual transvenous electrodes/leads (pacing and defibrillation)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31500","name":"Insert emergency airway","description":"Intubation, endotracheal, emergency procedure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63103","name":"Remove vertebral body add-on","description":"Vertebral corpectomy (vertebral body resection), partial or complete, lateral extracavitary approach with decompression of spinal cord and/or nerve root(s) (eg, for tumor or retropulsed bone fragments); thoracic or lumbar, each additional segment (list separately in addition to code for primary proc","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1405","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9161","name":"Inj denileuk difti-cxdl 1mcg","description":"Injection, denileukin diftitox-cxdl, 1 mcg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1503","name":"Vascular surgery mvp","description":"Vascular surgery mips value pathway","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37265","name":"Revsc evsc fpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80503","name":"Path clin consltj sf 5-20","description":"Pathology clinical consultation; for a clinical problem, with limited review of patients history and medical records and straightforward medical decision making when using time for code selection, 5-20 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4545","name":"Suppl accessor tibial stim","description":"Supplies and accessories for external tibial nerve stimulator (e.g., socks, gel pads, electrodes, etc.), needed for one month","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1326","name":"Pts dx hypotony","description":"Patients with a diagnosis of hypotony","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49188","name":"Opn exc/dst ntra-abd 10.1-20","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 10.1 to 20 cm","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4341","name":"Simplimax, per sq cm","description":"Simplimax, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"Endoskel posit rotat unit","description":"Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0564U","name":"Nfct ds pthgn-sna 10vir&4bct","description":"Nfct ds pthgn-sna 10vir&4bct","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15780","name":"Dermabrasion total face","description":"Dermabrasion; total face (eg, for acne scarring, fine wrinkling, rhytids, general keratosis)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":733.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1411","name":"1st ln ici no chemo","description":"Currently on first-line immune checkpoint inhibitors without chemotherapy","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81349","name":"Cytog alys chrml abnr lw-ps","description":"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and loss-of-heterozygosity variants, low-pass sequencing analysis","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0388","name":"Bitewing image capture only","description":"Bitewing image capture only","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31002","name":"Irrigation sphenoid sinus","description":"Lavage by cannulation; sphenoid sinus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0166","name":"Inj epinephrine (bpi)","description":"Injection, epinephrine (bpi), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5948","name":"Max implt sup fix part","description":"Max implt sup fix part","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37259","name":"Revsc evasc ivt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9999","name":"Doc sys rsn <3 colon","description":"Documentation of system reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., unable to locate previous colonoscopy report, patient cannot provide precise date or details from previous colonoscopy, previous colonoscopy report was incomplete)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0365U","name":"Onc bldr 10 prb bldr ca","description":"Onc bldr 10 prb bldr ca","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2794","name":"Crown-titanium","description":"Crown-titanium","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78072","name":"Parathyrd planar w/spect&ct","description":"Parathyroid planar imaging (including subtraction, when performed); with tomographic (spect), and concurrently acquired computed tomography (ct) for anatomical localization","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1436","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1198","name":"Isa not red 3pts /no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98980","name":"Rtm tx mgmt 1st 20 min","description":"Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least 1 real-time interactive communication with the patient or caregiver during the calendar month; first 20 minutes","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1405","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1574","name":"Inj, ganciclovir (exela)","description":"Injection, ganciclovir sodium (exela), not therapeutically equivalent to j1570, 500 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1411","name":"1st ln ici no chemo","description":"Currently on first-line immune checkpoint inhibitors without chemotherapy","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0811T","name":"Rem mlt day uroflow setup","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); set-up and patient education on use of equipment","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1168","name":"Pt recd flu vax 7/1-6/30","description":"Patient received an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0973T","name":"Slctv nzmtc dbrdmt t/a/l 1st","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; first 100 sq cm","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88313","name":"Special stains group 2","description":"Special stain including interpretation and report; group ii, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistochemistry","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70472","name":"Ct cere prfu alys c+w/ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed with concurrent ct or ct angiography of the same anatomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0749T","name":"B1 str&fx rsk assmt dxr-bmd","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4339","name":"Artacent vericlen, per sq cm","description":"Artacent vericlen, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0509","name":"Crit care telehea consult 50","description":"Telehealth consultation, critical care, subsequent, physicians typically spend 50 minutes communicating with the patient and providers via telehealth","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2329","name":"Inj ublituximab-xiiy, 1 mg","description":"Injection, ublituximab-xiiy, 1mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1302","name":"Inj, sutimlimab-jome, 10 mg","description":"Injection, sutimlimab-jome, 10 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4438","name":"Adhesive clip ext ens contr","description":"Adhesive clip applied to the skin to secure external electrical nerve stimulator controller, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37268","name":"Revsc evasc fpvt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1454","name":"New cied","description":"New cied","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5162","name":"Inj, denosumab-nxxp, 1 mg","description":"Injection, denosumab-nxxp (bildyos/bilprevda), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0483U","name":"Nfct ds ng gyra s91f pt mut","description":"Nfct ds ng gyra s91f pt mut","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0949T","name":"Rem interrog dev ccm tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2040","name":"Microlyte painguard pr sq cm","description":"Microlyte painguard, per square centimeter","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7911","name":"Dental suture wound to 5 cm","description":"Complicated suture-up to 5 cm","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P3000","name":"Screen pap by tech w md supv","description":"Screening papanicolaou smear, cervical or vaginal, up to three smears, by technician under physician supervision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99232","name":"Sbsq hosp ip/obs moderate 35","description":"Subsequent hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 35 minut","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0538","name":"Ascvd rsk mng clin stf pr mo","description":"Atherosclerotic cardiovascular disease (ascvd) risk management services; clinical staff time; per calendar month","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35901","name":"Excision graft neck","description":"Excision of infected graft; neck","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":660.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87913","name":"Nfct agt gntyp alys sarscov2","description":"Infectious agent genotype analysis by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), mutation identification in targeted region(s)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9573","name":"Inj, gadopiclenol, 1 ml","description":"Injection, gadopiclenol, 1 ml","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0979T","name":"Sbmcsl crylys ther sft palt","description":"Submucosal cryolysis therapy; soft palate only","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1176","name":"No 2 hzv 10/2017-meas pd","description":"Patient did not receive two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61585","name":"Orbitocranial approach/skull","description":"Orbitocranial approach to anterior cranial fossa, extradural, including supraorbital ridge osteotomy and elevation of frontal and/or temporal lobe(s); with orbital exenteration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3290.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0794T","name":"Pt spec alg rx-onc tx option","description":"Patient-specific, assistive, rules-based algorithm for ranking pharmaco-oncologic treatment options based on the patients tumor-specific cancer marker information obtained from prior molecular pathology, immunohistochemical, or other pathology results which have been previously interpreted and repor","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35686","name":"Bypass graft/av fist patency","description":"Creation of distal arteriovenous fistula during lower extremity bypass surgery (non-hemodialysis) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":220.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9061","name":"Inj, amivantamab-vmjw","description":"Injection, amivantamab-vmjw, 2 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22851","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":529.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93897","name":"Emboli detcj wo iv mbubb njx","description":"Emboli detection without intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58580","name":"Transcrv abltj utrn fibrd rf","description":"Transcervical ablation of uterine fibroid(s), including intraoperative ultrasound guidance and monitoring, radiofrequency","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99445","name":"Rem mntr physiol param 2-15","description":"Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate); device(s) supply with daily recording(s) or programmed alert(s) transmission, 2-15 days in a 30-day period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1022T","name":"Prq tis dsplmt ntra-abdl/pel","description":"Percutaneous tissue displacement, any method, including imaging guidance; intra-abdominal/pelvic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4359","name":"Choriply, per sq cm","description":"Choriply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68841","name":"Insj rx elut implt lac canal","description":"Insertion of drug-eluting implant, including punctal dilation when performed, into lacrimal canaliculus, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0939T","name":"Xtrnl ecg rec>15d<30d scan","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; scanning analysis with report","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2002","name":"Inj, lidocaine in d5w, 1 mg","description":"Injection, lidocaine hcl in 5% dextrose, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27750","name":"Treatment of tibia fracture","description":"Closed treatment of tibial shaft fracture (with or without fibular fracture); without manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6524","name":"G com garmnt lwr leg/ft nght","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76529","name":"Echo exam of eye","description":"Ophthalmic ultrasonic foreign body localization","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64655","name":"Revj/rplcmt bat mod sys lead","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; lead only","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4345","name":"Matrix hd allogrft per sq cm","description":"Matrix hd allograft dermis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0347U","name":"Rx metab/pcx dna 16 gen alys","description":"Rx metab/pcx dna 16 gen alys","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0594U","name":"Nfct ds sepsis pncrtc spc","description":"Nfct ds sepsis pncrtc spc","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87490","name":"Chlmyd trach dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); chlamydia trachomatis, direct probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1350","name":"Pt w/ suic saf pln init rev","description":"Patients who had a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5933","name":"Refitting of obturator","description":"Obturator prosthesis modification","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1198","name":"Isa not red 3pts /no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1105","name":"Dexmedetomidine film, 1 mcg","description":"Dexmedetomidine, oral, 1 mcg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0918T","name":"Insj perm ccm-d sys dual ld","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; dual transvenous leads (pacing and defibrillation) only","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5909","name":"Max guid prothes w/ flange","description":"Max guid prothes w/ flange","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9064","name":"Inj, cabazitaxel (sandoz)","description":"Injection, cabazitaxel (sandoz), not therapeutically equivalent to j9043, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0998T","name":"Precuneus mag stimj tx dlvr","description":"Precuneus magnetic stimulation; personalized treatment delivery of magnetic stimulation therapy to a prespecified target area derived from analysis of evoked potentials within the precuneus, utilizing magnetic resonance imaging-based neuronavigation, with management, per day","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87880","name":"Strep a assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; streptococcus, group a","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0860T","name":"Ncntc ifr spctrsc scr pad","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), for screening for peripheral arterial disease, including provocative maneuvers, image acquisition, interpretation, and report, one or both lower extremities","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1340","name":"Indx whodas 2.0 or sds","description":"Index assessment completed using the 12-item whodas 2.0 or sds during the denominator identification period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43227","name":"Esophagoscopy control bleed","description":"Esophagoscopy, flexible, transoral; with control of bleeding, any method","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0502","name":"Other oral pathology procedu","description":"Other oral pathology procedures by report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93524","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2916.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86701","name":"Hiv-1antibody","description":"Antibody; hiv-1","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0837T","name":"Dgtz gls mcrscp fna i&r","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; interpretation and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87086","name":"Urine culture/colony count","description":"Culture, bacterial; quantitative colony count, urine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":8.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9871","name":"Bhv couns dm prev, onln 60 m","description":"Behavioral counseling for diabetes prevention, online, 60 minutes","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4426","name":"Dermbnd tl+, tlx per sq cm","description":"Dermabind tl + or dermabind tl x,  per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0681","name":"App of non-sheet skin sub","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; first 25 sq cm or less of wound surface area","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59426","name":"Antepartum care only","description":"Antepartum care only; 7 or more visits","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":1286.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":886.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5155","name":"Inj, aflibercept-jbvf, 1 mg","description":"Injection, aflibercept-jbvf (yesafili), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24576","name":"Cltx humrl cndylr fx wo mnpj","description":"Closed treatment of humeral condylar fracture, medial or lateral; without manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87164","name":"Dark field exam spec collj","description":"Dark field examination, any source (eg, penile, vaginal, oral, skin); includes specimen collection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1258","name":"Cvd risk assess perf","description":"Cvd risk assessment performed, have a documented calculated risk score","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0499U","name":"Onc clrct&lng dna ngs 8gene","description":"Onc clrct&lng dna ngs 8gene","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0685T","name":"Interrog dev eval isdss ip","description":"Interrogation device evaluation (in-person) with analysis, review and report by a physician or other qualified health care professional, including connection, recording and disconnection per patient encounter, permanent implantable synchronized diaphragmatic stimulation system for augmentation of ca","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4329","name":"Singlay, per sq cm","description":"Singlay, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49614","name":"Rpr aa hrn rcr < 3 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, incarcerated or strangulated","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15015","name":"App skn cl ssp agrft t/a/l 1","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; first 480 sq cm or less","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0971T","name":"Ablt mal brst tum pq lsr uni","description":"Ablation, malignant breast tumor(s), percutaneous, laser, including imaging guidance when performed, unilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4409","name":"Amniomatrixf3x per sq cm","description":"Amniomatrixf3x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1393","name":"Pr no dx rec mlnm","description":"Patients who were not diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76986","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4332","name":"Axolotl dualgraft, per sq cm","description":"Axolotl dualgraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25065","name":"Biopsy forearm soft tissues","description":"Biopsy, soft tissue of forearm and/or wrist; superficial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0816T","name":"Opn insj/rplcmt ins ptn subq","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0510U","name":"Onc pncrtc ca alg alys 16gen","description":"Onc pncrtc ca alg alys 16gen","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0890T","name":"Arhfcmrigtbs 1st tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including target assessment, initial motor threshold determination, neuronavigation, delivery and management, initial treatment day","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92920","name":"Prq trluml c angiop 1art&/br","description":"Percutaneous transluminal coronary angioplasty, single major coronary artery and/or its branch(es)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1481","name":"Pt in hosp/pal care who died","description":"Patients receiving hospice or palliative care or who died during the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61715","name":"Mrgfus strtctc ablt trgt icr","description":"Magnetic resonance image guided high intensity focused ultrasound (mrgfus), stereotactic ablation of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70134","name":"X-ray exam of middle ear","description":"Radiologic examination, internal auditory meati, complete","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7957","name":"Tiss regen edent nonresorb","description":"Tiss regen edent nonresorb","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0538","name":"Ascvd rsk mng clin stf pr mo","description":"Atherosclerotic cardiovascular disease (ascvd) risk management services; clinical staff time; per calendar month","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1394","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0562U","name":"Onc sol tum tgsa 33gens snvs","description":"Onc sol tum tgsa 33gens snvs","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0678T","name":"Laps repos lead isdss ea add","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional repositioned lead (list separately in addition to code for primary proce","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1420","name":"Complete ophthalmologic mvp","description":"Complete ophthalmologic care mips value pathway","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4422","name":"Ac wrap per sq cm","description":"A/c wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43889","name":"Gstr rstcv px trnsorl esg","description":"Gastric restrictive procedure, transoral, endoscopic sleeve gastroplasty (esg), including argon plasma coagulation, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93593","name":"R hrt cath chd nml nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; normal native connections","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39501","name":"Repair diaphragm laceration","description":"Repair, laceration of diaphragm, any approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":955.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1499","name":"Interventional radiology mvp","description":"Interventional radiology mips value pathway","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80426","name":"Gonadotropin hormone panel","description":"Gonadotropin releasing hormone stimulation panel this panel must include the following: follicle stimulating hormone (fsh) (83001 x 4) luteinizing hormone (lh) (83002 x 4)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92636","name":"Hearing aid post-fitg f-up 1","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0570U","name":"Neurol tbi alys gfap&uch-l1","description":"Neurol tbi alys gfap&uch-l1","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0618U","name":"Psyc bd dna mthyl alys>10000","description":"Psyc bd dna mthyl alys>10000","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1466","name":"Pt disc/lam proc same day","description":"Patient had a lumbar fusion on the same date as the discectomy/laminectomy procedure","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78591","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0283U","name":"Vw factor type 2b eval plsm","description":"Von willebrand factor (vwf), type 2b, platelet-binding evaluation, radioimmunoassay, plasma","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0771T","name":"Vr px dissoc svc sm phy 1st","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7411","name":"Excision benign lesion>1.25c","description":"Excision of benign lesion greater than 1.25 cm","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2919","name":"Inj, methylpred sod succ 5mg","description":"Injection, methylprednisolone sodium succinate, 5 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7171","name":"Inj, adzynma, 10 iu","description":"Injection, adamts13, recombinant-krhn, 10 iu","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76989","name":"Dx intraop epcar us chd i&r","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; interpretation and report only","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87077","name":"Culture aerobic identify","description":"Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28345","name":"Repair webbed toe(s)","description":"Reconstruction, toe(s); syndactyly, with or without skin graft(s), each web","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92642","name":"Hearing asstv dev fitg svc","description":"Hearing assistive device, supplemental technology fitting services (eg, personal frequency modulation [fm]/digital modulation [dm] system, remote microphone, alerting devices)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43633","name":"Removal of stomach partial","description":"Gastrectomy, partial, distal; with roux-en-y reconstruction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1578.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9996","name":"Ustekinumab- ttwe sub cu inj","description":"Injection, ustekinumab-ttwe (pyzchiva), subcutaneous, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64596","name":"Ins/rplcmt prq eltrd ra pn 1","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; initial electrode array","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2312","name":"Inj naloxone hcl nos, 0.01mg","description":"Injection, naloxone hydrochloride, not otherwise specified, 0.01 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4306","name":"Americ amnion ac per sq cm","description":"American amnion ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9611","name":"Flurpiridaz f18, diag, 1 mci","description":"Flurpiridaz f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1440","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2425","name":"Palifermin injection","description":"Injection, palifermin, 50 micrograms","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96103","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0512U","name":"Onc prst8 alys dgtz img msi","description":"Onc prst8 alys dgtz img msi","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25560","name":"Cltx rdl&uln shft fx wo mnpj","description":"Closed treatment of radial and ulnar shaft fractures; without manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP09","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92623","name":"Dx aly aud oi snd prcsr each","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; each additional 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2021","name":"Inj, linezolid (hospira)","description":"Injection, linezolid (hospira), not therapeutically equivalent to j2020, 200 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46934","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0589U","name":"Pfas24cmpnd hi-perf lc-ms/ms","description":"Pfas24cmpnd hi-perf lc-ms/ms","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0706T","name":"Rem tx amblyopia i&r phy/qhp","description":"Remote treatment of amblyopia using an eye tracking device; interpretation and report by physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83521","name":"Ig light chains free each","description":"Immunoglobulin light chains (ie, kappa, lambda), free, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0879","name":"Difelikefalin, esrd on dialy","description":"Injection, difelikefalin, 0.1 microgram, (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33287","name":"Rmv&rplcmt phrnc nrv stim pg","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81462","name":"So gsap cll fr dna/dna&rna","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants and rearrangements","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0820T","name":"Mntr psychdlc med 1stphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; first physician or other qualified health care professional, each hour","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27409","name":"Repair of knee ligaments","description":"Repair, primary, torn ligament and/or capsule, knee; collateral and cruciate ligaments","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1144.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7912","name":"Suture complicate wnd > 5 cm","description":"Complicated suture-greater than 5 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0628U","name":"Nfro kdn ds genetic cond 449","description":"Nfro kdn ds genetic cond 449","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35495","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1382","name":"Enc dur perf pd pos 11","description":"Patient encounter during the performance period with place of service code 11","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0589U","name":"Pfas24cmpnd hi-perf lc-ms/ms","description":"Pfas24cmpnd hi-perf lc-ms/ms","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0830T","name":"Dgtz gls mcrscp cytp slctv","description":"Digitization of glass microscope slides for cytopathology, selective-cellular enhancement technique with interpretation (eg, liquid-based slide preparation method), except cervical or vaginal (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1414","name":"Inj, beqvez, per tx dose","description":"Injection, fidanacogene elaparvovec-dzkt, per therapeutic dose","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1181","name":"Gr 2 or> dia or gr2 or> col","description":"Grade 2 or above diarrhea and/or grade 2 or above colitis","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72156","name":"Mri neck spine w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; cervical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1434.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99342","name":"Home/res vst new low mdm 30","description":"Home or residence visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6092","name":"Recement supp crown","description":"Recement implant/abutment supported crown","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85220","name":"Blooc clot factor v test","description":"Clotting; factor v (acg or proaccelerin), labile factor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1711","name":"Moderna vacc admin booster","description":"Moderna vacc admin booster","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81456","name":"So/hl 51/>gsap rna alys","description":"Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic sequence analysis panel, interrogation for sequence variants and copy number variants or rearrangements, or isoform expression or mrna expression levels, if performed; rna analysis","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0334U","name":"Onc sld orgn tgsa dna 84/+","description":"Onc sld orgn tgsa dna 84/+","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83884","name":"Assay neurflmnt light chain","description":"Neurofilament light chain (nfl)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1318","name":"Pts no csp doc contact","description":"Patients who did not have documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening or documentation that there was no contact with a csp","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44620","name":"Repair bowel opening","description":"Closure of enterostomy, large or small intestine;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":846.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33267","name":"Excl laa open any method","description":"Exclusion of left atrial appendage, open, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6214","name":"Pontic titanium","description":"Pontic - titanium","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85730","name":"Thromboplastin time partial","description":"Thromboplastin time, partial (ptt); plasma or whole blood","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0994T","name":"Evasc dlvr a-wal stbl rx prq","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; percutaneous","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21620","name":"Ostectomy sternum partial","description":"Ostectomy of sternum, partial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":623.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0465","name":"Autolog prp diab wound ulcer","description":"Autologous platelet rich plasma (prp) or other blood-derived product for diabetic chronic wounds/ulcers, using an fda-cleared device for this indication, (includes as applicable administration, dressings, phlebotomy, centrifugation or mixing, and all other preparatory procedures, per treatment)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69730","name":"Rplc oi implt sk tc esp>=100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4301","name":"Activate matrix, per sq cm","description":"Activate matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1325","name":"Doc med rsn not seen","description":"Patients who were not seen for reasons documented by clinician for patient or medical reasons (e.g., inadequate time for follow-up, patients who received a prior intravitreal or periocular steroid injection within the last six (6) months and had a subsequent iop evaluation with iop <25mm hg within s","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2221","name":"Ank mcrop plant & dorsi flex","description":"Addition to lower extremity orthosis, ankle system, microprocessor-controlled feature plantarflexion and/or dorsiflexion, includes power source","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0366U","name":"Onc bldr 10 prb recr bldr ca","description":"Onc bldr 10 prb recr bldr ca","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7521","name":"Incision/drain abscess extra","description":"Incision and drainage of abscess - extraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96381","name":"Admn rsv monoc antb im njx","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5783","name":"Add low ext mec limb vol lam","description":"Addition to lower extremity, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3150.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0618U","name":"Psyc bd dna mthyl alys>10000","description":"Psyc bd dna mthyl alys>10000","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9046","name":"Inj, bortezomib, dr. reddys","description":"Injection, bortezomib (dr. reddys), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33523","name":"Cabg art-vein six or more","description":"Coronary artery bypass, using venous graft(s) and arterial graft(s); 6 or more venous grafts (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":916.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75577","name":"Quan&char c athrosclrtc plaq","description":"Quantification and characterization of coronary atherosclerotic plaque to assess severity of coronary disease, derived from augmentative software analysis of the data set from a coronary computed tomographic angiography, with interpretation and report by a physician or other qualified health care pr","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31243","name":"Nsl/sinus ndsc cryoabltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by cryoablation, posterior nasal nerve","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77089","name":"Tbs dxa cal w/i&r fx risk","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; using dual x-ray absorptiometry (dxa) or other imaging data on gray-scale variogram, calculation, with interpretation and report on fracture-risk","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87300","name":"Ag detection polyval if","description":"Infectious agent antigen detection by immunofluorescent technique, polyvalent for multiple organisms, each polyvalent antiserum","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4348","name":"Sentry sl matrix per sq cm","description":"Sentry sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80504","name":"Path clin consltj mod 21-40","description":"Pathology clinical consultation; for a moderately complex clinical problem, with review of patients history and medical records and moderate level of medical decision making when using time for code selection, 21-40 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1781","name":"Vac admin human pap dose 1","description":"Vac admin human pap dose 1","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0384U","name":"Neph ckd rsk hi stg kdn ds","description":"Neph ckd rsk hi stg kdn ds","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58823","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36481","name":"Insertion of catheter vein","description":"Percutaneous portal vein catheterization by any method","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69728","name":"Rmv ntr oi imp sk tc>=100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0466U","name":"Crd cad dna gwas 564856 snp","description":"Crd cad dna gwas 564856 snp","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17003","name":"Destruct premalg les 2-14","description":"Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (eg, actinic keratoses); second through 14 lesions, each (list separately in addition to code for first lesion)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":1.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22860","name":"Tot disc arthrp 2ntrspc lmbr","description":"Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression); second interspace, lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4018","name":"Ob/gyn ss","description":"Obstetrics/gynecology mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1482","name":"Pos quan hep c or qual rna","description":"Positive/detectable hepatitis c virus quantitative or qualitative rna test result during the denominator identification period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6607","name":"G com bandage tub protct lyr","description":"Gradient compression bandaging supply, tubular protective absorption layer, per linear yard, any width, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"Evaluation of wheezing","description":"Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5098","name":"Inj ustekinumab-srlf, 1 mg","description":"Injection, ustekinumab-srlf (imuldosa), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44402","name":"Colonoscopy w/stent plcmt","description":"Colonoscopy through stoma; with endoscopic stent placement (including pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4300","name":"Acesso tl, per sq cm","description":"Acesso tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1452","name":"Pt dx dementia ever","description":"Patient ever had a diagnosis of dementia","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1274","name":"Pts snf exl mo","description":"Patients who were admitted to a skilled nursing facility (snf) during the month of evaluation were excluded from that month","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1490","name":"Pt status not doc","description":"Patient status not documented","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0019M","name":"Cv ds plasma alys prtn bmrk","description":"Cardiovascular disease, plasma, analysis of protein biomarkers by aptamer-based microarray and algorithm reported as 4-year likelihood of coronary event in high-risk populations","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2010","name":"Apis, per square centimeter","description":"Apis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1186","name":"Pt w/ rx for hspc/plltv care","description":"Patients who have an order for or are receiving hospice or palliative care","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74291","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9275","name":"Inj cosibelimab-ipdl, 2 mg","description":"Injection, cosibelimab-ipdl, 2 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0465U","name":"Onc urthl carc dna qmsp 2gen","description":"Onc urthl carc dna qmsp 2gen","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99231","name":"Sbsq hosp ip/obs sf/low 25","description":"Subsequent hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward or low level of medical decision making. when using total time on the date of the encounter for code selec","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1209","name":">=2 same hi-rsk med w/o diag","description":"At least two orders for high-risk medications from the same drug class, (table 4), without appropriate diagnoses","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99461","name":"Init nb em per day non-fac","description":"Initial care, per day, for evaluation and management of normal newborn infant seen in other than hospital or birthing center","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":106.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0962T","name":"Asstv alg alys acous&ecg rec","description":"Assistive algorithmic analysis of acoustic and electrocardiogram recording for detection of cardiac dysfunction (eg, reduced ejection fraction, cardiac murmurs, atrial fibrillation), with review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55708","name":"Bx prst8 trct us w/mri fus 1","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant) with mri-fusion-guidance, first targeted lesion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4100","name":"Nosht skin sub fda clrd nos","description":"Non-sheet form skin substitute, fda cleared as a device, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86015","name":"Actin antibody each","description":"Actin (smooth muscle) antibody (asma), each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0666","name":"Team remote e/m est pt 15 mn","description":"Team remote e/m est. pt 15mins","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4384","name":"Axolotl dual ult per sq cm","description":"Axolotl dualgraft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1401","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23920","name":"Disarticulation shoulder","description":"Disarticulation of shoulder;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1221.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27458","name":"Osteot femur imed lngth dev","description":"Osteotomy(ies), femur, unilateral, with insertion of an externally controlled intramedullary lengthening device, including iliotibial band release when performed, imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80503","name":"Path clin consltj sf 5-20","description":"Pathology clinical consultation; for a clinical problem, with limited review of patients history and medical records and straightforward medical decision making when using time for code selection, 5-20 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92611","name":"Motion fluoroscopy/swallow","description":"Motion fluoroscopic evaluation of swallowing function by cine or video recording","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0569","name":"Subs psych care mng, subs mo","description":"Subsequent psychiatric collaborative care management, in a subsequent month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required elements: tracking ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0603","name":"Sevelamer hydrochloride 20mg","description":"Sevelamer hydrochloride (renagel or therapeutically equivalent), oral, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7485","name":"Surg reduct osseoustuberosit","description":"Surgical reduction of osseous tuberosity","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0031","name":"Pall serv during meas","description":"Palliative care services given to patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22836","name":"Ant thrc vrt body tethrg <7","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; up to 7 vertebral segments","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58580","name":"Transcrv abltj utrn fibrd rf","description":"Transcervical ablation of uterine fibroid(s), including intraoperative ultrasound guidance and monitoring, radiofrequency","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7213","name":"Inj, ixinity, 1 i.u.","description":"Injection, coagulation factor ix (recombinant), ixinity, 1 i.u.","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9292","name":"Pres dig visual therapy fda","description":"Prescription digital visual therapy, software-only, fda cleared, per course of treatment","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4293","name":"Acesso dl, per sq cm","description":"Acesso dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4404","name":"Xwrap hydro plus per sq cm","description":"Xwrap hydro plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78802","name":"Rp loclzj tum whbdy 1 d img","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, single day imaging","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1308","name":"Inj, famotidine, 0.25 mg","description":"Injection, famotidine, 0.25 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1363","name":"Pts no f/u 120 dys","description":"Patients who did not have a follow-up assessment within 120 days of the index assessment","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9028","name":"Inj, nogapendekin pmln, 1mcg","description":"Injection, nogapendekin alfa inbakicept-pmln, for intravesical use, 1 microgram","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4225","name":"Amnio or derma tl, per sq cm","description":"Amniobind or dermabind tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1238","name":"Doc 2nd recom hzv 2-6 mo int","description":"Documentation that administration of second recombinant zoster vaccine could not occur during the performance period due to the recommended 2-6 month interval between doses (i.e, first dose received after october 31)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4035","name":"Thoracic surgery ss","description":"Thoracic surgery mips specialty set","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9996","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0964T","name":"I&cust prep jaw xpnsj 1arch","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; single arch, without mandibular advancement mechanism","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84206","name":"Assay of proinsulin","description":"Proinsulin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33894","name":"Evasc st rpr thrc/aa acrs br","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; across major side branches","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37299","name":"Revsc evsc imvt angio cpx ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0023","name":"Pin service 60m per month","description":"Principal illness navigation services by certified or trained auxiliary personnel under the direction of a physician or other practitioner, including a patient navigator; 60 minutes per calendar month, in the following activities:  person-centered assessment, performed to better understand the indiv","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50620","name":"Removal of ureter stone","description":"Ureterolithotomy; middle one-third of ureter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":985.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4319","name":"Sanograft, per sq cm","description":"Sanograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0915T","name":"Insj perm ccm-d sys pg&eltrd","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator and dual transvenous electrodes/leads (pacing and defibrillation)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0049","name":"Main hemo in-cntr","description":"With maintenance hemodialysis (in-center and home hd) for the complete reporting month","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1834","name":"Inj, isoniazid, 1 mg","description":"Injection, isoniazid, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1217","name":"Sys rsn no doc spiro","description":"Documentation of system reason(s) for not documenting and reviewing spirometry results (e.g., spirometry equipment not available at the time of the encounter)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9048","name":"Inj, bortezomib freseniuskab","description":"Injection, bortezomib (fresenius kabi), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1493","name":"No fall doc med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0927T","name":"Interrog dev eval ccm-d ip","description":"Interrogation device evaluation (in person) with analysis, review, and report, including connection, recording, and disconnection, per patient encounter, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0829T","name":"Dgtz gls mcrscp cytp conctrj","description":"Digitization of glass microscope slides for cytopathology, concentration technique, smears, and interpretation (eg, saccomanno technique) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4361","name":"Pneuma/vac walk boot pre ots","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0836T","name":"Dgtz gls mcrscp fna ea addl","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23625","name":"Cltx gr hmrl tbrs fx w/mnpj","description":"Closed treatment of greater humeral tuberosity fracture; with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01938","name":"Anes drg/aspir lmbr/sac","description":"Anesthesia for percutaneous image-guided injection, drainage or aspiration procedures on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0044","name":"Pt mitral stenosis","description":"Patients with moderate or severe mitral stenosis","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81560","name":"Trnsplj pd lvr&bwl cd154+cll","description":"Transplantation medicine (allograft rejection, pediatric liver and small bowel), measurement of donor and third-party-induced cd154+t-cytotoxic memory cells, utilizing whole peripheral blood, algorithm reported as a rejection risk score","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86403","name":"Particle agglut antbdy scrn","description":"Particle agglutination; screen, each antibody","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6613","name":"Onlay cst base mtl >=3 surfa","description":"Onlay - cast predominantly base metal three or more surfaces","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9329","name":"Inj, tislelizumab-jsgr","description":"Injection, tislelizumab-jsgr, 1mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1217","name":"Sys rsn no doc spiro","description":"Documentation of system reason(s) for not documenting and reviewing spirometry results (e.g., spirometry equipment not available at the time of the encounter)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0979T","name":"Sbmcsl crylys ther sft palt","description":"Submucosal cryolysis therapy; soft palate only","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6604","name":"Cst bse mtl inlay 2 surfaces","description":"Inlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1808","name":"Inj, folic acid, 0.1 mg","description":"Injection, folic acid, 0.1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1456","name":"Inj, fosaprepitant (teva)","description":"Injection, fosaprepitant (teva), not therapeutically equivalent to j1453, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1361","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0326U","name":"Trgt gen seq alys pnl 83+","description":"Trgt gen seq alys pnl 83+","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59200","name":"Insert cervical dilator","description":"Insertion of cervical dilator (eg, laminaria, prostaglandin) (separate procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":55.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2850","name":"Inj secretin synthetic human","description":"Injection, secretin, synthetic, human, 1 microgram","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0751T","name":"Dgtz gls mcrscp sld level ii","description":"Digitization of glass microscope slides for level ii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0305U","name":"Hem rbc fnclty&dfrm shr strs","description":"Hem rbc fnclty&dfrm shr strs","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24371","name":"Revise reconst elbow joint","description":"Revision of total elbow arthroplasty, including allograft when performed; humeral and ulnar component","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2169.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37274","name":"Rvsc evsc fpvt athrc cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4309","name":"Via matrix, per sq cm","description":"Via matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43497","name":"Transorl lwr esophgl myotomy","description":"Lower esophageal myotomy, transoral (ie, peroral endoscopic myotomy [poem])","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85280","name":"Clot factor xii hageman","description":"Clotting; factor xii (hageman)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0918T","name":"Insj perm ccm-d sys dual ld","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; dual transvenous leads (pacing and defibrillation) only","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83593","name":"Fractionation ketosteroids","description":"Ketosteroids, 17- (17-ks); fractionation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5160","name":"Inj, jobevne, 10 mg","description":"Injection, bevacizumab-nwgd (jobevne), biosimilar, 10 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0926T","name":"Prgrmg dev eval ccm-d ip","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, including review and report, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0536","name":"Peer recover support svs","description":"Peer recovery support services, provided directly or by referral; including leveraging knowledge of the condition or lived experience to provide support, mentorship, or inspiration to meet oud treatment and recovery goals; conducting a person-centered interview to understand the patients life story,","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1209","name":">=2 same hi-rsk med w/o diag","description":"At least two orders for high-risk medications from the same drug class, (table 4), without appropriate diagnoses","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0801T","name":"Tcat rmv&rpl 2chmbr ldls pm","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; dual-cha","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7939","name":"Indexing for osteotomy","description":"Indexing for osteotomy","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0371U","name":"Iadna gu pthgn semiq dna16&1","description":"Iadna gu pthgn semiq dna16&1","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6602","name":"G com bandge hgh dn foamroll","description":"Gradient compression bandaging supply, high density foam roll for bandage, per linear yard, any width, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9275","name":"Inj cosibelimab-ipdl, 2 mg","description":"Injection, cosibelimab-ipdl, 2 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0540U","name":"Trnsplj med quan dd-cfdna","description":"Trnsplj med quan dd-cfdna","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70472","name":"Ct cere prfu alys c+w/ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed with concurrent ct or ct angiography of the same anatomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4457","name":"Enema tube any type repl","description":"Enema tube, with or without adapter, any type, replacement only, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9333","name":"Inj rozanolixizum-noli 1 mg","description":"Injection, rozanolixizumab-noli, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0315U","name":"Onc cutan sq cll ca mrna 40","description":"Onc cutan sq cll ca mrna 40","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6036","name":"Prosthetic thumb mechanical","description":"Prosthetic thumb, mechanical, can include metacarpophalangeal (mcp), interphalangeal (ip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1485","name":"Neg viro resp hep c/qual rna","description":"Patients who did not achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93574","name":"Njx cath slct pulm vn angrph","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary venous angiography of each distinct pulmonary vein during cardiac catheterization (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0414U","name":"Onc lng aug alg aly whl sld8","description":"Onc lng aug alg aly whl sld8","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0039","name":"Pt no ref, rn spec","description":"Patient not referred, reason not otherwise specified","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11046","name":"Dbrdmt musc&/fsca ea addl","description":"Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); each additional 20 sq cm, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":45.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0679T","name":"Laps rmvl lead isdss","description":"Laparoscopic removal of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52597","name":"Trurl rbtc wtrjt rescj prst8","description":"Transurethral robotic-assisted waterjet resection of prostate, including intraoperative planning, ultrasound guidance, control of postoperative bleeding, complete, including vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2792","name":"Crown full cast noble metal","description":"Crown-full cast noble metal","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0608U","name":"Reprdtve med ema rtpcr 10bct","description":"Reprdtve med ema rtpcr 10bct","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0048","name":"Pall serv during meas","description":"Patients who receive palliative care services any time during the intake period through the end of the measurement year","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2010","name":"Apis, per square centimeter","description":"Apis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2050","name":"Financial mgt waiver/diem","description":"Financial management, self-directed, waiver; per diem","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6253","name":"Provisional pontic","description":"Provisional pontic","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1441","name":"Init dx slp apn = 1st enc","description":"Encounter corresponds to initial diagnosis of sleep apnea or first contact with sleep apnea diagnosed patient","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2801","name":"Inj, rykindo, 0.5 mg","description":"Injection, risperidone (rykindo), 0.5 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0459","name":"Telehealth inpt pharm mgmt","description":"Inpatient telehealth pharmacologic management, including prescription, use, and review of medication with no more than minimal medical psychotherapy","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1612","name":"Inj glucagon (gvoke) 0.01 mg","description":"Injection, glucagon (gvoke), 0.01 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9322","name":"Inj pemetrexed (bluepoint)","description":"Injection, pemetrexed (bluepoint), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1175","name":"Doc med rsn no hzv","description":"Documentation of medical reason(s) for not administering zoster vaccine (e.g., prior anaphylaxis due to the zoster vaccine)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4371","name":"Neoguard per sq cm","description":"Neoguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0271","name":"Group mnt 2 or more 30 mins","description":"Medical nutrition therapy, reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition, or treatment regimen (including additional hours needed for renal disease), group (2 or more individuals), each 30 minutes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":13.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9275","name":"Inj cosibelimab-ipdl, 2 mg","description":"Injection, cosibelimab-ipdl, 2 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"Adju cgm supply allowance","description":"Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0485U","name":"Onc sol tum cfdna&rna ngs gm","description":"Onc sol tum cfdna&rna ngs gm","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49621","name":"Rpr parastomal hernia rdc","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; reducible","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4279","name":"Vendaje ac, per sq cm","description":"Vendaje ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55881","name":"Ablt trurl prst8 tis thrm us","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation;","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9345","name":"Inj, retifanlimab-dlwr, 1 mg","description":"Injection, retifanlimab-dlwr, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0797T","name":"Tcat ins 2chmbr ldls pm rv","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ventricular pace","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6107","name":"Tissue regen non-resorbable","description":"Tissue regen non-resorbable","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0923T","name":"Rmvl&rplcmt perm ccm-d pg","description":"Removal and replacement of permanent cardiac contractility modulation-defibrillation pulse generator only","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12011","name":"Rpr f/e/e/n/l/m 2.5 cm/<","description":"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":152.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27165","name":"Incision/fixation of femur","description":"Osteotomy, intertrochanteric or subtrochanteric including internal or external fixation and/or cast","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1545.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8005","name":"Grip glove w microprocessor","description":"Powered, cable driven grip assist glove, hand, finger, includes microprocessor, pressure sensors, all components and accessories, custom fitted","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9292","name":"Pres dig visual therapy fda","description":"Prescription digital visual therapy, software-only, fda cleared, per course of treatment","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4357","name":"Xwrap plus, per sq cm","description":"Xwrap plus, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9277","name":"Pembrolizumab 1mg berahyalur","description":"Injection, pembrolizumab, 1 mg and berahyaluronidase alfa-pmph","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2679","name":"Inj fluphenazine hcl 1.25 mg","description":"Injection, fluphenazine hcl, 1.25 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78300","name":"Bone imaging limited area","description":"Bone and/or joint imaging; limited area","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0666","name":"Inj, bupivacaine liposome","description":"Injection, bupivacaine liposome, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0112","name":"Potassium hydroxide preps","description":"All potassium hydroxide (koh) preparations","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90637","name":"Vacc qirv mrna 30mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 30 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0463","name":"Inj atropine (fresenius te)","description":"Injection, atropine sulfate (fresenius and therapeutically equivalent), 0.01 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4001","name":"Diagnostic rad ss","description":"Diagnostic radiology mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83894","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1274","name":"Pts snf exl mo","description":"Patients who were admitted to a skilled nursing facility (snf) during the month of evaluation were excluded from that month","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41115","name":"Excision of tongue fold","description":"Excision of lingual frenum (frenectomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0268U","name":"Hem ahus gen seq alys 15 gen","description":"Hematology (atypical hemolytic uremic syndrome [ahus]), genomic sequence analysis of 15 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28160","name":"Partial removal of toe","description":"Hemiphalangectomy or interphalangeal joint excision, toe, proximal end of phalanx, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0556","name":"Adv prim care mgmt lvl 1","description":"Advanced primary care management services for a patient with one chronic condition [expected to last at least 12 months, or until the death of the patient, which place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline], or fewer, provided by clinical ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0612","name":"Inj, calcium gluconate, nos","description":"Injection, calcium gluconate, not otherwise specified, 10 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98016","name":"Brief comunicaj tech-bsd svc","description":"Brief communication technology-based service (eg, virtual check-in) by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related evaluation and management service provided within the p","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0812T","name":"Rem mlt day uroflow dev sply","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); device supply with automated report generation, up to 10 days","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1448","name":"Injection, trilaciclib, 1mg","description":"Injection, trilaciclib, 1mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87594","name":"Pneumcysts jirovecii amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); pneumocystis jirovecii, amplified probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1445","name":"Pp care visit by 12 weeks","description":"Postpartum care visit before or at 12 weeks of giving birth","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74020","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2037","name":"G4derm plus/suprello, pr ml","description":"G4derm plus/suprello, per milliliter","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1355","name":"Caries med app per tooth","description":"Caries med app per tooth","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0970T","name":"Ablt b9 brst tum perq lsr ea","description":"Ablation, benign breast tumor (eg, fibroadenoma), percutaneous, laser, including imaging guidance when performed, each tumor","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34701","name":"Evasc rpr a-ao ndgft","description":"Endovascular repair of infrarenal aorta by deployment of an aorto-aortic tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the aorta from the level ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1051.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44383","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0776T","name":"Ther indctj ntrabrn hypthrm","description":"Therapeutic induction of intra-brain hypothermia, including placement of a mechanical temperature-controlled cooling device to the neck over carotids and head, including monitoring (eg, vital signs and sport concussion assessment tool 5 [scat5]), 30 minutes of treatment","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0845T","name":"Dgtz gls mcrscp imfluor 1st","description":"Digitization of glass microscope slides for immunofluorescence, per specimen; initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4294","name":"Amnio quad-core, per sq cm","description":"Amnio quad-core, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9061","name":"Inj, amivantamab-vmjw","description":"Injection, amivantamab-vmjw, 2 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0558U","name":"Onc clrct elisa bf7 ag serum","description":"Onc clrct elisa bf7 ag serum","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5160","name":"Inj, jobevne, 10 mg","description":"Injection, bevacizumab-nwgd (jobevne), biosimilar, 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1203","name":"Inj, cipaglucosidase, 5 mg","description":"Injection, cipaglucosidase alfa-atga, 5 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1277","name":"Colorectal ca screen doc rev","description":"Colorectal cancer screening results documented and reviewed","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1299","name":"Flu immunize order/admin","description":"Influenza immunization administered or previously received","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26951","name":"Amputation of finger/thumb","description":"Amputation, finger or thumb, primary or secondary, any joint or phalanx, single, including neurectomies; with direct closure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5135","name":"Inj, tyenne, 1 mg","description":"Injection, tocilizumab-aazg (tyenne), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7700","name":"Pros soc insert gasket/seal","description":"Gasket or seal, for use with prosthetic socket insert, any type, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0270U","name":"Hem cgen coagj do 20 genes","description":"Hematology (congenital coagulation disorders), genomic sequence analysis of 20 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5141","name":"Inj adalimumab-aaty, 1 mg","description":"Injection, adalimumab-aaty, biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0582U","name":"Rare ds rpd whlgen dna vrnts","description":"Rare ds rpd whlgen dna vrnts","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0012A","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83014","name":"H pylori drug admin","description":"Helicobacter pylori; drug administration","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87523","name":"Hepatitis d quantification","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis d (delta), quantification, including reverse transcription, when performed","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21120","name":"Genioplasty augmentation","description":"Genioplasty; augmentation (autograft, allograft, prosthetic material)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":597.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59160","name":"D & c after delivery","description":"Curettage, postpartum","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":195.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1276","name":"Calc bmi out nrm param nof/u","description":"Bmi documented outside normal parameters, no follow-up plan documented, no reason given","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2998","name":"Inj plasminogen tvmh 1mg","description":"Injection, plasminogen, human-tvmh, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0605","name":"Antibody test pub hlth path","description":"Antibody test pub hlth path","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1245","name":"Pt othr thn true person","description":"Patient provided a response other than completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84702","name":"Chorionic gonadotropin test","description":"Gonadotropin, chorionic (hcg); quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1474","name":"Pt dx dementia","description":"Patients with diagnosis of dementia","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83884","name":"Assay neurflmnt light chain","description":"Neurofilament light chain (nfl)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90461","name":"Im admin each addl component","description":"Immunization administration through 18 years of age via any route of administration, with counseling by physician or other qualified health care professional; each additional vaccine or toxoid component administered (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93260","name":"Prgrmg dev eval impltbl sys","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; implantable subcutaneous lead d","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1311","name":"Aphlx to vax bef enc","description":"Anaphylaxis due to the vaccine on or before the date of the encounter","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0544","name":"Post d/c phone follow up","description":"Post discharge telephonic follow-up contacts performed in conjunction with a discharge from the emergency department for behavioral health or other crisis encounter, 4 calls per calendar month","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0810T","name":"Subrta njx rx agt w/vtrc","description":"Subretinal injection of a pharmacologic agent, including vitrectomy and 1 or more retinotomies","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4354","name":"Palingen dl-palingen dl-x","description":"Palingen dual-layer membrane and dual-layer palingen x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72040","name":"X-ray exam neck spine 2-3 vw","description":"Radiologic examination, spine, cervical; 2 or 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97037","name":"Appl modality 1+lllt po pain","description":"Application of a modality to 1 or more areas; low-level laser therapy (ie, nonthermal and non-ablative) for post-operative pain reduction","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70373","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0535U","name":"Pfas lc-ms/ms plsm/srm quan","description":"Pfas lc-ms/ms plsm/srm quan","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4353","name":"Xceed tl matrix per sq cm","description":"Xceed tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9997","name":"Ustekinumab-ttwe iv inj 1 mg","description":"Injection, ustekinumab-ttwe (pyzchiva), intravenous, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1018T","name":"Elec alys npgs esoph sbsq w/","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1438","name":"Lst knwn well <=210 min","description":"Time last known well to hospital arrival less than or equal to 3.5 hours (<= 210 minutes)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81463","name":"So gsap cl fr cpy nmbr&mcrst","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis, copy number variants, and microsatellite instability","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87077","name":"Culture aerobic identify","description":"Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8005","name":"Grip glove w microprocessor","description":"Powered, cable driven grip assist glove, hand, finger, includes microprocessor, pressure sensors, all components and accessories, custom fitted","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64658","name":"Rmvl bat modul sys lead only","description":"Removal of baroreflex activation therapy (bat) modulation system; lead only","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0355","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0564U","name":"Nfct ds pthgn-sna 10vir&4bct","description":"Nfct ds pthgn-sna 10vir&4bct","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0543","name":"Group train w/o patient","description":"Group caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient pre","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4340","name":"Simpligraft, per sq cm","description":"Simpligraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0370","name":"Max ultrasound capt & interp","description":"Max ultrasound capt & interp","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37271","name":"Revsc evsc fpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78491","name":"Myocrd img pet 1std rst/strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); single study, at rest or stress (exercise or pharmacologic)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1444.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77085","name":"Dxa bone density axl vrt fx","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9049","name":"Inj, bortezomib, hospira","description":"Injection, bortezomib (hospira), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90695","name":"H5n8 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n8, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0037","name":"Pt not able to participate","description":"On date of encounter, patient is not able to participate in assessment or screening, including non-verbal patients, delirious, severely aphasic, severely developmentally delayed, severe visual or hearing impairment and for those patients, no knowledgeable informant available","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37254","name":"Revsc evasc ivt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1266","name":"Pts admit snf","description":"Patients admitted to a skilled nursing facility (snf)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2267","name":"Inj, mirikizumab-mrkz, 1 mg","description":"Injection, mirikizumab-mrkz, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1469","name":"Hx of hep b, or pos bld test","description":"Patient has a history of hepatitis b illness or received a hepatitis b surface antigen, hepatitis b surface antibody, or total antibody to hepatitis b core antigen test with a positive result any time before or during the measurement period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1391","name":"All pt dx w/ rec mlnm","description":"All patients who were diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49425","name":"Insert abdomen-venous drain","description":"Insertion of peritoneal-venous shunt","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":825.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89160","name":"Exam feces for meat fibers","description":"Meat fibers, feces","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1321","name":"Pts no 7wk inj,no iop,iop>25","description":"Patients who were not seen within 7 weeks following the date of injection for follow up or who did not have a documented iop or no plan of care documented if the iop was >25 mm hg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0443","name":"Brief alcohol misuse counsel","description":"Brief face-to-face behavioral counseling for alcohol misuse, 15 minutes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":28.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9129","name":"Photobio therpy-sub 15 mins","description":"Photobio therpy-sub 15 mins","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9049","name":"Inj, bortezomib, hospira","description":"Injection, bortezomib (hospira), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7485","name":"Surg reduct osseoustuberosit","description":"Surgical reduction of osseous tuberosity","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6517","name":"Grad com wrap w strap bn cus","description":"Gradient compression wrap with adjustable straps, below knee, each, custom","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1459","name":"Pt hosp/pal care dur perf pd","description":"Patient was in hospice or receiving palliative care services at any time during the performance period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2055","name":"Idecabtagene vicleucel car","description":"Idecabtagene vicleucel, up to 510 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0807T","name":"Pulm tiss vntj alys prev ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with previously acquired computed tomography (ct) images, including data preparation and transmission, quantification of pulmonary tissue ventilation, data re","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31259","name":"Nsl/sins ndsc sphn tiss rmvl","description":"Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior), including sphenoidotomy, with removal of tissue from the sphenoid sinus","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1445","name":"Pp care visit by 12 weeks","description":"Postpartum care visit before or at 12 weeks of giving birth","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1482","name":"Pos quan hep c or qual rna","description":"Positive/detectable hepatitis c virus quantitative or qualitative rna test result during the denominator identification period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4033","name":"Skilled nursing facility ss","description":"Skilled nursing facility mips specialty set","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0402U","name":"Nfct agt sti mult amp prb tq","description":"Nfct agt sti mult amp prb tq","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0517U","name":"Ther rx mntr 80+ psyactiv rx","description":"Ther rx mntr 80+ psyactiv rx","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37273","name":"Revsc evsc fpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5148","name":"Inj, nyposi 1 mcg","description":"Injection, filgrastim-txid (nypozi), biosimilar, 1 microgram","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78608","name":"Brain imaging (pet)","description":"Brain imaging, positron emission tomography (pet); metabolic evaluation","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84433","name":"Asy thiopurin s-mthyltrnsfrs","description":"Thiopurine s-methyltransferase (tpmt)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52500","name":"Trurl resection bladder neck","description":"Transurethral resection of bladder neck (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37280","name":"Revsc evsc tpvt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5783","name":"Add low ext mec limb vol lam","description":"Addition to lower extremity, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3150.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19083","name":"Bx breast 1st lesion us imag","description":"Biopsy, breast, with placement of breast localization device(s) (eg, clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; first lesion, including ultrasound guidance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37294","name":"Rvsc evsc tpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93897","name":"Emboli detcj wo iv mbubb njx","description":"Emboli detection without intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1010","name":"Inj, methylpred acetate 1 mg","description":"Injection, methylprednisolone acetate, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7214","name":"Altuviiio per factor viii iu","description":"Injection, factor viii/von willebrand factor complex, recombinant (altuviiio), per factor viii i.u.","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99345","name":"Home/res vst new high mdm 75","description":"Home or residence visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 75 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0555","name":"Replacment pt electronic sys","description":"Provision of replacement patient electronics system (e.g., system pillow, handheld reader) for home pulmonary artery pressure monitoring","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4225","name":"Amnio or derma tl, per sq cm","description":"Amniobind or dermabind tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43310","name":"Repair of esophagus","description":"Esophagoplasty (plastic repair or reconstruction), thoracic approach; without repair of tracheoesophageal fistula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1778.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26665","name":"Treat thumb fracture","description":"Open treatment of carpometacarpal fracture dislocation, thumb (bennett fracture), includes internal fixation, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7626","name":"Budesonide non-comp unit","description":"Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0522U","name":"Ca vi psp&sp1 antb cl semiql","description":"Ca vi psp&sp1 antb cl semiql","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92632","name":"Hearing aid slctn svc ea add","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4332","name":"Axolotl dualgraft, per sq cm","description":"Axolotl dualgraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5930","name":"Max guid prothes w/o flange","description":"Max guid prothes w/o flange","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87426","name":"Sarscov coronavirus ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; severe acute respiratory syndrome coronavirus (eg, sars-cov, s","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0881T","name":"Cryotherapy oral cavity","description":"Cryotherapy of the oral cavity using temperature regulated fluid cooling system, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0883T","name":"Intraop ther estim pn ue ea","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; each additional nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0765T","name":"Asstv alg ecg rsk asmt prev","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to previously performed electrocardiogram","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2976","name":"Band stabilization per tooth","description":"Band stabilization per tooth","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0266U","name":"Unxpl cnst hrtbl do gn xprsn","description":"Unexplained constitutional or other heritable disorders or syndromes, tissue-specific gene expression by whole-transcriptome and next-generation sequencing, blood, formalin-fixed paraffin-embedded (ffpe) tissue or fresh frozen tissue, reported as presence or absence of splicing or expression changes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37268","name":"Revsc evasc fpvt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36836","name":"Prq av fstl crtj uxtr 1 acs","description":"Percutaneous arteriovenous fistula creation, upper extremity, single access of both the peripheral artery and peripheral vein, including fistula maturation procedures (eg, transluminal balloon angioplasty, coil embolization) when performed, including all vascular access, imaging guidance and radiolo","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9026","name":"Cryo fib comp path redu each","description":"Cryoprecipitated fibrinogen complex, pathogen reduced, each unit","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6561","name":"G stockng full/chap 40+ cust","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, custom, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4433","name":"361 hct/p skin subs, nos","description":"361 hct/p skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86701","name":"Hiv-1antibody","description":"Antibody; hiv-1","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9992","name":"Pall serv during meas","description":"Palliative care services used by patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37261","name":"Revsc evasc ivt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0262U","name":"Onc sld tum rt-pcr 7 gen","description":"Oncology (solid tumor), gene expression profiling by real-time rt-pcr of 7 gene pathways (er, ar, pi3k, mapk, hh, tgfb, notch), formalin-fixed paraffin-embedded (ffpe), algorithm reported as gene pathway activity score","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92634","name":"Hearing aid fitg svc 1st 60","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; first 60 minutes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71048","name":"X-ray exam chest 4+ views","description":"Radiologic examination, chest; 4 or more views","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0033","name":"2+ benzo seiz","description":"Two or more benzodiazepine prescriptions ordered for patients who had a diagnosis of seizure disorders, rapid eye movement sleep behavior disorder, benzodiazepine withdrawal, ethanol withdrawal, or severe generalized anxiety disorder on or between january 1 of the year prior to the measurement perio","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1465","name":"F/u > 180 days after rx","description":"Patient follow up more than 180 days after treatment","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1271","name":"Pts dem any time/dur mo","description":"Patients with dementia at any time prior to or during the month","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5144","name":"Inj, idacio, 1 mg","description":"Injection, adalimumab-aacf (idacio), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5146","name":"Inj, hercessi, 10 mg","description":"Injection, trastuzumab-strf (hercessi), biosimilar, 10 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76102","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1192","name":"Pt w/ dx sq cell ca of esoph","description":"Patients with an existing diagnosis of squamous cell carcinoma of the esophagus","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64629","name":"Trml dstrj ios bvn ea addl","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; each additional vertebral body, lumbar or sacral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J0715","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3393","name":"Inj, betibeglogene autotemce","description":"Injection, betibeglogene autotemcel, per treatment","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35011","name":"Repair defect of artery","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm and associated occlusive disease, axillary-brachial artery, by arm incision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1272.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1271","name":"Inj doxycycline hyclate 1 mg","description":"Injection, doxycycline hyclate, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61692","name":"Intracranial vessel surgery","description":"Surgery of intracranial arteriovenous malformation; dural, complex","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4297.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6603","name":"Cst hgh nble mtl inlay >=3sr","description":"Inlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49616","name":"Rpr aa hrn rcr 3-10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1232","name":"Pt hcv tst reactive result","description":"Patient receives hcv antibody test with reactive result","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9128","name":"Photobio therpy-first 15 min","description":"Photobio therpy-first 15 min","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0449U","name":"Car scr sev inh cond 5 genes","description":"Car scr sev inh cond 5 genes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4342","name":"Theramend, per sq cm","description":"Theramend, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1014T","name":"Lap rv/rmv eso sph nstm eltr","description":"Laparoscopic revision or removal, lower esophageal sphincter neurostimulator electrodes","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1611","name":"Inj glucagon hcl, fresenius","description":"Injection, glucagon hydrochloride (fresenius kabi), not therapeutically equivalent to j1610, per 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0235","name":"Intrav inf, mon anti, fir do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0523U","name":"Onc soltum dna ngs snv 22gen","description":"Onc soltum dna ngs snv 22gen","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20975","name":"Estim aid bone healg invasiv","description":"Electrical stimulation to aid bone healing; invasive (operative)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":220.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49596","name":"Rpr aa hrn 1st > 10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0541","name":"No pt prsnt train initial 30","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7300","name":"Rem anchorage dev w/o flap","description":"Rem anchorage dev w/o flap","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0933T","name":"Tcat impl wrls l atr prs snr","description":"Transcatheter implantation of wireless left atrial pressure sensor for long-term left atrial pressure monitoring, including sensor calibration and deployment, right heart catheterization, transseptal puncture, imaging guidance, and radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2351","name":"Inj ocrelizumab 1mg hya-ocsq","description":"Injection, ocrelizumab, 1 mg and hyaluronidase-ocsq","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70472","name":"Ct cere prfu alys c+w/ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed with concurrent ct or ct angiography of the same anatomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0675T","name":"Laps insj nw/rpcmt isdss 1ld","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first lead","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1463","name":"2 f/u wthn 180 day rx atmp","description":"Documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16030","name":"Dress/debrid p-thick burn l","description":"Dressings and/or debridement of partial-thickness burns, initial or subsequent; large (eg, more than 1 extremity, or greater than 10% total body surface area)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":247.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0350","name":"Oral/facial photo images","description":"Oral/facial photographic images","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1072","name":"Inj, testosterone, azmiro","description":"Injection, testosterone cypionate (azmiro), 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43889","name":"Gstr rstcv px trnsorl esg","description":"Gastric restrictive procedure, transoral, endoscopic sleeve gastroplasty (esg), including argon plasma coagulation, when performed","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91125","name":"Anrct mano rct snsatn&balo","description":"Anorectal manometry, with rectal sensation and rectal balloon expulsion test, when performed","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9249","name":"Inj, melphalan (apotex) 1 mg","description":"Injection, melphalan (apotex), 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0696T","name":"Bdy surf mapg pm/cvdfb f/up","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of follow-up interrogation or programming device evaluatio","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93319","name":"3d echo img cgen car anomal","description":"3d echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac structure(s) (eg, cardiac chambers and valves, left atrial appendage, interatrial septum, interventricular","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39010","name":"Exploration of chest","description":"Mediastinotomy with exploration, drainage, removal of foreign body, or biopsy; transthoracic approach, including either transthoracic or median sternotomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":947.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28730","name":"Fusion of foot bones","description":"Arthrodesis, midtarsal or tarsometatarsal, multiple or transverse;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":951.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58555","name":"Hysteroscopy dx sep proc","description":"Hysteroscopy, diagnostic (separate procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":128.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82040","name":"Assay of serum albumin","description":"Albumin; serum, plasma or whole blood","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1265","name":"Cms 2728 completed","description":"Cms medical evidence form 2728 for dialysis patients: initial form completed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56605","name":"Biopsy of vulva/perineum","description":"Biopsy of vulva or perineum (separate procedure); 1 lesion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85420","name":"Fibrinolytic plasminogen","description":"Fibrinolytic factors and inhibitors; plasminogen, except antigenic assay","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0727T","name":"Rmvl&rplcmt implt vstblr dev","description":"Removal and replacement of implanted vestibular device, unilateral","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98013","name":"Synch audio-only est low 20","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code select","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5934","name":"Mandibular flange prosthesis","description":"Mandibular resection prosthesis with guide flange","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6251","name":"Bridge resin base metal","description":"Pontic-resin with predominantly base metal","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0915T","name":"Insj perm ccm-d sys pg&eltrd","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator and dual transvenous electrodes/leads (pacing and defibrillation)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34701","name":"Evasc rpr a-ao ndgft","description":"Endovascular repair of infrarenal aorta by deployment of an aorto-aortic tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the aorta from the level ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6594","name":"G comp bandge liner lwr extr","description":"Gradient compression bandaging supply, bandage liner, lower extremity, any size or length, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0548U","name":"Gfap cleia plasma","description":"Gfap cleia plasma","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"Rec cath any transanal, each","description":"Rectal catheter with or without balloon, for use with any type transanal irrigation system, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4326","name":"Woundplus, per sq cm","description":"Woundplus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1347","name":"Pt pam incr 3 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 3 points in a 4 to 12 month period (passing)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33370","name":"Tcat plmt&rmvl cepd perq","description":"Transcatheter placement and subsequent removal of cerebral embolic protection device(s), including arterial access, catheterization, imaging, and radiological supervision and interpretation, percutaneous (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6197","name":"Replace material prosthesis","description":"Replace material prosthesis","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0738T","name":"Tx pln mag fld abltj prst8","description":"Treatment planning for magnetic field induction ablation of malignant prostate tissue, using data from previously performed magnetic resonance imaging (mri) examination","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6071","name":"Abutment supported retainer","description":"Abutment supported retainer for porcelain fused to metal fpd (noble metal)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0851T","name":"Dgtz gls mcrscp mphmtrc 1st","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95910","name":"Nrv cndj test 7-8 studies","description":"Nerve conduction studies; 7-8 studies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0281U","name":"Hem vwd propeptide ag lvl","description":"Hematology (von willebrand disease [vwd]), von willebrand propeptide, enzyme-linked immunosorbent assays (elisa), plasma, diagnostic report of von willebrand factor (vwf) propeptide antigen level","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25335","name":"Centralization wrist on ulna","description":"Centralization of wrist on ulna (eg, radial club hand)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1201.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63271","name":"Excise intrspinl lesion thrc","description":"Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; thoracic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2264.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2542","name":"Dental onlay metallic 2 surf","description":"Onlay-metallic-two surfaces","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0031","name":"Pall serv during meas","description":"Palliative care services given to patient any time during the measurement period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46715","name":"Rep perf anoper fistu","description":"Repair of low imperforate anus; with anoperineal fistula (cut-back procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":522.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2019","name":"Kerecis marigen shld sq cm","description":"Kerecis omega3 marigen shield, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7912","name":"Suture complicate wnd > 5 cm","description":"Complicated suture-greater than 5 cm","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9049","name":"Inj, bortezomib, hospira","description":"Injection, bortezomib (hospira), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82055","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0843T","name":"Dgtz gls mcrscp cslt cyt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), initial site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0562U","name":"Onc sol tum tgsa 33gens snvs","description":"Onc sol tum tgsa 33gens snvs","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91124","name":"Rct snsatn tone&cmplianc std","description":"Rectal sensation, tone, and compliance study (eg, barostat)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0606U","name":"Hem red cll memb do rbc oge","description":"Hem red cll memb do rbc oge","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28308","name":"Incision of metatarsal","description":"Osteotomy, with or without lengthening, shortening or angular correction, metatarsal; other than first metatarsal, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0455U","name":"Nfct agt sti mult amp prb ur","description":"Nfct agt sti mult amp prb ur","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37280","name":"Revsc evsc tpvt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4438","name":"Adhesive clip ext ens contr","description":"Adhesive clip applied to the skin to secure external electrical nerve stimulator controller, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55712","name":"Bx prst8 tprnl mri-us 1st","description":"Biopsy, prostate, transperineal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1308","name":"Flu immunize no admin","description":"Influenza immunization was not administered, reason not given","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0458","name":"Aztreonam/avibactam 10 mg","description":"Injection, aztreonam/avibactam, 7.5 mg/2.5 mg (10 mg)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1284","name":"Pt 66+ snp or ltc pos > 90d","description":"Patients age 66 or older in institutional special needs plans (snp) or residing in long term care with pos code 32, 33, 34, 54, or 56 for more than 90 consecutive days during the measurement period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33214","name":"Upgrade of pacemaker system","description":"Upgrade of implanted pacemaker system, conversion of single chamber system to dual chamber system (includes removal of previously placed pulse generator, testing of existing lead, insertion of new lead, insertion of new pulse generator)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62351","name":"Implant spinal canal cath","description":"Implantation, revision or repositioning of tunneled intrathecal or epidural catheter, for long-term medication administration via an external pump or implantable reservoir/infusion pump; with laminectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":889.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1261","name":"Pts on wtlist bef dialysis","description":"Patients that were on the kidney or kidney-pancreas waitlist prior to initiation of dialysis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S4024","name":"Air polymer foam per study","description":"Air polymer-type a intrauterine foam, per study dose","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97552","name":"Group caregiver training","description":"Group caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1179","name":"No pcv recd","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine, on or after their 19th birthday and before or during measurement period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1471","name":"Ffs hep b not covered","description":"Documentation that patient is a medicare fee-for-service beneficiary and without additional supplementary insurance coverage for whom hep b vaccination is not reimbursable under current medicare part b coverage rules","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87275","name":"Influenza b ag if","description":"Infectious agent antigen detection by immunofluorescent technique; influenza b virus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4378","name":"Renew ft matrix per sq cm","description":"Renew ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7471","name":"Rem exostosis any site","description":"Removal of lateral exostosis (maxilla or mandible)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1345","name":"Pt bsln pam, 2nd scr 4-12 mo","description":"Patients who had a baseline pam score and a second score within 4 to 12 month of baseline pam score","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0680","name":"Cr art clc art vlv clc w rpt","description":"Detection and quantification of coronary artery calcium and/or aortic valve calcification from algorithmic analysis of computed tomography of the chest with report","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6072","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (high noble metal)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1225","name":"Iop dec>=20% from base","description":"Intraocular pressure (iop) reduced by a value of greater than or equal to 20% from the pre-intervention level","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0536U","name":"Rbcag ftl rhd pcr alys exon4","description":"Rbcag ftl rhd pcr alys exon4","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0836T","name":"Dgtz gls mcrscp fna ea addl","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2711","name":"Inj neostigmin/glycopyrrolat","description":"Injection, neostigmine methylsulfate 0.1 mg and glycopyrrolate 0.02 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0155","name":"Dronabinol (syndros) 0.1 mg","description":"Dronabinol (syndros), 0.1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19082","name":"Bx breast add lesion strtctc","description":"Biopsy, breast, with placement of breast localization device(s) (eg, clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; each additional lesion, including stereotactic guidance (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4324","name":"Amniotx, per sq cm","description":"Amniotx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37217","name":"Stent placemt retro carotid","description":"Transcatheter placement of intravascular stent(s), intrathoracic common carotid artery or innominate artery by retrograde treatment, open ipsilateral cervical carotid artery exposure, including angioplasty, when performed, and radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1230.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7962","name":"Lingual frenectomy","description":"Lingual frenectomy","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9341","name":"Inj thiotepa (tepylute) 1 mg","description":"Injection, thiotepa (tepylute), 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2643","name":"Dental onlay porcelin 3 surf","description":"Onlay - porcelain/ceramic - three surfaces","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4012","name":"Interventional rad ss","description":"Interventional radiology mips specialty set","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85536","name":"Iron stain peripheral blood","description":"Iron stain, peripheral blood","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40819","name":"Excise lip or cheek fold","description":"Excision of frenum, labial or buccal (frenumectomy, frenulectomy, frenectomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1709","name":"Pfizer vaccine admin booster","description":"Pfizer vaccine admin booster","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1164","name":"Inj diltiazem in 0.72% nacl","description":"Injection, diltiazem hydrochloride in 0.72% sodium chloride, 0.5 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4358","name":"Xwrap dual, per sq cm","description":"Xwrap dual, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6601","name":"G com bandge hgh dn foam pad","description":"Gradient compression bandaging supply, high density foam pad, any size or shape, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1720","name":"Influenza vacc admin","description":"Influenza vacc admin","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0788T","name":"Elec aly smp iins sp/sac nrv","description":"Electronic analysis with simple programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detecti","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7021","name":"Suppl and access lung expan","description":"Supplies and accessories for lung expansion airway clearance, continuous high frequency oscillation, and nebulization device (e.g., handset, nebulizer kit, biofilter)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0998T","name":"Precuneus mag stimj tx dlvr","description":"Precuneus magnetic stimulation; personalized treatment delivery of magnetic stimulation therapy to a prespecified target area derived from analysis of evoked potentials within the precuneus, utilizing magnetic resonance imaging-based neuronavigation, with management, per day","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4325","name":"Acapatch, per sq cm","description":"Acapatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11426","name":"Exc h-f-nk-sp b9+marg >4 cm","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter over 4.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1255","name":"Pts w/ othr rsn vst,+prg tst","description":"Patients who have another reason for visiting the clinic [not prenatal or postpartum care] and have a positive pregnancy test but have not established the clinic as an ob provider (e.g., plan to terminate the pregnancy or seek prenatal services elsewhere)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0666","name":"Team remote e/m est pt 15 mn","description":"Team remote e/m est. pt 15mins","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83655","name":"Assay of lead","description":"Lead","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0168","name":"Epinephrine (intl med sys)","description":"Injection, epinephrine (international medication systems), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62145","name":"Repair of skull & brain","description":"Cranioplasty for skull defect with reparative brain surgery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1568.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43290","name":"Egd flx trnsorl dplmnt balo","description":"Esophagogastroduodenoscopy, flexible, transoral; with deployment of intragastric bariatric balloon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6114","name":"Implnt/abut fixed dent max","description":"Implnt/abut fixed dent max","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9293","name":"Fertility cycl tracking soft","description":"Fertility cycle (contraception & conception) tracking software application, fda cleared, per month, includes accessories (e.g., thermometer)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33548","name":"Restore/remodel ventricle","description":"Surgical ventricular restoration procedure, includes prosthetic patch, when performed (eg, ventricular remodeling, svr, saver, dor procedures)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2825.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0182","name":"Hospice care supervision","description":"Physician supervision of a patient under a medicare-approved hospice (patient not present) requiring complex and multidisciplinary care modalities involving regular physician development and/or revision of care plans, review of subsequent reports of patient status, review of laboratory and other stu","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4258","name":"Enverse, per sq cm","description":"Enverse, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0461U","name":"Onc rxgenom alys rtpcr 24gen","description":"Onc rxgenom alys rtpcr 24gen","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37270","name":"Revsc evasc fpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J7051","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1276","name":"Calc bmi out nrm param nof/u","description":"Bmi documented outside normal parameters, no follow-up plan documented, no reason given","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0533","name":"Buprenorphone inj weekly","description":"Medication assisted treatment, buprenorphine (injectable) administered on a weekly basis; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid tre","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0555","name":"Replacment pt electronic sys","description":"Provision of replacement patient electronics system (e.g., system pillow, handheld reader) for home pulmonary artery pressure monitoring","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33602","name":"Closure of valve","description":"Closure of semilunar valve (aortic or pulmonary) by suture or patch","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1997.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98016","name":"Brief comunicaj tech-bsd svc","description":"Brief communication technology-based service (eg, virtual check-in) by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related evaluation and management service provided within the p","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5944","name":"Max implt sup remv part","description":"Max implt sup remv part","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0299U","name":"Onc pan tum whl gen opt mapg","description":"Onc pan tum whl gen opt mapg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90785","name":"Psytx complex interactive","description":"Interactive complexity (list separately in addition to the code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":11.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98007","name":"Synch audio-video est hi 40","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high medical decision making. when using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0743T","name":"B1 str & fx rsk vrt fx assmt","description":"Bone strength and fracture risk using finite element analysis of functional data and bone mineral density (bmd), with concurrent vertebral fracture assessment, utilizing data from a computed tomography scan, retrieval and transmission of the scan data, measurement of bone strength and bmd and classi","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54152","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21340","name":"Perq tx nasoethmoid fx","description":"Percutaneous treatment of nasoethmoid complex fracture, with splint, wire or headcap fixation, including repair of canthal ligaments and/or the nasolacrimal apparatus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25400","name":"Repair radius or ulna","description":"Repair of nonunion or malunion, radius or ulna; without graft (eg, compression technique)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1596","name":"Inj, glycopyrrolate, 0.1 mg","description":"Injection, glycopyrrolate, 0.1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2003","name":"Inj, lidocaine hcl, 1 mg","description":"Injection, lidocaine hydrochloride, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4320","name":"Pellograft, per sq cm","description":"Pellograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55842","name":"Extensive prostate surgery","description":"Prostatectomy, retropubic radical, with or without nerve sparing; with lymph node biopsy(s) (limited pelvic lymphadenectomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1563.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4371","name":"Neoguard per sq cm","description":"Neoguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64885","name":"Nerve graft head/neck <4 cm","description":"Nerve graft (includes obtaining graft), head or neck; up to 4 cm in length","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1372.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92635","name":"Hearing aid fitg svc ea addl","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; each additional 15 minutes (list separately in addition to code","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0868T","name":"Hi-res gastric ep mapping","description":"High-resolution gastric electrophysiology mapping with simultaneous patient-symptom profiling, with interpretation and report","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4415","name":"Alexiguard st-l per sq cm","description":"Alexiguard sl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0343U","name":"Onc prst8 xom aly 442 sncrna","description":"Onc prst8 xom aly 442 sncrna","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4013","name":"Mntal/behav/psych hlth ss","description":"Mental/behavioral and psychiatry mips specialty set","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0531U","name":"Nfct ds afb&inv fng 673orgs","description":"Nfct ds afb&inv fng 673orgs","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4328","name":"Most, per sq cm","description":"Most, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80061","name":"Lipid panel","description":"Lipid panel this panel must include the following: cholesterol, serum, total (82465) lipoprotein, direct measurement, high density cholesterol (hdl cholesterol) (83718) triglycerides (84478)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4439","name":"Instagraft per sq cm","description":"Instagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4356","name":"Abio mem abio hyd per sq cm","description":"Abiomend membrane and abiomend hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99445","name":"Rem mntr physiol param 2-15","description":"Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate); device(s) supply with daily recording(s) or programmed alert(s) transmission, 2-15 days in a 30-day period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6599","name":"G comp bandage short stretch","description":"Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63001","name":"Remove spine lamina 1/2 crvl","description":"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), 1 or 2 vertebral segments; cervical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1337.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5995","name":"Peri medicament w/seal, max","description":"Peri medicament w/seal, max","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74018","name":"Radex abdomen 1 view","description":"Radiologic examination, abdomen; 1 view","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9323","name":"Inj pemetrexed ditromethamin","description":"Injection, pemetrexed ditromethamine, 10 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99186","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0208","name":"Inj, pedmark, 100 mg","description":"Injection, sodium thiosulfate (pedmark), 100 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78230","name":"Salivary gland imaging","description":"Salivary gland imaging;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31298","name":"Nsl/sins ndsc surg frnt&sphn","description":"Nasal/sinus endoscopy, surgical, with dilation (eg, balloon dilation); frontal and sphenoid sinus ostia","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2819.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":207.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1456","name":"Inj, fosaprepitant (teva)","description":"Injection, fosaprepitant (teva), not therapeutically equivalent to j1453, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0441U","name":"Nfct ds bct fngl/viral semiq","description":"Nfct ds bct fngl/viral semiq","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94626","name":"Phy/qhp op pulm rhb w/mntr","description":"Physician or other qualified health care professional services for outpatient pulmonary rehabilitation; with continuous oximetry monitoring (per session)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8612","name":"Oral methotrexate (xatmep)","description":"Methotrexate (xatmep), oral, 2.5 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64508","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1413","name":"Inj delandistrogene mox rokl","description":"Injection, delandistrogene moxeparvovec-rokl, per therapeutic dose","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0719T","name":"Pst vrt jt rplcmt lmbr 1 sgm","description":"Posterior vertebral joint replacement, including bilateral facetectomy, laminectomy, and radical discectomy, including imaging guidance, lumbar spine, single segment","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31717","name":"Bronchial brush biopsy","description":"Catheterization with bronchial brush biopsy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4351","name":"Enclose tl matrix, per sq cm","description":"Enclose tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2019","name":"Kerecis marigen shld sq cm","description":"Kerecis omega3 marigen shield, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80439","name":"Trh stimulation panel","description":"Thyrotropin releasing hormone (trh) stimulation panel; 2 hour this panel must include the following: thyroid stimulating hormone (tsh) (84443 x 4)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57420","name":"Exam of vagina w/scope","description":"Colposcopy of the entire vagina, with cervix if present;","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":130.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37760","name":"Lig prfratr vn radical 1 leg","description":"Ligation of perforator veins, subfascial, radical (linton type), including skin graft, when performed, open,1 leg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":770.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0117","name":"Glaucoma scrn hgh risk direc","description":"Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1404","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4388","name":"Neothelium 4l per sq cm","description":"Neothelium 4l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44345","name":"Revision of colostomy","description":"Revision of colostomy; complicated (reconstruction in-depth) (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1080.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0275U","name":"Hem heprn nduc trmbctpna srm","description":"Hematology (heparin-induced thrombocytopenia) platelet antibody reactivity by flow cytometry, serum","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0952T","name":"Tot impl amei rev/rplc mstdc","description":"Totally implantable active middle ear hearing implant; revision or replacement, with mastoidectomy and replacement of sound processor","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1153","name":"Pt w/ dx osteo doe","description":"Patient with diagnosis of osteoporosis on date of encounter","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0480U","name":"Nfct ds csf metag ngs alys","description":"Nfct ds csf metag ngs alys","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0688","name":"Inj cefazolin sodium, hikma","description":"Injection, cefazolin sodium (hikma), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47370","name":"Laparo ablate liver tumor rf","description":"Laparoscopy, surgical, ablation of 1 or more liver tumor(s); radiofrequency","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1346.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1341","name":"Pt no f/u 30-180 dys","description":"Patients who did not have a follow-up assessment or did not have an assessment within 30 to 180 days after the index assessment during the performance period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4305","name":"Amer am ac tri-lay per sq cm","description":"American amnion ac tri-layer, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29877","name":"Arthrs knee surg dbrdmt/shvg","description":"Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":703.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"Rec cath any transanal, each","description":"Rectal catheter with or without balloon, for use with any type transanal irrigation system, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4397","name":"Summit aaa per sq cm","description":"Summit aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12006","name":"Rpr s/n/a/gen/trk20.1-30.0cm","description":"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 20.1 cm to 30.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1281","name":"Bp scrn no perf at interval","description":"Blood pressure reading not documented, reason not given","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66989","name":"Xcpsl ctrc rmvl cplx insj 1+","description":"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification), complex, requiring devices or techniques not generally used in routine cataract surgery (eg, iris expansion device,","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0796T","name":"Tcat ins 2chmbr ldls pm ra","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right atrial pacemaker","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21925","name":"Biopsy soft tissue of back","description":"Biopsy, soft tissue of back or flank; deep","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49591","name":"Rpr aa hrn 1st < 3 cm rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, reducible","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4369","name":"Amnioplast 3 per sq cm","description":"Amnioplast 3, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37260","name":"Revsc evasc ivt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69410","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0285U","name":"Onc rsps radj cll fr dna tox","description":"Onc rsps radj cll fr dna tox","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31526","name":"Dx laryngoscopy w/oper scope","description":"Laryngoscopy direct, with or without tracheoscopy; diagnostic, with operating microscope or telescope","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0533U","name":"Rx metab advrs gnotyp 16gens","description":"Rx metab advrs gnotyp 16gens","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9997","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9038","name":"Inj axatilimab-csfr 0.1 mg","description":"Injection, axatilimab-csfr, 0.1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81003","name":"Urinalysis auto w/o scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; automated, without microscopy","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"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":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3391","name":"Inj, atidarsagene autotemcel","description":"Injection, atidarsagene autotemcel, per treatment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24149","name":"Radical resection of elbow","description":"Radical resection of capsule, soft tissue, and heterotopic bone, elbow, with contracture release (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1282.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75580","name":"N-invas est c ffr sw aly cta","description":"Noninvasive estimate of coronary fractional flow reserve (ffr) derived from augmentative software analysis of the data set from a coronary computed tomography angiography, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0804T","name":"Prgrmg evl ldls pm 2chmbr ip","description":"Programming device evaluation (in person) with iterative adjustment of implantable device to test the function of device and to select optimal permanent programmed values, with analysis, review, and report, by a physician or other qualified health care professional, leadless pacemaker system in dual","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0463U","name":"Onc crvx mrna genxprsn 14bmk","description":"Onc crvx mrna genxprsn 14bmk","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4304","name":"Grafix plus, per sq cm","description":"Grafix plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0976T","name":"Slctv nzmtc dbrdmt s/n/hf ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; each additional 100 sq cm (list separately in addition to code for p","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0610U","name":"Nfct ds antmcr sc phenotypic","description":"Nfct ds antmcr sc phenotypic","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4342","name":"Theramend, per sq cm","description":"Theramend, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4399","name":"Summit fx per sq cm","description":"Summit fx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9272","name":"Inj, dostarlimab-gxly, 10 mg","description":"Injection, dostarlimab-gxly, 10 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0728T","name":"Dx alys vstblr implt uni 1st","description":"Diagnostic analysis of vestibular implant, unilateral; with initial programming","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2247","name":"Inj, micafungin (par pharm)","description":"Injection, micafungin sodium (par pharm) not thereapeutically equivalent to j2248, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1200","name":"Ace-i/arb rx","description":"Ace inhibitor (ace-i) or arb therapy prescribed during the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1032","name":"Sv doula brth wrk per 15 min","description":"Services performed by a doula birth worker, per 15 minutes","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24635","name":"Optx monteggia fx dislc elbw","description":"Open treatment of monteggia type of fracture dislocation at elbow (fracture proximal end of ulna with dislocation of radial head), includes internal fixation, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1355.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1203","name":"No rsn ace-i/arb rx","description":"Ace inhibitor or arb therapy not prescribed during the measurement period, reason not given","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2561","name":"Inj, sezaby, 1 mg","description":"Injection, phenobarbital sodium (sezaby), 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76830","name":"Transvaginal us non-ob","description":"Ultrasound, transvaginal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0297U","name":"Onc pan tum whl gen seq dna","description":"Onc pan tum whl gen seq dna","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27713","name":"Osteot tibia imed lngth dev","description":"Osteotomy(ies), tibia, including fibula when performed, unilateral, with insertion of an externally controlled intramedullary lengthening device, including imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96041","name":"Genetic counseling svc ea 30","description":"Medical genetics and genetic counseling services, each 30 minutes of total time provided by the genetic counselor on the date of the encounter","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0298U","name":"Onc pan tum whl trns seq rna","description":"Onc pan tum whl trns seq rna","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2030","name":"Miro3d fibers, per mg","description":"Miro3d fibers, per milligram","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3299","name":"Inj xipere 1 mg","description":"Injection, triamcinolone acetonide (xipere), 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7412","name":"Excision benign lesion compl","description":"Excision of benign lesion complicated","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87088","name":"Urine bacteria culture","description":"Culture, bacterial; with isolation and presumptive identification of each isolate, urine","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0426U","name":"Genome ultra-rapid seq alys","description":"Genome ultra-rapid seq alys","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0340U","name":"Onc pan ca alys mrd plasma","description":"Onc pan ca alys mrd plasma","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0609U","name":"Onc prostate ia tot&free psa","description":"Onc prostate ia tot&free psa","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6517","name":"Grad com wrap w strap bn cus","description":"Gradient compression wrap with adjustable straps, below knee, each, custom","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33755","name":"Shunt as-aort to pulm art","description":"Shunt; ascending aorta to pulmonary artery (waterston type operation)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1514.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0349","name":"Inj, rezafungin, 1 mg","description":"Injection, rezafungin, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0423U","name":"Psyc genomic alys pnl 26 gen","description":"Psyc genomic alys pnl 26 gen","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1458","name":"Pt died bef end meas pd","description":"Patient died prior to the end of the performance period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93575","name":"Njx cath slct p angrph mapca","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary angiography of major aortopulmonary collateral arteries (mapcas) arising off the aorta or its systemic branches, during cardiac catheterization for congenital heart d","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8612","name":"Oral methotrexate (xatmep)","description":"Methotrexate (xatmep), oral, 2.5 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6252","name":"Bridge resin w/noble metal","description":"Pontic-resin with noble metal","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28495","name":"Treat big toe fracture","description":"Closed treatment of fracture great toe, phalanx or phalanges; with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61697","name":"Brain aneurysm repr complx","description":"Surgery of complex intracranial aneurysm, intracranial approach; carotid circulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4211.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97550","name":"Caregiver traing 1st 30 min","description":"Caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patie","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9998","name":"Inj ustekinumab-aekn, 1 mg","description":"Injection, ustekinumab-aekn (selarsdi), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26262","name":"Resect distal finger tumor","description":"Radical resection of tumor, distal phalanx of finger","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":542.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0596U","name":"Neuro alzds plsm 3dstnct isp","description":"Neuro alzds plsm 3dstnct isp","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92961","name":"Cardioversion electric int","description":"Cardioversion, elective, electrical conversion of arrhythmia; internal (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49618","name":"Rpr aa hrn rcr > 10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, incarcerated or strangulate","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0724T","name":"Qmrcp w/dx mri same anatomy","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained with diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in additio","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0717T","name":"Adrc ther prtl rc tear","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; adipose tissue harvesting, isolation and preparation of harvested cells, including incubation with cell dissociation enzymes, filtration, washing, and concentration of adrcs","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96548","name":"Ntraop hipec px ea add 30min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1596","name":"Inj, glycopyrrolate, 0.1 mg","description":"Injection, glycopyrrolate, 0.1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9603","name":"Inj, pafolacianine, 0.1 mg","description":"Injection, pafolacianine, 0.1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61891","name":"Rev/rplcmt sk-mnt crnl nstm","description":"Revision or replacement of skull-mounted cranial neurostimulator pulse generator or receiver with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27828","name":"Treat lower leg fracture","description":"Open treatment of fracture of weight bearing articular surface/portion of distal tibia (eg, pilon or tibial plafond), with internal fixation, when performed; of both tibia and fibula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1506.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4355","name":"Abio xpl abio xpl hy p sq cm","description":"Abiomend xplus membrane and abiomend xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93152","name":"Interrog&prgrmg ipnss polysm","description":"Interrogation and programming of implanted phrenic nerve stimulator system during polysomnography","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9051","name":"Inj, bortezomib (maia)","description":"Injection, bortezomib (maia), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5911","name":"Facial moulage sectional","description":"Facial moulage (sectional)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1249","name":"Pt resp true imprt to me","description":"Patient responded completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37185","name":"Prim art m-thrmbc sbsq vsl","description":"Primary percutaneous transluminal mechanical thrombectomy, noncoronary, non-intracranial, arterial or arterial bypass graft, including fluoroscopic guidance and intraprocedural pharmacological thrombolytic injection(s); second and all subsequent vessel(s) within the same vascular family (list separa","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49614","name":"Rpr aa hrn rcr < 3 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58960","name":"Exploration of abdomen","description":"Laparotomy, for staging or restaging of ovarian, tubal, or primary peritoneal malignancy (second look), with or without omentectomy, peritoneal washing, biopsy of abdominal and pelvic peritoneum, diaphragmatic assessment with pelvic and limited para-aortic lymphadenectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1059.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21260","name":"Revise eye sockets","description":"Periorbital osteotomies for orbital hypertelorism, with bone grafts; extracranial approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1340.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2040","name":"Coord specialty care, month","description":"Coordinated specialty care, team-based, for first episode psychosis, per month","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0945T","name":"Intraop assmt abnl tum tiss","description":"Intraoperative assessment for abnormal (tumor) tissue, in-vivo, following partial mastectomy (eg, lumpectomy) using computer-aided fluorescence imaging (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0826T","name":"Prgrmg evl ldls pm 1chmbr ip","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional, leadless pacemaker system in si","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6251","name":"Bridge resin base metal","description":"Pontic-resin with predominantly base metal","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9608","name":"Flotufolastat f18 diag 1 mci","description":"Flotufolastat f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5827","name":"Endo knee shin single axis","description":"Endoskeletal knee-shin system, single axis, electromechanical swing and stance phase control, with or without shock absorption and stance extension damping","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2035","name":"Corpl p therac p allac p mg","description":"Corplex p or theracor p or allacor p, per milligram","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21800","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0729T","name":"Dx alys vstblr implt uni sbq","description":"Diagnostic analysis of vestibular implant, unilateral; with subsequent programming","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0208","name":"Inj, pedmark, 100 mg","description":"Injection, sodium thiosulfate (pedmark), 100 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0893","name":"Inj, decitabine (sun pharma)","description":"Injection, decitabine (sun pharma), not therapeutically equivalent to j0894, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43291","name":"Egd flx trnsorl rmvl balo","description":"Esophagogastroduodenoscopy, flexible, transoral; with removal of intragastric bariatric balloon(s)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9273","name":"Inj tisotu vedotin-tftv, 1mg","description":"Injection, tisotumab vedotin-tftv, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4350","name":"Palisade dm matrix per sq cm","description":"Palisade dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4543","name":"Supply trans elec nerve stim","description":"Supplies for transcutaneous electrical nerve stimulator, for nerves in the auricular region, per month","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2054","name":"Lisocabtagene mara car pos t","description":"Lisocabtagene maraleucel, up to 110 million autologous anti-cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5227","name":"Immed max part denture","description":"Immed max part denture","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0895T","name":"Connj lvr algrft prfu dev 1","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; initial 4 hours of monitoring time, including hourly physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary ","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0391","name":"Inj, artesunate, 1mg","description":"Injection, artesunate, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93501","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1072.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0618U","name":"Psyc bd dna mthyl alys>10000","description":"Psyc bd dna mthyl alys>10000","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9322","name":"Inj pemetrexed (bluepoint)","description":"Injection, pemetrexed (bluepoint), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9615","name":"Inj, pegulicianine, 1 mg","description":"Injection, pegulicianine, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D8671","name":"Periodic orth treat w surg","description":"Periodic orth treat w surg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0827T","name":"Dgtz gls mcrscp cytp smears","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; smears with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45825","name":"Repair fistula w/colostomy","description":"Closure of rectourethral fistula; with colostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1478.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0865T","name":"Quan mri alys brn w/o dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion identification, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transm","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1402","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77081","name":"Dxa bone density appendiculr","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9986","name":"Missed appointment","description":"Missed appointment","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0777T","name":"R-t prs sensing edrl gdn sys","description":"Real-time pressure-sensing epidural guidance system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76150","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0422","name":"Collect & prep genetic samp","description":"Collect & prep genetic samp","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9038","name":"Inj axatilimab-csfr 0.1 mg","description":"Injection, axatilimab-csfr, 0.1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0908T","name":"Opn imp int nstm sys vgs nrv","description":"Open implantation of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87468","name":"Anaplsma phgcytophlm amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); anaplasma phagocytophilum, amplified probe technique","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0317U","name":"Onc lung ca 4-prb fish assay","description":"Onc lung ca 4-prb fish assay","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1177","name":"Pt recd pcv on/aft 19","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0857T","name":"Opto-acoustic img breast uni","description":"Opto-acoustic imaging, breast, unilateral, including axilla when performed, real-time with image documentation, augmentative analysis and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5136","name":"Inj. denosumab-bbdz, 1 mg","description":"Injection, denosumab-bbdz (jubbonti/wyost), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11042","name":"Dbrdmt subq tis 1st 20sqcm/<","description":"Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":65.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":23.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5930","name":"Max guid prothes w/o flange","description":"Max guid prothes w/o flange","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0628U","name":"Nfro kdn ds genetic cond 449","description":"Nfro kdn ds genetic cond 449","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36640","name":"Insertion catheter artery","description":"Arterial catheterization for prolonged infusion therapy (chemotherapy), cutdown","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91200","name":"Liver elastography","description":"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33904","name":"Perq p-art revsc each addl","description":"Percutaneous pulmonary artery revascularization by stent placement, each additional vessel or separate lesion, normal or abnormal connections (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1272","name":"Pts kid transplt wtlst","description":"Patients observed on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7956","name":"Tiss regen edent resorb","description":"Tiss regen edent resorb","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4350","name":"Palisade dm matrix per sq cm","description":"Palisade dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0772T","name":"Vr px dissoc svc sm phy ea","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37294","name":"Rvsc evsc tpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67255","name":"Reinforce/graft eye wall","description":"Scleral reinforcement (separate procedure); with graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":861.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82272","name":"Occult bld feces 1-3 tests","description":"Blood, occult, by peroxidase activity (eg, guaiac), qualitative, feces, 1-3 simultaneous determinations, performed for other than colorectal neoplasm screening","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1353","name":"Sealant repair per tooth","description":"Sealant repair per tooth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0764T","name":"Asstv alg ecg rsk asmt cncrt","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to concurrently performed electrocardiogram (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51020","name":"Cystotomy/cystostomy w/fulg","description":"Cystotomy or cystostomy, with fulguration and/or insertion of radioactive material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2401","name":"Chloroprocaine hcl injection","description":"Injection, chloroprocaine hydrochloride, per 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1211","name":"Gsa level>9.0%","description":"Most recent glycemic status assessment (hba1c or gmi) level > 9.0%","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51990","name":"Laparo urethral suspension","description":"Laparoscopy, surgical; urethral suspension for stress incontinence","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":890.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0569","name":"Subs psych care mng, subs mo","description":"Subsequent psychiatric collaborative care management, in a subsequent month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required elements: tracking ","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0795T","name":"Tcat ins 2chmbr ldls pm cmpl","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; complete system (ie, r","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4332","name":"Axolotl dualgraft, per sq cm","description":"Axolotl dualgraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77090","name":"Tbs techl prep&transmis data","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81000","name":"Urinalysis nonauto w/scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; non-automated, with microscopy","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0799","name":"Hiv prep, fda approved, noc","description":"Fda approved prescription drug, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv), not otherwise classified","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62330","name":"Dcmprn prq rmv lig flv 1lmbr","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; one interspace, lumbar","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68100","name":"Biopsy conjunctiva","description":"Biopsy of conjunctiva","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2024","name":"Resolve or xenopatch sq cm","description":"Resolve matrix or xenopatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1316","name":"Tobacco non-user","description":"Current tobacco non-user","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0740T","name":"Rem auton alg nsln cal setup","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; initial set-up and patient education","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0662","name":"Team remote e/m new pt 30 mn","description":"Team remote e/m new pt 30 mins","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99345","name":"Home/res vst new high mdm 75","description":"Home or residence visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 75 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":239.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45378","name":"Diagnostic colonoscopy","description":"Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1221","name":"Dre w/o rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; without evidence of retinopathy","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0988T","name":"Opn ins/rplc ins ptn sbq&sbf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15150","name":"Tis cltr skn agrft t/a/l 1st","description":"Tissue cultured skin autograft, trunk, arms, legs; first 25 sq cm or less","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":719.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0440U","name":"Crd chd dna alys 10 snp 6dna","description":"Crd chd dna alys 10 snp 6dna","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64657","name":"Rmvl bat modulj sys tot sys","description":"Removal of baroreflex activation therapy (bat) modulation system; total system, including lead and pulse generator","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86041","name":"Acetylcholn rcptr bndng antb","description":"Acetylcholine receptor (achr); binding antibody","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95079","name":"Ingest challenge addl 60 min","description":"Ingestion challenge test (sequential and incremental ingestion of test items, eg, food, drug or other substance); each additional 60 minutes of testing (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88130","name":"Sex chromatin identification","description":"Sex chromatin identification; barr bodies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9276","name":"Inj zanidatamab-hrii, 2 mg","description":"Injection, zanidatamab-hrii, 2 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0741T","name":"Rem auton alg nsln data coll","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; provision of software, data collection, transmission, and storage, each 30 days","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0250","name":"Md inr test revie inter mgmt","description":"Physician review, interpretation, and patient management of home inr testing for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria; testing not occurring more frequently than once a week; billing units of servic","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1226","name":"Iop not doc","description":"Iop measurement not documented, reason not otherwise specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97814","name":"Acup 1/> w/estim ea addl 15","description":"Acupuncture, 1 or more needles; with electrical stimulation, each additional 15 minutes of personal one-on-one contact with the patient, with insertion of needle(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":22.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0043","name":"Pt mech pros ht valv","description":"Patients with mechanical prosthetic heart valve","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0541","name":"No pt prsnt train initial 30","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49615","name":"Rpr aa hrn rcr 3-10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, reducible","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1245","name":"Pt othr thn true person","description":"Patient provided a response other than completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4367","name":"Amniocore sl, per sq cm","description":"Amniocore sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9027","name":"Rbc o2 co2 reduced","description":"Red blood cells, leukocytes reduced, oxygen/ carbon dioxide reduced, each unit","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0940T","name":"Xtrnl ecg rec>15d<30d r&i","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92639","name":"Hearing aid meas verif","description":"Hearing-aid measurement, verification with probe-microphone (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1447","name":"Pt dx bd bef end meas pd","description":"Patients with an active diagnosis of bipolar disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0706","name":"Intraoral occlus radio image","description":"Intraoral occlus radio image","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0993T","name":"N-invas assmt car rsk w/ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat with concurrent computed tomography scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional (list s","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0992T","name":"N-invas assmt car rsk w/o ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat without concurrent computed tomography (ct) scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86826","name":"Hla x-match noncytotoxc addl","description":"Human leukocyte antigen (hla) crossmatch, non-cytotoxic (eg, using flow cytometry); each additional serum sample or sample dilution (list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0958T","name":"Rmv s-sclp eltr ra rcvr&tlmt","description":"Removal of sub-scalp implanted electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":946.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1362","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0898","name":"Argatroban nonesrd (auromed)","description":"Injection, argatroban (auromedics), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9027","name":"Rbc o2 co2 reduced","description":"Red blood cells, leukocytes reduced, oxygen/ carbon dioxide reduced, each unit","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0339U","name":"Onc prst8 mrna hoxc6 & dlx1","description":"Onc prst8 mrna hoxc6 & dlx1","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4378","name":"Renew ft matrix per sq cm","description":"Renew ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4028","name":"Podiatry ss","description":"Podiatry mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2508","name":"Pegunigalsidase alfa-iwxj","description":"Injection, pegunigalsidase alfa-iwxj, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90637","name":"Vacc qirv mrna 30mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 30 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63032","name":"Lamot rpr anulr dfct 1 lmbr","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; with repair of annular defect by implantation of bone-anchored annular closure device, including all imaging guidance, 1 interspace, lumbar","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0280U","name":"Hem vw factor&clgn iv bndg","description":"Hematology (von willebrand disease [vwd]), von willebrand factor (vwf) and collagen iv binding by enzyme-linked immunosorbent assays (elisa), plasma, report of collagen iv binding","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0337U","name":"Onc plsm cell do&myeloma id","description":"Onc plsm cell do&myeloma id","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5878","name":"Dup of complt dent-mandib","description":"Dup of complt dent-mandib","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4016","name":"Neurosurgical ss","description":"Neurosurgical mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58925","name":"Removal of ovarian cyst(s)","description":"Ovarian cystectomy, unilateral or bilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":822.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0709","name":"Intraoral cmplt radio images","description":"Intraoral cmplt radio images","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0872T","name":"Rplcmt ndwllg bldr&prtl cath","description":"Replacement of indwelling bladder and peritoneal catheters, including tunneling of catheter(s) and connection with previously implanted peritoneal ascites pump, including imaging and programming, when performed","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0876T","name":"Duplex scan hemo fstl lmtd","description":"Duplex scan of hemodialysis fistula, computer-aided, limited (volume flow, diameter, and depth, including only body of fistula)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97550","name":"Caregiver traing 1st 30 min","description":"Caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patie","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81456","name":"So/hl 51/>gsap rna alys","description":"Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic sequence analysis panel, interrogation for sequence variants and copy number variants or rearrangements, or isoform expression or mrna expression levels, if performed; rna analysis","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4326","name":"Woundplus, per sq cm","description":"Woundplus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21366","name":"Opn tx complx malar w/grft","description":"Open treatment of complicated (eg, comminuted or involving cranial nerve foramina) fracture(s) of malar area, including zygomatic arch and malar tripod; with bone grafting (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1424.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48180","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1695.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81463","name":"So gsap cl fr cpy nmbr&mcrst","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis, copy number variants, and microsatellite instability","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0350U","name":"Rx metab/pcx dna 27 gen alys","description":"Rx metab/pcx dna 27 gen alys","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0914T","name":"Prq tcat thr rx ntrc bal sep","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting) performed on a separate target lesion from the target lesion treated with balloon angioplasty, coronary stent placement or coronary atherectomy, including mechanical dilation b","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26250","name":"Extensive hand surgery","description":"Radical resection of tumor, metacarpal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":683.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99243","name":"Off/op cnsltj new/est low 30","description":"Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":109.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0363U","name":"Onc urthl mrna 5 gen alg","description":"Onc urthl mrna 5 gen alg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96105","name":"Assessment of aphasia","description":"Assessment of aphasia (includes assessment of expressive and receptive speech and language function, language comprehension, speech production ability, reading, spelling, writing, eg, by boston diagnostic aphasia examination) with interpretation and report, per hour","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96380","name":"Admn rsv monoc antb im cnsl","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection, with counseling by physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0719T","name":"Pst vrt jt rplcmt lmbr 1 sgm","description":"Posterior vertebral joint replacement, including bilateral facetectomy, laminectomy, and radical discectomy, including imaging guidance, lumbar spine, single segment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1440","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0911T","name":"Elec aly nstm sys vgs nrv wo","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; without programming by physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1410","name":"No gmln brca1/brca2 couns","description":"Patients who did not have germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9603","name":"Inj, pafolacianine, 0.1 mg","description":"Injection, pafolacianine, 0.1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0780T","name":"Instlj fecal microbiota ssp","description":"Instillation of fecal microbiota suspension via rectal enema into lower gastrointestinal tract","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0002","name":"Opt care kidney hlth mvp","description":"Optimal care for kidney health mips value pathways","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59300","name":"Episiotomy or vaginal repair","description":"Episiotomy or vaginal repair, by other than attending","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":263.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4345","name":"Matrix hd allogrft per sq cm","description":"Matrix hd allograft dermis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6072","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (high noble metal)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0042","name":"Ref to therapy","description":"Referral to physical, occupational, speech, or recreational therapy","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9046","name":"Inj, bortezomib, dr. reddys","description":"Injection, bortezomib (dr. reddys), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4373","name":"Membrane wrp lt per sq cm","description":"Membrane wrap lite, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0570","name":"Care manage serv, pr cal mo","description":"Care management services for behavioral health conditions, directed by a physician or other qualified health care professional, per calendar month, with the following required elements: initial assessment or follow-up monitoring, including the use of applicable validated rating scales, behavioral he","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34101","name":"Removal of artery clot","description":"Embolectomy or thrombectomy, with or without catheter; axillary, brachial, innominate, subclavian artery, by arm incision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":751.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4000","name":"Dermatology ss","description":"Dermatology mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1181","name":"Gr 2 or> dia or gr2 or> col","description":"Grade 2 or above diarrhea and/or grade 2 or above colitis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0862T","name":"Rlcj pg wcs lv battery only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; battery component only","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9800","name":"Gallium locametz 1 millicuri","description":"Gallium ga-68 gozetotide, diagnostic, (locametz), 1 millicurie","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81168","name":"Ccnd1/igh translocation alys","description":"Ccnd1/igh (t(11;14)) (eg, mantle cell lymphoma) translocation analysis, major breakpoint, qualitative and quantitative, if performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1260","name":"Dolasetron mesylate","description":"Injection, dolasetron mesylate, 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49591","name":"Rpr aa hrn 1st < 3 cm rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, reducible","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93321","name":"Doppler echo f-up/lmtd std","description":"Doppler echocardiography, pulsed wave and/or continuous wave with spectral display (list separately in addition to codes for echocardiographic imaging); follow-up or limited study (list separately in addition to codes for echocardiographic imaging)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0417U","name":"Rare ds alys 335 nuc genes","description":"Rare ds alys 335 nuc genes","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0471U","name":"Onc clrc ca 35 vrn kras&nras","description":"Onc clrc ca 35 vrn kras&nras","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73500","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33611","name":"Repair double ventricle","description":"Repair of double outlet right ventricle with intraventricular tunnel repair;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2334.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43770","name":"Lap place gastr adj device","description":"Laparoscopy, surgical, gastric restrictive procedure; placement of adjustable gastric restrictive device (eg, gastric band and subcutaneous port components)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1188.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J9010","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0582","name":"Bivalirudin (endo) 1 mg","description":"Injection, bivalirudin (endo), not therapeutically equivalent to j0583, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93598","name":"Car outp meas drg cath chd","description":"Cardiac output measurement(s), thermodilution or other indicator dilution method, performed during cardiac catheterization for the evaluation of congenital heart defects (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83704","name":"Lipoprotein bld quan part","description":"Lipoprotein, blood; quantitation of lipoprotein particle number(s) (eg, by nuclear magnetic resonance spectroscopy), includes lipoprotein particle subclass(es), when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0665","name":"Team remote e/m est pt 10 mn","description":"Team remote e/m est. pt 10mins","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1189","name":"Doc khe pef w/efgr/uacr","description":"Documentation of a kidney health evaluation defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr) performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7284","name":"Exc biopsy of saliv glands","description":"Exc biopsy of saliv glands","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0139","name":"Inj, adalimumab, 1 mg","description":"Injection, adalimumab, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82378","name":"Carcinoembryonic antigen","description":"Carcinoembryonic antigen (cea)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87811","name":"Sars-cov-2 covid19 w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19])","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0525U","name":"Onc sphrd cell cul 11-rx pnl","description":"Onc sphrd cell cul 11-rx pnl","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0767T","name":"Tc mag stimj pn ea addl nrv","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; each additional nerve (list separat","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11300","name":"Shave skin lesion 0.5 cm/<","description":"Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion diameter 0.5 cm or less","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":30.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93596","name":"R&l hrt cath chd nml nt cnj","description":"Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); normal native connections","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0901T","name":"Plmt bone marrow smplg port","description":"Placement of bone marrow sampling port, including imaging guidance when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29843","name":"Wrist arthroscopy/surgery","description":"Arthroscopy, wrist, surgical; for infection, lavage and drainage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1492","name":"No reported fall","description":"Patients who did not report a fall","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4317","name":"Vitograft, per sq cm","description":"Vitograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36000","name":"Place needle in vein","description":"Introduction of needle or intracatheter, vein","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99425","name":"Prin care mgmt phys ea addl","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44406","name":"Colonoscopy w/ultrasound","description":"Colonoscopy through stoma; with endoscopic ultrasound examination, limited to the sigmoid, descending, transverse, or ascending colon and cecum and adjacent structures","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78010","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0431U","name":"Gly rcptr alpha1 igg srm/csf","description":"Gly rcptr alpha1 igg srm/csf","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1415","name":"No pos pdl1 bef ici ther","description":"Patients who did not have a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49618","name":"Rpr aa hrn rcr > 10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, incarcerated or strangulate","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97811","name":"Acup 1/> w/o estim ea add 15","description":"Acupuncture, 1 or more needles; without electrical stimulation, each additional 15 minutes of personal one-on-one contact with the patient, with insertion of needle(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":31.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0773T","name":"Vr px dissoc svc oth phy 1st","description":"Virtual reality (vr) procedural dissociation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports; initial 15 min","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0350","name":"Oral/facial photo images","description":"Oral/facial photographic images","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81459","name":"So neo gsap dna/dna&rna","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants, microsatellite instability, tumor mutation burden, and rearrangements","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0013","name":"Esketamine, nasal spray","description":"Esketamine, nasal spray, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1463","name":"2 f/u wthn 180 day rx atmp","description":"Documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33954","name":"Ecmo/ecls insj prph cannula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; insertion of peripheral (arterial and/or venous) cannula(e), open, 6 years and older","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":482.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6624","name":"Inlay titanium","description":"Inlay - titanium","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2599","name":"Inj vasopressin (am reg) 1 u","description":"Injection, vasopressin (american regent), not therapeutically equivalent to j2598, 1 unit","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4023","name":"Pathology ss","description":"Pathology mips specialty set","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4225","name":"Amnio or derma tl, per sq cm","description":"Amniobind or dermabind tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4435","name":"Renati membrane per sq cm","description":"Renati membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0530","name":"Adult daycare center, 8 hr u","description":"Adult day center, 8-hour unit, for use in cmmi model","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2023","name":"Innovamatrix pd, 1 mg","description":"Innovamatrix pd, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4436","name":"Renati ac membrane per sq cm","description":"Renati ac membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28450","name":"Tx tarsal b1 fx w/o mnpj ea","description":"Treatment of tarsal bone fracture (except talus and calcaneus); without manipulation, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0836T","name":"Dgtz gls mcrscp fna ea addl","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","name":"Scoliosis orth sag/ cor","description":"Scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla to trochanter, includes all accessory pads, straps and interface, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual ","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1263","name":"Pts hosp dialysis dt","description":"Patients in hospice on their initiation of dialysis date or during the month of evaluation","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93585","name":"Vngrph chd azygs/hemiazygs","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; azygos/hemiazygos venous system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78608","name":"Brain imaging (pet)","description":"Brain imaging, positron emission tomography (pet); metabolic evaluation","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1747","name":"Inj, spesolimab-sbzo, 1 mg","description":"Injection, spesolimab-sbzo, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1004T","name":"Elec alys s-scl eeg wo prgrm","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; without programming","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1404","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65875","name":"Incise inner eye adhesions","description":"Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); posterior synechiae","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":609.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0878T","name":"Augmnt alys ch ct ild w/ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained with concurrent ct examination of the same structure","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4362","name":"Cygnus disk, per sq cm","description":"Cygnus disk, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0783T","name":"Tc auriculr neurostimulation","description":"Transcutaneous auricular neurostimulation, set-up, calibration, and patient education on use of equipment","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31000","name":"Irrigation maxillary sinus","description":"Lavage by cannulation; maxillary sinus (antrum puncture or natural ostium)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47384","name":"Abltj ire liver 1+ tum perq","description":"Ablation, irreversible electroporation, liver, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11006","name":"Dbrdmt skin xtrnl gent per","description":"Debridement of skin, subcutaneous tissue, muscle and fascia for necrotizing soft tissue infection; external genitalia, perineum and abdominal wall, with or without fascial closure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":825.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0986T","name":"Iv img icr cere vsl oct 1st","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17003","name":"Destruct premalg les 2-14","description":"Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (eg, actinic keratoses); second through 14 lesions, each (list separately in addition to code for first lesion)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":1.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":7.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0818T","name":"Revj/rmvl ins ptn subq","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2596","name":"Vasopressin (long grove) 1 u","description":"Injection, vasopressin (long grove), not therapeutically equivalent to j2598, 1 unit","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0522","name":"Mgt nw pt dementia low cmplx","description":"Management of a new patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65450","name":"Treatment of corneal lesion","description":"Destruction of lesion of cornea by cryotherapy, photocoagulation or thermocauterization","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5946","name":"Max implt sup fix","description":"Max implt sup fix","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53060","name":"Drainage of urethra abscess","description":"Drainage of skenes gland abscess or cyst","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36837","name":"Prq av fstl crt uxtr sep acs","description":"Percutaneous arteriovenous fistula creation, upper extremity, separate access sites of the peripheral artery and peripheral vein, including fistula maturation procedures (eg, transluminal balloon angioplasty, coil embolization) when performed, including all vascular access, imaging guidance and radi","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":249.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98015","name":"Synch audio-only est high 40","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selec","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0553U","name":"Repr med pga embry te strux","description":"Repr med pga embry te strux","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0927T","name":"Interrog dev eval ccm-d ip","description":"Interrogation device evaluation (in person) with analysis, review, and report, including connection, recording, and disconnection, per patient encounter, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4267","name":"Neostim dl per sq cm","description":"Neostim dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1440","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0426","name":"Coll, analys of saliva","description":"Coll, analys of saliva","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4012","name":"Interventional rad ss","description":"Interventional radiology mips specialty set","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0898T","name":"N-invas prst8 cancer est map","description":"Noninvasive prostate cancer estimation map, derived from augmentative analysis of image-guided fusion biopsy and pathology, including visualization of margin volume and location, with margin determination and physician interpretation and report","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4224","name":"Hhf10-p per sq cm","description":"Human health factor 10 amniotic patch (hhf10-p), per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75741","name":"Artery x-rays lung","description":"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":725.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0974T","name":"Slctv nzmtc dbrdmt t/a/l ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; each additional 100 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"Add upp ext mec limb vol lam","description":"Addition to upper extremity prosthesis, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0862T","name":"Rlcj pg wcs lv battery only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; battery component only","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97124","name":"Massage therapy","description":"Therapeutic procedure, 1 or more areas, each 15 minutes; massage, including effleurage, petrissage and/or tapotement (stroking, compression, percussion)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0660","name":"Team remote e/m new pt 10 mn","description":"Team remote e/m new pt 10mins","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0766T","name":"Tc mag stimj pn 1st nerve","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; first nerve","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4368","name":"Amchothick per sq cm","description":"Amchothick, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4375","name":"Duograft ac per sq cm","description":"Duograft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87118","name":"Mycobacteric identification","description":"Culture, mycobacterial, definitive identification, each isolate","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1023T","name":"Prq tis dsplmt intrathoracic","description":"Percutaneous tissue displacement, any method, including imaging guidance; intrathoracic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2780","name":"Crown 3/4 cast hi noble met","description":"Crown - 3/4 cast high noble metal","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4001","name":"Diagnostic rad ss","description":"Diagnostic radiology mips specialty set","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0661","name":"Team remote e/m new pt 20 mn","description":"Team remote e/m new pt 20mins","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0051","name":"Traditional healing service","description":"Traditional healing service","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15839","name":"Exc excessive skn other area","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy); other area","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":762.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6527","name":"G garmt full leg/ft nght cus","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, custom, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0825T","name":"Tcat rmv&rpl1chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or prog","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0882T","name":"Intraop ther estim pn ue 1st","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; initial nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1073","name":"Testosterone pellet 75 mg","description":"Testosterone pellet, implant, 75 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1954","name":"Inj leu acet lutr dpt 7.5 mg","description":"Injection, leuprolide acetate for depot suspension (lutrate depot), 7.5 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0924T","name":"Rpos prv ccm-d trnsvns eltrd","description":"Repositioning of previously implanted cardiac contractility modulation-defibrillation transvenous electrode(s)/lead(s), including fluoroscopic guidance and programming of sensing and therapeutic parameters","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11622","name":"Exc s/n/h/f/g mal+mrg 1.1-2","description":"Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 1.1 to 2.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2393","name":"Post 3 srfc resinbased cmpst","description":"Resin-based composite - three surfaces posterior","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0940T","name":"Xtrnl ecg rec>15d<30d r&i","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4318","name":"Fem urinary cup w/wo attch","description":"Female external urinary collection cup, with or without ring attachment, per day","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4007","name":"General surgery ss","description":"General surgery mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1653","name":"Ho abduction static ots","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, off the shelf","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93586","name":"Vngrph chd coronary sinus","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; coronary sinus (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5135","name":"Inj, tyenne, 1 mg","description":"Injection, tocilizumab-aazg (tyenne), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0483","name":"Indirect immunofluorescence","description":"Indirect immunofluorescence","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7261","name":"Primary closure sinus perf","description":"Primary closure of a sinus perforation","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1437","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99495","name":"Transj care mgmt mod f2f 14d","description":"Transitional care management services with the following required elements: communication (direct contact, telephone, electronic) with the patient and/or caregiver within 2 business days of discharge at least moderate level of medical decision making during the service period face-to-face visit, wit","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":250.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87109","name":"Mycoplasma","description":"Culture, mycoplasma, any source","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7473","name":"Remove torus mandibularis","description":"Removal of torus mandibularis","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1190","name":"Doc khe not pef w/efgr/uacr","description":"Documentation of a kidney health evaluation was not performed or defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82653","name":"El-1 fecal quantitative","description":"Elastase, pancreatic (el-1), fecal; quantitative","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0496U","name":"Onc clrct cfdna 8/7 genes","description":"Onc clrct cfdna 8/7 genes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0629U","name":"Nfct ds tb dna aly 1trgt pcr","description":"Nfct ds tb dna aly 1trgt pcr","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0869T","name":"Njx b1 sub mtrl hw fixj aug","description":"Injection(s), bone-substitute material for bone and/or soft tissue hardware fixation augmentation, including intraoperative imaging guidance, when performed","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0789T","name":"Elec aly cpx iins sp/sac nrv","description":"Electronic analysis with complex programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detect","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28665","name":"Treat toe dislocation","description":"Closed treatment of interphalangeal joint dislocation; requiring anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0758T","name":"Dgtz gls mcrscp sl spc hchem","description":"Digitization of glass microscope slides for special stain, including interpretation and report, histochemical stain on frozen tissue block (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9049","name":"Inj, bortezomib, hospira","description":"Injection, bortezomib (hospira), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0552U","name":"Repr med pga gdo te bx locus","description":"Repr med pga gdo te bx locus","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1288","name":"Doc rsn no hbp scrn or f/u","description":"Documented reason for not screening or recommending a follow-up for high blood pressure","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0726T","name":"Rmvl implt vstibular dev uni","description":"Removal of implanted vestibular device, unilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99202","name":"Office o/p new sf 15 min","description":"Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 15 minutes must be met or exceede","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":45.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4409","name":"Amniomatrixf3x per sq cm","description":"Amniomatrixf3x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0677T","name":"Laps repos lead isdss 1st ld","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first repositioned lead","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4304","name":"Grafix plus, per sq cm","description":"Grafix plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22836","name":"Ant thrc vrt body tethrg <7","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; up to 7 vertebral segments","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1006T","name":"Elec alys s-scl eeg prgrm ea","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, each additional 15 minutes face-to-face time with physician or other qua","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75577","name":"Quan&char c athrosclrtc plaq","description":"Quantification and characterization of coronary atherosclerotic plaque to assess severity of coronary disease, derived from augmentative software analysis of the data set from a coronary computed tomographic angiography, with interpretation and report by a physician or other qualified health care pr","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5914","name":"Auricular prosthesis","description":"Auricular prosthesis","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1199","name":"Pt recg rrt","description":"Patients receiving rrt","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"Basic vestibular evaluation","description":"Basic vestibular evaluation, includes spontaneous nystagmus test with eccentric gaze fixation nystagmus, with recording, positional nystagmus test, minimum of 4 positions, with recording, optokinetic nystagmus test, bidirectional foveal and peripheral stimulation, with recording, and oscillating tra","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6555","name":"G com stcking bk 40+ custm","description":"Gradient compression stocking, below knee, 40 mmhg or greater, custom, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0276U","name":"Hem inh thrombocytopenia 23","description":"Hematology (inherited thrombocytopenia), genomic sequence analysis of 23 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71045","name":"X-ray exam chest 1 view","description":"Radiologic examination, chest; single view","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4350","name":"Palisade dm matrix per sq cm","description":"Palisade dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1370","name":"Inj, esomeprazole sod, 1 mg","description":"Injection, esomeprazole sodium, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86826","name":"Hla x-match noncytotoxc addl","description":"Human leukocyte antigen (hla) crossmatch, non-cytotoxic (eg, using flow cytometry); each additional serum sample or sample dilution (list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0880T","name":"Augmnt alys ch ct ild i&r","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1240","name":"Pt no resp best int","description":"Patient did not respond to the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78593","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69210","name":"Remove impacted ear wax uni","description":"Removal impacted cerumen requiring instrumentation, unilateral","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1348","name":"Pam incr 6 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 6-points in a 4 to 12 month period (excellent)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0921T","name":"Rmvl perm ccm-d sys 1 dfb ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous defibrillation lead only","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55860","name":"Surgical exposure prostate","description":"Exposure of prostate, any approach, for insertion of radioactive substance;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":955.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98984","name":"Rtm dev sply resp sys 2-15 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of respiratory system, 2-15 days in a 30-day period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4318","name":"Fem urinary cup w/wo attch","description":"Female external urinary collection cup, with or without ring attachment, per day","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26426","name":"Repair finger/hand tendon","description":"Repair of extensor tendon, central slip, secondary (eg, boutonniere deformity); using local tissue(s), including lateral band(s), each finger","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":940.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9996","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2544","name":"Dental onlay metl 4/more sur","description":"Onlay - metallic - four or more surfaces","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27713","name":"Osteot tibia imed lngth dev","description":"Osteotomy(ies), tibia, including fibula when performed, unilateral, with insertion of an externally controlled intramedullary lengthening device, including imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1362","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9063","name":"Inj, elahere, 1 mg","description":"Injection, mirvetuximab soravtansine-gynx, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01941","name":"Anes neuromd/ntrvrt crv/thrc","description":"Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J1470","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1426","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1272","name":"Pts kid transplt wtlst","description":"Patients observed on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1173","name":"Pt no rec td/tdap 9yrs prior","description":"Patient did not receive at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34712","name":"Tcat dlvr enhncd fixj dev","description":"Transcatheter delivery of enhanced fixation device(s) to the endograft (eg, anchor, screw, tack) and all associated radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2037","name":"G4derm plus/suprello, pr ml","description":"G4derm plus/suprello, per milliliter","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99415","name":"Prolng clin staff svc 1st hr","description":"Prolonged clinical staff service (the service beyond the highest time in the range of total time of the service) during an evaluation and management service in the office or outpatient setting, direct patient contact with physician supervision; first hour (list separately in addition to code for out","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1184","name":"Doc med rsn no cst/ist rx","description":"Documentation of medical reason(s) for not prescribing or administering corticosteroid or immunosuppressant treatment (e.g., allergy, intolerance, infectious etiology, pancreatic insufficiency, hyperthyroidism, prior bowel surgical interventions, celiac disease, receiving other medication, awaiting ","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41822","name":"Excision of gum lesion","description":"Excision of fibrous tuberosities, dentoalveolar structures","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88372","name":"Protein analysis w/probe","description":"Protein analysis of tissue by western blot, with interpretation and report; immunological probe for band identification, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88237","name":"Tissue culture bone marrow","description":"Tissue culture for neoplastic disorders; bone marrow, blood cells","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7295","name":"Eth estr and eton monthly","description":"Ethinyl estradiol and etonogestrel 0.015mg, 0.12mg per 24 hours; monthly vaginal ring, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0431U","name":"Gly rcptr alpha1 igg srm/csf","description":"Gly rcptr alpha1 igg srm/csf","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0517","name":"Remove drug implant","description":"Removal of non-biodegradable drug delivery implants, 4 or more (services for subdermal implants)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":111.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0304U","name":"Hem rbc ads whl bld normoxic","description":"Hem rbc ads whl bld normoxic","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9129","name":"Photobio therpy-sub 15 mins","description":"Photobio therpy-sub 15 mins","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4030","name":"Pulmonology ss","description":"Pulmonology mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0285U","name":"Onc rsps radj cll fr dna tox","description":"Onc rsps radj cll fr dna tox","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4309","name":"Via matrix, per sq cm","description":"Via matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3404","name":"Inj zopapogene per ther dose","description":"Injection, zopapogene imadenovec-drba suspension, per therapeutic dose","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1459","name":"Pt hosp/pal care dur perf pd","description":"Patient was in hospice or receiving palliative care services at any time during the performance period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0466","name":"Home vent non-invasive inter","description":"Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0618","name":"Inj, calcium chloride, 2 mg","description":"Injection, calcium chloride, 2 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5657","name":"Add low ext man aut vol any","description":"Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4380","name":"Advograft one per sq cm","description":"Advograft one, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1222","name":"Glaucoma pln of care not doc","description":"Glaucoma plan of care not documented, reason not otherwise specified","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0524U","name":"Ob pe sflt-1/plgf ia srm/pls","description":"Ob pe sflt-1/plgf ia srm/pls","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0762T","name":"Dgtz gls mcrscp sl imm ea m","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, each multiplex antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0766T","name":"Tc mag stimj pn 1st nerve","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; first nerve","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6602","name":"Cst hgh nble mtl inlay 2 srf","description":"Inlay - cast high noble metal two surfaces","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1371","name":"Mst rec gsa<7","description":"Most recent glycemic status assessment (hba1c or gmi) level < 7.0%","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5157","name":"Inj, denosumab-bmwo, 1 mg","description":"Injection, denosumab-bmwo (stoboclo/osenvelt), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5159","name":"Inj, denosumab-dssb, 1 mg","description":"Injection, denosumab-dssb (ospomyv/xbryk), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76015","name":"Mr sfty mplt&/fb asmt stf ea","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86747","name":"Parvovirus antibody","description":"Antibody; parvovirus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2542","name":"Dental onlay metallic 2 surf","description":"Onlay-metallic-two surfaces","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1170","name":"Pt w/o flu vax 7/1-6/30","description":"Patient did not receive an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35700","name":"Reoperation bypass graft","description":"Reoperation, femoral-popliteal or femoral (popliteal)-anterior tibial, posterior tibial, peroneal artery, or other distal vessels, more than 1 month after original operation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4241","name":"Gngvl flap w rootplan 1-3 th","description":"Gingival flap procedure including root planing - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2405","name":"Ondansetron hcl injection","description":"Injection, ondansetron hydrochloride, per 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31579","name":"Laryngoscopy telescopic","description":"Laryngoscopy, flexible or rigid telescopic, with stroboscopy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59400","name":"Obstetrical care","description":"Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2078.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91322","name":"Sarscov2 vac 50 mcg/0.5ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 50 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5948","name":"Max implt sup fix part","description":"Max implt sup fix part","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87494","name":"Chlmy trch&neisra gonor mult","description":"Infectious agent detection by nucleic acid (dna or rna); chlamydia trachomatis and neisseria gonorrhoeae, multiplex amplified probe technique","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0577","name":"Inj, brixadi, 7 days or less","description":"Injection, buprenorphine extended-release (brixadi), less than or equal to 7 days of therapy","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4029","name":"Preventive medicine ss","description":"Preventive medicine mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0331U","name":"Onc hl neo opt gen mapping","description":"Onc hl neo opt gen mapping","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0593U","name":"Nfct ds gu pthgn dna 46trgt","description":"Nfct ds gu pthgn dna 46trgt","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4314","name":"Reeva, per sq cm","description":"Reeva ft, per square cenitmeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99231","name":"Sbsq hosp ip/obs sf/low 25","description":"Subsequent hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward or low level of medical decision making. when using total time on the date of the encounter for code selec","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15017","name":"App skn cll ssp f/n/g/hf 1st","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 480 sq cm or less","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0771T","name":"Vr px dissoc svc sm phy 1st","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0733T","name":"Rem r-t mtn nrehab ther sply","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; supply and technical support, per 30 days","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9292","name":"Inj, pemetrexed dipotassium","description":"Injection, pemetrexed dipotassium, 10 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1296","name":"Calc bmi norm parameters","description":"Bmi is documented within normal parameters and no follow-up plan is required","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1361","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1419","name":"Pt not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0747T","name":"Car ablt rad arrhyt dlvr rad","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; delivery of radiation therapy, arrhythmia","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93320","name":"Doppler echo complete","description":"Doppler echocardiography, pulsed wave and/or continuous wave with spectral display (list separately in addition to codes for echocardiographic imaging); complete","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81002","name":"Urinalysis nonauto w/o scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; non-automated, without microscopy","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2403","name":"Chloroprocaine opht gel, 1mg","description":"Chloroprocaine hcl ophthalmic, 3% gel, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4271","name":"Complete ft per sq cm","description":"Complete ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7023","name":"Mech allergen parti barrier","description":"Mechanical allergen particle barrier/inhalation filter, cream, nasal, topical","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1331","name":"Pts eval ini xm 8 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 8 weeks from initial exam","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1176","name":"No 2 hzv 10/2017-meas pd","description":"Patient did not receive two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0963T","name":"Anosc sbmcsl njx bulking agt","description":"Anoscopy with directed submucosal injection of bulking agent into anal canal","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0275U","name":"Hem heprn nduc trmbctpna srm","description":"Hematology (heparin-induced thrombocytopenia) platelet antibody reactivity by flow cytometry, serum","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4321","name":"Renograft, per sq cm","description":"Renograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G3003","name":"Chronic pain mgmt addl 15m","description":"Each additional 15 minutes of chronic pain management and treatment by a physician or other qualified health care professional, per calendar month. (list separately in addition to code for g3002. when using g3003, 15 minutes must be met or exceeded.)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37258","name":"Revsc evasc ivt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0763T","name":"Dgtz gls mcrscp mphmtrc alys","description":"Digitization of glass microscope slides for morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure, manual (list separately in addition to code for primary proced","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33684","name":"Clsr 1 vsd w/wo patch w/vlvt","description":"Closure of single ventricular septal defect, with or without patch; with pulmonary valvotomy or infundibular resection (acyanotic)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2077.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1471","name":"Ffs hep b not covered","description":"Documentation that patient is a medicare fee-for-service beneficiary and without additional supplementary insurance coverage for whom hep b vaccination is not reimbursable under current medicare part b coverage rules","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55867","name":"Laps surg prst8ect smpl stot","description":"Laparoscopy, surgical prostatectomy, simple subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy), includes robotic assistance, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0833T","name":"Dgtz gls mcrscp cytp oth prp","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; preparation, screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61584","name":"Orbitocranial approach/skull","description":"Orbitocranial approach to anterior cranial fossa, extradural, including supraorbital ridge osteotomy and elevation of frontal and/or temporal lobe(s); without orbital exenteration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3086.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0874T","name":"Rmvl pertl ascites pmp sys","description":"Removal of a peritoneal ascites pump system, including implanted peritoneal ascites pump and indwelling bladder and peritoneal catheters","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1932","name":"Inj, lanreotide, (cipla) 1mg","description":"Injection, lanreotide, (cipla), 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31805","name":"Repair of windpipe injury","description":"Suture of tracheal wound or injury; intrathoracic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":995.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0165","name":"Inj epinephrine nos 0.1 mg","description":"Injection, epinephrine, not otherwise specified, 0.1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0402","name":"Inj, abilify asimtufii, 1 mg","description":"Injection, aripiprazole (abilify asimtufii), 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9071","name":"Inj cyclophosphamd auromedic","description":"Injection, cyclophosphamide (auromedics), 5 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1483","name":"Neg quan hep c or qual rna","description":"Patients who achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72198","name":"Mr angio pelvis w/o & w/dye","description":"Magnetic resonance angiography, pelvis, with or without contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":683.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0788T","name":"Elec aly smp iins sp/sac nrv","description":"Electronic analysis with simple programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detecti","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1265.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99397","name":"Per pm reeval est pat 65+ yr","description":"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 65 ye","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":94.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0662","name":"Team remote e/m new pt 30 mn","description":"Team remote e/m new pt 30 mins","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0462U","name":"Melatonin lvl tst slp std7/9","description":"Melatonin lvl tst slp std7/9","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4295","name":"Amnio tri-core, per sq cm","description":"Amnio tri-core amniotic, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49593","name":"Rpr aa hrn 1st 3-10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, reducible","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1396","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9948","name":"Adjust sleep apnea appliance","description":"Adjust sleep apnea appliance","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15920","name":"Exc coccygl pr ulc prim sutr","description":"Excision, coccygeal pressure ulcer, with coccygectomy; with primary suture","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1781","name":"Vac admin human pap dose 1","description":"Vac admin human pap dose 1","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85041","name":"Automated rbc count","description":"Blood count; red blood cell (rbc), automated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":3.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58291","name":"Vag hyst incl t/o complex","description":"Vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1475.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85018","name":"Hemoglobin","description":"Blood count; hemoglobin (hgb)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37299","name":"Revsc evsc imvt angio cpx ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0412U","name":"Beta amyloid ab42/40 imprcip","description":"Beta amyloid ab42/40 imprcip","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64657","name":"Rmvl bat modulj sys tot sys","description":"Removal of baroreflex activation therapy (bat) modulation system; total system, including lead and pulse generator","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0858T","name":"Ext trnscranl mag stimj meas","description":"Externally applied transcranial magnetic stimulation with concomitant measurement of evoked cortical potentials with automated report","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0326U","name":"Trgt gen seq alys pnl 83+","description":"Trgt gen seq alys pnl 83+","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38228","name":"Car-t admn autologous","description":"Chimeric antigen receptor t-cell (car-t) therapy; car-t cell administration, autologous","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87084","name":"Culture of specimen by kit","description":"Culture, presumptive, pathogenic organisms, screening only; with colony estimation from density chart","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69120","name":"Removal of external ear","description":"Excision external ear; complete amputation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4339","name":"Artacent vericlen, per sq cm","description":"Artacent vericlen, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0938T","name":"Xtrnl ecg rec>15d<30d rec","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; recording (including connection and initial recording)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52284","name":"Cysto rx balo cath urtl strx","description":"Cystourethroscopy, with mechanical urethral dilation and urethral therapeutic drug delivery by drug-coated balloon catheter for urethral stricture or stenosis, male, including fluoroscopy, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4427","name":"Dermbnd dln dl+ dlx sq cm","description":"Dermabind dl n or dermabind dl + or dermabind dl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0749T","name":"B1 str&fx rsk assmt dxr-bmd","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5158","name":"Inj, denosumab-bnht, 1 mg","description":"Injection, denosumab-bnht (bomyntra/conexxence), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9999","name":"Doc sys rsn <3 colon","description":"Documentation of system reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., unable to locate previous colonoscopy report, patient cannot provide precise date or details from previous colonoscopy, previous colonoscopy report was incomplete)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98015","name":"Synch audio-only est high 40","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selec","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87478","name":"Borrelia miyamotoi amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); borrelia miyamotoi, amplified probe technique","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81003","name":"Urinalysis auto w/o scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; automated, without microscopy","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5160","name":"Inj, jobevne, 10 mg","description":"Injection, bevacizumab-nwgd (jobevne), biosimilar, 10 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0882T","name":"Intraop ther estim pn ue 1st","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; initial nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0701T","name":"Molec fluor img sus nev ea","description":"Molecular fluorescent imaging of suspicious nevus; each additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0286U","name":"Cep72 nudt15&tpmt gene alys","description":"Cep72 nudt15&tpmt gene alys","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0680","name":"Cr art clc art vlv clc w rpt","description":"Detection and quantification of coronary artery calcium and/or aortic valve calcification from algorithmic analysis of computed tomography of the chest with report","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1414","name":"Med rsn no pdl1 bef 1st ther","description":"Documentation of medical reason(s) for not performing the pd-l1 biomarker expression test prior to initiation of first-line immune checkpoint inhibitor therapy (e.g., patient is in an urgent or emergent situation where delay of treatment would jeopardize the patients health status; other medical rea","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9184","name":"Inj gemcitabin (avyxa) 200mg","description":"Injection, gemcitabine hydrochloride (avyxa), 200 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4400","name":"Polygon3 per sq cm","description":"Polygon3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0515U","name":"Gi ibd ia quan deter ifx lvl","description":"Gi ibd ia quan deter ifx lvl","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85041","name":"Automated rbc count","description":"Blood count; red blood cell (rbc), automated","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0439U","name":"Crd chd dna alys 5 snp 3 dna","description":"Crd chd dna alys 5 snp 3 dna","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0879","name":"Difelikefalin, esrd on dialy","description":"Injection, difelikefalin, 0.1 microgram, (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38225","name":"Car-t hrv bld-drv t lymphcyt","description":"Chimeric antigen receptor t-cell (car-t) therapy; harvesting of blood-derived t lymphocytes for development of genetically modified autologous car-t cells, per day","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86041","name":"Acetylcholn rcptr bndng antb","description":"Acetylcholine receptor (achr); binding antibody","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2034","name":"Found drs solo, per sq cm","description":"Foundation drs solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2031","name":"Mirodry, per sq cm","description":"Mirodry wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0473U","name":"Onc sld tum bld/slv 648 gene","description":"Onc sld tum bld/slv 648 gene","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19318","name":"Breast reduction","description":"Breast reduction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1356.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33882","name":"Evasc rpr ta dplmt mltpc sys","description":"Endovascular repair of the thoracic aorta by deployment of a branched endograft multipiece system involving an aorto-aortic tube device with a fenestration for the left subclavian artery stent graft(s) and all aortic tube endograft extension(s) placed from the level of the left common carotid artery","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0166","name":"Inj epinephrine (bpi)","description":"Injection, epinephrine (bpi), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0109","name":"Diab manage trn ind/group","description":"Diabetes outpatient self-management training services, group session (2 or more), per 30 minutes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6214","name":"Pontic titanium","description":"Pontic - titanium","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2008","name":"Theragenesis, per sq cm","description":"Theragenesis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4319","name":"Sanograft, per sq cm","description":"Sanograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0388","name":"Bitewing image capture only","description":"Bitewing image capture only","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26705","name":"Treat knuckle dislocation","description":"Closed treatment of metacarpophalangeal dislocation, single, with manipulation; requiring anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":415.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1387","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5422","name":"Dentures adjust part mandbl","description":"Adjust partial denture - mandibular","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2598","name":"Inj, vasopressin, 1 unit","description":"Injection, vasopressin, 1 unit","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31090","name":"Exploration of sinuses","description":"Sinusotomy, unilateral, 3 or more paranasal sinuses (frontal, maxillary, ethmoid, sphenoid)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1047.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37236","name":"Open/perq place stent 1st","description":"Transcatheter placement of an intravascular stent(s) (except lower extremity artery(s) for occlusive disease, cervical carotid, extracranial vertebral or intrathoracic carotid, intracranial, or coronary), open or percutaneous, including radiological supervision and interpretation and including all a","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3134.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9609","name":"F18 fdg, 15 millicuries","description":"Fludeoxyglucose f18 up to 15 millicuries","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1285","name":"Scrn mam perf rslts not doc","description":"Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed, reason not otherwise specified","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49189","name":"Opn exc/dst ntra-abd 20.1-30","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 20.1 to 30 cm","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70310","name":"X-ray exam of teeth","description":"Radiologic examination, teeth; partial examination, less than full mouth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9184","name":"Inj gemcitabin (avyxa) 200mg","description":"Injection, gemcitabine hydrochloride (avyxa), 200 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9255","name":"Inj, methotrexate (accord)","description":"Injection, methotrexate (accord), not therapeutically equivalent to j9260, 50 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0977T","name":"Upr gi bld detcj snr capsule","description":"Upper gastrointestinal blood detection, sensor capsule, with interpretation and report","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67345","name":"Destroy nerve of eye muscle","description":"Chemodenervation of extraocular muscle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0779T","name":"Gi myoelectrical actv study","description":"Gastrointestinal myoelectrical activity study, stomach through colon, with interpretation and report","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11301","name":"Shave skin lesion 0.6-1.0 cm","description":"Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion diameter 0.6 to 1.0 cm","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":44.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1258","name":"Cvd risk assess perf","description":"Cvd risk assessment performed, have a documented calculated risk score","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0319U","name":"Neph rna pretrnspl perph bld","description":"Neph rna pretrnspl perph bld","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97755","name":"Assistive technology assess","description":"Assistive technology assessment (eg, to restore, augment or compensate for existing function, optimize functional tasks and/or maximize environmental accessibility), direct one-on-one contact, with written report, each 15 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76988","name":"Dx ntrop epcr us chd img acq","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; placement, manipulation of transducer, and image acquisition only","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76988","name":"Dx ntrop epcr us chd img acq","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; placement, manipulation of transducer, and image acquisition only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1369","name":"Qualcare mental hlth/sud mvp","description":"Quality care in mental health and substance use disorders mips value pathway","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9936","name":"Clean occ guard","description":"Clean occ guard","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87183","name":"Sc std carbapenem resist gen","description":"Susceptibility studies, antimicrobial agent; carbapenem resistance genes (eg, blakpc, blandm, blavim, blaoxa-48, blaimp), amplified probe technique, per isolate","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0374","name":"Tomo periapical image","description":"Tomo periapical image","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3379","name":"Inj, valproate sod, 5 mg","description":"Injection, valproate sodium, 5 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1199","name":"Pt recg rrt","description":"Patients receiving rrt","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0972T","name":"Asstv alg clsfctn burn hlg","description":"Assistive algorithmic classification of burn healing (ie, healing or nonhealing) by noninvasive multispectral imaging, including system set-up and acquisition, selection, and transmission of images, with automated generation of report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1783","name":"Vac admin human pap dose 3","description":"Vac admin human pap dose 3","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3431","name":"Biological materials","description":"Biological materials","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0667","name":"Team remote e/m est pt 25 mn","description":"Team remote e/m est. pt 25mins","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55708","name":"Bx prst8 trct us w/mri fus 1","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant) with mri-fusion-guidance, first targeted lesion","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0702","name":"2d cephal radio image","description":"2d cephal radio image","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5827","name":"Endo knee shin single axis","description":"Endoskeletal knee-shin system, single axis, electromechanical swing and stance phase control, with or without shock absorption and stance extension damping","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93793","name":"Anticoag mgmt pt warfarin","description":"Anticoagulant management for a patient taking warfarin, must include review and interpretation of a new home, office, or lab international normalized ratio (inr) test result, patient instructions, dosage adjustment (as needed), and scheduling of additional test(s), when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6092","name":"Recement supp crown","description":"Recement implant/abutment supported crown","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0317U","name":"Onc lung ca 4-prb fish assay","description":"Onc lung ca 4-prb fish assay","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9274","name":"Inj, tebentafusp-tebn, 1 mcg","description":"Injection, tebentafusp-tebn, 1 microgram","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22838","name":"Rev rplc/rmv thrc vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracic vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80220","name":"Drug asy hydroxychloroquine","description":"Hydroxychloroquine","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33902","name":"Perq p-art revsc 1 abnor uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, unilateral","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9246","name":"Mod sedation noniv-15 min","description":"Mod sedation noniv-15 min","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0435U","name":"Onc chemo rx cytox csc 14 rx","description":"Onc chemo rx cytox csc 14 rx","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1163","name":"Pt anphx due to hpv bef 13","description":"Patient had anaphylaxis due to the hpv vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0611U","name":"Onc lvr alys >1000 mr cfdna","description":"Onc lvr alys >1000 mr cfdna","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24102","name":"Arthrt elbow w/synovectomy","description":"Arthrotomy, elbow; with synovectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":737.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0965T","name":"I&cst prp jw xpn dl arch non","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, non-fixed hinge mechanism","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92622","name":"Dx aly aud oi snd prcsr 1st","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; first 60 minutes","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6251","name":"Bridge resin base metal","description":"Pontic-resin with predominantly base metal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4025","name":"Physical medicine ss","description":"Physical medicine mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26320","name":"Removal of implant from hand","description":"Removal of implant from finger or hand","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":405.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37145","name":"Revision of circulation","description":"Venous anastomosis, open; renoportal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1725.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9997","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1202","name":"Pt rsn no ace-i/arb rx","description":"Documentation of patient reason(s) for not prescribing ace inhibitor or arb therapy during the measurement period, (e.g., patient declined, other patient reasons)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1282","name":"Pt scrn tbco id as non user","description":"Patient screened for tobacco use and identified as a tobacco non-user","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90839","name":"Psytx crisis initial 60 min","description":"Psychotherapy for crisis; first 60 minutes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":175.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85013","name":"Spun microhematocrit","description":"Blood count; spun microhematocrit","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9063","name":"Inj, elahere, 1 mg","description":"Injection, mirvetuximab soravtansine-gynx, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0964T","name":"I&cust prep jaw xpnsj 1arch","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; single arch, without mandibular advancement mechanism","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP18","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1737","name":"Inj meloxicam (azurity) 1mg","description":"Injection, meloxicam (azurity), 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33370","name":"Tcat plmt&rmvl cepd perq","description":"Transcatheter placement and subsequent removal of cerebral embolic protection device(s), including arterial access, catheterization, imaging, and radiological supervision and interpretation, percutaneous (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":76.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0438U","name":"Rx metab advrs vrnt alys 33","description":"Rx metab advrs vrnt alys 33","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1376","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6035","name":"Prosthetic digit mechanical","description":"Single prosthetic digit, mechanical, can include metacarpophalangeal (mcp), proximal interphalangeal (pip), and/or distal interphalangeal (dip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2791","name":"Crown full cast base metal","description":"Crown-full cast predominantly base metal","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0555U","name":"Repr med pga embryonic te qc","description":"Repr med pga embryonic te qc","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1250","name":"Pt resp true heard","description":"Patient responded as completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1319","name":"Pts csp doc contact","description":"Patients who had documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82164","name":"Angiotensin i enzyme test","description":"Angiotensin i - converting enzyme (ace)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2051","name":"Support broker waiver/diem","description":"Supports brokerage, self-directed, waiver; per diem","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1313","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7299","name":"Rem anchorage device w/flap","description":"Rem anchorage device w/flap","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6038","name":"Multiax rotation attachment","description":"Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4314","name":"Reeva, per sq cm","description":"Reeva ft, per square cenitmeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D8671","name":"Periodic orth treat w surg","description":"Periodic orth treat w surg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51721","name":"Ins trurl ablt trnsdc thr us","description":"Insertion of transurethral ablation transducer for delivery of thermal ultrasound for prostate tissue ablation, including suprapubic tube placement during the same session and placement of an endorectal cooling device, when performed","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97552","name":"Group caregiver training","description":"Group caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4211","name":"Gingivectomy/plasty per toot","description":"Gingivectomy or gingivoplasty - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9376","name":"Inj pozelimab-bbfg, 1 mg","description":"Injection, pozelimab-bbfg, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0250","name":"Adm tocilizu covid-19 2nd","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0804","name":"3d facial scan indirect","description":"3d facial scan indirect","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0419U","name":"Nrpsyc gen seq vrnt aly 13","description":"Nrpsyc gen seq vrnt aly 13","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83987","name":"Exhaled breath condensate","description":"Ph; exhaled breath condensate","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0680","name":"Cr art clc art vlv clc w rpt","description":"Detection and quantification of coronary artery calcium and/or aortic valve calcification from algorithmic analysis of computed tomography of the chest with report","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0387U","name":"Onc mlnma ambra1&amlo","description":"Onc mlnma ambra1&amlo","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5159","name":"Inj, denosumab-dssb, 1 mg","description":"Injection, denosumab-dssb (ospomyv/xbryk), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1164","name":"Pt w/ dementia any time","description":"Patients with dementia any time during the patients history through the end of the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0141","name":"Scr c/v cyto,autosys and md","description":"Screening cytopathology smears, cervical or vaginal, performed by automated system, with manual rescreening, requiring interpretation by physician","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4033","name":"Skilled nursing facility ss","description":"Skilled nursing facility mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4007","name":"General surgery ss","description":"General surgery mips specialty set","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0319U","name":"Neph rna pretrnspl perph bld","description":"Neph rna pretrnspl perph bld","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98002","name":"Synch audio-video new mod 45","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate medical decision making. when using total time on the date of the encounter for code selection, 45 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64728","name":"Dcmprn median nrv carpl tunl","description":"Decompression; median nerve at the carpal tunnel, percutaneous, with intracarpal tunnel balloon dilation, including ultrasound guidance","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0844T","name":"Dgtz gls mcrscp cslt cyt ea","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), each additional site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55709","name":"Bx prst8 tprnl us guided","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5940","name":"Resct proth max part remov","description":"Resct proth max part remov","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1335","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1225","name":"Iop dec>=20% from base","description":"Intraocular pressure (iop) reduced by a value of greater than or equal to 20% from the pre-intervention level","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7213","name":"Inj, ixinity, 1 i.u.","description":"Injection, coagulation factor ix (recombinant), ixinity, 1 i.u.","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0707","name":"Intraoral periap radio image","description":"Intraoral periap radio image","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76516","name":"Echo exam of eye","description":"Ophthalmic biometry by ultrasound echography, a-scan;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2357","name":"Omalizumab injection","description":"Injection, omalizumab, 5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83825","name":"Assay of mercury","description":"Mercury, quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6106","name":"Tissue regen resorbable","description":"Tissue regen resorbable","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0323","name":"Care manage beh svs 20mins","description":"Care management services for behavioral health conditions, at least 20 minutes of clinical psychologist, clinical social worker, mental health counselor, or marriage and family therapist time, per calendar month. (these services include the following required elements: initial assessment or follow-u","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42106","name":"Excision lesion mouth roof","description":"Excision, lesion of palate, uvula; with simple primary closure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2185","name":"Meropenem","description":"Injection, meropenem, 100 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82233","name":"Beta-amyloid 1-40 (abeta 40)","description":"Beta-amyloid; 1-40 (abeta 40)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2402","name":"Chloroprocaine (clorotekal)","description":"Injection, chloroprocaine hydrochloride (clorotekal), per 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1336","name":"Pts eval ini xm 2 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 2 weeks","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6049","name":"Scale implt peri-implt inflm","description":"Scale implt peri-implt inflm","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0543","name":"Group train w/o patient","description":"Group caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient pre","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51715","name":"Endoscopic injection/implant","description":"Endoscopic injection of implant material into the submucosal tissues of the urethra and/or bladder neck","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0667","name":"Team remote e/m est pt 25 mn","description":"Team remote e/m est. pt 25mins","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65420","name":"Removal of eye lesion","description":"Excision or transposition of pterygium; without graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":394.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4148","name":"Enteral feed elastomer daily","description":"Enteral feeding supply kit; elastomeric control fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81464","name":"So gsap cll fr mcrstl ins","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants, microsatellite instability, tumor mutation burden, and rearrangements","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4272","name":"Esano a, per sq cm","description":"Esano a, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43620","name":"Removal of stomach","description":"Gastrectomy, total; with esophagoenterostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2034.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0524","name":"Est pt-cg dyad dem low cmplx","description":"Management of established patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1163","name":"Pt anphx due to hpv bef 13","description":"Patient had anaphylaxis due to the hpv vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64584","name":"Rmvl hpglsl nstim ary pg","description":"Removal of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1714","name":"Pfizer vacc adm ped 2nd dose","description":"Pfizer vacc adm ped 2nd dose","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1391","name":"All pt dx w/ rec mlnm","description":"All patients who were diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9026","name":"Inj, tarlatamab-dlle, 1 mg","description":"Injection, tarlatamab-dlle, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37261","name":"Revsc evasc ivt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3393","name":"Inj, betibeglogene autotemce","description":"Injection, betibeglogene autotemcel, per treatment","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1187","name":"Pt w/ esrd","description":"Patients with a diagnosis of end stage renal disease (esrd)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5228","name":"Immed mand part denture","description":"Immed mand part denture","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9073","name":"Inj cyclophos dr reddys 5 mg","description":"Injection, cyclophosphamide (dr. reddys), 5 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26770","name":"Treat finger dislocation","description":"Closed treatment of interphalangeal joint dislocation, single, with manipulation; without anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3393","name":"Inj, betibeglogene autotemce","description":"Injection, betibeglogene autotemcel, per treatment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86581","name":"Strptcs pneum antb serot ia","description":"Streptococcus pneumoniae antibody (igg), serotypes, multiplex immunoassay, quantitative","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0316U","name":"B brgdrferi lyme ds ospa evl","description":"B brgdrferi lyme ds ospa evl","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0698T","name":"Quan mr tiss w/mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained with diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, target ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9277","name":"Pembrolizumab 1mg berahyalur","description":"Injection, pembrolizumab, 1 mg and berahyaluronidase alfa-pmph","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1302","name":"Scrn mam perf rslts doc","description":"Screening, diagnostic, film digital or digital breast tomosynthesis (3d) mammography results documented and reviewed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0012","name":"Injection of hiv prep drug","description":"Injection of pre-exposure prophylaxis (prep) drug for hiv prevention, under skin or into muscle","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4413","name":"Cygnus solo per sq cm","description":"Cygnus solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78267","name":"Urea breath tst c-14 acquisj","description":"Urea breath test, c-14 (isotopic); acquisition for analysis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0485U","name":"Onc sol tum cfdna&rna ngs gm","description":"Onc sol tum cfdna&rna ngs gm","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15787","name":"Abrasion lesions add-on","description":"Abrasion; each additional 4 lesions or less (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4388","name":"Neothelium 4l per sq cm","description":"Neothelium 4l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1381","name":"Pt sec strk wthin 5 days","description":"Patients with secondary stroke (e.g., a subsequent stroke that may occur with vasospasm in the setting of subarachnoid hemorrhage) within 5 days of the initial procedure","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1176","name":"No 2 hzv 10/2017-meas pd","description":"Patient did not receive two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62162","name":"Remove colloid cyst w/scope","description":"Neuroendoscopy, intracranial; with fenestration or excision of colloid cyst, including placement of external ventricular catheter for drainage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2120.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77081","name":"Dxa bone density appendiculr","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5127","name":"Inj, stimufend, 0.5 mg","description":"Injection, pegfilgrastim-fpgk (stimufend), biosimilar, 0.5 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0445U","name":"Abeta42 & ptau181 eclia csf","description":"Abeta42 & ptau181 eclia csf","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1806","name":"Inj esmolol hcl wg crit care","description":"Injection, esmolol hydrochloride (wg critical care), not therapeutically equivalent to j1805, 10 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62330","name":"Dcmprn prq rmv lig flv 1lmbr","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; one interspace, lumbar","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6584","name":"Grad com wrap w straps","description":"Gradient compression wrap with adjustable straps, not otherwise specified","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64596","name":"Ins/rplcmt prq eltrd ra pn 1","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; initial electrode array","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0861T","name":"Rmvl pg wcs lv both compnt","description":"Removal of pulse generator for wireless cardiac stimulator for left ventricular pacing; both components (battery and transmitter)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1809","name":"Inj, fosdenopterin, 0.1mg","description":"Injection, fosdenopterin, 0.1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0326U","name":"Trgt gen seq alys pnl 83+","description":"Trgt gen seq alys pnl 83+","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1169","name":"Doc med rsn no flu vax","description":"Documentation of medical reason(s) for not administering influenza vaccine (e.g., prior anaphylaxis due to the influenza vaccine)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1475","name":"Pt dx huntington","description":"Patients with diagnosis of huntingtons disease","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2038","name":"Skill train and dev/diem","description":"Skills training and development, per diem","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2021","name":"Neomatrix per sq cm","description":"Neomatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76377","name":"3d render w/intrp postproces","description":"3d rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality with image postprocessing under concurrent supervision; requiring image postprocessing on an independent workstation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91321","name":"Sarscov2 vac 25 mcg/.25ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 25 mcg/0.25 ml dosage, for intramuscular use","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3374","name":"Inj, vancomycin (mylan) 10mg","description":"Injection, vancomycin hydrochloride (mylan) not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0042","name":"Ref to therapy","description":"Referral to physical, occupational, speech, or recreational therapy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9959","name":"Unspec sleep ap proc","description":"Unspec sleep ap proc","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35602","name":"Bpg crtd-clat crtd","description":"Bypass graft, with other than vein; carotid-contralateral carotid","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71045","name":"X-ray exam chest 1 view","description":"Radiologic examination, chest; single view","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0932T","name":"N-invs det hrt fail aug echo","description":"Noninvasive detection of heart failure derived from augmentative analysis of an echocardiogram that demonstrated preserved ejection fraction, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1480","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76818","name":"Fetal biophys profile w/nst","description":"Fetal biophysical profile; with non-stress testing","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7259","name":"Nerve dissection","description":"Nerve dissection","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47550","name":"Bile duct endoscopy add-on","description":"Biliary endoscopy, intraoperative (choledochoscopy) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0423","name":"Genetic test spec analysis","description":"Genetic test spec analysis","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6038","name":"Multiax rotation attachment","description":"Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1162","name":"Digoxin immune fab (ovine)","description":"Injection, digoxin immune fab (ovine), per vial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":540.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0926T","name":"Prgrmg dev eval ccm-d ip","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, including review and report, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0740T","name":"Rem auton alg nsln cal setup","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; initial set-up and patient education","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0513U","name":"Onc prst8 alg alys msi&hrd","description":"Onc prst8 alg alys msi&hrd","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0626U","name":"Neurol pd dna alys >20000","description":"Neurol pd dna alys >20000","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4426","name":"Dermbnd tl+, tlx per sq cm","description":"Dermabind tl + or dermabind tl x,  per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59076","name":"Fetal shunt placement w/us","description":"Fetal shunt placement, including ultrasound guidance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99425","name":"Prin care mgmt phys ea addl","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4380","name":"Advograft one per sq cm","description":"Advograft one, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2642","name":"Dental onlay porcelin 2 surf","description":"Onlay - porcelain/ceramic - two surfaces","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5947","name":"Mand implt sup fix","description":"Mand implt sup fix","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0821T","name":"Mntr psychdlc med 2ndphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; second physician or other qualified health care professional, concurrent with first physician or other qualified health care professional, each hour (list sepa","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5914","name":"Auricular prosthesis","description":"Auricular prosthesis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"3075F","name":"Syst bp ge 130 - 139mm hg","description":"Most recent systolic blood pressure 130-139 mm hg (dm) (htn, ckd, cad)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44121","name":"Removal of small intestine","description":"Enterectomy, resection of small intestine; each additional resection and anastomosis (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":289.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0778T","name":"Smmg cncrnt appl imu snr","description":"Surface mechanomyography (smmg) with concurrent application of inertial measurement unit (imu) sensors for measurement of multi-joint range of motion, posture, gait, and muscle function","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26412","name":"Repair/graft hand tendon","description":"Repair, extensor tendon, hand, primary or secondary; with free graft (includes obtaining graft), each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":954.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0995T","name":"Evasc dlvr a-wal stbl rx opn","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; open","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30450","name":"Revision of nose","description":"Rhinoplasty, secondary; major revision (nasal tip work and osteotomies)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1928.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37278","name":"Rvsc evsc fpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44405","name":"Colonoscopy w/dilation","description":"Colonoscopy through stoma; with transendoscopic balloon dilation","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":708.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0041","name":"Pt/ptn decln referral","description":"Patient and/or care partner decline referral","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2356","name":"Inj tezepelumab-ekko, 1mg","description":"Injection, tezepelumab-ekko, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0238","name":"Intrav inf, toci, second dos","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0422U","name":"Onc pan solid tum alys dna","description":"Onc pan solid tum alys dna","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0474","name":"Micro w exam of surg margins","description":"Accession of tissue gross and microscopic examination including assessment of surgical margins for presence of disease preparation and transmission of writte","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4241","name":"Gngvl flap w rootplan 1-3 th","description":"Gingival flap procedure including root planing - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0900T","name":"N-invas est aqmbf asstv cmr","description":"Noninvasive estimate of absolute quantitation of myocardial blood flow (aqmbf), derived from assistive algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health care profes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62331","name":"Dcmprn prq rmv lig flv addl","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; additional interspace(s), lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98000","name":"Synch audio-video new sf 15","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 15 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"Evoked auditory test limited","description":"Distortion product evoked otoacoustic emissions; limited evaluation (to confirm the presence or absence of hearing disorder, 3-6 frequencies) or transient evoked otoacoustic emissions, with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1319","name":"Pts csp doc contact","description":"Patients who had documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1411","name":"1st ln ici no chemo","description":"Currently on first-line immune checkpoint inhibitors without chemotherapy","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0841T","name":"Dgtz gls mcrscp pth cslt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; first tissue block, with frozen section(s), single specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0948T","name":"Rem interrog dev ccm phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system with interim analysis, review, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66989","name":"Xcpsl ctrc rmvl cplx insj 1+","description":"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification), complex, requiring devices or techniques not generally used in routine cataract surgery (eg, iris expansion device,","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1461","name":"Pt dx chron hepc","description":"Patient diagnosis for chronic hepatitis c","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82681","name":"Assay dir meas fr estradiol","description":"Estradiol; free, direct measurement (eg, equilibrium dialysis)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6253","name":"Provisional pontic","description":"Provisional pontic","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66740","name":"Destruction ciliary body","description":"Ciliary body destruction; cyclodialysis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":397.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0708","name":"Intraoral bite radio image","description":"Intraoral bite radio image","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0672T","name":"Ndovag cryg rf remdl tiss","description":"Endovaginal cryogen-cooled, monopolar radiofrequency remodeling of the tissues surrounding the female bladder neck and proximal urethra for urinary incontinence","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0382U","name":"Hyprphenylalninmia mntr quan","description":"Hyprphenylalninmia mntr quan","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63020","name":"Lamot dcmprn nrv rt 1 cerv","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, cervical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1301.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6559","name":"G stckng full/chap18-30 cust","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9064","name":"Inj, cabazitaxel (sandoz)","description":"Injection, cabazitaxel (sandoz), not therapeutically equivalent to j9043, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43217","name":"Esophagoscopy snare les remv","description":"Esophagoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1401","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4289","name":"Revoshield+ amnio, per sq cm","description":"Revoshield + amniotic barrier, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84431","name":"Thromboxane urine","description":"Thromboxane metabolite(s), including thromboxane if performed, urine","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1653","name":"Ho abduction static ots","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, off the shelf","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":427.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4322","name":"Caregraft, per sq cm","description":"Caregraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99195","name":"Phlebotomy","description":"Phlebotomy, therapeutic (separate procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69610","name":"Tympanic membrane repair","description":"Tympanic membrane repair, with or without site preparation of perforation for closure, with or without patch","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33509","name":"Ndsc hrv uxtr art 1 sgm cab","description":"Harvest of upper extremity artery, 1 segment, for coronary artery bypass procedure, endoscopic","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4027","name":"Plastic surgery ss","description":"Plastic surgery mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11421","name":"Exc h-f-nk-sp b9+marg 0.6-1","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 0.6 to 1.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1224","name":"Iop dec <20% from base","description":"Intraocular pressure (iop) reduced by a value less than 20% from the pre-intervention level","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1491","name":"Recd esrd mcp dur perf pd","description":"Receiving esrd mcp dialysis services by the provider during the performance period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0902T","name":"Qtc ntrvl augmnt alg aly ecg","description":"Qtc interval derived by augmentative algorithmic analysis of input from an external, patient-activated mobile ecg device","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35490","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":721.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2004","name":"Inj, lidocaine w epinephrine","description":"Injection, lidocaine hcl with epinephrine, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42725","name":"I&d absc phrngl xtrnl appr","description":"Incision and drainage abscess; retropharyngeal or parapharyngeal, external approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":889.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6609","name":"G compression bandaging","description":"Gradient compression bandaging supply, not otherwise specified","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0898T","name":"N-invas prst8 cancer est map","description":"Noninvasive prostate cancer estimation map, derived from augmentative analysis of image-guided fusion biopsy and pathology, including visualization of margin volume and location, with margin determination and physician interpretation and report","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33517","name":"Cabg artery-vein single","description":"Coronary artery bypass, using venous graft(s) and arterial graft(s); single vein graft (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98009","name":"Synch audio-only new low 30","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 30 m","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9220","name":"Indigotindisulfonate sod 1mg","description":"Injection, indigotindisulfonate sodium, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93569","name":"Njx cth slct p-art angrp uni","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4038","name":"Vascular surgery ss","description":"Vascular surgery mips specialty set","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50845","name":"Appendico-vesicostomy","description":"Cutaneous appendico-vesicostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1368.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0765T","name":"Asstv alg ecg rsk asmt prev","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to previously performed electrocardiogram","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0766","name":"Elec stim cancer treatment","description":"Electrical stimulation device used for cancer treatment, includes all accessories, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16384.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37262","name":"Iv lithotrp ivt w/in sm art","description":"Intravascular lithotripsy(ies), iliac vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0053","name":"Ht mental health and care","description":"Historical trauma (ht) mental health and clinical care for indigenous persons","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1233","name":"Pt no hcv aby or result","description":"Patient does not receive hcv antibody test or patient does receive hcv antibody test but results not documented, reason not given","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0781T","name":"Brnchsc rf dstrj pulm nrv bi","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; bilateral mainstem bronchi","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6196","name":"Remv of ind rest on implt","description":"Remv of ind rest on implt","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2526","name":"Cntct lens blue violet","description":"Contact lens, hydrophilic, with blue-violet filter, per lens","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80220","name":"Drug asy hydroxychloroquine","description":"Hydroxychloroquine","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55714","name":"Bx prst8 in-bore ct/mri 1","description":"Biopsy, prostate, in-bore ct- or mri-guided targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2036","name":"Cohealyx col dml mx pr sq cm","description":"Cohealyx collagen dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0276U","name":"Hem inh thrombocytopenia 23","description":"Hematology (inherited thrombocytopenia), genomic sequence analysis of 23 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1429","name":"Retinopathy in od, os, ou","description":"Retinal exam finding with evidence of retinopathy in left, right or both eyes with severity level documented","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2011","name":"Supra sdrm, per sq cm","description":"Supra sdrm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61611","name":"Transect artery sinus","description":"Transection or ligation, carotid artery in petrous canal; without repair (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":607.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37271","name":"Revsc evsc fpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95056","name":"Photo tests","description":"Photo tests","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82948","name":"Reagent strip/blood glucose","description":"Glucose; blood, reagent strip","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1749","name":"Inj, iloprost, 0.1 mcg","description":"Injection, iloprost, 0.1 mcg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0953T","name":"Tot impl amei rev/rplc w/o","description":"Totally implantable active middle ear hearing implant; revision or replacement, without mastoidectomy and replacement of sound processor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71047","name":"X-ray exam chest 3 views","description":"Radiologic examination, chest; 3 views","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4231","name":"Ana crown exp 1-3 per quad","description":"Anatomical crown exposure - one to three teeth per quadrant","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0519","name":"New pt-cg dyad dem low cmplx","description":"Management of new patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49220","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1041.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9999","name":"Doc sys rsn <3 colon","description":"Documentation of system reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., unable to locate previous colonoscopy report, patient cannot provide precise date or details from previous colonoscopy, previous colonoscopy report was incomplete)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21155","name":"Rcnstj mdfc lefort iii w/i","description":"Reconstruction midface, lefort iii (extracranial), any type, requiring bone grafts (includes obtaining autografts); with lefort i","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2975.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9273","name":"Inj tisotu vedotin-tftv, 1mg","description":"Injection, tisotumab vedotin-tftv, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64596","name":"Ins/rplcmt prq eltrd ra pn 1","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; initial electrode array","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29440","name":"Adding walker to prev cast","description":"Adding walker to previously applied cast","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66840","name":"Removal of lens material","description":"Removal of lens material; aspiration technique, 1 or more stages","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":672.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3244","name":"Inj. tigecycline (accord)","description":"Injection, tigecycline (accord), not therapeutically equivalent to j3243, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44406","name":"Colonoscopy w/ultrasound","description":"Colonoscopy through stoma; with endoscopic ultrasound examination, limited to the sigmoid, descending, transverse, or ascending colon and cecum and adjacent structures","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84394","name":"Total tau","description":"Tau, total (ttau)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0379U","name":"Tgsap sl or neo dna523&rna55","description":"Tgsap sl or neo dna523&rna55","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33288","name":"Rmv&rplcmt phrnc nrv stim ld","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0383U","name":"Tyrosinemia typ i mntr quan","description":"Tyrosinemia typ i mntr quan","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84580","name":"Assay of urine urobilinogen","description":"Urobilinogen, urine; quantitative, timed specimen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33279","name":"Rmvl phrnc nrv stim transvns","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s) only","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88369","name":"M/phmtrc alysishquant/semiq","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0846T","name":"Dgtz gls mcrscp imfluor ea","description":"Digitization of glass microscope slides for immunofluorescence, per specimen; each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0822T","name":"Mntr psychdlc med cln staff","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; clinical staff under the direction of a physician or other qualified health care professional, concurrent with first physician or other qualified health care p","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0528U","name":"Lrt iad 18bct/8vir&7arg rna","description":"Lrt iad 18bct/8vir&7arg rna","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0954T","name":"Tot impl amei rplc snd proc","description":"Totally implantable active middle ear hearing implant; replacement of sound processor only, with attachment to existing transducers","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0683","name":"App of non-sheet skin sub g","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1611","name":"Inj glucagon hcl, fresenius","description":"Injection, glucagon hydrochloride (fresenius kabi), not therapeutically equivalent to j1610, per 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2016","name":"Permeaderm b, per sq cm","description":"Permeaderm b, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1193","name":"Rpts w/ imp/con mmr/msi","description":"Surgical pathology reports that contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35631","name":"Bpg aor-celiac-msn-renal","description":"Bypass graft, with other than vein; aortoceliac, aortomesenteric, aortorenal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2356.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0459U","name":"Abeta42 & ttau eclia csf","description":"Abeta42 & ttau eclia csf","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49623","name":"Rmvl ninfct mesh hernia rpr","description":"Removal of total or near total non-infected mesh or other prosthesis at the time of initial or recurrent anterior abdominal hernia repair or parastomal hernia repair, any approach (ie, open, laparoscopic, robotic) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4027","name":"Plastic surgery ss","description":"Plastic surgery mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0813T","name":"Egd vol adjmt bariatric balo","description":"Esophagogastroduodenoscopy, flexible, transoral, with volume adjustment of intragastric bariatric balloon","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7911","name":"Dental suture wound to 5 cm","description":"Complicated suture-up to 5 cm","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0569U","name":"Onc sol tum ngs tmm>20000dmr","description":"Onc sol tum ngs tmm>20000dmr","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4272","name":"Esano a, per sq cm","description":"Esano a, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91322","name":"Sarscov2 vac 50 mcg/0.5ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 50 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0612","name":"Inj, calcium gluconate, nos","description":"Injection, calcium gluconate, not otherwise specified, 10 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0041","name":"Pt/ptn decln referral","description":"Patient and/or care partner decline referral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0802","name":"3d dental scan indirect","description":"3d dental scan indirect","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43880","name":"Closure gastrocolic fistula","description":"Closure of gastrocolic fistula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1678.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0546","name":"Phone/internet ehr assess","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty   whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patien","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0435U","name":"Onc chemo rx cytox csc 14 rx","description":"Onc chemo rx cytox csc 14 rx","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99309","name":"Sbsq nf care moderate mdm 30","description":"Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":128.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1273","name":"Pts snf 1 yr dialysis","description":"Patients who were admitted to a skilled nursing facility (snf) within one year of dialysis initiation according to the cms-2728 form","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0234","name":"Intra inf, toci, second dos","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3374","name":"Inj, vancomycin (mylan) 10mg","description":"Injection, vancomycin hydrochloride (mylan) not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2780","name":"Crown 3/4 cast hi noble met","description":"Crown - 3/4 cast high noble metal","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75956","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":457.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86036","name":"Anca screen each antibody","description":"Antineutrophil cytoplasmic antibody (anca); screen, each antibody","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0957T","name":"Rev s-sclp eltr ra rcvr&tlmt","description":"Revision of sub-scalp implanted electrode array, receiver, and telemetry unit for electrode, when required, including imaging guidance","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0138","name":"Iv cipaglucosidase alfa-atga","description":"Intravenous infusion of cipaglucosidase alfa-atga, including provider/supplier acquisition and clinical supervision of oral administration of miglustat in preparation of receipt of cipaglucosidase alfa-atga","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64555","name":"Implant neuroelectrodes","description":"Percutaneous implantation of neurostimulator electrode array; peripheral nerve (excludes sacral nerve)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81195","name":"Cytog genom-wid alys hem mal","description":"Cytogenomic (genome-wide) analysis, hematologic malignancy, structural variants and copy number variants, optical genome mapping (ogm)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27713","name":"Osteot tibia imed lngth dev","description":"Osteotomy(ies), tibia, including fibula when performed, unilateral, with insertion of an externally controlled intramedullary lengthening device, including imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":946.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1259","name":"Pt stat doc <= 1 yr dialysis","description":"Patient status documented within the first year of initiating dialysis","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0751","name":"Hiv prep, ftc/taf 200/25mg","description":"Emtricitabine 200mg and tenofovir alafenamide 25mg, oral, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0062","name":"Audiology ss","description":"Audiology mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0616","name":"Inj metoprolol tartrate 1 mg","description":"Injection, metoprolol tartrate, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37254","name":"Revsc evasc ivt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69915","name":"Incise inner ear nerve","description":"Vestibular nerve section, translabyrinthine approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1754.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92945","name":"Prq trl rvs ch occ ant&rtrgr","description":"Percutaneous transluminal revascularization of chronic total occlusion, single coronary artery, coronary artery branch, or coronary artery bypass graft, and/or subtended major coronary artery branches of the bypass graft, any combination of intracoronary stent, atherectomy and angioplasty; combined ","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91125","name":"Anrct mano rct snsatn&balo","description":"Anorectal manometry, with rectal sensation and rectal balloon expulsion test, when performed","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0545U","name":"Achr antb id imfluor livecll","description":"Achr antb id imfluor livecll","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9274","name":"Inj, tebentafusp-tebn, 1 mcg","description":"Injection, tebentafusp-tebn, 1 microgram","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1447","name":"Pt dx bd bef end meas pd","description":"Patients with an active diagnosis of bipolar disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66030","name":"Injection treatment of eye","description":"Injection, anterior chamber of eye (separate procedure); medication","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1403","name":"Bslne and fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2403","name":"Chloroprocaine opht gel, 1mg","description":"Chloroprocaine hcl ophthalmic, 3% gel, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0284U","name":"Vw factor type 2n eval plsm","description":"Von willebrand factor (vwd), type 2n, factor viii and vwf binding evaluation, enzyme-linked immunosorbent assays (elisa), plasma","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1333","name":"Acute vitreous hemorrhage","description":"Acute vitreous hemorrhage","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0269U","name":"Hem aut dm cgen trmbctpna 14","description":"Hematology (autosomal dominant congenital thrombocytopenia), genomic sequence analysis of 14 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5135","name":"Inj, tyenne, 1 mg","description":"Injection, tocilizumab-aazg (tyenne), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99404","name":"Prev med cnsl indiv apprx 60","description":"Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 60 minutes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":91.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76818","name":"Fetal biophys profile w/nst","description":"Fetal biophysical profile; with non-stress testing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0323U","name":"Iadna cns pthgn next gen seq","description":"Iadna cns pthgn next gen seq","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1483","name":"Neg quan hep c or qual rna","description":"Patients who achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4016","name":"Neurosurgical ss","description":"Neurosurgical mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8625","name":"Charger coch impl/aoi battry","description":"External recharging system for battery for use with cochlear implant or auditory osseointegrated device, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86363","name":"Mog-igg1 antb flo cytmtry ea","description":"Myelin oligodendrocyte glycoprotein (mog-igg1) antibody; flow cytometry (ie, fluorescence-activated cell sorting [facs]), each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1479","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36450","name":"Bld exchange truj newborn","description":"Exchange transfusion, blood; newborn","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85027","name":"Complete cbc automated","description":"Blood count; complete (cbc), automated (hgb, hct, rbc, wbc and platelet count)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1484","name":"No rpt hcv rna perf med rsn","description":"Patients who did not have a repeat hcv rna labs performed for medical reasons documented by clinician (e.g., patient with limited life expectancy, delay in treatment of hcv related to treatment of hiv, hbv, hepatocellular carcinoma, decompensated cirrhosis)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33882","name":"Evasc rpr ta dplmt mltpc sys","description":"Endovascular repair of the thoracic aorta by deployment of a branched endograft multipiece system involving an aorto-aortic tube device with a fenestration for the left subclavian artery stent graft(s) and all aortic tube endograft extension(s) placed from the level of the left common carotid artery","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1320","name":"Pts scrn + hrsn","description":"Patients who screened positive for at least 1 of the 5 hrsns","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1248","name":"Pt resp true seen as person","description":"Patient responded completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0890T","name":"Arhfcmrigtbs 1st tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including target assessment, initial motor threshold determination, neuronavigation, delivery and management, initial treatment day","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3299","name":"Inj xipere 1 mg","description":"Injection, triamcinolone acetonide (xipere), 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1164","name":"Inj diltiazem in 0.72% nacl","description":"Injection, diltiazem hydrochloride in 0.72% sodium chloride, 0.5 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4284","name":"Dermabind sl, per sq cm","description":"Dermabind sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21079","name":"Impres&prep intrm obt prosth","description":"Impression and custom preparation; interim obturator prosthesis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1925.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0459U","name":"Abeta42 & ttau eclia csf","description":"Abeta42 & ttau eclia csf","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0946T","name":"Ortho impl mvmt alys pair ct","description":"Orthopedic implant movement analysis using paired computed tomography (ct) examination of the target structure, including data acquisition, data preparation and transmission, interpretation and report (including ct scan of the joint or extremity performed with paired views)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0699","name":"Inj, cefiderocol, 10 mg","description":"Injection, cefiderocol, 10 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59830","name":"Treat uterus infection","description":"Treatment of septic abortion, completed surgically","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":517.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4004","name":"Endocrinology ss","description":"Endocrinology mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1315","name":"Crc no doc no rsn","description":"Colorectal cancer screening results were not documented and reviewed; reason not otherwise specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0710T","name":"N-invas artl plaq alys","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; including data preparation and transmission, quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess a","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0426","name":"Coll, analys of saliva","description":"Coll, analys of saliva","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1328","name":"Pts dx acute vitreous hem","description":"Patients with a diagnosis of acute vitreous hemorrhage","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6611","name":"Grad com wrap w strap ak cus","description":"Gradient compression wrap with adjustable straps, above knee, each, custom","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0836T","name":"Dgtz gls mcrscp fna ea addl","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0537","name":"Risk ascvd tst once pr 12 mo","description":"Administration of a standardized, evidence-based atherosclerotic cardiovascular disease (ascvd) risk assessment, 5-15 minutes, not more often than every 12 months","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1153","name":"Pt w/ dx osteo doe","description":"Patient with diagnosis of osteoporosis on date of encounter","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49622","name":"Rpr parastomal hrna ncr/strn","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; incarcerated or strangulated","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0566U","name":"Onc lng qpcr-bsd alys 13dmrs","description":"Onc lng qpcr-bsd alys 13dmrs","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1360","name":"Suicd c-ssrs assessment","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0780T","name":"Instlj fecal microbiota ssp","description":"Instillation of fecal microbiota suspension via rectal enema into lower gastrointestinal tract","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93588","name":"Vngrph chd vnvn cltrl below","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating below the heart (eg, from the inferior vena cava) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6601","name":"Porc/ceram inlay >= 3 surfac","description":"Inlay - porcelain/ceramic three or more surfaces","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98011","name":"Synch audio-only new high 60","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 60 ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1043.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0909T","name":"Rplcmt int nstim sys vgs nrv","description":"Replacement of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81005","name":"Urinalysis","description":"Urinalysis; qualitative or semiquantitative, except immunoassays","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0273U","name":"Hem gen hyprfibrnlysis 8 gen","description":"Hematology (genetic hyperfibrinolysis, delayed bleeding), genomic sequence analysis of 8 genes (f13a1, f13b, fga, fgb, fgg, serpina1, serpine1, serpinf2, plau) blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4270","name":"Complete sl per sq cm","description":"Complete sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6624","name":"Inlay titanium","description":"Inlay - titanium","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0840T","name":"Dgtz gls mcrscp cslt compre","description":"Digitization of glass microscope slides for consultation, comprehensive, with review of records and specimens, with report on referred material (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92636","name":"Hearing aid post-fitg f-up 1","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92629","name":"Eval hearing aid cand ea add","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4366","name":"Dl amnio bur x-mem per sq cm","description":"Dual layer amnio burgeon x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64744","name":"Incise nerve back of head","description":"Transection or avulsion of; greater occipital nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":464.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33276","name":"Insj phrnc nrv stim sys","description":"Insertion of phrenic nerve stimulator system (pulse generator and stimulating lead[s]), including vessel catheterization, all imaging guidance, and pulse generator initial analysis with diagnostic mode activation, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38227","name":"Car-t receipt&prepj admn","description":"Chimeric antigen receptor t-cell (car-t) therapy; receipt and preparation of car-t cells for administration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93040","name":"Rhythm ecg with report","description":"Rhythm ecg, 1-3 leads; with interpretation and report","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62330","name":"Dcmprn prq rmv lig flv 1lmbr","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; one interspace, lumbar","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7511","name":"Incision/drain abscess intra","description":"Incision and drainage of abscess - intraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0946T","name":"Ortho impl mvmt alys pair ct","description":"Orthopedic implant movement analysis using paired computed tomography (ct) examination of the target structure, including data acquisition, data preparation and transmission, interpretation and report (including ct scan of the joint or extremity performed with paired views)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3244","name":"Inj. tigecycline (accord)","description":"Injection, tigecycline (accord), not therapeutically equivalent to j3243, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5941","name":"Resct proth mand part remov","description":"Resct proth mand part remov","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2044","name":"Biobrane glove, each","description":"Biobrane glove, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5100","name":"Inj ustekinumab-kfce, 1 mg","description":"Injection, ustekinumab-kfce (yesintek), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0859T","name":"Ncntc ifr spctrsc o/t pad ea","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), other than for screening for peripheral arterial disease, image acquisition, interpretation, and report; each additional anatomic site (list separately in addition to code ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51797","name":"Intraabdominal pressure test","description":"Voiding pressure studies, intra-abdominal (ie, rectal, gastric, intraperitoneal) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70471","name":"Cta h&n c+ w/noncontrast img","description":"Computed tomographic angiography (cta), head and neck, with contrast material(s), including noncontrast images, when performed, and image postprocessing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53601","name":"Dilate urethra stricture","description":"Dilation of urethral stricture by passage of sound or urethral dilator, male; subsequent","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":79.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17000","name":"Destruct premalg lesion","description":"Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (eg, actinic keratoses); first lesion","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":76.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46712","name":"Repr per/vag pouch dbl proc","description":"Repair of ileoanal pouch fistula/sinus (eg, perineal or vaginal), pouch advancement; combined transperineal and transabdominal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2334.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21198","name":"Reconstr lwr jaw segment","description":"Osteotomy, mandible, segmental;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1274.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q0224","name":"Inj, pemivibart, 4500 mg","description":"Injection, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, and who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppressive ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1335","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1243","name":"Pt othr thn true heard","description":"Patient provided a response other than completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55700","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86352","name":"Cell function assay w/stim","description":"Cellular function assay involving stimulation (eg, mitogen or antigen) and detection of biomarker (eg, atp)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9871","name":"Bhv couns dm prev, onln 60 m","description":"Behavioral counseling for diabetes prevention, online, 60 minutes","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1387","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0739T","name":"Abltj mal prst8 mag fld ndct","description":"Ablation of malignant prostate tissue by magnetic field induction, including all intraprocedural, transperineal needle/catheter placement for nanoparticle installation and intraprocedural temperature monitoring, thermal dosimetry, bladder irrigation, and magnetic field nanoparticle activation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0760T","name":"Dgtz gls mcrscp sl imm 1st","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0881T","name":"Cryotherapy oral cavity","description":"Cryotherapy of the oral cavity using temperature regulated fluid cooling system, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54650","name":"Orchiopexy (fowler-stephens)","description":"Orchiopexy, abdominal approach, for intra-abdominal testis (eg, fowler-stephens)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":795.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4386","name":"Acesso trifaca per sq cm","description":"Acesso trifaca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51721","name":"Ins trurl ablt trnsdc thr us","description":"Insertion of transurethral ablation transducer for delivery of thermal ultrasound for prostate tissue ablation, including suprapubic tube placement during the same session and placement of an endorectal cooling device, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1178","name":"Doc med rsn no pcv","description":"Documentation of medical reason(s) for not administering pneumococcal vaccine (e.g., prior anaphylaxis due to the pneumococcal vaccine)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63052","name":"Lam facetc/frmt arthrd lum 1","description":"Laminectomy, facetectomy, or foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s] [eg, spinal or lateral recess stenosis]), during posterior interbody arthrodesis, lumbar; single vertebral segment (list separately in addition to code for primary ","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9321","name":"Inj epcoritamab-bysp 0.16 mg","description":"Injection, epcoritamab-bysp, 0.16 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2027","name":"Matriderm per sq cm","description":"Matriderm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21255","name":"Reconstruct lower jaw bone","description":"Reconstruction of zygomatic arch and glenoid fossa with bone and cartilage (includes obtaining autografts)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1604.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86003","name":"Allg spec ige crude xtrc ea","description":"Allergen specific ige; quantitative or semiquantitative, crude allergen extract, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0137","name":"Inj, acetaminophen (hikma)","description":"Injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0937T","name":"Xtrnl ecg rec>15d<30d","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; including recording, scanning analysis with report, review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28750","name":"Fusion of big toe joint","description":"Arthrodesis, great toe; metatarsophalangeal joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":687.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1457","name":"Dx asth dur crnt/prv perf pd","description":"Patient had a diagnosis of asthma with any contact during the current or prior performance period or had asthma present on an active problem list any time during the performance period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52354","name":"Cystouretero w/biopsy","description":"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with biopsy and/or fulguration of ureteral or renal pelvic lesion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":457.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4009","name":"Hospitalists ss","description":"Hospitalists mips specialty set","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33882","name":"Evasc rpr ta dplmt mltpc sys","description":"Endovascular repair of the thoracic aorta by deployment of a branched endograft multipiece system involving an aorto-aortic tube device with a fenestration for the left subclavian artery stent graft(s) and all aortic tube endograft extension(s) placed from the level of the left common carotid artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":951.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0914T","name":"Prq tcat thr rx ntrc bal sep","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting) performed on a separate target lesion from the target lesion treated with balloon angioplasty, coronary stent placement or coronary atherectomy, including mechanical dilation b","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48556","name":"Removal allograft pancreas","description":"Removal of transplanted pancreatic allograft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1152.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2253","name":"Inj midazolam (seizalam)","description":"Injection, midazolam (seizalam), 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77090","name":"Tbs techl prep&transmis data","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4338","name":"Artacent velos, per sq cm","description":"Artacent velos, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1321","name":"Couns for high risk sub use","description":"Couns for high risk sub use","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87593","name":"Orthopoxvirus amp prb each","description":"Infectious agent detection by nucleic acid (dna or rna); orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus), amplified probe technique, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99437","name":"Chrnc care mgmt phys ea addl","description":"Chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, or funct","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6561","name":"G stockng full/chap 40+ cust","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, custom, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0853T","name":"Dgtz gls mcrscp mphmtrc ea m","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0856T","name":"Dgtz gls mcrscp electron mic","description":"Digitization of glass microscope slides for electron microscopy, diagnostic (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90481","name":"Admn sarscov2 vac ea add cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; each additional component administered (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1373","name":"Mst rec gsa >=8 and <=9","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 8.0% and <= 9.0%","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0136","name":"Adm of pa/n assess 5-15 m","description":"Administration of a standardized, evidence-based assessment of physical activity and nutrition, 5-15 minutes, not more often than every 6 months","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0575U","name":"Trnsplj med lar rtpcr 4genes","description":"Trnsplj med lar rtpcr 4genes","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4310","name":"Procenta, per 100 mg","description":"Procenta, per 100 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0493U","name":"Trnspl med quan dd-cfdna ngs","description":"Trnspl med quan dd-cfdna ngs","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2679","name":"Inj fluphenazine hcl 1.25 mg","description":"Injection, fluphenazine hcl, 1.25 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1406","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0811T","name":"Rem mlt day uroflow setup","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); set-up and patient education on use of equipment","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0744T","name":"Insj bioprostc vlv fem vn","description":"Insertion of bioprosthetic valve, open, femoral vein, including duplex ultrasound imaging guidance, when performed, including autogenous or nonautogenous patch graft (eg, polyester, eptfe, bovine pericardium), when performed","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6608","name":"G com bandage tub protct pad","description":"Gradient compression bandaging supply, tubular protective absorption padded layer, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74260","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1222","name":"Glaucoma pln of care not doc","description":"Glaucoma plan of care not documented, reason not otherwise specified","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37292","name":"Rvsc evsc tpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1209","name":">=2 same hi-rsk med w/o diag","description":"At least two orders for high-risk medications from the same drug class, (table 4), without appropriate diagnoses","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1420","name":"Complete ophthalmologic mvp","description":"Complete ophthalmologic care mips value pathway","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1177","name":"Pt recd pcv on/aft 19","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86329","name":"Immunodiffusion nes","description":"Immunodiffusion; not elsewhere specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9061","name":"Inj, amivantamab-vmjw","description":"Injection, amivantamab-vmjw, 2 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0387U","name":"Onc mlnma ambra1&amlo","description":"Onc mlnma ambra1&amlo","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0563","name":"Sbrt w/positron emission del","description":"Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance and real-time positron emissions-based delivery adjustments to 1 or more lesions, entire course not to exceed 5 fractions","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D8091","name":"Compre ortho treat w surg","description":"Compre ortho treat w surg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9049","name":"Inj, bortezomib, hospira","description":"Injection, bortezomib (hospira), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44365","name":"Small bowel endoscopy","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0609","name":"Ferric citrate orl 3 mg iron","description":"Ferric citrate, oral, 3 mg ferric iron, (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4365","name":"Amnio bur dl mem per sq cm","description":"Amnio burgeon dual-layer membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0541","name":"No pt prsnt train initial 30","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0314U","name":"Onc cutan mlnma mrna 35 gene","description":"Onc cutan mlnma mrna 35 gene","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61567","name":"Incision of brain tissue","description":"Craniotomy with elevation of bone flap; for multiple subpial transections, with electrocorticography during surgery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2854.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1393","name":"Pr no dx rec mlnm","description":"Patients who were not diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2183","name":"Inj meropenem (wg crit care)","description":"Injection, meropenem (wg critical care), not therapeutically equivalent to j2185, 100 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0419U","name":"Nrpsyc gen seq vrnt aly 13","description":"Nrpsyc gen seq vrnt aly 13","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6049","name":"Scale implt peri-implt inflm","description":"Scale implt peri-implt inflm","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43216","name":"Esophagoscopy lesion removal","description":"Esophagoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51800","name":"Revision of bladder/urethra","description":"Cystoplasty or cystourethroplasty, plastic operation on bladder and/or vesical neck (anterior y-plasty, vesical fundus resection), any procedure, with or without wedge resection of posterior vesical neck","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1152.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19180","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77089","name":"Tbs dxa cal w/i&r fx risk","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; using dual x-ray absorptiometry (dxa) or other imaging data on gray-scale variogram, calculation, with interpretation and report on fracture-risk","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1323","name":"Pts 7wk inj, scrn iop >25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop >25 mm hg and a plan of care was documented","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0521","name":"Supply fee hiv prep fda appr","description":"Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4009","name":"Hospitalists ss","description":"Hospitalists mips specialty set","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33279","name":"Rmvl phrnc nrv stim transvns","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s) only","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43122","name":"Partial removal of esophagus","description":"Partial esophagectomy, thoracoabdominal or abdominal approach, with or without proximal gastrectomy; with esophagogastrostomy, with or without pyloroplasty","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2793.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1321","name":"Couns for high risk sub use","description":"Couns for high risk sub use","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0893","name":"Inj, decitabine (sun pharma)","description":"Injection, decitabine (sun pharma), not therapeutically equivalent to j0894, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57522","name":"Conization of cervix","description":"Conization of cervix, with or without fulguration, with or without dilation and curettage, with or without repair; loop electrode excision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0767T","name":"Tc mag stimj pn ea addl nrv","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; each additional nerve (list separat","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64469","name":"Thrc fascial pln blk bi nfs","description":"Thoracic fascial plane block, bilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1431","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7485","name":"Surg reduct osseoustuberosit","description":"Surgical reduction of osseous tuberosity","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7911","name":"Dental suture wound to 5 cm","description":"Complicated suture-up to 5 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15343","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6596","name":"G comp bandge conform gauze","description":"Gradient compression bandaging supply, conforming gauze, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0908T","name":"Opn imp int nstm sys vgs nrv","description":"Open implantation of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4279","name":"Vendaje ac, per sq cm","description":"Vendaje ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2791","name":"Crown full cast base metal","description":"Crown-full cast predominantly base metal","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0517","name":"Remove drug implant","description":"Removal of non-biodegradable drug delivery implants, 4 or more (services for subdermal implants)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":226.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4022","name":"Otolaryngology ss","description":"Otolaryngology mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0678T","name":"Laps repos lead isdss ea add","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional repositioned lead (list separately in addition to code for primary proce","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4317","name":"Vitograft, per sq cm","description":"Vitograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30140","name":"Resect inferior turbinate","description":"Submucous resection inferior turbinate, partial or complete, any method","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5134","name":"Inj, tyruko, 1 mg","description":"Injection, natalizumab-sztn (tyruko), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0619U","name":"Pulm copd dna alys >18000","description":"Pulm copd dna alys >18000","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20225","name":"Bone biopsy trocar/ndl deep","description":"Biopsy, bone, trocar, or needle; deep (eg, vertebral body, femur)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0897T","name":"N-invas augmnt arrhyt alys","description":"Noninvasive augmentative arrhythmia analysis derived from quantitative computational cardiac arrhythmia simulations, based on selected intervals of interest from 12-lead electrocardiogram and uploaded clinical parameters, including uploading clinical parameters with interpretation and report","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1252","name":"Pts no cmplt hu survey","description":"Patients who did not complete at least one of the four patient experience hu survey items and return the hu survey within 60 days of the ambulatory palliative care visit","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4291","name":"Lamellas xt, per sq cm","description":"Lamellas xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1463","name":"2 f/u wthn 180 day rx atmp","description":"Documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61605","name":"Resect/excise cranial lesion","description":"Resection or excision of neoplastic, vascular or infectious lesion of infratemporal fossa, parapharyngeal space, petrous apex; extradural","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2420.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9003","name":"Leupro inj, camcevi etm, 1mg","description":"Leuprolide injectable (camcevi etm), 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1503","name":"Vascular surgery mvp","description":"Vascular surgery mips value pathway","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31291","name":"Nasal/sinus endoscopy surg","description":"Nasal/sinus endoscopy, surgical, with repair of cerebrospinal fluid leak; sphenoid region","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1440.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1411","name":"Inj, hemgenix, per tx dose","description":"Injection, etranacogene dezaparvovec-drlb, per therapeutic dose","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4258","name":"Enverse, per sq cm","description":"Enverse, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5944","name":"Max implt sup remv part","description":"Max implt sup remv part","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1597","name":"Inj glycopyrrolate, glyrx-pf","description":"Injection, glycopyrrolate (glyrx-pf), 0.1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33975","name":"Implant ventricular device","description":"Insertion of ventricular assist device; extracorporeal, single ventricle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76801","name":"Ob us < 14 wks single fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6193","name":"Replace implnt screw","description":"Replace implnt screw","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4267","name":"Neostim dl per sq cm","description":"Neostim dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5099","name":"Inj ustekinumab-stba, 1 mg","description":"Injection, ustekinumab-stba (steqeyma), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1436","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15015","name":"App skn cl ssp agrft t/a/l 1","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; first 480 sq cm or less","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0540","name":"Train for caregiver add 15","description":"Caregiver training in behavior management/modification for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face; each additional 15 minutes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1836","name":"Inj, metronidazole, 10 mg","description":"Injection, metronidazole, 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1022T","name":"Prq tis dsplmt ntra-abdl/pel","description":"Percutaneous tissue displacement, any method, including imaging guidance; intra-abdominal/pelvic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9319","name":"Inj romidepsin lyophil 0.1mg","description":"Injection, romidepsin, lyophilized, 0.1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0736T","name":"Colonic lavage 35+l water","description":"Colonic lavage, 35 or more liters of water, gravity-fed, with induced defecation, including insertion of rectal catheter","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86051","name":"Aquaporin-4 antb elisa","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; enzyme-linked immunosorbent immunoassay (elisa)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26580","name":"Repair cleft hand","description":"Repair cleft hand","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1537.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0802T","name":"Tcat rmv&rpl2chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right at","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2711","name":"Inj neostigmin/glycopyrrolat","description":"Injection, neostigmine methylsulfate 0.1 mg and glycopyrrolate 0.02 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7299","name":"Intraut copp cont (miudella)","description":"Intrauterine copper contraceptive (miudella)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9002","name":"Intra-vag motion sens biofk","description":"Intra-vaginal motion sensor system, provides biofeedback for pelvic floor muscle rehabilitation device","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68841","name":"Insj rx elut implt lac canal","description":"Insertion of drug-eluting implant, including punctal dilation when performed, into lacrimal canaliculus, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1335","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1418","name":"Med rsn not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination because of a medical contraindication documented by clinician","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1248","name":"Pt resp true seen as person","description":"Patient responded completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48148","name":"Removal of pancreatic duct","description":"Excision of ampulla of vater","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1209.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0587U","name":"Ther rx mntr 60-150rx&metabl","description":"Ther rx mntr 60-150rx&metabl","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":547.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1479","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93150","name":"Therapy activation ipnss","description":"Therapy activation of implanted phrenic nerve stimulator system, including all interrogation and programming","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9025","name":"Plasma cryo redu path each","description":"Plasma, cryoprecipitate reduced, pathogen reduced, each unit","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69715","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1552.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0993T","name":"N-invas assmt car rsk w/ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat with concurrent computed tomography scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional (list s","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99282","name":"Emergency dept visit sf mdm","description":"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward medical decision making","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12013","name":"Rpr f/e/e/n/l/m 2.6-5.0 cm","description":"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.6 cm to 5.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5725","name":"Rebase hybrid prosthesis","description":"Rebase hybrid prosthesis","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99396","name":"Prev visit est age 40-64","description":"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 40-64","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":86.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0528","name":"Mgt est pt dem mod-hi cmplx","description":"Management of established patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87075","name":"Cultr bacteria except blood","description":"Culture, bacterial; any source, except blood, anaerobic with isolation and presumptive identification of isolates","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0571","name":"Intraop nerve cryoablation","description":"Intraoperative nerve(s) cryoablation for post-surgical pain relief (list separately in addition to code for primary service)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4433","name":"361 hct/p skin subs, nos","description":"361 hct/p skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5765","name":"Liner compl/partial rem dent","description":"Liner compl/partial rem dent","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0320","name":"Two-way audio and video hhs","description":"Home health services furnished using synchronous telemedicine rendered via a real-time two-way audio and video telecommunications system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":791.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16025","name":"Dress/debrid p-thick burn m","description":"Dressings and/or debridement of partial-thickness burns, initial or subsequent; medium (eg, whole face or whole extremity, or 5% to 10% total body surface area)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":116.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90635","name":"H5n1 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n1, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6525","name":"G com garm lwrleg/ft ngt cus","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, custom, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":773.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0528U","name":"Lrt iad 18bct/8vir&7arg rna","description":"Lrt iad 18bct/8vir&7arg rna","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99459","name":"Pelvic examination","description":"Pelvic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46924","name":"Destruction anal lesion(s)","description":"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65750","name":"Corneal transplant","description":"Keratoplasty (corneal transplant); penetrating (in aphakia)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1226.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0592U","name":"Onc hl neo dna tgs 417 genes","description":"Onc hl neo dna tgs 417 genes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5932","name":"Postsurgical obturator","description":"Obturator prosthesis definitive","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59025","name":"Fetal non-stress test","description":"Fetal non-stress test","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1342","name":"Pts died perf per","description":"Patients who died during the performance period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98978","name":"Rtm dev sply cbt 16-30 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of cognitive behavioral therapy, 16-30 days in a 30-day period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"Basic vestibular evaluation","description":"Basic vestibular evaluation, includes spontaneous nystagmus test with eccentric gaze fixation nystagmus, with recording, positional nystagmus test, minimum of 4 positions, with recording, optokinetic nystagmus test, bidirectional foveal and peripheral stimulation, with recording, and oscillating tra","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99335","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76018","name":"Mr safety implant elec prepj","description":"Mr safety implant electronics preparation under supervision of physician or other qualified health care professional, including mr-specific programming of pulse generator and/or transmitter to verify device integrity, protection of device internal circuitry from mr electromagnetic fields, and protec","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":254.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0377U","name":"Cv ds quan advsrm/plsm lprtn","description":"Cv ds quan advsrm/plsm lprtn","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0845T","name":"Dgtz gls mcrscp imfluor 1st","description":"Digitization of glass microscope slides for immunofluorescence, per specimen; initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0796T","name":"Tcat ins 2chmbr ldls pm ra","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right atrial pacemaker","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9957","name":"Screening sleep disorders","description":"Screening sleep disorders","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5124","name":"Inj. byooviz, 0.1 mg","description":"Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0753T","name":"Dgtz gls mcrscp sld level iv","description":"Digitization of glass microscope slides for level iv, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0920T","name":"Rmvl perm ccm-d sys 1 pac ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous pacing lead only","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21188","name":"Reconstruction of midface","description":"Reconstruction midface, osteotomies (other than lefort type) and bone grafts (includes obtaining autografts)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1919.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0915T","name":"Insj perm ccm-d sys pg&eltrd","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator and dual transvenous electrodes/leads (pacing and defibrillation)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0932T","name":"N-invs det hrt fail aug echo","description":"Noninvasive detection of heart failure derived from augmentative analysis of an echocardiogram that demonstrated preserved ejection fraction, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37276","name":"Rvsc evsc fpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0693T","name":"Compre ful bdy 3d mtn alys","description":"Comprehensive full body computer-based markerless 3d kinematic and kinetic motion analysis and report","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0475U","name":"Hered prst8 ca gsap 23 genes","description":"Hered prst8 ca gsap 23 genes","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0393U","name":"Neu prksn msfl a-syncln prtn","description":"Neu prksn msfl a-syncln prtn","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9128","name":"Photobio therpy-first 15 min","description":"Photobio therpy-first 15 min","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8541","name":"Oral, hemady, 0.25 mg","description":"Dexamethasone (hemady), oral, 0.25 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99254","name":"Ip/obs cnsltj new/est mod 60","description":"Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1008T","name":"Rem mntr s-scl eeg sys setup","description":"Remote monitoring of sub-scalp implanted continuous bilateral electroencephalography monitoring system, device fitting, initial set-up, and patient education in wearing of system and use of equipment","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86366","name":"Muscle-specific kinase antb","description":"Muscle-specific kinase (musk) antibody","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0405U","name":"Onc pncrtc 59 mthltn blk mrk","description":"Onc pncrtc 59 mthltn blk mrk","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43420","name":"Repair esophagus opening","description":"Closure of esophagostomy or fistula; cervical approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1028.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78707","name":"K flow/funct image w/o drug","description":"Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5138","name":"Inj, wezlana, iv, 1 mg","description":"Injection, ustekinumab-auub (wezlana), biosimilar, intravenous, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4100","name":"Nosht skin sub fda clrd nos","description":"Non-sheet form skin substitute, fda cleared as a device, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27418","name":"Repair degenerated kneecap","description":"Anterior tibial tubercleplasty (eg, maquet type procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":988.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44364","name":"Small bowel endoscopy","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0841T","name":"Dgtz gls mcrscp pth cslt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; first tissue block, with frozen section(s), single specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93545","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3431","name":"Biological materials","description":"Biological materials","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25215","name":"Removal of wrist bones","description":"Carpectomy; all bones of proximal row","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":816.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0705T","name":"Rem tx amblyopia tech sprt","description":"Remote treatment of amblyopia using an eye tracking device; surveillance center technical support including data transmission with analysis, with a minimum of 18 training hours, each 30 days","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49062","name":"Drain to peritoneal cavity","description":"Drainage of extraperitoneal lymphocele to peritoneal cavity, open","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":810.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1469","name":"Hx of hep b, or pos bld test","description":"Patient has a history of hepatitis b illness or received a hepatitis b surface antigen, hepatitis b surface antibody, or total antibody to hepatitis b core antigen test with a positive result any time before or during the measurement period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22837","name":"Ant thrc vrt body tethrg 8+","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; 8 or more vertebral segments","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1482","name":"Pos quan hep c or qual rna","description":"Positive/detectable hepatitis c virus quantitative or qualitative rna test result during the denominator identification period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1360","name":"Suicd c-ssrs assessment","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1380","name":"2 rx in perf pd any com meds","description":"Filled at least two prescriptions during the performance period for any combination of the qualifying oral antipsychotic medications listed under denominator note or the long-acting injectable antipsychotic medications listed under denominator note","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52260","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with dilation of bladder for interstitial cystitis; general or conduction (spinal) anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67810","name":"Incal bx eyelid skn lid mrgn","description":"Incisional biopsy of eyelid skin including lid margin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17110","name":"Destruction b9 les up to 14","description":"Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), of benign lesions other than skin tags or cutaneous vascular proliferative lesions; up to 14 lesions","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":71.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0601","name":"Sevelamer carbonate 20 mg","description":"Sevelamer carbonate (renvela or therapeutically equivalent), oral, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0530U","name":"Onc pan-sol tum ctdna 77 gen","description":"Onc pan-sol tum ctdna 77 gen","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4323","name":"Alloply, per sq cm","description":"Alloply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0611U","name":"Onc lvr alys >1000 mr cfdna","description":"Onc lvr alys >1000 mr cfdna","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0717T","name":"Adrc ther prtl rc tear","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; adipose tissue harvesting, isolation and preparation of harvested cells, including incubation with cell dissociation enzymes, filtration, washing, and concentration of adrcs","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0357","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0752T","name":"Dgtz gls mcrscp sld lvl iii","description":"Digitization of glass microscope slides for level iii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52284","name":"Cysto rx balo cath urtl strx","description":"Cystourethroscopy, with mechanical urethral dilation and urethral therapeutic drug delivery by drug-coated balloon catheter for urethral stricture or stenosis, male, including fluoroscopy, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5156","name":"Inj, tocilizumab-anoh, 1 mg","description":"Injection, tocilizumab-anoh (avtozma), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4263","name":"Surgraft tl, per sq cm","description":"Surgraft tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98008","name":"Synch audio-only new sf 15","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code sel","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9174","name":"Inj, docetaxel (beizray) 1mg","description":"Injection, docetaxel (beizray), 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0298U","name":"Onc pan tum whl trns seq rna","description":"Onc pan tum whl trns seq rna","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98981","name":"Rtm tx mgmt ea addl 20 min","description":"Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least 1 real-time interactive communication with the patient or caregiver during the calendar month; each additional 20 minutes (list separately in","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0666","name":"Team remote e/m est pt 15 mn","description":"Team remote e/m est. pt 15mins","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1250","name":"Pt resp true heard","description":"Patient responded as completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48545","name":"Pancreatorrhaphy","description":"Pancreatorrhaphy for injury","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1268.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86581","name":"Strptcs pneum antb serot ia","description":"Streptococcus pneumoniae antibody (igg), serotypes, multiplex immunoassay, quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4265","name":"Neostim tl per sq cm","description":"Neostim tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29130","name":"Appl finger splint static","description":"Application of finger splint; static","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":54.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4372","name":"Amchoplast excl per sq cm","description":"Amchoplast excel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9331","name":"Inj sirolimus prot part 1 mg","description":"Injection, sirolimus protein-bound particles, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0306U","name":"Onc mrd nxt-gnrj alys 1st","description":"Onc mrd nxt-gnrj alys 1st","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2040","name":"Microlyte painguard pr sq cm","description":"Microlyte painguard, per square centimeter","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4378","name":"Renew ft matrix per sq cm","description":"Renew ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1442","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4387","name":"Neothelium ft per sq cm","description":"Neothelium ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99459","name":"Pelvic examination","description":"Pelvic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1434","name":"Orl chemo wthn 30 d post enc","description":"Patient on oral chemotherapy on or within 30 days after denominator eligible encounter","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0344U","name":"Hep nafld semiq evl 28 lipid","description":"Hep nafld semiq evl 28 lipid","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0262U","name":"Onc sld tum rt-pcr 7 gen","description":"Oncology (solid tumor), gene expression profiling by real-time rt-pcr of 7 gene pathways (er, ar, pi3k, mapk, hh, tgfb, notch), formalin-fixed paraffin-embedded (ffpe), algorithm reported as gene pathway activity score","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1019T","name":"Lymphovenous bypass per xtr","description":"Lymphovenous bypass, including robotic assistance, when performed, per extremity","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1299","name":"Flu immunize order/admin","description":"Influenza immunization administered or previously received","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6192","name":"Semi precision attachment","description":"Semi precision attachment","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1383","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4355","name":"Abio xpl abio xpl hy p sq cm","description":"Abiomend xplus membrane and abiomend xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1032","name":"Sv doula brth wrk per 15 min","description":"Services performed by a doula birth worker, per 15 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33615","name":"Repair modified fontan","description":"Repair of complex cardiac anomalies (eg, tricuspid atresia) by closure of atrial septal defect and anastomosis of atria or vena cava to pulmonary artery (simple fontan procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2282.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9394","name":"Inj, fulvestrant (fresenius)","description":"Injection, fulvestrant (fresenius kabi) not therapeutically equivalent to j9395, 25 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0522U","name":"Ca vi psp&sp1 antb cl semiql","description":"Ca vi psp&sp1 antb cl semiql","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0598U","name":"Gi ibs igg antb 18food items","description":"Gi ibs igg antb 18food items","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1026","name":"Pt hemo > 3mo","description":"The number of adult patient-months in the denominator who were on maintenance hemodialysis using a catheter continuously for three months or longer under the care of the same practitioner or group partner as of the last hemodialysis session of the reporting month","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1188","name":"Pt w/ ckd stg 5","description":"Patients with a diagnosis of chronic kidney disease (ckd) stage 5","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59812","name":"Treatment of miscarriage","description":"Treatment of incomplete abortion, any trimester, completed surgically","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":419.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":325.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1351","name":"Pt cmplt suicd saf pln 120dy","description":"Patients who had a suicide safety plan initiated, reviewed, or updated and reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33277","name":"Insj phrnc nrv stim transvns","description":"Insertion of phrenic nerve stimulator transvenous sensing lead (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98012","name":"Synch audio-only est sf 10","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85025","name":"Complete cbc w/auto diff wbc","description":"Blood count; complete (cbc), automated (hgb, hct, rbc, wbc and platelet count) and automated differential wbc count","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4354","name":"Palingen dl-palingen dl-x","description":"Palingen dual-layer membrane and dual-layer palingen x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0539U","name":"Onc sol tumor cfctdna 152gen","description":"Onc sol tumor cfctdna 152gen","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1782","name":"Vac admin human pap dose 2","description":"Vac admin human pap dose 2","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82952","name":"Gtt-added samples","description":"Glucose; tolerance test, each additional beyond 3 specimens (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88325","name":"Consltj compre rvw rec reprt","description":"Consultation, comprehensive, with review of records and specimens, with report on referred material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93898","name":"Ven-artl shunt det mbubb njx","description":"Venous-arterial shunt detection with intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0878T","name":"Augmnt alys ch ct ild w/ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained with concurrent ct examination of the same structure","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0806T","name":"Tcat s&ivc prstc vl impl opn","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); open femoral vein approach","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5946","name":"Max implt sup fix","description":"Max implt sup fix","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37281","name":"Revsc evsc tpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0444U","name":"Onc sld orgn neo tgsap 361","description":"Onc sld orgn neo tgsap 361","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86308","name":"Heterophile antibody screen","description":"Heterophile antibodies; screening","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5995","name":"Peri medicament w/seal, max","description":"Peri medicament w/seal, max","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"Endoskel posit rotat unit","description":"Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94640","name":"Airway inhalation treatment","description":"Pressurized or nonpressurized inhalation treatment for acute airway obstruction for therapeutic purposes and/or for diagnostic purposes such as sputum induction with an aerosol generator, nebulizer, metered dose inhaler or intermittent positive pressure breathing (ippb) device","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1492","name":"No reported fall","description":"Patients who did not report a fall","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1441","name":"Init dx slp apn = 1st enc","description":"Encounter corresponds to initial diagnosis of sleep apnea or first contact with sleep apnea diagnosed patient","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37275","name":"Rvsc evsc fpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0024","name":"Pin srv add 30 min pr m","description":"Principal illness navigation services, additional 30 minutes per calendar month (list separately in addition to g0023)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5376.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4365","name":"Amnio bur dl mem per sq cm","description":"Amnio burgeon dual-layer membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6031","name":"Rep interface handfng molded","description":"Replacement socket/interface, partial hand including fingers, molded to patient model, for use with or without external power","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1312","name":"No pt tbco scrn rng","description":"Patient not screened for tobacco use","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0973T","name":"Slctv nzmtc dbrdmt t/a/l 1st","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; first 100 sq cm","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64596","name":"Ins/rplcmt prq eltrd ra pn 1","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; initial electrode array","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0853T","name":"Dgtz gls mcrscp mphmtrc ea m","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1177","name":"Pt recd pcv on/aft 19","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1337","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1390","name":"Pt no doc exm for rec","description":"Patients who do not have a documented exam performed for recurrence of melanoma or no documentation within the performance period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82465","name":"Assay bld/serum cholesterol","description":"Cholesterol, serum or whole blood, total","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90624","name":"Menb-4c&menacwy vacc im","description":"Meningococcal pentavalent vaccine, men b-4c recombinant proteins and outer membrane vesicle and conjugated men a, c, w, y-diphtheria toxoid carrier, for intramuscular use","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0727T","name":"Rmvl&rplcmt implt vstblr dev","description":"Removal and replacement of implanted vestibular device, unilateral","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9611","name":"Flurpiridaz f18, diag, 1 mci","description":"Flurpiridaz f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0881T","name":"Cryotherapy oral cavity","description":"Cryotherapy of the oral cavity using temperature regulated fluid cooling system, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0608","name":"Lanthanum carbonate pwdr 5mg","description":"Lanthanum carbonate, oral, powder, 5 mg, not therapeutically equivalent to j0607 (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4435","name":"Renati membrane per sq cm","description":"Renati membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1961","name":"Inj lenacapavir (hiv tx) 1mg","description":"Injection, lenacapavir (only for use as hiv treatment), 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2991","name":"App of hydroxyapatite","description":"App of hydroxyapatite","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1421","name":"Dermatological care mvp","description":"Dermatological care mips value pathway","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1451","name":"Pt dx ppd dur id/pf pd","description":"Patients with an active diagnosis of pervasive developmental disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4259","name":"Celera per sq cm","description":"Celera dual layer or celera dual membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93598","name":"Car outp meas drg cath chd","description":"Cardiac output measurement(s), thermodilution or other indicator dilution method, performed during cardiac catheterization for the evaluation of congenital heart defects (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87426","name":"Sarscov coronavirus ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; severe acute respiratory syndrome coronavirus (eg, sars-cov, s","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4281","name":"Barrera slor dl per sq cm","description":"Barrera sl or barrera dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90846","name":"Family psytx w/o pt 50 min","description":"Family psychotherapy (without the patient present), 50 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":107.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":43.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0771T","name":"Vr px dissoc svc sm phy 1st","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66989","name":"Xcpsl ctrc rmvl cplx insj 1+","description":"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification), complex, requiring devices or techniques not generally used in routine cataract surgery (eg, iris expansion device,","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59850","name":"Induced abortion 1+ njx","description":"Induced abortion, by 1 or more intra-amniotic injections (amniocentesis-injections), including hospital admission and visits, delivery of fetus and secundines;","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4343","name":"Dermacyte ac matrx per sq cm","description":"Dermacyte ac matrix amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1279","name":"Pre-htn/htn, no f/u, not gvn","description":"Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5877","name":"Dup of complt dent-maxill","description":"Dup of complt dent-maxill","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4281","name":"Barrera slor dl per sq cm","description":"Barrera sl or barrera dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2002","name":"Inj, lidocaine in d5w, 1 mg","description":"Injection, lidocaine hcl in 5% dextrose, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2801","name":"Inj, rykindo, 0.5 mg","description":"Injection, risperidone (rykindo), 0.5 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1302","name":"Inj, sutimlimab-jome, 10 mg","description":"Injection, sutimlimab-jome, 10 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9347","name":"Inj, tremelimumab-actl, 1 mg","description":"Injection, tremelimumab-actl, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7957","name":"Tiss regen edent nonresorb","description":"Tiss regen edent nonresorb","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0436U","name":"Onc lng plsm alys 388 prtn","description":"Onc lng plsm alys 388 prtn","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1172","name":"Doc med rsn no td/tdap","description":"Documentation of medical reason(s) for not administering td or tdap vaccine (e.g., prior anaphylaxis due to the td or tdap vaccine or history of encephalopathy within seven days after a previous dose of a td-containing vaccine)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83987","name":"Exhaled breath condensate","description":"Ph; exhaled breath condensate","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0276U","name":"Hem inh thrombocytopenia 23","description":"Hematology (inherited thrombocytopenia), genomic sequence analysis of 23 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0954T","name":"Tot impl amei rplc snd proc","description":"Totally implantable active middle ear hearing implant; replacement of sound processor only, with attachment to existing transducers","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59870","name":"Evacuate mole of uterus","description":"Uterine evacuation and curettage for hydatidiform mole","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9602","name":"Fluorodopa f-18 diag per mci","description":"Fluorodopa f-18, diagnostic, per millicurie","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37257","name":"Revsc evsc ivt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86258","name":"Dgp antibody each ig class","description":"Gliadin (deamidated) (dgp) antibody, each immunoglobulin (ig) class","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0341U","name":"Ftl aneup dna seq cmpr alys","description":"Ftl aneup dna seq cmpr alys","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0738T","name":"Tx pln mag fld abltj prst8","description":"Treatment planning for magnetic field induction ablation of malignant prostate tissue, using data from previously performed magnetic resonance imaging (mri) examination","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0224","name":"Pemivibart infusion","description":"Intravenous infusion, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppr","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1150","name":"Lvef <=40% or mod/sev l vsf","description":"Current or prior left ventricular ejection fraction (lvef) less than or equal to 40% or documentation of moderately or severely depressed left ventricular systolic function","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82465","name":"Assay bld/serum cholesterol","description":"Cholesterol, serum or whole blood, total","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75736","name":"Artery x-rays pelvis","description":"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1314","name":"Bmi not calculated","description":"Bmi not documented and no reason is given","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31235","name":"Nsl/sins ndsc dx sphn sinusc","description":"Nasal/sinus endoscopy, diagnostic; with sphenoid sinusoscopy (via puncture of sphenoidal face or cannulation of ostium)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0859T","name":"Ncntc ifr spctrsc o/t pad ea","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), other than for screening for peripheral arterial disease, image acquisition, interpretation, and report; each additional anatomic site (list separately in addition to code ","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78001","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4368","name":"Amchothick per sq cm","description":"Amchothick, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6598","name":"G comp bandage med stretch","description":"Gradient compression bandage roll, elastic medium stretch, per linear yard, any width, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0582","name":"Bivalirudin (endo) 1 mg","description":"Injection, bivalirudin (endo), not therapeutically equivalent to j0583, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4314","name":"Reeva, per sq cm","description":"Reeva ft, per square cenitmeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55868","name":"Lap srg prst8ct lymph nod bx","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with lymph node biopsy(ies) (limited pelvic lymphadenectomy)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0562","name":"Complex simulation w/pet-ct","description":"Therapeutic radiology simulation-aided field setting; complex, including acquisition of pet and ct imaging data required for radiopharmaceutical-directed radiation therapy treatment planning (i.e., modeling)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77085","name":"Dxa bone density axl vrt fx","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49651","name":"Lap ing hernia repair recur","description":"Laparoscopy, surgical; repair recurrent inguinal hernia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0050","name":"Alcohol/drug service 15 min","description":"Alcohol and/or drug services, brief intervention, per 15 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99324","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45347","name":"Sigmoidoscopy w/plcmt stent","description":"Sigmoidoscopy, flexible; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4366","name":"Dl amnio bur x-mem per sq cm","description":"Dual layer amnio burgeon x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1281","name":"Bp scrn no perf at interval","description":"Blood pressure reading not documented, reason not given","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69320","name":"Rebuild outer ear canal","description":"Reconstruction external auditory canal for congenital atresia, single stage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1822.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0283U","name":"Vw factor type 2b eval plsm","description":"Von willebrand factor (vwf), type 2b, platelet-binding evaluation, radioimmunoassay, plasma","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4279","name":"Vendaje ac, per sq cm","description":"Vendaje ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4290","name":"Membrane wrap hydr per sq cm","description":"Membrane wrap-hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4022","name":"Otolaryngology ss","description":"Otolaryngology mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0802","name":"Inj. (ani), up to 40 units","description":"Injection, corticotropin (ani), up to 40 units","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64474","name":"Lwr xtr fscl pln blk uni nfs","description":"Lower extremity fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1259","name":"Pt stat doc <= 1 yr dialysis","description":"Patient status documented within the first year of initiating dialysis","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0758T","name":"Dgtz gls mcrscp sl spc hchem","description":"Digitization of glass microscope slides for special stain, including interpretation and report, histochemical stain on frozen tissue block (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1503","name":"Vascular surgery mvp","description":"Vascular surgery mips value pathway","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0734T","name":"Rem r-t mtn nrehab tx mgmt","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; treatment management services by a physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0303U","name":"Hem rbc ads whl bld hypoxic","description":"Hem rbc ads whl bld hypoxic","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11303","name":"Shave skin lesion >2.0 cm","description":"Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion diameter over 2.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1213","name":"No hx spiro prs spiro>=70%","description":"No history of spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) and present spirometry is >= 70%","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1033","name":"Sv doula brth wrk per diem","description":"Services performed by a doula birth worker, per diem","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0909T","name":"Rplcmt int nstim sys vgs nrv","description":"Replacement of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62194","name":"Replace/irrigate catheter","description":"Replacement or irrigation, subarachnoid/subdural catheter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84119","name":"Test urine for porphyrins","description":"Porphyrins, urine; qualitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43497","name":"Transorl lwr esophgl myotomy","description":"Lower esophageal myotomy, transoral (ie, peroral endoscopic myotomy [poem])","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81457","name":"So neo gsap dna mcrstl ins","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis, microsatellite instability","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1427","name":"Doc med rsn bone scn","description":"Documentation of medical reason(s) for performing a bone scan (including documented pain related to prostate cancer, salvage therapy, other medical reasons)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0925T","name":"Rlcj skin pocket ccm-d pg","description":"Relocation of skin pocket for implanted cardiac contractility modulation-defibrillation pulse generator","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1000T","name":"Autol musc cell therapy admn","description":"Autologous muscle cell therapy, administration of muscle progenitor cells into the urethral sphincter, including cystoscopy and post-void residual ultrasound, when performed","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0746T","name":"Car ablt rad arr cnv loc map","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; conversion of arrhythmia localization and mapping of arrhythmia site (nidus) into a multidimensional radiation treatment plan","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0787T","name":"Revj/rmvl nea sac w/nstim","description":"Revision or removal of neurostimulator electrode array, sacral, with integrated neurostimulator","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35645","name":"Bpg subclavian-vertebral","description":"Bypass graft, with other than vein; subclavian-vertebral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1264.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81360","name":"Zrsr2 gene common variants","description":"Zrsr2 (zinc finger ccch-type, rna binding motif and serine/arginine-rich 2) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variant(s) (eg, e65fs, e122fs, r448fs)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0454U","name":"U rare ds id opt genome mapg","description":"U rare ds id opt genome mapg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45398","name":"Colonoscopy w/band ligation","description":"Colonoscopy, flexible; with band ligation(s) (eg, hemorrhoids)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":983.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4307","name":"American amnion, per sq cm","description":"American amnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4012","name":"Interventional rad ss","description":"Interventional radiology mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17286","name":"Dstr mal ls f/e/e/n/l/m>4.0","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), face, ears, eyelids, nose, lips, mucous membrane; lesion diameter over 4.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2976","name":"Band stabilization per tooth","description":"Band stabilization per tooth","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2032","name":"Myriad matrix, per sq cm","description":"Myriad matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0863T","name":"Rlcj pg wcs lv trnsmtr only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; transmitter component only","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92070","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0383U","name":"Tyrosinemia typ i mntr quan","description":"Tyrosinemia typ i mntr quan","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0343","name":"Laparotomy islet cell transp","description":"Laparotomy for islet cell transplant, includes portal vein catheterization and infusion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1355.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0395U","name":"Onc lng multiomics plsm alg","description":"Onc lng multiomics plsm alg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2021","name":"Neomatrix per sq cm","description":"Neomatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0908T","name":"Opn imp int nstm sys vgs nrv","description":"Open implantation of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92622","name":"Dx aly aud oi snd prcsr 1st","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; first 60 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0831T","name":"Dgtz gls mcrscp cytp c/v","description":"Digitization of glass microscope slides for cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9026","name":"Cryo fib comp path redu each","description":"Cryoprecipitated fibrinogen complex, pathogen reduced, each unit","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36836","name":"Prq av fstl crtj uxtr 1 acs","description":"Percutaneous arteriovenous fistula creation, upper extremity, single access of both the peripheral artery and peripheral vein, including fistula maturation procedures (eg, transluminal balloon angioplasty, coil embolization) when performed, including all vascular access, imaging guidance and radiolo","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6072","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (high noble metal)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50045","name":"Nephrotomy w/exploration","description":"Nephrotomy, with exploration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1021.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98005","name":"Synch audio-video est low 20","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low medical decision making. when using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1369","name":"Qualcare mental hlth/sud mvp","description":"Quality care in mental health and substance use disorders mips value pathway","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0679T","name":"Laps rmvl lead isdss","description":"Laparoscopic removal of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93593","name":"R hrt cath chd nml nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; normal native connections","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0319U","name":"Neph rna pretrnspl perph bld","description":"Neph rna pretrnspl perph bld","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76006","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9128","name":"Photobio therpy-first 15 min","description":"Photobio therpy-first 15 min","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4029","name":"Preventive medicine ss","description":"Preventive medicine mips specialty set","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99215","name":"Office o/p est hi 40 min","description":"Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 40 minutes must be met or ","date_of_service":"2026-06-05","other_properties":[{"name":"BillingTaxonomy","value":["207V00000X","207VB0002X","207VE0102X","207VF0040X","207VG0400X","207VM0101X","207VX0000X","207VX0201X","363LX0001X"]},{"name":"RenderingTaxonomy","value":["207V00000X","207VB0002X","207VE0102X","207VF0040X","207VG0400X","207VM0101X","207VX0000X","207VX0201X","363LX0001X"]},{"name":"ClaimSpecialtyCode","value":["904","905","907","AMGY","APNOB","COLP","FPEM","GYNE","GYON","GYSU","MAFE","NPAG","NPGY","NPOB","OBEM","OBGY","OBHR","OBST","REND","URGY"]},{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TH"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TH"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9161","name":"Inj denileuk difti-cxdl 1mcg","description":"Injection, denileukin diftitox-cxdl, 1 mcg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1292","name":"Pt 66+ frail inpt adv ill","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and an advanced illness diagnosis during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4424","name":"Revive ft per sq cm","description":"Revive ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39531","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1161.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0388","name":"Bitewing image capture only","description":"Bitewing image capture only","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0029","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0869T","name":"Njx b1 sub mtrl hw fixj aug","description":"Injection(s), bone-substitute material for bone and/or soft tissue hardware fixation augmentation, including intraoperative imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99494","name":"1st/sbsq psyc collab care","description":"Initial or subsequent psychiatric collaborative care management, each additional 30 minutes in a calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional (list separa","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":69.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87811","name":"Sars-cov-2 covid19 w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19])","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1073","name":"Testosterone pellet 75 mg","description":"Testosterone pellet, implant, 75 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0211","name":"Inj, nithiodote, 3mg / 125mg","description":"Injection, sodium nitrite 3 mg and sodium thiosulfate 125 mg (nithiodote)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0627U","name":"Psyc scz dna alys >15000","description":"Psyc scz dna alys >15000","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2543","name":"Dental onlay metallic 3 surf","description":"Onlay - metallic - three surfaces","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82962","name":"Glucose blood test","description":"Glucose, blood by glucose monitoring device(s) cleared by the fda specifically for home use","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90612","name":"Inf&sarscov2 vacc 31.7/.32im","description":"Influenza virus vaccine, trivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 31.7 mcg/0.32 ml dosage, for intramuscular use","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9573","name":"Inj, gadopiclenol, 1 ml","description":"Injection, gadopiclenol, 1 ml","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1474","name":"Pt dx dementia","description":"Patients with diagnosis of dementia","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88152","name":"Cytopath c/v auto redo","description":"Cytopathology, slides, cervical or vaginal; with manual screening and computer-assisted rescreening under physician supervision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2390","name":"Ant resin-based cmpst crown","description":"Resin-based composite crown anterior","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0445U","name":"Abeta42 & ptau181 eclia csf","description":"Abeta42 & ptau181 eclia csf","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6072","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (high noble metal)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34705","name":"Evac rpr a-biiliac ndgft","description":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-bi-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1294.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0503U","name":"Neuro alz ds bamyl&tau prtn","description":"Neuro alz ds bamyl&tau prtn","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0327U","name":"Ftl aneuploidy trsmy dna seq","description":"Ftl aneuploidy trsmy dna seq","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0300","name":"Amobarbital 125 mg inj","description":"Injection, amobarbital, up to 125 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1335","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1358","name":"Pts no <suicd idea 120 dys","description":"Patients who did not have a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9027","name":"Rbc o2 co2 reduced","description":"Red blood cells, leukocytes reduced, oxygen/ carbon dioxide reduced, each unit","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25455","name":"Epiphysl arrst dstl rds&ulna","description":"Epiphyseal arrest by epiphysiodesis or stapling; distal radius and ulna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":966.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83521","name":"Ig light chains free each","description":"Immunoglobulin light chains (ie, kappa, lambda), free, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4319","name":"Sanograft, per sq cm","description":"Sanograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1388","name":"Pt doc exm rec melmn","description":"Patients with documentation of an exam performed for recurrence of melanoma","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0431","name":"Diag tst detect mucos abnorm","description":"Adjunctive pre-diagnostic test that aids in detection of mucosal abnormalities including premalignant and malignant lesions not to include cytology or biopsy","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43889","name":"Gstr rstcv px trnsorl esg","description":"Gastric restrictive procedure, transoral, endoscopic sleeve gastroplasty (esg), including argon plasma coagulation, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36833","name":"Av fistula revision","description":"Revision, open, arteriovenous fistula; with thrombectomy, autogenous or nonautogenous dialysis graft (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":839.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33280","name":"Rmvl phrnc nrv stim pg only","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33276","name":"Insj phrnc nrv stim sys","description":"Insertion of phrenic nerve stimulator system (pulse generator and stimulating lead[s]), including vessel catheterization, all imaging guidance, and pulse generator initial analysis with diagnostic mode activation, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4543","name":"Supply trans elec nerve stim","description":"Supplies for transcutaneous electrical nerve stimulator, for nerves in the auricular region, per month","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33681","name":"Closure 1 vsd w/wo patch","description":"Closure of single ventricular septal defect, with or without patch;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2228.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82157","name":"Assay of androstenedione","description":"Androstenedione","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7601","name":"Ensifentrine inh 3 mg","description":"Ensifentrine, inhalation suspension, fda approved final product, non-compounded, administered through dme, unit dose form, 3 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26510","name":"Thumb tendon transfer","description":"Cross intrinsic transfer, each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":815.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"Evoked auditory test limited","description":"Distortion product evoked otoacoustic emissions; limited evaluation (to confirm the presence or absence of hearing disorder, 3-6 frequencies) or transient evoked otoacoustic emissions, with interpretation and report","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0898","name":"Argatroban nonesrd (auromed)","description":"Injection, argatroban (auromedics), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0454U","name":"U rare ds id opt genome mapg","description":"U rare ds id opt genome mapg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4334","name":"Amnioplast 1, per sq cm","description":"Amnioplast 1, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2644","name":"Dental onlay porc 4/more sur","description":"Onlay - porcelain/ceramic - four or more surfaces","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82945","name":"Glucose other fluid","description":"Glucose, body fluid, other than blood","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5992","name":"Low prosth foot shell repl","description":"All lower extremity prosthesis, foot shell for modular foot/non-solid ankle cushion heel (sach) replacement only","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4264","name":"Cocoon membrane, per sq cm","description":"Cocoon membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0287U","name":"Onc thyr dna&mrna 112 genes","description":"Onc thyr dna&mrna 112 genes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1469","name":"Hx of hep b, or pos bld test","description":"Patient has a history of hepatitis b illness or received a hepatitis b surface antigen, hepatitis b surface antibody, or total antibody to hepatitis b core antigen test with a positive result any time before or during the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6049","name":"Scale implt peri-implt inflm","description":"Scale implt peri-implt inflm","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9993","name":"Pall serv during meas","description":"Patient was provided palliative care services any time during the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1018T","name":"Elec alys npgs esoph sbsq w/","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35182","name":"Rpr cgen av fistula thrx&abd","description":"Repair, congenital arteriovenous fistula; thorax and abdomen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2108.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83906","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4323","name":"Alloply, per sq cm","description":"Alloply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9196","name":"Inj gemcitabine hcl (accord)","description":"Injection, gemcitabine hydrochloride (accord), not therapeutically equivalent to j9201, 200 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99494","name":"1st/sbsq psyc collab care","description":"Initial or subsequent psychiatric collaborative care management, each additional 30 minutes in a calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional (list separa","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":38.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47010","name":"Hepatot opn drg absc/cst 1/2","description":"Hepatotomy, for open drainage of abscess or cyst, 1 or 2 stages","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1164.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80220","name":"Drug asy hydroxychloroquine","description":"Hydroxychloroquine","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1326","name":"Pts dx hypotony","description":"Patients with a diagnosis of hypotony","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49621","name":"Rpr parastomal hernia rdc","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; reducible","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9220","name":"Indigotindisulfonate sod 1mg","description":"Injection, indigotindisulfonate sodium, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1166","name":"Path rpt tis spec wle/reexc","description":"Pathology report for tissue specimens produced from wide local excisions or re-excisions","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1255","name":"Pts w/ othr rsn vst,+prg tst","description":"Patients who have another reason for visiting the clinic [not prenatal or postpartum care] and have a positive pregnancy test but have not established the clinic as an ob provider (e.g., plan to terminate the pregnancy or seek prenatal services elsewhere)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0741T","name":"Rem auton alg nsln data coll","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; provision of software, data collection, transmission, and storage, each 30 days","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0417U","name":"Rare ds alys 335 nuc genes","description":"Rare ds alys 335 nuc genes","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0859T","name":"Ncntc ifr spctrsc o/t pad ea","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), other than for screening for peripheral arterial disease, image acquisition, interpretation, and report; each additional anatomic site (list separately in addition to code ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0134","name":"Inj acetaminophen -fresenius","description":"Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0723T","name":"Qmrcp w/o dx mri sm anat ses","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained without diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) during the same session","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0990T","name":"Trncrv inst biod hydrgl mtrl","description":"Transcervical instillation of biodegradable hydrogel materials, intrauterine","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29837","name":"Elbow arthroscopy/surgery","description":"Arthroscopy, elbow, surgical; debridement, limited","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":649.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22837","name":"Ant thrc vrt body tethrg 8+","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; 8 or more vertebral segments","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0336U","name":"Rare ds whl gen seq bld/slv","description":"Rare ds whl gen seq bld/slv","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6092","name":"Recement supp crown","description":"Recement implant/abutment supported crown","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4344","name":"Tri membrane wrap, per sq cm","description":"Tri-membrane wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0772T","name":"Vr px dissoc svc sm phy ea","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0683","name":"App of non-sheet skin sub g","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5133","name":"Inj, tofidence, 1 mg","description":"Injection, tocilizumab-bavi (tofidence), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26561","name":"Repair of web finger","description":"Repair of syndactyly (web finger) each web space; with skin flaps and grafts","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1128.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0708T","name":"Id ca immntx prep & 1st njx","description":"Intradermal cancer immunotherapy; preparation and initial injection","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1454","name":"New cied","description":"New cied","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7911","name":"Dental suture wound to 5 cm","description":"Complicated suture-up to 5 cm","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1448","name":"Pt dx pd bef end meas pd","description":"Patients with an active diagnosis of personality disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2018","name":"Permeaderm c, per sq cm","description":"Permeaderm c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24575","name":"Optx humeral epcndylr fx","description":"Open treatment of humeral epicondylar fracture, medial or lateral, includes internal fixation, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":953.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97750","name":"Physical performance test","description":"Physical performance test or measurement (eg, musculoskeletal, functional capacity), with written report, each 15 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0413U","name":"Onc hl neo opt gen mapg dna","description":"Onc hl neo opt gen mapg dna","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0577U","name":"Onc ovr serum alys 39 gps","description":"Onc ovr serum alys 39 gps","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38228","name":"Car-t admn autologous","description":"Chimeric antigen receptor t-cell (car-t) therapy; car-t cell administration, autologous","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46751","name":"Repair of anal sphincter","description":"Sphincteroplasty, anal, for incontinence or prolapse; child","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":675.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0138","name":"Inj acetaminoph 10mg/ibu 3mg","description":"Injection, acetaminophen 10 mg and ibuprofen 3 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0834T","name":"Dgtz gls mcrscp cytp oth xtn","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3425","name":"Hydroxocobalamin im 10mcg","description":"Injection, hydroxocobalamin, intramuscular, 10 mcg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0799T","name":"Tcat rmvl 2chmbr ldls pm ra","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right atrial pacemaker component","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1238","name":"Doc 2nd recom hzv 2-6 mo int","description":"Documentation that administration of second recombinant zoster vaccine could not occur during the performance period due to the recommended 2-6 month interval between doses (i.e, first dose received after october 31)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5992","name":"Low prosth foot shell repl","description":"All lower extremity prosthesis, foot shell for modular foot/non-solid ankle cushion heel (sach) replacement only","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0272U","name":"Hem genetic bld do 51 genes","description":"Hematology (genetic bleeding disorders), genomic sequence analysis of 51 genes, blood, buccal swab, or amniotic fluid, comprehensive","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9200","name":"Floxuridine injection","description":"Injection, floxuridine, 500 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2038","name":"Marigen pacto, per sq cm","description":"Marigen pacto, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85013","name":"Spun microhematocrit","description":"Blood count; spun microhematocrit","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0664","name":"Team remote e/m new pt 60 mn","description":"Team remote e/m new pt 60mins","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1193","name":"Rpts w/ imp/con mmr/msi","description":"Surgical pathology reports that contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4405","name":"Xwrap fenestra plus sq cm","description":"Xwrap fenestra plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81007","name":"Urine screen for bacteria","description":"Urinalysis; bacteriuria screen, except by culture or dipstick","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1385","name":"Pt rsn not seen 2nd pam","description":"Documentation of patient reasons for patients who were not seen for the second pam survey (e.g., less than four months between baseline pam assessment and follow-up","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43107","name":"Removal of esophagus","description":"Total or near total esophagectomy, without thoracotomy; with pharyngogastrostomy or cervical esophagogastrostomy, with or without pyloroplasty (transhiatal)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2820.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24332","name":"Tenolysis triceps","description":"Tenolysis, triceps","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":706.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0999T","name":"Autol musc cell therapy hrvg","description":"Autologous muscle cell therapy, harvesting of muscle progenitor cells, including ultrasound guidance, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7414","name":"Excision malig lesion>1.25cm","description":"Excision of malignant lesion greater than 1.25 cm","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88188","name":"Flowcytometry/read 9-15","description":"Flow cytometry, interpretation; 9 to 15 markers","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9697","name":"Inj, magtrace per study dose","description":"Injection, carboxydextran-coated superparamagnetic iron oxide, per study dose","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1189","name":"Doc khe pef w/efgr/uacr","description":"Documentation of a kidney health evaluation defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr) performed","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95919","name":"Quan puplmtry phy/qhp uni/bi","description":"Quantitative pupillometry with physician or other qualified health care professional interpretation and report, unilateral or bilateral","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1203","name":"No rsn ace-i/arb rx","description":"Ace inhibitor or arb therapy not prescribed during the measurement period, reason not given","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2327","name":"Inj risankizumab-rzaa 1 mg","description":"Injection, risankizumab-rzaa, intravenous, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6073","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (predominantly base metal)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1384","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98010","name":"Synch audio-only new mod 45","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection,","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2976","name":"Band stabilization per tooth","description":"Band stabilization per tooth","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6613","name":"Onlay cst base mtl >=3 surfa","description":"Onlay - cast predominantly base metal three or more surfaces","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0137","name":"Inten outpt svs,min 9 pr 7 d","description":"Intensive outpatient services; weekly bundle, minimum of 9 services over a 7 contiguous day period, which can include individual and group therapy with physicians or psychologists (or other mental health professionals to the extent authorized under state law); occupational therapy requiring the skil","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0300U","name":"Onc pan tum whl gen seq&opt","description":"Onc pan tum whl gen seq&opt","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1491","name":"Recd esrd mcp dur perf pd","description":"Receiving esrd mcp dialysis services by the provider during the performance period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1442","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0030","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1473","name":"Pt func cap not allow impr","description":"Patient situations, at any point during the denominator identification period, where the patients functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools, such as delirium, dementia, intellectual disabilities, and pervasive and specific de","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6517","name":"Grad com wrap w strap bn cus","description":"Gradient compression wrap with adjustable straps, below knee, each, custom","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6602","name":"Cst hgh nble mtl inlay 2 srf","description":"Inlay - cast high noble metal two surfaces","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9998","name":"Inj ustekinumab-aekn, 1 mg","description":"Injection, ustekinumab-aekn (selarsdi), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0259U","name":"Neph ckd nuc mrs meas gfr","description":"Nephrology (chronic kidney disease), nuclear magnetic resonance spectroscopy measurement of myo-inositol, valine, and creatinine, algorithmically combined with cystatin c (by immunoassay) and demographic data to determine estimated glomerular filtration rate (gfr), serum, quantitative","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5100","name":"Inj ustekinumab-kfce, 1 mg","description":"Injection, ustekinumab-kfce (yesintek), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0935T","name":"Cysto w/rnl pel symp dnrvtj","description":"Cystourethroscopy with renal pelvic sympathetic denervation, radiofrequency ablation, retrograde ureteral approach, including insertion of guide wire, selective placement of ureteral sheath(s) and multiple conformable electrodes, contrast injection(s), and fluoroscopy, bilateral","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95170","name":"Antigen therapy services","description":"Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy; whole body extract of biting insect or other arthropod (specify number of doses)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1192","name":"Pt w/ dx sq cell ca of esoph","description":"Patients with an existing diagnosis of squamous cell carcinoma of the esophagus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2035","name":"Corpl p therac p allac p mg","description":"Corplex p or theracor p or allacor p, per milligram","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0888T","name":"Histotripsy mal renal tissue","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant renal tissue, including imaging guidance","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0473","name":"Micro exam prep & report","description":"Accession of tissue gross and microscopic examination preparation and transmission of written report","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45388","name":"Colonoscopy w/ablation","description":"Colonoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":2529.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19364","name":"Brst rcnstj free flap","description":"Breast reconstruction; with free flap (eg, ftram, diep, siea, gap flap)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3188.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93595","name":"L hrt cath chd nm/abn nt cnj","description":"Left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone, normal or abnormal native connections","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1467","name":"Pt dx lynch syn","description":"Patients with an existing diagnosis of lynch syndrome","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5612","name":"Rep resin part dent base max","description":"Rep resin part dent base max","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75580","name":"N-invas est c ffr sw aly cta","description":"Noninvasive estimate of coronary fractional flow reserve (ffr) derived from augmentative software analysis of the data set from a coronary computed tomography angiography, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0709","name":"Intraoral cmplt radio images","description":"Intraoral cmplt radio images","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9886","name":"In-person attendance g code","description":"Behavioral counseling for diabetes prevention, in-person, group, 60 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74021","name":"Radex abdomen 3+ views","description":"Radiologic examination, abdomen; 3 or more views","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2956","name":"Indirect rest remov","description":"Indirect rest remov","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2472","name":"Inj, pantoprazole sodium chl","description":"Injection, pantoprazole sodium in sodium chloride (baxter), 40 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0788T","name":"Elec aly smp iins sp/sac nrv","description":"Electronic analysis with simple programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detecti","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0762T","name":"Dgtz gls mcrscp sl imm ea m","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, each multiplex antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67805","name":"Remove eyelid lesions","description":"Excision of chalazion; multiple, different lids","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1713","name":"Pfizer vacc adm ped 1st dose","description":"Pfizer vacc adm ped 1st dose","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7671","name":"Alveolus open reduction","description":"Alveolus - open reduction may include stabilization of teeth","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1020T","name":"Raman spectroscopy 1+skn les","description":"Raman spectroscopy of 1 or more skin lesions, with probability score for malignant risk derived by algorithmic analysis of data from each lesion","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1267","name":"Pt no act kid transplt wtlst","description":"Patients not observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"3074F","name":"Syst bp lt 130 mm hg","description":"Most recent systolic blood pressure less than 130 mm hg (dm) (htn, ckd, cad)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0343U","name":"Onc prst8 xom aly 442 sncrna","description":"Onc prst8 xom aly 442 sncrna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84433","name":"Asy thiopurin s-mthyltrnsfrs","description":"Thiopurine s-methyltransferase (tpmt)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1384","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0209","name":"Inj, sod thiosulfate (hope)","description":"Injection, sodium thiosulfate (hope), 100 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0523U","name":"Onc soltum dna ngs snv 22gen","description":"Onc soltum dna ngs snv 22gen","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2009","name":"Symphony, per sq cm","description":"Symphony, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4029","name":"Preventive medicine ss","description":"Preventive medicine mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0449U","name":"Car scr sev inh cond 5 genes","description":"Car scr sev inh cond 5 genes","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4423","name":"Biolab tri wrap fl per sq cm","description":"Biolab tri-membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9294","name":"Biofeed dig cog behav tx fda","description":"Prescription digital cognitive and/or behavioral therapy, biofeedback, fda cleared, per course of treatment","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83785","name":"Assay of manganese","description":"Manganese","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28575","name":"Treat foot dislocation","description":"Closed treatment of talotarsal joint dislocation; requiring anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0432U","name":"Klhl11 antb sr/csf asy qual","description":"Klhl11 antb sr/csf asy qual","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4319","name":"Sanograft, per sq cm","description":"Sanograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87182","name":"Sc std carbapenemase nzm det","description":"Susceptibility studies, antimicrobial agent; carbapenemase enzyme detection (eg, klebsiella pneumoniae carbapenemase [kpc], new delhi metallo-beta-lactamase [ndm], verona integron-encoded metallo-beta-lactamase [vim]), multiplex immunoassay, qualitative, per isolate","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0752T","name":"Dgtz gls mcrscp sld lvl iii","description":"Digitization of glass microscope slides for level iii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78609","name":"Brain imaging (pet)","description":"Brain imaging, positron emission tomography (pet); perfusion evaluation","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6525","name":"G com garm lwrleg/ft ngt cus","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, custom, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0665","name":"Team remote e/m est pt 10 mn","description":"Team remote e/m est. pt 10mins","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4560","name":"Nmes disposable","description":"Neuromuscular electrical stimulator (nmes), disposable, replacement only","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4005","name":"Family medicine ss","description":"Family medicine mips specialty set","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85018","name":"Hemoglobin","description":"Blood count; hemoglobin (hgb)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53853","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0258U","name":"Ai psor mrna 50-100 gen alg","description":"Autoimmune (psoriasis), mrna, next-generation sequencing, gene expression profiling of 50-100 genes, skin- surface collection using adhesive patch, algorithm reported as likelihood of response to psoriasis biologics","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0930T","name":"Ephys eval ccm-d ld 1st impl","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), at time of initial implantation or replacement with testing of cardiac contrac","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0963T","name":"Anosc sbmcsl njx bulking agt","description":"Anoscopy with directed submucosal injection of bulking agent into anal canal","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15017","name":"App skn cll ssp f/n/g/hf 1st","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 480 sq cm or less","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98015","name":"Synch audio-only est high 40","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selec","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1354","name":"Int caries med app per tooth","description":"Interim caries med app","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1003T","name":"Arthrp 1st crp/mtcrpl prostc","description":"Arthroplasty, first carpometacarpal joint, with distal trapezial and proximal first metacarpal prosthetic replacement (eg, first carpometacarpal total joint)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84560","name":"Assay of urine/uric acid","description":"Uric acid; other source","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4257","name":"Relese, per sq cm","description":"Relese, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0360U","name":"Onc lung elisa 7 autoant alg","description":"Onc lung elisa 7 autoant alg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0558U","name":"Onc clrct elisa bf7 ag serum","description":"Onc clrct elisa bf7 ag serum","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86826","name":"Hla x-match noncytotoxc addl","description":"Human leukocyte antigen (hla) crossmatch, non-cytotoxic (eg, using flow cytometry); each additional serum sample or sample dilution (list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0967T","name":"Tranal ins tmp clrc anst dev","description":"Transanal insertion of endoluminal temporary colorectal anastomosis protection device, including vacuum anchoring component and flexible sheath connected to external vacuum source and monitoring system","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9999","name":"Doc sys rsn <3 colon","description":"Documentation of system reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., unable to locate previous colonoscopy report, patient cannot provide precise date or details from previous colonoscopy, previous colonoscopy report was incomplete)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98978","name":"Rtm dev sply cbt 16-30 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of cognitive behavioral therapy, 16-30 days in a 30-day period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37261","name":"Revsc evasc ivt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88307","name":"Tissue exam by pathologist","description":"Level v - surgical pathology, gross and microscopic examination adrenal, resection bone - biopsy/curettings bone fragment(s), pathologic fracture brain, biopsy brain/meninges, tumor resection breast, excision of lesion, requiring microscopic evaluation of surgical margins breast, mastectomy - partia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0472U","name":"Ca vi psp&sp1 antb sjogren","description":"Ca vi psp&sp1 antb sjogren","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86037","name":"Anca titer each antibody","description":"Antineutrophil cytoplasmic antibody (anca); titer, each antibody","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45393","name":"Colonoscopy w/decompression","description":"Colonoscopy, flexible; with decompression (for pathologic distention) (eg, volvulus, megacolon), including placement of decompression tube, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97018","name":"Paraffin bath therapy","description":"Application of a modality to 1 or more areas; paraffin bath","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0425U","name":"Genom rpd seq alys ea cmprtr","description":"Genom rpd seq alys ea cmprtr","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4429","name":"Dermbnd chn, chx per sq cm","description":"Dermabind ch n or dermabind ch x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5811","name":"Denture interm cmplt mandbl","description":"Interim complete denture (mandibular)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4294","name":"Amnio quad-core, per sq cm","description":"Amnio quad-core, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0804","name":"3d facial scan indirect","description":"3d facial scan indirect","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97009","name":"Mchnl sclp cool after chemo","description":"Mechanical scalp cooling; provided after discontinuation of chemotherapy, each 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92639","name":"Hearing aid meas verif","description":"Hearing-aid measurement, verification with probe-microphone (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1596","name":"Inj, glycopyrrolate, 0.1 mg","description":"Injection, glycopyrrolate, 0.1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0447","name":"Behavior counsel obesity 15m","description":"Face-to-face behavioral counseling for obesity, 15 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":29.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93585","name":"Vngrph chd azygs/hemiazygs","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; azygos/hemiazygos venous system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0010","name":"Eom meos payment","description":"Enhancing oncology model (eom) monthly enhanced oncology services (meos) payment for eom enhanced services","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90613","name":"Inf&sarscov2 vacc 40/0.4 im","description":"Influenza virus vaccine, quadrivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 40 mcg/0.4 ml dosage, for intramuscular use","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2051","name":"Support broker waiver/diem","description":"Supports brokerage, self-directed, waiver; per diem","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1289","name":"No pt tbco cess interv rng","description":"Patient identified as tobacco user did not receive tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99497","name":"Advncd care plan 30 min","description":"Advance care planning including the explanation and discussion of advance directives such as standard forms (with completion of such forms, when performed), by the physician or other qualified health care professional; first 30 minutes, face-to-face with the patient, family member(s), and/or surroga","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":92.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9275","name":"Inj cosibelimab-ipdl, 2 mg","description":"Injection, cosibelimab-ipdl, 2 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0557","name":"Adv prim care mgmt lvl 2","description":"Advanced primary care management services for a patient with multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, which place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline, provided by c","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0811T","name":"Rem mlt day uroflow setup","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); set-up and patient education on use of equipment","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1432","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7911","name":"Dental suture wound to 5 cm","description":"Complicated suture-up to 5 cm","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0870T","name":"Imp subq prtl ascts pmp sys","description":"Implantation of subcutaneous peritoneal ascites pump system, percutaneous, including pump-pocket creation, insertion of tunneled indwelling bladder and peritoneal catheters with pump connections, including all imaging and initial programming, when performed","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24530","name":"Cltx sprcndylr humeral fx wo","description":"Closed treatment of supracondylar or transcondylar humeral fracture, with or without intercondylar extension; without manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5143","name":"Inj adalimumab-adbm, 1 mg","description":"Injection, adalimumab-adbm, biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64480","name":"Njx aa&/strd tfrm epi c/t ea","description":"Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or ct), cervical or thoracic, each additional level (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1372","name":"Mst rec gsa >=7 and<8","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 7.0% and < 8.0%","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1009T","name":"Rem mntr s-sclp cont eeg sys","description":"Remote monitoring of a sub-scalp implanted continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0037","name":"Pt not able to participate","description":"On date of encounter, patient is not able to participate in assessment or screening, including non-verbal patients, delirious, severely aphasic, severely developmentally delayed, severe visual or hearing impairment and for those patients, no knowledgeable informant available","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41016","name":"Drainage of mouth lesion","description":"Extraoral incision and drainage of abscess, cyst, or hematoma of floor of mouth; submental","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21245","name":"Reconstruction of jaw","description":"Reconstruction of mandible or maxilla, subperiosteal implant; partial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1028.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73222","name":"Mri joint upr extrem w/dye","description":"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":771.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4344","name":"Tri membrane wrap, per sq cm","description":"Tri-membrane wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49594","name":"Rpr aa hrn 1st 3-10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0538","name":"Ascvd rsk mng clin stf pr mo","description":"Atherosclerotic cardiovascular disease (ascvd) risk management services; clinical staff time; per calendar month","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86695","name":"Herpes simplex type 1 test","description":"Antibody; herpes simplex, type 1","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86305","name":"Human epididymis protein 4","description":"Human epididymis protein 4 (he4)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93792","name":"Pt/caregiver traing home inr","description":"Patient/caregiver training for initiation of home international normalized ratio (inr) monitoring under the direction of a physician or other qualified health care professional, face-to-face, including use and care of the inr monitor, obtaining blood sample, instructions for reporting home inr test ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6196","name":"Remv of ind rest on implt","description":"Remv of ind rest on implt","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0366U","name":"Onc bldr 10 prb recr bldr ca","description":"Onc bldr 10 prb recr bldr ca","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93598","name":"Car outp meas drg cath chd","description":"Cardiac output measurement(s), thermodilution or other indicator dilution method, performed during cardiac catheterization for the evaluation of congenital heart defects (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2710","name":"Neostigmine methylslfte inj","description":"Injection, neostigmine methylsulfate, up to 0.5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81560","name":"Trnsplj pd lvr&bwl cd154+cll","description":"Transplantation medicine (allograft rejection, pediatric liver and small bowel), measurement of donor and third-party-induced cd154+t-cytotoxic memory cells, utilizing whole peripheral blood, algorithm reported as a rejection risk score","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9244","name":"Office min sed drug enteral","description":"Office min sed drug enteral","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4429","name":"Dermbnd chn, chx per sq cm","description":"Dermabind ch n or dermabind ch x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4376","name":"Duograft aa per sq cm","description":"Duograft aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9563","name":"Ht inj immuno diem","description":"Home injectable therapy, immunotherapy, 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":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0821T","name":"Mntr psychdlc med 2ndphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; second physician or other qualified health care professional, concurrent with first physician or other qualified health care professional, each hour (list sepa","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85007","name":"Bl smear w/diff wbc count","description":"Blood count; blood smear, microscopic examination with manual differential wbc count","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86258","name":"Dgp antibody each ig class","description":"Gliadin (deamidated) (dgp) antibody, each immunoglobulin (ig) class","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78608","name":"Brain imaging (pet)","description":"Brain imaging, positron emission tomography (pet); metabolic evaluation","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0972T","name":"Asstv alg clsfctn burn hlg","description":"Assistive algorithmic classification of burn healing (ie, healing or nonhealing) by noninvasive multispectral imaging, including system set-up and acquisition, selection, and transmission of images, with automated generation of report","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60505","name":"Explore parathyroid glands","description":"Parathyroidectomy or exploration of parathyroid(s); with mediastinal exploration, sternal split or transthoracic approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1563.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37615","name":"Ligation major artery neck","description":"Ligation, major artery (eg, post-traumatic, rupture); neck","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":474.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1231","name":"Pt hcv tst no reactive res","description":"Patient receives hcv antibody test with nonreactive result","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0282U","name":"Rbc dna gntyp 12 bld grp gen","description":"Red blood cell antigen typing, dna, genotyping of 12 blood group system genes to predict 44 red blood cell antigen phenotypes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4364","name":"Am bur xp mem xpl hy p sq cm","description":"Amnio burgeon xplus membrane and xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3387","name":"Inj elivaldogene autotemecel","description":"Injection, elivaldogene autotemcel, per treatment","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1457","name":"Dx asth dur crnt/prv perf pd","description":"Patient had a diagnosis of asthma with any contact during the current or prior performance period or had asthma present on an active problem list any time during the performance period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2525","name":"Cl, hydrophilic, dual focus","description":"Contact lens, hydrophilic, dual focus, per lens","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7771","name":"Alveolus clsd reduc stblz te","description":"Alveolus closed reduction stabilization of teeth","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90785","name":"Psytx complex interactive","description":"Interactive complexity (list separately in addition to the code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":12.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":16.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5938","name":"Resct proth max comp remov","description":"Resct proth max comp remov","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"Ctlso a-p-l control custom","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2249.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0608U","name":"Reprdtve med ema rtpcr 10bct","description":"Reprdtve med ema rtpcr 10bct","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34712","name":"Tcat dlvr enhncd fixj dev","description":"Transcatheter delivery of enhanced fixation device(s) to the endograft (eg, anchor, screw, tack) and all associated radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":722.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0580U","name":"Bbrgdrferi antb detc 24rprtn","description":"Bbrgdrferi antb detc 24rprtn","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0801T","name":"Tcat rmv&rpl 2chmbr ldls pm","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; dual-cha","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52327","name":"Cystoscopy inject material","description":"Cystourethroscopy (including ureteral catheterization); with subureteric injection of implant material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0901T","name":"Plmt bone marrow smplg port","description":"Placement of bone marrow sampling port, including imaging guidance when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55715","name":"Bx prst8 ea add mri-us/ct/mr","description":"Biopsy, prostate, each additional, mri-ultrasound fusion or in-bore ct- or mri-guided targeted lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4479","name":"Transanal irrigation, electr","description":"Electronic transanal irrigation system, includes electronic pump, water reservoir, tubing, and accessories, without catheter, any type","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6560","name":"G stckng full/chap30-40 cust","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, custom, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6603","name":"Cst hgh nble mtl inlay >=3sr","description":"Inlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0526","name":"Est pt-cg dyad dem hig cmplx","description":"Management of established patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0697T","name":"Quan mr tis wo mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained without diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, targ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93304","name":"Echo transthoracic","description":"Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2644","name":"Dental onlay porc 4/more sur","description":"Onlay - porcelain/ceramic - four or more surfaces","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37277","name":"Rvsc evsc fpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52597","name":"Trurl rbtc wtrjt rescj prst8","description":"Transurethral robotic-assisted waterjet resection of prostate, including intraoperative planning, ultrasound guidance, control of postoperative bleeding, complete, including vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1316","name":"Tobacco non-user","description":"Current tobacco non-user","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81558","name":"Trnspl rej kdn mrna qpcr 139","description":"Transplantation medicine (allograft rejection, kidney), mrna, gene expression profiling by quantitative polymerase chain reaction (qpcr) of 139 genes, utilizing whole blood, algorithm reported as a binary categorization as transplant excellence, which indicates immune quiescence, or not transplant e","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5154","name":"Inj, omlyclo, 5 mg","description":"Injection, omalizumab-igec (omlyclo), biosimilar, 5 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37272","name":"Revsc evsc fpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0654","name":"Inj, liothyronine, 1 mcg","description":"Injection, liothyronine, 1 mcg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0423","name":"Genetic test spec analysis","description":"Genetic test spec analysis","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4479","name":"Transanal irrigation, electr","description":"Electronic transanal irrigation system, includes electronic pump, water reservoir, tubing, and accessories, without catheter, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0756T","name":"Dgtz gls mcrscp sld spc grpi","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group i, for microorganisms (eg, acid fast, methenamine silver) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0907T","name":"Coms ther ea addl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; each additional application, total wound(s) surface area less than or equal to 50 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0017","name":"Crisis psychotherapy 60m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); first 60 minutes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59025","name":"Fetal non-stress test","description":"Fetal non-stress test","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"Sup/ext non-ins inf pump syr","description":"Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0837T","name":"Dgtz gls mcrscp fna i&r","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; interpretation and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96203","name":"Mlt fam grp bhv train ea add","description":"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face with multiple sets of paren","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15853","name":"Removal sutr/stapl xreq anes","description":"Removal of sutures or staples not requiring anesthesia (list separately in addition to e/m code)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4364","name":"Am bur xp mem xpl hy p sq cm","description":"Amnio burgeon xplus membrane and xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2543","name":"Dental onlay metallic 3 surf","description":"Onlay - metallic - three surfaces","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85009","name":"Manual diff wbc count b-coat","description":"Blood count; manual differential wbc count, buffy coat","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92930","name":"Prq tcat plmt ntrac st 2+les","description":"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 2 or more distinct coronary lesions with 2 or more coronary stents deployed in 2 or more coronary segments, or a bifurcation lesion requiring ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":268.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1433","name":"Oral chemo wthn 30 days enc","description":"Patient on oral chemotherapy on or within 30 days before denominator eligible encounter","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0458U","name":"Onc brst ca s100 a8&a9 elisa","description":"Onc brst ca s100 a8&a9 elisa","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7295","name":"Eth estr and eton monthly","description":"Ethinyl estradiol and etonogestrel 0.015mg, 0.12mg per 24 hours; monthly vaginal ring, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4422","name":"Ac wrap per sq cm","description":"A/c wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92608","name":"Ex for speech device rx addl","description":"Evaluation for prescription for speech-generating augmentative and alternative communication device, face-to-face with the patient; each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1299","name":"Inj, eculizumab, 2 mg","description":"Injection, eculizumab, 2 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3809","name":"Whfo w/o joints pre ots","description":"Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9999","name":"Doc sys rsn <3 colon","description":"Documentation of system reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., unable to locate previous colonoscopy report, patient cannot provide precise date or details from previous colonoscopy, previous colonoscopy report was incomplete)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92288","name":"Scr dark adaptation meas i&r","description":"Screening dark adaptation measurement (eg, rod recovery intercept time), with interpretation and report","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2031","name":"Mirodry, per sq cm","description":"Mirodry wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0029","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1288","name":"Doc rsn no hbp scrn or f/u","description":"Documented reason for not screening or recommending a follow-up for high blood pressure","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31638","name":"Bronchoscopy revise stent","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with revision of tracheal or bronchial stent inserted at previous session (includes tracheal/bronchial dilation as required)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4284","name":"Dermabind sl, per sq cm","description":"Dermabind sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64474","name":"Lwr xtr fscl pln blk uni nfs","description":"Lower extremity fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37275","name":"Rvsc evsc fpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":270.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0335U","name":"Rare ds whl gen seq fetal","description":"Rare ds whl gen seq fetal","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0579U","name":"Nfro dbtc ckd elisa apoa4","description":"Nfro dbtc ckd elisa apoa4","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1294","name":"Bp scrn perf rec interval","description":"Normal blood pressure reading documented, follow-up not required","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1283","name":"Pt scrn tbco and id as user","description":"Patient screened for tobacco use and identified as a tobacco user","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1487","name":"Pt adm to hospice dur eval","description":"Patients in hospice in the year before or during the period of evaluation","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15778","name":"Impl absrb msh/prsth dly cls","description":"Implantation of absorbable mesh or other prosthesis for delayed closure of defect(s) (ie, external genitalia, perineum, abdominal wall) due to soft tissue infection or trauma","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49186","name":"Opn exc/dstr ntra-abd 5 cm/<","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5 cm or less","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9341","name":"Inj thiotepa (tepylute) 1 mg","description":"Injection, thiotepa (tepylute), 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96402","name":"Chemo hormon antineopl sq/im","description":"Chemotherapy administration, subcutaneous or intramuscular; hormonal anti-neoplastic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4327","name":"Duoamnion, per sq cm","description":"Duoamnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85007","name":"Bl smear w/diff wbc count","description":"Blood count; blood smear, microscopic examination with manual differential wbc count","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0701T","name":"Molec fluor img sus nev ea","description":"Molecular fluorescent imaging of suspicious nevus; each additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0827T","name":"Dgtz gls mcrscp cytp smears","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; smears with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19295","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0224","name":"Pemivibart infusion","description":"Intravenous infusion, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppr","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0928T","name":"Rem interrog dev ccm-d phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system with interim analysis and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1265","name":"Cms 2728 completed","description":"Cms medical evidence form 2728 for dialysis patients: initial form completed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6590","name":"Urinary cath disp suc pump","description":"External urinary catheters; disposable, with wicking material, for use with suction pump, per month","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0732T","name":"Immntx admn electroporatn im","description":"Immunotherapy administration with electroporation, intramuscular","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1497","name":"No doc fall med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93153","name":"Interrog w/o prgrmg ipnss","description":"Interrogation without programming of implanted phrenic nerve stimulator system","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9432","name":"Med food non inborn err meta","description":"Medical foods for non-inborn errors of metabolism","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0968T","name":"Insj/rplcmt epcrnl nstim sys","description":"Insertion or replacement of epicranial neurostimulator system, including electrode array and pulse generator, with connection to electrode array","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0524","name":"Est pt-cg dyad dem low cmplx","description":"Management of established patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35507","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1432.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15017","name":"App skn cll ssp f/n/g/hf 1st","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 480 sq cm or less","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38225","name":"Car-t hrv bld-drv t lymphcyt","description":"Chimeric antigen receptor t-cell (car-t) therapy; harvesting of blood-derived t lymphocytes for development of genetically modified autologous car-t cells, per day","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5142","name":"Inj adalimumab-ryvk, 1 mg","description":"Injection, adalimumab-ryvk biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6180","name":"Implnt maint proced","description":"Implnt maint proced","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9994","name":"Pall serv during meas","description":"Patient is using palliative care services any time during the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1472","name":"Hep b vaccine not received","description":"Patient did not receive recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5911","name":"Facial moulage sectional","description":"Facial moulage (sectional)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94625","name":"Phy/qhp op pulm rhb w/o mntr","description":"Physician or other qualified health care professional services for outpatient pulmonary rehabilitation; without continuous oximetry monitoring (per session)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1025T","name":"Alt elec fld dos&dlv sim mdl","description":"Alternating electric fields dosimetry and delivery-simulation modeling, creation and selection of patient-specific array layouts, and placement verification","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93574","name":"Njx cath slct pulm vn angrph","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary venous angiography of each distinct pulmonary vein during cardiac catheterization (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0270U","name":"Hem cgen coagj do 20 genes","description":"Hematology (congenital coagulation disorders), genomic sequence analysis of 20 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54115","name":"Treatment of penis lesion","description":"Removal foreign body from deep penile tissue (eg, plastic implant)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33280","name":"Rmvl phrnc nrv stim pg only","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator only","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9064","name":"Inj, cabazitaxel (sandoz)","description":"Injection, cabazitaxel (sandoz), not therapeutically equivalent to j9043, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22802","name":"Arthrd pst dfrm 7-12 vrt sgm","description":"Arthrodesis, posterior, for spinal deformity, with or without cast; 7 to 12 vertebral segments","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2589.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0925T","name":"Rlcj skin pocket ccm-d pg","description":"Relocation of skin pocket for implanted cardiac contractility modulation-defibrillation pulse generator","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93898","name":"Ven-artl shunt det mbubb njx","description":"Venous-arterial shunt detection with intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80506","name":"Path clin consltj prolng svc","description":"Pathology clinical consultation; prolonged service, each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7601","name":"Ensifentrine inh 3 mg","description":"Ensifentrine, inhalation suspension, fda approved final product, non-compounded, administered through dme, unit dose form, 3 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4333","name":"Ardeograft, per sq cm","description":"Ardeograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0873","name":"Inj daptomycin (xellia)","description":"Injection, daptomycin (xellia), not therapeutically equivalent to j0878 or j0872, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0747T","name":"Car ablt rad arrhyt dlvr rad","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; delivery of radiation therapy, arrhythmia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1370","name":"Inj, esomeprazole sod, 1 mg","description":"Injection, esomeprazole sodium, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4425","name":"Revive tl per sq cm","description":"Revive tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0011","name":"Hiv prep counsel, md 15-30m","description":"Individual counseling for pre-exposure prophylaxis (prep) by physician or qualified health care professional (qhp) to prevent human immunodeficiency virus (hiv), includes hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence, 15-30 minutes","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6564","name":"G com stckng waist 40+ cust","description":"Gradient compression stocking, waist length, 40 mmhg or greater, custom, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0623U","name":"Ai ms dna mthyl alys >5000","description":"Ai ms dna mthyl alys >5000","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9196","name":"Inj gemcitabine hcl (accord)","description":"Injection, gemcitabine hydrochloride (accord), not therapeutically equivalent to j9201, 200 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7299","name":"Rem anchorage device w/flap","description":"Rem anchorage device w/flap","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0595U","name":"Nfct ds tfp vctrbrn&zoonotic","description":"Nfct ds tfp vctrbrn&zoonotic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0948T","name":"Rem interrog dev ccm phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system with interim analysis, review, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1720","name":"Influenza vacc admin","description":"Influenza vacc admin","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4263","name":"Surgraft tl, per sq cm","description":"Surgraft tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9376","name":"Inj pozelimab-bbfg, 1 mg","description":"Injection, pozelimab-bbfg, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1407","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76989","name":"Dx intraop epcar us chd i&r","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; interpretation and report only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33824","name":"Repair pda div 18 yrs&older","description":"Repair of patent ductus arteriosus; by division, 18 years and older","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1455.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0589U","name":"Pfas24cmpnd hi-perf lc-ms/ms","description":"Pfas24cmpnd hi-perf lc-ms/ms","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0413U","name":"Onc hl neo opt gen mapg dna","description":"Onc hl neo opt gen mapg dna","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1170","name":"Pt w/o flu vax 7/1-6/30","description":"Patient did not receive an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9997","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11313","name":"Shave skin lesion >2.0 cm","description":"Shaving of epidermal or dermal lesion, single lesion, face, ears, eyelids, nose, lips, mucous membrane; lesion diameter over 2.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50970","name":"Ureter endoscopy","description":"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":439.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G3002","name":"Chronic pain mgmt 30 mins","description":"Chronic pain management and treatment, monthly bundle including, diagnosis; assessment and monitoring; administration of a validated pain rating scale or tool; the development, implementation, revision, and/or maintenance of a person-centered care plan that includes strengths, goals, clinical needs,","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93897","name":"Emboli detcj wo iv mbubb njx","description":"Emboli detection without intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0983T","name":"Rem mntr impl ivc snr phys","description":"Remote monitoring of an implanted inferior vena cava sensor for up to 30 days, including at least weekly downloads of inferior vena cava area recordings, interpretation(s), trend analysis, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1237","name":"Pt rsn no scrn","description":"Patient reason for not screening for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety (e.g., patient declined or other patient reasons)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49186","name":"Opn exc/dstr ntra-abd 5 cm/<","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5 cm or less","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59855","name":"Induced abortion 1+vag supp","description":"Induced abortion, by 1 or more vaginal suppositories (eg, prostaglandin) with or without cervical dilation (eg, laminaria), including hospital admission and visits, delivery of fetus and secundines;","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0793T","name":"Prq tcat thrm ablt nrv p-art","description":"Percutaneous transcatheter thermal ablation of nerves innervating the pulmonary arteries, including right heart catheterization, pulmonary artery angiography, and all imaging guidance","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93896","name":"Vsrctv std tcd icr art compl","description":"Vasoreactivity study performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0442U","name":"Nfct ds respir nfctj mxa&crp","description":"Nfct ds respir nfctj mxa&crp","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1202","name":"Pt rsn no ace-i/arb rx","description":"Documentation of patient reason(s) for not prescribing ace inhibitor or arb therapy during the measurement period, (e.g., patient declined, other patient reasons)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9003","name":"Leupro inj, camcevi etm, 1mg","description":"Leuprolide injectable (camcevi etm), 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9615","name":"Inj, pegulicianine, 1 mg","description":"Injection, pegulicianine, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0773T","name":"Vr px dissoc svc oth phy 1st","description":"Virtual reality (vr) procedural dissociation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports; initial 15 min","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4318","name":"E-graft, per sq cm","description":"E-graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0705","name":"Extra oral post radio image","description":"Extra oral post radio image","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99484","name":"Care mgmt svc bhvl hlth cond","description":"Care management services for behavioral health conditions, at least 20 minutes of clinical staff time, directed by a physician or other qualified health care professional, per calendar month, with the following required elements: initial assessment or follow-up monitoring, including the use of appli","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":42.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4283","name":"Biovance tri or 3l, sq cm","description":"Biovance tri-layer or biovance 3l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1492","name":"No reported fall","description":"Patients who did not report a fall","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1013T","name":"Lap srg imp/rpl eso nea&pg/r","description":"Laparoscopy, surgical, implantation or replacement of lower esophageal sphincter neurostimulator electrode array and neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver, including cruroplasty and/or electronic ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87811","name":"Sars-cov-2 covid19 w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19])","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9174","name":"Inj, docetaxel (beizray) 1mg","description":"Injection, docetaxel (beizray), 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0300U","name":"Onc pan tum whl gen seq&opt","description":"Onc pan tum whl gen seq&opt","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5946","name":"Max implt sup fix","description":"Max implt sup fix","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4328","name":"Most, per sq cm","description":"Most, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4411","name":"Amniomatrixf4x per sq cm","description":"Amniomatrixf4x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4414","name":"Simplichor per sq cm","description":"Simplichor, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95808","name":"Polysom any age 1-3> param","description":"Polysomnography; any age, sleep staging with 1-3 additional parameters of sleep, attended by a technologist","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":776.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0046","name":"No mrs 90 days post stk","description":"Clinical follow-up and mrs score not assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1205","name":"Isa reduced >=3","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4268","name":"Surgraft ft per sq cm","description":"Surgraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61590","name":"Infratemporal approach/skull","description":"Infratemporal pre-auricular approach to middle cranial fossa (parapharyngeal space, infratemporal and midline skull base, nasopharynx), with or without disarticulation of the mandible, including parotidectomy, craniotomy, decompression and/or mobilization of the facial nerve and/or petrous carotid a","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3399.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19316","name":"Mastopexy","description":"Mastopexy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":897.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98985","name":"Rtm dev sply mscsk sys 2-15d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of musculoskeletal system, 2-15 days in a 30-day period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0906T","name":"Coms ther 1st appl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; first application, total wound(s) surface area less than or equal to 50 sq cm","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15015","name":"App skn cl ssp agrft t/a/l 1","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; first 480 sq cm or less","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27217","name":"Treat pelvic ring fracture","description":"Open treatment of anterior pelvic bone fracture and/or dislocation for fracture patterns that disrupt the pelvic ring, unilateral, includes internal fixation, when performed (includes pubic symphysis and/or ipsilateral superior/inferior rami)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1211.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27033","name":"Arthrt hip expl/rmv loose/fb","description":"Arthrotomy, hip, including exploration or removal of loose or foreign body","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1167.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0687T","name":"Tx amblyopia dev setup 1st","description":"Treatment of amblyopia using an online digital program; device supply, educational set-up, and initial session","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99459","name":"Pelvic examination","description":"Pelvic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55708","name":"Bx prst8 trct us w/mri fus 1","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant) with mri-fusion-guidance, first targeted lesion","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1246","name":"Pt othr thn true imprt to me","description":"Patient provided a response other than completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93598","name":"Car outp meas drg cath chd","description":"Cardiac output measurement(s), thermodilution or other indicator dilution method, performed during cardiac catheterization for the evaluation of congenital heart defects (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4391","name":"Amnioplast double per sq cm","description":"Amnioplast double, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4298","name":"Amniocore pro, per sq cm","description":"Amniocore pro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59409","name":"Obstetrical care","description":"Vaginal delivery only (with or without episiotomy and/or forceps);","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0391","name":"Inj, artesunate, 1mg","description":"Injection, artesunate, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90968","name":"Esrd svc pr day pt 2-11","description":"End-stage renal disease (esrd) related services for dialysis less than a full month of service, per day; for patients 2-11 years of age","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87627","name":"Jt spc pthgn&rx rsist gen26+","description":"Infectious agent detection by nucleic acid (dna or rna); joint space pathogens and drug resistance genes, multiplex amplified probe technique, 26 or more targets","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93575","name":"Njx cath slct p angrph mapca","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary angiography of major aortopulmonary collateral arteries (mapcas) arising off the aorta or its systemic branches, during cardiac catheterization for congenital heart d","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6192","name":"Semi precision attachment","description":"Semi precision attachment","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0461","name":"Testing for cracked tooth","description":"Testing for cracked tooth","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0479U","name":"Tau phosphorylated ptau217","description":"Tau phosphorylated ptau217","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81459","name":"So neo gsap dna/dna&rna","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants, microsatellite instability, tumor mutation burden, and rearrangements","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0400U","name":"Ob xpnd car scr 145 genes","description":"Ob xpnd car scr 145 genes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86826","name":"Hla x-match noncytotoxc addl","description":"Human leukocyte antigen (hla) crossmatch, non-cytotoxic (eg, using flow cytometry); each additional serum sample or sample dilution (list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5949","name":"Mand implt sup fix part","description":"Mand implt sup fix part","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78608","name":"Brain imaging (pet)","description":"Brain imaging, positron emission tomography (pet); metabolic evaluation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1480","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0587U","name":"Ther rx mntr 60-150rx&metabl","description":"Ther rx mntr 60-150rx&metabl","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0064","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0605","name":"Antibody test pub hlth path","description":"Antibody test pub hlth path","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25492","name":"Prophylactic tx radius&ulna","description":"Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate; radius and ulna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1371.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0683","name":"App of non-sheet skin sub g","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82492","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1241","name":"Pt no resp seen as person","description":"Patient did not respond to the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30420","name":"Reconstruction of nose","description":"Rhinoplasty, primary; including major septal repair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1595.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7414","name":"Excision malig lesion>1.25cm","description":"Excision of malignant lesion greater than 1.25 cm","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0716T","name":"Car acous wavfrm rec cad rsk","description":"Cardiac acoustic waveform recording with automated analysis and generation of coronary artery disease risk score","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65112","name":"Remove eye/revise socket","description":"Exenteration of orbit (does not include skin graft), removal of orbital contents; with therapeutic removal of bone","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1524.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2039","name":"Innovamatrix fd, per sq cm","description":"Innovamatrix fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96573","name":"Pdt dstr prmlg les phys/qhp","description":"Photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosensitizing drug(s) provided by a physician or other qualified health care professional, per day","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4273","name":"Esano aaa, per sq cm","description":"Esano aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61892","name":"Rmv sk-mnt crnl nstm pg/rcvr","description":"Removal of skull-mounted cranial neurostimulator pulse generator or receiver with cranioplasty, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5155","name":"Inj, aflibercept-jbvf, 1 mg","description":"Injection, aflibercept-jbvf (yesafili), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54135","name":"Remove penis & nodes","description":"Amputation of penis, radical; in continuity with bilateral pelvic lymphadenectomy, including external iliac, hypogastric and obturator nodes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1670.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54660","name":"Revision of testis","description":"Insertion of testicular prosthesis (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71270","name":"Ct thorax dx c-/c+","description":"Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0052","name":"Mmip mental health and care","description":"Missing and murdered indigenous persons (mmip) mental health and clinical care","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74430","name":"Contrast x-ray bladder","description":"Cystography, minimum of 3 views, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99387","name":"Init pm e/m new pat 65+ yrs","description":"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; 65 years and old","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":118.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7414","name":"Excision malig lesion>1.25cm","description":"Excision of malignant lesion greater than 1.25 cm","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0598U","name":"Gi ibs igg antb 18food items","description":"Gi ibs igg antb 18food items","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36223","name":"Place cath carotid/inom art","description":"Selective catheter placement, common carotid or innominate artery, unilateral, any approach, with angiography of the ipsilateral intracranial carotid circulation and all associated radiological supervision and interpretation, includes angiography of the extracranial carotid and cervicocerebral arch,","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1971.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99427","name":"Prin care mgmt staff ea addl","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1281","name":"Bp scrn no perf at interval","description":"Blood pressure reading not documented, reason not given","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4540","name":"Trans elec nerv periph nerv","description":"Distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1399","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1442","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1430","name":"Ret exm ou no retinopthy doc","description":"Retinal exam finding without evidence of retinopathy in both eyes with severity level documented (in measurement year or in the prior year)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9247","name":"Mod sedation noniv-sub15min","description":"Mod sedation noniv-sub15min","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0945T","name":"Intraop assmt abnl tum tiss","description":"Intraoperative assessment for abnormal (tumor) tissue, in-vivo, following partial mastectomy (eg, lumpectomy) using computer-aided fluorescence imaging (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4422","name":"Ac wrap per sq cm","description":"A/c wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0836T","name":"Dgtz gls mcrscp fna ea addl","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1783","name":"Vac admin human pap dose 3","description":"Vac admin human pap dose 3","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0677T","name":"Laps repos lead isdss 1st ld","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first repositioned lead","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64567","name":"Perq elec nrv field stimj cn","description":"Percutaneous electrical nerve field stimulation, cranial nerves, without implantation","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6526","name":"G com garmt full leg/ft nght","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0834T","name":"Dgtz gls mcrscp cytp oth xtn","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80503","name":"Path clin consltj sf 5-20","description":"Pathology clinical consultation; for a clinical problem, with limited review of patients history and medical records and straightforward medical decision making when using time for code selection, 5-20 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4012","name":"Interventional rad ss","description":"Interventional radiology mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63085","name":"Remove vert body dcmprn thrc","description":"Vertebral corpectomy (vertebral body resection), partial or complete, transthoracic approach with decompression of spinal cord and/or nerve root(s); thoracic, single segment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2104.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01942","name":"Anes neuromd/ntrvrt lmbr/sac","description":"Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37272","name":"Revsc evsc fpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49615","name":"Rpr aa hrn rcr 3-10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, reducible","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1487","name":"Pt adm to hospice dur eval","description":"Patients in hospice in the year before or during the period of evaluation","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0316U","name":"B brgdrferi lyme ds ospa evl","description":"B brgdrferi lyme ds ospa evl","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9248","name":"Inj melphalan (hepzato) 1 mg","description":"Injection, melphalan (hepzato), 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43211","name":"Esophagoscop mucosal resect","description":"Esophagoscopy, flexible, transoral; with endoscopic mucosal resection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82926","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64467","name":"Thrc fascial pln blk uni nfs","description":"Thoracic fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0250","name":"Adm tocilizu covid-19 2nd","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9323","name":"Inj pemetrexed ditromethamin","description":"Injection, pemetrexed ditromethamine, 10 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1260","name":"Pt not doc <= 1 yr dialysis","description":"Patient status not documented within the first year of initiating dialysis","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55882","name":"Ablt trurl prst8 tis trnsdcr","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation; with insertion of transurethral ultrasound transducer for delivery of thermal ultrasound, including suprapubic tube placement and placement of ","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4264","name":"Cocoon membrane, per sq cm","description":"Cocoon membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5143","name":"Inj adalimumab-adbm, 1 mg","description":"Injection, adalimumab-adbm, biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97008","name":"Mchnl sclp cool prep plmt","description":"Mechanical scalp cooling; including hair preparation, individual cap placement, therapy initiation, and precooling period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4001","name":"Diagnostic rad ss","description":"Diagnostic radiology mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33845","name":"Excision coa w/graft","description":"Excision of coarctation of aorta, with or without associated patent ductus arteriosus; with graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1647.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87529","name":"Hsv dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); herpes simplex virus, amplified probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0525","name":"Inj cefotetan disodium 10 mg","description":"Injection, cefotetan disodium, 10 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1243","name":"Pt othr thn true heard","description":"Patient provided a response other than completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2998","name":"Inj plasminogen tvmh 1mg","description":"Injection, plasminogen, human-tvmh, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2281","name":"Inj moxifloxacin (fres kabi)","description":"Injection, moxifloxacin (fresenius kabi), not therapeutically equivalent to j2280, 100 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0238","name":"Intrav inf, toci, second dos","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37285","name":"Revsc evasc tpvt st sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2039","name":"Innovamatrix fd, per sq cm","description":"Innovamatrix fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1468","name":"Hep b vaccine received","description":"Patient received recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9002","name":"Intra-vag motion sens biofk","description":"Intra-vaginal motion sensor system, provides biofeedback for pelvic floor muscle rehabilitation device","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1153","name":"Pt w/ dx osteo doe","description":"Patient with diagnosis of osteoporosis on date of encounter","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49596","name":"Rpr aa hrn 1st > 10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0390U","name":"Ob pe kdr eng&rbp4 ia alg","description":"Ob pe kdr eng&rbp4 ia alg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1350","name":"Pt w/ suic saf pln init rev","description":"Patients who had a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0523","name":"Mgt nw pt dem mod-high cmplx","description":"Management of a new patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44316","name":"Devise bowel pouch","description":"Continent ileostomy (kock procedure) (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1415.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85247","name":"Clot factor viii multimetric","description":"Clotting; factor viii, von willebrand factor, multimetric analysis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4289","name":"Revoshield+ amnio, per sq cm","description":"Revoshield + amniotic barrier, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1385","name":"Pt rsn not seen 2nd pam","description":"Documentation of patient reasons for patients who were not seen for the second pam survey (e.g., less than four months between baseline pam assessment and follow-up","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4383","name":"Axolotl graft ult per sq cm","description":"Axolotl graft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1353","name":"Sealant repair per tooth","description":"Sealant repair per tooth","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6113","name":"Imp/abut rem dent part mand","description":"Imp/abut rem dent part mand","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0667","name":"Team remote e/m est pt 25 mn","description":"Team remote e/m est. pt 25mins","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0749T","name":"B1 str&fx rsk assmt dxr-bmd","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6105","name":"Remove implant body","description":"Remove implant body","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0234","name":"Intra inf, toci, second dos","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0993T","name":"N-invas assmt car rsk w/ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat with concurrent computed tomography scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional (list s","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53865","name":"Cysto insj dev ischmc rmdlg","description":"Cystourethroscopy with insertion of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3402","name":"Inj. remestemcel-l-rknd/ td","description":"Injection, remestemcel-l-rknd, per therapeutic dose","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0893T","name":"N-invas assmt bld oxygnation","description":"Noninvasive assessment of blood oxygenation, gas exchange efficiency, and cardiorespiratory status, with physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4035","name":"Thoracic surgery ss","description":"Thoracic surgery mips specialty set","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69140","name":"Remove ear canal lesion(s)","description":"Excision exostosis(es), external auditory canal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1002.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0688","name":"Inj cefazolin sodium, hikma","description":"Injection, cefazolin sodium (hikma), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93897","name":"Emboli detcj wo iv mbubb njx","description":"Emboli detection without intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64629","name":"Trml dstrj ios bvn ea addl","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; each additional vertebral body, lumbar or sacral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0897T","name":"N-invas augmnt arrhyt alys","description":"Noninvasive augmentative arrhythmia analysis derived from quantitative computational cardiac arrhythmia simulations, based on selected intervals of interest from 12-lead electrocardiogram and uploaded clinical parameters, including uploading clinical parameters with interpretation and report","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15100","name":"Splt agrft t/a/l 1st 100sqcm","description":"Split-thickness autograft, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children (except 15050)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":822.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4273","name":"Esano aaa, per sq cm","description":"Esano aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37284","name":"Revsc evasc tpvt st sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0521U","name":"Rf iga&igm ccp antb sr-a ia","description":"Rf iga&igm ccp antb sr-a ia","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1476","name":"Pt dx cog imp or ad","description":"Patients with diagnosis of cognitive impairment or alzheimers disease","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1412","name":"Inj roctavian ml 2x10^13vc g","description":"Injection, valoctocogene roxaparvovec-rvox, per ml, containing nominal 2 x 10^13 vector genomes","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0875T","name":"Prgrm subq prtl asct pmp sys","description":"Programming of subcutaneously implanted peritoneal ascites pump system by physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0528","name":"Mgt est pt dem mod-hi cmplx","description":"Management of established patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4309","name":"Via matrix, per sq cm","description":"Via matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1495","name":"Fall w/ poc, no fall","description":"Patients that reported a fall occurred who had a plan of care for falls documented or patients that did not report a fall","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0447U","name":"Ai ds sle alys 11 cytokine","description":"Ai ds sle alys 11 cytokine","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"Limited visual field xm","description":"Visual field examination, unilateral or bilateral, with interpretation and report; limited examination (eg, tangent screen, autoplot, arc perimeter, or single stimulus level automated test, such as octopus 3 or 7 equivalent)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99348","name":"Home/res vst est low mdm 30","description":"Home or residence visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0875T","name":"Prgrm subq prtl asct pmp sys","description":"Programming of subcutaneously implanted peritoneal ascites pump system by physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2510","name":"Penicillin g procaine inj","description":"Injection, penicillin g procaine, aqueous, up to 600,000 units","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1382","name":"Enc dur perf pd pos 11","description":"Patient encounter during the performance period with place of service code 11","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0526","name":"Est pt-cg dyad dem hig cmplx","description":"Management of established patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0488U","name":"Ob fetal ag nipt cfdna alys","description":"Ob fetal ag nipt cfdna alys","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4409","name":"Amniomatrixf3x per sq cm","description":"Amniomatrixf3x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77080","name":"Dxa bone density axial","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61892","name":"Rmv sk-mnt crnl nstm pg/rcvr","description":"Removal of skull-mounted cranial neurostimulator pulse generator or receiver with cranioplasty, when performed","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78492","name":"Myocrd img pet mlt rst&strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); multiple studies at rest and stress (exercise or pharmacologic)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4419","name":"Biolab wrap flw lt per sq cm","description":"Biolab membrane wrap lite flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","name":"Scoliosis orth sag/ cor","description":"Scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla to trochanter, includes all accessory pads, straps and interface, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual ","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50740","name":"Fusion of ureter & kidney","description":"Ureteropyelostomy, anastomosis of ureter and renal pelvis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1242.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21347","name":"Opn tx nasomax fx multple","description":"Open treatment of nasomaxillary complex fracture (lefort ii type); requiring multiple open approaches","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1383.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0360U","name":"Onc lung elisa 7 autoant alg","description":"Onc lung elisa 7 autoant alg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4318","name":"E-graft, per sq cm","description":"E-graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6039","name":"Passive custom digit/thumb","description":"Passive prosthetic digit or thumb prosthesis not including hand restoration partial hand, full or partial, custom made, any material, initial or replacement, per single passive prosthetic digit or thumb","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0484U","name":"Nfct ds mgen 23s rrna pt mut","description":"Nfct ds mgen 23s rrna pt mut","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30620","name":"Intranasal reconstruction","description":"Septal or other intranasal dermatoplasty (does not include obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":701.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1330","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9573","name":"Inj, gadopiclenol, 1 ml","description":"Injection, gadopiclenol, 1 ml","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9912","name":"Pre-visit patient screening","description":"Pre-visit patient screening","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0675","name":"Inj, carboprost, 0.1 mg","description":"Injection, carboprost tromethamine, 0.1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58580","name":"Transcrv abltj utrn fibrd rf","description":"Transcervical ablation of uterine fibroid(s), including intraoperative ultrasound guidance and monitoring, radiofrequency","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0165","name":"Inj epinephrine nos 0.1 mg","description":"Injection, epinephrine, not otherwise specified, 0.1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4283","name":"Biovance tri or 3l, sq cm","description":"Biovance tri-layer or biovance 3l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38300","name":"Drainage lymph node lesion","description":"Drainage of lymph node abscess or lymphadenitis; simple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76014","name":"Mr sfty implt&/fb asmt stf 1","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0692T","name":"Therapeutic ultrafiltration","description":"Therapeutic ultrafiltration","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7528","name":"Mycophen mofetil for susp","description":"Mycophenolate mofetil, for suspension, oral, 100 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17250","name":"Chem caut of granltj tissue","description":"Chemical cauterization of granulation tissue (ie, proud flesh)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":106.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":41.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96381","name":"Admn rsv monoc antb im njx","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33210","name":"Insert electrd/pm cath sngl","description":"Insertion or replacement of temporary transvenous single chamber cardiac electrode or pacemaker catheter (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35685","name":"Bypass graft patency/patch","description":"Placement of vein patch or cuff at distal anastomosis of bypass graft, synthetic conduit (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1261","name":"Pts on wtlist bef dialysis","description":"Patients that were on the kidney or kidney-pancreas waitlist prior to initiation of dialysis","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93350","name":"Stress tte only","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"Non-adju cgm supply allow","description":"Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KF"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4468","name":"Exsuff belt incl all sup acc","description":"Exsufflation belt, includes all supplies and accessories","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2393","name":"Post 3 srfc resinbased cmpst","description":"Resin-based composite - three surfaces posterior","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7411","name":"Excision benign lesion>1.25c","description":"Excision of benign lesion greater than 1.25 cm","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0673T","name":"Abltj b9 thyr ndul perq lasr","description":"Ablation, benign thyroid nodule(s), percutaneous, laser, including imaging guidance","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0967T","name":"Tranal ins tmp clrc anst dev","description":"Transanal insertion of endoluminal temporary colorectal anastomosis protection device, including vacuum anchoring component and flexible sheath connected to external vacuum source and monitoring system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1460","name":"Dx copd, cf, or arf","description":"Diagnosis for chronic obstructive pulmonary disease, emphysema, cystic fibrosis, or acute respiratory failure","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4288","name":"Replacement breastpump valve","description":"Valve for breast pump, replacement","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6253","name":"Provisional pontic","description":"Provisional pontic","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1193","name":"Rpts w/ imp/con mmr/msi","description":"Surgical pathology reports that contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0952T","name":"Tot impl amei rev/rplc mstdc","description":"Totally implantable active middle ear hearing implant; revision or replacement, with mastoidectomy and replacement of sound processor","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7259","name":"Nerve dissection","description":"Nerve dissection","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36410","name":"Vnpnxr 3yr/> phy/qhp dx/ther","description":"Venipuncture, age 3 years or older, necessitating the skill of a physician or other qualified health care professional (separate procedure), for diagnostic or therapeutic purposes (not to be used for routine venipuncture)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":18.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37268","name":"Revsc evasc fpvt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0483","name":"Indirect immunofluorescence","description":"Indirect immunofluorescence","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51597","name":"Removal of pelvic structures","description":"Pelvic exenteration, complete, for vesical, prostatic or urethral malignancy, with removal of bladder and ureteral transplantations, with or without hysterectomy and/or abdominoperineal resection of rectum and colon and colostomy, or any combination thereof","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2440.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93588","name":"Vngrph chd vnvn cltrl below","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating below the heart (eg, from the inferior vena cava) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2025","name":"Miro3d per cubic cm","description":"Miro3d, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0017","name":"Crisis psychotherapy 60m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); first 60 minutes","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0741","name":"Inj, cabote rilpivir 2mg 3mg","description":"Injection, cabotegravir and rilpivirine, 2mg/3mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35246","name":"Rpr blvsl vn grf ntrthrc w/o","description":"Repair blood vessel with vein graft; intrathoracic, without bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1858.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1355","name":"Caries med app per tooth","description":"Caries med app per tooth","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1291","name":"Pt 66+ frailty and med dem","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4439","name":"Instagraft per sq cm","description":"Instagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93153","name":"Interrog w/o prgrmg ipnss","description":"Interrogation without programming of implanted phrenic nerve stimulator system","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93792","name":"Pt/caregiver traing home inr","description":"Patient/caregiver training for initiation of home international normalized ratio (inr) monitoring under the direction of a physician or other qualified health care professional, face-to-face, including use and care of the inr monitor, obtaining blood sample, instructions for reporting home inr test ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31585","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":532.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0467U","name":"Onc bldr dna ngs 60gen&aneup","description":"Onc bldr dna ngs 60gen&aneup","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4287","name":"Dermabind dl, per sq cm","description":"Dermabind dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0461","name":"Testing for cracked tooth","description":"Testing for cracked tooth","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9954","name":"Fab/del oral appliance thxpy","description":"Fab/del oral appliance thxpy","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28555","name":"Repair foot dislocation","description":"Open treatment of tarsal bone dislocation, includes internal fixation, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92635","name":"Hearing aid fitg svc ea addl","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; each additional 15 minutes (list separately in addition to code","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0561U","name":"Onc mrd gsa cfdna subsequent","description":"Onc mrd gsa cfdna subsequent","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0533","name":"Buprenorphone inj weekly","description":"Medication assisted treatment, buprenorphine (injectable) administered on a weekly basis; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid tre","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64654","name":"1st opn implt bat modulj sys","description":"Initial open implantation of baroreflex activation therapy (bat) modulation system, including lead placement onto the carotid sinus, lead tunnelling, connection to a pulse generator placed in a distant subcutaneous pocket (ie, total system), and intraoperative interrogation and programming","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J7513","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42220","name":"Reconstruct cleft palate","description":"Palatoplasty for cleft palate; secondary lengthening procedure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":655.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0754T","name":"Dgtz gls mcrscp sld level v","description":"Digitization of glass microscope slides for level v, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0236","name":"Intrav inf, mon anti, sec do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4256","name":"Mlg complet, per sq cm","description":"Mlg-complete, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55881","name":"Ablt trurl prst8 tis thrm us","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation;","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0736","name":"Inj, clindamycin phosp 300mg","description":"Injection, clindamycin phosphate, 300 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87513","name":"H pylri clrthmcn rst amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); helicobacter pylori (h. pylori), clarithromycin resistance, amplified probe technique","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52234","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; small bladder tumor(s) (0.5 up to 2.0 cm)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4025","name":"Physical medicine ss","description":"Physical medicine mips specialty set","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01941","name":"Anes neuromd/ntrvrt crv/thrc","description":"Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1443","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98002","name":"Synch audio-video new mod 45","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate medical decision making. when using total time on the date of the encounter for code selection, 45 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81418","name":"Rx metab gen seq alys pnl 6","description":"Drug metabolism (eg, pharmacogenomics) genomic sequence analysis panel, must include testing of at least 6 genes, including cyp2c19, cyp2d6, and cyp2d6 duplication/deletion analysis","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4005","name":"Family medicine ss","description":"Family medicine mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3291","name":"Tranexamic acid in sod chlor","description":"Injection, tranexamic acid in sodium chloride, 5 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26373","name":"Repair finger/hand tendon","description":"Repair or advancement of profundus tendon, with intact superficialis tendon; secondary without free graft, each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1180.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4287","name":"Disp col sto bag breast milk","description":"Disposable collection and storage bag for breast milk, any size, any type, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0390U","name":"Ob pe kdr eng&rbp4 ia alg","description":"Ob pe kdr eng&rbp4 ia alg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74181","name":"Mri abdomen w/o contrast","description":"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":653.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91113","name":"Gi trc img intral colon i&r","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5130","name":"Inj, fylnetra, 0.5 mg","description":"Injection, pegfilgrastim-pbbk (fylnetra), biosimilar, 0.5 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61026","name":"Injection into brain canal","description":"Ventricular puncture through previous burr hole, fontanelle, suture, or implanted ventricular catheter/reservoir; with injection of medication or other substance for diagnosis or treatment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G3003","name":"Chronic pain mgmt addl 15m","description":"Each additional 15 minutes of chronic pain management and treatment by a physician or other qualified health care professional, per calendar month. (list separately in addition to code for g3002. when using g3003, 15 minutes must be met or exceeded.)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0718T","name":"Adrc ther prtl rc tear njx","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; injection into supraspinatus tendon including ultrasound guidance, unilateral","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1025T","name":"Alt elec fld dos&dlv sim mdl","description":"Alternating electric fields dosimetry and delivery-simulation modeling, creation and selection of patient-specific array layouts, and placement verification","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97035","name":"App mdlty 1+ultrasound ea 15","description":"Application of a modality to 1 or more areas; ultrasound, each 15 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96381","name":"Admn rsv monoc antb im njx","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0405U","name":"Onc pncrtc 59 mthltn blk mrk","description":"Onc pncrtc 59 mthltn blk mrk","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0566U","name":"Onc lng qpcr-bsd alys 13dmrs","description":"Onc lng qpcr-bsd alys 13dmrs","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4346","name":"Shelter dm matrix per sq cm","description":"Shelter dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1188","name":"Pt w/ ckd stg 5","description":"Patients with a diagnosis of chronic kidney disease (ckd) stage 5","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0528","name":"Mgt est pt dem mod-hi cmplx","description":"Management of established patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81007","name":"Urine screen for bacteria","description":"Urinalysis; bacteriuria screen, except by culture or dipstick","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7252","name":"Part extract for implant","description":"Part extract for implant","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2246","name":"Inj, micafungin (baxter)","description":"Injection, micafungin in sodium (baxter), not therapeutically equivalent to j2248, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0774T","name":"Vr px dissoc svc oth phy ea","description":"Virtual reality (vr) procedural dissociation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports; each additiona","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4382","name":"Advograft dual per sq cm","description":"Advograft dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20520","name":"Rmvl fb musc/tdn simple","description":"Removal of foreign body in muscle or tendon sheath; simple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0808T","name":"Pulm tiss vntj alys w/ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with computed tomography (ct) images taken for the purpose of pulmonary tissue ventilation analysis, including data preparation and transmission, quantificati","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90785","name":"Psytx complex interactive","description":"Interactive complexity (list separately in addition to the code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":12.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1250","name":"Inj dobutamine hcl/250 mg","description":"Injection, dobutamine hydrochloride, per 250 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82272","name":"Occult bld feces 1-3 tests","description":"Blood, occult, by peroxidase activity (eg, guaiac), qualitative, feces, 1-3 simultaneous determinations, performed for other than colorectal neoplasm screening","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0542","name":"No pt prsnt train add 15","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0559U","name":"Onc brs quan elisa bf9ag srm","description":"Onc brs quan elisa bf9ag srm","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1015T","name":"Rev/rmv lw esoph sphnc npg/r","description":"Revision or removal, lower esophageal sphincter neurostimulator pulse generator or receiver","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2780","name":"Crown 3/4 cast hi noble met","description":"Crown - 3/4 cast high noble metal","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49614","name":"Rpr aa hrn rcr < 3 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, incarcerated or strangulated","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64598","name":"Revj/rmvl nea pn w/int nstim","description":"Revision or removal of neurostimulator electrode array, peripheral nerve, with integrated neurostimulator","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0520U","name":"Ther rx mntr 200+ rx/sbsts","description":"Ther rx mntr 200+ rx/sbsts","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2050","name":"Financial mgt waiver/diem","description":"Financial management, self-directed, waiver; per diem","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49591","name":"Rpr aa hrn 1st < 3 cm rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, reducible","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5612","name":"Rep resin part dent base max","description":"Rep resin part dent base max","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0891","name":"Argatroban nonesrd (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1596","name":"Inj, glycopyrrolate, 0.1 mg","description":"Injection, glycopyrrolate, 0.1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77092","name":"Tbs i&r fx rsk qhp","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; interpretation and report on fracture-risk only by other qualified health care professional","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87468","name":"Anaplsma phgcytophlm amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); anaplasma phagocytophilum, amplified probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5811","name":"Denture interm cmplt mandbl","description":"Interim complete denture (mandibular)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80150","name":"Assay of amikacin","description":"Amikacin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71048","name":"X-ray exam chest 4+ views","description":"Radiologic examination, chest; 4 or more views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1151","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76984","name":"Dx intraop thoracic aorta us","description":"Ultrasound, intraoperative thoracic aorta (eg, epiaortic), diagnostic","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1445","name":"Pp care visit by 12 weeks","description":"Postpartum care visit before or at 12 weeks of giving birth","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99468","name":"Neonate crit care initial","description":"Initial inpatient neonatal critical care, per day, for the evaluation and management of a critically ill neonate, 28 days of age or younger","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":857.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0930T","name":"Ephys eval ccm-d ld 1st impl","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), at time of initial implantation or replacement with testing of cardiac contrac","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1243","name":"Pt othr thn true heard","description":"Patient provided a response other than completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0943T","name":"Cysto flx rmvl urtl scaffold","description":"Cystourethroscopy, flexible; with removal of prostatic urethral scaffold","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23505","name":"Cltx clavicular fx w/mnpj","description":"Closed treatment of clavicular fracture; with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9052","name":"Inj, carmustine (accord)","description":"Injection, carmustine (accord), not therapeutically equivalent to j9050, 100 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1574","name":"Inj, ganciclovir (exela)","description":"Injection, ganciclovir sodium (exela), not therapeutically equivalent to j1570, 500 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67516","name":"Sprchoroidal spc njx rx agt","description":"Suprachoroidal space injection of pharmacologic agent (separate procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9955","name":"Oral app thxpy titration vis","description":"Oral app thxpy titration vis","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0573U","name":"Onc pancreas 3bmrk pclf alg","description":"Onc pancreas 3bmrk pclf alg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98927","name":"Osteopath manj 5-6 regions","description":"Osteopathic manipulative treatment (omt); 5-6 body regions involved","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":20.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":69.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99459","name":"Pelvic examination","description":"Pelvic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49189","name":"Opn exc/dst ntra-abd 20.1-30","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 20.1 to 30 cm","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0316U","name":"B brgdrferi lyme ds ospa evl","description":"B brgdrferi lyme ds ospa evl","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2781","name":"Crown 3/4 cast base metal","description":"Crown - 3/4 cast predominantly base metal","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1497","name":"No doc fall med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77438","name":"Surf rad thr orthvlt>150-500","description":"Surface radiation therapy; orthovoltage, delivery, >150-500 kv, per fraction","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4014","name":"Nephrology ss","description":"Nephrology mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4027","name":"Plastic surgery ss","description":"Plastic surgery mips specialty set","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4281","name":"Barrera slor dl per sq cm","description":"Barrera sl or barrera dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0625U","name":"Endocrinol op dna alys>5000","description":"Endocrinol op dna alys>5000","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50576","name":"Kidney endoscopy & treatment","description":"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without biopsy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":669.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4275","name":"Esano aca, per sq cm","description":"Esano aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33288","name":"Rmv&rplcmt phrnc nrv stim ld","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4335","name":"Amnioplast 2, per sq cm","description":"Amnioplast 2, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86043","name":"Acetylcholn rcptr modlg antb","description":"Acetylcholine receptor (achr); modulating antibody","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92628","name":"Eval hearing aid cand 1st 30","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0954T","name":"Tot impl amei rplc snd proc","description":"Totally implantable active middle ear hearing implant; replacement of sound processor only, with attachment to existing transducers","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37265","name":"Revsc evsc fpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0682","name":"App non-sheet skin sub add","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (list separately in addition to code for pri","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0577U","name":"Onc ovr serum alys 39 gps","description":"Onc ovr serum alys 39 gps","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61305","name":"Crnec/crnot expl infratntorl","description":"Craniectomy or craniotomy, exploratory; infratentorial (posterior fossa)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2192.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82172","name":"Assay of apolipoprotein","description":"Apolipoprotein, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0168","name":"Epinephrine (intl med sys)","description":"Injection, epinephrine (international medication systems), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85660","name":"Rbc sickle cell test","description":"Sickling of rbc, reduction","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83013","name":"H pylori (c-13) breath","description":"Helicobacter pylori; breath test analysis for urease activity, non-radioactive isotope (eg, c-13)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82272","name":"Occult bld feces 1-3 tests","description":"Blood, occult, by peroxidase activity (eg, guaiac), qualitative, feces, 1-3 simultaneous determinations, performed for other than colorectal neoplasm screening","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0801","name":"3d dental scan direct","description":"3d dental scan direct","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0622U","name":"Psyc mdd dna alys >20000","description":"Psyc mdd dna alys >20000","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37274","name":"Rvsc evsc fpvt athrc cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4011","name":"Internal medicine ss","description":"Internal medicine mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4033","name":"Skilled nursing facility ss","description":"Skilled nursing facility mips specialty set","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S4024","name":"Air polymer foam per study","description":"Air polymer-type a intrauterine foam, per study dose","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2001","name":"Suct pum ext mgmt sys","description":"Suction pump, home model, portable or stationary, electric, any type, for use with external urine and/or fecal management system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0861T","name":"Rmvl pg wcs lv both compnt","description":"Removal of pulse generator for wireless cardiac stimulator for left ventricular pacing; both components (battery and transmitter)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37286","name":"Revsc evasc tpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0369","name":"Max mri capture & interprete","description":"Max mri capture & interprete","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1248","name":"Pt resp true seen as person","description":"Patient responded completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0818T","name":"Revj/rmvl ins ptn subq","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0882T","name":"Intraop ther estim pn ue 1st","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; initial nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9071","name":"Inj cyclophosphamd auromedic","description":"Injection, cyclophosphamide (auromedics), 5 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0682T","name":"Removal pulse gen only isdss","description":"Removal of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0688T","name":"Tx amblyopia assmt w/report","description":"Treatment of amblyopia using an online digital program; assessment of patient performance and program data by physician or other qualified health care professional, with report, per calendar month","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0500U","name":"Autoinflam ds vexas synd dna","description":"Autoinflam ds vexas synd dna","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33881","name":"Evasc rpr ta ndgft xcov lsa","description":"Endovascular repair of thoracic aorta, including pre-procedure sizing and device selection, nonselective catheterization(s), all associated radiological supervision and interpretation; by deployment of an aorto-aortic tube endograft not involving coverage of the left subclavian artery origin and all","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1854.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1191","name":"Hspc svc any time in meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37600","name":"Ligation xtrnl carotid art","description":"Ligation; external carotid artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":864.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1321","name":"Couns for high risk sub use","description":"Couns for high risk sub use","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1288","name":"Doc rsn no hbp scrn or f/u","description":"Documented reason for not screening or recommending a follow-up for high blood pressure","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1414","name":"Inj, beqvez, per tx dose","description":"Injection, fidanacogene elaparvovec-dzkt, per therapeutic dose","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63053","name":"Lam factc/frmt arthrd lum ea","description":"Laminectomy, facetectomy, or foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s] [eg, spinal or lateral recess stenosis]), during posterior interbody arthrodesis, lumbar; each additional vertebral segment (list separately in addition to code for","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0737","name":"Inj, clindamycin (baxter)","description":"Injection, clindamycin phosphate (baxter), not therapeutically equivalent to j0736, 300 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1496","name":"No doc of fall or poc","description":"Patients that had a fall who did not have a plan of care for falls documented or do not have documentation of being assessed for falls","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99294","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1026","name":"Pt hemo > 3mo","description":"The number of adult patient-months in the denominator who were on maintenance hemodialysis using a catheter continuously for three months or longer under the care of the same practitioner or group partner as of the last hemodialysis session of the reporting month","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85660","name":"Rbc sickle cell test","description":"Sickling of rbc, reduction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":5.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2033","name":"Myriad morcells, 4 mg","description":"Myriad morcells, 4 milligrams","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83866","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0521U","name":"Rf iga&igm ccp antb sr-a ia","description":"Rf iga&igm ccp antb sr-a ia","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90684","name":"Pcv21 vaccine im","description":"Pneumococcal conjugate vaccine, 21 valent (pcv21), for intramuscular use","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2472","name":"Inj, pantoprazole sodium chl","description":"Injection, pantoprazole sodium in sodium chloride (baxter), 40 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9616","name":"Gallium gozellix 1 millicuri","description":"Gallium ga-68 gozetotide (gozellix), diagnostic, 1 millicurie","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57330","name":"Repair bladder-vagina lesion","description":"Closure of vesicovaginal fistula; transvesical and vaginal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":840.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2781","name":"Inj, pegcetacoplan, 1mg","description":"Injection, pegcetacoplan, intravitreal, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90870","name":"Electroconvulsive therapy","description":"Electroconvulsive therapy (includes necessary monitoring)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1781","name":"Vac admin human pap dose 1","description":"Vac admin human pap dose 1","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4425","name":"Revive tl per sq cm","description":"Revive tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1470","name":"Hep b vac not recd med rsn","description":"Documentation of medical reason(s) for not administering hepatitis b vaccine (e.g., prior anaphylaxis due to the hepatitis b vaccine)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0722T","name":"Quan ct tiss charac w/ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained with concurrent ct examination of any structure contained in the concurrently acquired diagnostic imaging dataset (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76018","name":"Mr safety implant elec prepj","description":"Mr safety implant electronics preparation under supervision of physician or other qualified health care professional, including mr-specific programming of pulse generator and/or transmitter to verify device integrity, protection of device internal circuitry from mr electromagnetic fields, and protec","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0620U","name":"Onc hcc dna mthyln alys>5000","description":"Onc hcc dna mthyln alys>5000","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0793T","name":"Prq tcat thrm ablt nrv p-art","description":"Percutaneous transcatheter thermal ablation of nerves innervating the pulmonary arteries, including right heart catheterization, pulmonary artery angiography, and all imaging guidance","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0487U","name":"Onc sol tum cfcdna tgsap 84","description":"Onc sol tum cfcdna tgsap 84","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9075","name":"Inj, cyclophosphamide, nos","description":"Injection, cyclophosphamide, not otherwise specified, 5 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1938","name":"Inj, furosemide, 1 mg","description":"Injection, furosemide, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7911","name":"Dental suture wound to 5 cm","description":"Complicated suture-up to 5 cm","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92638","name":"Bhvl verif of amplification","description":"Behavioral verification of amplification including aided thresholds, functional gain, speech-in-noise, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2015","name":"Phoenix wnd mtrx, per sq cm","description":"Phoenix wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1423","name":"Opt care urologic cnd mvp","description":"Optimal care for patients with urologic conditions mips value pathway","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0518U","name":"Ther rx mntr 90+ pn&mtl hlth","description":"Ther rx mntr 90+ pn&mtl hlth","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33288","name":"Rmv&rplcmt phrnc nrv stim ld","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5153","name":"Inj, aflibercept-yszy, 1 mg","description":"Injection, aflibercept-yszy (opuviz), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93152","name":"Interrog&prgrmg ipnss polysm","description":"Interrogation and programming of implanted phrenic nerve stimulator system during polysomnography","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5942","name":"Proth max implt sup remv","description":"Proth max implt sup remv","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33572","name":"Open coronary endarterectomy","description":"Coronary endarterectomy, open, any method, of left anterior descending, circumflex, or right coronary artery performed in conjunction with coronary artery bypass graft procedure, each vessel (list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7519","name":"Inj. mycophenolate mofetil","description":"Injection, mycophenolate mofetil, 10 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1168","name":"Pt recd flu vax 7/1-6/30","description":"Patient received an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0801","name":"Inj. acthar gel to 40 units","description":"Injection, corticotropin (acthar gel), up to 40 units","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37265","name":"Revsc evsc fpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96115","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64659","name":"Rmvl bat modulj sys pg only","description":"Removal of baroreflex activation therapy (bat) modulation system; pulse generator only","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77408","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2928","name":"Prefab porc/cer crown perm","description":"Prefab porc/cer crown perm","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1252","name":"Pts no cmplt hu survey","description":"Patients who did not complete at least one of the four patient experience hu survey items and return the hu survey within 60 days of the ambulatory palliative care visit","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0728T","name":"Dx alys vstblr implt uni 1st","description":"Diagnostic analysis of vestibular implant, unilateral; with initial programming","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1363","name":"Pts no f/u 120 dys","description":"Patients who did not have a follow-up assessment within 120 days of the index assessment","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0779T","name":"Gi myoelectrical actv study","description":"Gastrointestinal myoelectrical activity study, stomach through colon, with interpretation and report","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81558","name":"Trnspl rej kdn mrna qpcr 139","description":"Transplantation medicine (allograft rejection, kidney), mrna, gene expression profiling by quantitative polymerase chain reaction (qpcr) of 139 genes, utilizing whole blood, algorithm reported as a binary categorization as transplant excellence, which indicates immune quiescence, or not transplant e","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98976","name":"Rtm dev sply resp sys 16-30d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of respiratory system, 16-30 days in a 30-day period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6555","name":"G com stcking bk 40+ custm","description":"Gradient compression stocking, below knee, 40 mmhg or greater, custom, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2542","name":"Dental onlay metallic 2 surf","description":"Onlay-metallic-two surfaces","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7504","name":"Lymphocyte immune globulin","description":"Lymphocyte immune globulin, antithymocyte globulin, equine, parenteral, 250 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90845","name":"Psychoanalysis","description":"Psychoanalysis","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":115.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0799","name":"Hiv prep, fda approved, noc","description":"Fda approved prescription drug, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv), not otherwise classified","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1460","name":"Dx copd, cf, or arf","description":"Diagnosis for chronic obstructive pulmonary disease, emphysema, cystic fibrosis, or acute respiratory failure","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0845T","name":"Dgtz gls mcrscp imfluor 1st","description":"Digitization of glass microscope slides for immunofluorescence, per specimen; initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0387U","name":"Onc mlnma ambra1&amlo","description":"Onc mlnma ambra1&amlo","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93898","name":"Ven-artl shunt det mbubb njx","description":"Venous-arterial shunt detection with intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15018","name":"App skn cll ssp f/n/g/hf ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 480 sq cm or part thereof (list separately in addition to code for prima","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92631","name":"Hearing aid slctn svc 1st 30","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86357","name":"Nk cells total count","description":"Natural killer (nk) cells, total count","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9382","name":"Inj zenocutuzumab-zbco 1 mg","description":"Injection, zenocutuzumab-zbco, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60660","name":"Abltj 1/+thyr ndul 1lobe prq","description":"Ablation of 1 or more thyroid nodule(s), one lobe or the isthmus, percutaneous, including imaging guidance, radiofrequency","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37261","name":"Revsc evasc ivt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49617","name":"Rpr aa hrn rcr > 10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, reducible","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61715","name":"Mrgfus strtctc ablt trgt icr","description":"Magnetic resonance image guided high intensity focused ultrasound (mrgfus), stereotactic ablation of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25448","name":"Arthrp ntrcrpl/crp/mtcrp ssp","description":"Arthroplasty, intercarpal or carpometacarpal joints; suspension, including transfer or transplant of tendon, with interposition, when performed","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2643","name":"Dental onlay porcelin 3 surf","description":"Onlay - porcelain/ceramic - three surfaces","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2792","name":"Crown full cast noble metal","description":"Crown-full cast noble metal","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3362.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6601","name":"Porc/ceram inlay >= 3 surfac","description":"Inlay - porcelain/ceramic three or more surfaces","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87077","name":"Culture aerobic identify","description":"Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4001","name":"Diagnostic rad ss","description":"Diagnostic radiology mips specialty set","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37266","name":"Rvsc evsc fpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5725","name":"Rebase hybrid prosthesis","description":"Rebase hybrid prosthesis","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0569U","name":"Onc sol tum ngs tmm>20000dmr","description":"Onc sol tum ngs tmm>20000dmr","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1351","name":"Pt cmplt suicd saf pln 120dy","description":"Patients who had a suicide safety plan initiated, reviewed, or updated and reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0973T","name":"Slctv nzmtc dbrdmt t/a/l 1st","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; first 100 sq cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81003","name":"Urinalysis auto w/o scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; automated, without microscopy","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3391","name":"Inj, atidarsagene autotemcel","description":"Injection, atidarsagene autotemcel, per treatment","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32488","name":"Completion pneumonectomy","description":"Removal of lung, other than pneumonectomy; with all remaining lung following previous removal of a portion of lung (completion pneumonectomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1939.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24577","name":"Cltx humrl cndylr fx w/mnpj","description":"Closed treatment of humeral condylar fracture, medial or lateral; with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":575.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2031","name":"Mirodry, per sq cm","description":"Mirodry wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79445","name":"Nuclear rx intra-arterial","description":"Radiopharmaceutical therapy, by intra-arterial particulate administration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6197","name":"Replace material prosthesis","description":"Replace material prosthesis","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9986","name":"Missed appointment","description":"Missed appointment","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0410U","name":"Onc pncrtc dna whl gn seq 5-","description":"Onc pncrtc dna whl gn seq 5-","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0985T","name":"Iv img xtrc cere vsl oct ea","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0725T","name":"Vestibular dev impltj uni","description":"Vestibular device implantation, unilateral","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43280","name":"Laparoscopy fundoplasty","description":"Laparoscopy, surgical, esophagogastric fundoplasty (eg, nissen, toupet procedures)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1192.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5992","name":"Low prosth foot shell repl","description":"All lower extremity prosthesis, foot shell for modular foot/non-solid ankle cushion heel (sach) replacement only","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"Add upp ext mec limb vol lam","description":"Addition to upper extremity prosthesis, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76075","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7509","name":"Marsupialization odon cyst","description":"Marsupialization odon cyst","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1294","name":"Bp scrn perf rec interval","description":"Normal blood pressure reading documented, follow-up not required","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6036","name":"Prosthetic thumb mechanical","description":"Prosthetic thumb, mechanical, can include metacarpophalangeal (mcp), interphalangeal (ip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0284U","name":"Vw factor type 2n eval plsm","description":"Von willebrand factor (vwd), type 2n, factor viii and vwf binding evaluation, enzyme-linked immunosorbent assays (elisa), plasma","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4393","name":"Surgraft ac per sq cm","description":"Surgraft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0268U","name":"Hem ahus gen seq alys 15 gen","description":"Hematology (atypical hemolytic uremic syndrome [ahus]), genomic sequence analysis of 15 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1391","name":"All pt dx w/ rec mlnm","description":"All patients who were diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2526","name":"Cntct lens blue violet","description":"Contact lens, hydrophilic, with blue-violet filter, per lens","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2390","name":"Ant resin-based cmpst crown","description":"Resin-based composite crown anterior","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0802","name":"3d dental scan indirect","description":"3d dental scan indirect","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0677T","name":"Laps repos lead isdss 1st ld","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first repositioned lead","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0542U","name":"Nefro renal trnspl ur nmr 84","description":"Nefro renal trnspl ur nmr 84","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70371","name":"Speech evaluation complex","description":"Complex dynamic pharyngeal and speech evaluation by cine or video recording","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4543","name":"Supply trans elec nerve stim","description":"Supplies for transcutaneous electrical nerve stimulator, for nerves in the auricular region, per month","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1781","name":"Vac admin human pap dose 1","description":"Vac admin human pap dose 1","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0542","name":"No pt prsnt train add 15","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9997","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12021","name":"Tx supfc wnd dehsn w/packing","description":"Treatment of superficial wound dehiscence; with packing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":220.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":159.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93656","name":"Compre ep eval abltj atr fib","description":"Comprehensive electrophysiologic evaluation with transseptal catheterizations, insertion and repositioning of multiple electrode catheters, induction or attempted induction of an arrhythmia including left or right atrial pacing/recording, and intracardiac catheter ablation of atrial fibrillation by ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1325.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6094","name":"Abut support crown titanium","description":"Abutment supported crown - (titanium)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0482U","name":"Ob pe biochem asy sfit1&pigf","description":"Ob pe biochem asy sfit1&pigf","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0928T","name":"Rem interrog dev ccm-d phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system with interim analysis and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0267U","name":"Rare do id opt gen mapg&seq","description":"Rare constitutional and other heritable disorders, identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping and whole-genome sequencing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2472","name":"Inj, pantoprazole sodium chl","description":"Injection, pantoprazole sodium in sodium chloride (baxter), 40 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0901T","name":"Plmt bone marrow smplg port","description":"Placement of bone marrow sampling port, including imaging guidance when performed","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1241","name":"Pt no resp seen as person","description":"Patient did not respond to the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5157","name":"Inj, denosumab-bmwo, 1 mg","description":"Injection, denosumab-bmwo (stoboclo/osenvelt), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98926","name":"Osteopath manj 3-4 regions","description":"Osteopathic manipulative treatment (omt); 3-4 body regions involved","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":16.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":33.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0206","name":"Inj allopurinol sodium 1 mg","description":"Injection, allopurinol sodium, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0017","name":"Crisis psychotherapy 60m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); first 60 minutes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1367","name":"Qual care ent disorder mvp","description":"Quality care for the treatment of ear, nose, and throat disorders mips value pathway","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0824T","name":"Tcat rmv 1chmbr ldls pm ra","description":"Transcatheter removal of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography), when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2015","name":"Phoenix wnd mtrx, per sq cm","description":"Phoenix wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4265","name":"Neostim tl per sq cm","description":"Neostim tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2151","name":"Inj, mannitol, 250 mg","description":"Injection, mannitol, 250 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6197","name":"Replace material prosthesis","description":"Replace material prosthesis","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4030","name":"Pulmonology ss","description":"Pulmonology mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35494","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33973","name":"Insert balloon device","description":"Insertion of intra-aortic balloon assist device through the ascending aorta","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0366U","name":"Onc bldr 10 prb recr bldr ca","description":"Onc bldr 10 prb recr bldr ca","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0756T","name":"Dgtz gls mcrscp sld spc grpi","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group i, for microorganisms (eg, acid fast, methenamine silver) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37276","name":"Rvsc evsc fpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0539","name":"Initial care training 30 m","description":"Caregiver training in behavior management/modification for caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face; initial 30 minutes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37285","name":"Revsc evasc tpvt st sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7997","name":"Appliance removal","description":"Appliance removal (not by dentist who placed appliance) includes removal of archbar","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4260","name":"Signature apatch, per sq cm","description":"Signature apatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J0560","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0401U","name":"Crd c hrt ds 9 gen 12 vrnts","description":"Crd c hrt ds 9 gen 12 vrnts","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45333","name":"Sigmoidoscopy & polypectomy","description":"Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5162","name":"Inj, denosumab-nxxp, 1 mg","description":"Injection, denosumab-nxxp (bildyos/bilprevda), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53502","name":"Repair of urethra injury","description":"Urethrorrhaphy, suture of urethral wound or injury, female","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0557","name":"Adv prim care mgmt lvl 2","description":"Advanced primary care management services for a patient with multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, which place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline, provided by c","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0137","name":"Inten outpt svs,min 9 pr 7 d","description":"Intensive outpatient services; weekly bundle, minimum of 9 services over a 7 contiguous day period, which can include individual and group therapy with physicians or psychologists (or other mental health professionals to the extent authorized under state law); occupational therapy requiring the skil","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4386","name":"Acesso trifaca per sq cm","description":"Acesso trifaca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91125","name":"Anrct mano rct snsatn&balo","description":"Anorectal manometry, with rectal sensation and rectal balloon expulsion test, when performed","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0927T","name":"Interrog dev eval ccm-d ip","description":"Interrogation device evaluation (in person) with analysis, review, and report, including connection, recording, and disconnection, per patient encounter, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4419","name":"Biolab wrap flw lt per sq cm","description":"Biolab membrane wrap lite flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38222","name":"Dx bone marrow bx & aspir","description":"Diagnostic bone marrow; biopsy(ies) and aspiration(s)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":66.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1355","name":"Caries med app per tooth","description":"Caries med app per tooth","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4382","name":"Advograft dual per sq cm","description":"Advograft dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1355","name":"Caries med app per tooth","description":"Caries med app per tooth","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33281","name":"Reposg phrnc nrv stim trnsvn","description":"Repositioning of phrenic nerve stimulator transvenous lead(s)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0166","name":"Inj epinephrine (bpi)","description":"Injection, epinephrine (bpi), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1821","name":"Ko elas w/ condyle pads otf","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, off the shelf","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83498","name":"Asy hydroxyprogesterone 17-d","description":"Hydroxyprogesterone, 17-d","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33766","name":"Shunt supr v/c p-art 1 lung","description":"Shunt; superior vena cava to pulmonary artery for flow to 1 lung (classical glenn procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1721.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0839T","name":"Dgtz gls mcrscp cslt mat prp","description":"Digitization of glass microscope slides for consultation and report on referred material requiring preparation of slides (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72190","name":"X-ray exam of pelvis","description":"Radiologic examination, pelvis; complete, minimum of 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4273","name":"Esano aaa, per sq cm","description":"Esano aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0816T","name":"Opn insj/rplcmt ins ptn subq","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0800T","name":"Tcat rmvl 2chmbr ldls pm rv","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right ventricular pacemaker component (when part of a dual-chamber leadless pacem","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27648","name":"Injection for ankle x-ray","description":"Injection procedure for ankle arthrography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92610","name":"Evaluate swallowing function","description":"Evaluation of oral and pharyngeal swallowing function","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2029","name":"Mirotract matrix sheet","description":"Mirotract wound matrix sheet, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6114","name":"Implnt/abut fixed dent max","description":"Implnt/abut fixed dent max","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87220","name":"Tissue exam for fungi","description":"Tissue examination by koh slide of samples from skin, hair, or nails for fungi or ectoparasite ova or mites (eg, scabies)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1488","name":"Dx dementia in msr timeframe","description":"Patients with a diagnosis for dementia in the year before or during the period of evaluation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0368U","name":"Onc clrct ca mut&mthyltn mrk","description":"Onc clrct ca mut&mthyltn mrk","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4422","name":"Ac wrap per sq cm","description":"A/c wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5949","name":"Mand implt sup fix part","description":"Mand implt sup fix part","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1293","name":"Calc bmi abv up param f/u","description":"Bmi is documented above normal parameters and a follow-up plan is documented","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1235","name":"Doc pt hcv aby rna tst","description":"Documentation or patient report of hcv antibody test or hcv rna test which occurred prior to the performance period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95904","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7412","name":"Excision benign lesion compl","description":"Excision of benign lesion complicated","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9610","name":"Xe129 xenon, diagnostic","description":"Xenon xe-129 hyperpolarized gas, diagnostic, per study dose","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1284","name":"Pt 66+ snp or ltc pos > 90d","description":"Patients age 66 or older in institutional special needs plans (snp) or residing in long term care with pos code 32, 33, 34, 54, or 56 for more than 90 consecutive days during the measurement period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0704T","name":"Rem tx amblyopia setup&edu","description":"Remote treatment of amblyopia using an eye tracking device; device supply with initial set-up and patient education on use of equipment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0971T","name":"Ablt mal brst tum pq lsr uni","description":"Ablation, malignant breast tumor(s), percutaneous, laser, including imaging guidance when performed, unilateral","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0738","name":"Hiv prep, inj, lenacapavir","description":"Injection, lenacapavir, 1 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86362","name":"Mog-igg1 antb cba each","description":"Myelin oligodendrocyte glycoprotein (mog-igg1) antibody; cell-based immunofluorescence assay (cba), each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0458","name":"Aztreonam/avibactam 10 mg","description":"Injection, aztreonam/avibactam, 7.5 mg/2.5 mg (10 mg)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0368U","name":"Onc clrct ca mut&mthyltn mrk","description":"Onc clrct ca mut&mthyltn mrk","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9318","name":"Inj romidepsin non-lyo 0.1mg","description":"Injection, romidepsin, non-lyophilized, 0.1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5996","name":"Peri medicament w/seal, mand","description":"Peri medicament w/seal, mand","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6605","name":"G com bandage padded foam","description":"Gradient compression bandaging supply, padded foam, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1006T","name":"Elec alys s-scl eeg prgrm ea","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, each additional 15 minutes face-to-face time with physician or other qua","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1247","name":"Pt resp true best int","description":"Patient responded completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4275","name":"Esano aca, per sq cm","description":"Esano aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11983","name":"Remove/insert drug implant","description":"Removal with reinsertion, non-biodegradable drug delivery implant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53453","name":"Tprnl balo cntnc dev rmvl ea","description":"Periurethral transperineal adjustable balloon continence device; removal, each balloon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1433","name":"Oral chemo wthn 30 days enc","description":"Patient on oral chemotherapy on or within 30 days before denominator eligible encounter","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9075","name":"Inj, cyclophosphamide, nos","description":"Injection, cyclophosphamide, not otherwise specified, 5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1185","name":"Imm ckpt inhib not hld no rx","description":"Documentation of immune checkpoint inhibitor therapy not held and/or corticosteroids or immunosuppressants prescribed or administered was not performed, reason not given","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61715","name":"Mrgfus strtctc ablt trgt icr","description":"Magnetic resonance image guided high intensity focused ultrasound (mrgfus), stereotactic ablation of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92555","name":"Speech threshold audiometry","description":"Speech audiometry threshold;","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64656","name":"Revj/rplcmt bat mod sys pg","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; pulse generator only","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96548","name":"Ntraop hipec px ea add 30min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47384","name":"Abltj ire liver 1+ tum perq","description":"Ablation, irreversible electroporation, liver, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69727","name":"Rmv ntr oi imp sk tc esp<100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28008","name":"Incision of foot fascia","description":"Fasciotomy, foot and/or toe","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33251","name":"Ablate heart dysrhythm focus","description":"Operative ablation of supraventricular arrhythmogenic focus or pathway (eg, wolff-parkinson-white, atrioventricular node re-entry), tract(s) and/or focus (foci); with cardiopulmonary bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1793.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1105","name":"Dexmedetomidine film, 1 mcg","description":"Dexmedetomidine, oral, 1 mcg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1273","name":"Pts snf 1 yr dialysis","description":"Patients who were admitted to a skilled nursing facility (snf) within one year of dialysis initiation according to the cms-2728 form","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1162","name":"Pt enceph due to dtp bef 13","description":"Patient had encephalitis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4311","name":"Acesso, per sq cm","description":"Acesso, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9296","name":"Inj pemetrexed (accord) 10mg","description":"Injection, pemetrexed (accord), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87594","name":"Pneumcysts jirovecii amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); pneumocystis jirovecii, amplified probe technique","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1495","name":"Fall w/ poc, no fall","description":"Patients that reported a fall occurred who had a plan of care for falls documented or patients that did not report a fall","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2601","name":"Inj, vasopressin (baxter)","description":"Injection, vasopressin (baxter), 1 unit","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6091","name":"Repl semi/precision attach","description":"Replacement of semi-precision or precision attachment (male or female component) of implant/abutment supported prosthesis per attachment","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4421","name":"Biolab wrap solo per sq cm","description":"Biolab membrane wrap solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90631","name":"H5 vaccine pandemic im use","description":"Influenza virus vaccine (iiv), h5, pandemic formulation, split virus, adjuvanted, for intramuscular use","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0563U","name":"Nfct ds pthgn-sna 11vir&4bct","description":"Nfct ds pthgn-sna 11vir&4bct","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0049","name":"Main hemo in-cntr","description":"With maintenance hemodialysis (in-center and home hd) for the complete reporting month","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38228","name":"Car-t admn autologous","description":"Chimeric antigen receptor t-cell (car-t) therapy; car-t cell administration, autologous","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7049","name":"Epap nasal valve","description":"Expiratory positive airway pressure intranasal resistance valve","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0511U","name":"Onc sol tum 3dmicroenvir 36+","description":"Onc sol tum 3dmicroenvir 36+","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0540","name":"Train for caregiver add 15","description":"Caregiver training in behavior management/modification for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face; each additional 15 minutes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0886T","name":"Sgmdsc flx 1st tndsc dilat","description":"Sigmoidoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25448","name":"Arthrp ntrcrpl/crp/mtcrp ssp","description":"Arthroplasty, intercarpal or carpometacarpal joints; suspension, including transfer or transplant of tendon, with interposition, when performed","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9611","name":"Flurpiridaz f18, diag, 1 mci","description":"Flurpiridaz f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1444","name":"Del < 39 weeks gest","description":"Delivery at < 39 weeks of gestation","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0898T","name":"N-invas prst8 cancer est map","description":"Noninvasive prostate cancer estimation map, derived from augmentative analysis of image-guided fusion biopsy and pathology, including visualization of margin volume and location, with margin determination and physician interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69210","name":"Remove impacted ear wax uni","description":"Removal impacted cerumen requiring instrumentation, unilateral","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":28.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0752","name":"Hiv prep, oral lenacapavir","description":"Oral, lenacapavir, 300 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6607","name":"G com bandage tub protct lyr","description":"Gradient compression bandaging supply, tubular protective absorption layer, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37279","name":"Iv lithotrp fpvt w/in sm art","description":"Intravascular lithotripsy(ies), femoral and popliteal vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76989","name":"Dx intraop epcar us chd i&r","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; interpretation and report only","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0465","name":"Autolog prp diab wound ulcer","description":"Autologous platelet rich plasma (prp) or other blood-derived product for diabetic chronic wounds/ulcers, using an fda-cleared device for this indication, (includes as applicable administration, dressings, phlebotomy, centrifugation or mixing, and all other preparatory procedures, per treatment)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44404","name":"Colonoscopy w/injection","description":"Colonoscopy through stoma; with directed submucosal injection(s), any substance","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":536.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2782","name":"Inj avacincaptad pegol 0.1mg","description":"Injection, avacincaptad pegol, 0.1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4373","name":"Membrane wrp lt per sq cm","description":"Membrane wrap lite, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4398","name":"Summit ac per sq cm","description":"Summit ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0744T","name":"Insj bioprostc vlv fem vn","description":"Insertion of bioprosthetic valve, open, femoral vein, including duplex ultrasound imaging guidance, when performed, including autogenous or nonautogenous patch graft (eg, polyester, eptfe, bovine pericardium), when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28340","name":"Resect enlarged toe tissue","description":"Reconstruction, toe, macrodactyly; soft tissue resection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":540.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38226","name":"Car-t prep t lymphcyt f/trns","description":"Chimeric antigen receptor t-cell (car-t) therapy; preparation of blood-derived t lymphocytes for transportation (eg, cryopreservation, storage)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4411","name":"Amniomatrixf4x per sq cm","description":"Amniomatrixf4x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4440","name":"Curamatrix per sq cm","description":"Curamatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43497","name":"Transorl lwr esophgl myotomy","description":"Lower esophageal myotomy, transoral (ie, peroral endoscopic myotomy [poem])","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1408","name":"Gmln brca bef dx ca","description":"Patients who have germline brca testing completed before diagnosis of epithelial ovarian, fallopian tube, or primary peritoneal cancer","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4342","name":"Theramend, per sq cm","description":"Theramend, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1486","name":"Pt admitted to snf dur eval","description":"Patients admitted to a skilled nursing facility (snf) during the period of evaluation","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92928","name":"Prq tcat plmt ntrac st 1 les","description":"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 1 lesion involving 1 or more coronary segments","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5134","name":"Inj, tyruko, 1 mg","description":"Injection, natalizumab-sztn (tyruko), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43266","name":"Egd endoscopic stent place","description":"Esophagogastroduodenoscopy, flexible, transoral; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97552","name":"Group caregiver training","description":"Group caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9297","name":"Inj pemetrexed (sandoz) 10mg","description":"Injection, pemetrexed (sandoz), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7299","name":"Intraut copp cont (miudella)","description":"Intrauterine copper contraceptive (miudella)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64474","name":"Lwr xtr fscl pln blk uni nfs","description":"Lower extremity fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86352","name":"Cell function assay w/stim","description":"Cellular function assay involving stimulation (eg, mitogen or antigen) and detection of biomarker (eg, atp)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0277U","name":"Hem gen pltlt funcj do 31","description":"Hematology (genetic platelet function disorder), genomic sequence analysis of 31 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15016","name":"App skn cl ssp agrf t/a/l ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; each additional 480 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1098","name":"Articaine ophthalmi 8% 0.4ml","description":"Articaine ophthalmic, 8% solution, 0.4 ml","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2253","name":"Inj midazolam (seizalam)","description":"Injection, midazolam (seizalam), 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1292","name":"Pt 66+ frail inpt adv ill","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and an advanced illness diagnosis during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0282U","name":"Rbc dna gntyp 12 bld grp gen","description":"Red blood cell antigen typing, dna, genotyping of 12 blood group system genes to predict 44 red blood cell antigen phenotypes","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2023","name":"Innovamatrix pd, 1 mg","description":"Innovamatrix pd, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9319","name":"Inj romidepsin lyophil 0.1mg","description":"Injection, romidepsin, lyophilized, 0.1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0577U","name":"Onc ovr serum alys 39 gps","description":"Onc ovr serum alys 39 gps","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49594","name":"Rpr aa hrn 1st 3-10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, incarcerated or strangulated","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26011","name":"Drainage of finger abscess","description":"Drainage of finger abscess; complicated (eg, felon)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":599.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":210.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0700T","name":"Molec fluor img sus nev 1st","description":"Molecular fluorescent imaging of suspicious nevus; first lesion","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1195","name":"Rpt wo imp/con mmr/msi","description":"Surgical pathology reports that do not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both, reason not given","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90832","name":"Psytx w pt 30 minutes","description":"Psychotherapy, 30 minutes with patient","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":84.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1196","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6517","name":"Grad com wrap w strap bn cus","description":"Gradient compression wrap with adjustable straps, below knee, each, custom","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4407","name":"Xwrap tribus per sq cm","description":"Xwrap tribus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0455U","name":"Nfct agt sti mult amp prb ur","description":"Nfct agt sti mult amp prb ur","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92628","name":"Eval hearing aid cand 1st 30","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0815T","name":"Us rems b1 dns hips plvs/spi","description":"Ultrasound-based radiofrequency echographic multi-spectrometry (rems), bone-density study and fracture-risk assessment, 1 or more sites, hips, pelvis, or spine","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1299","name":"Flu immunize order/admin","description":"Influenza immunization administered or previously received","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0991T","name":"Cysto lo-nrg lithtrp&mcrsphr","description":"Cystourethroscopy, with low-energy lithotripsy and acoustically actuated microspheres, including imaging","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43502","name":"Surgical repair of stomach","description":"Gastrotomy; with suture repair of pre-existing esophagogastric laceration (eg, mallory-weiss)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1588.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1162","name":"Pt enceph due to dtp bef 13","description":"Patient had encephalitis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1013T","name":"Lap srg imp/rpl eso nea&pg/r","description":"Laparoscopy, surgical, implantation or replacement of lower esophageal sphincter neurostimulator electrode array and neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver, including cruroplasty and/or electronic ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0446U","name":"Ai ds sle alys 10 cytokine","description":"Ai ds sle alys 10 cytokine","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4426","name":"Dermbnd tl+, tlx per sq cm","description":"Dermabind tl + or dermabind tl x,  per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64702","name":"Revise finger/toe nerve","description":"Neuroplasty; digital, 1 or both, same digit","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":395.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9948","name":"Adjust sleep apnea appliance","description":"Adjust sleep apnea appliance","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21143","name":"Rcnstj mdface lefort i 3/>pc","description":"Reconstruction midface, lefort i; 3 or more pieces, segment movement in any direction, without bone graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1583.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4363","name":"Am bur mem hydro per sq cm","description":"Amnio burgeon membrane and hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22327","name":"Treat thorax spine fracture","description":"Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; thoracic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1625.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2250","name":"Inj midazolam hydrochloride","description":"Injection, midazolam hydrochloride, per 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7241","name":"Impact tooth rem bony w/comp","description":"Removal of impacted tooth-completely bony with unusual surgical complications","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1342","name":"Pts died perf per","description":"Patients who died during the performance period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40702","name":"Repair cleft lip/nasal","description":"Plastic repair of cleft lip/nasal deformity; primary bilateral, 1 of 2 stages","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1002.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1455","name":"Foscarnet sodium injection","description":"Injection, foscarnet sodium, per 1000 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11920","name":"Correct skin color 6.0 cm/<","description":"Tattooing, intradermal introduction of insoluble opaque pigments to correct color defects of skin, including micropigmentation; 6.0 sq cm or less","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1238","name":"Doc 2nd recom hzv 2-6 mo int","description":"Documentation that administration of second recombinant zoster vaccine could not occur during the performance period due to the recommended 2-6 month interval between doses (i.e, first dose received after october 31)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0746T","name":"Car ablt rad arr cnv loc map","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; conversion of arrhythmia localization and mapping of arrhythmia site (nidus) into a multidimensional radiation treatment plan","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55882","name":"Ablt trurl prst8 tis trnsdcr","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation; with insertion of transurethral ultrasound transducer for delivery of thermal ultrasound, including suprapubic tube placement and placement of ","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3502","name":"Surg exp root surf premolar","description":"Surg exp root surf premolar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2506","name":"Inj pegfilgrast ex bio 0.5mg","description":"Injection, pegfilgrastim, excludes biosimilar, 0.5 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4403","name":"Xwrap dual plus per sq cm","description":"Xwrap dual plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0560","name":"Safety plan interven","description":"Safety planning interventions, each 20 minutes personally performed by the billing practitioner, including assisting the patient in the identification of the following personalized elements of a safety plan: recognizing warning signs of an impending suicidal or substance use-related crisis; employin","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0543","name":"Group train w/o patient","description":"Group caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient pre","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0233","name":"Intra inf, toci, first dose","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1161","name":"Pt anphx due to dtp bef 13","description":"Patient had anaphylaxis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90635","name":"H5n1 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n1, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86258","name":"Dgp antibody each ig class","description":"Gliadin (deamidated) (dgp) antibody, each immunoglobulin (ig) class","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0389","name":"Periopic image capture only","description":"Periopic image capture only","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9154","name":"Artificial saliva, 1 ml","description":"Artificial saliva, 1 ml","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0547","name":"Phone/internet svs 11-20 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37258","name":"Revsc evasc ivt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1369","name":"Qualcare mental hlth/sud mvp","description":"Quality care in mental health and substance use disorders mips value pathway","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77403","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0566U","name":"Onc lng qpcr-bsd alys 13dmrs","description":"Onc lng qpcr-bsd alys 13dmrs","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91030","name":"Acid perfusion of esophagus","description":"Esophagus, acid perfusion (bernstein) test for esophagitis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26011","name":"Drainage of finger abscess","description":"Drainage of finger abscess; complicated (eg, felon)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":210.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4398","name":"Summit ac per sq cm","description":"Summit ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0846T","name":"Dgtz gls mcrscp imfluor ea","description":"Digitization of glass microscope slides for immunofluorescence, per specimen; each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4438","name":"Pretect per sq cm","description":"Pretect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0137","name":"Inten outpt svs,min 9 pr 7 d","description":"Intensive outpatient services; weekly bundle, minimum of 9 services over a 7 contiguous day period, which can include individual and group therapy with physicians or psychologists (or other mental health professionals to the extent authorized under state law); occupational therapy requiring the skil","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1203","name":"No rsn ace-i/arb rx","description":"Ace inhibitor or arb therapy not prescribed during the measurement period, reason not given","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0615","name":"Calcium acetate, oral, 23 mg","description":"Calcium acetate, oral, 23 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1250","name":"Pt resp true heard","description":"Patient responded as completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4012","name":"Interventional rad ss","description":"Interventional radiology mips specialty set","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0524","name":"Est pt-cg dyad dem low cmplx","description":"Management of established patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9994","name":"Pall serv during meas","description":"Patient is using palliative care services any time during the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4289","name":"Revoshield+ amnio, per sq cm","description":"Revoshield + amniotic barrier, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0335U","name":"Rare ds whl gen seq fetal","description":"Rare ds whl gen seq fetal","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0852T","name":"Dgtz gls mcrscp mphmtrc ea 1","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0957T","name":"Rev s-sclp eltr ra rcvr&tlmt","description":"Revision of sub-scalp implanted electrode array, receiver, and telemetry unit for electrode, when required, including imaging guidance","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0799","name":"Hiv prep, fda approved, noc","description":"Fda approved prescription drug, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv), not otherwise classified","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"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":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31241","name":"Nsl/sns ndsc lig sphnptn art","description":"Nasal/sinus endoscopy, surgical; with ligation of sphenopalatine artery","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90638","name":"Vacc qirv mrna 60mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 60 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4400","name":"Polygon3 per sq cm","description":"Polygon3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0771T","name":"Vr px dissoc svc sm phy 1st","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49190","name":"Opn exc/dstr ntra-abd >30 cm","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); greater than 30 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":1527.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0431","name":"Diag tst detect mucos abnorm","description":"Adjunctive pre-diagnostic test that aids in detection of mucosal abnormalities including premalignant and malignant lesions not to include cytology or biopsy","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1207","name":"Pt scrn sdoh","description":"Patient is screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4439","name":"Instagraft per sq cm","description":"Instagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1270","name":"Pts no kid transplt wtlst","description":"Patients not on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95955","name":"Eeg during surgery","description":"Electroencephalogram (eeg) during nonintracranial surgery (eg, carotid surgery)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2027","name":"Matriderm per sq cm","description":"Matriderm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98003","name":"Synch audio-video new hi 60","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high medical decision making. when using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61304","name":"Crnec/crnot expl supratntorl","description":"Craniectomy or craniotomy, exploratory; supratentorial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1847.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6590","name":"Urinary cath disp suc pump","description":"External urinary catheters; disposable, with wicking material, for use with suction pump, per month","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":446.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4543","name":"Supply trans elec nerve stim","description":"Supplies for transcutaneous electrical nerve stimulator, for nerves in the auricular region, per month","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53865","name":"Cysto insj dev ischmc rmdlg","description":"Cystourethroscopy with insertion of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60660","name":"Abltj 1/+thyr ndul 1lobe prq","description":"Ablation of 1 or more thyroid nodule(s), one lobe or the isthmus, percutaneous, including imaging guidance, radiofrequency","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81515","name":"Nfct ds bv&vaginitis dna alg","description":"Infectious disease, bacterial vaginosis and vaginitis, real-time pcr amplification of dna markers for atopobium vaginae, atopobium species, megasphaera type 1, and bacterial vaginosis associated bacteria-2 (bvab-2), utilizing vaginal-fluid specimens, algorithm reported as positive or negative for hi","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77437","name":"Surf radj ther supfc<=150kv","description":"Surface radiation therapy; superficial, delivery, </=150 kv, per fraction (eg, electronic brachytherapy)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5938","name":"Resct proth max comp remov","description":"Resct proth max comp remov","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1316","name":"Tobacco non-user","description":"Current tobacco non-user","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49570","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9028","name":"Inj, nogapendekin pmln, 1mcg","description":"Injection, nogapendekin alfa inbakicept-pmln, for intravesical use, 1 microgram","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0307U","name":"Onc mrd nxt-gnrj alys sbsq","description":"Onc mrd nxt-gnrj alys sbsq","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4307","name":"American amnion, per sq cm","description":"American amnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37257","name":"Revsc evsc ivt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4542","name":"Supp ext up limb tremor stim","description":"Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0422","name":"Collect & prep genetic samp","description":"Collect & prep genetic samp","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98000","name":"Synch audio-video new sf 15","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 15 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0759T","name":"Dgtz gls mcrscp sl sp grpiii","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group iii, for enzyme constituents (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25290","name":"Incise wrist/forearm tendon","description":"Tenotomy, open, flexor or extensor tendon, forearm and/or wrist, single, each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3404","name":"Inj zopapogene per ther dose","description":"Injection, zopapogene imadenovec-drba suspension, per therapeutic dose","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2253","name":"Inj midazolam (seizalam)","description":"Injection, midazolam (seizalam), 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0974T","name":"Slctv nzmtc dbrdmt t/a/l ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; each additional 100 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44604","name":"Suture large intestine","description":"Suture of large intestine (colorrhaphy) for perforated ulcer, diverticulum, wound, injury or rupture (single or multiple perforations); without colostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9390","name":"Vinorelbine tartrate inj","description":"Injection, vinorelbine tartrate, 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99222","name":"1st hosp ip/obs moderate 55","description":"Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 55 minutes ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":48.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6560","name":"G stckng full/chap30-40 cust","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, custom, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0491U","name":"Onc sol tum ctc slct er prtn","description":"Onc sol tum ctc slct er prtn","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93594","name":"R hrt cath chd abnl nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; abnormal native connections","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67107","name":"Repair detached retina","description":"Repair of retinal detachment; scleral buckling (such as lamellar scleral dissection, imbrication or encircling procedure), including, when performed, implant, cryotherapy, photocoagulation, and drainage of subretinal fluid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1186.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01938","name":"Anes drg/aspir lmbr/sac","description":"Anesthesia for percutaneous image-guided injection, drainage or aspiration procedures on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0852T","name":"Dgtz gls mcrscp mphmtrc ea 1","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64469","name":"Thrc fascial pln blk bi nfs","description":"Thoracic fascial plane block, bilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6039","name":"Passive custom digit/thumb","description":"Passive prosthetic digit or thumb prosthesis not including hand restoration partial hand, full or partial, custom made, any material, initial or replacement, per single passive prosthetic digit or thumb","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4411","name":"Amniomatrixf4x per sq cm","description":"Amniomatrixf4x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1345","name":"Pt bsln pam, 2nd scr 4-12 mo","description":"Patients who had a baseline pam score and a second score within 4 to 12 month of baseline pam score","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0459U","name":"Abeta42 & ttau eclia csf","description":"Abeta42 & ttau eclia csf","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1192","name":"Pt w/ dx sq cell ca of esoph","description":"Patients with an existing diagnosis of squamous cell carcinoma of the esophagus","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1278","name":"Pre-htn or htn doc, f/u indc","description":"Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0767T","name":"Tc mag stimj pn ea addl nrv","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; each additional nerve (list separat","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2782","name":"Inj avacincaptad pegol 0.1mg","description":"Injection, avacincaptad pegol, 0.1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0535","name":"Pt navigat svs direct/ref","description":"Patient navigational services, provided directly or by referral; including helping the patient to navigate health systems and identify care providers and supportive services, to build patient self-advocacy and communication skills with care providers, and to promote patient-driven action plans and g","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1298","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0822T","name":"Mntr psychdlc med cln staff","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; clinical staff under the direction of a physician or other qualified health care professional, concurrent with first physician or other qualified health care p","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1263","name":"Pts hosp dialysis dt","description":"Patients in hospice on their initiation of dialysis date or during the month of evaluation","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6610","name":"G com stcking bk 18-30 custm","description":"Gradient compression stocking, below knee, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1032","name":"Sv doula brth wrk per 15 min","description":"Services performed by a doula birth worker, per 15 minutes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77436","name":"Surf radj ther tx planning","description":"Surface radiation therapy; superficial or orthovoltage, treatment planning and simulation-aided field setting","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0671T","name":"Insj ant sgm aq drg dev 1+","description":"Insertion of anterior segment aqueous drainage device into the trabecular meshwork, without external reservoir, and without concomitant cataract removal, one or more","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12055","name":"Intmd rpr face/mm 12.6-20 cm","description":"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 12.6 cm to 20.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0859T","name":"Ncntc ifr spctrsc o/t pad ea","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), other than for screening for peripheral arterial disease, image acquisition, interpretation, and report; each additional anatomic site (list separately in addition to code ","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1492","name":"No reported fall","description":"Patients who did not report a fall","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93270","name":"Remote 30 day ecg rev/report","description":"External patient and, when performed, auto activated electrocardiographic rhythm derived event recording with symptom-related memory loop with remote download capability up to 30 days, 24-hour attended monitoring; recording (includes connection, recording, and disconnection)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0022","name":"Comm hlth intg svs add 30 m","description":"Community health integration services, each additional 30 minutes per calendar month (list separately in addition to g0019)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33606","name":"Anastomosis/artery-aorta","description":"Anastomosis of pulmonary artery to aorta (damus-kaye-stansel procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2184.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4405","name":"Xwrap fenestra plus sq cm","description":"Xwrap fenestra plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0568U","name":"Neurol dementia bamyl ptau","description":"Neurol dementia bamyl ptau","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2599","name":"Inj vasopressin (am reg) 1 u","description":"Injection, vasopressin (american regent), not therapeutically equivalent to j2598, 1 unit","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99232","name":"Sbsq hosp ip/obs moderate 35","description":"Subsequent hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 35 minut","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":26.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0502","name":"Other oral pathology procedu","description":"Other oral pathology procedures by report","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92636","name":"Hearing aid post-fitg f-up 1","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1199","name":"Pt recg rrt","description":"Patients receiving rrt","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4299","name":"Amniocore pro+, per sq cm","description":"Amniocore pro+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4356","name":"Abio mem abio hyd per sq cm","description":"Abiomend membrane and abiomend hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0298U","name":"Onc pan tum whl trns seq rna","description":"Onc pan tum whl trns seq rna","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0886T","name":"Sgmdsc flx 1st tndsc dilat","description":"Sigmoidoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2025","name":"Miro3d per cubic cm","description":"Miro3d, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44403","name":"Colonoscopy w/resection","description":"Colonoscopy through stoma; with endoscopic mucosal resection","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":284.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4395","name":"Acelagraft per sq cm","description":"Acelagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49595","name":"Rpr aa hrn 1st > 10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, reducible","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31636","name":"Bronchoscopy bronch stents","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with placement of bronchial stent(s) (includes tracheal/bronchial dilation as required), initial bronchus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42810","name":"Excision of neck cyst","description":"Excision branchial cleft cyst or vestige, confined to skin and subcutaneous tissues","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9954","name":"Fab/del oral appliance thxpy","description":"Fab/del oral appliance thxpy","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1016T","name":"Elec alys npgs esoph intraop","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35201","name":"Repair blood vessel dir neck","description":"Repair blood vessel, direct; neck","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1183.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6106","name":"Tissue regen resorbable","description":"Tissue regen resorbable","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4300","name":"Acesso tl, per sq cm","description":"Acesso tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1653","name":"Ho abduction static ots","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, off the shelf","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0976T","name":"Slctv nzmtc dbrdmt s/n/hf ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; each additional 100 sq cm (list separately in addition to code for p","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27065","name":"Remove hip bone les super","description":"Excision of bone cyst or benign tumor, wing of ilium, symphysis pubis, or greater trochanter of femur; superficial, includes autograft, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":561.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53446","name":"Remove uro sphincter","description":"Removal of inflatable urethral/bladder neck sphincter, including pump, reservoir, and cuff","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1188","name":"Pt w/ ckd stg 5","description":"Patients with a diagnosis of chronic kidney disease (ckd) stage 5","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2051","name":"Support broker waiver/diem","description":"Supports brokerage, self-directed, waiver; per diem","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31257","name":"Nsl/sins ndsc tot w/sphendt","description":"Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior), including sphenoidotomy","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6518","name":"Grad com wrap w strap arm cu","description":"Gradient compression wrap with adjustable straps, arm, each, custom","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0439","name":"Ppps, subseq visit","description":"Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7213","name":"Inj, ixinity, 1 i.u.","description":"Injection, coagulation factor ix (recombinant), ixinity, 1 i.u.","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7165","name":"Inj, human-lans, per i.u","description":"Injection, prothrombin complex concentrate, human-lans, per i.u. of factor ix activity","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32556","name":"Insert cath pleura w/o image","description":"Pleural drainage, percutaneous, with insertion of indwelling catheter; without imaging guidance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":754.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1370","name":"Inj, esomeprazole sod, 1 mg","description":"Injection, esomeprazole sodium, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31253","name":"Nsl/sins ndsc total","description":"Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior), including frontal sinus exploration, with removal of tissue from frontal sinus, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1414","name":"Inj, beqvez, per tx dose","description":"Injection, fidanacogene elaparvovec-dzkt, per therapeutic dose","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0916T","name":"Insj perm ccm-d sys pg only","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator only","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99416","name":"Prolng clin staff svc ea add","description":"Prolonged clinical staff service (the service beyond the highest time in the range of total time of the service) during an evaluation and management service in the office or outpatient setting, direct patient contact with physician supervision; each additional 30 minutes (list separately in addition","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0541U","name":"Cv ds hdl rct cec lc-ms/ms 5","description":"Cv ds hdl rct cec lc-ms/ms 5","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28305","name":"Incise/graft midfoot bones","description":"Osteotomy, tarsal bones, other than calcaneus or talus; with autograft (includes obtaining graft) (eg, fowler type)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":829.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0805T","name":"Tcat s&ivc prstc vl impl prq","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); percutaneous femoral vein approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0208","name":"Inj, pedmark, 100 mg","description":"Injection, sodium thiosulfate (pedmark), 100 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5942","name":"Proth max implt sup remv","description":"Proth max implt sup remv","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1375","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45307","name":"Proctosigmoidoscopy fb","description":"Proctosigmoidoscopy, rigid; with removal of foreign body","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9172","name":"Docetaxel (docivyx), 1 mg","description":"Injection, docetaxel (docivyx), 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0288U","name":"Onc lung mrna quan pcr 11&3","description":"Onc lung mrna quan pcr 11&3","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4394","name":"Surgraft aca per sq cm","description":"Surgraft aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0721T","name":"Quan ct tiss charac w/o ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99313","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0806T","name":"Tcat s&ivc prstc vl impl opn","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); open femoral vein approach","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62281","name":"Treat spinal cord lesion","description":"Injection/infusion of neurolytic substance (eg, alcohol, phenol, iced saline solutions), with or without other therapeutic substance; epidural, cervical or thoracic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4320","name":"Pellograft, per sq cm","description":"Pellograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95811","name":"Polysom 6/>yrs cpap 4/> parm","description":"Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bilevel ventilation, attended by a technologist","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1114.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0248","name":"Inj, remdesivir, 1 mg","description":"Injection, remdesivir, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83987","name":"Exhaled breath condensate","description":"Ph; exhaled breath condensate","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1321","name":"Pts no 7wk inj,no iop,iop>25","description":"Patients who were not seen within 7 weeks following the date of injection for follow up or who did not have a documented iop or no plan of care documented if the iop was >25 mm hg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95919","name":"Quan puplmtry phy/qhp uni/bi","description":"Quantitative pupillometry with physician or other qualified health care professional interpretation and report, unilateral or bilateral","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38226","name":"Car-t prep t lymphcyt f/trns","description":"Chimeric antigen receptor t-cell (car-t) therapy; preparation of blood-derived t lymphocytes for transportation (eg, cryopreservation, storage)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36410","name":"Vnpnxr 3yr/> phy/qhp dx/ther","description":"Venipuncture, age 3 years or older, necessitating the skill of a physician or other qualified health care professional (separate procedure), for diagnostic or therapeutic purposes (not to be used for routine venipuncture)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":21.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80061","name":"Lipid panel","description":"Lipid panel this panel must include the following: cholesterol, serum, total (82465) lipoprotein, direct measurement, high density cholesterol (hdl cholesterol) (83718) triglycerides (84478)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0697T","name":"Quan mr tis wo mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained without diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, targ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25076","name":"Exc forearm tum deep < 3 cm","description":"Excision, tumor, soft tissue of forearm and/or wrist area, subfascial (eg, intramuscular); less than 3 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85300","name":"Antithrombin iii activity","description":"Clotting inhibitors or anticoagulants; antithrombin iii, activity","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81007","name":"Urine screen for bacteria","description":"Urinalysis; bacteriuria screen, except by culture or dipstick","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89321","name":"Semen anal sperm detection","description":"Semen analysis; sperm presence and motility of sperm, if performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1212","name":"Missing gsa not perf","description":"Glycemic status assessment (hba1c or gmi) level is missing, or was not performed during the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5422","name":"Dentures adjust part mandbl","description":"Adjust partial denture - mandibular","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6212","name":"Bridge noble metal cast","description":"Pontic-cast noble metal","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33276","name":"Insj phrnc nrv stim sys","description":"Insertion of phrenic nerve stimulator system (pulse generator and stimulating lead[s]), including vessel catheterization, all imaging guidance, and pulse generator initial analysis with diagnostic mode activation, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4285","name":"Nudyn dl or dl mesh pr sq cm","description":"Nudyn dl or nudyn dl mesh, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69719","name":"Rplcm oi implt sk tc esp<100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4380","name":"Advograft one per sq cm","description":"Advograft one, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64728","name":"Dcmprn median nrv carpl tunl","description":"Decompression; median nerve at the carpal tunnel, percutaneous, with intracarpal tunnel balloon dilation, including ultrasound guidance","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0863T","name":"Rlcj pg wcs lv trnsmtr only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; transmitter component only","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22590","name":"Arthrd pst tq craniocervical","description":"Arthrodesis, posterior technique, craniocervical (occiput-c2)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1774.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0373","name":"Tomo bitewing image","description":"Tomo bitewing image","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1286","name":"Bmi doc onl fup not cmpltd","description":"Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26416","name":"Graft hand or finger tendon","description":"Removal of synthetic rod and insertion of extensor tendon graft (includes obtaining graft), hand or finger, each rod","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1129.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0278","name":"Iliac art angio,cardiac cath","description":"Iliac and/or femoral artery angiography, non-selective, bilateral or ipsilateral to catheter insertion, performed at the same time as cardiac catheterization and/or coronary angiography, includes positioning or placement of the catheter in the distal aorta or ipsilateral femoral or iliac artery, inj","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81515","name":"Nfct ds bv&vaginitis dna alg","description":"Infectious disease, bacterial vaginosis and vaginitis, real-time pcr amplification of dna markers for atopobium vaginae, atopobium species, megasphaera type 1, and bacterial vaginosis associated bacteria-2 (bvab-2), utilizing vaginal-fluid specimens, algorithm reported as positive or negative for hi","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4264","name":"Cocoon membrane, per sq cm","description":"Cocoon membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1954","name":"Inj leu acet lutr dpt 7.5 mg","description":"Injection, leuprolide acetate for depot suspension (lutrate depot), 7.5 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9129","name":"Photobio therpy-sub 15 mins","description":"Photobio therpy-sub 15 mins","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0484","name":"Consult slides prep elsewher","description":"Consultation on slides prepared elsewhere","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7284","name":"Exc biopsy of saliv glands","description":"Exc biopsy of saliv glands","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64598","name":"Revj/rmvl nea pn w/int nstim","description":"Revision or removal of neurostimulator electrode array, peripheral nerve, with integrated neurostimulator","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1459","name":"Pt hosp/pal care dur perf pd","description":"Patient was in hospice or receiving palliative care services at any time during the performance period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9603","name":"Inj, pafolacianine, 0.1 mg","description":"Injection, pafolacianine, 0.1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1417","name":"Pt up to date cov","description":"Patients who are up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0688","name":"Inj cefazolin sodium, hikma","description":"Injection, cefazolin sodium (hikma), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0516U","name":"Rx metab rxgenomic gnotyp 40","description":"Rx metab rxgenomic gnotyp 40","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0399U","name":"Neuro cere folate defncy srm","description":"Neuro cere folate defncy srm","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1313","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0503U","name":"Neuro alz ds bamyl&tau prtn","description":"Neuro alz ds bamyl&tau prtn","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1020T","name":"Raman spectroscopy 1+skn les","description":"Raman spectroscopy of 1 or more skin lesions, with probability score for malignant risk derived by algorithmic analysis of data from each lesion","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37291","name":"Revsc evsc tpvt athr cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01937","name":"Anes drg/aspir crv/thrc","description":"Anesthesia for percutaneous image-guided injection, drainage or aspiration procedures on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6071","name":"Abutment supported retainer","description":"Abutment supported retainer for porcelain fused to metal fpd (noble metal)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31781","name":"Reconstruct windpipe","description":"Excision tracheal stenosis and anastomosis; cervicothoracic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1674.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60522","name":"Removal of thymus gland","description":"Thymectomy, partial or total; sternal split or transthoracic approach, with radical mediastinal dissection (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1684.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87494","name":"Chlmy trch&neisra gonor mult","description":"Infectious agent detection by nucleic acid (dna or rna); chlamydia trachomatis and neisseria gonorrhoeae, multiplex amplified probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1293","name":"Calc bmi abv up param f/u","description":"Bmi is documented above normal parameters and a follow-up plan is documented","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62330","name":"Dcmprn prq rmv lig flv 1lmbr","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; one interspace, lumbar","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1364","name":"Ascvd risk >=20pct","description":"Calculated 10-year ascvd risk score of >= 20 percent during the performance period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1471","name":"Ffs hep b not covered","description":"Documentation that patient is a medicare fee-for-service beneficiary and without additional supplementary insurance coverage for whom hep b vaccination is not reimbursable under current medicare part b coverage rules","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2002","name":"Inj, lidocaine in d5w, 1 mg","description":"Injection, lidocaine hcl in 5% dextrose, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4011","name":"Internal medicine ss","description":"Internal medicine mips specialty set","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0037","name":"Pt not able to participate","description":"On date of encounter, patient is not able to participate in assessment or screening, including non-verbal patients, delirious, severely aphasic, severely developmentally delayed, severe visual or hearing impairment and for those patients, no knowledgeable informant available","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33895","name":"Evasc st rpr thrc/aa x crsg","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; not crossing major side branches","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":445.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99427","name":"Prin care mgmt staff ea addl","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1266","name":"Pts admit snf","description":"Patients admitted to a skilled nursing facility (snf)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0900T","name":"N-invas est aqmbf asstv cmr","description":"Noninvasive estimate of absolute quantitation of myocardial blood flow (aqmbf), derived from assistive algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health care profes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0765T","name":"Asstv alg ecg rsk asmt prev","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to previously performed electrocardiogram","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27760","name":"Cltx medial ankle fx","description":"Closed treatment of medial malleolus fracture; without manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73130","name":"X-ray exam of hand","description":"Radiologic examination, hand; minimum of 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78608","name":"Brain imaging (pet)","description":"Brain imaging, positron emission tomography (pet); metabolic evaluation","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31242","name":"Nsl/sinus ndsc rf abltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by radiofrequency ablation, posterior nasal nerve","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3472","name":"Surg rep root res premolar","description":"Surg rep root res premolar","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0446U","name":"Ai ds sle alys 10 cytokine","description":"Ai ds sle alys 10 cytokine","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33280","name":"Rmvl phrnc nrv stim pg only","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator only","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4241","name":"Gngvl flap w rootplan 1-3 th","description":"Gingival flap procedure including root planing - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0798T","name":"Tcat rmv 2chmbr ldls pm cmpl","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; complete system (ie, right atrial and right ventricular pacemaker components)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7214","name":"Altuviiio per factor viii iu","description":"Injection, factor viii/von willebrand factor complex, recombinant (altuviiio), per factor viii i.u.","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2040","name":"Microlyte painguard pr sq cm","description":"Microlyte painguard, per square centimeter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0545","name":"Inherent visit to inpt","description":"Visit complexity inherent to hospital inpatient or observation care associated with a confirmed or suspected infectious disease by an infectious diseases specialist, including disease transmission risk assessment and mitigation, public health investigation, analysis, and testing, and complex antimic","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1809","name":"Inj, fosdenopterin, 0.1mg","description":"Injection, fosdenopterin, 0.1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0714T","name":"Tpla b9 prst8 hyprplsa<50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume less than 50 ml","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76856","name":"Us exam pelvic complete","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96547","name":"Intraop hipec px 1st 60 min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; first 60 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0609","name":"Ferric citrate orl 3 mg iron","description":"Ferric citrate, oral, 3 mg ferric iron, (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87183","name":"Sc std carbapenem resist gen","description":"Susceptibility studies, antimicrobial agent; carbapenem resistance genes (eg, blakpc, blandm, blavim, blaoxa-48, blaimp), amplified probe technique, per isolate","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96548","name":"Ntraop hipec px ea add 30min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0766T","name":"Tc mag stimj pn 1st nerve","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; first nerve","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99223","name":"1st hosp ip/obs high 75","description":"Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 75 minutes must","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82233","name":"Beta-amyloid 1-40 (abeta 40)","description":"Beta-amyloid; 1-40 (abeta 40)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85027","name":"Complete cbc automated","description":"Blood count; complete (cbc), automated (hgb, hct, rbc, wbc and platelet count)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9376","name":"Inj pozelimab-bbfg, 1 mg","description":"Injection, pozelimab-bbfg, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85610","name":"Prothrombin time","description":"Prothrombin time;","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0576U","name":"Trnsplj med lar quan ddcfdna","description":"Trnsplj med lar quan ddcfdna","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0295U","name":"Onc brst dux carc 7 proteins","description":"Onc brst dux carc 7 proteins","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2916","name":"Na ferric gluconate complex","description":"Injection, sodium ferric gluconate complex in sucrose injection, 12.5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7354","name":"Cantharidin top, applicator","description":"Cantharidin for topical administration, 0.7%, single unit dose applicator (3.2 mg)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0403U","name":"Onc prst8 mrna 18 gen dre ur","description":"Onc prst8 mrna 18 gen dre ur","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0927T","name":"Interrog dev eval ccm-d ip","description":"Interrogation device evaluation (in person) with analysis, review, and report, including connection, recording, and disconnection, per patient encounter, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0744T","name":"Insj bioprostc vlv fem vn","description":"Insertion of bioprosthetic valve, open, femoral vein, including duplex ultrasound imaging guidance, when performed, including autogenous or nonautogenous patch graft (eg, polyester, eptfe, bovine pericardium), when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2253","name":"Inj midazolam (seizalam)","description":"Injection, midazolam (seizalam), 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2403","name":"Chloroprocaine opht gel, 1mg","description":"Chloroprocaine hcl ophthalmic, 3% gel, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86317","name":"Immunoassay infectious agent","description":"Immunoassay for infectious agent antibody, quantitative, not otherwise specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1028","name":"Take home supply 8mg per 0.1","description":"Take-home supply of nasal naloxone; 2-pack of 8mg per 0.1 ml nasal spray (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87230","name":"Toxin/antitoxin asy tiss cul","description":"Toxin or antitoxin assay, tissue culture (eg, clostridium difficile toxin)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0745T","name":"Car ablt rad arr n-invas loc","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; noninvasive arrhythmia localization and mapping of arrhythmia site (nidus), derived from anatomical image data (eg, ct, mri, or myocardial perfusion scan) and electrical data (eg, 12-lead ecg data), and identification of areas of avo","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64582","name":"Opn mpltj hpglsl nstm ary pg","description":"Open implantation of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43415","name":"Repair esophagus wound","description":"Suture of esophageal wound or injury; transthoracic or transabdominal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1795.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0770T","name":"Vr technology assist therapy","description":"Virtual reality technology to assist therapy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98008","name":"Synch audio-only new sf 15","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code sel","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1161","name":"Pt anphx due to dtp bef 13","description":"Patient had anaphylaxis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0112","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0741","name":"Inj, cabote rilpivir 2mg 3mg","description":"Injection, cabotegravir and rilpivirine, 2mg/3mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0505U","name":"Nfct ds vag infctj id 32orgs","description":"Nfct ds vag infctj id 32orgs","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9326","name":"Telisotuzumab vedotin-tllv","description":"Injection, telisotuzumab vedotin-tllv, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0672T","name":"Ndovag cryg rf remdl tiss","description":"Endovaginal cryogen-cooled, monopolar radiofrequency remodeling of the tissues surrounding the female bladder neck and proximal urethra for urinary incontinence","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1478","name":"Psychoactive sub abuse","description":"Psychoactive substance abuse","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1480","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2057","name":"Afamitresgene autoleucel","description":"Afamitresgene autoleucel, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0496U","name":"Onc clrct cfdna 8/7 genes","description":"Onc clrct cfdna 8/7 genes","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83690","name":"Assay of lipase","description":"Lipase","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3263","name":"Inj, toripalimab-tpzi, 1 mg","description":"Injection, toripalimab-tpzi, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4365","name":"Amnio bur dl mem per sq cm","description":"Amnio burgeon dual-layer membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S4024","name":"Air polymer foam per study","description":"Air polymer-type a intrauterine foam, per study dose","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0559","name":"Unrelat prac follow up visit","description":"Post-operative follow-up visit complexity inherent to evaluation and management services addressing surgical procedure(s), provided by a physician or qualified health care professional who is not the practitioner who performed the procedure (or in the same group practice) and is of the same or of a ","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0774T","name":"Vr px dissoc svc oth phy ea","description":"Virtual reality (vr) procedural dissociation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports; each additiona","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4416","name":"Alexiguard tl-t per sq cm","description":"Alexiguard tl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1188","name":"Pt w/ ckd stg 5","description":"Patients with a diagnosis of chronic kidney disease (ckd) stage 5","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87420","name":"Resp syncytial virus ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; respiratory syncytial virus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1213","name":"No hx spiro prs spiro>=70%","description":"No history of spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) and present spirometry is >= 70%","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4345","name":"Matrix hd allogrft per sq cm","description":"Matrix hd allograft dermis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0280U","name":"Hem vw factor&clgn iv bndg","description":"Hematology (von willebrand disease [vwd]), von willebrand factor (vwf) and collagen iv binding by enzyme-linked immunosorbent assays (elisa), plasma, report of collagen iv binding","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9393","name":"Inj, fulvestrant (teva)","description":"Injection, fulvestrant (teva), not therapeutically equivalent to j9395, 25 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0248","name":"Inj, remdesivir, 1 mg","description":"Injection, remdesivir, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7962","name":"Lingual frenectomy","description":"Lingual frenectomy","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77295","name":"3-d radiotherapy plan","description":"3-dimensional radiotherapy plan, including dose-volume histograms","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1709.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4383","name":"Axolotl graft ult per sq cm","description":"Axolotl graft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4411","name":"Amniomatrixf4x per sq cm","description":"Amniomatrixf4x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9278","name":"Inj, carboplatin (avyxa)","description":"Injection, carboplatin (avyxa), 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1151","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86587","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4148","name":"Enteral feed elastomer daily","description":"Enteral feeding supply kit; elastomeric control fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98002","name":"Synch audio-video new mod 45","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate medical decision making. when using total time on the date of the encounter for code selection, 45 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1411","name":"Inj, hemgenix, per tx dose","description":"Injection, etranacogene dezaparvovec-drlb, per therapeutic dose","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17305","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9999","name":"Inj ustekinumab-aauz 1 mg","description":"Injection, ustekinumab-aauz (otulfi), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6196","name":"Remv of ind rest on implt","description":"Remv of ind rest on implt","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0474U","name":"Hered pan ca gsap 88gene ngs","description":"Hered pan ca gsap 88gene ngs","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69716","name":"Impl oi implt sk tc esp<100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or resulting in removal of less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27333","name":"Removal of knee cartilage","description":"Arthrotomy, with excision of semilunar cartilage (meniscectomy) knee; medial and lateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":698.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5140","name":"Inj adalimumab-fkjp, 1 mg","description":"Injection, adalimumab-fkjp, biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2372","name":"Inj, biorphen, 20 micrograms","description":"Injection, phenylephrine hydrochloride (biorphen), 20 micrograms","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2026","name":"Restrata minimatrix, 5 mg","description":"Restrata minimatrix, 5 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1203","name":"Inj, cipaglucosidase, 5 mg","description":"Injection, cipaglucosidase alfa-atga, 5 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0358U","name":"Neuro alys b-amyl 1-42&1-40","description":"Neuro alys b-amyl 1-42&1-40","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4296","name":"Rebound matrix, per sq cm","description":"Rebound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78491","name":"Myocrd img pet 1std rst/strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); single study, at rest or stress (exercise or pharmacologic)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47620","name":"Removal of gallbladder","description":"Cholecystectomy with exploration of common duct; with transduodenal sphincterotomy or sphincteroplasty, with or without cholangiography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98011","name":"Synch audio-only new high 60","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 60 ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9026","name":"Inj, tarlatamab-dlle, 1 mg","description":"Injection, tarlatamab-dlle, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6596","name":"G comp bandge conform gauze","description":"Gradient compression bandaging supply, conforming gauze, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1382","name":"Enc dur perf pd pos 11","description":"Patient encounter during the performance period with place of service code 11","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0731T","name":"Augmnt ai-based fcl phnt a/r","description":"Augmentative ai-based facial phenotype analysis with report","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0250","name":"Adm tocilizu covid-19 2nd","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9296","name":"Inj pemetrexed (accord) 10mg","description":"Injection, pemetrexed (accord), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1207","name":"Pt scrn sdoh","description":"Patient is screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1450","name":"Pt hos/pal care dur id/pf pd","description":"Patients who received hospice or palliative care service any time during denominator identification period or the measure assessment period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2390","name":"Ant resin-based cmpst crown","description":"Resin-based composite crown anterior","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87101","name":"Skin fungi culture","description":"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; skin, hair, or nail","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6180","name":"Implnt maint proced","description":"Implnt maint proced","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0864T","name":"Low ntsty eswt corpus cvrnsm","description":"Low-intensity extracorporeal shock wave therapy involving corpus cavernosum, low energy","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7259","name":"Nerve dissection","description":"Nerve dissection","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0349U","name":"Rx metab/pcx dna 27gen rx ia","description":"Rx metab/pcx dna 27gen rx ia","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59850","name":"Induced abortion 1+ njx","description":"Induced abortion, by 1 or more intra-amniotic injections (amniocentesis-injections), including hospital admission and visits, delivery of fetus and secundines;","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":419.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27080","name":"Removal of tail bone","description":"Coccygectomy, primary","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":550.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15841","name":"Nerve palsy muscle graft","description":"Graft for facial nerve paralysis; free muscle graft (including obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1825.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1320","name":"Pts scrn + hrsn","description":"Patients who screened positive for at least 1 of the 5 hrsns","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1551","name":"Inj cutaquig 100 mg","description":"Injection, immune globulin (cutaquig), 100 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1410","name":"No gmln brca1/brca2 couns","description":"Patients who did not have germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1210","name":">=2 same meds tbl4 not ord","description":"At least two orders for high-risk medications from the same drug class, (table 4), not ordered","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0578","name":"Inj brixadi, more than 7 day","description":"Injection, buprenorphine extended release (brixadi), greater than 7 days and up to 28 days of therapy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87076","name":"Culture anaerobe ident each","description":"Culture, bacterial; anaerobic isolate, additional methods required for definitive identification, each isolate","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2043","name":"Biobrane, per sq cm","description":"Biobrane, per square centimeter","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31624","name":"Dx bronchoscope/lavage","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial alveolar lavage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1357","name":"Pt w/red suic idea 120 days","description":"Patients who had a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1399","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0572U","name":"Onc prst8 httl qfish whl bld","description":"Onc prst8 httl qfish whl bld","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7298","name":"Remove screw retained plate","description":"Remove screw retained plate","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4339","name":"Artacent vericlen, per sq cm","description":"Artacent vericlen, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0601","name":"Sevelamer carbonate 20 mg","description":"Sevelamer carbonate (renvela or therapeutically equivalent), oral, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5155","name":"Inj, aflibercept-jbvf, 1 mg","description":"Injection, aflibercept-jbvf (yesafili), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15940","name":"Exc ischial pr ulc prim sutr","description":"Excision, ischial pressure ulcer, with primary suture;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":758.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0607U","name":"Reprdtve med ema rtpcr 31bct","description":"Reprdtve med ema rtpcr 31bct","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0442","name":"Annual alcohol screen 15 min","description":"Annual alcohol misuse screening, 5 to 15 minutes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":8.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90954","name":"Esrd serv 4 vsts p mo 2-11","description":"End-stage renal disease (esrd) related services monthly, for patients 2-11 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 4 or more face-to-face visits by a physician or other qualified health care professional ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93584","name":"Vngrph chd anom/persist svc","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; anomalous or persistent superior vena cava when it exists as a second contralateral superior vena cava, with native drainage to heart (list separately in addition to code for pri","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86384","name":"Nitroblue tetrazolium dye","description":"Nitroblue tetrazolium dye test (ntd)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1175","name":"Doc med rsn no hzv","description":"Documentation of medical reason(s) for not administering zoster vaccine (e.g., prior anaphylaxis due to the zoster vaccine)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0024","name":"Pin srv add 30 min pr m","description":"Principal illness navigation services, additional 30 minutes per calendar month (list separately in addition to g0023)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1227","name":"Eb therapy prescribed","description":"Evidence-based therapy was prescribed","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55867","name":"Laps surg prst8ect smpl stot","description":"Laparoscopy, surgical prostatectomy, simple subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy), includes robotic assistance, when performed","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9268","name":"Programmer orally ingest cap","description":"Programmer for transient, orally ingested capsule","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0542","name":"No pt prsnt train add 15","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1265","name":"Cms 2728 completed","description":"Cms medical evidence form 2728 for dialysis patients: initial form completed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8502","name":"Inj, aponvie, 1 mg","description":"Injection, aprepitant (aponvie), 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90482","name":"Imm cnsl not admn sm 3<10","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; 3 minutes up to 10 minutes","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1464","name":"No record of f/u by 180 days","description":"No documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33278","name":"Rmvl phrnc nrv stim sys","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; system, including pulse generator and lead(s)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71047","name":"X-ray exam chest 3 views","description":"Radiologic examination, chest; 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21421","name":"Cltx palatal/max fx wire fix","description":"Closed treatment of palatal or maxillary fracture (lefort i type), with interdental wire fixation or fixation of denture or splint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":651.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1343","name":"Pt pam lvl 4 base or srt lin","description":"Patients who are at pam level 4 at baseline or patients who are flagged with extreme straight line response sets on the pam or with excessive missing responses","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0165","name":"Inj epinephrine nos 0.1 mg","description":"Injection, epinephrine, not otherwise specified, 0.1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1307","name":"Inj, crovalimab-akkz, 10 mg","description":"Injection, crovalimab-akkz, 10 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43121","name":"Partial removal of esophagus","description":"Partial esophagectomy, distal two-thirds, with thoracotomy only, with or without proximal gastrectomy, with thoracic esophagogastrostomy, with or without pyloroplasty","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2087.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1355","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47780","name":"Fuse bile ducts and bowel","description":"Anastomosis, roux-en-y, of extrahepatic biliary ducts and gastrointestinal tract","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1831.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9601","name":"Flortaucipir inj 1 millicuri","description":"Flortaucipir f 18 injection, diagnostic, 1 millicurie","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0275U","name":"Hem heprn nduc trmbctpna srm","description":"Hematology (heparin-induced thrombocytopenia) platelet antibody reactivity by flow cytometry, serum","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38222","name":"Dx bone marrow bx & aspir","description":"Diagnostic bone marrow; biopsy(ies) and aspiration(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":71.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9011","name":"Datopotamab deruxtecan, 1 mg","description":"Injection, datopotamab deruxtecan-dlnk, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0296U","name":"Onc orl&/orop ca 20 mlc feat","description":"Onc orl&/orop ca 20 mlc feat","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1417","name":"Pt up to date cov","description":"Patients who are up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90635","name":"H5n1 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n1, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93005","name":"Electrocardiogram tracing","description":"Electrocardiogram, routine ecg with at least 12 leads; tracing only, without interpretation and report","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0052","name":"Mmip mental health and care","description":"Missing and murdered indigenous persons (mmip) mental health and clinical care","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0701","name":"Pano radio image","description":"Pano radio image","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1474","name":"Pt dx dementia","description":"Patients with diagnosis of dementia","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86352","name":"Cell function assay w/stim","description":"Cellular function assay involving stimulation (eg, mitogen or antigen) and detection of biomarker (eg, atp)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92945","name":"Prq trl rvs ch occ ant&rtrgr","description":"Percutaneous transluminal revascularization of chronic total occlusion, single coronary artery, coronary artery branch, or coronary artery bypass graft, and/or subtended major coronary artery branches of the bypass graft, any combination of intracoronary stent, atherectomy and angioplasty; combined ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77091","name":"Tbs techl calculation only","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical calculation only","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90951","name":"Esrd serv 4 visits p mo <2yr","description":"End-stage renal disease (esrd) related services monthly, for patients younger than 2 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 4 or more face-to-face visits by a physician or other qualified health care pro","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1152.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1366","name":"Focus on womens health mvp","description":"Focusing on womens health mips value pathway","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43644","name":"Lap gastric bypass/roux-en-y","description":"Laparoscopy, surgical, gastric restrictive procedure; with gastric bypass and roux-en-y gastroenterostomy (roux limb 150 cm or less)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1867.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0673T","name":"Abltj b9 thyr ndul perq lasr","description":"Ablation, benign thyroid nodule(s), percutaneous, laser, including imaging guidance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0174","name":"Lecanemab-irmb, for iv inj","description":"Lecanemab-irmb, for intravenous injection, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0602U","name":"Endocrin dm ins gen mthyltn","description":"Endocrin dm ins gen mthyltn","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1393","name":"Pr no dx rec mlnm","description":"Patients who were not diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69727","name":"Rmv ntr oi imp sk tc esp<100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1191","name":"Hspc svc any time in meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1497","name":"No doc fall med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42300","name":"Drainage of salivary gland","description":"Drainage of abscess; parotid, simple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0459U","name":"Abeta42 & ttau eclia csf","description":"Abeta42 & ttau eclia csf","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2014","name":"Omeza collag compl 100 mg","description":"Omeza collagen matrix or omeza complete matrix, per 100 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4288","name":"Dermabind ch, per sq cm","description":"Dermabind ch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1553","name":"Inj yimmugo 100 mg","description":"Injection, immune globulin (yimmugo), 100 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1206","name":"Isa not red 3pts/no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41009","name":"Drainage of mouth lesion","description":"Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; masticator space","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0520U","name":"Ther rx mntr 200+ rx/sbsts","description":"Ther rx mntr 200+ rx/sbsts","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0389","name":"Periopic image capture only","description":"Periopic image capture only","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0846T","name":"Dgtz gls mcrscp imfluor ea","description":"Digitization of glass microscope slides for immunofluorescence, per specimen; each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93152","name":"Interrog&prgrmg ipnss polysm","description":"Interrogation and programming of implanted phrenic nerve stimulator system during polysomnography","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0334U","name":"Onc sld orgn tgsa dna 84/+","description":"Onc sld orgn tgsa dna 84/+","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0887T","name":"End-tidal ctrl inhaled anes","description":"End-tidal control of inhaled anesthetic agents and oxygen to assist anesthesia care delivery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62331","name":"Dcmprn prq rmv lig flv addl","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; additional interspace(s), lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12002","name":"Rpr s/n/ax/gen/trnk2.6-7.5cm","description":"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 2.6 cm to 7.5 cm","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":132.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9061","name":"Inj, amivantamab-vmjw","description":"Injection, amivantamab-vmjw, 2 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1237","name":"Pt rsn no scrn","description":"Patient reason for not screening for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety (e.g., patient declined or other patient reasons)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64654","name":"1st opn implt bat modulj sys","description":"Initial open implantation of baroreflex activation therapy (bat) modulation system, including lead placement onto the carotid sinus, lead tunnelling, connection to a pulse generator placed in a distant subcutaneous pocket (ie, total system), and intraoperative interrogation and programming","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69661","name":"Revise middle ear bone","description":"Stapedectomy or stapedotomy with reestablishment of ossicular continuity, with or without use of foreign material; with footplate drill out","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1422.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87380","name":"Hepatitis delta agent ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; hepatitis, delta agent","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6038","name":"Multiax rotation attachment","description":"Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1221","name":"Dre w/o rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; without evidence of retinopathy","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38228","name":"Car-t admn autologous","description":"Chimeric antigen receptor t-cell (car-t) therapy; car-t cell administration, autologous","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0835T","name":"Dgtz gls mcrscp fna 1st ea","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0369","name":"Max mri capture & interprete","description":"Max mri capture & interprete","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9244","name":"Office min sed drug enteral","description":"Office min sed drug enteral","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0852T","name":"Dgtz gls mcrscp mphmtrc ea 1","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0462","name":"Atropine sulf, nte, 0.01 mg","description":"Injection, atropine sulfate, not therapeutically equivalent to j0461, 0.01 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32482","name":"Bilobectomy","description":"Removal of lung, other than pneumonectomy; 2 lobes (bilobectomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1860.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1257","name":"Cvd risk assess not perf","description":"Cvd risk assessment not performed or incomplete (e.g., cvd risk assessment was not documented), reason not otherwise specified","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21485","name":"Cltx tmprmand dislc comp","description":"Closed treatment of temporomandibular dislocation; complicated (eg, recurrent requiring intermaxillary fixation or splinting), initial or subsequent","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":561.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1235","name":"Doc pt hcv aby rna tst","description":"Documentation or patient report of hcv antibody test or hcv rna test which occurred prior to the performance period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83945","name":"Assay of oxalate","description":"Oxalate","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3376","name":"Inj vancomycin (hikma) 10mg","description":"Injection, vancomycin hcl (hikma), not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1236","name":"Baseline mrs > 2","description":"Baseline mrs > 2","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0406U","name":"Onc lung flow cytmtry 5 mrk","description":"Onc lung flow cytmtry 5 mrk","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J9070","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4327","name":"Duoamnion, per sq cm","description":"Duoamnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0693T","name":"Compre ful bdy 3d mtn alys","description":"Comprehensive full body computer-based markerless 3d kinematic and kinetic motion analysis and report","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70390","name":"X-ray exam of salivary duct","description":"Sialography, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4436","name":"Renati ac membrane per sq cm","description":"Renati ac membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0936T","name":"Photobiomodulation ther rta","description":"Photobiomodulation therapy of retina, single session","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1073","name":"Testosterone pellet 75 mg","description":"Testosterone pellet, implant, 75 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4333","name":"Ardeograft, per sq cm","description":"Ardeograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2040","name":"Microlyte painguard pr sq cm","description":"Microlyte painguard, per square centimeter","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27458","name":"Osteot femur imed lngth dev","description":"Osteotomy(ies), femur, unilateral, with insertion of an externally controlled intramedullary lengthening device, including iliotibial band release when performed, imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5941","name":"Resct proth mand part remov","description":"Resct proth mand part remov","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1246","name":"Pt othr thn true imprt to me","description":"Patient provided a response other than completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9246","name":"Mod sedation noniv-15 min","description":"Mod sedation noniv-15 min","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99202","name":"Office o/p new sf 15 min","description":"Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 15 minutes must be met or exceede","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":85.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4415","name":"Alexiguard st-l per sq cm","description":"Alexiguard sl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0893","name":"Inj, decitabine (sun pharma)","description":"Injection, decitabine (sun pharma), not therapeutically equivalent to j0894, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55714","name":"Bx prst8 in-bore ct/mri 1","description":"Biopsy, prostate, in-bore ct- or mri-guided targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83529","name":"Asay of interleukin-6 (il-6)","description":"Interleukin-6 (il-6)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0519U","name":"Ther rx mntr meds p/d/a 110+","description":"Ther rx mntr meds p/d/a 110+","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84061","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0667","name":"Team remote e/m est pt 25 mn","description":"Team remote e/m est. pt 25mins","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4364","name":"Am bur xp mem xpl hy p sq cm","description":"Amnio burgeon xplus membrane and xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55712","name":"Bx prst8 tprnl mri-us 1st","description":"Biopsy, prostate, transperineal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6559","name":"G stckng full/chap18-30 cust","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2032","name":"Myriad matrix, per sq cm","description":"Myriad matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":547.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1472","name":"Hep b vaccine not received","description":"Patient did not receive recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1126F","name":"Amnt pain noted none prsnt","description":"Pain severity quantified; no pain present (coa) (onc)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1352","name":"Suicd c-ssrs assessment, equ","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs or equivalent assessment","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80102","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1163","name":"Inj, diltiazem hcl, 0.5 mg","description":"Injection, diltiazem hydrochloride, 0.5 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1252","name":"Pts no cmplt hu survey","description":"Patients who did not complete at least one of the four patient experience hu survey items and return the hu survey within 60 days of the ambulatory palliative care visit","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0620U","name":"Onc hcc dna mthyln alys>5000","description":"Onc hcc dna mthyln alys>5000","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1458","name":"Pt died bef end meas pd","description":"Patient died prior to the end of the performance period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76802","name":"Ob us < 14 wks addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1445","name":"Pp care visit by 12 weeks","description":"Postpartum care visit before or at 12 weeks of giving birth","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0293U","name":"Psyc suicidal idea mrna 54","description":"Psyc suicidal idea mrna 54","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49591","name":"Rpr aa hrn 1st < 3 cm rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, reducible","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87150","name":"Dna/rna amplified probe","description":"Culture, typing; identification by nucleic acid (dna or rna) probe, amplified probe technique, per culture or isolate, each organism probed","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0511U","name":"Onc sol tum 3dmicroenvir 36+","description":"Onc sol tum 3dmicroenvir 36+","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69645","name":"Revise middle ear & mastoid","description":"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); radical or complete, without ossicular chain reconstruction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1707.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64567","name":"Perq elec nrv field stimj cn","description":"Percutaneous electrical nerve field stimulation, cranial nerves, without implantation","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1010","name":"Inj, methylpred acetate 1 mg","description":"Injection, methylprednisolone acetate, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3387","name":"Inj elivaldogene autotemecel","description":"Injection, elivaldogene autotemcel, per treatment","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0444U","name":"Onc sld orgn neo tgsap 361","description":"Onc sld orgn neo tgsap 361","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0873T","name":"Revj subq prtl asct pmp sys","description":"Revision of a subcutaneously implanted peritoneal ascites pump system, any component (ascites pump, associated peritoneal catheter, associated bladder catheter), including imaging and programming, when performed","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0138","name":"Iv cipaglucosidase alfa-atga","description":"Intravenous infusion of cipaglucosidase alfa-atga, including provider/supplier acquisition and clinical supervision of oral administration of miglustat in preparation of receipt of cipaglucosidase alfa-atga","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12017","name":"Rpr fe/e/en/l/m 20.1-30.0 cm","description":"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 20.1 cm to 30.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0658","name":"Seg pneum comp 2 arm chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1451","name":"Pt dx ppd dur id/pf pd","description":"Patients with an active diagnosis of pervasive developmental disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86363","name":"Mog-igg1 antb flo cytmtry ea","description":"Myelin oligodendrocyte glycoprotein (mog-igg1) antibody; flow cytometry (ie, fluorescence-activated cell sorting [facs]), each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9052","name":"Inj, carmustine (accord)","description":"Injection, carmustine (accord), not therapeutically equivalent to j9050, 100 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17281","name":"Dstr mal ls f/e/e/n/l/m .6-1","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 0.6 to 1.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4338","name":"Artacent velos, per sq cm","description":"Artacent velos, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0013","name":"Esketamine, nasal spray","description":"Esketamine, nasal spray, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64659","name":"Rmvl bat modulj sys pg only","description":"Removal of baroreflex activation therapy (bat) modulation system; pulse generator only","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84146","name":"Assay of prolactin","description":"Prolactin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5725","name":"Rebase hybrid prosthesis","description":"Rebase hybrid prosthesis","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43112","name":"Esphg tot w/thrcm","description":"Total or near total esophagectomy, with thoracotomy; with pharyngogastrostomy or cervical esophagogastrostomy, with or without pyloroplasty (ie, mckeown esophagectomy or tri-incisional esophagectomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3056.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G3003","name":"Chronic pain mgmt addl 15m","description":"Each additional 15 minutes of chronic pain management and treatment by a physician or other qualified health care professional, per calendar month. (list separately in addition to code for g3002. when using g3003, 15 minutes must be met or exceeded.)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7299","name":"Intraut copp cont (miudella)","description":"Intrauterine copper contraceptive (miudella)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2020","name":"Ac5 wound system","description":"Ac5 advanced wound system (ac5)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1487","name":"Pt adm to hospice dur eval","description":"Patients in hospice in the year before or during the period of evaluation","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0984T","name":"Iv img xtrc cere vsl oct 1st","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27050","name":"Biopsy of sacroiliac joint","description":"Arthrotomy, with biopsy; sacroiliac joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":427.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33267","name":"Excl laa open any method","description":"Exclusion of left atrial appendage, open, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1388","name":"Pt doc exm rec melmn","description":"Patients with documentation of an exam performed for recurrence of melanoma","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76856","name":"Us exam pelvic complete","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9268","name":"Programmer orally ingest cap","description":"Programmer for transient, orally ingested capsule","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0800T","name":"Tcat rmvl 2chmbr ldls pm rv","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right ventricular pacemaker component (when part of a dual-chamber leadless pacem","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9334","name":"Inj efgart-alfa 2mg hya-qvfc","description":"Injection, efgartigimod alfa, 2 mg and hyaluronidase-qvfc","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0175","name":"Inj, donanemab-azbt, 2 mg","description":"Injection, donanemab-azbt, 2 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4345","name":"Matrix hd allogrft per sq cm","description":"Matrix hd allograft dermis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q2012","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4383","name":"Axolotl graft ult per sq cm","description":"Axolotl graft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11046","name":"Dbrdmt musc&/fsca ea addl","description":"Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); each additional 20 sq cm, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":82.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93598","name":"Car outp meas drg cath chd","description":"Cardiac output measurement(s), thermodilution or other indicator dilution method, performed during cardiac catheterization for the evaluation of congenital heart defects (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37620","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":760.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0037","name":"Pt not able to participate","description":"On date of encounter, patient is not able to participate in assessment or screening, including non-verbal patients, delirious, severely aphasic, severely developmentally delayed, severe visual or hearing impairment and for those patients, no knowledgeable informant available","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1028","name":"Take home supply 8mg per 0.1","description":"Take-home supply of nasal naloxone; 2-pack of 8mg per 0.1 ml nasal spray (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81278","name":"Igh@/bcl2 translocation alys","description":"Igh@/bcl2 (t(14;18)) (eg, follicular lymphoma) translocation analysis, major breakpoint region (mbr) and minor cluster region (mcr) breakpoints, qualitative or quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4268","name":"Surgraft ft per sq cm","description":"Surgraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69209","name":"Remove impacted ear wax uni","description":"Removal impacted cerumen using irrigation/lavage, unilateral","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5939","name":"Resct proth mand comp remov","description":"Resct proth mand comp remov","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0408U","name":"Iaad blk ac wv bsnsr sarscv2","description":"Iaad blk ac wv bsnsr sarscv2","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0540","name":"Train for caregiver add 15","description":"Caregiver training in behavior management/modification for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face; each additional 15 minutes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67030","name":"Incise inner eye strands","description":"Discission of vitreous strands (without removal), pars plana approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":490.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1348","name":"Pam incr 6 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 6-points in a 4 to 12 month period (excellent)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70472","name":"Ct cere prfu alys c+w/ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed with concurrent ct or ct angiography of the same anatomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12021","name":"Tx supfc wnd dehsn w/packing","description":"Treatment of superficial wound dehiscence; with packing","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":154.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43130","name":"Removal of esophagus pouch","description":"Diverticulectomy of hypopharynx or esophagus, with or without myotomy; cervical approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":913.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0895T","name":"Connj lvr algrft prfu dev 1","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; initial 4 hours of monitoring time, including hourly physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77091","name":"Tbs techl calculation only","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical calculation only","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51721","name":"Ins trurl ablt trnsdc thr us","description":"Insertion of transurethral ablation transducer for delivery of thermal ultrasound for prostate tissue ablation, including suprapubic tube placement during the same session and placement of an endorectal cooling device, when performed","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86596","name":"Voltage-gtd ca chnl antb ea","description":"Voltage-gated calcium channel antibody, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6527","name":"G garmt full leg/ft nght cus","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, custom, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85362","name":"Fibrin degradation products","description":"Fibrin(ogen) degradation (split) products (fdp) (fsp); agglutination slide, semiquantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78492","name":"Myocrd img pet mlt rst&strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); multiple studies at rest and stress (exercise or pharmacologic)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0694T","name":"3d vol img&rcnstj brst/ax","description":"3-dimensional volumetric imaging and reconstruction of breast or axillary lymph node tissue, each excised specimen, 3-dimensional automatic specimen reorientation, interpretation and report, real-time intraoperative","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35491","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":513.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4305","name":"Amer am ac tri-lay per sq cm","description":"American amnion ac tri-layer, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4437","name":"Revival ac per sq cm","description":"Revival ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99459","name":"Pelvic examination","description":"Pelvic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1491","name":"Recd esrd mcp dur perf pd","description":"Receiving esrd mcp dialysis services by the provider during the performance period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96160","name":"Pt-focused hlth risk assmt","description":"Administration of patient-focused health risk assessment instrument (eg, health hazard appraisal) with scoring and documentation, per standardized instrument","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0236","name":"Intrav inf, mon anti, sec do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58321","name":"Artificial insemination","description":"Artificial insemination; intra-cervical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9326","name":"Telisotuzumab vedotin-tllv","description":"Injection, telisotuzumab vedotin-tllv, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0563","name":"Sbrt w/positron emission del","description":"Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance and real-time positron emissions-based delivery adjustments to 1 or more lesions, entire course not to exceed 5 fractions","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86403","name":"Particle agglut antbdy scrn","description":"Particle agglutination; screen, each antibody","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5913","name":"Nasal prosthesis","description":"Nasal prosthesis","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0799T","name":"Tcat rmvl 2chmbr ldls pm ra","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right atrial pacemaker component","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9912","name":"Pre-visit patient screening","description":"Pre-visit patient screening","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1176","name":"No 2 hzv 10/2017-meas pd","description":"Patient did not receive two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9224","name":"Gen anes adv air-15 min","description":"Gen anes adv air-15 min","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57456","name":"Endocerv curettage w/scope","description":"Colposcopy of the cervix including upper/adjacent vagina; with endocervical curettage","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":173.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0400U","name":"Ob xpnd car scr 145 genes","description":"Ob xpnd car scr 145 genes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9999","name":"Inj ustekinumab-aauz 1 mg","description":"Injection, ustekinumab-aauz (otulfi), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4225","name":"Amnio or derma tl, per sq cm","description":"Amniobind or dermabind tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4362","name":"Cygnus disk, per sq cm","description":"Cygnus disk, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0577U","name":"Onc ovr serum alys 39 gps","description":"Onc ovr serum alys 39 gps","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1807","name":"Inj, ethacrynate sod, 1 mg","description":"Injection, ethacrynate sodium, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9347","name":"Inj, tremelimumab-actl, 1 mg","description":"Injection, tremelimumab-actl, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0706T","name":"Rem tx amblyopia i&r phy/qhp","description":"Remote treatment of amblyopia using an eye tracking device; interpretation and report by physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1952","name":"Afo spiral prefab ots","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, off-the-shelf","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7171","name":"Inj, adzynma, 10 iu","description":"Injection, adamts13, recombinant-krhn, 10 iu","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1279","name":"Pre-htn/htn, no f/u, not gvn","description":"Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0970T","name":"Ablt b9 brst tum perq lsr ea","description":"Ablation, benign breast tumor (eg, fibroadenoma), percutaneous, laser, including imaging guidance when performed, each tumor","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4408","name":"Xwrap hydro per sq cm","description":"Xwrap hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5912","name":"Facial moulage complete","description":"Facial moulage (complete)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1460","name":"Dx copd, cf, or arf","description":"Diagnosis for chronic obstructive pulmonary disease, emphysema, cystic fibrosis, or acute respiratory failure","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35693","name":"Art trnsposj subclavian","description":"Transposition and/or reimplantation; vertebral to subclavian artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1135.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87880","name":"Strep a assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; streptococcus, group a","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10081","name":"I&d pilonidal cyst comp","description":"Incision and drainage of pilonidal cyst; complicated","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":413.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5765","name":"Liner compl/partial rem dent","description":"Liner compl/partial rem dent","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0063","name":"Cardiology ss","description":"Cardiology mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93596","name":"R&l hrt cath chd nml nt cnj","description":"Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); normal native connections","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0278U","name":"Hem gen thrombosis 12 genes","description":"Hematology (genetic thrombosis), genomic sequence analysis of 12 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J1530","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1183","name":"Doc imm ckpt inhib hld","description":"Documentation of immune checkpoint inhibitor therapy held and corticosteroids or immunosuppressants prescribed or administered","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5138","name":"Inj, wezlana, iv, 1 mg","description":"Injection, ustekinumab-auub (wezlana), biosimilar, intravenous, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76015","name":"Mr sfty mplt&/fb asmt stf ea","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0318U","name":"Ped whl gen mthyltn alys 50+","description":"Ped whl gen mthyltn alys 50+","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0925T","name":"Rlcj skin pocket ccm-d pg","description":"Relocation of skin pocket for implanted cardiac contractility modulation-defibrillation pulse generator","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69716","name":"Impl oi implt sk tc esp<100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or resulting in removal of less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1375","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0392U","name":"Rx metab genrx ia 16 genes","description":"Rx metab genrx ia 16 genes","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64763","name":"Incise hip/thigh nerve","description":"Transection or avulsion of obturator nerve, extrapelvic, with or without adductor tenotomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79403","name":"Hematopoietic nuclear tx","description":"Radiopharmaceutical therapy, radiolabeled monoclonal antibody by intravenous infusion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":354.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43020","name":"Incision of esophagus","description":"Esophagotomy, cervical approach, with removal of foreign body","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":643.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0675","name":"Inj, carboprost, 0.1 mg","description":"Injection, carboprost tromethamine, 0.1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0806T","name":"Tcat s&ivc prstc vl impl opn","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); open femoral vein approach","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47800","name":"Reconstruction of bile ducts","description":"Reconstruction, plastic, of extrahepatic biliary ducts with end-to-end anastomosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1618.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7771","name":"Alveolus clsd reduc stblz te","description":"Alveolus closed reduction stabilization of teeth","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1160","name":"Digoxin injection","description":"Injection, digoxin, up to 0.5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19294","name":"Prepj tum cav iort prtl mast","description":"Preparation of tumor cavity, with placement of a radiation therapy applicator for intraoperative radiation therapy (iort) concurrent with partial mastectomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1482","name":"Pos quan hep c or qual rna","description":"Positive/detectable hepatitis c virus quantitative or qualitative rna test result during the denominator identification period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49592","name":"Rpr aa hrn 1st < 3 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1807","name":"Inj, ethacrynate sod, 1 mg","description":"Injection, ethacrynate sodium, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1283","name":"Pt scrn tbco and id as user","description":"Patient screened for tobacco use and identified as a tobacco user","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0704T","name":"Rem tx amblyopia setup&edu","description":"Remote treatment of amblyopia using an eye tracking device; device supply with initial set-up and patient education on use of equipment","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0732T","name":"Immntx admn electroporatn im","description":"Immunotherapy administration with electroporation, intramuscular","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9275","name":"Inj cosibelimab-ipdl, 2 mg","description":"Injection, cosibelimab-ipdl, 2 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6036","name":"Prosthetic thumb mechanical","description":"Prosthetic thumb, mechanical, can include metacarpophalangeal (mcp), interphalangeal (ip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1502.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1597","name":"Inj glycopyrrolate, glyrx-pf","description":"Injection, glycopyrrolate (glyrx-pf), 0.1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1336","name":"Pts eval ini xm 2 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 2 weeks","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88341","name":"Imhchem/imcytchm ea add antb","description":"Immunohistochemistry or immunocytochemistry, per specimen; each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0892","name":"Argatroban dialysis (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0001","name":"Advancing cancer care mvp","description":"Advancing cancer care mips value pathways","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1289","name":"No pt tbco cess interv rng","description":"Patient identified as tobacco user did not receive tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1485","name":"Neg viro resp hep c/qual rna","description":"Patients who did not achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0823T","name":"Tcat ins 1chmbr ldls pm ra","description":"Transcatheter insertion of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or programming), when","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1414","name":"Inj, beqvez, per tx dose","description":"Injection, fidanacogene elaparvovec-dzkt, per therapeutic dose","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1150","name":"Lvef <=40% or mod/sev l vsf","description":"Current or prior left ventricular ejection fraction (lvef) less than or equal to 40% or documentation of moderately or severely depressed left ventricular systolic function","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0334U","name":"Onc sld orgn tgsa dna 84/+","description":"Onc sld orgn tgsa dna 84/+","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69727","name":"Rmv ntr oi imp sk tc esp<100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37264","name":"Revsc evasc fpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1453","name":"Preop vis acu > 20/40","description":"Patients with a pre-operative visual acuity better than 20/40","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2016","name":"Permeaderm b, per sq cm","description":"Permeaderm b, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97520","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2038","name":"Marigen pacto, per sq cm","description":"Marigen pacto, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59300","name":"Episiotomy or vaginal repair","description":"Episiotomy or vaginal repair, by other than attending","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":265.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98010","name":"Synch audio-only new mod 45","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection,","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1162","name":"Pt enceph due to dtp bef 13","description":"Patient had encephalitis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17261","name":"Dstrj mal les t/a/l .6-1.0cm","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), trunk, arms or legs; lesion diameter 0.6 to 1.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76019","name":"Mr safety implt pos&/immoblj","description":"Mr safety implant positioning and/or immobilization under supervision of physician or other qualified health care professional, including application of physical protections to secure implanted medical device from mr-induced translational or vibrational forces, magnetically induced functional change","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15750","name":"Neurovascular pedicle flap","description":"Flap; neurovascular pedicle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":985.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81462","name":"So gsap cll fr dna/dna&rna","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants and rearrangements","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1208","name":"Pt no scrn sdoh","description":"Patient is not screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85270","name":"Clot factor xi pta","description":"Clotting; factor xi (pta)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49187","name":"Opn exc/dstr ntra-abd 5.1-10","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5.1 to 10 cm","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9274","name":"Inj, tebentafusp-tebn, 1 mcg","description":"Injection, tebentafusp-tebn, 1 microgram","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86381","name":"Mitochondrial antibody each","description":"Mitochondrial antibody (eg, m2), each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24930","name":"Amputation follow-up surgery","description":"Amputation, arm through humerus; re-amputation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":867.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23921","name":"Disarticulation sho sec clsr","description":"Disarticulation of shoulder; secondary closure or scar revision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9277","name":"Pembrolizumab 1mg berahyalur","description":"Injection, pembrolizumab, 1 mg and berahyaluronidase alfa-pmph","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99383","name":"Prev visit new age 5-11","description":"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; late childhood (","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":139.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0589U","name":"Pfas24cmpnd hi-perf lc-ms/ms","description":"Pfas24cmpnd hi-perf lc-ms/ms","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90613","name":"Inf&sarscov2 vacc 40/0.4 im","description":"Influenza virus vaccine, quadrivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 40 mcg/0.4 ml dosage, for intramuscular use","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8005","name":"Grip glove w microprocessor","description":"Powered, cable driven grip assist glove, hand, finger, includes microprocessor, pressure sensors, all components and accessories, custom fitted","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99223","name":"1st hosp ip/obs high 75","description":"Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 75 minutes must","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0533","name":"Buprenorphone inj weekly","description":"Medication assisted treatment, buprenorphine (injectable) administered on a weekly basis; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid tre","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5948","name":"Max implt sup fix part","description":"Max implt sup fix part","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46612","name":"Anoscopy remove lesions","description":"Anoscopy; with removal of multiple tumors, polyps, or other lesions by hot biopsy forceps, bipolar cautery or snare technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45150","name":"Excision of rectal stricture","description":"Division of stricture of rectum","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55877","name":"Abltj ire prst8 1+ tum perq","description":"Ablation, irreversible electroporation, prostate, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1160","name":"Pt anphx due to mengb bef 13","description":"Patient had anaphylaxis due to the meningococcal vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97037","name":"Appl modality 1+lllt po pain","description":"Application of a modality to 1 or more areas; low-level laser therapy (ie, nonthermal and non-ablative) for post-operative pain reduction","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4359","name":"Choriply, per sq cm","description":"Choriply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J1500","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0268U","name":"Hem ahus gen seq alys 15 gen","description":"Hematology (atypical hemolytic uremic syndrome [ahus]), genomic sequence analysis of 15 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0708","name":"Intraoral bite radio image","description":"Intraoral bite radio image","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82270","name":"Occult blood feces","description":"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (ie, patient was provided 3 cards or single triple card for consecutive collection)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92555","name":"Speech threshold audiometry","description":"Speech audiometry threshold;","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0814T","name":"Prq njx biod osteo matrl fem","description":"Percutaneous injection of calcium-based biodegradable osteoconductive material, proximal femur, including imaging guidance, unilateral","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1482","name":"Pos quan hep c or qual rna","description":"Positive/detectable hepatitis c virus quantitative or qualitative rna test result during the denominator identification period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81451","name":"Hl neo gsap 5-50 rna alys","description":"Hematolymphoid neoplasm or disorder, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants, and copy number variants or rearrangements, or isoform expression or mrna expression levels, if performed; rna analysis","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37261","name":"Revsc evasc ivt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0665","name":"Inj, bupivacaine, nos, 0.5mg","description":"Injection, bupivicaine, not otherwise specified, 0.5 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1375","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2305","name":"Inj, nitroglycerin, 5 mg","description":"Injection, nitroglycerin, 5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0249","name":"Adm tocilizu covid-19 1st","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92512","name":"Nasal function studies","description":"Nasal function studies (eg, rhinomanometry)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9046","name":"Albumin (human), 25%, 20 ml","description":"Infusion, albumin (human), 25%, 20 ml","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0779T","name":"Gi myoelectrical actv study","description":"Gastrointestinal myoelectrical activity study, stomach through colon, with interpretation and report","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90482","name":"Imm cnsl not admn sm 3<10","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; 3 minutes up to 10 minutes","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76857","name":"Us exam pelvic limited","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6518","name":"Grad com wrap w strap arm cu","description":"Gradient compression wrap with adjustable straps, arm, each, custom","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0937T","name":"Xtrnl ecg rec>15d<30d","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; including recording, scanning analysis with report, review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1478","name":"Psychoactive sub abuse","description":"Psychoactive substance abuse","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33894","name":"Evasc st rpr thrc/aa acrs br","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; across major side branches","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3244","name":"Inj. tigecycline (accord)","description":"Injection, tigecycline (accord), not therapeutically equivalent to j3243, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33267","name":"Excl laa open any method","description":"Exclusion of left atrial appendage, open, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0861T","name":"Rmvl pg wcs lv both compnt","description":"Removal of pulse generator for wireless cardiac stimulator for left ventricular pacing; both components (battery and transmitter)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1932","name":"Inj, lanreotide, (cipla) 1mg","description":"Injection, lanreotide, (cipla), 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G3002","name":"Chronic pain mgmt 30 mins","description":"Chronic pain management and treatment, monthly bundle including, diagnosis; assessment and monitoring; administration of a validated pain rating scale or tool; the development, implementation, revision, and/or maintenance of a person-centered care plan that includes strengths, goals, clinical needs,","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69210","name":"Remove impacted ear wax uni","description":"Removal impacted cerumen requiring instrumentation, unilateral","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45397","name":"Lap remove rectum w/pouch","description":"Laparoscopy, surgical; proctectomy, combined abdominoperineal pull-through procedure (eg, colo-anal anastomosis), with creation of colonic reservoir (eg, j-pouch), with diverting enterostomy, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2296.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97550","name":"Caregiver traing 1st 30 min","description":"Caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patie","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99234","name":"Hosp ip/obs sm dt sf/low 45","description":"Hospital inpatient or observation care, for the evaluation and management of a patient including admission and discharge on the same date, which requires a medically appropriate history and/or examination and straightforward or low level of medical decision making. when using total time on the date ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77439","name":"Surf rad thr img gdn us plmt","description":"Surface radiation therapy; superficial or orthovoltage, image guidance, ultrasound for placement of radiation therapy fields for treatment of cutaneous tumors, per course of treatment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4323","name":"Alloply, per sq cm","description":"Alloply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5141","name":"Inj adalimumab-aaty, 1 mg","description":"Injection, adalimumab-aaty, biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0247","name":"Routine footcare pt w lops","description":"Routine foot care by a physician of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) to include, the local care of superficial wounds (i.e. superficial to muscle and fascia) and at least the following if present: (1) local care of superficial wou","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33984","name":"Ecmo/ecls rmvl prph cannula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; removal of peripheral (arterial and/or venous) cannula(e), open, 6 years and older","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":439.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0048","name":"Pall serv during meas","description":"Patients who receive palliative care services any time during the intake period through the end of the measurement year","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0943T","name":"Cysto flx rmvl urtl scaffold","description":"Cystourethroscopy, flexible; with removal of prostatic urethral scaffold","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4357","name":"Xwrap plus, per sq cm","description":"Xwrap plus, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7472","name":"Removal of torus palatinus","description":"Removal of torus palatinus","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4285","name":"Nudyn dl or dl mesh pr sq cm","description":"Nudyn dl or nudyn dl mesh, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66983","name":"Cataract surg w/iol 1 stage","description":"Intracapsular cataract extraction with insertion of intraocular lens prosthesis (1 stage procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J9160","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1205.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61736","name":"Litt icr 1 traj 1 smpl les","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; single trajectory for 1 simple lesion","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0554U","name":"Repr med pga 24chrm te bx qc","description":"Repr med pga 24chrm te bx qc","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76857","name":"Us exam pelvic limited","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0882T","name":"Intraop ther estim pn ue 1st","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; initial nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20922","name":"Removal of fascia for graft","description":"Fascia lata graft; by incision and area exposure, complex or sheet","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0017","name":"Crisis psychotherapy 60m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); first 60 minutes","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1574","name":"Inj, ganciclovir (exela)","description":"Injection, ganciclovir sodium (exela), not therapeutically equivalent to j1570, 500 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1363","name":"Pts no f/u 120 dys","description":"Patients who did not have a follow-up assessment within 120 days of the index assessment","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2393","name":"Post 3 srfc resinbased cmpst","description":"Resin-based composite - three surfaces posterior","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0681T","name":"Rlcj pulse gen only isdss","description":"Relocation of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing dual leads","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0812T","name":"Rem mlt day uroflow dev sply","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); device supply with automated report generation, up to 10 days","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0793T","name":"Prq tcat thrm ablt nrv p-art","description":"Percutaneous transcatheter thermal ablation of nerves innervating the pulmonary arteries, including right heart catheterization, pulmonary artery angiography, and all imaging guidance","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26035","name":"Decompress fingers/hand","description":"Decompression fingers and/or hand, injection injury (eg, grease gun)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":855.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59515","name":"Cesarean delivery","description":"Cesarean delivery only; including postpartum care","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1420.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4284","name":"Dermabind sl, per sq cm","description":"Dermabind sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86850","name":"Rbc antibody screen","description":"Antibody screen, rbc, each serum technique","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36217","name":"Place catheter in artery","description":"Selective catheter placement, arterial system; initial third order or more selective thoracic or brachiocephalic branch, within a vascular family","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61735","name":"Incise skull/brain surgery","description":"Creation of lesion by stereotactic method, including burr hole(s) and localizing and recording techniques, single or multiple stages; subcortical structure(s) other than globus pallidus or thalamus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1584.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4336","name":"Artecent c, per sq cm","description":"Artacent c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0304U","name":"Hem rbc ads whl bld normoxic","description":"Hem rbc ads whl bld normoxic","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0733T","name":"Rem r-t mtn nrehab ther sply","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; supply and technical support, per 30 days","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4268","name":"Surgraft ft per sq cm","description":"Surgraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0326U","name":"Trgt gen seq alys pnl 83+","description":"Trgt gen seq alys pnl 83+","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64598","name":"Revj/rmvl nea pn w/int nstim","description":"Revision or removal of neurostimulator electrode array, peripheral nerve, with integrated neurostimulator","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0709","name":"Intraoral cmplt radio images","description":"Intraoral cmplt radio images","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4003","name":"Emergency med ss","description":"Emergency medicine mips specialty set","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95866","name":"Needle emg hemidiaphragm","description":"Needle electromyography; hemidiaphragm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1714","name":"Pfizer vacc adm ped 2nd dose","description":"Pfizer vacc adm ped 2nd dose","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0975T","name":"Slctv nzmtc dbrdmt s/n/hf 1","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; first 100 sq cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61891","name":"Rev/rplcmt sk-mnt crnl nstm","description":"Revision or replacement of skull-mounted cranial neurostimulator pulse generator or receiver with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9996","name":"Ustekinumab- ttwe sub cu inj","description":"Injection, ustekinumab-ttwe (pyzchiva), subcutaneous, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0435U","name":"Onc chemo rx cytox csc 14 rx","description":"Onc chemo rx cytox csc 14 rx","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7671","name":"Alveolus open reduction","description":"Alveolus - open reduction may include stabilization of teeth","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93573","name":"Njx cath slct p-art angrp bi","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, bilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1193","name":"Rpts w/ imp/con mmr/msi","description":"Surgical pathology reports that contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96202","name":"Mlt fam grp bhv train 1st 60","description":"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face with multiple sets of paren","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5138","name":"Inj, wezlana, iv, 1 mg","description":"Injection, ustekinumab-auub (wezlana), biosimilar, intravenous, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71047","name":"X-ray exam chest 3 views","description":"Radiologic examination, chest; 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37288","name":"Revsc evsc tpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4379","name":"Amniodefend ft per sq cm","description":"Amniodefend ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0702","name":"2d cephal radio image","description":"2d cephal radio image","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66989","name":"Xcpsl ctrc rmvl cplx insj 1+","description":"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification), complex, requiring devices or techniques not generally used in routine cataract surgery (eg, iris expansion device,","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"Home vent dual fnct incl all","description":"Home ventilator, dual-function respiratory device, also performs additional function of cough stimulation, includes all accessories, components and supplies for all functions","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]},{"negotiated_type":"negotiated","negotiated_rate":1459.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0467U","name":"Onc bldr dna ngs 60gen&aneup","description":"Onc bldr dna ngs 60gen&aneup","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2044","name":"Biobrane glove, each","description":"Biobrane glove, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98928","name":"Osteopath manj 7-8 regions","description":"Osteopathic manipulative treatment (omt); 7-8 body regions involved","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":78.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1254","name":"Pts deceased prior hu surv","description":"Patients who were deceased when the hu survey reached them","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7300","name":"Rem anchorage dev w/o flap","description":"Rem anchorage dev w/o flap","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9596","name":"Gallium illuccix 1 millicure","description":"Gallium ga-68 gozetotide, diagnostic, (illuccix), 1 millicurie","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83884","name":"Assay neurflmnt light chain","description":"Neurofilament light chain (nfl)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1361","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4349","name":"Mantle dl matrix per sq cm","description":"Mantle dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83521","name":"Ig light chains free each","description":"Immunoglobulin light chains (ie, kappa, lambda), free, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q2014","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":876.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63064","name":"Decompress spinal cord thrc","description":"Costovertebral approach with decompression of spinal cord or nerve root(s) (eg, herniated intervertebral disc), thoracic; single segment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2047.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1372","name":"Mst rec gsa >=7 and<8","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 7.0% and < 8.0%","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9048","name":"Inj, bortezomib freseniuskab","description":"Injection, bortezomib (fresenius kabi), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59025","name":"Fetal non-stress test","description":"Fetal non-stress test","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0551","name":"Phn/intr svs fr dx treat 30m","description":"Interprofessional telephone/internet/electronic health record referral service(s) provided by a treating/requesting practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, 30 minutes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4360","name":"Amchoplast fd per sq cm","description":"Amchoplast fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5943","name":"Proth mandib implt sup remv","description":"Proth mandib implt sup remv","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0883T","name":"Intraop ther estim pn ue ea","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; each additional nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4269","name":"Surgraft xt per sq cm","description":"Surgraft xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4308","name":"Sanopellis, per sq cm","description":"Sanopellis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1484","name":"No rpt hcv rna perf med rsn","description":"Patients who did not have a repeat hcv rna labs performed for medical reasons documented by clinician (e.g., patient with limited life expectancy, delay in treatment of hcv related to treatment of hiv, hbv, hepatocellular carcinoma, decompensated cirrhosis)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86352","name":"Cell function assay w/stim","description":"Cellular function assay involving stimulation (eg, mitogen or antigen) and detection of biomarker (eg, atp)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1299","name":"Flu immunize order/admin","description":"Influenza immunization administered or previously received","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4008","name":"Geriatrics ss","description":"Geriatrics mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0333U","name":"Onc lvr surveilanc hcc cfdna","description":"Onc lvr surveilanc hcc cfdna","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5162","name":"Inj, denosumab-nxxp, 1 mg","description":"Injection, denosumab-nxxp (bildyos/bilprevda), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1194","name":"Med rsn no imp/con mmr/msi","description":"Documentation of medical reason(s) surgical pathology reports did not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both tests were not included (e.g., patient will not be treated with checkpoint inhibitor therap","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33281","name":"Reposg phrnc nrv stim trnsvn","description":"Repositioning of phrenic nerve stimulator transvenous lead(s)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4410","name":"Amchomatrixdl per sq cm","description":"Amchomatrixdl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5949","name":"Mand implt sup fix part","description":"Mand implt sup fix part","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98980","name":"Rtm tx mgmt 1st 20 min","description":"Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least 1 real-time interactive communication with the patient or caregiver during the calendar month; first 20 minutes","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0845T","name":"Dgtz gls mcrscp imfluor 1st","description":"Digitization of glass microscope slides for immunofluorescence, per specimen; initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84443","name":"Assay thyroid stim hormone","description":"Thyroid stimulating hormone (tsh)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0146","name":"Nav srv peer sup add 30 pr m","description":"Principal illness navigation - peer support, additional 30 minutes per calendar month (list separately in addition to g0140)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20802","name":"Replantation arm complete","description":"Replantation, arm (includes surgical neck of humerus through elbow joint), complete amputation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2911.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50551","name":"Kidney endoscopy","description":"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6091","name":"Repl semi/precision attach","description":"Replacement of semi-precision or precision attachment (male or female component) of implant/abutment supported prosthesis per attachment","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77439","name":"Surf rad thr img gdn us plmt","description":"Surface radiation therapy; superficial or orthovoltage, image guidance, ultrasound for placement of radiation therapy fields for treatment of cutaneous tumors, per course of treatment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5938","name":"Resct proth max comp remov","description":"Resct proth max comp remov","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1328","name":"Pts dx acute vitreous hem","description":"Patients with a diagnosis of acute vitreous hemorrhage","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2991","name":"App of hydroxyapatite","description":"App of hydroxyapatite","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4406","name":"Xwrap fenestra per sq cm","description":"Xwrap fenestra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27420","name":"Revision of unstable kneecap","description":"Reconstruction of dislocating patella; (eg, hauser type procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":896.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45393","name":"Colonoscopy w/decompression","description":"Colonoscopy, flexible; with decompression (for pathologic distention) (eg, volvulus, megacolon), including placement of decompression tube, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42400","name":"Biopsy of salivary gland","description":"Biopsy of salivary gland; needle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83655","name":"Assay of lead","description":"Lead","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6609","name":"G compression bandaging","description":"Gradient compression bandaging supply, not otherwise specified","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0263U","name":"Neuro asd meas 16 c metblt","description":"Neurology (autism spectrum disorder [asd]), quantitative measurements of 16 central carbon metabolites (ie, a-ketoglutarate, alanine, lactate, phenylalanine, pyruvate, succinate, carnitine, citrate, fumarate, hypoxanthine, inosine, malate, s-sulfocysteine, taurine, urate, and xanthine), liquid chrom","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1196","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0276U","name":"Hem inh thrombocytopenia 23","description":"Hematology (inherited thrombocytopenia), genomic sequence analysis of 23 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1202","name":"Miglustat oral 65 mg","description":"Miglustat, oral, 65 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4299","name":"Amniocore pro+, per sq cm","description":"Amniocore pro+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0474U","name":"Hered pan ca gsap 88gene ngs","description":"Hered pan ca gsap 88gene ngs","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0963T","name":"Anosc sbmcsl njx bulking agt","description":"Anoscopy with directed submucosal injection of bulking agent into anal canal","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0739T","name":"Abltj mal prst8 mag fld ndct","description":"Ablation of malignant prostate tissue by magnetic field induction, including all intraprocedural, transperineal needle/catheter placement for nanoparticle installation and intraprocedural temperature monitoring, thermal dosimetry, bladder irrigation, and magnetic field nanoparticle activation","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64862","name":"Repair of low back nerves","description":"Suture of; lumbar plexus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1641.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0389U","name":"Ped fbrl kd ifi27&mcemp1 rna","description":"Ped fbrl kd ifi27&mcemp1 rna","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1417","name":"Pt up to date cov","description":"Patients who are up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0696T","name":"Bdy surf mapg pm/cvdfb f/up","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of follow-up interrogation or programming device evaluatio","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9888","name":"5% wl maintnd from bsline wt","description":"Maintenance 5% wl from baseline weight in months 7-12","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1805","name":"Inj, esmolol hcl, 10mg","description":"Injection, esmolol hydrochloride, 10 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0285U","name":"Onc rsps radj cll fr dna tox","description":"Onc rsps radj cll fr dna tox","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0711T","name":"N-nvs artl plaq alys dat prp","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data preparation and transmission","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83036","name":"Hemoglobin glycosylated a1c","description":"Hemoglobin; glycosylated (a1c)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37290","name":"Revsc evsc tpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1290","name":"Pt not eli d/t act dig htn","description":"Patient not eligible due to active diagnosis of hypertension","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0012","name":"Injection of hiv prep drug","description":"Injection of pre-exposure prophylaxis (prep) drug for hiv prevention, under skin or into muscle","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6094","name":"Abut support crown titanium","description":"Abutment supported crown - (titanium)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0858T","name":"Ext trnscranl mag stimj meas","description":"Externally applied transcranial magnetic stimulation with concomitant measurement of evoked cortical potentials with automated report","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87880","name":"Strep a assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; streptococcus, group a","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33414","name":"Repair of aortic valve","description":"Repair of left ventricular outflow tract obstruction by patch enlargement of the outflow tract","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2196.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1408","name":"Gmln brca bef dx ca","description":"Patients who have germline brca testing completed before diagnosis of epithelial ovarian, fallopian tube, or primary peritoneal cancer","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1105","name":"Dexmedetomidine film, 1 mcg","description":"Dexmedetomidine, oral, 1 mcg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12002","name":"Rpr s/n/ax/gen/trnk2.6-7.5cm","description":"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 2.6 cm to 7.5 cm","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":151.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0464U","name":"Onc clrct scr qrtsa dna mrk","description":"Onc clrct scr qrtsa dna mrk","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0869T","name":"Njx b1 sub mtrl hw fixj aug","description":"Injection(s), bone-substitute material for bone and/or soft tissue hardware fixation augmentation, including intraoperative imaging guidance, when performed","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49615","name":"Rpr aa hrn rcr 3-10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, reducible","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2029","name":"Mirotract matrix sheet","description":"Mirotract wound matrix sheet, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4264","name":"Cocoon membrane, per sq cm","description":"Cocoon membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69401","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0774T","name":"Vr px dissoc svc oth phy ea","description":"Virtual reality (vr) procedural dissociation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports; each additiona","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4212","name":"Gingivectomy/plasty rest","description":"Gingivectomy/plasty rest","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3403","name":"Revakinagene, per implant","description":"Revakinagene taroretcel-lwey, per implant","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86762","name":"Rubella antibody","description":"Antibody; rubella","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0987T","name":"Iv img icr cere vsl oct ea","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0802T","name":"Tcat rmv&rpl2chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right at","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0211","name":"Inj, nithiodote, 3mg / 125mg","description":"Injection, sodium nitrite 3 mg and sodium thiosulfate 125 mg (nithiodote)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0342U","name":"Onc pncrtc ca mult ia eclia","description":"Onc pncrtc ca mult ia eclia","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0961T","name":"Shortwave ifr radiation img","description":"Shortwave infrared radiation imaging, surgical pathology specimen, to assist gross examination for lymph node localization in fibroadipose tissue, per specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5992","name":"Low prosth foot shell repl","description":"All lower extremity prosthesis, foot shell for modular foot/non-solid ankle cushion heel (sach) replacement only","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65110","name":"Removal of eye","description":"Exenteration of orbit (does not include skin graft), removal of orbital contents; only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1272.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38227","name":"Car-t receipt&prepj admn","description":"Chimeric antigen receptor t-cell (car-t) therapy; receipt and preparation of car-t cells for administration","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1388","name":"Pt doc exm rec melmn","description":"Patients with documentation of an exam performed for recurrence of melanoma","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2015","name":"Phoenix wnd mtrx, per sq cm","description":"Phoenix wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0314U","name":"Onc cutan mlnma mrna 35 gene","description":"Onc cutan mlnma mrna 35 gene","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2305","name":"Inj, nitroglycerin, 5 mg","description":"Injection, nitroglycerin, 5 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99342","name":"Home/res vst new low mdm 30","description":"Home or residence visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1269","name":"Recd esrd mcp lst day of mo","description":"Receiving esrd mcp dialysis services by the provider on the last day of the reporting month","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55866","name":"Laps surg prst8ect rpbic rad","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1939.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47562","name":"Laparoscopic cholecystectomy","description":"Laparoscopy, surgical; cholecystectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0699T","name":"Njx pst chmbr eye medication","description":"Injection, posterior chamber of eye, medication","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9697","name":"Inj, magtrace per study dose","description":"Injection, carboxydextran-coated superparamagnetic iron oxide, per study dose","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36836","name":"Prq av fstl crtj uxtr 1 acs","description":"Percutaneous arteriovenous fistula creation, upper extremity, single access of both the peripheral artery and peripheral vein, including fistula maturation procedures (eg, transluminal balloon angioplasty, coil embolization) when performed, including all vascular access, imaging guidance and radiolo","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1354","name":"Int caries med app per tooth","description":"Interim caries med app","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82274","name":"Assay test for blood fecal","description":"Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93593","name":"R hrt cath chd nml nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; normal native connections","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49190","name":"Opn exc/dstr ntra-abd >30 cm","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); greater than 30 cm","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85293","name":"Clot factor wght kininogen","description":"Clotting; high molecular weight kininogen assay (fitzgerald factor assay)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0590U","name":"Nfct ds bct&fngl dna 44 orgs","description":"Nfct ds bct&fngl dna 44 orgs","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93573","name":"Njx cath slct p-art angrp bi","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, bilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92642","name":"Hearing asstv dev fitg svc","description":"Hearing assistive device, supplemental technology fitting services (eg, personal frequency modulation [fm]/digital modulation [dm] system, remote microphone, alerting devices)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36800","name":"Insertion of cannula","description":"Insertion of cannula for hemodialysis, other purpose (separate procedure); vein to vein","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76856","name":"Us exam pelvic complete","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99195","name":"Phlebotomy","description":"Phlebotomy, therapeutic (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1189","name":"Doc khe pef w/efgr/uacr","description":"Documentation of a kidney health evaluation defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr) performed","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0923T","name":"Rmvl&rplcmt perm ccm-d pg","description":"Removal and replacement of permanent cardiac contractility modulation-defibrillation pulse generator only","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9129","name":"Photobio therpy-sub 15 mins","description":"Photobio therpy-sub 15 mins","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10121","name":"Inc&rmvl fb subq tiss comp","description":"Incision and removal of foreign body, subcutaneous tissues; complicated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":324.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":88.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53450","name":"Revision of urethra","description":"Urethromeatoplasty, with mucosal advancement","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":433.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0323U","name":"Iadna cns pthgn next gen seq","description":"Iadna cns pthgn next gen seq","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63688","name":"Rev/rmv imp sp npg/r dtch cn","description":"Revision or removal of implanted spinal neurostimulator pulse generator or receiver, with detachable connection to electrode array","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99406","name":"Behav chng smoking 3-10 min","description":"Smoking and tobacco use cessation counseling visit; intermediate, greater than 3 minutes up to 10 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":12.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":11.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D8091","name":"Compre ortho treat w surg","description":"Compre ortho treat w surg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0435U","name":"Onc chemo rx cytox csc 14 rx","description":"Onc chemo rx cytox csc 14 rx","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1435","name":"Oral chemo in perf pd","description":"Patient on oral chemotherapy during the performance period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33894","name":"Evasc st rpr thrc/aa acrs br","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; across major side branches","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4330","name":"Total, per sq cm","description":"Total, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0516","name":"Insert drug del implant, >=4","description":"Insertion of non-biodegradable drug delivery implants, 4 or more (services for subdermal rod implant)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":201.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0949T","name":"Rem interrog dev ccm tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0830T","name":"Dgtz gls mcrscp cytp slctv","description":"Digitization of glass microscope slides for cytopathology, selective-cellular enhancement technique with interpretation (eg, liquid-based slide preparation method), except cervical or vaginal (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1008T","name":"Rem mntr s-scl eeg sys setup","description":"Remote monitoring of sub-scalp implanted continuous bilateral electroencephalography monitoring system, device fitting, initial set-up, and patient education in wearing of system and use of equipment","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1033","name":"Sv doula brth wrk per diem","description":"Services performed by a doula birth worker, per diem","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0294U","name":"Lngvty&mrtlty rsk mrna 18gen","description":"Lngvty&mrtlty rsk mrna 18gen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0326U","name":"Trgt gen seq alys pnl 83+","description":"Trgt gen seq alys pnl 83+","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99298","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0482","name":"Direct immunofluorescence","description":"Direct immunofluorescence","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0853T","name":"Dgtz gls mcrscp mphmtrc ea m","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81025","name":"Urine pregnancy test","description":"Urine pregnancy test, by visual color comparison methods","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99349","name":"Home/res vst est mod mdm 40","description":"Home or residence visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 40 minutes must be met or excee","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":68.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0912T","name":"Elec alys nstim sys vgs smpl","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; with simple programming by physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0433U","name":"Onc prst8 5 dna reg mrk pcr","description":"Onc prst8 5 dna reg mrk pcr","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0310U","name":"Ped vsclts kd alys 3 bmrks","description":"Ped vsclts kd alys 3 bmrks","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86364","name":"Tiss trnsgltmnase ea ig clas","description":"Tissue transglutaminase, each immunoglobulin (ig) class","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0498U","name":"Onc clrct ngs mut detc 43gen","description":"Onc clrct ngs mut detc 43gen","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21820","name":"Treat sternum fracture","description":"Closed treatment of sternum fracture","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49188","name":"Opn exc/dst ntra-abd 10.1-20","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 10.1 to 20 cm","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9334","name":"Inj efgart-alfa 2mg hya-qvfc","description":"Injection, efgartigimod alfa, 2 mg and hyaluronidase-qvfc","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64656","name":"Revj/rplcmt bat mod sys pg","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; pulse generator only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99283","name":"Emergency dept visit low mdm","description":"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and low level of medical decision making","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1436","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1015T","name":"Rev/rmv lw esoph sphnc npg/r","description":"Revision or removal, lower esophageal sphincter neurostimulator pulse generator or receiver","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1714","name":"Pfizer vacc adm ped 2nd dose","description":"Pfizer vacc adm ped 2nd dose","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1470","name":"Hep b vac not recd med rsn","description":"Documentation of medical reason(s) for not administering hepatitis b vaccine (e.g., prior anaphylaxis due to the hepatitis b vaccine)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4337","name":"Artecent trident, per sq cm","description":"Artacent trident, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0829T","name":"Dgtz gls mcrscp cytp conctrj","description":"Digitization of glass microscope slides for cytopathology, concentration technique, smears, and interpretation (eg, saccomanno technique) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73219","name":"Mri upper extremity w/dye","description":"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":772.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85004","name":"Automated diff wbc count","description":"Blood count; automated differential wbc count","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0219","name":"Inj aval alfa-nqpt 4mg","description":"Injection, avalglucosidase alfa-ngpt, 4 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0915T","name":"Insj perm ccm-d sys pg&eltrd","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator and dual transvenous electrodes/leads (pacing and defibrillation)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49423","name":"Exchange drainage catheter","description":"Exchange of previously placed abscess or cyst drainage catheter under radiological guidance (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58660","name":"Laparoscopy lysis","description":"Laparoscopy, surgical; with lysis of adhesions (salpingolysis, ovariolysis) (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":797.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87550","name":"Mycobacteria dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacteria species, direct probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0984T","name":"Iv img xtrc cere vsl oct 1st","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0529","name":"In home respite care, 4 hr u","description":"In-home respite care, 4-hour unit, for use in cmmi model","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4332","name":"Axolotl dualgraft, per sq cm","description":"Axolotl dualgraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6593","name":"Grad com accessory gmt_wrap","description":"Accessory for gradient compression garment or wrap with adjustable straps, not-otherwise specified","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0820T","name":"Mntr psychdlc med 1stphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; first physician or other qualified health care professional, each hour","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55881","name":"Ablt trurl prst8 tis thrm us","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation;","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87181","name":"Sc std agar dilution per agt","description":"Susceptibility studies, antimicrobial agent; agar dilution method, per agent (eg, antibiotic gradient strip)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1391","name":"All pt dx w/ rec mlnm","description":"All patients who were diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1343.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5913","name":"Nasal prosthesis","description":"Nasal prosthesis","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0831T","name":"Dgtz gls mcrscp cytp c/v","description":"Digitization of glass microscope slides for cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1427","name":"Doc med rsn bone scn","description":"Documentation of medical reason(s) for performing a bone scan (including documented pain related to prostate cancer, salvage therapy, other medical reasons)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1551","name":"Inj cutaquig 100 mg","description":"Injection, immune globulin (cutaquig), 100 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1262","name":"Pts transplt bef dialysis","description":"Patients who had a transplant prior to initiation of dialysis","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1282","name":"Pt scrn tbco id as non user","description":"Patient screened for tobacco use and identified as a tobacco non-user","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0571","name":"Intraop nerve cryoablation","description":"Intraoperative nerve(s) cryoablation for post-surgical pain relief (list separately in addition to code for primary service)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0261U","name":"Onc clrct ca img alys w/ai","description":"Oncology (colorectal cancer), image analysis with artificial intelligence assessment of 4 histologic and immunohistochemical features (cd3 and cd8 within tumor-stroma border and tumor core), tissue, reported as immune response and recurrence-risk score","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95015","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37298","name":"Revsc evsc imvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90612","name":"Inf&sarscov2 vacc 31.7/.32im","description":"Influenza virus vaccine, trivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 31.7 mcg/0.32 ml dosage, for intramuscular use","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"Motor &/ sens nrve cndj test","description":"Motor and/or sensory nerve conduction, using preconfigured electrode array(s), amplitude and latency/velocity study, each limb, includes f-wave study when performed, with interpretation and report","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1411","name":"Inj, hemgenix, per tx dose","description":"Injection, etranacogene dezaparvovec-drlb, per therapeutic dose","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58520","name":"Repair of ruptured uterus","description":"Hysterorrhaphy, repair of ruptured uterus (nonobstetrical)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":866.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0701","name":"Pano radio image","description":"Pano radio image","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1317","name":"Pts counsl cpt opt out","description":"Patients who are counseled on connection with a csp and explicitly opt out","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11305","name":"Shave skin lesion 0.5 cm/<","description":"Shaving of epidermal or dermal lesion, single lesion, scalp, neck, hands, feet, genitalia; lesion diameter 0.5 cm or less","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":116.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0039","name":"Pt no ref, rn spec","description":"Patient not referred, reason not otherwise specified","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25565","name":"Cltx rdl&uln shft fx w/mnpj","description":"Closed treatment of radial and ulnar shaft fractures; with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5933","name":"Refitting of obturator","description":"Obturator prosthesis modification","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19126","name":"Excision addl breast lesion","description":"Excision of breast lesion identified by preoperative placement of radiological marker, open; each additional lesion separately identified by a preoperative radiological marker (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0563U","name":"Nfct ds pthgn-sna 11vir&4bct","description":"Nfct ds pthgn-sna 11vir&4bct","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92135","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94640","name":"Airway inhalation treatment","description":"Pressurized or nonpressurized inhalation treatment for acute airway obstruction for therapeutic purposes and/or for diagnostic purposes such as sputum induction with an aerosol generator, nebulizer, metered dose inhaler or intermittent positive pressure breathing (ippb) device","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0999T","name":"Autol musc cell therapy hrvg","description":"Autologous muscle cell therapy, harvesting of muscle progenitor cells, including ultrasound guidance, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1490","name":"Pt status not doc","description":"Patient status not documented","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17271","name":"Dstr mal les s/n/h/f/g 0.6-1","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia; lesion diameter 0.6 to 1.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4379","name":"Amniodefend ft per sq cm","description":"Amniodefend ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4382","name":"Advograft dual per sq cm","description":"Advograft dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"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":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4416","name":"Alexiguard tl-t per sq cm","description":"Alexiguard tl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1025T","name":"Alt elec fld dos&dlv sim mdl","description":"Alternating electric fields dosimetry and delivery-simulation modeling, creation and selection of patient-specific array layouts, and placement verification","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6601","name":"Porc/ceram inlay >= 3 surfac","description":"Inlay - porcelain/ceramic three or more surfaces","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41153","name":"Tongue mouth neck surgery","description":"Glossectomy; composite procedure with resection floor of mouth, with suprahyoid neck dissection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2293.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99401","name":"Prev med cnsl indiv apprx 15","description":"Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 15 minutes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":45.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9611","name":"Flurpiridaz f18, diag, 1 mci","description":"Flurpiridaz f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0578U","name":"Onc cutan mln rna qpcr 10gen","description":"Onc cutan mln rna qpcr 10gen","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83521","name":"Ig light chains free each","description":"Immunoglobulin light chains (ie, kappa, lambda), free, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2180","name":"Meperidine/promethazine inj","description":"Injection, meperidine and promethazine hcl, up to 50 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55714","name":"Bx prst8 in-bore ct/mri 1","description":"Biopsy, prostate, in-bore ct- or mri-guided targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2001","name":"Suct pum ext mgmt sys","description":"Suction pump, home model, portable or stationary, electric, any type, for use with external urine and/or fecal management system","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4344","name":"Tri membrane wrap, per sq cm","description":"Tri-membrane wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7412","name":"Excision benign lesion compl","description":"Excision of benign lesion complicated","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5944","name":"Max implt sup remv part","description":"Max implt sup remv part","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1211","name":"Gsa level>9.0%","description":"Most recent glycemic status assessment (hba1c or gmi) level > 9.0%","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0316U","name":"B brgdrferi lyme ds ospa evl","description":"B brgdrferi lyme ds ospa evl","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8502","name":"Inj, aponvie, 1 mg","description":"Injection, aprepitant (aponvie), 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0306U","name":"Onc mrd nxt-gnrj alys 1st","description":"Onc mrd nxt-gnrj alys 1st","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9800","name":"Gallium locametz 1 millicuri","description":"Gallium ga-68 gozetotide, diagnostic, (locametz), 1 millicurie","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1242","name":"Pt no resp imprt to me","description":"Patient did not respond to the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0353","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9004","name":"Va whole health partner serv","description":"Department of veterans affairs whole health partner services","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99476","name":"Ped crit care age 2-5 subsq","description":"Subsequent inpatient pediatric critical care, per day, for the evaluation and management of a critically ill infant or young child, 2 through 5 years of age","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3431","name":"Biological materials","description":"Biological materials","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0899","name":"Argatroban dialysis, auromed","description":"Injection, argatroban (auromedics), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58553","name":"Laparo-vag hyst complex","description":"Laparoscopy, surgical, with vaginal hysterectomy, for uterus greater than 250 g;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1344.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1379","name":"10 yr fu no rec rsn not giv","description":"A 10 year follow-up interval for colonoscopy not recommended, reason not otherwise specified","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64892","name":"Nrv grf 1strnd arm/leg <4cm","description":"Nerve graft (includes obtaining graft), single strand, arm or leg; up to 4 cm length","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1178.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2037","name":"G4derm plus/suprello, pr ml","description":"G4derm plus/suprello, per milliliter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4302","name":"Complete aca, per sq cm","description":"Complete aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1384","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1003T","name":"Arthrp 1st crp/mtcrpl prostc","description":"Arthroplasty, first carpometacarpal joint, with distal trapezial and proximal first metacarpal prosthetic replacement (eg, first carpometacarpal total joint)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76016","name":"Mr safety deter phys/qhp","description":"Mr safety determination by a physician or other qualified health care professional responsible for the safety of the mr procedure, including review of implant mr conditions for indicated mr examination, analysis of risk vs clinical benefit of performing mr examination, and determination of mr equipm","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67025","name":"Replace eye fluid","description":"Injection of vitreous substitute, pars plana or limbal approach (fluid-gas exchange), with or without aspiration (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0972T","name":"Asstv alg clsfctn burn hlg","description":"Assistive algorithmic classification of burn healing (ie, healing or nonhealing) by noninvasive multispectral imaging, including system set-up and acquisition, selection, and transmission of images, with automated generation of report","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7295","name":"Eth estr and eton monthly","description":"Ethinyl estradiol and etonogestrel 0.015mg, 0.12mg per 24 hours; monthly vaginal ring, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0259U","name":"Neph ckd nuc mrs meas gfr","description":"Nephrology (chronic kidney disease), nuclear magnetic resonance spectroscopy measurement of myo-inositol, valine, and creatinine, algorithmically combined with cystatin c (by immunoassay) and demographic data to determine estimated glomerular filtration rate (gfr), serum, quantitative","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP12","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0852T","name":"Dgtz gls mcrscp mphmtrc ea 1","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61737","name":"Litt icr mlt trj mlt/cplx ls","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; multiple trajectories for multiple or complex lesion(s)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1195","name":"Rpt wo imp/con mmr/msi","description":"Surgical pathology reports that do not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both, reason not given","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0674T","name":"Laps insj nw/rpcmt prm isdss","description":"Laparoscopic insertion of new or replacement of permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including an implantable pulse generator and diaphragmatic lead(s)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"Endoskel posit rotat unit","description":"Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6599","name":"G comp bandage short stretch","description":"Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1321","name":"Pts no 7wk inj,no iop,iop>25","description":"Patients who were not seen within 7 weeks following the date of injection for follow up or who did not have a documented iop or no plan of care documented if the iop was >25 mm hg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1014T","name":"Lap rv/rmv eso sph nstm eltr","description":"Laparoscopic revision or removal, lower esophageal sphincter neurostimulator electrodes","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6034","name":"Part hand finger distal amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s)/thumb, amputation at distal to metacarpal joint, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l669","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2038","name":"Marigen pacto, per sq cm","description":"Marigen pacto, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2058","name":"Obecbtge autol up to 400 mil","description":"Obecabtagene autoleucel, 10 up to 400 million cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per infusion","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6113","name":"Imp/abut rem dent part mand","description":"Imp/abut rem dent part mand","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0727T","name":"Rmvl&rplcmt implt vstblr dev","description":"Removal and replacement of implanted vestibular device, unilateral","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0525","name":"Est pt-cg dyad dem mod cmplx","description":"Management of established patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0530","name":"Adult daycare center, 8 hr u","description":"Adult day center, 8-hour unit, for use in cmmi model","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0873T","name":"Revj subq prtl asct pmp sys","description":"Revision of a subcutaneously implanted peritoneal ascites pump system, any component (ascites pump, associated peritoneal catheter, associated bladder catheter), including imaging and programming, when performed","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1179","name":"No pcv recd","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine, on or after their 19th birthday and before or during measurement period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55041","name":"Removal of hydroceles","description":"Excision of hydrocele; bilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0017","name":"Crisis psychotherapy 60m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); first 60 minutes","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1420","name":"Complete ophthalmologic mvp","description":"Complete ophthalmologic care mips value pathway","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1462","name":"Pt clin ind hd image","description":"Patients with clinical indications for imaging of the head","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99462","name":"Sbsq nb em per day hosp","description":"Subsequent hospital care, per day, for evaluation and management of normal newborn","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93586","name":"Vngrph chd coronary sinus","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; coronary sinus (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1331","name":"Pts eval ini xm 8 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 8 weeks from initial exam","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0544","name":"Post d/c phone follow up","description":"Post discharge telephonic follow-up contacts performed in conjunction with a discharge from the emergency department for behavioral health or other crisis encounter, 4 calls per calendar month","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7284","name":"Exc biopsy of saliv glands","description":"Exc biopsy of saliv glands","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87592","name":"N.gonorrhoeae dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); neisseria gonorrhoeae, quantification","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29867","name":"Allgrft implnt knee w/scope","description":"Arthroscopy, knee, surgical; osteochondral allograft (eg, mosaicplasty)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1503.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6214","name":"Pontic titanium","description":"Pontic - titanium","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99213","name":"Office o/p est low 20 min","description":"Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 20 minutes must be met or e","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":63.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1713","name":"Pfizer vacc adm ped 1st dose","description":"Pfizer vacc adm ped 1st dose","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1783","name":"Vac admin human pap dose 3","description":"Vac admin human pap dose 3","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4339","name":"Artacent vericlen, per sq cm","description":"Artacent vericlen, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80503","name":"Path clin consltj sf 5-20","description":"Pathology clinical consultation; for a clinical problem, with limited review of patients history and medical records and straightforward medical decision making when using time for code selection, 5-20 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98986","name":"Rtm dev sply cbt 2-15 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of cognitive behavioral therapy, 2-15 days in a 30-day period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0719T","name":"Pst vrt jt rplcmt lmbr 1 sgm","description":"Posterior vertebral joint replacement, including bilateral facetectomy, laminectomy, and radical discectomy, including imaging guidance, lumbar spine, single segment","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0772T","name":"Vr px dissoc svc sm phy ea","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9064","name":"Inj, cabazitaxel (sandoz)","description":"Injection, cabazitaxel (sandoz), not therapeutically equivalent to j9043, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0552","name":"Supply of digital device","description":"Supply of digital mental health treatment device and initial education and onboarding, per course of treatment that augments a behavioral therapy plan","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1481","name":"Pt in hosp/pal care who died","description":"Patients receiving hospice or palliative care or who died during the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84439","name":"Assay of free thyroxine","description":"Thyroxine; free","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2525","name":"Cl, hydrophilic, dual focus","description":"Contact lens, hydrophilic, dual focus, per lens","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42226","name":"Lengthening of palate","description":"Lengthening of palate, and pharyngeal flap","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1174.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86051","name":"Aquaporin-4 antb elisa","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; enzyme-linked immunosorbent immunoassay (elisa)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0802","name":"3d dental scan indirect","description":"3d dental scan indirect","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61690","name":"Intracranial vessel surgery","description":"Surgery of intracranial arteriovenous malformation; dural, simple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2442.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74710","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1356","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0219","name":"Inj aval alfa-nqpt 4mg","description":"Injection, avalglucosidase alfa-ngpt, 4 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5934","name":"Mandibular flange prosthesis","description":"Mandibular resection prosthesis with guide flange","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1379","name":"10 yr fu no rec rsn not giv","description":"A 10 year follow-up interval for colonoscopy not recommended, reason not otherwise specified","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64736","name":"Incision of chin nerve","description":"Transection or avulsion of; mental nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92631","name":"Hearing aid slctn svc 1st 30","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36825","name":"Artery-vein autograft","description":"Creation of arteriovenous fistula by other than direct arteriovenous anastomosis (separate procedure); autogenous graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0284U","name":"Vw factor type 2n eval plsm","description":"Von willebrand factor (vwd), type 2n, factor viii and vwf binding evaluation, enzyme-linked immunosorbent assays (elisa), plasma","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1429","name":"Retinopathy in od, os, ou","description":"Retinal exam finding with evidence of retinopathy in left, right or both eyes with severity level documented","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0387","name":"Comp image capture only","description":"Comp image capture only","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7241","name":"Impact tooth rem bony w/comp","description":"Removal of impacted tooth-completely bony with unusual surgical complications","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1160","name":"Pt anphx due to mengb bef 13","description":"Patient had anaphylaxis due to the meningococcal vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0899","name":"Argatroban dialysis, auromed","description":"Injection, argatroban (auromedics), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1282","name":"Pt scrn tbco id as non user","description":"Patient screened for tobacco use and identified as a tobacco non-user","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4439","name":"Instagraft per sq cm","description":"Instagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4345","name":"Matrix hd allogrft per sq cm","description":"Matrix hd allograft dermis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9175","name":"Elliotts b solution per ml","description":"Injection, elliotts b solution, 1 ml","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4408","name":"Xwrap hydro per sq cm","description":"Xwrap hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2029","name":"Mirotract matrix sheet","description":"Mirotract wound matrix sheet, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1442","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1007T","name":"Eeg impl s-sclp eeg w/o vid","description":"Electroencephalogram from implanted sub-scalp continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9914","name":"Admin of dermal fill","description":"Admin of dermal fill","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62350","name":"Implant spinal canal cath","description":"Implantation, revision or repositioning of tunneled intrathecal or epidural catheter, for long-term medication administration via an external pump or implantable reservoir/infusion pump; without laminectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":530.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2329","name":"Inj ublituximab-xiiy, 1 mg","description":"Injection, ublituximab-xiiy, 1mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98010","name":"Synch audio-only new mod 45","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection,","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5411","name":"Dentures adjust cmplt mand","description":"Adjust complete denture - mandibular","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5939","name":"Resct proth mand comp remov","description":"Resct proth mand comp remov","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3299","name":"Inj xipere 1 mg","description":"Injection, triamcinolone acetonide (xipere), 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0349U","name":"Rx metab/pcx dna 27gen rx ia","description":"Rx metab/pcx dna 27gen rx ia","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","name":"Gait mod systm rhym auditory","description":"Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19260","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1294.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92628","name":"Eval hearing aid cand 1st 30","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4363","name":"Am bur mem hydro per sq cm","description":"Amnio burgeon membrane and hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4389","name":"Neothelium 4l+ per sq cm","description":"Neothelium 4l+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4303","name":"Complete aa, per sq cm","description":"Complete aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-06-05","zip":"10985","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0652","name":"Inj, levothyroxine, hikma","description":"Injection, levothyroxine sodium (hikma), not therapeutically equivalent to j0650, 10 mcg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1318","name":"Pts no csp doc contact","description":"Patients who did not have documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening or documentation that there was no contact with a csp","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99472","name":"Ped critical care subsq","description":"Subsequent inpatient pediatric critical care, per day, for the evaluation and management of a critically ill infant or young child, 29 days through 24 months of age","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":374.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37286","name":"Revsc evasc tpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":333.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0948T","name":"Rem interrog dev ccm phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system with interim analysis, review, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0961T","name":"Shortwave ifr radiation img","description":"Shortwave infrared radiation imaging, surgical pathology specimen, to assist gross examination for lymph node localization in fibroadipose tissue, per specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38226","name":"Car-t prep t lymphcyt f/trns","description":"Chimeric antigen receptor t-cell (car-t) therapy; preparation of blood-derived t lymphocytes for transportation (eg, cryopreservation, storage)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4261","name":"Tag, per square centimeter","description":"Tag, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0441U","name":"Nfct ds bct fngl/viral semiq","description":"Nfct ds bct fngl/viral semiq","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0842T","name":"Dgtz gls mcrscp pth cslt ea","description":"Digitization of glass microscope slides for pathology consultation during surgery; each additional tissue block with frozen section(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1748","name":"Inj, zymfentra, 10 mg","description":"Injection, infliximab-dyyb (zymfentra), 10 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1268","name":"Pt ac stat kid trnsplt wtlst","description":"Patients observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1409","name":"Recd gmln brca1/brca2 couns","description":"Patients who received germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0547U","name":"Neurflmnt lt chn cleia plsm","description":"Neurflmnt lt chn cleia plsm","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1182","name":"Not elg pre ex ibd/uc/crohn","description":"Patients not eligible due to pre-existing inflammatory bowel disease (ibd) (e.g., ulcerative colitis, crohns disease)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1390","name":"Pt no doc exm for rec","description":"Patients who do not have a documented exam performed for recurrence of melanoma or no documentation within the performance period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87220","name":"Tissue exam for fungi","description":"Tissue examination by koh slide of samples from skin, hair, or nails for fungi or ectoparasite ova or mites (eg, scabies)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0779T","name":"Gi myoelectrical actv study","description":"Gastrointestinal myoelectrical activity study, stomach through colon, with interpretation and report","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0340U","name":"Onc pan ca alys mrd plasma","description":"Onc pan ca alys mrd plasma","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66991","name":"Xcapsl ctrc rmvl insj 1+","description":"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); with insertion of intraocular (eg, trabecular meshwork, supraciliary, suprachoroidal) anterior segment aqueous drai","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46040","name":"I&d ischiorct&/perirct absc","description":"Incision and drainage of ischiorectal and/or perirectal abscess (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0474U","name":"Hered pan ca gsap 88gene ngs","description":"Hered pan ca gsap 88gene ngs","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0873T","name":"Revj subq prtl asct pmp sys","description":"Revision of a subcutaneously implanted peritoneal ascites pump system, any component (ascites pump, associated peritoneal catheter, associated bladder catheter), including imaging and programming, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0827T","name":"Dgtz gls mcrscp cytp smears","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; smears with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4263","name":"Surgraft tl, per sq cm","description":"Surgraft tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0238","name":"Inj, tocilizumab-aazg, hospi","description":"Injection, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4351","name":"Enclose tl matrix, per sq cm","description":"Enclose tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0835T","name":"Dgtz gls mcrscp fna 1st ea","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4316","name":"Amchoplast, per sq cm","description":"Amchoplast, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25441","name":"Arthrp w/prostc dstl rds","description":"Arthroplasty with prosthetic replacement; distal radius","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1133.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0561","name":"Temp tube delivery, unil","description":"Tympanostomy with local or topical anesthesia and insertion of a ventilating tube when performed with tympanostomy tube delivery device, unilateral (list separately in addition to 69433) (do not use in conjunction with 0583t)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0874","name":"Inj, daptomycin (baxter)","description":"Injection, daptomycin (baxter), not therapeutically equivalent to j0878, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0607","name":"Lanthanum carbonate oral 5mg","description":"Lanthanum carbonate, oral, 5 mg (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1316","name":"Tobacco non-user","description":"Current tobacco non-user","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0895T","name":"Connj lvr algrft prfu dev 1","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; initial 4 hours of monitoring time, including hourly physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20600","name":"Drain/inj joint/bursa w/o us","description":"Arthrocentesis, aspiration and/or injection, small joint or bursa (eg, fingers, toes); without ultrasound guidance","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":60.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5134","name":"Inj, tyruko, 1 mg","description":"Injection, natalizumab-sztn (tyruko), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1268","name":"Pt ac stat kid trnsplt wtlst","description":"Patients observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1216","name":"No spiro doc no res doc","description":"No spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and/or no spirometry performed with results documented during the encounter","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0813T","name":"Egd vol adjmt bariatric balo","description":"Esophagogastroduodenoscopy, flexible, transoral, with volume adjustment of intragastric bariatric balloon","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4307","name":"American amnion, per sq cm","description":"American amnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2305","name":"Inj, nitroglycerin, 5 mg","description":"Injection, nitroglycerin, 5 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15935","name":"Exc sac pr ulc skn flp ostc","description":"Excision, sacral pressure ulcer, with skin flap closure; with ostectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1218.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55710","name":"Bx prst8 tprn us w/mri fus 1","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant) with mri-fusion-guidance biopsy, first targeted lesion","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76984","name":"Dx intraop thoracic aorta us","description":"Ultrasound, intraoperative thoracic aorta (eg, epiaortic), diagnostic","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91304","name":"Sarscov2 vac 5mcg/0.5ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, 5 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25075","name":"Exc forearm les sc < 3 cm","description":"Excision, tumor, soft tissue of forearm and/or wrist area, subcutaneous; less than 3 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7023","name":"Mech allergen parti barrier","description":"Mechanical allergen particle barrier/inhalation filter, cream, nasal, topical","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9003","name":"Leupro inj, camcevi etm, 1mg","description":"Leuprolide injectable (camcevi etm), 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92945","name":"Prq trl rvs ch occ ant&rtrgr","description":"Percutaneous transluminal revascularization of chronic total occlusion, single coronary artery, coronary artery branch, or coronary artery bypass graft, and/or subtended major coronary artery branches of the bypass graft, any combination of intracoronary stent, atherectomy and angioplasty; combined ","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93587","name":"Vngrph chd vnvn cltrl at/abv","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating at or above the heart (eg, from innominate vein) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5944","name":"Max implt sup remv part","description":"Max implt sup remv part","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1287","name":"Calc bmi blw low param f/u","description":"Bmi is documented below normal parameters and a follow-up plan is documented","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1405","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5912","name":"Facial moulage complete","description":"Facial moulage (complete)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0462","name":"Atropine sulf, nte, 0.01 mg","description":"Injection, atropine sulfate, not therapeutically equivalent to j0461, 0.01 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7261","name":"Primary closure sinus perf","description":"Primary closure of a sinus perforation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0407U","name":"Neph dbtc ckd mult eclia alg","description":"Neph dbtc ckd mult eclia alg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0024","name":"Pin srv add 30 min pr m","description":"Principal illness navigation services, additional 30 minutes per calendar month (list separately in addition to g0023)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9331","name":"Inj sirolimus prot part 1 mg","description":"Injection, sirolimus protein-bound particles, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34001","name":"Removal of artery clot","description":"Embolectomy or thrombectomy, with or without catheter; carotid, subclavian or innominate artery, by neck incision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0393U","name":"Neu prksn msfl a-syncln prtn","description":"Neu prksn msfl a-syncln prtn","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37263","name":"Revsc evasc fpvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84478","name":"Assay of triglycerides","description":"Triglycerides","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59025","name":"Fetal non-stress test","description":"Fetal non-stress test","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83060","name":"Hgb sulfhemoglobin quan","description":"Hemoglobin; sulfhemoglobin, quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33363","name":"Replace aortic valve open","description":"Transcatheter aortic valve replacement (tavr/tavi) with prosthetic valve; open axillary artery approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1848.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6032","name":"Part handfng ultralite tcf/=","description":"Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4025","name":"Physical medicine ss","description":"Physical medicine mips specialty set","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6517","name":"Grad com wrap w strap bn cus","description":"Gradient compression wrap with adjustable straps, below knee, each, custom","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64505","name":"N block spenopalatine gangl","description":"Injection, anesthetic agent; sphenopalatine ganglion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0211","name":"Inj, nithiodote, 3mg / 125mg","description":"Injection, sodium nitrite 3 mg and sodium thiosulfate 125 mg (nithiodote)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0539U","name":"Onc sol tumor cfctdna 152gen","description":"Onc sol tumor cfctdna 152gen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1447","name":"Pt dx bd bef end meas pd","description":"Patients with an active diagnosis of bipolar disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0445","name":"High inten beh couns std 30m","description":"High intensity behavioral counseling to prevent sexually transmitted infection; face-to-face, individual, includes: education, skills training and guidance on how to change sexual behavior; performed semi-annually, 30 minutes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":36.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0972T","name":"Asstv alg clsfctn burn hlg","description":"Assistive algorithmic classification of burn healing (ie, healing or nonhealing) by noninvasive multispectral imaging, including system set-up and acquisition, selection, and transmission of images, with automated generation of report","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70473","name":"Ct cere prfu aly c+wo ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed without concurrent ct or ct angiography of the same anatomy","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0510U","name":"Onc pncrtc ca alg alys 16gen","description":"Onc pncrtc ca alg alys 16gen","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1454","name":"New cied","description":"New cied","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0841T","name":"Dgtz gls mcrscp pth cslt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; first tissue block, with frozen section(s), single specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0296","name":"Visit to determ ldct elig","description":"Counseling visit to discuss need for lung cancer screening using low dose ct scan (ldct) (service is for eligibility determination and shared decision making)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":21.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0709","name":"Intraoral cmplt radio images","description":"Intraoral cmplt radio images","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6093","name":"Recement supp part denture","description":"Recement implant/abutment supported fixed partial denture","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5912","name":"Facial moulage complete","description":"Facial moulage (complete)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67921","name":"Repair eyelid defect","description":"Repair of entropion; suture","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9276","name":"Inj zanidatamab-hrii, 2 mg","description":"Injection, zanidatamab-hrii, 2 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22511","name":"Perq lumbosacral injection","description":"Percutaneous vertebroplasty (bone biopsy included when performed), 1 vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance; lumbosacral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2008.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9297","name":"Inj pemetrexed (sandoz) 10mg","description":"Injection, pemetrexed (sandoz), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64474","name":"Lwr xtr fscl pln blk uni nfs","description":"Lower extremity fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30120","name":"Revision of nose","description":"Excision or surgical planing of skin of nose for rhinophyma","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2025","name":"Miro3d per cubic cm","description":"Miro3d, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0829T","name":"Dgtz gls mcrscp cytp conctrj","description":"Digitization of glass microscope slides for cytopathology, concentration technique, smears, and interpretation (eg, saccomanno technique) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94375","name":"Respiratory flow volume loop","description":"Respiratory flow volume loop","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":29.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2508","name":"Pegunigalsidase alfa-iwxj","description":"Injection, pegunigalsidase alfa-iwxj, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26260","name":"Resect prox finger tumor","description":"Radical resection of tumor, proximal or middle phalanx of finger","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":644.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33287","name":"Rmv&rplcmt phrnc nrv stim pg","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4399","name":"Summit fx per sq cm","description":"Summit fx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0892","name":"Argatroban dialysis (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84392","name":"Assay of urine sulfate","description":"Sulfate, urine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1423","name":"Opt care urologic cnd mvp","description":"Optimal care for patients with urologic conditions mips value pathway","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6603","name":"Cst hgh nble mtl inlay >=3sr","description":"Inlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0916T","name":"Insj perm ccm-d sys pg only","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator only","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87070","name":"Culture othr specimn aerobic","description":"Culture, bacterial; any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6113","name":"Imp/abut rem dent part mand","description":"Imp/abut rem dent part mand","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1196","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1421","name":"Dermatological care mvp","description":"Dermatological care mips value pathway","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0411U","name":"Psyc genom alys pnl 15 gen","description":"Psyc genom alys pnl 15 gen","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0522U","name":"Ca vi psp&sp1 antb cl semiql","description":"Ca vi psp&sp1 antb cl semiql","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0879T","name":"Augmnt alys ch ct ild prep","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; radiological data preparation and transmission","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5153","name":"Inj, aflibercept-yszy, 1 mg","description":"Injection, aflibercept-yszy (opuviz), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1168","name":"Pt recd flu vax 7/1-6/30","description":"Patient received an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85610","name":"Prothrombin time","description":"Prothrombin time;","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64474","name":"Lwr xtr fscl pln blk uni nfs","description":"Lower extremity fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0271","name":"Group mnt 2 or more 30 mins","description":"Medical nutrition therapy, reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition, or treatment regimen (including additional hours needed for renal disease), group (2 or more individuals), each 30 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":19.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64467","name":"Thrc fascial pln blk uni nfs","description":"Thoracic fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1317","name":"Pts counsl cpt opt out","description":"Patients who are counseled on connection with a csp and explicitly opt out","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37263","name":"Revsc evasc fpvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15853","name":"Removal sutr/stapl xreq anes","description":"Removal of sutures or staples not requiring anesthesia (list separately in addition to e/m code)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98001","name":"Synch audio-video new low 30","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2246","name":"Inj, micafungin (baxter)","description":"Injection, micafungin in sodium (baxter), not therapeutically equivalent to j2248, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0391U","name":"Onc sld tum dna&rna 437 gen","description":"Onc sld tum dna&rna 437 gen","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0491U","name":"Onc sol tum ctc slct er prtn","description":"Onc sol tum ctc slct er prtn","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6035","name":"Prosthetic digit mechanical","description":"Single prosthetic digit, mechanical, can include metacarpophalangeal (mcp), proximal interphalangeal (pip), and/or distal interphalangeal (dip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0721T","name":"Quan ct tiss charac w/o ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1612","name":"Inj glucagon (gvoke) 0.01 mg","description":"Injection, glucagon (gvoke), 0.01 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0570U","name":"Neurol tbi alys gfap&uch-l1","description":"Neurol tbi alys gfap&uch-l1","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82654","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1307","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0698T","name":"Quan mr tiss w/mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained with diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, target ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99469","name":"Neonate crit care subsq","description":"Subsequent inpatient neonatal critical care, per day, for the evaluation and management of a critically ill neonate, 28 days of age or younger","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":357.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0483U","name":"Nfct ds ng gyra s91f pt mut","description":"Nfct ds ng gyra s91f pt mut","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4038","name":"Vascular surgery ss","description":"Vascular surgery mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1809","name":"Inj, fosdenopterin, 0.1mg","description":"Injection, fosdenopterin, 0.1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5161","name":"Inj, denosumab-kyqq, 1 mg","description":"Injection, denosumab-kyqq (aukelso/bosaya), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0732T","name":"Immntx admn electroporatn im","description":"Immunotherapy administration with electroporation, intramuscular","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4365","name":"Amnio bur dl mem per sq cm","description":"Amnio burgeon dual-layer membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9319","name":"Inj romidepsin lyophil 0.1mg","description":"Injection, romidepsin, lyophilized, 0.1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0307U","name":"Onc mrd nxt-gnrj alys sbsq","description":"Onc mrd nxt-gnrj alys sbsq","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90960","name":"Esrd srv 4 visits p mo 20+","description":"End-stage renal disease (esrd) related services monthly, for patients 20 years of age and older; with 4 or more face-to-face visits by a physician or other qualified health care professional per month","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":146.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93151","name":"Interrog&prgrmg ipnss","description":"Interrogation and programming (minimum one parameter) of implanted phrenic nerve stimulator system","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0675","name":"Inj, carboprost, 0.1 mg","description":"Injection, carboprost tromethamine, 0.1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0699T","name":"Njx pst chmbr eye medication","description":"Injection, posterior chamber of eye, medication","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0020M","name":"Onc cns alys 30000 dna loci","description":"Oncology (central nervous system), analysis of 30,000 dna methylation loci by methylation array, utilizing dna extracted from tumor tissue, diagnostic algorithm reported as probability of matching a reference tumor subclass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0950T","name":"Abltj b9 prst8 tissue hifu","description":"Ablation of benign prostate tissue, transrectal, with high intensity-focused ultrasound (hifu), including ultrasound guidance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1223","name":"Glaucoma plan of care doc","description":"Glaucoma plan of care documented","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87531","name":"Hhv-6 dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); herpes virus-6, direct probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85004","name":"Automated diff wbc count","description":"Blood count; automated differential wbc count","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0967T","name":"Tranal ins tmp clrc anst dev","description":"Transanal insertion of endoluminal temporary colorectal anastomosis protection device, including vacuum anchoring component and flexible sheath connected to external vacuum source and monitoring system","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61889","name":"Ins sk-mnt crnl nstm pg/rcvr","description":"Insertion of skull-mounted cranial neurostimulator pulse generator or receiver, including craniectomy or craniotomy, when performed, with direct or inductive coupling, with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4292","name":"Lamellas, per sq cm","description":"Lamellas, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1424","name":"Pulmonology care mvp","description":"Pulmonology care mips value pathway","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0155","name":"Dronabinol (syndros) 0.1 mg","description":"Dronabinol (syndros), 0.1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6211","name":"Bridge base metal cast","description":"Pontic-cast predominantly base metal","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9318","name":"Inj romidepsin non-lyo 0.1mg","description":"Injection, romidepsin, non-lyophilized, 0.1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11000","name":"Dbrdmt ecz/infected skin<10%","description":"Debridement of extensive eczematous or infected skin; up to 10% of body surface","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":67.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59820","name":"Care of miscarriage","description":"Treatment of missed abortion, completed surgically; first trimester","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":405.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0909T","name":"Rplcmt int nstim sys vgs nrv","description":"Replacement of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35548","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1516.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99432","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0544","name":"Post d/c phone follow up","description":"Post discharge telephonic follow-up contacts performed in conjunction with a discharge from the emergency department for behavioral health or other crisis encounter, 4 calls per calendar month","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0337U","name":"Onc plsm cell do&myeloma id","description":"Onc plsm cell do&myeloma id","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0481","name":"Electron microscopy diagnost","description":"Electron microscopy - diagnostic","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0945T","name":"Intraop assmt abnl tum tiss","description":"Intraoperative assessment for abnormal (tumor) tissue, in-vivo, following partial mastectomy (eg, lumpectomy) using computer-aided fluorescence imaging (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1072","name":"Inj, testosterone, azmiro","description":"Injection, testosterone cypionate (azmiro), 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81449","name":"So neo gsap 5-50 rna alys","description":"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; rna analysis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77086","name":"Vrt fracture assmt via dxa","description":"Vertebral fracture assessment via dual-energy x-ray absorptiometry (dxa)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93593","name":"R hrt cath chd nml nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; normal native connections","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6605","name":"G com bandage padded foam","description":"Gradient compression bandaging supply, padded foam, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6280","name":"Implt maint procd remv implt","description":"Implt maint procd remv implt","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1498","name":"Diagnostic radiology mvp","description":"Diagnostic radiology mips value pathway","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0987T","name":"Iv img icr cere vsl oct ea","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1475","name":"Pt dx huntington","description":"Patients with diagnosis of huntingtons disease","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6518","name":"Grad com wrap w strap arm cu","description":"Gradient compression wrap with adjustable straps, arm, each, custom","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81462","name":"So gsap cll fr dna/dna&rna","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants and rearrangements","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0997T","name":"Precuneus mag stimj tx plng","description":"Precuneus magnetic stimulation; treatment planning using magnetic resonance imaging-guided neuronavigation to determine optimal location, dose, and intensity for magnetic stimulation therapy, derived from evoked potentials from single pulses of electromagnetic energy recorded by 64-channel electroen","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26565","name":"Correct metacarpal flaw","description":"Osteotomy; metacarpal, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":913.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1189","name":"Doc khe pef w/efgr/uacr","description":"Documentation of a kidney health evaluation defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr) performed","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51005","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2468","name":"Inj, palonosetron (posfrea)","description":"Injection, palonosetron hydrochloride (posfrea), 25 micrograms","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1390","name":"Pt no doc exm for rec","description":"Patients who do not have a documented exam performed for recurrence of melanoma or no documentation within the performance period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78258","name":"Esophageal motility","description":"Esophageal motility","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0474U","name":"Hered pan ca gsap 88gene ngs","description":"Hered pan ca gsap 88gene ngs","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9246","name":"Mod sedation noniv-15 min","description":"Mod sedation noniv-15 min","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9154","name":"Artificial saliva, 1 ml","description":"Artificial saliva, 1 ml","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42831","name":"Removal of adenoids","description":"Adenoidectomy, primary; age 12 or over","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0675","name":"Inj, carboprost, 0.1 mg","description":"Injection, carboprost tromethamine, 0.1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87332","name":"Cytomegalovirus ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; cytomegalovirus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86635","name":"Coccidioides antibody","description":"Antibody; coccidioides","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4274","name":"Esano ac, per sq cm","description":"Esano ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33288","name":"Rmv&rplcmt phrnc nrv stim ld","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0667","name":"Team remote e/m est pt 25 mn","description":"Team remote e/m est. pt 25mins","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9997","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57105","name":"Biopsy vaginal mucosa xtnsv","description":"Biopsy of vaginal mucosa; extensive, requiring suture (including cysts)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2644","name":"Dental onlay porc 4/more sur","description":"Onlay - porcelain/ceramic - four or more surfaces","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4003","name":"Emergency med ss","description":"Emergency medicine mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0423U","name":"Psyc genomic alys pnl 26 gen","description":"Psyc genomic alys pnl 26 gen","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29130","name":"Appl finger splint static","description":"Application of finger splint; static","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":24.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1105","name":"Dexmedetomidine film, 1 mcg","description":"Dexmedetomidine, oral, 1 mcg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0895T","name":"Connj lvr algrft prfu dev 1","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; initial 4 hours of monitoring time, including hourly physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary ","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86682","name":"Helminth antibody","description":"Antibody; helminth, not elsewhere specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0219","name":"Inj aval alfa-nqpt 4mg","description":"Injection, avalglucosidase alfa-ngpt, 4 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6516","name":"Grad com wrap w strap foo cu","description":"Gradient compression wrap with adjustable straps, foot, each, custom","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0082A","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1293","name":"Calc bmi abv up param f/u","description":"Bmi is documented above normal parameters and a follow-up plan is documented","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"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":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27713","name":"Osteot tibia imed lngth dev","description":"Osteotomy(ies), tibia, including fibula when performed, unilateral, with insertion of an externally controlled intramedullary lengthening device, including imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2041","name":"Coord special care encounter","description":"Coordinated specialty care, team-based, for first episode psychosis, per encounter","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1449","name":"Pt dx scz/pys bef end msr pd","description":"Patients with an active diagnosis of schizophrenia or psychotic disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1183","name":"Doc imm ckpt inhib hld","description":"Documentation of immune checkpoint inhibitor therapy held and corticosteroids or immunosuppressants prescribed or administered","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87484","name":"Ehrlicha chaffeensis amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); ehrlichia chaffeensis, amplified probe technique","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99341","name":"Home/res vst new sf mdm 15","description":"Home or residence visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 15 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9184","name":"Inj gemcitabin (avyxa) 200mg","description":"Injection, gemcitabine hydrochloride (avyxa), 200 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92632","name":"Hearing aid slctn svc ea add","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23802","name":"Arthrd glenohumeral jt w/grf","description":"Arthrodesis, glenohumeral joint; with autogenous graft (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1335.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68110","name":"Exc les conjunctiva <1 cm","description":"Excision of lesion, conjunctiva; up to 1 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5099","name":"Inj ustekinumab-stba, 1 mg","description":"Injection, ustekinumab-stba (steqeyma), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1383","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2003","name":"Inj, lidocaine hcl, 1 mg","description":"Injection, lidocaine hydrochloride, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37284","name":"Revsc evasc tpvt st sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0010","name":"Eom meos payment","description":"Enhancing oncology model (eom) monthly enhanced oncology services (meos) payment for eom enhanced services","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37278","name":"Rvsc evsc fpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0258U","name":"Ai psor mrna 50-100 gen alg","description":"Autoimmune (psoriasis), mrna, next-generation sequencing, gene expression profiling of 50-100 genes, skin- surface collection using adhesive patch, algorithm reported as likelihood of response to psoriasis biologics","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39503","name":"Repair of diaphragm hernia","description":"Repair, neonatal diaphragmatic hernia, with or without chest tube insertion and with or without creation of ventral hernia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6147.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6601","name":"G com bandge hgh dn foam pad","description":"Gradient compression bandaging supply, high density foam pad, any size or shape, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1283","name":"Pt scrn tbco and id as user","description":"Patient screened for tobacco use and identified as a tobacco user","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9612","name":"Inj, fluorescein, 1 mg","description":"Injection, fluorescein, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4006","name":"Gastroenterology ss","description":"Gastro-enterology mips specialty set","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9184","name":"Inj gemcitabin (avyxa) 200mg","description":"Injection, gemcitabine hydrochloride (avyxa), 200 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31051","name":"Sphenoid sinus surgery","description":"Sinusotomy, sphenoid, with or without biopsy; with mucosal stripping or removal of polyp(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":723.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1961","name":"Inj lenacapavir (hiv tx) 1mg","description":"Injection, lenacapavir (only for use as hiv treatment), 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87070","name":"Culture othr specimn aerobic","description":"Culture, bacterial; any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":8.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0706","name":"Intraoral occlus radio image","description":"Intraoral occlus radio image","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49595","name":"Rpr aa hrn 1st > 10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, reducible","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90612","name":"Inf&sarscov2 vacc 31.7/.32im","description":"Influenza virus vaccine, trivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 31.7 mcg/0.32 ml dosage, for intramuscular use","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69209","name":"Remove impacted ear wax uni","description":"Removal impacted cerumen using irrigation/lavage, unilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93575","name":"Njx cath slct p angrph mapca","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary angiography of major aortopulmonary collateral arteries (mapcas) arising off the aorta or its systemic branches, during cardiac catheterization for congenital heart d","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0487U","name":"Onc sol tum cfcdna tgsap 84","description":"Onc sol tum cfcdna tgsap 84","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0270U","name":"Hem cgen coagj do 20 genes","description":"Hematology (congenital coagulation disorders), genomic sequence analysis of 20 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7214","name":"Altuviiio per factor viii iu","description":"Injection, factor viii/von willebrand factor complex, recombinant (altuviiio), per factor viii i.u.","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76987","name":"Dx intraop epicar car us chd","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; including placement and manipulation of transducer, image acquisition, interpretation and report","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1328","name":"Pts dx acute vitreous hem","description":"Patients with a diagnosis of acute vitreous hemorrhage","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64468","name":"Thrc fascial pln blk bi njx","description":"Thoracic fascial plane block, bilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0952T","name":"Tot impl amei rev/rplc mstdc","description":"Totally implantable active middle ear hearing implant; revision or replacement, with mastoidectomy and replacement of sound processor","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20150","name":"Excision epiphyseal bar","description":"Excision of epiphyseal bar, with or without autogenous soft tissue graft obtained through same fascial incision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1022.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0798T","name":"Tcat rmv 2chmbr ldls pm cmpl","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; complete system (ie, right atrial and right ventricular pacemaker components)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0283","name":"Inj, amiodarone (nexterone)","description":"Injection, amiodarone hydrochloride (nexterone), 30 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76017","name":"Mr sfty med physics xm cstmz","description":"Mr safety medical physics examination customization, planning and performance monitoring by medical physicist or mr safety expert, with review and analysis by physician or other qualified health care professional to prioritize and select views and imaging sequences, to tailor mr acquisition specific","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4265","name":"Neostim tl per sq cm","description":"Neostim tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3374","name":"Inj, vancomycin (mylan) 10mg","description":"Injection, vancomycin hydrochloride (mylan) not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0688T","name":"Tx amblyopia assmt w/report","description":"Treatment of amblyopia using an online digital program; assessment of patient performance and program data by physician or other qualified health care professional, with report, per calendar month","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96161","name":"Caregiver health risk assmt","description":"Administration of caregiver-focused health risk assessment instrument (eg, depression inventory) for the benefit of the patient, with scoring and documentation, per standardized instrument","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1749","name":"Inj, iloprost, 0.1 mcg","description":"Injection, iloprost, 0.1 mcg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0707T","name":"Njx b1 sub mtrl sbchdrl dfct","description":"Injection(s), bone-substitute material (eg, calcium phosphate) into subchondral bone defect (ie, bone marrow lesion, bone bruise, stress injury, microtrabecular fracture), including imaging guidance and arthroscopic assistance for joint visualization","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97009","name":"Mchnl sclp cool after chemo","description":"Mechanical scalp cooling; provided after discontinuation of chemotherapy, each 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15220","name":"Fth/gft fr s/a/l 20 sq cm/<","description":"Full thickness graft, free, including direct closure of donor site, scalp, arms, and/or legs; 20 sq cm or less","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":692.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0966T","name":"I&cst prp jw xpn dl arch fxd","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, fixed hinge mechanism","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81441","name":"Ibmfs seq alys pnl 30 genes","description":"Inherited bone marrow failure syndromes (ibmfs) (eg, fanconi anemia, dyskeratosis congenita, diamond-blackfan anemia, shwachman-diamond syndrome, gata2 deficiency syndrome, congenital amegakaryocytic thrombocytopenia) sequence analysis panel, must include sequencing of at least 30 genes, including b","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1250","name":"Pt resp true heard","description":"Patient responded as completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0808T","name":"Pulm tiss vntj alys w/ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with computed tomography (ct) images taken for the purpose of pulmonary tissue ventilation analysis, including data preparation and transmission, quantificati","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1551","name":"Inj cutaquig 100 mg","description":"Injection, immune globulin (cutaquig), 100 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70471","name":"Cta h&n c+ w/noncontrast img","description":"Computed tomographic angiography (cta), head and neck, with contrast material(s), including noncontrast images, when performed, and image postprocessing","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4026","name":"Phys/occ therapy ss","description":"Physical therapy/occupational therapy mips specialty set","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49189","name":"Opn exc/dst ntra-abd 20.1-30","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 20.1 to 30 cm","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0370","name":"Max ultrasound capt & interp","description":"Max ultrasound capt & interp","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0679T","name":"Laps rmvl lead isdss","description":"Laparoscopic removal of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1448","name":"Pt dx pd bef end meas pd","description":"Patients with an active diagnosis of personality disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69728","name":"Rmv ntr oi imp sk tc>=100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33903","name":"Perq p-art revsc 1 abnor bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, bilateral","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1153","name":"Pt w/ dx osteo doe","description":"Patient with diagnosis of osteoporosis on date of encounter","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4384","name":"Axolotl dual ult per sq cm","description":"Axolotl dualgraft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0032","name":"2+ antipsy schiz","description":"Two or more antipsychotic prescriptions ordered for patients who had a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder on or between january 1 of the year prior to the measurement period and the index prescription start date (ipsd) for antipsychotics","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2004","name":"Inj, lidocaine w epinephrine","description":"Injection, lidocaine hcl with epinephrine, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5154","name":"Inj, omlyclo, 5 mg","description":"Injection, omalizumab-igec (omlyclo), biosimilar, 5 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2277","name":"Inj, motixafortide, 0.25 mg","description":"Injection, motixafortide, 0.25 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95052","name":"Photo patch tests","description":"Photo patch test(s) (specify number of tests)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29848","name":"Wrist endoscopy/surgery","description":"Endoscopy, wrist, surgical, with release of transverse carpal ligament","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":545.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0279U","name":"Hem vw factor&clgn iii bndg","description":"Hematology (von willebrand disease [vwd]), von willebrand factor (vwf) and collagen iii binding by enzyme-linked immunosorbent assays (elisa), plasma, report of collagen iii binding","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55600","name":"Vesiculotomy","description":"Vesiculotomy;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":457.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55867","name":"Laps surg prst8ect smpl stot","description":"Laparoscopy, surgical prostatectomy, simple subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy), includes robotic assistance, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":566.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01939","name":"Anes nulyt agt crv/thrc","description":"Anesthesia for percutaneous image-guided destruction procedures by neurolytic agent on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6525","name":"G com garm lwrleg/ft ngt cus","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, custom, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0260U","name":"Rare ds id opt genome mapg","description":"Rare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0583U","name":"Rare ds rpd whlgen cmptr dna","description":"Rare ds rpd whlgen cmptr dna","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1169","name":"Doc med rsn no flu vax","description":"Documentation of medical reason(s) for not administering influenza vaccine (e.g., prior anaphylaxis due to the influenza vaccine)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9063","name":"Inj, elahere, 1 mg","description":"Injection, mirvetuximab soravtansine-gynx, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37297","name":"Revsc evasc imvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1355","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0453U","name":"Onc clrct ca cfdna qpcr asy","description":"Onc clrct ca cfdna qpcr asy","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1324","name":"Pts intravitreal/pci","description":"Patients who had an intravitreal or periocular corticosteroid injection (e.g., triamcinolone, preservative-free triamcinolone, dexamethasone, dexamethasone intravitreal implant, or fluocinolone intravitreal implant)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7411","name":"Excision benign lesion>1.25c","description":"Excision of benign lesion greater than 1.25 cm","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4308","name":"Sanopellis, per sq cm","description":"Sanopellis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1807","name":"Inj, ethacrynate sod, 1 mg","description":"Injection, ethacrynate sodium, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4285","name":"Nudyn dl or dl mesh pr sq cm","description":"Nudyn dl or nudyn dl mesh, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53200","name":"Biopsy of urethra","description":"Biopsy of urethra","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4422","name":"Ac wrap per sq cm","description":"A/c wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2050","name":"Financial mgt waiver/diem","description":"Financial management, self-directed, waiver; per diem","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0216","name":"Inj, alfentanil hcl, 500mcg","description":"Injection, alfentanil hydrochloride, 500 micrograms","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87593","name":"Orthopoxvirus amp prb each","description":"Infectious agent detection by nucleic acid (dna or rna); orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus), amplified probe technique, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1210","name":">=2 same meds tbl4 not ord","description":"At least two orders for high-risk medications from the same drug class, (table 4), not ordered","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0778T","name":"Smmg cncrnt appl imu snr","description":"Surface mechanomyography (smmg) with concurrent application of inertial measurement unit (imu) sensors for measurement of multi-joint range of motion, posture, gait, and muscle function","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21179","name":"Rcnstj forehead with grafts","description":"Reconstruction, entire or majority of forehead and/or supraorbital rims; with grafts (allograft or prosthetic material)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27713","name":"Osteot tibia imed lngth dev","description":"Osteotomy(ies), tibia, including fibula when performed, unilateral, with insertion of an externally controlled intramedullary lengthening device, including imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0674T","name":"Laps insj nw/rpcmt prm isdss","description":"Laparoscopic insertion of new or replacement of permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including an implantable pulse generator and diaphragmatic lead(s)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2991","name":"App of hydroxyapatite","description":"App of hydroxyapatite","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4286","name":"Remove non-resorb barrier","description":"Remove non-resorb barrier","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4271","name":"Complete ft per sq cm","description":"Complete ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01938","name":"Anes drg/aspir lmbr/sac","description":"Anesthesia for percutaneous image-guided injection, drainage or aspiration procedures on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4308","name":"Sanopellis, per sq cm","description":"Sanopellis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55715","name":"Bx prst8 ea add mri-us/ct/mr","description":"Biopsy, prostate, each additional, mri-ultrasound fusion or in-bore ct- or mri-guided targeted lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4320","name":"Pellograft, per sq cm","description":"Pellograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0585U","name":"Tgsap so neo cfdna 521 genes","description":"Tgsap so neo cfdna 521 genes","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2801","name":"Inj, rykindo, 0.5 mg","description":"Injection, risperidone (rykindo), 0.5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7298","name":"Remove screw retained plate","description":"Remove screw retained plate","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4007","name":"General surgery ss","description":"General surgery mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1292","name":"Pt 66+ frail inpt adv ill","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and an advanced illness diagnosis during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4028","name":"Podiatry ss","description":"Podiatry mips specialty set","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90960","name":"Esrd srv 4 visits p mo 20+","description":"End-stage renal disease (esrd) related services monthly, for patients 20 years of age and older; with 4 or more face-to-face visits by a physician or other qualified health care professional per month","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":417.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0313U","name":"Onc pncrs dna&mrna seq 74","description":"Onc pncrs dna&mrna seq 74","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0515U","name":"Gi ibd ia quan deter ifx lvl","description":"Gi ibd ia quan deter ifx lvl","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42800","name":"Biopsy of throat","description":"Biopsy; oropharynx","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76018","name":"Mr safety implant elec prepj","description":"Mr safety implant electronics preparation under supervision of physician or other qualified health care professional, including mr-specific programming of pulse generator and/or transmitter to verify device integrity, protection of device internal circuitry from mr electromagnetic fields, and protec","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1720","name":"Influenza vacc admin","description":"Influenza vacc admin","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82553","name":"Creatine mb fraction","description":"Creatine kinase (ck), (cpk); mb fraction only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0543","name":"Group train w/o patient","description":"Group caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient pre","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4468","name":"Exsuff belt incl all sup acc","description":"Exsufflation belt, includes all supplies and accessories","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0578","name":"Inj brixadi, more than 7 day","description":"Injection, buprenorphine extended release (brixadi), greater than 7 days and up to 28 days of therapy","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0120","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9294","name":"Biofeed dig cog behav tx fda","description":"Prescription digital cognitive and/or behavioral therapy, biofeedback, fda cleared, per course of treatment","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97008","name":"Mchnl sclp cool prep plmt","description":"Mechanical scalp cooling; including hair preparation, individual cap placement, therapy initiation, and precooling period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2780","name":"Crown 3/4 cast hi noble met","description":"Crown - 3/4 cast high noble metal","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37279","name":"Iv lithotrp fpvt w/in sm art","description":"Intravascular lithotripsy(ies), femoral and popliteal vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1439","name":"Sig ocu cond imp surg out","description":"Significant ocular conditions that impact the visual outcome of surgery","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1382","name":"Enc dur perf pd pos 11","description":"Patient encounter during the performance period with place of service code 11","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0372","name":"Tomo comp series images","description":"Tomo comp series images","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0984T","name":"Iv img xtrc cere vsl oct 1st","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1448","name":"Pt dx pd bef end meas pd","description":"Patients with an active diagnosis of personality disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1245","name":"Pt othr thn true person","description":"Patient provided a response other than completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99498","name":"Advncd care plan addl 30 min","description":"Advance care planning including the explanation and discussion of advance directives such as standard forms (with completion of such forms, when performed), by the physician or other qualified health care professional; each additional 30 minutes (list separately in addition to code for primary proce","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":71.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1471","name":"Ffs hep b not covered","description":"Documentation that patient is a medicare fee-for-service beneficiary and without additional supplementary insurance coverage for whom hep b vaccination is not reimbursable under current medicare part b coverage rules","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0565U","name":"Onc hcc ngs detc 6626epigalt","description":"Onc hcc ngs detc 6626epigalt","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27889","name":"Ankle disarticulation","description":"Ankle disarticulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":808.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96380","name":"Admn rsv monoc antb im cnsl","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection, with counseling by physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1414","name":"Med rsn no pdl1 bef 1st ther","description":"Documentation of medical reason(s) for not performing the pd-l1 biomarker expression test prior to initiation of first-line immune checkpoint inhibitor therapy (e.g., patient is in an urgent or emergent situation where delay of treatment would jeopardize the patients health status; other medical rea","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0874T","name":"Rmvl pertl ascites pmp sys","description":"Removal of a peritoneal ascites pump system, including implanted peritoneal ascites pump and indwelling bladder and peritoneal catheters","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6560","name":"G stckng full/chap30-40 cust","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, custom, each","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0434U","name":"Rx metab advrs vrnt alys 25","description":"Rx metab advrs vrnt alys 25","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0238","name":"Intrav inf, toci, second dos","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4028","name":"Podiatry ss","description":"Podiatry mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6089","name":"Access/retorq implant screw","description":"Access/retorq implant screw","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4296","name":"Rebound matrix, per sq cm","description":"Rebound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0497U","name":"Onc prst8 mrna rt-pcr 6 gene","description":"Onc prst8 mrna rt-pcr 6 gene","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1170","name":"Pt w/o flu vax 7/1-6/30","description":"Patient did not receive an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1048.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0019","name":"Comm hlth intg svs sdoh 60mn","description":"Community health integration services performed by certified or trained auxiliary personnel, including a community health worker, under the direction of a physician or other practitioner; 60 minutes per calendar month, in the following activities to address social determinants of health (sdoh) need(","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0458U","name":"Onc brst ca s100 a8&a9 elisa","description":"Onc brst ca s100 a8&a9 elisa","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78320","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":366.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2267","name":"Inj, mirikizumab-mrkz, 1 mg","description":"Injection, mirikizumab-mrkz, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19182","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":608.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0522","name":"Mgt nw pt dementia low cmplx","description":"Management of a new patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1441","name":"Init dx slp apn = 1st enc","description":"Encounter corresponds to initial diagnosis of sleep apnea or first contact with sleep apnea diagnosed patient","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2599","name":"Inj vasopressin (am reg) 1 u","description":"Injection, vasopressin (american regent), not therapeutically equivalent to j2598, 1 unit","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34826","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15011","name":"Hrv skn cll ssp agrft 1st 25","description":"Harvest of skin for skin cell suspension autograft; first 25 sq cm or less","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64628","name":"Trml dstrj ios bvn 1st 2 l/s","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; first 2 vertebral bodies, lumbar or sacral","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29530","name":"Strapping of knee","description":"Strapping; knee","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5130","name":"Inj, fylnetra, 0.5 mg","description":"Injection, pegfilgrastim-pbbk (fylnetra), biosimilar, 0.5 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1177","name":"Pt recd pcv on/aft 19","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2020","name":"Ac5 wound system","description":"Ac5 advanced wound system (ac5)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0658","name":"Seg pneum comp 2 arm chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54332","name":"Revise penis/urethra","description":"1-stage proximal penile or penoscrotal hypospadias repair requiring extensive dissection to correct chordee and urethroplasty by use of skin graft tube and/or island flap","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1136.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27235","name":"Treat thigh fracture","description":"Percutaneous skeletal fixation of femoral fracture, proximal end, neck","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1081.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36836","name":"Prq av fstl crtj uxtr 1 acs","description":"Percutaneous arteriovenous fistula creation, upper extremity, single access of both the peripheral artery and peripheral vein, including fistula maturation procedures (eg, transluminal balloon angioplasty, coil embolization) when performed, including all vascular access, imaging guidance and radiolo","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55867","name":"Laps surg prst8ect smpl stot","description":"Laparoscopy, surgical prostatectomy, simple subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy), includes robotic assistance, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84577","name":"Assay of feces/urobilinogen","description":"Urobilinogen, feces, quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2596","name":"Vasopressin (long grove) 1 u","description":"Injection, vasopressin (long grove), not therapeutically equivalent to j2598, 1 unit","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2008","name":"Theragenesis, per sq cm","description":"Theragenesis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4035","name":"Thoracic surgery ss","description":"Thoracic surgery mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0614","name":"Inj, treosulfan, 50 mg","description":"Injection, treosulfan, 50 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0798T","name":"Tcat rmv 2chmbr ldls pm cmpl","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; complete system (ie, right atrial and right ventricular pacemaker components)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4252","name":"Vendaje, per square centimet","description":"Vendaje, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0744T","name":"Insj bioprostc vlv fem vn","description":"Insertion of bioprosthetic valve, open, femoral vein, including duplex ultrasound imaging guidance, when performed, including autogenous or nonautogenous patch graft (eg, polyester, eptfe, bovine pericardium), when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37260","name":"Revsc evasc ivt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4036","name":"Urgent care ss","description":"Urgent care mips specialty set","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1442","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0682T","name":"Removal pulse gen only isdss","description":"Removal of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84145","name":"Procalcitonin (pct)","description":"Procalcitonin (pct)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2024","name":"Resolve or xenopatch sq cm","description":"Resolve matrix or xenopatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26410","name":"Repair hand tendon","description":"Repair, extensor tendon, hand, primary or secondary; without free graft, each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":806.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27692","name":"Revise additional leg tendon","description":"Transfer or transplant of single tendon (with muscle redirection or rerouting); each additional tendon (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0562U","name":"Onc sol tum tgsa 33gens snvs","description":"Onc sol tum tgsa 33gens snvs","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0044","name":"Pt mitral stenosis","description":"Patients with moderate or severe mitral stenosis","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37273","name":"Revsc evsc fpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":310.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9074","name":"Inj, cyclophosphamd, sandoz","description":"Injection, cyclophosphamide (sandoz), 5 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1471","name":"Ffs hep b not covered","description":"Documentation that patient is a medicare fee-for-service beneficiary and without additional supplementary insurance coverage for whom hep b vaccination is not reimbursable under current medicare part b coverage rules","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90637","name":"Vacc qirv mrna 30mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 30 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81560","name":"Trnsplj pd lvr&bwl cd154+cll","description":"Transplantation medicine (allograft rejection, pediatric liver and small bowel), measurement of donor and third-party-induced cd154+t-cytotoxic memory cells, utilizing whole peripheral blood, algorithm reported as a rejection risk score","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2011","name":"Supra sdrm, per sq cm","description":"Supra sdrm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1315","name":"Crc no doc no rsn","description":"Colorectal cancer screening results were not documented and reviewed; reason not otherwise specified","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1952","name":"Leuprolide inj, camcevi, 1mg","description":"Leuprolide injectable, camcevi, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1214","name":"Spiro results wth obs doc","description":"Spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and reviewed","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33281","name":"Reposg phrnc nrv stim trnsvn","description":"Repositioning of phrenic nerve stimulator transvenous lead(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0736","name":"Inj, clindamycin phosp 300mg","description":"Injection, clindamycin phosphate, 300 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1364","name":"Ascvd risk >=20pct","description":"Calculated 10-year ascvd risk score of >= 20 percent during the performance period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0839T","name":"Dgtz gls mcrscp cslt mat prp","description":"Digitization of glass microscope slides for consultation and report on referred material requiring preparation of slides (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2543","name":"Dental onlay metallic 3 surf","description":"Onlay - metallic - three surfaces","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2006","name":"Kaf sng/dbl swg/stn mcpr cus","description":"Knee ankle foot device, any material, single or double upright, swing and stance phase microprocessor control with adjustability, includes all components (e.g., sensors, batteries, charger), any type activation, with or without ankle joint(s), custom fabricated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40019.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73540","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45349","name":"Sigmoidoscopy w/resection","description":"Sigmoidoscopy, flexible; with endoscopic mucosal resection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91321","name":"Sarscov2 vac 25 mcg/.25ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 25 mcg/0.25 ml dosage, for intramuscular use","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0874","name":"Inj, daptomycin (baxter)","description":"Injection, daptomycin (baxter), not therapeutically equivalent to j0878, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8522","name":"Capecitabine, oral, 50 mg","description":"Capecitabine, oral, 50 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78708","name":"K flow/funct image w/drug","description":"Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0876T","name":"Duplex scan hemo fstl lmtd","description":"Duplex scan of hemodialysis fistula, computer-aided, limited (volume flow, diameter, and depth, including only body of fistula)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0279U","name":"Hem vw factor&clgn iii bndg","description":"Hematology (von willebrand disease [vwd]), von willebrand factor (vwf) and collagen iii binding by enzyme-linked immunosorbent assays (elisa), plasma, report of collagen iii binding","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5133","name":"Inj, tofidence, 1 mg","description":"Injection, tocilizumab-bavi (tofidence), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1280","name":"Bilat mast/hx bi /unilat mas","description":"Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1251","name":"Pts proxy cmplt hu surv","description":"Patients for whom a proxy completed the entire hu survey on their behalf for any reason (no patient involvement)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0412U","name":"Beta amyloid ab42/40 imprcip","description":"Beta amyloid ab42/40 imprcip","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3392","name":"Inj, exagamglogene autotem","description":"Injection, exagamglogene autotemcel, per treatment","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4279","name":"Vendaje ac, per sq cm","description":"Vendaje ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5912","name":"Facial moulage complete","description":"Facial moulage (complete)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90969","name":"Esrd svc pr day pt 12-19","description":"End-stage renal disease (esrd) related services for dialysis less than a full month of service, per day; for patients 12-19 years of age","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1407","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2390","name":"Ant resin-based cmpst crown","description":"Resin-based composite crown anterior","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59121","name":"Treat ectopic pregnancy","description":"Surgical treatment of ectopic pregnancy; tubal or ovarian, without salpingectomy and/or oophorectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":957.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93145","name":"Interrog crtd sins bat ip wo","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0531","name":"Fclty-based respite, 24 hr u","description":"Facility-based respite, 24-hour unit, for use in cmmi model","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0876T","name":"Duplex scan hemo fstl lmtd","description":"Duplex scan of hemodialysis fistula, computer-aided, limited (volume flow, diameter, and depth, including only body of fistula)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84393","name":"Tau phosphorylated ea","description":"Tau, phosphorylated (eg, ptau 181, ptau 217), each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1206","name":"Isa not red 3pts/no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45389","name":"Colonoscopy w/stent plcmt","description":"Colonoscopy, flexible; with endoscopic stent placement (includes pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0312","name":"Immunize couns < 21yr 5-15 m","description":"Immunization counseling by a physician or other qualified health care professional when the vaccine(s) is not administered on the same date of service for ages under 21, 5 to 15 mins time (this code is used for medicaid billing purposes)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98015","name":"Synch audio-only est high 40","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selec","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86318","name":"Ia infectious agent antibody","description":"Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5611","name":"Rep resin part dent base man","description":"Rep resin part dent base man","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0612","name":"Inj, calcium gluconate, nos","description":"Injection, calcium gluconate, not otherwise specified, 10 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0802","name":"Inj. (ani), up to 40 units","description":"Injection, corticotropin (ani), up to 40 units","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0893T","name":"N-invas assmt bld oxygnation","description":"Noninvasive assessment of blood oxygenation, gas exchange efficiency, and cardiorespiratory status, with physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0901","name":"Vadadustat oral 1mg for esrd","description":"Vadadustat, oral, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2989","name":"Excavate tooth non-restorabl","description":"Excavate tooth non-restorabl","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93898","name":"Ven-artl shunt det mbubb njx","description":"Venous-arterial shunt detection with intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4383","name":"Axolotl graft ult per sq cm","description":"Axolotl graft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84110","name":"Assay of porphobilinogen","description":"Porphobilinogen, urine; quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0476U","name":"Rx metab psyc 14gen&cyp2d6","description":"Rx metab psyc 14gen&cyp2d6","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0022","name":"Comm hlth intg svs add 30 m","description":"Community health integration services, each additional 30 minutes per calendar month (list separately in addition to g0019)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1409","name":"Recd gmln brca1/brca2 couns","description":"Patients who received germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0790T","name":"Revj rplcmt/rmvl vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracolumbar or lumbar vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0519","name":"New pt-cg dyad dem low cmplx","description":"Management of new patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6524","name":"G com garmnt lwr leg/ft nght","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1220","name":"Dre wth interp rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; with evidence of retinopathy","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0402U","name":"Nfct agt sti mult amp prb tq","description":"Nfct agt sti mult amp prb tq","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92629","name":"Eval hearing aid cand ea add","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80506","name":"Path clin consltj prolng svc","description":"Pathology clinical consultation; prolonged service, each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76018","name":"Mr safety implant elec prepj","description":"Mr safety implant electronics preparation under supervision of physician or other qualified health care professional, including mr-specific programming of pulse generator and/or transmitter to verify device integrity, protection of device internal circuitry from mr electromagnetic fields, and protec","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70472","name":"Ct cere prfu alys c+w/ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed with concurrent ct or ct angiography of the same anatomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0363U","name":"Onc urthl mrna 5 gen alg","description":"Onc urthl mrna 5 gen alg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0532","name":"Take home supp nasal spray","description":"Take-home supply of nasal nalmefene hydrochloride; one carton of two, 2.7 mg per 0.1 ml nasal sprays (provision of the services by a medicare-enrolled opioid treatment program);( list separately in addition to each primary code)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1173","name":"Pt no rec td/tdap 9yrs prior","description":"Patient did not receive at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4427","name":"Dermbnd dln dl+ dlx sq cm","description":"Dermabind dl n or dermabind dl + or dermabind dl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34401","name":"Removal of vein clot","description":"Thrombectomy, direct or with catheter; vena cava, iliac vein, by abdominal incision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1713.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1216","name":"No spiro doc no res doc","description":"No spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and/or no spirometry performed with results documented during the encounter","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4407","name":"Xwrap tribus per sq cm","description":"Xwrap tribus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4362","name":"Cygnus disk, per sq cm","description":"Cygnus disk, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75580","name":"N-invas est c ffr sw aly cta","description":"Noninvasive estimate of coronary fractional flow reserve (ffr) derived from augmentative software analysis of the data set from a coronary computed tomography angiography, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0851T","name":"Dgtz gls mcrscp mphmtrc 1st","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4262","name":"Dual layer impax, per sq cm","description":"Dual layer impax membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4036","name":"Urgent care ss","description":"Urgent care mips specialty set","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0296U","name":"Onc orl&/orop ca 20 mlc feat","description":"Onc orl&/orop ca 20 mlc feat","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78491","name":"Myocrd img pet 1std rst/strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); single study, at rest or stress (exercise or pharmacologic)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80410","name":"Calcitonin stimul panel","description":"Calcitonin stimulation panel (eg, calcium, pentagastrin) this panel must include the following: calcitonin (82308 x 3)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0994T","name":"Evasc dlvr a-wal stbl rx prq","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; percutaneous","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0945T","name":"Intraop assmt abnl tum tiss","description":"Intraoperative assessment for abnormal (tumor) tissue, in-vivo, following partial mastectomy (eg, lumpectomy) using computer-aided fluorescence imaging (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49592","name":"Rpr aa hrn 1st < 3 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, incarcerated or strangulated","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6604","name":"Cst bse mtl inlay 2 surfaces","description":"Inlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1220","name":"Dre wth interp rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; with evidence of retinopathy","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90484","name":"Imm cnsl not admn sm>20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 20 minutes","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3070","name":"Pentazocine injection","description":"Injection, pentazocine, 30 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25425","name":"Repair/graft radius or ulna","description":"Repair of defect with autograft; radius or ulna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1677.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4376","name":"Duograft aa per sq cm","description":"Duograft aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1396","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0415U","name":"Cv ds acs bld alg 5 yr score","description":"Cv ds acs bld alg 5 yr score","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90483","name":"Imm cnsl not admn sm>10<20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 10 minutes up to 20 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3432","name":"Guided tissue regeneration","description":"Guided tissue regeneration","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83884","name":"Assay neurflmnt light chain","description":"Neurofilament light chain (nfl)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0912T","name":"Elec alys nstim sys vgs smpl","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; with simple programming by physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98003","name":"Synch audio-video new hi 60","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high medical decision making. when using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0552U","name":"Repr med pga gdo te bx locus","description":"Repr med pga gdo te bx locus","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9332","name":"Inj efgartigimod 2mg","description":"Injection, efgartigimod alfa-fcab, 2mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"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":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6564","name":"G com stckng waist 40+ cust","description":"Gradient compression stocking, waist length, 40 mmhg or greater, custom, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1413","name":"Pos pdl1 bef init ici tx","description":"Patients who had a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37280","name":"Revsc evsc tpvt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9948","name":"Adjust sleep apnea appliance","description":"Adjust sleep apnea appliance","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0433U","name":"Onc prst8 5 dna reg mrk pcr","description":"Onc prst8 5 dna reg mrk pcr","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4308","name":"Sanopellis, per sq cm","description":"Sanopellis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1476","name":"Pt dx cog imp or ad","description":"Patients with diagnosis of cognitive impairment or alzheimers disease","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27278","name":"Arthrd si jt plmt iartic dev","description":"Arthrodesis, sacroiliac joint, percutaneous or minimally invasive, with image guidance, includes obtaining bone graft when performed, unilateral; placement of intra-articular device(s), without cortical piercing","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69729","name":"Impl oi implt sk tc esp>=100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside of the mastoid and resulting in removal of greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0206","name":"Inj allopurinol sodium 1 mg","description":"Injection, allopurinol sodium, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82233","name":"Beta-amyloid 1-40 (abeta 40)","description":"Beta-amyloid; 1-40 (abeta 40)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75625","name":"Contrast exam abdominl aorta","description":"Aortography, abdominal, by serialography, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1171","name":"Pt recd 1 td/tdap 9yrs prior","description":"Patient received at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1312","name":"No pt tbco scrn rng","description":"Patient not screened for tobacco use","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0623U","name":"Ai ms dna mthyl alys >5000","description":"Ai ms dna mthyl alys >5000","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83876","name":"Assay myeloperoxidase","description":"Myeloperoxidase (mpo)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4211","name":"Gingivectomy/plasty per toot","description":"Gingivectomy or gingivoplasty - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8006","name":"Grip glove replacement only","description":"Powered, cable driven grip assist glove, hand, finger, includes pressure sensors, glove replacement only","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0573U","name":"Onc pancreas 3bmrk pclf alg","description":"Onc pancreas 3bmrk pclf alg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D8671","name":"Periodic orth treat w surg","description":"Periodic orth treat w surg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0673T","name":"Abltj b9 thyr ndul perq lasr","description":"Ablation, benign thyroid nodule(s), percutaneous, laser, including imaging guidance","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1306","name":"Injection, inclisiran, 1 mg","description":"Injection, inclisiran, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1737","name":"Inj meloxicam (azurity) 1mg","description":"Injection, meloxicam (azurity), 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0721T","name":"Quan ct tiss charac w/o ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7671","name":"Alveolus open reduction","description":"Alveolus - open reduction may include stabilization of teeth","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0491","name":"Inj anifrolumab-fnia 1mg","description":"Injection, anifrolumab-fnia, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0692T","name":"Therapeutic ultrafiltration","description":"Therapeutic ultrafiltration","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25391","name":"Lengthen radius or ulna","description":"Osteoplasty, radius or ulna; lengthening with autograft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1490.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1371","name":"Mst rec gsa<7","description":"Most recent glycemic status assessment (hba1c or gmi) level < 7.0%","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70472","name":"Ct cere prfu alys c+w/ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed with concurrent ct or ct angiography of the same anatomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55877","name":"Abltj ire prst8 1+ tum perq","description":"Ablation, irreversible electroporation, prostate, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5930","name":"Max guid prothes w/o flange","description":"Max guid prothes w/o flange","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6252","name":"Bridge resin w/noble metal","description":"Pontic-resin with noble metal","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0403U","name":"Onc prst8 mrna 18 gen dre ur","description":"Onc prst8 mrna 18 gen dre ur","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4407","name":"Xwrap tribus per sq cm","description":"Xwrap tribus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84145","name":"Procalcitonin (pct)","description":"Procalcitonin (pct)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2034","name":"Found drs solo, per sq cm","description":"Foundation drs solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78140","name":"Red cell sequestration","description":"Labeled red cell sequestration, differential organ/tissue (eg, splenic and/or hepatic)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5134","name":"Inj, tyruko, 1 mg","description":"Injection, natalizumab-sztn (tyruko), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0174A","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0996T","name":"Ins&sclr fix caps bag prosth","description":"Insertion and scleral fixation of a capsular bag prosthesis containing an intraocular lens prosthesis, with vitrectomy, including removal of crystalline lens or dislocated intraocular lens prosthesis, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0034","name":"Pall serv during meas","description":"Patients receiving palliative care during the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82948","name":"Reagent strip/blood glucose","description":"Glucose; blood, reagent strip","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"Limited visual field xm","description":"Visual field examination, unilateral or bilateral, with interpretation and report; limited examination (eg, tangent screen, autoplot, arc perimeter, or single stimulus level automated test, such as octopus 3 or 7 equivalent)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50225","name":"Removal kidney open complex","description":"Nephrectomy, including partial ureterectomy, any open approach including rib resection; complicated because of previous surgery on same kidney","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1303.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"Sup/ext non-ins inf pump syr","description":"Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0668","name":"Team remote e/m est pt 40 mn","description":"Team remote e/m est. pt 40mins","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4305","name":"Amer am ac tri-lay per sq cm","description":"American amnion ac tri-layer, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4018","name":"Ob/gyn ss","description":"Obstetrics/gynecology mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0697T","name":"Quan mr tis wo mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained without diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, targ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76014","name":"Mr sfty implt&/fb asmt stf 1","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1362","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0473","name":"Micro exam prep & report","description":"Accession of tissue gross and microscopic examination preparation and transmission of written report","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2001","name":"Suct pum ext mgmt sys","description":"Suction pump, home model, portable or stationary, electric, any type, for use with external urine and/or fecal management system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1238","name":"Doc 2nd recom hzv 2-6 mo int","description":"Documentation that administration of second recombinant zoster vaccine could not occur during the performance period due to the recommended 2-6 month interval between doses (i.e, first dose received after october 31)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4429","name":"Dermbnd chn, chx per sq cm","description":"Dermabind ch n or dermabind ch x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6032","name":"Part handfng ultralite tcf/=","description":"Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6553","name":"G com stcking bk 30-40 custm","description":"Gradient compression stocking, below knee, 30-40 mmhg, custom, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1073","name":"Testosterone pellet 75 mg","description":"Testosterone pellet, implant, 75 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92984","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2643","name":"Dental onlay porcelin 3 surf","description":"Onlay - porcelain/ceramic - three surfaces","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4545","name":"Suppl accessor tibial stim","description":"Supplies and accessories for external tibial nerve stimulator (e.g., socks, gel pads, electrodes, etc.), needed for one month","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5811","name":"Denture interm cmplt mandbl","description":"Interim complete denture (mandibular)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1477","name":"Dx delirium","description":"Diagnosis of delirium","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1346","name":"No pam inc 6 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 6 points within a 4 to 12 month period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4284","name":"Dermabind sl, per sq cm","description":"Dermabind sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1401","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0302U","name":"Iadna brtnla ddpcr flwg liq","description":"Iadna brtnla ddpcr flwg liq","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1022T","name":"Prq tis dsplmt ntra-abdl/pel","description":"Percutaneous tissue displacement, any method, including imaging guidance; intra-abdominal/pelvic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9220","name":"Indigotindisulfonate sod 1mg","description":"Injection, indigotindisulfonate sodium, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26125","name":"Release palm contracture","description":"Fasciectomy, partial palmar with release of single digit including proximal interphalangeal joint, with or without z-plasty, other local tissue rearrangement, or skin grafting (includes obtaining graft); each additional digit (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6601","name":"G com bandge hgh dn foam pad","description":"Gradient compression bandaging supply, high density foam pad, any size or shape, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69729","name":"Impl oi implt sk tc esp>=100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside of the mastoid and resulting in removal of greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82272","name":"Occult bld feces 1-3 tests","description":"Blood, occult, by peroxidase activity (eg, guaiac), qualitative, feces, 1-3 simultaneous determinations, performed for other than colorectal neoplasm screening","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6605","name":"G com bandage padded foam","description":"Gradient compression bandaging supply, padded foam, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0736","name":"Inj, clindamycin phosp 300mg","description":"Injection, clindamycin phosphate, 300 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11626","name":"Exc s/n/h/f/g mal+mrg >4 cm","description":"Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter over 4.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6604","name":"Cst bse mtl inlay 2 surfaces","description":"Inlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1243","name":"Pt othr thn true heard","description":"Patient provided a response other than completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0889T","name":"Prsnlz trgt dvl arhfcmrigtbs","description":"Personalized target development for accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation derived from a structural and resting-state functional mri, including data preparation and transmission, generation of the target, motor threshold-starting location, neuro","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"Non-adju cgm supply allow","description":"Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1449","name":"Inj eflapegrastim-xnst 0.1mg","description":"Injection, eflapegrastim-xnst, 0.1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99375","name":"Home health care supervision","description":"Supervision of a patient under care of home health agency (patient not present) in home, domiciliary or equivalent environment (eg, alzheimers facility) requiring complex and multidisciplinary care modalities involving regular development and/or revision of care plans by that individual, review of s","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":102.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80435","name":"Insulin tolerance panel","description":"Insulin tolerance panel; for growth hormone deficiency this panel must include the following: glucose (82947 x 5) human growth hormone (hgh) (83003 x 5)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4011","name":"Internal medicine ss","description":"Internal medicine mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9245","name":"Admin mod sedation-enteral","description":"Admin mod sedation-enteral","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9297","name":"Inj pemetrexed (sandoz) 10mg","description":"Injection, pemetrexed (sandoz), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5148","name":"Inj, nyposi 1 mcg","description":"Injection, filgrastim-txid (nypozi), biosimilar, 1 microgram","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0415U","name":"Cv ds acs bld alg 5 yr score","description":"Cv ds acs bld alg 5 yr score","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49595","name":"Rpr aa hrn 1st > 10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, reducible","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0717T","name":"Adrc ther prtl rc tear","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; adipose tissue harvesting, isolation and preparation of harvested cells, including incubation with cell dissociation enzymes, filtration, washing, and concentration of adrcs","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4318","name":"E-graft, per sq cm","description":"E-graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9615","name":"Inj, pegulicianine, 1 mg","description":"Injection, pegulicianine, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3503","name":"Surg exp root surf molar","description":"Surg exp root surf molar","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2428","name":"Inj, erzofri, 1 mg","description":"Injection, paliperidone palmitate extended release (erzofri), 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27676","name":"Repair lower leg tendons","description":"Repair, dislocating peroneal tendons; with fibular osteotomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":754.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0307U","name":"Onc mrd nxt-gnrj alys sbsq","description":"Onc mrd nxt-gnrj alys sbsq","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0680T","name":"Insj/rplcmt pg only isdss","description":"Insertion or replacement of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing lead(s)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4281","name":"Barrera slor dl per sq cm","description":"Barrera sl or barrera dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0287U","name":"Onc thyr dna&mrna 112 genes","description":"Onc thyr dna&mrna 112 genes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0948T","name":"Rem interrog dev ccm phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system with interim analysis, review, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0804","name":"3d facial scan indirect","description":"3d facial scan indirect","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9997","name":"Ustekinumab-ttwe iv inj 1 mg","description":"Injection, ustekinumab-ttwe (pyzchiva), intravenous, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4331","name":"Axolotl graft, per sq cm","description":"Axolotl graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0830T","name":"Dgtz gls mcrscp cytp slctv","description":"Digitization of glass microscope slides for cytopathology, selective-cellular enhancement technique with interpretation (eg, liquid-based slide preparation method), except cervical or vaginal (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0986T","name":"Iv img icr cere vsl oct 1st","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0030","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44721","name":"Prep donor intestine/artery","description":"Backbench reconstruction of cadaver or living donor intestine allograft prior to transplantation; arterial anastomosis, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9939","name":"Placemnt removable appliance","description":"Placemnt removable appliance","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0583U","name":"Rare ds rpd whlgen cmptr dna","description":"Rare ds rpd whlgen cmptr dna","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0563","name":"Sbrt w/positron emission del","description":"Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance and real-time positron emissions-based delivery adjustments to 1 or more lesions, entire course not to exceed 5 fractions","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9004","name":"Va whole health partner serv","description":"Department of veterans affairs whole health partner services","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4379","name":"Amniodefend ft per sq cm","description":"Amniodefend ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76506","name":"Echo exam of head","description":"Echoencephalography, real time with image documentation (gray scale) (for determination of ventricular size, delineation of cerebral contents, and detection of fluid masses or other intracranial abnormalities), including a-mode encephalography as secondary component where indicated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0392U","name":"Rx metab genrx ia 16 genes","description":"Rx metab genrx ia 16 genes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2394","name":"Post >=4srfc resinbase cmpst","description":"Resin-based composite - four or more surfaces posterior","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22524","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2351","name":"Inj ocrelizumab 1mg hya-ocsq","description":"Injection, ocrelizumab, 1 mg and hyaluronidase-ocsq","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3401","name":"Vyjuvek 5x10^9pfu/ml, 0.1 ml","description":"Beremagene geperpavec-svdt for topical administration, containing nominal 5 x 10^9 pfu/ml vector genomes, per 0.1 ml","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61751","name":"Brain biopsy w/ct/mr guide","description":"Stereotactic biopsy, aspiration, or excision, including burr hole(s), for intracranial lesion; with computed tomography and/or magnetic resonance guidance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1522.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76019","name":"Mr safety implt pos&/immoblj","description":"Mr safety implant positioning and/or immobilization under supervision of physician or other qualified health care professional, including application of physical protections to secure implanted medical device from mr-induced translational or vibrational forces, magnetically induced functional change","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1400","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93569","name":"Njx cth slct p-art angrp uni","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5155","name":"Inj, aflibercept-jbvf, 1 mg","description":"Injection, aflibercept-jbvf (yesafili), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0948T","name":"Rem interrog dev ccm phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system with interim analysis, review, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0401U","name":"Crd c hrt ds 9 gen 12 vrnts","description":"Crd c hrt ds 9 gen 12 vrnts","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0411","name":"Hba1c in office testing","description":"Hba1c in office testing","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0311U","name":"Nfct ds bct quan antmcrb sc","description":"Nfct ds bct quan antmcrb sc","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9230","name":"Mechlorethamine hcl inj","description":"Injection, mechlorethamine hydrochloride, (nitrogen mustard), 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4321","name":"Renograft, per sq cm","description":"Renograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92632","name":"Hearing aid slctn svc ea add","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99462","name":"Sbsq nb em per day hosp","description":"Subsequent hospital care, per day, for evaluation and management of normal newborn","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6518","name":"Grad com wrap w strap arm cu","description":"Gradient compression wrap with adjustable straps, arm, each, custom","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1325","name":"Doc med rsn not seen","description":"Patients who were not seen for reasons documented by clinician for patient or medical reasons (e.g., inadequate time for follow-up, patients who received a prior intravitreal or periocular steroid injection within the last six (6) months and had a subsequent iop evaluation with iop <25mm hg within s","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82962","name":"Glucose blood test","description":"Glucose, blood by glucose monitoring device(s) cleared by the fda specifically for home use","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0318U","name":"Ped whl gen mthyltn alys 50+","description":"Ped whl gen mthyltn alys 50+","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98975","name":"Rtm 1st set-up&pt educaj eqp","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); initial set-up and patient education on use of equipment","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1279","name":"Pre-htn/htn, no f/u, not gvn","description":"Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97813","name":"Acup 1/> w/estim 1st 15 min","description":"Acupuncture, 1 or more needles; with electrical stimulation, initial 15 minutes of personal one-on-one contact with the patient","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":63.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9608","name":"Flotufolastat f18 diag 1 mci","description":"Flotufolastat f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2428","name":"Inj, erzofri, 1 mg","description":"Injection, paliperidone palmitate extended release (erzofri), 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3431","name":"Biological materials","description":"Biological materials","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49623","name":"Rmvl ninfct mesh hernia rpr","description":"Removal of total or near total non-infected mesh or other prosthesis at the time of initial or recurrent anterior abdominal hernia repair or parastomal hernia repair, any approach (ie, open, laparoscopic, robotic) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50543","name":"Laparo partial nephrectomy","description":"Laparoscopy, surgical; partial nephrectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1285","name":"Scrn mam perf rslts not doc","description":"Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed, reason not otherwise specified","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50574","name":"Kidney endoscopy & biopsy","description":"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":674.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97761","name":"Prosthetic traing 1st enc","description":"Prosthetic(s) training, upper and/or lower extremity(ies), initial prosthetic(s) encounter, each 15 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0707","name":"Intraoral periap radio image","description":"Intraoral periap radio image","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9956","name":"Admin home sleep apnea test","description":"Admin home sleep apnea test","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0042","name":"Ref to therapy","description":"Referral to physical, occupational, speech, or recreational therapy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19291","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0306U","name":"Onc mrd nxt-gnrj alys 1st","description":"Onc mrd nxt-gnrj alys 1st","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0553U","name":"Repr med pga embry te strux","description":"Repr med pga embry te strux","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0896T","name":"Connj lvr algrft prfu dev ea","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; each additional hour, including physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary bicarbonate, lactate ","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0965T","name":"I&cst prp jw xpn dl arch non","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, non-fixed hinge mechanism","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1783","name":"Vac admin human pap dose 3","description":"Vac admin human pap dose 3","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1363","name":"Pts no f/u 120 dys","description":"Patients who did not have a follow-up assessment within 120 days of the index assessment","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1305","name":"Pneum vax admin 19+","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0309U","name":"Crd cv ds aly 4 prtn plm alg","description":"Crd cv ds aly 4 prtn plm alg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98927","name":"Osteopath manj 5-6 regions","description":"Osteopathic manipulative treatment (omt); 5-6 body regions involved","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":42.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1323","name":"Inj, elranatamab-bcmm, 1 mg","description":"Injection, elranatamab-bcmm, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2277","name":"Inj, motixafortide, 0.25 mg","description":"Injection, motixafortide, 0.25 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0748T","name":"Njx stm cl prdct anl sft tis","description":"Injections of stem cell product into perianal perifistular soft tissue, including fistula preparation (eg, removal of setons, fistula curettage, closure of internal openings)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1436","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"Limited visual field xm","description":"Visual field examination, unilateral or bilateral, with interpretation and report; limited examination (eg, tangent screen, autoplot, arc perimeter, or single stimulus level automated test, such as octopus 3 or 7 equivalent)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33971","name":"Aortic circulation assist","description":"Removal of intra-aortic balloon assist device including repair of femoral artery, with or without graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":758.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0899T","name":"N-invas deter aqmbf aug cmr","description":"Noninvasive determination of absolute quantitation of myocardial blood flow (aqmbf), derived from augmentative algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health car","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63707","name":"Repair spinal fluid leakage","description":"Repair of dural/cerebrospinal fluid leak, not requiring laminectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":983.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4424","name":"Revive ft per sq cm","description":"Revive ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4299","name":"Amniocore pro+, per sq cm","description":"Amniocore pro+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37280","name":"Revsc evsc tpvt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99215","name":"Office o/p est hi 40 min","description":"Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 40 minutes must be met or ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":221.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":142.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G3002","name":"Chronic pain mgmt 30 mins","description":"Chronic pain management and treatment, monthly bundle including, diagnosis; assessment and monitoring; administration of a validated pain rating scale or tool; the development, implementation, revision, and/or maintenance of a person-centered care plan that includes strengths, goals, clinical needs,","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98001","name":"Synch audio-video new low 30","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92950","name":"Heart/lung resuscitation cpr","description":"Cardiopulmonary resuscitation (eg, in cardiac arrest)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90382","name":"Rsv monoc antb seasn .7ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose, 0.7 ml, for intramuscular use","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0716T","name":"Car acous wavfrm rec cad rsk","description":"Cardiac acoustic waveform recording with automated analysis and generation of coronary artery disease risk score","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4364","name":"Am bur xp mem xpl hy p sq cm","description":"Amnio burgeon xplus membrane and xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1253","name":"Pts hu surv no amb plltv","description":"Patients who respond on the patient experience hu survey that they did not receive care by the listed ambulatory palliative care provider in the last 60 days (disavowal)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93587","name":"Vngrph chd vnvn cltrl at/abv","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating at or above the heart (eg, from innominate vein) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J0835","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37785","name":"Ligate/divide/excise vein","description":"Ligation, division, and/or excision of varicose vein cluster(s), 1 leg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87523","name":"Hepatitis d quantification","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis d (delta), quantification, including reverse transcription, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4410","name":"Amchomatrixdl per sq cm","description":"Amchomatrixdl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88309","name":"Tissue exam by pathologist","description":"Level vi - surgical pathology, gross and microscopic examination bone resection breast, mastectomy - with regional lymph nodes colon, segmental resection for tumor colon, total resection esophagus, partial/total resection extremity, disarticulation fetus, with dissection larynx, partial/total resect","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1469","name":"Hx of hep b, or pos bld test","description":"Patient has a history of hepatitis b illness or received a hepatitis b surface antigen, hepatitis b surface antibody, or total antibody to hepatitis b core antigen test with a positive result any time before or during the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1314","name":"Bmi not calculated","description":"Bmi not documented and no reason is given","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1360","name":"Suicd c-ssrs assessment","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1410","name":"No gmln brca1/brca2 couns","description":"Patients who did not have germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0751","name":"Hiv prep, ftc/taf 200/25mg","description":"Emtricitabine 200mg and tenofovir alafenamide 25mg, oral, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4321","name":"Renograft, per sq cm","description":"Renograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90966","name":"Esrd home pt serv p mo 20+","description":"End-stage renal disease (esrd) related services for home dialysis per full month, for patients 20 years of age and older","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":116.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1022T","name":"Prq tis dsplmt ntra-abdl/pel","description":"Percutaneous tissue displacement, any method, including imaging guidance; intra-abdominal/pelvic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0623U","name":"Ai ms dna mthyl alys >5000","description":"Ai ms dna mthyl alys >5000","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77307","name":"Telethx isodose plan cplx","description":"Teletherapy isodose plan; complex (multiple treatment areas, tangential ports, the use of wedges, blocking, rotational beam, or special beam considerations), includes basic dosimetry calculation(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90684","name":"Pcv21 vaccine im","description":"Pneumococcal conjugate vaccine, 21 valent (pcv21), for intramuscular use","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1171","name":"Pt recd 1 td/tdap 9yrs prior","description":"Patient received at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0842T","name":"Dgtz gls mcrscp pth cslt ea","description":"Digitization of glass microscope slides for pathology consultation during surgery; each additional tissue block with frozen section(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9611","name":"Flurpiridaz f18, diag, 1 mci","description":"Flurpiridaz f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0910T","name":"Rmvl int nstim sys vagus nrv","description":"Removal of integrated neurostimulation system, vagus nerve","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76802","name":"Ob us < 14 wks addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0365U","name":"Onc bldr 10 prb bldr ca","description":"Onc bldr 10 prb bldr ca","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81463","name":"So gsap cl fr cpy nmbr&mcrst","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis, copy number variants, and microsatellite instability","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0233","name":"Intra inf, toci, first dose","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0510U","name":"Onc pncrtc ca alg alys 16gen","description":"Onc pncrtc ca alg alys 16gen","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0529U","name":"Hem vte snp f2&f5 gen leiden","description":"Hem vte snp f2&f5 gen leiden","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0542","name":"No pt prsnt train add 15","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1482","name":"Pos quan hep c or qual rna","description":"Positive/detectable hepatitis c virus quantitative or qualitative rna test result during the denominator identification period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7911","name":"Dental suture wound to 5 cm","description":"Complicated suture-up to 5 cm","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0510U","name":"Onc pncrtc ca alg alys 16gen","description":"Onc pncrtc ca alg alys 16gen","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2782","name":"Inj avacincaptad pegol 0.1mg","description":"Injection, avacincaptad pegol, 0.1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0496U","name":"Onc clrct cfdna 8/7 genes","description":"Onc clrct cfdna 8/7 genes","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2544","name":"Dental onlay metl 4/more sur","description":"Onlay - metallic - four or more surfaces","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37266","name":"Rvsc evsc fpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90613","name":"Inf&sarscov2 vacc 40/0.4 im","description":"Influenza virus vaccine, quadrivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 40 mcg/0.4 ml dosage, for intramuscular use","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7049","name":"Epap nasal valve","description":"Expiratory positive airway pressure intranasal resistance valve","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0571","name":"Intraop nerve cryoablation","description":"Intraoperative nerve(s) cryoablation for post-surgical pain relief (list separately in addition to code for primary service)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9297","name":"Inj pemetrexed (sandoz) 10mg","description":"Injection, pemetrexed (sandoz), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27713","name":"Osteot tibia imed lngth dev","description":"Osteotomy(ies), tibia, including fibula when performed, unilateral, with insertion of an externally controlled intramedullary lengthening device, including imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1420","name":"Complete ophthalmologic mvp","description":"Complete ophthalmologic care mips value pathway","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5947","name":"Mand implt sup fix","description":"Mand implt sup fix","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2014","name":"Omeza collag compl 100 mg","description":"Omeza collagen matrix or omeza complete matrix, per 100 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6253","name":"Provisional pontic","description":"Provisional pontic","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9558","name":"Xe133 xenon 10mci","description":"Xenon xe-133 gas, diagnostic, per 10 millicuries","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75577","name":"Quan&char c athrosclrtc plaq","description":"Quantification and characterization of coronary atherosclerotic plaque to assess severity of coronary disease, derived from augmentative software analysis of the data set from a coronary computed tomographic angiography, with interpretation and report by a physician or other qualified health care pr","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4341","name":"Simplimax, per sq cm","description":"Simplimax, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0811T","name":"Rem mlt day uroflow setup","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); set-up and patient education on use of equipment","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29505","name":"Application long leg splint","description":"Application of long leg splint (thigh to ankle or toes)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54160","name":"Circumcision neonate","description":"Circumcision, surgical excision other than clamp, device, or dorsal slit; neonate (28 days of age or less)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"Adju cgm supply allowance","description":"Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8541","name":"Oral, hemady, 0.25 mg","description":"Dexamethasone (hemady), oral, 0.25 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0398U","name":"Gi baret esph dna mthyln aly","description":"Gi baret esph dna mthyln aly","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1328","name":"Pts dx acute vitreous hem","description":"Patients with a diagnosis of acute vitreous hemorrhage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01940","name":"Anes nulyt agt lmbr/sac","description":"Anesthesia for percutaneous image-guided destruction procedures by neurolytic agent on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9956","name":"Admin home sleep apnea test","description":"Admin home sleep apnea test","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82234","name":"Beta-amyloid 1-42 (abeta 42)","description":"Beta-amyloid; 1-42 (abeta 42)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37289","name":"Revsc evsc tpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2057","name":"Afamitresgene autoleucel","description":"Afamitresgene autoleucel, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2039","name":"Innovamatrix fd, per sq cm","description":"Innovamatrix fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2253","name":"Inj midazolam (seizalam)","description":"Injection, midazolam (seizalam), 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71045","name":"X-ray exam chest 1 view","description":"Radiologic examination, chest; single view","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0349","name":"Inj, rezafungin, 1 mg","description":"Injection, rezafungin, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1183","name":"Doc imm ckpt inhib hld","description":"Documentation of immune checkpoint inhibitor therapy held and corticosteroids or immunosuppressants prescribed or administered","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1491","name":"Recd esrd mcp dur perf pd","description":"Receiving esrd mcp dialysis services by the provider during the performance period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4393","name":"Surgraft ac per sq cm","description":"Surgraft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9998","name":"Doc med rsn <3 colon","description":"Documentation of medical reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., last colonoscopy incomplete, last colonoscopy had inadequate prep, piecemeal removal of adenomas, or sessile serrated polyps >= 20 mm in size, last colonoscopy found greater than 10 adenomas, lo","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7023","name":"Mech allergen parti barrier","description":"Mechanical allergen particle barrier/inhalation filter, cream, nasal, topical","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75945","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87523","name":"Hepatitis d quantification","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis d (delta), quantification, including reverse transcription, when performed","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85520","name":"Heparin assay","description":"Heparin assay","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85025","name":"Complete cbc w/auto diff wbc","description":"Blood count; complete (cbc), automated (hgb, hct, rbc, wbc and platelet count) and automated differential wbc count","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4371","name":"Neoguard per sq cm","description":"Neoguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90834","name":"Psytx w pt 45 minutes","description":"Psychotherapy, 45 minutes with patient","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":112.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37281","name":"Revsc evsc tpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44126","name":"Enterectomy w/o taper cong","description":"Enterectomy, resection of small intestine for congenital atresia, single resection and anastomosis of proximal segment of intestine; without tapering","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2416.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7049","name":"Epap nasal valve","description":"Expiratory positive airway pressure intranasal resistance valve","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84182","name":"Protein western blot test","description":"Protein; western blot, with interpretation and report, blood or other body fluid, immunological probe for band identification, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1475","name":"Pt dx huntington","description":"Patients with diagnosis of huntingtons disease","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0823T","name":"Tcat ins 1chmbr ldls pm ra","description":"Transcatheter insertion of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or programming), when","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1413","name":"Inj delandistrogene mox rokl","description":"Injection, delandistrogene moxeparvovec-rokl, per therapeutic dose","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0277U","name":"Hem gen pltlt funcj do 31","description":"Hematology (genetic platelet function disorder), genomic sequence analysis of 31 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0561U","name":"Onc mrd gsa cfdna subsequent","description":"Onc mrd gsa cfdna subsequent","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0474","name":"Micro w exam of surg margins","description":"Accession of tissue gross and microscopic examination including assessment of surgical margins for presence of disease preparation and transmission of writte","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0391","name":"Inj, artesunate, 1mg","description":"Injection, artesunate, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0784T","name":"Ins/rplmt eltrd ra spi nstim","description":"Insertion or replacement of percutaneous electrode array, spinal, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99459","name":"Pelvic examination","description":"Pelvic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5140","name":"Inj adalimumab-fkjp, 1 mg","description":"Injection, adalimumab-fkjp, biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1262","name":"Pts transplt bef dialysis","description":"Patients who had a transplant prior to initiation of dialysis","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0397","name":"Alcohol/subs interv >30 min","description":"Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and intervention, greater than 30 minutes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":71.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4015","name":"Neurology ss","description":"Neurology mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0652","name":"Inj, levothyroxine, hikma","description":"Injection, levothyroxine sodium (hikma), not therapeutically equivalent to j0650, 10 mcg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6593","name":"Grad com accessory gmt_wrap","description":"Accessory for gradient compression garment or wrap with adjustable straps, not-otherwise specified","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36465","name":"Njx noncmpnd sclrsnt 1 vein","description":"Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate, inclusive of all imaging guidance and monitoring; single incompetent extremity truncal vein (eg, great saphenous vein, accessory saphenous vein)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":1406.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01938","name":"Anes drg/aspir lmbr/sac","description":"Anesthesia for percutaneous image-guided injection, drainage or aspiration procedures on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0165","name":"Inj epinephrine nos 0.1 mg","description":"Injection, epinephrine, not otherwise specified, 0.1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93897","name":"Emboli detcj wo iv mbubb njx","description":"Emboli detection without intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1467","name":"Pt dx lynch syn","description":"Patients with an existing diagnosis of lynch syndrome","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69726","name":"Rmv ntr oi implt skl prq esp","description":"Removal, entire osseointegrated implant, skull; with percutaneous attachment to external speech processor","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88173","name":"Cytopath eval fna report","description":"Cytopathology, evaluation of fine needle aspirate; interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4377","name":"Trigraft ft per sq cm","description":"Trigraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0566U","name":"Onc lng qpcr-bsd alys 13dmrs","description":"Onc lng qpcr-bsd alys 13dmrs","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0304U","name":"Hem rbc ads whl bld normoxic","description":"Hem rbc ads whl bld normoxic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4288","name":"Dermabind ch, per sq cm","description":"Dermabind ch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4300","name":"Acesso tl, per sq cm","description":"Acesso tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0702","name":"2d cephal radio image","description":"2d cephal radio image","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9025","name":"Plasma cryo redu path each","description":"Plasma, cryoprecipitate reduced, pathogen reduced, each unit","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0940T","name":"Xtrnl ecg rec>15d<30d r&i","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9596","name":"Gallium illuccix 1 millicure","description":"Gallium ga-68 gozetotide, diagnostic, (illuccix), 1 millicurie","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0509","name":"Crit care telehea consult 50","description":"Telehealth consultation, critical care, subsequent, physicians typically spend 50 minutes communicating with the patient and providers via telehealth","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0277U","name":"Hem gen pltlt funcj do 31","description":"Hematology (genetic platelet function disorder), genomic sequence analysis of 31 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0179","name":"Md recertification hha pt","description":"Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initi","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0850T","name":"Dgtz gls mcrscp ish ea mult","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1421","name":"Dermatological care mvp","description":"Dermatological care mips value pathway","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"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":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0610U","name":"Nfct ds antmcr sc phenotypic","description":"Nfct ds antmcr sc phenotypic","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4352","name":"Overlay sl matrix, per sq cm","description":"Overlay sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0396","name":"3d print of 3d surface scan","description":"3d print of 3d surface scan","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1291","name":"Pt 66+ frailty and med dem","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0618U","name":"Psyc bd dna mthyl alys>10000","description":"Psyc bd dna mthyl alys>10000","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0471U","name":"Onc clrc ca 35 vrn kras&nras","description":"Onc clrc ca 35 vrn kras&nras","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51960","name":"Revision of bladder & bowel","description":"Enterocystoplasty, including intestinal anastomosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1496.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4348","name":"Sentry sl matrix per sq cm","description":"Sentry sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0827T","name":"Dgtz gls mcrscp cytp smears","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; smears with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4339","name":"Artacent vericlen, per sq cm","description":"Artacent vericlen, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5152","name":"Inj, eculizumab-aeeb, 2 mg","description":"Injection, eculizumab-aeeb (bkemv), biosimilar, 2 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5160","name":"Inj, jobevne, 10 mg","description":"Injection, bevacizumab-nwgd (jobevne), biosimilar, 10 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2561","name":"Inj, sezaby, 1 mg","description":"Injection, phenobarbital sodium (sezaby), 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43305","name":"Repair esophagus and fistula","description":"Esophagoplasty (plastic repair or reconstruction), cervical approach; with repair of tracheoesophageal fistula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1317.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33287","name":"Rmv&rplcmt phrnc nrv stim pg","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1361","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01939","name":"Anes nulyt agt crv/thrc","description":"Anesthesia for percutaneous image-guided destruction procedures by neurolytic agent on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2034","name":"Found drs solo, per sq cm","description":"Foundation drs solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1301","name":"Pt recv tbco cess interv","description":"Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4307","name":"American amnion, per sq cm","description":"American amnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77790","name":"Radiation handling","description":"Supervision, handling, loading of radiation source","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1182","name":"Not elg pre ex ibd/uc/crohn","description":"Patients not eligible due to pre-existing inflammatory bowel disease (ibd) (e.g., ulcerative colitis, crohns disease)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0372U","name":"Nfct ds gu pthgn arg detcj","description":"Nfct ds gu pthgn arg detcj","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0423U","name":"Psyc genomic alys pnl 26 gen","description":"Psyc genomic alys pnl 26 gen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0539","name":"Initial care training 30 m","description":"Caregiver training in behavior management/modification for caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face; initial 30 minutes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1259","name":"Pt stat doc <= 1 yr dialysis","description":"Patient status documented within the first year of initiating dialysis","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9616","name":"Gallium gozellix 1 millicuri","description":"Gallium ga-68 gozetotide (gozellix), diagnostic, 1 millicurie","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0681","name":"App of non-sheet skin sub","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; first 25 sq cm or less of wound surface area","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0474","name":"Micro w exam of surg margins","description":"Accession of tissue gross and microscopic examination including assessment of surgical margins for presence of disease preparation and transmission of writte","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0770","name":"Colistimethate sodium inj","description":"Injection, colistimethate sodium, up to 150 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0814T","name":"Prq njx biod osteo matrl fem","description":"Percutaneous injection of calcium-based biodegradable osteoconductive material, proximal femur, including imaging guidance, unilateral","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84591","name":"Assay of nos vitamin","description":"Vitamin, not otherwise specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82045","name":"Albumin ischemia modified","description":"Albumin; ischemia modified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5136","name":"Inj. denosumab-bbdz, 1 mg","description":"Injection, denosumab-bbdz (jubbonti/wyost), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"Evoked auditory test limited","description":"Distortion product evoked otoacoustic emissions; limited evaluation (to confirm the presence or absence of hearing disorder, 3-6 frequencies) or transient evoked otoacoustic emissions, with interpretation and report","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4259","name":"Celera per sq cm","description":"Celera dual layer or celera dual membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4302","name":"Complete aca, per sq cm","description":"Complete aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0373","name":"Tomo bitewing image","description":"Tomo bitewing image","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0877T","name":"Augmnt alys ch ct ild w/o ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31641","name":"Bronchoscopy treat blockage","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with destruction of tumor or relief of stenosis by any method other than excision (eg, laser therapy, cryotherapy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22860","name":"Tot disc arthrp 2ntrspc lmbr","description":"Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression); second interspace, lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1289","name":"No pt tbco cess interv rng","description":"Patient identified as tobacco user did not receive tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0336U","name":"Rare ds whl gen seq bld/slv","description":"Rare ds whl gen seq bld/slv","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1448","name":"Pt dx pd bef end meas pd","description":"Patients with an active diagnosis of personality disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97037","name":"Appl modality 1+lllt po pain","description":"Application of a modality to 1 or more areas; low-level laser therapy (ie, nonthermal and non-ablative) for post-operative pain reduction","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31086","name":"Removal of frontal sinus","description":"Sinusotomy frontal; nonobliterative, with osteoplastic flap, brow incision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1226.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0877","name":"Inj, daptomycin (hospira)","description":"Injection, daptomycin (hospira), not therapeutically equivalent to j0878, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0990T","name":"Trncrv inst biod hydrgl mtrl","description":"Transcervical instillation of biodegradable hydrogel materials, intrauterine","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1205","name":"Isa reduced >=3","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1463","name":"2 f/u wthn 180 day rx atmp","description":"Documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34705","name":"Evac rpr a-biiliac ndgft","description":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-bi-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1605.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1001T","name":"Autol musc cell therapy njx","description":"Autologous muscle cell therapy, injection of muscle progenitor cells into the external anal sphincter, including ultrasound guidance, when performed","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69620","name":"Myringoplasty","description":"Myringoplasty (surgery confined to drumhead and donor area)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":569.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2010","name":"Apis, per square centimeter","description":"Apis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1021T","name":"Active thrc irrigation spx","description":"Active thoracic irrigation (separate procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38564","name":"Removal abdomen lymph nodes","description":"Limited lymphadenectomy for staging (separate procedure); retroperitoneal (aortic and/or splenic)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":774.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0849T","name":"Dgtz gls mcrscp ish ea adl 1","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4271","name":"Home lancing/test cartridges","description":"Integrated lancing and blood sample testing cartridges for home blood glucose monitor, per 50 tests","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1501","name":"Pathology mvp","description":"Pathology mips value pathway","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0327U","name":"Ftl aneuploidy trsmy dna seq","description":"Ftl aneuploidy trsmy dna seq","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9286","name":"Inj glofitamab gxbm, 2.5 mg","description":"Injection, glofitamab-gxbm, 2.5 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4025","name":"Physical medicine ss","description":"Physical medicine mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0336U","name":"Rare ds whl gen seq bld/slv","description":"Rare ds whl gen seq bld/slv","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0537","name":"Risk ascvd tst once pr 12 mo","description":"Administration of a standardized, evidence-based atherosclerotic cardiovascular disease (ascvd) risk assessment, 5-15 minutes, not more often than every 12 months","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0162","name":"Inj epinephrine (fresenius)","description":"Injection, epinephrine (fresenius), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37273","name":"Revsc evsc fpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44202","name":"Lap enterectomy","description":"Laparoscopy, surgical; enterectomy, resection of small intestine, single resection and anastomosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1502.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0803","name":"3d facial scan direct","description":"3d facial scan direct","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4024","name":"Pediatrics ss","description":"Pediatrics mips specialty set","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85335","name":"Factor inhibitor test","description":"Factor inhibitor test","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1258","name":"Cvd risk assess perf","description":"Cvd risk assessment performed, have a documented calculated risk score","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0567U","name":"Rare ds whl gen seq srs&lrs","description":"Rare ds whl gen seq srs&lrs","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93585","name":"Vngrph chd azygs/hemiazygs","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; azygos/hemiazygos venous system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64597","name":"Ins/rplcm prq eltrd ra pn ea","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; each additional electrode array (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0426U","name":"Genome ultra-rapid seq alys","description":"Genome ultra-rapid seq alys","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20610","name":"Drain/inj joint/bursa w/o us","description":"Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, subacromial bursa); without ultrasound guidance","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":79.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6280","name":"Implt maint procd remv implt","description":"Implt maint procd remv implt","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1222","name":"Glaucoma pln of care not doc","description":"Glaucoma plan of care not documented, reason not otherwise specified","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1400","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67880","name":"Revision of eyelid","description":"Construction of intermarginal adhesions, median tarsorrhaphy, or canthorrhaphy;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1834","name":"Inj, isoniazid, 1 mg","description":"Injection, isoniazid, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99348","name":"Home/res vst est low mdm 30","description":"Home or residence visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":89.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4378","name":"Renew ft matrix per sq cm","description":"Renew ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86480","name":"Tb test cell immun measure","description":"Tuberculosis test, cell mediated immunity antigen response measurement; gamma interferon","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9278","name":"Inj, carboplatin (avyxa)","description":"Injection, carboplatin (avyxa), 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0923T","name":"Rmvl&rplcmt perm ccm-d pg","description":"Removal and replacement of permanent cardiac contractility modulation-defibrillation pulse generator only","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0464U","name":"Onc clrct scr qrtsa dna mrk","description":"Onc clrct scr qrtsa dna mrk","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7511","name":"Incision/drain abscess intra","description":"Incision and drainage of abscess - intraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62330","name":"Dcmprn prq rmv lig flv 1lmbr","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; one interspace, lumbar","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28226","name":"Release of foot tendons","description":"Tenolysis, extensor, foot; multiple tendons","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3247","name":"Inj secukinumab intrav 1mg","description":"Injection, secukinumab, intravenous, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9183","name":"Gemcitabine intravesical sys","description":"Gemcitabine intravesical system, 225 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77407","name":"Radiation tx delivery lvl 2","description":"Radiation treatment delivery; level 2, single-isocenter (eg, 3d or imrt), photons, including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1306","name":"Injection, inclisiran, 1 mg","description":"Injection, inclisiran, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0470U","name":"Onc orop detcj mrd 8 dna hpv","description":"Onc orop detcj mrd 8 dna hpv","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1256","name":"Prior history of known cvd","description":"Prior history of known cvd","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8006","name":"Grip glove replacement only","description":"Powered, cable driven grip assist glove, hand, finger, includes pressure sensors, glove replacement only","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2596","name":"Vasopressin (long grove) 1 u","description":"Injection, vasopressin (long grove), not therapeutically equivalent to j2598, 1 unit","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22319","name":"Treat odontoid fx w/graft","description":"Open treatment and/or reduction of odontoid fracture(s) and or dislocation(s) (including os odontoideum), anterior approach, including placement of internal fixation; with grafting","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2069.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1008T","name":"Rem mntr s-scl eeg sys setup","description":"Remote monitoring of sub-scalp implanted continuous bilateral electroencephalography monitoring system, device fitting, initial set-up, and patient education in wearing of system and use of equipment","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49596","name":"Rpr aa hrn 1st > 10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, incarcerated or strangulated","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4278","name":"Epieffect, per sq cm","description":"Epieffect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0936T","name":"Photobiomodulation ther rta","description":"Photobiomodulation therapy of retina, single session","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99219","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0165","name":"Inj epinephrine nos 0.1 mg","description":"Injection, epinephrine, not otherwise specified, 0.1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2031","name":"Mirodry, per sq cm","description":"Mirodry wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1643","name":"Inj heparin, pfizer, 1000u","description":"Injection, heparin sodium (pfizer), not therapeutically equivalent to j1644, per 1000 units","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1230","name":"Pt hcv rctv aby no f/u tst","description":"Patient has a reactive hcv antibody test and does not have a follow up hcv viral test, or patient has a reactive hcv antibody test and has a follow up hcv viral test that detects hcv viremia and is not referred to a clinician who treats hcv infection within 1 month and does not have hcv treatment in","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1274","name":"Pts snf exl mo","description":"Patients who were admitted to a skilled nursing facility (snf) during the month of evaluation were excluded from that month","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2040","name":"Microlyte painguard pr sq cm","description":"Microlyte painguard, per square centimeter","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1395","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0368","name":"Cone beam ct interprete tmj","description":"Cone beam ct interprete tmj","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2021","name":"Neomatrix per sq cm","description":"Neomatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9609","name":"F18 fdg, 15 millicuries","description":"Fludeoxyglucose f18 up to 15 millicuries","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0823T","name":"Tcat ins 1chmbr ldls pm ra","description":"Transcatheter insertion of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or programming), when","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1463","name":"2 f/u wthn 180 day rx atmp","description":"Documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0497U","name":"Onc prst8 mrna rt-pcr 6 gene","description":"Onc prst8 mrna rt-pcr 6 gene","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1242","name":"Pt no resp imprt to me","description":"Patient did not respond to the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7509","name":"Marsupialization odon cyst","description":"Marsupialization odon cyst","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70130","name":"X-ray exam of mastoids","description":"Radiologic examination, mastoids; complete, minimum of 3 views per side","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27428","name":"Reconstruction knee","description":"Ligamentous reconstruction (augmentation), knee; intra-articular (open)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1261.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54060","name":"Excision of penis lesion(s)","description":"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; surgical excision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1419","name":"Pt not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1353","name":"Pts no cmplt suicd saf pln","description":"Patients who did not have a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0630U","name":"Onc brst mrna gen prflg 80","description":"Onc brst mrna gen prflg 80","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37187","name":"Venous mech thrombectomy","description":"Percutaneous transluminal mechanical thrombectomy, vein(s), including intraprocedural pharmacological thrombolytic injections and fluoroscopic guidance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1347","name":"Pt pam incr 3 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 3 points in a 4 to 12 month period (passing)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96530","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0702","name":"2d cephal radio image","description":"2d cephal radio image","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0306U","name":"Onc mrd nxt-gnrj alys 1st","description":"Onc mrd nxt-gnrj alys 1st","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8530","name":"Cyclophosphamide oral 25 mg","description":"Cyclophosphamide; oral, 25 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0264U","name":"Rare ds id opt genome mapg","description":"Rare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4005","name":"Family medicine ss","description":"Family medicine mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0470U","name":"Onc orop detcj mrd 8 dna hpv","description":"Onc orop detcj mrd 8 dna hpv","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2022","name":"Innovabrn/innovamatx xl sqcm","description":"Innovaburn or innovamatrix xl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0446","name":"Intens behave ther cardio dx","description":"Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":29.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1319","name":"Pts csp doc contact","description":"Patients who had documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82274","name":"Assay test for blood fecal","description":"Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1319","name":"Pts csp doc contact","description":"Patients who had documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9072","name":"Inj cyclophos frindovyx 5 mg","description":"Injection, cyclophosphamide (frindovyx), 5 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90624","name":"Menb-4c&menacwy vacc im","description":"Meningococcal pentavalent vaccine, men b-4c recombinant proteins and outer membrane vesicle and conjugated men a, c, w, y-diphtheria toxoid carrier, for intramuscular use","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0349","name":"Inj, rezafungin, 1 mg","description":"Injection, rezafungin, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77436","name":"Surf radj ther tx planning","description":"Surface radiation therapy; superficial or orthovoltage, treatment planning and simulation-aided field setting","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0680T","name":"Insj/rplcmt pg only isdss","description":"Insertion or replacement of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing lead(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86037","name":"Anca titer each antibody","description":"Antineutrophil cytoplasmic antibody (anca); titer, each antibody","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99384","name":"Prev visit new age 12-17","description":"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; adolescent (age ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":156.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0235","name":"Intrav inf, mon anti, fir do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9988","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53453","name":"Tprnl balo cntnc dev rmvl ea","description":"Periurethral transperineal adjustable balloon continence device; removal, each balloon","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0743T","name":"B1 str & fx rsk vrt fx assmt","description":"Bone strength and fracture risk using finite element analysis of functional data and bone mineral density (bmd), with concurrent vertebral fracture assessment, utilizing data from a computed tomography scan, retrieval and transmission of the scan data, measurement of bone strength and bmd and classi","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27560","name":"Treat kneecap dislocation","description":"Closed treatment of patellar dislocation; without anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0662","name":"Team remote e/m new pt 30 mn","description":"Team remote e/m new pt 30 mins","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0757T","name":"Dgtz gls mcrscp sl spc grpii","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group ii, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistochemistry (list separately in addition to code for primary","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1388","name":"Pt doc exm rec melmn","description":"Patients with documentation of an exam performed for recurrence of melanoma","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78135","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83634","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2601","name":"Inj, vasopressin (baxter)","description":"Injection, vasopressin (baxter), 1 unit","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15175","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":529.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4015","name":"Neurology ss","description":"Neurology mips specialty set","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1321","name":"Pts no 7wk inj,no iop,iop>25","description":"Patients who were not seen within 7 weeks following the date of injection for follow up or who did not have a documented iop or no plan of care documented if the iop was >25 mm hg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6251","name":"Bridge resin base metal","description":"Pontic-resin with predominantly base metal","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86677","name":"Helicobacter pylori antibody","description":"Antibody; helicobacter pylori","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0699T","name":"Njx pst chmbr eye medication","description":"Injection, posterior chamber of eye, medication","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33904","name":"Perq p-art revsc each addl","description":"Percutaneous pulmonary artery revascularization by stent placement, each additional vessel or separate lesion, normal or abnormal connections (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91321","name":"Sarscov2 vac 25 mcg/.25ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 25 mcg/0.25 ml dosage, for intramuscular use","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37258","name":"Revsc evasc ivt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37261","name":"Revsc evasc ivt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7472","name":"Removal of torus palatinus","description":"Removal of torus palatinus","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1235","name":"Doc pt hcv aby rna tst","description":"Documentation or patient report of hcv antibody test or hcv rna test which occurred prior to the performance period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2394","name":"Post >=4srfc resinbase cmpst","description":"Resin-based composite - four or more surfaces posterior","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90471","name":"Immunization admin","description":"Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); 1 vaccine (single or combination vaccine/toxoid)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98979","name":"Rtm tx mgmt 1st 10 min","description":"Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least 1 real-time interactive communication with the patient or caregiver during the calendar month; first 10 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1494","name":"Fall rep since last visit","description":"Patients that reported a fall since the last visit","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0615U","name":"Bbrgdrferi ld antb detcj 26","description":"Bbrgdrferi ld antb detcj 26","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83521","name":"Ig light chains free each","description":"Immunoglobulin light chains (ie, kappa, lambda), free, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96041","name":"Genetic counseling svc ea 30","description":"Medical genetics and genetic counseling services, each 30 minutes of total time provided by the genetic counselor on the date of the encounter","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4377","name":"Trigraft ft per sq cm","description":"Trigraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1576","name":"Inj, panzyga, 500 mg","description":"Injection, immune globulin (panzyga), intravenous, non-lyophilized (e.g., liquid), 500 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1222","name":"Glaucoma pln of care not doc","description":"Glaucoma plan of care not documented, reason not otherwise specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9888","name":"5% wl maintnd from bsline wt","description":"Maintenance 5% wl from baseline weight in months 7-12","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0537U","name":"Onc clrct ca cfdna >2500 dmr","description":"Onc clrct ca cfdna >2500 dmr","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6038","name":"Multiax rotation attachment","description":"Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67005","name":"Partial removal of eye fluid","description":"Removal of vitreous, anterior approach (open sky technique or limbal incision); partial removal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":480.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4330","name":"Total, per sq cm","description":"Total, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86826","name":"Hla x-match noncytotoxc addl","description":"Human leukocyte antigen (hla) crossmatch, non-cytotoxic (eg, using flow cytometry); each additional serum sample or sample dilution (list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0873","name":"Inj daptomycin (xellia)","description":"Injection, daptomycin (xellia), not therapeutically equivalent to j0878 or j0872, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7261","name":"Primary closure sinus perf","description":"Primary closure of a sinus perforation","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4367","name":"Amniocore sl, per sq cm","description":"Amniocore sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0747T","name":"Car ablt rad arrhyt dlvr rad","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; delivery of radiation therapy, arrhythmia","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49617","name":"Rpr aa hrn rcr > 10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, reducible","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1073","name":"Testosterone pellet 75 mg","description":"Testosterone pellet, implant, 75 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9073","name":"Inj cyclophos dr reddys 5 mg","description":"Injection, cyclophosphamide (dr. reddys), 5 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4287","name":"Dermabind dl, per sq cm","description":"Dermabind dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0458","name":"Aztreonam/avibactam 10 mg","description":"Injection, aztreonam/avibactam, 7.5 mg/2.5 mg (10 mg)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27506","name":"Treatment of thigh fracture","description":"Open treatment of femoral shaft fracture, with or without external fixation, with insertion of intramedullary implant, with or without cerclage and/or locking screws","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1512.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0478U","name":"Onc nsclc dna&rna dpcr 9 gen","description":"Onc nsclc dna&rna dpcr 9 gen","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58555","name":"Hysteroscopy dx sep proc","description":"Hysteroscopy, diagnostic (separate procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":152.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5878","name":"Dup of complt dent-mandib","description":"Dup of complt dent-mandib","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28192","name":"Removal of foot foreign body","description":"Removal of foreign body, foot; deep","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87540","name":"Legion pneumo dna dir prob","description":"Infectious agent detection by nucleic acid (dna or rna); legionella pneumophila, direct probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19298","name":"Place breast rad tube/caths","description":"Placement of radiotherapy after loading brachytherapy catheters (multiple tube and button type) into the breast for interstitial radioelement application following (at the time of or subsequent to) partial mastectomy, includes imaging guidance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0589","name":"Inj daxibotulinumtoxina-lanm","description":"Injection, daxibotulinumtoxina-lanm, 1 unit","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21465","name":"Optx mndblr cndylr fx","description":"Open treatment of mandibular condylar fracture","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1049.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78607","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0481U","name":"Idh1 idh2&tert promoter ngs","description":"Idh1 idh2&tert promoter ngs","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31660","name":"Bronch thermoplsty 1 lobe","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial thermoplasty, 1 lobe","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4309","name":"Via matrix, per sq cm","description":"Via matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4415","name":"Alexiguard st-l per sq cm","description":"Alexiguard sl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53661","name":"Dilation of urethra","description":"Dilation of female urethra including suppository and/or instillation; subsequent","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4318","name":"Fem urinary cup w/wo attch","description":"Female external urinary collection cup, with or without ring attachment, per day","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61601","name":"Resect/excise cranial lesion","description":"Resection or excision of neoplastic, vascular or infectious lesion of base of anterior cranial fossa; intradural, including dural repair, with or without graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2530.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33900","name":"Perq p-art revsc 1 nm nt uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, unilateral","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0410U","name":"Onc pncrtc dna whl gn seq 5-","description":"Onc pncrtc dna whl gn seq 5-","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1008T","name":"Rem mntr s-scl eeg sys setup","description":"Remote monitoring of sub-scalp implanted continuous bilateral electroencephalography monitoring system, device fitting, initial set-up, and patient education in wearing of system and use of equipment","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1386","name":"Exc sx melmn or mlnm is","description":"Patients with an excisional surgery for melanoma or melanoma in situ in the past 5 years with an initial ajcc staging of 0, i, or ii at the start of the performance period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1305","name":"Pneum vax admin 19+","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65435","name":"Curette/treat cornea","description":"Removal of corneal epithelium; with or without chemocauterization (abrasion, curettage)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81003","name":"Urinalysis auto w/o scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; automated, without microscopy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21159","name":"Rcnst mdfc lfrtiii advm wo i","description":"Reconstruction midface, lefort iii (extra and intracranial) with forehead advancement (eg, mono bloc), requiring bone grafts (includes obtaining autografts); without lefort i","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3645.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0812T","name":"Rem mlt day uroflow dev sply","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); device supply with automated report generation, up to 10 days","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6519","name":"Grad com garm noc night use","description":"Gradient compression garment, not otherwise specified, for nighttime use, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5948","name":"Max implt sup fix part","description":"Max implt sup fix part","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1321","name":"Couns for high risk sub use","description":"Couns for high risk sub use","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2402","name":"Chloroprocaine (clorotekal)","description":"Injection, chloroprocaine hydrochloride (clorotekal), per 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0560U","name":"Onc mrd gsa cfdna baseline","description":"Onc mrd gsa cfdna baseline","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0904T","name":"Ecg alg 12 ld rdcd trcg only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; tracing only","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69730","name":"Rplc oi implt sk tc esp>=100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0738","name":"Upper extremity rehab","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15297.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1175","name":"Doc med rsn no hzv","description":"Documentation of medical reason(s) for not administering zoster vaccine (e.g., prior anaphylaxis due to the zoster vaccine)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9350","name":"Inj mosunetuzumab-axgb, 1 mg","description":"Injection, mosunetuzumab-axgb, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2042","name":"Foundation drs+ solo, sq cm","description":"Foundation drs+ solo, per square centimeter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0142A","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87468","name":"Anaplsma phgcytophlm amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); anaplasma phagocytophilum, amplified probe technique","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2508","name":"Pegunigalsidase alfa-iwxj","description":"Injection, pegunigalsidase alfa-iwxj, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0892T","name":"Arhfcmrigtbs sbsq per tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent motor threshold redetermination with delivery and management, per treatment day","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69210","name":"Remove impacted ear wax uni","description":"Removal impacted cerumen requiring instrumentation, unilateral","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1023T","name":"Prq tis dsplmt intrathoracic","description":"Percutaneous tissue displacement, any method, including imaging guidance; intrathoracic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59025","name":"Fetal non-stress test","description":"Fetal non-stress test","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59618","name":"Attempted vbac delivery","description":"Routine obstetric care including antepartum care, cesarean delivery, and postpartum care, following attempted vaginal delivery after previous cesarean delivery","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2907.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0269U","name":"Hem aut dm cgen trmbctpna 14","description":"Hematology (autosomal dominant congenital thrombocytopenia), genomic sequence analysis of 14 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90635","name":"H5n1 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n1, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99306","name":"1st nf care high mdm 50","description":"Initial nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 50 minutes must be met or exceed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":173.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0482","name":"Direct immunofluorescence","description":"Direct immunofluorescence","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0365","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1456","name":"Inj, fosaprepitant (teva)","description":"Injection, fosaprepitant (teva), not therapeutically equivalent to j1453, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1378","name":"Med rsn no 10 yr fu colscope","description":"Documentation of medical reason(s) for not recommending a 10 year follow-up interval (e.g., inadequate prep, familial or personal history of colonic polyps, patient had no adenoma and age is >= 66 years old, or life expectancy < 10 years, other medical reasons)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1307","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99391","name":"Per pm reeval est pat infant","description":"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; infan","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":64.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0238","name":"Intrav inf, toci, second dos","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9887","name":"Distance learning attendance","description":"Behavioral counseling for diabetes prevention, distance learning, 60 minutes","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1004T","name":"Elec alys s-scl eeg wo prgrm","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; without programming","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85245","name":"Clot factor viii vw ristoctn","description":"Clotting; factor viii, vw factor, ristocetin cofactor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99311","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49189","name":"Opn exc/dst ntra-abd 20.1-30","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 20.1 to 30 cm","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4400","name":"Polygon3 per sq cm","description":"Polygon3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1452","name":"Pt dx dementia ever","description":"Patient ever had a diagnosis of dementia","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1258","name":"Cvd risk assess perf","description":"Cvd risk assessment performed, have a documented calculated risk score","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6092","name":"Recement supp crown","description":"Recement implant/abutment supported crown","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37276","name":"Rvsc evsc fpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2023","name":"Innovamatrix pd, 1 mg","description":"Innovamatrix pd, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0545","name":"Inherent visit to inpt","description":"Visit complexity inherent to hospital inpatient or observation care associated with a confirmed or suspected infectious disease by an infectious diseases specialist, including disease transmission risk assessment and mitigation, public health investigation, analysis, and testing, and complex antimic","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0031","name":"Pall serv during meas","description":"Palliative care services given to patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57421","name":"Exam/biopsy of vag w/scope","description":"Colposcopy of the entire vagina, with cervix if present; with biopsy(s) of vagina/cervix","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":117.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74022","name":"Radex compl aqt abd series","description":"Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4285","name":"Nudyn dl or dl mesh pr sq cm","description":"Nudyn dl or nudyn dl mesh, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81523","name":"Onc brst mrna 70 cnt 31 gene","description":"Oncology (breast), mrna, next-generation sequencing gene expression profiling of 70 content genes and 31 housekeeping genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as index related to risk to distant metastasis","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49623","name":"Rmvl ninfct mesh hernia rpr","description":"Removal of total or near total non-infected mesh or other prosthesis at the time of initial or recurrent anterior abdominal hernia repair or parastomal hernia repair, any approach (ie, open, laparoscopic, robotic) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0463U","name":"Onc crvx mrna genxprsn 14bmk","description":"Onc crvx mrna genxprsn 14bmk","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0929T","name":"Rem interrog dev ccm-d tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1210","name":">=2 same meds tbl4 not ord","description":"At least two orders for high-risk medications from the same drug class, (table 4), not ordered","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0943T","name":"Cysto flx rmvl urtl scaffold","description":"Cystourethroscopy, flexible; with removal of prostatic urethral scaffold","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0010","name":"Eom meos payment","description":"Enhancing oncology model (eom) monthly enhanced oncology services (meos) payment for eom enhanced services","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4305","name":"Amer am ac tri-lay per sq cm","description":"American amnion ac tri-layer, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61320","name":"Crnec/crnot drg icr abs sttl","description":"Craniectomy or craniotomy, drainage of intracranial abscess; supratentorial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2157.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0613","name":"Calcium glucon (wg critical)","description":"Injection, calcium gluconate (wg critical care), not therapeutically equivalent to j0612, 10 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0576U","name":"Trnsplj med lar quan ddcfdna","description":"Trnsplj med lar quan ddcfdna","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46750","name":"Repair of anal sphincter","description":"Sphincteroplasty, anal, for incontinence or prolapse; adult","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":726.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0590U","name":"Nfct ds bct&fngl dna 44 orgs","description":"Nfct ds bct&fngl dna 44 orgs","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7111","name":"Extraction coronal remnants","description":"Extraction coronal remnants - deciduous tooth","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0519","name":"New pt-cg dyad dem low cmplx","description":"Management of new patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0351U","name":"Nfct ds bct/viral trail ip10","description":"Nfct ds bct/viral trail ip10","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95911","name":"Nrv cndj test 9-10 studies","description":"Nerve conduction studies; 9-10 studies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0304U","name":"Hem rbc ads whl bld normoxic","description":"Hem rbc ads whl bld normoxic","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1438","name":"Lst knwn well <=210 min","description":"Time last known well to hospital arrival less than or equal to 3.5 hours (<= 210 minutes)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9957","name":"Screening sleep disorders","description":"Screening sleep disorders","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4252","name":"Vendaje, per square centimet","description":"Vendaje, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1713","name":"Pfizer vacc adm ped 1st dose","description":"Pfizer vacc adm ped 1st dose","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9612","name":"Thera par drugs 2 or > admin","description":"Therapeutic parenteral drugs two or more administrations different medications","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0871T","name":"Rplcmt subq prtl ascites pmp","description":"Replacement of a subcutaneous peritoneal ascites pump, including reconnection between pump and indwelling bladder and peritoneal catheters, including initial programming and imaging, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9601","name":"Flortaucipir inj 1 millicuri","description":"Flortaucipir f 18 injection, diagnostic, 1 millicurie","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0249","name":"Adm tocilizu covid-19 1st","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4350","name":"Palisade dm matrix per sq cm","description":"Palisade dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1171","name":"Inj, hydromorphone, 0.1 mg","description":"Injection, hydromorphone, 0.1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1412","name":"Inj roctavian ml 2x10^13vc g","description":"Injection, valoctocogene roxaparvovec-rvox, per ml, containing nominal 2 x 10^13 vector genomes","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0729T","name":"Dx alys vstblr implt uni sbq","description":"Diagnostic analysis of vestibular implant, unilateral; with subsequent programming","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0737","name":"Inj, clindamycin (baxter)","description":"Injection, clindamycin phosphate (baxter), not therapeutically equivalent to j0736, 300 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0625U","name":"Endocrinol op dna alys>5000","description":"Endocrinol op dna alys>5000","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4427","name":"Dermbnd dln dl+ dlx sq cm","description":"Dermabind dl n or dermabind dl + or dermabind dl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38227","name":"Car-t receipt&prepj admn","description":"Chimeric antigen receptor t-cell (car-t) therapy; receipt and preparation of car-t cells for administration","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0621U","name":"Nfct ds lb dna alys>10000","description":"Nfct ds lb dna alys>10000","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4304","name":"Grafix plus, per sq cm","description":"Grafix plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1173","name":"Pt no rec td/tdap 9yrs prior","description":"Patient did not receive at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50815","name":"Urine shunt to intestine","description":"Ureterocolon conduit, including intestine anastomosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1312.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1167","name":"Hspc dur meas pd","description":"In hospice or using hospice services during the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0019","name":"Comm hlth intg svs sdoh 60mn","description":"Community health integration services performed by certified or trained auxiliary personnel, including a community health worker, under the direction of a physician or other practitioner; 60 minutes per calendar month, in the following activities to address social determinants of health (sdoh) need(","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89055","name":"Leukocyte assessment fecal","description":"Leukocyte assessment, fecal, qualitative or semiquantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0449U","name":"Car scr sev inh cond 5 genes","description":"Car scr sev inh cond 5 genes","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0739","name":"Rehab sys active assist rt","description":"Rehabilitation system with interactive interface providing active assistance in rehabilitation therapy, includes all components and accessories, motors, microprocessors, sensors","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0277U","name":"Hem gen pltlt funcj do 31","description":"Hematology (genetic platelet function disorder), genomic sequence analysis of 31 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2002","name":"Inj, lidocaine in d5w, 1 mg","description":"Injection, lidocaine hcl in 5% dextrose, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0024","name":"Pin srv add 30 min pr m","description":"Principal illness navigation services, additional 30 minutes per calendar month (list separately in addition to g0023)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1254","name":"Pts deceased prior hu surv","description":"Patients who were deceased when the hu survey reached them","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9026","name":"Inj, tarlatamab-dlle, 1 mg","description":"Injection, tarlatamab-dlle, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1021T","name":"Active thrc irrigation spx","description":"Active thoracic irrigation (separate procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58350","name":"Reopen fallopian tube","description":"Chromotubation of oviduct, including materials","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1294","name":"Bp scrn perf rec interval","description":"Normal blood pressure reading documented, follow-up not required","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1432","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1485","name":"Neg viro resp hep c/qual rna","description":"Patients who did not achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9361","name":"Inj, efbemalenograstim alfa-","description":"Injection, efbemalenograstim alfa-vuxw, 0.5 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0976T","name":"Slctv nzmtc dbrdmt s/n/hf ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; each additional 100 sq cm (list separately in addition to code for p","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0312U","name":"Ai ds sle alys 8 igg autoant","description":"Ai ds sle alys 8 igg autoant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6094","name":"Abut support crown titanium","description":"Abutment supported crown - (titanium)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42280","name":"Preparation palate mold","description":"Maxillary impression for palatal prosthesis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43300","name":"Repair of esophagus","description":"Esophagoplasty (plastic repair or reconstruction), cervical approach; without repair of tracheoesophageal fistula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":744.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4322","name":"Splint intra-coronal","description":"Splint intra-coronal","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1245","name":"Pt othr thn true person","description":"Patient provided a response other than completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0979T","name":"Sbmcsl crylys ther sft palt","description":"Submucosal cryolysis therapy; soft palate only","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93014","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83516","name":"Immunoassay nonantibody","description":"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, multiple step method","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7298","name":"Remove screw retained plate","description":"Remove screw retained plate","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64658","name":"Rmvl bat modul sys lead only","description":"Removal of baroreflex activation therapy (bat) modulation system; lead only","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1382","name":"Enc dur perf pd pos 11","description":"Patient encounter during the performance period with place of service code 11","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0863T","name":"Rlcj pg wcs lv trnsmtr only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; transmitter component only","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0236","name":"Intrav inf, mon anti, sec do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11450","name":"Exc skn hdrdnt ax smpl/ntrm","description":"Excision of skin and subcutaneous tissue for hidradenitis, axillary; with simple or intermediate repair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9255","name":"Inj, methotrexate (accord)","description":"Injection, methotrexate (accord), not therapeutically equivalent to j9260, 50 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0521","name":"Supply fee hiv prep fda appr","description":"Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1407","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0626U","name":"Neurol pd dna alys >20000","description":"Neurol pd dna alys >20000","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q0224","name":"Inj, pemivibart, 4500 mg","description":"Injection, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, and who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppressive ","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6516","name":"Grad com wrap w strap foo cu","description":"Gradient compression wrap with adjustable straps, foot, each, custom","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0714T","name":"Tpla b9 prst8 hyprplsa<50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume less than 50 ml","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69716","name":"Impl oi implt sk tc esp<100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or resulting in removal of less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":317.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1356","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84135","name":"Assay of pregnanediol","description":"Pregnanediol","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0051","name":"Traditional healing service","description":"Traditional healing service","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0801","name":"Inj. acthar gel to 40 units","description":"Injection, corticotropin (acthar gel), up to 40 units","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4022","name":"Otolaryngology ss","description":"Otolaryngology mips specialty set","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9156","name":"Oral mucoadhesive per 1 ml","description":"Oral mucoadhesive, any type (liquid, gel, paste, etc.), per 1 ml","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83876","name":"Assay myeloperoxidase","description":"Myeloperoxidase (mpo)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9573","name":"Inj, gadopiclenol, 1 ml","description":"Injection, gadopiclenol, 1 ml","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45130","name":"Excision of rectal prolapse","description":"Excision of rectal procidentia, with anastomosis; perineal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1103.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0349","name":"Inj, rezafungin, 1 mg","description":"Injection, rezafungin, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0488U","name":"Ob fetal ag nipt cfdna alys","description":"Ob fetal ag nipt cfdna alys","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0584U","name":"Neuro csf prion prtn qual","description":"Neuro csf prion prtn qual","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90482","name":"Imm cnsl not admn sm 3<10","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; 3 minutes up to 10 minutes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0650","name":"Inj, levothyroxine nos 10mcg","description":"Injection, levothyroxine sodium, not otherwise specified, 10 mcg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3421","name":"Root surgery bicuspid","description":"Apicoectomy/periradicular surgery-bicuspid (first root)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87320","name":"Chlmyd trach ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; chlamydia trachomatis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98986","name":"Rtm dev sply cbt 2-15 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of cognitive behavioral therapy, 2-15 days in a 30-day period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6603","name":"Cst hgh nble mtl inlay >=3sr","description":"Inlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1439","name":"Sig ocu cond imp surg out","description":"Significant ocular conditions that impact the visual outcome of surgery","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4302","name":"Complete aca, per sq cm","description":"Complete aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33267","name":"Excl laa open any method","description":"Exclusion of left atrial appendage, open, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58661","name":"Laparoscopy remove adnexa","description":"Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":778.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87385","name":"Histoplasma capsul ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; histoplasma capsulatum","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5151","name":"Inj, eculizumab-aagh, 2 mg","description":"Injection, eculizumab-aagh (epysqli), biosimilar, 2 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4274","name":"Esano ac, per sq cm","description":"Esano ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0963T","name":"Anosc sbmcsl njx bulking agt","description":"Anoscopy with directed submucosal injection of bulking agent into anal canal","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0138","name":"Iv cipaglucosidase alfa-atga","description":"Intravenous infusion of cipaglucosidase alfa-atga, including provider/supplier acquisition and clinical supervision of oral administration of miglustat in preparation of receipt of cipaglucosidase alfa-atga","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74021","name":"Radex abdomen 3+ views","description":"Radiologic examination, abdomen; 3 or more views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1365","name":"Hosp+pall care spec code 17","description":"Patient encounter during the performance period with hospice and palliative care specialty code 17","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5149","name":"Inj, aflibercept-abzv, 1 mg","description":"Injection, aflibercept-abzv (enzeevu), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91320","name":"Sarscv2 vac 30mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 30 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9595","name":"Piflu f-18, dia 1 millicurie","description":"Piflufolastat f-18, diagnostic, 1 millicurie","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0818T","name":"Revj/rmvl ins ptn subq","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4386","name":"Acesso trifaca per sq cm","description":"Acesso trifaca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0460U","name":"Onc whl bld/bucc rtpcr 24gen","description":"Onc whl bld/bucc rtpcr 24gen","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0802","name":"3d dental scan indirect","description":"3d dental scan indirect","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43850","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1677.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92637","name":"Hearing aid pst-fitg f-up ea","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4285","name":"Nudyn dl or dl mesh pr sq cm","description":"Nudyn dl or nudyn dl mesh, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1311","name":"Aphlx to vax bef enc","description":"Anaphylaxis due to the vaccine on or before the date of the encounter","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0725T","name":"Vestibular dev impltj uni","description":"Vestibular device implantation, unilateral","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4413","name":"Cygnus solo per sq cm","description":"Cygnus solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1327","name":"Pts no eval ini xm no 8 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 8 weeks","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7415","name":"Excision malig les complicat","description":"Excision of malignant lesion complicated","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4004","name":"Endocrinology ss","description":"Endocrinology mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28002","name":"Treatment of foot infection","description":"Incision and drainage below fascia, with or without tendon sheath involvement, foot; single bursal space","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":408.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0502U","name":"Hpv e6/e7 mrk hi-rsk typ crv","description":"Hpv e6/e7 mrk hi-rsk typ crv","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78608","name":"Brain imaging (pet)","description":"Brain imaging, positron emission tomography (pet); metabolic evaluation","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0457","name":"Injection, aztreonam, 100 mg","description":"Injection, aztreonam, 100 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0922T","name":"Rmvl perm ccm-d sys dual ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); dual (pacing and defibrillation) transvenous leads only","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58545","name":"Laparoscopic myomectomy","description":"Laparoscopy, surgical, myomectomy, excision; 1 to 4 intramural myomas with total weight of 250 g or less and/or removal of surface myomas","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1049.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7601","name":"Ensifentrine inh 3 mg","description":"Ensifentrine, inhalation suspension, fda approved final product, non-compounded, administered through dme, unit dose form, 3 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1204","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0155","name":"Dronabinol (syndros) 0.1 mg","description":"Dronabinol (syndros), 0.1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1398","name":"Bslne and  fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1425","name":"Surgical care mvp","description":"Surgical care mips value pathway","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1017T","name":"Elec aly npgs esoph sbsq w/o","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31571","name":"Laryngoscop w/vc inj + scope","description":"Laryngoscopy, direct, with injection into vocal cord(s), therapeutic; with operating microscope or telescope","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33786","name":"Repair arterial trunk","description":"Total repair, truncus arteriosus (rastelli type operation)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2748.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0584U","name":"Neuro csf prion prtn qual","description":"Neuro csf prion prtn qual","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0676T","name":"Laps insj nw/rpcmt isdss ea","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional lead (list separately in addition to code for primary ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19200","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1131.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59430","name":"Care after delivery","description":"Postpartum care only (separate procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":284.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7957","name":"Tiss regen edent nonresorb","description":"Tiss regen edent nonresorb","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27098","name":"Transfer tendon to pelvis","description":"Transfer, adductor to ischium","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":755.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0783T","name":"Tc auriculr neurostimulation","description":"Transcutaneous auricular neurostimulation, set-up, calibration, and patient education on use of equipment","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23540","name":"Cltx acromclav dislc wo mnpj","description":"Closed treatment of acromioclavicular dislocation; without manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9073","name":"Inj cyclophos dr reddys 5 mg","description":"Injection, cyclophosphamide (dr. reddys), 5 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0556U","name":"Nfct ds p-s dna&rna 12 trgts","description":"Nfct ds p-s dna&rna 12 trgts","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54322","name":"Reconstruction of urethra","description":"1-stage distal hypospadias repair (with or without chordee or circumcision); with simple meatal advancement (eg, magpi, v-flap)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":893.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32201","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0484","name":"Consult slides prep elsewher","description":"Consultation on slides prepared elsewhere","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0414","name":"Lab process microbial spec","description":"Lab process microbial spec","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81523","name":"Onc brst mrna 70 cnt 31 gene","description":"Oncology (breast), mrna, next-generation sequencing gene expression profiling of 70 content genes and 31 housekeeping genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as index related to risk to distant metastasis","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77438","name":"Surf rad thr orthvlt>150-500","description":"Surface radiation therapy; orthovoltage, delivery, >150-500 kv, per fraction","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0516U","name":"Rx metab rxgenomic gnotyp 40","description":"Rx metab rxgenomic gnotyp 40","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0805T","name":"Tcat s&ivc prstc vl impl prq","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); percutaneous femoral vein approach","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6111","name":"Implnt/abut remov dent mand","description":"Implnt/abut remov dent mand","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92623","name":"Dx aly aud oi snd prcsr each","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; each additional 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48005","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2853.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76076","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0598U","name":"Gi ibs igg antb 18food items","description":"Gi ibs igg antb 18food items","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0683T","name":"Prgrmg dev eval isdss ip","description":"Programming device evaluation (in-person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional, permanent implantable synchroni","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1396","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8612","name":"Oral methotrexate (xatmep)","description":"Methotrexate (xatmep), oral, 2.5 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3392","name":"Inj, exagamglogene autotem","description":"Injection, exagamglogene autotemcel, per treatment","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0531U","name":"Nfct ds afb&inv fng 673orgs","description":"Nfct ds afb&inv fng 673orgs","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84145","name":"Procalcitonin (pct)","description":"Procalcitonin (pct)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1256","name":"Prior history of known cvd","description":"Prior history of known cvd","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1367","name":"Qual care ent disorder mvp","description":"Quality care for the treatment of ear, nose, and throat disorders mips value pathway","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92629","name":"Eval hearing aid cand ea add","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1204","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0302U","name":"Iadna brtnla ddpcr flwg liq","description":"Iadna brtnla ddpcr flwg liq","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2004","name":"Inj, lidocaine w epinephrine","description":"Injection, lidocaine hcl with epinephrine, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9993","name":"Pall serv during meas","description":"Patient was provided palliative care services any time during the measurement period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1268","name":"Pt ac stat kid trnsplt wtlst","description":"Patients observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2039","name":"Innovamatrix fd, per sq cm","description":"Innovamatrix fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1346","name":"No pam inc 6 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 6 points within a 4 to 12 month period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0893T","name":"N-invas assmt bld oxygnation","description":"Noninvasive assessment of blood oxygenation, gas exchange efficiency, and cardiorespiratory status, with physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0803","name":"3d facial scan direct","description":"3d facial scan direct","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP11","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1440","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1441","name":"Init dx slp apn = 1st enc","description":"Encounter corresponds to initial diagnosis of sleep apnea or first contact with sleep apnea diagnosed patient","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0472U","name":"Ca vi psp&sp1 antb sjogren","description":"Ca vi psp&sp1 antb sjogren","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1183","name":"Doc imm ckpt inhib hld","description":"Documentation of immune checkpoint inhibitor therapy held and corticosteroids or immunosuppressants prescribed or administered","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1301","name":"Pt recv tbco cess interv","description":"Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44401","name":"Colonoscopy with ablation","description":"Colonoscopy through stoma; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre-and post-dilation and guide wire passage, when performed)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":2821.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31243","name":"Nsl/sinus ndsc cryoabltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by cryoablation, posterior nasal nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1309","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24126","name":"Exc/crtg b1 cst/tum rds algr","description":"Excision or curettage of bone cyst or benign tumor of head or neck of radius or olecranon process; with allograft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":748.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1372","name":"Mst rec gsa >=7 and<8","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 7.0% and < 8.0%","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1837","name":"Inj, posaconazole, 1 mg","description":"Injection, posaconazole, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34707","name":"Evasc rpr ilio-iliac ndgft","description":"Endovascular repair of iliac artery by deployment of an ilio-iliac tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, and all endograft extension(s) proximally to the aortic bifurcation ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1279.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0334U","name":"Onc sld orgn tgsa dna 84/+","description":"Onc sld orgn tgsa dna 84/+","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0947T","name":"Mrgfus strtctc bl-br disrpj","description":"Magnetic resonance image guided low intensity focused ultrasound (mrgfus), stereotactic blood-brain barrier disruption using microbubble resonators to increase the concentration of blood-based biomarkers of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1403","name":"Bslne and fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4335","name":"Amnioplast 2, per sq cm","description":"Amnioplast 2, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25448","name":"Arthrp ntrcrpl/crp/mtcrp ssp","description":"Arthroplasty, intercarpal or carpometacarpal joints; suspension, including transfer or transplant of tendon, with interposition, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3222","name":"Part pulp for apexogenesis","description":"Partial pulpotomy for apexogenesis - permanent tooth with incomplete root development","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0667","name":"Team remote e/m est pt 25 mn","description":"Team remote e/m est. pt 25mins","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0981T","name":"Tcat impl wrls ivc snr","description":"Transcatheter implantation of wireless inferior vena cava sensor for long-term hemodynamic monitoring, including deployment of the sensor, radiological supervision and interpretation, right heart catheterization, and inferior vena cava venography, when performed","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0555U","name":"Repr med pga embryonic te qc","description":"Repr med pga embryonic te qc","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0958T","name":"Rmv s-sclp eltr ra rcvr&tlmt","description":"Removal of sub-scalp implanted electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1169","name":"Doc med rsn no flu vax","description":"Documentation of medical reason(s) for not administering influenza vaccine (e.g., prior anaphylaxis due to the influenza vaccine)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37660","name":"Ligation common iliac vein","description":"Ligation of common iliac vein","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1443.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4251","name":"Vim, per square centimeter","description":"Vim, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0705T","name":"Rem tx amblyopia tech sprt","description":"Remote treatment of amblyopia using an eye tracking device; surveillance center technical support including data transmission with analysis, with a minimum of 18 training hours, each 30 days","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0922T","name":"Rmvl perm ccm-d sys dual ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); dual (pacing and defibrillation) transvenous leads only","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0034","name":"Pall serv during meas","description":"Patients receiving palliative care during the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81025","name":"Urine pregnancy test","description":"Urine pregnancy test, by visual color comparison methods","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1455","name":"Rep/rev cied","description":"Replaced or revised cied","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0771T","name":"Vr px dissoc svc sm phy 1st","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33288","name":"Rmv&rplcmt phrnc nrv stim ld","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0748T","name":"Njx stm cl prdct anl sft tis","description":"Injections of stem cell product into perianal perifistular soft tissue, including fistula preparation (eg, removal of setons, fistula curettage, closure of internal openings)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4313","name":"Dermabind fm, per sq cm","description":"Dermabind fm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1304","name":"No pneum vax admin 19+","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0578","name":"Inj brixadi, more than 7 day","description":"Injection, buprenorphine extended release (brixadi), greater than 7 days and up to 28 days of therapy","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0458","name":"Aztreonam/avibactam 10 mg","description":"Injection, aztreonam/avibactam, 7.5 mg/2.5 mg (10 mg)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4400","name":"Polygon3 per sq cm","description":"Polygon3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0474U","name":"Hered pan ca gsap 88gene ngs","description":"Hered pan ca gsap 88gene ngs","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5932","name":"Postsurgical obturator","description":"Obturator prosthesis definitive","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0019","name":"Comm hlth intg svs sdoh 60mn","description":"Community health integration services performed by certified or trained auxiliary personnel, including a community health worker, under the direction of a physician or other practitioner; 60 minutes per calendar month, in the following activities to address social determinants of health (sdoh) need(","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61595","name":"Transtemporal approach/skull","description":"Transtemporal approach to posterior cranial fossa, jugular foramen or midline skull base, including mastoidectomy, decompression of sigmoid sinus and/or facial nerve, with or without mobilization","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2519.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86580","name":"Tb intradermal test","description":"Skin test; tuberculosis, intradermal","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9225","name":"Gen anes adv air-sub 15 min","description":"Gen anes adv air-sub 15 min","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0039","name":"Pt no ref, rn spec","description":"Patient not referred, reason not otherwise specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33280","name":"Rmvl phrnc nrv stim pg only","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator only","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82947","name":"Assay glucose blood quant","description":"Glucose; quantitative, blood (except reagent strip)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59025","name":"Fetal non-stress test","description":"Fetal non-stress test","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15778","name":"Impl absrb msh/prsth dly cls","description":"Implantation of absorbable mesh or other prosthesis for delayed closure of defect(s) (ie, external genitalia, perineum, abdominal wall) due to soft tissue infection or trauma","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0529","name":"In home respite care, 4 hr u","description":"In-home respite care, 4-hour unit, for use in cmmi model","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0674T","name":"Laps insj nw/rpcmt prm isdss","description":"Laparoscopic insertion of new or replacement of permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including an implantable pulse generator and diaphragmatic lead(s)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92637","name":"Hearing aid pst-fitg f-up ea","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99424","name":"Prin care mgmt phys 1st 30","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59100","name":"Remove uterus lesion","description":"Hysterotomy, abdominal (eg, for hydatidiform mole, abortion)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1001.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61737","name":"Litt icr mlt trj mlt/cplx ls","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; multiple trajectories for multiple or complex lesion(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0042","name":"Ref to therapy","description":"Referral to physical, occupational, speech, or recreational therapy","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0960T","name":"Rpl s-sclp eltr ra rcvr&tlmt","description":"Replacement of sub-scalp implanted electrode array, receiver, and telemetry unit with tunneling of electrode for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25650","name":"Cltx ulnar styloid fracture","description":"Closed treatment of ulnar styloid fracture","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0023","name":"Pin service 60m per month","description":"Principal illness navigation services by certified or trained auxiliary personnel under the direction of a physician or other practitioner, including a patient navigator; 60 minutes per calendar month, in the following activities:  person-centered assessment, performed to better understand the indiv","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0335U","name":"Rare ds whl gen seq fetal","description":"Rare ds whl gen seq fetal","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49190","name":"Opn exc/dstr ntra-abd >30 cm","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); greater than 30 cm","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43261","name":"Endo cholangiopancreatograph","description":"Endoscopic retrograde cholangiopancreatography (ercp); with biopsy, single or multiple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":397.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74018","name":"Radex abdomen 1 view","description":"Radiologic examination, abdomen; 1 view","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20550","name":"Njx 1 tendon sheath/ligament","description":"Injection(s); single tendon sheath, or ligament, aponeurosis (eg, plantar fascia)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":32.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15014","name":"Prepj skn cll ssp agrft ea","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; each additional 25 sq cm of harvested skin or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39502","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1142.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96547","name":"Intraop hipec px 1st 60 min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; first 60 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99418","name":"Prolng ip/obs e/m ea 15 min","description":"Prolonged inpatient or observation evaluation and management service(s) time with or without direct patient contact beyond the required time of the primary service when the primary service level has been selected using total time, each 15 minutes of total time (list separately in addition to the cod","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1253","name":"Pts hu surv no amb plltv","description":"Patients who respond on the patient experience hu survey that they did not receive care by the listed ambulatory palliative care provider in the last 60 days (disavowal)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86341","name":"Islet cell antibody","description":"Islet cell antibody","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0403U","name":"Onc prst8 mrna 18 gen dre ur","description":"Onc prst8 mrna 18 gen dre ur","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34151","name":"Removal of artery clot","description":"Embolectomy or thrombectomy, with or without catheter; renal, celiac, mesentery, aortoiliac artery, by abdominal incision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1736.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9612","name":"Inj, fluorescein, 1 mg","description":"Injection, fluorescein, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0835T","name":"Dgtz gls mcrscp fna 1st ea","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2249","name":"Inj, remimazolam, 1 mg","description":"Injection, remimazolam, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91323","name":"Sarscov2 vac 10 mcg/0.2ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 10 mcg/0.2 ml dosage, for intramuscular use","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9269","name":"Programable ingest capsule","description":"Programable, transient, orally ingested capsule, for use with external programmer, per month","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0390U","name":"Ob pe kdr eng&rbp4 ia alg","description":"Ob pe kdr eng&rbp4 ia alg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97007","name":"Mchnl sclp cool meas fitg","description":"Mechanical scalp cooling, including individual cap supply with head measurement, fitting, and patient education","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70472","name":"Ct cere prfu alys c+w/ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed with concurrent ct or ct angiography of the same anatomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9026","name":"Cryo fib comp path redu each","description":"Cryoprecipitated fibrinogen complex, pathogen reduced, each unit","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0763T","name":"Dgtz gls mcrscp mphmtrc alys","description":"Digitization of glass microscope slides for morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure, manual (list separately in addition to code for primary proced","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64488","name":"Tap block bi injection","description":"Transversus abdominis plane (tap) block (abdominal plane block, rectus sheath block) bilateral; by injections (includes imaging guidance, when performed)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1273","name":"Pts snf 1 yr dialysis","description":"Patients who were admitted to a skilled nursing facility (snf) within one year of dialysis initiation according to the cms-2728 form","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0683T","name":"Prgrmg dev eval isdss ip","description":"Programming device evaluation (in-person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional, permanent implantable synchroni","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49623","name":"Rmvl ninfct mesh hernia rpr","description":"Removal of total or near total non-infected mesh or other prosthesis at the time of initial or recurrent anterior abdominal hernia repair or parastomal hernia repair, any approach (ie, open, laparoscopic, robotic) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76810","name":"Ob us >/= 14 wks addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9608","name":"Flotufolastat f18 diag 1 mci","description":"Flotufolastat f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0522","name":"Mgt nw pt dementia low cmplx","description":"Management of a new patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4355","name":"Abio xpl abio xpl hy p sq cm","description":"Abiomend xplus membrane and abiomend xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4321","name":"Renograft, per sq cm","description":"Renograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67112","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1298.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88271","name":"Cytogenetics dna probe","description":"Molecular cytogenetics; dna probe, each (eg, fish)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4389","name":"Neothelium 4l+ per sq cm","description":"Neothelium 4l+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9955","name":"Oral app thxpy titration vis","description":"Oral app thxpy titration vis","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2017","name":"Permeaderm glove, each","description":"Permeaderm glove, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59821","name":"Treatment of miscarriage","description":"Treatment of missed abortion, completed surgically; second trimester","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":321.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49621","name":"Rpr parastomal hernia rdc","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; reducible","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87150","name":"Dna/rna amplified probe","description":"Culture, typing; identification by nucleic acid (dna or rna) probe, amplified probe technique, per culture or isolate, each organism probed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6049","name":"Scale implt peri-implt inflm","description":"Scale implt peri-implt inflm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1303","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93316","name":"Echo transesophageal","description":"Transesophageal echocardiography for congenital cardiac anomalies; placement of transesophageal probe only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1456","name":"Inj, fosaprepitant (teva)","description":"Injection, fosaprepitant (teva), not therapeutically equivalent to j1453, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25135","name":"Remove & graft wrist lesion","description":"Excision or curettage of bone cyst or benign tumor of carpal bones; with autograft (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":703.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5154","name":"Inj, omlyclo, 5 mg","description":"Injection, omalizumab-igec (omlyclo), biosimilar, 5 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49614","name":"Rpr aa hrn rcr < 3 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0599U","name":"Onc pncrtc ca mult ia serum","description":"Onc pncrtc ca mult ia serum","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0371","name":"Sialoendoscopy capt & interp","description":"Sialoendoscopy capt & interp","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1265","name":"Cms 2728 completed","description":"Cms medical evidence form 2728 for dialysis patients: initial form completed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1483","name":"Neg quan hep c or qual rna","description":"Patients who achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4287","name":"Dermabind dl, per sq cm","description":"Dermabind dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6611","name":"Grad com wrap w strap ak cus","description":"Gradient compression wrap with adjustable straps, above knee, each, custom","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86381","name":"Mitochondrial antibody each","description":"Mitochondrial antibody (eg, m2), each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2281","name":"Inj moxifloxacin (fres kabi)","description":"Injection, moxifloxacin (fresenius kabi), not therapeutically equivalent to j2280, 100 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1303","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0405U","name":"Onc pncrtc 59 mthltn blk mrk","description":"Onc pncrtc 59 mthltn blk mrk","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1212","name":"Missing gsa not perf","description":"Glycemic status assessment (hba1c or gmi) level is missing, or was not performed during the measurement period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0561U","name":"Onc mrd gsa cfdna subsequent","description":"Onc mrd gsa cfdna subsequent","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0524","name":"Est pt-cg dyad dem low cmplx","description":"Management of established patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96425","name":"Chemotherapy infusion method","description":"Chemotherapy administration, intra-arterial; infusion technique, initiation of prolonged infusion (more than 8 hours), requiring the use of a portable or implantable pump","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1271","name":"Pts dem any time/dur mo","description":"Patients with dementia at any time prior to or during the month","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4403","name":"Xwrap dual plus per sq cm","description":"Xwrap dual plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0368U","name":"Onc clrct ca mut&mthyltn mrk","description":"Onc clrct ca mut&mthyltn mrk","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33288","name":"Rmv&rplcmt phrnc nrv stim ld","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27759","name":"Treatment of tibia fracture","description":"Treatment of tibial shaft fracture (with or without fibular fracture) by intramedullary implant, with or without interlocking screws and/or cerclage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1205.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32653","name":"Thoracoscopy remov fb/fibrin","description":"Thoracoscopy, surgical; with removal of intrapleural foreign body or fibrin deposit","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":971.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1256","name":"Prior history of known cvd","description":"Prior history of known cvd","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0391U","name":"Onc sld tum dna&rna 437 gen","description":"Onc sld tum dna&rna 437 gen","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1488","name":"Dx dementia in msr timeframe","description":"Patients with a diagnosis for dementia in the year before or during the period of evaluation","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0985T","name":"Iv img xtrc cere vsl oct ea","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1373","name":"Mst rec gsa >=8 and <=9","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 8.0% and <= 9.0%","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1307","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0574U","name":"Mtb cfp-10 serum/plsm lc-ms","description":"Mtb cfp-10 serum/plsm lc-ms","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7168.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0955T","name":"Tot impl amei removal","description":"Totally implantable active middle ear hearing implant; removal, including removal of sound processor and all implant components","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3503","name":"Surg exp root surf molar","description":"Surg exp root surf molar","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4002","name":"Ep cardio ss","description":"Electrophysiology cardiac specialist mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96203","name":"Mlt fam grp bhv train ea add","description":"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face with multiple sets of paren","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0813T","name":"Egd vol adjmt bariatric balo","description":"Esophagogastroduodenoscopy, flexible, transoral, with volume adjustment of intragastric bariatric balloon","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9319","name":"Inj romidepsin lyophil 0.1mg","description":"Injection, romidepsin, lyophilized, 0.1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"X-ray exam chest 2 views","description":"Radiologic examination, chest; 2 views","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6601","name":"Porc/ceram inlay >= 3 surfac","description":"Inlay - porcelain/ceramic three or more surfaces","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9333","name":"Inj rozanolixizum-noli 1 mg","description":"Injection, rozanolixizumab-noli, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6608","name":"G com bandage tub protct pad","description":"Gradient compression bandaging supply, tubular protective absorption padded layer, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99349","name":"Home/res vst est mod mdm 40","description":"Home or residence visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 40 minutes must be met or excee","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0764T","name":"Asstv alg ecg rsk asmt cncrt","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to concurrently performed electrocardiogram (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0520","name":"New pt-cg dyad dem mod cmplx","description":"Management of new patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2779","name":"Inj, susvimo 0.1 mg","description":"Injection, ranibizumab, via intravitreal implant (susvimo), 0.1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0879T","name":"Augmnt alys ch ct ild prep","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; radiological data preparation and transmission","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0140","name":"Nav srv peer sup 60 min pr m","description":"Principal illness navigation - peer support by certified or trained auxiliary personnel under the direction of a physician or other practitioner, including a certified peer specialist; 60 minutes per calendar month, in the following activities:  person-centered interview, performed to better underst","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5945","name":"Mand implt sup remv part","description":"Mand implt sup remv part","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97037","name":"Appl modality 1+lllt po pain","description":"Application of a modality to 1 or more areas; low-level laser therapy (ie, nonthermal and non-ablative) for post-operative pain reduction","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0819T","name":"Revj/rmvl ins ptn subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63610","name":"Stimulation of spinal cord","description":"Stereotactic stimulation of spinal cord, percutaneous, separate procedure not followed by other surgery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1304","name":"No pneum vax admin 19+","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0808T","name":"Pulm tiss vntj alys w/ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with computed tomography (ct) images taken for the purpose of pulmonary tissue ventilation analysis, including data preparation and transmission, quantificati","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2043","name":"Biobrane, per sq cm","description":"Biobrane, per square centimeter","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25420","name":"Repair/graft radius & ulna","description":"Repair of nonunion or malunion, radius and ulna; with autograft (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1706.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50329","name":"Prep renal graft/ureteral","description":"Backbench reconstruction of cadaver or living donor renal allograft prior to transplantation; ureteral anastomosis, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4432","name":"510(k) skin subs, nos","description":"510(k) skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0553","name":"Monthly tx for dmht 20mins","description":"First 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing information related to the use of","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0461U","name":"Onc rxgenom alys rtpcr 24gen","description":"Onc rxgenom alys rtpcr 24gen","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9334","name":"Inj efgart-alfa 2mg hya-qvfc","description":"Injection, efgartigimod alfa, 2 mg and hyaluronidase-qvfc","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69667","name":"Repair middle ear structures","description":"Repair round window fistula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":923.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11772","name":"Exc pilonidal cyst comp","description":"Excision of pilonidal cyst or sinus; complicated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":582.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4338","name":"Artacent velos, per sq cm","description":"Artacent velos, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4259","name":"Celera per sq cm","description":"Celera dual layer or celera dual membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37292","name":"Rvsc evsc tpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4479","name":"Transanal irrigation, electr","description":"Electronic transanal irrigation system, includes electronic pump, water reservoir, tubing, and accessories, without catheter, any type","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0839T","name":"Dgtz gls mcrscp cslt mat prp","description":"Digitization of glass microscope slides for consultation and report on referred material requiring preparation of slides (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1254","name":"Pts deceased prior hu surv","description":"Patients who were deceased when the hu survey reached them","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7261","name":"Primary closure sinus perf","description":"Primary closure of a sinus perforation","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0514U","name":"Gi ibd ia quan deter adl lvl","description":"Gi ibd ia quan deter adl lvl","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0184","name":"Inj, amisulpride, 1 mg","description":"Injection, amisulpride, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76019","name":"Mr safety implt pos&/immoblj","description":"Mr safety implant positioning and/or immobilization under supervision of physician or other qualified health care professional, including application of physical protections to secure implanted medical device from mr-induced translational or vibrational forces, magnetically induced functional change","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1199","name":"Pt recg rrt","description":"Patients receiving rrt","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6092","name":"Recement supp crown","description":"Recement implant/abutment supported crown","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37298","name":"Revsc evsc imvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1470","name":"Hep b vac not recd med rsn","description":"Documentation of medical reason(s) for not administering hepatitis b vaccine (e.g., prior anaphylaxis due to the hepatitis b vaccine)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5151","name":"Inj, eculizumab-aagh, 2 mg","description":"Injection, eculizumab-aagh (epysqli), biosimilar, 2 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9156","name":"Oral mucoadhesive per 1 ml","description":"Oral mucoadhesive, any type (liquid, gel, paste, etc.), per 1 ml","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64466","name":"Thrc fascial pln blk uni njx","description":"Thoracic fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0338U","name":"Onc sld tum crcg tum cl slct","description":"Onc sld tum crcg tum cl slct","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35180","name":"Rpr cgen av fistula head&nck","description":"Repair, congenital arteriovenous fistula; head and neck","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":946.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90382","name":"Rsv monoc antb seasn .7ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose, 0.7 ml, for intramuscular use","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4346","name":"Shelter dm matrix per sq cm","description":"Shelter dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6593","name":"Grad com accessory gmt_wrap","description":"Accessory for gradient compression garment or wrap with adjustable straps, not-otherwise specified","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86051","name":"Aquaporin-4 antb elisa","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; enzyme-linked immunosorbent immunoassay (elisa)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0650","name":"Inj, levothyroxine nos 10mcg","description":"Injection, levothyroxine sodium, not otherwise specified, 10 mcg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0823T","name":"Tcat ins 1chmbr ldls pm ra","description":"Transcatheter insertion of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or programming), when","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0683T","name":"Prgrmg dev eval isdss ip","description":"Programming device evaluation (in-person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional, permanent implantable synchroni","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63017","name":"Remove spine lamina >2 lmbr","description":"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), more than 2 vertebral segments; lumbar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1378.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0559","name":"Unrelat prac follow up visit","description":"Post-operative follow-up visit complexity inherent to evaluation and management services addressing surgical procedure(s), provided by a physician or qualified health care professional who is not the practitioner who performed the procedure (or in the same group practice) and is of the same or of a ","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2998","name":"Inj plasminogen tvmh 1mg","description":"Injection, plasminogen, human-tvmh, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1278","name":"Pre-htn or htn doc, f/u indc","description":"Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27831","name":"Treat lower leg dislocation","description":"Closed treatment of proximal tibiofibular joint dislocation; requiring anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":446.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0046","name":"No mrs 90 days post stk","description":"Clinical follow-up and mrs score not assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0876T","name":"Duplex scan hemo fstl lmtd","description":"Duplex scan of hemodialysis fistula, computer-aided, limited (volume flow, diameter, and depth, including only body of fistula)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0371","name":"Sialoendoscopy capt & interp","description":"Sialoendoscopy capt & interp","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49618","name":"Rpr aa hrn rcr > 10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, incarcerated or strangulate","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0739T","name":"Abltj mal prst8 mag fld ndct","description":"Ablation of malignant prostate tissue by magnetic field induction, including all intraprocedural, transperineal needle/catheter placement for nanoparticle installation and intraprocedural temperature monitoring, thermal dosimetry, bladder irrigation, and magnetic field nanoparticle activation","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4038","name":"Vascular surgery ss","description":"Vascular surgery mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88148","name":"Cytopath c/v auto rescreen","description":"Cytopathology smears, cervical or vaginal; screening by automated system with manual rescreening under physician supervision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43271","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58552","name":"Laparo-vag hyst incl t/o","description":"Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1141.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1330","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0984T","name":"Iv img xtrc cere vsl oct 1st","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0674T","name":"Laps insj nw/rpcmt prm isdss","description":"Laparoscopic insertion of new or replacement of permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including an implantable pulse generator and diaphragmatic lead(s)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49591","name":"Rpr aa hrn 1st < 3 cm rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, reducible","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1351","name":"Dental sealant per tooth","description":"Sealant-per tooth","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15014","name":"Prepj skn cll ssp agrft ea","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; each additional 25 sq cm of harvested skin or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2024","name":"Resolve or xenopatch sq cm","description":"Resolve matrix or xenopatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1160","name":"Pt anphx due to mengb bef 13","description":"Patient had anaphylaxis due to the meningococcal vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36837","name":"Prq av fstl crt uxtr sep acs","description":"Percutaneous arteriovenous fistula creation, upper extremity, separate access sites of the peripheral artery and peripheral vein, including fistula maturation procedures (eg, transluminal balloon angioplasty, coil embolization) when performed, including all vascular access, imaging guidance and radi","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27215","name":"Treat pelvic fracture(s)","description":"Open treatment of iliac spine(s), tuberosity avulsion, or iliac wing fracture(s), unilateral, for pelvic bone fracture patterns that do not disrupt the pelvic ring, includes internal fixation, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":873.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1709","name":"Pfizer vaccine admin booster","description":"Pfizer vaccine admin booster","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4263","name":"Surgraft tl, per sq cm","description":"Surgraft tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2041","name":"Coord special care encounter","description":"Coordinated specialty care, team-based, for first episode psychosis, per encounter","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82941","name":"Assay of gastrin","description":"Gastrin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0550","name":"Phone/inter for dx/treat >5m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a written report to the patients treating/r","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1426","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21685","name":"Hyoid myotomy & suspension","description":"Hyoid myotomy and suspension","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1071.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1323","name":"Pts 7wk inj, scrn iop >25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop >25 mm hg and a plan of care was documented","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99412","name":"Preventive counseling group","description":"Preventive medicine counseling and/or risk factor reduction intervention(s) provided to individuals in a group setting (separate procedure); approximately 60 minutes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":11.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63057","name":"Decompress spine cord add-on","description":"Transpedicular approach with decompression of spinal cord, equina and/or nerve root(s) (eg, herniated intervertebral disc), single segment; each additional segment, thoracic or lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5947","name":"Mand implt sup fix","description":"Mand implt sup fix","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64425","name":"Njx aa&/strd ii ih nerves","description":"Injection(s), anesthetic agent(s) and/or steroid; ilioinguinal, iliohypogastric nerves","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3404","name":"Inj zopapogene per ther dose","description":"Injection, zopapogene imadenovec-drba suspension, per therapeutic dose","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25315","name":"Revise palsy hand tendon(s)","description":"Flexor origin slide (eg, for cerebral palsy, volkmann contracture), forearm and/or wrist;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1205.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97009","name":"Mchnl sclp cool after chemo","description":"Mechanical scalp cooling; provided after discontinuation of chemotherapy, each 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7997","name":"Appliance removal","description":"Appliance removal (not by dentist who placed appliance) includes removal of archbar","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0806T","name":"Tcat s&ivc prstc vl impl opn","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); open femoral vein approach","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0733T","name":"Rem r-t mtn nrehab ther sply","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; supply and technical support, per 30 days","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33895","name":"Evasc st rpr thrc/aa x crsg","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; not crossing major side branches","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0048","name":"Pall serv during meas","description":"Patients who receive palliative care services any time during the intake period through the end of the measurement year","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92920","name":"Prq trluml c angiop 1art&/br","description":"Percutaneous transluminal coronary angioplasty, single major coronary artery and/or its branch(es)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0368","name":"Cone beam ct interprete tmj","description":"Cone beam ct interprete tmj","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9345","name":"Inj, retifanlimab-dlwr, 1 mg","description":"Injection, retifanlimab-dlwr, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0234","name":"Intra inf, toci, second dos","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1365","name":"Hosp+pall care spec code 17","description":"Patient encounter during the performance period with hospice and palliative care specialty code 17","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2014","name":"Omeza collag compl 100 mg","description":"Omeza collagen matrix or omeza complete matrix, per 100 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33922","name":"Transect pulmonary artery","description":"Transection of pulmonary artery with cardiopulmonary bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1673.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6602","name":"Cst hgh nble mtl inlay 2 srf","description":"Inlay - cast high noble metal two surfaces","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1413","name":"Pos pdl1 bef init ici tx","description":"Patients who had a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4343","name":"Dermacyte ac matrx per sq cm","description":"Dermacyte ac matrix amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27284","name":"Arthrodesis hip joint","description":"Arthrodesis, hip joint (including obtaining graft);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1911.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54308","name":"Reconstruction of urethra","description":"Urethroplasty for second stage hypospadias repair (including urinary diversion); less than 3 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":816.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92945","name":"Prq trl rvs ch occ ant&rtrgr","description":"Percutaneous transluminal revascularization of chronic total occlusion, single coronary artery, coronary artery branch, or coronary artery bypass graft, and/or subtended major coronary artery branches of the bypass graft, any combination of intracoronary stent, atherectomy and angioplasty; combined ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64469","name":"Thrc fascial pln blk bi nfs","description":"Thoracic fascial plane block, bilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26034","name":"Treat hand bone lesion","description":"Incision, bone cortex, hand or finger (eg, osteomyelitis or bone abscess)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":620.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92634","name":"Hearing aid fitg svc 1st 60","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; first 60 minutes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37287","name":"Revsc evasc tpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9024","name":"Inj atezolizumb 5mg hya-tqjs","description":"Injection, atezolizumab, 5 mg and hyaluronidase-tqjs","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1150","name":"Lvef <=40% or mod/sev l vsf","description":"Current or prior left ventricular ejection fraction (lvef) less than or equal to 40% or documentation of moderately or severely depressed left ventricular systolic function","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24640","name":"Cltx rdl head sublxtj nrsemd","description":"Closed treatment of radial head subluxation in child, nursemaid elbow, with manipulation","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":80.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0725T","name":"Vestibular dev impltj uni","description":"Vestibular device implantation, unilateral","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0735T","name":"Prep tum cav iort prim crnot","description":"Preparation of tumor cavity, with placement of a radiation therapy applicator for intraoperative radiation therapy (iort) concurrent with primary craniotomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6114","name":"Implnt/abut fixed dent max","description":"Implnt/abut fixed dent max","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1411","name":"Inj, hemgenix, per tx dose","description":"Injection, etranacogene dezaparvovec-drlb, per therapeutic dose","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0719T","name":"Pst vrt jt rplcmt lmbr 1 sgm","description":"Posterior vertebral joint replacement, including bilateral facetectomy, laminectomy, and radical discectomy, including imaging guidance, lumbar spine, single segment","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9376","name":"Inj pozelimab-bbfg, 1 mg","description":"Injection, pozelimab-bbfg, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49622","name":"Rpr parastomal hrna ncr/strn","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90638","name":"Vacc qirv mrna 60mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 60 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9998","name":"Doc med rsn <3 colon","description":"Documentation of medical reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., last colonoscopy incomplete, last colonoscopy had inadequate prep, piecemeal removal of adenomas, or sessile serrated polyps >= 20 mm in size, last colonoscopy found greater than 10 adenomas, lo","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7295","name":"Eth estr and eton monthly","description":"Ethinyl estradiol and etonogestrel 0.015mg, 0.12mg per 24 hours; monthly vaginal ring, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64658","name":"Rmvl bat modul sys lead only","description":"Removal of baroreflex activation therapy (bat) modulation system; lead only","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0259U","name":"Neph ckd nuc mrs meas gfr","description":"Nephrology (chronic kidney disease), nuclear magnetic resonance spectroscopy measurement of myo-inositol, valine, and creatinine, algorithmically combined with cystatin c (by immunoassay) and demographic data to determine estimated glomerular filtration rate (gfr), serum, quantitative","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0290U","name":"Pain mgmt mrna gen xprsn 36","description":"Pain mgmt mrna gen xprsn 36","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93325","name":"Doppler echo color flow mapg","description":"Doppler echocardiography color flow velocity mapping (list separately in addition to codes for echocardiography)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3055","name":"Inj talquetamab-tgvs 0.25 mg","description":"Injection, talquetamab-tgvs, 0.25 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37258","name":"Revsc evasc ivt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9256","name":"Inj, nipocalimab-aahu, 3 mg","description":"Injection, nipocalimab-aahu, 3 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77438","name":"Surf rad thr orthvlt>150-500","description":"Surface radiation therapy; orthovoltage, delivery, >150-500 kv, per fraction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0886T","name":"Sgmdsc flx 1st tndsc dilat","description":"Sigmoidoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1162","name":"Pt enceph due to dtp bef 13","description":"Patient had encephalitis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37268","name":"Revsc evasc fpvt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25119","name":"Partial removal of ulna","description":"Synovectomy, extensor tendon sheath, wrist, single compartment; with resection of distal ulna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":669.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94664","name":"Demo&/eval pt use inhaler","description":"Demonstration and/or evaluation of patient utilization of an aerosol generator, nebulizer, metered dose inhaler or ippb device","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9224","name":"Gen anes adv air-15 min","description":"Gen anes adv air-15 min","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87154","name":"Cul typ id bld pthgn 6+ trgt","description":"Culture, typing; identification of blood pathogen and resistance typing, when performed, by nucleic acid (dna or rna) probe, multiplexed amplified probe technique including multiplex reverse transcription, when performed, per culture or isolate, 6 or more targets","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0552","name":"Supply of digital device","description":"Supply of digital mental health treatment device and initial education and onboarding, per course of treatment that augments a behavioral therapy plan","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27278","name":"Arthrd si jt plmt iartic dev","description":"Arthrodesis, sacroiliac joint, percutaneous or minimally invasive, with image guidance, includes obtaining bone graft when performed, unilateral; placement of intra-articular device(s), without cortical piercing","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9912","name":"Pre-visit patient screening","description":"Pre-visit patient screening","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5137","name":"Inj, wezlana, sub cu, 1 mg","description":"Injection, ustekinumab-auub (wezlana), biosimilar, subcutaneous, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90638","name":"Vacc qirv mrna 60mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 60 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0797T","name":"Tcat ins 2chmbr ldls pm rv","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ventricular pace","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0552","name":"Supply of digital device","description":"Supply of digital mental health treatment device and initial education and onboarding, per course of treatment that augments a behavioral therapy plan","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4390","name":"Ascendion per sq cm","description":"Ascendion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1453","name":"Preop vis acu > 20/40","description":"Patients with a pre-operative visual acuity better than 20/40","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1271","name":"Inj doxycycline hyclate 1 mg","description":"Injection, doxycycline hyclate, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1737","name":"Inj meloxicam (azurity) 1mg","description":"Injection, meloxicam (azurity), 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7299","name":"Rem anchorage device w/flap","description":"Rem anchorage device w/flap","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5128","name":"Inj, cimerli, 0.1 mg","description":"Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1435","name":"Oral chemo in perf pd","description":"Patient on oral chemotherapy during the performance period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0892T","name":"Arhfcmrigtbs sbsq per tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent motor threshold redetermination with delivery and management, per treatment day","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9382","name":"Inj zenocutuzumab-zbco 1 mg","description":"Injection, zenocutuzumab-zbco, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87088","name":"Urine bacteria culture","description":"Culture, bacterial; with isolation and presumptive identification of each isolate, urine","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22586","name":"Arthrd pre-sac ntrbdy l5-s1","description":"Arthrodesis, pre-sacral interbody technique, including disc space preparation, discectomy, with posterior instrumentation, with image guidance, includes bone graft when performed, l5-s1 interspace","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1861.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9888","name":"5% wl maintnd from bsline wt","description":"Maintenance 5% wl from baseline weight in months 7-12","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0427U","name":"Monocyte dstrbj wdth whl bld","description":"Monocyte dstrbj wdth whl bld","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6603","name":"G com bandge low dn foamchnl","description":"Gradient compression bandaging supply, low density channel foam sheet, per 250 square centimeters, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0986T","name":"Iv img icr cere vsl oct 1st","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2305","name":"Inj, nitroglycerin, 5 mg","description":"Injection, nitroglycerin, 5 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59820","name":"Care of miscarriage","description":"Treatment of missed abortion, completed surgically; first trimester","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":395.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":431.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":526.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1384","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5228","name":"Immed mand part denture","description":"Immed mand part denture","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26080","name":"Explore/treat finger joint","description":"Arthrotomy, with exploration, drainage, or removal of loose or foreign body; interphalangeal joint, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99440","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4013","name":"Mntal/behav/psych hlth ss","description":"Mental/behavioral and psychiatry mips specialty set","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0398U","name":"Gi baret esph dna mthyln aly","description":"Gi baret esph dna mthyln aly","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1274","name":"Pts snf exl mo","description":"Patients who were admitted to a skilled nursing facility (snf) during the month of evaluation were excluded from that month","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1308","name":"Flu immunize no admin","description":"Influenza immunization was not administered, reason not given","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0032","name":"2+ antipsy schiz","description":"Two or more antipsychotic prescriptions ordered for patients who had a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder on or between january 1 of the year prior to the measurement period and the index prescription start date (ipsd) for antipsychotics","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31800","name":"Repair of windpipe injury","description":"Suture of tracheal wound or injury; cervical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":794.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81002","name":"Urinalysis nonauto w/o scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; non-automated, without microscopy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64832","name":"Repair nerve add-on","description":"Suture of digital nerve, hand or foot; each additional digital nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87088","name":"Urine bacteria culture","description":"Culture, bacterial; with isolation and presumptive identification of each isolate, urine","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0031","name":"Pall serv during meas","description":"Palliative care services given to patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7356","name":"Inj foscarb/foslevodopa 5 mg","description":"Injection, foscarbidopa 0.25 mg/foslevodopa 5 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33279","name":"Rmvl phrnc nrv stim transvns","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s) only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0484","name":"Consult slides prep elsewher","description":"Consultation on slides prepared elsewhere","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19369","name":"Brst rcnstj 2 pdcl tram flap","description":"Breast reconstruction; with bipedicled transverse rectus abdominis myocutaneous (tram) flap","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2379.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0374","name":"Tomo periapical image","description":"Tomo periapical image","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87523","name":"Hepatitis d quantification","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis d (delta), quantification, including reverse transcription, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0976T","name":"Slctv nzmtc dbrdmt s/n/hf ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; each additional 100 sq cm (list separately in addition to code for p","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15017","name":"App skn cll ssp f/n/g/hf 1st","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 480 sq cm or less","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2956","name":"Indirect rest remov","description":"Indirect rest remov","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15013","name":"Prepj skn cll ssp agrft 1st","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; first 25 sq cm or less of harvested skin","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2249","name":"Inj, remimazolam, 1 mg","description":"Injection, remimazolam, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50650","name":"Removal of ureter","description":"Ureterectomy, with bladder cuff (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1129.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53453","name":"Tprnl balo cntnc dev rmvl ea","description":"Periurethral transperineal adjustable balloon continence device; removal, each balloon","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75790","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5421","name":"Dentures adjust part maxill","description":"Adjust partial denture - maxillary","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0164","name":"Epinephrine in nacl (baxter)","description":"Injection, epinephrine in sodium chloride (baxter), 0.1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5930","name":"Max guid prothes w/o flange","description":"Max guid prothes w/o flange","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27194","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":863.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9324","name":"Inj, pemrydi rtu, 10 mg","description":"Injection, pemetrexed (pemrydi rtu), 10 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1221","name":"Dre w/o rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; without evidence of retinopathy","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83876","name":"Assay myeloperoxidase","description":"Myeloperoxidase (mpo)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4439","name":"Instagraft per sq cm","description":"Instagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0277U","name":"Hem gen pltlt funcj do 31","description":"Hematology (genetic platelet function disorder), genomic sequence analysis of 31 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1653","name":"Ho abduction static ots","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, off the shelf","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4375","name":"Duograft ac per sq cm","description":"Duograft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41828","name":"Excision of gum lesion","description":"Excision of hyperplastic alveolar mucosa, each quadrant (specify)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77089","name":"Tbs dxa cal w/i&r fx risk","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; using dual x-ray absorptiometry (dxa) or other imaging data on gray-scale variogram, calculation, with interpretation and report on fracture-risk","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0430U","name":"Gi malabs aat calpro pncrtc","description":"Gi malabs aat calpro pncrtc","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1325","name":"Doc med rsn not seen","description":"Patients who were not seen for reasons documented by clinician for patient or medical reasons (e.g., inadequate time for follow-up, patients who received a prior intravitreal or periocular steroid injection within the last six (6) months and had a subsequent iop evaluation with iop <25mm hg within s","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0854T","name":"Dgtz gls mcrscp bld smr prph","description":"Digitization of glass microscope slides for blood smear, peripheral, interpretation by physician with written report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1553","name":"Inj yimmugo 100 mg","description":"Injection, immune globulin (yimmugo), 100 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0965T","name":"I&cst prp jw xpn dl arch non","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, non-fixed hinge mechanism","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0453U","name":"Onc clrct ca cfdna qpcr asy","description":"Onc clrct ca cfdna qpcr asy","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0939T","name":"Xtrnl ecg rec>15d<30d scan","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; scanning analysis with report","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1178","name":"Doc med rsn no pcv","description":"Documentation of medical reason(s) for not administering pneumococcal vaccine (e.g., prior anaphylaxis due to the pneumococcal vaccine)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4411","name":"Amniomatrixf4x per sq cm","description":"Amniomatrixf4x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76017","name":"Mr sfty med physics xm cstmz","description":"Mr safety medical physics examination customization, planning and performance monitoring by medical physicist or mr safety expert, with review and analysis by physician or other qualified health care professional to prioritize and select views and imaging sequences, to tailor mr acquisition specific","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85048","name":"Automated leukocyte count","description":"Blood count; leukocyte (wbc), automated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59830","name":"Treat uterus infection","description":"Treatment of septic abortion, completed surgically","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":495.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37295","name":"Rvsc evsc tpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3392","name":"Inj, exagamglogene autotem","description":"Injection, exagamglogene autotemcel, per treatment","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85530","name":"Heparin-protamine tolerance","description":"Heparin-protamine tolerance test","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6612","name":"Onlay cst base mtl 2 surface","description":"Onlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4294","name":"Amnio quad-core, per sq cm","description":"Amnio quad-core, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1353","name":"Pts no cmplt suicd saf pln","description":"Patients who did not have a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1952","name":"Leuprolide inj, camcevi, 1mg","description":"Leuprolide injectable, camcevi, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6524","name":"G com garmnt lwr leg/ft nght","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0577U","name":"Onc ovr serum alys 39 gps","description":"Onc ovr serum alys 39 gps","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0879","name":"Difelikefalin, esrd on dialy","description":"Injection, difelikefalin, 0.1 microgram, (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0548U","name":"Gfap cleia plasma","description":"Gfap cleia plasma","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0705T","name":"Rem tx amblyopia tech sprt","description":"Remote treatment of amblyopia using an eye tracking device; surveillance center technical support including data transmission with analysis, with a minimum of 18 training hours, each 30 days","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53442","name":"Remove/revise male sling","description":"Removal or revision of sling for male urinary incontinence (eg, fascia or synthetic)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":780.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24134","name":"Sequestrectomy shft/dstl hum","description":"Sequestrectomy (eg, for osteomyelitis or bone abscess), shaft or distal humerus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":924.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4370","name":"Aeroguard per sq cm","description":"Aeroguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"X-ray exam chest 2 views","description":"Radiologic examination, chest; 2 views","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0387","name":"Comp image capture only","description":"Comp image capture only","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1458","name":"Pt died bef end meas pd","description":"Patient died prior to the end of the performance period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38225","name":"Car-t hrv bld-drv t lymphcyt","description":"Chimeric antigen receptor t-cell (car-t) therapy; harvesting of blood-derived t lymphocytes for development of genetically modified autologous car-t cells, per day","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1016T","name":"Elec alys npgs esoph intraop","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57500","name":"Biopsy of cervix","description":"Biopsy of cervix, single or multiple, or local excision of lesion, with or without fulguration (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":76.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":179.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0846T","name":"Dgtz gls mcrscp imfluor ea","description":"Digitization of glass microscope slides for immunofluorescence, per specimen; each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2782","name":"Inj avacincaptad pegol 0.1mg","description":"Injection, avacincaptad pegol, 0.1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7511","name":"Incision/drain abscess intra","description":"Incision and drainage of abscess - intraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0903T","name":"Ecg alg 12 lead reduced i&r","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4224","name":"Supply insulin inf cath/wk","description":"Supplies for maintenance of insulin infusion catheter, per week","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27054","name":"Removal of hip joint lining","description":"Arthrotomy with synovectomy, hip joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":793.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84275","name":"Assay of sialic acid","description":"Sialic acid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69727","name":"Rmv ntr oi imp sk tc esp<100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5100","name":"Inj ustekinumab-kfce, 1 mg","description":"Injection, ustekinumab-kfce (yesintek), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1381","name":"Pt sec strk wthin 5 days","description":"Patients with secondary stroke (e.g., a subsequent stroke that may occur with vasospasm in the setting of subarachnoid hemorrhage) within 5 days of the initial procedure","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11440","name":"Exc face-mm b9+marg 0.5 cm/<","description":"Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 0.5 cm or less","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9596","name":"Gallium illuccix 1 millicure","description":"Gallium ga-68 gozetotide, diagnostic, (illuccix), 1 millicurie","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2313","name":"Inj, naloxone (zimhi) 0.01mg","description":"Injection, naloxone hydrochloride (zimhi), 0.01 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99411","name":"Preventive counseling group","description":"Preventive medicine counseling and/or risk factor reduction intervention(s) provided to individuals in a group setting (separate procedure); approximately 30 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":7.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0795T","name":"Tcat ins 2chmbr ldls pm cmpl","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; complete system (ie, r","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1197","name":"Isa reduced >=3 fr ixv","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1420","name":"Complete ophthalmologic mvp","description":"Complete ophthalmologic care mips value pathway","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42440","name":"Excise submaxillary gland","description":"Excision of submandibular (submaxillary) gland","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":550.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98929","name":"Osteopath manj 9-10 regions","description":"Osteopathic manipulative treatment (omt); 9-10 body regions involved","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":96.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5155","name":"Inj, aflibercept-jbvf, 1 mg","description":"Injection, aflibercept-jbvf (yesafili), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0902T","name":"Qtc ntrvl augmnt alg aly ecg","description":"Qtc interval derived by augmentative algorithmic analysis of input from an external, patient-activated mobile ecg device","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0880T","name":"Augmnt alys ch ct ild i&r","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8502","name":"Inj, aponvie, 1 mg","description":"Injection, aprepitant (aponvie), 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99406","name":"Behav chng smoking 3-10 min","description":"Smoking and tobacco use cessation counseling visit; intermediate, greater than 3 minutes up to 10 minutes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":17.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49621","name":"Rpr parastomal hernia rdc","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; reducible","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0620U","name":"Onc hcc dna mthyln alys>5000","description":"Onc hcc dna mthyln alys>5000","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0863T","name":"Rlcj pg wcs lv trnsmtr only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; transmitter component only","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27178","name":"Treat slipped epiphysis","description":"Open treatment of slipped femoral epiphysis; closed manipulation with single or multiple pinning","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1024.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0776T","name":"Ther indctj ntrabrn hypthrm","description":"Therapeutic induction of intra-brain hypothermia, including placement of a mechanical temperature-controlled cooling device to the neck over carotids and head, including monitoring (eg, vital signs and sport concussion assessment tool 5 [scat5]), 30 minutes of treatment","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0991T","name":"Cysto lo-nrg lithtrp&mcrsphr","description":"Cystourethroscopy, with low-energy lithotripsy and acoustically actuated microspheres, including imaging","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27248","name":"Treat thigh fracture","description":"Open treatment of greater trochanteric fracture, includes internal fixation, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":933.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1681","name":"Ho bilateral hip abduction","description":"Hip orthosis, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42450","name":"Excise sublingual gland","description":"Excision of sublingual gland","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":417.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46938","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78458","name":"Ven thrombosis images bilat","description":"Venous thrombosis imaging, venogram; bilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0593U","name":"Nfct ds gu pthgn dna 46trgt","description":"Nfct ds gu pthgn dna 46trgt","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01941","name":"Anes neuromd/ntrvrt crv/thrc","description":"Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0355U","name":"Apol1 risk variants","description":"Apol1 risk variants","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5156","name":"Inj, tocilizumab-anoh, 1 mg","description":"Injection, tocilizumab-anoh (avtozma), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0419U","name":"Nrpsyc gen seq vrnt aly 13","description":"Nrpsyc gen seq vrnt aly 13","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0603U","name":"Rx asy prsmv 77rx/metablt ur","description":"Rx asy prsmv 77rx/metablt ur","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32036","name":"Thoracostomy w/flap drainage","description":"Thoracostomy; with open flap drainage for empyema","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":790.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9999","name":"Inj ustekinumab-aauz 1 mg","description":"Injection, ustekinumab-aauz (otulfi), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24640","name":"Cltx rdl head sublxtj nrsemd","description":"Closed treatment of radial head subluxation in child, nursemaid elbow, with manipulation","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":100.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9615","name":"Inj, pegulicianine, 1 mg","description":"Injection, pegulicianine, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0832T","name":"Dgtz gls mcrscp cytp oth scr","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28475","name":"Cltx metatarsal fx w/mnpj ea","description":"Closed treatment of metatarsal fracture; with manipulation, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6525","name":"G com garm lwrleg/ft ngt cus","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, custom, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4339","name":"Artacent vericlen, per sq cm","description":"Artacent vericlen, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2024","name":"Resolve or xenopatch sq cm","description":"Resolve matrix or xenopatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80186","name":"Assay of phenytoin free","description":"Phenytoin; free","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99489","name":"Cplx chrnc care ea addl 30","description":"Complex chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":42.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0624U","name":"Hep nash dna mthyl alys 5000","description":"Hep nash dna mthyl alys 5000","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33220","name":"Repair lead pace-defib dual","description":"Repair of 2 transvenous electrodes for permanent pacemaker or implantable defibrillator","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95919","name":"Quan puplmtry phy/qhp uni/bi","description":"Quantitative pupillometry with physician or other qualified health care professional interpretation and report, unilateral or bilateral","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5140","name":"Inj adalimumab-fkjp, 1 mg","description":"Injection, adalimumab-fkjp, biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61715","name":"Mrgfus strtctc ablt trgt icr","description":"Magnetic resonance image guided high intensity focused ultrasound (mrgfus), stereotactic ablation of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6584","name":"Grad com wrap w straps","description":"Gradient compression wrap with adjustable straps, not otherwise specified","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68440","name":"Snip inc lacrimal punctum","description":"Snip incision of lacrimal punctum","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0297U","name":"Onc pan tum whl gen seq dna","description":"Onc pan tum whl gen seq dna","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1368","name":"Prev trt inf d/o hiv/hep mvp","description":"Prevention and treatment of infectious disorders including hepatitis c and hiv mips value pathway","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0945T","name":"Intraop assmt abnl tum tiss","description":"Intraoperative assessment for abnormal (tumor) tissue, in-vivo, following partial mastectomy (eg, lumpectomy) using computer-aided fluorescence imaging (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9038","name":"Inj axatilimab-csfr 0.1 mg","description":"Injection, axatilimab-csfr, 0.1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33894","name":"Evasc st rpr thrc/aa acrs br","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; across major side branches","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1297","name":"Bmi not doc medrsn ptref","description":"Bmi not documented due to medical reason or patient refusal of height or weight measurement","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9269","name":"Programable ingest capsule","description":"Programable, transient, orally ingested capsule, for use with external programmer, per month","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53452","name":"Tprnl balo cntnc dev uni","description":"Periurethral transperineal adjustable balloon continence device; unilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4267","name":"Neostim dl per sq cm","description":"Neostim dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83014","name":"H pylori drug admin","description":"Helicobacter pylori; drug administration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58825","name":"Transposition ovary(s)","description":"Transposition, ovary(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":807.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4542","name":"Supp ext up limb tremor stim","description":"Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2601","name":"Inj, vasopressin (baxter)","description":"Injection, vasopressin (baxter), 1 unit","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4288","name":"Replacement breastpump valve","description":"Valve for breast pump, replacement","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3000","name":"Streptomycin injection","description":"Injection, streptomycin, up to 1 gm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1493","name":"No fall doc med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2526","name":"Cntct lens blue violet","description":"Contact lens, hydrophilic, with blue-violet filter, per lens","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0349","name":"Inj, rezafungin, 1 mg","description":"Injection, rezafungin, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0796T","name":"Tcat ins 2chmbr ldls pm ra","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right atrial pacemaker","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1326","name":"Pts dx hypotony","description":"Patients with a diagnosis of hypotony","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4321","name":"Renograft, per sq cm","description":"Renograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1413","name":"Inj delandistrogene mox rokl","description":"Injection, delandistrogene moxeparvovec-rokl, per therapeutic dose","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1463","name":"2 f/u wthn 180 day rx atmp","description":"Documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0483U","name":"Nfct ds ng gyra s91f pt mut","description":"Nfct ds ng gyra s91f pt mut","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9244","name":"Office min sed drug enteral","description":"Office min sed drug enteral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5099","name":"Inj ustekinumab-stba, 1 mg","description":"Injection, ustekinumab-stba (steqeyma), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27282","name":"Arthrodesis symphysis pubis","description":"Arthrodesis, symphysis pubis (including obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":963.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37288","name":"Revsc evsc tpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0547U","name":"Neurflmnt lt chn cleia plsm","description":"Neurflmnt lt chn cleia plsm","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0957T","name":"Rev s-sclp eltr ra rcvr&tlmt","description":"Revision of sub-scalp implanted electrode array, receiver, and telemetry unit for electrode, when required, including imaging guidance","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70471","name":"Cta h&n c+ w/noncontrast img","description":"Computed tomographic angiography (cta), head and neck, with contrast material(s), including noncontrast images, when performed, and image postprocessing","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0543","name":"Group train w/o patient","description":"Group caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient pre","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4326","name":"Woundplus, per sq cm","description":"Woundplus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0868T","name":"Hi-res gastric ep mapping","description":"High-resolution gastric electrophysiology mapping with simultaneous patient-symptom profiling, with interpretation and report","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93575","name":"Njx cath slct p angrph mapca","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary angiography of major aortopulmonary collateral arteries (mapcas) arising off the aorta or its systemic branches, during cardiac catheterization for congenital heart d","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0323U","name":"Iadna cns pthgn next gen seq","description":"Iadna cns pthgn next gen seq","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37259","name":"Revsc evasc ivt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71060","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64771","name":"Sever cranial nerve","description":"Transection or avulsion of other cranial nerve, extradural","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":643.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22521","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":662.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0547U","name":"Neurflmnt lt chn cleia plsm","description":"Neurflmnt lt chn cleia plsm","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38226","name":"Car-t prep t lymphcyt f/trns","description":"Chimeric antigen receptor t-cell (car-t) therapy; preparation of blood-derived t lymphocytes for transportation (eg, cryopreservation, storage)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4373","name":"Membrane wrp lt per sq cm","description":"Membrane wrap lite, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0401U","name":"Crd c hrt ds 9 gen 12 vrnts","description":"Crd c hrt ds 9 gen 12 vrnts","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1426","name":"Injection, casimersen, 10 mg","description":"Injection, casimersen, 10 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5909","name":"Max guid prothes w/ flange","description":"Max guid prothes w/ flange","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0342U","name":"Onc pncrtc ca mult ia eclia","description":"Onc pncrtc ca mult ia eclia","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9293","name":"Fertility cycl tracking soft","description":"Fertility cycle (contraception & conception) tracking software application, fda cleared, per month, includes accessories (e.g., thermometer)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91322","name":"Sarscov2 vac 50 mcg/0.5ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 50 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S4024","name":"Air polymer foam per study","description":"Air polymer-type a intrauterine foam, per study dose","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1643","name":"Inj heparin, pfizer, 1000u","description":"Injection, heparin sodium (pfizer), not therapeutically equivalent to j1644, per 1000 units","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0759T","name":"Dgtz gls mcrscp sl sp grpiii","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group iii, for enzyme constituents (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0800T","name":"Tcat rmvl 2chmbr ldls pm rv","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right ventricular pacemaker component (when part of a dual-chamber leadless pacem","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23120","name":"Claviculectomy partial","description":"Claviculectomy; partial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":677.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0611U","name":"Onc lvr alys >1000 mr cfdna","description":"Onc lvr alys >1000 mr cfdna","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0709","name":"Intraoral cmplt radio images","description":"Intraoral cmplt radio images","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0618U","name":"Psyc bd dna mthyl alys>10000","description":"Psyc bd dna mthyl alys>10000","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2779","name":"Inj, susvimo 0.1 mg","description":"Injection, ranibizumab, via intravitreal implant (susvimo), 0.1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0052A","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9072","name":"Inj cyclophos frindovyx 5 mg","description":"Injection, cyclophosphamide (frindovyx), 5 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4418","name":"Biolab wrap flow per sq cm","description":"Biolab membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7471","name":"Rem exostosis any site","description":"Removal of lateral exostosis (maxilla or mandible)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","name":"Scoliosis orth sag/ cor","description":"Scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla to trochanter, includes all accessory pads, straps and interface, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual ","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1309.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82962","name":"Glucose blood test","description":"Glucose, blood by glucose monitoring device(s) cleared by the fda specifically for home use","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4033","name":"Skilled nursing facility ss","description":"Skilled nursing facility mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84155","name":"Assay of protein serum","description":"Protein, total, except by refractometry; serum, plasma or whole blood","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0603U","name":"Rx asy prsmv 77rx/metablt ur","description":"Rx asy prsmv 77rx/metablt ur","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31241","name":"Nsl/sns ndsc lig sphnptn art","description":"Nasal/sinus endoscopy, surgical; with ligation of sphenopalatine artery","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53865","name":"Cysto insj dev ischmc rmdlg","description":"Cystourethroscopy with insertion of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0382U","name":"Hyprphenylalninmia mntr quan","description":"Hyprphenylalninmia mntr quan","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1466","name":"Pt disc/lam proc same day","description":"Patient had a lumbar fusion on the same date as the discectomy/laminectomy procedure","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7213","name":"Inj, ixinity, 1 i.u.","description":"Injection, coagulation factor ix (recombinant), ixinity, 1 i.u.","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0273U","name":"Hem gen hyprfibrnlysis 8 gen","description":"Hematology (genetic hyperfibrinolysis, delayed bleeding), genomic sequence analysis of 8 genes (f13a1, f13b, fga, fgb, fgg, serpina1, serpine1, serpinf2, plau) blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9345","name":"Inj, retifanlimab-dlwr, 1 mg","description":"Injection, retifanlimab-dlwr, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1152","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1482","name":"Pos quan hep c or qual rna","description":"Positive/detectable hepatitis c virus quantitative or qualitative rna test result during the denominator identification period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1244","name":"Pt othr thn true best int","description":"Patient provided a response other than completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9611","name":"Flurpiridaz f18, diag, 1 mci","description":"Flurpiridaz f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","name":"Gait mod systm rhym auditory","description":"Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63285","name":"Bx/exc idrl imed lesn cervl","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, cervical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3007.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6072","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (high noble metal)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6074","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (noble metal)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21431","name":"Cltx craniofacial separation","description":"Closed treatment of craniofacial separation (lefort iii type) using interdental wire fixation of denture or splint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":786.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33967","name":"Insert i-aort percut device","description":"Insertion of intra-aortic balloon assist device, percutaneous","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0460U","name":"Onc whl bld/bucc rtpcr 24gen","description":"Onc whl bld/bucc rtpcr 24gen","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2989","name":"Excavate tooth non-restorabl","description":"Excavate tooth non-restorabl","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1222","name":"Glaucoma pln of care not doc","description":"Glaucoma plan of care not documented, reason not otherwise specified","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0838T","name":"Dgtz gls mcrscp cslt sld els","description":"Digitization of glass microscope slides for consultation and report on referred slides prepared elsewhere (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82270","name":"Occult blood feces","description":"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (ie, patient was provided 3 cards or single triple card for consecutive collection)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88349","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2221","name":"Ank mcrop plant & dorsi flex","description":"Addition to lower extremity orthosis, ankle system, microprocessor-controlled feature plantarflexion and/or dorsiflexion, includes power source","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":1887.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1366","name":"Focus on womens health mvp","description":"Focusing on womens health mips value pathway","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99282","name":"Emergency dept visit sf mdm","description":"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward medical decision making","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":39.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D8091","name":"Compre ortho treat w surg","description":"Compre ortho treat w surg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0909T","name":"Rplcmt int nstim sys vgs nrv","description":"Replacement of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0696T","name":"Bdy surf mapg pm/cvdfb f/up","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of follow-up interrogation or programming device evaluatio","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51701","name":"Insert bladder catheter","description":"Insertion of non-indwelling bladder catheter (eg, straight catheterization for residual urine)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9992","name":"Pall serv during meas","description":"Palliative care services used by patient any time during the measurement period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59160","name":"D & c after delivery","description":"Curettage, postpartum","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":309.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1313","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6212","name":"Bridge noble metal cast","description":"Pontic-cast noble metal","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"Sup/ext non-ins inf pump syr","description":"Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0484U","name":"Nfct ds mgen 23s rrna pt mut","description":"Nfct ds mgen 23s rrna pt mut","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6553","name":"G com stcking bk 30-40 custm","description":"Gradient compression stocking, below knee, 30-40 mmhg, custom, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9220","name":"Indigotindisulfonate sod 1mg","description":"Injection, indigotindisulfonate sodium, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0870","name":"Injection, imetelstat, 1 mg","description":"Injection, imetelstat, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4315","name":"Regenelink amniotic mem allo","description":"Regenelink amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87811","name":"Sars-cov-2 covid19 w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19])","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0824T","name":"Tcat rmv 1chmbr ldls pm ra","description":"Transcatheter removal of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography), when performed","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0406U","name":"Onc lung flow cytmtry 5 mrk","description":"Onc lung flow cytmtry 5 mrk","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37285","name":"Revsc evasc tpvt st sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66165","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":791.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97008","name":"Mchnl sclp cool prep plmt","description":"Mechanical scalp cooling; including hair preparation, individual cap placement, therapy initiation, and precooling period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2008","name":"Theragenesis, per sq cm","description":"Theragenesis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5421","name":"Dentures adjust part maxill","description":"Adjust partial denture - maxillary","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2394","name":"Post >=4srfc resinbase cmpst","description":"Resin-based composite - four or more surfaces posterior","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5943","name":"Proth mandib implt sup remv","description":"Proth mandib implt sup remv","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0004","name":"Qual care neurologic cnd mvp","description":"Quality care for patients with neurological conditions mips value pathway","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0238","name":"Inj, tocilizumab-aazg, hospi","description":"Injection, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0565U","name":"Onc hcc ngs detc 6626epigalt","description":"Onc hcc ngs detc 6626epigalt","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9947","name":"Sleep apnea appliance","description":"Sleep apnea appliance","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36555","name":"Insert non-tunnel cv cath","description":"Insertion of non-tunneled centrally inserted central venous catheter; younger than 5 years of age","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1353","name":"Sealant repair per tooth","description":"Sealant repair per tooth","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1465","name":"F/u > 180 days after rx","description":"Patient follow up more than 180 days after treatment","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5941","name":"Resct proth mand part remov","description":"Resct proth mand part remov","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0519U","name":"Ther rx mntr meds p/d/a 110+","description":"Ther rx mntr meds p/d/a 110+","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26445","name":"Release hand/finger tendon","description":"Tenolysis, extensor tendon, hand or finger, each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":846.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37291","name":"Revsc evsc tpvt athr cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87802","name":"Strep b assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; streptococcus, group b","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59612","name":"Vbac delivery only","description":"Vaginal delivery only, after previous cesarean delivery (with or without episiotomy and/or forceps);","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":894.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31400","name":"Revision of larynx","description":"Arytenoidectomy or arytenoidopexy, external approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1131.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85210","name":"Clot factor ii prothrom spec","description":"Clotting; factor ii, prothrombin, specific","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3424","name":"Inj hydroxocobalamin iv 25mg","description":"Injection, hydroxocobalamin, intravenous, 25 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37270","name":"Revsc evasc fpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25240","name":"Partial removal of ulna","description":"Excision distal ulna partial or complete (eg, darrach type or matched resection)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81462","name":"So gsap cll fr dna/dna&rna","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants and rearrangements","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86631","name":"Chlamydia antibody","description":"Antibody; chlamydia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1284","name":"Pt 66+ snp or ltc pos > 90d","description":"Patients age 66 or older in institutional special needs plans (snp) or residing in long term care with pos code 32, 33, 34, 54, or 56 for more than 90 consecutive days during the measurement period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0536","name":"Peer recover support svs","description":"Peer recovery support services, provided directly or by referral; including leveraging knowledge of the condition or lived experience to provide support, mentorship, or inspiration to meet oud treatment and recovery goals; conducting a person-centered interview to understand the patients life story,","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0400U","name":"Ob xpnd car scr 145 genes","description":"Ob xpnd car scr 145 genes","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1179","name":"No pcv recd","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine, on or after their 19th birthday and before or during measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0369","name":"Max mri capture & interprete","description":"Max mri capture & interprete","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9953","name":"Reline sleep apnea appliance","description":"Reline sleep apnea appliance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1474","name":"Pt dx dementia","description":"Patients with diagnosis of dementia","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4393","name":"Surgraft ac per sq cm","description":"Surgraft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1749","name":"Inj, iloprost, 0.1 mcg","description":"Injection, iloprost, 0.1 mcg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86581","name":"Strptcs pneum antb serot ia","description":"Streptococcus pneumoniae antibody (igg), serotypes, multiplex immunoassay, quantitative","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76987","name":"Dx intraop epicar car us chd","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; including placement and manipulation of transducer, image acquisition, interpretation and report","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0739","name":"Hiv prep, inj, cabotegravir","description":"Injection, cabotegravir, 1mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0810T","name":"Subrta njx rx agt w/vtrc","description":"Subretinal injection of a pharmacologic agent, including vitrectomy and 1 or more retinotomies","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1491","name":"Recd esrd mcp dur perf pd","description":"Receiving esrd mcp dialysis services by the provider during the performance period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9381","name":"Inj teplizumab mzwv 5 mcg","description":"Injection, teplizumab-mzwv, 5 mcg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0682","name":"App non-sheet skin sub add","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (list separately in addition to code for pri","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93597","name":"R&l hrt cath chd abnl nt cnj","description":"Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); abnormal native connections","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80402","name":"Acth stimulation panel","description":"Acth stimulation panel; for 21 hydroxylase deficiency this panel must include the following: cortisol (82533 x 2) 17 hydroxyprogesterone (83498 x 2)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27881","name":"Amputation of lower leg","description":"Amputation, leg, through tibia and fibula; with immediate fitting technique including application of first cast","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1050.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0614","name":"Inj, treosulfan, 50 mg","description":"Injection, treosulfan, 50 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15778","name":"Impl absrb msh/prsth dly cls","description":"Implantation of absorbable mesh or other prosthesis for delayed closure of defect(s) (ie, external genitalia, perineum, abdominal wall) due to soft tissue infection or trauma","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3401","name":"Vyjuvek 5x10^9pfu/ml, 0.1 ml","description":"Beremagene geperpavec-svdt for topical administration, containing nominal 5 x 10^9 pfu/ml vector genomes, per 0.1 ml","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87468","name":"Anaplsma phgcytophlm amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); anaplasma phagocytophilum, amplified probe technique","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G3003","name":"Chronic pain mgmt addl 15m","description":"Each additional 15 minutes of chronic pain management and treatment by a physician or other qualified health care professional, per calendar month. (list separately in addition to code for g3002. when using g3003, 15 minutes must be met or exceeded.)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5911","name":"Facial moulage sectional","description":"Facial moulage (sectional)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0618","name":"Inj, calcium chloride, 2 mg","description":"Injection, calcium chloride, 2 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4253","name":"Zenith amniotic membrane psc","description":"Zenith amniotic membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41116","name":"Excision of mouth lesion","description":"Excision, lesion of floor of mouth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1460","name":"Dx copd, cf, or arf","description":"Diagnosis for chronic obstructive pulmonary disease, emphysema, cystic fibrosis, or acute respiratory failure","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1301","name":"Immunization counseling","description":"Immunization counseling","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0329U","name":"Onc neo xome&trns seq alys","description":"Onc neo xome&trns seq alys","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87140","name":"Culture type immunofluoresc","description":"Culture, typing; immunofluorescent method, each antiserum","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87552","name":"Mycobacteria dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacteria species, quantification","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5827","name":"Endo knee shin single axis","description":"Endoskeletal knee-shin system, single axis, electromechanical swing and stance phase control, with or without shock absorption and stance extension damping","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25035","name":"Inc dp bone crtx f/arm&/wrst","description":"Incision, deep, bone cortex, forearm and/or wrist (eg, osteomyelitis or bone abscess)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1028.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0525","name":"Est pt-cg dyad dem mod cmplx","description":"Management of established patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66850","name":"Removal of lens material","description":"Removal of lens material; phacofragmentation technique (mechanical or ultrasonic) (eg, phacoemulsification), with aspiration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":761.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9276","name":"Inj zanidatamab-hrii, 2 mg","description":"Injection, zanidatamab-hrii, 2 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5947","name":"Mand implt sup fix","description":"Mand implt sup fix","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0408U","name":"Iaad blk ac wv bsnsr sarscv2","description":"Iaad blk ac wv bsnsr sarscv2","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15016","name":"App skn cl ssp agrf t/a/l ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; each additional 480 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01942","name":"Anes neuromd/ntrvrt lmbr/sac","description":"Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0599U","name":"Onc pncrtc ca mult ia serum","description":"Onc pncrtc ca mult ia serum","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2406","name":"Injection, oritavancin 10 mg","description":"Injection, oritavancin (kimyrsa), 10 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37281","name":"Revsc evsc tpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q4077","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1150","name":"Lvef <=40% or mod/sev l vsf","description":"Current or prior left ventricular ejection fraction (lvef) less than or equal to 40% or documentation of moderately or severely depressed left ventricular systolic function","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0350U","name":"Rx metab/pcx dna 27 gen alys","description":"Rx metab/pcx dna 27 gen alys","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1473","name":"Pt func cap not allow impr","description":"Patient situations, at any point during the denominator identification period, where the patients functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools, such as delirium, dementia, intellectual disabilities, and pervasive and specific de","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4411","name":"Amniomatrixf4x per sq cm","description":"Amniomatrixf4x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7299","name":"Rem anchorage device w/flap","description":"Rem anchorage device w/flap","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45120","name":"Removal of rectum","description":"Proctectomy, complete (for congenital megacolon), abdominal and perineal approach; with pull-through procedure and anastomosis (eg, swenson, duhamel, or soave type operation)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1665.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1025T","name":"Alt elec fld dos&dlv sim mdl","description":"Alternating electric fields dosimetry and delivery-simulation modeling, creation and selection of patient-specific array layouts, and placement verification","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28820","name":"Amputation of toe","description":"Amputation, toe; metatarsophalangeal joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0545","name":"Inherent visit to inpt","description":"Visit complexity inherent to hospital inpatient or observation care associated with a confirmed or suspected infectious disease by an infectious diseases specialist, including disease transmission risk assessment and mitigation, public health investigation, analysis, and testing, and complex antimic","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4337","name":"Artecent trident, per sq cm","description":"Artacent trident, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9027","name":"Rbc o2 co2 reduced","description":"Red blood cells, leukocytes reduced, oxygen/ carbon dioxide reduced, each unit","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1223","name":"Glaucoma plan of care doc","description":"Glaucoma plan of care documented","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4231","name":"Ana crown exp 1-3 per quad","description":"Anatomical crown exposure - one to three teeth per quadrant","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0363U","name":"Onc urthl mrna 5 gen alg","description":"Onc urthl mrna 5 gen alg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0363U","name":"Onc urthl mrna 5 gen alg","description":"Onc urthl mrna 5 gen alg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5949","name":"Mand implt sup fix part","description":"Mand implt sup fix part","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26356","name":"Repair finger/hand tendon","description":"Repair or advancement, flexor tendon, in zone 2 digital flexor tendon sheath (eg, no mans land); primary, without free graft, each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1286.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90735","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15421","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25246","name":"Injection for wrist x-ray","description":"Injection procedure for wrist arthrography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9939","name":"Placemnt removable appliance","description":"Placemnt removable appliance","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1250","name":"Pt resp true heard","description":"Patient responded as completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0723T","name":"Qmrcp w/o dx mri sm anat ses","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained without diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) during the same session","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0969T","name":"Removal epicranial nstim sys","description":"Removal of epicranial neurostimulator system","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27715","name":"Ostpl tibfib lngth/shrt","description":"Osteoplasty, tibia and fibula, lengthening or shortening","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1259.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76801","name":"Ob us < 14 wks single fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0614U","name":"Iem pmd alys 4 nzm cplx page","description":"Iem pmd alys 4 nzm cplx page","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0959T","name":"Rmv/rplc magnet coil assem","description":"Removal or replacement of magnet from coil assembly that is connected to continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98009","name":"Synch audio-only new low 30","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 30 m","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99427","name":"Prin care mgmt staff ea addl","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0743T","name":"B1 str & fx rsk vrt fx assmt","description":"Bone strength and fracture risk using finite element analysis of functional data and bone mineral density (bmd), with concurrent vertebral fracture assessment, utilizing data from a computed tomography scan, retrieval and transmission of the scan data, measurement of bone strength and bmd and classi","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4347","name":"Rampart dl matrix per sq cm","description":"Rampart dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82948","name":"Reagent strip/blood glucose","description":"Glucose; blood, reagent strip","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0314","name":"Counsel immune <21 16-30 m","description":"Immunization counseling by a physician or other qualified health care professional for covid-19, ages under 21, 16-30 mins time (this code is used for the medicaid early and periodic screening, diagnostic, and treatment benefit (epsdt)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":562.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1385","name":"Pt rsn not seen 2nd pam","description":"Documentation of patient reasons for patients who were not seen for the second pam survey (e.g., less than four months between baseline pam assessment and follow-up","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1387","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1232","name":"Pt hcv tst reactive result","description":"Patient receives hcv antibody test with reactive result","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69910","name":"Remove inner ear & mastoid","description":"Labyrinthectomy; with mastoidectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0489U","name":"Ob sgnipt cfdna seq alys 1+","description":"Ob sgnipt cfdna seq alys 1+","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0308U","name":"Crd cad alys 3 prtn plsm alg","description":"Crd cad alys 3 prtn plsm alg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33287","name":"Rmv&rplcmt phrnc nrv stim pg","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0506U","name":"Gi barretts esophgl cell 89","description":"Gi barretts esophgl cell 89","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25394","name":"Repair carpal bone shorten","description":"Osteoplasty, carpal bone, shortening","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":910.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0682","name":"App non-sheet skin sub add","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (list separately in addition to code for pri","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0539U","name":"Onc sol tumor cfctdna 152gen","description":"Onc sol tumor cfctdna 152gen","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37279","name":"Iv lithotrp fpvt w/in sm art","description":"Intravascular lithotripsy(ies), femoral and popliteal vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0137","name":"Inten outpt svs,min 9 pr 7 d","description":"Intensive outpatient services; weekly bundle, minimum of 9 services over a 7 contiguous day period, which can include individual and group therapy with physicians or psychologists (or other mental health professionals to the extent authorized under state law); occupational therapy requiring the skil","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4008","name":"Geriatrics ss","description":"Geriatrics mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1370","name":"Inj, esomeprazole sod, 1 mg","description":"Injection, esomeprazole sodium, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0869T","name":"Njx b1 sub mtrl hw fixj aug","description":"Injection(s), bone-substitute material for bone and/or soft tissue hardware fixation augmentation, including intraoperative imaging guidance, when performed","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0389U","name":"Ped fbrl kd ifi27&mcemp1 rna","description":"Ped fbrl kd ifi27&mcemp1 rna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0959T","name":"Rmv/rplc magnet coil assem","description":"Removal or replacement of magnet from coil assembly that is connected to continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1737","name":"Inj meloxicam (azurity) 1mg","description":"Injection, meloxicam (azurity), 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2032","name":"Myriad matrix, per sq cm","description":"Myriad matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99492","name":"1st psyc collab care mgmt","description":"Initial psychiatric collaborative care management, first 70 minutes in the first calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":154.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1450","name":"Pt hos/pal care dur id/pf pd","description":"Patients who received hospice or palliative care service any time during denominator identification period or the measure assessment period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1347","name":"Pt pam incr 3 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 3 points in a 4 to 12 month period (passing)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99394","name":"Prev visit est age 12-17","description":"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; adole","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":80.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0733T","name":"Rem r-t mtn nrehab ther sply","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; supply and technical support, per 30 days","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49614","name":"Rpr aa hrn rcr < 3 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, incarcerated or strangulated","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0389","name":"Periopic image capture only","description":"Periopic image capture only","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0801T","name":"Tcat rmv&rpl 2chmbr ldls pm","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; dual-cha","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57421","name":"Exam/biopsy of vag w/scope","description":"Colposcopy of the entire vagina, with cervix if present; with biopsy(s) of vagina/cervix","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":103.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1503","name":"Vascular surgery mvp","description":"Vascular surgery mips value pathway","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81524","name":"Onc cns tum dna mthyl 10,000","description":"Oncology (central nervous system tumor), dna methylation analysis of at least 10,000 methylation sites, utilizing dna extracted from formalin-fixed tumor tissue, algorithm(s) reported as probability of matching a reference tumor family and class, and mgmt (o-6-methylguanine-dna methyltransferase) pr","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98002","name":"Synch audio-video new mod 45","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate medical decision making. when using total time on the date of the encounter for code selection, 45 minutes must be met or exceeded.","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5913","name":"Nasal prosthesis","description":"Nasal prosthesis","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4015","name":"Neurology ss","description":"Neurology mips specialty set","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3247","name":"Inj secukinumab intrav 1mg","description":"Injection, secukinumab, intravenous, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0742T","name":"Aqmbf spect xers/strs & rest","description":"Absolute quantitation of myocardial blood flow (aqmbf), single-photon emission computed tomography (spect), with exercise or pharmacologic stress, and at rest, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2253","name":"Inj midazolam (seizalam)","description":"Injection, midazolam (seizalam), 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0573U","name":"Onc pancreas 3bmrk pclf alg","description":"Onc pancreas 3bmrk pclf alg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0531","name":"Fclty-based respite, 24 hr u","description":"Facility-based respite, 24-hour unit, for use in cmmi model","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6603","name":"G com bandge low dn foamchnl","description":"Gradient compression bandaging supply, low density channel foam sheet, per 250 square centimeters, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4266","name":"Neostim per sq cm","description":"Neostim membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33280","name":"Rmvl phrnc nrv stim pg only","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator only","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52317","name":"Remove bladder stone","description":"Litholapaxy: crushing or fragmentation of calculus by any means in bladder and removal of fragments; simple or small (less than 2.5 cm)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64567","name":"Perq elec nrv field stimj cn","description":"Percutaneous electrical nerve field stimulation, cranial nerves, without implantation","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0548U","name":"Gfap cleia plasma","description":"Gfap cleia plasma","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0784T","name":"Ins/rplmt eltrd ra spi nstim","description":"Insertion or replacement of percutaneous electrode array, spinal, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4400","name":"Polygon3 per sq cm","description":"Polygon3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0582","name":"Bivalirudin (endo) 1 mg","description":"Injection, bivalirudin (endo), not therapeutically equivalent to j0583, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0681","name":"Inj ceftobipole medocarl 3mg","description":"Injection, ceftobiprole medocaril sodium, 3 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0485U","name":"Onc sol tum cfdna&rna ngs gm","description":"Onc sol tum cfdna&rna ngs gm","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12001","name":"Rpr s/n/ax/gen/trnk 2.5cm/<","description":"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 2.5 cm or less","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":51.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78006","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0528U","name":"Lrt iad 18bct/8vir&7arg rna","description":"Lrt iad 18bct/8vir&7arg rna","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0888T","name":"Histotripsy mal renal tissue","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant renal tissue, including imaging guidance","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0206","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9297","name":"Inj pemetrexed (sandoz) 10mg","description":"Injection, pemetrexed (sandoz), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84138","name":"Assay of pregnanetriol","description":"Pregnanetriol","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9998","name":"Inj ustekinumab-aekn, 1 mg","description":"Injection, ustekinumab-aekn (selarsdi), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1438","name":"Lst knwn well <=210 min","description":"Time last known well to hospital arrival less than or equal to 3.5 hours (<= 210 minutes)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84075","name":"Assay alkaline phosphatase","description":"Phosphatase, alkaline;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7509","name":"Marsupialization odon cyst","description":"Marsupialization odon cyst","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3222","name":"Part pulp for apexogenesis","description":"Partial pulpotomy for apexogenesis - permanent tooth with incomplete root development","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7195","name":"Factor ix recombinant nos","description":"Injection, factor ix (antihemophilic factor, recombinant) per iu, not otherwise specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1166","name":"Path rpt tis spec wle/reexc","description":"Pathology report for tissue specimens produced from wide local excisions or re-excisions","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86431","name":"Rheumatoid factor quant","description":"Rheumatoid factor; quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1023T","name":"Prq tis dsplmt intrathoracic","description":"Percutaneous tissue displacement, any method, including imaging guidance; intrathoracic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2039","name":"Innovamatrix fd, per sq cm","description":"Innovamatrix fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0488U","name":"Ob fetal ag nipt cfdna alys","description":"Ob fetal ag nipt cfdna alys","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9071","name":"Inj cyclophosphamd auromedic","description":"Injection, cyclophosphamide (auromedics), 5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0988T","name":"Opn ins/rplc ins ptn sbq&sbf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0442U","name":"Nfct ds respir nfctj mxa&crp","description":"Nfct ds respir nfctj mxa&crp","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55715","name":"Bx prst8 ea add mri-us/ct/mr","description":"Biopsy, prostate, each additional, mri-ultrasound fusion or in-bore ct- or mri-guided targeted lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59300","name":"Episiotomy or vaginal repair","description":"Episiotomy or vaginal repair, by other than attending","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":145.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95937","name":"Neuromuscular junction test","description":"Neuromuscular junction testing (repetitive stimulation, paired stimuli), each nerve, any 1 method","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9038","name":"Inj axatilimab-csfr 0.1 mg","description":"Injection, axatilimab-csfr, 0.1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69728","name":"Rmv ntr oi imp sk tc>=100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6594","name":"G comp bandge liner lwr extr","description":"Gradient compression bandaging supply, bandage liner, lower extremity, any size or length, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5944","name":"Max implt sup remv part","description":"Max implt sup remv part","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1401","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80101","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53454","name":"Tprnl balo cntnc dev adjmt","description":"Periurethral transperineal adjustable balloon continence device; percutaneous adjustment of balloon(s) fluid volume","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0527U","name":"Hsv 1&2 vzv amp prb tq pthgn","description":"Hsv 1&2 vzv amp prb tq pthgn","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4396","name":"Natalin per sq cm","description":"Natalin, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33737","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1614.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4360","name":"Amchoplast fd per sq cm","description":"Amchoplast fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4018","name":"Ob/gyn ss","description":"Obstetrics/gynecology mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0563","name":"Sbrt w/positron emission del","description":"Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance and real-time positron emissions-based delivery adjustments to 1 or more lesions, entire course not to exceed 5 fractions","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1240","name":"Pt no resp best int","description":"Patient did not respond to the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4347","name":"Rampart dl matrix per sq cm","description":"Rampart dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49427","name":"Injection abdominal shunt","description":"Injection procedure (eg, contrast media) for evaluation of previously placed peritoneal-venous shunt","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4020","name":"Ophthalmology/optometry ss","description":"Ophthalmology/optometry mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4035","name":"Thoracic surgery ss","description":"Thoracic surgery mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4284","name":"Dermabind sl, per sq cm","description":"Dermabind sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86363","name":"Mog-igg1 antb flo cytmtry ea","description":"Myelin oligodendrocyte glycoprotein (mog-igg1) antibody; flow cytometry (ie, fluorescence-activated cell sorting [facs]), each","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1323","name":"Pts 7wk inj, scrn iop >25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop >25 mm hg and a plan of care was documented","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4387","name":"Neothelium ft per sq cm","description":"Neothelium ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64907","name":"Nerve pedicle transfer","description":"Nerve pedicle transfer; second stage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1567.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4412","name":"Choriofix per sq cm","description":"Choriofix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74470","name":"X-ray exam of kidney lesion","description":"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37289","name":"Revsc evsc tpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6614","name":"Onlay cst nbl mtl 2 surfaces","description":"Onlay - cast noble metal two surfaces","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4027","name":"Plastic surgery ss","description":"Plastic surgery mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4362","name":"Cygnus disk, per sq cm","description":"Cygnus disk, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0594U","name":"Nfct ds sepsis pncrtc spc","description":"Nfct ds sepsis pncrtc spc","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0211","name":"Inj, nithiodote, 3mg / 125mg","description":"Injection, sodium nitrite 3 mg and sodium thiosulfate 125 mg (nithiodote)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J1170","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98014","name":"Synch audio-only est mod 30","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code s","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4281","name":"Barrera slor dl per sq cm","description":"Barrera sl or barrera dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0792T","name":"Appl slvr diamn fluoride 38%","description":"Application of silver diamine fluoride 38%, by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43124","name":"Removal of esophagus","description":"Total or partial esophagectomy, without reconstruction (any approach), with cervical esophagostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1971.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0289U","name":"Neuro alzheimer mrna 24 gen","description":"Neuro alzheimer mrna 24 gen","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4358","name":"Xwrap dual, per sq cm","description":"Xwrap dual, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0547","name":"Phone/internet svs 11-20 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4346","name":"Shelter dm matrix per sq cm","description":"Shelter dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0279U","name":"Hem vw factor&clgn iii bndg","description":"Hematology (von willebrand disease [vwd]), von willebrand factor (vwf) and collagen iii binding by enzyme-linked immunosorbent assays (elisa), plasma, report of collagen iii binding","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0474","name":"Micro w exam of surg margins","description":"Accession of tissue gross and microscopic examination including assessment of surgical margins for presence of disease preparation and transmission of writte","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0756T","name":"Dgtz gls mcrscp sld spc grpi","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group i, for microorganisms (eg, acid fast, methenamine silver) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54390","name":"Repair penis and bladder","description":"Plastic operation on penis for epispadias distal to external sphincter; with exstrophy of bladder","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1422.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1469","name":"Hx of hep b, or pos bld test","description":"Patient has a history of hepatitis b illness or received a hepatitis b surface antigen, hepatitis b surface antibody, or total antibody to hepatitis b core antigen test with a positive result any time before or during the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43288","name":"Esphg thrsc moblj","description":"Esophagectomy, total or near total, with thoracoscopic mobilization of the upper, middle, and lower mediastinal esophagus, with separate laparoscopic proximal gastrectomy, with laparoscopic pyloric drainage procedure if performed, with open cervical pharyngogastrostomy or esophagogastrostomy (ie, th","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3981.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0615U","name":"Bbrgdrferi ld antb detcj 26","description":"Bbrgdrferi ld antb detcj 26","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2804","name":"Inj, rifampin, 1 mg","description":"Injection, rifampin, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23406","name":"Incise tendon(s) & muscle(s)","description":"Tenotomy, shoulder area; multiple tendons through same incision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":955.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0438U","name":"Rx metab advrs vrnt alys 33","description":"Rx metab advrs vrnt alys 33","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0933T","name":"Tcat impl wrls l atr prs snr","description":"Transcatheter implantation of wireless left atrial pressure sensor for long-term left atrial pressure monitoring, including sensor calibration and deployment, right heart catheterization, transseptal puncture, imaging guidance, and radiological supervision and interpretation","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2371","name":"Inj phenylephrine hcl 20 mcg","description":"Injection, phenylephrine hydrochloride, 20 micrograms","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27552","name":"Treat knee dislocation","description":"Closed treatment of knee dislocation; requiring anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":740.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3387","name":"Inj elivaldogene autotemecel","description":"Injection, elivaldogene autotemcel, per treatment","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2026","name":"Restrata minimatrix, 5 mg","description":"Restrata minimatrix, 5 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67974","name":"Reconstruction of eyelid","description":"Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; total eyelid, upper, 1 stage or first stage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1008.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0619U","name":"Pulm copd dna alys >18000","description":"Pulm copd dna alys >18000","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0201","name":"Pne flu hepb cov home admin","description":"Administration of pneumococcal, influenza, hepatitis b, and/or covid-19 vaccine inside a patients home; reported only once per individual home per date of service when such vaccine administration(s) are performed at the patients home","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28485","name":"Optx metatarsal fx each","description":"Open treatment of metatarsal fracture, includes internal fixation, when performed, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0665","name":"Inj, bupivacaine, nos, 0.5mg","description":"Injection, bupivicaine, not otherwise specified, 0.5 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37274","name":"Rvsc evsc fpvt athrc cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0289U","name":"Neuro alzheimer mrna 24 gen","description":"Neuro alzheimer mrna 24 gen","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27695","name":"Repair of ankle ligament","description":"Repair, primary, disrupted ligament, ankle; collateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35506","name":"Art byp grft subclav-carotid","description":"Bypass graft, with vein; carotid-subclavian or subclavian-carotid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81517","name":"Liver ds alys 3 bmrk srm alg","description":"Liver disease, analysis of 3 biomarkers (hyaluronic acid [ha], procollagen iii amino terminal peptide [piiinp], tissue inhibitor of metalloproteinase 1 [timp-1]), using immunoassays, utilizing serum, prognostic algorithm reported as a risk score and risk of liver fibrosis and liver-related clinical ","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4391","name":"Amnioplast double per sq cm","description":"Amnioplast double, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7521","name":"Incision/drain abscess extra","description":"Incision and drainage of abscess - extraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9289","name":"Inj nivolumab 2 mg hyaluron","description":"Injection, nivolumab, 2 mg and hyaluronidase-nvhy","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24362","name":"Reconstruct elbow joint","description":"Arthroplasty, elbow; with implant and fascia lata ligament reconstruction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1257.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86581","name":"Strptcs pneum antb serot ia","description":"Streptococcus pneumoniae antibody (igg), serotypes, multiplex immunoassay, quantitative","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15854","name":"Removal sutr&stapl xreq anes","description":"Removal of sutures and staples not requiring anesthesia (list separately in addition to e/m code)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0462","name":"Atropine sulf, nte, 0.01 mg","description":"Injection, atropine sulfate, not therapeutically equivalent to j0461, 0.01 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49592","name":"Rpr aa hrn 1st < 3 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, incarcerated or strangulated","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90836","name":"Psytx w pt w e/m 45 min","description":"Psychotherapy, 45 minutes with patient when performed with an evaluation and management service (list separately in addition to the code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":90.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99480","name":"Sbsq ic inf pbw 2,501-5,000","description":"Subsequent intensive care, per day, for the evaluation and management of the recovering infant (present body weight of 2,501-5,000 grams)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9609","name":"F18 fdg, 15 millicuries","description":"Fludeoxyglucose f18 up to 15 millicuries","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0940T","name":"Xtrnl ecg rec>15d<30d r&i","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67412","name":"Explore/treat eye socket","description":"Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of lesion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":941.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0841T","name":"Dgtz gls mcrscp pth cslt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; first tissue block, with frozen section(s), single specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55869","name":"Lap srg prst8ct bi pl lmphad","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36837","name":"Prq av fstl crt uxtr sep acs","description":"Percutaneous arteriovenous fistula creation, upper extremity, separate access sites of the peripheral artery and peripheral vein, including fistula maturation procedures (eg, transluminal balloon angioplasty, coil embolization) when performed, including all vascular access, imaging guidance and radi","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76014","name":"Mr sfty implt&/fb asmt stf 1","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20553","name":"Njx 1/mlt trigger points 3/>","description":"Injection(s); single or multiple trigger point(s), 3 or more muscles","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":45.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1374","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01941","name":"Anes neuromd/ntrvrt crv/thrc","description":"Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34701","name":"Evasc rpr a-ao ndgft","description":"Endovascular repair of infrarenal aorta by deployment of an aorto-aortic tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the aorta from the level ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1205.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82670","name":"Assay of total estradiol","description":"Estradiol; total","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0954T","name":"Tot impl amei rplc snd proc","description":"Totally implantable active middle ear hearing implant; replacement of sound processor only, with attachment to existing transducers","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0968T","name":"Insj/rplcmt epcrnl nstim sys","description":"Insertion or replacement of epicranial neurostimulator system, including electrode array and pulse generator, with connection to electrode array","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2794","name":"Crown-titanium","description":"Crown-titanium","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4251","name":"Vim, per square centimeter","description":"Vim, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6106","name":"Tissue regen resorbable","description":"Tissue regen resorbable","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9393","name":"Inj, fulvestrant (teva)","description":"Injection, fulvestrant (teva), not therapeutically equivalent to j9395, 25 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0697T","name":"Quan mr tis wo mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained without diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, targ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2151","name":"Inj, mannitol, 250 mg","description":"Injection, mannitol, 250 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4415","name":"Alexiguard st-l per sq cm","description":"Alexiguard sl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5911","name":"Facial moulage sectional","description":"Facial moulage (sectional)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0709T","name":"Id ca immntx each addl njx","description":"Intradermal cancer immunotherapy; each additional injection (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33962","name":"Ecmo/ecls repos perph cnula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; reposition peripheral (arterial and/or venous) cannula(e), open, 6 years and older (includes fluoroscopic guidance, when performed)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":457.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0541U","name":"Cv ds hdl rct cec lc-ms/ms 5","description":"Cv ds hdl rct cec lc-ms/ms 5","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0011","name":"Hiv prep counsel, md 15-30m","description":"Individual counseling for pre-exposure prophylaxis (prep) by physician or qualified health care professional (qhp) to prevent human immunodeficiency virus (hiv), includes hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence, 15-30 minutes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0738T","name":"Tx pln mag fld abltj prst8","description":"Treatment planning for magnetic field induction ablation of malignant prostate tissue, using data from previously performed magnetic resonance imaging (mri) examination","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4252","name":"Vendaje, per square centimet","description":"Vendaje, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7353","name":"Anacaulase-bcdb 8.8% gel 1 g","description":"Anacaulase-bcdb, 8.8% gel, 1 gram","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4016","name":"Neurosurgical ss","description":"Neurosurgical mips specialty set","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72050","name":"X-ray exam neck spine 4/5vws","description":"Radiologic examination, spine, cervical; 4 or 5 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6211","name":"Bridge base metal cast","description":"Pontic-cast predominantly base metal","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1921","name":"Inj labetalol hcl hikma, 5mg","description":"Injection, labetalol hydrochloride (hikma), not therapeutically equivalent to j1920, 5 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90484","name":"Imm cnsl not admn sm>20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 20 minutes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0622U","name":"Psyc mdd dna alys >20000","description":"Psyc mdd dna alys >20000","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30100","name":"Intranasal biopsy","description":"Biopsy, intranasal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2782","name":"Crown 3/4 cast noble metal","description":"Crown - 3/4 cast noble metal","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0138","name":"Iv cipaglucosidase alfa-atga","description":"Intravenous infusion of cipaglucosidase alfa-atga, including provider/supplier acquisition and clinical supervision of oral administration of miglustat in preparation of receipt of cipaglucosidase alfa-atga","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50520","name":"Close kidney-skin fistula","description":"Closure of nephrocutaneous or pyelocutaneous fistula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1147.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1259","name":"Pt stat doc <= 1 yr dialysis","description":"Patient status documented within the first year of initiating dialysis","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0422","name":"Collect & prep genetic samp","description":"Collect & prep genetic samp","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4343","name":"Dermacyte ac matrx per sq cm","description":"Dermacyte ac matrix amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9996","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0921T","name":"Rmvl perm ccm-d sys 1 dfb ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous defibrillation lead only","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6094","name":"Abut support crown titanium","description":"Abutment supported crown - (titanium)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42107","name":"Excision lesion mouth roof","description":"Excision, lesion of palate, uvula; with local flap closure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":397.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81418","name":"Rx metab gen seq alys pnl 6","description":"Drug metabolism (eg, pharmacogenomics) genomic sequence analysis panel, must include testing of at least 6 genes, including cyp2c19, cyp2d6, and cyp2d6 duplication/deletion analysis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9886","name":"In-person attendance g code","description":"Behavioral counseling for diabetes prevention, in-person, group, 60 minutes","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93595","name":"L hrt cath chd nm/abn nt cnj","description":"Left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone, normal or abnormal native connections","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0668","name":"Instill, bupivac and meloxic","description":"Instillation, bupivacaine and meloxicam, 1 mg/0.03 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7485","name":"Surg reduct osseoustuberosit","description":"Surgical reduction of osseous tuberosity","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1736","name":"Inj meloxicam (delova) 1mg","description":"Injection, meloxicam (delova), 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0936T","name":"Photobiomodulation ther rta","description":"Photobiomodulation therapy of retina, single session","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27498","name":"Decompression of thigh/knee","description":"Decompression fasciotomy, thigh and/or knee, multiple compartments;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":689.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0470U","name":"Onc orop detcj mrd 8 dna hpv","description":"Onc orop detcj mrd 8 dna hpv","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1245","name":"Pt othr thn true person","description":"Patient provided a response other than completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1400","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1209","name":">=2 same hi-rsk med w/o diag","description":"At least two orders for high-risk medications from the same drug class, (table 4), without appropriate diagnoses","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84143","name":"Assay of 17-hydroxypregneno","description":"17-hydroxypregnenolone","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9382","name":"Inj zenocutuzumab-zbco 1 mg","description":"Injection, zenocutuzumab-zbco, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0505U","name":"Nfct ds vag infctj id 32orgs","description":"Nfct ds vag infctj id 32orgs","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5160","name":"Inj, jobevne, 10 mg","description":"Injection, bevacizumab-nwgd (jobevne), biosimilar, 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92335","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7040","name":"Normal saline solution infus","description":"Infusion, normal saline solution, sterile (500 ml = 1 unit)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1368","name":"Prev trt inf d/o hiv/hep mvp","description":"Prevention and treatment of infectious disorders including hepatitis c and hiv mips value pathway","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92634","name":"Hearing aid fitg svc 1st 60","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; first 60 minutes","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0344U","name":"Hep nafld semiq evl 28 lipid","description":"Hep nafld semiq evl 28 lipid","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1711","name":"Moderna vacc admin booster","description":"Moderna vacc admin booster","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0585","name":"Injection,onabotulinumtoxina","description":"Injection, onabotulinumtoxina, 1 unit","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0444U","name":"Onc sld orgn neo tgsap 361","description":"Onc sld orgn neo tgsap 361","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1011T","name":"Pbm therapy of oral cavity","description":"Photobiomodulation (pbm) therapy of oral cavity, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88155","name":"Cytopath c/v index add-on","description":"Cytopathology, slides, cervical or vaginal, definitive hormonal evaluation (eg, maturation index, karyopyknotic index, estrogenic index) (list separately in addition to code[s] for other technical and interpretation services)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1242","name":"Pt no resp imprt to me","description":"Patient did not respond to the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0799T","name":"Tcat rmvl 2chmbr ldls pm ra","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right atrial pacemaker component","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0516U","name":"Rx metab rxgenomic gnotyp 40","description":"Rx metab rxgenomic gnotyp 40","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80504","name":"Path clin consltj mod 21-40","description":"Pathology clinical consultation; for a moderately complex clinical problem, with review of patients history and medical records and moderate level of medical decision making when using time for code selection, 21-40 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1328","name":"Pts dx acute vitreous hem","description":"Patients with a diagnosis of acute vitreous hemorrhage","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33904","name":"Perq p-art revsc each addl","description":"Percutaneous pulmonary artery revascularization by stent placement, each additional vessel or separate lesion, normal or abnormal connections (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1397","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0958T","name":"Rmv s-sclp eltr ra rcvr&tlmt","description":"Removal of sub-scalp implanted electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2711","name":"Inj neostigmin/glycopyrrolat","description":"Injection, neostigmine methylsulfate 0.1 mg and glycopyrrolate 0.02 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4352","name":"Overlay sl matrix, per sq cm","description":"Overlay sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0321U","name":"Iadna gu pthgn 20bct&fng org","description":"Iadna gu pthgn 20bct&fng org","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0861T","name":"Rmvl pg wcs lv both compnt","description":"Removal of pulse generator for wireless cardiac stimulator for left ventricular pacing; both components (battery and transmitter)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0926T","name":"Prgrmg dev eval ccm-d ip","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, including review and report, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82950","name":"Glucose test","description":"Glucose; post glucose dose (includes glucose)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2013","name":"Innovamatrix fs, per sq cm","description":"Innovamatrix fs, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98984","name":"Rtm dev sply resp sys 2-15 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of respiratory system, 2-15 days in a 30-day period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1436","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2056","name":"Ciltacabtagene car-pos t","description":"Ciltacabtagene autoleucel, up to 100 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0374","name":"Tomo periapical image","description":"Tomo periapical image","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0259U","name":"Neph ckd nuc mrs meas gfr","description":"Nephrology (chronic kidney disease), nuclear magnetic resonance spectroscopy measurement of myo-inositol, valine, and creatinine, algorithmically combined with cystatin c (by immunoassay) and demographic data to determine estimated glomerular filtration rate (gfr), serum, quantitative","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5156","name":"Inj, tocilizumab-anoh, 1 mg","description":"Injection, tocilizumab-anoh (avtozma), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"Motor &/ sens nrve cndj test","description":"Motor and/or sensory nerve conduction, using preconfigured electrode array(s), amplitude and latency/velocity study, each limb, includes f-wave study when performed, with interpretation and report","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0662","name":"Team remote e/m new pt 30 mn","description":"Team remote e/m new pt 30 mins","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0137","name":"Inj, acetaminophen (hikma)","description":"Injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98004","name":"Synch audio-video est sf 10","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 10 minutes must be met or e","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5941","name":"Resct proth mand part remov","description":"Resct proth mand part remov","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42845","name":"Extensive surgery of throat","description":"Radical resection of tonsil, tonsillar pillars, and/or retromolar trigone; closure with other flap","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2225.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2024","name":"Resolve or xenopatch sq cm","description":"Resolve matrix or xenopatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20552","name":"Njx 1/mlt trigger point 1/2","description":"Injection(s); single or multiple trigger point(s), 1 or 2 muscle(s)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":59.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37262","name":"Iv lithotrp ivt w/in sm art","description":"Intravascular lithotripsy(ies), iliac vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0712T","name":"N-nvs artl plaq alys quan","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess atherosclerotic plaque stability","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32525","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1928.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9156","name":"Oral mucoadhesive per 1 ml","description":"Oral mucoadhesive, any type (liquid, gel, paste, etc.), per 1 ml","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1201","name":"Med rsn no ace-i/arb rx","description":"Documentation of medical reason(s) for not prescribing ace inhibitor (ace-i) or arb therapy during the measurement period (e.g., pregnancy, history of angioedema to ace-i, other allergy to ace-i and arb, hyperkalemia or history of hyperkalemia while on ace-i or arb therapy, acute kidney injury due t","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1448","name":"Injection, trilaciclib, 1mg","description":"Injection, trilaciclib, 1mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0689T","name":"Quan us tis charac w/o dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained without diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99218","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0426","name":"Coll, analys of saliva","description":"Coll, analys of saliva","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1486","name":"Pt admitted to snf dur eval","description":"Patients admitted to a skilled nursing facility (snf) during the period of evaluation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33474","name":"Revision of pulmonary valve","description":"Valvotomy, pulmonary valve, open heart, with cardiopulmonary bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1661.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0398U","name":"Gi baret esph dna mthyln aly","description":"Gi baret esph dna mthyln aly","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1327","name":"Pts no eval ini xm no 8 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 8 weeks","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2359","name":"Inj. olanzapine, 0.5mg","description":"Injection, olanzapine, 0.5 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58580","name":"Transcrv abltj utrn fibrd rf","description":"Transcervical ablation of uterine fibroid(s), including intraoperative ultrasound guidance and monitoring, radiofrequency","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6524","name":"G com garmnt lwr leg/ft nght","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58280","name":"Hysterectomy/revise vagina","description":"Vaginal hysterectomy, with total or partial vaginectomy; with repair of enterocele","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1212.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99342","name":"Home/res vst new low mdm 30","description":"Home or residence visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":88.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2021","name":"Neomatrix per sq cm","description":"Neomatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0321U","name":"Iadna gu pthgn 20bct&fng org","description":"Iadna gu pthgn 20bct&fng org","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94725","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4328","name":"Most, per sq cm","description":"Most, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0552U","name":"Repr med pga gdo te bx locus","description":"Repr med pga gdo te bx locus","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0403U","name":"Onc prst8 mrna 18 gen dre ur","description":"Onc prst8 mrna 18 gen dre ur","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4019","name":"Oncology/hema ss","description":"Oncology/hematology mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93971","name":"Extremity study","description":"Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86042","name":"Acetylcholn rcptr blckg antb","description":"Acetylcholine receptor (achr); blocking antibody","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0556","name":"Adv prim care mgmt lvl 1","description":"Advanced primary care management services for a patient with one chronic condition [expected to last at least 12 months, or until the death of the patient, which place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline], or fewer, provided by clinical ","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1186","name":"Pt w/ rx for hspc/plltv care","description":"Patients who have an order for or are receiving hospice or palliative care","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87153","name":"Dna/rna sequencing","description":"Culture, typing; identification by nucleic acid sequencing method, each isolate (eg, sequencing of the 16s rrna gene)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96041","name":"Genetic counseling svc ea 30","description":"Medical genetics and genetic counseling services, each 30 minutes of total time provided by the genetic counselor on the date of the encounter","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49492","name":"Rpr ing hern premie blocked","description":"Repair, initial inguinal hernia, preterm infant (younger than 37 weeks gestation at birth), performed from birth up to 50 weeks postconception age, with or without hydrocelectomy; incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26567","name":"Correct finger deformity","description":"Osteotomy; phalanx of finger, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":916.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98985","name":"Rtm dev sply mscsk sys 2-15d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of musculoskeletal system, 2-15 days in a 30-day period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85004","name":"Automated diff wbc count","description":"Blood count; automated differential wbc count","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20103","name":"Expl pentrg wound extremity","description":"Exploration of penetrating wound (separate procedure); extremity","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":423.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1375","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33894","name":"Evasc st rpr thrc/aa acrs br","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; across major side branches","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0315U","name":"Onc cutan sq cll ca mrna 40","description":"Onc cutan sq cll ca mrna 40","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4376","name":"Duograft aa per sq cm","description":"Duograft aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6036","name":"Prosthetic thumb mechanical","description":"Prosthetic thumb, mechanical, can include metacarpophalangeal (mcp), interphalangeal (ip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1032","name":"Sv doula brth wrk per 15 min","description":"Services performed by a doula birth worker, per 15 minutes","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1246","name":"Pt othr thn true imprt to me","description":"Patient provided a response other than completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4438","name":"Pretect per sq cm","description":"Pretect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0763T","name":"Dgtz gls mcrscp mphmtrc alys","description":"Digitization of glass microscope slides for morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure, manual (list separately in addition to code for primary proced","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1215","name":"Med rsn for no doc spiro","description":"Documentation of medical reason(s) for not documenting and reviewing spirometry results (e.g., patients with dementia or tracheostomy)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2471","name":"Inj pantoprazole(hikma) 40mg","description":"Injection, pantoprazole (hikma), not therapeutically equivalent to j2470, 40 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1747","name":"Inj, spesolimab-sbzo, 1 mg","description":"Injection, spesolimab-sbzo, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62318","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4263","name":"Surgraft tl, per sq cm","description":"Surgraft tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4368","name":"Amchothick per sq cm","description":"Amchothick, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7021","name":"Suppl and access lung expan","description":"Supplies and accessories for lung expansion airway clearance, continuous high frequency oscillation, and nebulization device (e.g., handset, nebulizer kit, biofilter)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83900","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1166","name":"Path rpt tis spec wle/reexc","description":"Pathology report for tissue specimens produced from wide local excisions or re-excisions","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5949","name":"Mand implt sup fix part","description":"Mand implt sup fix part","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0020M","name":"Onc cns alys 30000 dna loci","description":"Oncology (central nervous system), analysis of 30,000 dna methylation loci by methylation array, utilizing dna extracted from tumor tissue, diagnostic algorithm reported as probability of matching a reference tumor subclass","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5913","name":"Nasal prosthesis","description":"Nasal prosthesis","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0432U","name":"Klhl11 antb sr/csf asy qual","description":"Klhl11 antb sr/csf asy qual","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49187","name":"Opn exc/dstr ntra-abd 5.1-10","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5.1 to 10 cm","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1391","name":"All pt dx w/ rec mlnm","description":"All patients who were diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1270","name":"Pts no kid transplt wtlst","description":"Patients not on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28800","name":"Amputation of midfoot","description":"Amputation, foot; midtarsal (eg, chopart type procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69209","name":"Remove impacted ear wax uni","description":"Removal impacted cerumen using irrigation/lavage, unilateral","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15152","name":"Tis cltr skn agrft t/a/l ea","description":"Tissue cultured skin autograft, trunk, arms, legs; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5948","name":"Max implt sup fix part","description":"Max implt sup fix part","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":800.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0011","name":"Hiv prep counsel, md 15-30m","description":"Individual counseling for pre-exposure prophylaxis (prep) by physician or qualified health care professional (qhp) to prevent human immunodeficiency virus (hiv), includes hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence, 15-30 minutes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0851T","name":"Dgtz gls mcrscp mphmtrc 1st","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4340","name":"Simpligraft, per sq cm","description":"Simpligraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1407","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0496U","name":"Onc clrct cfdna 8/7 genes","description":"Onc clrct cfdna 8/7 genes","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59430","name":"Care after delivery","description":"Postpartum care only (separate procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":190.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29873","name":"Arthrs knee surg w/lat rls","description":"Arthroscopy, knee, surgical; with lateral release","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":625.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0716T","name":"Car acous wavfrm rec cad rsk","description":"Cardiac acoustic waveform recording with automated analysis and generation of coronary artery disease risk score","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98012","name":"Synch audio-only est sf 10","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0668","name":"Team remote e/m est pt 40 mn","description":"Team remote e/m est. pt 40mins","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0540U","name":"Trnsplj med quan dd-cfdna","description":"Trnsplj med quan dd-cfdna","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5940","name":"Resct proth max part remov","description":"Resct proth max part remov","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0707T","name":"Njx b1 sub mtrl sbchdrl dfct","description":"Injection(s), bone-substitute material (eg, calcium phosphate) into subchondral bone defect (ie, bone marrow lesion, bone bruise, stress injury, microtrabecular fracture), including imaging guidance and arthroscopic assistance for joint visualization","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1291","name":"Pt 66+ frailty and med dem","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61891","name":"Rev/rplcmt sk-mnt crnl nstm","description":"Revision or replacement of skull-mounted cranial neurostimulator pulse generator or receiver with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0536","name":"Peer recover support svs","description":"Peer recovery support services, provided directly or by referral; including leveraging knowledge of the condition or lived experience to provide support, mentorship, or inspiration to meet oud treatment and recovery goals; conducting a person-centered interview to understand the patients life story,","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1284","name":"Pt 66+ snp or ltc pos > 90d","description":"Patients age 66 or older in institutional special needs plans (snp) or residing in long term care with pos code 32, 33, 34, 54, or 56 for more than 90 consecutive days during the measurement period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98013","name":"Synch audio-only est low 20","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code select","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0978T","name":"Submucosal cryolysis therapy","description":"Submucosal cryolysis therapy; soft palate, base of tongue, and lingual tonsil","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87811","name":"Sars-cov-2 covid19 w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19])","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29871","name":"Arthrs knee surg for infctj","description":"Arthroscopy, knee, surgical; for infection, lavage and drainage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":620.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99202","name":"Office o/p new sf 15 min","description":"Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 15 minutes must be met or exceede","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":72.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1848","name":"Ko dbl upright w/air pre ots","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated, off-the-shelf","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":689.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1255","name":"Pts w/ othr rsn vst,+prg tst","description":"Patients who have another reason for visiting the clinic [not prenatal or postpartum care] and have a positive pregnancy test but have not established the clinic as an ob provider (e.g., plan to terminate the pregnancy or seek prenatal services elsewhere)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0735T","name":"Prep tum cav iort prim crnot","description":"Preparation of tumor cavity, with placement of a radiation therapy applicator for intraoperative radiation therapy (iort) concurrent with primary craniotomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4542","name":"Supp ext up limb tremor stim","description":"Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25250","name":"Removal of wrist prosthesis","description":"Removal of wrist prosthesis; (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":623.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87469","name":"Babesia microti amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); babesia microti, amplified probe technique","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66683","name":"Implantation iris prosthesis","description":"Implantation of iris prosthesis, including suture fixation and repair or removal of iris, when performed","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0138","name":"Inj acetaminoph 10mg/ibu 3mg","description":"Injection, acetaminophen 10 mg and ibuprofen 3 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71045","name":"X-ray exam chest 1 view","description":"Radiologic examination, chest; single view","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0278U","name":"Hem gen thrombosis 12 genes","description":"Hematology (genetic thrombosis), genomic sequence analysis of 12 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0603","name":"Sevelamer hydrochloride 20mg","description":"Sevelamer hydrochloride (renagel or therapeutically equivalent), oral, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22216","name":"Incis addl spine segment","description":"Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; each additional vertebral segment (list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":478.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37279","name":"Iv lithotrp fpvt w/in sm art","description":"Intravascular lithotripsy(ies), femoral and popliteal vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1217","name":"Sys rsn no doc spiro","description":"Documentation of system reason(s) for not documenting and reviewing spirometry results (e.g., spirometry equipment not available at the time of the encounter)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99472","name":"Ped critical care subsq","description":"Subsequent inpatient pediatric critical care, per day, for the evaluation and management of a critically ill infant or young child, 29 days through 24 months of age","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":397.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33369","name":"Replace aortic valve w/byp","description":"Transcatheter aortic valve replacement (tavr/tavi) with prosthetic valve; cardiopulmonary bypass support with central arterial and venous cannulation (eg, aorta, right atrium, pulmonary artery) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1212.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2221","name":"Ank mcrop plant & dorsi flex","description":"Addition to lower extremity orthosis, ankle system, microprocessor-controlled feature plantarflexion and/or dorsiflexion, includes power source","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35266","name":"Rpr blvsl grf oth/th vn uxtr","description":"Repair blood vessel with graft other than vein; upper extremity","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1072.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1408","name":"Gmln brca bef dx ca","description":"Patients who have germline brca testing completed before diagnosis of epithelial ovarian, fallopian tube, or primary peritoneal cancer","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64615","name":"Chemodenerv musc migraine","description":"Chemodenervation of muscle(s); muscle(s) innervated by facial, trigeminal, cervical spinal and accessory nerves, bilateral (eg, for chronic migraine)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2037","name":"G4derm plus/suprello, pr ml","description":"G4derm plus/suprello, per milliliter","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94618","name":"Pulmonary stress testing","description":"Pulmonary stress testing (eg, 6-minute walk test), including measurement of heart rate, oximetry, and oxygen titration, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27510","name":"Treatment of thigh fracture","description":"Closed treatment of femoral fracture, distal end, medial or lateral condyle, with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":818.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2057","name":"Afamitresgene autoleucel","description":"Afamitresgene autoleucel, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0770T","name":"Vr technology assist therapy","description":"Virtual reality technology to assist therapy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1320","name":"Pts scrn + hrsn","description":"Patients who screened positive for at least 1 of the 5 hrsns","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4391","name":"Amnioplast double per sq cm","description":"Amnioplast double, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15001","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50592","name":"Perc rf ablate renal tumor","description":"Ablation, 1 or more renal tumor(s), percutaneous, unilateral, radiofrequency","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64467","name":"Thrc fascial pln blk uni nfs","description":"Thoracic fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67430","name":"Explore/treat eye socket","description":"Orbitotomy with bone flap or window, lateral approach (eg, kroenlein); with removal of foreign body","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1313.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6595","name":"G comp bandge liner upr extr","description":"Gradient compression bandaging supply, bandage liner, upper extremity, any size or length, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6074","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (noble metal)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1362","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61715","name":"Mrgfus strtctc ablt trgt icr","description":"Magnetic resonance image guided high intensity focused ultrasound (mrgfus), stereotactic ablation of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94762","name":"N-invas ear/pls oximtry cont","description":"Noninvasive ear or pulse oximetry for oxygen saturation; by continuous overnight monitoring (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0382U","name":"Hyprphenylalninmia mntr quan","description":"Hyprphenylalninmia mntr quan","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0628U","name":"Nfro kdn ds genetic cond 449","description":"Nfro kdn ds genetic cond 449","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0674T","name":"Laps insj nw/rpcmt prm isdss","description":"Laparoscopic insertion of new or replacement of permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including an implantable pulse generator and diaphragmatic lead(s)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4322","name":"Caregraft, per sq cm","description":"Caregraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3424","name":"Inj hydroxocobalamin iv 25mg","description":"Injection, hydroxocobalamin, intravenous, 25 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1231","name":"Pt hcv tst no reactive res","description":"Patient receives hcv antibody test with nonreactive result","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0701T","name":"Molec fluor img sus nev ea","description":"Molecular fluorescent imaging of suspicious nevus; each additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4301","name":"Activate matrix, per sq cm","description":"Activate matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1398","name":"Bslne and  fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4400","name":"Polygon3 per sq cm","description":"Polygon3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0959T","name":"Rmv/rplc magnet coil assem","description":"Removal or replacement of magnet from coil assembly that is connected to continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31715","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0913T","name":"Prq tcat ther rx ntrac balo1","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting), including mechanical dilation by nondrug-delivery balloon angioplasty, endoluminal imaging using intravascular ultrasound (ivus) or optical coherence tomography (oct) when per","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0532","name":"Take home supp nasal spray","description":"Take-home supply of nasal nalmefene hydrochloride; one carton of two, 2.7 mg per 0.1 ml nasal sprays (provision of the services by a medicare-enrolled opioid treatment program);( list separately in addition to each primary code)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1749","name":"Inj, iloprost, 0.1 mcg","description":"Injection, iloprost, 0.1 mcg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7111","name":"Extraction coronal remnants","description":"Extraction coronal remnants - deciduous tooth","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39200","name":"Resect mediastinal cyst","description":"Resection of mediastinal cyst","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4324","name":"Amniotx, per sq cm","description":"Amniotx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0691T","name":"Auto alys xst ct std vrt fx","description":"Automated analysis of an existing computed tomography study for vertebral fracture(s), including assessment of bone density when performed, data preparation, interpretation, and report","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7912","name":"Suture complicate wnd > 5 cm","description":"Complicated suture-greater than 5 cm","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6590","name":"Urinary cath disp suc pump","description":"External urinary catheters; disposable, with wicking material, for use with suction pump, per month","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1280","name":"Bilat mast/hx bi /unilat mas","description":"Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3389","name":"Topi adm prad zami per treat","description":"Topical administration, prademagene zamikeracel, per treatment","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99493","name":"Sbsq psyc collab care mgmt","description":"Subsequent psychiatric collaborative care management, first 60 minutes in a subsequent month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required el","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":98.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0472","name":"Gross exam prep & report","description":"Accession of tissue gross examination preparation and transmission of written report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0049","name":"Main hemo in-cntr","description":"With maintenance hemodialysis (in-center and home hd) for the complete reporting month","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0377U","name":"Cv ds quan advsrm/plsm lprtn","description":"Cv ds quan advsrm/plsm lprtn","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31259","name":"Nsl/sins ndsc sphn tiss rmvl","description":"Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior), including sphenoidotomy, with removal of tissue from the sphenoid sinus","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46910","name":"Destruction anal lesion(s)","description":"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; electrodesiccation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87467","name":"Hepatitis b surface ag quan","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; hepatitis b surface antigen (hbsag), quantitative","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4349","name":"Mantle dl matrix per sq cm","description":"Mantle dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0347U","name":"Rx metab/pcx dna 16 gen alys","description":"Rx metab/pcx dna 16 gen alys","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0840T","name":"Dgtz gls mcrscp cslt compre","description":"Digitization of glass microscope slides for consultation, comprehensive, with review of records and specimens, with report on referred material (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5931","name":"Surgical obturator","description":"Obturator prosthesis surgical","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0545","name":"Inherent visit to inpt","description":"Visit complexity inherent to hospital inpatient or observation care associated with a confirmed or suspected infectious disease by an infectious diseases specialist, including disease transmission risk assessment and mitigation, public health investigation, analysis, and testing, and complex antimic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78496","name":"Heart first pass add-on","description":"Cardiac blood pool imaging, gated equilibrium, single study, at rest, with right ventricular ejection fraction by first pass technique (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":389.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86256","name":"Fluorescent antibody titer","description":"Fluorescent noninfectious agent antibody; titer, each antibody","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9027","name":"Rbc o2 co2 reduced","description":"Red blood cells, leukocytes reduced, oxygen/ carbon dioxide reduced, each unit","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0390U","name":"Ob pe kdr eng&rbp4 ia alg","description":"Ob pe kdr eng&rbp4 ia alg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37207","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9275","name":"Inj cosibelimab-ipdl, 2 mg","description":"Injection, cosibelimab-ipdl, 2 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80198","name":"Assay of theophylline","description":"Theophylline","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1404","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52001","name":"Cysto w/irrg&evac mlt clots","description":"Cystourethroscopy with irrigation and evacuation of multiple obstructing clots","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1232","name":"Pt hcv tst reactive result","description":"Patient receives hcv antibody test with reactive result","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2027","name":"Matriderm per sq cm","description":"Matriderm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0381U","name":"Maple syrup ur ds mntr quan","description":"Maple syrup ur ds mntr quan","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0038","name":"Clin pt no ref","description":"Clinician determines patient does not require referral","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6073","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (predominantly base metal)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2042","name":"Foundation drs+ solo, sq cm","description":"Foundation drs+ solo, per square centimeter","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0529","name":"In home respite care, 4 hr u","description":"In-home respite care, 4-hour unit, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83527","name":"Assay of insulin","description":"Insulin; free","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0281","name":"Inj aminocaproic acid 1 gram","description":"Injection, aminocaproic acid, 1 gram","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85651","name":"Rbc sed rate nonautomated","description":"Sedimentation rate, erythrocyte; non-automated","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4361","name":"Epixpress, per sq cm","description":"Epixpress, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90849","name":"Multiple family group psytx","description":"Multiple-family group psychotherapy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39541","name":"Repair of diaphragm hernia","description":"Repair, diaphragmatic hernia (other than neonatal), traumatic; chronic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1022.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0866T","name":"Quan mri alys brn w/dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion detection, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transmissio","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0249","name":"Adm tocilizu covid-19 1st","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86701","name":"Hiv-1antibody","description":"Antibody; hiv-1","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6584","name":"Grad com wrap w straps","description":"Gradient compression wrap with adjustable straps, not otherwise specified","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4364","name":"Am bur xp mem xpl hy p sq cm","description":"Amnio burgeon xplus membrane and xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76078","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0968T","name":"Insj/rplcmt epcrnl nstim sys","description":"Insertion or replacement of epicranial neurostimulator system, including electrode array and pulse generator, with connection to electrode array","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7171","name":"Inj, adzynma, 10 iu","description":"Injection, adamts13, recombinant-krhn, 10 iu","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4422","name":"Ac wrap per sq cm","description":"A/c wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1353","name":"Sealant repair per tooth","description":"Sealant repair per tooth","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9939","name":"Placemnt removable appliance","description":"Placemnt removable appliance","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4224","name":"Hhf10-p per sq cm","description":"Human health factor 10 amniotic patch (hhf10-p), per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6280","name":"Implt maint procd remv implt","description":"Implt maint procd remv implt","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0628U","name":"Nfro kdn ds genetic cond 449","description":"Nfro kdn ds genetic cond 449","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1197","name":"Isa reduced >=3 fr ixv","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0039","name":"Pt no ref, rn spec","description":"Patient not referred, reason not otherwise specified","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4401","name":"Absolv3 per sq cm","description":"Absolv3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0434U","name":"Rx metab advrs vrnt alys 25","description":"Rx metab advrs vrnt alys 25","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1458","name":"Pt died bef end meas pd","description":"Patient died prior to the end of the performance period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0805T","name":"Tcat s&ivc prstc vl impl prq","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); percutaneous femoral vein approach","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98985","name":"Rtm dev sply mscsk sys 2-15d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of musculoskeletal system, 2-15 days in a 30-day period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0824T","name":"Tcat rmv 1chmbr ldls pm ra","description":"Transcatheter removal of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography), when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6093","name":"Recement supp part denture","description":"Recement implant/abutment supported fixed partial denture","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82735","name":"Assay of fluoride","description":"Fluoride","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0974T","name":"Slctv nzmtc dbrdmt t/a/l ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; each additional 100 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26785","name":"Treat finger dislocation","description":"Open treatment of interphalangeal joint dislocation, includes internal fixation, when performed, single","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9616","name":"Gallium gozellix 1 millicuri","description":"Gallium ga-68 gozetotide (gozellix), diagnostic, 1 millicurie","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87626","name":"Hpv sep hi-rsk typ&pool rslt","description":"Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), separately reported high-risk types (eg, 16, 18, 31, 45, 51, 52) and high-risk pooled result(s)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0853T","name":"Dgtz gls mcrscp mphmtrc ea m","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42310","name":"Drainage of salivary gland","description":"Drainage of abscess; submaxillary or sublingual, intraoral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26910","name":"Amputate metacarpal bone","description":"Amputation, metacarpal, with finger or thumb (ray amputation), single, with or without interosseous transfer","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":921.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62303","name":"Myelography lumbar injection","description":"Myelography via lumbar injection, including radiological supervision and interpretation; thoracic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0297U","name":"Onc pan tum whl gen seq dna","description":"Onc pan tum whl gen seq dna","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6613","name":"Onlay cst base mtl >=3 surfa","description":"Onlay - cast predominantly base metal three or more surfaces","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76015","name":"Mr sfty mplt&/fb asmt stf ea","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78494","name":"Heart image spect","description":"Cardiac blood pool imaging, gated equilibrium, spect, at rest, wall motion study plus ejection fraction, with or without quantitative processing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9956","name":"Admin home sleep apnea test","description":"Admin home sleep apnea test","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9272","name":"Inj, dostarlimab-gxly, 10 mg","description":"Injection, dostarlimab-gxly, 10 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0255U","name":"Andrology infertility assmt","description":"Andrology (infertility), sperm-capacitation assessment of ganglioside gm1 distribution patterns, fluorescence microscopy, fresh or frozen specimen, reported as percentage of capacitated sperm and probability of generating a pregnancy score","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9004","name":"Va whole health partner serv","description":"Department of veterans affairs whole health partner services","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4310","name":"Procenta, per 100 mg","description":"Procenta, per 100 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44960","name":"Appendectomy","description":"Appendectomy; for ruptured appendix with abscess or generalized peritonitis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":859.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1257","name":"Cvd risk assess not perf","description":"Cvd risk assessment not performed or incomplete (e.g., cvd risk assessment was not documented), reason not otherwise specified","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0608U","name":"Reprdtve med ema rtpcr 10bct","description":"Reprdtve med ema rtpcr 10bct","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0964T","name":"I&cust prep jaw xpnsj 1arch","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; single arch, without mandibular advancement mechanism","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1187","name":"Pt w/ esrd","description":"Patients with a diagnosis of end stage renal disease (esrd)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64628","name":"Trml dstrj ios bvn 1st 2 l/s","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; first 2 vertebral bodies, lumbar or sacral","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82103","name":"Alpha-1-antitrypsin total","description":"Alpha-1-antitrypsin; total","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1272","name":"Pts kid transplt wtlst","description":"Patients observed on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2598","name":"Inj, vasopressin, 1 unit","description":"Injection, vasopressin, 1 unit","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0706","name":"Intraoral occlus radio image","description":"Intraoral occlus radio image","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50727","name":"Revise ureter","description":"Revision of urinary-cutaneous anastomosis (any type urostomy);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":575.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1222","name":"Glaucoma pln of care not doc","description":"Glaucoma plan of care not documented, reason not otherwise specified","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4034","name":"Speech language path ss","description":"Speech language pathology mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26720","name":"Treat finger fracture each","description":"Closed treatment of phalangeal shaft fracture, proximal or middle phalanx, finger or thumb; without manipulation, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1396","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0738","name":"Upper extremity rehab","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2039.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1449","name":"Inj eflapegrastim-xnst 0.1mg","description":"Injection, eflapegrastim-xnst, 0.1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4327","name":"Duoamnion, per sq cm","description":"Duoamnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0575U","name":"Trnsplj med lar rtpcr 4genes","description":"Trnsplj med lar rtpcr 4genes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37271","name":"Revsc evsc fpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0556","name":"Adv prim care mgmt lvl 1","description":"Advanced primary care management services for a patient with one chronic condition [expected to last at least 12 months, or until the death of the patient, which place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline], or fewer, provided by clinical ","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9609","name":"F18 fdg, 15 millicuries","description":"Fludeoxyglucose f18 up to 15 millicuries","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20600","name":"Drain/inj joint/bursa w/o us","description":"Arthrocentesis, aspiration and/or injection, small joint or bursa (eg, fingers, toes); without ultrasound guidance","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":53.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1444","name":"Del < 39 weeks gest","description":"Delivery at < 39 weeks of gestation","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98981","name":"Rtm tx mgmt ea addl 20 min","description":"Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least 1 real-time interactive communication with the patient or caregiver during the calendar month; each additional 20 minutes (list separately in","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0901","name":"Vadadustat oral 1mg for esrd","description":"Vadadustat, oral, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0802T","name":"Tcat rmv&rpl2chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right at","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0917T","name":"Insj perm ccm-d sys 1 lead","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; single transvenous lead (pacing or defibrillation) only","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1490","name":"Pt status not doc","description":"Patient status not documented","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3055","name":"Inj talquetamab-tgvs 0.25 mg","description":"Injection, talquetamab-tgvs, 0.25 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33647","name":"Repair heart septum defects","description":"Repair of atrial septal defect and ventricular septal defect, with direct or patch closure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2031.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85306","name":"Clot inhibit prot s free","description":"Clotting inhibitors or anticoagulants; protein s, free","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0785T","name":"Revj/rmvl nea spi w/nstim","description":"Revision or removal of neurostimulator electrode array, spinal, with integrated neurostimulator","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J9151","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2801","name":"Inj, rykindo, 0.5 mg","description":"Injection, risperidone (rykindo), 0.5 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2045","name":"Novashield/novogen pr sq cm","description":"Novashield or novogen wound matrix, per square centimeter","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7528","name":"Mycophen mofetil for susp","description":"Mycophenolate mofetil, for suspension, oral, 100 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5148","name":"Inj, nyposi 1 mcg","description":"Injection, filgrastim-txid (nypozi), biosimilar, 1 microgram","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1385","name":"Pt rsn not seen 2nd pam","description":"Documentation of patient reasons for patients who were not seen for the second pam survey (e.g., less than four months between baseline pam assessment and follow-up","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1441","name":"Init dx slp apn = 1st enc","description":"Encounter corresponds to initial diagnosis of sleep apnea or first contact with sleep apnea diagnosed patient","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85651","name":"Rbc sed rate nonautomated","description":"Sedimentation rate, erythrocyte; non-automated","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93319","name":"3d echo img cgen car anomal","description":"3d echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac structure(s) (eg, cardiac chambers and valves, left atrial appendage, interatrial septum, interventricular","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91124","name":"Rct snsatn tone&cmplianc std","description":"Rectal sensation, tone, and compliance study (eg, barostat)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93582","name":"Perq transcath closure pda","description":"Percutaneous transcatheter closure of patent ductus arteriosus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64489","name":"Tap block bi by infusion","description":"Transversus abdominis plane (tap) block (abdominal plane block, rectus sheath block) bilateral; by continuous infusions (includes imaging guidance, when performed)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1434","name":"Inj, focinvez, 1mg","description":"Injection, fosaprepitant (focinvez), 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57454","name":"Bx/curett of cervix w/scope","description":"Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix and endocervical curettage","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":113.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33612","name":"Repair double ventricle","description":"Repair of double outlet right ventricle with intraventricular tunnel repair; with repair of right ventricular outflow tract obstruction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2484.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0426U","name":"Genome ultra-rapid seq alys","description":"Genome ultra-rapid seq alys","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0938T","name":"Xtrnl ecg rec>15d<30d rec","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; recording (including connection and initial recording)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0898T","name":"N-invas prst8 cancer est map","description":"Noninvasive prostate cancer estimation map, derived from augmentative analysis of image-guided fusion biopsy and pathology, including visualization of margin volume and location, with margin determination and physician interpretation and report","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0375U","name":"Onc ovrn bchm asy 7 prtn alg","description":"Onc ovrn bchm asy 7 prtn alg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36823","name":"Insertion of cannula(s)","description":"Insertion of arterial and venous cannula(s) for isolated extracorporeal circulation including regional chemotherapy perfusion to an extremity, with or without hyperthermia, with removal of cannula(s) and repair of arteriotomy and venotomy sites","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1482.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0462","name":"Atropine sulf, nte, 0.01 mg","description":"Injection, atropine sulfate, not therapeutically equivalent to j0461, 0.01 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4540","name":"Trans elec nerv periph nerv","description":"Distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2991","name":"App of hydroxyapatite","description":"App of hydroxyapatite","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9994","name":"Pall serv during meas","description":"Patient is using palliative care services any time during the measurement period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1178","name":"Doc med rsn no pcv","description":"Documentation of medical reason(s) for not administering pneumococcal vaccine (e.g., prior anaphylaxis due to the pneumococcal vaccine)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96203","name":"Mlt fam grp bhv train ea add","description":"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face with multiple sets of paren","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52224","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) or treatment of minor (less than 0.5 cm) lesion(s) with or without biopsy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73530","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28238","name":"Revision of foot tendon","description":"Reconstruction (advancement), posterior tibial tendon with excision of accessory tarsal navicular bone (eg, kidner type procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0594U","name":"Nfct ds sepsis pncrtc spc","description":"Nfct ds sepsis pncrtc spc","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J2940","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6610","name":"G com stcking bk 18-30 custm","description":"Gradient compression stocking, below knee, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0963T","name":"Anosc sbmcsl njx bulking agt","description":"Anoscopy with directed submucosal injection of bulking agent into anal canal","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64580","name":"Opn impltj nea neuromuscular","description":"Open implantation of neurostimulator electrode array; neuromuscular","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0874T","name":"Rmvl pertl ascites pmp sys","description":"Removal of a peritoneal ascites pump system, including implanted peritoneal ascites pump and indwelling bladder and peritoneal catheters","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0615","name":"Calcium acetate, oral, 23 mg","description":"Calcium acetate, oral, 23 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0377U","name":"Cv ds quan advsrm/plsm lprtn","description":"Cv ds quan advsrm/plsm lprtn","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9249","name":"Inj, melphalan (apotex) 1 mg","description":"Injection, melphalan (apotex), 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98009","name":"Synch audio-only new low 30","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 30 m","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4333","name":"Ardeograft, per sq cm","description":"Ardeograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0955T","name":"Tot impl amei removal","description":"Totally implantable active middle ear hearing implant; removal, including removal of sound processor and all implant components","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61715","name":"Mrgfus strtctc ablt trgt icr","description":"Magnetic resonance image guided high intensity focused ultrasound (mrgfus), stereotactic ablation of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0573U","name":"Onc pancreas 3bmrk pclf alg","description":"Onc pancreas 3bmrk pclf alg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49615","name":"Rpr aa hrn rcr 3-10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, reducible","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0890T","name":"Arhfcmrigtbs 1st tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including target assessment, initial motor threshold determination, neuronavigation, delivery and management, initial treatment day","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63709","name":"Repair spinal fluid leakage","description":"Repair of dural/cerebrospinal fluid leak or pseudomeningocele, with laminectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1229.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99418","name":"Prolng ip/obs e/m ea 15 min","description":"Prolonged inpatient or observation evaluation and management service(s) time with or without direct patient contact beyond the required time of the primary service when the primary service level has been selected using total time, each 15 minutes of total time (list separately in addition to the cod","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5098","name":"Inj ustekinumab-srlf, 1 mg","description":"Injection, ustekinumab-srlf (imuldosa), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0815T","name":"Us rems b1 dns hips plvs/spi","description":"Ultrasound-based radiofrequency echographic multi-spectrometry (rems), bone-density study and fracture-risk assessment, 1 or more sites, hips, pelvis, or spine","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1417","name":"Pt up to date cov","description":"Patients who are up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37299","name":"Revsc evsc imvt angio cpx ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":120.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0217","name":"Inj velmanase alfa-tycv 1 mg","description":"Injection, velmanase alfa-tycv, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0283","name":"Inj, amiodarone (nexterone)","description":"Injection, amiodarone hydrochloride (nexterone), 30 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4288","name":"Replacement breastpump valve","description":"Valve for breast pump, replacement","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93540","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62291","name":"Njx px discography crv/thrc","description":"Injection procedure for discography, each level; cervical or thoracic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93562","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1215","name":"Med rsn for no doc spiro","description":"Documentation of medical reason(s) for not documenting and reviewing spirometry results (e.g., patients with dementia or tracheostomy)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0901T","name":"Plmt bone marrow smplg port","description":"Placement of bone marrow sampling port, including imaging guidance when performed","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0396","name":"3d print of 3d surface scan","description":"3d print of 3d surface scan","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0385U","name":"Neph ckd alg rsk dbtc kdn ds","description":"Neph ckd alg rsk dbtc kdn ds","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7353","name":"Anacaulase-bcdb 8.8% gel 1 g","description":"Anacaulase-bcdb, 8.8% gel, 1 gram","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53452","name":"Tprnl balo cntnc dev uni","description":"Periurethral transperineal adjustable balloon continence device; unilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0541","name":"No pt prsnt train initial 30","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58346","name":"Insert heyman uteri capsule","description":"Insertion of heyman capsules for clinical brachytherapy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":498.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92622","name":"Dx aly aud oi snd prcsr 1st","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; first 60 minutes","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5128","name":"Inj, cimerli, 0.1 mg","description":"Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24535","name":"Cltx sprcndylr humeral fx w/","description":"Closed treatment of supracondylar or transcondylar humeral fracture, with or without intercondylar extension; with manipulation, with or without skin or skeletal traction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":670.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1446","name":"Pt died bef end meas pd","description":"Patients who died any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66683","name":"Implantation iris prosthesis","description":"Implantation of iris prosthesis, including suture fixation and repair or removal of iris, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0975T","name":"Slctv nzmtc dbrdmt s/n/hf 1","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; first 100 sq cm","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0136","name":"Adm of pa/n assess 5-15 m","description":"Administration of a standardized, evidence-based assessment of physical activity and nutrition, 5-15 minutes, not more often than every 6 months","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4356","name":"Abio mem abio hyd per sq cm","description":"Abiomend membrane and abiomend hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0537U","name":"Onc clrct ca cfdna >2500 dmr","description":"Onc clrct ca cfdna >2500 dmr","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45347","name":"Sigmoidoscopy w/plcmt stent","description":"Sigmoidoscopy, flexible; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55712","name":"Bx prst8 tprnl mri-us 1st","description":"Biopsy, prostate, transperineal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0879T","name":"Augmnt alys ch ct ild prep","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; radiological data preparation and transmission","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78012","name":"Thyroid uptake measurement","description":"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0470U","name":"Onc orop detcj mrd 8 dna hpv","description":"Onc orop detcj mrd 8 dna hpv","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0218","name":"Inj olipudase alfa-rpcp 1mg","description":"Injection, olipudase alfa-rpcp, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49621","name":"Rpr parastomal hernia rdc","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; reducible","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7299","name":"Rem anchorage device w/flap","description":"Rem anchorage device w/flap","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83721","name":"Assay of blood lipoprotein","description":"Lipoprotein, direct measurement; ldl cholesterol","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1331","name":"Pts eval ini xm 8 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 8 weeks from initial exam","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76988","name":"Dx ntrop epcr us chd img acq","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; placement, manipulation of transducer, and image acquisition only","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4414","name":"Simplichor per sq cm","description":"Simplichor, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1355","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4302","name":"Complete aca, per sq cm","description":"Complete aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0834T","name":"Dgtz gls mcrscp cytp oth xtn","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70553","name":"Mri brain stem w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1421.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5149","name":"Inj, aflibercept-abzv, 1 mg","description":"Injection, aflibercept-abzv (enzeevu), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67950","name":"Revision of eyelid","description":"Canthoplasty (reconstruction of canthus)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1338","name":"Pt f/u 30-180 dys no + imprv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who did not demonstrate positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0738","name":"Upper extremity rehab","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0431U","name":"Gly rcptr alpha1 igg srm/csf","description":"Gly rcptr alpha1 igg srm/csf","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77090","name":"Tbs techl prep&transmis data","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0908T","name":"Opn imp int nstm sys vgs nrv","description":"Open implantation of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2246","name":"Inj, micafungin (baxter)","description":"Injection, micafungin in sodium (baxter), not therapeutically equivalent to j2248, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1653","name":"Ho abduction static ots","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, off the shelf","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1358","name":"Pts no <suicd idea 120 dys","description":"Patients who did not have a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4400","name":"Polygon3 per sq cm","description":"Polygon3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0744T","name":"Insj bioprostc vlv fem vn","description":"Insertion of bioprosthetic valve, open, femoral vein, including duplex ultrasound imaging guidance, when performed, including autogenous or nonautogenous patch graft (eg, polyester, eptfe, bovine pericardium), when performed","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36013","name":"Place catheter in artery","description":"Introduction of catheter, right heart or main pulmonary artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4391","name":"Amnioplast double per sq cm","description":"Amnioplast double, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4395","name":"Acelagraft per sq cm","description":"Acelagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69719","name":"Rplcm oi implt sk tc esp<100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4024","name":"Pediatrics ss","description":"Pediatrics mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4036","name":"Urgent care ss","description":"Urgent care mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64597","name":"Ins/rplcm prq eltrd ra pn ea","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; each additional electrode array (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0030","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0514","name":"Prolong prev svcs, addl 30m","description":"Prolonged preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient contact beyond the usual service; each additional 30 minutes (list separately in addition to code g0513 for additional 30 minutes of preventi","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":56.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1456","name":"Inj, fosaprepitant (teva)","description":"Injection, fosaprepitant (teva), not therapeutically equivalent to j1453, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27405","name":"Repair of knee ligament","description":"Repair, primary, torn ligament and/or capsule, knee; collateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":807.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37275","name":"Rvsc evsc fpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1708","name":"Pfizer vacc admin 3rd dose","description":"Pfizer vacc admin 3rd dose","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0671T","name":"Insj ant sgm aq drg dev 1+","description":"Insertion of anterior segment aqueous drainage device into the trabecular meshwork, without external reservoir, and without concomitant cataract removal, one or more","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0740T","name":"Rem auton alg nsln cal setup","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; initial set-up and patient education","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3404","name":"Inj zopapogene per ther dose","description":"Injection, zopapogene imadenovec-drba suspension, per therapeutic dose","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1450","name":"Pt hos/pal care dur id/pf pd","description":"Patients who received hospice or palliative care service any time during denominator identification period or the measure assessment period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0551","name":"Phn/intr svs fr dx treat 30m","description":"Interprofessional telephone/internet/electronic health record referral service(s) provided by a treating/requesting practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, 30 minutes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0004","name":"Qual care neurologic cnd mvp","description":"Quality care for patients with neurological conditions mips value pathway","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22845","name":"Insert spine fixation device","description":"Anterior instrumentation; 2 to 3 vertebral segments (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":957.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37284","name":"Revsc evasc tpvt st sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0435U","name":"Onc chemo rx cytox csc 14 rx","description":"Onc chemo rx cytox csc 14 rx","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87182","name":"Sc std carbapenemase nzm det","description":"Susceptibility studies, antimicrobial agent; carbapenemase enzyme detection (eg, klebsiella pneumoniae carbapenemase [kpc], new delhi metallo-beta-lactamase [ndm], verona integron-encoded metallo-beta-lactamase [vim]), multiplex immunoassay, qualitative, per isolate","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81459","name":"So neo gsap dna/dna&rna","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants, microsatellite instability, tumor mutation burden, and rearrangements","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0317U","name":"Onc lung ca 4-prb fish assay","description":"Onc lung ca 4-prb fish assay","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1484","name":"No rpt hcv rna perf med rsn","description":"Patients who did not have a repeat hcv rna labs performed for medical reasons documented by clinician (e.g., patient with limited life expectancy, delay in treatment of hcv related to treatment of hiv, hbv, hepatocellular carcinoma, decompensated cirrhosis)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0999T","name":"Autol musc cell therapy hrvg","description":"Autologous muscle cell therapy, harvesting of muscle progenitor cells, including ultrasound guidance, when performed","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2782","name":"Crown 3/4 cast noble metal","description":"Crown - 3/4 cast noble metal","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0883T","name":"Intraop ther estim pn ue ea","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; each additional nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7528","name":"Mycophen mofetil for susp","description":"Mycophenolate mofetil, for suspension, oral, 100 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0811T","name":"Rem mlt day uroflow setup","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); set-up and patient education on use of equipment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87538","name":"Hiv-2 probe&revrse trnscripj","description":"Infectious agent detection by nucleic acid (dna or rna); hiv-2, amplified probe technique, includes reverse transcription when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0937T","name":"Xtrnl ecg rec>15d<30d","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; including recording, scanning analysis with report, review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1301","name":"Immunization counseling","description":"Immunization counseling","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6105","name":"Remove implant body","description":"Remove implant body","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69730","name":"Rplc oi implt sk tc esp>=100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1446","name":"Pt died bef end meas pd","description":"Patients who died any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86200","name":"Ccp antibody","description":"Cyclic citrullinated peptide (ccp), antibody","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6601","name":"G com bandge hgh dn foam pad","description":"Gradient compression bandaging supply, high density foam pad, any size or shape, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":3.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50220","name":"Remove kidney open","description":"Nephrectomy, including partial ureterectomy, any open approach including rib resection;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0266U","name":"Unxpl cnst hrtbl do gn xprsn","description":"Unexplained constitutional or other heritable disorders or syndromes, tissue-specific gene expression by whole-transcriptome and next-generation sequencing, blood, formalin-fixed paraffin-embedded (ffpe) tissue or fresh frozen tissue, reported as presence or absence of splicing or expression changes","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0728T","name":"Dx alys vstblr implt uni 1st","description":"Diagnostic analysis of vestibular implant, unilateral; with initial programming","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7050","name":"Normal saline solution infus","description":"Infusion, normal saline solution, 250 cc","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82803","name":"Blood gases any combination","description":"Gases, blood, any combination of ph, pco2, po2, co2, hco3 (including calculated o2 saturation);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3501","name":"Surg exp root surf anterior","description":"Surg exp root surf anterior","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1782","name":"Vac admin human pap dose 2","description":"Vac admin human pap dose 2","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49622","name":"Rpr parastomal hrna ncr/strn","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1814","name":"Inj. insulin (lyumjev)","description":"Insulin (lyumjev), per 5 units","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0708T","name":"Id ca immntx prep & 1st njx","description":"Intradermal cancer immunotherapy; preparation and initial injection","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15342","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93594","name":"R hrt cath chd abnl nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; abnormal native connections","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1487","name":"Pt adm to hospice dur eval","description":"Patients in hospice in the year before or during the period of evaluation","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4286","name":"Nudyn sl or slw, per sq cm","description":"Nudyn sl or nudyn slw, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64473","name":"Lwr xtr fscl pln blk uni njx","description":"Lower extremity fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5227","name":"Immed max part denture","description":"Immed max part denture","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0847T","name":"Dgtz gls mcrscp xm arch tiss","description":"Digitization of glass microscope slides for examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, kras mutational analysis) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1404","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0538U","name":"Onc sol tum ngts ffpe 600gen","description":"Onc sol tum ngts ffpe 600gen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98008","name":"Synch audio-only new sf 15","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code sel","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8522","name":"Capecitabine, oral, 50 mg","description":"Capecitabine, oral, 50 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0969T","name":"Removal epicranial nstim sys","description":"Removal of epicranial neurostimulator system","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9154","name":"Artificial saliva, 1 ml","description":"Artificial saliva, 1 ml","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0300U","name":"Onc pan tum whl gen seq&opt","description":"Onc pan tum whl gen seq&opt","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2041","name":"Foundation drs+ duo pr sq cm","description":"Foundation drs+ duo, per square centimeter","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1288","name":"Doc rsn no hbp scrn or f/u","description":"Documented reason for not screening or recommending a follow-up for high blood pressure","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0763T","name":"Dgtz gls mcrscp mphmtrc alys","description":"Digitization of glass microscope slides for morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure, manual (list separately in addition to code for primary proced","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0966T","name":"I&cst prp jw xpn dl arch fxd","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, fixed hinge mechanism","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4288","name":"Dermabind ch, per sq cm","description":"Dermabind ch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1370","name":"Inj, esomeprazole sod, 1 mg","description":"Injection, esomeprazole sodium, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0806T","name":"Tcat s&ivc prstc vl impl opn","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); open femoral vein approach","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6598","name":"G comp bandage med stretch","description":"Gradient compression bandage roll, elastic medium stretch, per linear yard, any width, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0457U","name":"Pfas 9 cmpnd lcms/ms pls/sr","description":"Pfas 9 cmpnd lcms/ms pls/sr","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9220","name":"Indigotindisulfonate sod 1mg","description":"Injection, indigotindisulfonate sodium, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1151","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4348","name":"Sentry sl matrix per sq cm","description":"Sentry sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86231","name":"Ema each ig class","description":"Endomysial antibody (ema), each immunoglobulin (ig) class","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99426","name":"Prin care mgmt staff 1st 30","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37276","name":"Rvsc evsc fpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1448","name":"Pt dx pd bef end meas pd","description":"Patients with an active diagnosis of personality disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91125","name":"Anrct mano rct snsatn&balo","description":"Anorectal manometry, with rectal sensation and rectal balloon expulsion test, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1295","name":"Pt hx tot col or colon ca","description":"Patients with a diagnosis or past history of total colectomy or colorectal cancer","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0801","name":"3d dental scan direct","description":"3d dental scan direct","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0444U","name":"Onc sld orgn neo tgsap 361","description":"Onc sld orgn neo tgsap 361","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1737","name":"Inj meloxicam (azurity) 1mg","description":"Injection, meloxicam (azurity), 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1300","name":"Flu imm no admin doc rea","description":"Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33234","name":"Removal of pacemaker system","description":"Removal of transvenous pacemaker electrode(s); single lead system, atrial or ventricular","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":588.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93040","name":"Rhythm ecg with report","description":"Rhythm ecg, 1-3 leads; with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":7.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0522U","name":"Ca vi psp&sp1 antb cl semiql","description":"Ca vi psp&sp1 antb cl semiql","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69650","name":"Stapes mobilization","description":"Stapes mobilization","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":915.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2020","name":"Ac5 wound system","description":"Ac5 advanced wound system (ac5)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1014T","name":"Lap rv/rmv eso sph nstm eltr","description":"Laparoscopic revision or removal, lower esophageal sphincter neurostimulator electrodes","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0136","name":"Inj, acetaminophen (b braun)","description":"Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98980","name":"Rtm tx mgmt 1st 20 min","description":"Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least 1 real-time interactive communication with the patient or caregiver during the calendar month; first 20 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41145","name":"Tongue removal neck surgery","description":"Glossectomy; complete or total, with or without tracheostomy, with unilateral radical neck dissection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2845.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1427","name":"Doc med rsn bone scn","description":"Documentation of medical reason(s) for performing a bone scan (including documented pain related to prostate cancer, salvage therapy, other medical reasons)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15730","name":"Mdfc flap w/prsrv vasc pedcl","description":"Midface flap (ie, zygomaticofacial flap) with preservation of vascular pedicle(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1691.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":908.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0782T","name":"Brnchsc rf dstrj plm nrv uni","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; unilateral mainstem bronchus","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82653","name":"El-1 fecal quantitative","description":"Elastase, pancreatic (el-1), fecal; quantitative","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76988","name":"Dx ntrop epcr us chd img acq","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; placement, manipulation of transducer, and image acquisition only","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1260","name":"Pt not doc <= 1 yr dialysis","description":"Patient status not documented within the first year of initiating dialysis","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81002","name":"Urinalysis nonauto w/o scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; non-automated, without microscopy","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0455U","name":"Nfct agt sti mult amp prb ur","description":"Nfct agt sti mult amp prb ur","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2792","name":"Crown full cast noble metal","description":"Crown-full cast noble metal","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0235","name":"Intrav inf, mon anti, fir do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0905T","name":"Ecg alg 12 ld rdcd i&r only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; interpretation and report only","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0884T","name":"Esphgsc flx 1st tndsc dilat","description":"Esophagoscopy, flexible, transoral, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for esophageal stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37282","name":"Rvsc evsc tpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0034","name":"Pall serv during meas","description":"Patients receiving palliative care during the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1322","name":"Pts 7wk inj, scrn iop =<25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop =<25 mm hg for injected eye","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1344","name":"No bsln/2nd pam score 4-12mo","description":"Patients who did not have a baseline pam score and/or a second score within 4 to 12 months of baseline pam score","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86042","name":"Acetylcholn rcptr blckg antb","description":"Acetylcholine receptor (achr); blocking antibody","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1322","name":"Pts 7wk inj, scrn iop =<25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop =<25 mm hg for injected eye","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1500","name":"Neuropsychology mvp","description":"Neuropsychology mips value pathway","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75880","name":"Vein x-ray eye socket","description":"Venography, orbital, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0857T","name":"Opto-acoustic img breast uni","description":"Opto-acoustic imaging, breast, unilateral, including axilla when performed, real-time with image documentation, augmentative analysis and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78491","name":"Myocrd img pet 1std rst/strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); single study, at rest or stress (exercise or pharmacologic)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3222","name":"Part pulp for apexogenesis","description":"Partial pulpotomy for apexogenesis - permanent tooth with incomplete root development","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0479U","name":"Tau phosphorylated ptau217","description":"Tau phosphorylated ptau217","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1414","name":"Inj, beqvez, per tx dose","description":"Injection, fidanacogene elaparvovec-dzkt, per therapeutic dose","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93593","name":"R hrt cath chd nml nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; normal native connections","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0569","name":"Subs psych care mng, subs mo","description":"Subsequent psychiatric collaborative care management, in a subsequent month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required elements: tracking ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98002","name":"Synch audio-video new mod 45","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate medical decision making. when using total time on the date of the encounter for code selection, 45 minutes must be met or exceeded.","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0759T","name":"Dgtz gls mcrscp sl sp grpiii","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group iii, for enzyme constituents (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0603U","name":"Rx asy prsmv 77rx/metablt ur","description":"Rx asy prsmv 77rx/metablt ur","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1319","name":"Pts csp doc contact","description":"Patients who had documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99387","name":"Init pm e/m new pat 65+ yrs","description":"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; 65 years and old","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":163.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59857","name":"Induced ab 1+vag supp hyst","description":"Induced abortion, by 1 or more vaginal suppositories (eg, prostaglandin) with or without cervical dilation (eg, laminaria), including hospital admission and visits, delivery of fetus and secundines; with hysterotomy (failed medical evacuation)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":647.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":734.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5945","name":"Mand implt sup remv part","description":"Mand implt sup remv part","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1501","name":"Pathology mvp","description":"Pathology mips value pathway","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0808T","name":"Pulm tiss vntj alys w/ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with computed tomography (ct) images taken for the purpose of pulmonary tissue ventilation analysis, including data preparation and transmission, quantificati","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0745T","name":"Car ablt rad arr n-invas loc","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; noninvasive arrhythmia localization and mapping of arrhythmia site (nidus), derived from anatomical image data (eg, ct, mri, or myocardial perfusion scan) and electrical data (eg, 12-lead ecg data), and identification of areas of avo","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94618","name":"Pulmonary stress testing","description":"Pulmonary stress testing (eg, 6-minute walk test), including measurement of heart rate, oximetry, and oxygen titration, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0391U","name":"Onc sld tum dna&rna 437 gen","description":"Onc sld tum dna&rna 437 gen","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0388","name":"Bitewing image capture only","description":"Bitewing image capture only","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0828T","name":"Dgtz gls mcrscp cytp smpl fl","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; simple filter method with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1276","name":"Calc bmi out nrm param nof/u","description":"Bmi documented outside normal parameters, no follow-up plan documented, no reason given","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0174","name":"Lecanemab-irmb, for iv inj","description":"Lecanemab-irmb, for intravenous injection, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1228","name":"Pt + hcv aby +vir w/ rx 3 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, has hcv treatment initiated within 3 months of the reactive hcv antibody test","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36483","name":"Endoven ther chem adhes sbsq","description":"Endovenous ablation therapy of incompetent vein, extremity, by transcatheter delivery of a chemical adhesive (eg, cyanoacrylate) remote from the access site, inclusive of all imaging guidance and monitoring, percutaneous; subsequent vein(s) treated in a single extremity, each through separate access","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":153.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98925","name":"Osteopath manj 1-2 regions","description":"Osteopathic manipulative treatment (omt); 1-2 body regions involved","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":19.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3375","name":"Inj, vanco (tyzavan) 10mg","description":"Injection, vancomycin hydrochloride (tyzavan), not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37264","name":"Revsc evasc fpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33277","name":"Insj phrnc nrv stim transvns","description":"Insertion of phrenic nerve stimulator transvenous sensing lead (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4438","name":"Adhesive clip ext ens contr","description":"Adhesive clip applied to the skin to secure external electrical nerve stimulator controller, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0275U","name":"Hem heprn nduc trmbctpna srm","description":"Hematology (heparin-induced thrombocytopenia) platelet antibody reactivity by flow cytometry, serum","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37278","name":"Rvsc evsc fpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2506","name":"Inj pegfilgrast ex bio 0.5mg","description":"Injection, pegfilgrastim, excludes biosimilar, 0.5 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87176","name":"Tissue homogenization cultr","description":"Homogenization, tissue, for culture","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1307","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0885T","name":"Colsc flx 1st tndsc dilat","description":"Colonoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67516","name":"Sprchoroidal spc njx rx agt","description":"Suprachoroidal space injection of pharmacologic agent (separate procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98978","name":"Rtm dev sply cbt 16-30 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of cognitive behavioral therapy, 16-30 days in a 30-day period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37269","name":"Revsc evasc fpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1954","name":"Inj leu acet lutr dpt 7.5 mg","description":"Injection, leuprolide acetate for depot suspension (lutrate depot), 7.5 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9274","name":"Inj, tebentafusp-tebn, 1 mcg","description":"Injection, tebentafusp-tebn, 1 microgram","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0256U","name":"Tma/tmao prfl ms/ms ur alg","description":"Trimethylamine/trimethylamine n-oxide (tma/tmao) profile, tandem mass spectrometry (ms/ms), urine, with algorithmic analysis and interpretive report","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0468U","name":"Hep nash mir34a5p a2m ykl40","description":"Hep nash mir34a5p a2m ykl40","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1152","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92642","name":"Hearing asstv dev fitg svc","description":"Hearing assistive device, supplemental technology fitting services (eg, personal frequency modulation [fm]/digital modulation [dm] system, remote microphone, alerting devices)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0862T","name":"Rlcj pg wcs lv battery only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; battery component only","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23575","name":"Cltx scap fx w/mnpj +-tractj","description":"Closed treatment of scapular fracture; with manipulation, with or without skeletal traction (with or without shoulder joint involvement)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37293","name":"Rvsc evsc tpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5944","name":"Max implt sup remv part","description":"Max implt sup remv part","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1736","name":"Inj meloxicam (delova) 1mg","description":"Injection, meloxicam (delova), 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0907T","name":"Coms ther ea addl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; each additional application, total wound(s) surface area less than or equal to 50 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11310","name":"Shave skin lesion 0.5 cm/<","description":"Shaving of epidermal or dermal lesion, single lesion, face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 0.5 cm or less","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0216","name":"Inj, alfentanil hcl, 500mcg","description":"Injection, alfentanil hydrochloride, 500 micrograms","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1169","name":"Doc med rsn no flu vax","description":"Documentation of medical reason(s) for not administering influenza vaccine (e.g., prior anaphylaxis due to the influenza vaccine)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98984","name":"Rtm dev sply resp sys 2-15 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of respiratory system, 2-15 days in a 30-day period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1736","name":"Inj meloxicam (delova) 1mg","description":"Injection, meloxicam (delova), 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3394","name":"Inj, lovotibeglogene autotem","description":"Injection, lovotibeglogene autotemcel, per treatment","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0870T","name":"Imp subq prtl ascts pmp sys","description":"Implantation of subcutaneous peritoneal ascites pump system, percutaneous, including pump-pocket creation, insertion of tunneled indwelling bladder and peritoneal catheters with pump connections, including all imaging and initial programming, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0701T","name":"Molec fluor img sus nev ea","description":"Molecular fluorescent imaging of suspicious nevus; each additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4325","name":"Acapatch, per sq cm","description":"Acapatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4321","name":"Renograft, per sq cm","description":"Renograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23465","name":"Repair shoulder capsule","description":"Capsulorrhaphy, glenohumeral joint, posterior, with or without bone block","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1355.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2543","name":"Dental onlay metallic 3 surf","description":"Onlay - metallic - three surfaces","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1391","name":"All pt dx w/ rec mlnm","description":"All patients who were diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0943T","name":"Cysto flx rmvl urtl scaffold","description":"Cystourethroscopy, flexible; with removal of prostatic urethral scaffold","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5148","name":"Inj, nyposi 1 mcg","description":"Injection, filgrastim-txid (nypozi), biosimilar, 1 microgram","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0407U","name":"Neph dbtc ckd mult eclia alg","description":"Neph dbtc ckd mult eclia alg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64474","name":"Lwr xtr fscl pln blk uni nfs","description":"Lower extremity fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35881","name":"Revise graft w/vein","description":"Revision, lower extremity arterial bypass, without thrombectomy, open; with segmental vein interposition","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1308.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3401","name":"Vyjuvek 5x10^9pfu/ml, 0.1 ml","description":"Beremagene geperpavec-svdt for topical administration, containing nominal 5 x 10^9 pfu/ml vector genomes, per 0.1 ml","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0571U","name":"Onc sol tum dna80&rna10g ngs","description":"Onc sol tum dna80&rna10g ngs","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87274","name":"Herpes simplex 1 ag if","description":"Infectious agent antigen detection by immunofluorescent technique; herpes simplex virus type 1","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74021","name":"Radex abdomen 3+ views","description":"Radiologic examination, abdomen; 3 or more views","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93595","name":"L hrt cath chd nm/abn nt cnj","description":"Left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone, normal or abnormal native connections","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4373","name":"Membrane wrp lt per sq cm","description":"Membrane wrap lite, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9616","name":"Gallium gozellix 1 millicuri","description":"Gallium ga-68 gozetotide (gozellix), diagnostic, 1 millicurie","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4304","name":"Grafix plus, per sq cm","description":"Grafix plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9342","name":"Inj thiotepa nos 1 mg","description":"Injection, thiotepa, not otherwise specified, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1324","name":"Pts intravitreal/pci","description":"Patients who had an intravitreal or periocular corticosteroid injection (e.g., triamcinolone, preservative-free triamcinolone, dexamethasone, dexamethasone intravitreal implant, or fluocinolone intravitreal implant)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59510","name":"Cesarean delivery","description":"Routine obstetric care including antepartum care, cesarean delivery, and postpartum care","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2689.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93319","name":"3d echo img cgen car anomal","description":"3d echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac structure(s) (eg, cardiac chambers and valves, left atrial appendage, interatrial septum, interventricular","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9998","name":"Inj ustekinumab-aekn, 1 mg","description":"Injection, ustekinumab-aekn (selarsdi), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0248","name":"Inj, remdesivir, 1 mg","description":"Injection, remdesivir, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26562","name":"Repair of web finger","description":"Repair of syndactyly (web finger) each web space; complex (eg, involving bone, nails)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1574.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0830T","name":"Dgtz gls mcrscp cytp slctv","description":"Digitization of glass microscope slides for cytopathology, selective-cellular enhancement technique with interpretation (eg, liquid-based slide preparation method), except cervical or vaginal (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68200","name":"Treat eyelid by injection","description":"Subconjunctival injection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4035","name":"Thoracic surgery ss","description":"Thoracic surgery mips specialty set","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82491","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4334","name":"Amnioplast 1, per sq cm","description":"Amnioplast 1, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0612U","name":"Onc lvr alys >1000 mr cfdna","description":"Onc lvr alys >1000 mr cfdna","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19110","name":"Nipple exploration","description":"Nipple exploration, with or without excision of a solitary lactiferous duct or a papilloma lactiferous duct","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1189","name":"Doc khe pef w/efgr/uacr","description":"Documentation of a kidney health evaluation defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr) performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1303","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1401","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0737T","name":"Xenograft impltj artclr surf","description":"Xenograft implantation into the articular surface","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0384U","name":"Neph ckd rsk hi stg kdn ds","description":"Neph ckd rsk hi stg kdn ds","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2782","name":"Crown 3/4 cast noble metal","description":"Crown - 3/4 cast noble metal","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2012","name":"Suprathel, per sq cm","description":"Suprathel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7511","name":"Incision/drain abscess intra","description":"Incision and drainage of abscess - intraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0430U","name":"Gi malabs aat calpro pncrtc","description":"Gi malabs aat calpro pncrtc","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1282","name":"Pt scrn tbco id as non user","description":"Patient screened for tobacco use and identified as a tobacco non-user","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0852T","name":"Dgtz gls mcrscp mphmtrc ea 1","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6091","name":"Repl semi/precision attach","description":"Replacement of semi-precision or precision attachment (male or female component) of implant/abutment supported prosthesis per attachment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0421U","name":"Onc clrct scr sgl amp 8 rna","description":"Onc clrct scr sgl amp 8 rna","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4457","name":"Enema tube any type repl","description":"Enema tube, with or without adapter, any type, replacement only, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76988","name":"Dx ntrop epcr us chd img acq","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; placement, manipulation of transducer, and image acquisition only","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5138","name":"Inj, wezlana, iv, 1 mg","description":"Injection, ustekinumab-auub (wezlana), biosimilar, intravenous, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4148","name":"Enteral feed elastomer daily","description":"Enteral feeding supply kit; elastomeric control fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2103.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0796T","name":"Tcat ins 2chmbr ldls pm ra","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right atrial pacemaker","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4224","name":"Hhf10-p per sq cm","description":"Human health factor 10 amniotic patch (hhf10-p), per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1327","name":"Pts no eval ini xm no 8 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 8 weeks","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7171","name":"Inj, adzynma, 10 iu","description":"Injection, adamts13, recombinant-krhn, 10 iu","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1355","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q9947","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6593","name":"Grad com accessory gmt_wrap","description":"Accessory for gradient compression garment or wrap with adjustable straps, not-otherwise specified","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0371","name":"Sialoendoscopy capt & interp","description":"Sialoendoscopy capt & interp","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6198","name":"Remove interim implant","description":"Remove interim implant","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9029","name":"Instill adstiladrin, tx dose","description":"Intravesical instillation, nadofaragene firadenovec-vncg, per therapeutic dose","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5941","name":"Resct proth mand part remov","description":"Resct proth mand part remov","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90759","name":"Hep b vac 3ag 10mcg 3 dos im","description":"Hepatitis b vaccine (hepb), 3-antigen (s, pre-s1, pre-s2), 10 mcg dosage, 3 dose schedule, for intramuscular use","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0540U","name":"Trnsplj med quan dd-cfdna","description":"Trnsplj med quan dd-cfdna","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64657","name":"Rmvl bat modulj sys tot sys","description":"Removal of baroreflex activation therapy (bat) modulation system; total system, including lead and pulse generator","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98976","name":"Rtm dev sply resp sys 16-30d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of respiratory system, 16-30 days in a 30-day period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0718T","name":"Adrc ther prtl rc tear njx","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; injection into supraspinatus tendon including ultrasound guidance, unilateral","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0804T","name":"Prgrmg evl ldls pm 2chmbr ip","description":"Programming device evaluation (in person) with iterative adjustment of implantable device to test the function of device and to select optimal permanent programmed values, with analysis, review, and report, by a physician or other qualified health care professional, leadless pacemaker system in dual","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77404","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95857","name":"Cholinesterase challenge","description":"Cholinesterase inhibitor challenge test for myasthenia gravis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0609U","name":"Onc prostate ia tot&free psa","description":"Onc prostate ia tot&free psa","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64629","name":"Trml dstrj ios bvn ea addl","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; each additional vertebral body, lumbar or sacral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0628U","name":"Nfro kdn ds genetic cond 449","description":"Nfro kdn ds genetic cond 449","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4375","name":"Duograft ac per sq cm","description":"Duograft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33364","name":"Replace aortic valve open","description":"Transcatheter aortic valve replacement (tavr/tavi) with prosthetic valve; open iliac artery approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1967.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33777","name":"Rpr tga bfl rpr sbpulm obstr","description":"Repair of transposition of the great arteries, atrial baffle procedure (eg, mustard or senning type) with cardiopulmonary bypass; with repair of subpulmonic obstruction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2459.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6032","name":"Part handfng ultralite tcf/=","description":"Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0560U","name":"Onc mrd gsa cfdna baseline","description":"Onc mrd gsa cfdna baseline","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4412","name":"Choriofix per sq cm","description":"Choriofix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0326U","name":"Trgt gen seq alys pnl 83+","description":"Trgt gen seq alys pnl 83+","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22836","name":"Ant thrc vrt body tethrg <7","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; up to 7 vertebral segments","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6590","name":"Urinary cath disp suc pump","description":"External urinary catheters; disposable, with wicking material, for use with suction pump, per month","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5152","name":"Inj, eculizumab-aeeb, 2 mg","description":"Injection, eculizumab-aeeb (bkemv), biosimilar, 2 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3285","name":"Treprostinil injection","description":"Injection, treprostinil, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0829T","name":"Dgtz gls mcrscp cytp conctrj","description":"Digitization of glass microscope slides for cytopathology, concentration technique, smears, and interpretation (eg, saccomanno technique) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4299","name":"Amniocore pro+, per sq cm","description":"Amniocore pro+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0718T","name":"Adrc ther prtl rc tear njx","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; injection into supraspinatus tendon including ultrasound guidance, unilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9049","name":"Inj, bortezomib, hospira","description":"Injection, bortezomib (hospira), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0485U","name":"Onc sol tum cfdna&rna ngs gm","description":"Onc sol tum cfdna&rna ngs gm","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1370","name":"Rehab support msk care mvp","description":"Rehabilitative support for musculoskeletal care mips value pathway","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1952","name":"Afo spiral prefab ots","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, off-the-shelf","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0482","name":"Direct immunofluorescence","description":"Direct immunofluorescence","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83521","name":"Ig light chains free each","description":"Immunoglobulin light chains (ie, kappa, lambda), free, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4372","name":"Amchoplast excl per sq cm","description":"Amchoplast excel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0545U","name":"Achr antb id imfluor livecll","description":"Achr antb id imfluor livecll","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99483","name":"Assmt & care pln pt cog imp","description":"Assessment of and care planning for a patient with cognitive impairment, requiring an independent historian, in the office or other outpatient, home or domiciliary or rest home, with all of the following required elements: cognition-focused evaluation including a pertinent history and examination, m","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":165.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57461","name":"Conz of cervix w/scope leep","description":"Colposcopy of the cervix including upper/adjacent vagina; with loop electrode conization of the cervix","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1180","name":"Pt imm ckpt inhib therapy","description":"Patients on immune checkpoint inhibitor therapy","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1448","name":"Pt dx pd bef end meas pd","description":"Patients with an active diagnosis of personality disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1448","name":"Injection, trilaciclib, 1mg","description":"Injection, trilaciclib, 1mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61736","name":"Litt icr 1 traj 1 smpl les","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; single trajectory for 1 simple lesion","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4418","name":"Biolab wrap flow per sq cm","description":"Biolab membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1952","name":"Afo spiral prefab ots","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, off-the-shelf","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5098","name":"Inj ustekinumab-srlf, 1 mg","description":"Injection, ustekinumab-srlf (imuldosa), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4009","name":"Hospitalists ss","description":"Hospitalists mips specialty set","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1209","name":">=2 same hi-rsk med w/o diag","description":"At least two orders for high-risk medications from the same drug class, (table 4), without appropriate diagnoses","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1472","name":"Hep b vaccine not received","description":"Patient did not receive recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0385U","name":"Neph ckd alg rsk dbtc kdn ds","description":"Neph ckd alg rsk dbtc kdn ds","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35879","name":"Revise graft w/vein","description":"Revision, lower extremity arterial bypass, without thrombectomy, open; with vein patch angioplasty","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1163.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1237","name":"Pt rsn no scrn","description":"Patient reason for not screening for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety (e.g., patient declined or other patient reasons)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1190","name":"Doc khe not pef w/efgr/uacr","description":"Documentation of a kidney health evaluation was not performed or defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1159","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51721","name":"Ins trurl ablt trnsdc thr us","description":"Insertion of transurethral ablation transducer for delivery of thermal ultrasound for prostate tissue ablation, including suprapubic tube placement during the same session and placement of an endorectal cooling device, when performed","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J0152","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4395","name":"Acelagraft per sq cm","description":"Acelagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5154","name":"Inj, omlyclo, 5 mg","description":"Injection, omalizumab-igec (omlyclo), biosimilar, 5 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9953","name":"Reline sleep apnea appliance","description":"Reline sleep apnea appliance","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64466","name":"Thrc fascial pln blk uni njx","description":"Thoracic fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82234","name":"Beta-amyloid 1-42 (abeta 42)","description":"Beta-amyloid; 1-42 (abeta 42)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01939","name":"Anes nulyt agt crv/thrc","description":"Anesthesia for percutaneous image-guided destruction procedures by neurolytic agent on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1205","name":"Isa reduced >=3","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0538","name":"Ascvd rsk mng clin stf pr mo","description":"Atherosclerotic cardiovascular disease (ascvd) risk management services; clinical staff time; per calendar month","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86052","name":"Aquaporin-4 antb cba each","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; cell-based immunofluorescence assay (cba), each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0660","name":"Team remote e/m new pt 10 mn","description":"Team remote e/m new pt 10mins","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91320","name":"Sarscv2 vac 30mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 30 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2025","name":"Miro3d per cubic cm","description":"Miro3d, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4267","name":"Neostim dl per sq cm","description":"Neostim dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57421","name":"Exam/biopsy of vag w/scope","description":"Colposcopy of the entire vagina, with cervix if present; with biopsy(s) of vagina/cervix","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":216.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":130.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76989","name":"Dx intraop epcar us chd i&r","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; interpretation and report only","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0682","name":"App non-sheet skin sub add","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (list separately in addition to code for pri","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2371","name":"Inj phenylephrine hcl 20 mcg","description":"Injection, phenylephrine hydrochloride, 20 micrograms","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91320","name":"Sarscv2 vac 30mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 30 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6180","name":"Implnt maint proced","description":"Implnt maint proced","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82175","name":"Assay of arsenic","description":"Arsenic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99239","name":"Hosp ip/obs dschrg mgmt >30","description":"Hospital inpatient or observation discharge day management; more than 30 minutes on the date of the encounter","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64658","name":"Rmvl bat modul sys lead only","description":"Removal of baroreflex activation therapy (bat) modulation system; lead only","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82127","name":"Amino acid single qual","description":"Amino acids; single, qualitative, each specimen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0599U","name":"Onc pncrtc ca mult ia serum","description":"Onc pncrtc ca mult ia serum","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87088","name":"Urine bacteria culture","description":"Culture, bacterial; with isolation and presumptive identification of each isolate, urine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0020M","name":"Onc cns alys 30000 dna loci","description":"Oncology (central nervous system), analysis of 30,000 dna methylation loci by methylation array, utilizing dna extracted from tumor tissue, diagnostic algorithm reported as probability of matching a reference tumor subclass","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0332U","name":"Onc pan tum gen prflg 8 dna","description":"Onc pan tum gen prflg 8 dna","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1410","name":"No gmln brca1/brca2 couns","description":"Patients who did not have germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1314","name":"Bmi not calculated","description":"Bmi not documented and no reason is given","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0605U","name":"All&immunology hat tpsab1","description":"All&immunology hat tpsab1","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4291","name":"Lamellas xt, per sq cm","description":"Lamellas xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4296","name":"Rebound matrix, per sq cm","description":"Rebound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66852","name":"Removal of lens material","description":"Removal of lens material; pars plana approach, with or without vitrectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":821.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53515","name":"Repair of urethra injury","description":"Urethrorrhaphy, suture of urethral wound or injury; prostatomembranous","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":888.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5940","name":"Resct proth max part remov","description":"Resct proth max part remov","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43889","name":"Gstr rstcv px trnsorl esg","description":"Gastric restrictive procedure, transoral, endoscopic sleeve gastroplasty (esg), including argon plasma coagulation, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4371","name":"Neoguard per sq cm","description":"Neoguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97116","name":"Gait training therapy","description":"Therapeutic procedure, 1 or more areas, each 15 minutes; gait training (includes stair climbing)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0685T","name":"Interrog dev eval isdss ip","description":"Interrogation device evaluation (in-person) with analysis, review and report by a physician or other qualified health care professional, including connection, recording and disconnection per patient encounter, permanent implantable synchronized diaphragmatic stimulation system for augmentation of ca","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0519","name":"New pt-cg dyad dem low cmplx","description":"Management of new patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2472","name":"Inj, pantoprazole sodium chl","description":"Injection, pantoprazole sodium in sodium chloride (baxter), 40 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2359","name":"Inj. olanzapine, 0.5mg","description":"Injection, olanzapine, 0.5 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0891T","name":"Arhfcmrigtbs sbsq tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent treatment day","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1272","name":"Pts kid transplt wtlst","description":"Patients observed on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0535","name":"Pt navigat svs direct/ref","description":"Patient navigational services, provided directly or by referral; including helping the patient to navigate health systems and identify care providers and supportive services, to build patient self-advocacy and communication skills with care providers, and to promote patient-driven action plans and g","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0826T","name":"Prgrmg evl ldls pm 1chmbr ip","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional, leadless pacemaker system in si","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0570","name":"Care manage serv, pr cal mo","description":"Care management services for behavioral health conditions, directed by a physician or other qualified health care professional, per calendar month, with the following required elements: initial assessment or follow-up monitoring, including the use of applicable validated rating scales, behavioral he","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49595","name":"Rpr aa hrn 1st > 10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, reducible","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0799","name":"Hiv prep, fda approved, noc","description":"Fda approved prescription drug, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv), not otherwise classified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92635","name":"Hearing aid fitg svc ea addl","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; each additional 15 minutes (list separately in addition to code","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62355","name":"Remove spinal canal catheter","description":"Removal of previously implanted intrathecal or epidural catheter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1073","name":"Testosterone pellet 75 mg","description":"Testosterone pellet, implant, 75 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0884T","name":"Esphgsc flx 1st tndsc dilat","description":"Esophagoscopy, flexible, transoral, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for esophageal stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0522","name":"Mgt nw pt dementia low cmplx","description":"Management of a new patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1956","name":"Levofloxacin injection","description":"Injection, levofloxacin, 250 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92636","name":"Hearing aid post-fitg f-up 1","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99307","name":"Sbsq nf care sf mdm 10","description":"Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 10 minutes must be met or e","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":41.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82330","name":"Assay of calcium","description":"Calcium; ionized","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0323U","name":"Iadna cns pthgn next gen seq","description":"Iadna cns pthgn next gen seq","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0605U","name":"All&immunology hat tpsab1","description":"All&immunology hat tpsab1","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0473","name":"Micro exam prep & report","description":"Accession of tissue gross and microscopic examination preparation and transmission of written report","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2038","name":"Marigen pacto, per sq cm","description":"Marigen pacto, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3424","name":"Inj hydroxocobalamin iv 25mg","description":"Injection, hydroxocobalamin, intravenous, 25 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0906T","name":"Coms ther 1st appl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; first application, total wound(s) surface area less than or equal to 50 sq cm","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0912T","name":"Elec alys nstim sys vgs smpl","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; with simple programming by physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37274","name":"Rvsc evsc fpvt athrc cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87582","name":"M.pneumon dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); mycoplasma pneumoniae, quantification","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9021","name":"Inj, aspara, rylaze, 0.1 mg","description":"Injection, asparaginase, recombinant, (rylaze), 0.1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43889","name":"Gstr rstcv px trnsorl esg","description":"Gastric restrictive procedure, transoral, endoscopic sleeve gastroplasty (esg), including argon plasma coagulation, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"3079F","name":"Diast bp 80-89 mm hg","description":"Most recent diastolic blood pressure 80-89 mm hg (htn, ckd, cad) (dm)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0711T","name":"N-nvs artl plaq alys dat prp","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data preparation and transmission","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1453","name":"Preop vis acu > 20/40","description":"Patients with a pre-operative visual acuity better than 20/40","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9061","name":"Inj, amivantamab-vmjw","description":"Injection, amivantamab-vmjw, 2 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1003T","name":"Arthrp 1st crp/mtcrpl prostc","description":"Arthroplasty, first carpometacarpal joint, with distal trapezial and proximal first metacarpal prosthetic replacement (eg, first carpometacarpal total joint)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93595","name":"L hrt cath chd nm/abn nt cnj","description":"Left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone, normal or abnormal native connections","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0905T","name":"Ecg alg 12 ld rdcd i&r only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; interpretation and report only","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4301","name":"Activate matrix, per sq cm","description":"Activate matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4316","name":"Amchoplast, per sq cm","description":"Amchoplast, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0763T","name":"Dgtz gls mcrscp mphmtrc alys","description":"Digitization of glass microscope slides for morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure, manual (list separately in addition to code for primary proced","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55180","name":"Revision of scrotum","description":"Scrotoplasty; complicated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":747.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0650","name":"Inj, levothyroxine nos 10mcg","description":"Injection, levothyroxine sodium, not otherwise specified, 10 mcg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6526","name":"G com garmt full leg/ft nght","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1001T","name":"Autol musc cell therapy njx","description":"Autologous muscle cell therapy, injection of muscle progenitor cells into the external anal sphincter, including ultrasound guidance, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0615","name":"Calcium acetate, oral, 23 mg","description":"Calcium acetate, oral, 23 mg (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1302","name":"Scrn mam perf rslts doc","description":"Screening, diagnostic, film digital or digital breast tomosynthesis (3d) mammography results documented and reviewed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0440U","name":"Crd chd dna alys 10 snp 6dna","description":"Crd chd dna alys 10 snp 6dna","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6602","name":"Cst hgh nble mtl inlay 2 srf","description":"Inlay - cast high noble metal two surfaces","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1812","name":"Ko elastic w/joints pre ots","description":"Knee orthosis, elastic with joints, prefabricated, off-the-shelf","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87205","name":"Smear gram stain","description":"Smear, primary source with interpretation; gram or giemsa stain for bacteria, fungi, or cell types","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53520","name":"Repair of urethra defect","description":"Closure of urethrostomy or urethrocutaneous fistula, male (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0330U","name":"Iadna vag pthgn panel 27 org","description":"Iadna vag pthgn panel 27 org","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0555U","name":"Repr med pga embryonic te qc","description":"Repr med pga embryonic te qc","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4252","name":"Vendaje, per square centimet","description":"Vendaje, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63197","name":"Lam w/cordotomy 1stg thrc","description":"Laminectomy with cordotomy, with section of both spinothalamic tracts, 1 stage, thoracic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1792.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93792","name":"Pt/caregiver traing home inr","description":"Patient/caregiver training for initiation of home international normalized ratio (inr) monitoring under the direction of a physician or other qualified health care professional, face-to-face, including use and care of the inr monitor, obtaining blood sample, instructions for reporting home inr test ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46916","name":"Cryosurgery anal lesion(s)","description":"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; cryosurgery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1226","name":"Iop not doc","description":"Iop measurement not documented, reason not otherwise specified","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71090","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0741","name":"Inj, cabote rilpivir 2mg 3mg","description":"Injection, cabotegravir and rilpivirine, 2mg/3mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4410","name":"Amchomatrixdl per sq cm","description":"Amchomatrixdl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4025","name":"Physical medicine ss","description":"Physical medicine mips specialty set","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0832T","name":"Dgtz gls mcrscp cytp oth scr","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25025","name":"Decompress forearm 2 spaces","description":"Decompression fasciotomy, forearm and/or wrist, flexor and extensor compartment; with debridement of nonviable muscle and/or nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1258.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0874","name":"Inj, daptomycin (baxter)","description":"Injection, daptomycin (baxter), not therapeutically equivalent to j0878, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49617","name":"Rpr aa hrn rcr > 10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, reducible","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1399","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9887","name":"Distance learning attendance","description":"Behavioral counseling for diabetes prevention, distance learning, 60 minutes","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4028","name":"Podiatry ss","description":"Podiatry mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9025","name":"Plasma cryo redu path each","description":"Plasma, cryoprecipitate reduced, pathogen reduced, each unit","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1450","name":"Pt hos/pal care dur id/pf pd","description":"Patients who received hospice or palliative care service any time during denominator identification period or the measure assessment period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97803","name":"Med nutrition indiv subseq","description":"Medical nutrition therapy; re-assessment and intervention, individual, face-to-face with the patient, each 15 minutes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":24.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9345","name":"Inj, retifanlimab-dlwr, 1 mg","description":"Injection, retifanlimab-dlwr, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0528U","name":"Lrt iad 18bct/8vir&7arg rna","description":"Lrt iad 18bct/8vir&7arg rna","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1340","name":"Indx whodas 2.0 or sds","description":"Index assessment completed using the 12-item whodas 2.0 or sds during the denominator identification period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0916T","name":"Insj perm ccm-d sys pg only","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator only","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29826","name":"Sho arthrs srg decompression","description":"Arthroscopy, shoulder, surgical; decompression of subacromial space with partial acromioplasty, with coracoacromial ligament (ie, arch) release, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":826.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1183","name":"Doc imm ckpt inhib hld","description":"Documentation of immune checkpoint inhibitor therapy held and corticosteroids or immunosuppressants prescribed or administered","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92972","name":"Perq trluml coronry lithotrp","description":"Percutaneous transluminal coronary lithotripsy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0872T","name":"Rplcmt ndwllg bldr&prtl cath","description":"Replacement of indwelling bladder and peritoneal catheters, including tunneling of catheter(s) and connection with previously implanted peritoneal ascites pump, including imaging and programming, when performed","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2390","name":"Ant resin-based cmpst crown","description":"Resin-based composite crown anterior","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1461","name":"Pt dx chron hepc","description":"Patient diagnosis for chronic hepatitis c","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1256","name":"Prior history of known cvd","description":"Prior history of known cvd","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6214","name":"Pontic titanium","description":"Pontic - titanium","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4326","name":"Woundplus, per sq cm","description":"Woundplus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0260U","name":"Rare ds id opt genome mapg","description":"Rare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29260","name":"Strapping of elbow or wrist","description":"Strapping; elbow or wrist","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3425","name":"Hydroxocobalamin im 10mcg","description":"Injection, hydroxocobalamin, intramuscular, 10 mcg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1022T","name":"Prq tis dsplmt ntra-abdl/pel","description":"Percutaneous tissue displacement, any method, including imaging guidance; intra-abdominal/pelvic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22222","name":"Osteot dsc ant 1vrt sgm thrc","description":"Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; thoracic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1629.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90846","name":"Family psytx w/o pt 50 min","description":"Family psychotherapy (without the patient present), 50 minutes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":111.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53451","name":"Tprnl balo cntnc dev bi","description":"Periurethral transperineal adjustable balloon continence device; bilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37285","name":"Revsc evasc tpvt st sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5129","name":"Inj, vegzelma, 10 mg","description":"Injection, bevacizumab-adcd (vegzelma), biosimilar, 10 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61889","name":"Ins sk-mnt crnl nstm pg/rcvr","description":"Insertion of skull-mounted cranial neurostimulator pulse generator or receiver, including craniectomy or craniotomy, when performed, with direct or inductive coupling, with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4281","name":"Barrera slor dl per sq cm","description":"Barrera sl or barrera dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7049","name":"Epap nasal valve","description":"Expiratory positive airway pressure intranasal resistance valve","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81441","name":"Ibmfs seq alys pnl 30 genes","description":"Inherited bone marrow failure syndromes (ibmfs) (eg, fanconi anemia, dyskeratosis congenita, diamond-blackfan anemia, shwachman-diamond syndrome, gata2 deficiency syndrome, congenital amegakaryocytic thrombocytopenia) sequence analysis panel, must include sequencing of at least 30 genes, including b","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99302","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0916T","name":"Insj perm ccm-d sys pg only","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator only","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7021","name":"Suppl and access lung expan","description":"Supplies and accessories for lung expansion airway clearance, continuous high frequency oscillation, and nebulization device (e.g., handset, nebulizer kit, biofilter)","date_of_service":"2026-06-05","zip":"10985","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26992","name":"Drainage of bone lesion","description":"Incision, bone cortex, pelvis and/or hip joint (eg, osteomyelitis or bone abscess)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1164.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4297","name":"Emerge matrix, per sq cm","description":"Emerge matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57420","name":"Exam of vagina w/scope","description":"Colposcopy of the entire vagina, with cervix if present;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":108.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":96.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1215","name":"Med rsn for no doc spiro","description":"Documentation of medical reason(s) for not documenting and reviewing spirometry results (e.g., patients with dementia or tracheostomy)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2525","name":"Cl, hydrophilic, dual focus","description":"Contact lens, hydrophilic, dual focus, per lens","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36483","name":"Endoven ther chem adhes sbsq","description":"Endovenous ablation therapy of incompetent vein, extremity, by transcatheter delivery of a chemical adhesive (eg, cyanoacrylate) remote from the access site, inclusive of all imaging guidance and monitoring, percutaneous; subsequent vein(s) treated in a single extremity, each through separate access","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":163.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7956","name":"Tiss regen edent resorb","description":"Tiss regen edent resorb","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0382U","name":"Hyprphenylalninmia mntr quan","description":"Hyprphenylalninmia mntr quan","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90635","name":"H5n1 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n1, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6093","name":"Recement supp part denture","description":"Recement implant/abutment supported fixed partial denture","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2252","name":"Inj midazolam in 0.8% nacl","description":"Injection, midazolam in 0.8% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4365","name":"Amnio bur dl mem per sq cm","description":"Amnio burgeon dual-layer membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0838T","name":"Dgtz gls mcrscp cslt sld els","description":"Digitization of glass microscope slides for consultation and report on referred slides prepared elsewhere (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0424U","name":"Onc prst8 xom alys 53 sncrna","description":"Onc prst8 xom alys 53 sncrna","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4419","name":"Biolab wrap flw lt per sq cm","description":"Biolab membrane wrap lite flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0335U","name":"Rare ds whl gen seq fetal","description":"Rare ds whl gen seq fetal","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9996","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0479U","name":"Tau phosphorylated ptau217","description":"Tau phosphorylated ptau217","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0553U","name":"Repr med pga embry te strux","description":"Repr med pga embry te strux","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76819","name":"Fetal biophys profil w/o nst","description":"Fetal biophysical profile; without non-stress testing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5931","name":"Surgical obturator","description":"Obturator prosthesis surgical","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82962","name":"Glucose blood test","description":"Glucose, blood by glucose monitoring device(s) cleared by the fda specifically for home use","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0683","name":"App of non-sheet skin sub g","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5129","name":"Inj, vegzelma, 10 mg","description":"Injection, bevacizumab-adcd (vegzelma), biosimilar, 10 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1020T","name":"Raman spectroscopy 1+skn les","description":"Raman spectroscopy of 1 or more skin lesions, with probability score for malignant risk derived by algorithmic analysis of data from each lesion","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0825T","name":"Tcat rmv&rpl1chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or prog","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6196","name":"Remv of ind rest on implt","description":"Remv of ind rest on implt","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1745","name":"Infliximab not biosimil 10mg","description":"Injection, infliximab, excludes biosimilar, 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11400","name":"Exc tr-ext b9+marg 0.5 cm<","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 0.5 cm or less","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":82.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7472","name":"Removal of torus palatinus","description":"Removal of torus palatinus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7485","name":"Surg reduct osseoustuberosit","description":"Surgical reduction of osseous tuberosity","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37275","name":"Rvsc evsc fpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52276","name":"Cystoscopy and treatment","description":"Cystourethroscopy with direct vision internal urethrotomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67924","name":"Repair eyelid defect","description":"Repair of entropion; extensive (eg, tarsal strip or capsulopalpebral fascia repairs operation)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":478.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35509","name":"Art byp grft contral carotid","description":"Bypass graft, with vein; carotid-contralateral carotid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1321.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1339","name":"Pts f/u 30-180 dys + improv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who demonstrated positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1487","name":"Pt adm to hospice dur eval","description":"Patients in hospice in the year before or during the period of evaluation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0183","name":"Software meas of cardiac vol","description":"Quantitative software measurements of cardiac volume, cardiac chambers volumes and left ventricular wall mass derived from ct scan(s) data of the chest/heart (with or without contrast)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0837T","name":"Dgtz gls mcrscp fna i&r","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; interpretation and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95832","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0329U","name":"Onc neo xome&trns seq alys","description":"Onc neo xome&trns seq alys","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87486","name":"Chlmyd pneum dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); chlamydia pneumoniae, amplified probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0542","name":"No pt prsnt train add 15","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77762","name":"Apply intrcav radiat interm","description":"Intracavitary radiation source application; intermediate","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":523.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2543","name":"Dental onlay metallic 3 surf","description":"Onlay - metallic - three surfaces","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0772T","name":"Vr px dissoc svc sm phy ea","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0752T","name":"Dgtz gls mcrscp sld lvl iii","description":"Digitization of glass microscope slides for level iii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1835","name":"Itraconazole injection","description":"Injection, itraconazole, 50 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0971T","name":"Ablt mal brst tum pq lsr uni","description":"Ablation, malignant breast tumor(s), percutaneous, laser, including imaging guidance when performed, unilateral","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37256","name":"Revsc evasc ivt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6081","name":"Scale & debride, single imp","description":"Scale & debride, single imp","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0532","name":"Take home supp nasal spray","description":"Take-home supply of nasal nalmefene hydrochloride; one carton of two, 2.7 mg per 0.1 ml nasal sprays (provision of the services by a medicare-enrolled opioid treatment program);( list separately in addition to each primary code)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81459","name":"So neo gsap dna/dna&rna","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants, microsatellite instability, tumor mutation burden, and rearrangements","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1303","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84160","name":"Assay of protein any source","description":"Protein, total, by refractometry, any source","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86041","name":"Acetylcholn rcptr bndng antb","description":"Acetylcholine receptor (achr); binding antibody","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0749T","name":"B1 str&fx rsk assmt dxr-bmd","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0963T","name":"Anosc sbmcsl njx bulking agt","description":"Anoscopy with directed submucosal injection of bulking agent into anal canal","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0042","name":"Ref to therapy","description":"Referral to physical, occupational, speech, or recreational therapy","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82042","name":"Other source albumin quan ea","description":"Albumin; other source, quantitative, each specimen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0491","name":"Oral dv nm mouthpc hw remote","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2277","name":"Inj, motixafortide, 0.25 mg","description":"Injection, motixafortide, 0.25 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77439","name":"Surf rad thr img gdn us plmt","description":"Surface radiation therapy; superficial or orthovoltage, image guidance, ultrasound for placement of radiation therapy fields for treatment of cutaneous tumors, per course of treatment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93539","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33278","name":"Rmvl phrnc nrv stim sys","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; system, including pulse generator and lead(s)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0895T","name":"Connj lvr algrft prfu dev 1","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; initial 4 hours of monitoring time, including hourly physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary ","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1422","name":"Gastroenterology care mvp","description":"Gastroenterology care mips value pathway","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0942T","name":"Cysto flx rmv&rplc urtl scaf","description":"Cystourethroscopy, flexible; with removal and replacement of prostatic urethral scaffold","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1379","name":"10 yr fu no rec rsn not giv","description":"A 10 year follow-up interval for colonoscopy not recommended, reason not otherwise specified","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0663","name":"Team remote e/m new pt 45 mn","description":"Team remote e/m new pt 45mins","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0745T","name":"Car ablt rad arr n-invas loc","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; noninvasive arrhythmia localization and mapping of arrhythmia site (nidus), derived from anatomical image data (eg, ct, mri, or myocardial perfusion scan) and electrical data (eg, 12-lead ecg data), and identification of areas of avo","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7261","name":"Primary closure sinus perf","description":"Primary closure of a sinus perforation","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2272","name":"Inj, morphine (fresenius)","description":"Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4316","name":"Amchoplast, per sq cm","description":"Amchoplast, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0351U","name":"Nfct ds bct/viral trail ip10","description":"Nfct ds bct/viral trail ip10","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1368","name":"Prev trt inf d/o hiv/hep mvp","description":"Prevention and treatment of infectious disorders including hepatitis c and hiv mips value pathway","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1459","name":"Pt hosp/pal care dur perf pd","description":"Patient was in hospice or receiving palliative care services at any time during the performance period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23485","name":"Revision of collar bone","description":"Osteotomy, clavicle, with or without internal fixation; with bone graft for nonunion or malunion (includes obtaining graft and/or necessary fixation)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1168.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0570U","name":"Neurol tbi alys gfap&uch-l1","description":"Neurol tbi alys gfap&uch-l1","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69730","name":"Rplc oi implt sk tc esp>=100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97008","name":"Mchnl sclp cool prep plmt","description":"Mechanical scalp cooling; including hair preparation, individual cap placement, therapy initiation, and precooling period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27040","name":"Biopsy of soft tissues","description":"Biopsy, soft tissue of pelvis and hip area; superficial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2782","name":"Inj avacincaptad pegol 0.1mg","description":"Injection, avacincaptad pegol, 0.1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1681","name":"Ho bilateral hip abduction","description":"Hip orthosis, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80061","name":"Lipid panel","description":"Lipid panel this panel must include the following: cholesterol, serum, total (82465) lipoprotein, direct measurement, high density cholesterol (hdl cholesterol) (83718) triglycerides (84478)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9992","name":"Pall serv during meas","description":"Palliative care services used by patient any time during the measurement period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1372","name":"Mst rec gsa >=7 and<8","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 7.0% and < 8.0%","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91321","name":"Sarscov2 vac 25 mcg/.25ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 25 mcg/0.25 ml dosage, for intramuscular use","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0828T","name":"Dgtz gls mcrscp cytp smpl fl","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; simple filter method with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1470","name":"Hep b vac not recd med rsn","description":"Documentation of medical reason(s) for not administering hepatitis b vaccine (e.g., prior anaphylaxis due to the hepatitis b vaccine)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0578U","name":"Onc cutan mln rna qpcr 10gen","description":"Onc cutan mln rna qpcr 10gen","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4284","name":"Dermabind sl, per sq cm","description":"Dermabind sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55882","name":"Ablt trurl prst8 tis trnsdcr","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation; with insertion of transurethral ultrasound transducer for delivery of thermal ultrasound, including suprapubic tube placement and placement of ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9595","name":"Piflu f-18, dia 1 millicurie","description":"Piflufolastat f-18, diagnostic, 1 millicurie","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4433","name":"361 hct/p skin subs, nos","description":"361 hct/p skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4342","name":"Theramend, per sq cm","description":"Theramend, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43889","name":"Gstr rstcv px trnsorl esg","description":"Gastric restrictive procedure, transoral, endoscopic sleeve gastroplasty (esg), including argon plasma coagulation, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0447","name":"Port o2 cont, liq over 4 lpm","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit, prescribed amount at rest or nighttime exceeds 4 liters per minute (lpm)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1266","name":"Pts admit snf","description":"Patients admitted to a skilled nursing facility (snf)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9996","name":"Ustekinumab- ttwe sub cu inj","description":"Injection, ustekinumab-ttwe (pyzchiva), subcutaneous, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1423","name":"Opt care urologic cnd mvp","description":"Optimal care for patients with urologic conditions mips value pathway","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6596","name":"G comp bandge conform gauze","description":"Gradient compression bandaging supply, conforming gauze, per linear yard, any width, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1196","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0732T","name":"Immntx admn electroporatn im","description":"Immunotherapy administration with electroporation, intramuscular","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33750","name":"Shunt subclavian to pulm art","description":"Shunt; subclavian to pulmonary artery (blalock-taussig type operation)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1427.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2596","name":"Vasopressin (long grove) 1 u","description":"Injection, vasopressin (long grove), not therapeutically equivalent to j2598, 1 unit","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1463","name":"2 f/u wthn 180 day rx atmp","description":"Documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1709","name":"Pfizer vaccine admin booster","description":"Pfizer vaccine admin booster","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1321","name":"Pts no 7wk inj,no iop,iop>25","description":"Patients who were not seen within 7 weeks following the date of injection for follow up or who did not have a documented iop or no plan of care documented if the iop was >25 mm hg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0977T","name":"Upr gi bld detcj snr capsule","description":"Upper gastrointestinal blood detection, sensor capsule, with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0701T","name":"Molec fluor img sus nev ea","description":"Molecular fluorescent imaging of suspicious nevus; each additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1199","name":"Pt recg rrt","description":"Patients receiving rrt","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0602","name":"Sevelamer carbonate pdr 20mg","description":"Sevelamer carbonate (renvela or therapeutically equivalent), oral, powder, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4371","name":"Neoguard per sq cm","description":"Neoguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0870T","name":"Imp subq prtl ascts pmp sys","description":"Implantation of subcutaneous peritoneal ascites pump system, percutaneous, including pump-pocket creation, insertion of tunneled indwelling bladder and peritoneal catheters with pump connections, including all imaging and initial programming, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1072","name":"Inj, testosterone, azmiro","description":"Injection, testosterone cypionate (azmiro), 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77436","name":"Surf radj ther tx planning","description":"Surface radiation therapy; superficial or orthovoltage, treatment planning and simulation-aided field setting","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5150","name":"Inj, aflibercept-mrbb, 1 mg","description":"Injection, aflibercept-mrbb (ahzantive), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33882","name":"Evasc rpr ta dplmt mltpc sys","description":"Endovascular repair of the thoracic aorta by deployment of a branched endograft multipiece system involving an aorto-aortic tube device with a fenestration for the left subclavian artery stent graft(s) and all aortic tube endograft extension(s) placed from the level of the left common carotid artery","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2782","name":"Crown 3/4 cast noble metal","description":"Crown - 3/4 cast noble metal","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1226","name":"Iop not doc","description":"Iop measurement not documented, reason not otherwise specified","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35251","name":"Rpr blvsl vn grf intra-abdl","description":"Repair blood vessel with vein graft; intra-abdominal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2050.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0977T","name":"Upr gi bld detcj snr capsule","description":"Upper gastrointestinal blood detection, sensor capsule, with interpretation and report","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95922","name":"Autonomic nrv adrenrg inervj","description":"Testing of autonomic nervous system function; vasomotor adrenergic innervation (sympathetic adrenergic function), including beat-to-beat blood pressure and r-r interval changes during valsalva maneuver and at least 5 minutes of passive tilt","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76125","name":"Cine/video x-rays add-on","description":"Cineradiography/videoradiography to complement routine examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37267","name":"Revsc evsc fpvt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32652","name":"Thoracoscopy rem totl cortex","description":"Thoracoscopy, surgical; with total pulmonary decortication, including intrapleural pneumonolysis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1410.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0293U","name":"Psyc suicidal idea mrna 54","description":"Psyc suicidal idea mrna 54","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93897","name":"Emboli detcj wo iv mbubb njx","description":"Emboli detection without intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98981","name":"Rtm tx mgmt ea addl 20 min","description":"Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least 1 real-time interactive communication with the patient or caregiver during the calendar month; each additional 20 minutes (list separately in","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0681","name":"Inj ceftobipole medocarl 3mg","description":"Injection, ceftobiprole medocaril sodium, 3 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11752","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":274.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4006","name":"Gastroenterology ss","description":"Gastro-enterology mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0371","name":"Sialoendoscopy capt & interp","description":"Sialoendoscopy capt & interp","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81517","name":"Liver ds alys 3 bmrk srm alg","description":"Liver disease, analysis of 3 biomarkers (hyaluronic acid [ha], procollagen iii amino terminal peptide [piiinp], tissue inhibitor of metalloproteinase 1 [timp-1]), using immunoassays, utilizing serum, prognostic algorithm reported as a risk score and risk of liver fibrosis and liver-related clinical ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0568","name":"Int psych care mng, 1 cal mo","description":"Initial psychiatric collaborative care management, in the first calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required elements: outrea","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4323","name":"Alloply, per sq cm","description":"Alloply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0350U","name":"Rx metab/pcx dna 27 gen alys","description":"Rx metab/pcx dna 27 gen alys","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35286","name":"Rpr blvsl grf oth/th vn lxtr","description":"Repair blood vessel with graft other than vein; lower extremity","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1418","name":"Med rsn not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination because of a medical contraindication documented by clinician","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33370","name":"Tcat plmt&rmvl cepd perq","description":"Transcatheter placement and subsequent removal of cerebral embolic protection device(s), including arterial access, catheterization, imaging, and radiological supervision and interpretation, percutaneous (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0885T","name":"Colsc flx 1st tndsc dilat","description":"Colonoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90482","name":"Imm cnsl not admn sm 3<10","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; 3 minutes up to 10 minutes","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58558","name":"Hysteroscopy biopsy","description":"Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without d & c","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":1491.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0293U","name":"Psyc suicidal idea mrna 54","description":"Psyc suicidal idea mrna 54","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27278","name":"Arthrd si jt plmt iartic dev","description":"Arthrodesis, sacroiliac joint, percutaneous or minimally invasive, with image guidance, includes obtaining bone graft when performed, unilateral; placement of intra-articular device(s), without cortical piercing","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0403U","name":"Onc prst8 mrna 18 gen dre ur","description":"Onc prst8 mrna 18 gen dre ur","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0501U","name":"Onc clrc bld quan meas cfdna","description":"Onc clrc bld quan meas cfdna","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0693T","name":"Compre ful bdy 3d mtn alys","description":"Comprehensive full body computer-based markerless 3d kinematic and kinetic motion analysis and report","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5913","name":"Nasal prosthesis","description":"Nasal prosthesis","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99233","name":"Sbsq hosp ip/obs high 50","description":"Subsequent hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 50 minutes m","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37256","name":"Revsc evasc ivt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0340U","name":"Onc pan ca alys mrd plasma","description":"Onc pan ca alys mrd plasma","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75577","name":"Quan&char c athrosclrtc plaq","description":"Quantification and characterization of coronary atherosclerotic plaque to assess severity of coronary disease, derived from augmentative software analysis of the data set from a coronary computed tomographic angiography, with interpretation and report by a physician or other qualified health care pr","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49505","name":"Prp i/hern init reduc >5 yr","description":"Repair initial inguinal hernia, age 5 years or older; reducible","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0489U","name":"Ob sgnipt cfdna seq alys 1+","description":"Ob sgnipt cfdna seq alys 1+","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7213","name":"Inj, ixinity, 1 i.u.","description":"Injection, coagulation factor ix (recombinant), ixinity, 1 i.u.","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0022","name":"Comm hlth intg svs add 30 m","description":"Community health integration services, each additional 30 minutes per calendar month (list separately in addition to g0019)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1150","name":"Lvef <=40% or mod/sev l vsf","description":"Current or prior left ventricular ejection fraction (lvef) less than or equal to 40% or documentation of moderately or severely depressed left ventricular systolic function","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9506","name":"Tc-99m graphite crucible","description":"Graphite crucible for preparation of technetium tc 99m-labeled carbon aerosol, one crucible","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9993","name":"Pall serv during meas","description":"Patient was provided palliative care services any time during the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4336","name":"Artecent c, per sq cm","description":"Artacent c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44381","name":"Small bowel endoscopy br/wa","description":"Ileoscopy, through stoma; with transendoscopic balloon dilation","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":1257.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6598","name":"G comp bandage med stretch","description":"Gradient compression bandage roll, elastic medium stretch, per linear yard, any width, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1335","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0327U","name":"Ftl aneuploidy trsmy dna seq","description":"Ftl aneuploidy trsmy dna seq","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77439","name":"Surf rad thr img gdn us plmt","description":"Surface radiation therapy; superficial or orthovoltage, image guidance, ultrasound for placement of radiation therapy fields for treatment of cutaneous tumors, per course of treatment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15017","name":"App skn cll ssp f/n/g/hf 1st","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 480 sq cm or less","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1413","name":"Pos pdl1 bef init ici tx","description":"Patients who had a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1333","name":"Acute vitreous hemorrhage","description":"Acute vitreous hemorrhage","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0404U","name":"Onc brst semiq meas thym kn","description":"Onc brst semiq meas thym kn","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0814T","name":"Prq njx biod osteo matrl fem","description":"Percutaneous injection of calcium-based biodegradable osteoconductive material, proximal femur, including imaging guidance, unilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96913","name":"Photochemotx sev dermatoses","description":"Photochemotherapy (goeckerman and/or puva) for severe photoresponsive dermatoses requiring at least 4-8 hours of care under direct supervision of the physician (includes application of medication and dressings)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1344","name":"No bsln/2nd pam score 4-12mo","description":"Patients who did not have a baseline pam score and/or a second score within 4 to 12 months of baseline pam score","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1490","name":"Pt status not doc","description":"Patient status not documented","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4313","name":"Dermabind fm, per sq cm","description":"Dermabind fm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25365","name":"Revise radius & ulna","description":"Osteotomy; radius and ulna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1391.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9150","name":"Daunorubicin injection","description":"Injection, daunorubicin, 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0746T","name":"Car ablt rad arr cnv loc map","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; conversion of arrhythmia localization and mapping of arrhythmia site (nidus) into a multidimensional radiation treatment plan","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6611","name":"Grad com wrap w strap ak cus","description":"Gradient compression wrap with adjustable straps, above knee, each, custom","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91124","name":"Rct snsatn tone&cmplianc std","description":"Rectal sensation, tone, and compliance study (eg, barostat)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4348","name":"Sentry sl matrix per sq cm","description":"Sentry sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1941","name":"Inj, furoscix, 20 mg","description":"Injection, furosemide (furoscix), 20 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1467","name":"Pt dx lynch syn","description":"Patients with an existing diagnosis of lynch syndrome","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1253","name":"Pts hu surv no amb plltv","description":"Patients who respond on the patient experience hu survey that they did not receive care by the listed ambulatory palliative care provider in the last 60 days (disavowal)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65815","name":"Drainage of eye","description":"Paracentesis of anterior chamber of eye (separate procedure); with removal of blood, with or without irrigation and/or air injection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37288","name":"Revsc evsc tpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2781","name":"Crown 3/4 cast base metal","description":"Crown - 3/4 cast predominantly base metal","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84165","name":"Protein e-phoresis serum","description":"Protein; electrophoretic fractionation and quantitation, serum","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80505","name":"Path clin consltj high 41-60","description":"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patients history and medical records and high level of medical decision making when using time for code selection, 41-60 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31545","name":"Remove vc lesion w/scope","description":"Laryngoscopy, direct, operative, with operating microscope or telescope, with submucosal removal of non-neoplastic lesion(s) of vocal cord; reconstruction with local tissue flap(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2023","name":"Innovamatrix pd, 1 mg","description":"Innovamatrix pd, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33774","name":"Rpr tga atrial baffle px","description":"Repair of transposition of the great arteries, atrial baffle procedure (eg, mustard or senning type) with cardiopulmonary bypass;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2267.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0387U","name":"Onc mlnma ambra1&amlo","description":"Onc mlnma ambra1&amlo","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4341","name":"Simplimax, per sq cm","description":"Simplimax, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0952T","name":"Tot impl amei rev/rplc mstdc","description":"Totally implantable active middle ear hearing implant; revision or replacement, with mastoidectomy and replacement of sound processor","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1005T","name":"Elec alys s-scl eeg prgr 1st","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, first 15 minutes face-to-face time with physician or other qualified hea","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0827T","name":"Dgtz gls mcrscp cytp smears","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; smears with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6597","name":"G comp bandage long stretch","description":"Gradient compression bandage roll, elastic long stretch, linear yard, any width, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0554U","name":"Repr med pga 24chrm te bx qc","description":"Repr med pga 24chrm te bx qc","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0996T","name":"Ins&sclr fix caps bag prosth","description":"Insertion and scleral fixation of a capsular bag prosthesis containing an intraocular lens prosthesis, with vitrectomy, including removal of crystalline lens or dislocated intraocular lens prosthesis, when performed","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37293","name":"Rvsc evsc tpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0801T","name":"Tcat rmv&rpl 2chmbr ldls pm","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; dual-cha","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9997","name":"Ustekinumab-ttwe iv inj 1 mg","description":"Injection, ustekinumab-ttwe (pyzchiva), intravenous, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6035","name":"Prosthetic digit mechanical","description":"Single prosthetic digit, mechanical, can include metacarpophalangeal (mcp), proximal interphalangeal (pip), and/or distal interphalangeal (dip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9046","name":"Inj, bortezomib, dr. reddys","description":"Injection, bortezomib (dr. reddys), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1494","name":"Fall rep since last visit","description":"Patients that reported a fall since the last visit","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2001","name":"Suct pum ext mgmt sys","description":"Suction pump, home model, portable or stationary, electric, any type, for use with external urine and/or fecal management system","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0508","name":"Crit care telehea consult 60","description":"Telehealth consultation, critical care, initial , physicians typically spend 60 minutes communicating with the patient and providers via telehealth","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92637","name":"Hearing aid pst-fitg f-up ea","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84228","name":"Assay of quinine","description":"Quinine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4328","name":"Most, per sq cm","description":"Most, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5725","name":"Rebase hybrid prosthesis","description":"Rebase hybrid prosthesis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32654","name":"Thoracoscopy contrl bleeding","description":"Thoracoscopy, surgical; with control of traumatic hemorrhage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":969.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0974T","name":"Slctv nzmtc dbrdmt t/a/l ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; each additional 100 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0613U","name":"Onc uc dna mthyltn&mut 6bmrk","description":"Onc uc dna mthyltn&mut 6bmrk","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0995T","name":"Evasc dlvr a-wal stbl rx opn","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; open","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0177","name":"Inj, aflibercept hd, 1 mg","description":"Injection, aflibercept hd, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6037","name":"Postop dsg cast chg handfing","description":"Immediate post-surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, partial hand including fingers","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0858T","name":"Ext trnscranl mag stimj meas","description":"Externally applied transcranial magnetic stimulation with concomitant measurement of evoked cortical potentials with automated report","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0264U","name":"Rare ds id opt genome mapg","description":"Rare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4341","name":"Simplimax, per sq cm","description":"Simplimax, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26420","name":"Repair/graft finger tendon","description":"Repair, extensor tendon, finger, primary or secondary; with free graft (includes obtaining graft) each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":997.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0727T","name":"Rmvl&rplcmt implt vstblr dev","description":"Removal and replacement of implanted vestibular device, unilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26357","name":"Repair finger/hand tendon","description":"Repair or advancement, flexor tendon, in zone 2 digital flexor tendon sheath (eg, no mans land); secondary, without free graft, each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1183.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4390","name":"Ascendion per sq cm","description":"Ascendion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1290","name":"Pt not eli d/t act dig htn","description":"Patient not eligible due to active diagnosis of hypertension","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5725","name":"Rebase hybrid prosthesis","description":"Rebase hybrid prosthesis","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0048","name":"Pall serv during meas","description":"Patients who receive palliative care services any time during the intake period through the end of the measurement year","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37290","name":"Revsc evsc tpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2028","name":"Micromatrix flex per mg","description":"Micromatrix flex, per mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4357","name":"Xwrap plus, per sq cm","description":"Xwrap plus, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64584","name":"Rmvl hpglsl nstim ary pg","description":"Removal of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0515U","name":"Gi ibd ia quan deter ifx lvl","description":"Gi ibd ia quan deter ifx lvl","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90484","name":"Imm cnsl not admn sm>20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 20 minutes","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0699","name":"Inj, cefiderocol, 10 mg","description":"Injection, cefiderocol, 10 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35695","name":"Art trnsposj carotid subclav","description":"Transposition and/or reimplantation; carotid to subclavian artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1362.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81351","name":"Tp53 gene full gene sequence","description":"Tp53 (tumor protein 53) (eg, li-fraumeni syndrome) gene analysis; full gene sequence","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":641.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0328U","name":"Drug assay 120+ rx&metablt","description":"Drug assay 120+ rx&metablt","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1468","name":"Hep b vaccine received","description":"Patient received recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1256","name":"Prior history of known cvd","description":"Prior history of known cvd","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25272","name":"Repair forearm tendon/muscle","description":"Repair, tendon or muscle, extensor, forearm and/or wrist; secondary, single, each tendon or muscle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":969.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82653","name":"El-1 fecal quantitative","description":"Elastase, pancreatic (el-1), fecal; quantitative","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97552","name":"Group caregiver training","description":"Group caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5611","name":"Rep resin part dent base man","description":"Rep resin part dent base man","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4012","name":"Interventional rad ss","description":"Interventional radiology mips specialty set","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1385","name":"Pt rsn not seen 2nd pam","description":"Documentation of patient reasons for patients who were not seen for the second pam survey (e.g., less than four months between baseline pam assessment and follow-up","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0523U","name":"Onc soltum dna ngs snv 22gen","description":"Onc soltum dna ngs snv 22gen","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1202","name":"Pt rsn no ace-i/arb rx","description":"Documentation of patient reason(s) for not prescribing ace inhibitor or arb therapy during the measurement period, (e.g., patient declined, other patient reasons)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2404","name":"Inj, nicardipine 0.1 mg","description":"Injection, nicardipine, 0.1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5137","name":"Inj, wezlana, sub cu, 1 mg","description":"Injection, ustekinumab-auub (wezlana), biosimilar, subcutaneous, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3502","name":"Surg exp root surf premolar","description":"Surg exp root surf premolar","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4382","name":"Advograft dual per sq cm","description":"Advograft dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0233","name":"Intra inf, toci, first dose","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0321U","name":"Iadna gu pthgn 20bct&fng org","description":"Iadna gu pthgn 20bct&fng org","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4321","name":"Renograft, per sq cm","description":"Renograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2040","name":"Coord specialty care, month","description":"Coordinated specialty care, team-based, for first episode psychosis, per month","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50660","name":"Removal of ureter","description":"Ureterectomy, total, ectopic ureter, combination abdominal, vaginal and/or perineal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1262.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0629U","name":"Nfct ds tb dna aly 1trgt pcr","description":"Nfct ds tb dna aly 1trgt pcr","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0739T","name":"Abltj mal prst8 mag fld ndct","description":"Ablation of malignant prostate tissue by magnetic field induction, including all intraprocedural, transperineal needle/catheter placement for nanoparticle installation and intraprocedural temperature monitoring, thermal dosimetry, bladder irrigation, and magnetic field nanoparticle activation","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92637","name":"Hearing aid pst-fitg f-up ea","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99341","name":"Home/res vst new sf mdm 15","description":"Home or residence visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 15 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99202","name":"Office o/p new sf 15 min","description":"Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 15 minutes must be met or exceede","date_of_service":"2026-06-05","other_properties":[{"name":"BillingTaxonomy","value":["207V00000X","207VB0002X","207VE0102X","207VF0040X","207VG0400X","207VM0101X","207VX0000X","207VX0201X","363LX0001X"]},{"name":"RenderingTaxonomy","value":["207V00000X","207VB0002X","207VE0102X","207VF0040X","207VG0400X","207VM0101X","207VX0000X","207VX0201X","363LX0001X"]},{"name":"ClaimSpecialtyCode","value":["904","905","907","AMGY","APNOB","COLP","FPEM","GYNE","GYON","GYSU","MAFE","NPAG","NPGY","NPOB","OBEM","OBGY","OBHR","OBST","REND","URGY"]},{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TH"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TH"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1325","name":"Doc med rsn not seen","description":"Patients who were not seen for reasons documented by clinician for patient or medical reasons (e.g., inadequate time for follow-up, patients who received a prior intravitreal or periocular steroid injection within the last six (6) months and had a subsequent iop evaluation with iop <25mm hg within s","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0732T","name":"Immntx admn electroporatn im","description":"Immunotherapy administration with electroporation, intramuscular","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70140","name":"X-ray exam of facial bones","description":"Radiologic examination, facial bones; less than 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5145","name":"Inj, abrilada, 1 mg","description":"Injection, adalimumab-afzb (abrilada), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0909T","name":"Rplcmt int nstim sys vgs nrv","description":"Replacement of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9999","name":"Inj ustekinumab-aauz 1 mg","description":"Injection, ustekinumab-aauz (otulfi), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0184","name":"Inj, amisulpride, 1 mg","description":"Injection, amisulpride, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87799","name":"Detect agent nos dna quant","description":"Infectious agent detection by nucleic acid (dna or rna), not otherwise specified; quantification, each organism","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1221","name":"Dre w/o rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; without evidence of retinopathy","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80503","name":"Path clin consltj sf 5-20","description":"Pathology clinical consultation; for a clinical problem, with limited review of patients history and medical records and straightforward medical decision making when using time for code selection, 5-20 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4395","name":"Acelagraft per sq cm","description":"Acelagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2404","name":"Inj, nicardipine 0.1 mg","description":"Injection, nicardipine, 0.1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69727","name":"Rmv ntr oi imp sk tc esp<100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0688","name":"Inj cefazolin sodium, hikma","description":"Injection, cefazolin sodium (hikma), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93574","name":"Njx cath slct pulm vn angrph","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary venous angiography of each distinct pulmonary vein during cardiac catheterization (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4423","name":"Biolab tri wrap fl per sq cm","description":"Biolab tri-membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1478","name":"Psychoactive sub abuse","description":"Psychoactive substance abuse","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0414U","name":"Onc lng aug alg aly whl sld8","description":"Onc lng aug alg aly whl sld8","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0920T","name":"Rmvl perm ccm-d sys 1 pac ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous pacing lead only","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92634","name":"Hearing aid fitg svc 1st 60","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; first 60 minutes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2044","name":"Biobrane glove, each","description":"Biobrane glove, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87487","name":"Chlmyd pneum dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); chlamydia pneumoniae, quantification","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7961","name":"Buccal/labial frenectomy","description":"Buccal/labial frenectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0834T","name":"Dgtz gls mcrscp cytp oth xtn","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0563U","name":"Nfct ds pthgn-sna 11vir&4bct","description":"Nfct ds pthgn-sna 11vir&4bct","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20912","name":"Remove cartilage for graft","description":"Cartilage graft; nasal septum","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0533","name":"Buprenorphone inj weekly","description":"Medication assisted treatment, buprenorphine (injectable) administered on a weekly basis; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid tre","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0457","name":"Injection, aztreonam, 100 mg","description":"Injection, aztreonam, 100 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0628U","name":"Nfro kdn ds genetic cond 449","description":"Nfro kdn ds genetic cond 449","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1175","name":"Doc med rsn no hzv","description":"Documentation of medical reason(s) for not administering zoster vaccine (e.g., prior anaphylaxis due to the zoster vaccine)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0611U","name":"Onc lvr alys >1000 mr cfdna","description":"Onc lvr alys >1000 mr cfdna","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0765T","name":"Asstv alg ecg rsk asmt prev","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to previously performed electrocardiogram","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1551","name":"Inj cutaquig 100 mg","description":"Injection, immune globulin (cutaquig), 100 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1317","name":"Pts counsl cpt opt out","description":"Patients who are counseled on connection with a csp and explicitly opt out","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1276","name":"Calc bmi out nrm param nof/u","description":"Bmi documented outside normal parameters, no follow-up plan documented, no reason given","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0400U","name":"Ob xpnd car scr 145 genes","description":"Ob xpnd car scr 145 genes","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36200","name":"Place catheter in aorta","description":"Introduction of catheter, aorta","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2038","name":"Marigen pacto, per sq cm","description":"Marigen pacto, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1354","name":"Pt no suicd saf pln 120dy","description":"Patients who did not have a suicide safety plan initiated, reviewed, or updated or reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1475","name":"Pt dx huntington","description":"Patients with diagnosis of huntingtons disease","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0514U","name":"Gi ibd ia quan deter adl lvl","description":"Gi ibd ia quan deter adl lvl","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0856T","name":"Dgtz gls mcrscp electron mic","description":"Digitization of glass microscope slides for electron microscopy, diagnostic (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0465","name":"Autolog prp diab wound ulcer","description":"Autologous platelet rich plasma (prp) or other blood-derived product for diabetic chronic wounds/ulcers, using an fda-cleared device for this indication, (includes as applicable administration, dressings, phlebotomy, centrifugation or mixing, and all other preparatory procedures, per treatment)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0685T","name":"Interrog dev eval isdss ip","description":"Interrogation device evaluation (in-person) with analysis, review and report by a physician or other qualified health care professional, including connection, recording and disconnection per patient encounter, permanent implantable synchronized diaphragmatic stimulation system for augmentation of ca","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86364","name":"Tiss trnsgltmnase ea ig clas","description":"Tissue transglutaminase, each immunoglobulin (ig) class","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4361","name":"Pneuma/vac walk boot pre ots","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87077","name":"Culture aerobic identify","description":"Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1362","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0206","name":"Inj allopurinol sodium 1 mg","description":"Injection, allopurinol sodium, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0977T","name":"Upr gi bld detcj snr capsule","description":"Upper gastrointestinal blood detection, sensor capsule, with interpretation and report","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35558","name":"Art byp grft fem-femoral","description":"Bypass graft, with vein; femoral-femoral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1505.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0402U","name":"Nfct agt sti mult amp prb tq","description":"Nfct agt sti mult amp prb tq","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0350U","name":"Rx metab/pcx dna 27 gen alys","description":"Rx metab/pcx dna 27 gen alys","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76014","name":"Mr sfty implt&/fb asmt stf 1","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0538","name":"Ascvd rsk mng clin stf pr mo","description":"Atherosclerotic cardiovascular disease (ascvd) risk management services; clinical staff time; per calendar month","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0879","name":"Difelikefalin, esrd on dialy","description":"Injection, difelikefalin, 0.1 microgram, (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1417","name":"Pt up to date cov","description":"Patients who are up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1462","name":"Pt clin ind hd image","description":"Patients with clinical indications for imaging of the head","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0331U","name":"Onc hl neo opt gen mapping","description":"Onc hl neo opt gen mapping","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0922T","name":"Rmvl perm ccm-d sys dual ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); dual (pacing and defibrillation) transvenous leads only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62100","name":"Repair brain fluid leakage","description":"Craniotomy for repair of dural/cerebrospinal fluid leak, including surgery for rhinorrhea/otorrhea","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1815.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0029","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71030","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1236","name":"Baseline mrs > 2","description":"Baseline mrs > 2","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6612","name":"Onlay cst base mtl 2 surface","description":"Onlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40806","name":"Incision of lip fold","description":"Incision of labial frenum (frenotomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95940","name":"Ionm in operatng room 15 min","description":"Continuous intraoperative neurophysiology monitoring in the operating room, one on one monitoring requiring personal attendance, each 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0733T","name":"Rem r-t mtn nrehab ther sply","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; supply and technical support, per 30 days","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1229","name":"Pt w/ +hcv +vir ref win 1 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, is referred within 1 month of the reactive hcv antibody test to a clinician who treats hcv infection","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4224","name":"Hhf10-p per sq cm","description":"Human health factor 10 amniotic patch (hhf10-p), per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29805","name":"Sho arthrs dx +- synovial bx","description":"Arthroscopy, shoulder, diagnostic, with or without synovial biopsy (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":575.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0710T","name":"N-invas artl plaq alys","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; including data preparation and transmission, quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess a","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0722T","name":"Quan ct tiss charac w/ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained with concurrent ct examination of any structure contained in the concurrently acquired diagnostic imaging dataset (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1381","name":"Pt sec strk wthin 5 days","description":"Patients with secondary stroke (e.g., a subsequent stroke that may occur with vasospasm in the setting of subarachnoid hemorrhage) within 5 days of the initial procedure","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0426","name":"Coll, analys of saliva","description":"Coll, analys of saliva","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0683T","name":"Prgrmg dev eval isdss ip","description":"Programming device evaluation (in-person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional, permanent implantable synchroni","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0836T","name":"Dgtz gls mcrscp fna ea addl","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85041","name":"Automated rbc count","description":"Blood count; red blood cell (rbc), automated","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0528","name":"Mgt est pt dem mod-hi cmplx","description":"Management of established patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39000","name":"Exploration of chest","description":"Mediastinotomy with exploration, drainage, removal of foreign body, or biopsy; cervical approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0049","name":"Main hemo in-cntr","description":"With maintenance hemodialysis (in-center and home hd) for the complete reporting month","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0873T","name":"Revj subq prtl asct pmp sys","description":"Revision of a subcutaneously implanted peritoneal ascites pump system, any component (ascites pump, associated peritoneal catheter, associated bladder catheter), including imaging and programming, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9955","name":"Oral app thxpy titration vis","description":"Oral app thxpy titration vis","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1428","name":"Bilateral absence of eyes","description":"Patients who have bilateral absence of eyes any time during the patients history through the end of the measurement period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1237","name":"Pt rsn no scrn","description":"Patient reason for not screening for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety (e.g., patient declined or other patient reasons)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2794","name":"Crown-titanium","description":"Crown-titanium","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6607","name":"G com bandage tub protct lyr","description":"Gradient compression bandaging supply, tubular protective absorption layer, per linear yard, any width, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50250","name":"Opn abltj 1/> rnl mas crysrg","description":"Ablation, open, 1 or more renal mass lesion(s), cryosurgical, including intraoperative ultrasound guidance and monitoring, if performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1335.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2543","name":"Dental onlay metallic 3 surf","description":"Onlay - metallic - three surfaces","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1019T","name":"Lymphovenous bypass per xtr","description":"Lymphovenous bypass, including robotic assistance, when performed, per extremity","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1201","name":"Med rsn no ace-i/arb rx","description":"Documentation of medical reason(s) for not prescribing ace inhibitor (ace-i) or arb therapy during the measurement period (e.g., pregnancy, history of angioedema to ace-i, other allergy to ace-i and arb, hyperkalemia or history of hyperkalemia while on ace-i or arb therapy, acute kidney injury due t","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0666","name":"Team remote e/m est pt 15 mn","description":"Team remote e/m est. pt 15mins","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62304","name":"Myelography lumbar injection","description":"Myelography via lumbar injection, including radiological supervision and interpretation; lumbosacral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0036","name":"Pt/ptn decln assess","description":"Patient or care partner decline assessment","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27458","name":"Osteot femur imed lngth dev","description":"Osteotomy(ies), femur, unilateral, with insertion of an externally controlled intramedullary lengthening device, including iliotibial band release when performed, imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64645","name":"Chemodenerv 1 extrem 5/> ea","description":"Chemodenervation of one extremity; each additional extremity, 5 or more muscles (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77080","name":"Dxa bone density axial","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1448","name":"Pt dx pd bef end meas pd","description":"Patients with an active diagnosis of personality disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0855T","name":"Dgtz gls mcrscp b1 marow smr","description":"Digitization of glass microscope slides for bone marrow, smear interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1329","name":"Pts act pvd 2 wks 8 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 8 weeks after initial acute pvd encounter","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98012","name":"Synch audio-only est sf 10","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4298","name":"Amniocore pro, per sq cm","description":"Amniocore pro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87580","name":"M.pneumon dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); mycoplasma pneumoniae, direct probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5144","name":"Inj, idacio, 1 mg","description":"Injection, adalimumab-aacf (idacio), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5150","name":"Inj, aflibercept-mrbb, 1 mg","description":"Injection, aflibercept-mrbb (ahzantive), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4003","name":"Emergency med ss","description":"Emergency medicine mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9355","name":"Inj trastuzumab excl biosimi","description":"Injection, trastuzumab, excludes biosimilar, 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0738","name":"Upper extremity rehab","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20396.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96372","name":"Ther/proph/diag inj sc/im","description":"Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9988","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47384","name":"Abltj ire liver 1+ tum perq","description":"Ablation, irreversible electroporation, liver, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82270","name":"Occult blood feces","description":"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (ie, patient was provided 3 cards or single triple card for consecutive collection)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0931T","name":"Ephys eval ccm-d ld separate","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), separate from initial implantation or replacement with testing of cardiac cont","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9286","name":"Inj glofitamab gxbm, 2.5 mg","description":"Injection, glofitamab-gxbm, 2.5 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44147","name":"Partial removal of colon","description":"Colectomy, partial; abdominal and transanal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1416.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0482","name":"Direct immunofluorescence","description":"Direct immunofluorescence","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5939","name":"Resct proth mand comp remov","description":"Resct proth mand comp remov","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31541","name":"Larynscop w/tumr exc + scope","description":"Laryngoscopy, direct, operative, with excision of tumor and/or stripping of vocal cords or epiglottis; with operating microscope or telescope","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0019","name":"Comm hlth intg svs sdoh 60mn","description":"Community health integration services performed by certified or trained auxiliary personnel, including a community health worker, under the direction of a physician or other practitioner; 60 minutes per calendar month, in the following activities to address social determinants of health (sdoh) need(","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1500","name":"Neuropsychology mvp","description":"Neuropsychology mips value pathway","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0155","name":"Dronabinol (syndros) 0.1 mg","description":"Dronabinol (syndros), 0.1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0534","name":"Coordinated care/or referral","description":"Coordinated care and/or referral services, such as to adequate and accessible community resources to address unmet health-related social needs, including harm reduction interventions and recovery support services a patient needs and wishes to pursue, which significantly limit the ability to diagnose","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4303","name":"Complete aa, per sq cm","description":"Complete aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2305","name":"Inj, nitroglycerin, 5 mg","description":"Injection, nitroglycerin, 5 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92978","name":"Endoluminl ivus oct c 1st","description":"Endoluminal imaging of coronary vessel or graft using intravascular ultrasound (ivus) or optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention including imaging supervision, interpretation and report; initial vessel (list separately in addition to code for p","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":345.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96422","name":"Chemo ia infusion up to 1 hr","description":"Chemotherapy administration, intra-arterial; infusion technique, up to 1 hour","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1720","name":"Influenza vacc admin","description":"Influenza vacc admin","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93593","name":"R hrt cath chd nml nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; normal native connections","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83986","name":"Assay ph body fluid nos","description":"Ph; body fluid, not otherwise specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9025","name":"Plasma cryo redu path each","description":"Plasma, cryoprecipitate reduced, pathogen reduced, each unit","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60661","name":"Abltj 1/+thyr ndul addl prq","description":"Ablation of 1 or more thyroid nodule(s), additional lobe, percutaneous, including imaging guidance, radiofrequency (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2525","name":"Cl, hydrophilic, dual focus","description":"Contact lens, hydrophilic, dual focus, per lens","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":249.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4376","name":"Duograft aa per sq cm","description":"Duograft aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0830T","name":"Dgtz gls mcrscp cytp slctv","description":"Digitization of glass microscope slides for cytopathology, selective-cellular enhancement technique with interpretation (eg, liquid-based slide preparation method), except cervical or vaginal (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2401","name":"Chloroprocaine hcl injection","description":"Injection, chloroprocaine hydrochloride, per 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0951T","name":"Tot impl amei 1st plmt","description":"Totally implantable active middle ear hearing implant; initial placement, including mastoidectomy, placement of and attachment to sound processor","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0701","name":"Inj. cefepime hcl (baxter)","description":"Injection, cefepime hydrochloride (baxter), not therapeutically equivalent to maxipime, 500 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99308","name":"Sbsq nf care low mdm 20","description":"Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 20 minutes must be met or exce","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":24.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":90.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0687T","name":"Tx amblyopia dev setup 1st","description":"Treatment of amblyopia using an online digital program; device supply, educational set-up, and initial session","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7471","name":"Rem exostosis any site","description":"Removal of lateral exostosis (maxilla or mandible)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0526U","name":"Nefro rnl trnspl quan cxcl10","description":"Nefro rnl trnspl quan cxcl10","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0784T","name":"Ins/rplmt eltrd ra spi nstim","description":"Insertion or replacement of percutaneous electrode array, spinal, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0558","name":"Adv prim care mgmt lvl 3","description":"Advanced primary care management services for a patient that is a qualified medicare beneficiary with multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, which place the patient at significant risk of death, acute exacerbation/decompensat","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1342","name":"Pts died perf per","description":"Patients who died during the performance period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87469","name":"Babesia microti amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); babesia microti, amplified probe technique","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0439U","name":"Crd chd dna alys 5 snp 3 dna","description":"Crd chd dna alys 5 snp 3 dna","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0011","name":"Hiv prep counsel, md 15-30m","description":"Individual counseling for pre-exposure prophylaxis (prep) by physician or qualified health care professional (qhp) to prevent human immunodeficiency virus (hiv), includes hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence, 15-30 minutes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0040","name":"Pt phys/occ therapy","description":"Patient already receiving physical/occupational/speech/recreational therapy during the measurement period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1355","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93593","name":"R hrt cath chd nml nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; normal native connections","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0753T","name":"Dgtz gls mcrscp sld level iv","description":"Digitization of glass microscope slides for level iv, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49180","name":"Biopsy abdominal mass","description":"Biopsy, abdominal or retroperitoneal mass, percutaneous needle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4315","name":"Regenelink amniotic mem allo","description":"Regenelink amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11042","name":"Dbrdmt subq tis 1st 20sqcm/<","description":"Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":63.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50540","name":"Revision of horseshoe kidney","description":"Symphysiotomy for horseshoe kidney with or without pyeloplasty and/or other plastic procedure, unilateral or bilateral (1 operation)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1289.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6517","name":"Grad com wrap w strap bn cus","description":"Gradient compression wrap with adjustable straps, below knee, each, custom","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23333","name":"Remove shoulder fb deep","description":"Removal of foreign body, shoulder; deep (subfascial or intramuscular)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":498.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93588","name":"Vngrph chd vnvn cltrl below","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating below the heart (eg, from the inferior vena cava) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4364","name":"Am bur xp mem xpl hy p sq cm","description":"Amnio burgeon xplus membrane and xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7111","name":"Extraction coronal remnants","description":"Extraction coronal remnants - deciduous tooth","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0521","name":"New pt-cg dyad dem hig cmplx","description":"Management of new patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21026","name":"Excision of facial bone(s)","description":"Excision of bone (eg, for osteomyelitis or bone abscess); facial bone(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33280","name":"Rmvl phrnc nrv stim pg only","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator only","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87088","name":"Urine bacteria culture","description":"Culture, bacterial; with isolation and presumptive identification of each isolate, urine","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2277","name":"Inj, motixafortide, 0.25 mg","description":"Injection, motixafortide, 0.25 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96203","name":"Mlt fam grp bhv train ea add","description":"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face with multiple sets of paren","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3244","name":"Inj. tigecycline (accord)","description":"Injection, tigecycline (accord), not therapeutically equivalent to j3243, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0555U","name":"Repr med pga embryonic te qc","description":"Repr med pga embryonic te qc","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83014","name":"H pylori drug admin","description":"Helicobacter pylori; drug administration","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9347","name":"Inj, tremelimumab-actl, 1 mg","description":"Injection, tremelimumab-actl, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","name":"Gait mod systm rhym auditory","description":"Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8839.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37299","name":"Revsc evsc imvt angio cpx ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94625","name":"Phy/qhp op pulm rhb w/o mntr","description":"Physician or other qualified health care professional services for outpatient pulmonary rehabilitation; without continuous oximetry monitoring (per session)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20100","name":"Expl pentrg wound neck","description":"Exploration of penetrating wound (separate procedure); neck","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":701.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99299","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3391","name":"Inj, atidarsagene autotemcel","description":"Injection, atidarsagene autotemcel, per treatment","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0415U","name":"Cv ds acs bld alg 5 yr score","description":"Cv ds acs bld alg 5 yr score","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4306","name":"Americ amnion ac per sq cm","description":"American amnion ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0812T","name":"Rem mlt day uroflow dev sply","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); device supply with automated report generation, up to 10 days","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0866T","name":"Quan mri alys brn w/dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion detection, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transmissio","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0547","name":"Phone/internet svs 11-20 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0925T","name":"Rlcj skin pocket ccm-d pg","description":"Relocation of skin pocket for implanted cardiac contractility modulation-defibrillation pulse generator","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4294","name":"Amnio quad-core, per sq cm","description":"Amnio quad-core, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0305U","name":"Hem rbc fnclty&dfrm shr strs","description":"Hem rbc fnclty&dfrm shr strs","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1169","name":"Doc med rsn no flu vax","description":"Documentation of medical reason(s) for not administering influenza vaccine (e.g., prior anaphylaxis due to the influenza vaccine)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0815T","name":"Us rems b1 dns hips plvs/spi","description":"Ultrasound-based radiofrequency echographic multi-spectrometry (rems), bone-density study and fracture-risk assessment, 1 or more sites, hips, pelvis, or spine","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99344","name":"Home/res vst new mod mdm 60","description":"Home or residence visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":165.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0803T","name":"Tcat rmv&rpl2chmb ldls pm rv","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ve","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0704T","name":"Rem tx amblyopia setup&edu","description":"Remote treatment of amblyopia using an eye tracking device; device supply with initial set-up and patient education on use of equipment","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4468","name":"Exsuff belt incl all sup acc","description":"Exsufflation belt, includes all supplies and accessories","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4406","name":"Xwrap fenestra per sq cm","description":"Xwrap fenestra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87150","name":"Dna/rna amplified probe","description":"Culture, typing; identification by nucleic acid (dna or rna) probe, amplified probe technique, per culture or isolate, each organism probed","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7300","name":"Rem anchorage dev w/o flap","description":"Rem anchorage dev w/o flap","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3373","name":"Inj, vancomycin hcl, 10 mg","description":"Injection, vancomycin hydrochloride, 10 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9052","name":"Inj, carmustine (accord)","description":"Injection, carmustine (accord), not therapeutically equivalent to j9050, 100 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86581","name":"Strptcs pneum antb serot ia","description":"Streptococcus pneumoniae antibody (igg), serotypes, multiplex immunoassay, quantitative","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9293","name":"Fertility cycl tracking soft","description":"Fertility cycle (contraception & conception) tracking software application, fda cleared, per month, includes accessories (e.g., thermometer)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9161","name":"Inj denileuk difti-cxdl 1mcg","description":"Injection, denileukin diftitox-cxdl, 1 mcg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22525","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":337.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1170","name":"Pt w/o flu vax 7/1-6/30","description":"Patient did not receive an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0671T","name":"Insj ant sgm aq drg dev 1+","description":"Insertion of anterior segment aqueous drainage device into the trabecular meshwork, without external reservoir, and without concomitant cataract removal, one or more","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0364U","name":"Onc hl neo gen seq alys alg","description":"Onc hl neo gen seq alys alg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85009","name":"Manual diff wbc count b-coat","description":"Blood count; manual differential wbc count, buffy coat","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0437U","name":"Psyc anxiety do mrna 15 bmrk","description":"Psyc anxiety do mrna 15 bmrk","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9054","name":"Inj bortezomib boruzu 0.1 mg","description":"Injection, bortezomib (boruzu), 0.1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0687T","name":"Tx amblyopia dev setup 1st","description":"Treatment of amblyopia using an online digital program; device supply, educational set-up, and initial session","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5422","name":"Dentures adjust part mandbl","description":"Adjust partial denture - mandibular","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1287","name":"Calc bmi blw low param f/u","description":"Bmi is documented below normal parameters and a follow-up plan is documented","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9298","name":"Inj nivol relatlimab 3mg/1mg","description":"Injection, nivolumab and relatlimab-rmbw, 3 mg/1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9286","name":"Inj glofitamab gxbm, 2.5 mg","description":"Injection, glofitamab-gxbm, 2.5 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1301","name":"Pt recv tbco cess interv","description":"Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27713","name":"Osteot tibia imed lngth dev","description":"Osteotomy(ies), tibia, including fibula when performed, unilateral, with insertion of an externally controlled intramedullary lengthening device, including imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4542","name":"Supp ext up limb tremor stim","description":"Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7213","name":"Inj, ixinity, 1 i.u.","description":"Injection, coagulation factor ix (recombinant), ixinity, 1 i.u.","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43116","name":"Partial removal of esophagus","description":"Partial esophagectomy, cervical, with free intestinal graft, including microvascular anastomosis, obtaining the graft and intestinal reconstruction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2257.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1152","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9959","name":"Unspec sleep ap proc","description":"Unspec sleep ap proc","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0219","name":"Inj aval alfa-nqpt 4mg","description":"Injection, avalglucosidase alfa-ngpt, 4 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87077","name":"Culture aerobic identify","description":"Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0838T","name":"Dgtz gls mcrscp cslt sld els","description":"Digitization of glass microscope slides for consultation and report on referred slides prepared elsewhere (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0409U","name":"Onc sld tum dna 80 & rna 36","description":"Onc sld tum dna 80 & rna 36","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5765","name":"Liner compl/partial rem dent","description":"Liner compl/partial rem dent","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0137","name":"Inten outpt svs,min 9 pr 7 d","description":"Intensive outpatient services; weekly bundle, minimum of 9 services over a 7 contiguous day period, which can include individual and group therapy with physicians or psychologists (or other mental health professionals to the extent authorized under state law); occupational therapy requiring the skil","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0257U","name":"Vlcad leuk nzm actv whl bld","description":"Very long chain acyl- coenzyme a (coa) dehydrogenase (vlcad), leukocyte enzyme activity, whole blood","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1019T","name":"Lymphovenous bypass per xtr","description":"Lymphovenous bypass, including robotic assistance, when performed, per extremity","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9065","name":"Inj cladribine per 1 mg","description":"Injection, cladribine, per 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1423","name":"Opt care urologic cnd mvp","description":"Optimal care for patients with urologic conditions mips value pathway","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43263","name":"Ercp sphincter pressure meas","description":"Endoscopic retrograde cholangiopancreatography (ercp); with pressure measurement of sphincter of oddi","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80505","name":"Path clin consltj high 41-60","description":"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patients history and medical records and high level of medical decision making when using time for code selection, 41-60 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7997","name":"Appliance removal","description":"Appliance removal (not by dentist who placed appliance) includes removal of archbar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4375","name":"Duograft ac per sq cm","description":"Duograft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93598","name":"Car outp meas drg cath chd","description":"Cardiac output measurement(s), thermodilution or other indicator dilution method, performed during cardiac catheterization for the evaluation of congenital heart defects (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7354","name":"Cantharidin top, applicator","description":"Cantharidin for topical administration, 0.7%, single unit dose applicator (3.2 mg)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7514","name":"Mycophenol (myhibbin) 100 mg","description":"Mycophenolate mofetil (myhibbin), oral suspension, 100 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4391","name":"Amnioplast double per sq cm","description":"Amnioplast double, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1334","name":"Pts act pvd 2 wks 2 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 2 weeks after initial acute pvd encounter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5143","name":"Inj adalimumab-adbm, 1 mg","description":"Injection, adalimumab-adbm, biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4336","name":"Artecent c, per sq cm","description":"Artacent c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36837","name":"Prq av fstl crt uxtr sep acs","description":"Percutaneous arteriovenous fistula creation, upper extremity, separate access sites of the peripheral artery and peripheral vein, including fistula maturation procedures (eg, transluminal balloon angioplasty, coil embolization) when performed, including all vascular access, imaging guidance and radi","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7671","name":"Alveolus open reduction","description":"Alveolus - open reduction may include stabilization of teeth","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0871T","name":"Rplcmt subq prtl ascites pmp","description":"Replacement of a subcutaneous peritoneal ascites pump, including reconnection between pump and indwelling bladder and peritoneal catheters, including initial programming and imaging, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1412","name":"Inj roctavian ml 2x10^13vc g","description":"Injection, valoctocogene roxaparvovec-rvox, per ml, containing nominal 2 x 10^13 vector genomes","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0701T","name":"Molec fluor img sus nev ea","description":"Molecular fluorescent imaging of suspicious nevus; each additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0441U","name":"Nfct ds bct fngl/viral semiq","description":"Nfct ds bct fngl/viral semiq","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36820","name":"Av fusion/forearm vein","description":"Arteriovenous anastomosis, open; by forearm vein transposition","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":997.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27138","name":"Revise hip joint replacement","description":"Revision of total hip arthroplasty; femoral component only, with or without allograft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1836.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0261U","name":"Onc clrct ca img alys w/ai","description":"Oncology (colorectal cancer), image analysis with artificial intelligence assessment of 4 histologic and immunohistochemical features (cd3 and cd8 within tumor-stroma border and tumor core), tissue, reported as immune response and recurrence-risk score","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78130","name":"Red cell survival study","description":"Red cell survival study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0301U","name":"Iadna bartonella ddpcr","description":"Iadna bartonella ddpcr","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0038","name":"Clin pt no ref","description":"Clinician determines patient does not require referral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1260","name":"Pt not doc <= 1 yr dialysis","description":"Patient status not documented within the first year of initiating dialysis","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1814","name":"Inj. insulin (lyumjev)","description":"Insulin (lyumjev), per 5 units","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37287","name":"Revsc evasc tpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4414","name":"Simplichor per sq cm","description":"Simplichor, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1474","name":"Pt dx dementia","description":"Patients with diagnosis of dementia","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61760","name":"Implant brain electrodes","description":"Stereotactic implantation of depth electrodes into the cerebrum for long-term seizure monitoring","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1654.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87533","name":"Hhv-6 dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); herpes virus-6, quantification","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5148","name":"Inj, nyposi 1 mcg","description":"Injection, filgrastim-txid (nypozi), biosimilar, 1 microgram","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78122","name":"Whl bld volume determination","description":"Whole blood volume determination, including separate measurement of plasma volume and red cell volume (radiopharmaceutical volume-dilution technique)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0722T","name":"Quan ct tiss charac w/ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained with concurrent ct examination of any structure contained in the concurrently acquired diagnostic imaging dataset (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0605","name":"Sucroferric oxyhydroxide 5mg","description":"Sucroferric oxyhydroxide, oral, 5 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0539U","name":"Onc sol tumor cfctdna 152gen","description":"Onc sol tumor cfctdna 152gen","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0216","name":"Inj, alfentanil hcl, 500mcg","description":"Injection, alfentanil hydrochloride, 500 micrograms","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0334U","name":"Onc sld orgn tgsa dna 84/+","description":"Onc sld orgn tgsa dna 84/+","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0737T","name":"Xenograft impltj artclr surf","description":"Xenograft implantation into the articular surface","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1177","name":"Pt recd pcv on/aft 19","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69728","name":"Rmv ntr oi imp sk tc>=100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19272","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1973.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93594","name":"R hrt cath chd abnl nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; abnormal native connections","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4351","name":"Enclose tl matrix, per sq cm","description":"Enclose tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0381U","name":"Maple syrup ur ds mntr quan","description":"Maple syrup ur ds mntr quan","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54150","name":"Circumcision w/regionl block","description":"Circumcision, using clamp or other device with regional dorsal penile or ring block","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":90.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56440","name":"Mrsplzatn brthlns glnd cst","description":"Marsupialization of bartholins gland cyst","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2007","name":"Restrata, per sq cm","description":"Restrata, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0949T","name":"Rem interrog dev ccm tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4400","name":"Polygon3 per sq cm","description":"Polygon3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4288","name":"Replacement breastpump valve","description":"Valve for breast pump, replacement","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1414","name":"Med rsn no pdl1 bef 1st ther","description":"Documentation of medical reason(s) for not performing the pd-l1 biomarker expression test prior to initiation of first-line immune checkpoint inhibitor therapy (e.g., patient is in an urgent or emergent situation where delay of treatment would jeopardize the patients health status; other medical rea","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0284U","name":"Vw factor type 2n eval plsm","description":"Von willebrand factor (vwd), type 2n, factor viii and vwf binding evaluation, enzyme-linked immunosorbent assays (elisa), plasma","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0748T","name":"Njx stm cl prdct anl sft tis","description":"Injections of stem cell product into perianal perifistular soft tissue, including fistula preparation (eg, removal of setons, fistula curettage, closure of internal openings)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33901","name":"Perq p-art revsc 1 nm nt bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, bilateral","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7485","name":"Surg reduct osseoustuberosit","description":"Surgical reduction of osseous tuberosity","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0035","name":"Cardiokymography","description":"Cardiokymography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39560","name":"Resect diaphragm simple","description":"Resection, diaphragm; with simple repair (eg, primary suture)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":887.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91304","name":"Sarscov2 vac 5mcg/0.5ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, 5 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24105","name":"Excision olecranon bursa","description":"Excision, olecranon bursa","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":395.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6191","name":"Semi precision abutment","description":"Semi precision abutment","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7241","name":"Impact tooth rem bony w/comp","description":"Removal of impacted tooth-completely bony with unusual surgical complications","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27654","name":"Repair of achilles tendon","description":"Repair, secondary, achilles tendon, with or without graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":849.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0698T","name":"Quan mr tiss w/mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained with diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, target ","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0982T","name":"Rem mntr impl ivc snr set-up","description":"Remote monitoring of implantable inferior vena cava sensor, physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate), initial set-up and patient education on use of equipment","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6081","name":"Scale & debride, single imp","description":"Scale & debride, single imp","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0589U","name":"Pfas24cmpnd hi-perf lc-ms/ms","description":"Pfas24cmpnd hi-perf lc-ms/ms","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5162","name":"Inj, denosumab-nxxp, 1 mg","description":"Injection, denosumab-nxxp (bildyos/bilprevda), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0409U","name":"Onc sld tum dna 80 & rna 36","description":"Onc sld tum dna 80 & rna 36","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1502","name":"Podiatry mvp","description":"Podiatry mips value pathway","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87077","name":"Culture aerobic identify","description":"Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1441","name":"Init dx slp apn = 1st enc","description":"Encounter corresponds to initial diagnosis of sleep apnea or first contact with sleep apnea diagnosed patient","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0537","name":"Risk ascvd tst once pr 12 mo","description":"Administration of a standardized, evidence-based atherosclerotic cardiovascular disease (ascvd) risk assessment, 5-15 minutes, not more often than every 12 months","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1302","name":"Scrn mam perf rslts doc","description":"Screening, diagnostic, film digital or digital breast tomosynthesis (3d) mammography results documented and reviewed","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90482","name":"Imm cnsl not admn sm 3<10","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; 3 minutes up to 10 minutes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0727T","name":"Rmvl&rplcmt implt vstblr dev","description":"Removal and replacement of implanted vestibular device, unilateral","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4023","name":"Pathology ss","description":"Pathology mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2525","name":"Cl, hydrophilic, dual focus","description":"Contact lens, hydrophilic, dual focus, per lens","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2006","name":"Novosorb synpath per sq cm","description":"Novosorb synpath dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0999T","name":"Autol musc cell therapy hrvg","description":"Autologous muscle cell therapy, harvesting of muscle progenitor cells, including ultrasound guidance, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35560","name":"Art byp grft aortorenal","description":"Bypass graft, with vein; aortorenal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2237.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30000","name":"Drainage of nose lesion","description":"Drainage abscess or hematoma, nasal, internal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0295U","name":"Onc brst dux carc 7 proteins","description":"Onc brst dux carc 7 proteins","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0837T","name":"Dgtz gls mcrscp fna i&r","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; interpretation and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1208","name":"Pt no scrn sdoh","description":"Patient is not screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0924T","name":"Rpos prv ccm-d trnsvns eltrd","description":"Repositioning of previously implanted cardiac contractility modulation-defibrillation transvenous electrode(s)/lead(s), including fluoroscopic guidance and programming of sensing and therapeutic parameters","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6074","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (noble metal)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4030","name":"Pulmonology ss","description":"Pulmonology mips specialty set","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9196","name":"Inj gemcitabine hcl (accord)","description":"Injection, gemcitabine hydrochloride (accord), not therapeutically equivalent to j9201, 200 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4009","name":"Hospitalists ss","description":"Hospitalists mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1217","name":"Sys rsn no doc spiro","description":"Documentation of system reason(s) for not documenting and reviewing spirometry results (e.g., spirometry equipment not available at the time of the encounter)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11624","name":"Exc s/n/h/f/g mal+mrg 3.1-4","description":"Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 3.1 to 4.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3244","name":"Inj. tigecycline (accord)","description":"Injection, tigecycline (accord), not therapeutically equivalent to j3243, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1189","name":"Doc khe pef w/efgr/uacr","description":"Documentation of a kidney health evaluation defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr) performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64553","name":"Implant neuroelectrodes","description":"Percutaneous implantation of neurostimulator electrode array; cranial nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0276U","name":"Hem inh thrombocytopenia 23","description":"Hematology (inherited thrombocytopenia), genomic sequence analysis of 23 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0250","name":"Adm tocilizu covid-19 2nd","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0235","name":"Inj, monoclon antibody, 1 mg","description":"Injection, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extraco","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0965T","name":"I&cst prp jw xpn dl arch non","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, non-fixed hinge mechanism","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81456","name":"So/hl 51/>gsap rna alys","description":"Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic sequence analysis panel, interrogation for sequence variants and copy number variants or rearrangements, or isoform expression or mrna expression levels, if performed; rna analysis","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3911","name":"Intraorifice barrier","description":"Intraorifice barrier","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0660","name":"Team remote e/m new pt 10 mn","description":"Team remote e/m new pt 10mins","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5996","name":"Peri medicament w/seal, mand","description":"Peri medicament w/seal, mand","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4006","name":"Gastroenterology ss","description":"Gastro-enterology mips specialty set","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0885T","name":"Colsc flx 1st tndsc dilat","description":"Colonoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1229","name":"Pt w/ +hcv +vir ref win 1 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, is referred within 1 month of the reactive hcv antibody test to a clinician who treats hcv infection","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46748","name":"Repair of cloacal anomaly","description":"Repair of cloacal anomaly by anorectovaginoplasty and urethroplasty, combined abdominal and sacroperineal approach; with vaginal lengthening by intestinal graft or pedicle flaps","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3935.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80154","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76083","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0384U","name":"Neph ckd rsk hi stg kdn ds","description":"Neph ckd rsk hi stg kdn ds","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86780","name":"Treponema pallidum","description":"Antibody; treponema pallidum","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9331","name":"Inj sirolimus prot part 1 mg","description":"Injection, sirolimus protein-bound particles, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J0205","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85009","name":"Manual diff wbc count b-coat","description":"Blood count; manual differential wbc count, buffy coat","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4012","name":"Interventional rad ss","description":"Interventional radiology mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0502U","name":"Hpv e6/e7 mrk hi-rsk typ crv","description":"Hpv e6/e7 mrk hi-rsk typ crv","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52283","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with steroid injection into stricture","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86320","name":"Serum immunoelectrophoresis","description":"Immunoelectrophoresis; serum","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92548","name":"Cdp-sot 6 cond w/i&r","description":"Computerized dynamic posturography sensory organization test (cdp-sot), 6 conditions (ie, eyes open, eyes closed, visual sway, platform sway, eyes closed platform sway, platform and visual sway), including interpretation and report;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1312","name":"No pt tbco scrn rng","description":"Patient not screened for tobacco use","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32020","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0920T","name":"Rmvl perm ccm-d sys 1 pac ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous pacing lead only","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83891","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93153","name":"Interrog w/o prgrmg ipnss","description":"Interrogation without programming of implanted phrenic nerve stimulator system","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1220","name":"Dre wth interp rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; with evidence of retinopathy","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42405","name":"Biopsy of salivary gland","description":"Biopsy of salivary gland; incisional","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":268.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87391","name":"Hiv-2 ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; hiv-2","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99497","name":"Advncd care plan 30 min","description":"Advance care planning including the explanation and discussion of advance directives such as standard forms (with completion of such forms, when performed), by the physician or other qualified health care professional; first 30 minutes, face-to-face with the patient, family member(s), and/or surroga","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":84.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0602U","name":"Endocrin dm ins gen mthyltn","description":"Endocrin dm ins gen mthyltn","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0892","name":"Argatroban dialysis (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0702","name":"2d cephal radio image","description":"2d cephal radio image","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0527","name":"Mgt est pt dmentia low cmplx","description":"Management of established patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0338U","name":"Onc sld tum crcg tum cl slct","description":"Onc sld tum crcg tum cl slct","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1007T","name":"Eeg impl s-sclp eeg w/o vid","description":"Electroencephalogram from implanted sub-scalp continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6608","name":"G com bandage tub protct pad","description":"Gradient compression bandaging supply, tubular protective absorption padded layer, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":5.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4391","name":"Amnioplast double per sq cm","description":"Amnioplast double, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15854","name":"Removal sutr&stapl xreq anes","description":"Removal of sutures and staples not requiring anesthesia (list separately in addition to e/m code)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2041","name":"Coord special care encounter","description":"Coordinated specialty care, team-based, for first episode psychosis, per encounter","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1239","name":"Pt no resp heard","description":"Patient did not respond to the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9947","name":"Sleep apnea appliance","description":"Sleep apnea appliance","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1434","name":"Orl chemo wthn 30 d post enc","description":"Patient on oral chemotherapy on or within 30 days after denominator eligible encounter","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3404","name":"Inj zopapogene per ther dose","description":"Injection, zopapogene imadenovec-drba suspension, per therapeutic dose","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19100","name":"Bx breast percut w/o image","description":"Biopsy of breast; percutaneous, needle core, not using imaging guidance (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64655","name":"Revj/rplcmt bat mod sys lead","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; lead only","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9075","name":"Inj, cyclophosphamide, nos","description":"Injection, cyclophosphamide, not otherwise specified, 5 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0751","name":"Hiv prep, ftc/taf 200/25mg","description":"Emtricitabine 200mg and tenofovir alafenamide 25mg, oral, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0939T","name":"Xtrnl ecg rec>15d<30d scan","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; scanning analysis with report","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0163","name":"Epinephrine in nacl (endo)","description":"Injection, epinephrine in sodium chloride (endo), 0.1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2038","name":"Skill train and dev/diem","description":"Skills training and development, per diem","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1346","name":"No pam inc 6 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 6 points within a 4 to 12 month period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0934T","name":"Rem mntr wrls l atr prs snr","description":"Remote monitoring of a wireless left atrial pressure sensor for up to 30 days, including data from daily uploads of left atrial pressure recordings, interpretation(s) and trend analysis, with adjustments to the diuretics plan, treatment paradigm thresholds, medications or lifestyle modifications, wh","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15738","name":"Muscle-skin graft leg","description":"Muscle, myocutaneous, or fasciocutaneous flap; lower extremity","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1457.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51721","name":"Ins trurl ablt trnsdc thr us","description":"Insertion of transurethral ablation transducer for delivery of thermal ultrasound for prostate tissue ablation, including suprapubic tube placement during the same session and placement of an endorectal cooling device, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70471","name":"Cta h&n c+ w/noncontrast img","description":"Computed tomographic angiography (cta), head and neck, with contrast material(s), including noncontrast images, when performed, and image postprocessing","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0053A","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5144","name":"Inj, idacio, 1 mg","description":"Injection, adalimumab-aacf (idacio), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0895T","name":"Connj lvr algrft prfu dev 1","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; initial 4 hours of monitoring time, including hourly physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"Evaluation of wheezing","description":"Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0737","name":"Inj, clindamycin (baxter)","description":"Injection, clindamycin phosphate (baxter), not therapeutically equivalent to j0736, 300 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"Motor &/ sens nrve cndj test","description":"Motor and/or sensory nerve conduction, using preconfigured electrode array(s), amplitude and latency/velocity study, each limb, includes f-wave study when performed, with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4224","name":"Hhf10-p per sq cm","description":"Human health factor 10 amniotic patch (hhf10-p), per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33215","name":"Reposition pacing-defib lead","description":"Repositioning of previously implanted transvenous pacemaker or implantable defibrillator (right atrial or right ventricular) electrode","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62330","name":"Dcmprn prq rmv lig flv 1lmbr","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; one interspace, lumbar","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0440U","name":"Crd chd dna alys 10 snp 6dna","description":"Crd chd dna alys 10 snp 6dna","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26494","name":"Hand tendon/muscle transfer","description":"Opponensplasty; hypothenar muscle transfer","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1048.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90375","name":"Rabies ig im/sc","description":"Rabies immune globulin (rig), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1252","name":"Pts no cmplt hu survey","description":"Patients who did not complete at least one of the four patient experience hu survey items and return the hu survey within 60 days of the ambulatory palliative care visit","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1499","name":"Interventional radiology mvp","description":"Interventional radiology mips value pathway","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1105","name":"Dexmedetomidine film, 1 mcg","description":"Dexmedetomidine, oral, 1 mcg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1597","name":"Inj glycopyrrolate, glyrx-pf","description":"Injection, glycopyrrolate (glyrx-pf), 0.1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0756T","name":"Dgtz gls mcrscp sld spc grpi","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group i, for microorganisms (eg, acid fast, methenamine silver) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4261","name":"Tag, per square centimeter","description":"Tag, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7298","name":"Remove screw retained plate","description":"Remove screw retained plate","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4024","name":"Pediatrics ss","description":"Pediatrics mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5144","name":"Inj, idacio, 1 mg","description":"Injection, adalimumab-aacf (idacio), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93314","name":"Echo transesophageal","description":"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); image acquisition, interpretation and report only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0988T","name":"Opn ins/rplc ins ptn sbq&sbf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0892","name":"Argatroban dialysis (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0707","name":"Intraoral periap radio image","description":"Intraoral periap radio image","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4036","name":"Urgent care ss","description":"Urgent care mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91323","name":"Sarscov2 vac 10 mcg/0.2ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 10 mcg/0.2 ml dosage, for intramuscular use","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0974T","name":"Slctv nzmtc dbrdmt t/a/l ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; each additional 100 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42145","name":"Repair palate pharynx/uvula","description":"Palatopharyngoplasty (eg, uvulopalatopharyngoplasty, uvulopharyngoplasty)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":726.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43236","name":"Uppr gi scope w/submuc inj","description":"Esophagogastroduodenoscopy, flexible, transoral; with directed submucosal injection(s), any substance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0020M","name":"Onc cns alys 30000 dna loci","description":"Oncology (central nervous system), analysis of 30,000 dna methylation loci by methylation array, utilizing dna extracted from tumor tissue, diagnostic algorithm reported as probability of matching a reference tumor subclass","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4199","name":"Cygnus matrix, per sq cm","description":"Cygnus matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0009","name":"Admin pneumococcal vaccine","description":"Administration of pneumococcal vaccine","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9612","name":"Inj, fluorescein, 1 mg","description":"Injection, fluorescein, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0235","name":"Intrav inf, mon anti, fir do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7414","name":"Excision malig lesion>1.25cm","description":"Excision of malignant lesion greater than 1.25 cm","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9224","name":"Gen anes adv air-15 min","description":"Gen anes adv air-15 min","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43840","name":"Gstrrphy sutr duol/gstr ulcr","description":"Gastrorrhaphy, suture of perforated duodenal or gastric ulcer, wound, or injury","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87626","name":"Hpv sep hi-rsk typ&pool rslt","description":"Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), separately reported high-risk types (eg, 16, 18, 31, 45, 51, 52) and high-risk pooled result(s)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27698","name":"Repair of ankle ligament","description":"Repair, secondary, disrupted ligament, ankle, collateral (eg, watson-jones procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":808.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93569","name":"Njx cth slct p-art angrp uni","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6211","name":"Bridge base metal cast","description":"Pontic-cast predominantly base metal","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1266","name":"Pts admit snf","description":"Patients admitted to a skilled nursing facility (snf)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49621","name":"Rpr parastomal hernia rdc","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; reducible","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37295","name":"Rvsc evsc tpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0378U","name":"Rfc1 repeat xpnsj vrnt alys","description":"Rfc1 repeat xpnsj vrnt alys","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90638","name":"Vacc qirv mrna 60mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 60 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1399","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0864T","name":"Low ntsty eswt corpus cvrnsm","description":"Low-intensity extracorporeal shock wave therapy involving corpus cavernosum, low energy","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7514","name":"Mycophenol (myhibbin) 100 mg","description":"Mycophenolate mofetil (myhibbin), oral suspension, 100 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0555","name":"Replacment pt electronic sys","description":"Provision of replacement patient electronics system (e.g., system pillow, handheld reader) for home pulmonary artery pressure monitoring","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4392","name":"Grafix duo per sq cm","description":"Grafix duo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30320","name":"Remove nasal foreign body","description":"Removal foreign body, intranasal; by lateral rhinotomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":545.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1020T","name":"Raman spectroscopy 1+skn les","description":"Raman spectroscopy of 1 or more skin lesions, with probability score for malignant risk derived by algorithmic analysis of data from each lesion","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6211","name":"Bridge base metal cast","description":"Pontic-cast predominantly base metal","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7023","name":"Mech allergen parti barrier","description":"Mechanical allergen particle barrier/inhalation filter, cream, nasal, topical","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4289","name":"Revoshield+ amnio, per sq cm","description":"Revoshield + amniotic barrier, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6280","name":"Implt maint procd remv implt","description":"Implt maint procd remv implt","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9021","name":"Inj, aspara, rylaze, 0.1 mg","description":"Injection, asparaginase, recombinant, (rylaze), 0.1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0661","name":"Team remote e/m new pt 20 mn","description":"Team remote e/m new pt 20mins","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5160","name":"Inj, jobevne, 10 mg","description":"Injection, bevacizumab-nwgd (jobevne), biosimilar, 10 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1472","name":"Hep b vaccine not received","description":"Patient did not receive recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95249","name":"Cont gluc mntr pt prov eqp","description":"Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; patient-provided equipment, sensor placement, hook-up, calibration of monitor, patient training, and printout of recording","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0519U","name":"Ther rx mntr meds p/d/a 110+","description":"Ther rx mntr meds p/d/a 110+","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4351","name":"Enclose tl matrix, per sq cm","description":"Enclose tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26440","name":"Release palm/finger tendon","description":"Tenolysis, flexor tendon; palm or finger, each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":895.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0694","name":"Cefoxitin sodium injection","description":"Injection, cefoxitin sodium, 1 gm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76987","name":"Dx intraop epicar car us chd","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; including placement and manipulation of transducer, image acquisition, interpretation and report","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0545U","name":"Achr antb id imfluor livecll","description":"Achr antb id imfluor livecll","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1932","name":"Inj, lanreotide, (cipla) 1mg","description":"Injection, lanreotide, (cipla), 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81464","name":"So gsap cll fr mcrstl ins","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants, microsatellite instability, tumor mutation burden, and rearrangements","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86701","name":"Hiv-1antibody","description":"Antibody; hiv-1","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99441","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5136","name":"Inj. denosumab-bbdz, 1 mg","description":"Injection, denosumab-bbdz (jubbonti/wyost), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27620","name":"Explore/treat ankle joint","description":"Arthrotomy, ankle, with joint exploration, with or without biopsy, with or without removal of loose or foreign body","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":566.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1490","name":"Pt status not doc","description":"Patient status not documented","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99375","name":"Home health care supervision","description":"Supervision of a patient under care of home health agency (patient not present) in home, domiciliary or equivalent environment (eg, alzheimers facility) requiring complex and multidisciplinary care modalities involving regular development and/or revision of care plans by that individual, review of s","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":81.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7213","name":"Inj, ixinity, 1 i.u.","description":"Injection, coagulation factor ix (recombinant), ixinity, 1 i.u.","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96202","name":"Mlt fam grp bhv train 1st 60","description":"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face with multiple sets of paren","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0482","name":"Direct immunofluorescence","description":"Direct immunofluorescence","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1453","name":"Preop vis acu > 20/40","description":"Patients with a pre-operative visual acuity better than 20/40","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40701","name":"Repair cleft lip/nasal","description":"Plastic repair of cleft lip/nasal deformity; primary bilateral, 1-stage procedure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1290.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11971","name":"Rmvl tis xpndr wo insj implt","description":"Removal of tissue expander without insertion of implant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0039","name":"Pt no ref, rn spec","description":"Patient not referred, reason not otherwise specified","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4026","name":"Phys/occ therapy ss","description":"Physical therapy/occupational therapy mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0477U","name":"Rx metab psy 14&cyp2d6 gn-rx","description":"Rx metab psy 14&cyp2d6 gn-rx","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83521","name":"Ig light chains free each","description":"Immunoglobulin light chains (ie, kappa, lambda), free, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6602","name":"G com bandge hgh dn foamroll","description":"Gradient compression bandaging supply, high density foam roll for bandage, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7021","name":"Suppl and access lung expan","description":"Supplies and accessories for lung expansion airway clearance, continuous high frequency oscillation, and nebulization device (e.g., handset, nebulizer kit, biofilter)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1278","name":"Pre-htn or htn doc, f/u indc","description":"Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27664","name":"Repair of leg tendon each","description":"Repair, extensor tendon, leg; primary, without graft, each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":453.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0675","name":"Inj, carboprost, 0.1 mg","description":"Injection, carboprost tromethamine, 0.1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6611","name":"Grad com wrap w strap ak cus","description":"Gradient compression wrap with adjustable straps, above knee, each, custom","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1411","name":"Inj, hemgenix, per tx dose","description":"Injection, etranacogene dezaparvovec-drlb, per therapeutic dose","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5411","name":"Dentures adjust cmplt mand","description":"Adjust complete denture - mandibular","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9331","name":"Inj sirolimus prot part 1 mg","description":"Injection, sirolimus protein-bound particles, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0454U","name":"U rare ds id opt genome mapg","description":"U rare ds id opt genome mapg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0994T","name":"Evasc dlvr a-wal stbl rx prq","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; percutaneous","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4296","name":"Rebound matrix, per sq cm","description":"Rebound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2998","name":"Inj plasminogen tvmh 1mg","description":"Injection, plasminogen, human-tvmh, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1323","name":"Pts 7wk inj, scrn iop >25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop >25 mm hg and a plan of care was documented","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84244","name":"Assay of renin","description":"Renin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96381","name":"Admn rsv monoc antb im njx","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0140","name":"Nav srv peer sup 60 min pr m","description":"Principal illness navigation - peer support by certified or trained auxiliary personnel under the direction of a physician or other practitioner, including a certified peer specialist; 60 minutes per calendar month, in the following activities:  person-centered interview, performed to better underst","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1237","name":"Pt rsn no scrn","description":"Patient reason for not screening for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety (e.g., patient declined or other patient reasons)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0743T","name":"B1 str & fx rsk vrt fx assmt","description":"Bone strength and fracture risk using finite element analysis of functional data and bone mineral density (bmd), with concurrent vertebral fracture assessment, utilizing data from a computed tomography scan, retrieval and transmission of the scan data, measurement of bone strength and bmd and classi","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27458","name":"Osteot femur imed lngth dev","description":"Osteotomy(ies), femur, unilateral, with insertion of an externally controlled intramedullary lengthening device, including iliotibial band release when performed, imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4224","name":"Hhf10-p per sq cm","description":"Human health factor 10 amniotic patch (hhf10-p), per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98978","name":"Rtm dev sply cbt 16-30 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of cognitive behavioral therapy, 16-30 days in a 30-day period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1209","name":">=2 same hi-rsk med w/o diag","description":"At least two orders for high-risk medications from the same drug class, (table 4), without appropriate diagnoses","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0557","name":"Adv prim care mgmt lvl 2","description":"Advanced primary care management services for a patient with multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, which place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline, provided by c","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2470","name":"Inj pantoprazole sodium 40mg","description":"Injection, pantoprazole sodium, 40 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2329","name":"Inj ublituximab-xiiy, 1 mg","description":"Injection, ublituximab-xiiy, 1mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0472U","name":"Ca vi psp&sp1 antb sjogren","description":"Ca vi psp&sp1 antb sjogren","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83036","name":"Hemoglobin glycosylated a1c","description":"Hemoglobin; glycosylated (a1c)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99445","name":"Rem mntr physiol param 2-15","description":"Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate); device(s) supply with daily recording(s) or programmed alert(s) transmission, 2-15 days in a 30-day period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82653","name":"El-1 fecal quantitative","description":"Elastase, pancreatic (el-1), fecal; quantitative","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98978","name":"Rtm dev sply cbt 16-30 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of cognitive behavioral therapy, 16-30 days in a 30-day period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37268","name":"Revsc evasc fpvt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1234","name":"Pt hcv rctv aby f/u neg","description":"Patient has a reactive hcv antibody test, and has a follow up hcv viral test that does not detect hcv viremia","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01939","name":"Anes nulyt agt crv/thrc","description":"Anesthesia for percutaneous image-guided destruction procedures by neurolytic agent on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1344","name":"No bsln/2nd pam score 4-12mo","description":"Patients who did not have a baseline pam score and/or a second score within 4 to 12 months of baseline pam score","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29846","name":"Wrist arthroscopy/surgery","description":"Arthroscopy, wrist, surgical; excision and/or repair of triangular fibrocartilage and/or joint debridement","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":632.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1178","name":"Doc med rsn no pcv","description":"Documentation of medical reason(s) for not administering pneumococcal vaccine (e.g., prior anaphylaxis due to the pneumococcal vaccine)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94625","name":"Phy/qhp op pulm rhb w/o mntr","description":"Physician or other qualified health care professional services for outpatient pulmonary rehabilitation; without continuous oximetry monitoring (per session)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53451","name":"Tprnl balo cntnc dev bi","description":"Periurethral transperineal adjustable balloon continence device; bilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0541","name":"No pt prsnt train initial 30","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81002","name":"Urinalysis nonauto w/o scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; non-automated, without microscopy","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4279","name":"Vendaje ac, per sq cm","description":"Vendaje ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0475U","name":"Hered prst8 ca gsap 23 genes","description":"Hered prst8 ca gsap 23 genes","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59425","name":"Antepartum care only","description":"Antepartum care only; 4-6 visits","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":451.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":668.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1444","name":"Del < 39 weeks gest","description":"Delivery at < 39 weeks of gestation","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37268","name":"Revsc evasc fpvt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52300","name":"Cystoscopy and treatment","description":"Cystourethroscopy; with resection or fulguration of orthotopic ureterocele(s), unilateral or bilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0533","name":"Buprenorphone inj weekly","description":"Medication assisted treatment, buprenorphine (injectable) administered on a weekly basis; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid tre","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3263","name":"Inj, toripalimab-tpzi, 1 mg","description":"Injection, toripalimab-tpzi, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1163","name":"Pt anphx due to hpv bef 13","description":"Patient had anaphylaxis due to the hpv vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0605","name":"Antibody test pub hlth path","description":"Antibody test pub hlth path","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0683T","name":"Prgrmg dev eval isdss ip","description":"Programming device evaluation (in-person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional, permanent implantable synchroni","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62282","name":"Treat spinal canal lesion","description":"Injection/infusion of neurolytic substance (eg, alcohol, phenol, iced saline solutions), with or without other therapeutic substance; epidural, lumbar, sacral (caudal)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1349","name":"No pam inc 3 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 3 points within a 4 to 12 month period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9334","name":"Inj efgart-alfa 2mg hya-qvfc","description":"Injection, efgartigimod alfa, 2 mg and hyaluronidase-qvfc","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0465U","name":"Onc urthl carc dna qmsp 2gen","description":"Onc urthl carc dna qmsp 2gen","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31237","name":"Nsl/sins ndsc surg bx polypc","description":"Nasal/sinus endoscopy, surgical; with biopsy, polypectomy or debridement (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0877T","name":"Augmnt alys ch ct ild w/o ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9017","name":"Arsenic trioxide injection","description":"Injection, arsenic trioxide, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91113","name":"Gi trc img intral colon i&r","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"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":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9268","name":"Programmer orally ingest cap","description":"Programmer for transient, orally ingested capsule","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1436","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1367","name":"Qual care ent disorder mvp","description":"Quality care for the treatment of ear, nose, and throat disorders mips value pathway","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86602","name":"Antinomyces antibody","description":"Antibody; actinomyces","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4278","name":"Epieffect, per sq cm","description":"Epieffect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64567","name":"Perq elec nrv field stimj cn","description":"Percutaneous electrical nerve field stimulation, cranial nerves, without implantation","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1363","name":"Pts no f/u 120 dys","description":"Patients who did not have a follow-up assessment within 120 days of the index assessment","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2804","name":"Inj, rifampin, 1 mg","description":"Injection, rifampin, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31785","name":"Remove windpipe lesion","description":"Excision of tracheal tumor or carcinoma; cervical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1286.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6112","name":"Imp/abut rem dent part max","description":"Imp/abut rem dent part max","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"Limited visual field xm","description":"Visual field examination, unilateral or bilateral, with interpretation and report; limited examination (eg, tangent screen, autoplot, arc perimeter, or single stimulus level automated test, such as octopus 3 or 7 equivalent)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4323","name":"Splint extra-coronal","description":"Splint extra-coronal","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2401","name":"Chloroprocaine hcl injection","description":"Injection, chloroprocaine hydrochloride, per 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1255","name":"Pts w/ othr rsn vst,+prg tst","description":"Patients who have another reason for visiting the clinic [not prenatal or postpartum care] and have a positive pregnancy test but have not established the clinic as an ob provider (e.g., plan to terminate the pregnancy or seek prenatal services elsewhere)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55713","name":"Bx prst8 in-bore ct/mri bx 1","description":"Biopsy, prostate, in-bore ct- or mri-guided (ie, sextant), with biopsy of additional targeted lesion(s), first targeted lesion","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0972T","name":"Asstv alg clsfctn burn hlg","description":"Assistive algorithmic classification of burn healing (ie, healing or nonhealing) by noninvasive multispectral imaging, including system set-up and acquisition, selection, and transmission of images, with automated generation of report","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1098","name":"Articaine ophthalmi 8% 0.4ml","description":"Articaine ophthalmic, 8% solution, 0.4 ml","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0887T","name":"End-tidal ctrl inhaled anes","description":"End-tidal control of inhaled anesthetic agents and oxygen to assist anesthesia care delivery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0813T","name":"Egd vol adjmt bariatric balo","description":"Esophagogastroduodenoscopy, flexible, transoral, with volume adjustment of intragastric bariatric balloon","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37284","name":"Revsc evasc tpvt st sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1498","name":"Diagnostic radiology mvp","description":"Diagnostic radiology mips value pathway","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76093","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1003.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0303U","name":"Hem rbc ads whl bld hypoxic","description":"Hem rbc ads whl bld hypoxic","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2009","name":"Symphony, per sq cm","description":"Symphony, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21267","name":"Revise eye sockets","description":"Orbital repositioning, periorbital osteotomies, unilateral, with bone grafts; extracranial approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1820.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0606U","name":"Hem red cll memb do rbc oge","description":"Hem red cll memb do rbc oge","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9912","name":"Pre-visit patient screening","description":"Pre-visit patient screening","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0798T","name":"Tcat rmv 2chmbr ldls pm cmpl","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; complete system (ie, right atrial and right ventricular pacemaker components)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4425","name":"Revive tl per sq cm","description":"Revive tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4288","name":"Dermabind ch, per sq cm","description":"Dermabind ch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0717T","name":"Adrc ther prtl rc tear","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; adipose tissue harvesting, isolation and preparation of harvested cells, including incubation with cell dissociation enzymes, filtration, washing, and concentration of adrcs","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4034","name":"Speech language path ss","description":"Speech language pathology mips specialty set","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4355","name":"Abio xpl abio xpl hy p sq cm","description":"Abiomend xplus membrane and abiomend xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33904","name":"Perq p-art revsc each addl","description":"Percutaneous pulmonary artery revascularization by stent placement, each additional vessel or separate lesion, normal or abnormal connections (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43242","name":"Egd us fine needle bx/aspir","description":"Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s) (includes endoscopic ultrasound examination of the esophagus, stomach, and either the duodenum or a surgically altered stomach where the jejunum is examin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0425U","name":"Genom rpd seq alys ea cmprtr","description":"Genom rpd seq alys ea cmprtr","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0491","name":"Oral dv nm mouthpc hw remote","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0961T","name":"Shortwave ifr radiation img","description":"Shortwave infrared radiation imaging, surgical pathology specimen, to assist gross examination for lymph node localization in fibroadipose tissue, per specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49190","name":"Opn exc/dstr ntra-abd >30 cm","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); greater than 30 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1333","name":"Acute vitreous hemorrhage","description":"Acute vitreous hemorrhage","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5940","name":"Resct proth max part remov","description":"Resct proth max part remov","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1202","name":"Miglustat oral 65 mg","description":"Miglustat, oral, 65 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0735T","name":"Prep tum cav iort prim crnot","description":"Preparation of tumor cavity, with placement of a radiation therapy applicator for intraoperative radiation therapy (iort) concurrent with primary craniotomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4027","name":"Plastic surgery ss","description":"Plastic surgery mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1341","name":"Pt no f/u 30-180 dys","description":"Patients who did not have a follow-up assessment or did not have an assessment within 30 to 180 days after the index assessment during the performance period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0378U","name":"Rfc1 repeat xpnsj vrnt alys","description":"Rfc1 repeat xpnsj vrnt alys","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0465U","name":"Onc urthl carc dna qmsp 2gen","description":"Onc urthl carc dna qmsp 2gen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0405U","name":"Onc pncrtc 59 mthltn blk mrk","description":"Onc pncrtc 59 mthltn blk mrk","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37218","name":"Stent placemt ante carotid","description":"Transcatheter placement of intravascular stent(s), intrathoracic common carotid artery or innominate artery, open or percutaneous antegrade approach, including angioplasty, when performed, and radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1000.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58263","name":"Vag hyst w/t/o & vag repair","description":"Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s), and/or ovary(s), with repair of enterocele","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1152.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77091","name":"Tbs techl calculation only","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical calculation only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69200","name":"Clear outer ear canal","description":"Removal foreign body from external auditory canal; without general anesthesia","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":40.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69676","name":"Remove middle ear nerve","description":"Tympanic neurectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":951.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90638","name":"Vacc qirv mrna 60mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 60 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4006","name":"Gastroenterology ss","description":"Gastro-enterology mips specialty set","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4382","name":"Advograft dual per sq cm","description":"Advograft dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99347","name":"Home/res vst est sf mdm 20","description":"Home or residence visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 20 minutes must be met or exceede","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2006","name":"Novosorb synpath per sq cm","description":"Novosorb synpath dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0955T","name":"Tot impl amei removal","description":"Totally implantable active middle ear hearing implant; removal, including removal of sound processor and all implant components","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2043","name":"Biobrane, per sq cm","description":"Biobrane, per square centimeter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1426","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0276U","name":"Hem inh thrombocytopenia 23","description":"Hematology (inherited thrombocytopenia), genomic sequence analysis of 23 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45398","name":"Colonoscopy w/band ligation","description":"Colonoscopy, flexible; with band ligation(s) (eg, hemorrhoids)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":1055.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2561","name":"Inj, sezaby, 1 mg","description":"Injection, phenobarbital sodium (sezaby), 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15013","name":"Prepj skn cll ssp agrft 1st","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; first 25 sq cm or less of harvested skin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69716","name":"Impl oi implt sk tc esp<100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or resulting in removal of less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27612","name":"Exploration of ankle joint","description":"Arthrotomy, posterior capsular release, ankle, with or without achilles tendon lengthening","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":662.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9268","name":"Programmer orally ingest cap","description":"Programmer for transient, orally ingested capsule","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6112","name":"Imp/abut rem dent part max","description":"Imp/abut rem dent part max","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0901","name":"Vadadustat oral 1mg for esrd","description":"Vadadustat, oral, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27278","name":"Arthrd si jt plmt iartic dev","description":"Arthrodesis, sacroiliac joint, percutaneous or minimally invasive, with image guidance, includes obtaining bone graft when performed, unilateral; placement of intra-articular device(s), without cortical piercing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":397.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"U0002","name":"Covid-19 lab test non-cdc","description":"2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6212","name":"Bridge noble metal cast","description":"Pontic-cast noble metal","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2007","name":"Restrata, per sq cm","description":"Restrata, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0770T","name":"Vr technology assist therapy","description":"Virtual reality technology to assist therapy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69727","name":"Rmv ntr oi imp sk tc esp<100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1280","name":"Bilat mast/hx bi /unilat mas","description":"Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0535","name":"Pt navigat svs direct/ref","description":"Patient navigational services, provided directly or by referral; including helping the patient to navigate health systems and identify care providers and supportive services, to build patient self-advocacy and communication skills with care providers, and to promote patient-driven action plans and g","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49190","name":"Opn exc/dstr ntra-abd >30 cm","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); greater than 30 cm","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0721T","name":"Quan ct tiss charac w/o ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99424","name":"Prin care mgmt phys 1st 30","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1597","name":"Inj glycopyrrolate, glyrx-pf","description":"Injection, glycopyrrolate (glyrx-pf), 0.1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"U0002","name":"Covid-19 lab test non-cdc","description":"2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85305","name":"Clot inhibit prot s total","description":"Clotting inhibitors or anticoagulants; protein s, total","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31087","name":"Removal of frontal sinus","description":"Sinusotomy frontal; nonobliterative, with osteoplastic flap, coronal incision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1227.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3473","name":"Surg rep root res molar","description":"Surg rep root res molar","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86042","name":"Acetylcholn rcptr blckg antb","description":"Acetylcholine receptor (achr); blocking antibody","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":18.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38226","name":"Car-t prep t lymphcyt f/trns","description":"Chimeric antigen receptor t-cell (car-t) therapy; preparation of blood-derived t lymphocytes for transportation (eg, cryopreservation, storage)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0465U","name":"Onc urthl carc dna qmsp 2gen","description":"Onc urthl carc dna qmsp 2gen","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1487","name":"Pt adm to hospice dur eval","description":"Patients in hospice in the year before or during the period of evaluation","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0982T","name":"Rem mntr impl ivc snr set-up","description":"Remote monitoring of implantable inferior vena cava sensor, physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate), initial set-up and patient education on use of equipment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36600","name":"Withdrawal of arterial blood","description":"Arterial puncture, withdrawal of blood for diagnosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0296","name":"Visit to determ ldct elig","description":"Counseling visit to discuss need for lung cancer screening using low dose ct scan (ldct) (service is for eligibility determination and shared decision making)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":24.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1433","name":"Oral chemo wthn 30 days enc","description":"Patient on oral chemotherapy on or within 30 days before denominator eligible encounter","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9048","name":"Inj, bortezomib freseniuskab","description":"Injection, bortezomib (fresenius kabi), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0898T","name":"N-invas prst8 cancer est map","description":"Noninvasive prostate cancer estimation map, derived from augmentative analysis of image-guided fusion biopsy and pathology, including visualization of margin volume and location, with margin determination and physician interpretation and report","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0491","name":"Oral dv nm mouthpc hw remote","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4326","name":"Woundplus, per sq cm","description":"Woundplus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12001","name":"Rpr s/n/ax/gen/trnk 2.5cm/<","description":"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 2.5 cm or less","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":108.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0553U","name":"Repr med pga embry te strux","description":"Repr med pga embry te strux","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0698T","name":"Quan mr tiss w/mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained with diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, target ","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0802","name":"Inj. (ani), up to 40 units","description":"Injection, corticotropin (ani), up to 40 units","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99204","name":"Office o/p new mod 45 min","description":"Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 45 minutes must be met or excee","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":130.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4262","name":"Dual layer impax, per sq cm","description":"Dual layer impax membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0662","name":"Team remote e/m new pt 30 mn","description":"Team remote e/m new pt 30 mins","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1335","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1006T","name":"Elec alys s-scl eeg prgrm ea","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, each additional 15 minutes face-to-face time with physician or other qua","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8541","name":"Oral, hemady, 0.25 mg","description":"Dexamethasone (hemady), oral, 0.25 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5783","name":"Add low ext mec limb vol lam","description":"Addition to lower extremity, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25150","name":"Partial removal of ulna","description":"Partial excision (craterization, saucerization, or diaphysectomy) of bone (eg, for osteomyelitis); ulna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":756.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0841T","name":"Dgtz gls mcrscp pth cslt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; first tissue block, with frozen section(s), single specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9601","name":"Inj linvoseltamab-gcpt 1 mg","description":"Injection, linvoseltamab-gcpt, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95864","name":"Needle emg 4 extremities","description":"Needle electromyography; 4 extremities with or without related paraspinal areas","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29086","name":"Application cast finger","description":"Application, cast; finger (eg, contracture)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3402","name":"Inj. remestemcel-l-rknd/ td","description":"Injection, remestemcel-l-rknd, per therapeutic dose","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0802T","name":"Tcat rmv&rpl2chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right at","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0327U","name":"Ftl aneuploidy trsmy dna seq","description":"Ftl aneuploidy trsmy dna seq","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4400","name":"Polygon3 per sq cm","description":"Polygon3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44366","name":"Small bowel endoscopy","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with control of bleeding (eg, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1162","name":"Pt enceph due to dtp bef 13","description":"Patient had encephalitis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4318","name":"E-graft, per sq cm","description":"E-graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1163","name":"Pt anphx due to hpv bef 13","description":"Patient had anaphylaxis due to the hpv vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5931","name":"Surgical obturator","description":"Obturator prosthesis surgical","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0482","name":"Direct immunofluorescence","description":"Direct immunofluorescence","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1315","name":"Crc no doc no rsn","description":"Colorectal cancer screening results were not documented and reviewed; reason not otherwise specified","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0741T","name":"Rem auton alg nsln data coll","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; provision of software, data collection, transmission, and storage, each 30 days","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33509","name":"Ndsc hrv uxtr art 1 sgm cab","description":"Harvest of upper extremity artery, 1 segment, for coronary artery bypass procedure, endoscopic","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55713","name":"Bx prst8 in-bore ct/mri bx 1","description":"Biopsy, prostate, in-bore ct- or mri-guided (ie, sextant), with biopsy of additional targeted lesion(s), first targeted lesion","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94750","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0774T","name":"Vr px dissoc svc oth phy ea","description":"Virtual reality (vr) procedural dissociation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports; each additiona","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2711","name":"Inj neostigmin/glycopyrrolat","description":"Injection, neostigmine methylsulfate 0.1 mg and glycopyrrolate 0.02 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0206","name":"Inj allopurinol sodium 1 mg","description":"Injection, allopurinol sodium, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1243","name":"Pt othr thn true heard","description":"Patient provided a response other than completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4378","name":"Renew ft matrix per sq cm","description":"Renew ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1710","name":"Moderna vacc admin 3rd dose","description":"Moderna vacc admin 3rd dose","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97814","name":"Acup 1/> w/estim ea addl 15","description":"Acupuncture, 1 or more needles; with electrical stimulation, each additional 15 minutes of personal one-on-one contact with the patient, with insertion of needle(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":32.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9939","name":"Placemnt removable appliance","description":"Placemnt removable appliance","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0625U","name":"Endocrinol op dna alys>5000","description":"Endocrinol op dna alys>5000","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0063","name":"Cardiology ss","description":"Cardiology mips specialty set","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1348","name":"Pam incr 6 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 6-points in a 4 to 12 month period (excellent)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0793T","name":"Prq tcat thrm ablt nrv p-art","description":"Percutaneous transcatheter thermal ablation of nerves innervating the pulmonary arteries, including right heart catheterization, pulmonary artery angiography, and all imaging guidance","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6560","name":"G stckng full/chap30-40 cust","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, custom, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0484","name":"Consult slides prep elsewher","description":"Consultation on slides prepared elsewhere","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2794","name":"Crown-titanium","description":"Crown-titanium","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0526U","name":"Nefro rnl trnspl quan cxcl10","description":"Nefro rnl trnspl quan cxcl10","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64468","name":"Thrc fascial pln blk bi njx","description":"Thoracic fascial plane block, bilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5098","name":"Inj ustekinumab-srlf, 1 mg","description":"Injection, ustekinumab-srlf (imuldosa), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0861T","name":"Rmvl pg wcs lv both compnt","description":"Removal of pulse generator for wireless cardiac stimulator for left ventricular pacing; both components (battery and transmitter)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42842","name":"Extensive surgery of throat","description":"Radical resection of tonsil, tonsillar pillars, and/or retromolar trigone; without closure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0304U","name":"Hem rbc ads whl bld normoxic","description":"Hem rbc ads whl bld normoxic","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0876T","name":"Duplex scan hemo fstl lmtd","description":"Duplex scan of hemodialysis fistula, computer-aided, limited (volume flow, diameter, and depth, including only body of fistula)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0725","name":"Chorionic gonadotropin/1000u","description":"Injection, chorionic gonadotropin, per 1,000 usp units","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41007","name":"Drainage of mouth lesion","description":"Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; submental space","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27066","name":"Remove hip bone les deep","description":"Excision of bone cyst or benign tumor, wing of ilium, symphysis pubis, or greater trochanter of femur; deep (subfascial), includes autograft, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":936.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9359","name":"Inj lon tesirin-lpyl 0.075mg","description":"Injection, loncastuximab tesirine-lpyl, 0.075 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7961","name":"Buccal/labial frenectomy","description":"Buccal/labial frenectomy","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86037","name":"Anca titer each antibody","description":"Antineutrophil cytoplasmic antibody (anca); titer, each antibody","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0559","name":"Unrelat prac follow up visit","description":"Post-operative follow-up visit complexity inherent to evaluation and management services addressing surgical procedure(s), provided by a physician or qualified health care professional who is not the practitioner who performed the procedure (or in the same group practice) and is of the same or of a ","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0525","name":"Inj cefotetan disodium 10 mg","description":"Injection, cefotetan disodium, 10 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59515","name":"Cesarean delivery","description":"Cesarean delivery only; including postpartum care","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1451.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0863T","name":"Rlcj pg wcs lv trnsmtr only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; transmitter component only","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8005","name":"Grip glove w microprocessor","description":"Powered, cable driven grip assist glove, hand, finger, includes microprocessor, pressure sensors, all components and accessories, custom fitted","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4212","name":"Gingivectomy/plasty rest","description":"Gingivectomy/plasty rest","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1209","name":">=2 same hi-rsk med w/o diag","description":"At least two orders for high-risk medications from the same drug class, (table 4), without appropriate diagnoses","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1954","name":"Inj leu acet lutr dpt 7.5 mg","description":"Injection, leuprolide acetate for depot suspension (lutrate depot), 7.5 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1364","name":"Ascvd risk >=20pct","description":"Calculated 10-year ascvd risk score of >= 20 percent during the performance period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1017T","name":"Elec aly npgs esoph sbsq w/o","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4324","name":"Amniotx, per sq cm","description":"Amniotx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35621","name":"Bpg axillary-femoral","description":"Bypass graft, with other than vein; axillary-femoral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1411.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6114","name":"Implnt/abut fixed dent max","description":"Implnt/abut fixed dent max","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5931","name":"Surgical obturator","description":"Obturator prosthesis surgical","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1201","name":"Med rsn no ace-i/arb rx","description":"Documentation of medical reason(s) for not prescribing ace inhibitor (ace-i) or arb therapy during the measurement period (e.g., pregnancy, history of angioedema to ace-i, other allergy to ace-i and arb, hyperkalemia or history of hyperkalemia while on ace-i or arb therapy, acute kidney injury due t","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4440","name":"Curamatrix per sq cm","description":"Curamatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43278","name":"Ercp lesion ablate w/dilate","description":"Endoscopic retrograde cholangiopancreatography (ercp); with ablation of tumor(s), polyp(s), or other lesion(s), including pre- and post-dilation and guide wire passage, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":495.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87153","name":"Dna/rna sequencing","description":"Culture, typing; identification by nucleic acid sequencing method, each isolate (eg, sequencing of the 16s rrna gene)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"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":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6607","name":"G com bandage tub protct lyr","description":"Gradient compression bandaging supply, tubular protective absorption layer, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0703","name":"Inj, cefepime hcl (b braun)","description":"Injection, cefepime hydrochloride (b braun), not therapeutically equivalent to maxipime, 500 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93586","name":"Vngrph chd coronary sinus","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; coronary sinus (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31243","name":"Nsl/sinus ndsc cryoabltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by cryoablation, posterior nasal nerve","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92986","name":"Revision of aortic valve","description":"Percutaneous balloon valvuloplasty; aortic valve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1489.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24115","name":"Exc/crtg b1 cst/tum hum agrf","description":"Excision or curettage of bone cyst or benign tumor, humerus; with autograft (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":844.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1364","name":"Ascvd risk >=20pct","description":"Calculated 10-year ascvd risk score of >= 20 percent during the performance period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2041","name":"Coord special care encounter","description":"Coordinated specialty care, team-based, for first episode psychosis, per encounter","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4415","name":"Alexiguard st-l per sq cm","description":"Alexiguard sl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0741T","name":"Rem auton alg nsln data coll","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; provision of software, data collection, transmission, and storage, each 30 days","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6609","name":"G compression bandaging","description":"Gradient compression bandaging supply, not otherwise specified","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0680","name":"Cr art clc art vlv clc w rpt","description":"Detection and quantification of coronary artery calcium and/or aortic valve calcification from algorithmic analysis of computed tomography of the chest with report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6611","name":"Grad com wrap w strap ak cus","description":"Gradient compression wrap with adjustable straps, above knee, each, custom","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0384U","name":"Neph ckd rsk hi stg kdn ds","description":"Neph ckd rsk hi stg kdn ds","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"Non-adju cgm supply allow","description":"Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9607","name":"Lutetium lu 177 vipivotide","description":"Lutetium lu 177 vipivotide tetraxetan, therapeutic, 1 millicurie","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2403","name":"Chloroprocaine opht gel, 1mg","description":"Chloroprocaine hcl ophthalmic, 3% gel, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52597","name":"Trurl rbtc wtrjt rescj prst8","description":"Transurethral robotic-assisted waterjet resection of prostate, including intraoperative planning, ultrasound guidance, control of postoperative bleeding, complete, including vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy, when performed","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0175","name":"Inj, donanemab-azbt, 2 mg","description":"Injection, donanemab-azbt, 2 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81195","name":"Cytog genom-wid alys hem mal","description":"Cytogenomic (genome-wide) analysis, hematologic malignancy, structural variants and copy number variants, optical genome mapping (ogm)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0370","name":"Max ultrasound capt & interp","description":"Max ultrasound capt & interp","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1332","name":"Pts no eval ini xm no 2 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 2 weeks","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2472","name":"Inj, pantoprazole sodium chl","description":"Injection, pantoprazole sodium in sodium chloride (baxter), 40 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4037","name":"Urology ss","description":"Urology mips specialty set","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5099","name":"Inj ustekinumab-stba, 1 mg","description":"Injection, ustekinumab-stba (steqeyma), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49592","name":"Rpr aa hrn 1st < 3 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8702","name":"Ewhf s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand, finger, single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68801.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1714","name":"Pfizer vacc adm ped 2nd dose","description":"Pfizer vacc adm ped 2nd dose","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1348","name":"Pam incr 6 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 6-points in a 4 to 12 month period (excellent)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3432","name":"Guided tissue regeneration","description":"Guided tissue regeneration","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0817T","name":"Opn insj/rplcmt ins ptn subf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99426","name":"Prin care mgmt staff 1st 30","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2865","name":"Inj sulfameth/trim 5 mg/1 mg","description":"Injection, sulfamethoxazole 5 mg and trimethoprim 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4327","name":"Duoamnion, per sq cm","description":"Duoamnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1168","name":"Pt recd flu vax 7/1-6/30","description":"Patient received an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0679T","name":"Laps rmvl lead isdss","description":"Laparoscopic removal of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1496","name":"No doc of fall or poc","description":"Patients that had a fall who did not have a plan of care for falls documented or do not have documentation of being assessed for falls","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0874","name":"Inj, daptomycin (baxter)","description":"Injection, daptomycin (baxter), not therapeutically equivalent to j0878, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26010","name":"Drainage of finger abscess","description":"Drainage of finger abscess; simple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":445.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":172.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2043","name":"Biobrane, per sq cm","description":"Biobrane, per square centimeter","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1302","name":"Inj, sutimlimab-jome, 10 mg","description":"Injection, sutimlimab-jome, 10 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1391","name":"All pt dx w/ rec mlnm","description":"All patients who were diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6612","name":"Onlay cst base mtl 2 surface","description":"Onlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0399U","name":"Neuro cere folate defncy srm","description":"Neuro cere folate defncy srm","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0930T","name":"Ephys eval ccm-d ld 1st impl","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), at time of initial implantation or replacement with testing of cardiac contrac","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0693T","name":"Compre ful bdy 3d mtn alys","description":"Comprehensive full body computer-based markerless 3d kinematic and kinetic motion analysis and report","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44402","name":"Colonoscopy w/stent plcmt","description":"Colonoscopy through stoma; with endoscopic stent placement (including pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1443","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21180","name":"Rcnstj forehead w/autograft","description":"Reconstruction, entire or majority of forehead and/or supraorbital rims; with autograft (includes obtaining grafts)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1981.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1483.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37287","name":"Revsc evasc tpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61737","name":"Litt icr mlt trj mlt/cplx ls","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; multiple trajectories for multiple or complex lesion(s)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58580","name":"Transcrv abltj utrn fibrd rf","description":"Transcervical ablation of uterine fibroid(s), including intraoperative ultrasound guidance and monitoring, radiofrequency","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1747","name":"Inj, spesolimab-sbzo, 1 mg","description":"Injection, spesolimab-sbzo, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":189.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0293U","name":"Psyc suicidal idea mrna 54","description":"Psyc suicidal idea mrna 54","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33282","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7519","name":"Inj. mycophenolate mofetil","description":"Injection, mycophenolate mofetil, 10 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0525","name":"Est pt-cg dyad dem mod cmplx","description":"Management of established patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1372","name":"Mst rec gsa >=7 and<8","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 7.0% and < 8.0%","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27394","name":"Lengthening of thigh tendons","description":"Lengthening of hamstring tendon; multiple tendons, 1 leg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":785.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46505","name":"Chemodenervation anal musc","description":"Chemodenervation of internal anal sphincter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27818","name":"Treatment of ankle fracture","description":"Closed treatment of trimalleolar ankle fracture; with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":522.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2103.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0034","name":"Pall serv during meas","description":"Patients receiving palliative care during the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP07","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69200","name":"Clear outer ear canal","description":"Removal foreign body from external auditory canal; without general anesthesia","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":47.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0821T","name":"Mntr psychdlc med 2ndphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; second physician or other qualified health care professional, concurrent with first physician or other qualified health care professional, each hour (list sepa","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92550","name":"Tympanometry & reflex thresh","description":"Tympanometry and reflex threshold measurements","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0885T","name":"Colsc flx 1st tndsc dilat","description":"Colonoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2040","name":"Coord specialty care, month","description":"Coordinated specialty care, team-based, for first episode psychosis, per month","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59510","name":"Cesarean delivery","description":"Routine obstetric care including antepartum care, cesarean delivery, and postpartum care","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2874.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99212","name":"Office o/p est sf 10 min","description":"Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 10 minutes must be met o","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":64.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0349","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4396","name":"Natalin per sq cm","description":"Natalin, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77750","name":"Infuse radioactive materials","description":"Infusion or instillation of radioelement solution (includes 3-month follow-up care)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1368","name":"Prev trt inf d/o hiv/hep mvp","description":"Prevention and treatment of infectious disorders including hepatitis c and hiv mips value pathway","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6610","name":"G com stcking bk 18-30 custm","description":"Gradient compression stocking, below knee, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12011","name":"Rpr f/e/e/n/l/m 2.5 cm/<","description":"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":65.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":166.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2711","name":"Inj neostigmin/glycopyrrolat","description":"Injection, neostigmine methylsulfate 0.1 mg and glycopyrrolate 0.02 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5125","name":"Inj, releuko 1 mcg","description":"Injection, filgrastim-ayow, biosimilar, (releuko), 1 microgram","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68325","name":"Revise/graft eyelid lining","description":"Conjunctivoplasty; with buccal mucous membrane graft (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":638.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5129","name":"Inj, vegzelma, 10 mg","description":"Injection, bevacizumab-adcd (vegzelma), biosimilar, 10 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76984","name":"Dx intraop thoracic aorta us","description":"Ultrasound, intraoperative thoracic aorta (eg, epiaortic), diagnostic","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33509","name":"Ndsc hrv uxtr art 1 sgm cab","description":"Harvest of upper extremity artery, 1 segment, for coronary artery bypass procedure, endoscopic","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0499U","name":"Onc clrct&lng dna ngs 8gene","description":"Onc clrct&lng dna ngs 8gene","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0521","name":"Supply fee hiv prep fda appr","description":"Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61889","name":"Ins sk-mnt crnl nstm pg/rcvr","description":"Insertion of skull-mounted cranial neurostimulator pulse generator or receiver, including craniectomy or craniotomy, when performed, with direct or inductive coupling, with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0900T","name":"N-invas est aqmbf asstv cmr","description":"Noninvasive estimate of absolute quantitation of myocardial blood flow (aqmbf), derived from assistive algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health care profes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0887T","name":"End-tidal ctrl inhaled anes","description":"End-tidal control of inhaled anesthetic agents and oxygen to assist anesthesia care delivery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1244","name":"Pt othr thn true best int","description":"Patient provided a response other than completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9004","name":"Va whole health partner serv","description":"Department of veterans affairs whole health partner services","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35551","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1860.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69716","name":"Impl oi implt sk tc esp<100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or resulting in removal of less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7601","name":"Ensifentrine inh 3 mg","description":"Ensifentrine, inhalation suspension, fda approved final product, non-compounded, administered through dme, unit dose form, 3 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66989","name":"Xcpsl ctrc rmvl cplx insj 1+","description":"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification), complex, requiring devices or techniques not generally used in routine cataract surgery (eg, iris expansion device,","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1180","name":"Pt imm ckpt inhib therapy","description":"Patients on immune checkpoint inhibitor therapy","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5931","name":"Surgical obturator","description":"Obturator prosthesis surgical","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9993","name":"Pall serv during meas","description":"Patient was provided palliative care services any time during the measurement period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0724T","name":"Qmrcp w/dx mri same anatomy","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained with diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in additio","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4026","name":"Phys/occ therapy ss","description":"Physical therapy/occupational therapy mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7213","name":"Inj, ixinity, 1 i.u.","description":"Injection, coagulation factor ix (recombinant), ixinity, 1 i.u.","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1479","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4270","name":"Complete sl per sq cm","description":"Complete sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29885","name":"Arthrs kne srg drlg ost diss","description":"Arthroscopy, knee, surgical; drilling for osteochondritis dissecans with bone grafting, with or without internal fixation (including debridement of base of lesion)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0493U","name":"Trnspl med quan dd-cfdna ngs","description":"Trnspl med quan dd-cfdna ngs","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"13131","name":"Cmplx rpr f/c/c/m/n/ax/g/h/f","description":"Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; 1.1 cm to 2.5 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4262","name":"Dual layer impax, per sq cm","description":"Dual layer impax membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0443U","name":"Neurflmnt lt chn ultrsens ia","description":"Neurflmnt lt chn ultrsens ia","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99401","name":"Prev med cnsl indiv apprx 15","description":"Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 15 minutes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":20.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0530U","name":"Onc pan-sol tum ctdna 77 gen","description":"Onc pan-sol tum ctdna 77 gen","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0794T","name":"Pt spec alg rx-onc tx option","description":"Patient-specific, assistive, rules-based algorithm for ranking pharmaco-oncologic treatment options based on the patients tumor-specific cancer marker information obtained from prior molecular pathology, immunohistochemical, or other pathology results which have been previously interpreted and repor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1001T","name":"Autol musc cell therapy njx","description":"Autologous muscle cell therapy, injection of muscle progenitor cells into the external anal sphincter, including ultrasound guidance, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0675T","name":"Laps insj nw/rpcmt isdss 1ld","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first lead","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4032","name":"Rheumatology ss","description":"Rheumatology mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0849T","name":"Dgtz gls mcrscp ish ea adl 1","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0957T","name":"Rev s-sclp eltr ra rcvr&tlmt","description":"Revision of sub-scalp implanted electrode array, receiver, and telemetry unit for electrode, when required, including imaging guidance","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65105","name":"Remove eye/attach implant","description":"Enucleation of eye; with implant, muscles attached to implant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":871.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69210","name":"Remove impacted ear wax uni","description":"Removal impacted cerumen requiring instrumentation, unilateral","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0908T","name":"Opn imp int nstm sys vgs nrv","description":"Open implantation of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4022","name":"Otolaryngology ss","description":"Otolaryngology mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6519","name":"Grad com garm noc night use","description":"Gradient compression garment, not otherwise specified, for nighttime use, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4270","name":"Complete sl per sq cm","description":"Complete sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0467U","name":"Onc bldr dna ngs 60gen&aneup","description":"Onc bldr dna ngs 60gen&aneup","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2468","name":"Inj, palonosetron (posfrea)","description":"Injection, palonosetron hydrochloride (posfrea), 25 micrograms","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80195","name":"Assay of sirolimus","description":"Sirolimus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0741T","name":"Rem auton alg nsln data coll","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; provision of software, data collection, transmission, and storage, each 30 days","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0955T","name":"Tot impl amei removal","description":"Totally implantable active middle ear hearing implant; removal, including removal of sound processor and all implant components","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27502","name":"Treatment of thigh fracture","description":"Closed treatment of femoral shaft fracture, with manipulation, with or without skin or skeletal traction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90382","name":"Rsv monoc antb seasn .7ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose, 0.7 ml, for intramuscular use","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1447","name":"Pt dx bd bef end meas pd","description":"Patients with an active diagnosis of bipolar disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0311U","name":"Nfct ds bct quan antmcrb sc","description":"Nfct ds bct quan antmcrb sc","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43314","name":"Tracheo-esophagoplasty cong","description":"Esophagoplasty for congenital defect (plastic repair or reconstruction), thoracic approach; with repair of congenital tracheoesophageal fistula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3381.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0894T","name":"Cannulation liver allograft","description":"Cannulation of the liver allograft in preparation for connection to the normothermic perfusion device and decannulation of the liver allograft following normothermic perfusion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4279","name":"Vendaje ac, per sq cm","description":"Vendaje ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25100","name":"Biopsy of wrist joint","description":"Arthrotomy, wrist joint; with biopsy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77092","name":"Tbs i&r fx rsk qhp","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; interpretation and report on fracture-risk only by other qualified health care professional","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12002","name":"Rpr s/n/ax/gen/trnk2.6-7.5cm","description":"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 2.6 cm to 7.5 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":166.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":53.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87904","name":"Phenotype dna hiv w/clt add","description":"Infectious agent phenotype analysis by nucleic acid (dna or rna) with drug resistance tissue culture analysis, hiv 1; each additional drug tested (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72020","name":"X-ray exam of spine 1 view","description":"Radiologic examination, spine, single view, specify level","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88366","name":"Insitu hybridization (fish)","description":"In situ hybridization (eg, fish), per specimen; each multiplex probe stain procedure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1364","name":"Ascvd risk >=20pct","description":"Calculated 10-year ascvd risk score of >= 20 percent during the performance period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88289","name":"Chromosome study additional","description":"Chromosome analysis; additional high resolution study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1164","name":"Inj diltiazem in 0.72% nacl","description":"Injection, diltiazem hydrochloride in 0.72% sodium chloride, 0.5 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0008","name":"Admin influenza virus vac","description":"Administration of influenza virus vaccine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96041","name":"Genetic counseling svc ea 30","description":"Medical genetics and genetic counseling services, each 30 minutes of total time provided by the genetic counselor on the date of the encounter","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1359","name":"Indx suicd idea, no 0 scr","description":"Index assessment during the denominator period when the suicidal ideation and/or behavior symptoms or increased suicide risk by clinician determination occurs and a non-zero c-ssrs score is obtained","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4357","name":"Xwrap plus, per sq cm","description":"Xwrap plus, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85018","name":"Hemoglobin","description":"Blood count; hemoglobin (hgb)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86609","name":"Bacterium antibody","description":"Antibody; bacterium, not elsewhere specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98010","name":"Synch audio-only new mod 45","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection,","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37244","name":"Vasc embolize/occlude bleed","description":"Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; for arterial or venous hemorrhage or lymphatic extravasation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4300.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95919","name":"Quan puplmtry phy/qhp uni/bi","description":"Quantitative pupillometry with physician or other qualified health care professional interpretation and report, unilateral or bilateral","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1240","name":"Pt no resp best int","description":"Patient did not respond to the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1449","name":"Pt dx scz/pys bef end msr pd","description":"Patients with an active diagnosis of schizophrenia or psychotic disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92920","name":"Prq trluml c angiop 1art&/br","description":"Percutaneous transluminal coronary angioplasty, single major coronary artery and/or its branch(es)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99261","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87220","name":"Tissue exam for fungi","description":"Tissue examination by koh slide of samples from skin, hair, or nails for fungi or ectoparasite ova or mites (eg, scabies)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9996","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1010T","name":"Cptr oph alys monoc eye mvmt","description":"Computerized ophthalmic analysis of monocular eye movements using retinal-based eye-tracking without spatial calibration, including fixation, microsaccades, drift, and horizontal saccades, when performed, unilateral or bilateral, with interpretation and report","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21151","name":"Rcnstj mdfc lefrtii w/b1 grf","description":"Reconstruction midface, lefort ii; any direction, requiring bone grafts (includes obtaining autografts)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2390.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80415","name":"Tot estradiol response panel","description":"Chorionic gonadotropin stimulation panel; estradiol response this panel must include the following: estradiol, total (82670 x 2 on 3 pooled blood samples)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0292U","name":"Psyc strs do mrna 72 genes","description":"Psyc strs do mrna 72 genes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80053","name":"Comprehen metabolic panel","description":"Comprehensive metabolic panel this panel must include the following: albumin (82040) bilirubin, total (82247) calcium, total (82310) carbon dioxide (bicarbonate) (82374) chloride (82435) creatinine (82565) glucose (82947) phosphatase, alkaline (84075) potassium (84132) protein, total (84155) sodium ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7299","name":"Intraut copp cont (miudella)","description":"Intrauterine copper contraceptive (miudella)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0349","name":"Inj, rezafungin, 1 mg","description":"Injection, rezafungin, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5155","name":"Inj, aflibercept-jbvf, 1 mg","description":"Injection, aflibercept-jbvf (yesafili), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4339","name":"Artacent vericlen, per sq cm","description":"Artacent vericlen, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86701","name":"Hiv-1antibody","description":"Antibody; hiv-1","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80504","name":"Path clin consltj mod 21-40","description":"Pathology clinical consultation; for a moderately complex clinical problem, with review of patients history and medical records and moderate level of medical decision making when using time for code selection, 21-40 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0690T","name":"Quan us tis charac w/dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained with diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4420","name":"Nuform per sq cm","description":"Nuform, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26200","name":"Remove hand bone lesion","description":"Excision or curettage of bone cyst or benign tumor of metacarpal;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9286","name":"Inj glofitamab gxbm, 2.5 mg","description":"Injection, glofitamab-gxbm, 2.5 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77317","name":"Brachytx isodose intermed","description":"Brachytherapy isodose plan; intermediate (calculation[s] made from 5 to 10 sources, or remote afterloading brachytherapy, 2-12 channels), includes basic dosimetry calculation(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1224","name":"Iop dec <20% from base","description":"Intraocular pressure (iop) reduced by a value less than 20% from the pre-intervention level","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64657","name":"Rmvl bat modulj sys tot sys","description":"Removal of baroreflex activation therapy (bat) modulation system; total system, including lead and pulse generator","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85302","name":"Clot inhibit prot c antigen","description":"Clotting inhibitors or anticoagulants; protein c, antigen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2056","name":"Ciltacabtagene car-pos t","description":"Ciltacabtagene autoleucel, up to 100 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1225","name":"Iop dec>=20% from base","description":"Intraocular pressure (iop) reduced by a value of greater than or equal to 20% from the pre-intervention level","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94400","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0618","name":"Inj, calcium chloride, 2 mg","description":"Injection, calcium chloride, 2 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0509","name":"Crit care telehea consult 50","description":"Telehealth consultation, critical care, subsequent, physicians typically spend 50 minutes communicating with the patient and providers via telehealth","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0786T","name":"Insj/rplcmt prq ra sac nstim","description":"Insertion or replacement of percutaneous electrode array, sacral, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99284","name":"Emergency dept visit mod mdm","description":"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81459","name":"So neo gsap dna/dna&rna","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants, microsatellite instability, tumor mutation burden, and rearrangements","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1266","name":"Pts admit snf","description":"Patients admitted to a skilled nursing facility (snf)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51530","name":"Removal of bladder lesion","description":"Cystotomy; for excision of bladder tumor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":843.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0552U","name":"Repr med pga gdo te bx locus","description":"Repr med pga gdo te bx locus","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0044","name":"Pt mitral stenosis","description":"Patients with moderate or severe mitral stenosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76988","name":"Dx ntrop epcr us chd img acq","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; placement, manipulation of transducer, and image acquisition only","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0840T","name":"Dgtz gls mcrscp cslt compre","description":"Digitization of glass microscope slides for consultation, comprehensive, with review of records and specimens, with report on referred material (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0283U","name":"Vw factor type 2b eval plsm","description":"Von willebrand factor (vwf), type 2b, platelet-binding evaluation, radioimmunoassay, plasma","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0017","name":"Crisis psychotherapy 60m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); first 60 minutes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27681","name":"Release of lower leg tendons","description":"Tenolysis, flexor or extensor tendon, leg and/or ankle; multiple tendons (through separate incision[s])","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":634.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9381","name":"Inj teplizumab mzwv 5 mcg","description":"Injection, teplizumab-mzwv, 5 mcg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0410U","name":"Onc pncrtc dna whl gn seq 5-","description":"Onc pncrtc dna whl gn seq 5-","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54100","name":"Biopsy of penis","description":"Biopsy of penis; (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0563","name":"Sbrt w/positron emission del","description":"Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance and real-time positron emissions-based delivery adjustments to 1 or more lesions, entire course not to exceed 5 fractions","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5930","name":"Max guid prothes w/o flange","description":"Max guid prothes w/o flange","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77431","name":"Radiation therapy management","description":"Radiation therapy management with complete course of therapy consisting of 1 or 2 fractions only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0444U","name":"Onc sld orgn neo tgsap 361","description":"Onc sld orgn neo tgsap 361","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0681T","name":"Rlcj pulse gen only isdss","description":"Relocation of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing dual leads","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5141","name":"Inj adalimumab-aaty, 1 mg","description":"Injection, adalimumab-aaty, biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62331","name":"Dcmprn prq rmv lig flv addl","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; additional interspace(s), lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2428","name":"Inj, erzofri, 1 mg","description":"Injection, paliperidone palmitate extended release (erzofri), 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0396","name":"3d print of 3d surface scan","description":"3d print of 3d surface scan","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0513","name":"Prolong prev svcs, first 30m","description":"Prolonged preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient contact beyond the usual service; first 30 minutes (list separately in addition to code for preventive service)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":72.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0855T","name":"Dgtz gls mcrscp b1 marow smr","description":"Digitization of glass microscope slides for bone marrow, smear interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88342","name":"Imhchem/imcytchm 1st antb","description":"Immunohistochemistry or immunocytochemistry, per specimen; initial single antibody stain procedure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51795","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":426.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0887T","name":"End-tidal ctrl inhaled anes","description":"End-tidal control of inhaled anesthetic agents and oxygen to assist anesthesia care delivery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0970T","name":"Ablt b9 brst tum perq lsr ea","description":"Ablation, benign breast tumor (eg, fibroadenoma), percutaneous, laser, including imaging guidance when performed, each tumor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1168","name":"Pt recd flu vax 7/1-6/30","description":"Patient received an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4331","name":"Axolotl graft, per sq cm","description":"Axolotl graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0665","name":"Inj, bupivacaine, nos, 0.5mg","description":"Injection, bupivicaine, not otherwise specified, 0.5 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23490","name":"Reinforce clavicle","description":"Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate; clavicle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":991.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6198","name":"Remove interim implant","description":"Remove interim implant","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J3305","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87468","name":"Anaplsma phgcytophlm amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); anaplasma phagocytophilum, amplified probe technique","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85009","name":"Manual diff wbc count b-coat","description":"Blood count; manual differential wbc count, buffy coat","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33959","name":"Ecmo/ecls repos perph cnula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; reposition peripheral (arterial and/or venous) cannula(e), open, birth through 5 years of age (includes fluoroscopic guidance, when performed)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":476.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0277U","name":"Hem gen pltlt funcj do 31","description":"Hematology (genetic platelet function disorder), genomic sequence analysis of 31 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0683","name":"App of non-sheet skin sub g","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1188","name":"Pt w/ ckd stg 5","description":"Patients with a diagnosis of chronic kidney disease (ckd) stage 5","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46604","name":"Anoscopy and dilation","description":"Anoscopy; with dilation (eg, balloon, guide wire, bougie)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55711","name":"Bx prst8 trct mri-us 1st","description":"Biopsy, prostate, transrectal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4338","name":"Artacent velos, per sq cm","description":"Artacent velos, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0381U","name":"Maple syrup ur ds mntr quan","description":"Maple syrup ur ds mntr quan","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87425","name":"Rotavirus ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; rotavirus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1009T","name":"Rem mntr s-sclp cont eeg sys","description":"Remote monitoring of a sub-scalp implanted continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0752T","name":"Dgtz gls mcrscp sld lvl iii","description":"Digitization of glass microscope slides for level iii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44394","name":"Colonoscopy w/snare","description":"Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0174","name":"Lecanemab-irmb, for iv inj","description":"Lecanemab-irmb, for intravenous injection, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0911","name":"Inst tauro 1.35mg/hep 100u","description":"Instillation, taurolidine 1.35 mg and heparin sodium 100 units (central venous catheter lock for adult patients receiving chronic hemodialysis)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4335","name":"Amnioplast 2, per sq cm","description":"Amnioplast 2, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22632","name":"Arthrd pst tq 1ntrspc lm ea","description":"Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression), single interspace, lumbar; each additional interspace (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6612","name":"Onlay cst base mtl 2 surface","description":"Onlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0929T","name":"Rem interrog dev ccm-d tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5992","name":"Low prosth foot shell repl","description":"All lower extremity prosthesis, foot shell for modular foot/non-solid ankle cushion heel (sach) replacement only","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1182","name":"Not elg pre ex ibd/uc/crohn","description":"Patients not eligible due to pre-existing inflammatory bowel disease (ibd) (e.g., ulcerative colitis, crohns disease)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0991T","name":"Cysto lo-nrg lithtrp&mcrsphr","description":"Cystourethroscopy, with low-energy lithotripsy and acoustically actuated microspheres, including imaging","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0261U","name":"Onc clrct ca img alys w/ai","description":"Oncology (colorectal cancer), image analysis with artificial intelligence assessment of 4 histologic and immunohistochemical features (cd3 and cd8 within tumor-stroma border and tumor core), tissue, reported as immune response and recurrence-risk score","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73110","name":"X-ray exam of wrist","description":"Radiologic examination, wrist; complete, minimum of 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82270","name":"Occult blood feces","description":"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (ie, patient was provided 3 cards or single triple card for consecutive collection)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78709","name":"K flow/funct image multiple","description":"Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2009","name":"Fosphenytoin inj pe","description":"Injection, fosphenytoin, 50 mg phenytoin equivalent","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37298","name":"Revsc evsc imvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1814","name":"Inj. insulin (lyumjev)","description":"Insulin (lyumjev), per 5 units","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0914T","name":"Prq tcat thr rx ntrc bal sep","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting) performed on a separate target lesion from the target lesion treated with balloon angioplasty, coronary stent placement or coronary atherectomy, including mechanical dilation b","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0579U","name":"Nfro dbtc ckd elisa apoa4","description":"Nfro dbtc ckd elisa apoa4","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99418","name":"Prolng ip/obs e/m ea 15 min","description":"Prolonged inpatient or observation evaluation and management service(s) time with or without direct patient contact beyond the required time of the primary service when the primary service level has been selected using total time, each 15 minutes of total time (list separately in addition to the cod","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6524","name":"G com garmnt lwr leg/ft nght","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5150","name":"Inj, aflibercept-mrbb, 1 mg","description":"Injection, aflibercept-mrbb (ahzantive), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28436","name":"Prq skel fix talus fx w/mnpj","description":"Percutaneous skeletal fixation of talus fracture, with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9220","name":"Indigotindisulfonate sod 1mg","description":"Injection, indigotindisulfonate sodium, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31259","name":"Nsl/sins ndsc sphn tiss rmvl","description":"Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior), including sphenoidotomy, with removal of tissue from the sphenoid sinus","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":451.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9912","name":"Pre-visit patient screening","description":"Pre-visit patient screening","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4256","name":"Mlg complet, per sq cm","description":"Mlg-complete, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6609","name":"G compression bandaging","description":"Gradient compression bandaging supply, not otherwise specified","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0146","name":"Nav srv peer sup add 30 pr m","description":"Principal illness navigation - peer support, additional 30 minutes per calendar month (list separately in addition to g0140)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1195","name":"Rpt wo imp/con mmr/msi","description":"Surgical pathology reports that do not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both, reason not given","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0739","name":"Hiv prep, inj, cabotegravir","description":"Injection, cabotegravir, 1mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1299","name":"Flu immunize order/admin","description":"Influenza immunization administered or previously received","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0423U","name":"Psyc genomic alys pnl 26 gen","description":"Psyc genomic alys pnl 26 gen","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0146","name":"Nav srv peer sup add 30 pr m","description":"Principal illness navigation - peer support, additional 30 minutes per calendar month (list separately in addition to g0140)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84260","name":"Assay of serotonin","description":"Serotonin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92623","name":"Dx aly aud oi snd prcsr each","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; each additional 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0561","name":"Temp tube delivery, unil","description":"Tympanostomy with local or topical anesthesia and insertion of a ventilating tube when performed with tympanostomy tube delivery device, unilateral (list separately in addition to 69433) (do not use in conjunction with 0583t)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0012","name":"Injection of hiv prep drug","description":"Injection of pre-exposure prophylaxis (prep) drug for hiv prevention, under skin or into muscle","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9956","name":"Admin home sleep apnea test","description":"Admin home sleep apnea test","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1443","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9024","name":"Inj atezolizumb 5mg hya-tqjs","description":"Injection, atezolizumab, 5 mg and hyaluronidase-tqjs","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1218","name":"Pt copd symptoms","description":"Patient has copd symptoms (e.g., dyspnea, cough/sputum, wheezing)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1014T","name":"Lap rv/rmv eso sph nstm eltr","description":"Laparoscopic revision or removal, lower esophageal sphincter neurostimulator electrodes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87086","name":"Urine culture/colony count","description":"Culture, bacterial; quantitative colony count, urine","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1453","name":"Preop vis acu > 20/40","description":"Patients with a pre-operative visual acuity better than 20/40","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33405","name":"Replacement aortic valve opn","description":"Replacement, aortic valve, open, with cardiopulmonary bypass; with prosthetic valve other than homograft or stentless valve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2625.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6196","name":"Remv of ind rest on implt","description":"Remv of ind rest on implt","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87210","name":"Smear wet mount saline/ink","description":"Smear, primary source with interpretation; wet mount for infectious agents (eg, saline, india ink, koh preps)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33223","name":"Relocate pocket for defib","description":"Relocation of skin pocket for implantable defibrillator","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0832T","name":"Dgtz gls mcrscp cytp oth scr","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4260","name":"Signature apatch, per sq cm","description":"Signature apatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4347","name":"Rampart dl matrix per sq cm","description":"Rampart dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1551","name":"Inj cutaquig 100 mg","description":"Injection, immune globulin (cutaquig), 100 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1749","name":"Inj, iloprost, 0.1 mcg","description":"Injection, iloprost, 0.1 mcg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9268","name":"Programmer orally ingest cap","description":"Programmer for transient, orally ingested capsule","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4468","name":"Exsuff belt incl all sup acc","description":"Exsufflation belt, includes all supplies and accessories","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50920","name":"Closure ureter/skin fistula","description":"Closure of ureterocutaneous fistula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":957.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81005","name":"Urinalysis","description":"Urinalysis; qualitative or semiquantitative, except immunoassays","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0501U","name":"Onc clrc bld quan meas cfdna","description":"Onc clrc bld quan meas cfdna","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0941T","name":"Cysto flx ins&xpns urtl scaf","description":"Cystourethroscopy, flexible; with insertion and expansion of prostatic urethral scaffold using integrated cystoscopic visualization","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0527U","name":"Hsv 1&2 vzv amp prb tq pthgn","description":"Hsv 1&2 vzv amp prb tq pthgn","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0911","name":"Inst tauro 1.35mg/hep 100u","description":"Instillation, taurolidine 1.35 mg and heparin sodium 100 units (central venous catheter lock for adult patients receiving chronic hemodialysis)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7295","name":"Eth estr and eton monthly","description":"Ethinyl estradiol and etonogestrel 0.015mg, 0.12mg per 24 hours; monthly vaginal ring, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1711","name":"Moderna vacc admin booster","description":"Moderna vacc admin booster","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0964T","name":"I&cust prep jaw xpnsj 1arch","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; single arch, without mandibular advancement mechanism","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1001T","name":"Autol musc cell therapy njx","description":"Autologous muscle cell therapy, injection of muscle progenitor cells into the external anal sphincter, including ultrasound guidance, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94617","name":"Exercise tst brncspsm w/ecg","description":"Exercise test for bronchospasm, including pre- and post-spirometry and pulse oximetry; with electrocardiographic recording(s)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0618","name":"Inj, calcium chloride, 2 mg","description":"Injection, calcium chloride, 2 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0774T","name":"Vr px dissoc svc oth phy ea","description":"Virtual reality (vr) procedural dissociation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports; each additiona","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1420","name":"Complete ophthalmologic mvp","description":"Complete ophthalmologic care mips value pathway","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4427","name":"Dermbnd dln dl+ dlx sq cm","description":"Dermabind dl n or dermabind dl + or dermabind dl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43889","name":"Gstr rstcv px trnsorl esg","description":"Gastric restrictive procedure, transoral, endoscopic sleeve gastroplasty (esg), including argon plasma coagulation, when performed","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9172","name":"Docetaxel (docivyx), 1 mg","description":"Injection, docetaxel (docivyx), 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8702","name":"Ewhf s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand, finger, single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68801.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36836","name":"Prq av fstl crtj uxtr 1 acs","description":"Percutaneous arteriovenous fistula creation, upper extremity, single access of both the peripheral artery and peripheral vein, including fistula maturation procedures (eg, transluminal balloon angioplasty, coil embolization) when performed, including all vascular access, imaging guidance and radiolo","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1022T","name":"Prq tis dsplmt ntra-abdl/pel","description":"Percutaneous tissue displacement, any method, including imaging guidance; intra-abdominal/pelvic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37285","name":"Revsc evasc tpvt st sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93569","name":"Njx cth slct p-art angrp uni","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1003T","name":"Arthrp 1st crp/mtcrpl prostc","description":"Arthroplasty, first carpometacarpal joint, with distal trapezial and proximal first metacarpal prosthetic replacement (eg, first carpometacarpal total joint)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0572U","name":"Onc prst8 httl qfish whl bld","description":"Onc prst8 httl qfish whl bld","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0561","name":"Temp tube delivery, unil","description":"Tympanostomy with local or topical anesthesia and insertion of a ventilating tube when performed with tympanostomy tube delivery device, unilateral (list separately in addition to 69433) (do not use in conjunction with 0583t)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0433U","name":"Onc prst8 5 dna reg mrk pcr","description":"Onc prst8 5 dna reg mrk pcr","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0403","name":"Ekg for initial prevent exam","description":"Electrocardiogram, routine ecg with 12 leads; performed as a screening for the initial preventive physical examination with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0683","name":"App of non-sheet skin sub g","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9256","name":"Inj, nipocalimab-aahu, 3 mg","description":"Injection, nipocalimab-aahu, 3 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0842T","name":"Dgtz gls mcrscp pth cslt ea","description":"Digitization of glass microscope slides for pathology consultation during surgery; each additional tissue block with frozen section(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1436","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":310.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7471","name":"Rem exostosis any site","description":"Removal of lateral exostosis (maxilla or mandible)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9269","name":"Programable ingest capsule","description":"Programable, transient, orally ingested capsule, for use with external programmer, per month","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0860T","name":"Ncntc ifr spctrsc scr pad","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), for screening for peripheral arterial disease, including provocative maneuvers, image acquisition, interpretation, and report, one or both lower extremities","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68841","name":"Insj rx elut implt lac canal","description":"Insertion of drug-eluting implant, including punctal dilation when performed, into lacrimal canaliculus, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"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":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0278U","name":"Hem gen thrombosis 12 genes","description":"Hematology (genetic thrombosis), genomic sequence analysis of 12 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4360","name":"Amchoplast fd per sq cm","description":"Amchoplast fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0682","name":"App non-sheet skin sub add","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (list separately in addition to code for pri","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0951T","name":"Tot impl amei 1st plmt","description":"Totally implantable active middle ear hearing implant; initial placement, including mastoidectomy, placement of and attachment to sound processor","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5150","name":"Inj, aflibercept-mrbb, 1 mg","description":"Injection, aflibercept-mrbb (ahzantive), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0835T","name":"Dgtz gls mcrscp fna 1st ea","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87147","name":"Culture type immunologic","description":"Culture, typing; immunologic method, other than immunofluorescence (eg, agglutination grouping), per antiserum","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2019","name":"Kerecis marigen shld sq cm","description":"Kerecis omega3 marigen shield, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24900","name":"Amputation of upper arm","description":"Amputation, arm through humerus; with primary closure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":824.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99483","name":"Assmt & care pln pt cog imp","description":"Assessment of and care planning for a patient with cognitive impairment, requiring an independent historian, in the office or other outpatient, home or domiciliary or rest home, with all of the following required elements: cognition-focused evaluation including a pertinent history and examination, m","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":188.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1366","name":"Focus on womens health mvp","description":"Focusing on womens health mips value pathway","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86780","name":"Treponema pallidum","description":"Antibody; treponema pallidum","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7298","name":"Remove screw retained plate","description":"Remove screw retained plate","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2249","name":"Inj, remimazolam, 1 mg","description":"Injection, remimazolam, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0268","name":"Removal of impacted wax md","description":"Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93896","name":"Vsrctv std tcd icr art compl","description":"Vasoreactivity study performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36221","name":"Place cath thoracic aorta","description":"Non-selective catheter placement, thoracic aorta, with angiography of the extracranial carotid, vertebral, and/or intracranial vessels, unilateral or bilateral, and all associated radiological supervision and interpretation, includes angiography of the cervicocerebral arch, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1445.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69802","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1188.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85027","name":"Complete cbc automated","description":"Blood count; complete (cbc), automated (hgb, hct, rbc, wbc and platelet count)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0901","name":"Vadadustat oral 1mg for esrd","description":"Vadadustat, oral, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99205","name":"Office o/p new hi 60 min","description":"Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":268.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22838","name":"Rev rplc/rmv thrc vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracic vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1248","name":"Pt resp true seen as person","description":"Patient responded completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1005T","name":"Elec alys s-scl eeg prgr 1st","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, first 15 minutes face-to-face time with physician or other qualified hea","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0396","name":"Alcohol/subs interv 15-30mn","description":"Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":35.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33475","name":"Replacement pulmonary valve","description":"Replacement, pulmonary valve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2383.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4324","name":"Amniotx, per sq cm","description":"Amniotx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0304U","name":"Hem rbc ads whl bld normoxic","description":"Hem rbc ads whl bld normoxic","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81441","name":"Ibmfs seq alys pnl 30 genes","description":"Inherited bone marrow failure syndromes (ibmfs) (eg, fanconi anemia, dyskeratosis congenita, diamond-blackfan anemia, shwachman-diamond syndrome, gata2 deficiency syndrome, congenital amegakaryocytic thrombocytopenia) sequence analysis panel, must include sequencing of at least 30 genes, including b","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0440U","name":"Crd chd dna alys 10 snp 6dna","description":"Crd chd dna alys 10 snp 6dna","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1291","name":"Pt 66+ frailty and med dem","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0381U","name":"Maple syrup ur ds mntr quan","description":"Maple syrup ur ds mntr quan","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1223","name":"Glaucoma plan of care doc","description":"Glaucoma plan of care documented","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0368","name":"Cone beam ct interprete tmj","description":"Cone beam ct interprete tmj","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0864T","name":"Low ntsty eswt corpus cvrnsm","description":"Low-intensity extracorporeal shock wave therapy involving corpus cavernosum, low energy","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43847","name":"Gstr rstcv px sm int rcnstj","description":"Gastric restrictive procedure, with gastric bypass for morbid obesity; with small intestine reconstruction to limit absorption","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1839.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4378","name":"Renew ft matrix per sq cm","description":"Renew ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0738T","name":"Tx pln mag fld abltj prst8","description":"Treatment planning for magnetic field induction ablation of malignant prostate tissue, using data from previously performed magnetic resonance imaging (mri) examination","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0835T","name":"Dgtz gls mcrscp fna 1st ea","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77081","name":"Dxa bone density appendiculr","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1419","name":"Pt not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61700","name":"Brain aneurysm repr simple","description":"Surgery of simple intracranial aneurysm, intracranial approach; carotid circulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4211.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0400U","name":"Ob xpnd car scr 145 genes","description":"Ob xpnd car scr 145 genes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99424","name":"Prin care mgmt phys 1st 30","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0552","name":"Supply of digital device","description":"Supply of digital mental health treatment device and initial education and onboarding, per course of treatment that augments a behavioral therapy plan","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91320","name":"Sarscv2 vac 30mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 30 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5914","name":"Auricular prosthesis","description":"Auricular prosthesis","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0546","name":"Phone/internet ehr assess","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty   whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patien","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1211","name":"Gsa level>9.0%","description":"Most recent glycemic status assessment (hba1c or gmi) level > 9.0%","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1178","name":"Doc med rsn no pcv","description":"Documentation of medical reason(s) for not administering pneumococcal vaccine (e.g., prior anaphylaxis due to the pneumococcal vaccine)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2056","name":"Ciltacabtagene car-pos t","description":"Ciltacabtagene autoleucel, up to 100 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15400","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53420","name":"Reconstruct urethra stage 1","description":"Urethroplasty, 2-stage reconstruction or repair of prostatic or membranous urethra; first stage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":934.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86051","name":"Aquaporin-4 antb elisa","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; enzyme-linked immunosorbent immunoassay (elisa)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4038","name":"Vascular surgery ss","description":"Vascular surgery mips specialty set","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1007T","name":"Eeg impl s-sclp eeg w/o vid","description":"Electroencephalogram from implanted sub-scalp continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7509","name":"Marsupialization odon cyst","description":"Marsupialization odon cyst","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0992T","name":"N-invas assmt car rsk w/o ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat without concurrent computed tomography (ct) scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1360","name":"Suicd c-ssrs assessment","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1222","name":"Glaucoma pln of care not doc","description":"Glaucoma plan of care not documented, reason not otherwise specified","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5100","name":"Inj ustekinumab-kfce, 1 mg","description":"Injection, ustekinumab-kfce (yesintek), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77778","name":"Apply interstit radiat compl","description":"Interstitial radiation source application, complex, includes supervision, handling, loading of radiation source, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":922.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1332","name":"Pts no eval ini xm no 2 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 2 weeks","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7601","name":"Ensifentrine inh 3 mg","description":"Ensifentrine, inhalation suspension, fda approved final product, non-compounded, administered through dme, unit dose form, 3 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0771T","name":"Vr px dissoc svc sm phy 1st","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0034","name":"Pall serv during meas","description":"Patients receiving palliative care during the measurement period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78492","name":"Myocrd img pet mlt rst&strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); multiple studies at rest and stress (exercise or pharmacologic)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33901","name":"Perq p-art revsc 1 nm nt bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, bilateral","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62010","name":"Treatment of head injury","description":"Elevation of depressed skull fracture; with repair of dura and/or debridement of brain","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1681.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4286","name":"Remove non-resorb barrier","description":"Remove non-resorb barrier","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57454","name":"Bx/curett of cervix w/scope","description":"Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix and endocervical curettage","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":191.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86717","name":"Leishmania antibody","description":"Antibody; leishmania","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0486U","name":"Onc pan sol tum ngs cfctdna","description":"Onc pan sol tum ngs cfctdna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0593U","name":"Nfct ds gu pthgn dna 46trgt","description":"Nfct ds gu pthgn dna 46trgt","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77432","name":"Stereotactic radiation trmt","description":"Stereotactic radiation treatment management of cranial lesion(s) (complete course of treatment consisting of 1 session)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":485.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0250","name":"Adm tocilizu covid-19 2nd","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"Sup/ext non-ins inf pump syr","description":"Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1192","name":"Pt w/ dx sq cell ca of esoph","description":"Patients with an existing diagnosis of squamous cell carcinoma of the esophagus","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71021","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95249","name":"Cont gluc mntr pt prov eqp","description":"Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; patient-provided equipment, sensor placement, hook-up, calibration of monitor, patient training, and printout of recording","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0023","name":"Pin service 60m per month","description":"Principal illness navigation services by certified or trained auxiliary personnel under the direction of a physician or other practitioner, including a patient navigator; 60 minutes per calendar month, in the following activities:  person-centered assessment, performed to better understand the indiv","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25520","name":"Cltx rdl shft fx&dislc","description":"Closed treatment of radial shaft fracture and closed treatment of dislocation of distal radioulnar joint (galeazzi fracture/dislocation)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":610.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0893T","name":"N-invas assmt bld oxygnation","description":"Noninvasive assessment of blood oxygenation, gas exchange efficiency, and cardiorespiratory status, with physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4468","name":"Exsuff belt incl all sup acc","description":"Exsufflation belt, includes all supplies and accessories","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2989","name":"Excavate tooth non-restorabl","description":"Excavate tooth non-restorabl","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4002","name":"Ep cardio ss","description":"Electrophysiology cardiac specialist mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43290","name":"Egd flx trnsorl dplmnt balo","description":"Esophagogastroduodenoscopy, flexible, transoral; with deployment of intragastric bariatric balloon","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85301","name":"Antithrombin iii antigen","description":"Clotting inhibitors or anticoagulants; antithrombin iii, antigen assay","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78491","name":"Myocrd img pet 1std rst/strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); single study, at rest or stress (exercise or pharmacologic)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87183","name":"Sc std carbapenem resist gen","description":"Susceptibility studies, antimicrobial agent; carbapenem resistance genes (eg, blakpc, blandm, blavim, blaoxa-48, blaimp), amplified probe technique, per isolate","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0612U","name":"Onc lvr alys >1000 mr cfdna","description":"Onc lvr alys >1000 mr cfdna","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76987","name":"Dx intraop epicar car us chd","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; including placement and manipulation of transducer, image acquisition, interpretation and report","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1467","name":"Pt dx lynch syn","description":"Patients with an existing diagnosis of lynch syndrome","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9956","name":"Admin home sleep apnea test","description":"Admin home sleep apnea test","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0686T","name":"Histotripsy mal hepatcel tis","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant hepatocellular tissue, including image guidance","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0947T","name":"Mrgfus strtctc bl-br disrpj","description":"Magnetic resonance image guided low intensity focused ultrasound (mrgfus), stereotactic blood-brain barrier disruption using microbubble resonators to increase the concentration of blood-based biomarkers of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0287U","name":"Onc thyr dna&mrna 112 genes","description":"Onc thyr dna&mrna 112 genes","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0986T","name":"Iv img icr cere vsl oct 1st","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20956","name":"Iliac bone graft microvasc","description":"Bone graft with microvascular anastomosis; iliac crest","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3222.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0876T","name":"Duplex scan hemo fstl lmtd","description":"Duplex scan of hemodialysis fistula, computer-aided, limited (volume flow, diameter, and depth, including only body of fistula)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31242","name":"Nsl/sinus ndsc rf abltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by radiofrequency ablation, posterior nasal nerve","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0452U","name":"Onc bldr mthyl penk lte-qmsp","description":"Onc bldr mthyl penk lte-qmsp","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0907T","name":"Coms ther ea addl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; each additional application, total wound(s) surface area less than or equal to 50 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0491","name":"Oral dv nm mouthpc hw remote","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5147","name":"Inj, aflibercept-ayyh, 1 mg","description":"Injection, aflibercept-ayyh (pavblu), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43202","name":"Esophagoscopy flex biopsy","description":"Esophagoscopy, flexible, transoral; with biopsy, single or multiple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65101","name":"Removal of eye","description":"Enucleation of eye; without implant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":763.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4421","name":"Biolab wrap solo per sq cm","description":"Biolab membrane wrap solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49189","name":"Opn exc/dst ntra-abd 20.1-30","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 20.1 to 30 cm","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1503","name":"Vascular surgery mvp","description":"Vascular surgery mips value pathway","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4403","name":"Xwrap dual plus per sq cm","description":"Xwrap dual plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0501U","name":"Onc clrc bld quan meas cfdna","description":"Onc clrc bld quan meas cfdna","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0866T","name":"Quan mri alys brn w/dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion detection, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transmissio","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5153","name":"Inj, aflibercept-yszy, 1 mg","description":"Injection, aflibercept-yszy (opuviz), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0571U","name":"Onc sol tum dna80&rna10g ngs","description":"Onc sol tum dna80&rna10g ngs","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0011","name":"Hiv prep counsel, md 15-30m","description":"Individual counseling for pre-exposure prophylaxis (prep) by physician or qualified health care professional (qhp) to prevent human immunodeficiency virus (hiv), includes hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence, 15-30 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0867T","name":"Tpla b9 prst8 hyprplsa>=50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume greater or equal to 50 ml","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35665","name":"Bpg iliofemoral","description":"Bypass graft, with other than vein; iliofemoral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1495.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0802","name":"Inj. (ani), up to 40 units","description":"Injection, corticotropin (ani), up to 40 units","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65272","name":"Repair of eye wound","description":"Repair of laceration; conjunctiva, by mobilization and rearrangement, without hospitalization","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3502","name":"Surg exp root surf premolar","description":"Surg exp root surf premolar","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6607","name":"G com bandage tub protct lyr","description":"Gradient compression bandaging supply, tubular protective absorption layer, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9052","name":"Inj, carmustine (accord)","description":"Injection, carmustine (accord), not therapeutically equivalent to j9050, 100 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1939","name":"Inj, bumetanide, 0.5 mg","description":"Injection, bumetanide, 0.5 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33276","name":"Insj phrnc nrv stim sys","description":"Insertion of phrenic nerve stimulator system (pulse generator and stimulating lead[s]), including vessel catheterization, all imaging guidance, and pulse generator initial analysis with diagnostic mode activation, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99391","name":"Per pm reeval est pat infant","description":"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; infan","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":64.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59515","name":"Cesarean delivery","description":"Cesarean delivery only; including postpartum care","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1523.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81462","name":"So gsap cll fr dna/dna&rna","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants and rearrangements","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4421","name":"Biolab wrap solo per sq cm","description":"Biolab membrane wrap solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0782T","name":"Brnchsc rf dstrj plm nrv uni","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; unilateral mainstem bronchus","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6518","name":"Grad com wrap w strap arm cu","description":"Gradient compression wrap with adjustable straps, arm, each, custom","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59857","name":"Induced ab 1+vag supp hyst","description":"Induced abortion, by 1 or more vaginal suppositories (eg, prostaglandin) with or without cervical dilation (eg, laminaria), including hospital admission and visits, delivery of fetus and secundines; with hysterotomy (failed medical evacuation)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1283","name":"Pt scrn tbco and id as user","description":"Patient screened for tobacco use and identified as a tobacco user","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0466U","name":"Crd cad dna gwas 564856 snp","description":"Crd cad dna gwas 564856 snp","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0749T","name":"B1 str&fx rsk assmt dxr-bmd","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78645","name":"Csf shunt evaluation","description":"Cerebrospinal fluid flow, imaging (not including introduction of material); shunt evaluation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83529","name":"Asay of interleukin-6 (il-6)","description":"Interleukin-6 (il-6)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0899T","name":"N-invas deter aqmbf aug cmr","description":"Noninvasive determination of absolute quantitation of myocardial blood flow (aqmbf), derived from augmentative algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health car","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2791","name":"Crown full cast base metal","description":"Crown-full cast predominantly base metal","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0819T","name":"Revj/rmvl ins ptn subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2010","name":"Apis, per square centimeter","description":"Apis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1499","name":"Interventional radiology mvp","description":"Interventional radiology mips value pathway","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92584","name":"Electrocochleography","description":"Electrocochleography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0948T","name":"Rem interrog dev ccm phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system with interim analysis, review, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6105","name":"Remove implant body","description":"Remove implant body","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0835T","name":"Dgtz gls mcrscp fna 1st ea","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0675T","name":"Laps insj nw/rpcmt isdss 1ld","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first lead","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76094","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1326.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0556","name":"Adv prim care mgmt lvl 1","description":"Advanced primary care management services for a patient with one chronic condition [expected to last at least 12 months, or until the death of the patient, which place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline], or fewer, provided by clinical ","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0940T","name":"Xtrnl ecg rec>15d<30d r&i","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33948","name":"Ecmo/ecls daily mgmt-venous","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; daily management, each day, veno-venous","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6609","name":"G compression bandaging","description":"Gradient compression bandaging supply, not otherwise specified","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29049","name":"Appl cast figure-of-eight","description":"Application, cast; figure-of-eight","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0965T","name":"I&cst prp jw xpn dl arch non","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, non-fixed hinge mechanism","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4031","name":"Radiation oncology ss","description":"Radiation oncology mips specialty set","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78466","name":"Heart infarct image","description":"Myocardial imaging, infarct avid, planar; qualitative or quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3403","name":"Revakinagene, per implant","description":"Revakinagene taroretcel-lwey, per implant","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1395","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71047","name":"X-ray exam chest 3 views","description":"Radiologic examination, chest; 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2359","name":"Inj. olanzapine, 0.5mg","description":"Injection, olanzapine, 0.5 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92137","name":"Cptrz oph img pst sg rta oct","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), posterior segment, with interpretation and report, unilateral or bilateral; retina, including oct angiography","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1355","name":"Caries med app per tooth","description":"Caries med app per tooth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49621","name":"Rpr parastomal hernia rdc","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; reducible","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4258","name":"Enverse, per sq cm","description":"Enverse, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4394","name":"Surgraft aca per sq cm","description":"Surgraft aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90637","name":"Vacc qirv mrna 30mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 30 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41251","name":"Repair tongue laceration","description":"Repair of laceration 2.5 cm or less; posterior one-third of tongue","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86015","name":"Actin antibody each","description":"Actin (smooth muscle) antibody (asma), each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95831","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1492","name":"No reported fall","description":"Patients who did not report a fall","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69209","name":"Remove impacted ear wax uni","description":"Removal impacted cerumen using irrigation/lavage, unilateral","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2390","name":"Ant resin-based cmpst crown","description":"Resin-based composite crown anterior","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0004","name":"Qual care neurologic cnd mvp","description":"Quality care for patients with neurological conditions mips value pathway","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81462","name":"So gsap cll fr dna/dna&rna","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants and rearrangements","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0860T","name":"Ncntc ifr spctrsc scr pad","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), for screening for peripheral arterial disease, including provocative maneuvers, image acquisition, interpretation, and report, one or both lower extremities","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0201","name":"Pne flu hepb cov home admin","description":"Administration of pneumococcal, influenza, hepatitis b, and/or covid-19 vaccine inside a patients home; reported only once per individual home per date of service when such vaccine administration(s) are performed at the patients home","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55708","name":"Bx prst8 trct us w/mri fus 1","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant) with mri-fusion-guidance, first targeted lesion","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9174","name":"Inj, docetaxel (beizray) 1mg","description":"Injection, docetaxel (beizray), 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0972T","name":"Asstv alg clsfctn burn hlg","description":"Assistive algorithmic classification of burn healing (ie, healing or nonhealing) by noninvasive multispectral imaging, including system set-up and acquisition, selection, and transmission of images, with automated generation of report","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0723T","name":"Qmrcp w/o dx mri sm anat ses","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained without diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) during the same session","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0755T","name":"Dgtz gls mcrscp sld level vi","description":"Digitization of glass microscope slides for level vi, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1938","name":"Inj, furosemide, 1 mg","description":"Injection, furosemide, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2305","name":"Inj, nitroglycerin, 5 mg","description":"Injection, nitroglycerin, 5 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1220","name":"Dre wth interp rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; with evidence of retinopathy","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12053","name":"Intmd rpr face/mm 5.1-7.5 cm","description":"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 5.1 cm to 7.5 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6515","name":"Grad com wrap w str fu le cu","description":"Gradient compression wrap with adjustable straps, full leg, each, custom","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5152","name":"Inj, eculizumab-aeeb, 2 mg","description":"Injection, eculizumab-aeeb (bkemv), biosimilar, 2 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1306","name":"Pt anphx due to pneum","description":"Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86037","name":"Anca titer each antibody","description":"Antineutrophil cytoplasmic antibody (anca); titer, each antibody","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0257U","name":"Vlcad leuk nzm actv whl bld","description":"Very long chain acyl- coenzyme a (coa) dehydrogenase (vlcad), leukocyte enzyme activity, whole blood","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0250","name":"Adm tocilizu covid-19 2nd","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0847T","name":"Dgtz gls mcrscp xm arch tiss","description":"Digitization of glass microscope slides for examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, kras mutational analysis) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81558","name":"Trnspl rej kdn mrna qpcr 139","description":"Transplantation medicine (allograft rejection, kidney), mrna, gene expression profiling by quantitative polymerase chain reaction (qpcr) of 139 genes, utilizing whole blood, algorithm reported as a binary categorization as transplant excellence, which indicates immune quiescence, or not transplant e","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4302","name":"Complete aca, per sq cm","description":"Complete aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6039","name":"Passive custom digit/thumb","description":"Passive prosthetic digit or thumb prosthesis not including hand restoration partial hand, full or partial, custom made, any material, initial or replacement, per single passive prosthetic digit or thumb","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2160.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85660","name":"Rbc sickle cell test","description":"Sickling of rbc, reduction","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93897","name":"Emboli detcj wo iv mbubb njx","description":"Emboli detection without intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23550","name":"Optx acromclv dislc aqt/chrn","description":"Open treatment of acromioclavicular dislocation, acute or chronic;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26750","name":"Treat finger fracture each","description":"Closed treatment of distal phalangeal fracture, finger or thumb; without manipulation, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88141","name":"Cytopath c/v interpret","description":"Cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93153","name":"Interrog w/o prgrmg ipnss","description":"Interrogation without programming of implanted phrenic nerve stimulator system","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2011","name":"Supra sdrm, per sq cm","description":"Supra sdrm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0605","name":"Antibody test pub hlth path","description":"Antibody test pub hlth path","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7511","name":"Incision/drain abscess intra","description":"Incision and drainage of abscess - intraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"Home vent dual fnct incl all","description":"Home ventilator, dual-function respiratory device, also performs additional function of cough stimulation, includes all accessories, components and supplies for all functions","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1216","name":"No spiro doc no res doc","description":"No spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and/or no spirometry performed with results documented during the encounter","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1208","name":"Pt no scrn sdoh","description":"Patient is not screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0899","name":"Argatroban dialysis, auromed","description":"Injection, argatroban (auromedics), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25274","name":"Repair forearm tendon/muscle","description":"Repair, tendon or muscle, extensor, forearm and/or wrist; secondary, with free graft (includes obtaining graft), each tendon or muscle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1095.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37259","name":"Revsc evasc ivt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":97.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0411","name":"Hba1c in office testing","description":"Hba1c in office testing","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1720","name":"Influenza vacc admin","description":"Influenza vacc admin","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1073","name":"Testosterone pellet 75 mg","description":"Testosterone pellet, implant, 75 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92019","name":"Lmtd oph exam general anes","description":"Ophthalmological examination and evaluation, under general anesthesia, with or without manipulation of globe for passive range of motion or other manipulation to facilitate diagnostic examination; limited","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1412","name":"Inj roctavian ml 2x10^13vc g","description":"Injection, valoctocogene roxaparvovec-rvox, per ml, containing nominal 2 x 10^13 vector genomes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97608","name":"Neg prs wnd ther ndme>50sqcm","description":"Negative pressure wound therapy, (eg, vacuum assisted drainage collection), utilizing disposable, non-durable medical equipment including provision of exudate management collection system, topical application(s), wound assessment, and instructions for ongoing care, per session; total wound(s) surfac","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":25.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1710","name":"Moderna vacc admin 3rd dose","description":"Moderna vacc admin 3rd dose","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1248","name":"Pt resp true seen as person","description":"Patient responded completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55867","name":"Laps surg prst8ect smpl stot","description":"Laparoscopy, surgical prostatectomy, simple subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy), includes robotic assistance, when performed","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87075","name":"Cultr bacteria except blood","description":"Culture, bacterial; any source, except blood, anaerobic with isolation and presumptive identification of isolates","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70496","name":"Ct angiography head","description":"Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":650.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1380","name":"2 rx in perf pd any com meds","description":"Filled at least two prescriptions during the performance period for any combination of the qualifying oral antipsychotic medications listed under denominator note or the long-acting injectable antipsychotic medications listed under denominator note","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61624","name":"Tcat perm occls/embolj cns","description":"Transcatheter permanent occlusion or embolization (eg, for tumor destruction, to achieve hemostasis, to occlude a vascular malformation), including all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention, percutaneous,","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1268.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0888T","name":"Histotripsy mal renal tissue","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant renal tissue, including imaging guidance","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86051","name":"Aquaporin-4 antb elisa","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; enzyme-linked immunosorbent immunoassay (elisa)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4335","name":"Amnioplast 2, per sq cm","description":"Amnioplast 2, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4384","name":"Axolotl dual ult per sq cm","description":"Axolotl dualgraft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76856","name":"Us exam pelvic complete","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1209","name":">=2 same hi-rsk med w/o diag","description":"At least two orders for high-risk medications from the same drug class, (table 4), without appropriate diagnoses","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1332","name":"Pts no eval ini xm no 2 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 2 weeks","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1356","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98980","name":"Rtm tx mgmt 1st 20 min","description":"Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least 1 real-time interactive communication with the patient or caregiver during the calendar month; first 20 minutes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4431","name":"Pma skin substitute, nos","description":"Pma skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76375","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0237","name":"Intrav inf, toci, first dose","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96381","name":"Admn rsv monoc antb im njx","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2989","name":"Excavate tooth non-restorabl","description":"Excavate tooth non-restorabl","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0536","name":"Peer recover support svs","description":"Peer recovery support services, provided directly or by referral; including leveraging knowledge of the condition or lived experience to provide support, mentorship, or inspiration to meet oud treatment and recovery goals; conducting a person-centered interview to understand the patients life story,","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0711T","name":"N-nvs artl plaq alys dat prp","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data preparation and transmission","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15853","name":"Removal sutr/stapl xreq anes","description":"Removal of sutures or staples not requiring anesthesia (list separately in addition to e/m code)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1159","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87426","name":"Sarscov coronavirus ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; severe acute respiratory syndrome coronavirus (eg, sars-cov, s","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0568","name":"Int psych care mng, 1 cal mo","description":"Initial psychiatric collaborative care management, in the first calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required elements: outrea","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4015","name":"Neurology ss","description":"Neurology mips specialty set","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6252","name":"Bridge resin w/noble metal","description":"Pontic-resin with noble metal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4420","name":"Nuform per sq cm","description":"Nuform, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35800","name":"Explore neck vessels","description":"Exploration for postoperative hemorrhage, thrombosis or infection; neck","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1782","name":"Vac admin human pap dose 2","description":"Vac admin human pap dose 2","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0217","name":"Inj velmanase alfa-tycv 1 mg","description":"Injection, velmanase alfa-tycv, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0387","name":"Comp image capture only","description":"Comp image capture only","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35647","name":"Bpg aortofemoral","description":"Bypass graft, with other than vein; aortofemoral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1952.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1152","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4289","name":"Revoshield+ amnio, per sq cm","description":"Revoshield + amniotic barrier, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64836","name":"Repair of hand or foot nerve","description":"Suture of 1 nerve; ulnar motor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9003","name":"Leupro inj, camcevi etm, 1mg","description":"Leuprolide injectable (camcevi etm), 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0311U","name":"Nfct ds bct quan antmcrb sc","description":"Nfct ds bct quan antmcrb sc","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0752","name":"Hiv prep, oral lenacapavir","description":"Oral, lenacapavir, 300 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0847T","name":"Dgtz gls mcrscp xm arch tiss","description":"Digitization of glass microscope slides for examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, kras mutational analysis) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33509","name":"Ndsc hrv uxtr art 1 sgm cab","description":"Harvest of upper extremity artery, 1 segment, for coronary artery bypass procedure, endoscopic","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1315","name":"Crc no doc no rsn","description":"Colorectal cancer screening results were not documented and reviewed; reason not otherwise specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92930","name":"Prq tcat plmt ntrac st 2+les","description":"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 2 or more distinct coronary lesions with 2 or more coronary stents deployed in 2 or more coronary segments, or a bifurcation lesion requiring ","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4224","name":"Hhf10-p per sq cm","description":"Human health factor 10 amniotic patch (hhf10-p), per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9322","name":"Inj pemetrexed (bluepoint)","description":"Injection, pemetrexed (bluepoint), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1439","name":"Sig ocu cond imp surg out","description":"Significant ocular conditions that impact the visual outcome of surgery","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4304","name":"Grafix plus, per sq cm","description":"Grafix plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86052","name":"Aquaporin-4 antb cba each","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; cell-based immunofluorescence assay (cba), each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5151","name":"Inj, eculizumab-aagh, 2 mg","description":"Injection, eculizumab-aagh (epysqli), biosimilar, 2 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0977T","name":"Upr gi bld detcj snr capsule","description":"Upper gastrointestinal blood detection, sensor capsule, with interpretation and report","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0257U","name":"Vlcad leuk nzm actv whl bld","description":"Very long chain acyl- coenzyme a (coa) dehydrogenase (vlcad), leukocyte enzyme activity, whole blood","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4295","name":"Amnio tri-core, per sq cm","description":"Amnio tri-core amniotic, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5147","name":"Inj, aflibercept-ayyh, 1 mg","description":"Injection, aflibercept-ayyh (pavblu), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0037","name":"Pt not able to participate","description":"On date of encounter, patient is not able to participate in assessment or screening, including non-verbal patients, delirious, severely aphasic, severely developmentally delayed, severe visual or hearing impairment and for those patients, no knowledgeable informant available","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1736","name":"Inj meloxicam (delova) 1mg","description":"Injection, meloxicam (delova), 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6590","name":"Urinary cath disp suc pump","description":"External urinary catheters; disposable, with wicking material, for use with suction pump, per month","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J3355","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7284","name":"Exc biopsy of saliv glands","description":"Exc biopsy of saliv glands","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1852","name":"Ko double upright prefab ots","description":"Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":634.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0441U","name":"Nfct ds bct fngl/viral semiq","description":"Nfct ds bct fngl/viral semiq","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0753T","name":"Dgtz gls mcrscp sld level iv","description":"Digitization of glass microscope slides for level iv, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4012","name":"Interventional rad ss","description":"Interventional radiology mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87185","name":"Sc std enzyme detcj per nzm","description":"Susceptibility studies, antimicrobial agent; enzyme detection (eg, beta lactamase), per enzyme","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1355","name":"Caries med app per tooth","description":"Caries med app per tooth","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86648","name":"Diphtheria antibody","description":"Antibody; diphtheria","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1714","name":"Pfizer vacc adm ped 2nd dose","description":"Pfizer vacc adm ped 2nd dose","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93596","name":"R&l hrt cath chd nml nt cnj","description":"Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); normal native connections","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0903T","name":"Ecg alg 12 lead reduced i&r","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; with interpretation and report","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76801","name":"Ob us < 14 wks single fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0024","name":"Pin srv add 30 min pr m","description":"Principal illness navigation services, additional 30 minutes per calendar month (list separately in addition to g0023)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2006","name":"Novosorb synpath per sq cm","description":"Novosorb synpath dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80505","name":"Path clin consltj high 41-60","description":"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patients history and medical records and high level of medical decision making when using time for code selection, 41-60 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3921","name":"Decor or submerg erupt tooth","description":"Decor or submerg erupt tooth","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0596U","name":"Neuro alzds plsm 3dstnct isp","description":"Neuro alzds plsm 3dstnct isp","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4271","name":"Complete ft per sq cm","description":"Complete ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9225","name":"Gen anes adv air-sub 15 min","description":"Gen anes adv air-sub 15 min","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0910T","name":"Rmvl int nstim sys vagus nrv","description":"Removal of integrated neurostimulation system, vagus nerve","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0467U","name":"Onc bldr dna ngs 60gen&aneup","description":"Onc bldr dna ngs 60gen&aneup","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0387","name":"Comp image capture only","description":"Comp image capture only","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33269","name":"Excl laa thrscp any method","description":"Exclusion of left atrial appendage, thoracoscopic, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61538","name":"Removal of brain tissue","description":"Craniotomy with elevation of bone flap; for lobectomy, temporal lobe, with electrocorticography during surgery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2266.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0359U","name":"Onc prst8 ca alys all psa","description":"Onc prst8 ca alys all psa","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82075","name":"Assay of breath ethanol","description":"Alcohol (ethanol); breath","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0499U","name":"Onc clrct&lng dna ngs 8gene","description":"Onc clrct&lng dna ngs 8gene","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0799T","name":"Tcat rmvl 2chmbr ldls pm ra","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right atrial pacemaker component","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86366","name":"Muscle-specific kinase antb","description":"Muscle-specific kinase (musk) antibody","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2994.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0528U","name":"Lrt iad 18bct/8vir&7arg rna","description":"Lrt iad 18bct/8vir&7arg rna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7413","name":"Excision malig lesion<=1.25c","description":"Excision of malignant lesion up to 1.25 cm","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2327","name":"Inj risankizumab-rzaa 1 mg","description":"Injection, risankizumab-rzaa, intravenous, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0567","name":"Screening hep c detect","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis c, screening, amplified probe technique","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0452U","name":"Onc bldr mthyl penk lte-qmsp","description":"Onc bldr mthyl penk lte-qmsp","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0408U","name":"Iaad blk ac wv bsnsr sarscv2","description":"Iaad blk ac wv bsnsr sarscv2","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36563","name":"Insert tunneled cv cath","description":"Insertion of tunneled centrally inserted central venous access device with subcutaneous pump","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0906T","name":"Coms ther 1st appl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; first application, total wound(s) surface area less than or equal to 50 sq cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35515","name":"Art byp grft subclav-vertbrl","description":"Bypass graft, with vein; subclavian-vertebral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1378.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82205","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76400","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":671.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4429","name":"Dermbnd chn, chx per sq cm","description":"Dermabind ch n or dermabind ch x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27458","name":"Osteot femur imed lngth dev","description":"Osteotomy(ies), femur, unilateral, with insertion of an externally controlled intramedullary lengthening device, including iliotibial band release when performed, imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68326","name":"Revise/graft eyelid lining","description":"Conjunctivoplasty, reconstruction cul-de-sac; with conjunctival graft or extensive rearrangement","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":620.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5151","name":"Inj, eculizumab-aagh, 2 mg","description":"Injection, eculizumab-aagh (epysqli), biosimilar, 2 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0917T","name":"Insj perm ccm-d sys 1 lead","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; single transvenous lead (pacing or defibrillation) only","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93580","name":"Transcath closure of asd","description":"Percutaneous transcatheter closure of congenital interatrial communication (ie, fontan fenestration, atrial septal defect) with implant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1160.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0695T","name":"Bdy srf mpg pm/cvdfb tm impl","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of implant or replacement","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0431","name":"Diag tst detect mucos abnorm","description":"Adjunctive pre-diagnostic test that aids in detection of mucosal abnormalities including premalignant and malignant lesions not to include cytology or biopsy","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2643","name":"Dental onlay porcelin 3 surf","description":"Onlay - porcelain/ceramic - three surfaces","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1372","name":"Mst rec gsa >=7 and<8","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 7.0% and < 8.0%","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7507","name":"Tacrolimus imme rel oral 1mg","description":"Tacrolimus, immediate release, oral, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0959T","name":"Rmv/rplc magnet coil assem","description":"Removal or replacement of magnet from coil assembly that is connected to continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1492","name":"No reported fall","description":"Patients who did not report a fall","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9048","name":"Inj, bortezomib freseniuskab","description":"Injection, bortezomib (fresenius kabi), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1195","name":"Rpt wo imp/con mmr/msi","description":"Surgical pathology reports that do not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both, reason not given","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1298","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4352","name":"Overlay sl matrix, per sq cm","description":"Overlay sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35563","name":"Art byp grft ilioiliac","description":"Bypass graft, with vein; ilioiliac","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"Non-adju cgm supply allow","description":"Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0579U","name":"Nfro dbtc ckd elisa apoa4","description":"Nfro dbtc ckd elisa apoa4","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0630U","name":"Onc brst mrna gen prflg 80","description":"Onc brst mrna gen prflg 80","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4312","name":"Acesso ac, per sq cm","description":"Acesso ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0360U","name":"Onc lung elisa 7 autoant alg","description":"Onc lung elisa 7 autoant alg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1450","name":"Pt hos/pal care dur id/pf pd","description":"Patients who received hospice or palliative care service any time during denominator identification period or the measure assessment period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0680","name":"Cr art clc art vlv clc w rpt","description":"Detection and quantification of coronary artery calcium and/or aortic valve calcification from algorithmic analysis of computed tomography of the chest with report","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0984T","name":"Iv img xtrc cere vsl oct 1st","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1265","name":"Cms 2728 completed","description":"Cms medical evidence form 2728 for dialysis patients: initial form completed","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0945T","name":"Intraop assmt abnl tum tiss","description":"Intraoperative assessment for abnormal (tumor) tissue, in-vivo, following partial mastectomy (eg, lumpectomy) using computer-aided fluorescence imaging (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0362U","name":"Onc pap thyr ca rna 82&10","description":"Onc pap thyr ca rna 82&10","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4358","name":"Xwrap dual, per sq cm","description":"Xwrap dual, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1201","name":"Med rsn no ace-i/arb rx","description":"Documentation of medical reason(s) for not prescribing ace inhibitor (ace-i) or arb therapy during the measurement period (e.g., pregnancy, history of angioedema to ace-i, other allergy to ace-i and arb, hyperkalemia or history of hyperkalemia while on ace-i or arb therapy, acute kidney injury due t","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80506","name":"Path clin consltj prolng svc","description":"Pathology clinical consultation; prolonged service, each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0553U","name":"Repr med pga embry te strux","description":"Repr med pga embry te strux","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57220","name":"Revision of urethra","description":"Plastic operation on urethral sphincter, vaginal approach (eg, kelly urethral plication)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0724T","name":"Qmrcp w/dx mri same anatomy","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained with diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in additio","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0604U","name":"All&immunology crae 4bk pep","description":"All&immunology crae 4bk pep","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90613","name":"Inf&sarscov2 vacc 40/0.4 im","description":"Influenza virus vaccine, quadrivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 40 mcg/0.4 ml dosage, for intramuscular use","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0734T","name":"Rem r-t mtn nrehab tx mgmt","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; treatment management services by a physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36140","name":"Intro ndl icath upr/lxtr art","description":"Introduction of needle or intracatheter, upper or lower extremity artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93319","name":"3d echo img cgen car anomal","description":"3d echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac structure(s) (eg, cardiac chambers and valves, left atrial appendage, interatrial septum, interventricular","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0405U","name":"Onc pncrtc 59 mthltn blk mrk","description":"Onc pncrtc 59 mthltn blk mrk","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23182","name":"Prtl excision bone scapula","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), scapula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":825.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50390","name":"Drainage of kidney lesion","description":"Aspiration and/or injection of renal cyst or pelvis by needle, percutaneous","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0748T","name":"Njx stm cl prdct anl sft tis","description":"Injections of stem cell product into perianal perifistular soft tissue, including fistula preparation (eg, removal of setons, fistula curettage, closure of internal openings)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4293","name":"Acesso dl, per sq cm","description":"Acesso dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54316","name":"Reconstruction of urethra","description":"Urethroplasty for second stage hypospadias repair (including urinary diversion) with free skin graft obtained from site other than genitalia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1137.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98976","name":"Rtm dev sply resp sys 16-30d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of respiratory system, 16-30 days in a 30-day period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9064","name":"Inj, cabazitaxel (sandoz)","description":"Injection, cabazitaxel (sandoz), not therapeutically equivalent to j9043, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0287U","name":"Onc thyr dna&mrna 112 genes","description":"Onc thyr dna&mrna 112 genes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78491","name":"Myocrd img pet 1std rst/strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); single study, at rest or stress (exercise or pharmacologic)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55877","name":"Abltj ire prst8 1+ tum perq","description":"Ablation, irreversible electroporation, prostate, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1266","name":"Pts admit snf","description":"Patients admitted to a skilled nursing facility (snf)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29345","name":"Application of long leg cast","description":"Application of long leg cast (thigh to toes);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8005","name":"Grip glove w microprocessor","description":"Powered, cable driven grip assist glove, hand, finger, includes microprocessor, pressure sensors, all components and accessories, custom fitted","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0693T","name":"Compre ful bdy 3d mtn alys","description":"Comprehensive full body computer-based markerless 3d kinematic and kinetic motion analysis and report","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35602","name":"Bpg crtd-clat crtd","description":"Bypass graft, with other than vein; carotid-contralateral carotid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":624.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20938","name":"Sp bone agrft struct add-on","description":"Autograft for spine surgery only (includes harvesting the graft); structural, bicortical or tricortical (through separate skin or fascial incision) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94617","name":"Exercise tst brncspsm w/ecg","description":"Exercise test for bronchospasm, including pre- and post-spirometry and pulse oximetry; with electrocardiographic recording(s)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0419U","name":"Nrpsyc gen seq vrnt aly 13","description":"Nrpsyc gen seq vrnt aly 13","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4010","name":"Infectious disease ss","description":"Infectious disease mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1574","name":"Inj, ganciclovir (exela)","description":"Injection, ganciclovir sodium (exela), not therapeutically equivalent to j1570, 500 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5130","name":"Inj, fylnetra, 0.5 mg","description":"Injection, pegfilgrastim-pbbk (fylnetra), biosimilar, 0.5 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81558","name":"Trnspl rej kdn mrna qpcr 139","description":"Transplantation medicine (allograft rejection, kidney), mrna, gene expression profiling by quantitative polymerase chain reaction (qpcr) of 139 genes, utilizing whole blood, algorithm reported as a binary categorization as transplant excellence, which indicates immune quiescence, or not transplant e","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0800T","name":"Tcat rmvl 2chmbr ldls pm rv","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right ventricular pacemaker component (when part of a dual-chamber leadless pacem","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0466U","name":"Crd cad dna gwas 564856 snp","description":"Crd cad dna gwas 564856 snp","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0023","name":"Pin service 60m per month","description":"Principal illness navigation services by certified or trained auxiliary personnel under the direction of a physician or other practitioner, including a patient navigator; 60 minutes per calendar month, in the following activities:  person-centered assessment, performed to better understand the indiv","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1447","name":"Pt dx bd bef end meas pd","description":"Patients with an active diagnosis of bipolar disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"Home vent dual fnct incl all","description":"Home ventilator, dual-function respiratory device, also performs additional function of cough stimulation, includes all accessories, components and supplies for all functions","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]},{"negotiated_type":"negotiated","negotiated_rate":1459.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99384","name":"Prev visit new age 12-17","description":"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; adolescent (age ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":159.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3421","name":"Root surgery bicuspid","description":"Apicoectomy/periradicular surgery-bicuspid (first root)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0961T","name":"Shortwave ifr radiation img","description":"Shortwave infrared radiation imaging, surgical pathology specimen, to assist gross examination for lymph node localization in fibroadipose tissue, per specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49621","name":"Rpr parastomal hernia rdc","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; reducible","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9996","name":"Ustekinumab- ttwe sub cu inj","description":"Injection, ustekinumab-ttwe (pyzchiva), subcutaneous, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47384","name":"Abltj ire liver 1+ tum perq","description":"Ablation, irreversible electroporation, liver, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96004","name":"Phys review of motion tests","description":"Review and interpretation by physician or other qualified health care professional of comprehensive computer-based motion analysis, dynamic plantar pressure measurements, dynamic surface electromyography during walking or other functional activities, and dynamic fine wire electromyography, with writ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1423","name":"Opt care urologic cnd mvp","description":"Optimal care for patients with urologic conditions mips value pathway","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4364","name":"Am bur xp mem xpl hy p sq cm","description":"Amnio burgeon xplus membrane and xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8541","name":"Oral, hemady, 0.25 mg","description":"Dexamethasone (hemady), oral, 0.25 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9361","name":"Inj, efbemalenograstim alfa-","description":"Injection, efbemalenograstim alfa-vuxw, 0.5 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0683T","name":"Prgrmg dev eval isdss ip","description":"Programming device evaluation (in-person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional, permanent implantable synchroni","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0706T","name":"Rem tx amblyopia i&r phy/qhp","description":"Remote treatment of amblyopia using an eye tracking device; interpretation and report by physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5161","name":"Inj, denosumab-kyqq, 1 mg","description":"Injection, denosumab-kyqq (aukelso/bosaya), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69806","name":"Explore inner ear","description":"Endolymphatic sac operation; with shunt","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1093.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9612","name":"Inj, fluorescein, 1 mg","description":"Injection, fluorescein, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0033","name":"2+ benzo seiz","description":"Two or more benzodiazepine prescriptions ordered for patients who had a diagnosis of seizure disorders, rapid eye movement sleep behavior disorder, benzodiazepine withdrawal, ethanol withdrawal, or severe generalized anxiety disorder on or between january 1 of the year prior to the measurement perio","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8502","name":"Inj, aponvie, 1 mg","description":"Injection, aprepitant (aponvie), 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0356U","name":"Onc orop 17 dna ddpcr alg","description":"Onc orop 17 dna ddpcr alg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90840","name":"Psytx crisis ea addl 30 min","description":"Psychotherapy for crisis; each additional 30 minutes (list separately in addition to code for primary service)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":65.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0447U","name":"Ai ds sle alys 11 cytokine","description":"Ai ds sle alys 11 cytokine","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33788","name":"Revision of pulmonary artery","description":"Reimplantation of an anomalous pulmonary artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1911.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1747","name":"Inj, spesolimab-sbzo, 1 mg","description":"Injection, spesolimab-sbzo, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0291U","name":"Psyc mood do mrna 144 genes","description":"Psyc mood do mrna 144 genes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33280","name":"Rmvl phrnc nrv stim pg only","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator only","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1438","name":"Lst knwn well <=210 min","description":"Time last known well to hospital arrival less than or equal to 3.5 hours (<= 210 minutes)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0406U","name":"Onc lung flow cytmtry 5 mrk","description":"Onc lung flow cytmtry 5 mrk","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90759","name":"Hep b vac 3ag 10mcg 3 dos im","description":"Hepatitis b vaccine (hepb), 3-antigen (s, pre-s1, pre-s2), 10 mcg dosage, 3 dose schedule, for intramuscular use","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75807","name":"Lymph vessel x-ray trunk","description":"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47371","name":"Laparo ablate liver cryosurg","description":"Laparoscopy, surgical, ablation of 1 or more liver tumor(s); cryosurgical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1354.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4379","name":"Amniodefend ft per sq cm","description":"Amniodefend ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2007","name":"Restrata, per sq cm","description":"Restrata, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98007","name":"Synch audio-video est hi 40","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high medical decision making. when using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded.","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0291U","name":"Psyc mood do mrna 144 genes","description":"Psyc mood do mrna 144 genes","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1466","name":"Pt disc/lam proc same day","description":"Patient had a lumbar fusion on the same date as the discectomy/laminectomy procedure","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0832T","name":"Dgtz gls mcrscp cytp oth scr","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0989T","name":"Revj/rmvl ins ptn subq&subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98978","name":"Rtm dev sply cbt 16-30 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of cognitive behavioral therapy, 16-30 days in a 30-day period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0953T","name":"Tot impl amei rev/rplc w/o","description":"Totally implantable active middle ear hearing implant; revision or replacement, without mastoidectomy and replacement of sound processor","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62331","name":"Dcmprn prq rmv lig flv addl","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; additional interspace(s), lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3222","name":"Part pulp for apexogenesis","description":"Partial pulpotomy for apexogenesis - permanent tooth with incomplete root development","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2252","name":"Inj midazolam in 0.8% nacl","description":"Injection, midazolam in 0.8% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5783","name":"Add low ext mec limb vol lam","description":"Addition to lower extremity, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0329U","name":"Onc neo xome&trns seq alys","description":"Onc neo xome&trns seq alys","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92639","name":"Hearing aid meas verif","description":"Hearing-aid measurement, verification with probe-microphone (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81517","name":"Liver ds alys 3 bmrk srm alg","description":"Liver disease, analysis of 3 biomarkers (hyaluronic acid [ha], procollagen iii amino terminal peptide [piiinp], tissue inhibitor of metalloproteinase 1 [timp-1]), using immunoassays, utilizing serum, prognostic algorithm reported as a risk score and risk of liver fibrosis and liver-related clinical ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":176.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76802","name":"Ob us < 14 wks addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3503","name":"Surg exp root surf molar","description":"Surg exp root surf molar","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82271","name":"Occult blood other sources","description":"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; other sources","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1814","name":"Inj. insulin (lyumjev)","description":"Insulin (lyumjev), per 5 units","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4378","name":"Renew ft matrix per sq cm","description":"Renew ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9064","name":"Inj, cabazitaxel (sandoz)","description":"Injection, cabazitaxel (sandoz), not therapeutically equivalent to j9043, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4321","name":"Renograft, per sq cm","description":"Renograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95830","name":"Insert electrodes for eeg","description":"Insertion by physician or other qualified health care professional of sphenoidal electrodes for electroencephalographic (eeg) recording","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0288U","name":"Onc lung mrna quan pcr 11&3","description":"Onc lung mrna quan pcr 11&3","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2037","name":"G4derm plus/suprello, pr ml","description":"G4derm plus/suprello, per milliliter","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0870","name":"Injection, imetelstat, 1 mg","description":"Injection, imetelstat, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98015","name":"Synch audio-only est high 40","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selec","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1306","name":"Injection, inclisiran, 1 mg","description":"Injection, inclisiran, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0726T","name":"Rmvl implt vstibular dev uni","description":"Removal of implanted vestibular device, unilateral","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1105","name":"Dexmedetomidine film, 1 mcg","description":"Dexmedetomidine, oral, 1 mcg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65772","name":"Correction of astigmatism","description":"Corneal relaxing incision for correction of surgically induced astigmatism","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0701","name":"Pano radio image","description":"Pano radio image","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69726","name":"Rmv ntr oi implt skl prq esp","description":"Removal, entire osseointegrated implant, skull; with percutaneous attachment to external speech processor","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5877","name":"Dup of complt dent-maxill","description":"Dup of complt dent-maxill","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1811","name":"Fiasp for insulin pump use","description":"Insulin (fiasp) for administration through dme (i.e., insulin pump) per 50 units","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1198","name":"Isa not red 3pts /no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0294U","name":"Lngvty&mrtlty rsk mrna 18gen","description":"Lngvty&mrtlty rsk mrna 18gen","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62280","name":"Treat spinal cord lesion","description":"Injection/infusion of neurolytic substance (eg, alcohol, phenol, iced saline solutions), with or without other therapeutic substance; subarachnoid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6525","name":"G com garm lwrleg/ft ngt cus","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, custom, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0435U","name":"Onc chemo rx cytox csc 14 rx","description":"Onc chemo rx cytox csc 14 rx","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3404","name":"Inj zopapogene per ther dose","description":"Injection, zopapogene imadenovec-drba suspension, per therapeutic dose","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0174","name":"Lecanemab-irmb, for iv inj","description":"Lecanemab-irmb, for intravenous injection, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J9090","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0840T","name":"Dgtz gls mcrscp cslt compre","description":"Digitization of glass microscope slides for consultation, comprehensive, with review of records and specimens, with report on referred material (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9938","name":"Fab removable appliance","description":"Fab removable appliance","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4291","name":"Lamellas xt, per sq cm","description":"Lamellas xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29405","name":"Appl short leg cast","description":"Application of short leg cast (below knee to toes);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3392","name":"Inj, exagamglogene autotem","description":"Injection, exagamglogene autotemcel, per treatment","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43256","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4298","name":"Amniocore pro, per sq cm","description":"Amniocore pro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2508","name":"Pegunigalsidase alfa-iwxj","description":"Injection, pegunigalsidase alfa-iwxj, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21555","name":"Exc neck les sc < 3 cm","description":"Excision, tumor, soft tissue of neck or anterior thorax, subcutaneous; less than 3 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38227","name":"Car-t receipt&prepj admn","description":"Chimeric antigen receptor t-cell (car-t) therapy; receipt and preparation of car-t cells for administration","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98006","name":"Synch audio-video est mod 30","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7939","name":"Indexing for osteotomy","description":"Indexing for osteotomy","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81354","name":"Cytog alys chrml abnor ogm","description":"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of structural and copy number variants, optical genome mapping (ogm)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4359","name":"Choriply, per sq cm","description":"Choriply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44379","name":"S bowel endoscope w/stent","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, including ileum; with transendoscopic stent placement (includes predilation)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":481.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1782","name":"Vac admin human pap dose 2","description":"Vac admin human pap dose 2","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1812","name":"Inj. insulin (fiasp)","description":"Insulin (fiasp), per 5 units","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0292U","name":"Psyc strs do mrna 72 genes","description":"Psyc strs do mrna 72 genes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0885T","name":"Colsc flx 1st tndsc dilat","description":"Colonoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0618U","name":"Psyc bd dna mthyl alys>10000","description":"Psyc bd dna mthyl alys>10000","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87913","name":"Nfct agt gntyp alys sarscov2","description":"Infectious agent genotype analysis by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), mutation identification in targeted region(s)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6603","name":"Cst hgh nble mtl inlay >=3sr","description":"Inlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1200","name":"Ace-i/arb rx","description":"Ace inhibitor (ace-i) or arb therapy prescribed during the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0879","name":"Difelikefalin, esrd on dialy","description":"Injection, difelikefalin, 0.1 microgram, (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0368U","name":"Onc clrct ca mut&mthyltn mrk","description":"Onc clrct ca mut&mthyltn mrk","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5611","name":"Rep resin part dent base man","description":"Rep resin part dent base man","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4016","name":"Neurosurgical ss","description":"Neurosurgical mips specialty set","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0307U","name":"Onc mrd nxt-gnrj alys sbsq","description":"Onc mrd nxt-gnrj alys sbsq","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0884T","name":"Esphgsc flx 1st tndsc dilat","description":"Esophagoscopy, flexible, transoral, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for esophageal stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0533","name":"Buprenorphone inj weekly","description":"Medication assisted treatment, buprenorphine (injectable) administered on a weekly basis; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid tre","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9947","name":"Sleep apnea appliance","description":"Sleep apnea appliance","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1373","name":"Mst rec gsa >=8 and <=9","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 8.0% and <= 9.0%","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82003","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0209","name":"Inj, sod thiosulfate (hope)","description":"Injection, sodium thiosulfate (hope), 100 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6114","name":"Implnt/abut fixed dent max","description":"Implnt/abut fixed dent max","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0780","name":"Prochlorperazine injection","description":"Injection, prochlorperazine, up to 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37276","name":"Rvsc evsc fpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1954","name":"Inj leu acet lutr dpt 7.5 mg","description":"Injection, leuprolide acetate for depot suspension (lutrate depot), 7.5 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1202","name":"Pt rsn no ace-i/arb rx","description":"Documentation of patient reason(s) for not prescribing ace inhibitor or arb therapy during the measurement period, (e.g., patient declined, other patient reasons)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93575","name":"Njx cath slct p angrph mapca","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary angiography of major aortopulmonary collateral arteries (mapcas) arising off the aorta or its systemic branches, during cardiac catheterization for congenital heart d","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87077","name":"Culture aerobic identify","description":"Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0595U","name":"Nfct ds tfp vctrbrn&zoonotic","description":"Nfct ds tfp vctrbrn&zoonotic","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1990","name":"Chlordiazepoxide injection","description":"Injection, chlordiazepoxide hcl, up to 100 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8006","name":"Grip glove replacement only","description":"Powered, cable driven grip assist glove, hand, finger, includes pressure sensors, glove replacement only","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":815.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2267","name":"Inj, mirikizumab-mrkz, 1 mg","description":"Injection, mirikizumab-mrkz, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0934T","name":"Rem mntr wrls l atr prs snr","description":"Remote monitoring of a wireless left atrial pressure sensor for up to 30 days, including data from daily uploads of left atrial pressure recordings, interpretation(s) and trend analysis, with adjustments to the diuretics plan, treatment paradigm thresholds, medications or lifestyle modifications, wh","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90695","name":"H5n8 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n8, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8611","name":"Oral methotrexate (jylamvo)","description":"Methotrexate (jylamvo), oral, 2.5 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9269","name":"Programable ingest capsule","description":"Programable, transient, orally ingested capsule, for use with external programmer, per month","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4422","name":"Ac wrap per sq cm","description":"A/c wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6609","name":"G compression bandaging","description":"Gradient compression bandaging supply, not otherwise specified","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4031","name":"Radiation oncology ss","description":"Radiation oncology mips specialty set","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0666","name":"Inj, bupivacaine liposome","description":"Injection, bupivacaine liposome, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0183","name":"Software meas of cardiac vol","description":"Quantitative software measurements of cardiac volume, cardiac chambers volumes and left ventricular wall mass derived from ct scan(s) data of the chest/heart (with or without contrast)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97811","name":"Acup 1/> w/o estim ea add 15","description":"Acupuncture, 1 or more needles; without electrical stimulation, each additional 15 minutes of personal one-on-one contact with the patient, with insertion of needle(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":20.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0755T","name":"Dgtz gls mcrscp sld level vi","description":"Digitization of glass microscope slides for level vi, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5155","name":"Inj, aflibercept-jbvf, 1 mg","description":"Injection, aflibercept-jbvf (yesafili), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1419","name":"Pt not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2251","name":"Inj midazolam in 0.9% nacl","description":"Injection, midazolam in 0.9% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1220","name":"Dre wth interp rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; with evidence of retinopathy","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0794T","name":"Pt spec alg rx-onc tx option","description":"Patient-specific, assistive, rules-based algorithm for ranking pharmaco-oncologic treatment options based on the patients tumor-specific cancer marker information obtained from prior molecular pathology, immunohistochemical, or other pathology results which have been previously interpreted and repor","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6614","name":"Onlay cst nbl mtl 2 surfaces","description":"Onlay - cast noble metal two surfaces","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0944T","name":"3d cntr simula trgt lvr les","description":"3d contour simulation of target liver lesion(s) and margin(s) for image-guided percutaneous microwave ablation","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7259","name":"Nerve dissection","description":"Nerve dissection","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4025","name":"Physical medicine ss","description":"Physical medicine mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0754T","name":"Dgtz gls mcrscp sld level v","description":"Digitization of glass microscope slides for level v, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27035","name":"Denervation of hip joint","description":"Denervation, hip joint, intrapelvic or extrapelvic intra-articular branches of sciatic, femoral, or obturator nerves","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1350.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20102","name":"Expl pentrg wnd abd/flnk/bk","description":"Exploration of penetrating wound (separate procedure); abdomen/flank/back","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1201","name":"Med rsn no ace-i/arb rx","description":"Documentation of medical reason(s) for not prescribing ace inhibitor (ace-i) or arb therapy during the measurement period (e.g., pregnancy, history of angioedema to ace-i, other allergy to ace-i and arb, hyperkalemia or history of hyperkalemia while on ace-i or arb therapy, acute kidney injury due t","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1010T","name":"Cptr oph alys monoc eye mvmt","description":"Computerized ophthalmic analysis of monocular eye movements using retinal-based eye-tracking without spatial calibration, including fixation, microsaccades, drift, and horizontal saccades, when performed, unilateral or bilateral, with interpretation and report","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0820T","name":"Mntr psychdlc med 1stphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; first physician or other qualified health care professional, each hour","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0564U","name":"Nfct ds pthgn-sna 10vir&4bct","description":"Nfct ds pthgn-sna 10vir&4bct","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9289","name":"Inj nivolumab 2 mg hyaluron","description":"Injection, nivolumab, 2 mg and hyaluronidase-nvhy","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63032","name":"Lamot rpr anulr dfct 1 lmbr","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; with repair of annular defect by implantation of bone-anchored annular closure device, including all imaging guidance, 1 interspace, lumbar","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0267U","name":"Rare do id opt gen mapg&seq","description":"Rare constitutional and other heritable disorders, identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping and whole-genome sequencing","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4330","name":"Total, per sq cm","description":"Total, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01941","name":"Anes neuromd/ntrvrt crv/thrc","description":"Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0496U","name":"Onc clrct cfdna 8/7 genes","description":"Onc clrct cfdna 8/7 genes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78660","name":"Nuclear exam of tear flow","description":"Radiopharmaceutical dacryocystography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0268","name":"Removal of impacted wax md","description":"Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7171","name":"Inj, adzynma, 10 iu","description":"Injection, adamts13, recombinant-krhn, 10 iu","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88360","name":"Tumor immunohistochem/manual","description":"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; manual","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4024","name":"Pediatrics ss","description":"Pediatrics mips specialty set","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2028","name":"Micromatrix flex per mg","description":"Micromatrix flex, per mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15853","name":"Removal sutr/stapl xreq anes","description":"Removal of sutures or staples not requiring anesthesia (list separately in addition to e/m code)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61736","name":"Litt icr 1 traj 1 smpl les","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; single trajectory for 1 simple lesion","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33884","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":510.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57130","name":"Excision vaginal septum","description":"Excision of vaginal septum","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0328U","name":"Drug assay 120+ rx&metablt","description":"Drug assay 120+ rx&metablt","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0777T","name":"R-t prs sensing edrl gdn sys","description":"Real-time pressure-sensing epidural guidance system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0536U","name":"Rbcag ftl rhd pcr alys exon4","description":"Rbcag ftl rhd pcr alys exon4","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"Evaluation of wheezing","description":"Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0461","name":"Testing for cracked tooth","description":"Testing for cracked tooth","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9323","name":"Inj pemetrexed ditromethamin","description":"Injection, pemetrexed ditromethamine, 10 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4310","name":"Procenta, per 100 mg","description":"Procenta, per 100 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59620","name":"Attempted vbac delivery only","description":"Cesarean delivery only, following attempted vaginal delivery after previous cesarean delivery;","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1011.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0049","name":"Main hemo in-cntr","description":"With maintenance hemodialysis (in-center and home hd) for the complete reporting month","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0980T","name":"Sbmcsl crylys ther tng&tnsl","description":"Submucosal cryolysis therapy; base of tongue and lingual tonsil only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1318","name":"Pts no csp doc contact","description":"Patients who did not have documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening or documentation that there was no contact with a csp","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30300","name":"Remove nasal foreign body","description":"Removal foreign body, intranasal; office type procedure","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":133.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2030","name":"Miro3d fibers, per mg","description":"Miro3d fibers, per milligram","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62290","name":"Njx px discography lumbar","description":"Injection procedure for discography, each level; lumbar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60660","name":"Abltj 1/+thyr ndul 1lobe prq","description":"Ablation of 1 or more thyroid nodule(s), one lobe or the isthmus, percutaneous, including imaging guidance, radiofrequency","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0506U","name":"Gi barretts esophgl cell 89","description":"Gi barretts esophgl cell 89","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4337","name":"Artecent trident, per sq cm","description":"Artacent trident, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1204","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1458","name":"Pt died bef end meas pd","description":"Patient died prior to the end of the performance period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4357","name":"Xwrap plus, per sq cm","description":"Xwrap plus, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2404","name":"Inj, nicardipine 0.1 mg","description":"Injection, nicardipine, 0.1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20937","name":"Sp bone agrft morsel add-on","description":"Autograft for spine surgery only (includes harvesting the graft); morselized (through separate skin or fascial incision) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1343","name":"Pt pam lvl 4 base or srt lin","description":"Patients who are at pam level 4 at baseline or patients who are flagged with extreme straight line response sets on the pam or with excessive missing responses","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9329","name":"Inj, tislelizumab-jsgr","description":"Injection, tislelizumab-jsgr, 1mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9610","name":"Xe129 xenon, diagnostic","description":"Xenon xe-129 hyperpolarized gas, diagnostic, per study dose","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4360","name":"Amchoplast fd per sq cm","description":"Amchoplast fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2054","name":"Lisocabtagene mara car pos t","description":"Lisocabtagene maraleucel, up to 110 million autologous anti-cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1152","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61889","name":"Ins sk-mnt crnl nstm pg/rcvr","description":"Insertion of skull-mounted cranial neurostimulator pulse generator or receiver, including craniectomy or craniotomy, when performed, with direct or inductive coupling, with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4398","name":"Summit ac per sq cm","description":"Summit ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70473","name":"Ct cere prfu aly c+wo ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed without concurrent ct or ct angiography of the same anatomy","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1708","name":"Pfizer vacc admin 3rd dose","description":"Pfizer vacc admin 3rd dose","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0701T","name":"Molec fluor img sus nev ea","description":"Molecular fluorescent imaging of suspicious nevus; each additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87484","name":"Ehrlicha chaffeensis amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); ehrlichia chaffeensis, amplified probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7294","name":"Seg acet and eth estr yearly","description":"Segesterone acetate and ethinyl estradiol 0.15mg, 0.013mg per 24 hours; yearly vaginal system, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0560","name":"Safety plan interven","description":"Safety planning interventions, each 20 minutes personally performed by the billing practitioner, including assisting the patient in the identification of the following personalized elements of a safety plan: recognizing warning signs of an impending suicidal or substance use-related crisis; employin","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0764T","name":"Asstv alg ecg rsk asmt cncrt","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to concurrently performed electrocardiogram (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83898","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96101","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99483","name":"Assmt & care pln pt cog imp","description":"Assessment of and care planning for a patient with cognitive impairment, requiring an independent historian, in the office or other outpatient, home or domiciliary or rest home, with all of the following required elements: cognition-focused evaluation including a pertinent history and examination, m","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":315.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1453","name":"Preop vis acu > 20/40","description":"Patients with a pre-operative visual acuity better than 20/40","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0881T","name":"Cryotherapy oral cavity","description":"Cryotherapy of the oral cavity using temperature regulated fluid cooling system, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0556","name":"Adv prim care mgmt lvl 1","description":"Advanced primary care management services for a patient with one chronic condition [expected to last at least 12 months, or until the death of the patient, which place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline], or fewer, provided by clinical ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0893T","name":"N-invas assmt bld oxygnation","description":"Noninvasive assessment of blood oxygenation, gas exchange efficiency, and cardiorespiratory status, with physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4375","name":"Duograft ac per sq cm","description":"Duograft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6607","name":"G com bandage tub protct lyr","description":"Gradient compression bandaging supply, tubular protective absorption layer, per linear yard, any width, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6634","name":"Onlay titanium","description":"Onlay - titanium","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0845T","name":"Dgtz gls mcrscp imfluor 1st","description":"Digitization of glass microscope slides for immunofluorescence, per specimen; initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0799T","name":"Tcat rmvl 2chmbr ldls pm ra","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right atrial pacemaker component","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5130","name":"Inj, fylnetra, 0.5 mg","description":"Injection, pegfilgrastim-pbbk (fylnetra), biosimilar, 0.5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3404","name":"Inj zopapogene per ther dose","description":"Injection, zopapogene imadenovec-drba suspension, per therapeutic dose","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11000","name":"Dbrdmt ecz/infected skin<10%","description":"Debridement of extensive eczematous or infected skin; up to 10% of body surface","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":56.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47384","name":"Abltj ire liver 1+ tum perq","description":"Ablation, irreversible electroporation, liver, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27278","name":"Arthrd si jt plmt iartic dev","description":"Arthrodesis, sacroiliac joint, percutaneous or minimally invasive, with image guidance, includes obtaining bone graft when performed, unilateral; placement of intra-articular device(s), without cortical piercing","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0538","name":"Ascvd rsk mng clin stf pr mo","description":"Atherosclerotic cardiovascular disease (ascvd) risk management services; clinical staff time; per calendar month","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77436","name":"Surf radj ther tx planning","description":"Surface radiation therapy; superficial or orthovoltage, treatment planning and simulation-aided field setting","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93150","name":"Therapy activation ipnss","description":"Therapy activation of implanted phrenic nerve stimulator system, including all interrogation and programming","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66683","name":"Implantation iris prosthesis","description":"Implantation of iris prosthesis, including suture fixation and repair or removal of iris, when performed","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1494","name":"Fall rep since last visit","description":"Patients that reported a fall since the last visit","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0327U","name":"Ftl aneuploidy trsmy dna seq","description":"Ftl aneuploidy trsmy dna seq","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9612","name":"Inj, fluorescein, 1 mg","description":"Injection, fluorescein, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1378","name":"Med rsn no 10 yr fu colscope","description":"Documentation of medical reason(s) for not recommending a 10 year follow-up interval (e.g., inadequate prep, familial or personal history of colonic polyps, patient had no adenoma and age is >= 66 years old, or life expectancy < 10 years, other medical reasons)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4405","name":"Xwrap fenestra plus sq cm","description":"Xwrap fenestra plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4407","name":"Xwrap tribus per sq cm","description":"Xwrap tribus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1782","name":"Vac admin human pap dose 2","description":"Vac admin human pap dose 2","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6555","name":"G com stcking bk 40+ custm","description":"Gradient compression stocking, below knee, 40 mmhg or greater, custom, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":226.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0764T","name":"Asstv alg ecg rsk asmt cncrt","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to concurrently performed electrocardiogram (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92972","name":"Perq trluml coronry lithotrp","description":"Percutaneous transluminal coronary lithotripsy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0661","name":"Team remote e/m new pt 20 mn","description":"Team remote e/m new pt 20mins","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9048","name":"Inj, bortezomib freseniuskab","description":"Injection, bortezomib (fresenius kabi), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0453U","name":"Onc clrct ca cfdna qpcr asy","description":"Onc clrct ca cfdna qpcr asy","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0604U","name":"All&immunology crae 4bk pep","description":"All&immunology crae 4bk pep","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1271","name":"Pts dem any time/dur mo","description":"Patients with dementia at any time prior to or during the month","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92635","name":"Hearing aid fitg svc ea addl","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; each additional 15 minutes (list separately in addition to code","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1334","name":"Pts act pvd 2 wks 2 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 2 weeks after initial acute pvd encounter","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"Adju cgm supply allowance","description":"Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KF"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1450","name":"Pt hos/pal care dur id/pf pd","description":"Patients who received hospice or palliative care service any time during denominator identification period or the measure assessment period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1176","name":"No 2 hzv 10/2017-meas pd","description":"Patient did not receive two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78807","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4303","name":"Complete aa, per sq cm","description":"Complete aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2050","name":"Financial mgt waiver/diem","description":"Financial management, self-directed, waiver; per diem","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0931T","name":"Ephys eval ccm-d ld separate","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), separate from initial implantation or replacement with testing of cardiac cont","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91322","name":"Sarscov2 vac 50 mcg/0.5ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 50 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0454U","name":"U rare ds id opt genome mapg","description":"U rare ds id opt genome mapg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0851T","name":"Dgtz gls mcrscp mphmtrc 1st","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76856","name":"Us exam pelvic complete","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0864T","name":"Low ntsty eswt corpus cvrnsm","description":"Low-intensity extracorporeal shock wave therapy involving corpus cavernosum, low energy","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6105","name":"Remove implant body","description":"Remove implant body","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4325","name":"Acapatch, per sq cm","description":"Acapatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0559U","name":"Onc brs quan elisa bf9ag srm","description":"Onc brs quan elisa bf9ag srm","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93226","name":"Xtrnl ecg rec<48 hr scan a/r","description":"External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage; scanning analysis with report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81458","name":"So gsap dna cpy nmbr&mcrstl","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis, copy number variants and microsatellite instability","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0426U","name":"Genome ultra-rapid seq alys","description":"Genome ultra-rapid seq alys","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76987","name":"Dx intraop epicar car us chd","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; including placement and manipulation of transducer, image acquisition, interpretation and report","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1952","name":"Leuprolide inj, camcevi, 1mg","description":"Leuprolide injectable, camcevi, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0372U","name":"Nfct ds gu pthgn arg detcj","description":"Nfct ds gu pthgn arg detcj","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0792T","name":"Appl slvr diamn fluoride 38%","description":"Application of silver diamine fluoride 38%, by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74283","name":"Ther nma rdctj intus/obstrcj","description":"Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0855T","name":"Dgtz gls mcrscp b1 marow smr","description":"Digitization of glass microscope slides for bone marrow, smear interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26116","name":"Exc hand tum deep < 1.5 cm","description":"Excision, tumor, soft tissue, or vascular malformation, of hand or finger, subfascial (eg, intramuscular); less than 1.5 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":565.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5127","name":"Inj, stimufend, 0.5 mg","description":"Injection, pegfilgrastim-fpgk (stimufend), biosimilar, 0.5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0360U","name":"Onc lung elisa 7 autoant alg","description":"Onc lung elisa 7 autoant alg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82441","name":"Test for chlorohydrocarbons","description":"Chlorinated hydrocarbons, screen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0463","name":"Inj atropine (fresenius te)","description":"Injection, atropine sulfate (fresenius and therapeutically equivalent), 0.01 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1598","name":"Inj glycopyrrolate fres kabi","description":"Injection, glycopyrrolate (fresenius kabi), not therapeutically equivalent to j1596, 0.1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4340","name":"Simpligraft, per sq cm","description":"Simpligraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0443","name":"Brief alcohol misuse counsel","description":"Brief face-to-face behavioral counseling for alcohol misuse, 15 minutes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":38.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43276","name":"Ercp stent exchange w/dilate","description":"Endoscopic retrograde cholangiopancreatography (ercp); with removal and exchange of stent(s), biliary or pancreatic duct, including pre- and post-dilation and guide wire passage, when performed, including sphincterotomy, when performed, each stent exchanged","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37297","name":"Revsc evasc imvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":96.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85370","name":"Fibrinogen test","description":"Fibrin(ogen) degradation (split) products (fdp) (fsp); quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40820","name":"Treatment of mouth lesion","description":"Destruction of lesion or scar of vestibule of mouth by physical methods (eg, laser, thermal, cryo, chemical)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0569","name":"Subs psych care mng, subs mo","description":"Subsequent psychiatric collaborative care management, in a subsequent month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required elements: tracking ","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9601","name":"Flortaucipir inj 1 millicuri","description":"Flortaucipir f 18 injection, diagnostic, 1 millicurie","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1346","name":"No pam inc 6 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 6 points within a 4 to 12 month period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99426","name":"Prin care mgmt staff 1st 30","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37295","name":"Rvsc evsc tpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77080","name":"Dxa bone density axial","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98978","name":"Rtm dev sply cbt 16-30 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of cognitive behavioral therapy, 16-30 days in a 30-day period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4299","name":"Amniocore pro+, per sq cm","description":"Amniocore pro+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0885T","name":"Colsc flx 1st tndsc dilat","description":"Colonoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0932T","name":"N-invs det hrt fail aug echo","description":"Noninvasive detection of heart failure derived from augmentative analysis of an echocardiogram that demonstrated preserved ejection fraction, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0629U","name":"Nfct ds tb dna aly 1trgt pcr","description":"Nfct ds tb dna aly 1trgt pcr","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0497U","name":"Onc prst8 mrna rt-pcr 6 gene","description":"Onc prst8 mrna rt-pcr 6 gene","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61001","name":"Remove cranial cavity fluid","description":"Subdural tap through fontanelle, or suture, infant, unilateral or bilateral; subsequent taps","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0833T","name":"Dgtz gls mcrscp cytp oth prp","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; preparation, screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99348","name":"Home/res vst est low mdm 30","description":"Home or residence visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1227","name":"Eb therapy prescribed","description":"Evidence-based therapy was prescribed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1334","name":"Pts act pvd 2 wks 2 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 2 weeks after initial acute pvd encounter","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96203","name":"Mlt fam grp bhv train ea add","description":"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face with multiple sets of paren","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0708","name":"Intraoral bite radio image","description":"Intraoral bite radio image","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59426","name":"Antepartum care only","description":"Antepartum care only; 7 or more visits","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1226.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":828.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4437","name":"Revival ac per sq cm","description":"Revival ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5948","name":"Max implt sup fix part","description":"Max implt sup fix part","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0411U","name":"Psyc genom alys pnl 15 gen","description":"Psyc genom alys pnl 15 gen","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5160","name":"Inj, jobevne, 10 mg","description":"Injection, bevacizumab-nwgd (jobevne), biosimilar, 10 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6106","name":"Tissue regen resorbable","description":"Tissue regen resorbable","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33902","name":"Perq p-art revsc 1 abnor uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, unilateral","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0382U","name":"Hyprphenylalninmia mntr quan","description":"Hyprphenylalninmia mntr quan","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0846T","name":"Dgtz gls mcrscp imfluor ea","description":"Digitization of glass microscope slides for immunofluorescence, per specimen; each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1201","name":"Med rsn no ace-i/arb rx","description":"Documentation of medical reason(s) for not prescribing ace inhibitor (ace-i) or arb therapy during the measurement period (e.g., pregnancy, history of angioedema to ace-i, other allergy to ace-i and arb, hyperkalemia or history of hyperkalemia while on ace-i or arb therapy, acute kidney injury due t","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0319U","name":"Neph rna pretrnspl perph bld","description":"Neph rna pretrnspl perph bld","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1001T","name":"Autol musc cell therapy njx","description":"Autologous muscle cell therapy, injection of muscle progenitor cells into the external anal sphincter, including ultrasound guidance, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86352","name":"Cell function assay w/stim","description":"Cellular function assay involving stimulation (eg, mitogen or antigen) and detection of biomarker (eg, atp)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27501","name":"Treatment of thigh fracture","description":"Closed treatment of supracondylar or transcondylar femoral fracture with or without intercondylar extension, without manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5142","name":"Inj adalimumab-ryvk, 1 mg","description":"Injection, adalimumab-ryvk biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9601","name":"Flortaucipir inj 1 millicuri","description":"Flortaucipir f 18 injection, diagnostic, 1 millicurie","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78615","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37275","name":"Rvsc evsc fpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0479U","name":"Tau phosphorylated ptau217","description":"Tau phosphorylated ptau217","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57510","name":"Cauterization of cervix","description":"Cautery of cervix; electro or thermal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":121.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":194.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2545","name":"Pentamidine non-comp unit","description":"Pentamidine isethionate, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per 300 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1380","name":"2 rx in perf pd any com meds","description":"Filled at least two prescriptions during the performance period for any combination of the qualifying oral antipsychotic medications listed under denominator note or the long-acting injectable antipsychotic medications listed under denominator note","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4299","name":"Amniocore pro+, per sq cm","description":"Amniocore pro+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0719T","name":"Pst vrt jt rplcmt lmbr 1 sgm","description":"Posterior vertebral joint replacement, including bilateral facetectomy, laminectomy, and radical discectomy, including imaging guidance, lumbar spine, single segment","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0885T","name":"Colsc flx 1st tndsc dilat","description":"Colonoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60661","name":"Abltj 1/+thyr ndul addl prq","description":"Ablation of 1 or more thyroid nodule(s), additional lobe, percutaneous, including imaging guidance, radiofrequency (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0322U","name":"Neuro asd meas 14 acyl carn","description":"Neuro asd meas 14 acyl carn","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87471","name":"Bartonella dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); bartonella henselae and bartonella quintana, amplified probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59410","name":"Obstetrical care","description":"Vaginal delivery only (with or without episiotomy and/or forceps); including postpartum care","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1148.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25145","name":"Remove forearm bone lesion","description":"Sequestrectomy (eg, for osteomyelitis or bone abscess), forearm and/or wrist","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89130","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6105","name":"Remove implant body","description":"Remove implant body","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0824T","name":"Tcat rmv 1chmbr ldls pm ra","description":"Transcatheter removal of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography), when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7353","name":"Anacaulase-bcdb 8.8% gel 1 g","description":"Anacaulase-bcdb, 8.8% gel, 1 gram","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1332","name":"Pts no eval ini xm no 2 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 2 weeks","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3473","name":"Surg rep root res molar","description":"Surg rep root res molar","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1326","name":"Inj, zolbetuximab-clzb, 2 mg","description":"Injection, zolbetuximab-clzb, 2 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0316U","name":"B brgdrferi lyme ds ospa evl","description":"B brgdrferi lyme ds ospa evl","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80178","name":"Assay of lithium","description":"Lithium","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4271","name":"Complete ft per sq cm","description":"Complete ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0708","name":"Intraoral bite radio image","description":"Intraoral bite radio image","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1297","name":"Bmi not doc medrsn ptref","description":"Bmi not documented due to medical reason or patient refusal of height or weight measurement","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69310","name":"Rebuild outer ear canal","description":"Reconstruction of external auditory canal (meatoplasty) (eg, for stenosis due to injury, infection) (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1271.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6604","name":"Cst bse mtl inlay 2 surfaces","description":"Inlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0857T","name":"Opto-acoustic img breast uni","description":"Opto-acoustic imaging, breast, unilateral, including axilla when performed, real-time with image documentation, augmentative analysis and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1214","name":"Spiro results wth obs doc","description":"Spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and reviewed","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1413","name":"Pos pdl1 bef init ici tx","description":"Patients who had a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0758T","name":"Dgtz gls mcrscp sl spc hchem","description":"Digitization of glass microscope slides for special stain, including interpretation and report, histochemical stain on frozen tissue block (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1240","name":"Pt no resp best int","description":"Patient did not respond to the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0777T","name":"R-t prs sensing edrl gdn sys","description":"Real-time pressure-sensing epidural guidance system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99470","name":"Rpm tx mgmt 1st 10 min","description":"Remote physiologic monitoring treatment management services, clinical staff/physician/other qualified health care professional time in a calendar month requiring 1 real-time interactive communication with the patient/caregiver during the calendar month; first 10 minutes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0551","name":"Phn/intr svs fr dx treat 30m","description":"Interprofessional telephone/internet/electronic health record referral service(s) provided by a treating/requesting practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, 30 minutes","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33910","name":"Remove lung artery emboli","description":"Pulmonary artery embolectomy; with cardiopulmonary bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1779.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0578","name":"Inj brixadi, more than 7 day","description":"Injection, buprenorphine extended release (brixadi), greater than 7 days and up to 28 days of therapy","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0760T","name":"Dgtz gls mcrscp sl imm 1st","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9612","name":"Thera par drugs 2 or > admin","description":"Therapeutic parenteral drugs two or more administrations different medications","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1376","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15792","name":"Chem peel nonfacial epidrm","description":"Chemical peel, nonfacial; epidermal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7284","name":"Exc biopsy of saliv glands","description":"Exc biopsy of saliv glands","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6584","name":"Grad com wrap w straps","description":"Gradient compression wrap with adjustable straps, not otherwise specified","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1402","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5150","name":"Inj, aflibercept-mrbb, 1 mg","description":"Injection, aflibercept-mrbb (ahzantive), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76984","name":"Dx intraop thoracic aorta us","description":"Ultrasound, intraoperative thoracic aorta (eg, epiaortic), diagnostic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93574","name":"Njx cath slct pulm vn angrph","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary venous angiography of each distinct pulmonary vein during cardiac catheterization (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85610","name":"Prothrombin time","description":"Prothrombin time;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63052","name":"Lam facetc/frmt arthrd lum 1","description":"Laminectomy, facetectomy, or foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s] [eg, spinal or lateral recess stenosis]), during posterior interbody arthrodesis, lumbar; single vertebral segment (list separately in addition to code for primary ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4289","name":"Revoshield+ amnio, per sq cm","description":"Revoshield + amniotic barrier, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2356","name":"Inj tezepelumab-ekko, 1mg","description":"Injection, tezepelumab-ekko, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0855T","name":"Dgtz gls mcrscp b1 marow smr","description":"Digitization of glass microscope slides for bone marrow, smear interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36810","name":"Insertion of cannula","description":"Insertion of cannula for hemodialysis, other purpose (separate procedure); arteriovenous, external (scribner type)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1173","name":"Pt no rec td/tdap 9yrs prior","description":"Patient did not receive at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1159","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1397","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64567","name":"Perq elec nrv field stimj cn","description":"Percutaneous electrical nerve field stimulation, cranial nerves, without implantation","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0429U","name":"Hpv orop swab 14 hi-risk typ","description":"Hpv orop swab 14 hi-risk typ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1303","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4369","name":"Amnioplast 3 per sq cm","description":"Amnioplast 3, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0744T","name":"Insj bioprostc vlv fem vn","description":"Insertion of bioprosthetic valve, open, femoral vein, including duplex ultrasound imaging guidance, when performed, including autogenous or nonautogenous patch graft (eg, polyester, eptfe, bovine pericardium), when performed","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17004","name":"Destroy premal lesions 15/>","description":"Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (eg, actinic keratoses), 15 or more lesions","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":80.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":95.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6072","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (high noble metal)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0814T","name":"Prq njx biod osteo matrl fem","description":"Percutaneous injection of calcium-based biodegradable osteoconductive material, proximal femur, including imaging guidance, unilateral","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0558U","name":"Onc clrct elisa bf7 ag serum","description":"Onc clrct elisa bf7 ag serum","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0388U","name":"Onc nonsm cll lng ca 37 gen","description":"Onc nonsm cll lng ca 37 gen","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0567","name":"Screening hep c detect","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis c, screening, amplified probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1265","name":"Cms 2728 completed","description":"Cms medical evidence form 2728 for dialysis patients: initial form completed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0410U","name":"Onc pncrtc dna whl gn seq 5-","description":"Onc pncrtc dna whl gn seq 5-","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1211","name":"Gsa level>9.0%","description":"Most recent glycemic status assessment (hba1c or gmi) level > 9.0%","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86822","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85032","name":"Manual cell count each","description":"Blood count; manual cell count (erythrocyte, leukocyte, or platelet) each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0146","name":"Nav srv peer sup add 30 pr m","description":"Principal illness navigation - peer support, additional 30 minutes per calendar month (list separately in addition to g0140)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0341U","name":"Ftl aneup dna seq cmpr alys","description":"Ftl aneup dna seq cmpr alys","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2312","name":"Inj naloxone hcl nos, 0.01mg","description":"Injection, naloxone hydrochloride, not otherwise specified, 0.01 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9323","name":"Inj pemetrexed ditromethamin","description":"Injection, pemetrexed ditromethamine, 10 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42961","name":"Control throat bleeding","description":"Control oropharyngeal hemorrhage, primary or secondary (eg, post-tonsillectomy); complicated, requiring hospitalization","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":493.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35450","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":658.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6601","name":"Porc/ceram inlay >= 3 surfac","description":"Inlay - porcelain/ceramic three or more surfaces","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43291","name":"Egd flx trnsorl rmvl balo","description":"Esophagogastroduodenoscopy, flexible, transoral; with removal of intragastric bariatric balloon(s)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1413","name":"Inj delandistrogene mox rokl","description":"Injection, delandistrogene moxeparvovec-rokl, per therapeutic dose","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12001","name":"Rpr s/n/ax/gen/trnk 2.5cm/<","description":"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 2.5 cm or less","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":47.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":53.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0433U","name":"Onc prst8 5 dna reg mrk pcr","description":"Onc prst8 5 dna reg mrk pcr","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60660","name":"Abltj 1/+thyr ndul 1lobe prq","description":"Ablation of 1 or more thyroid nodule(s), one lobe or the isthmus, percutaneous, including imaging guidance, radiofrequency","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94013","name":"Meas lung vol thru 2 yrs","description":"Measurement of lung volumes (ie, functional residual capacity [frc], forced vital capacity [fvc], and expiratory reserve volume [erv]) in an infant or child through 2 years of age","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4023","name":"Pathology ss","description":"Pathology mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0985T","name":"Iv img xtrc cere vsl oct ea","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38225","name":"Car-t hrv bld-drv t lymphcyt","description":"Chimeric antigen receptor t-cell (car-t) therapy; harvesting of blood-derived t lymphocytes for development of genetically modified autologous car-t cells, per day","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5146","name":"Inj, hercessi, 10 mg","description":"Injection, trastuzumab-strf (hercessi), biosimilar, 10 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59820","name":"Care of miscarriage","description":"Treatment of missed abortion, completed surgically; first trimester","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":382.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1397","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0886T","name":"Sgmdsc flx 1st tndsc dilat","description":"Sigmoidoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9615","name":"Inj, pegulicianine, 1 mg","description":"Injection, pegulicianine, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0751T","name":"Dgtz gls mcrscp sld level ii","description":"Digitization of glass microscope slides for level ii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99212","name":"Office o/p est sf 10 min","description":"Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 10 minutes must be met o","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":30.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9298","name":"Inj nivol relatlimab 3mg/1mg","description":"Injection, nivolumab and relatlimab-rmbw, 3 mg/1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1182","name":"Not elg pre ex ibd/uc/crohn","description":"Patients not eligible due to pre-existing inflammatory bowel disease (ibd) (e.g., ulcerative colitis, crohns disease)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46600","name":"Diagnostic anoscopy spx","description":"Anoscopy; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":17.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":47.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0521","name":"Supply fee hiv prep fda appr","description":"Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1553","name":"Inj yimmugo 100 mg","description":"Injection, immune globulin (yimmugo), 100 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9615","name":"Inj, pegulicianine, 1 mg","description":"Injection, pegulicianine, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93261","name":"Interrogate subq defib","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; implantable subcutaneous lead defibrillator system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5161","name":"Inj, denosumab-kyqq, 1 mg","description":"Injection, denosumab-kyqq (aukelso/bosaya), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6071","name":"Abutment supported retainer","description":"Abutment supported retainer for porcelain fused to metal fpd (noble metal)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24579","name":"Optx humrl cndylr fracture","description":"Open treatment of humeral condylar fracture, medial or lateral, includes internal fixation, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1022.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5146","name":"Inj, hercessi, 10 mg","description":"Injection, trastuzumab-strf (hercessi), biosimilar, 10 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1941","name":"Inj, furoscix, 20 mg","description":"Injection, furosemide (furoscix), 20 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0237","name":"Intrav inf, toci, first dose","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0269U","name":"Hem aut dm cgen trmbctpna 14","description":"Hematology (autosomal dominant congenital thrombocytopenia), genomic sequence analysis of 14 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0440U","name":"Crd chd dna alys 10 snp 6dna","description":"Crd chd dna alys 10 snp 6dna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9888","name":"5% wl maintnd from bsline wt","description":"Maintenance 5% wl from baseline weight in months 7-12","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7471","name":"Rem exostosis any site","description":"Removal of lateral exostosis (maxilla or mandible)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1206","name":"Isa not red 3pts/no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1366","name":"Focus on womens health mvp","description":"Focusing on womens health mips value pathway","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1321","name":"Pts no 7wk inj,no iop,iop>25","description":"Patients who were not seen within 7 weeks following the date of injection for follow up or who did not have a documented iop or no plan of care documented if the iop was >25 mm hg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4224","name":"Hhf10-p per sq cm","description":"Human health factor 10 amniotic patch (hhf10-p), per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1363","name":"Pts no f/u 120 dys","description":"Patients who did not have a follow-up assessment within 120 days of the index assessment","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0789T","name":"Elec aly cpx iins sp/sac nrv","description":"Electronic analysis with complex programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detect","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3379","name":"Inj, valproate sod, 5 mg","description":"Injection, valproate sodium, 5 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0211","name":"Inj, nithiodote, 3mg / 125mg","description":"Injection, sodium nitrite 3 mg and sodium thiosulfate 125 mg (nithiodote)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91125","name":"Anrct mano rct snsatn&balo","description":"Anorectal manometry, with rectal sensation and rectal balloon expulsion test, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0360","name":"Hydralazine hcl injection","description":"Injection, hydralazine hcl, up to 20 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4346","name":"Shelter dm matrix per sq cm","description":"Shelter dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93882","name":"Extracranial uni/ltd study","description":"Duplex scan of extracranial arteries; unilateral or limited study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1203","name":"No rsn ace-i/arb rx","description":"Ace inhibitor or arb therapy not prescribed during the measurement period, reason not given","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43291","name":"Egd flx trnsorl rmvl balo","description":"Esophagogastroduodenoscopy, flexible, transoral; with removal of intragastric bariatric balloon(s)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1271","name":"Pts dem any time/dur mo","description":"Patients with dementia at any time prior to or during the month","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87339","name":"H pylori ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; helicobacter pylori","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37295","name":"Rvsc evsc tpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1353","name":"Pts no cmplt suicd saf pln","description":"Patients who did not have a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4420","name":"Nuform per sq cm","description":"Nuform, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9021","name":"Inj, aspara, rylaze, 0.1 mg","description":"Injection, asparaginase, recombinant, (rylaze), 0.1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0036","name":"Pt/ptn decln assess","description":"Patient or care partner decline assessment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0788T","name":"Elec aly smp iins sp/sac nrv","description":"Electronic analysis with simple programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detecti","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1448","name":"Injection, trilaciclib, 1mg","description":"Injection, trilaciclib, 1mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57454","name":"Bx/curett of cervix w/scope","description":"Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix and endocervical curettage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":140.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":196.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1596","name":"Inj, glycopyrrolate, 0.1 mg","description":"Injection, glycopyrrolate, 0.1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0681","name":"App of non-sheet skin sub","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; first 25 sq cm or less of wound surface area","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0261U","name":"Onc clrct ca img alys w/ai","description":"Oncology (colorectal cancer), image analysis with artificial intelligence assessment of 4 histologic and immunohistochemical features (cd3 and cd8 within tumor-stroma border and tumor core), tissue, reported as immune response and recurrence-risk score","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9913","name":"Admin of neuromod","description":"Admin of neuromod","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69210","name":"Remove impacted ear wax uni","description":"Removal impacted cerumen requiring instrumentation, unilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2253","name":"Inj midazolam (seizalam)","description":"Injection, midazolam (seizalam), 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8611","name":"Oral methotrexate (jylamvo)","description":"Methotrexate (jylamvo), oral, 2.5 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J1945","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53510","name":"Repair of urethra injury","description":"Urethrorrhaphy, suture of urethral wound or injury; perineal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6031","name":"Rep interface handfng molded","description":"Replacement socket/interface, partial hand including fingers, molded to patient model, for use with or without external power","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59414","name":"Deliver placenta","description":"Delivery of placenta (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"RenderingTaxonomy","value":["207V00000X","207VB0002X","207VE0102X","207VF0040X","207VG0400X","207VM0101X","207VX0000X","207VX0201X","363LX0001X"]},{"name":"Company Code","value":["01","20","42"]},{"name":"ClaimSpecialtyCode","value":["904","905","907","AMGY","APNOB","COLP","FPEM","GYNE","GYON","GYSU","MAFE","NPAG","NPGY","NPOB","OBEM","OBGY","OBHR","OBST","REND","URGY"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1733.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4358","name":"Xwrap dual, per sq cm","description":"Xwrap dual, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4419","name":"Biolab wrap flw lt per sq cm","description":"Biolab membrane wrap lite flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1227","name":"Eb therapy prescribed","description":"Evidence-based therapy was prescribed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4427","name":"Dermbnd dln dl+ dlx sq cm","description":"Dermabind dl n or dermabind dl + or dermabind dl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1022T","name":"Prq tis dsplmt ntra-abdl/pel","description":"Percutaneous tissue displacement, any method, including imaging guidance; intra-abdominal/pelvic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57510","name":"Cauterization of cervix","description":"Cautery of cervix; electro or thermal","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":117.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76080","name":"X-ray exam of fistula","description":"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98016","name":"Brief comunicaj tech-bsd svc","description":"Brief communication technology-based service (eg, virtual check-in) by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related evaluation and management service provided within the p","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2017","name":"Permeaderm glove, each","description":"Permeaderm glove, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9024","name":"Inj atezolizumb 5mg hya-tqjs","description":"Injection, atezolizumab, 5 mg and hyaluronidase-tqjs","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90791","name":"Psych diagnostic evaluation","description":"Psychiatric diagnostic evaluation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":60.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":147.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7961","name":"Buccal/labial frenectomy","description":"Buccal/labial frenectomy","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0460U","name":"Onc whl bld/bucc rtpcr 24gen","description":"Onc whl bld/bucc rtpcr 24gen","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0497U","name":"Onc prst8 mrna rt-pcr 6 gene","description":"Onc prst8 mrna rt-pcr 6 gene","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1244","name":"Pt othr thn true best int","description":"Patient provided a response other than completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98978","name":"Rtm dev sply cbt 16-30 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of cognitive behavioral therapy, 16-30 days in a 30-day period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4421","name":"Biolab wrap solo per sq cm","description":"Biolab membrane wrap solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0510U","name":"Onc pncrtc ca alg alys 16gen","description":"Onc pncrtc ca alg alys 16gen","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34713","name":"Perq access & clsr fem art","description":"Percutaneous access and closure of femoral artery for delivery of endograft through a large sheath (12 french or larger), including ultrasound guidance, when performed, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1495","name":"Fall w/ poc, no fall","description":"Patients that reported a fall occurred who had a plan of care for falls documented or patients that did not report a fall","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99375","name":"Home health care supervision","description":"Supervision of a patient under care of home health agency (patient not present) in home, domiciliary or equivalent environment (eg, alzheimers facility) requiring complex and multidisciplinary care modalities involving regular development and/or revision of care plans by that individual, review of s","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":113.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64654","name":"1st opn implt bat modulj sys","description":"Initial open implantation of baroreflex activation therapy (bat) modulation system, including lead placement onto the carotid sinus, lead tunnelling, connection to a pulse generator placed in a distant subcutaneous pocket (ie, total system), and intraoperative interrogation and programming","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80200","name":"Assay of tobramycin","description":"Tobramycin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37260","name":"Revsc evasc ivt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0017","name":"Crisis psychotherapy 60m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); first 60 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0530U","name":"Onc pan-sol tum ctdna 77 gen","description":"Onc pan-sol tum ctdna 77 gen","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1283","name":"Pt scrn tbco and id as user","description":"Patient screened for tobacco use and identified as a tobacco user","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0371","name":"Sialoendoscopy capt & interp","description":"Sialoendoscopy capt & interp","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0273U","name":"Hem gen hyprfibrnlysis 8 gen","description":"Hematology (genetic hyperfibrinolysis, delayed bleeding), genomic sequence analysis of 8 genes (f13a1, f13b, fga, fgb, fgg, serpina1, serpine1, serpinf2, plau) blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1464","name":"No record of f/u by 180 days","description":"No documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55709","name":"Bx prst8 tprnl us guided","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92972","name":"Perq trluml coronry lithotrp","description":"Percutaneous transluminal coronary lithotripsy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6180","name":"Implnt maint proced","description":"Implnt maint proced","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5932","name":"Postsurgical obturator","description":"Obturator prosthesis definitive","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31243","name":"Nsl/sinus ndsc cryoabltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by cryoablation, posterior nasal nerve","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63301","name":"Remove vert xdrl body thrc","description":"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, thoracic by transthoracic approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2184.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5944","name":"Max implt sup remv part","description":"Max implt sup remv part","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97007","name":"Mchnl sclp cool meas fitg","description":"Mechanical scalp cooling, including individual cap supply with head measurement, fitting, and patient education","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1296","name":"Calc bmi norm parameters","description":"Bmi is documented within normal parameters and no follow-up plan is required","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4304","name":"Grafix plus, per sq cm","description":"Grafix plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27259","name":"Treat hip dislocation","description":"Open treatment of spontaneous hip dislocation (developmental, including congenital or pathological), replacement of femoral head in acetabulum (including tenotomy, etc); with femoral shaft shortening","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1792.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25020","name":"Decompress forearm 1 space","description":"Decompression fasciotomy, forearm and/or wrist, flexor or extensor compartment; without debridement of nonviable muscle and/or nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":759.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0757T","name":"Dgtz gls mcrscp sl spc grpii","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group ii, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistochemistry (list separately in addition to code for primary","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4026","name":"Phys/occ therapy ss","description":"Physical therapy/occupational therapy mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0905T","name":"Ecg alg 12 ld rdcd i&r only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; interpretation and report only","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0877T","name":"Augmnt alys ch ct ild w/o ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53451","name":"Tprnl balo cntnc dev bi","description":"Periurethral transperineal adjustable balloon continence device; bilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0836T","name":"Dgtz gls mcrscp fna ea addl","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0521","name":"New pt-cg dyad dem hig cmplx","description":"Management of new patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6634","name":"Onlay titanium","description":"Onlay - titanium","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4252","name":"Vendaje, per square centimet","description":"Vendaje, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6612","name":"Onlay cst base mtl 2 surface","description":"Onlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1493","name":"No fall doc med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1163","name":"Pt anphx due to hpv bef 13","description":"Patient had anaphylaxis due to the hpv vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0553U","name":"Repr med pga embry te strux","description":"Repr med pga embry te strux","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4361","name":"Epixpress, per sq cm","description":"Epixpress, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0719T","name":"Pst vrt jt rplcmt lmbr 1 sgm","description":"Posterior vertebral joint replacement, including bilateral facetectomy, laminectomy, and radical discectomy, including imaging guidance, lumbar spine, single segment","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0284U","name":"Vw factor type 2n eval plsm","description":"Von willebrand factor (vwd), type 2n, factor viii and vwf binding evaluation, enzyme-linked immunosorbent assays (elisa), plasma","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1160","name":"Pt anphx due to mengb bef 13","description":"Patient had anaphylaxis due to the meningococcal vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S0190","name":"Mifepristone, oral, 200 mg","description":"Mifepristone, oral, 200 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4387","name":"Neothelium ft per sq cm","description":"Neothelium ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0616U","name":"Neurol dementia alys >30000","description":"Neurol dementia alys >30000","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87182","name":"Sc std carbapenemase nzm det","description":"Susceptibility studies, antimicrobial agent; carbapenemase enzyme detection (eg, klebsiella pneumoniae carbapenemase [kpc], new delhi metallo-beta-lactamase [ndm], verona integron-encoded metallo-beta-lactamase [vim]), multiplex immunoassay, qualitative, per isolate","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27536","name":"Treat knee fracture","description":"Open treatment of tibial fracture, proximal (plateau); bicondylar, with or without internal fixation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1366.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0654","name":"Inj, liothyronine, 1 mcg","description":"Injection, liothyronine, 1 mcg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82953","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0822T","name":"Mntr psychdlc med cln staff","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; clinical staff under the direction of a physician or other qualified health care professional, concurrent with first physician or other qualified health care p","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0524","name":"Est pt-cg dyad dem low cmplx","description":"Management of established patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4350","name":"Palisade dm matrix per sq cm","description":"Palisade dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3472","name":"Surg rep root res premolar","description":"Surg rep root res premolar","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0523U","name":"Onc soltum dna ngs snv 22gen","description":"Onc soltum dna ngs snv 22gen","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6518","name":"Grad com wrap w strap arm cu","description":"Gradient compression wrap with adjustable straps, arm, each, custom","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3421","name":"Root surgery bicuspid","description":"Apicoectomy/periradicular surgery-bicuspid (first root)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0624U","name":"Hep nash dna mthyl alys 5000","description":"Hep nash dna mthyl alys 5000","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0750T","name":"B1 str&fx rsk asmt dxrbmd1vw","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77776","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":374.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0620U","name":"Onc hcc dna mthyln alys>5000","description":"Onc hcc dna mthyln alys>5000","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1611","name":"Inj glucagon hcl, fresenius","description":"Injection, glucagon hydrochloride (fresenius kabi), not therapeutically equivalent to j1610, per 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"Limited visual field xm","description":"Visual field examination, unilateral or bilateral, with interpretation and report; limited examination (eg, tangent screen, autoplot, arc perimeter, or single stimulus level automated test, such as octopus 3 or 7 equivalent)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3403","name":"Revakinagene, per implant","description":"Revakinagene taroretcel-lwey, per implant","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36571","name":"Insert picvad cath","description":"Insertion of peripherally inserted central venous access device, with subcutaneous port; age 5 years or older","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9322","name":"Inj pemetrexed (bluepoint)","description":"Injection, pemetrexed (bluepoint), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99401","name":"Prev med cnsl indiv apprx 15","description":"Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 15 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":12.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":45.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27176","name":"Treat slipped epiphysis","description":"Treatment of slipped femoral epiphysis; by single or multiple pinning, in situ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1064.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0661","name":"Team remote e/m new pt 20 mn","description":"Team remote e/m new pt 20mins","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0987T","name":"Iv img icr cere vsl oct ea","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1383","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q4079","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J9291","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1360","name":"Suicd c-ssrs assessment","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4348","name":"Sentry sl matrix per sq cm","description":"Sentry sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6196","name":"Remv of ind rest on implt","description":"Remv of ind rest on implt","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0951T","name":"Tot impl amei 1st plmt","description":"Totally implantable active middle ear hearing implant; initial placement, including mastoidectomy, placement of and attachment to sound processor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0981T","name":"Tcat impl wrls ivc snr","description":"Transcatheter implantation of wireless inferior vena cava sensor for long-term hemodynamic monitoring, including deployment of the sensor, radiological supervision and interpretation, right heart catheterization, and inferior vena cava venography, when performed","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64581","name":"Opn impltj nea sacral nerve","description":"Open implantation of neurostimulator electrode array; sacral nerve (transforaminal placement)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":870.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0548","name":"Phone/inter svs 21-30 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99315","name":"Nf dschrg mgmt 30 min/less","description":"Nursing facility discharge management; 30 minutes or less total time on the date of the encounter","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":81.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1167","name":"Hspc dur meas pd","description":"In hospice or using hospice services during the measurement period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0423","name":"Genetic test spec analysis","description":"Genetic test spec analysis","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26060","name":"Incision of finger tendon","description":"Tenotomy, percutaneous, single, each digit","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2427","name":"Inj, invega hafyera/trinza","description":"Injection, paliperidone palmitate extended release (invega hafyera, or invega trinza), 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01939","name":"Anes nulyt agt crv/thrc","description":"Anesthesia for percutaneous image-guided destruction procedures by neurolytic agent on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99336","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1446","name":"Pt died bef end meas pd","description":"Patients who died any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6036","name":"Prosthetic thumb mechanical","description":"Prosthetic thumb, mechanical, can include metacarpophalangeal (mcp), interphalangeal (ip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0235","name":"Intrav inf, mon anti, fir do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2041","name":"Foundation drs+ duo pr sq cm","description":"Foundation drs+ duo, per square centimeter","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0138","name":"Iv cipaglucosidase alfa-atga","description":"Intravenous infusion of cipaglucosidase alfa-atga, including provider/supplier acquisition and clinical supervision of oral administration of miglustat in preparation of receipt of cipaglucosidase alfa-atga","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1255","name":"Pts w/ othr rsn vst,+prg tst","description":"Patients who have another reason for visiting the clinic [not prenatal or postpartum care] and have a positive pregnancy test but have not established the clinic as an ob provider (e.g., plan to terminate the pregnancy or seek prenatal services elsewhere)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1365","name":"Hosp+pall care spec code 17","description":"Patient encounter during the performance period with hospice and palliative care specialty code 17","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0481","name":"Electron microscopy diagnost","description":"Electron microscopy - diagnostic","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85018","name":"Hemoglobin","description":"Blood count; hemoglobin (hgb)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0718T","name":"Adrc ther prtl rc tear njx","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; injection into supraspinatus tendon including ultrasound guidance, unilateral","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1425","name":"Surgical care mvp","description":"Surgical care mips value pathway","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7192","name":"Factor viii recombinant nos","description":"Factor viii (antihemophilic factor, recombinant) per i.u., not otherwise specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87190","name":"Sc std myobacteria prop meth","description":"Susceptibility studies, antimicrobial agent; mycobacteria, proportion method, each agent","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0959T","name":"Rmv/rplc magnet coil assem","description":"Removal or replacement of magnet from coil assembly that is connected to continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33278","name":"Rmvl phrnc nrv stim sys","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; system, including pulse generator and lead(s)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33509","name":"Ndsc hrv uxtr art 1 sgm cab","description":"Harvest of upper extremity artery, 1 segment, for coronary artery bypass procedure, endoscopic","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86021","name":"Wbc antibody identification","description":"Antibody identification; leukocyte antibodies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99489","name":"Cplx chrnc care ea addl 30","description":"Complex chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":84.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9245","name":"Admin mod sedation-enteral","description":"Admin mod sedation-enteral","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0600U","name":"Nfct ds wnd infctj 65orgs&30","description":"Nfct ds wnd infctj 65orgs&30","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81456","name":"So/hl 51/>gsap rna alys","description":"Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic sequence analysis panel, interrogation for sequence variants and copy number variants or rearrangements, or isoform expression or mrna expression levels, if performed; rna analysis","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4005","name":"Family medicine ss","description":"Family medicine mips specialty set","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93980","name":"Penile vascular study","description":"Duplex scan of arterial inflow and venous outflow of penile vessels; complete study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0771T","name":"Vr px dissoc svc sm phy 1st","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4313","name":"Dermabind fm, per sq cm","description":"Dermabind fm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1339","name":"Pts f/u 30-180 dys + improv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who demonstrated positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0904T","name":"Ecg alg 12 ld rdcd trcg only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; tracing only","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4414","name":"Simplichor per sq cm","description":"Simplichor, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1574","name":"Inj, ganciclovir (exela)","description":"Injection, ganciclovir sodium (exela), not therapeutically equivalent to j1570, 500 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0507U","name":"Onc ovr dna whole gen w/5hmc","description":"Onc ovr dna whole gen w/5hmc","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0440U","name":"Crd chd dna alys 10 snp 6dna","description":"Crd chd dna alys 10 snp 6dna","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53866","name":"Cathj rmvl dev ischmc rmdlg","description":"Catheterization with removal of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1409","name":"Recd gmln brca1/brca2 couns","description":"Patients who received germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86318","name":"Ia infectious agent antibody","description":"Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0762T","name":"Dgtz gls mcrscp sl imm ea m","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, each multiplex antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0531U","name":"Nfct ds afb&inv fng 673orgs","description":"Nfct ds afb&inv fng 673orgs","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0305U","name":"Hem rbc fnclty&dfrm shr strs","description":"Hem rbc fnclty&dfrm shr strs","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4491.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4001","name":"Diagnostic rad ss","description":"Diagnostic radiology mips specialty set","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0288","name":"Recon, cta for surg plan","description":"Reconstruction, computed tomographic angiography of aorta for surgical planning for vascular surgery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23462","name":"Repair shoulder capsule","description":"Capsulorrhaphy, anterior, any type; with coracoid process transfer","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1303.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4002","name":"Ep cardio ss","description":"Electrophysiology cardiac specialist mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0595U","name":"Nfct ds tfp vctrbrn&zoonotic","description":"Nfct ds tfp vctrbrn&zoonotic","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0013","name":"Hiv prep counsel, clin staff","description":"Individual counseling for pre-exposure prophylaxis (prep) by clinical staff to prevent human immunodeficiency virus (hiv), includes: hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27347","name":"Remove knee cyst","description":"Excision of lesion of meniscus or capsule (eg, cyst, ganglion), knee","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":557.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0348U","name":"Rx metab/pcx dna 25 gen alys","description":"Rx metab/pcx dna 25 gen alys","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88321","name":"Consltj&reprt sld prep elswr","description":"Consultation and report on referred slides prepared elsewhere","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0903T","name":"Ecg alg 12 lead reduced i&r","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; with interpretation and report","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33902","name":"Perq p-art revsc 1 abnor uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, unilateral","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99426","name":"Prin care mgmt staff 1st 30","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27603","name":"Drain lower leg lesion","description":"Incision and drainage, leg or ankle; deep abscess or hematoma","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6605","name":"G com bandage padded foam","description":"Gradient compression bandaging supply, padded foam, per linear yard, any width, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0038","name":"Clin pt no ref","description":"Clinician determines patient does not require referral","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61566","name":"Removal of brain tissue","description":"Craniotomy with elevation of bone flap; for selective amygdalohippocampectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2552.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0612","name":"Inj, calcium gluconate, nos","description":"Injection, calcium gluconate, not otherwise specified, 10 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4341","name":"Simplimax, per sq cm","description":"Simplimax, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1403","name":"Bslne and fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83529","name":"Asay of interleukin-6 (il-6)","description":"Interleukin-6 (il-6)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99392","name":"Prev visit est age 1-4","description":"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; early","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":123.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1440","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6561","name":"G stockng full/chap 40+ cust","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, custom, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27538","name":"Treat knee fracture(s)","description":"Closed treatment of intercondylar spine(s) and/or tuberosity fracture(s) of knee, with or without manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0494U","name":"Rbc ag ftl rhd gene alys ngs","description":"Rbc ag ftl rhd gene alys ngs","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81457","name":"So neo gsap dna mcrstl ins","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis, microsatellite instability","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0503U","name":"Neuro alz ds bamyl&tau prtn","description":"Neuro alz ds bamyl&tau prtn","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10120","name":"Inc&rmvl fb subq tiss smpl","description":"Incision and removal of foreign body, subcutaneous tissues; simple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":119.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":43.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7509","name":"Marsupialization odon cyst","description":"Marsupialization odon cyst","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1469","name":"Hx of hep b, or pos bld test","description":"Patient has a history of hepatitis b illness or received a hepatitis b surface antigen, hepatitis b surface antibody, or total antibody to hepatitis b core antigen test with a positive result any time before or during the measurement period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53210","name":"Removal of urethra","description":"Urethrectomy, total, including cystostomy; female","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":846.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83013","name":"H pylori (c-13) breath","description":"Helicobacter pylori; breath test analysis for urease activity, non-radioactive isotope (eg, c-13)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0658","name":"Seg pneum comp 2 arm chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1791.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0184","name":"Inj, amisulpride, 1 mg","description":"Injection, amisulpride, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1329","name":"Pts act pvd 2 wks 8 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 8 weeks after initial acute pvd encounter","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99349","name":"Home/res vst est mod mdm 40","description":"Home or residence visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 40 minutes must be met or excee","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4299","name":"Amniocore pro+, per sq cm","description":"Amniocore pro+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0664","name":"Team remote e/m new pt 60 mn","description":"Team remote e/m new pt 60mins","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0725T","name":"Vestibular dev impltj uni","description":"Vestibular device implantation, unilateral","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0842T","name":"Dgtz gls mcrscp pth cslt ea","description":"Digitization of glass microscope slides for pathology consultation during surgery; each additional tissue block with frozen section(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4543","name":"Supply trans elec nerve stim","description":"Supplies for transcutaneous electrical nerve stimulator, for nerves in the auricular region, per month","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36836","name":"Prq av fstl crtj uxtr 1 acs","description":"Percutaneous arteriovenous fistula creation, upper extremity, single access of both the peripheral artery and peripheral vein, including fistula maturation procedures (eg, transluminal balloon angioplasty, coil embolization) when performed, including all vascular access, imaging guidance and radiolo","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0675","name":"Inj, carboprost, 0.1 mg","description":"Injection, carboprost tromethamine, 0.1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1195","name":"Rpt wo imp/con mmr/msi","description":"Surgical pathology reports that do not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both, reason not given","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7485","name":"Surg reduct osseoustuberosit","description":"Surgical reduction of osseous tuberosity","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0164","name":"Epinephrine in nacl (baxter)","description":"Injection, epinephrine in sodium chloride (baxter), 0.1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0248","name":"Inj, remdesivir, 1 mg","description":"Injection, remdesivir, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1413","name":"Pos pdl1 bef init ici tx","description":"Patients who had a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9161","name":"Inj denileuk difti-cxdl 1mcg","description":"Injection, denileukin diftitox-cxdl, 1 mcg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0773T","name":"Vr px dissoc svc oth phy 1st","description":"Virtual reality (vr) procedural dissociation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports; initial 15 min","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9027","name":"Rbc o2 co2 reduced","description":"Red blood cells, leukocytes reduced, oxygen/ carbon dioxide reduced, each unit","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67715","name":"Canthotomy","description":"Canthotomy (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9376","name":"Inj pozelimab-bbfg, 1 mg","description":"Injection, pozelimab-bbfg, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0039","name":"Pt no ref, rn spec","description":"Patient not referred, reason not otherwise specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4368","name":"Amchothick per sq cm","description":"Amchothick, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31257","name":"Nsl/sins ndsc tot w/sphendt","description":"Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior), including sphenoidotomy","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0398U","name":"Gi baret esph dna mthyln aly","description":"Gi baret esph dna mthyln aly","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26350","name":"Repair finger/hand tendon","description":"Repair or advancement, flexor tendon, not in zone 2 digital flexor tendon sheath (eg, no mans land); primary or secondary without free graft, each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1002.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92642","name":"Hearing asstv dev fitg svc","description":"Hearing assistive device, supplemental technology fitting services (eg, personal frequency modulation [fm]/digital modulation [dm] system, remote microphone, alerting devices)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92622","name":"Dx aly aud oi snd prcsr 1st","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; first 60 minutes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2016","name":"Permeaderm b, per sq cm","description":"Permeaderm b, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0995T","name":"Evasc dlvr a-wal stbl rx opn","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; open","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0995T","name":"Evasc dlvr a-wal stbl rx opn","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; open","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55708","name":"Bx prst8 trct us w/mri fus 1","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant) with mri-fusion-guidance, first targeted lesion","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61891","name":"Rev/rplcmt sk-mnt crnl nstm","description":"Revision or replacement of skull-mounted cranial neurostimulator pulse generator or receiver with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69719","name":"Rplcm oi implt sk tc esp<100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6518","name":"Grad com wrap w strap arm cu","description":"Gradient compression wrap with adjustable straps, arm, each, custom","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93598","name":"Car outp meas drg cath chd","description":"Cardiac output measurement(s), thermodilution or other indicator dilution method, performed during cardiac catheterization for the evaluation of congenital heart defects (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1452","name":"Pt dx dementia ever","description":"Patient ever had a diagnosis of dementia","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4265","name":"Neostim tl per sq cm","description":"Neostim tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0268U","name":"Hem ahus gen seq alys 15 gen","description":"Hematology (atypical hemolytic uremic syndrome [ahus]), genomic sequence analysis of 15 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1288","name":"Doc rsn no hbp scrn or f/u","description":"Documented reason for not screening or recommending a follow-up for high blood pressure","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3424","name":"Inj hydroxocobalamin iv 25mg","description":"Injection, hydroxocobalamin, intravenous, 25 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0953T","name":"Tot impl amei rev/rplc w/o","description":"Totally implantable active middle ear hearing implant; revision or replacement, without mastoidectomy and replacement of sound processor","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33238","name":"Remove electrode/thoracotomy","description":"Removal of permanent transvenous electrode(s) by thoracotomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1135.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6192","name":"Semi precision attachment","description":"Semi precision attachment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0206","name":"Inj allopurinol sodium 1 mg","description":"Injection, allopurinol sodium, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5911","name":"Facial moulage sectional","description":"Facial moulage (sectional)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0862T","name":"Rlcj pg wcs lv battery only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; battery component only","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1470","name":"Hep b vac not recd med rsn","description":"Documentation of medical reason(s) for not administering hepatitis b vaccine (e.g., prior anaphylaxis due to the hepatitis b vaccine)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11400","name":"Exc tr-ext b9+marg 0.5 cm<","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 0.5 cm or less","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":73.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0593U","name":"Nfct ds gu pthgn dna 46trgt","description":"Nfct ds gu pthgn dna 46trgt","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0901T","name":"Plmt bone marrow smplg port","description":"Placement of bone marrow sampling port, including imaging guidance when performed","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4015","name":"Neurology ss","description":"Neurology mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11100","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31530","name":"Laryngoscopy w/fb removal","description":"Laryngoscopy, direct, operative, with foreign body removal;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1275","name":"Pts hosp exl","description":"Patients determined to be in hospice were excluded from month of evaluation and the remainder of reporting period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2598","name":"Inj, vasopressin, 1 unit","description":"Injection, vasopressin, 1 unit","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2024","name":"Resolve or xenopatch sq cm","description":"Resolve matrix or xenopatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5145","name":"Inj, abrilada, 1 mg","description":"Injection, adalimumab-afzb (abrilada), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1198","name":"Isa not red 3pts /no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4319","name":"Sanograft, per sq cm","description":"Sanograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0476U","name":"Rx metab psyc 14gen&cyp2d6","description":"Rx metab psyc 14gen&cyp2d6","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0363U","name":"Onc urthl mrna 5 gen alg","description":"Onc urthl mrna 5 gen alg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9993","name":"Pall serv during meas","description":"Patient was provided palliative care services any time during the measurement period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0873T","name":"Revj subq prtl asct pmp sys","description":"Revision of a subcutaneously implanted peritoneal ascites pump system, any component (ascites pump, associated peritoneal catheter, associated bladder catheter), including imaging and programming, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0865T","name":"Quan mri alys brn w/o dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion identification, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transm","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44320","name":"Colostomy","description":"Colostomy or skin level cecostomy;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1225.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5098","name":"Inj ustekinumab-srlf, 1 mg","description":"Injection, ustekinumab-srlf (imuldosa), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99238","name":"Hosp ip/obs dschrg mgmt 30/<","description":"Hospital inpatient or observation discharge day management; 30 minutes or less on the date of the encounter","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4026","name":"Phys/occ therapy ss","description":"Physical therapy/occupational therapy mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82085","name":"Assay of aldolase","description":"Aldolase","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93587","name":"Vngrph chd vnvn cltrl at/abv","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating at or above the heart (eg, from innominate vein) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0235","name":"Inj, monoclon antibody, 1 mg","description":"Injection, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extraco","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20251","name":"Biopsy vrt bdy open lmbr/crv","description":"Biopsy, vertebral body, open; lumbar or cervical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0630U","name":"Onc brst mrna gen prflg 80","description":"Onc brst mrna gen prflg 80","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1474","name":"Pt dx dementia","description":"Patients with diagnosis of dementia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5992","name":"Low prosth foot shell repl","description":"All lower extremity prosthesis, foot shell for modular foot/non-solid ankle cushion heel (sach) replacement only","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82261","name":"Assay of biotinidase","description":"Biotinidase, each specimen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83655","name":"Assay of lead","description":"Lead","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91125","name":"Anrct mano rct snsatn&balo","description":"Anorectal manometry, with rectal sensation and rectal balloon expulsion test, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2801","name":"Inj, rykindo, 0.5 mg","description":"Injection, risperidone (rykindo), 0.5 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5612","name":"Rep resin part dent base max","description":"Rep resin part dent base max","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61316","name":"Inc&subq plmt crnl bone grf","description":"Incision and subcutaneous placement of cranial bone graft (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0472","name":"Gross exam prep & report","description":"Accession of tissue gross examination preparation and transmission of written report","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4005","name":"Family medicine ss","description":"Family medicine mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83036","name":"Hemoglobin glycosylated a1c","description":"Hemoglobin; glycosylated (a1c)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0002","name":"Opt care kidney hlth mvp","description":"Optimal care for kidney health mips value pathways","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43264","name":"Ercp remove duct calculi","description":"Endoscopic retrograde cholangiopancreatography (ercp); with removal of calculi/debris from biliary/pancreatic duct(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":559.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98013","name":"Synch audio-only est low 20","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code select","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1486","name":"Pt admitted to snf dur eval","description":"Patients admitted to a skilled nursing facility (snf) during the period of evaluation","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49525","name":"Repair ing hernia sliding","description":"Repair inguinal hernia, sliding, any age","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":614.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90481","name":"Admn sarscov2 vac ea add cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; each additional component administered (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78223","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0764T","name":"Asstv alg ecg rsk asmt cncrt","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to concurrently performed electrocardiogram (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4278","name":"Epieffect, per sq cm","description":"Epieffect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0941T","name":"Cysto flx ins&xpns urtl scaf","description":"Cystourethroscopy, flexible; with insertion and expansion of prostatic urethral scaffold using integrated cystoscopic visualization","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11720","name":"Debride nail 1-5","description":"Debridement of nail(s) by any method(s); 1 to 5","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67516","name":"Sprchoroidal spc njx rx agt","description":"Suprachoroidal space injection of pharmacologic agent (separate procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1220","name":"Dre wth interp rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; with evidence of retinopathy","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78018","name":"Thyroid met imaging body","description":"Thyroid carcinoma metastases imaging; whole body","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27687","name":"Revision of calf tendon","description":"Gastrocnemius recession (eg, strayer procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82143","name":"Amniotic fluid scan","description":"Amniotic fluid scan (spectrophotometric)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2036","name":"Cohealyx col dml mx pr sq cm","description":"Cohealyx collagen dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1334","name":"Pts act pvd 2 wks 2 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 2 weeks after initial acute pvd encounter","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0517","name":"Remove drug implant","description":"Removal of non-biodegradable drug delivery implants, 4 or more (services for subdermal implants)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":227.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1391","name":"All pt dx w/ rec mlnm","description":"All patients who were diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1552","name":"Inj, alyglo, 500 mg","description":"Injection, immune globulin (alyglo), 500 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1260","name":"Pt not doc <= 1 yr dialysis","description":"Patient status not documented within the first year of initiating dialysis","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0102","name":"Prostate ca screening; dre","description":"Prostate cancer screening; digital rectal examination","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86941","name":"Hemolysins/agglutinins","description":"Hemolysins and agglutinins; incubated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6611","name":"Onlay cst hgh nbl mtl >=3srf","description":"Onlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61520","name":"Removal of brain lesion","description":"Craniectomy for excision of brain tumor, infratentorial or posterior fossa; cerebellopontine angle tumor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4379.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37287","name":"Revsc evasc tpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1377","name":"Fu colscop 10 yr doc w/ disc","description":"Recommended follow-up interval for repeat colonoscopy of 10 years documented  in colonoscopy report and communicated with patient","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0744T","name":"Insj bioprostc vlv fem vn","description":"Insertion of bioprosthetic valve, open, femoral vein, including duplex ultrasound imaging guidance, when performed, including autogenous or nonautogenous patch graft (eg, polyester, eptfe, bovine pericardium), when performed","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0387U","name":"Onc mlnma ambra1&amlo","description":"Onc mlnma ambra1&amlo","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0952T","name":"Tot impl amei rev/rplc mstdc","description":"Totally implantable active middle ear hearing implant; revision or replacement, with mastoidectomy and replacement of sound processor","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29590","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2401","name":"Chloroprocaine hcl injection","description":"Injection, chloroprocaine hydrochloride, per 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3291","name":"Tranexamic acid in sod chlor","description":"Injection, tranexamic acid in sodium chloride, 5 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1376","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0907T","name":"Coms ther ea addl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; each additional application, total wound(s) surface area less than or equal to 50 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85610","name":"Prothrombin time","description":"Prothrombin time;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9289","name":"Inj nivolumab 2 mg hyaluron","description":"Injection, nivolumab, 2 mg and hyaluronidase-nvhy","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0553U","name":"Repr med pga embry te strux","description":"Repr med pga embry te strux","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1215","name":"Med rsn for no doc spiro","description":"Documentation of medical reason(s) for not documenting and reviewing spirometry results (e.g., patients with dementia or tracheostomy)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0921T","name":"Rmvl perm ccm-d sys 1 dfb ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous defibrillation lead only","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64628","name":"Trml dstrj ios bvn 1st 2 l/s","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; first 2 vertebral bodies, lumbar or sacral","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0969T","name":"Removal epicranial nstim sys","description":"Removal of epicranial neurostimulator system","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0740T","name":"Rem auton alg nsln cal setup","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; initial set-up and patient education","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4543","name":"Supply trans elec nerve stim","description":"Supplies for transcutaneous electrical nerve stimulator, for nerves in the auricular region, per month","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"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":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55120","name":"Removal of scrotum lesion","description":"Removal of foreign body in scrotum","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5151","name":"Inj, eculizumab-aagh, 2 mg","description":"Injection, eculizumab-aagh (epysqli), biosimilar, 2 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0672T","name":"Ndovag cryg rf remdl tiss","description":"Endovaginal cryogen-cooled, monopolar radiofrequency remodeling of the tissues surrounding the female bladder neck and proximal urethra for urinary incontinence","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0792T","name":"Appl slvr diamn fluoride 38%","description":"Application of silver diamine fluoride 38%, by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0879T","name":"Augmnt alys ch ct ild prep","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; radiological data preparation and transmission","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0883T","name":"Intraop ther estim pn ue ea","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; each additional nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37765","name":"Stab phleb veins xtr 10-20","description":"Stab phlebectomy of varicose veins, 1 extremity; 10-20 stab incisions","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99322","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0783T","name":"Tc auriculr neurostimulation","description":"Transcutaneous auricular neurostimulation, set-up, calibration, and patient education on use of equipment","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0478U","name":"Onc nsclc dna&rna dpcr 9 gen","description":"Onc nsclc dna&rna dpcr 9 gen","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0794T","name":"Pt spec alg rx-onc tx option","description":"Patient-specific, assistive, rules-based algorithm for ranking pharmaco-oncologic treatment options based on the patients tumor-specific cancer marker information obtained from prior molecular pathology, immunohistochemical, or other pathology results which have been previously interpreted and repor","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0832T","name":"Dgtz gls mcrscp cytp oth scr","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1163","name":"Inj, diltiazem hcl, 0.5 mg","description":"Injection, diltiazem hydrochloride, 0.5 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0610U","name":"Nfct ds antmcr sc phenotypic","description":"Nfct ds antmcr sc phenotypic","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70471","name":"Cta h&n c+ w/noncontrast img","description":"Computed tomographic angiography (cta), head and neck, with contrast material(s), including noncontrast images, when performed, and image postprocessing","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38747","name":"Remove abdominal lymph nodes","description":"Abdominal lymphadenectomy, regional, including celiac, gastric, portal, peripancreatic, with or without para-aortic and vena caval nodes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3375","name":"Inj, vanco (tyzavan) 10mg","description":"Injection, vancomycin hydrochloride (tyzavan), not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1165","name":"Pt use hspc dur meas pd","description":"Patients who use hospice services any time during the measurement period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87511","name":"Gardner vag dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); gardnerella vaginalis, amplified probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1306","name":"Pt anphx due to pneum","description":"Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0454U","name":"U rare ds id opt genome mapg","description":"U rare ds id opt genome mapg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0691T","name":"Auto alys xst ct std vrt fx","description":"Automated analysis of an existing computed tomography study for vertebral fracture(s), including assessment of bone density when performed, data preparation, interpretation, and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1305","name":"Pneum vax admin 19+","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1412","name":"Inj roctavian ml 2x10^13vc g","description":"Injection, valoctocogene roxaparvovec-rvox, per ml, containing nominal 2 x 10^13 vector genomes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6071","name":"Abutment supported retainer","description":"Abutment supported retainer for porcelain fused to metal fpd (noble metal)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1233","name":"Pt no hcv aby or result","description":"Patient does not receive hcv antibody test or patient does receive hcv antibody test but results not documented, reason not given","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33895","name":"Evasc st rpr thrc/aa x crsg","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; not crossing major side branches","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70547","name":"Mr angiography neck w/o dye","description":"Magnetic resonance angiography, neck; without contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":647.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0681","name":"App of non-sheet skin sub","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; first 25 sq cm or less of wound surface area","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3503","name":"Surg exp root surf molar","description":"Surg exp root surf molar","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26765","name":"Treat finger fracture each","description":"Open treatment of distal phalangeal fracture, finger or thumb, includes internal fixation, when performed, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17273","name":"Dstr mal les s/n/h/f/g 2.1-3","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia; lesion diameter 2.1 to 3.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0837T","name":"Dgtz gls mcrscp fna i&r","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; interpretation and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0042","name":"Ref to therapy","description":"Referral to physical, occupational, speech, or recreational therapy","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4028","name":"Podiatry ss","description":"Podiatry mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0622U","name":"Psyc mdd dna alys >20000","description":"Psyc mdd dna alys >20000","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0843T","name":"Dgtz gls mcrscp cslt cyt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), initial site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2036","name":"Cohealyx col dml mx pr sq cm","description":"Cohealyx collagen dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7300","name":"Rem anchorage dev w/o flap","description":"Rem anchorage dev w/o flap","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86352","name":"Cell function assay w/stim","description":"Cellular function assay involving stimulation (eg, mitogen or antigen) and detection of biomarker (eg, atp)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0612U","name":"Onc lvr alys >1000 mr cfdna","description":"Onc lvr alys >1000 mr cfdna","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0792T","name":"Appl slvr diamn fluoride 38%","description":"Application of silver diamine fluoride 38%, by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1179","name":"No pcv recd","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine, on or after their 19th birthday and before or during measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91037","name":"Esoph imped function test","description":"Esophageal function test, gastroesophageal reflux test with nasal catheter intraluminal impedance electrode(s) placement, recording, analysis and interpretation;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37275","name":"Rvsc evsc fpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95024","name":"Iq tests w/allergenic xtrcs","description":"Intracutaneous (intradermal) tests with allergenic extracts, immediate type reaction, including test interpretation and report, specify number of tests","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9988","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0713T","name":"N-nvs artl plaq alys rvw i&r","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data review, interpretation and report","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1437","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0484U","name":"Nfct ds mgen 23s rrna pt mut","description":"Nfct ds mgen 23s rrna pt mut","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21422","name":"Optx palatal/max fracture","description":"Open treatment of palatal or maxillary fracture (lefort i type);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":788.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1337","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0019","name":"Comm hlth intg svs sdoh 60mn","description":"Community health integration services performed by certified or trained auxiliary personnel, including a community health worker, under the direction of a physician or other practitioner; 60 minutes per calendar month, in the following activities to address social determinants of health (sdoh) need(","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6071","name":"Abutment supported retainer","description":"Abutment supported retainer for porcelain fused to metal fpd (noble metal)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92613","name":"Endoscopy swallow (fees) i&r","description":"Flexible endoscopic evaluation of swallowing by cine or video recording; interpretation and report only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28153","name":"Partial removal of toe","description":"Resection, condyle(s), distal end of phalanx, each toe","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1371","name":"Mst rec gsa<7","description":"Most recent glycemic status assessment (hba1c or gmi) level < 7.0%","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1294","name":"Bp scrn perf rec interval","description":"Normal blood pressure reading documented, follow-up not required","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86305","name":"Human epididymis protein 4","description":"Human epididymis protein 4 (he4)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1806","name":"Inj esmolol hcl wg crit care","description":"Injection, esmolol hydrochloride (wg critical care), not therapeutically equivalent to j1805, 10 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4021","name":"Orthopedic surgery ss","description":"Orthopedic surgery mips specialty set","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21160","name":"Rcnst mdfc lfrtiii advm w/i","description":"Reconstruction midface, lefort iii (extra and intracranial) with forehead advancement (eg, mono bloc), requiring bone grafts (includes obtaining autografts); with lefort i","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3457.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87086","name":"Urine culture/colony count","description":"Culture, bacterial; quantitative colony count, urine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2394","name":"Post >=4srfc resinbase cmpst","description":"Resin-based composite - four or more surfaces posterior","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0036","name":"Pt/ptn decln assess","description":"Patient or care partner decline assessment","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64658","name":"Rmvl bat modul sys lead only","description":"Removal of baroreflex activation therapy (bat) modulation system; lead only","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4424","name":"Revive ft per sq cm","description":"Revive ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9800","name":"Gallium locametz 1 millicuri","description":"Gallium ga-68 gozetotide, diagnostic, (locametz), 1 millicurie","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99478","name":"Sbsq ic vlbw inf<1,500 gm","description":"Subsequent intensive care, per day, for the evaluation and management of the recovering very low birth weight infant (present body weight less than 1,500 grams)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2371","name":"Inj phenylephrine hcl 20 mcg","description":"Injection, phenylephrine hydrochloride, 20 micrograms","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0759","name":"Inj, clevidipine, 1 mg","description":"Injection, clevidipine butyrate, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25085","name":"Incision of wrist capsule","description":"Capsulotomy, wrist (eg, contracture)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1440","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1813","name":"Lyumjev for insulin pump use","description":"Insulin (lyumjev) for administration through dme (i.e., insulin pump) per 50 units","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40818","name":"Excise oral mucosa for graft","description":"Excision of mucosa of vestibule of mouth as donor graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83835","name":"Assay of metanephrines","description":"Metanephrines","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54348","name":"Rpr hypspad comp dsj & urtp","description":"Repair of hypospadias complication(s) (ie, fistula, stricture, diverticula); requiring extensive dissection, and urethroplasty with flap, patch or tubed graft (including urinary diversion, when performed)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1171.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27185","name":"Revision of femur epiphysis","description":"Epiphyseal arrest by epiphysiodesis or stapling, greater trochanter of femur","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":889.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0856T","name":"Dgtz gls mcrscp electron mic","description":"Digitization of glass microscope slides for electron microscopy, diagnostic (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"Adju cgm supply allowance","description":"Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KF"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0997T","name":"Precuneus mag stimj tx plng","description":"Precuneus magnetic stimulation; treatment planning using magnetic resonance imaging-guided neuronavigation to determine optimal location, dose, and intensity for magnetic stimulation therapy, derived from evoked potentials from single pulses of electromagnetic energy recorded by 64-channel electroen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1010T","name":"Cptr oph alys monoc eye mvmt","description":"Computerized ophthalmic analysis of monocular eye movements using retinal-based eye-tracking without spatial calibration, including fixation, microsaccades, drift, and horizontal saccades, when performed, unilateral or bilateral, with interpretation and report","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0307U","name":"Onc mrd nxt-gnrj alys sbsq","description":"Onc mrd nxt-gnrj alys sbsq","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4331","name":"Axolotl graft, per sq cm","description":"Axolotl graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0910T","name":"Rmvl int nstim sys vagus nrv","description":"Removal of integrated neurostimulation system, vagus nerve","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99236","name":"Hosp ip/obs same date hi 85","description":"Hospital inpatient or observation care, for the evaluation and management of a patient including admission and discharge on the same date, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter f","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0830T","name":"Dgtz gls mcrscp cytp slctv","description":"Digitization of glass microscope slides for cytopathology, selective-cellular enhancement technique with interpretation (eg, liquid-based slide preparation method), except cervical or vaginal (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31708","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45392","name":"Colonoscopy w/endoscopic fnb","description":"Colonoscopy, flexible; with transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy(s), includes endoscopic ultrasound examination limited to the rectum, sigmoid, descending, transverse, or ascending colon and cecum, and adjacent structures","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0283","name":"Inj, amiodarone (nexterone)","description":"Injection, amiodarone hydrochloride (nexterone), 30 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9046","name":"Inj, bortezomib, dr. reddys","description":"Injection, bortezomib (dr. reddys), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86036","name":"Anca screen each antibody","description":"Antineutrophil cytoplasmic antibody (anca); screen, each antibody","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0345U","name":"Psyc genom alys pnl 15 gen","description":"Psyc genom alys pnl 15 gen","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0724T","name":"Qmrcp w/dx mri same anatomy","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained with diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in additio","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0437U","name":"Psyc anxiety do mrna 15 bmrk","description":"Psyc anxiety do mrna 15 bmrk","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4253","name":"Zenith amniotic membrane psc","description":"Zenith amniotic membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47552","name":"Biliary endo perq dx w/speci","description":"Biliary endoscopy, percutaneous via t-tube or other tract; diagnostic, with collection of specimen(s) by brushing and/or washing, when performed (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31242","name":"Nsl/sinus ndsc rf abltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by radiofrequency ablation, posterior nasal nerve","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37291","name":"Revsc evsc tpvt athr cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2780","name":"Crown 3/4 cast hi noble met","description":"Crown - 3/4 cast high noble metal","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37280","name":"Revsc evsc tpvt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36466","name":"Njx noncmpnd sclrsnt mlt vn","description":"Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate, inclusive of all imaging guidance and monitoring; multiple incompetent truncal veins (eg, great saphenous vein, accessory saphenous vein), same leg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1554.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":153.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4372","name":"Amchoplast excl per sq cm","description":"Amchoplast excel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1364","name":"Ascvd risk >=20pct","description":"Calculated 10-year ascvd risk score of >= 20 percent during the performance period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95900","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96041","name":"Genetic counseling svc ea 30","description":"Medical genetics and genetic counseling services, each 30 minutes of total time provided by the genetic counselor on the date of the encounter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0027","name":"Semen analysis","description":"Semen analysis; presence and/or motility of sperm excluding huhner","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J3320","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0664","name":"Team remote e/m new pt 60 mn","description":"Team remote e/m new pt 60mins","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4004","name":"Endocrinology ss","description":"Endocrinology mips specialty set","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0915T","name":"Insj perm ccm-d sys pg&eltrd","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator and dual transvenous electrodes/leads (pacing and defibrillation)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28456","name":"Prq skel fix tarsl fx w/mnpj","description":"Percutaneous skeletal fixation of tarsal bone fracture (except talus and calcaneus), with manipulation, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97552","name":"Group caregiver training","description":"Group caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0163","name":"Diphenhydramine hcl 50mg","description":"Diphenhydramine hydrochloride, 50 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at time of chemotherapy treatment not to exceed a 48 hour dosage regimen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1811","name":"Fiasp for insulin pump use","description":"Insulin (fiasp) for administration through dme (i.e., insulin pump) per 50 units","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1008T","name":"Rem mntr s-scl eeg sys setup","description":"Remote monitoring of sub-scalp implanted continuous bilateral electroencephalography monitoring system, device fitting, initial set-up, and patient education in wearing of system and use of equipment","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89329","name":"Sperm evaluation test","description":"Sperm evaluation; hamster penetration test","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9274","name":"Inj, tebentafusp-tebn, 1 mcg","description":"Injection, tebentafusp-tebn, 1 microgram","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77091","name":"Tbs techl calculation only","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical calculation only","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1355","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6603","name":"Cst hgh nble mtl inlay >=3sr","description":"Inlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86037","name":"Anca titer each antibody","description":"Antineutrophil cytoplasmic antibody (anca); titer, each antibody","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0023","name":"Pin service 60m per month","description":"Principal illness navigation services by certified or trained auxiliary personnel under the direction of a physician or other practitioner, including a patient navigator; 60 minutes per calendar month, in the following activities:  person-centered assessment, performed to better understand the indiv","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57545","name":"Remove cervix/repair pelvis","description":"Excision of cervical stump, abdominal approach; with pelvic floor repair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":944.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88280","name":"Chromosome karyotype study","description":"Chromosome analysis; additional karyotypes, each study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25310","name":"Transplant forearm tendon","description":"Tendon transplantation or transfer, flexor or extensor, forearm and/or wrist, single; each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1033.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33207","name":"Insert heart pm ventricular","description":"Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); ventricular","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":587.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4257","name":"Relese, per sq cm","description":"Relese, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21344","name":"Open tx compl front sinus fx","description":"Open treatment of complicated (eg, comminuted or involving posterior wall) frontal sinus fracture, via coronal or multiple approaches","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1740.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85018","name":"Hemoglobin","description":"Blood count; hemoglobin (hgb)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86381","name":"Mitochondrial antibody each","description":"Mitochondrial antibody (eg, m2), each","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92631","name":"Hearing aid slctn svc 1st 30","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1164","name":"Pt w/ dementia any time","description":"Patients with dementia any time during the patients history through the end of the measurement period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1396","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3431","name":"Biological materials","description":"Biological materials","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2032","name":"Myriad matrix, per sq cm","description":"Myriad matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0929T","name":"Rem interrog dev ccm-d tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1464","name":"No record of f/u by 180 days","description":"No documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37295","name":"Rvsc evsc tpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82234","name":"Beta-amyloid 1-42 (abeta 42)","description":"Beta-amyloid; 1-42 (abeta 42)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0585U","name":"Tgsap so neo cfdna 521 genes","description":"Tgsap so neo cfdna 521 genes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2013","name":"Innovamatrix fs, per sq cm","description":"Innovamatrix fs, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1338","name":"Pt f/u 30-180 dys no + imprv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who did not demonstrate positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85461","name":"Hemoglobin fetal","description":"Hemoglobin or rbcs, fetal, for fetomaternal hemorrhage; rosette","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1024T","name":"Perq tiss dsplmt soft tissue","description":"Percutaneous tissue displacement, any method, including imaging guidance; soft tissue (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87076","name":"Culture anaerobe ident each","description":"Culture, bacterial; anaerobic isolate, additional methods required for definitive identification, each isolate","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":11.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0929T","name":"Rem interrog dev ccm-d tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1211","name":"Gsa level>9.0%","description":"Most recent glycemic status assessment (hba1c or gmi) level > 9.0%","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77414","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99381","name":"Init pm e/m new pat infant","description":"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; infant (age youn","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":128.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0687","name":"Inj cefazolin (wg crit care)","description":"Injection, cefazolin sodium (wg critical care), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0548","name":"Phone/inter svs 21-30 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86318","name":"Ia infectious agent antibody","description":"Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip);","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0840T","name":"Dgtz gls mcrscp cslt compre","description":"Digitization of glass microscope slides for consultation, comprehensive, with review of records and specimens, with report on referred material (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0563","name":"Sbrt w/positron emission del","description":"Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance and real-time positron emissions-based delivery adjustments to 1 or more lesions, entire course not to exceed 5 fractions","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64656","name":"Revj/rplcmt bat mod sys pg","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; pulse generator only","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86352","name":"Cell function assay w/stim","description":"Cellular function assay involving stimulation (eg, mitogen or antigen) and detection of biomarker (eg, atp)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26775","name":"Treat finger dislocation","description":"Closed treatment of interphalangeal joint dislocation, single, with manipulation; requiring anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":366.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1380","name":"2 rx in perf pd any com meds","description":"Filled at least two prescriptions during the performance period for any combination of the qualifying oral antipsychotic medications listed under denominator note or the long-acting injectable antipsychotic medications listed under denominator note","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9992","name":"Pall serv during meas","description":"Palliative care services used by patient any time during the measurement period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6092","name":"Recement supp crown","description":"Recement implant/abutment supported crown","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0813T","name":"Egd vol adjmt bariatric balo","description":"Esophagogastroduodenoscopy, flexible, transoral, with volume adjustment of intragastric bariatric balloon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0538U","name":"Onc sol tum ngts ffpe 600gen","description":"Onc sol tum ngts ffpe 600gen","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31825","name":"Repair of windpipe defect","description":"Surgical closure tracheostomy or fistula; with plastic repair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9071","name":"Inj cyclophosphamd auromedic","description":"Injection, cyclophosphamide (auromedics), 5 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0480U","name":"Nfct ds csf metag ngs alys","description":"Nfct ds csf metag ngs alys","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87154","name":"Cul typ id bld pthgn 6+ trgt","description":"Culture, typing; identification of blood pathogen and resistance typing, when performed, by nucleic acid (dna or rna) probe, multiplexed amplified probe technique including multiplex reverse transcription, when performed, per culture or isolate, 6 or more targets","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98976","name":"Rtm dev sply resp sys 16-30d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of respiratory system, 16-30 days in a 30-day period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4564","name":"Pessary, disposable any type","description":"Pessary, disposable, any type","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2272","name":"Inj, morphine (fresenius)","description":"Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6561","name":"G stockng full/chap 40+ cust","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, custom, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1314","name":"Bmi not calculated","description":"Bmi not documented and no reason is given","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0737T","name":"Xenograft impltj artclr surf","description":"Xenograft implantation into the articular surface","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0626U","name":"Neurol pd dna alys >20000","description":"Neurol pd dna alys >20000","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0709T","name":"Id ca immntx each addl njx","description":"Intradermal cancer immunotherapy; each additional injection (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2644","name":"Dental onlay porc 4/more sur","description":"Onlay - porcelain/ceramic - four or more surfaces","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1480","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0234","name":"Intra inf, toci, second dos","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35585","name":"Vein byp fem-tibial peroneal","description":"In-situ vein bypass; femoral-anterior tibial, posterior tibial, or peroneal artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1993.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1311","name":"Aphlx to vax bef enc","description":"Anaphylaxis due to the vaccine on or before the date of the encounter","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91010","name":"Esophagus motility study","description":"Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81007","name":"Urine screen for bacteria","description":"Urinalysis; bacteriuria screen, except by culture or dipstick","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0234","name":"Intra inf, toci, second dos","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64658","name":"Rmvl bat modul sys lead only","description":"Removal of baroreflex activation therapy (bat) modulation system; lead only","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49188","name":"Opn exc/dst ntra-abd 10.1-20","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 10.1 to 20 cm","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99243","name":"Off/op cnsltj new/est low 30","description":"Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":48.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":128.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77438","name":"Surf rad thr orthvlt>150-500","description":"Surface radiation therapy; orthovoltage, delivery, >150-500 kv, per fraction","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1782","name":"Vac admin human pap dose 2","description":"Vac admin human pap dose 2","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0379U","name":"Tgsap sl or neo dna523&rna55","description":"Tgsap sl or neo dna523&rna55","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0981T","name":"Tcat impl wrls ivc snr","description":"Transcatheter implantation of wireless inferior vena cava sensor for long-term hemodynamic monitoring, including deployment of the sensor, radiological supervision and interpretation, right heart catheterization, and inferior vena cava venography, when performed","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9936","name":"Clean occ guard","description":"Clean occ guard","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76819","name":"Fetal biophys profil w/o nst","description":"Fetal biophysical profile; without non-stress testing","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76984","name":"Dx intraop thoracic aorta us","description":"Ultrasound, intraoperative thoracic aorta (eg, epiaortic), diagnostic","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36836","name":"Prq av fstl crtj uxtr 1 acs","description":"Percutaneous arteriovenous fistula creation, upper extremity, single access of both the peripheral artery and peripheral vein, including fistula maturation procedures (eg, transluminal balloon angioplasty, coil embolization) when performed, including all vascular access, imaging guidance and radiolo","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63685","name":"Ins/rplc spi npg/rcvr pocket","description":"Insertion or replacement of spinal neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":550.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5421","name":"Dentures adjust part maxill","description":"Adjust partial denture - maxillary","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0574U","name":"Mtb cfp-10 serum/plsm lc-ms","description":"Mtb cfp-10 serum/plsm lc-ms","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55605","name":"Vesiculotomy complicated","description":"Vesiculotomy; complicated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1186","name":"Pt w/ rx for hspc/plltv care","description":"Patients who have an order for or are receiving hospice or palliative care","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3502","name":"Surg exp root surf premolar","description":"Surg exp root surf premolar","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0864T","name":"Low ntsty eswt corpus cvrnsm","description":"Low-intensity extracorporeal shock wave therapy involving corpus cavernosum, low energy","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37270","name":"Revsc evasc fpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4038","name":"Vascular surgery ss","description":"Vascular surgery mips specialty set","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7472","name":"Removal of torus palatinus","description":"Removal of torus palatinus","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6595","name":"G comp bandge liner upr extr","description":"Gradient compression bandaging supply, bandage liner, upper extremity, any size or length, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1353","name":"Sealant repair per tooth","description":"Sealant repair per tooth","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0540","name":"Train for caregiver add 15","description":"Caregiver training in behavior management/modification for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face; each additional 15 minutes","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23470","name":"Reconstruct shoulder joint","description":"Arthroplasty, glenohumeral joint; hemiarthroplasty","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1473.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5145","name":"Inj, abrilada, 1 mg","description":"Injection, adalimumab-afzb (abrilada), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0547","name":"Phone/internet svs 11-20 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0681","name":"Inj ceftobipole medocarl 3mg","description":"Injection, ceftobiprole medocaril sodium, 3 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4367","name":"Amniocore sl, per sq cm","description":"Amniocore sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77081","name":"Dxa bone density appendiculr","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]},{"negotiated_type":"negotiated","negotiated_rate":26.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33269","name":"Excl laa thrscp any method","description":"Exclusion of left atrial appendage, thoracoscopic, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33903","name":"Perq p-art revsc 1 abnor bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, bilateral","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93588","name":"Vngrph chd vnvn cltrl below","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating below the heart (eg, from the inferior vena cava) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24350","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2007","name":"Restrata, per sq cm","description":"Restrata, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9947","name":"Sleep apnea appliance","description":"Sleep apnea appliance","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1441","name":"Init dx slp apn = 1st enc","description":"Encounter corresponds to initial diagnosis of sleep apnea or first contact with sleep apnea diagnosed patient","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98014","name":"Synch audio-only est mod 30","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code s","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4341","name":"Simplimax, per sq cm","description":"Simplimax, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37266","name":"Rvsc evsc fpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61583","name":"Craniofacial approach skull","description":"Craniofacial approach to anterior cranial fossa; intradural, including unilateral or bifrontal craniotomy, elevation or resection of frontal lobe, osteotomy of base of anterior cranial fossa","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3220.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49621","name":"Rpr parastomal hernia rdc","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; reducible","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86403","name":"Particle agglut antbdy scrn","description":"Particle agglutination; screen, each antibody","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6072","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (high noble metal)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41500","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":526.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95833","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93586","name":"Vngrph chd coronary sinus","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; coronary sinus (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","name":"Gait mod systm rhym auditory","description":"Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1178.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99344","name":"Home/res vst new mod mdm 60","description":"Home or residence visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1285","name":"Scrn mam perf rslts not doc","description":"Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed, reason not otherwise specified","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0664","name":"Team remote e/m new pt 60 mn","description":"Team remote e/m new pt 60mins","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1432","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4383","name":"Axolotl graft ult per sq cm","description":"Axolotl graft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1243","name":"Pt othr thn true heard","description":"Patient provided a response other than completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1260","name":"Pt not doc <= 1 yr dialysis","description":"Patient status not documented within the first year of initiating dialysis","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0398U","name":"Gi baret esph dna mthyln aly","description":"Gi baret esph dna mthyln aly","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9361","name":"Inj, efbemalenograstim alfa-","description":"Injection, efbemalenograstim alfa-vuxw, 0.5 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22836","name":"Ant thrc vrt body tethrg <7","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; up to 7 vertebral segments","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2403","name":"Chloroprocaine opht gel, 1mg","description":"Chloroprocaine hcl ophthalmic, 3% gel, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11976","name":"Remove contraceptive capsule","description":"Removal, implantable contraceptive capsules","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":86.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0529","name":"In home respite care, 4 hr u","description":"In-home respite care, 4-hour unit, for use in cmmi model","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0577","name":"Inj, brixadi, 7 days or less","description":"Injection, buprenorphine extended-release (brixadi), less than or equal to 7 days of therapy","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1402","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61863","name":"Implant neuroelectrode","description":"Twist drill, burr hole, craniotomy, or craniectomy with stereotactic implantation of neurostimulator electrode array in subcortical site (eg, thalamus, globus pallidus, subthalamic nucleus, periventricular, periaqueductal gray), without use of intraoperative microelectrode recording; first array","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1679.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4307","name":"American amnion, per sq cm","description":"American amnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0419U","name":"Nrpsyc gen seq vrnt aly 13","description":"Nrpsyc gen seq vrnt aly 13","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96202","name":"Mlt fam grp bhv train 1st 60","description":"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face with multiple sets of paren","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3394","name":"Inj, lovotibeglogene autotem","description":"Injection, lovotibeglogene autotemcel, per treatment","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9028","name":"Inj, nogapendekin pmln, 1mcg","description":"Injection, nogapendekin alfa inbakicept-pmln, for intravesical use, 1 microgram","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85378","name":"Fibrin degrade semiquant","description":"Fibrin degradation products, d-dimer; qualitative or semiquantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2251","name":"Inj midazolam in 0.9% nacl","description":"Injection, midazolam in 0.9% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77306","name":"Telethx isodose plan simple","description":"Teletherapy isodose plan; simple (1 or 2 unmodified ports directed to a single area of interest), includes basic dosimetry calculation(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91112","name":"Gi wireless capsule measure","description":"Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1489.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1163","name":"Pt anphx due to hpv bef 13","description":"Patient had anaphylaxis due to the hpv vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1574","name":"Inj, ganciclovir (exela)","description":"Injection, ganciclovir sodium (exela), not therapeutically equivalent to j1570, 500 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J3364","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98003","name":"Synch audio-video new hi 60","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high medical decision making. when using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95950","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33882","name":"Evasc rpr ta dplmt mltpc sys","description":"Endovascular repair of the thoracic aorta by deployment of a branched endograft multipiece system involving an aorto-aortic tube device with a fenestration for the left subclavian artery stent graft(s) and all aortic tube endograft extension(s) placed from the level of the left common carotid artery","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83090","name":"Assay of homocysteine","description":"Homocysteine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0992T","name":"N-invas assmt car rsk w/o ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat without concurrent computed tomography (ct) scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87812","name":"Sarscov2&inf typ a&b w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) and influenza virus types a and b","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0701","name":"Inj. cefepime hcl (baxter)","description":"Injection, cefepime hydrochloride (baxter), not therapeutically equivalent to maxipime, 500 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0444U","name":"Onc sld orgn neo tgsap 361","description":"Onc sld orgn neo tgsap 361","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1251","name":"Pts proxy cmplt hu surv","description":"Patients for whom a proxy completed the entire hu survey on their behalf for any reason (no patient involvement)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1251","name":"Pts proxy cmplt hu surv","description":"Patients for whom a proxy completed the entire hu survey on their behalf for any reason (no patient involvement)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G3003","name":"Chronic pain mgmt addl 15m","description":"Each additional 15 minutes of chronic pain management and treatment by a physician or other qualified health care professional, per calendar month. (list separately in addition to code for g3002. when using g3003, 15 minutes must be met or exceeded.)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0951T","name":"Tot impl amei 1st plmt","description":"Totally implantable active middle ear hearing implant; initial placement, including mastoidectomy, placement of and attachment to sound processor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4004","name":"Endocrinology ss","description":"Endocrinology mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0673T","name":"Abltj b9 thyr ndul perq lasr","description":"Ablation, benign thyroid nodule(s), percutaneous, laser, including imaging guidance","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0411","name":"Hba1c in office testing","description":"Hba1c in office testing","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11004","name":"Dbrdmt skin xtrnl gent&per","description":"Debridement of skin, subcutaneous tissue, muscle and fascia for necrotizing soft tissue infection; external genitalia and perineum","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":646.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0703","name":"Inj, cefepime hcl (b braun)","description":"Injection, cefepime hydrochloride (b braun), not therapeutically equivalent to maxipime, 500 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0736T","name":"Colonic lavage 35+l water","description":"Colonic lavage, 35 or more liters of water, gravity-fed, with induced defecation, including insertion of rectal catheter","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0759T","name":"Dgtz gls mcrscp sl sp grpiii","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group iii, for enzyme constituents (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0468U","name":"Hep nash mir34a5p a2m ykl40","description":"Hep nash mir34a5p a2m ykl40","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34715","name":"Opn ax/subcla art expos","description":"Open axillary/subclavian artery exposure for delivery of endovascular prosthesis by infraclavicular or supraclavicular incision, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":160.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4540","name":"Trans elec nerv periph nerv","description":"Distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4363","name":"Am bur mem hydro per sq cm","description":"Amnio burgeon membrane and hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0807T","name":"Pulm tiss vntj alys prev ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with previously acquired computed tomography (ct) images, including data preparation and transmission, quantification of pulmonary tissue ventilation, data re","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4337","name":"Artecent trident, per sq cm","description":"Artacent trident, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0030","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27331","name":"Explore/treat knee joint","description":"Arthrotomy, knee; including joint exploration, biopsy, or removal of loose or foreign bodies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7525","name":"Tacrolimus injection","description":"Tacrolimus, parenteral, 5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97034","name":"App mdlty 1+cntrst bth ea 15","description":"Application of a modality to 1 or more areas; contrast baths, each 15 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0719T","name":"Pst vrt jt rplcmt lmbr 1 sgm","description":"Posterior vertebral joint replacement, including bilateral facetectomy, laminectomy, and radical discectomy, including imaging guidance, lumbar spine, single segment","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0291U","name":"Psyc mood do mrna 144 genes","description":"Psyc mood do mrna 144 genes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0237","name":"Intrav inf, toci, first dose","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0348U","name":"Rx metab/pcx dna 25 gen alys","description":"Rx metab/pcx dna 25 gen alys","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9887","name":"Distance learning attendance","description":"Behavioral counseling for diabetes prevention, distance learning, 60 minutes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1207","name":"Pt scrn sdoh","description":"Patient is screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2642","name":"Dental onlay porcelin 2 surf","description":"Onlay - porcelain/ceramic - two surfaces","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0136","name":"Inj, acetaminophen (b braun)","description":"Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4016","name":"Neurosurgical ss","description":"Neurosurgical mips specialty set","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0571U","name":"Onc sol tum dna80&rna10g ngs","description":"Onc sol tum dna80&rna10g ngs","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47381","name":"Open ablate liver tumor cryo","description":"Ablation, open, of 1 or more liver tumor(s); cryosurgical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1583.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7671","name":"Alveolus open reduction","description":"Alveolus - open reduction may include stabilization of teeth","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15000","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2041","name":"Coord special care encounter","description":"Coordinated specialty care, team-based, for first episode psychosis, per encounter","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55711","name":"Bx prst8 trct mri-us 1st","description":"Biopsy, prostate, transrectal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1268","name":"Pt ac stat kid trnsplt wtlst","description":"Patients observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49593","name":"Rpr aa hrn 1st 3-10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, reducible","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0690T","name":"Quan us tis charac w/dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained with diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1453","name":"Preop vis acu > 20/40","description":"Patients with a pre-operative visual acuity better than 20/40","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37268","name":"Revsc evasc fpvt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1276","name":"Calc bmi out nrm param nof/u","description":"Bmi documented outside normal parameters, no follow-up plan documented, no reason given","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84450","name":"Transferase (ast) (sgot)","description":"Transferase; aspartate amino (ast) (sgot)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1302","name":"Inj, sutimlimab-jome, 10 mg","description":"Injection, sutimlimab-jome, 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1202","name":"Miglustat oral 65 mg","description":"Miglustat, oral, 65 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0805T","name":"Tcat s&ivc prstc vl impl prq","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); percutaneous femoral vein approach","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92313","name":"C-lens fitg corneosclrl lens","description":"Prescription of optical and physical characteristics of and fitting of contact lens, with medical supervision of adaptation; corneoscleral lens","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1412","name":"Inj roctavian ml 2x10^13vc g","description":"Injection, valoctocogene roxaparvovec-rvox, per ml, containing nominal 2 x 10^13 vector genomes","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56420","name":"I&d bartholins gland abscess","description":"Incision and drainage of bartholins gland abscess","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4272","name":"Esano a, per sq cm","description":"Esano a, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36595","name":"Mech remov tunneled cv cath","description":"Mechanical removal of pericatheter obstructive material (eg, fibrin sheath) from central venous device via separate venous access","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70380","name":"X-ray exam of salivary gland","description":"Radiologic examination, salivary gland for calculus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0516U","name":"Rx metab rxgenomic gnotyp 40","description":"Rx metab rxgenomic gnotyp 40","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4408","name":"Xwrap hydro per sq cm","description":"Xwrap hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0593U","name":"Nfct ds gu pthgn dna 46trgt","description":"Nfct ds gu pthgn dna 46trgt","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7517","name":"Mycophenolate mofetil oral","description":"Mycophenolate mofetil, oral, 250 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2598","name":"Inj, vasopressin, 1 unit","description":"Injection, vasopressin, 1 unit","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9028","name":"Inj, nogapendekin pmln, 1mcg","description":"Injection, nogapendekin alfa inbakicept-pmln, for intravesical use, 1 microgram","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1235","name":"Doc pt hcv aby rna tst","description":"Documentation or patient report of hcv antibody test or hcv rna test which occurred prior to the performance period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0260U","name":"Rare ds id opt genome mapg","description":"Rare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0990T","name":"Trncrv inst biod hydrgl mtrl","description":"Transcervical instillation of biodegradable hydrogel materials, intrauterine","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6113","name":"Imp/abut rem dent part mand","description":"Imp/abut rem dent part mand","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"Evaluation of wheezing","description":"Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1475","name":"Pt dx huntington","description":"Patients with diagnosis of huntingtons disease","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"Home vent dual fnct incl all","description":"Home ventilator, dual-function respiratory device, also performs additional function of cough stimulation, includes all accessories, components and supplies for all functions","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1440","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0605U","name":"All&immunology hat tpsab1","description":"All&immunology hat tpsab1","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64469","name":"Thrc fascial pln blk bi nfs","description":"Thoracic fascial plane block, bilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6614","name":"Onlay cst nbl mtl 2 surfaces","description":"Onlay - cast noble metal two surfaces","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45900","name":"Reduction of rectal prolapse","description":"Reduction of procidentia (separate procedure) under anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9029","name":"Instill adstiladrin, tx dose","description":"Intravesical instillation, nadofaragene firadenovec-vncg, per therapeutic dose","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0902T","name":"Qtc ntrvl augmnt alg aly ecg","description":"Qtc interval derived by augmentative algorithmic analysis of input from an external, patient-activated mobile ecg device","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0423","name":"Genetic test spec analysis","description":"Genetic test spec analysis","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1270","name":"Pts no kid transplt wtlst","description":"Patients not on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0562U","name":"Onc sol tum tgsa 33gens snvs","description":"Onc sol tum tgsa 33gens snvs","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98003","name":"Synch audio-video new hi 60","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high medical decision making. when using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6107","name":"Tissue regen non-resorbable","description":"Tissue regen non-resorbable","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0136","name":"Inj, acetaminophen (b braun)","description":"Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99348","name":"Home/res vst est low mdm 30","description":"Home or residence visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5140","name":"Inj adalimumab-fkjp, 1 mg","description":"Injection, adalimumab-fkjp, biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11012","name":"Deb skin bone at fx site","description":"Debridement including removal of foreign material at the site of an open fracture and/or an open dislocation (eg, excisional debridement); skin, subcutaneous tissue, muscle fascia, muscle, and bone","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9247","name":"Mod sedation noniv-sub15min","description":"Mod sedation noniv-sub15min","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0794T","name":"Pt spec alg rx-onc tx option","description":"Patient-specific, assistive, rules-based algorithm for ranking pharmaco-oncologic treatment options based on the patients tumor-specific cancer marker information obtained from prior molecular pathology, immunohistochemical, or other pathology results which have been previously interpreted and repor","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2393","name":"Post 3 srfc resinbased cmpst","description":"Resin-based composite - three surfaces posterior","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0520","name":"New pt-cg dyad dem mod cmplx","description":"Management of new patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2312","name":"Inj naloxone hcl nos, 0.01mg","description":"Injection, naloxone hydrochloride, not otherwise specified, 0.01 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1438","name":"Lst knwn well <=210 min","description":"Time last known well to hospital arrival less than or equal to 3.5 hours (<= 210 minutes)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81418","name":"Rx metab gen seq alys pnl 6","description":"Drug metabolism (eg, pharmacogenomics) genomic sequence analysis panel, must include testing of at least 6 genes, including cyp2c19, cyp2d6, and cyp2d6 duplication/deletion analysis","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5137","name":"Inj, wezlana, sub cu, 1 mg","description":"Injection, ustekinumab-auub (wezlana), biosimilar, subcutaneous, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21387","name":"Opn tx orbit fx combined","description":"Open treatment of orbital floor blowout fracture; combined approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":890.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6516","name":"Grad com wrap w strap foo cu","description":"Gradient compression wrap with adjustable straps, foot, each, custom","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0782T","name":"Brnchsc rf dstrj plm nrv uni","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; unilateral mainstem bronchus","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97763","name":"Orthc/prostc mgmt sbsq enc","description":"Orthotic(s)/prosthetic(s) management and/or training, upper extremity(ies), lower extremity(ies), and/or trunk, subsequent orthotic(s)/prosthetic(s) encounter, each 15 minutes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2644","name":"Dental onlay porc 4/more sur","description":"Onlay - porcelain/ceramic - four or more surfaces","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58580","name":"Transcrv abltj utrn fibrd rf","description":"Transcervical ablation of uterine fibroid(s), including intraoperative ultrasound guidance and monitoring, radiofrequency","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0682T","name":"Removal pulse gen only isdss","description":"Removal of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64658","name":"Rmvl bat modul sys lead only","description":"Removal of baroreflex activation therapy (bat) modulation system; lead only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0580U","name":"Bbrgdrferi antb detc 24rprtn","description":"Bbrgdrferi antb detc 24rprtn","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0544","name":"Post d/c phone follow up","description":"Post discharge telephonic follow-up contacts performed in conjunction with a discharge from the emergency department for behavioral health or other crisis encounter, 4 calls per calendar month","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5150","name":"Inj, aflibercept-mrbb, 1 mg","description":"Injection, aflibercept-mrbb (ahzantive), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0615","name":"Calcium acetate, oral, 23 mg","description":"Calcium acetate, oral, 23 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0407U","name":"Neph dbtc ckd mult eclia alg","description":"Neph dbtc ckd mult eclia alg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23221","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1478.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55040","name":"Removal of hydrocele","description":"Excision of hydrocele; unilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7528","name":"Mycophen mofetil for susp","description":"Mycophenolate mofetil, for suspension, oral, 100 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34451","name":"Removal of vein clot","description":"Thrombectomy, direct or with catheter; vena cava, iliac, femoropopliteal vein, by abdominal and leg incision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1882.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82633","name":"Desoxycorticosterone","description":"Desoxycorticosterone, 11-","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0339U","name":"Onc prst8 mrna hoxc6 & dlx1","description":"Onc prst8 mrna hoxc6 & dlx1","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1307","name":"Inj, crovalimab-akkz, 10 mg","description":"Injection, crovalimab-akkz, 10 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96202","name":"Mlt fam grp bhv train 1st 60","description":"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face with multiple sets of paren","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0483U","name":"Nfct ds ng gyra s91f pt mut","description":"Nfct ds ng gyra s91f pt mut","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4311","name":"Acesso, per sq cm","description":"Acesso, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92639","name":"Hearing aid meas verif","description":"Hearing-aid measurement, verification with probe-microphone (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37292","name":"Rvsc evsc tpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0879T","name":"Augmnt alys ch ct ild prep","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; radiological data preparation and transmission","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44950","name":"Appendectomy","description":"Appendectomy;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5811","name":"Denture interm cmplt mandbl","description":"Interim complete denture (mandibular)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9993","name":"Pall serv during meas","description":"Patient was provided palliative care services any time during the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4288","name":"Replacement breastpump valve","description":"Valve for breast pump, replacement","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0017","name":"Crisis psychotherapy 60m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); first 60 minutes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32480","name":"Partial removal of lung","description":"Removal of lung, other than pneumonectomy; single lobe (lobectomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1759.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0444","name":"Depression screen annual","description":"Annual depression screening, 5 to 15 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":21.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50953","name":"Endoscopy of ureter","description":"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without dilation of ureter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":393.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94626","name":"Phy/qhp op pulm rhb w/mntr","description":"Physician or other qualified health care professional services for outpatient pulmonary rehabilitation; with continuous oximetry monitoring (per session)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0780T","name":"Instlj fecal microbiota ssp","description":"Instillation of fecal microbiota suspension via rectal enema into lower gastrointestinal tract","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"Non-adju cgm supply allow","description":"Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KF"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5134","name":"Inj, tyruko, 1 mg","description":"Injection, natalizumab-sztn (tyruko), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11404","name":"Exc tr-ext b9+marg 3.1-4 cm","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 3.1 to 4.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5932","name":"Postsurgical obturator","description":"Obturator prosthesis definitive","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1162","name":"Pt enceph due to dtp bef 13","description":"Patient had encephalitis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1227","name":"Eb therapy prescribed","description":"Evidence-based therapy was prescribed","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0673T","name":"Abltj b9 thyr ndul perq lasr","description":"Ablation, benign thyroid nodule(s), percutaneous, laser, including imaging guidance","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9056","name":"Inj, vivimusta, 1 mg","description":"Injection, bendamustine hydrochloride (vivimusta), 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35601","name":"Bpg com crtd-ipsi int crtd","description":"Bypass graft, with other than vein; common carotid-ipsilateral internal carotid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1285.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6607","name":"G com bandage tub protct lyr","description":"Gradient compression bandaging supply, tubular protective absorption layer, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4279","name":"Vendaje ac, per sq cm","description":"Vendaje ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0405","name":"Ekg interpret & report preve","description":"Electrocardiogram, routine ecg with 12 leads; interpretation and report only, performed as a screening for the initial preventive physical examination","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90483","name":"Imm cnsl not admn sm>10<20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 10 minutes up to 20 minutes","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2526","name":"Cntct lens blue violet","description":"Contact lens, hydrophilic, with blue-violet filter, per lens","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26480","name":"Transplant hand tendon","description":"Transfer or transplant of tendon, carpometacarpal area or dorsum of hand; without free graft, each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1058.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1174","name":"Pt w/ 2 hzv 10/2017 - mp","description":"Patient received at least two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9002","name":"Intra-vag motion sens biofk","description":"Intra-vaginal motion sensor system, provides biofeedback for pelvic floor muscle rehabilitation device","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0752","name":"Hiv prep, oral lenacapavir","description":"Oral, lenacapavir, 300 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1443","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1377","name":"Fu colscop 10 yr doc w/ disc","description":"Recommended follow-up interval for repeat colonoscopy of 10 years documented  in colonoscopy report and communicated with patient","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81456","name":"So/hl 51/>gsap rna alys","description":"Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic sequence analysis panel, interrogation for sequence variants and copy number variants or rearrangements, or isoform expression or mrna expression levels, if performed; rna analysis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1177","name":"Pt recd pcv on/aft 19","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1714","name":"Pfizer vacc adm ped 2nd dose","description":"Pfizer vacc adm ped 2nd dose","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0045","name":"Mrs 90 days post stk","description":"Clinical follow-up and mrs score assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0510U","name":"Onc pncrtc ca alg alys 16gen","description":"Onc pncrtc ca alg alys 16gen","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0773T","name":"Vr px dissoc svc oth phy 1st","description":"Virtual reality (vr) procedural dissociation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports; initial 15 min","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36680","name":"Insert needle bone cavity","description":"Placement of needle for intraosseous infusion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76989","name":"Dx intraop epcar us chd i&r","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; interpretation and report only","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42120","name":"Remove palate/lesion","description":"Resection of palate or extensive resection of lesion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0390","name":"Chloroquine injection","description":"Injection, chloroquine hydrochloride, up to 250 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6037","name":"Postop dsg cast chg handfing","description":"Immediate post-surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, partial hand including fingers","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4266","name":"Neostim per sq cm","description":"Neostim membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0297U","name":"Onc pan tum whl gen seq dna","description":"Onc pan tum whl gen seq dna","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0561","name":"Temp tube delivery, unil","description":"Tympanostomy with local or topical anesthesia and insertion of a ventilating tube when performed with tympanostomy tube delivery device, unilateral (list separately in addition to 69433) (do not use in conjunction with 0583t)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1495","name":"Fall w/ poc, no fall","description":"Patients that reported a fall occurred who had a plan of care for falls documented or patients that did not report a fall","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0733T","name":"Rem r-t mtn nrehab ther sply","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; supply and technical support, per 30 days","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4300","name":"Acesso tl, per sq cm","description":"Acesso tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9800","name":"Gallium locametz 1 millicuri","description":"Gallium ga-68 gozetotide, diagnostic, (locametz), 1 millicurie","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0982T","name":"Rem mntr impl ivc snr set-up","description":"Remote monitoring of implantable inferior vena cava sensor, physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate), initial set-up and patient education on use of equipment","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76019","name":"Mr safety implt pos&/immoblj","description":"Mr safety implant positioning and/or immobilization under supervision of physician or other qualified health care professional, including application of physical protections to secure implanted medical device from mr-induced translational or vibrational forces, magnetically induced functional change","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1377","name":"Fu colscop 10 yr doc w/ disc","description":"Recommended follow-up interval for repeat colonoscopy of 10 years documented  in colonoscopy report and communicated with patient","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15014","name":"Prepj skn cll ssp agrft ea","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; each additional 25 sq cm of harvested skin or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0461U","name":"Onc rxgenom alys rtpcr 24gen","description":"Onc rxgenom alys rtpcr 24gen","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1274","name":"Pts snf exl mo","description":"Patients who were admitted to a skilled nursing facility (snf) during the month of evaluation were excluded from that month","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76016","name":"Mr safety deter phys/qhp","description":"Mr safety determination by a physician or other qualified health care professional responsible for the safety of the mr procedure, including review of implant mr conditions for indicated mr examination, analysis of risk vs clinical benefit of performing mr examination, and determination of mr equipm","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86305","name":"Human epididymis protein 4","description":"Human epididymis protein 4 (he4)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33268","name":"Excl laa opn oth px any meth","description":"Exclusion of left atrial appendage, open, performed at the time of other sternotomy or thoracotomy procedure(s), any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0983T","name":"Rem mntr impl ivc snr phys","description":"Remote monitoring of an implanted inferior vena cava sensor for up to 30 days, including at least weekly downloads of inferior vena cava area recordings, interpretation(s), trend analysis, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0201","name":"Pne flu hepb cov home admin","description":"Administration of pneumococcal, influenza, hepatitis b, and/or covid-19 vaccine inside a patients home; reported only once per individual home per date of service when such vaccine administration(s) are performed at the patients home","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0595U","name":"Nfct ds tfp vctrbrn&zoonotic","description":"Nfct ds tfp vctrbrn&zoonotic","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55877","name":"Abltj ire prst8 1+ tum perq","description":"Ablation, irreversible electroporation, prostate, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5156","name":"Inj, tocilizumab-anoh, 1 mg","description":"Injection, tocilizumab-anoh (avtozma), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4372","name":"Amchoplast excl per sq cm","description":"Amchoplast excel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0792T","name":"Appl slvr diamn fluoride 38%","description":"Application of silver diamine fluoride 38%, by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21705","name":"Revision of neck muscle/rib","description":"Division of scalenus anticus; with resection of cervical rib","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2543","name":"Dental onlay metallic 3 surf","description":"Onlay - metallic - three surfaces","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":72.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1273","name":"Pts snf 1 yr dialysis","description":"Patients who were admitted to a skilled nursing facility (snf) within one year of dialysis initiation according to the cms-2728 form","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1446","name":"Pt died bef end meas pd","description":"Patients who died any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0585U","name":"Tgsap so neo cfdna 521 genes","description":"Tgsap so neo cfdna 521 genes","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29834","name":"Elbow arthroscopy/surgery","description":"Arthroscopy, elbow, surgical; with removal of loose body or foreign body","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4560","name":"Nmes disposable","description":"Neuromuscular electrical stimulator (nmes), disposable, replacement only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92641","name":"Hearing dev verif eacous aly","description":"Hearing device verification, electroacoustic analysis","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9156","name":"Oral mucoadhesive per 1 ml","description":"Oral mucoadhesive, any type (liquid, gel, paste, etc.), per 1 ml","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6093","name":"Recement supp part denture","description":"Recement implant/abutment supported fixed partial denture","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1499","name":"Interventional radiology mvp","description":"Interventional radiology mips value pathway","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64473","name":"Lwr xtr fscl pln blk uni njx","description":"Lower extremity fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4354","name":"Palingen dl-palingen dl-x","description":"Palingen dual-layer membrane and dual-layer palingen x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0780T","name":"Instlj fecal microbiota ssp","description":"Instillation of fecal microbiota suspension via rectal enema into lower gastrointestinal tract","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2792","name":"Crown full cast noble metal","description":"Crown-full cast noble metal","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0592U","name":"Onc hl neo dna tgs 417 genes","description":"Onc hl neo dna tgs 417 genes","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0748T","name":"Njx stm cl prdct anl sft tis","description":"Injections of stem cell product into perianal perifistular soft tissue, including fistula preparation (eg, removal of setons, fistula curettage, closure of internal openings)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22838","name":"Rev rplc/rmv thrc vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracic vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26860","name":"Fusion of finger joint","description":"Arthrodesis, interphalangeal joint, with or without internal fixation;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92631","name":"Hearing aid slctn svc 1st 30","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9011","name":"Datopotamab deruxtecan, 1 mg","description":"Injection, datopotamab deruxtecan-dlnk, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99461","name":"Init nb em per day non-fac","description":"Initial care, per day, for evaluation and management of normal newborn infant seen in other than hospital or birthing center","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":59.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0411U","name":"Psyc genom alys pnl 15 gen","description":"Psyc genom alys pnl 15 gen","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4373","name":"Membrane wrp lt per sq cm","description":"Membrane wrap lite, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41872","name":"Gingivoplasty each quadrant","description":"Gingivoplasty, each quadrant (specify)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1355","name":"Caries med app per tooth","description":"Caries med app per tooth","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77436","name":"Surf radj ther tx planning","description":"Surface radiation therapy; superficial or orthovoltage, treatment planning and simulation-aided field setting","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4293","name":"Acesso dl, per sq cm","description":"Acesso dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0679T","name":"Laps rmvl lead isdss","description":"Laparoscopic removal of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0566","name":"3d bn img algor drvd fr mri","description":"3d radiodensity-value bone imaging, algorithm derived, from previous magnetic resonance examination of the same anatomy","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3222","name":"Part pulp for apexogenesis","description":"Partial pulpotomy for apexogenesis - permanent tooth with incomplete root development","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0650","name":"Inj, levothyroxine nos 10mcg","description":"Injection, levothyroxine sodium, not otherwise specified, 10 mcg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74249","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2017","name":"Permeaderm glove, each","description":"Permeaderm glove, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0983T","name":"Rem mntr impl ivc snr phys","description":"Remote monitoring of an implanted inferior vena cava sensor for up to 30 days, including at least weekly downloads of inferior vena cava area recordings, interpretation(s), trend analysis, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0373","name":"Tomo bitewing image","description":"Tomo bitewing image","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37259","name":"Revsc evasc ivt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92638","name":"Bhvl verif of amplification","description":"Behavioral verification of amplification including aided thresholds, functional gain, speech-in-noise, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0701","name":"Pano radio image","description":"Pano radio image","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0959T","name":"Rmv/rplc magnet coil assem","description":"Removal or replacement of magnet from coil assembly that is connected to continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1259","name":"Pt stat doc <= 1 yr dialysis","description":"Patient status documented within the first year of initiating dialysis","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9245","name":"Admin mod sedation-enteral","description":"Admin mod sedation-enteral","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9296","name":"Inj pemetrexed (accord) 10mg","description":"Injection, pemetrexed (accord), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64868","name":"Fusion of facial/other nerve","description":"Anastomosis; facial-hypoglossal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1208.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":823.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0426U","name":"Genome ultra-rapid seq alys","description":"Genome ultra-rapid seq alys","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9027","name":"Rbc o2 co2 reduced","description":"Red blood cells, leukocytes reduced, oxygen/ carbon dioxide reduced, each unit","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4387","name":"Neothelium ft per sq cm","description":"Neothelium ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0032","name":"2+ antipsy schiz","description":"Two or more antipsychotic prescriptions ordered for patients who had a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder on or between january 1 of the year prior to the measurement period and the index prescription start date (ipsd) for antipsychotics","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0855T","name":"Dgtz gls mcrscp b1 marow smr","description":"Digitization of glass microscope slides for bone marrow, smear interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49405","name":"Image cath fluid colxn visc","description":"Image-guided fluid collection drainage by catheter (eg, abscess, hematoma, seroma, lymphocele, cyst); visceral (eg, kidney, liver, spleen, lung/mediastinum), percutaneous","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":965.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1314","name":"Bmi not calculated","description":"Bmi not documented and no reason is given","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15958","name":"Exc trchntr pr ulc prep ostc","description":"Excision, trochanteric pressure ulcer, in preparation for muscle or myocutaneous flap or skin graft closure; with ostectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1300.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63030","name":"Lamot dcmprn nrv rt 1 lmbr","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, lumbar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1082.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0504U","name":"Nfct ds uti id 17 path orgs","description":"Nfct ds uti id 17 path orgs","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29823","name":"Sho arthrs srg xtnsv dbrdmt","description":"Arthroscopy, shoulder, surgical; debridement, extensive, 3 or more discrete structures (eg, humeral bone, humeral articular cartilage, glenoid bone, glenoid articular cartilage, biceps tendon, biceps anchor complex, labrum, articular capsule, articular side of the rotator cuff, bursal side of the ro","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":768.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3392","name":"Inj, exagamglogene autotem","description":"Injection, exagamglogene autotemcel, per treatment","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4425","name":"Revive tl per sq cm","description":"Revive tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0786T","name":"Insj/rplcmt prq ra sac nstim","description":"Insertion or replacement of percutaneous electrode array, sacral, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0136","name":"Adm of pa/n assess 5-15 m","description":"Administration of a standardized, evidence-based assessment of physical activity and nutrition, 5-15 minutes, not more often than every 6 months","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0831T","name":"Dgtz gls mcrscp cytp c/v","description":"Digitization of glass microscope slides for cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0893T","name":"N-invas assmt bld oxygnation","description":"Noninvasive assessment of blood oxygenation, gas exchange efficiency, and cardiorespiratory status, with physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92634","name":"Hearing aid fitg svc 1st 60","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; first 60 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"Basic vestibular evaluation","description":"Basic vestibular evaluation, includes spontaneous nystagmus test with eccentric gaze fixation nystagmus, with recording, positional nystagmus test, minimum of 4 positions, with recording, optokinetic nystagmus test, bidirectional foveal and peripheral stimulation, with recording, and oscillating tra","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6280","name":"Implt maint procd remv implt","description":"Implt maint procd remv implt","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0348U","name":"Rx metab/pcx dna 25 gen alys","description":"Rx metab/pcx dna 25 gen alys","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4211","name":"Gingivectomy/plasty per toot","description":"Gingivectomy or gingivoplasty - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4262","name":"Dual layer impax, per sq cm","description":"Dual layer impax membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0219","name":"Inj aval alfa-nqpt 4mg","description":"Injection, avalglucosidase alfa-ngpt, 4 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0666","name":"Inj, bupivacaine liposome","description":"Injection, bupivacaine liposome, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1210","name":">=2 same meds tbl4 not ord","description":"At least two orders for high-risk medications from the same drug class, (table 4), not ordered","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64809","name":"Sympathectomy thoracolumbar","description":"Sympathectomy, thoracolumbar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":926.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0872T","name":"Rplcmt ndwllg bldr&prtl cath","description":"Replacement of indwelling bladder and peritoneal catheters, including tunneling of catheter(s) and connection with previously implanted peritoneal ascites pump, including imaging and programming, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0340U","name":"Onc pan ca alys mrd plasma","description":"Onc pan ca alys mrd plasma","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2998","name":"Inj plasminogen tvmh 1mg","description":"Injection, plasminogen, human-tvmh, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99437","name":"Chrnc care mgmt phys ea addl","description":"Chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, or funct","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33902","name":"Perq p-art revsc 1 abnor uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, unilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":405.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2373","name":"Inj, immphentiv, 20 mcg","description":"Injection, phenylephrine hydrochloride (immphentiv), 20 micrograms","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2003","name":"Inj, lidocaine hcl, 1 mg","description":"Injection, lidocaine hydrochloride, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7671","name":"Alveolus open reduction","description":"Alveolus - open reduction may include stabilization of teeth","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1271","name":"Pts dem any time/dur mo","description":"Patients with dementia at any time prior to or during the month","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5913","name":"Nasal prosthesis","description":"Nasal prosthesis","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1187","name":"Pt w/ esrd","description":"Patients with a diagnosis of end stage renal disease (esrd)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70472","name":"Ct cere prfu alys c+w/ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed with concurrent ct or ct angiography of the same anatomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49904","name":"Omental flap extra-abdom","description":"Omental flap, extra-abdominal (eg, for reconstruction of sternal and chest wall defects)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1709.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67800","name":"Remove eyelid lesion","description":"Excision of chalazion; single","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81349","name":"Cytog alys chrml abnr lw-ps","description":"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and loss-of-heterozygosity variants, low-pass sequencing analysis","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67710","name":"Severing tarsorrhaphy","description":"Severing of tarsorrhaphy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43197","name":"Esophagoscopy flex dx brush","description":"Esophagoscopy, flexible, transnasal; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5949","name":"Mand implt sup fix part","description":"Mand implt sup fix part","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1032","name":"Sv doula brth wrk per 15 min","description":"Services performed by a doula birth worker, per 15 minutes","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5411","name":"Dentures adjust cmplt mand","description":"Adjust complete denture - mandibular","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2779","name":"Inj, susvimo 0.1 mg","description":"Injection, ranibizumab, via intravitreal implant (susvimo), 0.1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76641","name":"Ultrasound breast complete","description":"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0045","name":"Mrs 90 days post stk","description":"Clinical follow-up and mrs score assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0708T","name":"Id ca immntx prep & 1st njx","description":"Intradermal cancer immunotherapy; preparation and initial injection","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28306","name":"Incision of metatarsal","description":"Osteotomy, with or without lengthening, shortening or angular correction, metatarsal; first metatarsal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0661","name":"Team remote e/m new pt 20 mn","description":"Team remote e/m new pt 20mins","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0423U","name":"Psyc genomic alys pnl 26 gen","description":"Psyc genomic alys pnl 26 gen","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0562U","name":"Onc sol tum tgsa 33gens snvs","description":"Onc sol tum tgsa 33gens snvs","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37267","name":"Revsc evsc fpvt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43889","name":"Gstr rstcv px trnsorl esg","description":"Gastric restrictive procedure, transoral, endoscopic sleeve gastroplasty (esg), including argon plasma coagulation, when performed","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36836","name":"Prq av fstl crtj uxtr 1 acs","description":"Percutaneous arteriovenous fistula creation, upper extremity, single access of both the peripheral artery and peripheral vein, including fistula maturation procedures (eg, transluminal balloon angioplasty, coil embolization) when performed, including all vascular access, imaging guidance and radiolo","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3503","name":"Surg exp root surf molar","description":"Surg exp root surf molar","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1151","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4318","name":"E-graft, per sq cm","description":"E-graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33415","name":"Revision subvalvular tissue","description":"Resection or incision of subvalvular tissue for discrete subvalvular aortic stenosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1922.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0878T","name":"Augmnt alys ch ct ild w/ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained with concurrent ct examination of the same structure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29850","name":"Knee arthroscopy/surgery","description":"Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; without internal or external fixation (includes arthroscopy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":649.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0594U","name":"Nfct ds sepsis pncrtc spc","description":"Nfct ds sepsis pncrtc spc","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33279","name":"Rmvl phrnc nrv stim transvns","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s) only","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1491","name":"Recd esrd mcp dur perf pd","description":"Receiving esrd mcp dialysis services by the provider during the performance period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2041","name":"Coord special care encounter","description":"Coordinated specialty care, team-based, for first episode psychosis, per encounter","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0601U","name":"Nfct ds pji alys 11 bmrks ia","description":"Nfct ds pji alys 11 bmrks ia","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0391","name":"Inj, artesunate, 1mg","description":"Injection, artesunate, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7165","name":"Inj, human-lans, per i.u","description":"Injection, prothrombin complex concentrate, human-lans, per i.u. of factor ix activity","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4257","name":"Relese, per sq cm","description":"Relese, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69719","name":"Rplcm oi implt sk tc esp<100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0766T","name":"Tc mag stimj pn 1st nerve","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; first nerve","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4036","name":"Urgent care ss","description":"Urgent care mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75959","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3921","name":"Decor or submerg erupt tooth","description":"Decor or submerg erupt tooth","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9292","name":"Pres dig visual therapy fda","description":"Prescription digital visual therapy, software-only, fda cleared, per course of treatment","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11046","name":"Dbrdmt musc&/fsca ea addl","description":"Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); each additional 20 sq cm, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":88.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0462U","name":"Melatonin lvl tst slp std7/9","description":"Melatonin lvl tst slp std7/9","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9949","name":"Repair sleep apnea appliance","description":"Repair sleep apnea appliance","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1278","name":"Pre-htn or htn doc, f/u indc","description":"Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1171","name":"Inj, hydromorphone, 0.1 mg","description":"Injection, hydromorphone, 0.1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68841","name":"Insj rx elut implt lac canal","description":"Insertion of drug-eluting implant, including punctal dilation when performed, into lacrimal canaliculus, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1189","name":"Doc khe pef w/efgr/uacr","description":"Documentation of a kidney health evaluation defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr) performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76065","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0871T","name":"Rplcmt subq prtl ascites pmp","description":"Replacement of a subcutaneous peritoneal ascites pump, including reconnection between pump and indwelling bladder and peritoneal catheters, including initial programming and imaging, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4005","name":"Family medicine ss","description":"Family medicine mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0871T","name":"Rplcmt subq prtl ascites pmp","description":"Replacement of a subcutaneous peritoneal ascites pump, including reconnection between pump and indwelling bladder and peritoneal catheters, including initial programming and imaging, when performed","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99347","name":"Home/res vst est sf mdm 20","description":"Home or residence visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 20 minutes must be met or exceede","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99479","name":"Sbsq ic lbw inf 1,500-2,500","description":"Subsequent intensive care, per day, for the evaluation and management of the recovering low birth weight infant (present body weight of 1,500-2,500 grams)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":62.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3222","name":"Part pulp for apexogenesis","description":"Partial pulpotomy for apexogenesis - permanent tooth with incomplete root development","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0211","name":"Inj, nithiodote, 3mg / 125mg","description":"Injection, sodium nitrite 3 mg and sodium thiosulfate 125 mg (nithiodote)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1291","name":"Pt 66+ frailty and med dem","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4425","name":"Revive tl per sq cm","description":"Revive tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4148","name":"Enteral feed elastomer daily","description":"Enteral feeding supply kit; elastomeric control fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0816T","name":"Opn insj/rplcmt ins ptn subq","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3373","name":"Inj, vancomycin hcl, 10 mg","description":"Injection, vancomycin hydrochloride, 10 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J1452","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4350","name":"Palisade dm matrix per sq cm","description":"Palisade dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98014","name":"Synch audio-only est mod 30","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code s","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0536","name":"Peer recover support svs","description":"Peer recovery support services, provided directly or by referral; including leveraging knowledge of the condition or lived experience to provide support, mentorship, or inspiration to meet oud treatment and recovery goals; conducting a person-centered interview to understand the patients life story,","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0725T","name":"Vestibular dev impltj uni","description":"Vestibular device implantation, unilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3055","name":"Inj talquetamab-tgvs 0.25 mg","description":"Injection, talquetamab-tgvs, 0.25 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0469U","name":"Rare ds whl gen seq ftl samp","description":"Rare ds whl gen seq ftl samp","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4423","name":"Biolab tri wrap fl per sq cm","description":"Biolab tri-membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2001","name":"Suct pum ext mgmt sys","description":"Suction pump, home model, portable or stationary, electric, any type, for use with external urine and/or fecal management system","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35525","name":"Art byp grft brachial-brchl","description":"Bypass graft, with vein; brachial-brachial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1419.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0442U","name":"Nfct ds respir nfctj mxa&crp","description":"Nfct ds respir nfctj mxa&crp","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36815","name":"Insertion of cannula","description":"Insertion of cannula for hemodialysis, other purpose (separate procedure); arteriovenous, external revision, or closure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86043","name":"Acetylcholn rcptr modlg antb","description":"Acetylcholine receptor (achr); modulating antibody","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1236","name":"Baseline mrs > 2","description":"Baseline mrs > 2","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1383","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95117","name":"Immunotherapy injections","description":"Professional services for allergen immunotherapy not including provision of allergenic extracts; 2 or more injections","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0885T","name":"Colsc flx 1st tndsc dilat","description":"Colonoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0650","name":"Inj, levothyroxine nos 10mcg","description":"Injection, levothyroxine sodium, not otherwise specified, 10 mcg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1168","name":"Pt recd flu vax 7/1-6/30","description":"Patient received an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"Evoked auditory test limited","description":"Distortion product evoked otoacoustic emissions; limited evaluation (to confirm the presence or absence of hearing disorder, 3-6 frequencies) or transient evoked otoacoustic emissions, with interpretation and report","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29875","name":"Arthrs knee surg synvct lmtd","description":"Arthroscopy, knee, surgical; synovectomy, limited (eg, plica or shelf resection) (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37297","name":"Revsc evasc imvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93594","name":"R hrt cath chd abnl nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; abnormal native connections","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0738T","name":"Tx pln mag fld abltj prst8","description":"Treatment planning for magnetic field induction ablation of malignant prostate tissue, using data from previously performed magnetic resonance imaging (mri) examination","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80504","name":"Path clin consltj mod 21-40","description":"Pathology clinical consultation; for a moderately complex clinical problem, with review of patients history and medical records and moderate level of medical decision making when using time for code selection, 21-40 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0839T","name":"Dgtz gls mcrscp cslt mat prp","description":"Digitization of glass microscope slides for consultation and report on referred material requiring preparation of slides (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1286","name":"Bmi doc onl fup not cmpltd","description":"Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0492U","name":"Onc sol tum ctc slctn pd-l1","description":"Onc sol tum ctc slctn pd-l1","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4415","name":"Alexiguard st-l per sq cm","description":"Alexiguard sl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9298","name":"Inj nivol relatlimab 3mg/1mg","description":"Injection, nivolumab and relatlimab-rmbw, 3 mg/1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2802","name":"Inj, romiplostim 1 microgram","description":"Injection, romiplostim, 1 microgram","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27503","name":"Treatment of thigh fracture","description":"Closed treatment of supracondylar or transcondylar femoral fracture with or without intercondylar extension, with manipulation, with or without skin or skeletal traction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":943.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4006","name":"Gastroenterology ss","description":"Gastro-enterology mips specialty set","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28046","name":"Resect foot/toe tumor < 3 cm","description":"Radical resection of tumor (eg, sarcoma), soft tissue of foot or toe; less than 3 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":809.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9393","name":"Inj, fulvestrant (teva)","description":"Injection, fulvestrant (teva), not therapeutically equivalent to j9395, 25 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4343","name":"Dermacyte ac matrx per sq cm","description":"Dermacyte ac matrix amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0483","name":"Indirect immunofluorescence","description":"Indirect immunofluorescence","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0844T","name":"Dgtz gls mcrscp cslt cyt ea","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), each additional site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2601","name":"Inj, vasopressin (baxter)","description":"Injection, vasopressin (baxter), 1 unit","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0001","name":"Advancing cancer care mvp","description":"Advancing cancer care mips value pathways","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5940","name":"Resct proth max part remov","description":"Resct proth max part remov","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0537U","name":"Onc clrct ca cfdna >2500 dmr","description":"Onc clrct ca cfdna >2500 dmr","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64446","name":"Njx aa&/strd sc nrv nfs img","description":"Injection(s), anesthetic agent(s) and/or steroid; sciatic nerve, continuous infusion by catheter (including catheter placement), including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67820","name":"Revise eyelashes","description":"Correction of trichiasis; epilation, by forceps only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1248","name":"Pt resp true seen as person","description":"Patient responded completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4341","name":"Simplimax, per sq cm","description":"Simplimax, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85007","name":"Bl smear w/diff wbc count","description":"Blood count; blood smear, microscopic examination with manual differential wbc count","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45346","name":"Sigmoidoscopy w/ablation","description":"Sigmoidoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2725.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":153.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7049","name":"Epap nasal valve","description":"Expiratory positive airway pressure intranasal resistance valve","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74455","name":"X-ray urethra/bladder","description":"Urethrocystography, voiding, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41830","name":"Removal of gum tissue","description":"Alveolectomy, including curettage of osteitis or sequestrectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":337.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77081","name":"Dxa bone density appendiculr","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":18.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55535","name":"Revise spermatic cord veins","description":"Excision of varicocele or ligation of spermatic veins for varicocele; abdominal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4017","name":"Nutrition/dietician ss","description":"Nutrition/dietician mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57555","name":"Remove cervix/repair vagina","description":"Excision of cervical stump, vaginal approach; with anterior and/or posterior repair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":675.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0925T","name":"Rlcj skin pocket ccm-d pg","description":"Relocation of skin pocket for implanted cardiac contractility modulation-defibrillation pulse generator","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9255","name":"Inj, methotrexate (accord)","description":"Injection, methotrexate (accord), not therapeutically equivalent to j9260, 50 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0250","name":"Adm tocilizu covid-19 2nd","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0889T","name":"Prsnlz trgt dvl arhfcmrigtbs","description":"Personalized target development for accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation derived from a structural and resting-state functional mri, including data preparation and transmission, generation of the target, motor threshold-starting location, neuro","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6049","name":"Scale implt peri-implt inflm","description":"Scale implt peri-implt inflm","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4315","name":"Regenelink amniotic mem allo","description":"Regenelink amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90838","name":"Psytx w pt w e/m 60 min","description":"Psychotherapy, 60 minutes with patient when performed with an evaluation and management service (list separately in addition to the code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":120.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2373","name":"Inj, immphentiv, 20 mcg","description":"Injection, phenylephrine hydrochloride (immphentiv), 20 micrograms","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9608","name":"Flotufolastat f18 diag 1 mci","description":"Flotufolastat f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4034","name":"Speech language path ss","description":"Speech language pathology mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37280","name":"Revsc evsc tpvt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54162","name":"Lysis penil circumic lesion","description":"Lysis or excision of penile post-circumcision adhesions","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64473","name":"Lwr xtr fscl pln blk uni njx","description":"Lower extremity fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0517U","name":"Ther rx mntr 80+ psyactiv rx","description":"Ther rx mntr 80+ psyactiv rx","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64654","name":"1st opn implt bat modulj sys","description":"Initial open implantation of baroreflex activation therapy (bat) modulation system, including lead placement onto the carotid sinus, lead tunnelling, connection to a pulse generator placed in a distant subcutaneous pocket (ie, total system), and intraoperative interrogation and programming","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1176","name":"No 2 hzv 10/2017-meas pd","description":"Patient did not receive two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0531U","name":"Nfct ds afb&inv fng 673orgs","description":"Nfct ds afb&inv fng 673orgs","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1300","name":"Flu imm no admin doc rea","description":"Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72069","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4319","name":"Sanograft, per sq cm","description":"Sanograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0574U","name":"Mtb cfp-10 serum/plsm lc-ms","description":"Mtb cfp-10 serum/plsm lc-ms","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87520","name":"Hepatitis c rna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis c, direct probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1260","name":"Pt not doc <= 1 yr dialysis","description":"Patient status not documented within the first year of initiating dialysis","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33277","name":"Insj phrnc nrv stim transvns","description":"Insertion of phrenic nerve stimulator transvenous sensing lead (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99468","name":"Neonate crit care initial","description":"Initial inpatient neonatal critical care, per day, for the evaluation and management of a critically ill neonate, 28 days of age or younger","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":761.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J9310","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4418","name":"Biolab wrap flow per sq cm","description":"Biolab membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37264","name":"Revsc evasc fpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77080","name":"Dxa bone density axial","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":62.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94013","name":"Meas lung vol thru 2 yrs","description":"Measurement of lung volumes (ie, functional residual capacity [frc], forced vital capacity [fvc], and expiratory reserve volume [erv]) in an infant or child through 2 years of age","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2251","name":"Inj midazolam in 0.9% nacl","description":"Injection, midazolam in 0.9% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1435","name":"Injection estrone per 1 mg","description":"Injection, estrone, per 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1242","name":"Pt no resp imprt to me","description":"Patient did not respond to the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0414","name":"Lab process microbial spec","description":"Lab process microbial spec","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1312","name":"No pt tbco scrn rng","description":"Patient not screened for tobacco use","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4303","name":"Complete aa, per sq cm","description":"Complete aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86825","name":"Hla x-math non-cytotoxic","description":"Human leukocyte antigen (hla) crossmatch, non-cytotoxic (eg, using flow cytometry); first serum sample or dilution","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1203","name":"No rsn ace-i/arb rx","description":"Ace inhibitor or arb therapy not prescribed during the measurement period, reason not given","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5151","name":"Inj, eculizumab-aagh, 2 mg","description":"Injection, eculizumab-aagh (epysqli), biosimilar, 2 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2043","name":"Biobrane, per sq cm","description":"Biobrane, per square centimeter","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4301","name":"Activate matrix, per sq cm","description":"Activate matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0750T","name":"B1 str&fx rsk asmt dxrbmd1vw","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81463","name":"So gsap cl fr cpy nmbr&mcrst","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis, copy number variants, and microsatellite instability","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2919","name":"Inj, methylpred sod succ 5mg","description":"Injection, methylprednisolone sodium succinate, 5 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5155","name":"Inj, aflibercept-jbvf, 1 mg","description":"Injection, aflibercept-jbvf (yesafili), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0821T","name":"Mntr psychdlc med 2ndphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; second physician or other qualified health care professional, concurrent with first physician or other qualified health care professional, each hour (list sepa","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26437","name":"Realignment of tendons","description":"Realignment of extensor tendon, hand, each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0146","name":"Nav srv peer sup add 30 pr m","description":"Principal illness navigation - peer support, additional 30 minutes per calendar month (list separately in addition to g0140)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97551","name":"Caregiver traing ea addl 15","description":"Caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patie","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1352","name":"Suicd c-ssrs assessment, equ","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs or equivalent assessment","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1424","name":"Pulmonology care mvp","description":"Pulmonology care mips value pathway","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2056","name":"Ciltacabtagene car-pos t","description":"Ciltacabtagene autoleucel, up to 100 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0306U","name":"Onc mrd nxt-gnrj alys 1st","description":"Onc mrd nxt-gnrj alys 1st","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6614","name":"Onlay cst nbl mtl 2 surfaces","description":"Onlay - cast noble metal two surfaces","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1294","name":"Bp scrn perf rec interval","description":"Normal blood pressure reading documented, follow-up not required","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0783T","name":"Tc auriculr neurostimulation","description":"Transcutaneous auricular neurostimulation, set-up, calibration, and patient education on use of equipment","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82465","name":"Assay bld/serum cholesterol","description":"Cholesterol, serum or whole blood, total","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0517U","name":"Ther rx mntr 80+ psyactiv rx","description":"Ther rx mntr 80+ psyactiv rx","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26641","name":"Treat thumb dislocation","description":"Closed treatment of carpometacarpal dislocation, thumb, with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":354.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0364U","name":"Onc hl neo gen seq alys alg","description":"Onc hl neo gen seq alys alg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0998T","name":"Precuneus mag stimj tx dlvr","description":"Precuneus magnetic stimulation; personalized treatment delivery of magnetic stimulation therapy to a prespecified target area derived from analysis of evoked potentials within the precuneus, utilizing magnetic resonance imaging-based neuronavigation, with management, per day","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0506U","name":"Gi barretts esophgl cell 89","description":"Gi barretts esophgl cell 89","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0528U","name":"Lrt iad 18bct/8vir&7arg rna","description":"Lrt iad 18bct/8vir&7arg rna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86041","name":"Acetylcholn rcptr bndng antb","description":"Acetylcholine receptor (achr); binding antibody","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1237","name":"Pt rsn no scrn","description":"Patient reason for not screening for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety (e.g., patient declined or other patient reasons)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64567","name":"Perq elec nrv field stimj cn","description":"Percutaneous electrical nerve field stimulation, cranial nerves, without implantation","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1400","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87468","name":"Anaplsma phgcytophlm amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); anaplasma phagocytophilum, amplified probe technique","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5142","name":"Inj adalimumab-ryvk, 1 mg","description":"Injection, adalimumab-ryvk biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9871","name":"Bhv couns dm prev, onln 60 m","description":"Behavioral counseling for diabetes prevention, online, 60 minutes","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93261","name":"Interrogate subq defib","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; implantable subcutaneous lead defibrillator system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1276","name":"Calc bmi out nrm param nof/u","description":"Bmi documented outside normal parameters, no follow-up plan documented, no reason given","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5154","name":"Inj, omlyclo, 5 mg","description":"Injection, omalizumab-igec (omlyclo), biosimilar, 5 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0800T","name":"Tcat rmvl 2chmbr ldls pm rv","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right ventricular pacemaker component (when part of a dual-chamber leadless pacem","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1249","name":"Pt resp true imprt to me","description":"Patient responded completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4324","name":"Amniotx, per sq cm","description":"Amniotx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0738T","name":"Tx pln mag fld abltj prst8","description":"Treatment planning for magnetic field induction ablation of malignant prostate tissue, using data from previously performed magnetic resonance imaging (mri) examination","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85027","name":"Complete cbc automated","description":"Blood count; complete (cbc), automated (hgb, hct, rbc, wbc and platelet count)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6252","name":"Bridge resin w/noble metal","description":"Pontic-resin with noble metal","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1465","name":"F/u > 180 days after rx","description":"Patient follow up more than 180 days after treatment","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0489U","name":"Ob sgnipt cfdna seq alys 1+","description":"Ob sgnipt cfdna seq alys 1+","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19020","name":"Mastotomy expl drg absc dp","description":"Mastotomy with exploration or drainage of abscess, deep","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59614","name":"Vbac care after delivery","description":"Vaginal delivery only, after previous cesarean delivery (with or without episiotomy and/or forceps); including postpartum care","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1265.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64890","name":"Nrv grf 1strnd hnd/foot <4cm","description":"Nerve graft (includes obtaining graft), single strand, hand or foot; up to 4 cm length","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J9096","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6031","name":"Rep interface handfng molded","description":"Replacement socket/interface, partial hand including fingers, molded to patient model, for use with or without external power","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5411","name":"Dentures adjust cmplt mand","description":"Adjust complete denture - mandibular","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26070","name":"Explore/treat hand joint","description":"Arthrotomy, with exploration, drainage, or removal of loose or foreign body; carpometacarpal joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0761T","name":"Dgtz gls mcrscp sl imm ea 1","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9573","name":"Inj, gadopiclenol, 1 ml","description":"Injection, gadopiclenol, 1 ml","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63170","name":"Incise spinal cord tract(s)","description":"Laminectomy with myelotomy (eg, bischof or drez type), cervical, thoracic, or thoracolumbar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1689.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75801","name":"Lymph vessel x-ray arm/leg","description":"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1181","name":"Gr 2 or> dia or gr2 or> col","description":"Grade 2 or above diarrhea and/or grade 2 or above colitis","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15012","name":"Hrv skn cll ssp agrft ea add","description":"Harvest of skin for skin cell suspension autograft; each additional 25 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0735T","name":"Prep tum cav iort prim crnot","description":"Preparation of tumor cavity, with placement of a radiation therapy applicator for intraoperative radiation therapy (iort) concurrent with primary craniotomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0463U","name":"Onc crvx mrna genxprsn 14bmk","description":"Onc crvx mrna genxprsn 14bmk","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29355","name":"Appl long leg cast walker","description":"Application of long leg cast (thigh to toes); walker or ambulatory type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0681","name":"Inj ceftobipole medocarl 3mg","description":"Injection, ceftobiprole medocaril sodium, 3 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4302","name":"Complete aca, per sq cm","description":"Complete aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0316U","name":"B brgdrferi lyme ds ospa evl","description":"B brgdrferi lyme ds ospa evl","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64413","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77090","name":"Tbs techl prep&transmis data","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55712","name":"Bx prst8 tprnl mri-us 1st","description":"Biopsy, prostate, transperineal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86051","name":"Aquaporin-4 antb elisa","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; enzyme-linked immunosorbent immunoassay (elisa)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0469U","name":"Rare ds whl gen seq ftl samp","description":"Rare ds whl gen seq ftl samp","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0721T","name":"Quan ct tiss charac w/o ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0281U","name":"Hem vwd propeptide ag lvl","description":"Hematology (von willebrand disease [vwd]), von willebrand propeptide, enzyme-linked immunosorbent assays (elisa), plasma, diagnostic report of von willebrand factor (vwf) propeptide antigen level","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0475U","name":"Hered prst8 ca gsap 23 genes","description":"Hered prst8 ca gsap 23 genes","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0553","name":"Monthly tx for dmht 20mins","description":"First 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing information related to the use of","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0519U","name":"Ther rx mntr meds p/d/a 110+","description":"Ther rx mntr meds p/d/a 110+","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37274","name":"Rvsc evsc fpvt athrc cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1736","name":"Inj meloxicam (delova) 1mg","description":"Injection, meloxicam (delova), 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0480U","name":"Nfct ds csf metag ngs alys","description":"Nfct ds csf metag ngs alys","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84431","name":"Thromboxane urine","description":"Thromboxane metabolite(s), including thromboxane if performed, urine","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0033","name":"2+ benzo seiz","description":"Two or more benzodiazepine prescriptions ordered for patients who had a diagnosis of seizure disorders, rapid eye movement sleep behavior disorder, benzodiazepine withdrawal, ethanol withdrawal, or severe generalized anxiety disorder on or between january 1 of the year prior to the measurement perio","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J0886","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0696T","name":"Bdy surf mapg pm/cvdfb f/up","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of follow-up interrogation or programming device evaluatio","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75870","name":"Vein x-ray skull","description":"Venography, superior sagittal sinus, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28119","name":"Removal of heel spur","description":"Ostectomy, calcaneus; for spur, with or without plantar fascial release","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98979","name":"Rtm tx mgmt 1st 10 min","description":"Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least 1 real-time interactive communication with the patient or caregiver during the calendar month; first 10 minutes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45385","name":"Colonoscopy w/lesion removal","description":"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":338.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0573U","name":"Onc pancreas 3bmrk pclf alg","description":"Onc pancreas 3bmrk pclf alg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26037","name":"Decompress fingers/hand","description":"Decompressive fasciotomy, hand (excludes 26035)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":669.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4031","name":"Radiation oncology ss","description":"Radiation oncology mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4404","name":"Xwrap hydro plus per sq cm","description":"Xwrap hydro plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1248","name":"Pt resp true seen as person","description":"Patient responded completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2542","name":"Dental onlay metallic 2 surf","description":"Onlay-metallic-two surfaces","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1257","name":"Cvd risk assess not perf","description":"Cvd risk assessment not performed or incomplete (e.g., cvd risk assessment was not documented), reason not otherwise specified","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83987","name":"Exhaled breath condensate","description":"Ph; exhaled breath condensate","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2777","name":"Inj, faricimab-svoa, 0.1mg","description":"Injection, faricimab-svoa, 0.1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69660","name":"Revise middle ear bone","description":"Stapedectomy or stapedotomy with reestablishment of ossicular continuity, with or without use of foreign material;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1078.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9322","name":"Inj pemetrexed (bluepoint)","description":"Injection, pemetrexed (bluepoint), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2027","name":"Matriderm per sq cm","description":"Matriderm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9938","name":"Fab removable appliance","description":"Fab removable appliance","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5159","name":"Inj, denosumab-dssb, 1 mg","description":"Injection, denosumab-dssb (ospomyv/xbryk), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1473","name":"Pt func cap not allow impr","description":"Patient situations, at any point during the denominator identification period, where the patients functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools, such as delirium, dementia, intellectual disabilities, and pervasive and specific de","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1596","name":"Inj, glycopyrrolate, 0.1 mg","description":"Injection, glycopyrrolate, 0.1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0316U","name":"B brgdrferi lyme ds ospa evl","description":"B brgdrferi lyme ds ospa evl","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4024","name":"Pediatrics ss","description":"Pediatrics mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0283U","name":"Vw factor type 2b eval plsm","description":"Von willebrand factor (vwf), type 2b, platelet-binding evaluation, radioimmunoassay, plasma","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0932T","name":"N-invs det hrt fail aug echo","description":"Noninvasive detection of heart failure derived from augmentative analysis of an echocardiogram that demonstrated preserved ejection fraction, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9156","name":"Oral mucoadhesive per 1 ml","description":"Oral mucoadhesive, any type (liquid, gel, paste, etc.), per 1 ml","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93892","name":"Tcd emboli detect w/o inj","description":"Transcranial doppler study of the intracranial arteries; emboli detection without intravenous microbubble injection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0033","name":"2+ benzo seiz","description":"Two or more benzodiazepine prescriptions ordered for patients who had a diagnosis of seizure disorders, rapid eye movement sleep behavior disorder, benzodiazepine withdrawal, ethanol withdrawal, or severe generalized anxiety disorder on or between january 1 of the year prior to the measurement perio","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0675T","name":"Laps insj nw/rpcmt isdss 1ld","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first lead","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0491","name":"Oral dv nm mouthpc hw remote","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4316","name":"Amchoplast, per sq cm","description":"Amchoplast, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1184","name":"Doc med rsn no cst/ist rx","description":"Documentation of medical reason(s) for not prescribing or administering corticosteroid or immunosuppressant treatment (e.g., allergy, intolerance, infectious etiology, pancreatic insufficiency, hyperthyroidism, prior bowel surgical interventions, celiac disease, receiving other medication, awaiting ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53451","name":"Tprnl balo cntnc dev bi","description":"Periurethral transperineal adjustable balloon continence device; bilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0326U","name":"Trgt gen seq alys pnl 83+","description":"Trgt gen seq alys pnl 83+","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82980","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0310","name":"Immunize counsel 5-15 min","description":"Immunization counseling by a physician or other qualified health care professional when the vaccine(s) is not administered on the same date of service, 5 to 15 mins time (this code is used for medicaid billing purposes)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":632.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0532U","name":"Rare ds whlgen&mitochdrl dna","description":"Rare ds whlgen&mitochdrl dna","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0984T","name":"Iv img xtrc cere vsl oct 1st","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6515","name":"Grad com wrap w str fu le cu","description":"Gradient compression wrap with adjustable straps, full leg, each, custom","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5931","name":"Surgical obturator","description":"Obturator prosthesis surgical","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0605U","name":"All&immunology hat tpsab1","description":"All&immunology hat tpsab1","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2004","name":"Inj, lidocaine w epinephrine","description":"Injection, lidocaine hcl with epinephrine, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84681","name":"Assay of c-peptide","description":"C-peptide","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2272","name":"Inj, morphine (fresenius)","description":"Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76801","name":"Ob us < 14 wks single fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6105","name":"Remove implant body","description":"Remove implant body","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38225","name":"Car-t hrv bld-drv t lymphcyt","description":"Chimeric antigen receptor t-cell (car-t) therapy; harvesting of blood-derived t lymphocytes for development of genetically modified autologous car-t cells, per day","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9612","name":"Thera par drugs 2 or > admin","description":"Therapeutic parenteral drugs two or more administrations different medications","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98980","name":"Rtm tx mgmt 1st 20 min","description":"Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least 1 real-time interactive communication with the patient or caregiver during the calendar month; first 20 minutes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1422","name":"Gastroenterology care mvp","description":"Gastroenterology care mips value pathway","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23460","name":"Repair shoulder capsule","description":"Capsulorrhaphy, anterior, any type; with bone block","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1340.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2780","name":"Crown 3/4 cast hi noble met","description":"Crown - 3/4 cast high noble metal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1223","name":"Glaucoma plan of care doc","description":"Glaucoma plan of care documented","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44187","name":"Lap ileo/jejuno-stomy","description":"Laparoscopy, surgical; ileostomy or jejunostomy, non-tube","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1169.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5127","name":"Inj, stimufend, 0.5 mg","description":"Injection, pegfilgrastim-fpgk (stimufend), biosimilar, 0.5 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85610","name":"Prothrombin time","description":"Prothrombin time;","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0944T","name":"3d cntr simula trgt lvr les","description":"3d contour simulation of target liver lesion(s) and margin(s) for image-guided percutaneous microwave ablation","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0283U","name":"Vw factor type 2b eval plsm","description":"Von willebrand factor (vwf), type 2b, platelet-binding evaluation, radioimmunoassay, plasma","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1235","name":"Doc pt hcv aby rna tst","description":"Documentation or patient report of hcv antibody test or hcv rna test which occurred prior to the performance period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44155","name":"Removal of colon/ileostomy","description":"Colectomy, total, abdominal, with proctectomy; with ileostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1974.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0982T","name":"Rem mntr impl ivc snr set-up","description":"Remote monitoring of implantable inferior vena cava sensor, physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate), initial set-up and patient education on use of equipment","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4338","name":"Artacent velos, per sq cm","description":"Artacent velos, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1392","name":"Pt rsn no exm or lst to fu","description":"Documentation of patient reasons for no examination, i.e., refusal of examination or lost to follow-up (documentation must include information that the clinician was unable to reach the patient by phone, mail or secure electronic mail - at least one method must be documented)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0726T","name":"Rmvl implt vstibular dev uni","description":"Removal of implanted vestibular device, unilateral","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9154","name":"Artificial saliva, 1 ml","description":"Artificial saliva, 1 ml","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0207","name":"Amifostine","description":"Injection, amifostine, 500 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":417.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0995T","name":"Evasc dlvr a-wal stbl rx opn","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; open","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87426","name":"Sarscov coronavirus ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; severe acute respiratory syndrome coronavirus (eg, sars-cov, s","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1224","name":"Iop dec <20% from base","description":"Intraocular pressure (iop) reduced by a value less than 20% from the pre-intervention level","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64596","name":"Ins/rplcmt prq eltrd ra pn 1","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; initial electrode array","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90613","name":"Inf&sarscov2 vacc 40/0.4 im","description":"Influenza virus vaccine, quadrivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 40 mcg/0.4 ml dosage, for intramuscular use","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"Limited visual field xm","description":"Visual field examination, unilateral or bilateral, with interpretation and report; limited examination (eg, tangent screen, autoplot, arc perimeter, or single stimulus level automated test, such as octopus 3 or 7 equivalent)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1813","name":"Lyumjev for insulin pump use","description":"Insulin (lyumjev) for administration through dme (i.e., insulin pump) per 50 units","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1576","name":"Inj, panzyga, 500 mg","description":"Injection, immune globulin (panzyga), intravenous, non-lyophilized (e.g., liquid), 500 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56640","name":"Vlvctmy rad comp w/lymphadec","description":"Vulvectomy, radical, complete, with inguinofemoral, iliac, and pelvic lymphadenectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1587.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0387","name":"Comp image capture only","description":"Comp image capture only","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1414","name":"Inj, beqvez, per tx dose","description":"Injection, fidanacogene elaparvovec-dzkt, per therapeutic dose","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7300","name":"Rem anchorage dev w/o flap","description":"Rem anchorage dev w/o flap","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4344","name":"Tri membrane wrap, per sq cm","description":"Tri-membrane wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3391","name":"Inj, atidarsagene autotemcel","description":"Injection, atidarsagene autotemcel, per treatment","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86379","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0330U","name":"Iadna vag pthgn panel 27 org","description":"Iadna vag pthgn panel 27 org","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0422U","name":"Onc pan solid tum alys dna","description":"Onc pan solid tum alys dna","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0526","name":"Est pt-cg dyad dem hig cmplx","description":"Management of established patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0297U","name":"Onc pan tum whl gen seq dna","description":"Onc pan tum whl gen seq dna","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0022","name":"Comm hlth intg svs add 30 m","description":"Community health integration services, each additional 30 minutes per calendar month (list separately in addition to g0019)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2805","name":"Sincalide injection","description":"Injection, sincalide, 5 micrograms","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33050","name":"Resect heart sac lesion","description":"Resection of pericardial cyst or tumor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1092.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0521","name":"New pt-cg dyad dem hig cmplx","description":"Management of new patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0568","name":"Int psych care mng, 1 cal mo","description":"Initial psychiatric collaborative care management, in the first calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required elements: outrea","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0268","name":"Removal of impacted wax md","description":"Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0944T","name":"3d cntr simula trgt lvr les","description":"3d contour simulation of target liver lesion(s) and margin(s) for image-guided percutaneous microwave ablation","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2044","name":"Biobrane glove, each","description":"Biobrane glove, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93145","name":"Interrog crtd sins bat ip wo","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90612","name":"Inf&sarscov2 vacc 31.7/.32im","description":"Influenza virus vaccine, trivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 31.7 mcg/0.32 ml dosage, for intramuscular use","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4322","name":"Caregraft, per sq cm","description":"Caregraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90484","name":"Imm cnsl not admn sm>20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 20 minutes","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0547","name":"Phone/internet svs 11-20 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1163","name":"Inj, diltiazem hcl, 0.5 mg","description":"Injection, diltiazem hydrochloride, 0.5 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61490","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2179.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0922T","name":"Rmvl perm ccm-d sys dual ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); dual (pacing and defibrillation) transvenous leads only","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1267","name":"Pt no act kid transplt wtlst","description":"Patients not observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1713","name":"Pfizer vacc adm ped 1st dose","description":"Pfizer vacc adm ped 1st dose","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70472","name":"Ct cere prfu alys c+w/ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed with concurrent ct or ct angiography of the same anatomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1258","name":"Cvd risk assess perf","description":"Cvd risk assessment performed, have a documented calculated risk score","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98977","name":"Rtm dev sply mscskl 16-30 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of musculoskeletal system, 16-30 days in a 30-day period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4410","name":"Amchomatrixdl per sq cm","description":"Amchomatrixdl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11200","name":"Rmvl skin tags up to&inc 15","description":"Removal of skin tags, multiple fibrocutaneous tags, any area; up to and including 15 lesions","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":80.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":108.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1931","name":"Laronidase injection","description":"Injection, laronidase, 0.1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74400","name":"Urography iv +-kub tomog","description":"Urography (pyelography), intravenous, with or without kub, with or without tomography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1484","name":"No rpt hcv rna perf med rsn","description":"Patients who did not have a repeat hcv rna labs performed for medical reasons documented by clinician (e.g., patient with limited life expectancy, delay in treatment of hcv related to treatment of hiv, hbv, hepatocellular carcinoma, decompensated cirrhosis)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92628","name":"Eval hearing aid cand 1st 30","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0954T","name":"Tot impl amei rplc snd proc","description":"Totally implantable active middle ear hearing implant; replacement of sound processor only, with attachment to existing transducers","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4028","name":"Podiatry ss","description":"Podiatry mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1189","name":"Doc khe pef w/efgr/uacr","description":"Documentation of a kidney health evaluation defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr) performed","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1332","name":"Pts no eval ini xm no 2 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 2 weeks","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87593","name":"Orthopoxvirus amp prb each","description":"Infectious agent detection by nucleic acid (dna or rna); orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus), amplified probe technique, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49615","name":"Rpr aa hrn rcr 3-10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, reducible","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0903T","name":"Ecg alg 12 lead reduced i&r","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4427","name":"Dermbnd dln dl+ dlx sq cm","description":"Dermabind dl n or dermabind dl + or dermabind dl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28054","name":"Biopsy of toe joint lining","description":"Arthrotomy with biopsy; interphalangeal joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J0580","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0787T","name":"Revj/rmvl nea sac w/nstim","description":"Revision or removal of neurostimulator electrode array, sacral, with integrated neurostimulator","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47505","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1932","name":"Inj, lanreotide, (cipla) 1mg","description":"Injection, lanreotide, (cipla), 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0749T","name":"B1 str&fx rsk assmt dxr-bmd","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20551","name":"Njx 1 tendon origin/insj","description":"Injection(s); single tendon origin/insertion","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":31.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76513","name":"Oph us dx ant sgm us uni/bi","description":"Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) b-scan or high resolution biomicroscopy, unilateral or bilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1713","name":"Pfizer vacc adm ped 1st dose","description":"Pfizer vacc adm ped 1st dose","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0455U","name":"Nfct agt sti mult amp prb ur","description":"Nfct agt sti mult amp prb ur","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31646","name":"Brnchsc w/ther aspir sbsq","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with therapeutic aspiration of tracheobronchial tree, subsequent, same hospital stay","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1611","name":"Inj glucagon hcl, fresenius","description":"Injection, glucagon hydrochloride (fresenius kabi), not therapeutically equivalent to j1610, per 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25676","name":"Optx rad/uln dislc aqt/chrnc","description":"Open treatment of distal radioulnar dislocation, acute or chronic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":762.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1250","name":"Pt resp true heard","description":"Patient responded as completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0666","name":"Inj, bupivacaine liposome","description":"Injection, bupivacaine liposome, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5161","name":"Inj, denosumab-kyqq, 1 mg","description":"Injection, denosumab-kyqq (aukelso/bosaya), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0376U","name":"Onc prst8 ca img alys 128","description":"Onc prst8 ca img alys 128","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7165","name":"Inj, human-lans, per i.u","description":"Injection, prothrombin complex concentrate, human-lans, per i.u. of factor ix activity","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0923T","name":"Rmvl&rplcmt perm ccm-d pg","description":"Removal and replacement of permanent cardiac contractility modulation-defibrillation pulse generator only","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2780","name":"Crown 3/4 cast hi noble met","description":"Crown - 3/4 cast high noble metal","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1487","name":"Pt adm to hospice dur eval","description":"Patients in hospice in the year before or during the period of evaluation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"X-ray exam chest 2 views","description":"Radiologic examination, chest; 2 views","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0541U","name":"Cv ds hdl rct cec lc-ms/ms 5","description":"Cv ds hdl rct cec lc-ms/ms 5","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24130","name":"Excision radial head","description":"Excision, radial head","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":609.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7514","name":"Mycophenol (myhibbin) 100 mg","description":"Mycophenolate mofetil (myhibbin), oral suspension, 100 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4000","name":"Dermatology ss","description":"Dermatology mips specialty set","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33276","name":"Insj phrnc nrv stim sys","description":"Insertion of phrenic nerve stimulator system (pulse generator and stimulating lead[s]), including vessel catheterization, all imaging guidance, and pulse generator initial analysis with diagnostic mode activation, when performed","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4411","name":"Amniomatrixf4x per sq cm","description":"Amniomatrixf4x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0803T","name":"Tcat rmv&rpl2chmb ldls pm rv","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ve","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0498U","name":"Onc clrct ngs mut detc 43gen","description":"Onc clrct ngs mut detc 43gen","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93786","name":"Ambl bp mntr w/sw rec only","description":"Ambulatory blood pressure monitoring, utilizing report-generating software, automated, worn continuously for 24 hours or longer; recording only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81458","name":"So gsap dna cpy nmbr&mcrstl","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis, copy number variants and microsatellite instability","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24006","name":"Arthrt elbw capsl exc rls","description":"Arthrotomy of the elbow, with capsular excision for capsular release (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":845.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0041","name":"Pt/ptn decln referral","description":"Patient and/or care partner decline referral","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53866","name":"Cathj rmvl dev ischmc rmdlg","description":"Catheterization with removal of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90474","name":"Immune admin oral/nasal addl","description":"Immunization administration by intranasal or oral route; each additional vaccine (single or combination vaccine/toxoid) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2032","name":"Myriad matrix, per sq cm","description":"Myriad matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5947","name":"Mand implt sup fix","description":"Mand implt sup fix","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9255","name":"Inj, methotrexate (accord)","description":"Injection, methotrexate (accord), not therapeutically equivalent to j9260, 50 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"X-ray exam chest 2 views","description":"Radiologic examination, chest; 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]},{"negotiated_type":"negotiated","negotiated_rate":15.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96117","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90968","name":"Esrd svc pr day pt 2-11","description":"End-stage renal disease (esrd) related services for dialysis less than a full month of service, per day; for patients 2-11 years of age","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4394","name":"Surgraft aca per sq cm","description":"Surgraft aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1808","name":"Inj, folic acid, 0.1 mg","description":"Injection, folic acid, 0.1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0988T","name":"Opn ins/rplc ins ptn sbq&sbf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4012","name":"Interventional rad ss","description":"Interventional radiology mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6093","name":"Recement supp part denture","description":"Recement implant/abutment supported fixed partial denture","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1304","name":"Inj tofersen intrathec 1 mg","description":"Injection, tofersen, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33267","name":"Excl laa open any method","description":"Exclusion of left atrial appendage, open, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"Evoked auditory test limited","description":"Distortion product evoked otoacoustic emissions; limited evaluation (to confirm the presence or absence of hearing disorder, 3-6 frequencies) or transient evoked otoacoustic emissions, with interpretation and report","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3911","name":"Intraorifice barrier","description":"Intraorifice barrier","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2007","name":"Restrata, per sq cm","description":"Restrata, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0301U","name":"Iadna bartonella ddpcr","description":"Iadna bartonella ddpcr","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0020M","name":"Onc cns alys 30000 dna loci","description":"Oncology (central nervous system), analysis of 30,000 dna methylation loci by methylation array, utilizing dna extracted from tumor tissue, diagnostic algorithm reported as probability of matching a reference tumor subclass","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74210","name":"X-ray xm phrnx&/crv esoph c+","description":"Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0281","name":"Inj aminocaproic acid 1 gram","description":"Injection, aminocaproic acid, 1 gram","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1809","name":"Inj, fosdenopterin, 0.1mg","description":"Injection, fosdenopterin, 0.1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0705T","name":"Rem tx amblyopia tech sprt","description":"Remote treatment of amblyopia using an eye tracking device; surveillance center technical support including data transmission with analysis, with a minimum of 18 training hours, each 30 days","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1187","name":"Pt w/ esrd","description":"Patients with a diagnosis of end stage renal disease (esrd)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4313","name":"Dermabind fm, per sq cm","description":"Dermabind fm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57295","name":"Revise vag graft via vagina","description":"Revision (including removal) of prosthetic vaginal graft; vaginal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":573.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11644","name":"Exc f/e/e/n/l mal+mrg 3.1-4","description":"Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 3.1 to 4.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":304.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0893T","name":"N-invas assmt bld oxygnation","description":"Noninvasive assessment of blood oxygenation, gas exchange efficiency, and cardiorespiratory status, with physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77438","name":"Surf rad thr orthvlt>150-500","description":"Surface radiation therapy; orthovoltage, delivery, >150-500 kv, per fraction","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9986","name":"Missed appointment","description":"Missed appointment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0489U","name":"Ob sgnipt cfdna seq alys 1+","description":"Ob sgnipt cfdna seq alys 1+","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35518","name":"Art byp grft axillary-axilry","description":"Bypass graft, with vein; axillary-axillary","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1480.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0672T","name":"Ndovag cryg rf remdl tiss","description":"Endovaginal cryogen-cooled, monopolar radiofrequency remodeling of the tissues surrounding the female bladder neck and proximal urethra for urinary incontinence","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1013T","name":"Lap srg imp/rpl eso nea&pg/r","description":"Laparoscopy, surgical, implantation or replacement of lower esophageal sphincter neurostimulator electrode array and neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver, including cruroplasty and/or electronic ","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0765T","name":"Asstv alg ecg rsk asmt prev","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to previously performed electrocardiogram","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24155","name":"Resection of elbow joint","description":"Resection of elbow joint (arthrectomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1001.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1295","name":"Pt hx tot col or colon ca","description":"Patients with a diagnosis or past history of total colectomy or colorectal cancer","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1308","name":"Flu immunize no admin","description":"Influenza immunization was not administered, reason not given","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9913","name":"Admin of neuromod","description":"Admin of neuromod","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55708","name":"Bx prst8 trct us w/mri fus 1","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant) with mri-fusion-guidance, first targeted lesion","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0385U","name":"Neph ckd alg rsk dbtc kdn ds","description":"Neph ckd alg rsk dbtc kdn ds","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0686T","name":"Histotripsy mal hepatcel tis","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant hepatocellular tissue, including image guidance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5909","name":"Max guid prothes w/ flange","description":"Max guid prothes w/ flange","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0785T","name":"Revj/rmvl nea spi w/nstim","description":"Revision or removal of neurostimulator electrode array, spinal, with integrated neurostimulator","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2031","name":"Mirodry, per sq cm","description":"Mirodry wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4265","name":"Neostim tl per sq cm","description":"Neostim tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0979T","name":"Sbmcsl crylys ther sft palt","description":"Submucosal cryolysis therapy; soft palate only","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26991","name":"Drainage of pelvis bursa","description":"Incision and drainage, pelvis or hip joint area; infected bursa","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4560","name":"Nmes disposable","description":"Neuromuscular electrical stimulator (nmes), disposable, replacement only","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1711","name":"Moderna vacc admin booster","description":"Moderna vacc admin booster","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91323","name":"Sarscov2 vac 10 mcg/0.2ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 10 mcg/0.2 ml dosage, for intramuscular use","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0043","name":"Pt mech pros ht valv","description":"Patients with mechanical prosthetic heart valve","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4387","name":"Neothelium ft per sq cm","description":"Neothelium ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0816T","name":"Opn insj/rplcmt ins ptn subq","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0581U","name":"Trnspl med antb nohla 39trgt","description":"Trnspl med antb nohla 39trgt","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0977T","name":"Upr gi bld detcj snr capsule","description":"Upper gastrointestinal blood detection, sensor capsule, with interpretation and report","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92568","name":"Acoustic refl threshold tst","description":"Acoustic reflex testing, threshold","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":17.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0710T","name":"N-invas artl plaq alys","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; including data preparation and transmission, quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess a","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66683","name":"Implantation iris prosthesis","description":"Implantation of iris prosthesis, including suture fixation and repair or removal of iris, when performed","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93584","name":"Vngrph chd anom/persist svc","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; anomalous or persistent superior vena cava when it exists as a second contralateral superior vena cava, with native drainage to heart (list separately in addition to code for pri","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81005","name":"Urinalysis","description":"Urinalysis; qualitative or semiquantitative, except immunoassays","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1218","name":"Pt copd symptoms","description":"Patient has copd symptoms (e.g., dyspnea, cough/sputum, wheezing)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0438U","name":"Rx metab advrs vrnt alys 33","description":"Rx metab advrs vrnt alys 33","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0724T","name":"Qmrcp w/dx mri same anatomy","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained with diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in additio","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93585","name":"Vngrph chd azygs/hemiazygs","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; azygos/hemiazygos venous system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9055","name":"Cetuximab injection","description":"Injection, cetuximab, 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4440","name":"Curamatrix per sq cm","description":"Curamatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61576","name":"Skull base/brainstem surgery","description":"Transoral approach to skull base, brain stem or upper spinal cord for biopsy, decompression or excision of lesion; requiring splitting of tongue and/or mandible (including tracheostomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4141.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2561","name":"Inj, sezaby, 1 mg","description":"Injection, phenobarbital sodium (sezaby), 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63012","name":"Remove lamina/facets lumbar","description":"Laminectomy with removal of abnormal facets and/or pars inter-articularis with decompression of cauda equina and nerve roots for spondylolisthesis, lumbar (gill type procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1334.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1736","name":"Inj meloxicam (delova) 1mg","description":"Injection, meloxicam (delova), 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1380","name":"2 rx in perf pd any com meds","description":"Filled at least two prescriptions during the performance period for any combination of the qualifying oral antipsychotic medications listed under denominator note or the long-acting injectable antipsychotic medications listed under denominator note","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37294","name":"Rvsc evsc tpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64468","name":"Thrc fascial pln blk bi njx","description":"Thoracic fascial plane block, bilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1455","name":"Rep/rev cied","description":"Replaced or revised cied","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4008","name":"Geriatrics ss","description":"Geriatrics mips specialty set","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71047","name":"X-ray exam chest 3 views","description":"Radiologic examination, chest; 3 views","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64510","name":"N block stellate ganglion","description":"Injection, anesthetic agent; stellate ganglion (cervical sympathetic)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6524","name":"G com garmnt lwr leg/ft nght","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91320","name":"Sarscv2 vac 30mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 30 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1011T","name":"Pbm therapy of oral cavity","description":"Photobiomodulation (pbm) therapy of oral cavity, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78160","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92288","name":"Scr dark adaptation meas i&r","description":"Screening dark adaptation measurement (eg, rod recovery intercept time), with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4280","name":"Xcell amnio matrix per sq cm","description":"Xcell amnio matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5141","name":"Inj adalimumab-aaty, 1 mg","description":"Injection, adalimumab-aaty, biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4345","name":"Matrix hd allogrft per sq cm","description":"Matrix hd allograft dermis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0011","name":"Hiv prep counsel, md 15-30m","description":"Individual counseling for pre-exposure prophylaxis (prep) by physician or qualified health care professional (qhp) to prevent human immunodeficiency virus (hiv), includes hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence, 15-30 minutes","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1391","name":"All pt dx w/ rec mlnm","description":"All patients who were diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0427U","name":"Monocyte dstrbj wdth whl bld","description":"Monocyte dstrbj wdth whl bld","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0271U","name":"Hem cgen neutropenia 23 gen","description":"Hematology (congenital neutropenia), genomic sequence analysis of 23 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4014","name":"Nephrology ss","description":"Nephrology mips specialty set","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0974T","name":"Slctv nzmtc dbrdmt t/a/l ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; each additional 100 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92065","name":"Orthop traing pfrmd phys/qhp","description":"Orthoptic training; performed by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0165","name":"Inj epinephrine nos 0.1 mg","description":"Injection, epinephrine, not otherwise specified, 0.1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1394","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9616","name":"Gallium gozellix 1 millicuri","description":"Gallium ga-68 gozetotide (gozellix), diagnostic, 1 millicurie","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62365","name":"Remove spine infusion device","description":"Removal of subcutaneous reservoir or pump, previously implanted for intrathecal or epidural infusion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28118","name":"Removal of heel bone","description":"Ostectomy, calcaneus;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6113","name":"Imp/abut rem dent part mand","description":"Imp/abut rem dent part mand","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0610U","name":"Nfct ds antmcr sc phenotypic","description":"Nfct ds antmcr sc phenotypic","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0457","name":"Tlso flex trnk sj-ss pre ots","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":677.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0522U","name":"Ca vi psp&sp1 antb cl semiql","description":"Ca vi psp&sp1 antb cl semiql","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4299","name":"Amniocore pro+, per sq cm","description":"Amniocore pro+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74235","name":"Remove esophagus obstruction","description":"Removal of foreign body(s), esophageal, with use of balloon catheter, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6036","name":"Prosthetic thumb mechanical","description":"Prosthetic thumb, mechanical, can include metacarpophalangeal (mcp), interphalangeal (ip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36410","name":"Vnpnxr 3yr/> phy/qhp dx/ther","description":"Venipuncture, age 3 years or older, necessitating the skill of a physician or other qualified health care professional (separate procedure), for diagnostic or therapeutic purposes (not to be used for routine venipuncture)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":21.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0984T","name":"Iv img xtrc cere vsl oct 1st","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0525","name":"Inj cefotetan disodium 10 mg","description":"Injection, cefotetan disodium, 10 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0438","name":"Ppps, initial visit","description":"Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35741","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J1457","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4318","name":"E-graft, per sq cm","description":"E-graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2184","name":"Inj, meropenem (b. braun)","description":"Injection, meropenem (b. braun), not therapeutically equivalent to j2185, 100 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0608U","name":"Reprdtve med ema rtpcr 10bct","description":"Reprdtve med ema rtpcr 10bct","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0719T","name":"Pst vrt jt rplcmt lmbr 1 sgm","description":"Posterior vertebral joint replacement, including bilateral facetectomy, laminectomy, and radical discectomy, including imaging guidance, lumbar spine, single segment","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4311","name":"Acesso, per sq cm","description":"Acesso, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33514","name":"Cabg vein five","description":"Coronary artery bypass, vein only; 5 coronary venous grafts","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2496.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67250","name":"Reinforce eye wall","description":"Scleral reinforcement (separate procedure); without graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":819.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98016","name":"Brief comunicaj tech-bsd svc","description":"Brief communication technology-based service (eg, virtual check-in) by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related evaluation and management service provided within the p","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1274","name":"Pts snf exl mo","description":"Patients who were admitted to a skilled nursing facility (snf) during the month of evaluation were excluded from that month","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1406","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37291","name":"Revsc evsc tpvt athr cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2054","name":"Lisocabtagene mara car pos t","description":"Lisocabtagene maraleucel, up to 110 million autologous anti-cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6197","name":"Replace material prosthesis","description":"Replace material prosthesis","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0031","name":"Pall serv during meas","description":"Palliative care services given to patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96547","name":"Intraop hipec px 1st 60 min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; first 60 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37289","name":"Revsc evsc tpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87493","name":"C diff amplified probe","description":"Infectious agent detection by nucleic acid (dna or rna); clostridium difficile, toxin gene(s), amplified probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0405U","name":"Onc pncrtc 59 mthltn blk mrk","description":"Onc pncrtc 59 mthltn blk mrk","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37270","name":"Revsc evasc fpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90967","name":"Esrd svc pr day pt <2","description":"End-stage renal disease (esrd) related services for dialysis less than a full month of service, per day; for patients younger than 2 years of age","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4276","name":"Orion, per sq cm","description":"Orion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0270U","name":"Hem cgen coagj do 20 genes","description":"Hematology (congenital coagulation disorders), genomic sequence analysis of 20 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6614","name":"Onlay cst nbl mtl 2 surfaces","description":"Onlay - cast noble metal two surfaces","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93598","name":"Car outp meas drg cath chd","description":"Cardiac output measurement(s), thermodilution or other indicator dilution method, performed during cardiac catheterization for the evaluation of congenital heart defects (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0521","name":"Supply fee hiv prep fda appr","description":"Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0711T","name":"N-nvs artl plaq alys dat prp","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data preparation and transmission","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93596","name":"R&l hrt cath chd nml nt cnj","description":"Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); normal native connections","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0249","name":"Adm tocilizu covid-19 1st","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0146","name":"Nav srv peer sup add 30 pr m","description":"Principal illness navigation - peer support, additional 30 minutes per calendar month (list separately in addition to g0140)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1353","name":"Pts no cmplt suicd saf pln","description":"Patients who did not have a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2050","name":"Financial mgt waiver/diem","description":"Financial management, self-directed, waiver; per diem","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4030","name":"Pulmonology ss","description":"Pulmonology mips specialty set","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0381U","name":"Maple syrup ur ds mntr quan","description":"Maple syrup ur ds mntr quan","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1413","name":"Inj delandistrogene mox rokl","description":"Injection, delandistrogene moxeparvovec-rokl, per therapeutic dose","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1213","name":"No hx spiro prs spiro>=70%","description":"No history of spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) and present spirometry is >= 70%","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33902","name":"Perq p-art revsc 1 abnor uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, unilateral","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93529","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2776.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6039","name":"Passive custom digit/thumb","description":"Passive prosthetic digit or thumb prosthesis not including hand restoration partial hand, full or partial, custom made, any material, initial or replacement, per single passive prosthetic digit or thumb","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9128","name":"Photobio therpy-first 15 min","description":"Photobio therpy-first 15 min","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37266","name":"Rvsc evsc fpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2024","name":"Resolve or xenopatch sq cm","description":"Resolve matrix or xenopatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0278U","name":"Hem gen thrombosis 12 genes","description":"Hematology (genetic thrombosis), genomic sequence analysis of 12 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1497","name":"No doc fall med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54050","name":"Destruction penis lesion(s)","description":"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; chemical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9319","name":"Inj romidepsin lyophil 0.1mg","description":"Injection, romidepsin, lyophilized, 0.1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0855T","name":"Dgtz gls mcrscp b1 marow smr","description":"Digitization of glass microscope slides for bone marrow, smear interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7997","name":"Appliance removal","description":"Appliance removal (not by dentist who placed appliance) includes removal of archbar","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5161","name":"Inj, denosumab-kyqq, 1 mg","description":"Injection, denosumab-kyqq (aukelso/bosaya), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1807","name":"Inj, ethacrynate sod, 1 mg","description":"Injection, ethacrynate sodium, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0184","name":"Inj, amisulpride, 1 mg","description":"Injection, amisulpride, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1643","name":"Inj heparin, pfizer, 1000u","description":"Injection, heparin sodium (pfizer), not therapeutically equivalent to j1644, per 1000 units","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0496U","name":"Onc clrct cfdna 8/7 genes","description":"Onc clrct cfdna 8/7 genes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92553","name":"Audiometry air & bone","description":"Pure tone audiometry (threshold); air and bone","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0543U","name":"Onc sol tum ngs dna 517 gens","description":"Onc sol tum ngs dna 517 gens","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0898T","name":"N-invas prst8 cancer est map","description":"Noninvasive prostate cancer estimation map, derived from augmentative analysis of image-guided fusion biopsy and pathology, including visualization of margin volume and location, with margin determination and physician interpretation and report","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0330U","name":"Iadna vag pthgn panel 27 org","description":"Iadna vag pthgn panel 27 org","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93653","name":"Compre ep eval tx svt","description":"Comprehensive electrophysiologic evaluation with insertion and repositioning of multiple electrode catheters, induction or attempted induction of an arrhythmia with right atrial pacing and recording and catheter ablation of arrhythmogenic focus, including intracardiac electrophysiologic 3-dimensiona","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":993.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0038","name":"Clin pt no ref","description":"Clinician determines patient does not require referral","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0537U","name":"Onc clrct ca cfdna >2500 dmr","description":"Onc clrct ca cfdna >2500 dmr","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6034","name":"Part hand finger distal amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s)/thumb, amputation at distal to metacarpal joint, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l669","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1347","name":"Pt pam incr 3 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 3 points in a 4 to 12 month period (passing)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1006T","name":"Elec alys s-scl eeg prgrm ea","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, each additional 15 minutes face-to-face time with physician or other qua","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11600","name":"Exc tr-ext mal+marg 0.5 cm/<","description":"Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 0.5 cm or less","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7294","name":"Seg acet and eth estr yearly","description":"Segesterone acetate and ethinyl estradiol 0.15mg, 0.013mg per 24 hours; yearly vaginal system, each","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1653","name":"Ho abduction static ots","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, off the shelf","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":427.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78585","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0610U","name":"Nfct ds antmcr sc phenotypic","description":"Nfct ds antmcr sc phenotypic","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1407","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92987","name":"Revision of mitral valve","description":"Percutaneous balloon valvuloplasty; mitral valve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1545.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27784","name":"Treatment of fibula fracture","description":"Open treatment of proximal fibula or shaft fracture, includes internal fixation, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":677.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49591","name":"Rpr aa hrn 1st < 3 cm rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, reducible","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7174","name":"Injection fitusiran 0.04 mg","description":"Injection, fitusiran, 0.04 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0201","name":"Pne flu hepb cov home admin","description":"Administration of pneumococcal, influenza, hepatitis b, and/or covid-19 vaccine inside a patients home; reported only once per individual home per date of service when such vaccine administration(s) are performed at the patients home","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0301U","name":"Iadna bartonella ddpcr","description":"Iadna bartonella ddpcr","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91125","name":"Anrct mano rct snsatn&balo","description":"Anorectal manometry, with rectal sensation and rectal balloon expulsion test, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48155","name":"Removal of pancreas","description":"Pancreatectomy, total","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1763.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0682","name":"App non-sheet skin sub add","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (list separately in addition to code for pri","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35870","name":"Repair vessel graft defect","description":"Repair of graft-enteric fistula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1555.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0602","name":"Sevelamer carbonate pdr 20mg","description":"Sevelamer carbonate (renvela or therapeutically equivalent), oral, powder, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2035","name":"Corpl p therac p allac p mg","description":"Corplex p or theracor p or allacor p, per milligram","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6561","name":"G stockng full/chap 40+ cust","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, custom, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4297","name":"Emerge matrix, per sq cm","description":"Emerge matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78609","name":"Brain imaging (pet)","description":"Brain imaging, positron emission tomography (pet); perfusion evaluation","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0264U","name":"Rare ds id opt genome mapg","description":"Rare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49187","name":"Opn exc/dstr ntra-abd 5.1-10","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5.1 to 10 cm","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38225","name":"Car-t hrv bld-drv t lymphcyt","description":"Chimeric antigen receptor t-cell (car-t) therapy; harvesting of blood-derived t lymphocytes for development of genetically modified autologous car-t cells, per day","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2010","name":"Apis, per square centimeter","description":"Apis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0854T","name":"Dgtz gls mcrscp bld smr prph","description":"Digitization of glass microscope slides for blood smear, peripheral, interpretation by physician with written report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4385","name":"Apollo ft per sq cm","description":"Apollo ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92629","name":"Eval hearing aid cand ea add","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6559","name":"G stckng full/chap18-30 cust","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93594","name":"R hrt cath chd abnl nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; abnormal native connections","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4390","name":"Ascendion per sq cm","description":"Ascendion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2252","name":"Inj midazolam in 0.8% nacl","description":"Injection, midazolam in 0.8% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90631","name":"H5 vaccine pandemic im use","description":"Influenza virus vaccine (iiv), h5, pandemic formulation, split virus, adjuvanted, for intramuscular use","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0706","name":"Intraoral occlus radio image","description":"Intraoral occlus radio image","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0828T","name":"Dgtz gls mcrscp cytp smpl fl","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; simple filter method with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1001T","name":"Autol musc cell therapy njx","description":"Autologous muscle cell therapy, injection of muscle progenitor cells into the external anal sphincter, including ultrasound guidance, when performed","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9220","name":"Indigotindisulfonate sod 1mg","description":"Injection, indigotindisulfonate sodium, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1223","name":"Glaucoma plan of care doc","description":"Glaucoma plan of care documented","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0924T","name":"Rpos prv ccm-d trnsvns eltrd","description":"Repositioning of previously implanted cardiac contractility modulation-defibrillation transvenous electrode(s)/lead(s), including fluoroscopic guidance and programming of sensing and therapeutic parameters","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0053","name":"Ht mental health and care","description":"Historical trauma (ht) mental health and clinical care for indigenous persons","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1369","name":"Qualcare mental hlth/sud mvp","description":"Quality care in mental health and substance use disorders mips value pathway","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19271","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1794.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21315","name":"Clsd tx nsl fx mnpj wo stblj","description":"Closed treatment of nasal bone fracture with manipulation; without stabilization","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7298","name":"Remove screw retained plate","description":"Remove screw retained plate","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1019T","name":"Lymphovenous bypass per xtr","description":"Lymphovenous bypass, including robotic assistance, when performed, per extremity","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0767T","name":"Tc mag stimj pn ea addl nrv","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; each additional nerve (list separat","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9293","name":"Fertility cycl tracking soft","description":"Fertility cycle (contraception & conception) tracking software application, fda cleared, per month, includes accessories (e.g., thermometer)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3403","name":"Revakinagene, per implant","description":"Revakinagene taroretcel-lwey, per implant","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0898T","name":"N-invas prst8 cancer est map","description":"Noninvasive prostate cancer estimation map, derived from augmentative analysis of image-guided fusion biopsy and pathology, including visualization of margin volume and location, with margin determination and physician interpretation and report","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63032","name":"Lamot rpr anulr dfct 1 lmbr","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; with repair of annular defect by implantation of bone-anchored annular closure device, including all imaging guidance, 1 interspace, lumbar","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6031","name":"Rep interface handfng molded","description":"Replacement socket/interface, partial hand including fingers, molded to patient model, for use with or without external power","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59412","name":"Antepartum manipulation","description":"External cephalic version, with or without tocolysis","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0658","name":"Seg pneum comp 2 arm chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0660","name":"Team remote e/m new pt 10 mn","description":"Team remote e/m new pt 10mins","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0854T","name":"Dgtz gls mcrscp bld smr prph","description":"Digitization of glass microscope slides for blood smear, peripheral, interpretation by physician with written report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15853","name":"Removal sutr/stapl xreq anes","description":"Removal of sutures or staples not requiring anesthesia (list separately in addition to e/m code)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69209","name":"Remove impacted ear wax uni","description":"Removal impacted cerumen using irrigation/lavage, unilateral","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1449","name":"Pt dx scz/pys bef end msr pd","description":"Patients with an active diagnosis of schizophrenia or psychotic disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34530","name":"Leg vein fusion","description":"Saphenopopliteal vein anastomosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1196.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2561","name":"Inj, sezaby, 1 mg","description":"Injection, phenobarbital sodium (sezaby), 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2034","name":"Found drs solo, per sq cm","description":"Foundation drs solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4355","name":"Abio xpl abio xpl hy p sq cm","description":"Abiomend xplus membrane and abiomend xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83036","name":"Hemoglobin glycosylated a1c","description":"Hemoglobin; glycosylated (a1c)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37288","name":"Revsc evsc tpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37279","name":"Iv lithotrp fpvt w/in sm art","description":"Intravascular lithotripsy(ies), femoral and popliteal vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98012","name":"Synch audio-only est sf 10","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4417","name":"Alexiguard dl-t per sq cm","description":"Alexiguard dl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28289","name":"Corrj halux rigdus w/o implt","description":"Hallux rigidus correction with cheilectomy, debridement and capsular release of the first metatarsophalangeal joint; without implant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":627.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0851T","name":"Dgtz gls mcrscp mphmtrc 1st","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0999T","name":"Autol musc cell therapy hrvg","description":"Autologous muscle cell therapy, harvesting of muscle progenitor cells, including ultrasound guidance, when performed","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6613","name":"Onlay cst base mtl >=3 surfa","description":"Onlay - cast predominantly base metal three or more surfaces","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5995","name":"Peri medicament w/seal, max","description":"Peri medicament w/seal, max","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0851T","name":"Dgtz gls mcrscp mphmtrc 1st","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7300","name":"Rem anchorage dev w/o flap","description":"Rem anchorage dev w/o flap","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2039","name":"Innovamatrix fd, per sq cm","description":"Innovamatrix fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9996","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11401","name":"Exc tr-ext b9+marg 0.6-1 cm","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 0.6 to 1.0 cm","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":179.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0804","name":"3d facial scan indirect","description":"3d facial scan indirect","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93514","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2342.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0237","name":"Inj, tocilizumab-anoh, hospi","description":"Injection, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9011","name":"Datopotamab deruxtecan, 1 mg","description":"Injection, datopotamab deruxtecan-dlnk, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83014","name":"H pylori drug admin","description":"Helicobacter pylori; drug administration","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5942","name":"Proth max implt sup remv","description":"Proth max implt sup remv","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0888T","name":"Histotripsy mal renal tissue","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant renal tissue, including imaging guidance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11305","name":"Shave skin lesion 0.5 cm/<","description":"Shaving of epidermal or dermal lesion, single lesion, scalp, neck, hands, feet, genitalia; lesion diameter 0.5 cm or less","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":109.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5162","name":"Inj, denosumab-nxxp, 1 mg","description":"Injection, denosumab-nxxp (bildyos/bilprevda), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4319","name":"Sanograft, per sq cm","description":"Sanograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55877","name":"Abltj ire prst8 1+ tum perq","description":"Ablation, irreversible electroporation, prostate, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84163","name":"Pappa serum","description":"Pregnancy-associated plasma protein-a (papp-a)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78461","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0473U","name":"Onc sld tum bld/slv 648 gene","description":"Onc sld tum bld/slv 648 gene","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9986","name":"Missed appointment","description":"Missed appointment","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0741","name":"Inj, cabote rilpivir 2mg 3mg","description":"Injection, cabotegravir and rilpivirine, 2mg/3mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1280","name":"Bilat mast/hx bi /unilat mas","description":"Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4352","name":"Overlay sl matrix, per sq cm","description":"Overlay sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1781","name":"Vac admin human pap dose 1","description":"Vac admin human pap dose 1","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0136","name":"Adm of pa/n assess 5-15 m","description":"Administration of a standardized, evidence-based assessment of physical activity and nutrition, 5-15 minutes, not more often than every 6 months","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1363","name":"Pts no f/u 120 dys","description":"Patients who did not have a follow-up assessment within 120 days of the index assessment","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99203","name":"Office o/p new low 30 min","description":"Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":69.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0303U","name":"Hem rbc ads whl bld hypoxic","description":"Hem rbc ads whl bld hypoxic","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82928","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0707T","name":"Njx b1 sub mtrl sbchdrl dfct","description":"Injection(s), bone-substitute material (eg, calcium phosphate) into subchondral bone defect (ie, bone marrow lesion, bone bruise, stress injury, microtrabecular fracture), including imaging guidance and arthroscopic assistance for joint visualization","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9612","name":"Inj, fluorescein, 1 mg","description":"Injection, fluorescein, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1209","name":">=2 same hi-rsk med w/o diag","description":"At least two orders for high-risk medications from the same drug class, (table 4), without appropriate diagnoses","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1397","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35454","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7509","name":"Marsupialization odon cyst","description":"Marsupialization odon cyst","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1212","name":"Missing gsa not perf","description":"Glycemic status assessment (hba1c or gmi) level is missing, or was not performed during the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1297","name":"Bmi not doc medrsn ptref","description":"Bmi not documented due to medical reason or patient refusal of height or weight measurement","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0019","name":"Comm hlth intg svs sdoh 60mn","description":"Community health integration services performed by certified or trained auxiliary personnel, including a community health worker, under the direction of a physician or other practitioner; 60 minutes per calendar month, in the following activities to address social determinants of health (sdoh) need(","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4372","name":"Amchoplast excl per sq cm","description":"Amchoplast excel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96102","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1921","name":"Inj labetalol hcl hikma, 5mg","description":"Injection, labetalol hydrochloride (hikma), not therapeutically equivalent to j1920, 5 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1015T","name":"Rev/rmv lw esoph sphnc npg/r","description":"Revision or removal, lower esophageal sphincter neurostimulator pulse generator or receiver","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82948","name":"Reagent strip/blood glucose","description":"Glucose; blood, reagent strip","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90482","name":"Imm cnsl not admn sm 3<10","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; 3 minutes up to 10 minutes","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5996","name":"Peri medicament w/seal, mand","description":"Peri medicament w/seal, mand","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0982T","name":"Rem mntr impl ivc snr set-up","description":"Remote monitoring of implantable inferior vena cava sensor, physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate), initial set-up and patient education on use of equipment","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1834","name":"Inj, isoniazid, 1 mg","description":"Injection, isoniazid, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4393","name":"Surgraft ac per sq cm","description":"Surgraft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33267","name":"Excl laa open any method","description":"Exclusion of left atrial appendage, open, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0689","name":"Inj cefazolin sodium, baxter","description":"Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0848T","name":"Dgtz gls mcrscp ish 1st","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5944","name":"Max implt sup remv part","description":"Max implt sup remv part","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0691T","name":"Auto alys xst ct std vrt fx","description":"Automated analysis of an existing computed tomography study for vertebral fracture(s), including assessment of bone density when performed, data preparation, interpretation, and report","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6560","name":"G stckng full/chap30-40 cust","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, custom, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1196","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67121","name":"Remove eye implant material","description":"Removal of implanted material, posterior segment; intraocular","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":872.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0782T","name":"Brnchsc rf dstrj plm nrv uni","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; unilateral mainstem bronchus","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4032","name":"Rheumatology ss","description":"Rheumatology mips specialty set","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0320U","name":"Neph rna psttrnspl perph bld","description":"Neph rna psttrnspl perph bld","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0549U","name":"Onc urthl dna mthyltd rt pcr","description":"Onc urthl dna mthyltd rt pcr","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83884","name":"Assay neurflmnt light chain","description":"Neurofilament light chain (nfl)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0482U","name":"Ob pe biochem asy sfit1&pigf","description":"Ob pe biochem asy sfit1&pigf","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0545U","name":"Achr antb id imfluor livecll","description":"Achr antb id imfluor livecll","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1353","name":"Sealant repair per tooth","description":"Sealant repair per tooth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0515U","name":"Gi ibd ia quan deter ifx lvl","description":"Gi ibd ia quan deter ifx lvl","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0729T","name":"Dx alys vstblr implt uni sbq","description":"Diagnostic analysis of vestibular implant, unilateral; with subsequent programming","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0326U","name":"Trgt gen seq alys pnl 83+","description":"Trgt gen seq alys pnl 83+","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35081","name":"Repair defect of artery","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, abdominal aorta","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1937.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74019","name":"Radex abdomen 2 views","description":"Radiologic examination, abdomen; 2 views","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27025","name":"Fasciotomy hip/thigh any typ","description":"Fasciotomy, hip or thigh, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":978.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1457","name":"Dx asth dur crnt/prv perf pd","description":"Patient had a diagnosis of asthma with any contact during the current or prior performance period or had asthma present on an active problem list any time during the performance period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1163","name":"Pt anphx due to hpv bef 13","description":"Patient had anaphylaxis due to the hpv vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4343","name":"Dermacyte ac matrx per sq cm","description":"Dermacyte ac matrix amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62331","name":"Dcmprn prq rmv lig flv addl","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; additional interspace(s), lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"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":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87880","name":"Strep a assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; streptococcus, group a","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0605","name":"Sucroferric oxyhydroxide 5mg","description":"Sucroferric oxyhydroxide, oral, 5 mg (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0683T","name":"Prgrmg dev eval isdss ip","description":"Programming device evaluation (in-person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional, permanent implantable synchroni","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53010","name":"Incision of urethra","description":"Urethrotomy or urethrostomy, external (separate procedure); perineal urethra, external","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0924T","name":"Rpos prv ccm-d trnsvns eltrd","description":"Repositioning of previously implanted cardiac contractility modulation-defibrillation transvenous electrode(s)/lead(s), including fluoroscopic guidance and programming of sensing and therapeutic parameters","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64567","name":"Perq elec nrv field stimj cn","description":"Percutaneous electrical nerve field stimulation, cranial nerves, without implantation","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"Add upp ext mec limb vol lam","description":"Addition to upper extremity prosthesis, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82270","name":"Occult blood feces","description":"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (ie, patient was provided 3 cards or single triple card for consecutive collection)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0790T","name":"Revj rplcmt/rmvl vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracolumbar or lumbar vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91125","name":"Anrct mano rct snsatn&balo","description":"Anorectal manometry, with rectal sensation and rectal balloon expulsion test, when performed","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99445","name":"Rem mntr physiol param 2-15","description":"Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate); device(s) supply with daily recording(s) or programmed alert(s) transmission, 2-15 days in a 30-day period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0980T","name":"Sbmcsl crylys ther tng&tnsl","description":"Submucosal cryolysis therapy; base of tongue and lingual tonsil only","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50393","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2038","name":"Marigen pacto, per sq cm","description":"Marigen pacto, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37294","name":"Rvsc evsc tpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64719","name":"Revise ulnar nerve at wrist","description":"Neuroplasty and/or transposition; ulnar nerve at wrist","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5140","name":"Inj adalimumab-fkjp, 1 mg","description":"Injection, adalimumab-fkjp, biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3485","name":"Zidovudine","description":"Injection, zidovudine, 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1954","name":"Inj leu acet lutr dpt 7.5 mg","description":"Injection, leuprolide acetate for depot suspension (lutrate depot), 7.5 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1493","name":"No fall doc med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99466","name":"Ped crit care transport","description":"Critical care face-to-face services, during an interfacility transport of critically ill or critically injured pediatric patient, 24 months of age or younger; first 30-74 minutes of hands-on care during transport","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0824T","name":"Tcat rmv 1chmbr ldls pm ra","description":"Transcatheter removal of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography), when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11301","name":"Shave skin lesion 0.6-1.0 cm","description":"Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion diameter 0.6 to 1.0 cm","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":46.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9988","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0291U","name":"Psyc mood do mrna 144 genes","description":"Psyc mood do mrna 144 genes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0554U","name":"Repr med pga 24chrm te bx qc","description":"Repr med pga 24chrm te bx qc","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49600","name":"Repair umbilical lesion","description":"Repair of small omphalocele, with primary closure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":784.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75885","name":"Vein x-ray liver w/hemodynam","description":"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":733.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4002","name":"Ep cardio ss","description":"Electrophysiology cardiac specialist mips specialty set","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3396","name":"Verteporfin injection","description":"Injection, verteporfin, 0.1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4377","name":"Trigraft ft per sq cm","description":"Trigraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27780","name":"Treatment of fibula fracture","description":"Closed treatment of proximal fibula or shaft fracture; without manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0706","name":"Intraoral occlus radio image","description":"Intraoral occlus radio image","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4356","name":"Abio mem abio hyd per sq cm","description":"Abiomend membrane and abiomend hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1164","name":"Pt w/ dementia any time","description":"Patients with dementia any time during the patients history through the end of the measurement period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45320","name":"Proctosigmoidoscopy ablate","description":"Proctosigmoidoscopy, rigid; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique (eg, laser)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81005","name":"Urinalysis","description":"Urinalysis; qualitative or semiquantitative, except immunoassays","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1376","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0901T","name":"Plmt bone marrow smplg port","description":"Placement of bone marrow sampling port, including imaging guidance when performed","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33278","name":"Rmvl phrnc nrv stim sys","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; system, including pulse generator and lead(s)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6527","name":"G garmt full leg/ft nght cus","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, custom, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0736","name":"Inj, clindamycin phosp 300mg","description":"Injection, clindamycin phosphate, 300 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0484","name":"Consult slides prep elsewher","description":"Consultation on slides prepared elsewhere","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46940","name":"Treatment of anal fissure","description":"Curettage or cautery of anal fissure, including dilation of anal sphincter (separate procedure); initial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4483.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93151","name":"Interrog&prgrmg ipnss","description":"Interrogation and programming (minimum one parameter) of implanted phrenic nerve stimulator system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49618","name":"Rpr aa hrn rcr > 10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, incarcerated or strangulate","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98002","name":"Synch audio-video new mod 45","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate medical decision making. when using total time on the date of the encounter for code selection, 45 minutes must be met or exceeded.","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1239","name":"Pt no resp heard","description":"Patient did not respond to the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33895","name":"Evasc st rpr thrc/aa x crsg","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; not crossing major side branches","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9800","name":"Gallium locametz 1 millicuri","description":"Gallium ga-68 gozetotide, diagnostic, (locametz), 1 millicurie","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0312U","name":"Ai ds sle alys 8 igg autoant","description":"Ai ds sle alys 8 igg autoant","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0399U","name":"Neuro cere folate defncy srm","description":"Neuro cere folate defncy srm","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15842","name":"Nerve palsy microsurg graft","description":"Graft for facial nerve paralysis; free muscle flap by microsurgical technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2952.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5933","name":"Refitting of obturator","description":"Obturator prosthesis modification","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0521","name":"Supply fee hiv prep fda appr","description":"Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1403","name":"Bslne and fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0899","name":"Argatroban dialysis, auromed","description":"Injection, argatroban (auromedics), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1250","name":"Pt resp true heard","description":"Patient responded as completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1356","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0295U","name":"Onc brst dux carc 7 proteins","description":"Onc brst dux carc 7 proteins","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0371","name":"Sialoendoscopy capt & interp","description":"Sialoendoscopy capt & interp","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1348","name":"Pam incr 6 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 6-points in a 4 to 12 month period (excellent)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74018","name":"Radex abdomen 1 view","description":"Radiologic examination, abdomen; 1 view","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74185","name":"Mra abd w or w/o cntrst","description":"Magnetic resonance angiography, abdomen, with or without contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":683.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9345","name":"Inj, retifanlimab-dlwr, 1 mg","description":"Injection, retifanlimab-dlwr, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37278","name":"Rvsc evsc fpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6584","name":"Grad com wrap w straps","description":"Gradient compression wrap with adjustable straps, not otherwise specified","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0928T","name":"Rem interrog dev ccm-d phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system with interim analysis and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0442","name":"Annual alcohol screen 15 min","description":"Annual alcohol misuse screening, 5 to 15 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77080","name":"Dxa bone density axial","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]},{"negotiated_type":"negotiated","negotiated_rate":10.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0470U","name":"Onc orop detcj mrd 8 dna hpv","description":"Onc orop detcj mrd 8 dna hpv","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64657","name":"Rmvl bat modulj sys tot sys","description":"Removal of baroreflex activation therapy (bat) modulation system; total system, including lead and pulse generator","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26500","name":"Hand tendon reconstruction","description":"Reconstruction of tendon pulley, each tendon; with local tissues (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8502","name":"Inj, aponvie, 1 mg","description":"Injection, aprepitant (aponvie), 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1207","name":"Pt scrn sdoh","description":"Patient is screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1329","name":"Pts act pvd 2 wks 8 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 8 weeks after initial acute pvd encounter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1351","name":"Pt cmplt suicd saf pln 120dy","description":"Patients who had a suicide safety plan initiated, reviewed, or updated and reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0650","name":"Inj, levothyroxine nos 10mcg","description":"Injection, levothyroxine sodium, not otherwise specified, 10 mcg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4365","name":"Amnio bur dl mem per sq cm","description":"Amnio burgeon dual-layer membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0411U","name":"Psyc genom alys pnl 15 gen","description":"Psyc genom alys pnl 15 gen","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0979T","name":"Sbmcsl crylys ther sft palt","description":"Submucosal cryolysis therapy; soft palate only","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0552","name":"Supply of digital device","description":"Supply of digital mental health treatment device and initial education and onboarding, per course of treatment that augments a behavioral therapy plan","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64656","name":"Revj/rplcmt bat mod sys pg","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; pulse generator only","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0402U","name":"Nfct agt sti mult amp prb tq","description":"Nfct agt sti mult amp prb tq","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86077","name":"Phys blood bank serv xmatch","description":"Blood bank physician services; difficult cross match and/or evaluation of irregular antibody(s), interpretation and written report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8005","name":"Grip glove w microprocessor","description":"Powered, cable driven grip assist glove, hand, finger, includes microprocessor, pressure sensors, all components and accessories, custom fitted","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0550","name":"Phone/inter for dx/treat >5m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a written report to the patients treating/r","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0992T","name":"N-invas assmt car rsk w/o ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat without concurrent computed tomography (ct) scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1814","name":"Inj. insulin (lyumjev)","description":"Insulin (lyumjev), per 5 units","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01941","name":"Anes neuromd/ntrvrt crv/thrc","description":"Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9255","name":"Inj, methotrexate (accord)","description":"Injection, methotrexate (accord), not therapeutically equivalent to j9260, 50 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0673T","name":"Abltj b9 thyr ndul perq lasr","description":"Ablation, benign thyroid nodule(s), percutaneous, laser, including imaging guidance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6601","name":"Porc/ceram inlay >= 3 surfac","description":"Inlay - porcelain/ceramic three or more surfaces","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0001","name":"Advancing cancer care mvp","description":"Advancing cancer care mips value pathways","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6073","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (predominantly base metal)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38765","name":"Remove groin lymph nodes","description":"Inguinofemoral lymphadenectomy, superficial, in continuity with pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1390.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85732","name":"Thromboplastin time partial","description":"Thromboplastin time, partial (ptt); substitution, plasma fractions, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2596","name":"Vasopressin (long grove) 1 u","description":"Injection, vasopressin (long grove), not therapeutically equivalent to j2598, 1 unit","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0500U","name":"Autoinflam ds vexas synd dna","description":"Autoinflam ds vexas synd dna","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82383","name":"Assay blood catecholamines","description":"Catecholamines; blood","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0665","name":"Team remote e/m est pt 10 mn","description":"Team remote e/m est. pt 10mins","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49594","name":"Rpr aa hrn 1st 3-10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, incarcerated or strangulated","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12047","name":"Intmd rpr n-hf/genit >30.0cm","description":"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; over 30.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9172","name":"Docetaxel (docivyx), 1 mg","description":"Injection, docetaxel (docivyx), 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5939","name":"Resct proth mand comp remov","description":"Resct proth mand comp remov","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0596U","name":"Neuro alzds plsm 3dstnct isp","description":"Neuro alzds plsm 3dstnct isp","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1208","name":"Pt no scrn sdoh","description":"Patient is not screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1465","name":"F/u > 180 days after rx","description":"Patient follow up more than 180 days after treatment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96377","name":"Applicaton on-body injector","description":"Application of on-body injector (includes cannula insertion) for timed subcutaneous injection","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0441U","name":"Nfct ds bct fngl/viral semiq","description":"Nfct ds bct fngl/viral semiq","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0446U","name":"Ai ds sle alys 10 cytokine","description":"Ai ds sle alys 10 cytokine","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3387","name":"Inj elivaldogene autotemecel","description":"Injection, elivaldogene autotemcel, per treatment","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1326","name":"Pts dx hypotony","description":"Patients with a diagnosis of hypotony","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0567U","name":"Rare ds whl gen seq srs&lrs","description":"Rare ds whl gen seq srs&lrs","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1353","name":"Pts no cmplt suicd saf pln","description":"Patients who did not have a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47530","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38225","name":"Car-t hrv bld-drv t lymphcyt","description":"Chimeric antigen receptor t-cell (car-t) therapy; harvesting of blood-derived t lymphocytes for development of genetically modified autologous car-t cells, per day","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7259","name":"Nerve dissection","description":"Nerve dissection","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0459U","name":"Abeta42 & ttau eclia csf","description":"Abeta42 & ttau eclia csf","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1327","name":"Pts no eval ini xm no 8 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 8 weeks","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98984","name":"Rtm dev sply resp sys 2-15 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of respiratory system, 2-15 days in a 30-day period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4258","name":"Enverse, per sq cm","description":"Enverse, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3432","name":"Guided tissue regeneration","description":"Guided tissue regeneration","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7173","name":"Inj. concizumab-mtci, 0.5 mg","description":"Injection, concizumab-mtci, 0.5 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4401","name":"Absolv3 per sq cm","description":"Absolv3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30130","name":"Excise inferior turbinate","description":"Excision inferior turbinate, partial or complete, any method","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":425.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90472","name":"Immunization admin each add","description":"Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); each additional vaccine (single or combination vaccine/toxoid) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2998","name":"Inj plasminogen tvmh 1mg","description":"Injection, plasminogen, human-tvmh, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0742T","name":"Aqmbf spect xers/strs & rest","description":"Absolute quantitation of myocardial blood flow (aqmbf), single-photon emission computed tomography (spect), with exercise or pharmacologic stress, and at rest, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27640","name":"Partial removal of tibia","description":"Partial excision (craterization, saucerization, or diaphysectomy), bone (eg, osteomyelitis); tibia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1075.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9220","name":"Indigotindisulfonate sod 1mg","description":"Injection, indigotindisulfonate sodium, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1598","name":"Inj glycopyrrolate fres kabi","description":"Injection, glycopyrrolate (fresenius kabi), not therapeutically equivalent to j1596, 0.1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84134","name":"Assay of prealbumin","description":"Prealbumin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1481","name":"Pt in hosp/pal care who died","description":"Patients receiving hospice or palliative care or who died during the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4006","name":"Gastroenterology ss","description":"Gastro-enterology mips specialty set","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1002T","name":"Air displacmnt plethysmograp","description":"Air displacement plethysmography, whole-body composition assessment, with interpretation and report","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0790T","name":"Revj rplcmt/rmvl vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracolumbar or lumbar vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0814T","name":"Prq njx biod osteo matrl fem","description":"Percutaneous injection of calcium-based biodegradable osteoconductive material, proximal femur, including imaging guidance, unilateral","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98004","name":"Synch audio-video est sf 10","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 10 minutes must be met or e","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0901","name":"Vadadustat oral 1mg for esrd","description":"Vadadustat, oral, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0737","name":"Inj, clindamycin (baxter)","description":"Injection, clindamycin phosphate (baxter), not therapeutically equivalent to j0736, 300 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0779T","name":"Gi myoelectrical actv study","description":"Gastrointestinal myoelectrical activity study, stomach through colon, with interpretation and report","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37204","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64435","name":"Njx aa&/strd paracrv nrv","description":"Injection(s), anesthetic agent(s) and/or steroid; paracervical (uterine) nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54411","name":"Remov/replc penis pros comp","description":"Removal and replacement of all components of a multi-component inflatable penile prosthesis through an infected field at the same operative session, including irrigation and debridement of infected tissue","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1054.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4407","name":"Xwrap tribus per sq cm","description":"Xwrap tribus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1286","name":"Bmi doc onl fup not cmpltd","description":"Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1321","name":"Pts no 7wk inj,no iop,iop>25","description":"Patients who were not seen within 7 weeks following the date of injection for follow up or who did not have a documented iop or no plan of care documented if the iop was >25 mm hg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1821","name":"Ko elas w/ condyle pads otf","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, off the shelf","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0752","name":"Hiv prep, oral lenacapavir","description":"Oral, lenacapavir, 300 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J2910","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37289","name":"Revsc evsc tpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0370","name":"Max ultrasound capt & interp","description":"Max ultrasound capt & interp","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0834T","name":"Dgtz gls mcrscp cytp oth xtn","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37297","name":"Revsc evasc imvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56740","name":"Exc bartholins gland/cyst","description":"Excision of bartholins gland or cyst","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7771","name":"Alveolus clsd reduc stblz te","description":"Alveolus closed reduction stabilization of teeth","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46320","name":"Removal of hemorrhoid clot","description":"Excision of thrombosed hemorrhoid, external","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99425","name":"Prin care mgmt phys ea addl","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78491","name":"Myocrd img pet 1std rst/strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); single study, at rest or stress (exercise or pharmacologic)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1552.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0997T","name":"Precuneus mag stimj tx plng","description":"Precuneus magnetic stimulation; treatment planning using magnetic resonance imaging-guided neuronavigation to determine optimal location, dose, and intensity for magnetic stimulation therapy, derived from evoked potentials from single pulses of electromagnetic energy recorded by 64-channel electroen","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33503","name":"Coronary artery graft","description":"Repair of anomalous coronary artery from pulmonary artery origin; by graft, without cardiopulmonary bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1466.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11042","name":"Dbrdmt subq tis 1st 20sqcm/<","description":"Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":59.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37264","name":"Revsc evasc fpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0394U","name":"Pfas 16 pfas compnd lc ms/ms","description":"Pfas 16 pfas compnd lc ms/ms","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55650","name":"Remove sperm duct pouch","description":"Vesiculectomy, any approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":790.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4006","name":"Gastroenterology ss","description":"Gastro-enterology mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9011","name":"Datopotamab deruxtecan, 1 mg","description":"Injection, datopotamab deruxtecan-dlnk, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2025","name":"Miro3d per cubic cm","description":"Miro3d, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9289","name":"Inj nivolumab 2 mg hyaluron","description":"Injection, nivolumab, 2 mg and hyaluronidase-nvhy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2017","name":"Permeaderm glove, each","description":"Permeaderm glove, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2014","name":"Omeza collag compl 100 mg","description":"Omeza collagen matrix or omeza complete matrix, per 100 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0739","name":"Rehab sys active assist rt","description":"Rehabilitation system with interactive interface providing active assistance in rehabilitation therapy, includes all components and accessories, motors, microprocessors, sensors","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1597.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49593","name":"Rpr aa hrn 1st 3-10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, reducible","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55881","name":"Ablt trurl prst8 tis thrm us","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation;","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2051","name":"Support broker waiver/diem","description":"Supports brokerage, self-directed, waiver; per diem","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98001","name":"Synch audio-video new low 30","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0917T","name":"Insj perm ccm-d sys 1 lead","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; single transvenous lead (pacing or defibrillation) only","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0736","name":"Inj, clindamycin phosp 300mg","description":"Injection, clindamycin phosphate, 300 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9697","name":"Inj, magtrace per study dose","description":"Injection, carboxydextran-coated superparamagnetic iron oxide, per study dose","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1178","name":"Doc med rsn no pcv","description":"Documentation of medical reason(s) for not administering pneumococcal vaccine (e.g., prior anaphylaxis due to the pneumococcal vaccine)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2928","name":"Prefab porc/cer crown perm","description":"Prefab porc/cer crown perm","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9361","name":"Inj, efbemalenograstim alfa-","description":"Injection, efbemalenograstim alfa-vuxw, 0.5 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52612","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":537.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20552","name":"Njx 1/mlt trigger point 1/2","description":"Injection(s); single or multiple trigger point(s), 1 or 2 muscle(s)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":59.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52345","name":"Cysto/uretero w/up stricture","description":"Cystourethroscopy with ureteroscopy; with treatment of ureteropelvic junction stricture (eg, balloon dilation, laser, electrocautery, and incision)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0552","name":"Supply of digital device","description":"Supply of digital mental health treatment device and initial education and onboarding, per course of treatment that augments a behavioral therapy plan","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0426","name":"Coll, analys of saliva","description":"Coll, analys of saliva","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0210","name":"Methyldopate hcl injection","description":"Injection, methyldopate hcl, up to 250 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6599","name":"G comp bandage short stretch","description":"Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50234","name":"Removal of kidney & ureter","description":"Nephrectomy with total ureterectomy and bladder cuff; through same incision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2184","name":"Inj, meropenem (b. braun)","description":"Injection, meropenem (b. braun), not therapeutically equivalent to j2185, 100 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0502U","name":"Hpv e6/e7 mrk hi-rsk typ crv","description":"Hpv e6/e7 mrk hi-rsk typ crv","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0770T","name":"Vr technology assist therapy","description":"Virtual reality technology to assist therapy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37295","name":"Rvsc evsc tpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5996","name":"Peri medicament w/seal, mand","description":"Peri medicament w/seal, mand","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9956","name":"Admin home sleep apnea test","description":"Admin home sleep apnea test","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4435","name":"Renati membrane per sq cm","description":"Renati membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0831T","name":"Dgtz gls mcrscp cytp c/v","description":"Digitization of glass microscope slides for cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99461","name":"Init nb em per day non-fac","description":"Initial care, per day, for evaluation and management of normal newborn infant seen in other than hospital or birthing center","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":56.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7300","name":"Rem anchorage dev w/o flap","description":"Rem anchorage dev w/o flap","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2525","name":"Cl, hydrophilic, dual focus","description":"Contact lens, hydrophilic, dual focus, per lens","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4350","name":"Palisade dm matrix per sq cm","description":"Palisade dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4031","name":"Radiation oncology ss","description":"Radiation oncology mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0562U","name":"Onc sol tum tgsa 33gens snvs","description":"Onc sol tum tgsa 33gens snvs","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0514","name":"Prolong prev svcs, addl 30m","description":"Prolonged preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient contact beyond the usual service; each additional 30 minutes (list separately in addition to code g0513 for additional 30 minutes of preventi","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":49.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84145","name":"Procalcitonin (pct)","description":"Procalcitonin (pct)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4332","name":"Axolotl dualgraft, per sq cm","description":"Axolotl dualgraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0531U","name":"Nfct ds afb&inv fng 673orgs","description":"Nfct ds afb&inv fng 673orgs","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1190","name":"Doc khe not pef w/efgr/uacr","description":"Documentation of a kidney health evaluation was not performed or defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48547","name":"Duodenal exclusion","description":"Duodenal exclusion with gastrojejunostomy for pancreatic injury","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1763.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77437","name":"Surf radj ther supfc<=150kv","description":"Surface radiation therapy; superficial, delivery, </=150 kv, per fraction (eg, electronic brachytherapy)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7165","name":"Inj, human-lans, per i.u","description":"Injection, prothrombin complex concentrate, human-lans, per i.u. of factor ix activity","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99471","name":"Ped critical care initial","description":"Initial inpatient pediatric critical care, per day, for the evaluation and management of a critically ill infant or young child, 29 days through 24 months of age","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":745.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50750","name":"Fusion of ureter & kidney","description":"Ureterocalycostomy, anastomosis of ureter to renal calyx","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1258.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4032","name":"Rheumatology ss","description":"Rheumatology mips specialty set","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55710","name":"Bx prst8 tprn us w/mri fus 1","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant) with mri-fusion-guidance biopsy, first targeted lesion","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4347","name":"Rampart dl matrix per sq cm","description":"Rampart dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9997","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0682","name":"App non-sheet skin sub add","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (list separately in addition to code for pri","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47384","name":"Abltj ire liver 1+ tum perq","description":"Ablation, irreversible electroporation, liver, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1183","name":"Doc imm ckpt inhib hld","description":"Documentation of immune checkpoint inhibitor therapy held and corticosteroids or immunosuppressants prescribed or administered","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97607","name":"Neg prs wnd thr ndme<=50sqcm","description":"Negative pressure wound therapy, (eg, vacuum assisted drainage collection), utilizing disposable, non-durable medical equipment including provision of exudate management collection system, topical application(s), wound assessment, and instructions for ongoing care, per session; total wound(s) surfac","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":426.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0561U","name":"Onc mrd gsa cfdna subsequent","description":"Onc mrd gsa cfdna subsequent","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0506U","name":"Gi barretts esophgl cell 89","description":"Gi barretts esophgl cell 89","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1938","name":"Inj, furosemide, 1 mg","description":"Injection, furosemide, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9329","name":"Inj, tislelizumab-jsgr","description":"Injection, tislelizumab-jsgr, 1mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6214","name":"Pontic titanium","description":"Pontic - titanium","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0950T","name":"Abltj b9 prst8 tissue hifu","description":"Ablation of benign prostate tissue, transrectal, with high intensity-focused ultrasound (hifu), including ultrasound guidance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64583","name":"Rev/rplct hpglsl nstm ary pg","description":"Revision or replacement of hypoglossal nerve neurostimulator array and distal respiratory sensor electrode or electrode array, including connection to existing pulse generator","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88175","name":"Cytopath c/v auto fluid redo","description":"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with screening by automated system and manual rescreening or review, under physician supervision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6590","name":"Urinary cath disp suc pump","description":"External urinary catheters; disposable, with wicking material, for use with suction pump, per month","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94621","name":"Cardiopulm exercise testing","description":"Cardiopulmonary exercise testing, including measurements of minute ventilation, co2 production, o2 uptake, and electrocardiographic recordings","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0759T","name":"Dgtz gls mcrscp sl sp grpiii","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group iii, for enzyme constituents (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0918T","name":"Insj perm ccm-d sys dual ld","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; dual transvenous leads (pacing and defibrillation) only","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2045","name":"Novashield/novogen pr sq cm","description":"Novashield or novogen wound matrix, per square centimeter","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0035","name":"Pt ed pos 23","description":"Patient has any emergency department encounter during the performance period with place of service indicator 23","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0968T","name":"Insj/rplcmt epcrnl nstim sys","description":"Insertion or replacement of epicranial neurostimulator system, including electrode array and pulse generator, with connection to electrode array","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21046","name":"Remove mandible cyst complex","description":"Excision of benign tumor or cyst of mandible; requiring intra-oral osteotomy (eg, locally aggressive or destructive lesion[s])","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1216.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1185","name":"Imm ckpt inhib not hld no rx","description":"Documentation of immune checkpoint inhibitor therapy not held and/or corticosteroids or immunosuppressants prescribed or administered was not performed, reason not given","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0723T","name":"Qmrcp w/o dx mri sm anat ses","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained without diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) during the same session","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63191","name":"Incise spine accessory nerve","description":"Laminectomy with section of spinal accessory nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1631.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4373","name":"Membrane wrp lt per sq cm","description":"Membrane wrap lite, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4013","name":"Mntal/behav/psych hlth ss","description":"Mental/behavioral and psychiatry mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4468","name":"Exsuff belt incl all sup acc","description":"Exsufflation belt, includes all supplies and accessories","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0340U","name":"Onc pan ca alys mrd plasma","description":"Onc pan ca alys mrd plasma","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"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":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0550","name":"Phone/inter for dx/treat >5m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a written report to the patients treating/r","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"Sup/ext non-ins inf pump syr","description":"Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1249","name":"Pt resp true imprt to me","description":"Patient responded completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37291","name":"Revsc evsc tpvt athr cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33915","name":"Remove lung artery emboli","description":"Pulmonary artery embolectomy; without cardiopulmonary bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1417.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97008","name":"Mchnl sclp cool prep plmt","description":"Mechanical scalp cooling; including hair preparation, individual cap placement, therapy initiation, and precooling period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1491","name":"Recd esrd mcp dur perf pd","description":"Receiving esrd mcp dialysis services by the provider during the performance period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0249","name":"Tocilizumab for covid-19","description":"Injection, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2312","name":"Inj naloxone hcl nos, 0.01mg","description":"Injection, naloxone hydrochloride, not otherwise specified, 0.01 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1452","name":"Pt dx dementia ever","description":"Patient ever had a diagnosis of dementia","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9603","name":"Inj, pafolacianine, 0.1 mg","description":"Injection, pafolacianine, 0.1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1279","name":"Pre-htn/htn, no f/u, not gvn","description":"Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4100","name":"Nosht skin sub fda clrd nos","description":"Non-sheet form skin substitute, fda cleared as a device, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4265","name":"Neostim tl per sq cm","description":"Neostim tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4289","name":"Revoshield+ amnio, per sq cm","description":"Revoshield + amniotic barrier, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0458","name":"Aztreonam/avibactam 10 mg","description":"Injection, aztreonam/avibactam, 7.5 mg/2.5 mg (10 mg)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1496","name":"No doc of fall or poc","description":"Patients that had a fall who did not have a plan of care for falls documented or do not have documentation of being assessed for falls","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1338","name":"Pt f/u 30-180 dys no + imprv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who did not demonstrate positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1025","name":"Pt mnth 1 mcp prov","description":"Patient-months where there are more than one medicare capitated payment (mcp) provider listed for the month","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0711T","name":"N-nvs artl plaq alys dat prp","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data preparation and transmission","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9596","name":"Gallium illuccix 1 millicure","description":"Gallium ga-68 gozetotide, diagnostic, (illuccix), 1 millicurie","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0736T","name":"Colonic lavage 35+l water","description":"Colonic lavage, 35 or more liters of water, gravity-fed, with induced defecation, including insertion of rectal catheter","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1720","name":"Influenza vacc admin","description":"Influenza vacc admin","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15018","name":"App skn cll ssp f/n/g/hf ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 480 sq cm or part thereof (list separately in addition to code for prima","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90637","name":"Vacc qirv mrna 30mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 30 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1268","name":"Pt ac stat kid trnsplt wtlst","description":"Patients observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2372","name":"Inj, biorphen, 20 micrograms","description":"Injection, phenylephrine hydrochloride (biorphen), 20 micrograms","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15014","name":"Prepj skn cll ssp agrft ea","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; each additional 25 sq cm of harvested skin or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2015","name":"Phoenix wnd mtrx, per sq cm","description":"Phoenix wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1456","name":"Pt had htx","description":"Patient had a heart transplant","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4025","name":"Physical medicine ss","description":"Physical medicine mips specialty set","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1383","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5129","name":"Inj, vegzelma, 10 mg","description":"Injection, bevacizumab-adcd (vegzelma), biosimilar, 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81517","name":"Liver ds alys 3 bmrk srm alg","description":"Liver disease, analysis of 3 biomarkers (hyaluronic acid [ha], procollagen iii amino terminal peptide [piiinp], tissue inhibitor of metalloproteinase 1 [timp-1]), using immunoassays, utilizing serum, prognostic algorithm reported as a risk score and risk of liver fibrosis and liver-related clinical ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4319","name":"Sanograft, per sq cm","description":"Sanograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64583","name":"Rev/rplct hpglsl nstm ary pg","description":"Revision or replacement of hypoglossal nerve neurostimulator array and distal respiratory sensor electrode or electrode array, including connection to existing pulse generator","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1215","name":"Med rsn for no doc spiro","description":"Documentation of medical reason(s) for not documenting and reviewing spirometry results (e.g., patients with dementia or tracheostomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0650","name":"Inj, levothyroxine nos 10mcg","description":"Injection, levothyroxine sodium, not otherwise specified, 10 mcg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30300","name":"Remove nasal foreign body","description":"Removal foreign body, intranasal; office type procedure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":252.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":136.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4302","name":"Complete aca, per sq cm","description":"Complete aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0530U","name":"Onc pan-sol tum ctdna 77 gen","description":"Onc pan-sol tum ctdna 77 gen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88366","name":"Insitu hybridization (fish)","description":"In situ hybridization (eg, fish), per specimen; each multiplex probe stain procedure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0738","name":"Upper extremity rehab","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9394","name":"Inj, fulvestrant (fresenius)","description":"Injection, fulvestrant (fresenius kabi) not therapeutically equivalent to j9395, 25 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0400U","name":"Ob xpnd car scr 145 genes","description":"Ob xpnd car scr 145 genes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0885T","name":"Colsc flx 1st tndsc dilat","description":"Colonoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4323","name":"Splint extra-coronal","description":"Splint extra-coronal","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4347","name":"Rampart dl matrix per sq cm","description":"Rampart dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0002","name":"Opt care kidney hlth mvp","description":"Optimal care for kidney health mips value pathways","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1456","name":"Pt had htx","description":"Patient had a heart transplant","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94618","name":"Pulmonary stress testing","description":"Pulmonary stress testing (eg, 6-minute walk test), including measurement of heart rate, oximetry, and oxygen titration, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1375","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28675","name":"Repair of toe dislocation","description":"Open treatment of interphalangeal joint dislocation, includes internal fixation, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49322","name":"Laparoscopy aspiration","description":"Laparoscopy, surgical; with aspiration of cavity or cyst (eg, ovarian cyst) (single or multiple)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0446U","name":"Ai ds sle alys 10 cytokine","description":"Ai ds sle alys 10 cytokine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4366","name":"Dl amnio bur x-mem per sq cm","description":"Dual layer amnio burgeon x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0013","name":"Hiv prep counsel, clin staff","description":"Individual counseling for pre-exposure prophylaxis (prep) by clinical staff to prevent human immunodeficiency virus (hiv), includes: hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15013","name":"Prepj skn cll ssp agrft 1st","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; first 25 sq cm or less of harvested skin","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0957T","name":"Rev s-sclp eltr ra rcvr&tlmt","description":"Revision of sub-scalp implanted electrode array, receiver, and telemetry unit for electrode, when required, including imaging guidance","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55882","name":"Ablt trurl prst8 tis trnsdcr","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation; with insertion of transurethral ultrasound transducer for delivery of thermal ultrasound, including suprapubic tube placement and placement of ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6198","name":"Remove interim implant","description":"Remove interim implant","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0458U","name":"Onc brst ca s100 a8&a9 elisa","description":"Onc brst ca s100 a8&a9 elisa","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0607","name":"Lanthanum carbonate oral 5mg","description":"Lanthanum carbonate, oral, 5 mg (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93569","name":"Njx cth slct p-art angrp uni","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1396","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4010","name":"Infectious disease ss","description":"Infectious disease mips specialty set","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0414","name":"Lab process microbial spec","description":"Lab process microbial spec","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1265","name":"Cms 2728 completed","description":"Cms medical evidence form 2728 for dialysis patients: initial form completed","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37297","name":"Revsc evasc imvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0881T","name":"Cryotherapy oral cavity","description":"Cryotherapy of the oral cavity using temperature regulated fluid cooling system, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69727","name":"Rmv ntr oi imp sk tc esp<100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1417","name":"Pt up to date cov","description":"Patients who are up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4020","name":"Ophthalmology/optometry ss","description":"Ophthalmology/optometry mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1489","name":"Pt status doc","description":"Patient status documented","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7472","name":"Removal of torus palatinus","description":"Removal of torus palatinus","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3291","name":"Tranexamic acid in sod chlor","description":"Injection, tranexamic acid in sodium chloride, 5 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0937T","name":"Xtrnl ecg rec>15d<30d","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; including recording, scanning analysis with report, review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0975T","name":"Slctv nzmtc dbrdmt s/n/hf 1","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; first 100 sq cm","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36222","name":"Place cath carotid/inom art","description":"Selective catheter placement, common carotid or innominate artery, unilateral, any approach, with angiography of the ipsilateral extracranial carotid circulation and all associated radiological supervision and interpretation, includes angiography of the cervicocerebral arch, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1808.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0687","name":"Inj cefazolin (wg crit care)","description":"Injection, cefazolin sodium (wg critical care), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88377","name":"M/phmtrc alys ishquant/semiq","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each multiplex probe stain procedure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9064","name":"Inj, cabazitaxel (sandoz)","description":"Injection, cabazitaxel (sandoz), not therapeutically equivalent to j9043, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78110","name":"Plasma volume single","description":"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4342","name":"Theramend, per sq cm","description":"Theramend, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29058","name":"Appl cast plaster velpeau","description":"Application, cast; plaster velpeau","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1446","name":"Pt died bef end meas pd","description":"Patients who died any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88285","name":"Chromosome count additional","description":"Chromosome analysis; additional cells counted, each study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0840T","name":"Dgtz gls mcrscp cslt compre","description":"Digitization of glass microscope slides for consultation, comprehensive, with review of records and specimens, with report on referred material (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99393","name":"Prev visit est age 5-11","description":"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; late ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":124.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0840T","name":"Dgtz gls mcrscp cslt compre","description":"Digitization of glass microscope slides for consultation, comprehensive, with review of records and specimens, with report on referred material (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7962","name":"Lingual frenectomy","description":"Lingual frenectomy","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98002","name":"Synch audio-video new mod 45","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate medical decision making. when using total time on the date of the encounter for code selection, 45 minutes must be met or exceeded.","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0930T","name":"Ephys eval ccm-d ld 1st impl","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), at time of initial implantation or replacement with testing of cardiac contrac","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37272","name":"Revsc evsc fpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44385","name":"Endoscopy of bowel pouch","description":"Endoscopic evaluation of small intestinal pouch (eg, kock pouch, ileal reservoir [s or j]); diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0688","name":"Inj cefazolin sodium, hikma","description":"Injection, cefazolin sodium (hikma), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2711","name":"Inj neostigmin/glycopyrrolat","description":"Injection, neostigmine methylsulfate 0.1 mg and glycopyrrolate 0.02 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1353","name":"Pts no cmplt suicd saf pln","description":"Patients who did not have a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31242","name":"Nsl/sinus ndsc rf abltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by radiofrequency ablation, posterior nasal nerve","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J1094","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0459U","name":"Abeta42 & ttau eclia csf","description":"Abeta42 & ttau eclia csf","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99252","name":"Ip/obs consltj new/est sf 35","description":"Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 35 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0372","name":"Tomo comp series images","description":"Tomo comp series images","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1371","name":"Mst rec gsa<7","description":"Most recent glycemic status assessment (hba1c or gmi) level < 7.0%","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9208","name":"Ifosfamide injection","description":"Injection, ifosfamide, 1 gram","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0235","name":"Inj, monoclon antibody, 1 mg","description":"Injection, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extraco","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92637","name":"Hearing aid pst-fitg f-up ea","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0377U","name":"Cv ds quan advsrm/plsm lprtn","description":"Cv ds quan advsrm/plsm lprtn","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92972","name":"Perq trluml coronry lithotrp","description":"Percutaneous transluminal coronary lithotripsy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0543","name":"Group train w/o patient","description":"Group caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient pre","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0475U","name":"Hered prst8 ca gsap 23 genes","description":"Hered prst8 ca gsap 23 genes","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2711","name":"Inj neostigmin/glycopyrrolat","description":"Injection, neostigmine methylsulfate 0.1 mg and glycopyrrolate 0.02 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0923T","name":"Rmvl&rplcmt perm ccm-d pg","description":"Removal and replacement of permanent cardiac contractility modulation-defibrillation pulse generator only","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0891T","name":"Arhfcmrigtbs sbsq tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent treatment day","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37295","name":"Rvsc evsc tpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53425","name":"Reconstruct urethra stage 2","description":"Urethroplasty, 2-stage reconstruction or repair of prostatic or membranous urethra; second stage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1047.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0369","name":"Max mri capture & interprete","description":"Max mri capture & interprete","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0527U","name":"Hsv 1&2 vzv amp prb tq pthgn","description":"Hsv 1&2 vzv amp prb tq pthgn","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64657","name":"Rmvl bat modulj sys tot sys","description":"Removal of baroreflex activation therapy (bat) modulation system; total system, including lead and pulse generator","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1355","name":"Caries med app per tooth","description":"Caries med app per tooth","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96921","name":"Excimer lsr psriasis 250-500","description":"Excimer laser treatment for psoriasis; 250 sq cm to 500 sq cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0532","name":"Take home supp nasal spray","description":"Take-home supply of nasal nalmefene hydrochloride; one carton of two, 2.7 mg per 0.1 ml nasal sprays (provision of the services by a medicare-enrolled opioid treatment program);( list separately in addition to each primary code)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0265U","name":"Rar do whl gn&mtcdrl dna als","description":"Rare constitutional and other heritable disorders, whole- genome and mitochondrial dna sequence analysis, blood, frozen and formalin-fixed paraffin-embedded (ffpe) tissue, saliva, buccal swabs or cell lines, identification of single nucleotide and copy number variants","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0369","name":"Max mri capture & interprete","description":"Max mri capture & interprete","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"Evoked auditory test limited","description":"Distortion product evoked otoacoustic emissions; limited evaluation (to confirm the presence or absence of hearing disorder, 3-6 frequencies) or transient evoked otoacoustic emissions, with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9273","name":"Inj tisotu vedotin-tftv, 1mg","description":"Injection, tisotumab vedotin-tftv, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0565U","name":"Onc hcc ngs detc 6626epigalt","description":"Onc hcc ngs detc 6626epigalt","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15320","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0561","name":"Temp tube delivery, unil","description":"Tympanostomy with local or topical anesthesia and insertion of a ventilating tube when performed with tympanostomy tube delivery device, unilateral (list separately in addition to 69433) (do not use in conjunction with 0583t)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4035","name":"Thoracic surgery ss","description":"Thoracic surgery mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81003","name":"Urinalysis auto w/o scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; automated, without microscopy","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93585","name":"Vngrph chd azygs/hemiazygs","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; azygos/hemiazygos venous system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0426","name":"Coll, analys of saliva","description":"Coll, analys of saliva","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4271","name":"Complete ft per sq cm","description":"Complete ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01938","name":"Anes drg/aspir lmbr/sac","description":"Anesthesia for percutaneous image-guided injection, drainage or aspiration procedures on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7514","name":"Mycophenol (myhibbin) 100 mg","description":"Mycophenolate mofetil (myhibbin), oral suspension, 100 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1352","name":"Suicd c-ssrs assessment, equ","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs or equivalent assessment","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1394","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0468U","name":"Hep nash mir34a5p a2m ykl40","description":"Hep nash mir34a5p a2m ykl40","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1296","name":"Calc bmi norm parameters","description":"Bmi is documented within normal parameters and no follow-up plan is required","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93146","name":"Interrog crtd sins bat ip w/","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6527","name":"G garmt full leg/ft nght cus","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, custom, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0265U","name":"Rar do whl gn&mtcdrl dna als","description":"Rare constitutional and other heritable disorders, whole- genome and mitochondrial dna sequence analysis, blood, frozen and formalin-fixed paraffin-embedded (ffpe) tissue, saliva, buccal swabs or cell lines, identification of single nucleotide and copy number variants","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"Adju cgm supply allowance","description":"Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-06-05","zip":"10985","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KF"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0699","name":"Inj, cefiderocol, 10 mg","description":"Injection, cefiderocol, 10 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6112","name":"Imp/abut rem dent part max","description":"Imp/abut rem dent part max","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9997","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1479","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97009","name":"Mchnl sclp cool after chemo","description":"Mechanical scalp cooling; provided after discontinuation of chemotherapy, each 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57022","name":"I&d vaginal hematoma ob/pp","description":"Incision and drainage of vaginal hematoma; obstetrical/postpartum","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0495U","name":"Onc prst8 alys crcg plsm prt","description":"Onc prst8 alys crcg plsm prt","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1316","name":"Tobacco non-user","description":"Current tobacco non-user","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35587","name":"Vein byp pop-tibl peroneal","description":"In-situ vein bypass; popliteal-tibial, peroneal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1776.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4029","name":"Preventive medicine ss","description":"Preventive medicine mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4319","name":"Sanograft, per sq cm","description":"Sanograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0510U","name":"Onc pncrtc ca alg alys 16gen","description":"Onc pncrtc ca alg alys 16gen","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5149","name":"Inj, aflibercept-abzv, 1 mg","description":"Injection, aflibercept-abzv (enzeevu), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1369","name":"Qualcare mental hlth/sud mvp","description":"Quality care in mental health and substance use disorders mips value pathway","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0486U","name":"Onc pan sol tum ngs cfctdna","description":"Onc pan sol tum ngs cfctdna","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0543","name":"Group train w/o patient","description":"Group caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient pre","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1202","name":"Pt rsn no ace-i/arb rx","description":"Documentation of patient reason(s) for not prescribing ace inhibitor or arb therapy during the measurement period, (e.g., patient declined, other patient reasons)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75580","name":"N-invas est c ffr sw aly cta","description":"Noninvasive estimate of coronary fractional flow reserve (ffr) derived from augmentative software analysis of the data set from a coronary computed tomography angiography, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96381","name":"Admn rsv monoc antb im njx","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0578","name":"Inj brixadi, more than 7 day","description":"Injection, buprenorphine extended release (brixadi), greater than 7 days and up to 28 days of therapy","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0137","name":"Inj, acetaminophen (hikma)","description":"Injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1714","name":"Pfizer vacc adm ped 2nd dose","description":"Pfizer vacc adm ped 2nd dose","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9996","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1324","name":"Pts intravitreal/pci","description":"Patients who had an intravitreal or periocular corticosteroid injection (e.g., triamcinolone, preservative-free triamcinolone, dexamethasone, dexamethasone intravitreal implant, or fluocinolone intravitreal implant)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0372","name":"Tomo comp series images","description":"Tomo comp series images","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6559","name":"G stckng full/chap18-30 cust","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9886","name":"In-person attendance g code","description":"Behavioral counseling for diabetes prevention, in-person, group, 60 minutes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33269","name":"Excl laa thrscp any method","description":"Exclusion of left atrial appendage, thoracoscopic, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83884","name":"Assay neurflmnt light chain","description":"Neurofilament light chain (nfl)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87428","name":"Sarscov & inf vir a&b ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; severe acute respiratory syndrome coronavirus (eg, sars-cov, s","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4346","name":"Shelter dm matrix per sq cm","description":"Shelter dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4362","name":"Cygnus disk, per sq cm","description":"Cygnus disk, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0618","name":"Inj, calcium chloride, 2 mg","description":"Injection, calcium chloride, 2 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6611","name":"Onlay cst hgh nbl mtl >=3srf","description":"Onlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0900T","name":"N-invas est aqmbf asstv cmr","description":"Noninvasive estimate of absolute quantitation of myocardial blood flow (aqmbf), derived from assistive algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health care profes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4256","name":"Mlg complet, per sq cm","description":"Mlg-complete, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0277U","name":"Hem gen pltlt funcj do 31","description":"Hematology (genetic platelet function disorder), genomic sequence analysis of 31 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1024T","name":"Perq tiss dsplmt soft tissue","description":"Percutaneous tissue displacement, any method, including imaging guidance; soft tissue (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0651","name":"Inj, levothyroxine, freskabi","description":"Injection, levothyroxine sodium (fresenius kabi), not therapeutically equivalent to j0650, 10 mcg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0972T","name":"Asstv alg clsfctn burn hlg","description":"Assistive algorithmic classification of burn healing (ie, healing or nonhealing) by noninvasive multispectral imaging, including system set-up and acquisition, selection, and transmission of images, with automated generation of report","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27730","name":"Repair of tibia epiphysis","description":"Arrest, epiphyseal (epiphysiodesis), open; distal tibia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":720.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0852T","name":"Dgtz gls mcrscp mphmtrc ea 1","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43889","name":"Gstr rstcv px trnsorl esg","description":"Gastric restrictive procedure, transoral, endoscopic sleeve gastroplasty (esg), including argon plasma coagulation, when performed","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4406","name":"Xwrap fenestra per sq cm","description":"Xwrap fenestra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0349","name":"Inj, rezafungin, 1 mg","description":"Injection, rezafungin, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0473U","name":"Onc sld tum bld/slv 648 gene","description":"Onc sld tum bld/slv 648 gene","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4013","name":"Mntal/behav/psych hlth ss","description":"Mental/behavioral and psychiatry mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1457","name":"Dx asth dur crnt/prv perf pd","description":"Patient had a diagnosis of asthma with any contact during the current or prior performance period or had asthma present on an active problem list any time during the performance period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45346","name":"Sigmoidoscopy w/ablation","description":"Sigmoidoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2891.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":162.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0422","name":"Collect & prep genetic samp","description":"Collect & prep genetic samp","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4031","name":"Radiation oncology ss","description":"Radiation oncology mips specialty set","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34833","name":"Opn ilac art expos cndt crtj","description":"Open iliac artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass, by abdominal or retroperitoneal incision, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":804.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82274","name":"Assay test for blood fecal","description":"Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2542","name":"Dental onlay metallic 2 surf","description":"Onlay-metallic-two surfaces","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1241","name":"Pt no resp seen as person","description":"Patient did not respond to the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44389","name":"Colonoscopy with biopsy","description":"Colonoscopy through stoma; with biopsy, single or multiple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50974","name":"Ureter endoscopy & biopsy","description":"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21080","name":"Impres&prep def obt prosth","description":"Impression and custom preparation; definitive obturator prosthesis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0848T","name":"Dgtz gls mcrscp ish 1st","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9275","name":"Inj cosibelimab-ipdl, 2 mg","description":"Injection, cosibelimab-ipdl, 2 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91124","name":"Rct snsatn tone&cmplianc std","description":"Rectal sensation, tone, and compliance study (eg, barostat)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5422","name":"Dentures adjust part mandbl","description":"Adjust partial denture - mandibular","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2928","name":"Prefab porc/cer crown perm","description":"Prefab porc/cer crown perm","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57180","name":"Treat vaginal bleeding","description":"Introduction of any hemostatic agent or pack for spontaneous or traumatic nonobstetrical vaginal hemorrhage (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1177","name":"Pt recd pcv on/aft 19","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33730","name":"Repair heart-vein defect(s)","description":"Complete repair of anomalous pulmonary venous return (supracardiac, intracardiac, or infracardiac types)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2386.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1747","name":"Inj, spesolimab-sbzo, 1 mg","description":"Injection, spesolimab-sbzo, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0552","name":"Supply of digital device","description":"Supply of digital mental health treatment device and initial education and onboarding, per course of treatment that augments a behavioral therapy plan","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0782T","name":"Brnchsc rf dstrj plm nrv uni","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; unilateral mainstem bronchus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64567","name":"Perq elec nrv field stimj cn","description":"Percutaneous electrical nerve field stimulation, cranial nerves, without implantation","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83874","name":"Assay of myoglobin","description":"Myoglobin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97763","name":"Orthc/prostc mgmt sbsq enc","description":"Orthotic(s)/prosthetic(s) management and/or training, upper extremity(ies), lower extremity(ies), and/or trunk, subsequent orthotic(s)/prosthetic(s) encounter, each 15 minutes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80157","name":"Assay carbamazepine free","description":"Carbamazepine; free","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37269","name":"Revsc evasc fpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1166","name":"Path rpt tis spec wle/reexc","description":"Pathology report for tissue specimens produced from wide local excisions or re-excisions","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1020T","name":"Raman spectroscopy 1+skn les","description":"Raman spectroscopy of 1 or more skin lesions, with probability score for malignant risk derived by algorithmic analysis of data from each lesion","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66825","name":"Reposition intraocular lens","description":"Repositioning of intraocular lens prosthesis, requiring an incision (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":791.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9045","name":"Albumin (human), 5%, 250 ml","description":"Infusion, albumin (human), 5%, 250 ml","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80505","name":"Path clin consltj high 41-60","description":"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patients history and medical records and high level of medical decision making when using time for code selection, 41-60 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84379","name":"Sugars multiple quant","description":"Sugars (mono-, di-, and oligosaccharides); multiple quantitative, each specimen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4375","name":"Duograft ac per sq cm","description":"Duograft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4371","name":"Neoguard per sq cm","description":"Neoguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0363U","name":"Onc urthl mrna 5 gen alg","description":"Onc urthl mrna 5 gen alg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1293","name":"Calc bmi abv up param f/u","description":"Bmi is documented above normal parameters and a follow-up plan is documented","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0512U","name":"Onc prst8 alys dgtz img msi","description":"Onc prst8 alys dgtz img msi","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1450","name":"Pt hos/pal care dur id/pf pd","description":"Patients who received hospice or palliative care service any time during denominator identification period or the measure assessment period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63101","name":"Remove vert body dcmprn thrc","description":"Vertebral corpectomy (vertebral body resection), partial or complete, lateral extracavitary approach with decompression of spinal cord and/or nerve root(s) (eg, for tumor or retropulsed bone fragments); thoracic, single segment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2576.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5940","name":"Resct proth max part remov","description":"Resct proth max part remov","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1410","name":"No gmln brca1/brca2 couns","description":"Patients who did not have germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75970","name":"Vascular biopsy","description":"Transcatheter biopsy, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":643.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1162","name":"Pt enceph due to dtp bef 13","description":"Patient had encephalitis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3421","name":"Root surgery bicuspid","description":"Apicoectomy/periradicular surgery-bicuspid (first root)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9914","name":"Admin of dermal fill","description":"Admin of dermal fill","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33904","name":"Perq p-art revsc each addl","description":"Percutaneous pulmonary artery revascularization by stent placement, each additional vessel or separate lesion, normal or abnormal connections (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1273","name":"Pts snf 1 yr dialysis","description":"Patients who were admitted to a skilled nursing facility (snf) within one year of dialysis initiation according to the cms-2728 form","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1277","name":"Colorectal ca screen doc rev","description":"Colorectal cancer screening results documented and reviewed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0623U","name":"Ai ms dna mthyl alys >5000","description":"Ai ms dna mthyl alys >5000","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0584U","name":"Neuro csf prion prtn qual","description":"Neuro csf prion prtn qual","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0616U","name":"Neurol dementia alys >30000","description":"Neurol dementia alys >30000","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93584","name":"Vngrph chd anom/persist svc","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; anomalous or persistent superior vena cava when it exists as a second contralateral superior vena cava, with native drainage to heart (list separately in addition to code for pri","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0549U","name":"Onc urthl dna mthyltd rt pcr","description":"Onc urthl dna mthyltd rt pcr","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87555","name":"M.tuberculo dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacteria tuberculosis, direct probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87800","name":"Detect agnt mult dna direc","description":"Infectious agent detection by nucleic acid (dna or rna), multiple organisms; direct probe(s) technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7472","name":"Removal of torus palatinus","description":"Removal of torus palatinus","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59620","name":"Attempted vbac delivery only","description":"Cesarean delivery only, following attempted vaginal delivery after previous cesarean delivery;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1062.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":1306.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0819T","name":"Revj/rmvl ins ptn subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4011","name":"Internal medicine ss","description":"Internal medicine mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0724T","name":"Qmrcp w/dx mri same anatomy","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained with diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in additio","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1460","name":"Dx copd, cf, or arf","description":"Diagnosis for chronic obstructive pulmonary disease, emphysema, cystic fibrosis, or acute respiratory failure","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1197","name":"Isa reduced >=3 fr ixv","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2390","name":"Ant resin-based cmpst crown","description":"Resin-based composite crown anterior","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0555U","name":"Repr med pga embryonic te qc","description":"Repr med pga embryonic te qc","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1412","name":"Inj roctavian ml 2x10^13vc g","description":"Injection, valoctocogene roxaparvovec-rvox, per ml, containing nominal 2 x 10^13 vector genomes","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6599","name":"G comp bandage short stretch","description":"Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86147","name":"Cardiolipin antibody ea ig","description":"Cardiolipin (phospholipid) antibody, each ig class","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0849T","name":"Dgtz gls mcrscp ish ea adl 1","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0674T","name":"Laps insj nw/rpcmt prm isdss","description":"Laparoscopic insertion of new or replacement of permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including an implantable pulse generator and diaphragmatic lead(s)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49201","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1051.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5125","name":"Inj, releuko 1 mcg","description":"Injection, filgrastim-ayow, biosimilar, (releuko), 1 microgram","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1834","name":"Inj, isoniazid, 1 mg","description":"Injection, isoniazid, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4371","name":"Neoguard per sq cm","description":"Neoguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7471","name":"Rem exostosis any site","description":"Removal of lateral exostosis (maxilla or mandible)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55709","name":"Bx prst8 tprnl us guided","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4309","name":"Via matrix, per sq cm","description":"Via matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9318","name":"Inj romidepsin non-lyo 0.1mg","description":"Injection, romidepsin, non-lyophilized, 0.1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47610","name":"Removal of gallbladder","description":"Cholecystectomy with exploration of common duct;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1300.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82166","name":"Assay anti-mullerian horm","description":"Anti-mullerian hormone (amh)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4348","name":"Sentry sl matrix per sq cm","description":"Sentry sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59400","name":"Obstetrical care","description":"Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2601.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4429","name":"Dermbnd chn, chx per sq cm","description":"Dermabind ch n or dermabind ch x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0825T","name":"Tcat rmv&rpl1chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or prog","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90845","name":"Psychoanalysis","description":"Psychoanalysis","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":87.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0273U","name":"Hem gen hyprfibrnlysis 8 gen","description":"Hematology (genetic hyperfibrinolysis, delayed bleeding), genomic sequence analysis of 8 genes (f13a1, f13b, fga, fgb, fgg, serpina1, serpine1, serpinf2, plau) blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83892","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6561","name":"G stockng full/chap 40+ cust","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, custom, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0051","name":"Traditional healing service","description":"Traditional healing service","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0339U","name":"Onc prst8 mrna hoxc6 & dlx1","description":"Onc prst8 mrna hoxc6 & dlx1","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0708","name":"Intraoral bite radio image","description":"Intraoral bite radio image","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9345","name":"Inj, retifanlimab-dlwr, 1 mg","description":"Injection, retifanlimab-dlwr, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12020","name":"Tx supfc wnd dehsn smpl clsr","description":"Treatment of superficial wound dehiscence; simple closure","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":204.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0794T","name":"Pt spec alg rx-onc tx option","description":"Patient-specific, assistive, rules-based algorithm for ranking pharmaco-oncologic treatment options based on the patients tumor-specific cancer marker information obtained from prior molecular pathology, immunohistochemical, or other pathology results which have been previously interpreted and repor","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9992","name":"Pall serv during meas","description":"Palliative care services used by patient any time during the measurement period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1427","name":"Doc med rsn bone scn","description":"Documentation of medical reason(s) for performing a bone scan (including documented pain related to prostate cancer, salvage therapy, other medical reasons)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21077","name":"Impres&prep orbital prosth","description":"Impression and custom preparation; orbital prosthesis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2906.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1442","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0031","name":"Pall serv during meas","description":"Palliative care services given to patient any time during the measurement period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1713","name":"Pfizer vacc adm ped 1st dose","description":"Pfizer vacc adm ped 1st dose","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0138","name":"Iv cipaglucosidase alfa-atga","description":"Intravenous infusion of cipaglucosidase alfa-atga, including provider/supplier acquisition and clinical supervision of oral administration of miglustat in preparation of receipt of cipaglucosidase alfa-atga","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1494","name":"Fall rep since last visit","description":"Patients that reported a fall since the last visit","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0939T","name":"Xtrnl ecg rec>15d<30d scan","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; scanning analysis with report","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5144","name":"Inj, idacio, 1 mg","description":"Injection, adalimumab-aacf (idacio), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4006","name":"Gastroenterology ss","description":"Gastro-enterology mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5130","name":"Inj, fylnetra, 0.5 mg","description":"Injection, pegfilgrastim-pbbk (fylnetra), biosimilar, 0.5 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1299","name":"Inj, eculizumab, 2 mg","description":"Injection, eculizumab, 2 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37254","name":"Revsc evasc ivt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0872","name":"Daptomycin (xellia) unrefrig","description":"Injection, daptomycin (xellia), unrefrigerated, not therapeutically equivalent to j0878 or j0873, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0828T","name":"Dgtz gls mcrscp cytp smpl fl","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; simple filter method with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0359U","name":"Onc prst8 ca alys all psa","description":"Onc prst8 ca alys all psa","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0552U","name":"Repr med pga gdo te bx locus","description":"Repr med pga gdo te bx locus","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8625","name":"Charger coch impl/aoi battry","description":"External recharging system for battery for use with cochlear implant or auditory osseointegrated device, replacement only, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0481U","name":"Idh1 idh2&tert promoter ngs","description":"Idh1 idh2&tert promoter ngs","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2508","name":"Pegunigalsidase alfa-iwxj","description":"Injection, pegunigalsidase alfa-iwxj, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31238","name":"Nsl/sins ndsc srg nsl hemrrg","description":"Nasal/sinus endoscopy, surgical; with control of nasal hemorrhage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1171","name":"Inj, hydromorphone, 0.1 mg","description":"Injection, hydromorphone, 0.1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83904","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1319","name":"Pts csp doc contact","description":"Patients who had documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5142","name":"Inj adalimumab-ryvk, 1 mg","description":"Injection, adalimumab-ryvk biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68330","name":"Revise eyelid lining","description":"Repair of symblepharon; conjunctivoplasty, without graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93596","name":"R&l hrt cath chd nml nt cnj","description":"Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); normal native connections","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36260","name":"Insertion of infusion pump","description":"Insertion of implantable intra-arterial infusion pump (eg, for chemotherapy of liver)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4257","name":"Relese, per sq cm","description":"Relese, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1354","name":"Pt no suicd saf pln 120dy","description":"Patients who did not have a suicide safety plan initiated, reviewed, or updated or reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2184","name":"Inj, meropenem (b. braun)","description":"Injection, meropenem (b. braun), not therapeutically equivalent to j2185, 100 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25112","name":"Reremove wrist tendon lesion","description":"Excision of ganglion, wrist (dorsal or volar); recurrent","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":480.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9612","name":"Thera par drugs 2 or > admin","description":"Therapeutic parenteral drugs two or more administrations different medications","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43400","name":"Ligate esophagus veins","description":"Ligation, direct, esophageal varices","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1432.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67516","name":"Sprchoroidal spc njx rx agt","description":"Suprachoroidal space injection of pharmacologic agent (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87652","name":"Strep a dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); streptococcus, group a, quantification","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38228","name":"Car-t admn autologous","description":"Chimeric antigen receptor t-cell (car-t) therapy; car-t cell administration, autologous","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0847T","name":"Dgtz gls mcrscp xm arch tiss","description":"Digitization of glass microscope slides for examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, kras mutational analysis) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0415U","name":"Cv ds acs bld alg 5 yr score","description":"Cv ds acs bld alg 5 yr score","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1379","name":"10 yr fu no rec rsn not giv","description":"A 10 year follow-up interval for colonoscopy not recommended, reason not otherwise specified","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15016","name":"App skn cl ssp agrf t/a/l ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; each additional 480 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5126","name":"Inj alymsys 10 mg","description":"Injection, bevacizumab-maly, biosimilar, (alymsys), 10 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0528U","name":"Lrt iad 18bct/8vir&7arg rna","description":"Lrt iad 18bct/8vir&7arg rna","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37766","name":"Phleb veins - extrem 20+","description":"Stab phlebectomy of varicose veins, 1 extremity; more than 20 incisions","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":660.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0018","name":"Crisis psychotherapy add 30m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); each additional 30 minutes (list separately in addition to code for primary service)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1391","name":"All pt dx w/ rec mlnm","description":"All patients who were diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86580","name":"Tb intradermal test","description":"Skin test; tuberculosis, intradermal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":5.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55873","name":"Cryoablate prostate","description":"Cryosurgical ablation of the prostate (includes ultrasonic guidance and monitoring)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1302.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2002","name":"Inj, lidocaine in d5w, 1 mg","description":"Injection, lidocaine hcl in 5% dextrose, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0402","name":"Inj, abilify asimtufii, 1 mg","description":"Injection, aripiprazole (abilify asimtufii), 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0654","name":"Inj, liothyronine, 1 mcg","description":"Injection, liothyronine, 1 mcg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0256U","name":"Tma/tmao prfl ms/ms ur alg","description":"Trimethylamine/trimethylamine n-oxide (tma/tmao) profile, tandem mass spectrometry (ms/ms), urine, with algorithmic analysis and interpretive report","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0568U","name":"Neurol dementia bamyl ptau","description":"Neurol dementia bamyl ptau","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2043","name":"Biobrane, per sq cm","description":"Biobrane, per square centimeter","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1427","name":"Doc med rsn bone scn","description":"Documentation of medical reason(s) for performing a bone scan (including documented pain related to prostate cancer, salvage therapy, other medical reasons)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97550","name":"Caregiver traing 1st 30 min","description":"Caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patie","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4300","name":"Acesso tl, per sq cm","description":"Acesso tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51060","name":"Removal of ureter stone","description":"Transvesical ureterolithotomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":612.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4266","name":"Neostim per sq cm","description":"Neostim membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7485","name":"Surg reduct osseoustuberosit","description":"Surgical reduction of osseous tuberosity","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0340U","name":"Onc pan ca alys mrd plasma","description":"Onc pan ca alys mrd plasma","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0465","name":"Autolog prp diab wound ulcer","description":"Autologous platelet rich plasma (prp) or other blood-derived product for diabetic chronic wounds/ulcers, using an fda-cleared device for this indication, (includes as applicable administration, dressings, phlebotomy, centrifugation or mixing, and all other preparatory procedures, per treatment)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0568U","name":"Neurol dementia bamyl ptau","description":"Neurol dementia bamyl ptau","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27442","name":"Revision of knee joint","description":"Arthroplasty, femoral condyles or tibial plateau(s), knee;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1044.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35907","name":"Excision graft abdomen","description":"Excision of infected graft; abdomen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2410.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1390","name":"Pt no doc exm for rec","description":"Patients who do not have a documented exam performed for recurrence of melanoma or no documentation within the performance period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1317","name":"Pts counsl cpt opt out","description":"Patients who are counseled on connection with a csp and explicitly opt out","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0167","name":"Inj epinephrine (hospira)","description":"Injection, epinephrine (hospira), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0162","name":"Inj epinephrine (fresenius)","description":"Injection, epinephrine (fresenius), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92567","name":"Tympanometry","description":"Tympanometry (impedance testing)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":8.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0789T","name":"Elec aly cpx iins sp/sac nrv","description":"Electronic analysis with complex programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detect","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87530","name":"Hsv dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); herpes simplex virus, quantification","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0901T","name":"Plmt bone marrow smplg port","description":"Placement of bone marrow sampling port, including imaging guidance when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0034","name":"Pall serv during meas","description":"Patients receiving palliative care during the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0502","name":"Other oral pathology procedu","description":"Other oral pathology procedures by report","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86305","name":"Human epididymis protein 4","description":"Human epididymis protein 4 (he4)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"Home vent dual fnct incl all","description":"Home ventilator, dual-function respiratory device, also performs additional function of cough stimulation, includes all accessories, components and supplies for all functions","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99443","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0288U","name":"Onc lung mrna quan pcr 11&3","description":"Onc lung mrna quan pcr 11&3","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4314","name":"Reeva, per sq cm","description":"Reeva ft, per square cenitmeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2402","name":"Chloroprocaine (clorotekal)","description":"Injection, chloroprocaine hydrochloride (clorotekal), per 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0951T","name":"Tot impl amei 1st plmt","description":"Totally implantable active middle ear hearing implant; initial placement, including mastoidectomy, placement of and attachment to sound processor","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0872","name":"Daptomycin (xellia) unrefrig","description":"Injection, daptomycin (xellia), unrefrigerated, not therapeutically equivalent to j0878 or j0873, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1393","name":"Pr no dx rec mlnm","description":"Patients who were not diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45389","name":"Colonoscopy w/stent plcmt","description":"Colonoscopy, flexible; with endoscopic stent placement (includes pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99255","name":"Ip/obs consltj new/est hi 80","description":"Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 80 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":80.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4310","name":"Procenta, per 100 mg","description":"Procenta, per 100 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82651","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1033","name":"Sv doula brth wrk per diem","description":"Services performed by a doula birth worker, per diem","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86078","name":"Phys blood bank serv reactj","description":"Blood bank physician services; investigation of transfusion reaction including suspicion of transmissible disease, interpretation and written report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0959T","name":"Rmv/rplc magnet coil assem","description":"Removal or replacement of magnet from coil assembly that is connected to continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86826","name":"Hla x-match noncytotoxc addl","description":"Human leukocyte antigen (hla) crossmatch, non-cytotoxic (eg, using flow cytometry); each additional serum sample or sample dilution (list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0454U","name":"U rare ds id opt genome mapg","description":"U rare ds id opt genome mapg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86665","name":"Epstein-barr capsid vca","description":"Antibody; epstein-barr (eb) virus, viral capsid (vca)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63052","name":"Lam facetc/frmt arthrd lum 1","description":"Laminectomy, facetectomy, or foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s] [eg, spinal or lateral recess stenosis]), during posterior interbody arthrodesis, lumbar; single vertebral segment (list separately in addition to code for primary ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0570","name":"Care manage serv, pr cal mo","description":"Care management services for behavioral health conditions, directed by a physician or other qualified health care professional, per calendar month, with the following required elements: initial assessment or follow-up monitoring, including the use of applicable validated rating scales, behavioral he","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0453U","name":"Onc clrct ca cfdna qpcr asy","description":"Onc clrct ca cfdna qpcr asy","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28531","name":"Treat sesamoid bone fracture","description":"Open treatment of sesamoid fracture, with or without internal fixation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0139","name":"Inj, adalimumab, 1 mg","description":"Injection, adalimumab, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1340","name":"Indx whodas 2.0 or sds","description":"Index assessment completed using the 12-item whodas 2.0 or sds during the denominator identification period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5160","name":"Inj, jobevne, 10 mg","description":"Injection, bevacizumab-nwgd (jobevne), biosimilar, 10 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36837","name":"Prq av fstl crt uxtr sep acs","description":"Percutaneous arteriovenous fistula creation, upper extremity, separate access sites of the peripheral artery and peripheral vein, including fistula maturation procedures (eg, transluminal balloon angioplasty, coil embolization) when performed, including all vascular access, imaging guidance and radi","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23415","name":"Release of shoulder ligament","description":"Coracoacromial ligament release, with or without acromioplasty","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":898.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69150","name":"Extensive ear canal surgery","description":"Radical excision external auditory canal lesion; without neck dissection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1266.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1440","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9602","name":"Fluorodopa f-18 diag per mci","description":"Fluorodopa f-18, diagnostic, per millicurie","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0672T","name":"Ndovag cryg rf remdl tiss","description":"Endovaginal cryogen-cooled, monopolar radiofrequency remodeling of the tissues surrounding the female bladder neck and proximal urethra for urinary incontinence","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91124","name":"Rct snsatn tone&cmplianc std","description":"Rectal sensation, tone, and compliance study (eg, barostat)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4540","name":"Trans elec nerv periph nerv","description":"Distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9697","name":"Inj, magtrace per study dose","description":"Injection, carboxydextran-coated superparamagnetic iron oxide, per study dose","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0694T","name":"3d vol img&rcnstj brst/ax","description":"3-dimensional volumetric imaging and reconstruction of breast or axillary lymph node tissue, each excised specimen, 3-dimensional automatic specimen reorientation, interpretation and report, real-time intraoperative","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7259","name":"Nerve dissection","description":"Nerve dissection","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63055","name":"Decompress spinal cord thrc","description":"Transpedicular approach with decompression of spinal cord, equina and/or nerve root(s) (eg, herniated intervertebral disc), single segment; thoracic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1859.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15854","name":"Removal sutr&stapl xreq anes","description":"Removal of sutures and staples not requiring anesthesia (list separately in addition to e/m code)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67318","name":"Revise eye muscle(s)","description":"Strabismus surgery, any procedure, superior oblique muscle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":675.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59610","name":"Vbac delivery","description":"Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care, after previous cesarean delivery","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2176.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1421","name":"Dermatological care mvp","description":"Dermatological care mips value pathway","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4027","name":"Plastic surgery ss","description":"Plastic surgery mips specialty set","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4340","name":"Simpligraft, per sq cm","description":"Simpligraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81195","name":"Cytog genom-wid alys hem mal","description":"Cytogenomic (genome-wide) analysis, hematologic malignancy, structural variants and copy number variants, optical genome mapping (ogm)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0898","name":"Argatroban nonesrd (auromed)","description":"Injection, argatroban (auromedics), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21040","name":"Excise mandible lesion","description":"Excision of benign tumor or cyst of mandible, by enucleation and/or curettage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0795T","name":"Tcat ins 2chmbr ldls pm cmpl","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; complete system (ie, r","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4267","name":"Neostim dl per sq cm","description":"Neostim dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15015","name":"App skn cl ssp agrft t/a/l 1","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; first 480 sq cm or less","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4330","name":"Total, per sq cm","description":"Total, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0849T","name":"Dgtz gls mcrscp ish ea adl 1","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3432","name":"Guided tissue regeneration","description":"Guided tissue regeneration","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1234","name":"Pt hcv rctv aby f/u neg","description":"Patient has a reactive hcv antibody test, and has a follow up hcv viral test that does not detect hcv viremia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69209","name":"Remove impacted ear wax uni","description":"Removal impacted cerumen using irrigation/lavage, unilateral","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0699","name":"Inj, cefiderocol, 10 mg","description":"Injection, cefiderocol, 10 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38221","name":"Dx bone marrow biopsies","description":"Diagnostic bone marrow; biopsy(ies)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1392","name":"Pt rsn no exm or lst to fu","description":"Documentation of patient reasons for no examination, i.e., refusal of examination or lost to follow-up (documentation must include information that the clinician was unable to reach the patient by phone, mail or secure electronic mail - at least one method must be documented)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0609","name":"Ferric citrate orl 3 mg iron","description":"Ferric citrate, oral, 3 mg ferric iron, (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94625","name":"Phy/qhp op pulm rhb w/o mntr","description":"Physician or other qualified health care professional services for outpatient pulmonary rehabilitation; without continuous oximetry monitoring (per session)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28250","name":"Revision of foot fascia","description":"Division of plantar fascia and muscle (eg, steindler stripping) (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0481U","name":"Idh1 idh2&tert promoter ngs","description":"Idh1 idh2&tert promoter ngs","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98015","name":"Synch audio-only est high 40","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selec","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35583","name":"Vein byp grft fem-popliteal","description":"In-situ vein bypass; femoral-popliteal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1596.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0887T","name":"End-tidal ctrl inhaled anes","description":"End-tidal control of inhaled anesthetic agents and oxygen to assist anesthesia care delivery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1002T","name":"Air displacmnt plethysmograp","description":"Air displacement plethysmography, whole-body composition assessment, with interpretation and report","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1304","name":"No pneum vax admin 19+","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53451","name":"Tprnl balo cntnc dev bi","description":"Periurethral transperineal adjustable balloon continence device; bilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0891","name":"Argatroban nonesrd (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2403","name":"Chloroprocaine opht gel, 1mg","description":"Chloroprocaine hcl ophthalmic, 3% gel, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9056","name":"Inj, vivimusta, 1 mg","description":"Injection, bendamustine hydrochloride (vivimusta), 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0404","name":"Ekg tracing for initial prev","description":"Electrocardiogram, routine ecg with 12 leads; tracing only, without interpretation and report, performed as a screening for the initial preventive physical examination","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9361","name":"Inj, efbemalenograstim alfa-","description":"Injection, efbemalenograstim alfa-vuxw, 0.5 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1164","name":"Pt w/ dementia any time","description":"Patients with dementia any time during the patients history through the end of the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0527","name":"Mgt est pt dmentia low cmplx","description":"Management of established patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0372","name":"Tomo comp series images","description":"Tomo comp series images","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3391","name":"Inj, atidarsagene autotemcel","description":"Injection, atidarsagene autotemcel, per treatment","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93596","name":"R&l hrt cath chd nml nt cnj","description":"Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); normal native connections","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2041","name":"Coord special care encounter","description":"Coordinated specialty care, team-based, for first episode psychosis, per encounter","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55712","name":"Bx prst8 tprnl mri-us 1st","description":"Biopsy, prostate, transperineal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93543","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0926T","name":"Prgrmg dev eval ccm-d ip","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, including review and report, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0522","name":"Mgt nw pt dementia low cmplx","description":"Management of a new patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0581U","name":"Trnspl med antb nohla 39trgt","description":"Trnspl med antb nohla 39trgt","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0898T","name":"N-invas prst8 cancer est map","description":"Noninvasive prostate cancer estimation map, derived from augmentative analysis of image-guided fusion biopsy and pathology, including visualization of margin volume and location, with margin determination and physician interpretation and report","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33470","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1417.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2184","name":"Inj, meropenem (b. braun)","description":"Injection, meropenem (b. braun), not therapeutically equivalent to j2185, 100 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0237","name":"Intrav inf, toci, first dose","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1459","name":"Pt hosp/pal care dur perf pd","description":"Patient was in hospice or receiving palliative care services at any time during the performance period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59514","name":"Cesarean delivery only","description":"Cesarean delivery only;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1193.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":1023.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1710","name":"Moderna vacc admin 3rd dose","description":"Moderna vacc admin 3rd dose","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9563","name":"Ht inj immuno diem","description":"Home injectable therapy, immunotherapy, 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":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1182","name":"Not elg pre ex ibd/uc/crohn","description":"Patients not eligible due to pre-existing inflammatory bowel disease (ibd) (e.g., ulcerative colitis, crohns disease)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37288","name":"Revsc evsc tpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0578U","name":"Onc cutan mln rna qpcr 10gen","description":"Onc cutan mln rna qpcr 10gen","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0658","name":"Seg pneum comp 2 arm chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9161","name":"Inj denileuk difti-cxdl 1mcg","description":"Injection, denileukin diftitox-cxdl, 1 mcg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0900T","name":"N-invas est aqmbf asstv cmr","description":"Noninvasive estimate of absolute quantitation of myocardial blood flow (aqmbf), derived from assistive algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health care profes","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15013","name":"Prepj skn cll ssp agrft 1st","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; first 25 sq cm or less of harvested skin","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6515","name":"Grad com wrap w str fu le cu","description":"Gradient compression wrap with adjustable straps, full leg, each, custom","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1422","name":"Gastroenterology care mvp","description":"Gastroenterology care mips value pathway","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0368","name":"Cone beam ct interprete tmj","description":"Cone beam ct interprete tmj","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37268","name":"Revsc evasc fpvt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23570","name":"Cltx scapular fx w/o mnpj","description":"Closed treatment of scapular fracture; without manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0668","name":"Instill, bupivac and meloxic","description":"Instillation, bupivacaine and meloxicam, 1 mg/0.03 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0813T","name":"Egd vol adjmt bariatric balo","description":"Esophagogastroduodenoscopy, flexible, transoral, with volume adjustment of intragastric bariatric balloon","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0404U","name":"Onc brst semiq meas thym kn","description":"Onc brst semiq meas thym kn","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1025T","name":"Alt elec fld dos&dlv sim mdl","description":"Alternating electric fields dosimetry and delivery-simulation modeling, creation and selection of patient-specific array layouts, and placement verification","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27458","name":"Osteot femur imed lngth dev","description":"Osteotomy(ies), femur, unilateral, with insertion of an externally controlled intramedullary lengthening device, including iliotibial band release when performed, imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9361","name":"Inj, efbemalenograstim alfa-","description":"Injection, efbemalenograstim alfa-vuxw, 0.5 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4269","name":"Surgraft xt per sq cm","description":"Surgraft xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27507","name":"Treatment of thigh fracture","description":"Open treatment of femoral shaft fracture with plate/screws, with or without cerclage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1192.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0878T","name":"Augmnt alys ch ct ild w/ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained with concurrent ct examination of the same structure","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0434U","name":"Rx metab advrs vrnt alys 25","description":"Rx metab advrs vrnt alys 25","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1459","name":"Pt hosp/pal care dur perf pd","description":"Patient was in hospice or receiving palliative care services at any time during the performance period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4354","name":"Palingen dl-palingen dl-x","description":"Palingen dual-layer membrane and dual-layer palingen x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1502","name":"Podiatry mvp","description":"Podiatry mips value pathway","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85027","name":"Complete cbc automated","description":"Blood count; complete (cbc), automated (hgb, hct, rbc, wbc and platelet count)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0441U","name":"Nfct ds bct fngl/viral semiq","description":"Nfct ds bct fngl/viral semiq","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0402U","name":"Nfct agt sti mult amp prb tq","description":"Nfct agt sti mult amp prb tq","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1574","name":"Inj, ganciclovir (exela)","description":"Injection, ganciclovir sodium (exela), not therapeutically equivalent to j1570, 500 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0369","name":"Max mri capture & interprete","description":"Max mri capture & interprete","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82232","name":"Assay of beta-2 protein","description":"Beta-2 microglobulin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0902T","name":"Qtc ntrvl augmnt alg aly ecg","description":"Qtc interval derived by augmentative algorithmic analysis of input from an external, patient-activated mobile ecg device","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5934","name":"Mandibular flange prosthesis","description":"Mandibular resection prosthesis with guide flange","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64728","name":"Dcmprn median nrv carpl tunl","description":"Decompression; median nerve at the carpal tunnel, percutaneous, with intracarpal tunnel balloon dilation, including ultrasound guidance","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0321U","name":"Iadna gu pthgn 20bct&fng org","description":"Iadna gu pthgn 20bct&fng org","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0512U","name":"Onc prst8 alys dgtz img msi","description":"Onc prst8 alys dgtz img msi","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87153","name":"Dna/rna sequencing","description":"Culture, typing; identification by nucleic acid sequencing method, each isolate (eg, sequencing of the 16s rrna gene)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74775","name":"X-ray exam of perineum","description":"Perineogram (eg, vaginogram, for sex determination or extent of anomalies)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49591","name":"Rpr aa hrn 1st < 3 cm rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, reducible","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92635","name":"Hearing aid fitg svc ea addl","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; each additional 15 minutes (list separately in addition to code","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9061","name":"Inj, amivantamab-vmjw","description":"Injection, amivantamab-vmjw, 2 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43238","name":"Egd us fine needle bx/aspir","description":"Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s), (includes endoscopic ultrasound examination limited to the esophagus, stomach or duodenum, and adjacent structures)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0907T","name":"Coms ther ea addl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; each additional application, total wound(s) surface area less than or equal to 50 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87478","name":"Borrelia miyamotoi amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); borrelia miyamotoi, amplified probe technique","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0536","name":"Peer recover support svs","description":"Peer recovery support services, provided directly or by referral; including leveraging knowledge of the condition or lived experience to provide support, mentorship, or inspiration to meet oud treatment and recovery goals; conducting a person-centered interview to understand the patients life story,","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0857T","name":"Opto-acoustic img breast uni","description":"Opto-acoustic imaging, breast, unilateral, including axilla when performed, real-time with image documentation, augmentative analysis and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0524","name":"Est pt-cg dyad dem low cmplx","description":"Management of established patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6604","name":"G com bandge low dn foam flt","description":"Gradient compression bandaging supply, low density flat foam sheet, per 250 square centimeters, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0389","name":"Periopic image capture only","description":"Periopic image capture only","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4034","name":"Speech language path ss","description":"Speech language pathology mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0801","name":"Inj. acthar gel to 40 units","description":"Injection, corticotropin (acthar gel), up to 40 units","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27870","name":"Fusion of ankle joint open","description":"Arthrodesis, ankle, open","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1221.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0290U","name":"Pain mgmt mrna gen xprsn 36","description":"Pain mgmt mrna gen xprsn 36","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76883","name":"Us nrv&acc strux 1xtr compre","description":"Ultrasound, nerve(s) and accompanying structures throughout their entire anatomic course in one extremity, comprehensive, including real-time cine imaging with image documentation, per extremity","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1304","name":"Inj tofersen intrathec 1 mg","description":"Injection, tofersen, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59856","name":"Induced ab 1+vag supp d&c","description":"Induced abortion, by 1 or more vaginal suppositories (eg, prostaglandin) with or without cervical dilation (eg, laminaria), including hospital admission and visits, delivery of fetus and secundines; with dilation and curettage and/or evacuation","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1217","name":"Sys rsn no doc spiro","description":"Documentation of system reason(s) for not documenting and reviewing spirometry results (e.g., spirometry equipment not available at the time of the encounter)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0789T","name":"Elec aly cpx iins sp/sac nrv","description":"Electronic analysis with complex programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detect","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86406","name":"Particle agglut antbdy titr","description":"Particle agglutination; titer, each antibody","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4278","name":"Epieffect, per sq cm","description":"Epieffect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0700T","name":"Molec fluor img sus nev 1st","description":"Molecular fluorescent imaging of suspicious nevus; first lesion","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4368","name":"Amchothick per sq cm","description":"Amchothick, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0581U","name":"Trnspl med antb nohla 39trgt","description":"Trnspl med antb nohla 39trgt","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20694","name":"Rmvl ext fixj sys under anes","description":"Removal, under anesthesia, of external fixation system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2427","name":"Inj, invega hafyera/trinza","description":"Injection, paliperidone palmitate extended release (invega hafyera, or invega trinza), 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2542","name":"Dental onlay metallic 2 surf","description":"Onlay-metallic-two surfaces","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0541U","name":"Cv ds hdl rct cec lc-ms/ms 5","description":"Cv ds hdl rct cec lc-ms/ms 5","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6071","name":"Abutment supported retainer","description":"Abutment supported retainer for porcelain fused to metal fpd (noble metal)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1150","name":"Lvef <=40% or mod/sev l vsf","description":"Current or prior left ventricular ejection fraction (lvef) less than or equal to 40% or documentation of moderately or severely depressed left ventricular systolic function","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2252","name":"Inj midazolam in 0.8% nacl","description":"Injection, midazolam in 0.8% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0272U","name":"Hem genetic bld do 51 genes","description":"Hematology (genetic bleeding disorders), genomic sequence analysis of 51 genes, blood, buccal swab, or amniotic fluid, comprehensive","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0169","name":"Inj epinephrine (adrenalin)","description":"Injection, epinephrine (adrenalin), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51610","name":"Injection for bladder x-ray","description":"Injection procedure for retrograde urethrocystography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57454","name":"Bx/curett of cervix w/scope","description":"Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix and endocervical curettage","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":135.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0709","name":"Intraoral cmplt radio images","description":"Intraoral cmplt radio images","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61736","name":"Litt icr 1 traj 1 smpl les","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; single trajectory for 1 simple lesion","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0481U","name":"Idh1 idh2&tert promoter ngs","description":"Idh1 idh2&tert promoter ngs","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0002","name":"Opt care kidney hlth mvp","description":"Optimal care for kidney health mips value pathways","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0802T","name":"Tcat rmv&rpl2chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right at","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77436","name":"Surf radj ther tx planning","description":"Surface radiation therapy; superficial or orthovoltage, treatment planning and simulation-aided field setting","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4364","name":"Am bur xp mem xpl hy p sq cm","description":"Amnio burgeon xplus membrane and xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0688T","name":"Tx amblyopia assmt w/report","description":"Treatment of amblyopia using an online digital program; assessment of patient performance and program data by physician or other qualified health care professional, with report, per calendar month","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9048","name":"Inj, bortezomib freseniuskab","description":"Injection, bortezomib (fresenius kabi), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99415","name":"Prolng clin staff svc 1st hr","description":"Prolonged clinical staff service (the service beyond the highest time in the range of total time of the service) during an evaluation and management service in the office or outpatient setting, direct patient contact with physician supervision; first hour (list separately in addition to code for out","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84133","name":"Assay of urine potassium","description":"Potassium; urine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50820","name":"Construct bowel bladder","description":"Ureteroileal conduit (ileal bladder), including intestine anastomosis (bricker operation)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1419.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31242","name":"Nsl/sinus ndsc rf abltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by radiofrequency ablation, posterior nasal nerve","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0577","name":"Inj, brixadi, 7 days or less","description":"Injection, buprenorphine extended-release (brixadi), less than or equal to 7 days of therapy","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0294U","name":"Lngvty&mrtlty rsk mrna 18gen","description":"Lngvty&mrtlty rsk mrna 18gen","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1476","name":"Pt dx cog imp or ad","description":"Patients with diagnosis of cognitive impairment or alzheimers disease","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59620","name":"Attempted vbac delivery only","description":"Cesarean delivery only, following attempted vaginal delivery after previous cesarean delivery;","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":926.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64468","name":"Thrc fascial pln blk bi njx","description":"Thoracic fascial plane block, bilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36625","name":"Insertion catheter artery","description":"Arterial catheterization or cannulation for sampling, monitoring or transfusion (separate procedure); cutdown","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88369","name":"M/phmtrc alysishquant/semiq","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15014","name":"Prepj skn cll ssp agrft ea","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; each additional 25 sq cm of harvested skin or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88302","name":"Tissue exam by pathologist","description":"Level ii - surgical pathology, gross and microscopic examination appendix, incidental fallopian tube, sterilization fingers/toes, amputation, traumatic foreskin, newborn hernia sac, any location hydrocele sac nerve skin, plastic repair sympathetic ganglion testis, castration vaginal mucosa, incident","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55713","name":"Bx prst8 in-bore ct/mri bx 1","description":"Biopsy, prostate, in-bore ct- or mri-guided (ie, sextant), with biopsy of additional targeted lesion(s), first targeted lesion","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81523","name":"Onc brst mrna 70 cnt 31 gene","description":"Oncology (breast), mrna, next-generation sequencing gene expression profiling of 70 content genes and 31 housekeeping genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as index related to risk to distant metastasis","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5124","name":"Inj. byooviz, 0.1 mg","description":"Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4016","name":"Neurosurgical ss","description":"Neurosurgical mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0034","name":"Pall serv during meas","description":"Patients receiving palliative care during the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0934T","name":"Rem mntr wrls l atr prs snr","description":"Remote monitoring of a wireless left atrial pressure sensor for up to 30 days, including data from daily uploads of left atrial pressure recordings, interpretation(s) and trend analysis, with adjustments to the diuretics plan, treatment paradigm thresholds, medications or lifestyle modifications, wh","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77437","name":"Surf radj ther supfc<=150kv","description":"Surface radiation therapy; superficial, delivery, </=150 kv, per fraction (eg, electronic brachytherapy)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81000","name":"Urinalysis nonauto w/scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; non-automated, with microscopy","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0804","name":"3d facial scan indirect","description":"3d facial scan indirect","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87169","name":"Macroscopic exam parasite","description":"Macroscopic examination; parasite","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55707","name":"Bx prst8 trct us guided","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99416","name":"Prolng clin staff svc ea add","description":"Prolonged clinical staff service (the service beyond the highest time in the range of total time of the service) during an evaluation and management service in the office or outpatient setting, direct patient contact with physician supervision; each additional 30 minutes (list separately in addition","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87197","name":"Serum bactericidal titer","description":"Serum bactericidal titer (schlichter test)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92582","name":"Conditioning play audiometry","description":"Conditioning play audiometry","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69729","name":"Impl oi implt sk tc esp>=100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside of the mastoid and resulting in removal of greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92312","name":"Contact lens fitg aphakia ou","description":"Prescription of optical and physical characteristics of and fitting of contact lens, with medical supervision of adaptation; corneal lens for aphakia, both eyes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0046","name":"No mrs 90 days post stk","description":"Clinical follow-up and mrs score not assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01937","name":"Anes drg/aspir crv/thrc","description":"Anesthesia for percutaneous image-guided injection, drainage or aspiration procedures on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0751T","name":"Dgtz gls mcrscp sld level ii","description":"Digitization of glass microscope slides for level ii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97551","name":"Caregiver traing ea addl 15","description":"Caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patie","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68750","name":"Create tear duct drain","description":"Conjunctivorhinostomy (fistulization of conjunctiva to nasal cavity); with insertion of tube or stent","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":776.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9278","name":"Inj, carboplatin (avyxa)","description":"Injection, carboplatin (avyxa), 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9286","name":"Inj glofitamab gxbm, 2.5 mg","description":"Injection, glofitamab-gxbm, 2.5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1426","name":"Injection, casimersen, 10 mg","description":"Injection, casimersen, 10 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98000","name":"Synch audio-video new sf 15","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 15 minutes must be met or exceeded.","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33991","name":"Insj perq vad l hrt artl&ven","description":"Insertion of ventricular assist device, percutaneous, including radiological supervision and interpretation; left heart, both arterial and venous access, with transseptal puncture","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2028","name":"Micromatrix flex per mg","description":"Micromatrix flex, per mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6611","name":"Grad com wrap w strap ak cus","description":"Gradient compression wrap with adjustable straps, above knee, each, custom","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54111","name":"Treat penis lesion graft","description":"Excision of penile plaque (peyronie disease); with graft to 5 cm in length","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":886.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4322","name":"Splint intra-coronal","description":"Splint intra-coronal","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37281","name":"Revsc evsc tpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1281","name":"Bp scrn no perf at interval","description":"Blood pressure reading not documented, reason not given","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5913","name":"Nasal prosthesis","description":"Nasal prosthesis","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1952","name":"Afo spiral prefab ots","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, off-the-shelf","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12042","name":"Intmd rpr n-hf/genit2.6-7.5","description":"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 2.6 cm to 7.5 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0998T","name":"Precuneus mag stimj tx dlvr","description":"Precuneus magnetic stimulation; personalized treatment delivery of magnetic stimulation therapy to a prespecified target area derived from analysis of evoked potentials within the precuneus, utilizing magnetic resonance imaging-based neuronavigation, with management, per day","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0374","name":"Tomo periapical image","description":"Tomo periapical image","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93585","name":"Vngrph chd azygs/hemiazygs","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; azygos/hemiazygos venous system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15116","name":"Epdrm agrft f/s/n/h/f/g/m ea","description":"Epidermal autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1812","name":"Inj. insulin (fiasp)","description":"Insulin (fiasp), per 5 units","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1412","name":"Inj roctavian ml 2x10^13vc g","description":"Injection, valoctocogene roxaparvovec-rvox, per ml, containing nominal 2 x 10^13 vector genomes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0703","name":"Inj, cefepime hcl (b braun)","description":"Injection, cefepime hydrochloride (b braun), not therapeutically equivalent to maxipime, 500 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9992","name":"Pall serv during meas","description":"Palliative care services used by patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34834","name":"Opn brach art expos","description":"Open brachial artery exposure for delivery of endovascular prosthesis, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1708","name":"Pfizer vacc admin 3rd dose","description":"Pfizer vacc admin 3rd dose","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9938","name":"Fab removable appliance","description":"Fab removable appliance","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0466U","name":"Crd cad dna gwas 564856 snp","description":"Crd cad dna gwas 564856 snp","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50040","name":"Nfros nfrot w/drg","description":"Nephrostomy, nephrotomy with drainage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":997.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99306","name":"1st nf care high mdm 50","description":"Initial nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 50 minutes must be met or exceed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":187.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7294","name":"Seg acet and eth estr yearly","description":"Segesterone acetate and ethinyl estradiol 0.15mg, 0.013mg per 24 hours; yearly vaginal system, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0915T","name":"Insj perm ccm-d sys pg&eltrd","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator and dual transvenous electrodes/leads (pacing and defibrillation)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0998T","name":"Precuneus mag stimj tx dlvr","description":"Precuneus magnetic stimulation; personalized treatment delivery of magnetic stimulation therapy to a prespecified target area derived from analysis of evoked potentials within the precuneus, utilizing magnetic resonance imaging-based neuronavigation, with management, per day","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99236","name":"Hosp ip/obs same date hi 85","description":"Hospital inpatient or observation care, for the evaluation and management of a patient including admission and discharge on the same date, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter f","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":83.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0956T","name":"Prt crn ch cr&tun elt s-sclp","description":"Partial craniectomy, channel creation, and tunneling of electrode for sub-scalp implantation of an electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5725","name":"Rebase hybrid prosthesis","description":"Rebase hybrid prosthesis","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46261","name":"Remove in/ex hem grps & fiss","description":"Hemorrhoidectomy, internal and external, 2 or more columns/groups; with fissurectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":510.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0709T","name":"Id ca immntx each addl njx","description":"Intradermal cancer immunotherapy; each additional injection (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1406","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4002","name":"Ep cardio ss","description":"Electrophysiology cardiac specialist mips specialty set","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0724T","name":"Qmrcp w/dx mri same anatomy","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained with diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in additio","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62270","name":"Dx lmbr spi pnxr","description":"Spinal puncture, lumbar, diagnostic;","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":191.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33412","name":"Replacement of aortic valve","description":"Replacement, aortic valve; with transventricular aortic annulus enlargement (konno procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3089.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9256","name":"Inj, nipocalimab-aahu, 3 mg","description":"Injection, nipocalimab-aahu, 3 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01940","name":"Anes nulyt agt lmbr/sac","description":"Anesthesia for percutaneous image-guided destruction procedures by neurolytic agent on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7299","name":"Intraut copp cont (miudella)","description":"Intrauterine copper contraceptive (miudella)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9048","name":"Inj, bortezomib freseniuskab","description":"Injection, bortezomib (fresenius kabi), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4403","name":"Xwrap dual plus per sq cm","description":"Xwrap dual plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43241","name":"Egd tube/cath insertion","description":"Esophagogastroduodenoscopy, flexible, transoral; with insertion of intraluminal tube or catheter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5138","name":"Inj, wezlana, iv, 1 mg","description":"Injection, ustekinumab-auub (wezlana), biosimilar, intravenous, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2471","name":"Inj pantoprazole(hikma) 40mg","description":"Injection, pantoprazole (hikma), not therapeutically equivalent to j2470, 40 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1245","name":"Pt othr thn true person","description":"Patient provided a response other than completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4100","name":"Nosht skin sub fda clrd nos","description":"Non-sheet form skin substitute, fda cleared as a device, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76120","name":"Cine/video x-rays","description":"Cineradiography/videoradiography, except where specifically included","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0493U","name":"Trnspl med quan dd-cfdna ngs","description":"Trnspl med quan dd-cfdna ngs","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76821","name":"Middle cerebral artery echo","description":"Doppler velocimetry, fetal; middle cerebral artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1464","name":"No record of f/u by 180 days","description":"No documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1152","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4438","name":"Pretect per sq cm","description":"Pretect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0282U","name":"Rbc dna gntyp 12 bld grp gen","description":"Red blood cell antigen typing, dna, genotyping of 12 blood group system genes to predict 44 red blood cell antigen phenotypes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0901T","name":"Plmt bone marrow smplg port","description":"Placement of bone marrow sampling port, including imaging guidance when performed","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1430","name":"Ret exm ou no retinopthy doc","description":"Retinal exam finding without evidence of retinopathy in both eyes with severity level documented (in measurement year or in the prior year)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0289U","name":"Neuro alzheimer mrna 24 gen","description":"Neuro alzheimer mrna 24 gen","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2277","name":"Inj, motixafortide, 0.25 mg","description":"Injection, motixafortide, 0.25 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0913T","name":"Prq tcat ther rx ntrac balo1","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting), including mechanical dilation by nondrug-delivery balloon angioplasty, endoluminal imaging using intravascular ultrasound (ivus) or optical coherence tomography (oct) when per","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0557U","name":"Nfct ds bv dna mrk vag fluid","description":"Nfct ds bv dna mrk vag fluid","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0470U","name":"Onc orop detcj mrd 8 dna hpv","description":"Onc orop detcj mrd 8 dna hpv","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0739","name":"Rehab sys active assist rt","description":"Rehabilitation system with interactive interface providing active assistance in rehabilitation therapy, includes all components and accessories, motors, microprocessors, sensors","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1597.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1205","name":"Chlorothiazide sodium inj","description":"Injection, chlorothiazide sodium, per 500 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4241","name":"Gngvl flap w rootplan 1-3 th","description":"Gingival flap procedure including root planing - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0700T","name":"Molec fluor img sus nev 1st","description":"Molecular fluorescent imaging of suspicious nevus; first lesion","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82480","name":"Assay serum cholinesterase","description":"Cholinesterase; serum","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5145","name":"Inj, abrilada, 1 mg","description":"Injection, adalimumab-afzb (abrilada), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0395U","name":"Onc lng multiomics plsm alg","description":"Onc lng multiomics plsm alg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76815","name":"Ob us limited fetus(s)","description":"Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1026","name":"Pt hemo > 3mo","description":"The number of adult patient-months in the denominator who were on maintenance hemodialysis using a catheter continuously for three months or longer under the care of the same practitioner or group partner as of the last hemodialysis session of the reporting month","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9959","name":"Unspec sleep ap proc","description":"Unspec sleep ap proc","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28525","name":"Treat toe fracture","description":"Open treatment of fracture, phalanx or phalanges, other than great toe, includes internal fixation, when performed, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0593U","name":"Nfct ds gu pthgn dna 46trgt","description":"Nfct ds gu pthgn dna 46trgt","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35616","name":"Bpg subclavian-axillary","description":"Bypass graft, with other than vein; subclavian-axillary","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1162.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1552","name":"Inj, alyglo, 500 mg","description":"Injection, immune globulin (alyglo), 500 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0166","name":"Inj epinephrine (bpi)","description":"Injection, epinephrine (bpi), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98008","name":"Synch audio-only new sf 15","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code sel","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9938","name":"Fab removable appliance","description":"Fab removable appliance","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7671","name":"Alveolus open reduction","description":"Alveolus - open reduction may include stabilization of teeth","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1475","name":"Pt dx huntington","description":"Patients with diagnosis of huntingtons disease","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5128","name":"Inj, cimerli, 0.1 mg","description":"Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61715","name":"Mrgfus strtctc ablt trgt icr","description":"Magnetic resonance image guided high intensity focused ultrasound (mrgfus), stereotactic ablation of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0047","name":"Ped blunt hd traum","description":"Pediatric patient with minor blunt head trauma and pecarn prediction criteria are not assessed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0519U","name":"Ther rx mntr meds p/d/a 110+","description":"Ther rx mntr meds p/d/a 110+","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69716","name":"Impl oi implt sk tc esp<100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or resulting in removal of less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0464U","name":"Onc clrct scr qrtsa dna mrk","description":"Onc clrct scr qrtsa dna mrk","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1360","name":"Suicd c-ssrs assessment","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9292","name":"Pres dig visual therapy fda","description":"Prescription digital visual therapy, software-only, fda cleared, per course of treatment","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0849T","name":"Dgtz gls mcrscp ish ea adl 1","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87513","name":"H pylri clrthmcn rst amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); helicobacter pylori (h. pylori), clarithromycin resistance, amplified probe technique","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0599U","name":"Onc pncrtc ca mult ia serum","description":"Onc pncrtc ca mult ia serum","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4359","name":"Choriply, per sq cm","description":"Choriply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4358","name":"Xwrap dual, per sq cm","description":"Xwrap dual, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75580","name":"N-invas est c ffr sw aly cta","description":"Noninvasive estimate of coronary fractional flow reserve (ffr) derived from augmentative software analysis of the data set from a coronary computed tomography angiography, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1428","name":"Bilateral absence of eyes","description":"Patients who have bilateral absence of eyes any time during the patients history through the end of the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4004","name":"Endocrinology ss","description":"Endocrinology mips specialty set","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64659","name":"Rmvl bat modulj sys pg only","description":"Removal of baroreflex activation therapy (bat) modulation system; pulse generator only","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1174","name":"Pt w/ 2 hzv 10/2017 - mp","description":"Patient received at least two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1272","name":"Pts kid transplt wtlst","description":"Patients observed on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98980","name":"Rtm tx mgmt 1st 20 min","description":"Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least 1 real-time interactive communication with the patient or caregiver during the calendar month; first 20 minutes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1256","name":"Prior history of known cvd","description":"Prior history of known cvd","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1324","name":"Pts intravitreal/pci","description":"Patients who had an intravitreal or periocular corticosteroid injection (e.g., triamcinolone, preservative-free triamcinolone, dexamethasone, dexamethasone intravitreal implant, or fluocinolone intravitreal implant)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0478U","name":"Onc nsclc dna&rna dpcr 9 gen","description":"Onc nsclc dna&rna dpcr 9 gen","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4396","name":"Natalin per sq cm","description":"Natalin, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92642","name":"Hearing asstv dev fitg svc","description":"Hearing assistive device, supplemental technology fitting services (eg, personal frequency modulation [fm]/digital modulation [dm] system, remote microphone, alerting devices)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0970T","name":"Ablt b9 brst tum perq lsr ea","description":"Ablation, benign breast tumor (eg, fibroadenoma), percutaneous, laser, including imaging guidance when performed, each tumor","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91322","name":"Sarscov2 vac 50 mcg/0.5ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 50 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1279","name":"Pre-htn/htn, no f/u, not gvn","description":"Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0259U","name":"Neph ckd nuc mrs meas gfr","description":"Nephrology (chronic kidney disease), nuclear magnetic resonance spectroscopy measurement of myo-inositol, valine, and creatinine, algorithmically combined with cystatin c (by immunoassay) and demographic data to determine estimated glomerular filtration rate (gfr), serum, quantitative","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33287","name":"Rmv&rplcmt phrnc nrv stim pg","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0923T","name":"Rmvl&rplcmt perm ccm-d pg","description":"Removal and replacement of permanent cardiac contractility modulation-defibrillation pulse generator only","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0457U","name":"Pfas 9 cmpnd lcms/ms pls/sr","description":"Pfas 9 cmpnd lcms/ms pls/sr","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0582U","name":"Rare ds rpd whlgen dna vrnts","description":"Rare ds rpd whlgen dna vrnts","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0900T","name":"N-invas est aqmbf asstv cmr","description":"Noninvasive estimate of absolute quantitation of myocardial blood flow (aqmbf), derived from assistive algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health care profes","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2030","name":"Miro3d fibers, per mg","description":"Miro3d fibers, per milligram","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90593","name":"Chikungunya vacc recomb im","description":"Chikungunya virus vaccine, recombinant, for intramuscular use","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4540","name":"Trans elec nerv periph nerv","description":"Distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0423","name":"Genetic test spec analysis","description":"Genetic test spec analysis","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11005","name":"Dbrdmt skin abdominal wall","description":"Debridement of skin, subcutaneous tissue, muscle and fascia for necrotizing soft tissue infection; abdominal wall, with or without fascial closure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":884.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J0530","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"Non-adju cgm supply allow","description":"Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KF"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69502","name":"Mastoidectomy","description":"Mastoidectomy; complete","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1120.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76810","name":"Ob us >/= 14 wks addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4280","name":"Xcell amnio matrix per sq cm","description":"Xcell amnio matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0046","name":"No mrs 90 days post stk","description":"Clinical follow-up and mrs score not assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7174","name":"Injection fitusiran 0.04 mg","description":"Injection, fitusiran, 0.04 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1194","name":"Med rsn no imp/con mmr/msi","description":"Documentation of medical reason(s) surgical pathology reports did not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both tests were not included (e.g., patient will not be treated with checkpoint inhibitor therap","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4259","name":"Celera per sq cm","description":"Celera dual layer or celera dual membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2041","name":"Foundation drs+ duo pr sq cm","description":"Foundation drs+ duo, per square centimeter","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1241","name":"Pt no resp seen as person","description":"Patient did not respond to the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0365U","name":"Onc bldr 10 prb bldr ca","description":"Onc bldr 10 prb bldr ca","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5155","name":"Inj, aflibercept-jbvf, 1 mg","description":"Injection, aflibercept-jbvf (yesafili), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1730","name":"Diazoxide injection","description":"Injection, diazoxide, up to 300 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1482","name":"Pos quan hep c or qual rna","description":"Positive/detectable hepatitis c virus quantitative or qualitative rna test result during the denominator identification period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0906T","name":"Coms ther 1st appl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; first application, total wound(s) surface area less than or equal to 50 sq cm","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1470","name":"Hep b vac not recd med rsn","description":"Documentation of medical reason(s) for not administering hepatitis b vaccine (e.g., prior anaphylaxis due to the hepatitis b vaccine)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0837T","name":"Dgtz gls mcrscp fna i&r","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; interpretation and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98940","name":"Chiropract manj 1-2 regions","description":"Chiropractic manipulative treatment (cmt); spinal, 1-2 regions","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0610U","name":"Nfct ds antmcr sc phenotypic","description":"Nfct ds antmcr sc phenotypic","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37276","name":"Rvsc evsc fpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95919","name":"Quan puplmtry phy/qhp uni/bi","description":"Quantitative pupillometry with physician or other qualified health care professional interpretation and report, unilateral or bilateral","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6035","name":"Prosthetic digit mechanical","description":"Single prosthetic digit, mechanical, can include metacarpophalangeal (mcp), proximal interphalangeal (pip), and/or distal interphalangeal (dip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1496","name":"No doc of fall or poc","description":"Patients that had a fall who did not have a plan of care for falls documented or do not have documentation of being assessed for falls","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49618","name":"Rpr aa hrn rcr > 10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, incarcerated or strangulate","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99253","name":"Ip/obs cnsltj new/est low 45","description":"Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 45 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":111.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0891T","name":"Arhfcmrigtbs sbsq tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent treatment day","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1016T","name":"Elec alys npgs esoph intraop","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49623","name":"Rmvl ninfct mesh hernia rpr","description":"Removal of total or near total non-infected mesh or other prosthesis at the time of initial or recurrent anterior abdominal hernia repair or parastomal hernia repair, any approach (ie, open, laparoscopic, robotic) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0969T","name":"Removal epicranial nstim sys","description":"Removal of epicranial neurostimulator system","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93898","name":"Ven-artl shunt det mbubb njx","description":"Venous-arterial shunt detection with intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0506U","name":"Gi barretts esophgl cell 89","description":"Gi barretts esophgl cell 89","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37299","name":"Revsc evsc imvt angio cpx ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2394","name":"Post >=4srfc resinbase cmpst","description":"Resin-based composite - four or more surfaces posterior","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4267","name":"Neostim dl per sq cm","description":"Neostim dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81524","name":"Onc cns tum dna mthyl 10,000","description":"Oncology (central nervous system tumor), dna methylation analysis of at least 10,000 methylation sites, utilizing dna extracted from formalin-fixed tumor tissue, algorithm(s) reported as probability of matching a reference tumor family and class, and mgmt (o-6-methylguanine-dna methyltransferase) pr","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4438","name":"Pretect per sq cm","description":"Pretect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53453","name":"Tprnl balo cntnc dev rmvl ea","description":"Periurethral transperineal adjustable balloon continence device; removal, each balloon","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6604","name":"Cst bse mtl inlay 2 surfaces","description":"Inlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84586","name":"Assay of vip","description":"Vasoactive intestinal peptide (vip)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0177","name":"Inj, aflibercept hd, 1 mg","description":"Injection, aflibercept hd, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5154","name":"Inj, omlyclo, 5 mg","description":"Injection, omalizumab-igec (omlyclo), biosimilar, 5 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0580U","name":"Bbrgdrferi antb detc 24rprtn","description":"Bbrgdrferi antb detc 24rprtn","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5765","name":"Liner compl/partial rem dent","description":"Liner compl/partial rem dent","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4327","name":"Duoamnion, per sq cm","description":"Duoamnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4287","name":"Dermabind dl, per sq cm","description":"Dermabind dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77334","name":"Radiation treatment aid(s)","description":"Treatment devices, design and construction; complex (irregular blocks, special shields, compensators, wedges, molds or casts)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98985","name":"Rtm dev sply mscsk sys 2-15d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of musculoskeletal system, 2-15 days in a 30-day period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0857T","name":"Opto-acoustic img breast uni","description":"Opto-acoustic imaging, breast, unilateral, including axilla when performed, real-time with image documentation, augmentative analysis and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9292","name":"Inj, pemetrexed dipotassium","description":"Injection, pemetrexed dipotassium, 10 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1294","name":"Bp scrn perf rec interval","description":"Normal blood pressure reading documented, follow-up not required","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76984","name":"Dx intraop thoracic aorta us","description":"Ultrasound, intraoperative thoracic aorta (eg, epiaortic), diagnostic","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0977T","name":"Upr gi bld detcj snr capsule","description":"Upper gastrointestinal blood detection, sensor capsule, with interpretation and report","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0760T","name":"Dgtz gls mcrscp sl imm 1st","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77436","name":"Surf radj ther tx planning","description":"Surface radiation therapy; superficial or orthovoltage, treatment planning and simulation-aided field setting","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0773T","name":"Vr px dissoc svc oth phy 1st","description":"Virtual reality (vr) procedural dissociation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports; initial 15 min","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0577","name":"Inj, brixadi, 7 days or less","description":"Injection, buprenorphine extended-release (brixadi), less than or equal to 7 days of therapy","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87622","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0779T","name":"Gi myoelectrical actv study","description":"Gastrointestinal myoelectrical activity study, stomach through colon, with interpretation and report","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0746T","name":"Car ablt rad arr cnv loc map","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; conversion of arrhythmia localization and mapping of arrhythmia site (nidus) into a multidimensional radiation treatment plan","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21454","name":"Optx mndblr fx xtrnl fixj","description":"Open treatment of mandibular fracture with external fixation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":614.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48520","name":"Fuse pancreas cyst and bowel","description":"Internal anastomosis of pancreatic cyst to gastrointestinal tract; direct","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1083.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0722T","name":"Quan ct tiss charac w/ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained with concurrent ct examination of any structure contained in the concurrently acquired diagnostic imaging dataset (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4148","name":"Enteral feed elastomer daily","description":"Enteral feeding supply kit; elastomeric control fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86768","name":"Salmonella antibody","description":"Antibody; salmonella","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1355","name":"Caries med app per tooth","description":"Caries med app per tooth","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9280","name":"Mitomycin injection","description":"Injection, mitomycin, 5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9174","name":"Inj, docetaxel (beizray) 1mg","description":"Injection, docetaxel (beizray), 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35206","name":"Repair blood vessel dir uxtr","description":"Repair blood vessel, direct; upper extremity","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49592","name":"Rpr aa hrn 1st < 3 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78761","name":"Testicular imaging w/flow","description":"Testicular imaging with vascular flow","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37500","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":873.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3394","name":"Inj, lovotibeglogene autotem","description":"Injection, lovotibeglogene autotemcel, per treatment","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0684","name":"App non-sheet skin sb g addl","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area or part thereof, or each additional 1% o","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11981","name":"Insertion drug dlvr implant","description":"Insertion, drug-delivery implant (ie, bioresorbable, biodegradable, non-biodegradable)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":124.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44384","name":"Small bowel endoscopy","description":"Ileoscopy, through stoma; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81354","name":"Cytog alys chrml abnor ogm","description":"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of structural and copy number variants, optical genome mapping (ogm)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0529","name":"In home respite care, 4 hr u","description":"In-home respite care, 4-hour unit, for use in cmmi model","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4290","name":"Membrane wrap hydr per sq cm","description":"Membrane wrap-hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34501","name":"Repair valve femoral vein","description":"Valvuloplasty, femoral vein","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1197.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0216","name":"Inj, alfentanil hcl, 500mcg","description":"Injection, alfentanil hydrochloride, 500 micrograms","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92250","name":"Fundus photography w/i&r","description":"Fundus photography with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0996T","name":"Ins&sclr fix caps bag prosth","description":"Insertion and scleral fixation of a capsular bag prosthesis containing an intraocular lens prosthesis, with vitrectomy, including removal of crystalline lens or dislocated intraocular lens prosthesis, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0666","name":"Team remote e/m est pt 15 mn","description":"Team remote e/m est. pt 15mins","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1327","name":"Pts no eval ini xm no 8 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 8 weeks","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1024T","name":"Perq tiss dsplmt soft tissue","description":"Percutaneous tissue displacement, any method, including imaging guidance; soft tissue (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0482U","name":"Ob pe biochem asy sfit1&pigf","description":"Ob pe biochem asy sfit1&pigf","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0897T","name":"N-invas augmnt arrhyt alys","description":"Noninvasive augmentative arrhythmia analysis derived from quantitative computational cardiac arrhythmia simulations, based on selected intervals of interest from 12-lead electrocardiogram and uploaded clinical parameters, including uploading clinical parameters with interpretation and report","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0911","name":"Inst tauro 1.35mg/hep 100u","description":"Instillation, taurolidine 1.35 mg and heparin sodium 100 units (central venous catheter lock for adult patients receiving chronic hemodialysis)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87493","name":"C diff amplified probe","description":"Infectious agent detection by nucleic acid (dna or rna); clostridium difficile, toxin gene(s), amplified probe technique","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0549U","name":"Onc urthl dna mthyltd rt pcr","description":"Onc urthl dna mthyltd rt pcr","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1346","name":"No pam inc 6 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 6 points within a 4 to 12 month period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1263","name":"Pts hosp dialysis dt","description":"Patients in hospice on their initiation of dialysis date or during the month of evaluation","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85045","name":"Automated reticulocyte count","description":"Blood count; reticulocyte, automated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93319","name":"3d echo img cgen car anomal","description":"3d echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac structure(s) (eg, cardiac chambers and valves, left atrial appendage, interatrial septum, interventricular","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0348U","name":"Rx metab/pcx dna 25 gen alys","description":"Rx metab/pcx dna 25 gen alys","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55868","name":"Lap srg prst8ct lymph nod bx","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with lymph node biopsy(ies) (limited pelvic lymphadenectomy)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9603","name":"Inj, pafolacianine, 0.1 mg","description":"Injection, pafolacianine, 0.1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1398","name":"Bslne and  fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20550","name":"Njx 1 tendon sheath/ligament","description":"Injection(s); single tendon sheath, or ligament, aponeurosis (eg, plantar fascia)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":37.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44150","name":"Removal of colon","description":"Colectomy, total, abdominal, without proctectomy; with ileostomy or ileoproctostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1740.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4380","name":"Advograft one per sq cm","description":"Advograft one, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9004","name":"Va whole health partner serv","description":"Department of veterans affairs whole health partner services","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84234","name":"Assay of progesterone","description":"Receptor assay; progesterone","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1358","name":"Pts no <suicd idea 120 dys","description":"Patients who did not have a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0022","name":"Comm hlth intg svs add 30 m","description":"Community health integration services, each additional 30 minutes per calendar month (list separately in addition to g0019)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43360","name":"Gastrointestinal repair","description":"Gastrointestinal reconstruction for previous esophagectomy, for obstructing esophageal lesion or fistula, or for previous esophageal exclusion; with stomach, with or without pyloroplasty","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2481.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60660","name":"Abltj 1/+thyr ndul 1lobe prq","description":"Ablation of 1 or more thyroid nodule(s), one lobe or the isthmus, percutaneous, including imaging guidance, radiofrequency","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92557","name":"Comprehensive hearing test","description":"Comprehensive audiometry threshold evaluation and speech recognition (92553 and 92556 combined)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":39.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7241","name":"Impact tooth rem bony w/comp","description":"Removal of impacted tooth-completely bony with unusual surgical complications","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1347","name":"Pt pam incr 3 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 3 points in a 4 to 12 month period (passing)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69210","name":"Remove impacted ear wax uni","description":"Removal impacted cerumen requiring instrumentation, unilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":35.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":55.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0461","name":"Testing for cracked tooth","description":"Testing for cracked tooth","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95908","name":"Nrv cndj tst 3-4 studies","description":"Nerve conduction studies; 3-4 studies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0486U","name":"Onc pan sol tum ngs cfctdna","description":"Onc pan sol tum ngs cfctdna","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49187","name":"Opn exc/dstr ntra-abd 5.1-10","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5.1 to 10 cm","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6597","name":"G comp bandage long stretch","description":"Gradient compression bandage roll, elastic long stretch, linear yard, any width, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0924T","name":"Rpos prv ccm-d trnsvns eltrd","description":"Repositioning of previously implanted cardiac contractility modulation-defibrillation transvenous electrode(s)/lead(s), including fluoroscopic guidance and programming of sensing and therapeutic parameters","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0607U","name":"Reprdtve med ema rtpcr 31bct","description":"Reprdtve med ema rtpcr 31bct","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2313","name":"Inj, naloxone (zimhi) 0.01mg","description":"Injection, naloxone hydrochloride (zimhi), 0.01 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0737","name":"Inj, clindamycin (baxter)","description":"Injection, clindamycin phosphate (baxter), not therapeutically equivalent to j0736, 300 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0833T","name":"Dgtz gls mcrscp cytp oth prp","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; preparation, screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6180","name":"Implnt maint proced","description":"Implnt maint proced","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0814T","name":"Prq njx biod osteo matrl fem","description":"Percutaneous injection of calcium-based biodegradable osteoconductive material, proximal femur, including imaging guidance, unilateral","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92641","name":"Hearing dev verif eacous aly","description":"Hearing device verification, electroacoustic analysis","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62142","name":"Rmvl b1 flp/prostc plate skl","description":"Removal of bone flap or prosthetic plate of skull","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":940.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64628","name":"Trml dstrj ios bvn 1st 2 l/s","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; first 2 vertebral bodies, lumbar or sacral","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87469","name":"Babesia microti amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); babesia microti, amplified probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92616","name":"Fees w/laryngeal sense test","description":"Flexible endoscopic evaluation of swallowing and laryngeal sensory testing by cine or video recording;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9282","name":"Mitomycin intravesical inst","description":"Mitomycin, intravesical instillation, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5940","name":"Resct proth max part remov","description":"Resct proth max part remov","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0344U","name":"Hep nafld semiq evl 28 lipid","description":"Hep nafld semiq evl 28 lipid","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4363","name":"Am bur mem hydro per sq cm","description":"Amnio burgeon membrane and hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0265U","name":"Rar do whl gn&mtcdrl dna als","description":"Rare constitutional and other heritable disorders, whole- genome and mitochondrial dna sequence analysis, blood, frozen and formalin-fixed paraffin-embedded (ffpe) tissue, saliva, buccal swabs or cell lines, identification of single nucleotide and copy number variants","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0269U","name":"Hem aut dm cgen trmbctpna 14","description":"Hematology (autosomal dominant congenital thrombocytopenia), genomic sequence analysis of 14 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2041","name":"Foundation drs+ duo pr sq cm","description":"Foundation drs+ duo, per square centimeter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0341U","name":"Ftl aneup dna seq cmpr alys","description":"Ftl aneup dna seq cmpr alys","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2406","name":"Injection, oritavancin 10 mg","description":"Injection, oritavancin (kimyrsa), 10 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0202","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q0176","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91113","name":"Gi trc img intral colon i&r","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1495","name":"Fall w/ poc, no fall","description":"Patients that reported a fall occurred who had a plan of care for falls documented or patients that did not report a fall","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0801","name":"Inj. acthar gel to 40 units","description":"Injection, corticotropin (acthar gel), up to 40 units","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0465","name":"Autolog prp diab wound ulcer","description":"Autologous platelet rich plasma (prp) or other blood-derived product for diabetic chronic wounds/ulcers, using an fda-cleared device for this indication, (includes as applicable administration, dressings, phlebotomy, centrifugation or mixing, and all other preparatory procedures, per treatment)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1298","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1455","name":"Rep/rev cied","description":"Replaced or revised cied","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2040","name":"Microlyte painguard pr sq cm","description":"Microlyte painguard, per square centimeter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1342","name":"Pts died perf per","description":"Patients who died during the performance period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4312","name":"Acesso ac, per sq cm","description":"Acesso ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49041","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4363","name":"Am bur mem hydro per sq cm","description":"Amnio burgeon membrane and hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78609","name":"Brain imaging (pet)","description":"Brain imaging, positron emission tomography (pet); perfusion evaluation","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4344","name":"Tri membrane wrap, per sq cm","description":"Tri-membrane wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0530","name":"Adult daycare center, 8 hr u","description":"Adult day center, 8-hour unit, for use in cmmi model","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93146","name":"Interrog crtd sins bat ip w/","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0716T","name":"Car acous wavfrm rec cad rsk","description":"Cardiac acoustic waveform recording with automated analysis and generation of coronary artery disease risk score","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19284","name":"Perq dev breast add strtctc","description":"Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; each additional lesion, including stereotactic guidance (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59025","name":"Fetal non-stress test","description":"Fetal non-stress test","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0044A","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0747T","name":"Car ablt rad arrhyt dlvr rad","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; delivery of radiation therapy, arrhythmia","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0035","name":"Pt ed pos 23","description":"Patient has any emergency department encounter during the performance period with place of service indicator 23","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1176","name":"No 2 hzv 10/2017-meas pd","description":"Patient did not receive two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1214","name":"Spiro results wth obs doc","description":"Spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and reviewed","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0445","name":"High inten beh couns std 30m","description":"High intensity behavioral counseling to prevent sexually transmitted infection; face-to-face, individual, includes: education, skills training and guidance on how to change sexual behavior; performed semi-annually, 30 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":30.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7514","name":"Mycophenol (myhibbin) 100 mg","description":"Mycophenolate mofetil (myhibbin), oral suspension, 100 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4009","name":"Hospitalists ss","description":"Hospitalists mips specialty set","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0826T","name":"Prgrmg evl ldls pm 1chmbr ip","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional, leadless pacemaker system in si","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6600","name":"G com bandge hgh dn foam sht","description":"Gradient compression bandaging supply, high density foam sheet, per 250 square centimeters, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1379","name":"10 yr fu no rec rsn not giv","description":"A 10 year follow-up interval for colonoscopy not recommended, reason not otherwise specified","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87400","name":"Influenza a/b each ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; influenza, a or b, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61891","name":"Rev/rplcmt sk-mnt crnl nstm","description":"Revision or replacement of skull-mounted cranial neurostimulator pulse generator or receiver with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2470","name":"Inj pantoprazole sodium 40mg","description":"Injection, pantoprazole sodium, 40 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0608U","name":"Reprdtve med ema rtpcr 10bct","description":"Reprdtve med ema rtpcr 10bct","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90684","name":"Pcv21 vaccine im","description":"Pneumococcal conjugate vaccine, 21 valent (pcv21), for intramuscular use","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37299","name":"Revsc evsc imvt angio cpx ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"Evoked auditory test limited","description":"Distortion product evoked otoacoustic emissions; limited evaluation (to confirm the presence or absence of hearing disorder, 3-6 frequencies) or transient evoked otoacoustic emissions, with interpretation and report","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2267","name":"Inj, mirikizumab-mrkz, 1 mg","description":"Injection, mirikizumab-mrkz, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0785T","name":"Revj/rmvl nea spi w/nstim","description":"Revision or removal of neurostimulator electrode array, spinal, with integrated neurostimulator","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30300","name":"Remove nasal foreign body","description":"Removal foreign body, intranasal; office type procedure","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":231.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81001","name":"Urinalysis auto w/scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; automated, with microscopy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1412","name":"Met nsclc w/ egfr alk oth ab","description":"Patients with metastatic nsclc with epidermal growth factor receptor (egfr) mutations, alk genomic tumor aberrations, or other targetable genomic abnormalities with approved first-line targeted therapy, such as nsclc with ros1 rearrangement, braf v600e mutation, ntrk 1/2/3 gene fusion, met ex14 skip","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0986T","name":"Iv img icr cere vsl oct 1st","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0963T","name":"Anosc sbmcsl njx bulking agt","description":"Anoscopy with directed submucosal injection of bulking agent into anal canal","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87811","name":"Sars-cov-2 covid19 w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19])","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99185","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86364","name":"Tiss trnsgltmnase ea ig clas","description":"Tissue transglutaminase, each immunoglobulin (ig) class","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4402","name":"Xwrap 2.0 per sq cm","description":"Xwrap 2.0, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45340","name":"Sig w/tndsc balloon dilation","description":"Sigmoidoscopy, flexible; with transendoscopic balloon dilation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69210","name":"Remove impacted ear wax uni","description":"Removal impacted cerumen requiring instrumentation, unilateral","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0376U","name":"Onc prst8 ca img alys 128","description":"Onc prst8 ca img alys 128","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86052","name":"Aquaporin-4 antb cba each","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; cell-based immunofluorescence assay (cba), each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50825","name":"Construct bowel bladder","description":"Continent diversion, including intestine anastomosis using any segment of small and/or large intestine (kock pouch or camey enterocystoplasty)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1804.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0474","name":"Micro w exam of surg margins","description":"Accession of tissue gross and microscopic examination including assessment of surgical margins for presence of disease preparation and transmission of writte","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1282","name":"Pt scrn tbco id as non user","description":"Patient screened for tobacco use and identified as a tobacco non-user","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4402","name":"Xwrap 2.0 per sq cm","description":"Xwrap 2.0, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0412U","name":"Beta amyloid ab42/40 imprcip","description":"Beta amyloid ab42/40 imprcip","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99467","name":"Ped crit care transport addl","description":"Critical care face-to-face services, during an interfacility transport of critically ill or critically injured pediatric patient, 24 months of age or younger; each additional 30 minutes (list separately in addition to code for primary service)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90695","name":"H5n8 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n8, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84270","name":"Assay of sex hormone globul","description":"Sex hormone binding globulin (shbg)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0218","name":"Inj olipudase alfa-rpcp 1mg","description":"Injection, olipudase alfa-rpcp, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5146","name":"Inj, hercessi, 10 mg","description":"Injection, trastuzumab-strf (hercessi), biosimilar, 10 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0612U","name":"Onc lvr alys >1000 mr cfdna","description":"Onc lvr alys >1000 mr cfdna","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55714","name":"Bx prst8 in-bore ct/mri 1","description":"Biopsy, prostate, in-bore ct- or mri-guided targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01942","name":"Anes neuromd/ntrvrt lmbr/sac","description":"Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1312","name":"No pt tbco scrn rng","description":"Patient not screened for tobacco use","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86641","name":"Cryptococcus antibody","description":"Antibody; cryptococcus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0548","name":"Phone/inter svs 21-30 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2247","name":"Inj, micafungin (par pharm)","description":"Injection, micafungin sodium (par pharm) not thereapeutically equivalent to j2248, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4341","name":"Simplimax, per sq cm","description":"Simplimax, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36440","name":"Bld push tfuj 2 yr/<","description":"Push transfusion, blood, 2 years or younger","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4540","name":"Trans elec nerv periph nerv","description":"Distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42235","name":"Repair palate","description":"Repair of anterior palate, including vomer flap","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":933.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5140","name":"Inj adalimumab-fkjp, 1 mg","description":"Injection, adalimumab-fkjp, biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1496","name":"No doc of fall or poc","description":"Patients that had a fall who did not have a plan of care for falls documented or do not have documentation of being assessed for falls","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4199","name":"Cygnus matrix, per sq cm","description":"Cygnus matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56805","name":"Clitoroplasty intersex state","description":"Clitoroplasty for intersex state","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1351.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33277","name":"Insj phrnc nrv stim transvns","description":"Insertion of phrenic nerve stimulator transvenous sensing lead (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46258","name":"Remove in/ex hem grp w/fistu","description":"Hemorrhoidectomy, internal and external, single column/group; with fistulectomy, including fissurectomy, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":432.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6611","name":"Grad com wrap w strap ak cus","description":"Gradient compression wrap with adjustable straps, above knee, each, custom","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6031","name":"Rep interface handfng molded","description":"Replacement socket/interface, partial hand including fingers, molded to patient model, for use with or without external power","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70160","name":"X-ray exam of nasal bones","description":"Radiologic examination, nasal bones, complete, minimum of 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9361","name":"Inj, efbemalenograstim alfa-","description":"Injection, efbemalenograstim alfa-vuxw, 0.5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81523","name":"Onc brst mrna 70 cnt 31 gene","description":"Oncology (breast), mrna, next-generation sequencing gene expression profiling of 70 content genes and 31 housekeeping genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as index related to risk to distant metastasis","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0774T","name":"Vr px dissoc svc oth phy ea","description":"Virtual reality (vr) procedural dissociation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports; each additiona","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10120","name":"Inc&rmvl fb subq tiss smpl","description":"Incision and removal of foreign body, subcutaneous tissues; simple","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":150.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1407","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0488U","name":"Ob fetal ag nipt cfdna alys","description":"Ob fetal ag nipt cfdna alys","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6105","name":"Remove implant body","description":"Remove implant body","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1296","name":"Calc bmi norm parameters","description":"Bmi is documented within normal parameters and no follow-up plan is required","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0376U","name":"Onc prst8 ca img alys 128","description":"Onc prst8 ca img alys 128","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97009","name":"Mchnl sclp cool after chemo","description":"Mechanical scalp cooling; provided after discontinuation of chemotherapy, each 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6559","name":"G stckng full/chap18-30 cust","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27310","name":"Exploration of knee joint","description":"Arthrotomy, knee, with exploration, drainage, or removal of foreign body (eg, infection)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":842.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34704","name":"Evasc rpr a-unilac ndgft rpt","description":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-uni-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in th","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2311.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93151","name":"Interrog&prgrmg ipnss","description":"Interrogation and programming (minimum one parameter) of implanted phrenic nerve stimulator system","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6584","name":"Grad com wrap w straps","description":"Gradient compression wrap with adjustable straps, not otherwise specified","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0952T","name":"Tot impl amei rev/rplc mstdc","description":"Totally implantable active middle ear hearing implant; revision or replacement, with mastoidectomy and replacement of sound processor","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4260","name":"Signature apatch, per sq cm","description":"Signature apatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4405","name":"Xwrap fenestra plus sq cm","description":"Xwrap fenestra plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0899T","name":"N-invas deter aqmbf aug cmr","description":"Noninvasive determination of absolute quantitation of myocardial blood flow (aqmbf), derived from augmentative algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health car","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44970","name":"Laparoscopy appendectomy","description":"Laparoscopy, surgical, appendectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":621.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G3002","name":"Chronic pain mgmt 30 mins","description":"Chronic pain management and treatment, monthly bundle including, diagnosis; assessment and monitoring; administration of a validated pain rating scale or tool; the development, implementation, revision, and/or maintenance of a person-centered care plan that includes strengths, goals, clinical needs,","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75577","name":"Quan&char c athrosclrtc plaq","description":"Quantification and characterization of coronary atherosclerotic plaque to assess severity of coronary disease, derived from augmentative software analysis of the data set from a coronary computed tomographic angiography, with interpretation and report by a physician or other qualified health care pr","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4253","name":"Zenith amniotic membrane psc","description":"Zenith amniotic membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12031","name":"Intmd rpr s/a/t/ext 2.5 cm/<","description":"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 2.5 cm or less","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":127.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33509","name":"Ndsc hrv uxtr art 1 sgm cab","description":"Harvest of upper extremity artery, 1 segment, for coronary artery bypass procedure, endoscopic","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65850","name":"Trabeculotomy ab externo","description":"Trabeculotomy ab externo","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":861.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38724","name":"Removal of lymph nodes neck","description":"Cervical lymphadenectomy (modified radical neck dissection)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1143.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1178","name":"Doc med rsn no pcv","description":"Documentation of medical reason(s) for not administering pneumococcal vaccine (e.g., prior anaphylaxis due to the pneumococcal vaccine)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37287","name":"Revsc evasc tpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0739","name":"Hiv prep, inj, cabotegravir","description":"Injection, cabotegravir, 1mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0731T","name":"Augmnt ai-based fcl phnt a/r","description":"Augmentative ai-based facial phenotype analysis with report","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1278","name":"Pre-htn or htn doc, f/u indc","description":"Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4283","name":"Biovance tri or 3l, sq cm","description":"Biovance tri-layer or biovance 3l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0991T","name":"Cysto lo-nrg lithtrp&mcrsphr","description":"Cystourethroscopy, with low-energy lithotripsy and acoustically actuated microspheres, including imaging","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34714","name":"Opn fem art expos cndt crtj","description":"Open femoral artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass, by groin incision, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4311","name":"Acesso, per sq cm","description":"Acesso, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0682","name":"App non-sheet skin sub add","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (list separately in addition to code for pri","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94618","name":"Pulmonary stress testing","description":"Pulmonary stress testing (eg, 6-minute walk test), including measurement of heart rate, oximetry, and oxygen titration, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0954T","name":"Tot impl amei rplc snd proc","description":"Totally implantable active middle ear hearing implant; replacement of sound processor only, with attachment to existing transducers","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99212","name":"Office o/p est sf 10 min","description":"Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 10 minutes must be met o","date_of_service":"2026-06-05","other_properties":[{"name":"BillingTaxonomy","value":["207V00000X","207VB0002X","207VE0102X","207VF0040X","207VG0400X","207VM0101X","207VX0000X","207VX0201X","363LX0001X"]},{"name":"RenderingTaxonomy","value":["207V00000X","207VB0002X","207VE0102X","207VF0040X","207VG0400X","207VM0101X","207VX0000X","207VX0201X","363LX0001X"]},{"name":"ClaimSpecialtyCode","value":["904","905","907","AMGY","APNOB","COLP","FPEM","GYNE","GYON","GYSU","MAFE","NPAG","NPGY","NPOB","OBEM","OBGY","OBHR","OBST","REND","URGY"]},{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TH"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0982T","name":"Rem mntr impl ivc snr set-up","description":"Remote monitoring of implantable inferior vena cava sensor, physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate), initial set-up and patient education on use of equipment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9255","name":"Inj, methotrexate (accord)","description":"Injection, methotrexate (accord), not therapeutically equivalent to j9260, 50 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37297","name":"Revsc evasc imvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62294","name":"Injection into spinal artery","description":"Injection procedure, arterial, for occlusion of arteriovenous malformation, spinal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":825.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0665","name":"Team remote e/m est pt 10 mn","description":"Team remote e/m est. pt 10mins","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93000","name":"Electrocardiogram complete","description":"Electrocardiogram, routine ecg with at least 12 leads; with interpretation and report","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87534","name":"Hiv-1 dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); hiv-1, direct probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93152","name":"Interrog&prgrmg ipnss polysm","description":"Interrogation and programming of implanted phrenic nerve stimulator system during polysomnography","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0423U","name":"Psyc genomic alys pnl 26 gen","description":"Psyc genomic alys pnl 26 gen","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53453","name":"Tprnl balo cntnc dev rmvl ea","description":"Periurethral transperineal adjustable balloon continence device; removal, each balloon","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6089","name":"Access/retorq implant screw","description":"Access/retorq implant screw","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50395","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4366","name":"Dl amnio bur x-mem per sq cm","description":"Dual layer amnio burgeon x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1205","name":"Isa reduced >=3","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88245","name":"Chromosome analysis 20-25","description":"Chromosome analysis for breakage syndromes; baseline sister chromatid exchange (sce), 20-25 cells","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6596","name":"G comp bandge conform gauze","description":"Gradient compression bandaging supply, conforming gauze, per linear yard, any width, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0874","name":"Inj, daptomycin (baxter)","description":"Injection, daptomycin (baxter), not therapeutically equivalent to j0878, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97550","name":"Caregiver traing 1st 30 min","description":"Caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patie","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1295","name":"Pt hx tot col or colon ca","description":"Patients with a diagnosis or past history of total colectomy or colorectal cancer","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2013","name":"Innovamatrix fs, per sq cm","description":"Innovamatrix fs, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5725","name":"Rebase hybrid prosthesis","description":"Rebase hybrid prosthesis","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0557","name":"Adv prim care mgmt lvl 2","description":"Advanced primary care management services for a patient with multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, which place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline, provided by c","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0766T","name":"Tc mag stimj pn 1st nerve","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; first nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0979T","name":"Sbmcsl crylys ther sft palt","description":"Submucosal cryolysis therapy; soft palate only","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6560","name":"G stckng full/chap30-40 cust","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, custom, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96202","name":"Mlt fam grp bhv train 1st 60","description":"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face with multiple sets of paren","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0164","name":"Epinephrine in nacl (baxter)","description":"Injection, epinephrine in sodium chloride (baxter), 0.1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0736","name":"Inj, clindamycin phosp 300mg","description":"Injection, clindamycin phosphate, 300 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1333","name":"Acute vitreous hemorrhage","description":"Acute vitreous hemorrhage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26862","name":"Fusion/graft of finger joint","description":"Arthrodesis, interphalangeal joint, with or without internal fixation; with autograft (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":961.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90880","name":"Hypnotherapy","description":"Hypnotherapy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76989","name":"Dx intraop epcar us chd i&r","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; interpretation and report only","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0991T","name":"Cysto lo-nrg lithtrp&mcrsphr","description":"Cystourethroscopy, with low-energy lithotripsy and acoustically actuated microspheres, including imaging","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81000","name":"Urinalysis nonauto w/scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; non-automated, with microscopy","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90612","name":"Inf&sarscov2 vacc 31.7/.32im","description":"Influenza virus vaccine, trivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 31.7 mcg/0.32 ml dosage, for intramuscular use","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0594U","name":"Nfct ds sepsis pncrtc spc","description":"Nfct ds sepsis pncrtc spc","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1200","name":"Ace-i/arb rx","description":"Ace inhibitor (ace-i) or arb therapy prescribed during the measurement period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4257","name":"Relese, per sq cm","description":"Relese, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0209","name":"Inj, sod thiosulfate (hope)","description":"Injection, sodium thiosulfate (hope), 100 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1304","name":"No pneum vax admin 19+","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0506","name":"Comp asses care plan ccm svc","description":"Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":43.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27734","name":"Repair lower leg epiphyses","description":"Arrest, epiphyseal (epiphysiodesis), open; distal tibia and fibula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64567","name":"Perq elec nrv field stimj cn","description":"Percutaneous electrical nerve field stimulation, cranial nerves, without implantation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0497U","name":"Onc prst8 mrna rt-pcr 6 gene","description":"Onc prst8 mrna rt-pcr 6 gene","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87270","name":"Chlamydia trachomatis ag if","description":"Infectious agent antigen detection by immunofluorescent technique; chlamydia trachomatis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0583U","name":"Rare ds rpd whlgen cmptr dna","description":"Rare ds rpd whlgen cmptr dna","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3432","name":"Guided tissue regeneration","description":"Guided tissue regeneration","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1808","name":"Inj, folic acid, 0.1 mg","description":"Injection, folic acid, 0.1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1150","name":"Lvef <=40% or mod/sev l vsf","description":"Current or prior left ventricular ejection fraction (lvef) less than or equal to 40% or documentation of moderately or severely depressed left ventricular systolic function","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21627","name":"Sternal debridement","description":"Sternal debridement","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":642.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0964T","name":"I&cust prep jaw xpnsj 1arch","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; single arch, without mandibular advancement mechanism","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99479","name":"Sbsq ic lbw inf 1,500-2,500","description":"Subsequent intensive care, per day, for the evaluation and management of the recovering low birth weight infant (present body weight of 1,500-2,500 grams)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6611","name":"Grad com wrap w strap ak cus","description":"Gradient compression wrap with adjustable straps, above knee, each, custom","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90637","name":"Vacc qirv mrna 30mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 30 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4543","name":"Supply trans elec nerve stim","description":"Supplies for transcutaneous electrical nerve stimulator, for nerves in the auricular region, per month","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4382","name":"Advograft dual per sq cm","description":"Advograft dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85610","name":"Prothrombin time","description":"Prothrombin time;","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2791","name":"Crown full cast base metal","description":"Crown-full cast predominantly base metal","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1451","name":"Pt dx ppd dur id/pf pd","description":"Patients with an active diagnosis of pervasive developmental disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1201","name":"Med rsn no ace-i/arb rx","description":"Documentation of medical reason(s) for not prescribing ace inhibitor (ace-i) or arb therapy during the measurement period (e.g., pregnancy, history of angioedema to ace-i, other allergy to ace-i and arb, hyperkalemia or history of hyperkalemia while on ace-i or arb therapy, acute kidney injury due t","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0349U","name":"Rx metab/pcx dna 27gen rx ia","description":"Rx metab/pcx dna 27gen rx ia","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0616U","name":"Neurol dementia alys >30000","description":"Neurol dementia alys >30000","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15016","name":"App skn cl ssp agrf t/a/l ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; each additional 480 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37269","name":"Revsc evasc fpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0840T","name":"Dgtz gls mcrscp cslt compre","description":"Digitization of glass microscope slides for consultation, comprehensive, with review of records and specimens, with report on referred material (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60270","name":"Removal of thyroid","description":"Thyroidectomy, including substernal thyroid; sternal split or transthoracic approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1468.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1231","name":"Pt hcv tst no reactive res","description":"Patient receives hcv antibody test with nonreactive result","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1294","name":"Bp scrn perf rec interval","description":"Normal blood pressure reading documented, follow-up not required","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49595","name":"Rpr aa hrn 1st > 10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, reducible","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1486","name":"Pt admitted to snf dur eval","description":"Patients admitted to a skilled nursing facility (snf) during the period of evaluation","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90483","name":"Imm cnsl not admn sm>10<20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 10 minutes up to 20 minutes","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0524","name":"Est pt-cg dyad dem low cmplx","description":"Management of established patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1152","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1441","name":"Init dx slp apn = 1st enc","description":"Encounter corresponds to initial diagnosis of sleep apnea or first contact with sleep apnea diagnosed patient","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0525","name":"Inj cefotetan disodium 10 mg","description":"Injection, cefotetan disodium, 10 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1216","name":"No spiro doc no res doc","description":"No spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and/or no spirometry performed with results documented during the encounter","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87075","name":"Cultr bacteria except blood","description":"Culture, bacterial; any source, except blood, anaerobic with isolation and presumptive identification of isolates","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31267","name":"Endoscopy maxillary sinus","description":"Nasal/sinus endoscopy, surgical, with maxillary antrostomy; with removal of tissue from maxillary sinus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":413.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76805","name":"Ob us >/= 14 wks sngl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4318","name":"Fem urinary cup w/wo attch","description":"Female external urinary collection cup, with or without ring attachment, per day","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63283","name":"Bx/exc idrl spine lesn scrl","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, sacral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2126.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4331","name":"Axolotl graft, per sq cm","description":"Axolotl graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33281","name":"Reposg phrnc nrv stim trnsvn","description":"Repositioning of phrenic nerve stimulator transvenous lead(s)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24153","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":780.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1025","name":"Pt mnth 1 mcp prov","description":"Patient-months where there are more than one medicare capitated payment (mcp) provider listed for the month","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33903","name":"Perq p-art revsc 1 abnor bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, bilateral","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0945T","name":"Intraop assmt abnl tum tiss","description":"Intraoperative assessment for abnormal (tumor) tissue, in-vivo, following partial mastectomy (eg, lumpectomy) using computer-aided fluorescence imaging (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1308","name":"Inj, famotidine, 0.25 mg","description":"Injection, famotidine, 0.25 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7174","name":"Injection fitusiran 0.04 mg","description":"Injection, fitusiran, 0.04 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53430","name":"Reconstruction of urethra","description":"Urethroplasty, reconstruction of female urethra","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1072.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0741","name":"Inj, cabote rilpivir 2mg 3mg","description":"Injection, cabotegravir and rilpivirine, 2mg/3mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1235","name":"Doc pt hcv aby rna tst","description":"Documentation or patient report of hcv antibody test or hcv rna test which occurred prior to the performance period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76950","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0417U","name":"Rare ds alys 335 nuc genes","description":"Rare ds alys 335 nuc genes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92636","name":"Hearing aid post-fitg f-up 1","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0443U","name":"Neurflmnt lt chn ultrsens ia","description":"Neurflmnt lt chn ultrsens ia","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0680T","name":"Insj/rplcmt pg only isdss","description":"Insertion or replacement of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing lead(s)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7252","name":"Part extract for implant","description":"Part extract for implant","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25431","name":"Repair nonunion carpal bone","description":"Repair of nonunion of carpal bone (excluding carpal scaphoid (navicular)) (includes obtaining graft and necessary fixation), each bone","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":949.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81458","name":"So gsap dna cpy nmbr&mcrstl","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis, copy number variants and microsatellite instability","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70010","name":"Contrast x-ray of brain","description":"Myelography, posterior fossa, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93575","name":"Njx cath slct p angrph mapca","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary angiography of major aortopulmonary collateral arteries (mapcas) arising off the aorta or its systemic branches, during cardiac catheterization for congenital heart d","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64474","name":"Lwr xtr fscl pln blk uni nfs","description":"Lower extremity fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0605U","name":"All&immunology hat tpsab1","description":"All&immunology hat tpsab1","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37277","name":"Rvsc evsc fpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0992T","name":"N-invas assmt car rsk w/o ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat without concurrent computed tomography (ct) scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50526","name":"Close nephrovisceral fistula","description":"Closure of nephrovisceral fistula (eg, renocolic), including visceral repair; thoracic approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1567.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5657","name":"Add low ext man aut vol any","description":"Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1494","name":"Fall rep since last visit","description":"Patients that reported a fall since the last visit","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0887T","name":"End-tidal ctrl inhaled anes","description":"End-tidal control of inhaled anesthetic agents and oxygen to assist anesthesia care delivery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59200","name":"Insert cervical dilator","description":"Insertion of cervical dilator (eg, laminaria, prostaglandin) (separate procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":69.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33370","name":"Tcat plmt&rmvl cepd perq","description":"Transcatheter placement and subsequent removal of cerebral embolic protection device(s), including arterial access, catheterization, imaging, and radiological supervision and interpretation, percutaneous (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0529","name":"In home respite care, 4 hr u","description":"In-home respite care, 4-hour unit, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0051","name":"Traditional healing service","description":"Traditional healing service","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6517","name":"Grad com wrap w strap bn cus","description":"Gradient compression wrap with adjustable straps, below knee, each, custom","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49540","name":"Repair lumbar hernia","description":"Repair lumbar hernia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":735.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63053","name":"Lam factc/frmt arthrd lum ea","description":"Laminectomy, facetectomy, or foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s] [eg, spinal or lateral recess stenosis]), during posterior interbody arthrodesis, lumbar; each additional vertebral segment (list separately in addition to code for","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0552","name":"Supply of digital device","description":"Supply of digital mental health treatment device and initial education and onboarding, per course of treatment that augments a behavioral therapy plan","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9957","name":"Screening sleep disorders","description":"Screening sleep disorders","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4018","name":"Ob/gyn ss","description":"Obstetrics/gynecology mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0536","name":"Peer recover support svs","description":"Peer recovery support services, provided directly or by referral; including leveraging knowledge of the condition or lived experience to provide support, mentorship, or inspiration to meet oud treatment and recovery goals; conducting a person-centered interview to understand the patients life story,","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4302","name":"Complete aca, per sq cm","description":"Complete aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4404","name":"Xwrap hydro plus per sq cm","description":"Xwrap hydro plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2781","name":"Crown 3/4 cast base metal","description":"Crown - 3/4 cast predominantly base metal","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64584","name":"Rmvl hpglsl nstim ary pg","description":"Removal of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98010","name":"Synch audio-only new mod 45","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection,","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1812","name":"Inj. insulin (fiasp)","description":"Insulin (fiasp), per 5 units","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83903","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6198","name":"Remove interim implant","description":"Remove interim implant","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0918T","name":"Insj perm ccm-d sys dual ld","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; dual transvenous leads (pacing and defibrillation) only","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98011","name":"Synch audio-only new high 60","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 60 ","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70015","name":"Contrast x-ray of brain","description":"Cisternography, positive contrast, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4270","name":"Complete sl per sq cm","description":"Complete sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76830","name":"Transvaginal us non-ob","description":"Ultrasound, transvaginal","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86051","name":"Aquaporin-4 antb elisa","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; enzyme-linked immunosorbent immunoassay (elisa)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1425","name":"Surgical care mvp","description":"Surgical care mips value pathway","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4370","name":"Aeroguard per sq cm","description":"Aeroguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7298","name":"Remove screw retained plate","description":"Remove screw retained plate","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0543U","name":"Onc sol tum ngs dna 517 gens","description":"Onc sol tum ngs dna 517 gens","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12031","name":"Intmd rpr s/a/t/ext 2.5 cm/<","description":"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 2.5 cm or less","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":298.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34900","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1149.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70552","name":"Mri brain stem w/dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":797.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1443","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1372","name":"Mst rec gsa >=7 and<8","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 7.0% and < 8.0%","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37274","name":"Rvsc evsc fpvt athrc cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9988","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0388U","name":"Onc nonsm cll lng ca 37 gen","description":"Onc nonsm cll lng ca 37 gen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3391","name":"Inj, atidarsagene autotemcel","description":"Injection, atidarsagene autotemcel, per treatment","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59020","name":"Fetal contract stress test","description":"Fetal contraction stress test","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90955","name":"Esrd srv 2-3 vsts p mo 2-11","description":"End-stage renal disease (esrd) related services monthly, for patients 2-11 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 2-3 face-to-face visits by a physician or other qualified health care professional per mo","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1457","name":"Dx asth dur crnt/prv perf pd","description":"Patient had a diagnosis of asthma with any contact during the current or prior performance period or had asthma present on an active problem list any time during the performance period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93233","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25337","name":"Reconstruct ulna/radioulnar","description":"Reconstruction for stabilization of unstable distal ulna or distal radioulnar joint, secondary by soft tissue stabilization (eg, tendon transfer, tendon graft or weave, or tenodesis) with or without open reduction of distal radioulnar joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0688","name":"Inj cefazolin sodium, hikma","description":"Injection, cefazolin sodium (hikma), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0289U","name":"Neuro alzheimer mrna 24 gen","description":"Neuro alzheimer mrna 24 gen","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93146","name":"Interrog crtd sins bat ip w/","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99470","name":"Rpm tx mgmt 1st 10 min","description":"Remote physiologic monitoring treatment management services, clinical staff/physician/other qualified health care professional time in a calendar month requiring 1 real-time interactive communication with the patient/caregiver during the calendar month; first 10 minutes","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1577.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1392","name":"Pt rsn no exm or lst to fu","description":"Documentation of patient reasons for no examination, i.e., refusal of examination or lost to follow-up (documentation must include information that the clinician was unable to reach the patient by phone, mail or secure electronic mail - at least one method must be documented)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1299","name":"Flu immunize order/admin","description":"Influenza immunization administered or previously received","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1332","name":"Pts no eval ini xm no 2 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 2 weeks","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2720","name":"Inj protamine sulfate/10 mg","description":"Injection, protamine sulfate, per 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1328","name":"Pts dx acute vitreous hem","description":"Patients with a diagnosis of acute vitreous hemorrhage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1440","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0499U","name":"Onc clrct&lng dna ngs 8gene","description":"Onc clrct&lng dna ngs 8gene","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81000","name":"Urinalysis nonauto w/scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; non-automated, with microscopy","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1266","name":"Pts admit snf","description":"Patients admitted to a skilled nursing facility (snf)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0869T","name":"Njx b1 sub mtrl hw fixj aug","description":"Injection(s), bone-substitute material for bone and/or soft tissue hardware fixation augmentation, including intraoperative imaging guidance, when performed","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9298","name":"Inj nivol relatlimab 3mg/1mg","description":"Injection, nivolumab and relatlimab-rmbw, 3 mg/1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82271","name":"Occult blood other sources","description":"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; other sources","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0525","name":"Est pt-cg dyad dem mod cmplx","description":"Management of established patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1344","name":"No bsln/2nd pam score 4-12mo","description":"Patients who did not have a baseline pam score and/or a second score within 4 to 12 months of baseline pam score","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0601","name":"Sevelamer carbonate 20 mg","description":"Sevelamer carbonate (renvela or therapeutically equivalent), oral, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0674T","name":"Laps insj nw/rpcmt prm isdss","description":"Laparoscopic insertion of new or replacement of permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including an implantable pulse generator and diaphragmatic lead(s)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15011","name":"Hrv skn cll ssp agrft 1st 25","description":"Harvest of skin for skin cell suspension autograft; first 25 sq cm or less","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0436U","name":"Onc lng plsm alys 388 prtn","description":"Onc lng plsm alys 388 prtn","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4348","name":"Sentry sl matrix per sq cm","description":"Sentry sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1011T","name":"Pbm therapy of oral cavity","description":"Photobiomodulation (pbm) therapy of oral cavity, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6197","name":"Replace material prosthesis","description":"Replace material prosthesis","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3394","name":"Inj, lovotibeglogene autotem","description":"Injection, lovotibeglogene autotemcel, per treatment","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2006","name":"Novosorb synpath per sq cm","description":"Novosorb synpath dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9914","name":"Admin of dermal fill","description":"Admin of dermal fill","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4343","name":"Dermacyte ac matrx per sq cm","description":"Dermacyte ac matrix amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87484","name":"Ehrlicha chaffeensis amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); ehrlichia chaffeensis, amplified probe technique","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81517","name":"Liver ds alys 3 bmrk srm alg","description":"Liver disease, analysis of 3 biomarkers (hyaluronic acid [ha], procollagen iii amino terminal peptide [piiinp], tissue inhibitor of metalloproteinase 1 [timp-1]), using immunoassays, utilizing serum, prognostic algorithm reported as a risk score and risk of liver fibrosis and liver-related clinical ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0682T","name":"Removal pulse gen only isdss","description":"Removal of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81451","name":"Hl neo gsap 5-50 rna alys","description":"Hematolymphoid neoplasm or disorder, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants, and copy number variants or rearrangements, or isoform expression or mrna expression levels, if performed; rna analysis","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9888","name":"5% wl maintnd from bsline wt","description":"Maintenance 5% wl from baseline weight in months 7-12","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92928","name":"Prq tcat plmt ntrac st 1 les","description":"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 1 lesion involving 1 or more coronary segments","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1009T","name":"Rem mntr s-sclp cont eeg sys","description":"Remote monitoring of a sub-scalp implanted continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86826","name":"Hla x-match noncytotoxc addl","description":"Human leukocyte antigen (hla) crossmatch, non-cytotoxic (eg, using flow cytometry); each additional serum sample or sample dilution (list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99262","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5134","name":"Inj, tyruko, 1 mg","description":"Injection, natalizumab-sztn (tyruko), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0360U","name":"Onc lung elisa 7 autoant alg","description":"Onc lung elisa 7 autoant alg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1288","name":"Doc rsn no hbp scrn or f/u","description":"Documented reason for not screening or recommending a follow-up for high blood pressure","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0571U","name":"Onc sol tum dna80&rna10g ngs","description":"Onc sol tum dna80&rna10g ngs","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1493","name":"No fall doc med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7520","name":"Sirolimus, oral","description":"Sirolimus, oral, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0944T","name":"3d cntr simula trgt lvr les","description":"3d contour simulation of target liver lesion(s) and margin(s) for image-guided percutaneous microwave ablation","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61120","name":"Burr hole for ventr puncture","description":"Burr hole(s) for ventricular puncture (including injection of gas, contrast media, dye, or radioactive material)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":768.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0880T","name":"Augmnt alys ch ct ild i&r","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58267","name":"Vag hyst w/urinary repair","description":"Vaginal hysterectomy, for uterus 250 g or less; with colpo-urethrocystopexy (marshall-marchetti-krantz type, pereyra type) with or without endoscopic control","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1222.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4357","name":"Xwrap plus, per sq cm","description":"Xwrap plus, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86042","name":"Acetylcholn rcptr blckg antb","description":"Acetylcholine receptor (achr); blocking antibody","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9051","name":"Inj, bortezomib (maia)","description":"Injection, bortezomib (maia), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4000","name":"Dermatology ss","description":"Dermatology mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4305","name":"Amer am ac tri-lay per sq cm","description":"American amnion ac tri-layer, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66683","name":"Implantation iris prosthesis","description":"Implantation of iris prosthesis, including suture fixation and repair or removal of iris, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0484","name":"Consult slides prep elsewher","description":"Consultation on slides prepared elsewhere","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2010","name":"Apis, per square centimeter","description":"Apis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0728T","name":"Dx alys vstblr implt uni 1st","description":"Diagnostic analysis of vestibular implant, unilateral; with initial programming","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0770T","name":"Vr technology assist therapy","description":"Virtual reality technology to assist therapy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2781","name":"Crown 3/4 cast base metal","description":"Crown - 3/4 cast predominantly base metal","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3222","name":"Part pulp for apexogenesis","description":"Partial pulpotomy for apexogenesis - permanent tooth with incomplete root development","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0452U","name":"Onc bldr mthyl penk lte-qmsp","description":"Onc bldr mthyl penk lte-qmsp","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93654","name":"Compre ep eval tx vt","description":"Comprehensive electrophysiologic evaluation with insertion and repositioning of multiple electrode catheters, induction or attempted induction of an arrhythmia with right atrial pacing and recording and catheter ablation of arrhythmogenic focus, including intracardiac electrophysiologic 3-dimensiona","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1325.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0019M","name":"Cv ds plasma alys prtn bmrk","description":"Cardiovascular disease, plasma, analysis of protein biomarkers by aptamer-based microarray and algorithm reported as 4-year likelihood of coronary event in high-risk populations","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5144","name":"Inj, idacio, 1 mg","description":"Injection, adalimumab-aacf (idacio), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4328","name":"Most, per sq cm","description":"Most, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0826T","name":"Prgrmg evl ldls pm 1chmbr ip","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional, leadless pacemaker system in si","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0982T","name":"Rem mntr impl ivc snr set-up","description":"Remote monitoring of implantable inferior vena cava sensor, physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate), initial set-up and patient education on use of equipment","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59400","name":"Obstetrical care","description":"Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2563.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9245","name":"Inj melpha hydroch nos 50 mg","description":"Injection, melphalan hydrochloride, not otherwise specified, 50 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4403","name":"Xwrap dual plus per sq cm","description":"Xwrap dual plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49594","name":"Rpr aa hrn 1st 3-10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, incarcerated or strangulated","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58580","name":"Transcrv abltj utrn fibrd rf","description":"Transcervical ablation of uterine fibroid(s), including intraoperative ultrasound guidance and monitoring, radiofrequency","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4322","name":"Caregraft, per sq cm","description":"Caregraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0467U","name":"Onc bldr dna ngs 60gen&aneup","description":"Onc bldr dna ngs 60gen&aneup","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3921","name":"Decor or submerg erupt tooth","description":"Decor or submerg erupt tooth","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1457","name":"Dx asth dur crnt/prv perf pd","description":"Patient had a diagnosis of asthma with any contact during the current or prior performance period or had asthma present on an active problem list any time during the performance period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87076","name":"Culture anaerobe ident each","description":"Culture, bacterial; anaerobic isolate, additional methods required for definitive identification, each isolate","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0652","name":"Inj, levothyroxine, hikma","description":"Injection, levothyroxine sodium (hikma), not therapeutically equivalent to j0650, 10 mcg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1299","name":"Inj, eculizumab, 2 mg","description":"Injection, eculizumab, 2 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0627U","name":"Psyc scz dna alys >15000","description":"Psyc scz dna alys >15000","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0981T","name":"Tcat impl wrls ivc snr","description":"Transcatheter implantation of wireless inferior vena cava sensor for long-term hemodynamic monitoring, including deployment of the sensor, radiological supervision and interpretation, right heart catheterization, and inferior vena cava venography, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0314U","name":"Onc cutan mlnma mrna 35 gene","description":"Onc cutan mlnma mrna 35 gene","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21122","name":"Geniop sldg osteot 2/>","description":"Genioplasty; sliding osteotomies, 2 or more osteotomies (eg, wedge excision or bone wedge reversal for asymmetrical chin)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":827.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4397","name":"Summit aaa per sq cm","description":"Summit aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92612","name":"Endoscopy swallow (fees) vid","description":"Flexible endoscopic evaluation of swallowing by cine or video recording;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0878T","name":"Augmnt alys ch ct ild w/ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained with concurrent ct examination of the same structure","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24666","name":"Optx radial head/nck fx rplc","description":"Open treatment of radial head or neck fracture, includes internal fixation or radial head excision, when performed; with radial head prosthetic replacement","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":875.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9615","name":"Inj, pegulicianine, 1 mg","description":"Injection, pegulicianine, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0468U","name":"Hep nash mir34a5p a2m ykl40","description":"Hep nash mir34a5p a2m ykl40","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0510U","name":"Onc pncrtc ca alg alys 16gen","description":"Onc pncrtc ca alg alys 16gen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0031","name":"Pall serv during meas","description":"Palliative care services given to patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99407","name":"Behav chng smoking > 10 min","description":"Smoking and tobacco use cessation counseling visit; intensive, greater than 10 minutes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":28.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1809","name":"Inj, fosdenopterin, 0.1mg","description":"Injection, fosdenopterin, 0.1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0953T","name":"Tot impl amei rev/rplc w/o","description":"Totally implantable active middle ear hearing implant; revision or replacement, without mastoidectomy and replacement of sound processor","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93574","name":"Njx cath slct pulm vn angrph","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary venous angiography of each distinct pulmonary vein during cardiac catheterization (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0729T","name":"Dx alys vstblr implt uni sbq","description":"Diagnostic analysis of vestibular implant, unilateral; with subsequent programming","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0928T","name":"Rem interrog dev ccm-d phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system with interim analysis and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0960T","name":"Rpl s-sclp eltr ra rcvr&tlmt","description":"Replacement of sub-scalp implanted electrode array, receiver, and telemetry unit with tunneling of electrode for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99417","name":"Prolng op e/m each 15 min","description":"Prolonged outpatient evaluation and management service(s) time with or without direct patient contact beyond the required time of the primary service when the primary service level has been selected using total time, each 15 minutes of total time (list separately in addition to the code of the outpa","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37291","name":"Revsc evsc tpvt athr cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6039","name":"Passive custom digit/thumb","description":"Passive prosthetic digit or thumb prosthesis not including hand restoration partial hand, full or partial, custom made, any material, initial or replacement, per single passive prosthetic digit or thumb","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0370","name":"Max ultrasound capt & interp","description":"Max ultrasound capt & interp","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53085","name":"Drainage of urinary leakage","description":"Drainage of perineal urinary extravasation; complicated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":828.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0613U","name":"Onc uc dna mthyltn&mut 6bmrk","description":"Onc uc dna mthyltn&mut 6bmrk","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4012","name":"Interventional rad ss","description":"Interventional radiology mips specialty set","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92285","name":"External ocular photography","description":"External ocular photography with interpretation and report for documentation of medical progress (eg, close-up photography, slit lamp photography, goniophotography, stereo-photography)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6211","name":"Bridge base metal cast","description":"Pontic-cast predominantly base metal","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1503","name":"Vascular surgery mvp","description":"Vascular surgery mips value pathway","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21082","name":"Impres&prep paltl aug prosth","description":"Impression and custom preparation; palatal augmentation prosthesis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0545","name":"Inherent visit to inpt","description":"Visit complexity inherent to hospital inpatient or observation care associated with a confirmed or suspected infectious disease by an infectious diseases specialist, including disease transmission risk assessment and mitigation, public health investigation, analysis, and testing, and complex antimic","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69727","name":"Rmv ntr oi imp sk tc esp<100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0284U","name":"Vw factor type 2n eval plsm","description":"Von willebrand factor (vwd), type 2n, factor viii and vwf binding evaluation, enzyme-linked immunosorbent assays (elisa), plasma","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31700","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1407","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0822T","name":"Mntr psychdlc med cln staff","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; clinical staff under the direction of a physician or other qualified health care professional, concurrent with first physician or other qualified health care p","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98014","name":"Synch audio-only est mod 30","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code s","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4241","name":"Gngvl flap w rootplan 1-3 th","description":"Gingival flap procedure including root planing - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27488","name":"Removal of knee prosthesis","description":"Removal of prosthesis, including total knee prosthesis, methylmethacrylate with or without insertion of spacer, knee","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1375.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4407","name":"Xwrap tribus per sq cm","description":"Xwrap tribus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9273","name":"Inj tisotu vedotin-tftv, 1mg","description":"Injection, tisotumab vedotin-tftv, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17250","name":"Chem caut of granltj tissue","description":"Chemical cauterization of granulation tissue (ie, proud flesh)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":85.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61548","name":"Removal of pituitary gland","description":"Hypophysectomy or excision of pituitary tumor, transnasal or transseptal approach, nonstereotactic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1702.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95919","name":"Quan puplmtry phy/qhp uni/bi","description":"Quantitative pupillometry with physician or other qualified health care professional interpretation and report, unilateral or bilateral","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1004T","name":"Elec alys s-scl eeg wo prgrm","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; without programming","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5142","name":"Inj adalimumab-ryvk, 1 mg","description":"Injection, adalimumab-ryvk biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15011","name":"Hrv skn cll ssp agrft 1st 25","description":"Harvest of skin for skin cell suspension autograft; first 25 sq cm or less","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0745T","name":"Car ablt rad arr n-invas loc","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; noninvasive arrhythmia localization and mapping of arrhythmia site (nidus), derived from anatomical image data (eg, ct, mri, or myocardial perfusion scan) and electrical data (eg, 12-lead ecg data), and identification of areas of avo","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5827","name":"Endo knee shin single axis","description":"Endoskeletal knee-shin system, single axis, electromechanical swing and stance phase control, with or without shock absorption and stance extension damping","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0351U","name":"Nfct ds bct/viral trail ip10","description":"Nfct ds bct/viral trail ip10","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1025T","name":"Alt elec fld dos&dlv sim mdl","description":"Alternating electric fields dosimetry and delivery-simulation modeling, creation and selection of patient-specific array layouts, and placement verification","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1429","name":"Retinopathy in od, os, ou","description":"Retinal exam finding with evidence of retinopathy in left, right or both eyes with severity level documented","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22837","name":"Ant thrc vrt body tethrg 8+","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; 8 or more vertebral segments","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2151","name":"Inj, mannitol, 250 mg","description":"Injection, mannitol, 250 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0952T","name":"Tot impl amei rev/rplc mstdc","description":"Totally implantable active middle ear hearing implant; revision or replacement, with mastoidectomy and replacement of sound processor","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1178","name":"Doc med rsn no pcv","description":"Documentation of medical reason(s) for not administering pneumococcal vaccine (e.g., prior anaphylaxis due to the pneumococcal vaccine)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0707T","name":"Njx b1 sub mtrl sbchdrl dfct","description":"Injection(s), bone-substitute material (eg, calcium phosphate) into subchondral bone defect (ie, bone marrow lesion, bone bruise, stress injury, microtrabecular fracture), including imaging guidance and arthroscopic assistance for joint visualization","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0765T","name":"Asstv alg ecg rsk asmt prev","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to previously performed electrocardiogram","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4294","name":"Amnio quad-core, per sq cm","description":"Amnio quad-core, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6093","name":"Recement supp part denture","description":"Recement implant/abutment supported fixed partial denture","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77438","name":"Surf rad thr orthvlt>150-500","description":"Surface radiation therapy; orthovoltage, delivery, >150-500 kv, per fraction","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0935T","name":"Cysto w/rnl pel symp dnrvtj","description":"Cystourethroscopy with renal pelvic sympathetic denervation, radiofrequency ablation, retrograde ureteral approach, including insertion of guide wire, selective placement of ureteral sheath(s) and multiple conformable electrodes, contrast injection(s), and fluoroscopy, bilateral","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68328","name":"Revise/graft eyelid lining","description":"Conjunctivoplasty, reconstruction cul-de-sac; with buccal mucous membrane graft (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":714.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99433","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1301","name":"Immunization counseling","description":"Immunization counseling","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1012T","name":"Mtrz ab ntrno trph scl/tr mw","description":"Motorized ab interno trephination of sclera (sclerostomy), or trabecular meshwork (trabeculostomy), 1 or more, including injection of antifibrotic agents, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1273","name":"Pts snf 1 yr dialysis","description":"Patients who were admitted to a skilled nursing facility (snf) within one year of dialysis initiation according to the cms-2728 form","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0610U","name":"Nfct ds antmcr sc phenotypic","description":"Nfct ds antmcr sc phenotypic","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87523","name":"Hepatitis d quantification","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis d (delta), quantification, including reverse transcription, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0957T","name":"Rev s-sclp eltr ra rcvr&tlmt","description":"Revision of sub-scalp implanted electrode array, receiver, and telemetry unit for electrode, when required, including imaging guidance","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66982","name":"Xcapsl ctrc rmvl cplx wo ecp","description":"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification), complex, requiring devices or techniques not generally used in routine cataract surgery (eg, iris expansion device,","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1055.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0358U","name":"Neuro alys b-amyl 1-42&1-40","description":"Neuro alys b-amyl 1-42&1-40","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28171","name":"Resect tarsal tumor","description":"Radical resection of tumor; tarsal (except talus or calcaneus)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":735.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6252","name":"Bridge resin w/noble metal","description":"Pontic-resin with noble metal","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0572U","name":"Onc prst8 httl qfish whl bld","description":"Onc prst8 httl qfish whl bld","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43277","name":"Ercp ea duct/ampulla dilate","description":"Endoscopic retrograde cholangiopancreatography (ercp); with trans-endoscopic balloon dilation of biliary/pancreatic duct(s) or of ampulla (sphincteroplasty), including sphincterotomy, when performed, each duct","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1309","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0739","name":"Rehab sys active assist rt","description":"Rehabilitation system with interactive interface providing active assistance in rehabilitation therapy, includes all components and accessories, motors, microprocessors, sensors","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15976.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9245","name":"Admin mod sedation-enteral","description":"Admin mod sedation-enteral","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J3130","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0787T","name":"Revj/rmvl nea sac w/nstim","description":"Revision or removal of neurostimulator electrode array, sacral, with integrated neurostimulator","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"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":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1201","name":"Med rsn no ace-i/arb rx","description":"Documentation of medical reason(s) for not prescribing ace inhibitor (ace-i) or arb therapy during the measurement period (e.g., pregnancy, history of angioedema to ace-i, other allergy to ace-i and arb, hyperkalemia or history of hyperkalemia while on ace-i or arb therapy, acute kidney injury due t","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0609U","name":"Onc prostate ia tot&free psa","description":"Onc prostate ia tot&free psa","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1326","name":"Inj, zolbetuximab-clzb, 2 mg","description":"Injection, zolbetuximab-clzb, 2 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37260","name":"Revsc evasc ivt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0776T","name":"Ther indctj ntrabrn hypthrm","description":"Therapeutic induction of intra-brain hypothermia, including placement of a mechanical temperature-controlled cooling device to the neck over carotids and head, including monitoring (eg, vital signs and sport concussion assessment tool 5 [scat5]), 30 minutes of treatment","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0399U","name":"Neuro cere folate defncy srm","description":"Neuro cere folate defncy srm","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25101","name":"Explore/treat wrist joint","description":"Arthrotomy, wrist joint; with joint exploration, with or without biopsy, with or without removal of loose or foreign body","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98015","name":"Synch audio-only est high 40","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selec","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66683","name":"Implantation iris prosthesis","description":"Implantation of iris prosthesis, including suture fixation and repair or removal of iris, when performed","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43313","name":"Esophagoplasty congenital","description":"Esophagoplasty for congenital defect (plastic repair or reconstruction), thoracic approach; without repair of congenital tracheoesophageal fistula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3083.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0491","name":"Oral dv nm mouthpc hw remote","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52281","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with calibration and/or dilation of urethral stricture or stenosis, with or without meatotomy, with or without injection procedure for cystography, male or female","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1337","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2291","name":"Inj, nafcillin (baxter) 20mg","description":"Injection, nafcillin sodium (baxter), 20 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0939T","name":"Xtrnl ecg rec>15d<30d scan","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; scanning analysis with report","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64913","name":"Nrv rpr w/nrv algrft ea addl","description":"Nerve repair; with nerve allograft, each additional strand (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"Adju cgm supply allowance","description":"Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7956","name":"Tiss regen edent resorb","description":"Tiss regen edent resorb","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1239","name":"Pt no resp heard","description":"Patient did not respond to the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2022","name":"Innovabrn/innovamatx xl sqcm","description":"Innovaburn or innovamatrix xl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4300","name":"Acesso tl, per sq cm","description":"Acesso tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0148","name":"Scr c/v cyto, autosys, rescr","description":"Screening cytopathology smears, cervical or vaginal, performed by automated system with manual rescreening","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0665","name":"Team remote e/m est pt 10 mn","description":"Team remote e/m est. pt 10mins","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1192","name":"Pt w/ dx sq cell ca of esoph","description":"Patients with an existing diagnosis of squamous cell carcinoma of the esophagus","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J9062","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0790T","name":"Revj rplcmt/rmvl vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracolumbar or lumbar vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35761","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":457.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1411","name":"1st ln ici no chemo","description":"Currently on first-line immune checkpoint inhibitors without chemotherapy","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62120","name":"Repair skull cavity lesion","description":"Repair of encephalocele, skull vault, including cranioplasty","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2023.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97550","name":"Caregiver traing 1st 30 min","description":"Caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patie","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0473U","name":"Onc sld tum bld/slv 648 gene","description":"Onc sld tum bld/slv 648 gene","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5612","name":"Rep resin part dent base max","description":"Rep resin part dent base max","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0776T","name":"Ther indctj ntrabrn hypthrm","description":"Therapeutic induction of intra-brain hypothermia, including placement of a mechanical temperature-controlled cooling device to the neck over carotids and head, including monitoring (eg, vital signs and sport concussion assessment tool 5 [scat5]), 30 minutes of treatment","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4383","name":"Axolotl graft ult per sq cm","description":"Axolotl graft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J9092","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0926T","name":"Prgrmg dev eval ccm-d ip","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, including review and report, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0419U","name":"Nrpsyc gen seq vrnt aly 13","description":"Nrpsyc gen seq vrnt aly 13","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0012","name":"Injection of hiv prep drug","description":"Injection of pre-exposure prophylaxis (prep) drug for hiv prevention, under skin or into muscle","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0146","name":"Nav srv peer sup add 30 pr m","description":"Principal illness navigation - peer support, additional 30 minutes per calendar month (list separately in addition to g0140)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5765","name":"Liner compl/partial rem dent","description":"Liner compl/partial rem dent","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0031","name":"Pall serv during meas","description":"Palliative care services given to patient any time during the measurement period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0410U","name":"Onc pncrtc dna whl gn seq 5-","description":"Onc pncrtc dna whl gn seq 5-","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1004T","name":"Elec alys s-scl eeg wo prgrm","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; without programming","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37293","name":"Rvsc evsc tpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1255","name":"Pts w/ othr rsn vst,+prg tst","description":"Patients who have another reason for visiting the clinic [not prenatal or postpartum care] and have a positive pregnancy test but have not established the clinic as an ob provider (e.g., plan to terminate the pregnancy or seek prenatal services elsewhere)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0798T","name":"Tcat rmv 2chmbr ldls pm cmpl","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; complete system (ie, right atrial and right ventricular pacemaker components)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2470","name":"Inj pantoprazole sodium 40mg","description":"Injection, pantoprazole sodium, 40 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0467U","name":"Onc bldr dna ngs 60gen&aneup","description":"Onc bldr dna ngs 60gen&aneup","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5153","name":"Inj, aflibercept-yszy, 1 mg","description":"Injection, aflibercept-yszy (opuviz), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5939","name":"Resct proth mand comp remov","description":"Resct proth mand comp remov","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0839T","name":"Dgtz gls mcrscp cslt mat prp","description":"Digitization of glass microscope slides for consultation and report on referred material requiring preparation of slides (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1403","name":"Bslne and fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1439","name":"Sig ocu cond imp surg out","description":"Significant ocular conditions that impact the visual outcome of surgery","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9994","name":"Pall serv during meas","description":"Patient is using palliative care services any time during the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1164","name":"Pt w/ dementia any time","description":"Patients with dementia any time during the patients history through the end of the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0876T","name":"Duplex scan hemo fstl lmtd","description":"Duplex scan of hemodialysis fistula, computer-aided, limited (volume flow, diameter, and depth, including only body of fistula)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83014","name":"H pylori drug admin","description":"Helicobacter pylori; drug administration","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0888T","name":"Histotripsy mal renal tissue","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant renal tissue, including imaging guidance","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0417U","name":"Rare ds alys 335 nuc genes","description":"Rare ds alys 335 nuc genes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4278","name":"Epieffect, per sq cm","description":"Epieffect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0298U","name":"Onc pan tum whl trns seq rna","description":"Onc pan tum whl trns seq rna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76805","name":"Ob us >/= 14 wks sngl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0814T","name":"Prq njx biod osteo matrl fem","description":"Percutaneous injection of calcium-based biodegradable osteoconductive material, proximal femur, including imaging guidance, unilateral","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5154","name":"Inj, omlyclo, 5 mg","description":"Injection, omalizumab-igec (omlyclo), biosimilar, 5 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78608","name":"Brain imaging (pet)","description":"Brain imaging, positron emission tomography (pet); metabolic evaluation","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84394","name":"Total tau","description":"Tau, total (ttau)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93528","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3049.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0704T","name":"Rem tx amblyopia setup&edu","description":"Remote treatment of amblyopia using an eye tracking device; device supply with initial set-up and patient education on use of equipment","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99221","name":"1st hosp ip/obs sf/low 40","description":"Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward or low level medical decision making. when using total time on the date of the encounter for code selection, ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49189","name":"Opn exc/dst ntra-abd 20.1-30","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 20.1 to 30 cm","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1016T","name":"Elec alys npgs esoph intraop","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1711","name":"Moderna vacc admin booster","description":"Moderna vacc admin booster","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11451","name":"Exc skn hdrdnt ax complex","description":"Excision of skin and subcutaneous tissue for hidradenitis, axillary; with complex repair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6073","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (predominantly base metal)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1401","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0776T","name":"Ther indctj ntrabrn hypthrm","description":"Therapeutic induction of intra-brain hypothermia, including placement of a mechanical temperature-controlled cooling device to the neck over carotids and head, including monitoring (eg, vital signs and sport concussion assessment tool 5 [scat5]), 30 minutes of treatment","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0893","name":"Inj, decitabine (sun pharma)","description":"Injection, decitabine (sun pharma), not therapeutically equivalent to j0894, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1837","name":"Inj, posaconazole, 1 mg","description":"Injection, posaconazole, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0358U","name":"Neuro alys b-amyl 1-42&1-40","description":"Neuro alys b-amyl 1-42&1-40","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0733T","name":"Rem r-t mtn nrehab ther sply","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; supply and technical support, per 30 days","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1314","name":"Bmi not calculated","description":"Bmi not documented and no reason is given","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77437","name":"Surf radj ther supfc<=150kv","description":"Surface radiation therapy; superficial, delivery, </=150 kv, per fraction (eg, electronic brachytherapy)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G3002","name":"Chronic pain mgmt 30 mins","description":"Chronic pain management and treatment, monthly bundle including, diagnosis; assessment and monitoring; administration of a validated pain rating scale or tool; the development, implementation, revision, and/or maintenance of a person-centered care plan that includes strengths, goals, clinical needs,","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0338U","name":"Onc sld tum crcg tum cl slct","description":"Onc sld tum crcg tum cl slct","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4034","name":"Speech language path ss","description":"Speech language pathology mips specialty set","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0651","name":"Inj, levothyroxine, freskabi","description":"Injection, levothyroxine sodium (fresenius kabi), not therapeutically equivalent to j0650, 10 mcg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0750T","name":"B1 str&fx rsk asmt dxrbmd1vw","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9998","name":"Doc med rsn <3 colon","description":"Documentation of medical reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., last colonoscopy incomplete, last colonoscopy had inadequate prep, piecemeal removal of adenomas, or sessile serrated polyps >= 20 mm in size, last colonoscopy found greater than 10 adenomas, lo","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0405U","name":"Onc pncrtc 59 mthltn blk mrk","description":"Onc pncrtc 59 mthltn blk mrk","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6602","name":"G com bandge hgh dn foamroll","description":"Gradient compression bandaging supply, high density foam roll for bandage, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0559","name":"Unrelat prac follow up visit","description":"Post-operative follow-up visit complexity inherent to evaluation and management services addressing surgical procedure(s), provided by a physician or qualified health care professional who is not the practitioner who performed the procedure (or in the same group practice) and is of the same or of a ","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82728","name":"Assay of ferritin","description":"Ferritin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54550","name":"Exploration for testis","description":"Exploration for undescended testis (inguinal or scrotal area)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9329","name":"Inj, tislelizumab-jsgr","description":"Injection, tislelizumab-jsgr, 1mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4423","name":"Biolab tri wrap fl per sq cm","description":"Biolab tri-membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0978T","name":"Submucosal cryolysis therapy","description":"Submucosal cryolysis therapy; soft palate, base of tongue, and lingual tonsil","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1239","name":"Pt no resp heard","description":"Patient did not respond to the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49190","name":"Opn exc/dstr ntra-abd >30 cm","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); greater than 30 cm","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27458","name":"Osteot femur imed lngth dev","description":"Osteotomy(ies), femur, unilateral, with insertion of an externally controlled intramedullary lengthening device, including iliotibial band release when performed, imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57280","name":"Suspension of vagina","description":"Colpopexy, abdominal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1068.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0708","name":"Intraoral bite radio image","description":"Intraoral bite radio image","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01938","name":"Anes drg/aspir lmbr/sac","description":"Anesthesia for percutaneous image-guided injection, drainage or aspiration procedures on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0703","name":"Inj, cefepime hcl (b braun)","description":"Injection, cefepime hydrochloride (b braun), not therapeutically equivalent to maxipime, 500 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33882","name":"Evasc rpr ta dplmt mltpc sys","description":"Endovascular repair of the thoracic aorta by deployment of a branched endograft multipiece system involving an aorto-aortic tube device with a fenestration for the left subclavian artery stent graft(s) and all aortic tube endograft extension(s) placed from the level of the left common carotid artery","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53454","name":"Tprnl balo cntnc dev adjmt","description":"Periurethral transperineal adjustable balloon continence device; percutaneous adjustment of balloon(s) fluid volume","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1233","name":"Pt no hcv aby or result","description":"Patient does not receive hcv antibody test or patient does receive hcv antibody test but results not documented, reason not given","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0155","name":"Dronabinol (syndros) 0.1 mg","description":"Dronabinol (syndros), 0.1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0167","name":"Inj epinephrine (hospira)","description":"Injection, epinephrine (hospira), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4035","name":"Thoracic surgery ss","description":"Thoracic surgery mips specialty set","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1378","name":"Med rsn no 10 yr fu colscope","description":"Documentation of medical reason(s) for not recommending a 10 year follow-up interval (e.g., inadequate prep, familial or personal history of colonic polyps, patient had no adenoma and age is >= 66 years old, or life expectancy < 10 years, other medical reasons)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98001","name":"Synch audio-video new low 30","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0682T","name":"Removal pulse gen only isdss","description":"Removal of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4402","name":"Xwrap 2.0 per sq cm","description":"Xwrap 2.0, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99401","name":"Prev med cnsl indiv apprx 15","description":"Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 15 minutes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":21.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35512","name":"Art byp grft subclav-brchial","description":"Bypass graft, with vein; subclavian-brachial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1524.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50770","name":"Splicing of ureters","description":"Transureteroureterostomy, anastomosis of ureter to contralateral ureter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1265.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1172","name":"Doc med rsn no td/tdap","description":"Documentation of medical reason(s) for not administering td or tdap vaccine (e.g., prior anaphylaxis due to the td or tdap vaccine or history of encephalopathy within seven days after a previous dose of a td-containing vaccine)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1350","name":"Pt w/ suic saf pln init rev","description":"Patients who had a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4330","name":"Total, per sq cm","description":"Total, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38740","name":"Remove armpit lymph nodes","description":"Axillary lymphadenectomy; superficial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1473","name":"Pt func cap not allow impr","description":"Patient situations, at any point during the denominator identification period, where the patients functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools, such as delirium, dementia, intellectual disabilities, and pervasive and specific de","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76015","name":"Mr sfty mplt&/fb asmt stf ea","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0010","name":"Eom meos payment","description":"Enhancing oncology model (eom) monthly enhanced oncology services (meos) payment for eom enhanced services","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0690T","name":"Quan us tis charac w/dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained with diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0668","name":"Team remote e/m est pt 40 mn","description":"Team remote e/m est. pt 40mins","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0438U","name":"Rx metab advrs vrnt alys 33","description":"Rx metab advrs vrnt alys 33","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88377","name":"M/phmtrc alys ishquant/semiq","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each multiplex probe stain procedure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4281","name":"Barrera slor dl per sq cm","description":"Barrera sl or barrera dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0368","name":"Cone beam ct interprete tmj","description":"Cone beam ct interprete tmj","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0761T","name":"Dgtz gls mcrscp sl imm ea 1","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0878T","name":"Augmnt alys ch ct ild w/ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained with concurrent ct examination of the same structure","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93893","name":"Tcd std icr art ven-art shnt","description":"Transcranial doppler study of the intracranial arteries; venous-arterial shunt detection with intravenous microbubble injection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30580","name":"Repair upper jaw fistula","description":"Repair fistula; oromaxillary (combine with 31030 if antrotomy is included)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93594","name":"R hrt cath chd abnl nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; abnormal native connections","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64585","name":"Rev/rmv perph nstim eltrd ra","description":"Revision or removal of peripheral neurostimulator electrode array","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63087","name":"Remov vertbr dcmprn thrclmbr","description":"Vertebral corpectomy (vertebral body resection), partial or complete, combined thoracolumbar approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic or lumbar; single segment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2742.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20610","name":"Drain/inj joint/bursa w/o us","description":"Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, subacromial bursa); without ultrasound guidance","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":42.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30901","name":"Control of nosebleed","description":"Control nasal hemorrhage, anterior, simple (limited cautery and/or packing) any method","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":29.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":196.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G3003","name":"Chronic pain mgmt addl 15m","description":"Each additional 15 minutes of chronic pain management and treatment by a physician or other qualified health care professional, per calendar month. (list separately in addition to code for g3002. when using g3003, 15 minutes must be met or exceeded.)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1418","name":"Med rsn not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination because of a medical contraindication documented by clinician","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4401","name":"Absolv3 per sq cm","description":"Absolv3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0564U","name":"Nfct ds pthgn-sna 10vir&4bct","description":"Nfct ds pthgn-sna 10vir&4bct","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99239","name":"Hosp ip/obs dschrg mgmt >30","description":"Hospital inpatient or observation discharge day management; more than 30 minutes on the date of the encounter","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4252","name":"Vendaje, per square centimet","description":"Vendaje, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1709","name":"Pfizer vaccine admin booster","description":"Pfizer vaccine admin booster","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94626","name":"Phy/qhp op pulm rhb w/mntr","description":"Physician or other qualified health care professional services for outpatient pulmonary rehabilitation; with continuous oximetry monitoring (per session)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5995","name":"Peri medicament w/seal, max","description":"Peri medicament w/seal, max","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2782","name":"Crown 3/4 cast noble metal","description":"Crown - 3/4 cast noble metal","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65265","name":"Remove foreign body from eye","description":"Removal of foreign body, intraocular; from posterior segment, nonmagnetic extraction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1057.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0264U","name":"Rare ds id opt genome mapg","description":"Rare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1500","name":"Neuropsychology mvp","description":"Neuropsychology mips value pathway","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0578U","name":"Onc cutan mln rna qpcr 10gen","description":"Onc cutan mln rna qpcr 10gen","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0529","name":"In home respite care, 4 hr u","description":"In-home respite care, 4-hour unit, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53452","name":"Tprnl balo cntnc dev uni","description":"Periurethral transperineal adjustable balloon continence device; unilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99416","name":"Prolng clin staff svc ea add","description":"Prolonged clinical staff service (the service beyond the highest time in the range of total time of the service) during an evaluation and management service in the office or outpatient setting, direct patient contact with physician supervision; each additional 30 minutes (list separately in addition","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82693","name":"Assay of ethylene glycol","description":"Ethylene glycol","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0752","name":"Hiv prep, oral lenacapavir","description":"Oral, lenacapavir, 300 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4231","name":"Ana crown exp 1-3 per quad","description":"Anatomical crown exposure - one to three teeth per quadrant","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0560","name":"Safety plan interven","description":"Safety planning interventions, each 20 minutes personally performed by the billing practitioner, including assisting the patient in the identification of the following personalized elements of a safety plan: recognizing warning signs of an impending suicidal or substance use-related crisis; employin","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4006","name":"Gastroenterology ss","description":"Gastro-enterology mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2313","name":"Inj, naloxone (zimhi) 0.01mg","description":"Injection, naloxone hydrochloride (zimhi), 0.01 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46945","name":"Int hrhc lig 1 hroid w/o img","description":"Hemorrhoidectomy, internal, by ligation other than rubber band; single hemorrhoid column/group, without imaging guidance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97007","name":"Mchnl sclp cool meas fitg","description":"Mechanical scalp cooling, including individual cap supply with head measurement, fitting, and patient education","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0667","name":"Team remote e/m est pt 25 mn","description":"Team remote e/m est. pt 25mins","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0787T","name":"Revj/rmvl nea sac w/nstim","description":"Revision or removal of neurostimulator electrode array, sacral, with integrated neurostimulator","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0989T","name":"Revj/rmvl ins ptn subq&subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2054","name":"Lisocabtagene mara car pos t","description":"Lisocabtagene maraleucel, up to 110 million autologous anti-cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4251","name":"Vim, per square centimeter","description":"Vim, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4265","name":"Neostim tl per sq cm","description":"Neostim tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54235","name":"Njx corpora cavernosa rx agt","description":"Injection of corpora cavernosa with pharmacologic agent(s) (eg, papaverine, phentolamine)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1308","name":"Inj, famotidine, 0.25 mg","description":"Injection, famotidine, 0.25 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55713","name":"Bx prst8 in-bore ct/mri bx 1","description":"Biopsy, prostate, in-bore ct- or mri-guided (ie, sextant), with biopsy of additional targeted lesion(s), first targeted lesion","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0762T","name":"Dgtz gls mcrscp sl imm ea m","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, each multiplex antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0024","name":"Pin srv add 30 min pr m","description":"Principal illness navigation services, additional 30 minutes per calendar month (list separately in addition to g0023)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0249","name":"Provide inr test mater/equip","description":"Provision of test materials and equipment for home inr monitoring of patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria; includes: provision of materials for use in the home and reporting of test results to physi","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27495","name":"Reinforce thigh","description":"Prophylactic treatment (nailing, pinning, plating, or wiring) with or without methylmethacrylate, femur","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1351.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0404U","name":"Onc brst semiq meas thym kn","description":"Onc brst semiq meas thym kn","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61564","name":"Excision of skull tumor","description":"Excision, intra and extracranial, benign tumor of cranial bone (eg, fibrous dysplasia); with optic nerve decompression","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2820.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87088","name":"Urine bacteria culture","description":"Culture, bacterial; with isolation and presumptive identification of each isolate, urine","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62368","name":"Analyze sp inf pump w/reprog","description":"Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); with reprogramming","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4290","name":"Membrane wrap hydr per sq cm","description":"Membrane wrap-hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0962T","name":"Asstv alg alys acous&ecg rec","description":"Assistive algorithmic analysis of acoustic and electrocardiogram recording for detection of cardiac dysfunction (eg, reduced ejection fraction, cardiac murmurs, atrial fibrillation), with review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37286","name":"Revsc evasc tpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0905T","name":"Ecg alg 12 ld rdcd i&r only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; interpretation and report only","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0351U","name":"Nfct ds bct/viral trail ip10","description":"Nfct ds bct/viral trail ip10","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9432","name":"Med food non inborn err meta","description":"Medical foods for non-inborn errors of metabolism","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99470","name":"Rpm tx mgmt 1st 10 min","description":"Remote physiologic monitoring treatment management services, clinical staff/physician/other qualified health care professional time in a calendar month requiring 1 real-time interactive communication with the patient/caregiver during the calendar month; first 10 minutes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"Motor &/ sens nrve cndj test","description":"Motor and/or sensory nerve conduction, using preconfigured electrode array(s), amplitude and latency/velocity study, each limb, includes f-wave study when performed, with interpretation and report","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0463","name":"Inj atropine (fresenius te)","description":"Injection, atropine sulfate (fresenius and therapeutically equivalent), 0.01 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83876","name":"Assay myeloperoxidase","description":"Myeloperoxidase (mpo)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37285","name":"Revsc evasc tpvt st sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1257","name":"Cvd risk assess not perf","description":"Cvd risk assessment not performed or incomplete (e.g., cvd risk assessment was not documented), reason not otherwise specified","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6107","name":"Tissue regen non-resorbable","description":"Tissue regen non-resorbable","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4211","name":"Gingivectomy/plasty per toot","description":"Gingivectomy or gingivoplasty - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0964T","name":"I&cust prep jaw xpnsj 1arch","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; single arch, without mandibular advancement mechanism","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1159","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1241","name":"Pt no resp seen as person","description":"Patient did not respond to the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0281U","name":"Hem vwd propeptide ag lvl","description":"Hematology (von willebrand disease [vwd]), von willebrand propeptide, enzyme-linked immunosorbent assays (elisa), plasma, diagnostic report of von willebrand factor (vwf) propeptide antigen level","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9955","name":"Oral app thxpy titration vis","description":"Oral app thxpy titration vis","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1357","name":"Pt w/red suic idea 120 days","description":"Patients who had a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4034","name":"Speech language path ss","description":"Speech language pathology mips specialty set","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91323","name":"Sarscov2 vac 10 mcg/0.2ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 10 mcg/0.2 ml dosage, for intramuscular use","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55711","name":"Bx prst8 trct mri-us 1st","description":"Biopsy, prostate, transrectal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4291","name":"Lamellas xt, per sq cm","description":"Lamellas xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9610","name":"Xe129 xenon, diagnostic","description":"Xenon xe-129 hyperpolarized gas, diagnostic, per study dose","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1208","name":"Pt no scrn sdoh","description":"Patient is not screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0837T","name":"Dgtz gls mcrscp fna i&r","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; interpretation and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93319","name":"3d echo img cgen car anomal","description":"3d echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac structure(s) (eg, cardiac chambers and valves, left atrial appendage, interatrial septum, interventricular","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1834","name":"Inj, isoniazid, 1 mg","description":"Injection, isoniazid, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1447","name":"Pt dx bd bef end meas pd","description":"Patients with an active diagnosis of bipolar disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64466","name":"Thrc fascial pln blk uni njx","description":"Thoracic fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98980","name":"Rtm tx mgmt 1st 20 min","description":"Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least 1 real-time interactive communication with the patient or caregiver during the calendar month; first 20 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37274","name":"Rvsc evsc fpvt athrc cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1470","name":"Hep b vac not recd med rsn","description":"Documentation of medical reason(s) for not administering hepatitis b vaccine (e.g., prior anaphylaxis due to the hepatitis b vaccine)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90791","name":"Psych diagnostic evaluation","description":"Psychiatric diagnostic evaluation","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":136.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0471U","name":"Onc clrc ca 35 vrn kras&nras","description":"Onc clrc ca 35 vrn kras&nras","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66989","name":"Xcpsl ctrc rmvl cplx insj 1+","description":"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification), complex, requiring devices or techniques not generally used in routine cataract surgery (eg, iris expansion device,","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0183","name":"Software meas of cardiac vol","description":"Quantitative software measurements of cardiac volume, cardiac chambers volumes and left ventricular wall mass derived from ct scan(s) data of the chest/heart (with or without contrast)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1441","name":"Init dx slp apn = 1st enc","description":"Encounter corresponds to initial diagnosis of sleep apnea or first contact with sleep apnea diagnosed patient","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95117","name":"Immunotherapy injections","description":"Professional services for allergen immunotherapy not including provision of allergenic extracts; 2 or more injections","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1312","name":"No pt tbco scrn rng","description":"Patient not screened for tobacco use","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87564","name":"Mtb rifampin rst amp prb tq","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacterium tuberculosis, rifampin resistance, amplified probe technique","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0516U","name":"Rx metab rxgenomic gnotyp 40","description":"Rx metab rxgenomic gnotyp 40","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0426","name":"Coll, analys of saliva","description":"Coll, analys of saliva","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1427","name":"Doc med rsn bone scn","description":"Documentation of medical reason(s) for performing a bone scan (including documented pain related to prostate cancer, salvage therapy, other medical reasons)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0784T","name":"Ins/rplmt eltrd ra spi nstim","description":"Insertion or replacement of percutaneous electrode array, spinal, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33904","name":"Perq p-art revsc each addl","description":"Percutaneous pulmonary artery revascularization by stent placement, each additional vessel or separate lesion, normal or abnormal connections (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1205","name":"Isa reduced >=3","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0622U","name":"Psyc mdd dna alys >20000","description":"Psyc mdd dna alys >20000","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11970","name":"Rplcmt tiss xpndr perm implt","description":"Replacement of tissue expander with permanent implant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":646.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3393","name":"Inj, betibeglogene autotemce","description":"Injection, betibeglogene autotemcel, per treatment","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34820","name":"Opn iliac art expos","description":"Open iliac artery exposure for delivery of endovascular prosthesis or iliac occlusion during endovascular therapy, by abdominal or retroperitoneal incision, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":641.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86309","name":"Heterophile antibody titer","description":"Heterophile antibodies; titer","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26105","name":"Biopsy finger joint lining","description":"Arthrotomy with biopsy; metacarpophalangeal joint, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":390.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1342","name":"Pts died perf per","description":"Patients who died during the performance period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66683","name":"Implantation iris prosthesis","description":"Implantation of iris prosthesis, including suture fixation and repair or removal of iris, when performed","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4392","name":"Grafix duo per sq cm","description":"Grafix duo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0259U","name":"Neph ckd nuc mrs meas gfr","description":"Nephrology (chronic kidney disease), nuclear magnetic resonance spectroscopy measurement of myo-inositol, valine, and creatinine, algorithmically combined with cystatin c (by immunoassay) and demographic data to determine estimated glomerular filtration rate (gfr), serum, quantitative","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1347","name":"Pt pam incr 3 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 3 points in a 4 to 12 month period (passing)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61886","name":"Implant neurostim arrays","description":"Insertion or replacement of cranial neurostimulator pulse generator or receiver, direct or inductive coupling; with connection to 2 or more electrode arrays","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":755.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77438","name":"Surf rad thr orthvlt>150-500","description":"Surface radiation therapy; orthovoltage, delivery, >150-500 kv, per fraction","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55710","name":"Bx prst8 tprn us w/mri fus 1","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant) with mri-fusion-guidance biopsy, first targeted lesion","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1830","name":"Interferon beta-1b / .25 mg","description":"Injection, interferon beta-1b, 0.25 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98015","name":"Synch audio-only est high 40","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selec","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4376","name":"Duograft aa per sq cm","description":"Duograft aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63052","name":"Lam facetc/frmt arthrd lum 1","description":"Laminectomy, facetectomy, or foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s] [eg, spinal or lateral recess stenosis]), during posterior interbody arthrodesis, lumbar; single vertebral segment (list separately in addition to code for primary ","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0538U","name":"Onc sol tum ngts ffpe 600gen","description":"Onc sol tum ngts ffpe 600gen","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29435","name":"Appl patllr tdn bearing cast","description":"Application of patellar tendon bearing (ptb) cast","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7261","name":"Primary closure sinus perf","description":"Primary closure of a sinus perforation","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2406","name":"Injection, oritavancin 10 mg","description":"Injection, oritavancin (kimyrsa), 10 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2779","name":"Inj, susvimo 0.1 mg","description":"Injection, ranibizumab, via intravitreal implant (susvimo), 0.1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2028","name":"Micromatrix flex per mg","description":"Micromatrix flex, per mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4339","name":"Artacent vericlen, per sq cm","description":"Artacent vericlen, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2281","name":"Inj moxifloxacin (fres kabi)","description":"Injection, moxifloxacin (fresenius kabi), not therapeutically equivalent to j2280, 100 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4377","name":"Trigraft ft per sq cm","description":"Trigraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9294","name":"Biofeed dig cog behav tx fda","description":"Prescription digital cognitive and/or behavioral therapy, biofeedback, fda cleared, per course of treatment","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0660","name":"Team remote e/m new pt 10 mn","description":"Team remote e/m new pt 10mins","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1417","name":"Pt up to date cov","description":"Patients who are up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0961T","name":"Shortwave ifr radiation img","description":"Shortwave infrared radiation imaging, surgical pathology specimen, to assist gross examination for lymph node localization in fibroadipose tissue, per specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1358","name":"Pts no <suicd idea 120 dys","description":"Patients who did not have a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1414","name":"Inj, beqvez, per tx dose","description":"Injection, fidanacogene elaparvovec-dzkt, per therapeutic dose","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0706T","name":"Rem tx amblyopia i&r phy/qhp","description":"Remote treatment of amblyopia using an eye tracking device; interpretation and report by physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33278","name":"Rmvl phrnc nrv stim sys","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; system, including pulse generator and lead(s)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6560","name":"G stckng full/chap30-40 cust","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, custom, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0743T","name":"B1 str & fx rsk vrt fx assmt","description":"Bone strength and fracture risk using finite element analysis of functional data and bone mineral density (bmd), with concurrent vertebral fracture assessment, utilizing data from a computed tomography scan, retrieval and transmission of the scan data, measurement of bone strength and bmd and classi","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88319","name":"Enzyme histochemistry","description":"Special stain including interpretation and report; group iii, for enzyme constituents","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50722","name":"Release of ureter","description":"Ureterolysis for ovarian vein syndrome","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1157.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0364U","name":"Onc hl neo gen seq alys alg","description":"Onc hl neo gen seq alys alg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6517","name":"Grad com wrap w strap bn cus","description":"Gradient compression wrap with adjustable straps, below knee, each, custom","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6180","name":"Implnt maint proced","description":"Implnt maint proced","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0908T","name":"Opn imp int nstm sys vgs nrv","description":"Open implantation of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9183","name":"Gemcitabine intravesical sys","description":"Gemcitabine intravesical system, 225 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0411U","name":"Psyc genom alys pnl 15 gen","description":"Psyc genom alys pnl 15 gen","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0569U","name":"Onc sol tum ngs tmm>20000dmr","description":"Onc sol tum ngs tmm>20000dmr","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27454","name":"Realignment of thigh bone","description":"Osteotomy, multiple, with realignment on intramedullary rod, femoral shaft (eg, sofield type procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1510.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1298","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1176","name":"No 2 hzv 10/2017-meas pd","description":"Patient did not receive two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6598","name":"G comp bandage med stretch","description":"Gradient compression bandage roll, elastic medium stretch, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1262","name":"Pts transplt bef dialysis","description":"Patients who had a transplant prior to initiation of dialysis","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4285","name":"Nudyn dl or dl mesh pr sq cm","description":"Nudyn dl or nudyn dl mesh, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71047","name":"X-ray exam chest 3 views","description":"Radiologic examination, chest; 3 views","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"U0002","name":"Covid-19 lab test non-cdc","description":"2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9992","name":"Pall serv during meas","description":"Palliative care services used by patient any time during the measurement period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85032","name":"Manual cell count each","description":"Blood count; manual cell count (erythrocyte, leukocyte, or platelet) each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0610U","name":"Nfct ds antmcr sc phenotypic","description":"Nfct ds antmcr sc phenotypic","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58300","name":"Insert intrauterine device","description":"Insertion of intrauterine device (iud)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":48.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0421U","name":"Onc clrct scr sgl amp 8 rna","description":"Onc clrct scr sgl amp 8 rna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98984","name":"Rtm dev sply resp sys 2-15 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of respiratory system, 2-15 days in a 30-day period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1355","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1370","name":"Rehab support msk care mvp","description":"Rehabilitative support for musculoskeletal care mips value pathway","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33280","name":"Rmvl phrnc nrv stim pg only","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator only","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91110","name":"Gi trc img intral esoph-ile","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1221.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0699T","name":"Njx pst chmbr eye medication","description":"Injection, posterior chamber of eye, medication","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1292","name":"Pt 66+ frail inpt adv ill","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and an advanced illness diagnosis during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0484","name":"Consult slides prep elsewher","description":"Consultation on slides prepared elsewhere","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6106","name":"Tissue regen resorbable","description":"Tissue regen resorbable","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97802","name":"Medical nutrition indiv in","description":"Medical nutrition therapy; initial assessment and intervention, individual, face-to-face with the patient, each 15 minutes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":29.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1323","name":"Pts 7wk inj, scrn iop >25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop >25 mm hg and a plan of care was documented","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82653","name":"El-1 fecal quantitative","description":"Elastase, pancreatic (el-1), fecal; quantitative","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4256","name":"Mlg complet, per sq cm","description":"Mlg-complete, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0838T","name":"Dgtz gls mcrscp cslt sld els","description":"Digitization of glass microscope slides for consultation and report on referred slides prepared elsewhere (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94617","name":"Exercise tst brncspsm w/ecg","description":"Exercise test for bronchospasm, including pre- and post-spirometry and pulse oximetry; with electrocardiographic recording(s)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0701","name":"Inj. cefepime hcl (baxter)","description":"Injection, cefepime hydrochloride (baxter), not therapeutically equivalent to maxipime, 500 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90385","name":"Rh ig minidose im","description":"Rho(d) immune globulin (rhig), human, mini-dose, for intramuscular use","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q4055","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49594","name":"Rpr aa hrn 1st 3-10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21030","name":"Excise max/zygoma b9 tumor","description":"Excision of benign tumor or cyst of maxilla or zygoma by enucleation and curettage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":456.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1597","name":"Inj glycopyrrolate, glyrx-pf","description":"Injection, glycopyrrolate (glyrx-pf), 0.1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1483","name":"Neg quan hep c or qual rna","description":"Patients who achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0682T","name":"Removal pulse gen only isdss","description":"Removal of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1098","name":"Articaine ophthalmi 8% 0.4ml","description":"Articaine ophthalmic, 8% solution, 0.4 ml","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4284","name":"Dermabind sl, per sq cm","description":"Dermabind sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4333","name":"Ardeograft, per sq cm","description":"Ardeograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1005T","name":"Elec alys s-scl eeg prgr 1st","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, first 15 minutes face-to-face time with physician or other qualified hea","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7515","name":"Cyclosporine oral 25 mg","description":"Cyclosporine, oral, 25 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0695T","name":"Bdy srf mpg pm/cvdfb tm impl","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of implant or replacement","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0872T","name":"Rplcmt ndwllg bldr&prtl cath","description":"Replacement of indwelling bladder and peritoneal catheters, including tunneling of catheter(s) and connection with previously implanted peritoneal ascites pump, including imaging and programming, when performed","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76801","name":"Ob us < 14 wks single fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78492","name":"Myocrd img pet mlt rst&strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); multiple studies at rest and stress (exercise or pharmacologic)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2792","name":"Crown full cast noble metal","description":"Crown-full cast noble metal","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91125","name":"Anrct mano rct snsatn&balo","description":"Anorectal manometry, with rectal sensation and rectal balloon expulsion test, when performed","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95870","name":"Ndl emg lmtd std musc 1 xtr","description":"Needle electromyography; limited study of muscles in 1 extremity or non-limb (axial) muscles (unilateral or bilateral), other than thoracic paraspinal, cranial nerve supplied muscles, or sphincters","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16020","name":"Dress/debrid p-thick burn s","description":"Dressings and/or debridement of partial-thickness burns, initial or subsequent; small (less than 5% total body surface area)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":51.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1952","name":"Leuprolide inj, camcevi, 1mg","description":"Leuprolide injectable, camcevi, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44850","name":"Repair of mesentery","description":"Suture of mesentery (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":763.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1185","name":"Imm ckpt inhib not hld no rx","description":"Documentation of immune checkpoint inhibitor therapy not held and/or corticosteroids or immunosuppressants prescribed or administered was not performed, reason not given","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1710","name":"Moderna vacc admin 3rd dose","description":"Moderna vacc admin 3rd dose","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2777","name":"Inj, faricimab-svoa, 0.1mg","description":"Injection, faricimab-svoa, 0.1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37276","name":"Rvsc evsc fpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81458","name":"So gsap dna cpy nmbr&mcrstl","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis, copy number variants and microsatellite instability","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"Rec cath any transanal, each","description":"Rectal catheter with or without balloon, for use with any type transanal irrigation system, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":14.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49061","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3432","name":"Guided tissue regeneration","description":"Guided tissue regeneration","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3393","name":"Inj, betibeglogene autotemce","description":"Injection, betibeglogene autotemcel, per treatment","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37289","name":"Revsc evsc tpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0706T","name":"Rem tx amblyopia i&r phy/qhp","description":"Remote treatment of amblyopia using an eye tracking device; interpretation and report by physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0959T","name":"Rmv/rplc magnet coil assem","description":"Removal or replacement of magnet from coil assembly that is connected to continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49592","name":"Rpr aa hrn 1st < 3 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49616","name":"Rpr aa hrn rcr 3-10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37293","name":"Rvsc evsc tpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9956","name":"Admin home sleep apnea test","description":"Admin home sleep apnea test","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1197","name":"Isa reduced >=3 fr ixv","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1467","name":"Pt dx lynch syn","description":"Patients with an existing diagnosis of lynch syndrome","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0502U","name":"Hpv e6/e7 mrk hi-rsk typ crv","description":"Hpv e6/e7 mrk hi-rsk typ crv","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15945","name":"Exc isch pr ulc skn flp ostc","description":"Excision, ischial pressure ulcer, with skin flap closure; with ostectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1092.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9913","name":"Admin of neuromod","description":"Admin of neuromod","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62272","name":"Ther spi pnxr drg csf","description":"Spinal puncture, therapeutic, for drainage of cerebrospinal fluid (by needle or catheter);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3402","name":"Inj. remestemcel-l-rknd/ td","description":"Injection, remestemcel-l-rknd, per therapeutic dose","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0366U","name":"Onc bldr 10 prb recr bldr ca","description":"Onc bldr 10 prb recr bldr ca","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80505","name":"Path clin consltj high 41-60","description":"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patients history and medical records and high level of medical decision making when using time for code selection, 41-60 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38308","name":"Incision of lymph channels","description":"Lymphangiotomy or other operations on lymphatic channels","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":495.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33509","name":"Ndsc hrv uxtr art 1 sgm cab","description":"Harvest of upper extremity artery, 1 segment, for coronary artery bypass procedure, endoscopic","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9292","name":"Pres dig visual therapy fda","description":"Prescription digital visual therapy, software-only, fda cleared, per course of treatment","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21296","name":"Revision of jaw muscle/bone","description":"Reduction of masseter muscle and bone (eg, for treatment of benign masseteric hypertrophy); intraoral approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":428.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1412","name":"Met nsclc w/ egfr alk oth ab","description":"Patients with metastatic nsclc with epidermal growth factor receptor (egfr) mutations, alk genomic tumor aberrations, or other targetable genomic abnormalities with approved first-line targeted therapy, such as nsclc with ros1 rearrangement, braf v600e mutation, ntrk 1/2/3 gene fusion, met ex14 skip","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0434U","name":"Rx metab advrs vrnt alys 25","description":"Rx metab advrs vrnt alys 25","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93896","name":"Vsrctv std tcd icr art compl","description":"Vasoreactivity study performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76376","name":"3d render w/intrp postproces","description":"3d rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality with image postprocessing under concurrent supervision; not requiring image postprocessing on an independent workstation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1451","name":"Pt dx ppd dur id/pf pd","description":"Patients with an active diagnosis of pervasive developmental disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1223","name":"Glaucoma plan of care doc","description":"Glaucoma plan of care documented","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93898","name":"Ven-artl shunt det mbubb njx","description":"Venous-arterial shunt detection with intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0666","name":"Inj, bupivacaine liposome","description":"Injection, bupivacaine liposome, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0296U","name":"Onc orl&/orop ca 20 mlc feat","description":"Onc orl&/orop ca 20 mlc feat","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99395","name":"Prev visit est age 18-39","description":"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 18-39","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":117.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4295","name":"Amnio tri-core, per sq cm","description":"Amnio tri-core amniotic, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3431","name":"Biological materials","description":"Biological materials","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74410","name":"Urography nfs drip&/bolus","description":"Urography, infusion, drip technique and/or bolus technique;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9347","name":"Inj, tremelimumab-actl, 1 mg","description":"Injection, tremelimumab-actl, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2001","name":"Suct pum ext mgmt sys","description":"Suction pump, home model, portable or stationary, electric, any type, for use with external urine and/or fecal management system","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2040","name":"Microlyte painguard pr sq cm","description":"Microlyte painguard, per square centimeter","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34709","name":"Plmt xtn prosth evasc rpr","description":"Placement of extension prosthesis(es) distal to the common iliac artery(ies) or proximal to the renal artery(ies) for endovascular repair of infrarenal abdominal aortic or iliac aneurysm, false aneurysm, dissection, penetrating ulcer, including pre-procedure sizing and device selection, all nonselec","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1371","name":"Mst rec gsa<7","description":"Most recent glycemic status assessment (hba1c or gmi) level < 7.0%","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90967","name":"Esrd svc pr day pt <2","description":"End-stage renal disease (esrd) related services for dialysis less than a full month of service, per day; for patients younger than 2 years of age","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":10.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2017","name":"Permeaderm glove, each","description":"Permeaderm glove, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2278","name":"Ziconotide injection","description":"Injection, ziconotide, 1 microgram","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9914","name":"Admin of dermal fill","description":"Admin of dermal fill","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0585U","name":"Tgsap so neo cfdna 521 genes","description":"Tgsap so neo cfdna 521 genes","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81000","name":"Urinalysis nonauto w/scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; non-automated, with microscopy","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1227","name":"Eb therapy prescribed","description":"Evidence-based therapy was prescribed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87210","name":"Smear wet mount saline/ink","description":"Smear, primary source with interpretation; wet mount for infectious agents (eg, saline, india ink, koh preps)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1276","name":"Calc bmi out nrm param nof/u","description":"Bmi documented outside normal parameters, no follow-up plan documented, no reason given","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0548","name":"Phone/inter svs 21-30 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5940","name":"Resct proth max part remov","description":"Resct proth max part remov","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0752T","name":"Dgtz gls mcrscp sld lvl iii","description":"Digitization of glass microscope slides for level iii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32602","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43291","name":"Egd flx trnsorl rmvl balo","description":"Esophagogastroduodenoscopy, flexible, transoral; with removal of intragastric bariatric balloon(s)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76014","name":"Mr sfty implt&/fb asmt stf 1","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1166","name":"Path rpt tis spec wle/reexc","description":"Pathology report for tissue specimens produced from wide local excisions or re-excisions","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69000","name":"Drg xtrnl ear absc/hem smpl","description":"Drainage external ear, abscess or hematoma; simple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76856","name":"Us exam pelvic complete","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40700","name":"Repair cleft lip/nasal","description":"Plastic repair of cleft lip/nasal deformity; primary, partial or complete, unilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1012.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6074","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (noble metal)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1273","name":"Pts snf 1 yr dialysis","description":"Patients who were admitted to a skilled nursing facility (snf) within one year of dialysis initiation according to the cms-2728 form","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0465U","name":"Onc urthl carc dna qmsp 2gen","description":"Onc urthl carc dna qmsp 2gen","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97008","name":"Mchnl sclp cool prep plmt","description":"Mechanical scalp cooling; including hair preparation, individual cap placement, therapy initiation, and precooling period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1372","name":"Mst rec gsa >=7 and<8","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 7.0% and < 8.0%","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0930T","name":"Ephys eval ccm-d ld 1st impl","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), at time of initial implantation or replacement with testing of cardiac contrac","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5811","name":"Denture interm cmplt mandbl","description":"Interim complete denture (mandibular)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1395","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9361","name":"Inj, efbemalenograstim alfa-","description":"Injection, efbemalenograstim alfa-vuxw, 0.5 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0675T","name":"Laps insj nw/rpcmt isdss 1ld","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first lead","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4331","name":"Axolotl graft, per sq cm","description":"Axolotl graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4225","name":"Sup/ext insulin inf pump syr","description":"Supplies for external insulin infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9959","name":"Unspec sleep ap proc","description":"Unspec sleep ap proc","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0587U","name":"Ther rx mntr 60-150rx&metabl","description":"Ther rx mntr 60-150rx&metabl","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1319","name":"Pts csp doc contact","description":"Patients who had documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1475","name":"Pt dx huntington","description":"Patients with diagnosis of huntingtons disease","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28755","name":"Fusion of big toe joint","description":"Arthrodesis, great toe; interphalangeal joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":413.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5783","name":"Add low ext mec limb vol lam","description":"Addition to lower extremity, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92972","name":"Perq trluml coronry lithotrp","description":"Percutaneous transluminal coronary lithotripsy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4296","name":"Rebound matrix, per sq cm","description":"Rebound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4330","name":"Total, per sq cm","description":"Total, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99337","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1418","name":"Med rsn not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination because of a medical contraindication documented by clinician","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4267","name":"Neostim dl per sq cm","description":"Neostim dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2794","name":"Crown-titanium","description":"Crown-titanium","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70220","name":"X-ray exam of sinuses","description":"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40510","name":"Partial excision of lip","description":"Excision of lip; transverse wedge excision with primary closure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":413.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37272","name":"Revsc evsc fpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81524","name":"Onc cns tum dna mthyl 10,000","description":"Oncology (central nervous system tumor), dna methylation analysis of at least 10,000 methylation sites, utilizing dna extracted from formalin-fixed tumor tissue, algorithm(s) reported as probability of matching a reference tumor family and class, and mgmt (o-6-methylguanine-dna methyltransferase) pr","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1574","name":"Inj, ganciclovir (exela)","description":"Injection, ganciclovir sodium (exela), not therapeutically equivalent to j1570, 500 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3389","name":"Topi adm prad zami per treat","description":"Topical administration, prademagene zamikeracel, per treatment","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0701","name":"Pano radio image","description":"Pano radio image","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1345","name":"Pt bsln pam, 2nd scr 4-12 mo","description":"Patients who had a baseline pam score and a second score within 4 to 12 month of baseline pam score","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0932T","name":"N-invs det hrt fail aug echo","description":"Noninvasive detection of heart failure derived from augmentative analysis of an echocardiogram that demonstrated preserved ejection fraction, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0366U","name":"Onc bldr 10 prb recr bldr ca","description":"Onc bldr 10 prb recr bldr ca","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0162","name":"Inj epinephrine (fresenius)","description":"Injection, epinephrine (fresenius), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0402U","name":"Nfct agt sti mult amp prb tq","description":"Nfct agt sti mult amp prb tq","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0526","name":"Est pt-cg dyad dem hig cmplx","description":"Management of established patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9610","name":"Xe129 xenon, diagnostic","description":"Xenon xe-129 hyperpolarized gas, diagnostic, per study dose","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9274","name":"Inj, tebentafusp-tebn, 1 mcg","description":"Injection, tebentafusp-tebn, 1 microgram","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58400","name":"Suspension of uterus","description":"Uterine suspension, with or without shortening of round ligaments, with or without shortening of sacrouterine ligaments; (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":493.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4028","name":"Podiatry ss","description":"Podiatry mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83735","name":"Assay of magnesium","description":"Magnesium","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86885","name":"Coombs test indirect qual","description":"Antihuman globulin test (coombs test); indirect, qualitative, each reagent red cell","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0992T","name":"N-invas assmt car rsk w/o ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat without concurrent computed tomography (ct) scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0804T","name":"Prgrmg evl ldls pm 2chmbr ip","description":"Programming device evaluation (in person) with iterative adjustment of implantable device to test the function of device and to select optimal permanent programmed values, with analysis, review, and report, by a physician or other qualified health care professional, leadless pacemaker system in dual","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0736T","name":"Colonic lavage 35+l water","description":"Colonic lavage, 35 or more liters of water, gravity-fed, with induced defecation, including insertion of rectal catheter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0460U","name":"Onc whl bld/bucc rtpcr 24gen","description":"Onc whl bld/bucc rtpcr 24gen","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2038","name":"Marigen pacto, per sq cm","description":"Marigen pacto, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0396","name":"3d print of 3d surface scan","description":"3d print of 3d surface scan","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5611","name":"Rep resin part dent base man","description":"Rep resin part dent base man","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4279","name":"Vendaje ac, per sq cm","description":"Vendaje ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79440","name":"Nuclear rx intra-articular","description":"Radiopharmaceutical therapy, by intra-articular administration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0343U","name":"Onc prst8 xom aly 442 sncrna","description":"Onc prst8 xom aly 442 sncrna","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90819","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0882T","name":"Intraop ther estim pn ue 1st","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; initial nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0866T","name":"Quan mri alys brn w/dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion detection, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transmissio","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4413","name":"Cygnus solo per sq cm","description":"Cygnus solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27340","name":"Removal of kneecap bursa","description":"Excision, prepatellar bursa","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":434.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0419U","name":"Nrpsyc gen seq vrnt aly 13","description":"Nrpsyc gen seq vrnt aly 13","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46600","name":"Diagnostic anoscopy spx","description":"Anoscopy; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":46.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1295","name":"Pt hx tot col or colon ca","description":"Patients with a diagnosis or past history of total colectomy or colorectal cancer","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0011","name":"Hiv prep counsel, md 15-30m","description":"Individual counseling for pre-exposure prophylaxis (prep) by physician or qualified health care professional (qhp) to prevent human immunodeficiency virus (hiv), includes hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence, 15-30 minutes","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1349","name":"No pam inc 3 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 3 points within a 4 to 12 month period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0349U","name":"Rx metab/pcx dna 27gen rx ia","description":"Rx metab/pcx dna 27gen rx ia","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0684T","name":"Peri-px dev eval isdss ip","description":"Peri-procedural device evaluation (in-person) and programming of device system parameters before or after a surgery, procedure, or test with analysis, review, and report by a physician or other qualified health care professional, permanent implantable synchronized diaphragmatic stimulation system fo","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9292","name":"Inj, pemetrexed dipotassium","description":"Injection, pemetrexed dipotassium, 10 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43888","name":"Gstr rstcv px opn rmvl&rplc","description":"Gastric restrictive procedure, open; removal and replacement of subcutaneous port component only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33877","name":"Thoracoabdominal graft","description":"Repair of thoracoabdominal aortic aneurysm with graft, with or without cardiopulmonary bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2881.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82120","name":"Amines vaginal fluid qual","description":"Amines, vaginal fluid, qualitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9294","name":"Biofeed dig cog behav tx fda","description":"Prescription digital cognitive and/or behavioral therapy, biofeedback, fda cleared, per course of treatment","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4315","name":"Regenelink amniotic mem allo","description":"Regenelink amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50562","name":"Renal scope w/tumor resect","description":"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with resection of tumor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4280","name":"Xcell amnio matrix per sq cm","description":"Xcell amnio matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0556","name":"Adv prim care mgmt lvl 1","description":"Advanced primary care management services for a patient with one chronic condition [expected to last at least 12 months, or until the death of the patient, which place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline], or fewer, provided by clinical ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2544","name":"Dental onlay metl 4/more sur","description":"Onlay - metallic - four or more surfaces","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0755T","name":"Dgtz gls mcrscp sld level vi","description":"Digitization of glass microscope slides for level vi, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5947","name":"Mand implt sup fix","description":"Mand implt sup fix","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0322U","name":"Neuro asd meas 14 acyl carn","description":"Neuro asd meas 14 acyl carn","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0609","name":"Ferric citrate orl 3 mg iron","description":"Ferric citrate, oral, 3 mg ferric iron, (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0553","name":"Monthly tx for dmht 20mins","description":"First 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing information related to the use of","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0944T","name":"3d cntr simula trgt lvr les","description":"3d contour simulation of target liver lesion(s) and margin(s) for image-guided percutaneous microwave ablation","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64405","name":"Njx aa&/strd gr ocpl nrv","description":"Injection(s), anesthetic agent(s) and/or steroid; greater occipital nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93584","name":"Vngrph chd anom/persist svc","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; anomalous or persistent superior vena cava when it exists as a second contralateral superior vena cava, with native drainage to heart (list separately in addition to code for pri","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0180","name":"Md certification hha patient","description":"Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initial ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5940","name":"Resct proth max part remov","description":"Resct proth max part remov","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93597","name":"R&l hrt cath chd abnl nt cnj","description":"Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); abnormal native connections","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93897","name":"Emboli detcj wo iv mbubb njx","description":"Emboli detection without intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0439U","name":"Crd chd dna alys 5 snp 3 dna","description":"Crd chd dna alys 5 snp 3 dna","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99418","name":"Prolng ip/obs e/m ea 15 min","description":"Prolonged inpatient or observation evaluation and management service(s) time with or without direct patient contact beyond the required time of the primary service when the primary service level has been selected using total time, each 15 minutes of total time (list separately in addition to the cod","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1009T","name":"Rem mntr s-sclp cont eeg sys","description":"Remote monitoring of a sub-scalp implanted continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0957T","name":"Rev s-sclp eltr ra rcvr&tlmt","description":"Revision of sub-scalp implanted electrode array, receiver, and telemetry unit for electrode, when required, including imaging guidance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69729","name":"Impl oi implt sk tc esp>=100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside of the mastoid and resulting in removal of greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9276","name":"Inj zanidatamab-hrii, 2 mg","description":"Injection, zanidatamab-hrii, 2 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7771","name":"Alveolus clsd reduc stblz te","description":"Alveolus closed reduction stabilization of teeth","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9994","name":"Pall serv during meas","description":"Patient is using palliative care services any time during the measurement period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2460","name":"Oxytetracycline injection","description":"Injection, oxytetracycline hcl, up to 50 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98011","name":"Synch audio-only new high 60","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 60 ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1414","name":"Inj, beqvez, per tx dose","description":"Injection, fidanacogene elaparvovec-dzkt, per therapeutic dose","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0472U","name":"Ca vi psp&sp1 antb sjogren","description":"Ca vi psp&sp1 antb sjogren","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87880","name":"Strep a assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; streptococcus, group a","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1437","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80170","name":"Assay of gentamicin","description":"Gentamicin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37263","name":"Revsc evasc fpvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9603","name":"Inj, pafolacianine, 0.1 mg","description":"Injection, pafolacianine, 0.1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0551","name":"Phn/intr svs fr dx treat 30m","description":"Interprofessional telephone/internet/electronic health record referral service(s) provided by a treating/requesting practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, 30 minutes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4302","name":"Complete aca, per sq cm","description":"Complete aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2524","name":"Cntct lens hydrophil photoch","description":"Contact lens, hydrophilic, spherical, photochromic additive, per lens","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0874T","name":"Rmvl pertl ascites pmp sys","description":"Removal of a peritoneal ascites pump system, including implanted peritoneal ascites pump and indwelling bladder and peritoneal catheters","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4282","name":"Cygnus dual per sq cm","description":"Cygnus dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1191","name":"Hspc svc any time in meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0531","name":"Fclty-based respite, 24 hr u","description":"Facility-based respite, 24-hour unit, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2024","name":"Resolve or xenopatch sq cm","description":"Resolve matrix or xenopatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0749T","name":"B1 str&fx rsk assmt dxr-bmd","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2976","name":"Band stabilization per tooth","description":"Band stabilization per tooth","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88374","name":"M/phmtrc alys ishquant/semiq","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each multiplex probe stain procedure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11606","name":"Exc tr-ext mal+marg >4 cm","description":"Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter over 4.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64567","name":"Perq elec nrv field stimj cn","description":"Percutaneous electrical nerve field stimulation, cranial nerves, without implantation","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90955","name":"Esrd srv 2-3 vsts p mo 2-11","description":"End-stage renal disease (esrd) related services monthly, for patients 2-11 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 2-3 face-to-face visits by a physician or other qualified health care professional per mo","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":574.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84436","name":"Assay of total thyroxine","description":"Thyroxine; total","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5145","name":"Inj, abrilada, 1 mg","description":"Injection, adalimumab-afzb (abrilada), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0840T","name":"Dgtz gls mcrscp cslt compre","description":"Digitization of glass microscope slides for consultation, comprehensive, with review of records and specimens, with report on referred material (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0772T","name":"Vr px dissoc svc sm phy ea","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0384U","name":"Neph ckd rsk hi stg kdn ds","description":"Neph ckd rsk hi stg kdn ds","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9955","name":"Oral app thxpy titration vis","description":"Oral app thxpy titration vis","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0949T","name":"Rem interrog dev ccm tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84154","name":"Assay of psa free","description":"Prostate specific antigen (psa); free","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0723T","name":"Qmrcp w/o dx mri sm anat ses","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained without diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) during the same session","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1166","name":"Path rpt tis spec wle/reexc","description":"Pathology report for tissue specimens produced from wide local excisions or re-excisions","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98005","name":"Synch audio-video est low 20","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low medical decision making. when using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded.","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4353","name":"Xceed tl matrix per sq cm","description":"Xceed tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0753T","name":"Dgtz gls mcrscp sld level iv","description":"Digitization of glass microscope slides for level iv, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0757T","name":"Dgtz gls mcrscp sl spc grpii","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group ii, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistochemistry (list separately in addition to code for primary","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76801","name":"Ob us < 14 wks single fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37279","name":"Iv lithotrp fpvt w/in sm art","description":"Intravascular lithotripsy(ies), femoral and popliteal vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55710","name":"Bx prst8 tprn us w/mri fus 1","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant) with mri-fusion-guidance biopsy, first targeted lesion","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4231","name":"Ana crown exp 1-3 per quad","description":"Anatomical crown exposure - one to three teeth per quadrant","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1020T","name":"Raman spectroscopy 1+skn les","description":"Raman spectroscopy of 1 or more skin lesions, with probability score for malignant risk derived by algorithmic analysis of data from each lesion","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22015","name":"I&d abscess p-spine l/s/ls","description":"Incision and drainage, open, of deep abscess (subfascial), posterior spine; lumbar, sacral, or lumbosacral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":981.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83013","name":"H pylori (c-13) breath","description":"Helicobacter pylori; breath test analysis for urease activity, non-radioactive isotope (eg, c-13)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3375","name":"Inj, vanco (tyzavan) 10mg","description":"Injection, vancomycin hydrochloride (tyzavan), not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0296U","name":"Onc orl&/orop ca 20 mlc feat","description":"Onc orl&/orop ca 20 mlc feat","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0600U","name":"Nfct ds wnd infctj 65orgs&30","description":"Nfct ds wnd infctj 65orgs&30","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0438U","name":"Rx metab advrs vrnt alys 33","description":"Rx metab advrs vrnt alys 33","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1451","name":"Pt dx ppd dur id/pf pd","description":"Patients with an active diagnosis of pervasive developmental disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4317","name":"Vitograft, per sq cm","description":"Vitograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70472","name":"Ct cere prfu alys c+w/ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed with concurrent ct or ct angiography of the same anatomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4326","name":"Woundplus, per sq cm","description":"Woundplus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1025T","name":"Alt elec fld dos&dlv sim mdl","description":"Alternating electric fields dosimetry and delivery-simulation modeling, creation and selection of patient-specific array layouts, and placement verification","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2544","name":"Dental onlay metl 4/more sur","description":"Onlay - metallic - four or more surfaces","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93598","name":"Car outp meas drg cath chd","description":"Cardiac output measurement(s), thermodilution or other indicator dilution method, performed during cardiac catheterization for the evaluation of congenital heart defects (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98008","name":"Synch audio-only new sf 15","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code sel","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83655","name":"Assay of lead","description":"Lead","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7485","name":"Surg reduct osseoustuberosit","description":"Surgical reduction of osseous tuberosity","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0877","name":"Inj, daptomycin (hospira)","description":"Injection, daptomycin (hospira), not therapeutically equivalent to j0878, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1312","name":"No pt tbco scrn rng","description":"Patient not screened for tobacco use","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0299U","name":"Onc pan tum whl gen opt mapg","description":"Onc pan tum whl gen opt mapg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2021","name":"Neomatrix per sq cm","description":"Neomatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2038","name":"Marigen pacto, per sq cm","description":"Marigen pacto, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0296U","name":"Onc orl&/orop ca 20 mlc feat","description":"Onc orl&/orop ca 20 mlc feat","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3472","name":"Surg rep root res premolar","description":"Surg rep root res premolar","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6113","name":"Imp/abut rem dent part mand","description":"Imp/abut rem dent part mand","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0586U","name":"Onc mrna gen xprsn 216 genes","description":"Onc mrna gen xprsn 216 genes","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4412","name":"Choriofix per sq cm","description":"Choriofix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9376","name":"Inj pozelimab-bbfg, 1 mg","description":"Injection, pozelimab-bbfg, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9938","name":"Fab removable appliance","description":"Fab removable appliance","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1813","name":"Lyumjev for insulin pump use","description":"Insulin (lyumjev) for administration through dme (i.e., insulin pump) per 50 units","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0531U","name":"Nfct ds afb&inv fng 673orgs","description":"Nfct ds afb&inv fng 673orgs","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86231","name":"Ema each ig class","description":"Endomysial antibody (ema), each immunoglobulin (ig) class","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0675T","name":"Laps insj nw/rpcmt isdss 1ld","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first lead","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1449","name":"Inj eflapegrastim-xnst 0.1mg","description":"Injection, eflapegrastim-xnst, 0.1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0843T","name":"Dgtz gls mcrscp cslt cyt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), initial site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37295","name":"Rvsc evsc tpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0818T","name":"Revj/rmvl ins ptn subq","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58301","name":"Remove intrauterine device","description":"Removal of intrauterine device (iud)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":66.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3472","name":"Surg rep root res premolar","description":"Surg rep root res premolar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22837","name":"Ant thrc vrt body tethrg 8+","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; 8 or more vertebral segments","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11057","name":"Parng/cutg b9 hyprkr les >4","description":"Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); more than 4 lesions","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0605","name":"Sucroferric oxyhydroxide 5mg","description":"Sucroferric oxyhydroxide, oral, 5 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70498","name":"Ct angiography neck","description":"Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":650.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2221","name":"Ank mcrop plant & dorsi flex","description":"Addition to lower extremity orthosis, ankle system, microprocessor-controlled feature plantarflexion and/or dorsiflexion, includes power source","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0422U","name":"Onc pan solid tum alys dna","description":"Onc pan solid tum alys dna","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2802","name":"Inj, romiplostim 1 microgram","description":"Injection, romiplostim, 1 microgram","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40800","name":"Drainage of mouth lesion","description":"Drainage of abscess, cyst, hematoma, vestibule of mouth; simple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5160","name":"Inj, jobevne, 10 mg","description":"Injection, bevacizumab-nwgd (jobevne), biosimilar, 10 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99381","name":"Init pm e/m new pat infant","description":"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; infant (age youn","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":71.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0052","name":"Mmip mental health and care","description":"Missing and murdered indigenous persons (mmip) mental health and clinical care","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2779","name":"Inj, susvimo 0.1 mg","description":"Injection, ranibizumab, via intravitreal implant (susvimo), 0.1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1314","name":"Bmi not calculated","description":"Bmi not documented and no reason is given","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33476","name":"Revision of heart chamber","description":"Right ventricular resection for infundibular stenosis, with or without commissurotomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1769.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6192","name":"Semi precision attachment","description":"Semi precision attachment","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2865","name":"Inj sulfameth/trim 5 mg/1 mg","description":"Injection, sulfamethoxazole 5 mg and trimethoprim 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7294","name":"Seg acet and eth estr yearly","description":"Segesterone acetate and ethinyl estradiol 0.15mg, 0.013mg per 24 hours; yearly vaginal system, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0782T","name":"Brnchsc rf dstrj plm nrv uni","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; unilateral mainstem bronchus","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0911T","name":"Elec aly nstm sys vgs nrv wo","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; without programming by physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0529U","name":"Hem vte snp f2&f5 gen leiden","description":"Hem vte snp f2&f5 gen leiden","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4272","name":"Esano a, per sq cm","description":"Esano a, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33904","name":"Perq p-art revsc each addl","description":"Percutaneous pulmonary artery revascularization by stent placement, each additional vessel or separate lesion, normal or abnormal connections (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6111","name":"Implnt/abut remov dent mand","description":"Implnt/abut remov dent mand","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0792T","name":"Appl slvr diamn fluoride 38%","description":"Application of silver diamine fluoride 38%, by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1424","name":"Pulmonology care mvp","description":"Pulmonology care mips value pathway","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0248","name":"Inj, remdesivir, 1 mg","description":"Injection, remdesivir, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1446","name":"Pt died bef end meas pd","description":"Patients who died any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76017","name":"Mr sfty med physics xm cstmz","description":"Mr safety medical physics examination customization, planning and performance monitoring by medical physicist or mr safety expert, with review and analysis by physician or other qualified health care professional to prioritize and select views and imaging sequences, to tailor mr acquisition specific","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0819T","name":"Revj/rmvl ins ptn subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15017","name":"App skn cll ssp f/n/g/hf 1st","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 480 sq cm or less","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1172","name":"Doc med rsn no td/tdap","description":"Documentation of medical reason(s) for not administering td or tdap vaccine (e.g., prior anaphylaxis due to the td or tdap vaccine or history of encephalopathy within seven days after a previous dose of a td-containing vaccine)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53865","name":"Cysto insj dev ischmc rmdlg","description":"Cystourethroscopy with insertion of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88334","name":"Path consltj surg cyto xm ea","description":"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), each additional site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76857","name":"Us exam pelvic limited","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1184","name":"Doc med rsn no cst/ist rx","description":"Documentation of medical reason(s) for not prescribing or administering corticosteroid or immunosuppressant treatment (e.g., allergy, intolerance, infectious etiology, pancreatic insufficiency, hyperthyroidism, prior bowel surgical interventions, celiac disease, receiving other medication, awaiting ","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0001","name":"Advancing cancer care mvp","description":"Advancing cancer care mips value pathways","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J9020","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2777","name":"Inj, faricimab-svoa, 0.1mg","description":"Injection, faricimab-svoa, 0.1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1033","name":"Sv doula brth wrk per diem","description":"Services performed by a doula birth worker, per diem","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27137","name":"Revise hip joint replacement","description":"Revision of total hip arthroplasty; acetabular component only, with or without autograft or allograft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1763.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0311U","name":"Nfct ds bct quan antmcrb sc","description":"Nfct ds bct quan antmcrb sc","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27635","name":"Remove lower leg bone lesion","description":"Excision or curettage of bone cyst or benign tumor, tibia or fibula;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":722.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86781","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0616U","name":"Neurol dementia alys >30000","description":"Neurol dementia alys >30000","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1330","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61889","name":"Ins sk-mnt crnl nstm pg/rcvr","description":"Insertion of skull-mounted cranial neurostimulator pulse generator or receiver, including craniectomy or craniotomy, when performed, with direct or inductive coupling, with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1430","name":"Ret exm ou no retinopthy doc","description":"Retinal exam finding without evidence of retinopathy in both eyes with severity level documented (in measurement year or in the prior year)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4321","name":"Renograft, per sq cm","description":"Renograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49189","name":"Opn exc/dst ntra-abd 20.1-30","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 20.1 to 30 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0564U","name":"Nfct ds pthgn-sna 10vir&4bct","description":"Nfct ds pthgn-sna 10vir&4bct","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0136","name":"Inj, acetaminophen (b braun)","description":"Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0360U","name":"Onc lung elisa 7 autoant alg","description":"Onc lung elisa 7 autoant alg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1213","name":"No hx spiro prs spiro>=70%","description":"No history of spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) and present spirometry is >= 70%","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15012","name":"Hrv skn cll ssp agrft ea add","description":"Harvest of skin for skin cell suspension autograft; each additional 25 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0899T","name":"N-invas deter aqmbf aug cmr","description":"Noninvasive determination of absolute quantitation of myocardial blood flow (aqmbf), derived from augmentative algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health car","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65400","name":"Removal of eye lesion","description":"Excision of lesion, cornea (keratectomy, lamellar, partial), except pterygium","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":556.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92567","name":"Tympanometry","description":"Tympanometry (impedance testing)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":18.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55713","name":"Bx prst8 in-bore ct/mri bx 1","description":"Biopsy, prostate, in-bore ct- or mri-guided (ie, sextant), with biopsy of additional targeted lesion(s), first targeted lesion","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0994T","name":"Evasc dlvr a-wal stbl rx prq","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; percutaneous","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1151","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4302","name":"Complete aca, per sq cm","description":"Complete aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2404","name":"Inj, nicardipine 0.1 mg","description":"Injection, nicardipine, 0.1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99426","name":"Prin care mgmt staff 1st 30","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0360U","name":"Onc lung elisa 7 autoant alg","description":"Onc lung elisa 7 autoant alg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43291","name":"Egd flx trnsorl rmvl balo","description":"Esophagogastroduodenoscopy, flexible, transoral; with removal of intragastric bariatric balloon(s)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4013","name":"Mntal/behav/psych hlth ss","description":"Mental/behavioral and psychiatry mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67914","name":"Repair eyelid defect","description":"Repair of ectropion; suture","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1474","name":"Pt dx dementia","description":"Patients with diagnosis of dementia","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15811","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9289","name":"Inj nivolumab 2 mg hyaluron","description":"Injection, nivolumab, 2 mg and hyaluronidase-nvhy","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0044","name":"Pt mitral stenosis","description":"Patients with moderate or severe mitral stenosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7601","name":"Ensifentrine inh 3 mg","description":"Ensifentrine, inhalation suspension, fda approved final product, non-compounded, administered through dme, unit dose form, 3 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1597","name":"Inj glycopyrrolate, glyrx-pf","description":"Injection, glycopyrrolate (glyrx-pf), 0.1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0652","name":"Inj, levothyroxine, hikma","description":"Injection, levothyroxine sodium (hikma), not therapeutically equivalent to j0650, 10 mcg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5149","name":"Inj, aflibercept-abzv, 1 mg","description":"Injection, aflibercept-abzv (enzeevu), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64708","name":"Revise arm/leg nerve","description":"Neuroplasty, major peripheral nerve, arm or leg, open; other than specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":542.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61793","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1463.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63295","name":"Repair laminectomy defect","description":"Osteoplastic reconstruction of dorsal spinal elements, following primary intraspinal procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33287","name":"Rmv&rplcmt phrnc nrv stim pg","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1279","name":"Pre-htn/htn, no f/u, not gvn","description":"Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0776T","name":"Ther indctj ntrabrn hypthrm","description":"Therapeutic induction of intra-brain hypothermia, including placement of a mechanical temperature-controlled cooling device to the neck over carotids and head, including monitoring (eg, vital signs and sport concussion assessment tool 5 [scat5]), 30 minutes of treatment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92568","name":"Acoustic refl threshold tst","description":"Acoustic reflex testing, threshold","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2041","name":"Foundation drs+ duo pr sq cm","description":"Foundation drs+ duo, per square centimeter","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1275","name":"Pts hosp exl","description":"Patients determined to be in hospice were excluded from month of evaluation and the remainder of reporting period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0328U","name":"Drug assay 120+ rx&metablt","description":"Drug assay 120+ rx&metablt","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0422","name":"Collect & prep genetic samp","description":"Collect & prep genetic samp","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4351","name":"Enclose tl matrix, per sq cm","description":"Enclose tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90612","name":"Inf&sarscov2 vacc 31.7/.32im","description":"Influenza virus vaccine, trivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 31.7 mcg/0.32 ml dosage, for intramuscular use","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0423U","name":"Psyc genomic alys pnl 26 gen","description":"Psyc genomic alys pnl 26 gen","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0344U","name":"Hep nafld semiq evl 28 lipid","description":"Hep nafld semiq evl 28 lipid","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1213","name":"No hx spiro prs spiro>=70%","description":"No history of spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) and present spirometry is >= 70%","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73090","name":"X-ray exam of forearm","description":"Radiologic examination; forearm, 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4406","name":"Xwrap fenestra per sq cm","description":"Xwrap fenestra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87110","name":"Chlamydia culture","description":"Culture, chlamydia, any source","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0365U","name":"Onc bldr 10 prb bldr ca","description":"Onc bldr 10 prb bldr ca","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7519","name":"Inj. mycophenolate mofetil","description":"Injection, mycophenolate mofetil, 10 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0601U","name":"Nfct ds pji alys 11 bmrks ia","description":"Nfct ds pji alys 11 bmrks ia","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0969T","name":"Removal epicranial nstim sys","description":"Removal of epicranial neurostimulator system","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1244","name":"Pt othr thn true best int","description":"Patient provided a response other than completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87110","name":"Chlamydia culture","description":"Culture, chlamydia, any source","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0279U","name":"Hem vw factor&clgn iii bndg","description":"Hematology (von willebrand disease [vwd]), von willebrand factor (vwf) and collagen iii binding by enzyme-linked immunosorbent assays (elisa), plasma, report of collagen iii binding","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43257","name":"Egd w/thrml txmnt gerd","description":"Esophagogastroduodenoscopy, flexible, transoral; with delivery of thermal energy to the muscle of lower esophageal sphincter and/or gastric cardia, for treatment of gastroesophageal reflux disease","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1169","name":"Doc med rsn no flu vax","description":"Documentation of medical reason(s) for not administering influenza vaccine (e.g., prior anaphylaxis due to the influenza vaccine)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1028","name":"Take home supply 8mg per 0.1","description":"Take-home supply of nasal naloxone; 2-pack of 8mg per 0.1 ml nasal spray (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1191","name":"Hspc svc any time in meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0758T","name":"Dgtz gls mcrscp sl spc hchem","description":"Digitization of glass microscope slides for special stain, including interpretation and report, histochemical stain on frozen tissue block (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3392","name":"Inj, exagamglogene autotem","description":"Injection, exagamglogene autotemcel, per treatment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4355","name":"Abio xpl abio xpl hy p sq cm","description":"Abiomend xplus membrane and abiomend xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4415","name":"Alexiguard st-l per sq cm","description":"Alexiguard sl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0875T","name":"Prgrm subq prtl asct pmp sys","description":"Programming of subcutaneously implanted peritoneal ascites pump system by physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1302","name":"Inj, sutimlimab-jome, 10 mg","description":"Injection, sutimlimab-jome, 10 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0347U","name":"Rx metab/pcx dna 16 gen alys","description":"Rx metab/pcx dna 16 gen alys","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86043","name":"Acetylcholn rcptr modlg antb","description":"Acetylcholine receptor (achr); modulating antibody","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53452","name":"Tprnl balo cntnc dev uni","description":"Periurethral transperineal adjustable balloon continence device; unilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2277","name":"Inj, motixafortide, 0.25 mg","description":"Injection, motixafortide, 0.25 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0658","name":"Seg pneum comp 2 arm chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0752","name":"Hiv prep, oral lenacapavir","description":"Oral, lenacapavir, 300 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2525","name":"Cl, hydrophilic, dual focus","description":"Contact lens, hydrophilic, dual focus, per lens","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9076","name":"Inj, cyclophos (baxter) 5mg","description":"Injection, cyclophosphamide (baxter), 5 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4353","name":"Xceed tl matrix per sq cm","description":"Xceed tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0738","name":"Hiv prep, inj, lenacapavir","description":"Injection, lenacapavir, 1 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J3370","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6028","name":"Part hand finger metacar amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s) /thumb, amputation at metacarpal level, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0445U","name":"Abeta42 & ptau181 eclia csf","description":"Abeta42 & ptau181 eclia csf","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0725T","name":"Vestibular dev impltj uni","description":"Vestibular device implantation, unilateral","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86043","name":"Acetylcholn rcptr modlg antb","description":"Acetylcholine receptor (achr); modulating antibody","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0624U","name":"Hep nash dna mthyl alys 5000","description":"Hep nash dna mthyl alys 5000","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8611","name":"Oral methotrexate (jylamvo)","description":"Methotrexate (jylamvo), oral, 2.5 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4335","name":"Amnioplast 2, per sq cm","description":"Amnioplast 2, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66683","name":"Implantation iris prosthesis","description":"Implantation of iris prosthesis, including suture fixation and repair or removal of iris, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36860","name":"External cannula declotting","description":"External cannula declotting (separate procedure); without balloon catheter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0892","name":"Argatroban dialysis (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4004","name":"Endocrinology ss","description":"Endocrinology mips specialty set","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9333","name":"Inj rozanolixizum-noli 1 mg","description":"Injection, rozanolixizumab-noli, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4390","name":"Ascendion per sq cm","description":"Ascendion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0473","name":"Micro exam prep & report","description":"Accession of tissue gross and microscopic examination preparation and transmission of written report","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0879","name":"Difelikefalin, esrd on dialy","description":"Injection, difelikefalin, 0.1 microgram, (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9947","name":"Sleep apnea appliance","description":"Sleep apnea appliance","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0711T","name":"N-nvs artl plaq alys dat prp","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data preparation and transmission","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65782","name":"Ocular reconst transplant","description":"Ocular surface reconstruction; limbal conjunctival autograft (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1206.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4284","name":"Dermabind sl, per sq cm","description":"Dermabind sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J2400","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0969T","name":"Removal epicranial nstim sys","description":"Removal of epicranial neurostimulator system","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4362","name":"Cygnus disk, per sq cm","description":"Cygnus disk, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92622","name":"Dx aly aud oi snd prcsr 1st","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; first 60 minutes","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0482U","name":"Ob pe biochem asy sfit1&pigf","description":"Ob pe biochem asy sfit1&pigf","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1242","name":"Pt no resp imprt to me","description":"Patient did not respond to the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1216","name":"No spiro doc no res doc","description":"No spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and/or no spirometry performed with results documented during the encounter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4479","name":"Transanal irrigation, electr","description":"Electronic transanal irrigation system, includes electronic pump, water reservoir, tubing, and accessories, without catheter, any type","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1811","name":"Fiasp for insulin pump use","description":"Insulin (fiasp) for administration through dme (i.e., insulin pump) per 50 units","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1306","name":"Pt anphx due to pneum","description":"Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2468","name":"Inj, palonosetron (posfrea)","description":"Injection, palonosetron hydrochloride (posfrea), 25 micrograms","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3391","name":"Inj, atidarsagene autotemcel","description":"Injection, atidarsagene autotemcel, per treatment","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4027","name":"Plastic surgery ss","description":"Plastic surgery mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9049","name":"Inj, bortezomib, hospira","description":"Injection, bortezomib (hospira), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1234","name":"Pt hcv rctv aby f/u neg","description":"Patient has a reactive hcv antibody test, and has a follow up hcv viral test that does not detect hcv viremia","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1327","name":"Pts no eval ini xm no 8 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 8 weeks","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27253","name":"Treat hip dislocation","description":"Open treatment of hip dislocation, traumatic, without internal fixation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1136.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7414","name":"Excision malig lesion>1.25cm","description":"Excision of malignant lesion greater than 1.25 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4363","name":"Am bur mem hydro per sq cm","description":"Amnio burgeon membrane and hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93588","name":"Vngrph chd vnvn cltrl below","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating below the heart (eg, from the inferior vena cava) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0630U","name":"Onc brst mrna gen prflg 80","description":"Onc brst mrna gen prflg 80","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0979T","name":"Sbmcsl crylys ther sft palt","description":"Submucosal cryolysis therapy; soft palate only","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33279","name":"Rmvl phrnc nrv stim transvns","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s) only","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1748","name":"Inj, zymfentra, 10 mg","description":"Injection, infliximab-dyyb (zymfentra), 10 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16000","name":"Initial treatment of burn(s)","description":"Initial treatment, first degree burn, when no more than local treatment is required","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":47.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0554U","name":"Repr med pga 24chrm te bx qc","description":"Repr med pga 24chrm te bx qc","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55708","name":"Bx prst8 trct us w/mri fus 1","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant) with mri-fusion-guidance, first targeted lesion","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0291U","name":"Psyc mood do mrna 144 genes","description":"Psyc mood do mrna 144 genes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0710T","name":"N-invas artl plaq alys","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; including data preparation and transmission, quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess a","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6519","name":"Grad com garm noc night use","description":"Gradient compression garment, not otherwise specified, for nighttime use, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0541","name":"No pt prsnt train initial 30","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63003","name":"Remove spine lamina 1/2 thrc","description":"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), 1 or 2 vertebral segments; thoracic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1358.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2601","name":"Inj, vasopressin (baxter)","description":"Injection, vasopressin (baxter), 1 unit","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4036","name":"Urgent care ss","description":"Urgent care mips specialty set","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29010","name":"Appl risser jacket body only","description":"Application of risser jacket, localizer, body; only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2470","name":"Inj pantoprazole sodium 40mg","description":"Injection, pantoprazole sodium, 40 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49613","name":"Rpr aa hrn rcr < 3 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, reducible","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9603","name":"Inj, pafolacianine, 0.1 mg","description":"Injection, pafolacianine, 0.1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0474","name":"Micro w exam of surg margins","description":"Accession of tissue gross and microscopic examination including assessment of surgical margins for presence of disease preparation and transmission of writte","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64630","name":"Injection treatment of nerve","description":"Destruction by neurolytic agent; pudendal nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2017","name":"Permeaderm glove, each","description":"Permeaderm glove, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98012","name":"Synch audio-only est sf 10","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0008","name":"Admin influenza virus vac","description":"Administration of influenza virus vaccine","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7355","name":"Inj travoprost intra impl","description":"Injection, travoprost, intracameral implant, 1 microgram","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1002T","name":"Air displacmnt plethysmograp","description":"Air displacement plethysmography, whole-body composition assessment, with interpretation and report","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0857T","name":"Opto-acoustic img breast uni","description":"Opto-acoustic imaging, breast, unilateral, including axilla when performed, real-time with image documentation, augmentative analysis and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0546","name":"Phone/internet ehr assess","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty   whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patien","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0534","name":"Coordinated care/or referral","description":"Coordinated care and/or referral services, such as to adequate and accessible community resources to address unmet health-related social needs, including harm reduction interventions and recovery support services a patient needs and wishes to pursue, which significantly limit the ability to diagnose","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1458","name":"Pt died bef end meas pd","description":"Patient died prior to the end of the performance period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4271","name":"Home lancing/test cartridges","description":"Integrated lancing and blood sample testing cartridges for home blood glucose monitor, per 50 tests","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0177","name":"Inj, aflibercept hd, 1 mg","description":"Injection, aflibercept hd, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7299","name":"Rem anchorage device w/flap","description":"Rem anchorage device w/flap","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1450","name":"Pt hos/pal care dur id/pf pd","description":"Patients who received hospice or palliative care service any time during denominator identification period or the measure assessment period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0953T","name":"Tot impl amei rev/rplc w/o","description":"Totally implantable active middle ear hearing implant; revision or replacement, without mastoidectomy and replacement of sound processor","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0002","name":"Opt care kidney hlth mvp","description":"Optimal care for kidney health mips value pathways","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1304","name":"No pneum vax admin 19+","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52346","name":"Cystouretero w/renal strict","description":"Cystourethroscopy with ureteroscopy; with treatment of intra-renal stricture (eg, balloon dilation, laser, electrocautery, and incision)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":573.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46900","name":"Destruction anal lesion(s)","description":"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; chemical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0290U","name":"Pain mgmt mrna gen xprsn 36","description":"Pain mgmt mrna gen xprsn 36","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31050","name":"Exploration sphenoid sinus","description":"Sinusotomy, sphenoid, with or without biopsy;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1443","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15835","name":"Exc excessive skin buttock","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy); buttock","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":937.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1353","name":"Pts no cmplt suicd saf pln","description":"Patients who did not have a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64466","name":"Thrc fascial pln blk uni njx","description":"Thoracic fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1483","name":"Neg quan hep c or qual rna","description":"Patients who achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0843T","name":"Dgtz gls mcrscp cslt cyt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), initial site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0918T","name":"Insj perm ccm-d sys dual ld","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; dual transvenous leads (pacing and defibrillation) only","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0481U","name":"Idh1 idh2&tert promoter ngs","description":"Idh1 idh2&tert promoter ngs","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0518","name":"Remove w insert drug implant","description":"Removal with reinsertion, non-biodegradable drug delivery implants, 4 or more (services for subdermal implants)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":302.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9953","name":"Reline sleep apnea appliance","description":"Reline sleep apnea appliance","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37286","name":"Revsc evasc tpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4352","name":"Overlay sl matrix, per sq cm","description":"Overlay sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2560","name":"Phenobarbital sodium inj","description":"Injection, phenobarbital sodium, up to 120 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1711","name":"Moderna vacc admin booster","description":"Moderna vacc admin booster","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9296","name":"Inj pemetrexed (accord) 10mg","description":"Injection, pemetrexed (accord), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6035","name":"Prosthetic digit mechanical","description":"Single prosthetic digit, mechanical, can include metacarpophalangeal (mcp), proximal interphalangeal (pip), and/or distal interphalangeal (dip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0848T","name":"Dgtz gls mcrscp ish 1st","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64629","name":"Trml dstrj ios bvn ea addl","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; each additional vertebral body, lumbar or sacral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64658","name":"Rmvl bat modul sys lead only","description":"Removal of baroreflex activation therapy (bat) modulation system; lead only","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4352","name":"Overlay sl matrix, per sq cm","description":"Overlay sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6251","name":"Bridge resin base metal","description":"Pontic-resin with predominantly base metal","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0587U","name":"Ther rx mntr 60-150rx&metabl","description":"Ther rx mntr 60-150rx&metabl","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5934","name":"Mandibular flange prosthesis","description":"Mandibular resection prosthesis with guide flange","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77438","name":"Surf rad thr orthvlt>150-500","description":"Surface radiation therapy; orthovoltage, delivery, >150-500 kv, per fraction","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47561","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0872T","name":"Rplcmt ndwllg bldr&prtl cath","description":"Replacement of indwelling bladder and peritoneal catheters, including tunneling of catheter(s) and connection with previously implanted peritoneal ascites pump, including imaging and programming, when performed","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9595","name":"Piflu f-18, dia 1 millicurie","description":"Piflufolastat f-18, diagnostic, 1 millicurie","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4286","name":"Nudyn sl or slw, per sq cm","description":"Nudyn sl or nudyn slw, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3401","name":"Vyjuvek 5x10^9pfu/ml, 0.1 ml","description":"Beremagene geperpavec-svdt for topical administration, containing nominal 5 x 10^9 pfu/ml vector genomes, per 0.1 ml","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0699T","name":"Njx pst chmbr eye medication","description":"Injection, posterior chamber of eye, medication","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55712","name":"Bx prst8 tprnl mri-us 1st","description":"Biopsy, prostate, transperineal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9196","name":"Inj gemcitabine hcl (accord)","description":"Injection, gemcitabine hydrochloride (accord), not therapeutically equivalent to j9201, 200 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37280","name":"Revsc evsc tpvt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7412","name":"Excision benign lesion compl","description":"Excision of benign lesion complicated","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45382","name":"Colonoscopy w/control bleed","description":"Colonoscopy, flexible; with control of bleeding, any method","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1213","name":"No hx spiro prs spiro>=70%","description":"No history of spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) and present spirometry is >= 70%","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4360","name":"Amchoplast fd per sq cm","description":"Amchoplast fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86850","name":"Rbc antibody screen","description":"Antibody screen, rbc, each serum technique","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5912","name":"Facial moulage complete","description":"Facial moulage (complete)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9324","name":"Inj, pemrydi rtu, 10 mg","description":"Injection, pemetrexed (pemrydi rtu), 10 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1486","name":"Pt admitted to snf dur eval","description":"Patients admitted to a skilled nursing facility (snf) during the period of evaluation","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65150","name":"Revise ocular implant","description":"Reinsertion of ocular implant; with or without conjunctival graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":655.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99427","name":"Prin care mgmt staff ea addl","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1812","name":"Inj. insulin (fiasp)","description":"Insulin (fiasp), per 5 units","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41006","name":"Drainage of mouth lesion","description":"Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; sublingual, deep, supramylohyoid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4391","name":"Amnioplast double per sq cm","description":"Amnioplast double, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1551","name":"Inj cutaquig 100 mg","description":"Injection, immune globulin (cutaquig), 100 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9331","name":"Inj sirolimus prot part 1 mg","description":"Injection, sirolimus protein-bound particles, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9321","name":"Inj epcoritamab-bysp 0.16 mg","description":"Injection, epcoritamab-bysp, 0.16 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99300","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2014","name":"Omeza collag compl 100 mg","description":"Omeza collagen matrix or omeza complete matrix, per 100 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4297","name":"Emerge matrix, per sq cm","description":"Emerge matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99459","name":"Pelvic examination","description":"Pelvic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0439U","name":"Crd chd dna alys 5 snp 3 dna","description":"Crd chd dna alys 5 snp 3 dna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0692T","name":"Therapeutic ultrafiltration","description":"Therapeutic ultrafiltration","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2032","name":"Myriad matrix, per sq cm","description":"Myriad matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4001","name":"Diagnostic rad ss","description":"Diagnostic radiology mips specialty set","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35691","name":"Art trnsposj vertbrl carotid","description":"Transposition and/or reimplantation; vertebral to carotid artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1302.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5136","name":"Inj. denosumab-bbdz, 1 mg","description":"Injection, denosumab-bbdz (jubbonti/wyost), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2032","name":"Myriad matrix, per sq cm","description":"Myriad matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64583","name":"Rev/rplct hpglsl nstm ary pg","description":"Revision or replacement of hypoglossal nerve neurostimulator array and distal respiratory sensor electrode or electrode array, including connection to existing pulse generator","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":457.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0491U","name":"Onc sol tum ctc slct er prtn","description":"Onc sol tum ctc slct er prtn","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1239","name":"Pt no resp heard","description":"Patient did not respond to the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82947","name":"Assay glucose blood quant","description":"Glucose; quantitative, blood (except reagent strip)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53020","name":"Incision of urethra","description":"Meatotomy, cutting of meatus (separate procedure); except infant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96041","name":"Genetic counseling svc ea 30","description":"Medical genetics and genetic counseling services, each 30 minutes of total time provided by the genetic counselor on the date of the encounter","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1025","name":"Pt mnth 1 mcp prov","description":"Patient-months where there are more than one medicare capitated payment (mcp) provider listed for the month","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74018","name":"Radex abdomen 1 view","description":"Radiologic examination, abdomen; 1 view","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2359","name":"Inj. olanzapine, 0.5mg","description":"Injection, olanzapine, 0.5 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75860","name":"Vein x-ray neck","description":"Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0486U","name":"Onc pan sol tum ngs cfctdna","description":"Onc pan sol tum ngs cfctdna","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1485","name":"Neg viro resp hep c/qual rna","description":"Patients who did not achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4316","name":"Amchoplast, per sq cm","description":"Amchoplast, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4401","name":"Absolv3 per sq cm","description":"Absolv3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33720","name":"Repair of heart defect","description":"Repair sinus of valsalva aneurysm, with cardiopulmonary bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1908.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0526","name":"Est pt-cg dyad dem hig cmplx","description":"Management of established patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0886T","name":"Sgmdsc flx 1st tndsc dilat","description":"Sigmoidoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1336","name":"Pts eval ini xm 2 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 2 weeks","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0038","name":"Clin pt no ref","description":"Clinician determines patient does not require referral","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99292","name":"Critical care addl 30 min","description":"Critical care, evaluation and management of the critically ill or critically injured patient; each additional 30 minutes (list separately in addition to code for primary service)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":151.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5228","name":"Immed mand part denture","description":"Immed mand part denture","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1165","name":"Pt use hspc dur meas pd","description":"Patients who use hospice services any time during the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9076","name":"Inj, cyclophos (baxter) 5mg","description":"Injection, cyclophosphamide (baxter), 5 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0584U","name":"Neuro csf prion prtn qual","description":"Neuro csf prion prtn qual","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1805","name":"Inj, esmolol hcl, 10mg","description":"Injection, esmolol hydrochloride, 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6601","name":"Porc/ceram inlay >= 3 surfac","description":"Inlay - porcelain/ceramic three or more surfaces","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1368","name":"Prev trt inf d/o hiv/hep mvp","description":"Prevention and treatment of infectious disorders including hepatitis c and hiv mips value pathway","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1353","name":"Sealant repair per tooth","description":"Sealant repair per tooth","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4353","name":"Xceed tl matrix per sq cm","description":"Xceed tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4338","name":"Artacent velos, per sq cm","description":"Artacent velos, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1294","name":"Bp scrn perf rec interval","description":"Normal blood pressure reading documented, follow-up not required","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0661","name":"Team remote e/m new pt 20 mn","description":"Team remote e/m new pt 20mins","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9026","name":"Inj, tarlatamab-dlle, 1 mg","description":"Injection, tarlatamab-dlle, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0307U","name":"Onc mrd nxt-gnrj alys sbsq","description":"Onc mrd nxt-gnrj alys sbsq","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78480","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93597","name":"R&l hrt cath chd abnl nt cnj","description":"Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); abnormal native connections","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0311U","name":"Nfct ds bct quan antmcrb sc","description":"Nfct ds bct quan antmcrb sc","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6280","name":"Implt maint procd remv implt","description":"Implt maint procd remv implt","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0751","name":"Hiv prep, ftc/taf 200/25mg","description":"Emtricitabine 200mg and tenofovir alafenamide 25mg, oral, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34716","name":"Opn ax/subcla art expos cndt","description":"Open axillary/subclavian artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass, by infraclavicular or supraclavicular incision, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1179","name":"No pcv recd","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine, on or after their 19th birthday and before or during measurement period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96381","name":"Admn rsv monoc antb im njx","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4333","name":"Ardeograft, per sq cm","description":"Ardeograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49190","name":"Opn exc/dstr ntra-abd >30 cm","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); greater than 30 cm","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3247","name":"Inj secukinumab intrav 1mg","description":"Injection, secukinumab, intravenous, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86318","name":"Ia infectious agent antibody","description":"Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip);","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0514","name":"Prolong prev svcs, addl 30m","description":"Prolonged preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient contact beyond the usual service; each additional 30 minutes (list separately in addition to code g0513 for additional 30 minutes of preventi","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":57.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0475U","name":"Hered prst8 ca gsap 23 genes","description":"Hered prst8 ca gsap 23 genes","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1018T","name":"Elec alys npgs esoph sbsq w/","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47802","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1518.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0899","name":"Argatroban dialysis, auromed","description":"Injection, argatroban (auromedics), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2516","name":"Inj, pentamidine isethionate","description":"Injection, pentamidine isethionate, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27370","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0746T","name":"Car ablt rad arr cnv loc map","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; conversion of arrhythmia localization and mapping of arrhythmia site (nidus) into a multidimensional radiation treatment plan","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6072","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (high noble metal)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0771T","name":"Vr px dissoc svc sm phy 1st","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6193","name":"Replace implnt screw","description":"Replace implnt screw","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1611","name":"Inj glucagon hcl, fresenius","description":"Injection, glucagon hydrochloride (fresenius kabi), not therapeutically equivalent to j1610, per 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6600","name":"G com bandge hgh dn foam sht","description":"Gradient compression bandaging supply, high density foam sheet, per 250 square centimeters, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1354","name":"Int caries med app per tooth","description":"Interim caries med app","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64659","name":"Rmvl bat modulj sys pg only","description":"Removal of baroreflex activation therapy (bat) modulation system; pulse generator only","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2406","name":"Injection, oritavancin 10 mg","description":"Injection, oritavancin (kimyrsa), 10 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0436U","name":"Onc lng plsm alys 388 prtn","description":"Onc lng plsm alys 388 prtn","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0788T","name":"Elec aly smp iins sp/sac nrv","description":"Electronic analysis with simple programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detecti","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0822T","name":"Mntr psychdlc med cln staff","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; clinical staff under the direction of a physician or other qualified health care professional, concurrent with first physician or other qualified health care p","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9003","name":"Leupro inj, camcevi etm, 1mg","description":"Leuprolide injectable (camcevi etm), 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93313","name":"Echo transesophageal","description":"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); placement of transesophageal probe only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9275","name":"Inj cosibelimab-ipdl, 2 mg","description":"Injection, cosibelimab-ipdl, 2 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4304","name":"Grafix plus, per sq cm","description":"Grafix plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92634","name":"Hearing aid fitg svc 1st 60","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; first 60 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98012","name":"Synch audio-only est sf 10","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1308","name":"Flu immunize no admin","description":"Influenza immunization was not administered, reason not given","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0648","name":"Lso sag r an/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":699.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4268","name":"Surgraft ft per sq cm","description":"Surgraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1192","name":"Pt w/ dx sq cell ca of esoph","description":"Patients with an existing diagnosis of squamous cell carcinoma of the esophagus","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6609","name":"G compression bandaging","description":"Gradient compression bandaging supply, not otherwise specified","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0908T","name":"Opn imp int nstm sys vgs nrv","description":"Open implantation of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4002","name":"Ep cardio ss","description":"Electrophysiology cardiac specialist mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9282","name":"Mitomycin intravesical inst","description":"Mitomycin, intravesical instillation, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0375U","name":"Onc ovrn bchm asy 7 prtn alg","description":"Onc ovrn bchm asy 7 prtn alg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0422U","name":"Onc pan solid tum alys dna","description":"Onc pan solid tum alys dna","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70030","name":"X-ray eye for foreign body","description":"Radiologic examination, eye, for detection of foreign body","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1191","name":"Hspc svc any time in meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90461","name":"Im admin each addl component","description":"Immunization administration through 18 years of age via any route of administration, with counseling by physician or other qualified health care professional; each additional vaccine or toxoid component administered (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6039","name":"Passive custom digit/thumb","description":"Passive prosthetic digit or thumb prosthesis not including hand restoration partial hand, full or partial, custom made, any material, initial or replacement, per single passive prosthetic digit or thumb","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1307","name":"Inj, crovalimab-akkz, 10 mg","description":"Injection, crovalimab-akkz, 10 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0270U","name":"Hem cgen coagj do 20 genes","description":"Hematology (congenital coagulation disorders), genomic sequence analysis of 20 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4371","name":"Neoguard per sq cm","description":"Neoguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0965T","name":"I&cst prp jw xpn dl arch non","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, non-fixed hinge mechanism","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2042","name":"Foundation drs+ solo, sq cm","description":"Foundation drs+ solo, per square centimeter","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0420U","name":"Onc urthl mrna xprsn 6 snp","description":"Onc urthl mrna xprsn 6 snp","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85651","name":"Rbc sed rate nonautomated","description":"Sedimentation rate, erythrocyte; non-automated","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91011","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1328","name":"Pts dx acute vitreous hem","description":"Patients with a diagnosis of acute vitreous hemorrhage","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92639","name":"Hearing aid meas verif","description":"Hearing-aid measurement, verification with probe-microphone (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0983T","name":"Rem mntr impl ivc snr phys","description":"Remote monitoring of an implanted inferior vena cava sensor for up to 30 days, including at least weekly downloads of inferior vena cava area recordings, interpretation(s), trend analysis, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0523","name":"Mgt nw pt dem mod-high cmplx","description":"Management of a new patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0570U","name":"Neurol tbi alys gfap&uch-l1","description":"Neurol tbi alys gfap&uch-l1","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77438","name":"Surf rad thr orthvlt>150-500","description":"Surface radiation therapy; orthovoltage, delivery, >150-500 kv, per fraction","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2471","name":"Inj pantoprazole(hikma) 40mg","description":"Injection, pantoprazole (hikma), not therapeutically equivalent to j2470, 40 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0536U","name":"Rbcag ftl rhd pcr alys exon4","description":"Rbcag ftl rhd pcr alys exon4","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33901","name":"Perq p-art revsc 1 nm nt bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, bilateral","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3393","name":"Inj, betibeglogene autotemce","description":"Injection, betibeglogene autotemcel, per treatment","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4418","name":"Biolab wrap flow per sq cm","description":"Biolab membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0134","name":"Inj acetaminophen -fresenius","description":"Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0545","name":"Inherent visit to inpt","description":"Visit complexity inherent to hospital inpatient or observation care associated with a confirmed or suspected infectious disease by an infectious diseases specialist, including disease transmission risk assessment and mitigation, public health investigation, analysis, and testing, and complex antimic","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0603","name":"Sevelamer hydrochloride 20mg","description":"Sevelamer hydrochloride (renagel or therapeutically equivalent), oral, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57150","name":"Treat vagina infection","description":"Irrigation of vagina and/or application of medicament for treatment of bacterial, parasitic, or fungoid disease","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93569","name":"Njx cth slct p-art angrp uni","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0557U","name":"Nfct ds bv dna mrk vag fluid","description":"Nfct ds bv dna mrk vag fluid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95249","name":"Cont gluc mntr pt prov eqp","description":"Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; patient-provided equipment, sensor placement, hook-up, calibration of monitor, patient training, and printout of recording","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36406","name":"Vnpnxr<3yrs phy/qhp other vn","description":"Venipuncture, younger than age 3 years, necessitating the skill of a physician or other qualified health care professional, not to be used for routine venipuncture; other vein","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":8.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5612","name":"Rep resin part dent base max","description":"Rep resin part dent base max","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9269","name":"Programable ingest capsule","description":"Programable, transient, orally ingested capsule, for use with external programmer, per month","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37282","name":"Rvsc evsc tpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0010","name":"Eom meos payment","description":"Enhancing oncology model (eom) monthly enhanced oncology services (meos) payment for eom enhanced services","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49582","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":492.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98977","name":"Rtm dev sply mscskl 16-30 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of musculoskeletal system, 16-30 days in a 30-day period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6602","name":"Cst hgh nble mtl inlay 2 srf","description":"Inlay - cast high noble metal two surfaces","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9224","name":"Gen anes adv air-15 min","description":"Gen anes adv air-15 min","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6038","name":"Multiax rotation attachment","description":"Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":344.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4437","name":"Revival ac per sq cm","description":"Revival ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3402","name":"Inj. remestemcel-l-rknd/ td","description":"Injection, remestemcel-l-rknd, per therapeutic dose","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93153","name":"Interrog w/o prgrmg ipnss","description":"Interrogation without programming of implanted phrenic nerve stimulator system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0472","name":"Gross exam prep & report","description":"Accession of tissue gross examination preparation and transmission of written report","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0547U","name":"Neurflmnt lt chn cleia plsm","description":"Neurflmnt lt chn cleia plsm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8522","name":"Capecitabine, oral, 50 mg","description":"Capecitabine, oral, 50 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1489","name":"Pt status doc","description":"Patient status documented","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1466","name":"Pt disc/lam proc same day","description":"Patient had a lumbar fusion on the same date as the discectomy/laminectomy procedure","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1228","name":"Pt + hcv aby +vir w/ rx 3 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, has hcv treatment initiated within 3 months of the reactive hcv antibody test","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43848","name":"Revj open gstr rstcv px","description":"Revision, open, of gastric restrictive procedure for morbid obesity, other than adjustable gastric restrictive device (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2004.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1418","name":"Med rsn not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination because of a medical contraindication documented by clinician","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1033","name":"Sv doula brth wrk per diem","description":"Services performed by a doula birth worker, per diem","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"Evoked auditory test limited","description":"Distortion product evoked otoacoustic emissions; limited evaluation (to confirm the presence or absence of hearing disorder, 3-6 frequencies) or transient evoked otoacoustic emissions, with interpretation and report","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0294U","name":"Lngvty&mrtlty rsk mrna 18gen","description":"Lngvty&mrtlty rsk mrna 18gen","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89141","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0820T","name":"Mntr psychdlc med 1stphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; first physician or other qualified health care professional, each hour","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37255","name":"Revsc evasc ivt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58275","name":"Hysterectomy/revise vagina","description":"Vaginal hysterectomy, with total or partial vaginectomy;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1130.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1428","name":"Bilateral absence of eyes","description":"Patients who have bilateral absence of eyes any time during the patients history through the end of the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1423","name":"Opt care urologic cnd mvp","description":"Optimal care for patients with urologic conditions mips value pathway","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0173A","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2865","name":"Inj sulfameth/trim 5 mg/1 mg","description":"Injection, sulfamethoxazole 5 mg and trimethoprim 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1021T","name":"Active thrc irrigation spx","description":"Active thoracic irrigation (separate procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9273","name":"Inj tisotu vedotin-tftv, 1mg","description":"Injection, tisotumab vedotin-tftv, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6092","name":"Recement supp crown","description":"Recement implant/abutment supported crown","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5228","name":"Immed mand part denture","description":"Immed mand part denture","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9026","name":"Cryo fib comp path redu each","description":"Cryoprecipitated fibrinogen complex, pathogen reduced, each unit","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0826T","name":"Prgrmg evl ldls pm 1chmbr ip","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional, leadless pacemaker system in si","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37270","name":"Revsc evasc fpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0554","name":"Add 20 m of monthly tx","description":"Each additional 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing data generated from the","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1478","name":"Psychoactive sub abuse","description":"Psychoactive substance abuse","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2011","name":"Supra sdrm, per sq cm","description":"Supra sdrm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0684","name":"App non-sheet skin sb g addl","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area or part thereof, or each additional 1% o","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0271","name":"Group mnt 2 or more 30 mins","description":"Medical nutrition therapy, reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition, or treatment regimen (including additional hours needed for renal disease), group (2 or more individuals), each 30 minutes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":13.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0889T","name":"Prsnlz trgt dvl arhfcmrigtbs","description":"Personalized target development for accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation derived from a structural and resting-state functional mri, including data preparation and transmission, generation of the target, motor threshold-starting location, neuro","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0458U","name":"Onc brst ca s100 a8&a9 elisa","description":"Onc brst ca s100 a8&a9 elisa","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0274U","name":"Hem gen pltlt do 43 genes","description":"Hematology (genetic platelet disorders), genomic sequence analysis of 43 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64912","name":"Nrv rpr w/nrv algrft 1st","description":"Nerve repair; with nerve allograft, each nerve, first strand (cable)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":945.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0184","name":"Inj, amisulpride, 1 mg","description":"Injection, amisulpride, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6094","name":"Abut support crown titanium","description":"Abutment supported crown - (titanium)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92552","name":"Pure tone audiometry air","description":"Pure tone audiometry (threshold); air only","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7972","name":"Surg redct fibrous tuberosit","description":"Surgical reduction of fibrous tuberosity","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4251","name":"Vim, per square centimeter","description":"Vim, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4399","name":"Summit fx per sq cm","description":"Summit fx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76019","name":"Mr safety implt pos&/immoblj","description":"Mr safety implant positioning and/or immobilization under supervision of physician or other qualified health care professional, including application of physical protections to secure implanted medical device from mr-induced translational or vibrational forces, magnetically induced functional change","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9912","name":"Pre-visit patient screening","description":"Pre-visit patient screening","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0540","name":"Train for caregiver add 15","description":"Caregiver training in behavior management/modification for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face; each additional 15 minutes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38226","name":"Car-t prep t lymphcyt f/trns","description":"Chimeric antigen receptor t-cell (car-t) therapy; preparation of blood-derived t lymphocytes for transportation (eg, cryopreservation, storage)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9273","name":"Inj tisotu vedotin-tftv, 1mg","description":"Injection, tisotumab vedotin-tftv, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15931","name":"Exc sacral pr ulc prim sutr","description":"Excision, sacral pressure ulcer, with primary suture;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":726.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5422","name":"Dentures adjust part mandbl","description":"Adjust partial denture - mandibular","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0797T","name":"Tcat ins 2chmbr ldls pm rv","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ventricular pace","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9154","name":"Artificial saliva, 1 ml","description":"Artificial saliva, 1 ml","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0692T","name":"Therapeutic ultrafiltration","description":"Therapeutic ultrafiltration","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0381U","name":"Maple syrup ur ds mntr quan","description":"Maple syrup ur ds mntr quan","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0877","name":"Inj, daptomycin (hospira)","description":"Injection, daptomycin (hospira), not therapeutically equivalent to j0878, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0413U","name":"Onc hl neo opt gen mapg dna","description":"Onc hl neo opt gen mapg dna","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97150","name":"Group therapeutic procedures","description":"Therapeutic procedure(s), group (2 or more individuals)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33279","name":"Rmvl phrnc nrv stim transvns","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s) only","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92638","name":"Bhvl verif of amplification","description":"Behavioral verification of amplification including aided thresholds, functional gain, speech-in-noise, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26842","name":"Thumb fusion with graft","description":"Arthrodesis, carpometacarpal joint, thumb, with or without internal fixation; with autograft (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1061.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85013","name":"Spun microhematocrit","description":"Blood count; spun microhematocrit","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0730T","name":"Trabeculotomy lsr w/oct gdn","description":"Trabeculotomy by laser, including optical coherence tomography (oct) guidance","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"Breathing capacity test","description":"Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement(s), with or without maximal voluntary ventilation","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83663","name":"Fluoro polarize fetal lung","description":"Fetal lung maturity assessment; fluorescence polarization","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0328U","name":"Drug assay 120+ rx&metablt","description":"Drug assay 120+ rx&metablt","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0701","name":"Pano radio image","description":"Pano radio image","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5129","name":"Inj, vegzelma, 10 mg","description":"Injection, bevacizumab-adcd (vegzelma), biosimilar, 10 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98015","name":"Synch audio-only est high 40","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selec","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0984T","name":"Iv img xtrc cere vsl oct 1st","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4305","name":"Amer am ac tri-lay per sq cm","description":"American amnion ac tri-layer, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90382","name":"Rsv monoc antb seasn .7ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose, 0.7 ml, for intramuscular use","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1372","name":"Mst rec gsa >=7 and<8","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 7.0% and < 8.0%","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2029","name":"Mirotract matrix sheet","description":"Mirotract wound matrix sheet, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15017","name":"App skn cll ssp f/n/g/hf 1st","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 480 sq cm or less","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5421","name":"Dentures adjust part maxill","description":"Adjust partial denture - maxillary","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90484","name":"Imm cnsl not admn sm>20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 20 minutes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1232","name":"Pt hcv tst reactive result","description":"Patient receives hcv antibody test with reactive result","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6035","name":"Prosthetic digit mechanical","description":"Single prosthetic digit, mechanical, can include metacarpophalangeal (mcp), proximal interphalangeal (pip), and/or distal interphalangeal (dip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60100","name":"Biopsy of thyroid","description":"Biopsy thyroid, percutaneous core needle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15016","name":"App skn cl ssp agrf t/a/l ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; each additional 480 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0549U","name":"Onc urthl dna mthyltd rt pcr","description":"Onc urthl dna mthyltd rt pcr","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1211","name":"Gsa level>9.0%","description":"Most recent glycemic status assessment (hba1c or gmi) level > 9.0%","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4272","name":"Esano a, per sq cm","description":"Esano a, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85013","name":"Spun microhematocrit","description":"Blood count; spun microhematocrit","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9174","name":"Inj, docetaxel (beizray) 1mg","description":"Injection, docetaxel (beizray), 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0614","name":"Inj, treosulfan, 50 mg","description":"Injection, treosulfan, 50 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0590U","name":"Nfct ds bct&fngl dna 44 orgs","description":"Nfct ds bct&fngl dna 44 orgs","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0329U","name":"Onc neo xome&trns seq alys","description":"Onc neo xome&trns seq alys","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5657","name":"Add low ext man aut vol any","description":"Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0942T","name":"Cysto flx rmv&rplc urtl scaf","description":"Cystourethroscopy, flexible; with removal and replacement of prostatic urethral scaffold","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0391","name":"Inj, artesunate, 1mg","description":"Injection, artesunate, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1072","name":"Inj, testosterone, azmiro","description":"Injection, testosterone cypionate (azmiro), 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1212","name":"Missing gsa not perf","description":"Glycemic status assessment (hba1c or gmi) level is missing, or was not performed during the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1310","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78492","name":"Myocrd img pet mlt rst&strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); multiple studies at rest and stress (exercise or pharmacologic)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7021","name":"Suppl and access lung expan","description":"Supplies and accessories for lung expansion airway clearance, continuous high frequency oscillation, and nebulization device (e.g., handset, nebulizer kit, biofilter)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2010","name":"Apis, per square centimeter","description":"Apis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36015","name":"Place catheter in artery","description":"Selective catheter placement, segmental or subsegmental pulmonary artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1444","name":"Del < 39 weeks gest","description":"Delivery at < 39 weeks of gestation","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50240","name":"Nephrectomy partial","description":"Nephrectomy, partial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1421.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61537","name":"Removal of brain tissue","description":"Craniotomy with elevation of bone flap; for lobectomy, temporal lobe, without electrocorticography during surgery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2166.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0406U","name":"Onc lung flow cytmtry 5 mrk","description":"Onc lung flow cytmtry 5 mrk","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4231","name":"Ana crown exp 1-3 per quad","description":"Anatomical crown exposure - one to three teeth per quadrant","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25136","name":"Remove & graft wrist lesion","description":"Excision or curettage of bone cyst or benign tumor of carpal bones; with allograft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":625.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0820T","name":"Mntr psychdlc med 1stphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; first physician or other qualified health care professional, each hour","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64718","name":"Revise ulnar nerve at elbow","description":"Neuroplasty and/or transposition; ulnar nerve at elbow","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":597.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15854","name":"Removal sutr&stapl xreq anes","description":"Removal of sutures and staples not requiring anesthesia (list separately in addition to e/m code)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0616U","name":"Neurol dementia alys >30000","description":"Neurol dementia alys >30000","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61891","name":"Rev/rplcmt sk-mnt crnl nstm","description":"Revision or replacement of skull-mounted cranial neurostimulator pulse generator or receiver with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9277","name":"Pembrolizumab 1mg berahyalur","description":"Injection, pembrolizumab, 1 mg and berahyaluronidase alfa-pmph","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7957","name":"Tiss regen edent nonresorb","description":"Tiss regen edent nonresorb","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4457","name":"Enema tube any type repl","description":"Enema tube, with or without adapter, any type, replacement only, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0500U","name":"Autoinflam ds vexas synd dna","description":"Autoinflam ds vexas synd dna","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83630","name":"Lactoferrin fecal (qual)","description":"Lactoferrin, fecal; qualitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0627U","name":"Psyc scz dna alys >15000","description":"Psyc scz dna alys >15000","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57160","name":"Insert pessary/other device","description":"Fitting and insertion of pessary or other intravaginal support device","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1210","name":">=2 same meds tbl4 not ord","description":"At least two orders for high-risk medications from the same drug class, (table 4), not ordered","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0308U","name":"Crd cad alys 3 prtn plsm alg","description":"Crd cad alys 3 prtn plsm alg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4560","name":"Nmes disposable","description":"Neuromuscular electrical stimulator (nmes), disposable, replacement only","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0360U","name":"Onc lung elisa 7 autoant alg","description":"Onc lung elisa 7 autoant alg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42104","name":"Excision lesion mouth roof","description":"Excision, lesion of palate, uvula; without closure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1783","name":"Vac admin human pap dose 3","description":"Vac admin human pap dose 3","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11900","name":"Inject skin lesions </w 7","description":"Injection, intralesional; up to and including 7 lesions","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74019","name":"Radex abdomen 2 views","description":"Radiologic examination, abdomen; 2 views","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0665","name":"Inj, bupivacaine, nos, 0.5mg","description":"Injection, bupivicaine, not otherwise specified, 0.5 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80076","name":"Hepatic function panel","description":"Hepatic function panel this panel must include the following: albumin (82040) bilirubin, total (82247) bilirubin, direct (82248) phosphatase, alkaline (84075) protein, total (84155) transferase, alanine amino (alt) (sgpt) (84460) transferase, aspartate amino (ast) (sgot) (84450)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9064","name":"Inj, cabazitaxel (sandoz)","description":"Injection, cabazitaxel (sandoz), not therapeutically equivalent to j9043, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3472","name":"Surg rep root res premolar","description":"Surg rep root res premolar","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80428","name":"Growth hormone panel","description":"Growth hormone stimulation panel (eg, arginine infusion, l-dopa administration) this panel must include the following: human growth hormone (hgh) (83003 x 4)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9563","name":"Ht inj immuno diem","description":"Home injectable therapy, immunotherapy, 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":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93970","name":"Extremity study","description":"Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0281U","name":"Hem vwd propeptide ag lvl","description":"Hematology (von willebrand disease [vwd]), von willebrand propeptide, enzyme-linked immunosorbent assays (elisa), plasma, diagnostic report of von willebrand factor (vwf) propeptide antigen level","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9871","name":"Bhv couns dm prev, onln 60 m","description":"Behavioral counseling for diabetes prevention, online, 60 minutes","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0765T","name":"Asstv alg ecg rsk asmt prev","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to previously performed electrocardiogram","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0605U","name":"All&immunology hat tpsab1","description":"All&immunology hat tpsab1","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2402","name":"Chloroprocaine (clorotekal)","description":"Injection, chloroprocaine hydrochloride (clorotekal), per 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0681T","name":"Rlcj pulse gen only isdss","description":"Relocation of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing dual leads","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57700","name":"Revision of cervix","description":"Cerclage of uterine cervix, nonobstetrical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2057","name":"Afamitresgene autoleucel","description":"Afamitresgene autoleucel, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0267U","name":"Rare do id opt gen mapg&seq","description":"Rare constitutional and other heritable disorders, identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping and whole-genome sequencing","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0679T","name":"Laps rmvl lead isdss","description":"Laparoscopic removal of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4314","name":"Reeva, per sq cm","description":"Reeva ft, per square cenitmeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92972","name":"Perq trluml coronry lithotrp","description":"Percutaneous transluminal coronary lithotripsy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0530U","name":"Onc pan-sol tum ctdna 77 gen","description":"Onc pan-sol tum ctdna 77 gen","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0859T","name":"Ncntc ifr spctrsc o/t pad ea","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), other than for screening for peripheral arterial disease, image acquisition, interpretation, and report; each additional anatomic site (list separately in addition to code ","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2325","name":"Nesiritide injection","description":"Injection, nesiritide, 0.1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37271","name":"Revsc evsc fpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9947","name":"Sleep apnea appliance","description":"Sleep apnea appliance","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57106","name":"Vagnc prtl rmvl vag wall","description":"Vaginectomy, partial removal of vaginal wall;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93897","name":"Emboli detcj wo iv mbubb njx","description":"Emboli detection without intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1428","name":"Bilateral absence of eyes","description":"Patients who have bilateral absence of eyes any time during the patients history through the end of the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4016","name":"Neurosurgical ss","description":"Neurosurgical mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0915T","name":"Insj perm ccm-d sys pg&eltrd","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator and dual transvenous electrodes/leads (pacing and defibrillation)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55867","name":"Laps surg prst8ect smpl stot","description":"Laparoscopy, surgical prostatectomy, simple subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy), includes robotic assistance, when performed","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0458","name":"Aztreonam/avibactam 10 mg","description":"Injection, aztreonam/avibactam, 7.5 mg/2.5 mg (10 mg)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71048","name":"X-ray exam chest 4+ views","description":"Radiologic examination, chest; 4 or more views","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1437","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4360","name":"Amchoplast fd per sq cm","description":"Amchoplast fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0521","name":"New pt-cg dyad dem hig cmplx","description":"Management of new patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4438","name":"Adhesive clip ext ens contr","description":"Adhesive clip applied to the skin to secure external electrical nerve stimulator controller, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0777T","name":"R-t prs sensing edrl gdn sys","description":"Real-time pressure-sensing epidural guidance system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76946","name":"Echo guide for amniocentesis","description":"Ultrasonic guidance for amniocentesis, imaging supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1836","name":"Inj, metronidazole, 10 mg","description":"Injection, metronidazole, 10 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74480","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87468","name":"Anaplsma phgcytophlm amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); anaplasma phagocytophilum, amplified probe technique","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78111","name":"Plasma volume multiple","description":"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); multiple samplings","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1415","name":"No pos pdl1 bef ici ther","description":"Patients who did not have a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33953","name":"Ecmo/ecls insj prph cannula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; insertion of peripheral (arterial and/or venous) cannula(e), open, birth through 5 years of age","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":495.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90961","name":"Esrd srv 2-3 vsts p mo 20+","description":"End-stage renal disease (esrd) related services monthly, for patients 20 years of age and older; with 2-3 face-to-face visits by a physician or other qualified health care professional per month","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1255","name":"Pts w/ othr rsn vst,+prg tst","description":"Patients who have another reason for visiting the clinic [not prenatal or postpartum care] and have a positive pregnancy test but have not established the clinic as an ob provider (e.g., plan to terminate the pregnancy or seek prenatal services elsewhere)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90695","name":"H5n8 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n8, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5161","name":"Inj, denosumab-kyqq, 1 mg","description":"Injection, denosumab-kyqq (aukelso/bosaya), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64575","name":"Opn impltj nea perph nerve","description":"Open implantation of neurostimulator electrode array; peripheral nerve (excludes sacral nerve)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4023","name":"Pathology ss","description":"Pathology mips specialty set","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0987T","name":"Iv img icr cere vsl oct ea","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6114","name":"Implnt/abut fixed dent max","description":"Implnt/abut fixed dent max","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2403","name":"Chloroprocaine opht gel, 1mg","description":"Chloroprocaine hcl ophthalmic, 3% gel, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87076","name":"Culture anaerobe ident each","description":"Culture, bacterial; anaerobic isolate, additional methods required for definitive identification, each isolate","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82543","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0465","name":"Home vent invasive interface","description":"Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1360.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37267","name":"Revsc evsc fpvt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90957","name":"Esrd srv 4 vsts p mo 12-19","description":"End-stage renal disease (esrd) related services monthly, for patients 12-19 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 4 or more face-to-face visits by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":904.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0528U","name":"Lrt iad 18bct/8vir&7arg rna","description":"Lrt iad 18bct/8vir&7arg rna","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0819T","name":"Revj/rmvl ins ptn subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0759","name":"Inj, clevidipine, 1 mg","description":"Injection, clevidipine butyrate, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59020","name":"Fetal contract stress test","description":"Fetal contraction stress test","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86036","name":"Anca screen each antibody","description":"Antineutrophil cytoplasmic antibody (anca); screen, each antibody","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94760","name":"N-invas ear/pls oximetry 1","description":"Noninvasive ear or pulse oximetry for oxygen saturation; single determination","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98001","name":"Synch audio-video new low 30","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1028","name":"Take home supply 8mg per 0.1","description":"Take-home supply of nasal naloxone; 2-pack of 8mg per 0.1 ml nasal spray (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92924","name":"Prq trluml c athrc 1 art&/br","description":"Percutaneous transluminal coronary atherectomy, with coronary angioplasty when performed, single major coronary artery and/or its branch(es)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":779.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2468","name":"Inj, palonosetron (posfrea)","description":"Injection, palonosetron hydrochloride (posfrea), 25 micrograms","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0710T","name":"N-invas artl plaq alys","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; including data preparation and transmission, quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess a","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0771T","name":"Vr px dissoc svc sm phy 1st","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4341","name":"Simplimax, per sq cm","description":"Simplimax, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0710T","name":"N-invas artl plaq alys","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; including data preparation and transmission, quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess a","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1258","name":"Cvd risk assess perf","description":"Cvd risk assessment performed, have a documented calculated risk score","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D8091","name":"Compre ortho treat w surg","description":"Compre ortho treat w surg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1576","name":"Inj, panzyga, 500 mg","description":"Injection, immune globulin (panzyga), intravenous, non-lyophilized (e.g., liquid), 500 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81560","name":"Trnsplj pd lvr&bwl cd154+cll","description":"Transplantation medicine (allograft rejection, pediatric liver and small bowel), measurement of donor and third-party-induced cd154+t-cytotoxic memory cells, utilizing whole peripheral blood, algorithm reported as a rejection risk score","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0434U","name":"Rx metab advrs vrnt alys 25","description":"Rx metab advrs vrnt alys 25","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37266","name":"Rvsc evsc fpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68362","name":"Revise eyelid lining","description":"Conjunctival flap; total (such as gunderson thin flap or purse string flap)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":625.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39545","name":"Revision of diaphragm","description":"Imbrication of diaphragm for eventration, transthoracic or transabdominal, paralytic or nonparalytic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1020.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1460","name":"Dx copd, cf, or arf","description":"Diagnosis for chronic obstructive pulmonary disease, emphysema, cystic fibrosis, or acute respiratory failure","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9333","name":"Inj rozanolixizum-noli 1 mg","description":"Injection, rozanolixizumab-noli, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33904","name":"Perq p-art revsc each addl","description":"Percutaneous pulmonary artery revascularization by stent placement, each additional vessel or separate lesion, normal or abnormal connections (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1241","name":"Pt no resp seen as person","description":"Patient did not respond to the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0472","name":"Gross exam prep & report","description":"Accession of tissue gross examination preparation and transmission of written report","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4019","name":"Oncology/hema ss","description":"Oncology/hematology mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63053","name":"Lam factc/frmt arthrd lum ea","description":"Laminectomy, facetectomy, or foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s] [eg, spinal or lateral recess stenosis]), during posterior interbody arthrodesis, lumbar; each additional vertebral segment (list separately in addition to code for","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4414","name":"Simplichor per sq cm","description":"Simplichor, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15111","name":"Epidrm agrft t/a/l ea addl","description":"Epidermal autograft, trunk, arms, legs; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91112","name":"Gi wireless capsule measure","description":"Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1355.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1301","name":"Pt recv tbco cess interv","description":"Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0877T","name":"Augmnt alys ch ct ild w/o ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1921","name":"Inj labetalol hcl hikma, 5mg","description":"Injection, labetalol hydrochloride (hikma), not therapeutically equivalent to j1920, 5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1153","name":"Pt w/ dx osteo doe","description":"Patient with diagnosis of osteoporosis on date of encounter","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98013","name":"Synch audio-only est low 20","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code select","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0981T","name":"Tcat impl wrls ivc snr","description":"Transcatheter implantation of wireless inferior vena cava sensor for long-term hemodynamic monitoring, including deployment of the sensor, radiological supervision and interpretation, right heart catheterization, and inferior vena cava venography, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4305","name":"Amer am ac tri-lay per sq cm","description":"American amnion ac tri-layer, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90382","name":"Rsv monoc antb seasn .7ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose, 0.7 ml, for intramuscular use","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98007","name":"Synch audio-video est hi 40","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high medical decision making. when using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0781T","name":"Brnchsc rf dstrj pulm nrv bi","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; bilateral mainstem bronchi","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19220","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1162.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7241","name":"Impact tooth rem bony w/comp","description":"Removal of impacted tooth-completely bony with unusual surgical complications","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33268","name":"Excl laa opn oth px any meth","description":"Exclusion of left atrial appendage, open, performed at the time of other sternotomy or thoracotomy procedure(s), any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9154","name":"Artificial saliva, 1 ml","description":"Artificial saliva, 1 ml","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0982T","name":"Rem mntr impl ivc snr set-up","description":"Remote monitoring of implantable inferior vena cava sensor, physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate), initial set-up and patient education on use of equipment","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98003","name":"Synch audio-video new hi 60","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high medical decision making. when using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0787T","name":"Revj/rmvl nea sac w/nstim","description":"Revision or removal of neurostimulator electrode array, sacral, with integrated neurostimulator","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4370","name":"Aeroguard per sq cm","description":"Aeroguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86053","name":"Aqaprn-4 antb flo cytmtry ea","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; flow cytometry (ie, fluorescence-activated cell sorting [facs]), each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6253","name":"Provisional pontic","description":"Provisional pontic","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4412","name":"Choriofix per sq cm","description":"Choriofix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4292","name":"Lamellas, per sq cm","description":"Lamellas, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1173","name":"Pt no rec td/tdap 9yrs prior","description":"Patient did not receive at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11462","name":"Exc skn hdrdnt ing smpl/ntrm","description":"Excision of skin and subcutaneous tissue for hidradenitis, inguinal; with simple or intermediate repair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1012T","name":"Mtrz ab ntrno trph scl/tr mw","description":"Motorized ab interno trephination of sclera (sclerostomy), or trabecular meshwork (trabeculostomy), 1 or more, including injection of antifibrotic agents, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4424","name":"Revive ft per sq cm","description":"Revive ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4394","name":"Surgraft aca per sq cm","description":"Surgraft aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98003","name":"Synch audio-video new hi 60","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high medical decision making. when using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84588","name":"Assay of vasopressin","description":"Vasopressin (antidiuretic hormone, adh)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1275","name":"Pts hosp exl","description":"Patients determined to be in hospice were excluded from month of evaluation and the remainder of reporting period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"X-ray exam chest 2 views","description":"Radiologic examination, chest; 2 views","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0923T","name":"Rmvl&rplcmt perm ccm-d pg","description":"Removal and replacement of permanent cardiac contractility modulation-defibrillation pulse generator only","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5140","name":"Inj adalimumab-fkjp, 1 mg","description":"Injection, adalimumab-fkjp, biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0011","name":"Hiv prep counsel, md 15-30m","description":"Individual counseling for pre-exposure prophylaxis (prep) by physician or qualified health care professional (qhp) to prevent human immunodeficiency virus (hiv), includes hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence, 15-30 minutes","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33903","name":"Perq p-art revsc 1 abnor bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, bilateral","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4257","name":"Relese, per sq cm","description":"Relese, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0700T","name":"Molec fluor img sus nev 1st","description":"Molecular fluorescent imaging of suspicious nevus; first lesion","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9914","name":"Admin of dermal fill","description":"Admin of dermal fill","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","name":"Scoliosis orth sag/ cor","description":"Scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla to trochanter, includes all accessory pads, straps and interface, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0463","name":"Inj atropine (fresenius te)","description":"Injection, atropine sulfate (fresenius and therapeutically equivalent), 0.01 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2042","name":"Foundation drs+ solo, sq cm","description":"Foundation drs+ solo, per square centimeter","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5877","name":"Dup of complt dent-maxill","description":"Dup of complt dent-maxill","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0923T","name":"Rmvl&rplcmt perm ccm-d pg","description":"Removal and replacement of permanent cardiac contractility modulation-defibrillation pulse generator only","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0518U","name":"Ther rx mntr 90+ pn&mtl hlth","description":"Ther rx mntr 90+ pn&mtl hlth","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0265U","name":"Rar do whl gn&mtcdrl dna als","description":"Rare constitutional and other heritable disorders, whole- genome and mitochondrial dna sequence analysis, blood, frozen and formalin-fixed paraffin-embedded (ffpe) tissue, saliva, buccal swabs or cell lines, identification of single nucleotide and copy number variants","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0831T","name":"Dgtz gls mcrscp cytp c/v","description":"Digitization of glass microscope slides for cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9800","name":"Gallium locametz 1 millicuri","description":"Gallium ga-68 gozetotide, diagnostic, (locametz), 1 millicurie","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0256U","name":"Tma/tmao prfl ms/ms ur alg","description":"Trimethylamine/trimethylamine n-oxide (tma/tmao) profile, tandem mass spectrometry (ms/ms), urine, with algorithmic analysis and interpretive report","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1748","name":"Inj, zymfentra, 10 mg","description":"Injection, infliximab-dyyb (zymfentra), 10 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1286","name":"Bmi doc onl fup not cmpltd","description":"Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5996","name":"Peri medicament w/seal, mand","description":"Peri medicament w/seal, mand","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"Sup/ext non-ins inf pump syr","description":"Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1292","name":"Pt 66+ frail inpt adv ill","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and an advanced illness diagnosis during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68540","name":"Remove tear gland lesion","description":"Excision of lacrimal gland tumor; frontal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":916.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78220","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":220.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J1810","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0530U","name":"Onc pan-sol tum ctdna 77 gen","description":"Onc pan-sol tum ctdna 77 gen","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9957","name":"Screening sleep disorders","description":"Screening sleep disorders","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64596","name":"Ins/rplcmt prq eltrd ra pn 1","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; initial electrode array","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0463U","name":"Onc crvx mrna genxprsn 14bmk","description":"Onc crvx mrna genxprsn 14bmk","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85004","name":"Automated diff wbc count","description":"Blood count; automated differential wbc count","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2032","name":"Myriad matrix, per sq cm","description":"Myriad matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55869","name":"Lap srg prst8ct bi pl lmphad","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"13121","name":"Cmplx rpr s/a/l 2.6-7.5 cm","description":"Repair, complex, scalp, arms, and/or legs; 2.6 cm to 7.5 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21610","name":"Costotransversectomy","description":"Costotransversectomy (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1197.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0528","name":"Mgt est pt dem mod-hi cmplx","description":"Management of established patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0216","name":"Inj, alfentanil hcl, 500mcg","description":"Injection, alfentanil hydrochloride, 500 micrograms","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5783","name":"Add low ext mec limb vol lam","description":"Addition to lower extremity, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1290","name":"Pt not eli d/t act dig htn","description":"Patient not eligible due to active diagnosis of hypertension","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0051","name":"Traditional healing service","description":"Traditional healing service","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0691T","name":"Auto alys xst ct std vrt fx","description":"Automated analysis of an existing computed tomography study for vertebral fracture(s), including assessment of bone density when performed, data preparation, interpretation, and report","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4408","name":"Xwrap hydro per sq cm","description":"Xwrap hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0831T","name":"Dgtz gls mcrscp cytp c/v","description":"Digitization of glass microscope slides for cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93598","name":"Car outp meas drg cath chd","description":"Cardiac output measurement(s), thermodilution or other indicator dilution method, performed during cardiac catheterization for the evaluation of congenital heart defects (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7353","name":"Anacaulase-bcdb 8.8% gel 1 g","description":"Anacaulase-bcdb, 8.8% gel, 1 gram","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0805T","name":"Tcat s&ivc prstc vl impl prq","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); percutaneous femoral vein approach","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1317","name":"Pts counsl cpt opt out","description":"Patients who are counseled on connection with a csp and explicitly opt out","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0763T","name":"Dgtz gls mcrscp mphmtrc alys","description":"Digitization of glass microscope slides for morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure, manual (list separately in addition to code for primary proced","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4297","name":"Emerge matrix, per sq cm","description":"Emerge matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90461","name":"Im admin each addl component","description":"Immunization administration through 18 years of age via any route of administration, with counseling by physician or other qualified health care professional; each additional vaccine or toxoid component administered (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98986","name":"Rtm dev sply cbt 2-15 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of cognitive behavioral therapy, 2-15 days in a 30-day period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":317.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5878","name":"Dup of complt dent-mandib","description":"Dup of complt dent-mandib","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2799","name":"Inj, uzedy, 1 mg","description":"Injection, risperidone (uzedy), 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1411","name":"Inj, hemgenix, per tx dose","description":"Injection, etranacogene dezaparvovec-drlb, per therapeutic dose","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1281","name":"Bp scrn no perf at interval","description":"Blood pressure reading not documented, reason not given","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0608","name":"Lanthanum carbonate pwdr 5mg","description":"Lanthanum carbonate, oral, powder, 5 mg, not therapeutically equivalent to j0607 (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64582","name":"Opn mpltj hpglsl nstm ary pg","description":"Open implantation of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0814T","name":"Prq njx biod osteo matrl fem","description":"Percutaneous injection of calcium-based biodegradable osteoconductive material, proximal femur, including imaging guidance, unilateral","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1220","name":"Dre wth interp rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; with evidence of retinopathy","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0956T","name":"Prt crn ch cr&tun elt s-sclp","description":"Partial craniectomy, channel creation, and tunneling of electrode for sub-scalp implantation of an electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34703","name":"Evasc rpr a-unilac ndgft","description":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-uni-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in th","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1417.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93151","name":"Interrog&prgrmg ipnss","description":"Interrogation and programming (minimum one parameter) of implanted phrenic nerve stimulator system","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4402","name":"Xwrap 2.0 per sq cm","description":"Xwrap 2.0, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9997","name":"Ustekinumab-ttwe iv inj 1 mg","description":"Injection, ustekinumab-ttwe (pyzchiva), intravenous, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30410","name":"Reconstruction of nose","description":"Rhinoplasty, primary; complete, external parts including bony pyramid, lateral and alar cartilages, and/or elevation of nasal tip","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1497.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0897T","name":"N-invas augmnt arrhyt alys","description":"Noninvasive augmentative arrhythmia analysis derived from quantitative computational cardiac arrhythmia simulations, based on selected intervals of interest from 12-lead electrocardiogram and uploaded clinical parameters, including uploading clinical parameters with interpretation and report","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56515","name":"Destroy vulva lesion/s compl","description":"Destruction of lesion(s), vulva; extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2372","name":"Inj, biorphen, 20 micrograms","description":"Injection, phenylephrine hydrochloride (biorphen), 20 micrograms","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0383U","name":"Tyrosinemia typ i mntr quan","description":"Tyrosinemia typ i mntr quan","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1227","name":"Eb therapy prescribed","description":"Evidence-based therapy was prescribed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0224","name":"Pemivibart infusion","description":"Intravenous infusion, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppr","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37295","name":"Rvsc evsc tpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4429","name":"Dermbnd chn, chx per sq cm","description":"Dermabind ch n or dermabind ch x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0804T","name":"Prgrmg evl ldls pm 2chmbr ip","description":"Programming device evaluation (in person) with iterative adjustment of implantable device to test the function of device and to select optimal permanent programmed values, with analysis, review, and report, by a physician or other qualified health care professional, leadless pacemaker system in dual","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0877","name":"Inj, daptomycin (hospira)","description":"Injection, daptomycin (hospira), not therapeutically equivalent to j0878, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7961","name":"Buccal/labial frenectomy","description":"Buccal/labial frenectomy","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0867T","name":"Tpla b9 prst8 hyprplsa>=50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume greater or equal to 50 ml","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0011","name":"Hiv prep counsel, md 15-30m","description":"Individual counseling for pre-exposure prophylaxis (prep) by physician or qualified health care professional (qhp) to prevent human immunodeficiency virus (hiv), includes hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence, 15-30 minutes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35045","name":"Repair defect of arm artery","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, radial or ulnar artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1227.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7299","name":"Intraut copp cont (miudella)","description":"Intrauterine copper contraceptive (miudella)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0340U","name":"Onc pan ca alys mrd plasma","description":"Onc pan ca alys mrd plasma","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96041","name":"Genetic counseling svc ea 30","description":"Medical genetics and genetic counseling services, each 30 minutes of total time provided by the genetic counselor on the date of the encounter","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5145","name":"Inj, abrilada, 1 mg","description":"Injection, adalimumab-afzb (abrilada), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1612","name":"Inj glucagon (gvoke) 0.01 mg","description":"Injection, glucagon (gvoke), 0.01 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35511","name":"Art byp grft subclav-subclav","description":"Bypass graft, with vein; subclavian-subclavian","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1488.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0579U","name":"Nfro dbtc ckd elisa apoa4","description":"Nfro dbtc ckd elisa apoa4","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98986","name":"Rtm dev sply cbt 2-15 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of cognitive behavioral therapy, 2-15 days in a 30-day period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0991T","name":"Cysto lo-nrg lithtrp&mcrsphr","description":"Cystourethroscopy, with low-energy lithotripsy and acoustically actuated microspheres, including imaging","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9595","name":"Piflu f-18, dia 1 millicurie","description":"Piflufolastat f-18, diagnostic, 1 millicurie","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0430U","name":"Gi malabs aat calpro pncrtc","description":"Gi malabs aat calpro pncrtc","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0444","name":"Depression screen annual","description":"Annual depression screening, 5 to 15 minutes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":8.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0968T","name":"Insj/rplcmt epcrnl nstim sys","description":"Insertion or replacement of epicranial neurostimulator system, including electrode array and pulse generator, with connection to electrode array","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4037","name":"Urology ss","description":"Urology mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9073","name":"Inj cyclophos dr reddys 5 mg","description":"Injection, cyclophosphamide (dr. reddys), 5 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0479U","name":"Tau phosphorylated ptau217","description":"Tau phosphorylated ptau217","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0806T","name":"Tcat s&ivc prstc vl impl opn","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); open femoral vein approach","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23125","name":"Claviculectomy total","description":"Claviculectomy; total","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":847.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77315","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2471","name":"Inj pantoprazole(hikma) 40mg","description":"Injection, pantoprazole (hikma), not therapeutically equivalent to j2470, 40 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0268","name":"Removal of impacted wax md","description":"Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45350","name":"Sgmdsc w/band ligation","description":"Sigmoidoscopy, flexible; with band ligation(s) (eg, hemorrhoids)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":812.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2281","name":"Inj moxifloxacin (fres kabi)","description":"Injection, moxifloxacin (fresenius kabi), not therapeutically equivalent to j2280, 100 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6594","name":"G comp bandge liner lwr extr","description":"Gradient compression bandaging supply, bandage liner, lower extremity, any size or length, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1292","name":"Pt 66+ frail inpt adv ill","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and an advanced illness diagnosis during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4313","name":"Dermabind fm, per sq cm","description":"Dermabind fm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97007","name":"Mchnl sclp cool meas fitg","description":"Mechanical scalp cooling, including individual cap supply with head measurement, fitting, and patient education","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2023","name":"Innovamatrix pd, 1 mg","description":"Innovamatrix pd, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0562","name":"Complex simulation w/pet-ct","description":"Therapeutic radiology simulation-aided field setting; complex, including acquisition of pet and ct imaging data required for radiopharmaceutical-directed radiation therapy treatment planning (i.e., modeling)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0442U","name":"Nfct ds respir nfctj mxa&crp","description":"Nfct ds respir nfctj mxa&crp","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0827T","name":"Dgtz gls mcrscp cytp smears","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; smears with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27181","name":"Treat slipped epiphysis","description":"Open treatment of slipped femoral epiphysis; osteotomy and internal fixation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1183.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7197","name":"Antithrombin iii injection","description":"Antithrombin iii (human), per i.u.","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1383","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77438","name":"Surf rad thr orthvlt>150-500","description":"Surface radiation therapy; orthovoltage, delivery, >150-500 kv, per fraction","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80406","name":"Acth stimulation panel","description":"Acth stimulation panel; for 3 beta-hydroxydehydrogenase deficiency this panel must include the following: cortisol (82533 x 2) 17 hydroxypregnenolone (84143 x 2)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0898","name":"Argatroban nonesrd (auromed)","description":"Injection, argatroban (auromedics), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1232","name":"Pt hcv tst reactive result","description":"Patient receives hcv antibody test with reactive result","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1002T","name":"Air displacmnt plethysmograp","description":"Air displacement plethysmography, whole-body composition assessment, with interpretation and report","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0466","name":"Home vent non-invasive inter","description":"Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":731.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26555","name":"Positional change of finger","description":"Transfer, finger to another position without microvascular anastomosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82272","name":"Occult bld feces 1-3 tests","description":"Blood, occult, by peroxidase activity (eg, guaiac), qualitative, feces, 1-3 simultaneous determinations, performed for other than colorectal neoplasm screening","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99202","name":"Office o/p new sf 15 min","description":"Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 15 minutes must be met or exceede","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":46.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":87.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7414","name":"Excision malig lesion>1.25cm","description":"Excision of malignant lesion greater than 1.25 cm","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96203","name":"Mlt fam grp bhv train ea add","description":"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face with multiple sets of paren","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1461","name":"Pt dx chron hepc","description":"Patient diagnosis for chronic hepatitis c","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5137","name":"Inj, wezlana, sub cu, 1 mg","description":"Injection, ustekinumab-auub (wezlana), biosimilar, subcutaneous, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0296U","name":"Onc orl&/orop ca 20 mlc feat","description":"Onc orl&/orop ca 20 mlc feat","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1438","name":"Lst knwn well <=210 min","description":"Time last known well to hospital arrival less than or equal to 3.5 hours (<= 210 minutes)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34804","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1543.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29020","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82947","name":"Assay glucose blood quant","description":"Glucose; quantitative, blood (except reagent strip)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94375","name":"Respiratory flow volume loop","description":"Respiratory flow volume loop","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1328","name":"Pts dx acute vitreous hem","description":"Patients with a diagnosis of acute vitreous hemorrhage","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0713T","name":"N-nvs artl plaq alys rvw i&r","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data review, interpretation and report","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9172","name":"Docetaxel (docivyx), 1 mg","description":"Injection, docetaxel (docivyx), 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7671","name":"Alveolus open reduction","description":"Alveolus - open reduction may include stabilization of teeth","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4336","name":"Artecent c, per sq cm","description":"Artacent c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1456","name":"Inj, fosaprepitant (teva)","description":"Injection, fosaprepitant (teva), not therapeutically equivalent to j1453, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47142","name":"Partial removal donor liver","description":"Donor hepatectomy (including cold preservation), from living donor; total right lobectomy (segments v, vi, vii and viii)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4768.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2018","name":"Permeaderm c, per sq cm","description":"Permeaderm c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33400","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2167.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6564","name":"G com stckng waist 40+ cust","description":"Gradient compression stocking, waist length, 40 mmhg or greater, custom, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4457","name":"Enema tube any type repl","description":"Enema tube, with or without adapter, any type, replacement only, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86663","name":"Epstein-barr antibody","description":"Antibody; epstein-barr (eb) virus, early antigen (ea)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5909","name":"Max guid prothes w/ flange","description":"Max guid prothes w/ flange","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4015","name":"Neurology ss","description":"Neurology mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0915T","name":"Insj perm ccm-d sys pg&eltrd","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator and dual transvenous electrodes/leads (pacing and defibrillation)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99205","name":"Office o/p new hi 60 min","description":"Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":227.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1303","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4344","name":"Tri membrane wrap, per sq cm","description":"Tri-membrane wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9886","name":"In-person attendance g code","description":"Behavioral counseling for diabetes prevention, in-person, group, 60 minutes","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3376","name":"Inj vancomycin (hikma) 10mg","description":"Injection, vancomycin hcl (hikma), not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37259","name":"Revsc evasc ivt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0440U","name":"Crd chd dna alys 10 snp 6dna","description":"Crd chd dna alys 10 snp 6dna","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57452","name":"Exam of cervix w/scope","description":"Colposcopy of the cervix including upper/adjacent vagina;","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":88.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76015","name":"Mr sfty mplt&/fb asmt stf ea","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27893","name":"Decompression of leg","description":"Decompression fasciotomy, leg; posterior compartment(s) only, with debridement of nonviable muscle and/or nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":630.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3055","name":"Inj talquetamab-tgvs 0.25 mg","description":"Injection, talquetamab-tgvs, 0.25 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0283","name":"Inj, amiodarone (nexterone)","description":"Injection, amiodarone hydrochloride (nexterone), 30 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0763T","name":"Dgtz gls mcrscp mphmtrc alys","description":"Digitization of glass microscope slides for morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure, manual (list separately in addition to code for primary proced","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3911","name":"Intraorifice barrier","description":"Intraorifice barrier","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4312","name":"Acesso ac, per sq cm","description":"Acesso ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1331","name":"Pts eval ini xm 8 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 8 weeks from initial exam","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82234","name":"Beta-amyloid 1-42 (abeta 42)","description":"Beta-amyloid; 1-42 (abeta 42)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59614","name":"Vbac care after delivery","description":"Vaginal delivery only, after previous cesarean delivery (with or without episiotomy and/or forceps); including postpartum care","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1783","name":"Vac admin human pap dose 3","description":"Vac admin human pap dose 3","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64530","name":"N block inj celiac pelus","description":"Injection, anesthetic agent; celiac plexus, with or without radiologic monitoring","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59135","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1124.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0442U","name":"Nfct ds respir nfctj mxa&crp","description":"Nfct ds respir nfctj mxa&crp","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5933","name":"Refitting of obturator","description":"Obturator prosthesis modification","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1024T","name":"Perq tiss dsplmt soft tissue","description":"Percutaneous tissue displacement, any method, including imaging guidance; soft tissue (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32601","name":"Thoracoscopy diagnostic","description":"Thoracoscopy, diagnostic (separate procedure); lungs, pericardial sac, mediastinal or pleural space, without biopsy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4432","name":"510(k) skin subs, nos","description":"510(k) skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37270","name":"Revsc evasc fpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0761T","name":"Dgtz gls mcrscp sl imm ea 1","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1160","name":"Pt anphx due to mengb bef 13","description":"Patient had anaphylaxis due to the meningococcal vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0501U","name":"Onc clrc bld quan meas cfdna","description":"Onc clrc bld quan meas cfdna","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85013","name":"Spun microhematocrit","description":"Blood count; spun microhematocrit","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68801","name":"Dilate tear duct opening","description":"Dilation of lacrimal punctum, with or without irrigation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81515","name":"Nfct ds bv&vaginitis dna alg","description":"Infectious disease, bacterial vaginosis and vaginitis, real-time pcr amplification of dna markers for atopobium vaginae, atopobium species, megasphaera type 1, and bacterial vaginosis associated bacteria-2 (bvab-2), utilizing vaginal-fluid specimens, algorithm reported as positive or negative for hi","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9988","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49189","name":"Opn exc/dst ntra-abd 20.1-30","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 20.1 to 30 cm","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9224","name":"Gen anes adv air-15 min","description":"Gen anes adv air-15 min","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1178","name":"Doc med rsn no pcv","description":"Documentation of medical reason(s) for not administering pneumococcal vaccine (e.g., prior anaphylaxis due to the pneumococcal vaccine)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59120","name":"Treat ectopic pregnancy","description":"Surgical treatment of ectopic pregnancy; tubal or ovarian, requiring salpingectomy and/or oophorectomy, abdominal or vaginal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":940.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82775","name":"Assay galactose transferase","description":"Galactose-1-phosphate uridyl transferase; quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91321","name":"Sarscov2 vac 25 mcg/.25ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 25 mcg/0.25 ml dosage, for intramuscular use","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4322","name":"Splint intra-coronal","description":"Splint intra-coronal","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0515U","name":"Gi ibd ia quan deter ifx lvl","description":"Gi ibd ia quan deter ifx lvl","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2058","name":"Obecbtge autol up to 400 mil","description":"Obecabtagene autoleucel, 10 up to 400 million cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per infusion","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7412","name":"Excision benign lesion compl","description":"Excision of benign lesion complicated","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11444","name":"Exc face-mm b9+marg 3.1-4 cm","description":"Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 3.1 to 4.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4292","name":"Lamellas, per sq cm","description":"Lamellas, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0875T","name":"Prgrm subq prtl asct pmp sys","description":"Programming of subcutaneously implanted peritoneal ascites pump system by physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0035","name":"Pt ed pos 23","description":"Patient has any emergency department encounter during the performance period with place of service indicator 23","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0868T","name":"Hi-res gastric ep mapping","description":"High-resolution gastric electrophysiology mapping with simultaneous patient-symptom profiling, with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99236","name":"Hosp ip/obs same date hi 85","description":"Hospital inpatient or observation care, for the evaluation and management of a patient including admission and discharge on the same date, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter f","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0616U","name":"Neurol dementia alys >30000","description":"Neurol dementia alys >30000","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37279","name":"Iv lithotrp fpvt w/in sm art","description":"Intravascular lithotripsy(ies), femoral and popliteal vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37269","name":"Revsc evasc fpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1449","name":"Pt dx scz/pys bef end msr pd","description":"Patients with an active diagnosis of schizophrenia or psychotic disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1220","name":"Dre wth interp rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; with evidence of retinopathy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0545U","name":"Achr antb id imfluor livecll","description":"Achr antb id imfluor livecll","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86581","name":"Strptcs pneum antb serot ia","description":"Streptococcus pneumoniae antibody (igg), serotypes, multiplex immunoassay, quantitative","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99460","name":"Init nb em per day hosp","description":"Initial hospital or birthing center care, per day, for evaluation and management of normal newborn infant","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54001","name":"Slitting of prepuce","description":"Slitting of prepuce, dorsal or lateral (separate procedure); except newborn","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4399","name":"Summit fx per sq cm","description":"Summit fx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31075","name":"Exploration of frontal sinus","description":"Sinusotomy frontal; transorbital, unilateral (for mucocele or osteoma, lynch type)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":888.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0274U","name":"Hem gen pltlt do 43 genes","description":"Hematology (genetic platelet disorders), genomic sequence analysis of 43 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"Motor &/ sens nrve cndj test","description":"Motor and/or sensory nerve conduction, using preconfigured electrode array(s), amplitude and latency/velocity study, each limb, includes f-wave study when performed, with interpretation and report","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33897","name":"Perq trluml angp nt/recr coa","description":"Percutaneous transluminal angioplasty of native or recurrent coarctation of the aorta","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1293","name":"Calc bmi abv up param f/u","description":"Bmi is documented above normal parameters and a follow-up plan is documented","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9184","name":"Inj gemcitabin (avyxa) 200mg","description":"Injection, gemcitabine hydrochloride (avyxa), 200 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82233","name":"Beta-amyloid 1-40 (abeta 40)","description":"Beta-amyloid; 1-40 (abeta 40)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0041","name":"Pt/ptn decln referral","description":"Patient and/or care partner decline referral","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22838","name":"Rev rplc/rmv thrc vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracic vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2035","name":"Corpl p therac p allac p mg","description":"Corplex p or theracor p or allacor p, per milligram","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9615","name":"Inj, pegulicianine, 1 mg","description":"Injection, pegulicianine, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49596","name":"Rpr aa hrn 1st > 10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, incarcerated or strangulated","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01942","name":"Anes neuromd/ntrvrt lmbr/sac","description":"Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49187","name":"Opn exc/dstr ntra-abd 5.1-10","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5.1 to 10 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":891.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5100","name":"Inj ustekinumab-kfce, 1 mg","description":"Injection, ustekinumab-kfce (yesintek), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2291","name":"Inj, nafcillin (baxter) 20mg","description":"Injection, nafcillin sodium (baxter), 20 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0426","name":"Coll, analys of saliva","description":"Coll, analys of saliva","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2035","name":"Corpl p therac p allac p mg","description":"Corplex p or theracor p or allacor p, per milligram","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0581U","name":"Trnspl med antb nohla 39trgt","description":"Trnspl med antb nohla 39trgt","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53452","name":"Tprnl balo cntnc dev uni","description":"Periurethral transperineal adjustable balloon continence device; unilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96573","name":"Pdt dstr prmlg les phys/qhp","description":"Photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosensitizing drug(s) provided by a physician or other qualified health care professional, per day","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0607","name":"Lanthanum carbonate oral 5mg","description":"Lanthanum carbonate, oral, 5 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22101","name":"Remove part thorax vertebra","description":"Partial excision of posterior vertebral component (eg, spinous process, lamina or facet) for intrinsic bony lesion, single vertebral segment; thoracic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":879.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0570","name":"Care manage serv, pr cal mo","description":"Care management services for behavioral health conditions, directed by a physician or other qualified health care professional, per calendar month, with the following required elements: initial assessment or follow-up monitoring, including the use of applicable validated rating scales, behavioral he","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17262","name":"Dstrj mal les t/a/l 1.1-2.0","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), trunk, arms or legs; lesion diameter 1.1 to 2.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97009","name":"Mchnl sclp cool after chemo","description":"Mechanical scalp cooling; provided after discontinuation of chemotherapy, each 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4029","name":"Preventive medicine ss","description":"Preventive medicine mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1384","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59426","name":"Antepartum care only","description":"Antepartum care only; 7 or more visits","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1147.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":778.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97037","name":"Appl modality 1+lllt po pain","description":"Application of a modality to 1 or more areas; low-level laser therapy (ie, nonthermal and non-ablative) for post-operative pain reduction","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47146","name":"Prep donor liver/venous","description":"Backbench reconstruction of cadaver or living donor liver graft prior to allotransplantation; venous anastomosis, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":395.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0577","name":"Inj, brixadi, 7 days or less","description":"Injection, buprenorphine extended-release (brixadi), less than or equal to 7 days of therapy","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9172","name":"Docetaxel (docivyx), 1 mg","description":"Injection, docetaxel (docivyx), 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0590U","name":"Nfct ds bct&fngl dna 44 orgs","description":"Nfct ds bct&fngl dna 44 orgs","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0651","name":"Lso sag-co shell pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":809.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J9097","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25575","name":"Optx rdl&uln shft fx rds&uln","description":"Open treatment of radial and ulnar shaft fractures, with internal fixation, when performed; of radius and ulna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":994.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85612","name":"Viper venom prothrombin time","description":"Russell viper venom time (includes venom); undiluted","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0663","name":"Team remote e/m new pt 45 mn","description":"Team remote e/m new pt 45mins","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0782T","name":"Brnchsc rf dstrj plm nrv uni","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; unilateral mainstem bronchus","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63035","name":"Lamot dcmprn nrv rt ea addl","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; each additional interspace, cervical or lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81560","name":"Trnsplj pd lvr&bwl cd154+cll","description":"Transplantation medicine (allograft rejection, pediatric liver and small bowel), measurement of donor and third-party-induced cd154+t-cytotoxic memory cells, utilizing whole peripheral blood, algorithm reported as a rejection risk score","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90808","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77439","name":"Surf rad thr img gdn us plmt","description":"Surface radiation therapy; superficial or orthovoltage, image guidance, ultrasound for placement of radiation therapy fields for treatment of cutaneous tumors, per course of treatment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7023","name":"Mech allergen parti barrier","description":"Mechanical allergen particle barrier/inhalation filter, cream, nasal, topical","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1308","name":"Flu immunize no admin","description":"Influenza immunization was not administered, reason not given","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83925","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0576U","name":"Trnsplj med lar quan ddcfdna","description":"Trnsplj med lar quan ddcfdna","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0738","name":"Upper extremity rehab","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53453","name":"Tprnl balo cntnc dev rmvl ea","description":"Periurethral transperineal adjustable balloon continence device; removal, each balloon","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0956T","name":"Prt crn ch cr&tun elt s-sclp","description":"Partial craniectomy, channel creation, and tunneling of electrode for sub-scalp implantation of an electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98005","name":"Synch audio-video est low 20","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low medical decision making. when using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded.","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19350","name":"Nipple/areola reconstruction","description":"Nipple/areola reconstruction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":795.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4388","name":"Neothelium 4l per sq cm","description":"Neothelium 4l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61711","name":"Fusion of skull arteries","description":"Anastomosis, arterial, extracranial-intracranial (eg, middle cerebral/cortical) arteries","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3027.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1300","name":"Flu imm no admin doc rea","description":"Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8522","name":"Capecitabine, oral, 50 mg","description":"Capecitabine, oral, 50 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4352","name":"Overlay sl matrix, per sq cm","description":"Overlay sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76883","name":"Us nrv&acc strux 1xtr compre","description":"Ultrasound, nerve(s) and accompanying structures throughout their entire anatomic course in one extremity, comprehensive, including real-time cine imaging with image documentation, per extremity","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0338U","name":"Onc sld tum crcg tum cl slct","description":"Onc sld tum crcg tum cl slct","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99226","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0694T","name":"3d vol img&rcnstj brst/ax","description":"3-dimensional volumetric imaging and reconstruction of breast or axillary lymph node tissue, each excised specimen, 3-dimensional automatic specimen reorientation, interpretation and report, real-time intraoperative","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92638","name":"Bhvl verif of amplification","description":"Behavioral verification of amplification including aided thresholds, functional gain, speech-in-noise, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1202","name":"Pt rsn no ace-i/arb rx","description":"Documentation of patient reason(s) for not prescribing ace inhibitor or arb therapy during the measurement period, (e.g., patient declined, other patient reasons)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9174","name":"Inj, docetaxel (beizray) 1mg","description":"Injection, docetaxel (beizray), 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1348","name":"Pam incr 6 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 6-points in a 4 to 12 month period (excellent)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4322","name":"Caregraft, per sq cm","description":"Caregraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91322","name":"Sarscov2 vac 50 mcg/0.5ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 50 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1643","name":"Inj heparin, pfizer, 1000u","description":"Injection, heparin sodium (pfizer), not therapeutically equivalent to j1644, per 1000 units","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5933","name":"Refitting of obturator","description":"Obturator prosthesis modification","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0754T","name":"Dgtz gls mcrscp sld level v","description":"Digitization of glass microscope slides for level v, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01939","name":"Anes nulyt agt crv/thrc","description":"Anesthesia for percutaneous image-guided destruction procedures by neurolytic agent on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7473","name":"Remove torus mandibularis","description":"Removal of torus mandibularis","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5141","name":"Inj adalimumab-aaty, 1 mg","description":"Injection, adalimumab-aaty, biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25355","name":"Revision of radius","description":"Osteotomy, radius; middle or proximal third","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1225.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4426","name":"Dermbnd tl+, tlx per sq cm","description":"Dermabind tl + or dermabind tl x,  per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1247","name":"Pt resp true best int","description":"Patient responded completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37293","name":"Rvsc evsc tpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5156","name":"Inj, tocilizumab-anoh, 1 mg","description":"Injection, tocilizumab-anoh (avtozma), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0422","name":"Collect & prep genetic samp","description":"Collect & prep genetic samp","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0407U","name":"Neph dbtc ckd mult eclia alg","description":"Neph dbtc ckd mult eclia alg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0315","name":"Counsel immune <21  5-15 m","description":"Immunization counseling by a physician or other qualified health care professional for covid-19, ages under 21, 5-15 mins time (this code is used for the medicaid early and periodic screening, diagnostic, and treatment benefit (epsdt)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0758T","name":"Dgtz gls mcrscp sl spc hchem","description":"Digitization of glass microscope slides for special stain, including interpretation and report, histochemical stain on frozen tissue block (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58662","name":"Laparoscopy excise lesions","description":"Laparoscopy, surgical; with fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal surface by any method","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":846.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96381","name":"Admn rsv monoc antb im njx","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1171","name":"Inj, hydromorphone, 0.1 mg","description":"Injection, hydromorphone, 0.1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0912T","name":"Elec alys nstim sys vgs smpl","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; with simple programming by physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5913","name":"Nasal prosthesis","description":"Nasal prosthesis","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01939","name":"Anes nulyt agt crv/thrc","description":"Anesthesia for percutaneous image-guided destruction procedures by neurolytic agent on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1313","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1015T","name":"Rev/rmv lw esoph sphnc npg/r","description":"Revision or removal, lower esophageal sphincter neurostimulator pulse generator or receiver","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9612","name":"Thera par drugs 2 or > admin","description":"Therapeutic parenteral drugs two or more administrations different medications","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11732","name":"Avlsn nail plate simple each","description":"Avulsion of nail plate, partial or complete, simple; each additional nail plate (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"Endoskel posit rotat unit","description":"Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0802","name":"3d dental scan indirect","description":"3d dental scan indirect","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0543","name":"Group train w/o patient","description":"Group caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient pre","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55707","name":"Bx prst8 trct us guided","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49618","name":"Rpr aa hrn rcr > 10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, incarcerated or strangulate","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33927","name":"Impltj tot rplcmt hrt sys","description":"Implantation of a total replacement heart system (artificial heart) with recipient cardiectomy","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2499.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37286","name":"Revsc evasc tpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0629U","name":"Nfct ds tb dna aly 1trgt pcr","description":"Nfct ds tb dna aly 1trgt pcr","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0513U","name":"Onc prst8 alg alys msi&hrd","description":"Onc prst8 alg alys msi&hrd","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0701T","name":"Molec fluor img sus nev ea","description":"Molecular fluorescent imaging of suspicious nevus; each additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46500","name":"Injection into hemorrhoid(s)","description":"Injection of sclerosing solution, hemorrhoids","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84202","name":"Assay rbc protoporphyrin","description":"Protoporphyrin, rbc; quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4378","name":"Renew ft matrix per sq cm","description":"Renew ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0965T","name":"I&cst prp jw xpn dl arch non","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, non-fixed hinge mechanism","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0880T","name":"Augmnt alys ch ct ild i&r","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82677","name":"Assay of estriol","description":"Estriol","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87467","name":"Hepatitis b surface ag quan","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; hepatitis b surface antigen (hbsag), quantitative","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0530","name":"Adult daycare center, 8 hr u","description":"Adult day center, 8-hour unit, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93150","name":"Therapy activation ipnss","description":"Therapy activation of implanted phrenic nerve stimulator system, including all interrogation and programming","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0556","name":"Adv prim care mgmt lvl 1","description":"Advanced primary care management services for a patient with one chronic condition [expected to last at least 12 months, or until the death of the patient, which place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline], or fewer, provided by clinical ","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6594","name":"G comp bandge liner lwr extr","description":"Gradient compression bandaging supply, bandage liner, lower extremity, any size or length, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51525","name":"Removal of bladder lesion","description":"Cystotomy; for excision of bladder diverticulum, single or multiple (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":922.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0996T","name":"Ins&sclr fix caps bag prosth","description":"Insertion and scleral fixation of a capsular bag prosthesis containing an intraocular lens prosthesis, with vitrectomy, including removal of crystalline lens or dislocated intraocular lens prosthesis, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"13133","name":"Cmplx rpr f/c/c/m/n/ax/g/h/f","description":"Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; each additional 5 cm or less (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76818","name":"Fetal biophys profile w/nst","description":"Fetal biophysical profile; with non-stress testing","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78012","name":"Thyroid uptake measurement","description":"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7771","name":"Alveolus clsd reduc stblz te","description":"Alveolus closed reduction stabilization of teeth","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6036","name":"Prosthetic thumb mechanical","description":"Prosthetic thumb, mechanical, can include metacarpophalangeal (mcp), interphalangeal (ip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0554","name":"Add 20 m of monthly tx","description":"Each additional 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing data generated from the","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4429","name":"Dermbnd chn, chx per sq cm","description":"Dermabind ch n or dermabind ch x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98009","name":"Synch audio-only new low 30","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 30 m","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1258","name":"Cvd risk assess perf","description":"Cvd risk assessment performed, have a documented calculated risk score","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81025","name":"Urine pregnancy test","description":"Urine pregnancy test, by visual color comparison methods","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0673T","name":"Abltj b9 thyr ndul perq lasr","description":"Ablation, benign thyroid nodule(s), percutaneous, laser, including imaging guidance","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90965","name":"Esrd home pt serv p mo 12-19","description":"End-stage renal disease (esrd) related services for home dialysis per full month, for patients 12-19 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":586.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":222.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0270","name":"Mnt subs tx for change dx","description":"Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face to face with the patient, each 15 minutes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":23.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67516","name":"Sprchoroidal spc njx rx agt","description":"Suprachoroidal space injection of pharmacologic agent (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0997T","name":"Precuneus mag stimj tx plng","description":"Precuneus magnetic stimulation; treatment planning using magnetic resonance imaging-guided neuronavigation to determine optimal location, dose, and intensity for magnetic stimulation therapy, derived from evoked potentials from single pulses of electromagnetic energy recorded by 64-channel electroen","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49187","name":"Opn exc/dstr ntra-abd 5.1-10","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5.1 to 10 cm","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6192","name":"Semi precision attachment","description":"Semi precision attachment","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29868","name":"Meniscal trnspl knee w/scpe","description":"Arthroscopy, knee, surgical; meniscal transplantation (includes arthrotomy for meniscal insertion), medial or lateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0895T","name":"Connj lvr algrft prfu dev 1","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; initial 4 hours of monitoring time, including hourly physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2024","name":"Resolve or xenopatch sq cm","description":"Resolve matrix or xenopatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0625U","name":"Endocrinol op dna alys>5000","description":"Endocrinol op dna alys>5000","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9156","name":"Oral mucoadhesive per 1 ml","description":"Oral mucoadhesive, any type (liquid, gel, paste, etc.), per 1 ml","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5130","name":"Inj, fylnetra, 0.5 mg","description":"Injection, pegfilgrastim-pbbk (fylnetra), biosimilar, 0.5 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1374","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2642","name":"Dental onlay porcelin 2 surf","description":"Onlay - porcelain/ceramic - two surfaces","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26428","name":"Repair/graft finger tendon","description":"Repair of extensor tendon, central slip, secondary (eg, boutonniere deformity); with free graft (includes obtaining graft), each finger","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1027.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0767T","name":"Tc mag stimj pn ea addl nrv","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; each additional nerve (list separat","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87594","name":"Pneumcysts jirovecii amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); pneumocystis jirovecii, amplified probe technique","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0538","name":"Ascvd rsk mng clin stf pr mo","description":"Atherosclerotic cardiovascular disease (ascvd) risk management services; clinical staff time; per calendar month","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54416","name":"Remv/repl penis contain pros","description":"Removal and replacement of non-inflatable (semi-rigid) or inflatable (self-contained) penile prosthesis at the same operative session","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":745.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76856","name":"Us exam pelvic complete","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0691T","name":"Auto alys xst ct std vrt fx","description":"Automated analysis of an existing computed tomography study for vertebral fracture(s), including assessment of bone density when performed, data preparation, interpretation, and report","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0463U","name":"Onc crvx mrna genxprsn 14bmk","description":"Onc crvx mrna genxprsn 14bmk","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1429","name":"Retinopathy in od, os, ou","description":"Retinal exam finding with evidence of retinopathy in left, right or both eyes with severity level documented","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9947","name":"Sleep apnea appliance","description":"Sleep apnea appliance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90631","name":"H5 vaccine pandemic im use","description":"Influenza virus vaccine (iiv), h5, pandemic formulation, split virus, adjuvanted, for intramuscular use","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9245","name":"Admin mod sedation-enteral","description":"Admin mod sedation-enteral","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0040","name":"Pt phys/occ therapy","description":"Patient already receiving physical/occupational/speech/recreational therapy during the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28455","name":"Tx tarsal b1 fx w/mnpj each","description":"Treatment of tarsal bone fracture (except talus and calcaneus); with manipulation, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1317","name":"Pts counsl cpt opt out","description":"Patients who are counseled on connection with a csp and explicitly opt out","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4426","name":"Dermbnd tl+, tlx per sq cm","description":"Dermabind tl + or dermabind tl x,  per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49614","name":"Rpr aa hrn rcr < 3 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, incarcerated or strangulated","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59841","name":"Induced abortion dilat&evac","description":"Induced abortion, by dilation and evacuation","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":397.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":314.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43425","name":"Repair esophagus opening","description":"Closure of esophagostomy or fistula; transthoracic or transabdominal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1519.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0455U","name":"Nfct agt sti mult amp prb ur","description":"Nfct agt sti mult amp prb ur","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69100","name":"Biopsy of external ear","description":"Biopsy external ear","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7284","name":"Exc biopsy of saliv glands","description":"Exc biopsy of saliv glands","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5878","name":"Dup of complt dent-mandib","description":"Dup of complt dent-mandib","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6524","name":"G com garmnt lwr leg/ft nght","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5422","name":"Dentures adjust part mandbl","description":"Adjust partial denture - mandibular","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0285U","name":"Onc rsps radj cll fr dna tox","description":"Onc rsps radj cll fr dna tox","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37276","name":"Rvsc evsc fpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1941","name":"Inj, furoscix, 20 mg","description":"Injection, furosemide (furoscix), 20 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92638","name":"Bhvl verif of amplification","description":"Behavioral verification of amplification including aided thresholds, functional gain, speech-in-noise, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1420","name":"Complete ophthalmologic mvp","description":"Complete ophthalmologic care mips value pathway","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4382","name":"Advograft dual per sq cm","description":"Advograft dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0344U","name":"Hep nafld semiq evl 28 lipid","description":"Hep nafld semiq evl 28 lipid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0596U","name":"Neuro alzds plsm 3dstnct isp","description":"Neuro alzds plsm 3dstnct isp","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4542","name":"Supp ext up limb tremor stim","description":"Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1206","name":"Isa not red 3pts/no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0368","name":"Cone beam ct interprete tmj","description":"Cone beam ct interprete tmj","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59510","name":"Cesarean delivery","description":"Routine obstetric care including antepartum care, cesarean delivery, and postpartum care","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3059.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86043","name":"Acetylcholn rcptr modlg antb","description":"Acetylcholine receptor (achr); modulating antibody","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98975","name":"Rtm 1st set-up&pt educaj eqp","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); initial set-up and patient education on use of equipment","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0836T","name":"Dgtz gls mcrscp fna ea addl","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42975","name":"Dise eval slp do brth flx dx","description":"Drug-induced sleep endoscopy, with dynamic evaluation of velum, pharynx, tongue base, and larynx for evaluation of sleep-disordered breathing, flexible, diagnostic","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1365","name":"Hosp+pall care spec code 17","description":"Patient encounter during the performance period with hospice and palliative care specialty code 17","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78000","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82233","name":"Beta-amyloid 1-40 (abeta 40)","description":"Beta-amyloid; 1-40 (abeta 40)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0475U","name":"Hered prst8 ca gsap 23 genes","description":"Hered prst8 ca gsap 23 genes","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81515","name":"Nfct ds bv&vaginitis dna alg","description":"Infectious disease, bacterial vaginosis and vaginitis, real-time pcr amplification of dna markers for atopobium vaginae, atopobium species, megasphaera type 1, and bacterial vaginosis associated bacteria-2 (bvab-2), utilizing vaginal-fluid specimens, algorithm reported as positive or negative for hi","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90837","name":"Psytx w pt 60 minutes","description":"Psychotherapy, 60 minutes with patient","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":181.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4413","name":"Cygnus solo per sq cm","description":"Cygnus solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46753","name":"Reconstruction of anus","description":"Graft (thiersch operation) for rectal incontinence and/or prolapse","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1194","name":"Med rsn no imp/con mmr/msi","description":"Documentation of medical reason(s) surgical pathology reports did not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both tests were not included (e.g., patient will not be treated with checkpoint inhibitor therap","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0146","name":"Nav srv peer sup add 30 pr m","description":"Principal illness navigation - peer support, additional 30 minutes per calendar month (list separately in addition to g0140)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55711","name":"Bx prst8 trct mri-us 1st","description":"Biopsy, prostate, transrectal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73100","name":"X-ray exam of wrist","description":"Radiologic examination, wrist; 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0683","name":"App of non-sheet skin sub g","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27240","name":"Treat thigh fracture","description":"Closed treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; with manipulation, with or without skin or skeletal traction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1095.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4396","name":"Natalin per sq cm","description":"Natalin, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0373","name":"Tomo bitewing image","description":"Tomo bitewing image","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0934T","name":"Rem mntr wrls l atr prs snr","description":"Remote monitoring of a wireless left atrial pressure sensor for up to 30 days, including data from daily uploads of left atrial pressure recordings, interpretation(s) and trend analysis, with adjustments to the diuretics plan, treatment paradigm thresholds, medications or lifestyle modifications, wh","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1232","name":"Pt hcv tst reactive result","description":"Patient receives hcv antibody test with reactive result","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0574U","name":"Mtb cfp-10 serum/plsm lc-ms","description":"Mtb cfp-10 serum/plsm lc-ms","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63190","name":"Incise spine nrv >2 segmnts","description":"Laminectomy with rhizotomy; more than 2 segments","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1402.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0511U","name":"Onc sol tum 3dmicroenvir 36+","description":"Onc sol tum 3dmicroenvir 36+","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62269","name":"Needle biopsy spinal cord","description":"Biopsy of spinal cord, percutaneous needle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1362","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0563","name":"Sbrt w/positron emission del","description":"Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance and real-time positron emissions-based delivery adjustments to 1 or more lesions, entire course not to exceed 5 fractions","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4346","name":"Shelter dm matrix per sq cm","description":"Shelter dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4007","name":"General surgery ss","description":"General surgery mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0566","name":"3d bn img algor drvd fr mri","description":"3d radiodensity-value bone imaging, algorithm derived, from previous magnetic resonance examination of the same anatomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0271","name":"Group mnt 2 or more 30 mins","description":"Medical nutrition therapy, reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition, or treatment regimen (including additional hours needed for renal disease), group (2 or more individuals), each 30 minutes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":16.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1295","name":"Pt hx tot col or colon ca","description":"Patients with a diagnosis or past history of total colectomy or colorectal cancer","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4349","name":"Mantle dl matrix per sq cm","description":"Mantle dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0436U","name":"Onc lng plsm alys 388 prtn","description":"Onc lng plsm alys 388 prtn","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1171","name":"Pt recd 1 td/tdap 9yrs prior","description":"Patient received at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1278","name":"Pre-htn or htn doc, f/u indc","description":"Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0674T","name":"Laps insj nw/rpcmt prm isdss","description":"Laparoscopic insertion of new or replacement of permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including an implantable pulse generator and diaphragmatic lead(s)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4037","name":"Urology ss","description":"Urology mips specialty set","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61312","name":"Crnec/crnot sttl xdrl/sdrl","description":"Craniectomy or craniotomy for evacuation of hematoma, supratentorial; extradural or subdural","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2122.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0538","name":"Ascvd rsk mng clin stf pr mo","description":"Atherosclerotic cardiovascular disease (ascvd) risk management services; clinical staff time; per calendar month","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1277","name":"Colorectal ca screen doc rev","description":"Colorectal cancer screening results documented and reviewed","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q2003","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7111","name":"Extraction coronal remnants","description":"Extraction coronal remnants - deciduous tooth","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42953","name":"Repair throat esophagus","description":"Pharyngoesophageal repair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1251.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0721T","name":"Quan ct tiss charac w/o ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2928","name":"Prefab porc/cer crown perm","description":"Prefab porc/cer crown perm","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92623","name":"Dx aly aud oi snd prcsr each","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; each additional 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0707T","name":"Njx b1 sub mtrl sbchdrl dfct","description":"Injection(s), bone-substitute material (eg, calcium phosphate) into subchondral bone defect (ie, bone marrow lesion, bone bruise, stress injury, microtrabecular fracture), including imaging guidance and arthroscopic assistance for joint visualization","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9161","name":"Inj denileuk difti-cxdl 1mcg","description":"Injection, denileukin diftitox-cxdl, 1 mcg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64655","name":"Revj/rplcmt bat mod sys lead","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; lead only","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22836","name":"Ant thrc vrt body tethrg <7","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; up to 7 vertebral segments","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3401","name":"Vyjuvek 5x10^9pfu/ml, 0.1 ml","description":"Beremagene geperpavec-svdt for topical administration, containing nominal 5 x 10^9 pfu/ml vector genomes, per 0.1 ml","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1426","name":"Injection, casimersen, 10 mg","description":"Injection, casimersen, 10 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4435","name":"Renati membrane per sq cm","description":"Renati membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34709","name":"Plmt xtn prosth evasc rpr","description":"Placement of extension prosthesis(es) distal to the common iliac artery(ies) or proximal to the renal artery(ies) for endovascular repair of infrarenal abdominal aortic or iliac aneurysm, false aneurysm, dissection, penetrating ulcer, including pre-procedure sizing and device selection, all nonselec","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0538U","name":"Onc sol tum ngts ffpe 600gen","description":"Onc sol tum ngts ffpe 600gen","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98980","name":"Rtm tx mgmt 1st 20 min","description":"Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least 1 real-time interactive communication with the patient or caregiver during the calendar month; first 20 minutes","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4336","name":"Artecent c, per sq cm","description":"Artacent c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6608","name":"G com bandage tub protct pad","description":"Gradient compression bandaging supply, tubular protective absorption padded layer, per linear yard, any width, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9154","name":"Artificial saliva, 1 ml","description":"Artificial saliva, 1 ml","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88369","name":"M/phmtrc alysishquant/semiq","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0962T","name":"Asstv alg alys acous&ecg rec","description":"Assistive algorithmic analysis of acoustic and electrocardiogram recording for detection of cardiac dysfunction (eg, reduced ejection fraction, cardiac murmurs, atrial fibrillation), with review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11976","name":"Remove contraceptive capsule","description":"Removal, implantable contraceptive capsules","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":168.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0680T","name":"Insj/rplcmt pg only isdss","description":"Insertion or replacement of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing lead(s)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0684T","name":"Peri-px dev eval isdss ip","description":"Peri-procedural device evaluation (in-person) and programming of device system parameters before or after a surgery, procedure, or test with analysis, review, and report by a physician or other qualified health care professional, permanent implantable synchronized diaphragmatic stimulation system fo","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6037","name":"Postop dsg cast chg handfing","description":"Immediate post-surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, partial hand including fingers","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49614","name":"Rpr aa hrn rcr < 3 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4282","name":"Cygnus dual per sq cm","description":"Cygnus dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0577U","name":"Onc ovr serum alys 39 gps","description":"Onc ovr serum alys 39 gps","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3471","name":"Surg rep root res anterior","description":"Surg rep root res anterior","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93596","name":"R&l hrt cath chd nml nt cnj","description":"Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); normal native connections","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97552","name":"Group caregiver training","description":"Group caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78468","name":"Heart infarct image (ef)","description":"Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0732T","name":"Immntx admn electroporatn im","description":"Immunotherapy administration with electroporation, intramuscular","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4360","name":"Amchoplast fd per sq cm","description":"Amchoplast fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0555U","name":"Repr med pga embryonic te qc","description":"Repr med pga embryonic te qc","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0763T","name":"Dgtz gls mcrscp mphmtrc alys","description":"Digitization of glass microscope slides for morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure, manual (list separately in addition to code for primary proced","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0523U","name":"Onc soltum dna ngs snv 22gen","description":"Onc soltum dna ngs snv 22gen","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0801T","name":"Tcat rmv&rpl 2chmbr ldls pm","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; dual-cha","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43825","name":"Gastrojejunostomy w/vagotomy","description":"Gastrojejunostomy; with vagotomy, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1325.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7295","name":"Eth estr and eton monthly","description":"Ethinyl estradiol and etonogestrel 0.015mg, 0.12mg per 24 hours; monthly vaginal ring, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50394","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0941T","name":"Cysto flx ins&xpns urtl scaf","description":"Cystourethroscopy, flexible; with insertion and expansion of prostatic urethral scaffold using integrated cystoscopic visualization","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86041","name":"Acetylcholn rcptr bndng antb","description":"Acetylcholine receptor (achr); binding antibody","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5912","name":"Facial moulage complete","description":"Facial moulage (complete)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87324","name":"Clostridium ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; clostridium difficile toxin(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98986","name":"Rtm dev sply cbt 2-15 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of cognitive behavioral therapy, 2-15 days in a 30-day period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0001","name":"Advancing cancer care mvp","description":"Advancing cancer care mips value pathways","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0483U","name":"Nfct ds ng gyra s91f pt mut","description":"Nfct ds ng gyra s91f pt mut","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4369","name":"Amnioplast 3 per sq cm","description":"Amnioplast 3, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2014","name":"Omeza collag compl 100 mg","description":"Omeza collagen matrix or omeza complete matrix, per 100 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1352","name":"Suicd c-ssrs assessment, equ","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs or equivalent assessment","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33901","name":"Perq p-art revsc 1 nm nt bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, bilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":419.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1408","name":"Gmln brca bef dx ca","description":"Patients who have germline brca testing completed before diagnosis of epithelial ovarian, fallopian tube, or primary peritoneal cancer","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93896","name":"Vsrctv std tcd icr art compl","description":"Vasoreactivity study performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33895","name":"Evasc st rpr thrc/aa x crsg","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; not crossing major side branches","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0680","name":"Cr art clc art vlv clc w rpt","description":"Detection and quantification of coronary artery calcium and/or aortic valve calcification from algorithmic analysis of computed tomography of the chest with report","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55708","name":"Bx prst8 trct us w/mri fus 1","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant) with mri-fusion-guidance, first targeted lesion","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0618","name":"Inj, calcium chloride, 2 mg","description":"Injection, calcium chloride, 2 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0859T","name":"Ncntc ifr spctrsc o/t pad ea","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), other than for screening for peripheral arterial disease, image acquisition, interpretation, and report; each additional anatomic site (list separately in addition to code ","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2008","name":"Theragenesis, per sq cm","description":"Theragenesis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0443U","name":"Neurflmnt lt chn ultrsens ia","description":"Neurflmnt lt chn ultrsens ia","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98013","name":"Synch audio-only est low 20","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code select","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9324","name":"Inj, pemrydi rtu, 10 mg","description":"Injection, pemetrexed (pemrydi rtu), 10 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26010","name":"Drainage of finger abscess","description":"Drainage of finger abscess; simple","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":439.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9596","name":"Gallium illuccix 1 millicure","description":"Gallium ga-68 gozetotide, diagnostic, (illuccix), 1 millicurie","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90593","name":"Chikungunya vacc recomb im","description":"Chikungunya virus vaccine, recombinant, for intramuscular use","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39220","name":"Resect mediastinal tumor","description":"Resection of mediastinal tumor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1308.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0318U","name":"Ped whl gen mthyltn alys 50+","description":"Ped whl gen mthyltn alys 50+","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9956","name":"Admin home sleep apnea test","description":"Admin home sleep apnea test","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1179","name":"No pcv recd","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine, on or after their 19th birthday and before or during measurement period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4022","name":"Otolaryngology ss","description":"Otolaryngology mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0308U","name":"Crd cad alys 3 prtn plsm alg","description":"Crd cad alys 3 prtn plsm alg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1312","name":"No pt tbco scrn rng","description":"Patient not screened for tobacco use","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1313","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64626","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2249","name":"Inj, remimazolam, 1 mg","description":"Injection, remimazolam, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0534","name":"Coordinated care/or referral","description":"Coordinated care and/or referral services, such as to adequate and accessible community resources to address unmet health-related social needs, including harm reduction interventions and recovery support services a patient needs and wishes to pursue, which significantly limit the ability to diagnose","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59514","name":"Cesarean delivery only","description":"Cesarean delivery only;","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0879T","name":"Augmnt alys ch ct ild prep","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; radiological data preparation and transmission","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87210","name":"Smear wet mount saline/ink","description":"Smear, primary source with interpretation; wet mount for infectious agents (eg, saline, india ink, koh preps)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0734T","name":"Rem r-t mtn nrehab tx mgmt","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; treatment management services by a physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22514","name":"Perq vertebral augmentation","description":"Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (eg, kyphoplasty), 1 vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; lumbar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8582.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47015","name":"Lapt aspir&/njx hep prst cst","description":"Laparotomy, with aspiration and/or injection of hepatic parasitic (eg, amoebic or echinococcal) cyst(s) or abscess(es)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1086.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0480U","name":"Nfct ds csf metag ngs alys","description":"Nfct ds csf metag ngs alys","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32491","name":"Lung volume reduction","description":"Removal of lung, other than pneumonectomy; with resection-plication of emphysematous lung(s) (bullous or non-bullous) for lung volume reduction, sternal split or transthoracic approach, includes any pleural procedure, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1656.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84590","name":"Assay of vitamin a","description":"Vitamin a","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93897","name":"Emboli detcj wo iv mbubb njx","description":"Emboli detection without intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1455","name":"Rep/rev cied","description":"Replaced or revised cied","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5811","name":"Denture interm cmplt mandbl","description":"Interim complete denture (mandibular)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9996","name":"Ustekinumab- ttwe sub cu inj","description":"Injection, ustekinumab-ttwe (pyzchiva), subcutaneous, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1202","name":"Miglustat oral 65 mg","description":"Miglustat, oral, 65 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4300","name":"Acesso tl, per sq cm","description":"Acesso tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0587","name":"Inj, rimabotulinumtoxinb","description":"Injection, rimabotulinumtoxinb, 100 units","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0496U","name":"Onc clrct cfdna 8/7 genes","description":"Onc clrct cfdna 8/7 genes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37283","name":"Rvsc evsc tpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0538","name":"Ascvd rsk mng clin stf pr mo","description":"Atherosclerotic cardiovascular disease (ascvd) risk management services; clinical staff time; per calendar month","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99463","name":"Same day nb discharge","description":"Initial hospital or birthing center care, per day, for evaluation and management of normal newborn infant admitted and discharged on the same date","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7519","name":"Inj. mycophenolate mofetil","description":"Injection, mycophenolate mofetil, 10 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1186","name":"Pt w/ rx for hspc/plltv care","description":"Patients who have an order for or are receiving hospice or palliative care","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21432","name":"Optx cranfcl sep w/wiring","description":"Open treatment of craniofacial separation (lefort iii type); with wiring and/or internal fixation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":786.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99418","name":"Prolng ip/obs e/m ea 15 min","description":"Prolonged inpatient or observation evaluation and management service(s) time with or without direct patient contact beyond the required time of the primary service when the primary service level has been selected using total time, each 15 minutes of total time (list separately in addition to the cod","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2329","name":"Inj ublituximab-xiiy, 1 mg","description":"Injection, ublituximab-xiiy, 1mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9292","name":"Inj, pemetrexed dipotassium","description":"Injection, pemetrexed dipotassium, 10 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2277","name":"Inj, motixafortide, 0.25 mg","description":"Injection, motixafortide, 0.25 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0278U","name":"Hem gen thrombosis 12 genes","description":"Hematology (genetic thrombosis), genomic sequence analysis of 12 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0469U","name":"Rare ds whl gen seq ftl samp","description":"Rare ds whl gen seq ftl samp","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0546U","name":"Ldns lrp4 antb imflr livecll","description":"Ldns lrp4 antb imflr livecll","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5931","name":"Surgical obturator","description":"Obturator prosthesis surgical","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7355","name":"Inj travoprost intra impl","description":"Injection, travoprost, intracameral implant, 1 microgram","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58611","name":"Ligate oviduct(s) add-on","description":"Ligation or transection of fallopian tube(s) when done at the time of cesarean delivery or intra-abdominal surgery (not a separate procedure) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1153","name":"Pt w/ dx osteo doe","description":"Patient with diagnosis of osteoporosis on date of encounter","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0938T","name":"Xtrnl ecg rec>15d<30d rec","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; recording (including connection and initial recording)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0967T","name":"Tranal ins tmp clrc anst dev","description":"Transanal insertion of endoluminal temporary colorectal anastomosis protection device, including vacuum anchoring component and flexible sheath connected to external vacuum source and monitoring system","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G3003","name":"Chronic pain mgmt addl 15m","description":"Each additional 15 minutes of chronic pain management and treatment by a physician or other qualified health care professional, per calendar month. (list separately in addition to code for g3002. when using g3003, 15 minutes must be met or exceeded.)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97804","name":"Medical nutrition group","description":"Medical nutrition therapy; group (2 or more individual(s)), each 30 minutes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":19.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0857T","name":"Opto-acoustic img breast uni","description":"Opto-acoustic imaging, breast, unilateral, including axilla when performed, real-time with image documentation, augmentative analysis and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0489U","name":"Ob sgnipt cfdna seq alys 1+","description":"Ob sgnipt cfdna seq alys 1+","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3263","name":"Inj, toripalimab-tpzi, 1 mg","description":"Injection, toripalimab-tpzi, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1377","name":"Fu colscop 10 yr doc w/ disc","description":"Recommended follow-up interval for repeat colonoscopy of 10 years documented  in colonoscopy report and communicated with patient","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15011","name":"Hrv skn cll ssp agrft 1st 25","description":"Harvest of skin for skin cell suspension autograft; first 25 sq cm or less","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0298U","name":"Onc pan tum whl trns seq rna","description":"Onc pan tum whl trns seq rna","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0551","name":"Phn/intr svs fr dx treat 30m","description":"Interprofessional telephone/internet/electronic health record referral service(s) provided by a treating/requesting practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, 30 minutes","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99316","name":"Nf dschrg mgmt 30 min+","description":"Nursing facility discharge management; more than 30 minutes total time on the date of the encounter","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":125.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G3003","name":"Chronic pain mgmt addl 15m","description":"Each additional 15 minutes of chronic pain management and treatment by a physician or other qualified health care professional, per calendar month. (list separately in addition to code for g3002. when using g3003, 15 minutes must be met or exceeded.)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0813T","name":"Egd vol adjmt bariatric balo","description":"Esophagogastroduodenoscopy, flexible, transoral, with volume adjustment of intragastric bariatric balloon","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1004T","name":"Elec alys s-scl eeg wo prgrm","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; without programming","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15018","name":"App skn cll ssp f/n/g/hf ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 480 sq cm or part thereof (list separately in addition to code for prima","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9616","name":"Gallium gozellix 1 millicuri","description":"Gallium ga-68 gozetotide (gozellix), diagnostic, 1 millicurie","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84431","name":"Thromboxane urine","description":"Thromboxane metabolite(s), including thromboxane if performed, urine","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0425U","name":"Genom rpd seq alys ea cmprtr","description":"Genom rpd seq alys ea cmprtr","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2599","name":"Inj vasopressin (am reg) 1 u","description":"Injection, vasopressin (american regent), not therapeutically equivalent to j2598, 1 unit","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84703","name":"Chorionic gonadotropin assay","description":"Gonadotropin, chorionic (hcg); qualitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1304","name":"Inj tofersen intrathec 1 mg","description":"Injection, tofersen, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32110","name":"Explore/repair chest","description":"Thoracotomy; with control of traumatic hemorrhage and/or repair of lung tear","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1649.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1308","name":"Flu immunize no admin","description":"Influenza immunization was not administered, reason not given","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86480","name":"Tb test cell immun measure","description":"Tuberculosis test, cell mediated immunity antigen response measurement; gamma interferon","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38228","name":"Car-t admn autologous","description":"Chimeric antigen receptor t-cell (car-t) therapy; car-t cell administration, autologous","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7911","name":"Dental suture wound to 5 cm","description":"Complicated suture-up to 5 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2525","name":"Cl, hydrophilic, dual focus","description":"Contact lens, hydrophilic, dual focus, per lens","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4001","name":"Diagnostic rad ss","description":"Diagnostic radiology mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9129","name":"Photobio therpy-sub 15 mins","description":"Photobio therpy-sub 15 mins","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1026","name":"Pt hemo > 3mo","description":"The number of adult patient-months in the denominator who were on maintenance hemodialysis using a catheter continuously for three months or longer under the care of the same practitioner or group partner as of the last hemodialysis session of the reporting month","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4000","name":"Dermatology ss","description":"Dermatology mips specialty set","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1163","name":"Inj, diltiazem hcl, 0.5 mg","description":"Injection, diltiazem hydrochloride, 0.5 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36831","name":"Open thrombect av fistula","description":"Thrombectomy, open, arteriovenous fistula without revision, autogenous or nonautogenous dialysis graft (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":583.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1159","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1186","name":"Pt w/ rx for hspc/plltv care","description":"Patients who have an order for or are receiving hospice or palliative care","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0052","name":"Mmip mental health and care","description":"Missing and murdered indigenous persons (mmip) mental health and clinical care","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0262U","name":"Onc sld tum rt-pcr 7 gen","description":"Oncology (solid tumor), gene expression profiling by real-time rt-pcr of 7 gene pathways (er, ar, pi3k, mapk, hh, tgfb, notch), formalin-fixed paraffin-embedded (ffpe), algorithm reported as gene pathway activity score","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0964T","name":"I&cust prep jaw xpnsj 1arch","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; single arch, without mandibular advancement mechanism","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0681","name":"App of non-sheet skin sub","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; first 25 sq cm or less of wound surface area","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0725T","name":"Vestibular dev impltj uni","description":"Vestibular device implantation, unilateral","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42509","name":"Parotid duct diversion","description":"Parotid duct diversion, bilateral (wilke type procedure); with excision of both submandibular glands","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1014.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0805T","name":"Tcat s&ivc prstc vl impl prq","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); percutaneous femoral vein approach","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31259","name":"Nsl/sins ndsc sphn tiss rmvl","description":"Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior), including sphenoidotomy, with removal of tissue from the sphenoid sinus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":464.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9953","name":"Reline sleep apnea appliance","description":"Reline sleep apnea appliance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0831T","name":"Dgtz gls mcrscp cytp c/v","description":"Digitization of glass microscope slides for cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93886","name":"Intracranial complete study","description":"Transcranial doppler study of the intracranial arteries; complete study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":391.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96547","name":"Intraop hipec px 1st 60 min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; first 60 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86490","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0685T","name":"Interrog dev eval isdss ip","description":"Interrogation device evaluation (in-person) with analysis, review and report by a physician or other qualified health care professional, including connection, recording and disconnection per patient encounter, permanent implantable synchronized diaphragmatic stimulation system for augmentation of ca","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86596","name":"Voltage-gtd ca chnl antb ea","description":"Voltage-gated calcium channel antibody, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0522","name":"Mgt nw pt dementia low cmplx","description":"Management of a new patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66680","name":"Repair iris & ciliary body","description":"Repair of iris, ciliary body (as for iridodialysis)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1218","name":"Pt copd symptoms","description":"Patient has copd symptoms (e.g., dyspnea, cough/sputum, wheezing)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90785","name":"Psytx complex interactive","description":"Interactive complexity (list separately in addition to the code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":16.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1314","name":"Bmi not calculated","description":"Bmi not documented and no reason is given","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1941","name":"Inj, furoscix, 20 mg","description":"Injection, furosemide (furoscix), 20 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1461","name":"Pt dx chron hepc","description":"Patient diagnosis for chronic hepatitis c","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4560","name":"Nmes disposable","description":"Neuromuscular electrical stimulator (nmes), disposable, replacement only","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96003","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6071","name":"Abutment supported retainer","description":"Abutment supported retainer for porcelain fused to metal fpd (noble metal)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2393","name":"Post 3 srfc resinbased cmpst","description":"Resin-based composite - three surfaces posterior","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7471","name":"Rem exostosis any site","description":"Removal of lateral exostosis (maxilla or mandible)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0871T","name":"Rplcmt subq prtl ascites pmp","description":"Replacement of a subcutaneous peritoneal ascites pump, including reconnection between pump and indwelling bladder and peritoneal catheters, including initial programming and imaging, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0554U","name":"Repr med pga 24chrm te bx qc","description":"Repr med pga 24chrm te bx qc","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1153","name":"Pt w/ dx osteo doe","description":"Patient with diagnosis of osteoporosis on date of encounter","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76856","name":"Us exam pelvic complete","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1478","name":"Psychoactive sub abuse","description":"Psychoactive substance abuse","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5934","name":"Mandibular flange prosthesis","description":"Mandibular resection prosthesis with guide flange","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1210","name":">=2 same meds tbl4 not ord","description":"At least two orders for high-risk medications from the same drug class, (table 4), not ordered","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0872T","name":"Rplcmt ndwllg bldr&prtl cath","description":"Replacement of indwelling bladder and peritoneal catheters, including tunneling of catheter(s) and connection with previously implanted peritoneal ascites pump, including imaging and programming, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3247","name":"Inj secukinumab intrav 1mg","description":"Injection, secukinumab, intravenous, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58555","name":"Hysteroscopy dx sep proc","description":"Hysteroscopy, diagnostic (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":389.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":235.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":729.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1464","name":"No record of f/u by 180 days","description":"No documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0258U","name":"Ai psor mrna 50-100 gen alg","description":"Autoimmune (psoriasis), mrna, next-generation sequencing, gene expression profiling of 50-100 genes, skin- surface collection using adhesive patch, algorithm reported as likelihood of response to psoriasis biologics","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0793T","name":"Prq tcat thrm ablt nrv p-art","description":"Percutaneous transcatheter thermal ablation of nerves innervating the pulmonary arteries, including right heart catheterization, pulmonary artery angiography, and all imaging guidance","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1462","name":"Pt clin ind hd image","description":"Patients with clinical indications for imaging of the head","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4011","name":"Internal medicine ss","description":"Internal medicine mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0368","name":"Cone beam ct interprete tmj","description":"Cone beam ct interprete tmj","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0687","name":"Inj cefazolin (wg crit care)","description":"Injection, cefazolin sodium (wg critical care), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0960T","name":"Rpl s-sclp eltr ra rcvr&tlmt","description":"Replacement of sub-scalp implanted electrode array, receiver, and telemetry unit with tunneling of electrode for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7298","name":"Remove screw retained plate","description":"Remove screw retained plate","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1459","name":"Pt hosp/pal care dur perf pd","description":"Patient was in hospice or receiving palliative care services at any time during the performance period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0830T","name":"Dgtz gls mcrscp cytp slctv","description":"Digitization of glass microscope slides for cytopathology, selective-cellular enhancement technique with interpretation (eg, liquid-based slide preparation method), except cervical or vaginal (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0997T","name":"Precuneus mag stimj tx plng","description":"Precuneus magnetic stimulation; treatment planning using magnetic resonance imaging-guided neuronavigation to determine optimal location, dose, and intensity for magnetic stimulation therapy, derived from evoked potentials from single pulses of electromagnetic energy recorded by 64-channel electroen","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82948","name":"Reagent strip/blood glucose","description":"Glucose; blood, reagent strip","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4005","name":"Family medicine ss","description":"Family medicine mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0834T","name":"Dgtz gls mcrscp cytp oth xtn","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0604U","name":"All&immunology crae 4bk pep","description":"All&immunology crae 4bk pep","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0302U","name":"Iadna brtnla ddpcr flwg liq","description":"Iadna brtnla ddpcr flwg liq","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92971","name":"Cardioassist external","description":"Cardioassist-method of circulatory assist; external","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1833","name":"Ko adj jnt pos r sup pre ots","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":743.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99306","name":"1st nf care high mdm 50","description":"Initial nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 50 minutes must be met or exceed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":220.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":184.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0616","name":"Inj metoprolol tartrate 1 mg","description":"Injection, metoprolol tartrate, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0708","name":"Intraoral bite radio image","description":"Intraoral bite radio image","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0626U","name":"Neurol pd dna alys >20000","description":"Neurol pd dna alys >20000","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0932T","name":"N-invs det hrt fail aug echo","description":"Noninvasive detection of heart failure derived from augmentative analysis of an echocardiogram that demonstrated preserved ejection fraction, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49613","name":"Rpr aa hrn rcr < 3 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, reducible","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6599","name":"G comp bandage short stretch","description":"Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2028","name":"Micromatrix flex per mg","description":"Micromatrix flex, per mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1216","name":"No spiro doc no res doc","description":"No spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and/or no spirometry performed with results documented during the encounter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78491","name":"Myocrd img pet 1std rst/strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); single study, at rest or stress (exercise or pharmacologic)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1468.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38570","name":"Laparoscopy lymph node biop","description":"Laparoscopy, surgical; with retroperitoneal lymph node sampling (biopsy), single or multiple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":638.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5945","name":"Mand implt sup remv part","description":"Mand implt sup remv part","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82145","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99477","name":"Init day hosp neonate care","description":"Initial hospital care, per day, for the evaluation and management of the neonate, 28 days of age or younger, who requires intensive observation, frequent interventions, and other intensive care services","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":331.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36010","name":"Place catheter in vein","description":"Introduction of catheter, superior or inferior vena cava","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1270","name":"Pts no kid transplt wtlst","description":"Patients not on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1305","name":"Pneum vax admin 19+","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22585","name":"Arthrd ant ntrbd min dsc ea","description":"Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); each additional interspace (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27305","name":"Incise thigh tendon & fascia","description":"Fasciotomy, iliotibial (tenotomy), open","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9988","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15321","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4412","name":"Choriofix per sq cm","description":"Choriofix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6071","name":"Abutment supported retainer","description":"Abutment supported retainer for porcelain fused to metal fpd (noble metal)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4332","name":"Axolotl dualgraft, per sq cm","description":"Axolotl dualgraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1497","name":"No doc fall med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0248","name":"Demonstrate use home inr mon","description":"Demonstration, prior to initiation of home inr monitoring, for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria, under the direction of a physician; includes: face-to-face demonstration of use and care of the i","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1473","name":"Pt func cap not allow impr","description":"Patient situations, at any point during the denominator identification period, where the patients functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools, such as delirium, dementia, intellectual disabilities, and pervasive and specific de","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9051","name":"Inj, bortezomib (maia)","description":"Injection, bortezomib (maia), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J2912","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0468U","name":"Hep nash mir34a5p a2m ykl40","description":"Hep nash mir34a5p a2m ykl40","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15854","name":"Removal sutr&stapl xreq anes","description":"Removal of sutures and staples not requiring anesthesia (list separately in addition to e/m code)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24498","name":"Proph tx w/wo mthylmthcrylt","description":"Prophylactic treatment (nailing, pinning, plating or wiring), with or without methylmethacrylate, humeral shaft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1058.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0559","name":"Unrelat prac follow up visit","description":"Post-operative follow-up visit complexity inherent to evaluation and management services addressing surgical procedure(s), provided by a physician or qualified health care professional who is not the practitioner who performed the procedure (or in the same group practice) and is of the same or of a ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4378","name":"Renew ft matrix per sq cm","description":"Renew ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83036","name":"Hemoglobin glycosylated a1c","description":"Hemoglobin; glycosylated (a1c)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15733","name":"Musc myoq/fscq flp h&n pedcl","description":"Muscle, myocutaneous, or fasciocutaneous flap; head and neck with named vascular pedicle (ie, buccinators, genioglossus, temporalis, masseter, sternocleidomastoid, levator scapulae)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1041.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97813","name":"Acup 1/> w/estim 1st 15 min","description":"Acupuncture, 1 or more needles; with electrical stimulation, initial 15 minutes of personal one-on-one contact with the patient","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":65.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4321","name":"Renograft, per sq cm","description":"Renograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0879","name":"Difelikefalin, esrd on dialy","description":"Injection, difelikefalin, 0.1 microgram, (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0328U","name":"Drug assay 120+ rx&metablt","description":"Drug assay 120+ rx&metablt","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37257","name":"Revsc evsc ivt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0868T","name":"Hi-res gastric ep mapping","description":"High-resolution gastric electrophysiology mapping with simultaneous patient-symptom profiling, with interpretation and report","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1449","name":"Pt dx scz/pys bef end msr pd","description":"Patients with an active diagnosis of schizophrenia or psychotic disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99316","name":"Nf dschrg mgmt 30 min+","description":"Nursing facility discharge management; more than 30 minutes total time on the date of the encounter","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":134.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28737","name":"Revision of foot bones","description":"Arthrodesis, with tendon lengthening and advancement, midtarsal, tarsal navicular-cuneiform (eg, miller type procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":811.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42660","name":"Dilation of salivary duct","description":"Dilation and catheterization of salivary duct, with or without injection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4483.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1412","name":"Inj roctavian ml 2x10^13vc g","description":"Injection, valoctocogene roxaparvovec-rvox, per ml, containing nominal 2 x 10^13 vector genomes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4100","name":"Nosht skin sub fda clrd nos","description":"Non-sheet form skin substitute, fda cleared as a device, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87627","name":"Jt spc pthgn&rx rsist gen26+","description":"Infectious agent detection by nucleic acid (dna or rna); joint space pathogens and drug resistance genes, multiplex amplified probe technique, 26 or more targets","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1291","name":"Pt 66+ frailty and med dem","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1224","name":"Iop dec <20% from base","description":"Intraocular pressure (iop) reduced by a value less than 20% from the pre-intervention level","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0735T","name":"Prep tum cav iort prim crnot","description":"Preparation of tumor cavity, with placement of a radiation therapy applicator for intraoperative radiation therapy (iort) concurrent with primary craniotomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43497","name":"Transorl lwr esophgl myotomy","description":"Lower esophageal myotomy, transoral (ie, peroral endoscopic myotomy [poem])","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86480","name":"Tb test cell immun measure","description":"Tuberculosis test, cell mediated immunity antigen response measurement; gamma interferon","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86732","name":"Mucormycosis antibody","description":"Antibody; mucormycosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49321","name":"Laparoscopy biopsy","description":"Laparoscopy, surgical; with biopsy (single or multiple)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":389.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33900","name":"Perq p-art revsc 1 nm nt uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, unilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0904T","name":"Ecg alg 12 ld rdcd trcg only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; tracing only","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9334","name":"Inj efgart-alfa 2mg hya-qvfc","description":"Injection, efgartigimod alfa, 2 mg and hyaluronidase-qvfc","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1408","name":"Gmln brca bef dx ca","description":"Patients who have germline brca testing completed before diagnosis of epithelial ovarian, fallopian tube, or primary peritoneal cancer","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6593","name":"Grad com accessory gmt_wrap","description":"Accessory for gradient compression garment or wrap with adjustable straps, not-otherwise specified","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9382","name":"Inj zenocutuzumab-zbco 1 mg","description":"Injection, zenocutuzumab-zbco, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93593","name":"R hrt cath chd nml nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; normal native connections","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42200","name":"Reconstruct cleft palate","description":"Palatoplasty for cleft palate, soft and/or hard palate only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1057.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9949","name":"Repair sleep apnea appliance","description":"Repair sleep apnea appliance","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35091","name":"Repair defect of artery","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, abdominal aorta involving visceral vessels (mesenteric, celiac, renal)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2411.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93544","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4025","name":"Physical medicine ss","description":"Physical medicine mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6212","name":"Bridge noble metal cast","description":"Pontic-cast noble metal","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9282","name":"Mitomycin intravesical inst","description":"Mitomycin, intravesical instillation, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1475","name":"Pt dx huntington","description":"Patients with diagnosis of huntingtons disease","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2777","name":"Inj, faricimab-svoa, 0.1mg","description":"Injection, faricimab-svoa, 0.1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0374","name":"Tomo periapical image","description":"Tomo periapical image","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6601","name":"Porc/ceram inlay >= 3 surfac","description":"Inlay - porcelain/ceramic three or more surfaces","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4542","name":"Supp ext up limb tremor stim","description":"Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0555","name":"Replacment pt electronic sys","description":"Provision of replacement patient electronics system (e.g., system pillow, handheld reader) for home pulmonary artery pressure monitoring","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90638","name":"Vacc qirv mrna 60mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 60 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4259","name":"Celera per sq cm","description":"Celera dual layer or celera dual membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0787T","name":"Revj/rmvl nea sac w/nstim","description":"Revision or removal of neurostimulator electrode array, sacral, with integrated neurostimulator","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27147","name":"Revision of hip bone","description":"Osteotomy, iliac, acetabular or innominate bone; with open reduction of hip","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1700.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76015","name":"Mr sfty mplt&/fb asmt stf ea","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1191","name":"Hspc svc any time in meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5943","name":"Proth mandib implt sup remv","description":"Proth mandib implt sup remv","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5930","name":"Max guid prothes w/o flange","description":"Max guid prothes w/o flange","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2508","name":"Pegunigalsidase alfa-iwxj","description":"Injection, pegunigalsidase alfa-iwxj, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11981","name":"Insertion drug dlvr implant","description":"Insertion, drug-delivery implant (ie, bioresorbable, biodegradable, non-biodegradable)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":124.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67440","name":"Explore/drain eye socket","description":"Orbitotomy with bone flap or window, lateral approach (eg, kroenlein); with drainage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1261.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1485","name":"Neg viro resp hep c/qual rna","description":"Patients who did not achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0398U","name":"Gi baret esph dna mthyln aly","description":"Gi baret esph dna mthyln aly","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0536U","name":"Rbcag ftl rhd pcr alys exon4","description":"Rbcag ftl rhd pcr alys exon4","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1431","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9998","name":"Doc med rsn <3 colon","description":"Documentation of medical reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., last colonoscopy incomplete, last colonoscopy had inadequate prep, piecemeal removal of adenomas, or sessile serrated polyps >= 20 mm in size, last colonoscopy found greater than 10 adenomas, lo","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0430U","name":"Gi malabs aat calpro pncrtc","description":"Gi malabs aat calpro pncrtc","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1410","name":"No gmln brca1/brca2 couns","description":"Patients who did not have germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0427U","name":"Monocyte dstrbj wdth whl bld","description":"Monocyte dstrbj wdth whl bld","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1458","name":"Pt died bef end meas pd","description":"Patient died prior to the end of the performance period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85041","name":"Automated rbc count","description":"Blood count; red blood cell (rbc), automated","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93897","name":"Emboli detcj wo iv mbubb njx","description":"Emboli detection without intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0471U","name":"Onc clrc ca 35 vrn kras&nras","description":"Onc clrc ca 35 vrn kras&nras","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1403","name":"Bslne and fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2356","name":"Inj tezepelumab-ekko, 1mg","description":"Injection, tezepelumab-ekko, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1497","name":"No doc fall med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0393U","name":"Neu prksn msfl a-syncln prtn","description":"Neu prksn msfl a-syncln prtn","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33288","name":"Rmv&rplcmt phrnc nrv stim ld","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1379","name":"10 yr fu no rec rsn not giv","description":"A 10 year follow-up interval for colonoscopy not recommended, reason not otherwise specified","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11300","name":"Shave skin lesion 0.5 cm/<","description":"Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion diameter 0.5 cm or less","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":16.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":113.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15853","name":"Removal sutr/stapl xreq anes","description":"Removal of sutures or staples not requiring anesthesia (list separately in addition to e/m code)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1016T","name":"Elec alys npgs esoph intraop","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0051","name":"Traditional healing service","description":"Traditional healing service","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0526U","name":"Nefro rnl trnspl quan cxcl10","description":"Nefro rnl trnspl quan cxcl10","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74425","name":"Urography antegrade rs&i","description":"Urography, antegrade, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99332","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0554U","name":"Repr med pga 24chrm te bx qc","description":"Repr med pga 24chrm te bx qc","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86729","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2779","name":"Inj, susvimo 0.1 mg","description":"Injection, ranibizumab, via intravitreal implant (susvimo), 0.1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0268","name":"Removal of impacted wax md","description":"Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9322","name":"Inj pemetrexed (bluepoint)","description":"Injection, pemetrexed (bluepoint), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0667","name":"Team remote e/m est pt 25 mn","description":"Team remote e/m est. pt 25mins","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4344","name":"Tri membrane wrap, per sq cm","description":"Tri-membrane wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59812","name":"Treatment of miscarriage","description":"Treatment of incomplete abortion, any trimester, completed surgically","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":439.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":346.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":344.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86596","name":"Voltage-gtd ca chnl antb ea","description":"Voltage-gated calcium channel antibody, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58920","name":"Partial removal of ovary(s)","description":"Wedge resection or bisection of ovary, unilateral or bilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":818.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33288","name":"Rmv&rplcmt phrnc nrv stim ld","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7472","name":"Removal of torus palatinus","description":"Removal of torus palatinus","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59025","name":"Fetal non-stress test","description":"Fetal non-stress test","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0964T","name":"I&cust prep jaw xpnsj 1arch","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; single arch, without mandibular advancement mechanism","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87070","name":"Culture othr specimn aerobic","description":"Culture, bacterial; any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6196","name":"Remv of ind rest on implt","description":"Remv of ind rest on implt","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4022","name":"Otolaryngology ss","description":"Otolaryngology mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0833T","name":"Dgtz gls mcrscp cytp oth prp","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; preparation, screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1440","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31510","name":"Laryngoscopy with biopsy","description":"Laryngoscopy, indirect; with biopsy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67935","name":"Repair eyelid wound","description":"Suture of recent wound, eyelid, involving lid margin, tarsus, and/or palpebral conjunctiva direct closure; full thickness","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2042","name":"Foundation drs+ solo, sq cm","description":"Foundation drs+ solo, per square centimeter","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55713","name":"Bx prst8 in-bore ct/mri bx 1","description":"Biopsy, prostate, in-bore ct- or mri-guided (ie, sextant), with biopsy of additional targeted lesion(s), first targeted lesion","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0521","name":"New pt-cg dyad dem hig cmplx","description":"Management of new patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1383","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0216","name":"Inj, alfentanil hcl, 500mcg","description":"Injection, alfentanil hydrochloride, 500 micrograms","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67335","name":"Eye suture during surgery","description":"Placement of adjustable suture(s) during strabismus surgery, including postoperative adjustment(s) of suture(s) (list separately in addition to code for specific strabismus surgery)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2280","name":"Inj, moxifloxacin 100 mg","description":"Injection, moxifloxacin, 100 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4432","name":"510(k) skin subs, nos","description":"510(k) skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53453","name":"Tprnl balo cntnc dev rmvl ea","description":"Periurethral transperineal adjustable balloon continence device; removal, each balloon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0266U","name":"Unxpl cnst hrtbl do gn xprsn","description":"Unexplained constitutional or other heritable disorders or syndromes, tissue-specific gene expression by whole-transcriptome and next-generation sequencing, blood, formalin-fixed paraffin-embedded (ffpe) tissue or fresh frozen tissue, reported as presence or absence of splicing or expression changes","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2402","name":"Chloroprocaine (clorotekal)","description":"Injection, chloroprocaine hydrochloride (clorotekal), per 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4355","name":"Abio xpl abio xpl hy p sq cm","description":"Abiomend xplus membrane and abiomend xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5154","name":"Inj, omlyclo, 5 mg","description":"Injection, omalizumab-igec (omlyclo), biosimilar, 5 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43291","name":"Egd flx trnsorl rmvl balo","description":"Esophagogastroduodenoscopy, flexible, transoral; with removal of intragastric bariatric balloon(s)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5725","name":"Rebase hybrid prosthesis","description":"Rebase hybrid prosthesis","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1399","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33875","name":"Thoracic aortic graft","description":"Descending thoracic aorta graft, with or without bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2322.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92636","name":"Hearing aid post-fitg f-up 1","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4320","name":"Pellograft, per sq cm","description":"Pellograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99445","name":"Rem mntr physiol param 2-15","description":"Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate); device(s) supply with daily recording(s) or programmed alert(s) transmission, 2-15 days in a 30-day period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25670","name":"Optx rdcrpl/ntrcrpl dislc 1+","description":"Open treatment of radiocarpal or intercarpal dislocation, 1 or more bones","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0938T","name":"Xtrnl ecg rec>15d<30d rec","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; recording (including connection and initial recording)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1217","name":"Sys rsn no doc spiro","description":"Documentation of system reason(s) for not documenting and reviewing spirometry results (e.g., spirometry equipment not available at the time of the encounter)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0302U","name":"Iadna brtnla ddpcr flwg liq","description":"Iadna brtnla ddpcr flwg liq","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4018","name":"Ob/gyn ss","description":"Obstetrics/gynecology mips specialty set","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0175","name":"Inj, donanemab-azbt, 2 mg","description":"Injection, donanemab-azbt, 2 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9248","name":"Inj melphalan (hepzato) 1 mg","description":"Injection, melphalan (hepzato), 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15018","name":"App skn cll ssp f/n/g/hf ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 480 sq cm or part thereof (list separately in addition to code for prima","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0813T","name":"Egd vol adjmt bariatric balo","description":"Esophagogastroduodenoscopy, flexible, transoral, with volume adjustment of intragastric bariatric balloon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0356","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81418","name":"Rx metab gen seq alys pnl 6","description":"Drug metabolism (eg, pharmacogenomics) genomic sequence analysis panel, must include testing of at least 6 genes, including cyp2c19, cyp2d6, and cyp2d6 duplication/deletion analysis","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9610","name":"Xe129 xenon, diagnostic","description":"Xenon xe-129 hyperpolarized gas, diagnostic, per study dose","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","name":"Scoliosis orth sag/ cor","description":"Scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla to trochanter, includes all accessory pads, straps and interface, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual ","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0047","name":"Ped blunt hd traum","description":"Pediatric patient with minor blunt head trauma and pecarn prediction criteria are not assessed","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36838","name":"Dist revas ligation hemo","description":"Distal revascularization and interval ligation (dril), upper extremity hemodialysis access (steal syndrome)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1479.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37274","name":"Rvsc evsc fpvt athrc cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37180","name":"Revision of circulation","description":"Venous anastomosis, open; splenorenal, proximal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1704.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1023T","name":"Prq tis dsplmt intrathoracic","description":"Percutaneous tissue displacement, any method, including imaging guidance; intrathoracic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2305","name":"Inj, nitroglycerin, 5 mg","description":"Injection, nitroglycerin, 5 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29540","name":"Strapping ankle &/foot","description":"Strapping; ankle and/or foot","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0304U","name":"Hem rbc ads whl bld normoxic","description":"Hem rbc ads whl bld normoxic","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1351","name":"Pt cmplt suicd saf pln 120dy","description":"Patients who had a suicide safety plan initiated, reviewed, or updated and reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9608","name":"Flotufolastat f18 diag 1 mci","description":"Flotufolastat f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0473U","name":"Onc sld tum bld/slv 648 gene","description":"Onc sld tum bld/slv 648 gene","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1737","name":"Inj meloxicam (azurity) 1mg","description":"Injection, meloxicam (azurity), 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98001","name":"Synch audio-video new low 30","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1164","name":"Pt w/ dementia any time","description":"Patients with dementia any time during the patients history through the end of the measurement period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85014","name":"Hematocrit","description":"Blood count; hematocrit (hct)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7354","name":"Cantharidin top, applicator","description":"Cantharidin for topical administration, 0.7%, single unit dose applicator (3.2 mg)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0751T","name":"Dgtz gls mcrscp sld level ii","description":"Digitization of glass microscope slides for level ii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26055","name":"Incise finger tendon sheath","description":"Tendon sheath incision (eg, for trigger finger)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9595","name":"Piflu f-18, dia 1 millicurie","description":"Piflufolastat f-18, diagnostic, 1 millicurie","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0443U","name":"Neurflmnt lt chn ultrsens ia","description":"Neurflmnt lt chn ultrsens ia","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74019","name":"Radex abdomen 2 views","description":"Radiologic examination, abdomen; 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4319","name":"Sanograft, per sq cm","description":"Sanograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1553","name":"Inj yimmugo 100 mg","description":"Injection, immune globulin (yimmugo), 100 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1153","name":"Pt w/ dx osteo doe","description":"Patient with diagnosis of osteoporosis on date of encounter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4415","name":"Alexiguard st-l per sq cm","description":"Alexiguard sl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1493","name":"No fall doc med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37293","name":"Rvsc evsc tpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0045","name":"Mrs 90 days post stk","description":"Clinical follow-up and mrs score assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76802","name":"Ob us < 14 wks addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0290U","name":"Pain mgmt mrna gen xprsn 36","description":"Pain mgmt mrna gen xprsn 36","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0317U","name":"Onc lung ca 4-prb fish assay","description":"Onc lung ca 4-prb fish assay","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4021","name":"Orthopedic surgery ss","description":"Orthopedic surgery mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61715","name":"Mrgfus strtctc ablt trgt icr","description":"Magnetic resonance image guided high intensity focused ultrasound (mrgfus), stereotactic ablation of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1125.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9184","name":"Inj gemcitabin (avyxa) 200mg","description":"Injection, gemcitabine hydrochloride (avyxa), 200 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4362","name":"Cygnus disk, per sq cm","description":"Cygnus disk, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1452","name":"Pt dx dementia ever","description":"Patient ever had a diagnosis of dementia","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71048","name":"X-ray exam chest 4+ views","description":"Radiologic examination, chest; 4 or more views","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0544","name":"Post d/c phone follow up","description":"Post discharge telephonic follow-up contacts performed in conjunction with a discharge from the emergency department for behavioral health or other crisis encounter, 4 calls per calendar month","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91124","name":"Rct snsatn tone&cmplianc std","description":"Rectal sensation, tone, and compliance study (eg, barostat)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0312U","name":"Ai ds sle alys 8 igg autoant","description":"Ai ds sle alys 8 igg autoant","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0686T","name":"Histotripsy mal hepatcel tis","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant hepatocellular tissue, including image guidance","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0651","name":"Inj, levothyroxine, freskabi","description":"Injection, levothyroxine sodium (fresenius kabi), not therapeutically equivalent to j0650, 10 mcg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1346","name":"No pam inc 6 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 6 points within a 4 to 12 month period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93151","name":"Interrog&prgrmg ipnss","description":"Interrogation and programming (minimum one parameter) of implanted phrenic nerve stimulator system","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4339","name":"Artacent vericlen, per sq cm","description":"Artacent vericlen, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66991","name":"Xcapsl ctrc rmvl insj 1+","description":"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); with insertion of intraocular (eg, trabecular meshwork, supraciliary, suprachoroidal) anterior segment aqueous drai","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6624","name":"Inlay titanium","description":"Inlay - titanium","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4256","name":"Mlg complet, per sq cm","description":"Mlg-complete, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0758T","name":"Dgtz gls mcrscp sl spc hchem","description":"Digitization of glass microscope slides for special stain, including interpretation and report, histochemical stain on frozen tissue block (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85290","name":"Clot factor xiii fibrin stab","description":"Clotting; factor xiii (fibrin stabilizing)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0731T","name":"Augmnt ai-based fcl phnt a/r","description":"Augmentative ai-based facial phenotype analysis with report","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1303","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0533","name":"Buprenorphone inj weekly","description":"Medication assisted treatment, buprenorphine (injectable) administered on a weekly basis; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid tre","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0562","name":"Complex simulation w/pet-ct","description":"Therapeutic radiology simulation-aided field setting; complex, including acquisition of pet and ct imaging data required for radiopharmaceutical-directed radiation therapy treatment planning (i.e., modeling)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27392","name":"Incision of thigh tendons","description":"Tenotomy, open, hamstring, knee to hip; multiple tendons, bilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":838.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21261","name":"Revise eye sockets","description":"Periorbital osteotomies for orbital hypertelorism, with bone grafts; combined intra- and extracranial approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2654.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0971T","name":"Ablt mal brst tum pq lsr uni","description":"Ablation, malignant breast tumor(s), percutaneous, laser, including imaging guidance when performed, unilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0402U","name":"Nfct agt sti mult amp prb tq","description":"Nfct agt sti mult amp prb tq","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1166","name":"Path rpt tis spec wle/reexc","description":"Pathology report for tissue specimens produced from wide local excisions or re-excisions","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4377","name":"Trigraft ft per sq cm","description":"Trigraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0605","name":"Antibody test pub hlth path","description":"Antibody test pub hlth path","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86850","name":"Rbc antibody screen","description":"Antibody screen, rbc, each serum technique","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1351","name":"Dental sealant per tooth","description":"Sealant-per tooth","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0335U","name":"Rare ds whl gen seq fetal","description":"Rare ds whl gen seq fetal","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35231","name":"Repair blvsl vn grf neck","description":"Repair blood vessel with vein graft; neck","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1458.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1598","name":"Inj glycopyrrolate fres kabi","description":"Injection, glycopyrrolate (fresenius kabi), not therapeutically equivalent to j1596, 0.1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4286","name":"Remove non-resorb barrier","description":"Remove non-resorb barrier","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6073","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (predominantly base metal)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1494","name":"Fall rep since last visit","description":"Patients that reported a fall since the last visit","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0471U","name":"Onc clrc ca 35 vrn kras&nras","description":"Onc clrc ca 35 vrn kras&nras","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4282","name":"Cygnus dual per sq cm","description":"Cygnus dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92635","name":"Hearing aid fitg svc ea addl","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; each additional 15 minutes (list separately in addition to code","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0472U","name":"Ca vi psp&sp1 antb sjogren","description":"Ca vi psp&sp1 antb sjogren","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77418","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":871.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0705T","name":"Rem tx amblyopia tech sprt","description":"Remote treatment of amblyopia using an eye tracking device; surveillance center technical support including data transmission with analysis, with a minimum of 18 training hours, each 30 days","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4380","name":"Advograft one per sq cm","description":"Advograft one, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0568U","name":"Neurol dementia bamyl ptau","description":"Neurol dementia bamyl ptau","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46705","name":"Repair of anal stricture","description":"Anoplasty, plastic operation for stricture; infant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":514.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1224","name":"Iop dec <20% from base","description":"Intraocular pressure (iop) reduced by a value less than 20% from the pre-intervention level","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0537U","name":"Onc clrct ca cfdna >2500 dmr","description":"Onc clrct ca cfdna >2500 dmr","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0423","name":"Genetic test spec analysis","description":"Genetic test spec analysis","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0982T","name":"Rem mntr impl ivc snr set-up","description":"Remote monitoring of implantable inferior vena cava sensor, physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate), initial set-up and patient education on use of equipment","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6107","name":"Tissue regen non-resorbable","description":"Tissue regen non-resorbable","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2508","name":"Pegunigalsidase alfa-iwxj","description":"Injection, pegunigalsidase alfa-iwxj, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4323","name":"Splint extra-coronal","description":"Splint extra-coronal","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82233","name":"Beta-amyloid 1-40 (abeta 40)","description":"Beta-amyloid; 1-40 (abeta 40)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1383","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0001","name":"Advancing cancer care mvp","description":"Advancing cancer care mips value pathways","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84481","name":"Free assay (ft-3)","description":"Triiodothyronine t3; free","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90695","name":"H5n8 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n8, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0922T","name":"Rmvl perm ccm-d sys dual ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); dual (pacing and defibrillation) transvenous leads only","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44392","name":"Colonoscopy & polypectomy","description":"Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85007","name":"Bl smear w/diff wbc count","description":"Blood count; blood smear, microscopic examination with manual differential wbc count","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55710","name":"Bx prst8 tprn us w/mri fus 1","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant) with mri-fusion-guidance biopsy, first targeted lesion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":100.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1006T","name":"Elec alys s-scl eeg prgrm ea","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, each additional 15 minutes face-to-face time with physician or other qua","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4272","name":"Esano a, per sq cm","description":"Esano a, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5996","name":"Peri medicament w/seal, mand","description":"Peri medicament w/seal, mand","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1477","name":"Dx delirium","description":"Diagnosis of delirium","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0835T","name":"Dgtz gls mcrscp fna 1st ea","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83664","name":"Lamellar bdy fetal lung","description":"Fetal lung maturity assessment; lamellar body density","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98986","name":"Rtm dev sply cbt 2-15 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of cognitive behavioral therapy, 2-15 days in a 30-day period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90792","name":"Psych diag eval w/med srvcs","description":"Psychiatric diagnostic evaluation with medical services","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":116.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":226.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43214","name":"Esophagosc dilate balloon 30","description":"Esophagoscopy, flexible, transoral; with dilation of esophagus with balloon (30 mm diameter or larger) (includes fluoroscopic guidance, when performed)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57400","name":"Dilation of vagina","description":"Dilation of vagina under anesthesia (other than local)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9184","name":"Inj gemcitabin (avyxa) 200mg","description":"Injection, gemcitabine hydrochloride (avyxa), 200 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0514U","name":"Gi ibd ia quan deter adl lvl","description":"Gi ibd ia quan deter adl lvl","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1598","name":"Inj glycopyrrolate fres kabi","description":"Injection, glycopyrrolate (fresenius kabi), not therapeutically equivalent to j1596, 0.1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1163","name":"Pt anphx due to hpv bef 13","description":"Patient had anaphylaxis due to the hpv vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0440U","name":"Crd chd dna alys 10 snp 6dna","description":"Crd chd dna alys 10 snp 6dna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29820","name":"Sho arthrs srg prtl synvct","description":"Arthroscopy, shoulder, surgical; synovectomy, partial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":663.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2028","name":"Micromatrix flex per mg","description":"Micromatrix flex, per mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15776","name":"Hair trnspl >15 punch grafts","description":"Punch graft for hair transplant; more than 15 punch grafts","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":405.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27306","name":"Incision of thigh tendon","description":"Tenotomy, percutaneous, adductor or hamstring; single tendon (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":467.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7353","name":"Anacaulase-bcdb 8.8% gel 1 g","description":"Anacaulase-bcdb, 8.8% gel, 1 gram","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88174","name":"Cytopath c/v auto in fluid","description":"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; screening by automated system, under physician supervision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4564","name":"Pessary, disposable any type","description":"Pessary, disposable, any type","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0315U","name":"Onc cutan sq cll ca mrna 40","description":"Onc cutan sq cll ca mrna 40","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0941T","name":"Cysto flx ins&xpns urtl scaf","description":"Cystourethroscopy, flexible; with insertion and expansion of prostatic urethral scaffold using integrated cystoscopic visualization","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0582U","name":"Rare ds rpd whlgen dna vrnts","description":"Rare ds rpd whlgen dna vrnts","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01937","name":"Anes drg/aspir crv/thrc","description":"Anesthesia for percutaneous image-guided injection, drainage or aspiration procedures on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58558","name":"Hysteroscopy biopsy","description":"Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without d & c","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":1386.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2253","name":"Inj midazolam (seizalam)","description":"Injection, midazolam (seizalam), 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2027","name":"Matriderm per sq cm","description":"Matriderm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1328","name":"Pts dx acute vitreous hem","description":"Patients with a diagnosis of acute vitreous hemorrhage","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74230","name":"X-ray xm swlng funcj c+","description":"Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1351","name":"Dental sealant per tooth","description":"Sealant-per tooth","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82135","name":"Assay aminolevulinic acid","description":"Aminolevulinic acid, delta (ala)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0671T","name":"Insj ant sgm aq drg dev 1+","description":"Insertion of anterior segment aqueous drainage device into the trabecular meshwork, without external reservoir, and without concomitant cataract removal, one or more","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77300","name":"Radiation therapy dose plan","description":"Basic radiation dosimetry calculation, central axis depth dose calculation, tdf, nsd, gap calculation, off axis factor, tissue inhomogeneity factors, calculation of non-ionizing radiation surface and depth dose, as required during course of treatment, only when prescribed by the treating physician","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0510U","name":"Onc pncrtc ca alg alys 16gen","description":"Onc pncrtc ca alg alys 16gen","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49616","name":"Rpr aa hrn rcr 3-10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, incarcerated or strangulated","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37286","name":"Revsc evasc tpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0605","name":"Sucroferric oxyhydroxide 5mg","description":"Sucroferric oxyhydroxide, oral, 5 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54435","name":"Revision of penis","description":"Corpora cavernosa-glans penis fistulization (eg, biopsy needle, winter procedure, rongeur, or punch) for priapism","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3374","name":"Inj, vancomycin (mylan) 10mg","description":"Injection, vancomycin hydrochloride (mylan) not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4359","name":"Choriply, per sq cm","description":"Choriply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7962","name":"Lingual frenectomy","description":"Lingual frenectomy","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0162","name":"Inj epinephrine (fresenius)","description":"Injection, epinephrine (fresenius), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92603","name":"Cochlear implt f/up exam 7/>","description":"Diagnostic analysis of cochlear implant, age 7 years or older; with programming","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9321","name":"Inj epcoritamab-bysp 0.16 mg","description":"Injection, epcoritamab-bysp, 0.16 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0986T","name":"Iv img icr cere vsl oct 1st","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5161","name":"Inj, denosumab-kyqq, 1 mg","description":"Injection, denosumab-kyqq (aukelso/bosaya), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1340","name":"Indx whodas 2.0 or sds","description":"Index assessment completed using the 12-item whodas 2.0 or sds during the denominator identification period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98012","name":"Synch audio-only est sf 10","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31020","name":"Exploration maxillary sinus","description":"Sinusotomy, maxillary (antrotomy); intranasal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0740T","name":"Rem auton alg nsln cal setup","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; initial set-up and patient education","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21047","name":"Excise lwr jaw cyst w/repair","description":"Excision of benign tumor or cyst of mandible; requiring extra-oral osteotomy and partial mandibulectomy (eg, locally aggressive or destructive lesion[s])","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1538.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0175","name":"Inj, donanemab-azbt, 2 mg","description":"Injection, donanemab-azbt, 2 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4376","name":"Duograft aa per sq cm","description":"Duograft aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0651","name":"Inj, levothyroxine, freskabi","description":"Injection, levothyroxine sodium (fresenius kabi), not therapeutically equivalent to j0650, 10 mcg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0899T","name":"N-invas deter aqmbf aug cmr","description":"Noninvasive determination of absolute quantitation of myocardial blood flow (aqmbf), derived from augmentative algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health car","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20939","name":"Bone marrow aspir bone grfg","description":"Bone marrow aspiration for bone grafting, spine surgery only, through separate skin or fascial incision (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0761T","name":"Dgtz gls mcrscp sl imm ea 1","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27615","name":"Resect leg/ankle tum < 5 cm","description":"Radical resection of tumor (eg, sarcoma), soft tissue of leg or ankle area; less than 5 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1074.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6197","name":"Replace material prosthesis","description":"Replace material prosthesis","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99296","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":464.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":254.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4398","name":"Summit ac per sq cm","description":"Summit ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1476","name":"Pt dx cog imp or ad","description":"Patients with diagnosis of cognitive impairment or alzheimers disease","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9947","name":"Sleep apnea appliance","description":"Sleep apnea appliance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0327U","name":"Ftl aneuploidy trsmy dna seq","description":"Ftl aneuploidy trsmy dna seq","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81451","name":"Hl neo gsap 5-50 rna alys","description":"Hematolymphoid neoplasm or disorder, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants, and copy number variants or rearrangements, or isoform expression or mrna expression levels, if performed; rna analysis","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2023","name":"Innovamatrix pd, 1 mg","description":"Innovamatrix pd, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0287U","name":"Onc thyr dna&mrna 112 genes","description":"Onc thyr dna&mrna 112 genes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9887","name":"Distance learning attendance","description":"Behavioral counseling for diabetes prevention, distance learning, 60 minutes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1213","name":"No hx spiro prs spiro>=70%","description":"No history of spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) and present spirometry is >= 70%","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49580","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"Limited visual field xm","description":"Visual field examination, unilateral or bilateral, with interpretation and report; limited examination (eg, tangent screen, autoplot, arc perimeter, or single stimulus level automated test, such as octopus 3 or 7 equivalent)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2919","name":"Inj, methylpred sod succ 5mg","description":"Injection, methylprednisolone sodium succinate, 5 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92928","name":"Prq tcat plmt ntrac st 1 les","description":"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 1 lesion involving 1 or more coronary segments","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7521","name":"Incision/drain abscess extra","description":"Incision and drainage of abscess - extraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92635","name":"Hearing aid fitg svc ea addl","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; each additional 15 minutes (list separately in addition to code","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","name":"Gait mod systm rhym auditory","description":"Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69730","name":"Rplc oi implt sk tc esp>=100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33278","name":"Rmvl phrnc nrv stim sys","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; system, including pulse generator and lead(s)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82465","name":"Assay bld/serum cholesterol","description":"Cholesterol, serum or whole blood, total","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50580","name":"Kidney endoscopy & treatment","description":"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":725.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37297","name":"Revsc evasc imvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1382","name":"Enc dur perf pd pos 11","description":"Patient encounter during the performance period with place of service code 11","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0802","name":"Inj. (ani), up to 40 units","description":"Injection, corticotropin (ani), up to 40 units","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9955","name":"Oral app thxpy titration vis","description":"Oral app thxpy titration vis","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0561U","name":"Onc mrd gsa cfdna subsequent","description":"Onc mrd gsa cfdna subsequent","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43290","name":"Egd flx trnsorl dplmnt balo","description":"Esophagogastroduodenoscopy, flexible, transoral; with deployment of intragastric bariatric balloon","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3471","name":"Surg rep root res anterior","description":"Surg rep root res anterior","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1553","name":"Inj yimmugo 100 mg","description":"Injection, immune globulin (yimmugo), 100 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0511U","name":"Onc sol tum 3dmicroenvir 36+","description":"Onc sol tum 3dmicroenvir 36+","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42975","name":"Dise eval slp do brth flx dx","description":"Drug-induced sleep endoscopy, with dynamic evaluation of velum, pharynx, tongue base, and larynx for evaluation of sleep-disordered breathing, flexible, diagnostic","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0856T","name":"Dgtz gls mcrscp electron mic","description":"Digitization of glass microscope slides for electron microscopy, diagnostic (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1227","name":"Eb therapy prescribed","description":"Evidence-based therapy was prescribed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3374","name":"Inj, vancomycin (mylan) 10mg","description":"Injection, vancomycin hydrochloride (mylan) not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1496","name":"No doc of fall or poc","description":"Patients that had a fall who did not have a plan of care for falls documented or do not have documentation of being assessed for falls","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0983T","name":"Rem mntr impl ivc snr phys","description":"Remote monitoring of an implanted inferior vena cava sensor for up to 30 days, including at least weekly downloads of inferior vena cava area recordings, interpretation(s), trend analysis, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0803T","name":"Tcat rmv&rpl2chmb ldls pm rv","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ve","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5948","name":"Max implt sup fix part","description":"Max implt sup fix part","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4027","name":"Plastic surgery ss","description":"Plastic surgery mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98005","name":"Synch audio-video est low 20","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low medical decision making. when using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded.","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0803T","name":"Tcat rmv&rpl2chmb ldls pm rv","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ve","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0037","name":"Pt not able to participate","description":"On date of encounter, patient is not able to participate in assessment or screening, including non-verbal patients, delirious, severely aphasic, severely developmentally delayed, severe visual or hearing impairment and for those patients, no knowledgeable informant available","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28405","name":"Cltx calcaneal fx w/mnpj","description":"Closed treatment of calcaneal fracture; with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":453.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0797T","name":"Tcat ins 2chmbr ldls pm rv","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ventricular pace","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0364","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0980T","name":"Sbmcsl crylys ther tng&tnsl","description":"Submucosal cryolysis therapy; base of tongue and lingual tonsil only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4371","name":"Neoguard per sq cm","description":"Neoguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0169","name":"Inj epinephrine (adrenalin)","description":"Injection, epinephrine (adrenalin), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1206","name":"Isa not red 3pts/no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0507U","name":"Onc ovr dna whole gen w/5hmc","description":"Onc ovr dna whole gen w/5hmc","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73564","name":"X-ray exam knee 4 or more","description":"Radiologic examination, knee; complete, 4 or more views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0138","name":"Inj acetaminoph 10mg/ibu 3mg","description":"Injection, acetaminophen 10 mg and ibuprofen 3 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0569U","name":"Onc sol tum ngs tmm>20000dmr","description":"Onc sol tum ngs tmm>20000dmr","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4330","name":"Total, per sq cm","description":"Total, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1359","name":"Indx suicd idea, no 0 scr","description":"Index assessment during the denominator period when the suicidal ideation and/or behavior symptoms or increased suicide risk by clinician determination occurs and a non-zero c-ssrs score is obtained","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1368","name":"Prev trt inf d/o hiv/hep mvp","description":"Prevention and treatment of infectious disorders including hepatitis c and hiv mips value pathway","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90593","name":"Chikungunya vacc recomb im","description":"Chikungunya virus vaccine, recombinant, for intramuscular use","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1501","name":"Pathology mvp","description":"Pathology mips value pathway","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80184","name":"Assay of phenobarbital","description":"Phenobarbital","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42000","name":"Drainage mouth roof lesion","description":"Drainage of abscess of palate, uvula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0536","name":"Peer recover support svs","description":"Peer recovery support services, provided directly or by referral; including leveraging knowledge of the condition or lived experience to provide support, mentorship, or inspiration to meet oud treatment and recovery goals; conducting a person-centered interview to understand the patients life story,","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3402","name":"Inj. remestemcel-l-rknd/ td","description":"Injection, remestemcel-l-rknd, per therapeutic dose","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01938","name":"Anes drg/aspir lmbr/sac","description":"Anesthesia for percutaneous image-guided injection, drainage or aspiration procedures on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76941","name":"Echo guide for transfusion","description":"Ultrasonic guidance for intrauterine fetal transfusion or cordocentesis, imaging supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2471","name":"Inj pantoprazole(hikma) 40mg","description":"Injection, pantoprazole (hikma), not therapeutically equivalent to j2470, 40 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0988T","name":"Opn ins/rplc ins ptn sbq&sbf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4310","name":"Procenta, per 100 mg","description":"Procenta, per 100 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0861T","name":"Rmvl pg wcs lv both compnt","description":"Removal of pulse generator for wireless cardiac stimulator for left ventricular pacing; both components (battery and transmitter)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98005","name":"Synch audio-video est low 20","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low medical decision making. when using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0540","name":"Train for caregiver add 15","description":"Caregiver training in behavior management/modification for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face; each additional 15 minutes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9046","name":"Inj, bortezomib, dr. reddys","description":"Injection, bortezomib (dr. reddys), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49594","name":"Rpr aa hrn 1st 3-10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, incarcerated or strangulated","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1465","name":"F/u > 180 days after rx","description":"Patient follow up more than 180 days after treatment","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0457","name":"Injection, aztreonam, 100 mg","description":"Injection, aztreonam, 100 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75810","name":"Vein x-ray spleen/liver","description":"Splenoportography, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7521","name":"Tacrolim granules oral susp","description":"Tacrolimus, granules, oral suspension, 0.1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1218","name":"Pt copd symptoms","description":"Patient has copd symptoms (e.g., dyspnea, cough/sputum, wheezing)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77090","name":"Tbs techl prep&transmis data","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32605","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":482.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76775","name":"Us exam abdo back wall lim","description":"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93595","name":"L hrt cath chd nm/abn nt cnj","description":"Left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone, normal or abnormal native connections","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4396","name":"Natalin per sq cm","description":"Natalin, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93574","name":"Njx cath slct pulm vn angrph","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary venous angiography of each distinct pulmonary vein during cardiac catheterization (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1295","name":"Pt hx tot col or colon ca","description":"Patients with a diagnosis or past history of total colectomy or colorectal cancer","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2791","name":"Crown full cast base metal","description":"Crown-full cast predominantly base metal","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1287","name":"Calc bmi blw low param f/u","description":"Bmi is documented below normal parameters and a follow-up plan is documented","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0783T","name":"Tc auriculr neurostimulation","description":"Transcutaneous auricular neurostimulation, set-up, calibration, and patient education on use of equipment","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87428","name":"Sarscov & inf vir a&b ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; severe acute respiratory syndrome coronavirus (eg, sars-cov, s","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2013","name":"Innovamatrix fs, per sq cm","description":"Innovamatrix fs, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64596","name":"Ins/rplcmt prq eltrd ra pn 1","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; initial electrode array","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63702","name":"Repair of spinal herniation","description":"Repair of meningocele; larger than 5 cm diameter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1547.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80174","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4382","name":"Advograft dual per sq cm","description":"Advograft dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9609","name":"F18 fdg, 15 millicuries","description":"Fludeoxyglucose f18 up to 15 millicuries","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1287","name":"Calc bmi blw low param f/u","description":"Bmi is documented below normal parameters and a follow-up plan is documented","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35566","name":"Art byp fem-ant-post tib/prl","description":"Bypass graft, with vein; femoral-anterior tibial, posterior tibial, peroneal artery or other distal vessels","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1881.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1415","name":"No pos pdl1 bef ici ther","description":"Patients who did not have a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90684","name":"Pcv21 vaccine im","description":"Pneumococcal conjugate vaccine, 21 valent (pcv21), for intramuscular use","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5612","name":"Rep resin part dent base max","description":"Rep resin part dent base max","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0348U","name":"Rx metab/pcx dna 25 gen alys","description":"Rx metab/pcx dna 25 gen alys","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81558","name":"Trnspl rej kdn mrna qpcr 139","description":"Transplantation medicine (allograft rejection, kidney), mrna, gene expression profiling by quantitative polymerase chain reaction (qpcr) of 139 genes, utilizing whole blood, algorithm reported as a binary categorization as transplant excellence, which indicates immune quiescence, or not transplant e","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1224","name":"Iop dec <20% from base","description":"Intraocular pressure (iop) reduced by a value less than 20% from the pre-intervention level","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0414U","name":"Onc lng aug alg aly whl sld8","description":"Onc lng aug alg aly whl sld8","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1299","name":"Flu immunize order/admin","description":"Influenza immunization administered or previously received","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0384U","name":"Neph ckd rsk hi stg kdn ds","description":"Neph ckd rsk hi stg kdn ds","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0046","name":"No mrs 90 days post stk","description":"Clinical follow-up and mrs score not assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0945T","name":"Intraop assmt abnl tum tiss","description":"Intraoperative assessment for abnormal (tumor) tissue, in-vivo, following partial mastectomy (eg, lumpectomy) using computer-aided fluorescence imaging (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69820","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1013.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0940T","name":"Xtrnl ecg rec>15d<30d r&i","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0548U","name":"Gfap cleia plasma","description":"Gfap cleia plasma","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4037","name":"Urology ss","description":"Urology mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62264","name":"Epidural lysis on single day","description":"Percutaneous lysis of epidural adhesions using solution injection (eg, hypertonic saline, enzyme) or mechanical means (eg, catheter) including radiologic localization (includes contrast when administered), multiple adhesiolysis sessions; 1 day","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93230","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1025","name":"Pt mnth 1 mcp prov","description":"Patient-months where there are more than one medicare capitated payment (mcp) provider listed for the month","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1379","name":"10 yr fu no rec rsn not giv","description":"A 10 year follow-up interval for colonoscopy not recommended, reason not otherwise specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0732T","name":"Immntx admn electroporatn im","description":"Immunotherapy administration with electroporation, intramuscular","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0248","name":"Inj, remdesivir, 1 mg","description":"Injection, remdesivir, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64728","name":"Dcmprn median nrv carpl tunl","description":"Decompression; median nerve at the carpal tunnel, percutaneous, with intracarpal tunnel balloon dilation, including ultrasound guidance","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93145","name":"Interrog crtd sins bat ip wo","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1033","name":"Sv doula brth wrk per diem","description":"Services performed by a doula birth worker, per diem","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0872","name":"Daptomycin (xellia) unrefrig","description":"Injection, daptomycin (xellia), unrefrigerated, not therapeutically equivalent to j0878 or j0873, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9321","name":"Inj epcoritamab-bysp 0.16 mg","description":"Injection, epcoritamab-bysp, 0.16 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0267U","name":"Rare do id opt gen mapg&seq","description":"Rare constitutional and other heritable disorders, identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping and whole-genome sequencing","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86653","name":"Encephaltis st louis antbody","description":"Antibody; encephalitis, st. louis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6602","name":"Cst hgh nble mtl inlay 2 srf","description":"Inlay - cast high noble metal two surfaces","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1361","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5909","name":"Max guid prothes w/ flange","description":"Max guid prothes w/ flange","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86231","name":"Ema each ig class","description":"Endomysial antibody (ema), each immunoglobulin (ig) class","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44143","name":"Partial removal of colon","description":"Colectomy, partial; with end colostomy and closure of distal segment (hartmann type procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1634.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1185","name":"Imm ckpt inhib not hld no rx","description":"Documentation of immune checkpoint inhibitor therapy not held and/or corticosteroids or immunosuppressants prescribed or administered was not performed, reason not given","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0749T","name":"B1 str&fx rsk assmt dxr-bmd","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55712","name":"Bx prst8 tprnl mri-us 1st","description":"Biopsy, prostate, transperineal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0299U","name":"Onc pan tum whl gen opt mapg","description":"Onc pan tum whl gen opt mapg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0434U","name":"Rx metab advrs vrnt alys 25","description":"Rx metab advrs vrnt alys 25","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59025","name":"Fetal non-stress test","description":"Fetal non-stress test","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2782","name":"Crown 3/4 cast noble metal","description":"Crown - 3/4 cast noble metal","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0032","name":"2+ antipsy schiz","description":"Two or more antipsychotic prescriptions ordered for patients who had a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder on or between january 1 of the year prior to the measurement period and the index prescription start date (ipsd) for antipsychotics","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57500","name":"Biopsy of cervix","description":"Biopsy of cervix, single or multiple, or local excision of lesion, with or without fulguration (separate procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":78.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1195","name":"Rpt wo imp/con mmr/msi","description":"Surgical pathology reports that do not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both, reason not given","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0861T","name":"Rmvl pg wcs lv both compnt","description":"Removal of pulse generator for wireless cardiac stimulator for left ventricular pacing; both components (battery and transmitter)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0911T","name":"Elec aly nstm sys vgs nrv wo","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; without programming by physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1189","name":"Doc khe pef w/efgr/uacr","description":"Documentation of a kidney health evaluation defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr) performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9938","name":"Fab removable appliance","description":"Fab removable appliance","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0527","name":"Mgt est pt dmentia low cmplx","description":"Management of established patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9027","name":"Rbc o2 co2 reduced","description":"Red blood cells, leukocytes reduced, oxygen/ carbon dioxide reduced, each unit","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81459","name":"So neo gsap dna/dna&rna","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants, microsatellite instability, tumor mutation burden, and rearrangements","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5134","name":"Inj, tyruko, 1 mg","description":"Injection, natalizumab-sztn (tyruko), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1189","name":"Doc khe pef w/efgr/uacr","description":"Documentation of a kidney health evaluation defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr) performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87077","name":"Culture aerobic identify","description":"Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9051","name":"Inj, bortezomib (maia)","description":"Injection, bortezomib (maia), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0478U","name":"Onc nsclc dna&rna dpcr 9 gen","description":"Onc nsclc dna&rna dpcr 9 gen","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94375","name":"Respiratory flow volume loop","description":"Respiratory flow volume loop","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22847","name":"Insert spine fixation device","description":"Anterior instrumentation; 8 or more vertebral segments (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0499U","name":"Onc clrct&lng dna ngs 8gene","description":"Onc clrct&lng dna ngs 8gene","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0788T","name":"Elec aly smp iins sp/sac nrv","description":"Electronic analysis with simple programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detecti","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98986","name":"Rtm dev sply cbt 2-15 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of cognitive behavioral therapy, 2-15 days in a 30-day period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1597","name":"Inj glycopyrrolate, glyrx-pf","description":"Injection, glycopyrrolate (glyrx-pf), 0.1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47900","name":"Suture bile duct injury","description":"Suture of extrahepatic biliary duct for pre-existing injury (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1400.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33901","name":"Perq p-art revsc 1 nm nt bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, bilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68841","name":"Insj rx elut implt lac canal","description":"Insertion of drug-eluting implant, including punctal dilation when performed, into lacrimal canaliculus, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0051","name":"Traditional healing service","description":"Traditional healing service","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20973","name":"Bone/skin graft great toe","description":"Free osteocutaneous flap with microvascular anastomosis; great toe with web space","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3418.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22836","name":"Ant thrc vrt body tethrg <7","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; up to 7 vertebral segments","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":1451.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1441","name":"Init dx slp apn = 1st enc","description":"Encounter corresponds to initial diagnosis of sleep apnea or first contact with sleep apnea diagnosed patient","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96041","name":"Genetic counseling svc ea 30","description":"Medical genetics and genetic counseling services, each 30 minutes of total time provided by the genetic counselor on the date of the encounter","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5150","name":"Inj, aflibercept-mrbb, 1 mg","description":"Injection, aflibercept-mrbb (ahzantive), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0389","name":"Periopic image capture only","description":"Periopic image capture only","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15570","name":"Skin pedicle flap trunk","description":"Formation of direct or tubed pedicle, with or without transfer; trunk","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":779.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4266","name":"Neostim per sq cm","description":"Neostim membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23491","name":"Reinforce shoulder bones","description":"Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate; proximal humerus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1249.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49186","name":"Opn exc/dstr ntra-abd 5 cm/<","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5 cm or less","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76856","name":"Us exam pelvic complete","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86850","name":"Rbc antibody screen","description":"Antibody screen, rbc, each serum technique","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0870","name":"Injection, imetelstat, 1 mg","description":"Injection, imetelstat, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37299","name":"Revsc evsc imvt angio cpx ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2281","name":"Inj moxifloxacin (fres kabi)","description":"Injection, moxifloxacin (fresenius kabi), not therapeutically equivalent to j2280, 100 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1710","name":"Moderna vacc admin 3rd dose","description":"Moderna vacc admin 3rd dose","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1412","name":"Met nsclc w/ egfr alk oth ab","description":"Patients with metastatic nsclc with epidermal growth factor receptor (egfr) mutations, alk genomic tumor aberrations, or other targetable genomic abnormalities with approved first-line targeted therapy, such as nsclc with ros1 rearrangement, braf v600e mutation, ntrk 1/2/3 gene fusion, met ex14 skip","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1004T","name":"Elec alys s-scl eeg wo prgrm","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; without programming","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38226","name":"Car-t prep t lymphcyt f/trns","description":"Chimeric antigen receptor t-cell (car-t) therapy; preparation of blood-derived t lymphocytes for transportation (eg, cryopreservation, storage)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0894T","name":"Cannulation liver allograft","description":"Cannulation of the liver allograft in preparation for connection to the normothermic perfusion device and decannulation of the liver allograft following normothermic perfusion","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"Sup/ext non-ins inf pump syr","description":"Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0008","name":"Admin influenza virus vac","description":"Administration of influenza virus vaccine","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0873","name":"Inj daptomycin (xellia)","description":"Injection, daptomycin (xellia), not therapeutically equivalent to j0878 or j0872, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61889","name":"Ins sk-mnt crnl nstm pg/rcvr","description":"Insertion of skull-mounted cranial neurostimulator pulse generator or receiver, including craniectomy or craniotomy, when performed, with direct or inductive coupling, with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30469","name":"Rpr nsl vlv collapse w/rmdlg","description":"Repair of nasal valve collapse with low energy, temperature-controlled (ie, radiofrequency) subcutaneous/submucosal remodeling","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1181","name":"Gr 2 or> dia or gr2 or> col","description":"Grade 2 or above diarrhea and/or grade 2 or above colitis","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0383U","name":"Tyrosinemia typ i mntr quan","description":"Tyrosinemia typ i mntr quan","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0707","name":"Intraoral periap radio image","description":"Intraoral periap radio image","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87220","name":"Tissue exam for fungi","description":"Tissue examination by koh slide of samples from skin, hair, or nails for fungi or ectoparasite ova or mites (eg, scabies)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4324","name":"Amniotx, per sq cm","description":"Amniotx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1491","name":"Recd esrd mcp dur perf pd","description":"Receiving esrd mcp dialysis services by the provider during the performance period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0683T","name":"Prgrmg dev eval isdss ip","description":"Programming device evaluation (in-person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional, permanent implantable synchroni","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0812T","name":"Rem mlt day uroflow dev sply","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); device supply with automated report generation, up to 10 days","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0010","name":"Eom meos payment","description":"Enhancing oncology model (eom) monthly enhanced oncology services (meos) payment for eom enhanced services","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3425","name":"Hydroxocobalamin im 10mcg","description":"Injection, hydroxocobalamin, intramuscular, 10 mcg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0429U","name":"Hpv orop swab 14 hi-risk typ","description":"Hpv orop swab 14 hi-risk typ","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9359","name":"Inj lon tesirin-lpyl 0.075mg","description":"Injection, loncastuximab tesirine-lpyl, 0.075 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4421","name":"Biolab wrap solo per sq cm","description":"Biolab membrane wrap solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1023T","name":"Prq tis dsplmt intrathoracic","description":"Percutaneous tissue displacement, any method, including imaging guidance; intrathoracic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87153","name":"Dna/rna sequencing","description":"Culture, typing; identification by nucleic acid sequencing method, each isolate (eg, sequencing of the 16s rrna gene)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1262","name":"Pts transplt bef dialysis","description":"Patients who had a transplant prior to initiation of dialysis","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99211","name":"Off/op est may x req phy/qhp","description":"Office or other outpatient visit for the evaluation and management of an established patient that may not require the presence of a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":23.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61581","name":"Craniofacial approach skull","description":"Craniofacial approach to anterior cranial fossa; extradural, including lateral rhinotomy, orbital exenteration, ethmoidectomy, sphenoidectomy and/or maxillectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2774.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0549U","name":"Onc urthl dna mthyltd rt pcr","description":"Onc urthl dna mthyltd rt pcr","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29819","name":"Sho arthrs srg rmvl loose/fb","description":"Arthroscopy, shoulder, surgical; with removal of loose body or foreign body","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0413U","name":"Onc hl neo opt gen mapg dna","description":"Onc hl neo opt gen mapg dna","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9286","name":"Inj glofitamab gxbm, 2.5 mg","description":"Injection, glofitamab-gxbm, 2.5 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86363","name":"Mog-igg1 antb flo cytmtry ea","description":"Myelin oligodendrocyte glycoprotein (mog-igg1) antibody; flow cytometry (ie, fluorescence-activated cell sorting [facs]), each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9029","name":"Instill adstiladrin, tx dose","description":"Intravesical instillation, nadofaragene firadenovec-vncg, per therapeutic dose","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95867","name":"Ndl emg cranial nrv musc uni","description":"Needle electromyography; cranial nerve supplied muscle(s), unilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99375","name":"Home health care supervision","description":"Supervision of a patient under care of home health agency (patient not present) in home, domiciliary or equivalent environment (eg, alzheimers facility) requiring complex and multidisciplinary care modalities involving regular development and/or revision of care plans by that individual, review of s","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":81.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0559U","name":"Onc brs quan elisa bf9ag srm","description":"Onc brs quan elisa bf9ag srm","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J9290","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1350","name":"Pt w/ suic saf pln init rev","description":"Patients who had a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0206","name":"Inj allopurinol sodium 1 mg","description":"Injection, allopurinol sodium, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29870","name":"Arthrs knee dx w/wo syn bx","description":"Arthroscopy, knee, diagnostic, with or without synovial biopsy (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":494.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99424","name":"Prin care mgmt phys 1st 30","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2470","name":"Inj pantoprazole sodium 40mg","description":"Injection, pantoprazole sodium, 40 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4015","name":"Neurology ss","description":"Neurology mips specialty set","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49617","name":"Rpr aa hrn rcr > 10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, reducible","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50684","name":"Injection for ureter x-ray","description":"Injection procedure for ureterography or ureteropyelography through ureterostomy or indwelling ureteral catheter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1339","name":"Pts f/u 30-180 dys + improv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who demonstrated positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54110","name":"Treatment of penis lesion","description":"Excision of penile plaque (peyronie disease);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5160","name":"Inj, jobevne, 10 mg","description":"Injection, bevacizumab-nwgd (jobevne), biosimilar, 10 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0301U","name":"Iadna bartonella ddpcr","description":"Iadna bartonella ddpcr","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0660","name":"Team remote e/m new pt 10 mn","description":"Team remote e/m new pt 10mins","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0668","name":"Team remote e/m est pt 40 mn","description":"Team remote e/m est. pt 40mins","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37283","name":"Rvsc evsc tpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55707","name":"Bx prst8 trct us guided","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0443U","name":"Neurflmnt lt chn ultrsens ia","description":"Neurflmnt lt chn ultrsens ia","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1811","name":"Fiasp for insulin pump use","description":"Insulin (fiasp) for administration through dme (i.e., insulin pump) per 50 units","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0801","name":"3d dental scan direct","description":"3d dental scan direct","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1479","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15778","name":"Impl absrb msh/prsth dly cls","description":"Implantation of absorbable mesh or other prosthesis for delayed closure of defect(s) (ie, external genitalia, perineum, abdominal wall) due to soft tissue infection or trauma","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0537U","name":"Onc clrct ca cfdna >2500 dmr","description":"Onc clrct ca cfdna >2500 dmr","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1384","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3291","name":"Tranexamic acid in sod chlor","description":"Injection, tranexamic acid in sodium chloride, 5 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4438","name":"Pretect per sq cm","description":"Pretect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2472","name":"Inj, pantoprazole sodium chl","description":"Injection, pantoprazole sodium in sodium chloride (baxter), 40 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99418","name":"Prolng ip/obs e/m ea 15 min","description":"Prolonged inpatient or observation evaluation and management service(s) time with or without direct patient contact beyond the required time of the primary service when the primary service level has been selected using total time, each 15 minutes of total time (list separately in addition to the cod","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0783T","name":"Tc auriculr neurostimulation","description":"Transcutaneous auricular neurostimulation, set-up, calibration, and patient education on use of equipment","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1361","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1390","name":"Pt no doc exm for rec","description":"Patients who do not have a documented exam performed for recurrence of melanoma or no documentation within the performance period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0417U","name":"Rare ds alys 335 nuc genes","description":"Rare ds alys 335 nuc genes","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1268","name":"Pt ac stat kid trnsplt wtlst","description":"Patients observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37281","name":"Revsc evsc tpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7340","name":"Carbidopa levodopa ent 100ml","description":"Carbidopa 5 mg/levodopa 20 mg enteral suspension, 100 ml","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90846","name":"Family psytx w/o pt 50 min","description":"Family psychotherapy (without the patient present), 50 minutes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":98.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0602U","name":"Endocrin dm ins gen mthyltn","description":"Endocrin dm ins gen mthyltn","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37282","name":"Rvsc evsc tpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66930","name":"Extraction of lens","description":"Removal of lens material; intracapsular, for dislocated lens","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":831.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9174","name":"Inj, docetaxel (beizray) 1mg","description":"Injection, docetaxel (beizray), 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1014T","name":"Lap rv/rmv eso sph nstm eltr","description":"Laparoscopic revision or removal, lower esophageal sphincter neurostimulator electrodes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9913","name":"Admin of neuromod","description":"Admin of neuromod","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0874","name":"Inj, daptomycin (baxter)","description":"Injection, daptomycin (baxter), not therapeutically equivalent to j0878, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5145","name":"Inj, abrilada, 1 mg","description":"Injection, adalimumab-afzb (abrilada), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8611","name":"Oral methotrexate (jylamvo)","description":"Methotrexate (jylamvo), oral, 2.5 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1180","name":"Pt imm ckpt inhib therapy","description":"Patients on immune checkpoint inhibitor therapy","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49187","name":"Opn exc/dstr ntra-abd 5.1-10","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5.1 to 10 cm","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23035","name":"Incision bone cortex sho","description":"Incision, bone cortex (eg, osteomyelitis or bone abscess), shoulder area","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":839.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0792T","name":"Appl slvr diamn fluoride 38%","description":"Application of silver diamine fluoride 38%, by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84203","name":"Test rbc protoporphyrin","description":"Protoporphyrin, rbc; screen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92012","name":"Intrm oph exam est patient","description":"Ophthalmological services: medical examination and evaluation, with initiation or continuation of diagnostic and treatment program; intermediate, established patient","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77427","name":"Radiation tx management x5","description":"Radiation treatment management, 5 treatments","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49200","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2038","name":"Skill train and dev/diem","description":"Skills training and development, per diem","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0171A","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0989T","name":"Revj/rmvl ins ptn subq&subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98000","name":"Synch audio-video new sf 15","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 15 minutes must be met or exceeded.","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0662","name":"Team remote e/m new pt 30 mn","description":"Team remote e/m new pt 30 mins","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4314","name":"Reeva, per sq cm","description":"Reeva ft, per square cenitmeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27884","name":"Amputation follow-up surgery","description":"Amputation, leg, through tibia and fibula; secondary closure or scar revision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":686.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76883","name":"Us nrv&acc strux 1xtr compre","description":"Ultrasound, nerve(s) and accompanying structures throughout their entire anatomic course in one extremity, comprehensive, including real-time cine imaging with image documentation, per extremity","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0756T","name":"Dgtz gls mcrscp sld spc grpi","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group i, for microorganisms (eg, acid fast, methenamine silver) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1355","name":"Caries med app per tooth","description":"Caries med app per tooth","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0493U","name":"Trnspl med quan dd-cfdna ngs","description":"Trnspl med quan dd-cfdna ngs","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42550","name":"Injection for salivary x-ray","description":"Injection procedure for sialography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1404.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68550","name":"Remove tear gland lesion","description":"Excision of lacrimal gland tumor; involving osteotomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1129.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86738","name":"Mycoplasma antibody","description":"Antibody; mycoplasma","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4315","name":"Regenelink amniotic mem allo","description":"Regenelink amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4021","name":"Orthopedic surgery ss","description":"Orthopedic surgery mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0990T","name":"Trncrv inst biod hydrgl mtrl","description":"Transcervical instillation of biodegradable hydrogel materials, intrauterine","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0261U","name":"Onc clrct ca img alys w/ai","description":"Oncology (colorectal cancer), image analysis with artificial intelligence assessment of 4 histologic and immunohistochemical features (cd3 and cd8 within tumor-stroma border and tumor core), tissue, reported as immune response and recurrence-risk score","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11301","name":"Shave skin lesion 0.6-1.0 cm","description":"Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion diameter 0.6 to 1.0 cm","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":133.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1435","name":"Oral chemo in perf pd","description":"Patient on oral chemotherapy during the performance period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0942T","name":"Cysto flx rmv&rplc urtl scaf","description":"Cystourethroscopy, flexible; with removal and replacement of prostatic urethral scaffold","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0921T","name":"Rmvl perm ccm-d sys 1 dfb ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous defibrillation lead only","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70473","name":"Ct cere prfu aly c+wo ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed without concurrent ct or ct angiography of the same anatomy","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38225","name":"Car-t hrv bld-drv t lymphcyt","description":"Chimeric antigen receptor t-cell (car-t) therapy; harvesting of blood-derived t lymphocytes for development of genetically modified autologous car-t cells, per day","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2561","name":"Inj, sezaby, 1 mg","description":"Injection, phenobarbital sodium (sezaby), 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0882T","name":"Intraop ther estim pn ue 1st","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; initial nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0810T","name":"Subrta njx rx agt w/vtrc","description":"Subretinal injection of a pharmacologic agent, including vitrectomy and 1 or more retinotomies","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0543","name":"Group train w/o patient","description":"Group caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient pre","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1338","name":"Pt f/u 30-180 dys no + imprv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who did not demonstrate positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P2038","name":"Blood mucoprotein","description":"Mucoprotein, blood (seromucoid) (medical necessity procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55711","name":"Bx prst8 trct mri-us 1st","description":"Biopsy, prostate, transrectal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65780","name":"Ocular reconst transplant","description":"Ocular surface reconstruction; amniotic membrane transplantation, multiple layers","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":934.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0785T","name":"Revj/rmvl nea spi w/nstim","description":"Revision or removal of neurostimulator electrode array, spinal, with integrated neurostimulator","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7023","name":"Mech allergen parti barrier","description":"Mechanical allergen particle barrier/inhalation filter, cream, nasal, topical","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87181","name":"Sc std agar dilution per agt","description":"Susceptibility studies, antimicrobial agent; agar dilution method, per agent (eg, antibiotic gradient strip)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64598","name":"Revj/rmvl nea pn w/int nstim","description":"Revision or removal of neurostimulator electrode array, peripheral nerve, with integrated neurostimulator","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1215","name":"Med rsn for no doc spiro","description":"Documentation of medical reason(s) for not documenting and reviewing spirometry results (e.g., patients with dementia or tracheostomy)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0319U","name":"Neph rna pretrnspl perph bld","description":"Neph rna pretrnspl perph bld","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67916","name":"Repair eyelid defect","description":"Repair of ectropion; excision tarsal wedge","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5611","name":"Rep resin part dent base man","description":"Rep resin part dent base man","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0571","name":"Intraop nerve cryoablation","description":"Intraoperative nerve(s) cryoablation for post-surgical pain relief (list separately in addition to code for primary service)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43641","name":"Vagotomy & pylorus repair","description":"Vagotomy including pyloroplasty, with or without gastrostomy; parietal cell (highly selective)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1193.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1013T","name":"Lap srg imp/rpl eso nea&pg/r","description":"Laparoscopy, surgical, implantation or replacement of lower esophageal sphincter neurostimulator electrode array and neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver, including cruroplasty and/or electronic ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1708","name":"Pfizer vacc admin 3rd dose","description":"Pfizer vacc admin 3rd dose","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37263","name":"Revsc evasc fpvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1002T","name":"Air displacmnt plethysmograp","description":"Air displacement plethysmography, whole-body composition assessment, with interpretation and report","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2040","name":"Microlyte painguard pr sq cm","description":"Microlyte painguard, per square centimeter","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0784T","name":"Ins/rplmt eltrd ra spi nstim","description":"Insertion or replacement of percutaneous electrode array, spinal, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0658","name":"Seg pneum comp 2 arm chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98975","name":"Rtm 1st set-up&pt educaj eqp","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); initial set-up and patient education on use of equipment","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1000","name":"Depo-estradiol cypionate inj","description":"Injection, depo-estradiol cypionate, up to 5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32651","name":"Thoracoscopy remove cortex","description":"Thoracoscopy, surgical; with partial pulmonary decortication","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":987.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0040","name":"Pt phys/occ therapy","description":"Patient already receiving physical/occupational/speech/recreational therapy during the measurement period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9376","name":"Inj pozelimab-bbfg, 1 mg","description":"Injection, pozelimab-bbfg, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0719T","name":"Pst vrt jt rplcmt lmbr 1 sgm","description":"Posterior vertebral joint replacement, including bilateral facetectomy, laminectomy, and radical discectomy, including imaging guidance, lumbar spine, single segment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0781T","name":"Brnchsc rf dstrj pulm nrv bi","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; bilateral mainstem bronchi","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27258","name":"Treat hip dislocation","description":"Open treatment of spontaneous hip dislocation (developmental, including congenital or pathological), replacement of femoral head in acetabulum (including tenotomy, etc);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1315.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0369","name":"Max mri capture & interprete","description":"Max mri capture & interprete","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0535U","name":"Pfas lc-ms/ms plsm/srm quan","description":"Pfas lc-ms/ms plsm/srm quan","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65091","name":"Revise eye","description":"Evisceration of ocular contents; without implant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7299","name":"Rem anchorage device w/flap","description":"Rem anchorage device w/flap","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5948","name":"Max implt sup fix part","description":"Max implt sup fix part","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23466","name":"Repair shoulder capsule","description":"Capsulorrhaphy, glenohumeral joint, any type multidirectional instability","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1279.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01941","name":"Anes neuromd/ntrvrt crv/thrc","description":"Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1307","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0442U","name":"Nfct ds respir nfctj mxa&crp","description":"Nfct ds respir nfctj mxa&crp","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55709","name":"Bx prst8 tprnl us guided","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58345","name":"Reopen fallopian tube","description":"Transcervical introduction of fallopian tube catheter for diagnosis and/or re-establishing patency (any method), with or without hysterosalpingography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1340","name":"Indx whodas 2.0 or sds","description":"Index assessment completed using the 12-item whodas 2.0 or sds during the denominator identification period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64656","name":"Revj/rplcmt bat mod sys pg","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; pulse generator only","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0532U","name":"Rare ds whlgen&mitochdrl dna","description":"Rare ds whlgen&mitochdrl dna","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1207","name":"Pt scrn sdoh","description":"Patient is screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0732T","name":"Immntx admn electroporatn im","description":"Immunotherapy administration with electroporation, intramuscular","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0898","name":"Argatroban nonesrd (auromed)","description":"Injection, argatroban (auromedics), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37279","name":"Iv lithotrp fpvt w/in sm art","description":"Intravascular lithotripsy(ies), femoral and popliteal vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9024","name":"Inj atezolizumb 5mg hya-tqjs","description":"Injection, atezolizumab, 5 mg and hyaluronidase-tqjs","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4403","name":"Xwrap dual plus per sq cm","description":"Xwrap dual plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0819T","name":"Revj/rmvl ins ptn subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1493","name":"No fall doc med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1395","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0546","name":"Phone/internet ehr assess","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty   whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patien","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33897","name":"Perq trluml angp nt/recr coa","description":"Percutaneous transluminal angioplasty of native or recurrent coarctation of the aorta","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94626","name":"Phy/qhp op pulm rhb w/mntr","description":"Physician or other qualified health care professional services for outpatient pulmonary rehabilitation; with continuous oximetry monitoring (per session)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0459U","name":"Abeta42 & ttau eclia csf","description":"Abeta42 & ttau eclia csf","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77089","name":"Tbs dxa cal w/i&r fx risk","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; using dual x-ray absorptiometry (dxa) or other imaging data on gray-scale variogram, calculation, with interpretation and report on fracture-risk","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0454U","name":"U rare ds id opt genome mapg","description":"U rare ds id opt genome mapg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4010","name":"Infectious disease ss","description":"Infectious disease mips specialty set","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33261","name":"Ablate heart dysrhythm focus","description":"Operative ablation of ventricular arrhythmogenic focus with cardiopulmonary bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1791.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5938","name":"Resct proth max comp remov","description":"Resct proth max comp remov","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0675","name":"Inj, carboprost, 0.1 mg","description":"Injection, carboprost tromethamine, 0.1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1317","name":"Pts counsl cpt opt out","description":"Patients who are counseled on connection with a csp and explicitly opt out","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4273","name":"Esano aaa, per sq cm","description":"Esano aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41010","name":"Incision of tongue fold","description":"Incision of lingual frenum (frenotomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0553","name":"Monthly tx for dmht 20mins","description":"First 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing information related to the use of","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0848T","name":"Dgtz gls mcrscp ish 1st","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1318","name":"Pts no csp doc contact","description":"Patients who did not have documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening or documentation that there was no contact with a csp","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5934","name":"Mandibular flange prosthesis","description":"Mandibular resection prosthesis with guide flange","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1952","name":"Afo spiral prefab ots","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, off-the-shelf","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1007.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0248","name":"Inj, remdesivir, 1 mg","description":"Injection, remdesivir, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0757T","name":"Dgtz gls mcrscp sl spc grpii","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group ii, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistochemistry (list separately in addition to code for primary","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7511","name":"Incision/drain abscess intra","description":"Incision and drainage of abscess - intraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1314","name":"Bmi not calculated","description":"Bmi not documented and no reason is given","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0742T","name":"Aqmbf spect xers/strs & rest","description":"Absolute quantitation of myocardial blood flow (aqmbf), single-photon emission computed tomography (spect), with exercise or pharmacologic stress, and at rest, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0491U","name":"Onc sol tum ctc slct er prtn","description":"Onc sol tum ctc slct er prtn","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64912","name":"Nrv rpr w/nrv algrft 1st","description":"Nerve repair; with nerve allograft, each nerve, first strand (cable)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2354","name":"Octreotide inj, non-depot","description":"Injection, octreotide, non-depot form for subcutaneous or intravenous injection, 25 mcg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37272","name":"Revsc evsc fpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76016","name":"Mr safety deter phys/qhp","description":"Mr safety determination by a physician or other qualified health care professional responsible for the safety of the mr procedure, including review of implant mr conditions for indicated mr examination, analysis of risk vs clinical benefit of performing mr examination, and determination of mr equipm","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4287","name":"Disp col sto bag breast milk","description":"Disposable collection and storage bag for breast milk, any size, any type, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4265","name":"Neostim tl per sq cm","description":"Neostim tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0626U","name":"Neurol pd dna alys >20000","description":"Neurol pd dna alys >20000","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3421","name":"Root surgery bicuspid","description":"Apicoectomy/periradicular surgery-bicuspid (first root)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99415","name":"Prolng clin staff svc 1st hr","description":"Prolonged clinical staff service (the service beyond the highest time in the range of total time of the service) during an evaluation and management service in the office or outpatient setting, direct patient contact with physician supervision; first hour (list separately in addition to code for out","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7472","name":"Removal of torus palatinus","description":"Removal of torus palatinus","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1960","name":"Levorphanol tartrate inj","description":"Injection, levorphanol tartrate, up to 2 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6251","name":"Bridge resin base metal","description":"Pontic-resin with predominantly base metal","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0571U","name":"Onc sol tum dna80&rna10g ngs","description":"Onc sol tum dna80&rna10g ngs","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0841T","name":"Dgtz gls mcrscp pth cslt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; first tissue block, with frozen section(s), single specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7473","name":"Remove torus mandibularis","description":"Removal of torus mandibularis","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2422.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81005","name":"Urinalysis","description":"Urinalysis; qualitative or semiquantitative, except immunoassays","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9076","name":"Inj, cyclophos (baxter) 5mg","description":"Injection, cyclophosphamide (baxter), 5 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1363","name":"Pts no f/u 120 dys","description":"Patients who did not have a follow-up assessment within 120 days of the index assessment","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91304","name":"Sarscov2 vac 5mcg/0.5ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, 5 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99393","name":"Prev visit est age 5-11","description":"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; late ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":70.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1458","name":"Pt died bef end meas pd","description":"Patient died prior to the end of the performance period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2033","name":"Myriad morcells, 4 mg","description":"Myriad morcells, 4 milligrams","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76819","name":"Fetal biophys profil w/o nst","description":"Fetal biophysical profile; without non-stress testing","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0694T","name":"3d vol img&rcnstj brst/ax","description":"3-dimensional volumetric imaging and reconstruction of breast or axillary lymph node tissue, each excised specimen, 3-dimensional automatic specimen reorientation, interpretation and report, real-time intraoperative","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1367","name":"Qual care ent disorder mvp","description":"Quality care for the treatment of ear, nose, and throat disorders mips value pathway","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6114","name":"Implnt/abut fixed dent max","description":"Implnt/abut fixed dent max","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37267","name":"Revsc evsc fpvt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4272","name":"Esano a, per sq cm","description":"Esano a, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0612U","name":"Onc lvr alys >1000 mr cfdna","description":"Onc lvr alys >1000 mr cfdna","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92569","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7299","name":"Intraut copp cont (miudella)","description":"Intrauterine copper contraceptive (miudella)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2670","name":"Totazoline hcl injection","description":"Injection, tolazoline hcl, up to 25 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86157","name":"Cold agglutinin titer","description":"Cold agglutinin; titer","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7500","name":"Azathioprine oral 50mg","description":"Azathioprine, oral, 50 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0837T","name":"Dgtz gls mcrscp fna i&r","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; interpretation and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4431","name":"Pma skin substitute, nos","description":"Pma skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9886","name":"In-person attendance g code","description":"Behavioral counseling for diabetes prevention, in-person, group, 60 minutes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0624U","name":"Hep nash dna mthyl alys 5000","description":"Hep nash dna mthyl alys 5000","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2246","name":"Inj, micafungin (baxter)","description":"Injection, micafungin in sodium (baxter), not therapeutically equivalent to j2248, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0046","name":"No mrs 90 days post stk","description":"Clinical follow-up and mrs score not assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9021","name":"Inj, aspara, rylaze, 0.1 mg","description":"Injection, asparaginase, recombinant, (rylaze), 0.1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4437","name":"Revival ac per sq cm","description":"Revival ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9986","name":"Missed appointment","description":"Missed appointment","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":243.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1443","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0370","name":"Max ultrasound capt & interp","description":"Max ultrasound capt & interp","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1305","name":"Pneum vax admin 19+","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98005","name":"Synch audio-video est low 20","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low medical decision making. when using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0738","name":"Hiv prep, inj, lenacapavir","description":"Injection, lenacapavir, 1 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1709","name":"Pfizer vaccine admin booster","description":"Pfizer vaccine admin booster","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87523","name":"Hepatitis d quantification","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis d (delta), quantification, including reverse transcription, when performed","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1464","name":"No record of f/u by 180 days","description":"No documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4016","name":"Neurosurgical ss","description":"Neurosurgical mips specialty set","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1939","name":"Inj, bumetanide, 0.5 mg","description":"Injection, bumetanide, 0.5 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33267","name":"Excl laa open any method","description":"Exclusion of left atrial appendage, open, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77092","name":"Tbs i&r fx rsk qhp","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; interpretation and report on fracture-risk only by other qualified health care professional","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99470","name":"Rpm tx mgmt 1st 10 min","description":"Remote physiologic monitoring treatment management services, clinical staff/physician/other qualified health care professional time in a calendar month requiring 1 real-time interactive communication with the patient/caregiver during the calendar month; first 10 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0628U","name":"Nfro kdn ds genetic cond 449","description":"Nfro kdn ds genetic cond 449","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0785T","name":"Revj/rmvl nea spi w/nstim","description":"Revision or removal of neurostimulator electrode array, spinal, with integrated neurostimulator","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0391","name":"Inj, artesunate, 1mg","description":"Injection, artesunate, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0034","name":"Pall serv during meas","description":"Patients receiving palliative care during the measurement period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0375","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1363","name":"Pts no f/u 120 dys","description":"Patients who did not have a follow-up assessment within 120 days of the index assessment","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0708T","name":"Id ca immntx prep & 1st njx","description":"Intradermal cancer immunotherapy; preparation and initial injection","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64473","name":"Lwr xtr fscl pln blk uni njx","description":"Lower extremity fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0728T","name":"Dx alys vstblr implt uni 1st","description":"Diagnostic analysis of vestibular implant, unilateral; with initial programming","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0918T","name":"Insj perm ccm-d sys dual ld","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; dual transvenous leads (pacing and defibrillation) only","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0584U","name":"Neuro csf prion prtn qual","description":"Neuro csf prion prtn qual","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0402U","name":"Nfct agt sti mult amp prb tq","description":"Nfct agt sti mult amp prb tq","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1298","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0741T","name":"Rem auton alg nsln data coll","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; provision of software, data collection, transmission, and storage, each 30 days","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55869","name":"Lap srg prst8ct bi pl lmphad","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99195","name":"Phlebotomy","description":"Phlebotomy, therapeutic (separate procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66170","name":"Glaucoma surgery","description":"Fistulization of sclera for glaucoma; trabeculectomy ab externo in absence of previous surgery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1113.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0869T","name":"Njx b1 sub mtrl hw fixj aug","description":"Injection(s), bone-substitute material for bone and/or soft tissue hardware fixation augmentation, including intraoperative imaging guidance, when performed","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0817T","name":"Opn insj/rplcmt ins ptn subf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56800","name":"Plastic repair introitus","description":"Plastic repair of introitus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37297","name":"Revsc evasc imvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86593","name":"Syphilis test non-trep quant","description":"Syphilis test, non-treponemal antibody; quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5156","name":"Inj, tocilizumab-anoh, 1 mg","description":"Injection, tocilizumab-anoh (avtozma), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2711","name":"Inj neostigmin/glycopyrrolat","description":"Injection, neostigmine methylsulfate 0.1 mg and glycopyrrolate 0.02 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D8091","name":"Compre ortho treat w surg","description":"Compre ortho treat w surg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65775","name":"Correction of astigmatism","description":"Corneal wedge resection for correction of surgically induced astigmatism","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1183","name":"Doc imm ckpt inhib hld","description":"Documentation of immune checkpoint inhibitor therapy held and corticosteroids or immunosuppressants prescribed or administered","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91125","name":"Anrct mano rct snsatn&balo","description":"Anorectal manometry, with rectal sensation and rectal balloon expulsion test, when performed","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99382","name":"Init pm e/m new pat 1-4 yrs","description":"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; early childhood ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":72.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1231","name":"Pt hcv tst no reactive res","description":"Patient receives hcv antibody test with nonreactive result","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1376","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7355","name":"Inj travoprost intra impl","description":"Injection, travoprost, intracameral implant, 1 microgram","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1449","name":"Pt dx scz/pys bef end msr pd","description":"Patients with an active diagnosis of schizophrenia or psychotic disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0302U","name":"Iadna brtnla ddpcr flwg liq","description":"Iadna brtnla ddpcr flwg liq","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90970","name":"Esrd svc pr day pt 20+","description":"End-stage renal disease (esrd) related services for dialysis less than a full month of service, per day; for patients 20 years of age and older","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32997","name":"Total lung lavage","description":"Total lung lavage (unilateral)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2009","name":"Symphony, per sq cm","description":"Symphony, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50080","name":"Perq nl/pl lithotrp smpl<2cm","description":"Percutaneous nephrolithotomy or pyelolithotomy, lithotripsy, stone extraction, antegrade ureteroscopy, antegrade stent placement and nephrostomy tube placement, when performed, including imaging guidance; simple (eg, stone[s] up to 2 cm in single location of kidney or renal pelvis, nonbranching ston","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":961.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0471U","name":"Onc clrc ca 35 vrn kras&nras","description":"Onc clrc ca 35 vrn kras&nras","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2054","name":"Lisocabtagene mara car pos t","description":"Lisocabtagene maraleucel, up to 110 million autologous anti-cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0701T","name":"Molec fluor img sus nev ea","description":"Molecular fluorescent imaging of suspicious nevus; each additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85009","name":"Manual diff wbc count b-coat","description":"Blood count; manual differential wbc count, buffy coat","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9381","name":"Inj teplizumab mzwv 5 mcg","description":"Injection, teplizumab-mzwv, 5 mcg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93898","name":"Ven-artl shunt det mbubb njx","description":"Venous-arterial shunt detection with intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1749","name":"Inj, iloprost, 0.1 mcg","description":"Injection, iloprost, 0.1 mcg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1445","name":"Pp care visit by 12 weeks","description":"Postpartum care visit before or at 12 weeks of giving birth","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0556U","name":"Nfct ds p-s dna&rna 12 trgts","description":"Nfct ds p-s dna&rna 12 trgts","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87075","name":"Cultr bacteria except blood","description":"Culture, bacterial; any source, except blood, anaerobic with isolation and presumptive identification of isolates","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1230","name":"Pt hcv rctv aby no f/u tst","description":"Patient has a reactive hcv antibody test and does not have a follow up hcv viral test, or patient has a reactive hcv antibody test and has a follow up hcv viral test that detects hcv viremia and is not referred to a clinician who treats hcv infection within 1 month and does not have hcv treatment in","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1404","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87181","name":"Sc std agar dilution per agt","description":"Susceptibility studies, antimicrobial agent; agar dilution method, per agent (eg, antibiotic gradient strip)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92920","name":"Prq trluml c angiop 1art&/br","description":"Percutaneous transluminal coronary angioplasty, single major coronary artery and/or its branch(es)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6111","name":"Implnt/abut remov dent mand","description":"Implnt/abut remov dent mand","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1422","name":"Gastroenterology care mvp","description":"Gastroenterology care mips value pathway","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0277U","name":"Hem gen pltlt funcj do 31","description":"Hematology (genetic platelet function disorder), genomic sequence analysis of 31 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0805T","name":"Tcat s&ivc prstc vl impl prq","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); percutaneous femoral vein approach","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33288","name":"Rmv&rplcmt phrnc nrv stim ld","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0705","name":"Extra oral post radio image","description":"Extra oral post radio image","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86780","name":"Treponema pallidum","description":"Antibody; treponema pallidum","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0567","name":"Screening hep c detect","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis c, screening, amplified probe technique","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0036","name":"Pt/ptn decln assess","description":"Patient or care partner decline assessment","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98002","name":"Synch audio-video new mod 45","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate medical decision making. when using total time on the date of the encounter for code selection, 45 minutes must be met or exceeded.","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0989T","name":"Revj/rmvl ins ptn subq&subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0473U","name":"Onc sld tum bld/slv 648 gene","description":"Onc sld tum bld/slv 648 gene","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36425","name":"Venipuncture cutdown 1 yr/>","description":"Venipuncture, cutdown; age 1 or over","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1490","name":"Pt status not doc","description":"Patient status not documented","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87150","name":"Dna/rna amplified probe","description":"Culture, typing; identification by nucleic acid (dna or rna) probe, amplified probe technique, per culture or isolate, each organism probed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41105","name":"Biopsy of tongue","description":"Biopsy of tongue; posterior one-third","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44701","name":"Intraop colon lavage add-on","description":"Intraoperative colonic lavage (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90955","name":"Esrd srv 2-3 vsts p mo 2-11","description":"End-stage renal disease (esrd) related services monthly, for patients 2-11 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 2-3 face-to-face visits by a physician or other qualified health care professional per mo","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":523.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2804","name":"Inj, rifampin, 1 mg","description":"Injection, rifampin, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24650","name":"Cltx rdl head/nck fx wo mnpj","description":"Closed treatment of radial head or neck fracture; without manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0607U","name":"Reprdtve med ema rtpcr 31bct","description":"Reprdtve med ema rtpcr 31bct","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0040","name":"Pt phys/occ therapy","description":"Patient already receiving physical/occupational/speech/recreational therapy during the measurement period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1342","name":"Pts died perf per","description":"Patients who died during the performance period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1711","name":"Moderna vacc admin booster","description":"Moderna vacc admin booster","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0729T","name":"Dx alys vstblr implt uni sbq","description":"Diagnostic analysis of vestibular implant, unilateral; with subsequent programming","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84100","name":"Assay of phosphorus","description":"Phosphorus inorganic (phosphate);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0537U","name":"Onc clrct ca cfdna >2500 dmr","description":"Onc clrct ca cfdna >2500 dmr","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1270","name":"Pts no kid transplt wtlst","description":"Patients not on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0371U","name":"Iadna gu pthgn semiq dna16&1","description":"Iadna gu pthgn semiq dna16&1","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5996","name":"Peri medicament w/seal, mand","description":"Peri medicament w/seal, mand","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2291","name":"Inj, nafcillin (baxter) 20mg","description":"Injection, nafcillin sodium (baxter), 20 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0900T","name":"N-invas est aqmbf asstv cmr","description":"Noninvasive estimate of absolute quantitation of myocardial blood flow (aqmbf), derived from assistive algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health care profes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1331","name":"Pts eval ini xm 8 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 8 weeks from initial exam","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62330","name":"Dcmprn prq rmv lig flv 1lmbr","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; one interspace, lumbar","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0798T","name":"Tcat rmv 2chmbr ldls pm cmpl","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; complete system (ie, right atrial and right ventricular pacemaker components)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7411","name":"Excision benign lesion>1.25c","description":"Excision of benign lesion greater than 1.25 cm","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25448","name":"Arthrp ntrcrpl/crp/mtcrp ssp","description":"Arthroplasty, intercarpal or carpometacarpal joints; suspension, including transfer or transplant of tendon, with interposition, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81560","name":"Trnsplj pd lvr&bwl cd154+cll","description":"Transplantation medicine (allograft rejection, pediatric liver and small bowel), measurement of donor and third-party-induced cd154+t-cytotoxic memory cells, utilizing whole peripheral blood, algorithm reported as a rejection risk score","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1028","name":"Take home supply 8mg per 0.1","description":"Take-home supply of nasal naloxone; 2-pack of 8mg per 0.1 ml nasal spray (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1382","name":"Enc dur perf pd pos 11","description":"Patient encounter during the performance period with place of service code 11","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0694T","name":"3d vol img&rcnstj brst/ax","description":"3-dimensional volumetric imaging and reconstruction of breast or axillary lymph node tissue, each excised specimen, 3-dimensional automatic specimen reorientation, interpretation and report, real-time intraoperative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67912","name":"Correction eyelid w/implant","description":"Correction of lagophthalmos, with implantation of upper eyelid lid load (eg, gold weight)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":512.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25000","name":"Incision of tendon sheath","description":"Incision, extensor tendon sheath, wrist (eg, de quervains disease)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1834","name":"Inj, isoniazid, 1 mg","description":"Injection, isoniazid, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7528","name":"Mycophen mofetil for susp","description":"Mycophenolate mofetil, for suspension, oral, 100 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81000","name":"Urinalysis nonauto w/scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; non-automated, with microscopy","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1032","name":"Sv doula brth wrk per 15 min","description":"Services performed by a doula birth worker, per 15 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2184","name":"Inj, meropenem (b. braun)","description":"Injection, meropenem (b. braun), not therapeutically equivalent to j2185, 100 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0271","name":"Group mnt 2 or more 30 mins","description":"Medical nutrition therapy, reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition, or treatment regimen (including additional hours needed for renal disease), group (2 or more individuals), each 30 minutes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":19.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1269","name":"Recd esrd mcp lst day of mo","description":"Receiving esrd mcp dialysis services by the provider on the last day of the reporting month","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55869","name":"Lap srg prst8ct bi pl lmphad","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1357","name":"Pt w/red suic idea 120 days","description":"Patients who had a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92639","name":"Hearing aid meas verif","description":"Hearing-aid measurement, verification with probe-microphone (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92637","name":"Hearing aid pst-fitg f-up ea","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83987","name":"Exhaled breath condensate","description":"Ph; exhaled breath condensate","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15778","name":"Impl absrb msh/prsth dly cls","description":"Implantation of absorbable mesh or other prosthesis for delayed closure of defect(s) (ie, external genitalia, perineum, abdominal wall) due to soft tissue infection or trauma","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0585U","name":"Tgsap so neo cfdna 521 genes","description":"Tgsap so neo cfdna 521 genes","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33141","name":"Heart tmr w/other procedure","description":"Transmyocardial laser revascularization, by thoracotomy; performed at the time of other open cardiac procedure(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4017","name":"Nutrition/dietician ss","description":"Nutrition/dietician mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1373","name":"Mst rec gsa >=8 and <=9","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 8.0% and <= 9.0%","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7174","name":"Injection fitusiran 0.04 mg","description":"Injection, fitusiran, 0.04 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0447","name":"Behavior counsel obesity 15m","description":"Face-to-face behavioral counseling for obesity, 15 minutes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":29.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84630","name":"Assay of zinc","description":"Zinc","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4364","name":"Am bur xp mem xpl hy p sq cm","description":"Amnio burgeon xplus membrane and xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81464","name":"So gsap cll fr mcrstl ins","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants, microsatellite instability, tumor mutation burden, and rearrangements","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0892","name":"Argatroban dialysis (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5938","name":"Resct proth max comp remov","description":"Resct proth max comp remov","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77605","name":"Hyperthermia ext gen deep","description":"Hyperthermia, externally generated; deep (ie, heating to depths greater than 4 cm)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4407","name":"Xwrap tribus per sq cm","description":"Xwrap tribus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61715","name":"Mrgfus strtctc ablt trgt icr","description":"Magnetic resonance image guided high intensity focused ultrasound (mrgfus), stereotactic ablation of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5151","name":"Inj, eculizumab-aagh, 2 mg","description":"Injection, eculizumab-aagh (epysqli), biosimilar, 2 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0477U","name":"Rx metab psy 14&cyp2d6 gn-rx","description":"Rx metab psy 14&cyp2d6 gn-rx","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45805","name":"Repair fistula w/colostomy","description":"Closure of rectovesical fistula; with colostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0541","name":"No pt prsnt train initial 30","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0891","name":"Argatroban nonesrd (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0490U","name":"Onc cutan/uveal mlnma cd146","description":"Onc cutan/uveal mlnma cd146","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2782","name":"Inj avacincaptad pegol 0.1mg","description":"Injection, avacincaptad pegol, 0.1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1596","name":"Inj, glycopyrrolate, 0.1 mg","description":"Injection, glycopyrrolate, 0.1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0961T","name":"Shortwave ifr radiation img","description":"Shortwave infrared radiation imaging, surgical pathology specimen, to assist gross examination for lymph node localization in fibroadipose tissue, per specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9381","name":"Inj teplizumab mzwv 5 mcg","description":"Injection, teplizumab-mzwv, 5 mcg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0938T","name":"Xtrnl ecg rec>15d<30d rec","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; recording (including connection and initial recording)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87811","name":"Sars-cov-2 covid19 w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19])","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99424","name":"Prin care mgmt phys 1st 30","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86052","name":"Aquaporin-4 antb cba each","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; cell-based immunofluorescence assay (cba), each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6191","name":"Semi precision abutment","description":"Semi precision abutment","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4363","name":"Am bur mem hydro per sq cm","description":"Amnio burgeon membrane and hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4376","name":"Duograft aa per sq cm","description":"Duograft aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92137","name":"Cptrz oph img pst sg rta oct","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), posterior segment, with interpretation and report, unilateral or bilateral; retina, including oct angiography","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1402","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1460","name":"Dx copd, cf, or arf","description":"Diagnosis for chronic obstructive pulmonary disease, emphysema, cystic fibrosis, or acute respiratory failure","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6214","name":"Pontic titanium","description":"Pontic - titanium","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35641","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1749.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94625","name":"Phy/qhp op pulm rhb w/o mntr","description":"Physician or other qualified health care professional services for outpatient pulmonary rehabilitation; without continuous oximetry monitoring (per session)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0356U","name":"Onc orop 17 dna ddpcr alg","description":"Onc orop 17 dna ddpcr alg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24120","name":"Exc/crtg b1 cst/b9 tum rds","description":"Excision or curettage of bone cyst or benign tumor of head or neck of radius or olecranon process;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9697","name":"Inj, magtrace per study dose","description":"Injection, carboxydextran-coated superparamagnetic iron oxide, per study dose","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97607","name":"Neg prs wnd thr ndme<=50sqcm","description":"Negative pressure wound therapy, (eg, vacuum assisted drainage collection), utilizing disposable, non-durable medical equipment including provision of exudate management collection system, topical application(s), wound assessment, and instructions for ongoing care, per session; total wound(s) surfac","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":17.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0989T","name":"Revj/rmvl ins ptn subq&subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1172","name":"Doc med rsn no td/tdap","description":"Documentation of medical reason(s) for not administering td or tdap vaccine (e.g., prior anaphylaxis due to the td or tdap vaccine or history of encephalopathy within seven days after a previous dose of a td-containing vaccine)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0048","name":"Pall serv during meas","description":"Patients who receive palliative care services any time during the intake period through the end of the measurement year","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0219","name":"Inj aval alfa-nqpt 4mg","description":"Injection, avalglucosidase alfa-ngpt, 4 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0208","name":"Inj, pedmark, 100 mg","description":"Injection, sodium thiosulfate (pedmark), 100 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5143","name":"Inj adalimumab-adbm, 1 mg","description":"Injection, adalimumab-adbm, biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98926","name":"Osteopath manj 3-4 regions","description":"Osteopathic manipulative treatment (omt); 3-4 body regions involved","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":32.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9947","name":"Sleep apnea appliance","description":"Sleep apnea appliance","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2526","name":"Cntct lens blue violet","description":"Contact lens, hydrophilic, with blue-violet filter, per lens","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36500","name":"Insertion of catheter vein","description":"Venous catheterization for selective organ blood sampling","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4275","name":"Esano aca, per sq cm","description":"Esano aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0752T","name":"Dgtz gls mcrscp sld lvl iii","description":"Digitization of glass microscope slides for level iii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1453","name":"Preop vis acu > 20/40","description":"Patients with a pre-operative visual acuity better than 20/40","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0413U","name":"Onc hl neo opt gen mapg dna","description":"Onc hl neo opt gen mapg dna","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37261","name":"Revsc evasc ivt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87497","name":"Cytomeg dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); cytomegalovirus, quantification","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"Add upp ext mec limb vol lam","description":"Addition to upper extremity prosthesis, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0713T","name":"N-nvs artl plaq alys rvw i&r","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data review, interpretation and report","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4412","name":"Choriofix per sq cm","description":"Choriofix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0688T","name":"Tx amblyopia assmt w/report","description":"Treatment of amblyopia using an online digital program; assessment of patient performance and program data by physician or other qualified health care professional, with report, per calendar month","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9247","name":"Mod sedation noniv-sub15min","description":"Mod sedation noniv-sub15min","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4390","name":"Ascendion per sq cm","description":"Ascendion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74270","name":"X-ray xm colon 1cntrst std","description":"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"Limited visual field xm","description":"Visual field examination, unilateral or bilateral, with interpretation and report; limited examination (eg, tangent screen, autoplot, arc perimeter, or single stimulus level automated test, such as octopus 3 or 7 equivalent)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7353","name":"Anacaulase-bcdb 8.8% gel 1 g","description":"Anacaulase-bcdb, 8.8% gel, 1 gram","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4286","name":"Nudyn sl or slw, per sq cm","description":"Nudyn sl or nudyn slw, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0702","name":"2d cephal radio image","description":"2d cephal radio image","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1238","name":"Doc 2nd recom hzv 2-6 mo int","description":"Documentation that administration of second recombinant zoster vaccine could not occur during the performance period due to the recommended 2-6 month interval between doses (i.e, first dose received after october 31)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30300","name":"Remove nasal foreign body","description":"Removal foreign body, intranasal; office type procedure","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":202.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D8671","name":"Periodic orth treat w surg","description":"Periodic orth treat w surg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6517","name":"Grad com wrap w strap bn cus","description":"Gradient compression wrap with adjustable straps, below knee, each, custom","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86051","name":"Aquaporin-4 antb elisa","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; enzyme-linked immunosorbent immunoassay (elisa)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90471","name":"Immunization admin","description":"Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); 1 vaccine (single or combination vaccine/toxoid)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55714","name":"Bx prst8 in-bore ct/mri 1","description":"Biopsy, prostate, in-bore ct- or mri-guided targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44381","name":"Small bowel endoscopy br/wa","description":"Ileoscopy, through stoma; with transendoscopic balloon dilation","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1238.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":88.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49591","name":"Rpr aa hrn 1st < 3 cm rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, reducible","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2989","name":"Excavate tooth non-restorabl","description":"Excavate tooth non-restorabl","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0219","name":"Inj aval alfa-nqpt 4mg","description":"Injection, avalglucosidase alfa-ngpt, 4 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4001","name":"Diagnostic rad ss","description":"Diagnostic radiology mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1340","name":"Indx whodas 2.0 or sds","description":"Index assessment completed using the 12-item whodas 2.0 or sds during the denominator identification period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81517","name":"Liver ds alys 3 bmrk srm alg","description":"Liver disease, analysis of 3 biomarkers (hyaluronic acid [ha], procollagen iii amino terminal peptide [piiinp], tissue inhibitor of metalloproteinase 1 [timp-1]), using immunoassays, utilizing serum, prognostic algorithm reported as a risk score and risk of liver fibrosis and liver-related clinical ","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3424","name":"Inj hydroxocobalamin iv 25mg","description":"Injection, hydroxocobalamin, intravenous, 25 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1323","name":"Inj, elranatamab-bcmm, 1 mg","description":"Injection, elranatamab-bcmm, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2008","name":"Theragenesis, per sq cm","description":"Theragenesis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0326","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1105","name":"Dexmedetomidine film, 1 mcg","description":"Dexmedetomidine, oral, 1 mcg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0912T","name":"Elec alys nstim sys vgs smpl","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; with simple programming by physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4347","name":"Rampart dl matrix per sq cm","description":"Rampart dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28045","name":"Exc foot/toe tum deep <1.5cm","description":"Excision, tumor, soft tissue of foot or toe, subfascial (eg, intramuscular); less than 1.5 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9886","name":"In-person attendance g code","description":"Behavioral counseling for diabetes prevention, in-person, group, 60 minutes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84445","name":"Assay of tsi globulin","description":"Thyroid stimulating immune globulins (tsi)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26746","name":"Treat finger fracture each","description":"Open treatment of articular fracture, involving metacarpophalangeal or interphalangeal joint, includes internal fixation, when performed, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2027","name":"Matriderm per sq cm","description":"Matriderm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0563","name":"Sbrt w/positron emission del","description":"Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance and real-time positron emissions-based delivery adjustments to 1 or more lesions, entire course not to exceed 5 fractions","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0743T","name":"B1 str & fx rsk vrt fx assmt","description":"Bone strength and fracture risk using finite element analysis of functional data and bone mineral density (bmd), with concurrent vertebral fracture assessment, utilizing data from a computed tomography scan, retrieval and transmission of the scan data, measurement of bone strength and bmd and classi","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0746T","name":"Car ablt rad arr cnv loc map","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; conversion of arrhythmia localization and mapping of arrhythmia site (nidus) into a multidimensional radiation treatment plan","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83884","name":"Assay neurflmnt light chain","description":"Neurofilament light chain (nfl)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4031","name":"Radiation oncology ss","description":"Radiation oncology mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86618","name":"Lyme disease antibody","description":"Antibody; borrelia burgdorferi (lyme disease)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2804","name":"Inj, rifampin, 1 mg","description":"Injection, rifampin, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99305","name":"1st nf care moderate mdm 35","description":"Initial nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 35 minutes must be met or ex","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":150.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1489","name":"Pt status doc","description":"Patient status documented","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7298","name":"Remove screw retained plate","description":"Remove screw retained plate","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1177","name":"Pt recd pcv on/aft 19","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1007T","name":"Eeg impl s-sclp eeg w/o vid","description":"Electroencephalogram from implanted sub-scalp continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0793T","name":"Prq tcat thrm ablt nrv p-art","description":"Percutaneous transcatheter thermal ablation of nerves innervating the pulmonary arteries, including right heart catheterization, pulmonary artery angiography, and all imaging guidance","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21510","name":"Inc deep opng b1 crtx thorax","description":"Incision, deep, with opening of bone cortex (eg, for osteomyelitis or bone abscess), thorax","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":553.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58672","name":"Laparoscopy fimbrioplasty","description":"Laparoscopy, surgical; with fimbrioplasty","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":919.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90759","name":"Hep b vac 3ag 10mcg 3 dos im","description":"Hepatitis b vaccine (hepb), 3-antigen (s, pre-s1, pre-s2), 10 mcg dosage, 3 dose schedule, for intramuscular use","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2351","name":"Inj ocrelizumab 1mg hya-ocsq","description":"Injection, ocrelizumab, 1 mg and hyaluronidase-ocsq","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1384","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1302","name":"Scrn mam perf rslts doc","description":"Screening, diagnostic, film digital or digital breast tomosynthesis (3d) mammography results documented and reviewed","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37297","name":"Revsc evasc imvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64657","name":"Rmvl bat modulj sys tot sys","description":"Removal of baroreflex activation therapy (bat) modulation system; total system, including lead and pulse generator","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59409","name":"Obstetrical care","description":"Vaginal delivery only (with or without episiotomy and/or forceps);","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":831.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1295","name":"Pt hx tot col or colon ca","description":"Patients with a diagnosis or past history of total colectomy or colorectal cancer","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1320","name":"Pts scrn + hrsn","description":"Patients who screened positive for at least 1 of the 5 hrsns","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1805","name":"Inj, esmolol hcl, 10mg","description":"Injection, esmolol hydrochloride, 10 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2544","name":"Dental onlay metl 4/more sur","description":"Onlay - metallic - four or more surfaces","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38555","name":"Removal neck/armpit lesion","description":"Excision of cystic hygroma, axillary or cervical; with deep neurovascular dissection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1096.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4418","name":"Biolab wrap flow per sq cm","description":"Biolab membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2998","name":"Inj plasminogen tvmh 1mg","description":"Injection, plasminogen, human-tvmh, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1480","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0011","name":"Hiv prep counsel, md 15-30m","description":"Individual counseling for pre-exposure prophylaxis (prep) by physician or qualified health care professional (qhp) to prevent human immunodeficiency virus (hiv), includes hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence, 15-30 minutes","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77293","name":"Respirator motion mgmt simul","description":"Respiratory motion management simulation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0605U","name":"All&immunology hat tpsab1","description":"All&immunology hat tpsab1","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57505","name":"Endocervical curettage","description":"Endocervical curettage (not done as part of a dilation and curettage)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7911","name":"Dental suture wound to 5 cm","description":"Complicated suture-up to 5 cm","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76857","name":"Us exam pelvic limited","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1486","name":"Pt admitted to snf dur eval","description":"Patients admitted to a skilled nursing facility (snf) during the period of evaluation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64831","name":"Repair of digit nerve","description":"Suture of digital nerve, hand or foot; 1 nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":812.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0751","name":"Hiv prep, ftc/taf 200/25mg","description":"Emtricitabine 200mg and tenofovir alafenamide 25mg, oral, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27357","name":"Remove femur lesion/graft","description":"Excision or curettage of bone cyst or benign tumor of femur; with autograft (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":969.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0391","name":"Inj, artesunate, 1mg","description":"Injection, artesunate, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4318","name":"E-graft, per sq cm","description":"E-graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0536U","name":"Rbcag ftl rhd pcr alys exon4","description":"Rbcag ftl rhd pcr alys exon4","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99386","name":"Prev visit new age 40-64","description":"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; 40-64 years","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":110.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6049","name":"Scale implt peri-implt inflm","description":"Scale implt peri-implt inflm","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0701","name":"Pano radio image","description":"Pano radio image","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26471","name":"Fusion of finger tendons","description":"Tenodesis; of proximal interphalangeal joint, each joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":827.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9800","name":"Gallium locametz 1 millicuri","description":"Gallium ga-68 gozetotide, diagnostic, (locametz), 1 millicurie","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78492","name":"Myocrd img pet mlt rst&strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); multiple studies at rest and stress (exercise or pharmacologic)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1474.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2151","name":"Inj, mannitol, 250 mg","description":"Injection, mannitol, 250 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0731T","name":"Augmnt ai-based fcl phnt a/r","description":"Augmentative ai-based facial phenotype analysis with report","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0751T","name":"Dgtz gls mcrscp sld level ii","description":"Digitization of glass microscope slides for level ii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4263","name":"Surgraft tl, per sq cm","description":"Surgraft tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58953","name":"Tah rad dissect for debulk","description":"Bilateral salpingo-oophorectomy with omentectomy, total abdominal hysterectomy and radical dissection for debulking;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2234.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0739","name":"Hiv prep, inj, cabotegravir","description":"Injection, cabotegravir, 1mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0379U","name":"Tgsap sl or neo dna523&rna55","description":"Tgsap sl or neo dna523&rna55","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9913","name":"Admin of neuromod","description":"Admin of neuromod","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0855T","name":"Dgtz gls mcrscp b1 marow smr","description":"Digitization of glass microscope slides for bone marrow, smear interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1313","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93530","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1163.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9887","name":"Distance learning attendance","description":"Behavioral counseling for diabetes prevention, distance learning, 60 minutes","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9609","name":"F18 fdg, 15 millicuries","description":"Fludeoxyglucose f18 up to 15 millicuries","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4399","name":"Summit fx per sq cm","description":"Summit fx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0864T","name":"Low ntsty eswt corpus cvrnsm","description":"Low-intensity extracorporeal shock wave therapy involving corpus cavernosum, low energy","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0527","name":"Mgt est pt dmentia low cmplx","description":"Management of established patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0707T","name":"Njx b1 sub mtrl sbchdrl dfct","description":"Injection(s), bone-substitute material (eg, calcium phosphate) into subchondral bone defect (ie, bone marrow lesion, bone bruise, stress injury, microtrabecular fracture), including imaging guidance and arthroscopic assistance for joint visualization","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1643","name":"Inj heparin, pfizer, 1000u","description":"Injection, heparin sodium (pfizer), not therapeutically equivalent to j1644, per 1000 units","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4256","name":"Mlg complet, per sq cm","description":"Mlg-complete, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4323","name":"Splint extra-coronal","description":"Splint extra-coronal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0789T","name":"Elec aly cpx iins sp/sac nrv","description":"Electronic analysis with complex programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detect","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0881T","name":"Cryotherapy oral cavity","description":"Cryotherapy of the oral cavity using temperature regulated fluid cooling system, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4398","name":"Summit ac per sq cm","description":"Summit ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62360","name":"Insert spine infusion device","description":"Implantation or replacement of device for intrathecal or epidural drug infusion; subcutaneous reservoir","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4301","name":"Activate matrix, per sq cm","description":"Activate matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1566","name":"Immune globulin, powder","description":"Injection, immune globulin, intravenous, lyophilized (e.g., powder), not otherwise specified, 500 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1432","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55711","name":"Bx prst8 trct mri-us 1st","description":"Biopsy, prostate, transrectal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4564","name":"Pessary, disposable any type","description":"Pessary, disposable, any type","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0595U","name":"Nfct ds tfp vctrbrn&zoonotic","description":"Nfct ds tfp vctrbrn&zoonotic","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43497","name":"Transorl lwr esophgl myotomy","description":"Lower esophageal myotomy, transoral (ie, peroral endoscopic myotomy [poem])","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1009T","name":"Rem mntr s-sclp cont eeg sys","description":"Remote monitoring of a sub-scalp implanted continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24400","name":"Osteot humerus w/wo int fixj","description":"Osteotomy, humerus, with or without internal fixation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":993.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4026","name":"Phys/occ therapy ss","description":"Physical therapy/occupational therapy mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1420","name":"Complete ophthalmologic mvp","description":"Complete ophthalmologic care mips value pathway","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43760","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82507","name":"Assay of citrate","description":"Citrate","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7671","name":"Alveolus open reduction","description":"Alveolus - open reduction may include stabilization of teeth","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3472","name":"Surg rep root res premolar","description":"Surg rep root res premolar","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99183","name":"Hyperbaric oxygen therapy","description":"Physician or other qualified health care professional attendance and supervision of hyperbaric oxygen therapy, per session","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0474","name":"Micro w exam of surg margins","description":"Accession of tissue gross and microscopic examination including assessment of surgical margins for presence of disease preparation and transmission of writte","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1748","name":"Inj, zymfentra, 10 mg","description":"Injection, infliximab-dyyb (zymfentra), 10 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1492","name":"No reported fall","description":"Patients who did not report a fall","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4028","name":"Podiatry ss","description":"Podiatry mips specialty set","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53865","name":"Cysto insj dev ischmc rmdlg","description":"Cystourethroscopy with insertion of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6608","name":"G com bandage tub protct pad","description":"Gradient compression bandaging supply, tubular protective absorption padded layer, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7601","name":"Ensifentrine inh 3 mg","description":"Ensifentrine, inhalation suspension, fda approved final product, non-compounded, administered through dme, unit dose form, 3 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8522","name":"Capecitabine, oral, 50 mg","description":"Capecitabine, oral, 50 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9612","name":"Thera par drugs 2 or > admin","description":"Therapeutic parenteral drugs two or more administrations different medications","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0748T","name":"Njx stm cl prdct anl sft tis","description":"Injections of stem cell product into perianal perifistular soft tissue, including fistula preparation (eg, removal of setons, fistula curettage, closure of internal openings)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1478","name":"Psychoactive sub abuse","description":"Psychoactive substance abuse","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9394","name":"Inj, fulvestrant (fresenius)","description":"Injection, fulvestrant (fresenius kabi) not therapeutically equivalent to j9395, 25 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1414","name":"Med rsn no pdl1 bef 1st ther","description":"Documentation of medical reason(s) for not performing the pd-l1 biomarker expression test prior to initiation of first-line immune checkpoint inhibitor therapy (e.g., patient is in an urgent or emergent situation where delay of treatment would jeopardize the patients health status; other medical rea","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9610","name":"Xe129 xenon, diagnostic","description":"Xenon xe-129 hyperpolarized gas, diagnostic, per study dose","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0885","name":"Epoetin alfa, non-esrd","description":"Injection, epoetin alfa, (for non-esrd use), 1000 units","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54417","name":"Remv/replc penis pros compl","description":"Removal and replacement of non-inflatable (semi-rigid) or inflatable (self-contained) penile prosthesis through an infected field at the same operative session, including irrigation and debridement of infected tissue","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7299","name":"Intraut copp cont (miudella)","description":"Intrauterine copper contraceptive (miudella)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1382","name":"Enc dur perf pd pos 11","description":"Patient encounter during the performance period with place of service code 11","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1434","name":"Inj, focinvez, 1mg","description":"Injection, fosaprepitant (focinvez), 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5145","name":"Inj, abrilada, 1 mg","description":"Injection, adalimumab-afzb (abrilada), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0912T","name":"Elec alys nstim sys vgs smpl","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; with simple programming by physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95958","name":"Eeg monitoring/function test","description":"Wada activation test for hemispheric function, including electroencephalographic (eeg) monitoring","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0947T","name":"Mrgfus strtctc bl-br disrpj","description":"Magnetic resonance image guided low intensity focused ultrasound (mrgfus), stereotactic blood-brain barrier disruption using microbubble resonators to increase the concentration of blood-based biomarkers of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1028","name":"Take home supply 8mg per 0.1","description":"Take-home supply of nasal naloxone; 2-pack of 8mg per 0.1 ml nasal spray (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6196","name":"Remv of ind rest on implt","description":"Remv of ind rest on implt","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2782","name":"Crown 3/4 cast noble metal","description":"Crown - 3/4 cast noble metal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1163","name":"Inj, diltiazem hcl, 0.5 mg","description":"Injection, diltiazem hydrochloride, 0.5 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01939","name":"Anes nulyt agt crv/thrc","description":"Anesthesia for percutaneous image-guided destruction procedures by neurolytic agent on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5144","name":"Inj, idacio, 1 mg","description":"Injection, adalimumab-aacf (idacio), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7473","name":"Remove torus mandibularis","description":"Removal of torus mandibularis","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0850T","name":"Dgtz gls mcrscp ish ea mult","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4369","name":"Amnioplast 3 per sq cm","description":"Amnioplast 3, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0101","name":"Ca screen;pelvic/breast exam","description":"Cervical or vaginal cancer screening; pelvic and clinical breast examination","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":26.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1492","name":"No reported fall","description":"Patients who did not report a fall","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99347","name":"Home/res vst est sf mdm 20","description":"Home or residence visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 20 minutes must be met or exceede","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70486","name":"Ct maxillofacial w/o dye","description":"Computed tomography, maxillofacial area; without contrast material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":310.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0794T","name":"Pt spec alg rx-onc tx option","description":"Patient-specific, assistive, rules-based algorithm for ranking pharmaco-oncologic treatment options based on the patients tumor-specific cancer marker information obtained from prior molecular pathology, immunohistochemical, or other pathology results which have been previously interpreted and repor","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28102","name":"Remove/graft foot lesion","description":"Excision or curettage of bone cyst or benign tumor, talus or calcaneus; with iliac or other autograft (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":672.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0209","name":"Inj, sod thiosulfate (hope)","description":"Injection, sodium thiosulfate (hope), 100 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3291","name":"Tranexamic acid in sod chlor","description":"Injection, tranexamic acid in sodium chloride, 5 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0018M","name":"Trnsplj rnl meas cd154+cll","description":"Transplantation medicine (allograft rejection, renal), measurement of donor and third-party-induced cd154+t-cytotoxic memory cells, utilizing whole peripheral blood, algorithm reported as a rejection risk score","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1314","name":"Bmi not calculated","description":"Bmi not documented and no reason is given","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1351","name":"Dental sealant per tooth","description":"Sealant-per tooth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1455","name":"Rep/rev cied","description":"Replaced or revised cied","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78015","name":"Thyroid met imaging","description":"Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0360U","name":"Onc lung elisa 7 autoant alg","description":"Onc lung elisa 7 autoant alg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0522U","name":"Ca vi psp&sp1 antb cl semiql","description":"Ca vi psp&sp1 antb cl semiql","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1450","name":"Pt hos/pal care dur id/pf pd","description":"Patients who received hospice or palliative care service any time during denominator identification period or the measure assessment period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1366","name":"Focus on womens health mvp","description":"Focusing on womens health mips value pathway","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83521","name":"Ig light chains free each","description":"Immunoglobulin light chains (ie, kappa, lambda), free, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9272","name":"Inj, dostarlimab-gxly, 10 mg","description":"Injection, dostarlimab-gxly, 10 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53866","name":"Cathj rmvl dev ischmc rmdlg","description":"Catheterization with removal of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1005T","name":"Elec alys s-scl eeg prgr 1st","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, first 15 minutes face-to-face time with physician or other qualified hea","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0995T","name":"Evasc dlvr a-wal stbl rx opn","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; open","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57511","name":"Cryocautery of cervix","description":"Cautery of cervix; cryocautery, initial or repeat","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":180.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99170","name":"Anogenital exam child w imag","description":"Anogenital examination, magnified, in childhood for suspected trauma, including image recording when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66991","name":"Xcapsl ctrc rmvl insj 1+","description":"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); with insertion of intraocular (eg, trabecular meshwork, supraciliary, suprachoroidal) anterior segment aqueous drai","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1322","name":"Pts 7wk inj, scrn iop =<25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop =<25 mm hg for injected eye","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75805","name":"Lymph vessel x-ray trunk","description":"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37283","name":"Rvsc evsc tpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1417","name":"Pt up to date cov","description":"Patients who are up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76989","name":"Dx intraop epcar us chd i&r","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; interpretation and report only","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0047","name":"Ped blunt hd traum","description":"Pediatric patient with minor blunt head trauma and pecarn prediction criteria are not assessed","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0410U","name":"Onc pncrtc dna whl gn seq 5-","description":"Onc pncrtc dna whl gn seq 5-","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11200","name":"Rmvl skin tags up to&inc 15","description":"Removal of skin tags, multiple fibrocutaneous tags, any area; up to and including 15 lesions","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":106.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82690","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0845T","name":"Dgtz gls mcrscp imfluor 1st","description":"Digitization of glass microscope slides for immunofluorescence, per specimen; initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9956","name":"Admin home sleep apnea test","description":"Admin home sleep apnea test","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0049","name":"Main hemo in-cntr","description":"With maintenance hemodialysis (in-center and home hd) for the complete reporting month","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0621U","name":"Nfct ds lb dna alys>10000","description":"Nfct ds lb dna alys>10000","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9296","name":"Inj pemetrexed (accord) 10mg","description":"Injection, pemetrexed (accord), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0689T","name":"Quan us tis charac w/o dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained without diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43831","name":"Gastrostomy open neonatal","description":"Gastrostomy, open; neonatal, for feeding","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":597.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12004","name":"Rpr s/n/ax/gen/trk7.6-12.5cm","description":"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 7.6 cm to 12.5 cm","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":68.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0965T","name":"I&cst prp jw xpn dl arch non","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, non-fixed hinge mechanism","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3502","name":"Surg exp root surf premolar","description":"Surg exp root surf premolar","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69719","name":"Rplcm oi implt sk tc esp<100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0737","name":"Inj, clindamycin (baxter)","description":"Injection, clindamycin phosphate (baxter), not therapeutically equivalent to j0736, 300 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4018","name":"Ob/gyn ss","description":"Obstetrics/gynecology mips specialty set","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8612","name":"Oral methotrexate (xatmep)","description":"Methotrexate (xatmep), oral, 2.5 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4341","name":"Simplimax, per sq cm","description":"Simplimax, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9002","name":"Intra-vag motion sens biofk","description":"Intra-vaginal motion sensor system, provides biofeedback for pelvic floor muscle rehabilitation device","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1198","name":"Isa not red 3pts /no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4423","name":"Biolab tri wrap fl per sq cm","description":"Biolab tri-membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1463","name":"2 f/u wthn 180 day rx atmp","description":"Documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4353","name":"Xceed tl matrix per sq cm","description":"Xceed tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0292U","name":"Psyc strs do mrna 72 genes","description":"Psyc strs do mrna 72 genes","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52443","name":"Cysto 1st trurl prst8 comis","description":"Cystourethroscopy with initial transurethral anterior prostate commissurotomy with a nondrug-coated balloon catheter followed by therapeutic drug delivery into the prostate by a drug-coated balloon catheter, including transrectal ultrasound and fluoroscopy, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0747T","name":"Car ablt rad arrhyt dlvr rad","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; delivery of radiation therapy, arrhythmia","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0358U","name":"Neuro alys b-amyl 1-42&1-40","description":"Neuro alys b-amyl 1-42&1-40","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15778","name":"Impl absrb msh/prsth dly cls","description":"Implantation of absorbable mesh or other prosthesis for delayed closure of defect(s) (ie, external genitalia, perineum, abdominal wall) due to soft tissue infection or trauma","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27427","name":"Reconstruction knee","description":"Ligamentous reconstruction (augmentation), knee; extra-articular","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":856.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1500","name":"Neuropsychology mvp","description":"Neuropsychology mips value pathway","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7241","name":"Impact tooth rem bony w/comp","description":"Removal of impacted tooth-completely bony with unusual surgical complications","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59851","name":"Induced abortion 1+njx d&c","description":"Induced abortion, by 1 or more intra-amniotic injections (amniocentesis-injections), including hospital admission and visits, delivery of fetus and secundines; with dilation and curettage and/or evacuation","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":421.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9048","name":"Inj, bortezomib freseniuskab","description":"Injection, bortezomib (fresenius kabi), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"Ak 4 bar link hydl swg/stanc","description":"Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33660","name":"Repair of heart defects","description":"Repair of incomplete or partial atrioventricular canal (ostium primum atrial septal defect), with or without atrioventricular valve repair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2151.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0778T","name":"Smmg cncrnt appl imu snr","description":"Surface mechanomyography (smmg) with concurrent application of inertial measurement unit (imu) sensors for measurement of multi-joint range of motion, posture, gait, and muscle function","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4427","name":"Dermbnd dln dl+ dlx sq cm","description":"Dermabind dl n or dermabind dl + or dermabind dl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0582U","name":"Rare ds rpd whlgen dna vrnts","description":"Rare ds rpd whlgen dna vrnts","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J0460","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0920T","name":"Rmvl perm ccm-d sys 1 pac ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous pacing lead only","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43287","name":"Esphg dstl 2/3 w/laps moblj","description":"Esophagectomy, distal two-thirds, with laparoscopic mobilization of the abdominal and lower mediastinal esophagus and proximal gastrectomy, with laparoscopic pyloric drainage procedure if performed, with separate thoracoscopic mobilization of the middle and upper mediastinal esophagus and thoracic e","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3846.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0577","name":"Inj, brixadi, 7 days or less","description":"Injection, buprenorphine extended-release (brixadi), less than or equal to 7 days of therapy","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1231","name":"Pt hcv tst no reactive res","description":"Patient receives hcv antibody test with nonreactive result","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76098","name":"X-ray exam surgical specimen","description":"Radiological examination, surgical specimen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63199","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1894.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1180","name":"Dyphylline injection","description":"Injection, dyphylline, up to 500 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75635","name":"Ct angio abdominal arteries","description":"Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":931.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0513","name":"Prolong prev svcs, first 30m","description":"Prolonged preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient contact beyond the usual service; first 30 minutes (list separately in addition to code for preventive service)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":72.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3299","name":"Inj xipere 1 mg","description":"Injection, triamcinolone acetonide (xipere), 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4287","name":"Disp col sto bag breast milk","description":"Disposable collection and storage bag for breast milk, any size, any type, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9380","name":"Inj teclistamab cqyv 0.5 mg","description":"Injection, teclistamab-cqyv, 0.5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0658","name":"Seg pneum comp 2 arm chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1343.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81193","name":"Ntrk3 translocation analysis","description":"Ntrk3 (neurotrophic receptor tyrosine kinase 3) (eg, solid tumors) translocation analysis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2041","name":"Foundation drs+ duo pr sq cm","description":"Foundation drs+ duo, per square centimeter","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4401","name":"Absolv3 per sq cm","description":"Absolv3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0873T","name":"Revj subq prtl asct pmp sys","description":"Revision of a subcutaneously implanted peritoneal ascites pump system, any component (ascites pump, associated peritoneal catheter, associated bladder catheter), including imaging and programming, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0168","name":"Epinephrine (intl med sys)","description":"Injection, epinephrine (international medication systems), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2041","name":"Coord special care encounter","description":"Coordinated specialty care, team-based, for first episode psychosis, per encounter","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0266U","name":"Unxpl cnst hrtbl do gn xprsn","description":"Unexplained constitutional or other heritable disorders or syndromes, tissue-specific gene expression by whole-transcriptome and next-generation sequencing, blood, formalin-fixed paraffin-embedded (ffpe) tissue or fresh frozen tissue, reported as presence or absence of splicing or expression changes","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0020M","name":"Onc cns alys 30000 dna loci","description":"Oncology (central nervous system), analysis of 30,000 dna methylation loci by methylation array, utilizing dna extracted from tumor tissue, diagnostic algorithm reported as probability of matching a reference tumor subclass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9282","name":"Mitomycin intravesical inst","description":"Mitomycin, intravesical instillation, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0982T","name":"Rem mntr impl ivc snr set-up","description":"Remote monitoring of implantable inferior vena cava sensor, physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate), initial set-up and patient education on use of equipment","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55710","name":"Bx prst8 tprn us w/mri fus 1","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant) with mri-fusion-guidance biopsy, first targeted lesion","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87290","name":"Varicella zoster ag if","description":"Infectious agent antigen detection by immunofluorescent technique; varicella zoster virus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1954","name":"Inj leu acet lutr dpt 7.5 mg","description":"Injection, leuprolide acetate for depot suspension (lutrate depot), 7.5 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1479","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1008T","name":"Rem mntr s-scl eeg sys setup","description":"Remote monitoring of sub-scalp implanted continuous bilateral electroencephalography monitoring system, device fitting, initial set-up, and patient education in wearing of system and use of equipment","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2470","name":"Inj pantoprazole sodium 40mg","description":"Injection, pantoprazole sodium, 40 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0299U","name":"Onc pan tum whl gen opt mapg","description":"Onc pan tum whl gen opt mapg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98003","name":"Synch audio-video new hi 60","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high medical decision making. when using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9936","name":"Clean occ guard","description":"Clean occ guard","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0019","name":"Comm hlth intg svs sdoh 60mn","description":"Community health integration services performed by certified or trained auxiliary personnel, including a community health worker, under the direction of a physician or other practitioner; 60 minutes per calendar month, in the following activities to address social determinants of health (sdoh) need(","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2009","name":"Symphony, per sq cm","description":"Symphony, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0793T","name":"Prq tcat thrm ablt nrv p-art","description":"Percutaneous transcatheter thermal ablation of nerves innervating the pulmonary arteries, including right heart catheterization, pulmonary artery angiography, and all imaging guidance","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86041","name":"Acetylcholn rcptr bndng antb","description":"Acetylcholine receptor (achr); binding antibody","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1018T","name":"Elec alys npgs esoph sbsq w/","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52355","name":"Cystouretero w/excise tumor","description":"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with resection of ureteral or renal pelvic tumor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":547.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1319","name":"Pts csp doc contact","description":"Patients who had documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1498","name":"Diagnostic radiology mvp","description":"Diagnostic radiology mips value pathway","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80505","name":"Path clin consltj high 41-60","description":"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patients history and medical records and high level of medical decision making when using time for code selection, 41-60 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27250","name":"Treat hip dislocation","description":"Closed treatment of hip dislocation, traumatic; without anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52443","name":"Cysto 1st trurl prst8 comis","description":"Cystourethroscopy with initial transurethral anterior prostate commissurotomy with a nondrug-coated balloon catheter followed by therapeutic drug delivery into the prostate by a drug-coated balloon catheter, including transrectal ultrasound and fluoroscopy, when performed","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3299","name":"Inj xipere 1 mg","description":"Injection, triamcinolone acetonide (xipere), 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1326","name":"Pts dx hypotony","description":"Patients with a diagnosis of hypotony","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21338","name":"Open nasoethmoid fx w/o fixj","description":"Open treatment of nasoethmoid fracture; without external fixation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":985.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0486U","name":"Onc pan sol tum ngs cfctdna","description":"Onc pan sol tum ngs cfctdna","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67105","name":"Repair detached retina pc","description":"Repair of retinal detachment, including drainage of subretinal fluid when performed; photocoagulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":617.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0426U","name":"Genome ultra-rapid seq alys","description":"Genome ultra-rapid seq alys","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1166","name":"Path rpt tis spec wle/reexc","description":"Pathology report for tissue specimens produced from wide local excisions or re-excisions","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5913","name":"Nasal prosthesis","description":"Nasal prosthesis","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9936","name":"Clean occ guard","description":"Clean occ guard","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6593","name":"Grad com accessory gmt_wrap","description":"Accessory for gradient compression garment or wrap with adjustable straps, not-otherwise specified","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70471","name":"Cta h&n c+ w/noncontrast img","description":"Computed tomographic angiography (cta), head and neck, with contrast material(s), including noncontrast images, when performed, and image postprocessing","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4377","name":"Trigraft ft per sq cm","description":"Trigraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6113","name":"Imp/abut rem dent part mand","description":"Imp/abut rem dent part mand","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64656","name":"Revj/rplcmt bat mod sys pg","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; pulse generator only","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3501","name":"Surg exp root surf anterior","description":"Surg exp root surf anterior","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49186","name":"Opn exc/dstr ntra-abd 5 cm/<","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5 cm or less","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0233","name":"Intra inf, toci, first dose","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0434U","name":"Rx metab advrs vrnt alys 25","description":"Rx metab advrs vrnt alys 25","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0362","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0445U","name":"Abeta42 & ptau181 eclia csf","description":"Abeta42 & ptau181 eclia csf","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6113","name":"Imp/abut rem dent part mand","description":"Imp/abut rem dent part mand","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99263","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86603","name":"Adenovirus antibody","description":"Antibody; adenovirus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85013","name":"Spun microhematocrit","description":"Blood count; spun microhematocrit","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9341","name":"Inj thiotepa (tepylute) 1 mg","description":"Injection, thiotepa (tepylute), 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0575U","name":"Trnsplj med lar rtpcr 4genes","description":"Trnsplj med lar rtpcr 4genes","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0774T","name":"Vr px dissoc svc oth phy ea","description":"Virtual reality (vr) procedural dissociation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports; each additiona","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77438","name":"Surf rad thr orthvlt>150-500","description":"Surface radiation therapy; orthovoltage, delivery, >150-500 kv, per fraction","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29715","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40720","name":"Repair cleft lip/nasal","description":"Plastic repair of cleft lip/nasal deformity; secondary, by recreation of defect and reclosure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1138.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85004","name":"Automated diff wbc count","description":"Blood count; automated differential wbc count","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0889T","name":"Prsnlz trgt dvl arhfcmrigtbs","description":"Personalized target development for accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation derived from a structural and resting-state functional mri, including data preparation and transmission, generation of the target, motor threshold-starting location, neuro","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1009T","name":"Rem mntr s-sclp cont eeg sys","description":"Remote monitoring of a sub-scalp implanted continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"U0002","name":"Covid-19 lab test non-cdc","description":"2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3391","name":"Inj, atidarsagene autotemcel","description":"Injection, atidarsagene autotemcel, per treatment","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78608","name":"Brain imaging (pet)","description":"Brain imaging, positron emission tomography (pet); metabolic evaluation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1812.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86644","name":"Cmv antibody","description":"Antibody; cytomegalovirus (cmv)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1482","name":"Pos quan hep c or qual rna","description":"Positive/detectable hepatitis c virus quantitative or qualitative rna test result during the denominator identification period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85013","name":"Spun microhematocrit","description":"Blood count; spun microhematocrit","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6212","name":"Bridge noble metal cast","description":"Pontic-cast noble metal","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4440","name":"Curamatrix per sq cm","description":"Curamatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0499U","name":"Onc clrct&lng dna ngs 8gene","description":"Onc clrct&lng dna ngs 8gene","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0611U","name":"Onc lvr alys >1000 mr cfdna","description":"Onc lvr alys >1000 mr cfdna","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0912T","name":"Elec alys nstim sys vgs smpl","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; with simple programming by physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0950T","name":"Abltj b9 prst8 tissue hifu","description":"Ablation of benign prostate tissue, transrectal, with high intensity-focused ultrasound (hifu), including ultrasound guidance","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9959","name":"Unspec sleep ap proc","description":"Unspec sleep ap proc","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1258","name":"Cvd risk assess perf","description":"Cvd risk assessment performed, have a documented calculated risk score","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1033","name":"Sv doula brth wrk per diem","description":"Services performed by a doula birth worker, per diem","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1261","name":"Pts on wtlist bef dialysis","description":"Patients that were on the kidney or kidney-pancreas waitlist prior to initiation of dialysis","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1153","name":"Pt w/ dx osteo doe","description":"Patient with diagnosis of osteoporosis on date of encounter","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5141","name":"Inj adalimumab-aaty, 1 mg","description":"Injection, adalimumab-aaty, biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4383","name":"Axolotl graft ult per sq cm","description":"Axolotl graft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4328","name":"Most, per sq cm","description":"Most, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1432","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76948","name":"Echo guide ova aspiration","description":"Ultrasonic guidance for aspiration of ova, imaging supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1834","name":"Inj, isoniazid, 1 mg","description":"Injection, isoniazid, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42975","name":"Dise eval slp do brth flx dx","description":"Drug-induced sleep endoscopy, with dynamic evaluation of velum, pharynx, tongue base, and larynx for evaluation of sleep-disordered breathing, flexible, diagnostic","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55709","name":"Bx prst8 tprnl us guided","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0944T","name":"3d cntr simula trgt lvr les","description":"3d contour simulation of target liver lesion(s) and margin(s) for image-guided percutaneous microwave ablation","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64600","name":"Injection treatment of nerve","description":"Destruction by neurolytic agent, trigeminal nerve; supraorbital, infraorbital, mental, or inferior alveolar branch","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0929T","name":"Rem interrog dev ccm-d tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71048","name":"X-ray exam chest 4+ views","description":"Radiologic examination, chest; 4 or more views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0372U","name":"Nfct ds gu pthgn arg detcj","description":"Nfct ds gu pthgn arg detcj","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37264","name":"Revsc evasc fpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81418","name":"Rx metab gen seq alys pnl 6","description":"Drug metabolism (eg, pharmacogenomics) genomic sequence analysis panel, must include testing of at least 6 genes, including cyp2c19, cyp2d6, and cyp2d6 duplication/deletion analysis","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93224","name":"Xtrnl ecg rec up to 48 hrs","description":"External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage; includes recording, scanning analysis with report, review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4358","name":"Xwrap dual, per sq cm","description":"Xwrap dual, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0687T","name":"Tx amblyopia dev setup 1st","description":"Treatment of amblyopia using an online digital program; device supply, educational set-up, and initial session","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9608","name":"Flotufolastat f18 diag 1 mci","description":"Flotufolastat f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4389","name":"Neothelium 4l+ per sq cm","description":"Neothelium 4l+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0556","name":"Adv prim care mgmt lvl 1","description":"Advanced primary care management services for a patient with one chronic condition [expected to last at least 12 months, or until the death of the patient, which place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline], or fewer, provided by clinical ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0459U","name":"Abeta42 & ttau eclia csf","description":"Abeta42 & ttau eclia csf","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4424","name":"Revive ft per sq cm","description":"Revive ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92614","name":"Laryngoscopic sensory vid","description":"Flexible endoscopic evaluation, laryngeal sensory testing by cine or video recording;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44125","name":"Removal of small intestine","description":"Enterectomy, resection of small intestine; with enterostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1202.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64658","name":"Rmvl bat modul sys lead only","description":"Removal of baroreflex activation therapy (bat) modulation system; lead only","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84433","name":"Asy thiopurin s-mthyltrnsfrs","description":"Thiopurine s-methyltransferase (tpmt)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2543","name":"Dental onlay metallic 3 surf","description":"Onlay - metallic - three surfaces","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1371","name":"Mst rec gsa<7","description":"Most recent glycemic status assessment (hba1c or gmi) level < 7.0%","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28072","name":"Removal of foot joint lining","description":"Synovectomy; metatarsophalangeal joint, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9596","name":"Gallium illuccix 1 millicure","description":"Gallium ga-68 gozetotide, diagnostic, (illuccix), 1 millicurie","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3911","name":"Intraorifice barrier","description":"Intraorifice barrier","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37254","name":"Revsc evasc ivt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88365","name":"Insitu hybridization (fish)","description":"In situ hybridization (eg, fish), per specimen; initial single probe stain procedure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22116","name":"Remove extra spine segment","description":"Partial excision of vertebral body, for intrinsic bony lesion, without decompression of spinal cord or nerve root(s), single vertebral segment; each additional vertebral segment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31629","name":"Bronchoscopy/needle bx each","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial needle aspiration biopsy(s), trachea, main stem and/or lobar bronchus(i)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2782","name":"Crown 3/4 cast noble metal","description":"Crown - 3/4 cast noble metal","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86381","name":"Mitochondrial antibody each","description":"Mitochondrial antibody (eg, m2), each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33610","name":"Repair by enlargement","description":"Repair of complex cardiac anomalies (eg, single ventricle with subaortic obstruction) by surgical enlargement of ventricular septal defect","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2185.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37289","name":"Revsc evsc tpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5996","name":"Peri medicament w/seal, mand","description":"Peri medicament w/seal, mand","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4013","name":"Mntal/behav/psych hlth ss","description":"Mental/behavioral and psychiatry mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1597","name":"Inj glycopyrrolate, glyrx-pf","description":"Injection, glycopyrrolate (glyrx-pf), 0.1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43621","name":"Removal of stomach","description":"Gastrectomy, total; with roux-en-y reconstruction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2077.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0816T","name":"Opn insj/rplcmt ins ptn subq","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0933T","name":"Tcat impl wrls l atr prs snr","description":"Transcatheter implantation of wireless left atrial pressure sensor for long-term left atrial pressure monitoring, including sensor calibration and deployment, right heart catheterization, transseptal puncture, imaging guidance, and radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1415","name":"No pos pdl1 bef ici ther","description":"Patients who did not have a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4376","name":"Duograft aa per sq cm","description":"Duograft aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0468U","name":"Hep nash mir34a5p a2m ykl40","description":"Hep nash mir34a5p a2m ykl40","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8540","name":"Oral dexamethasone","description":"Dexamethasone, oral, 0.25 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0546U","name":"Ldns lrp4 antb imflr livecll","description":"Ldns lrp4 antb imflr livecll","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64583","name":"Rev/rplct hpglsl nstm ary pg","description":"Revision or replacement of hypoglossal nerve neurostimulator array and distal respiratory sensor electrode or electrode array, including connection to existing pulse generator","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"14061","name":"Tis trnfr e/n/e/l10.1-30sqcm","description":"Adjacent tissue transfer or rearrangement, eyelids, nose, ears and/or lips; defect 10.1 sq cm to 30.0 sq cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1000.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49594","name":"Rpr aa hrn 1st 3-10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, incarcerated or strangulated","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2976","name":"Band stabilization per tooth","description":"Band stabilization per tooth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83497","name":"Assay of 5-hiaa","description":"Hydroxyindolacetic acid, 5-(hiaa)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86317","name":"Immunoassay infectious agent","description":"Immunoassay for infectious agent antibody, quantitative, not otherwise specified","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1328","name":"Pts dx acute vitreous hem","description":"Patients with a diagnosis of acute vitreous hemorrhage","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82585","name":"Assay of cryofibrinogen","description":"Cryofibrinogen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4020","name":"Ophthalmology/optometry ss","description":"Ophthalmology/optometry mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0408U","name":"Iaad blk ac wv bsnsr sarscv2","description":"Iaad blk ac wv bsnsr sarscv2","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0607","name":"Lanthanum carbonate oral 5mg","description":"Lanthanum carbonate, oral, 5 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0534U","name":"Onc prst8 mirna snp 32 vrnt","description":"Onc prst8 mirna snp 32 vrnt","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0521","name":"New pt-cg dyad dem hig cmplx","description":"Management of new patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1017T","name":"Elec aly npgs esoph sbsq w/o","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33268","name":"Excl laa opn oth px any meth","description":"Exclusion of left atrial appendage, open, performed at the time of other sternotomy or thoracotomy procedure(s), any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1311","name":"Aphlx to vax bef enc","description":"Anaphylaxis due to the vaccine on or before the date of the encounter","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63053","name":"Lam factc/frmt arthrd lum ea","description":"Laminectomy, facetectomy, or foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s] [eg, spinal or lateral recess stenosis]), during posterior interbody arthrodesis, lumbar; each additional vertebral segment (list separately in addition to code for","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2327","name":"Inj risankizumab-rzaa 1 mg","description":"Injection, risankizumab-rzaa, intravenous, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90804","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9128","name":"Photobio therpy-first 15 min","description":"Photobio therpy-first 15 min","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1480","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1453","name":"Preop vis acu > 20/40","description":"Patients with a pre-operative visual acuity better than 20/40","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0279U","name":"Hem vw factor&clgn iii bndg","description":"Hematology (von willebrand disease [vwd]), von willebrand factor (vwf) and collagen iii binding by enzyme-linked immunosorbent assays (elisa), plasma, report of collagen iii binding","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16020","name":"Dress/debrid p-thick burn s","description":"Dressings and/or debridement of partial-thickness burns, initial or subsequent; small (less than 5% total body surface area)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":110.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":26.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22838","name":"Rev rplc/rmv thrc vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracic vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1332","name":"Pts no eval ini xm no 2 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 2 weeks","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4004","name":"Endocrinology ss","description":"Endocrinology mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4304","name":"Grafix plus, per sq cm","description":"Grafix plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87278","name":"Legion pneumophilia ag if","description":"Infectious agent antigen detection by immunofluorescent technique; legionella pneumophila","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77439","name":"Surf rad thr img gdn us plmt","description":"Surface radiation therapy; superficial or orthovoltage, image guidance, ultrasound for placement of radiation therapy fields for treatment of cutaneous tumors, per course of treatment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0658","name":"Seg pneum comp 2 arm chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1280","name":"Bilat mast/hx bi /unilat mas","description":"Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0785T","name":"Revj/rmvl nea spi w/nstim","description":"Revision or removal of neurostimulator electrode array, spinal, with integrated neurostimulator","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1289","name":"No pt tbco cess interv rng","description":"Patient identified as tobacco user did not receive tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57308","name":"Fistula repair transperine","description":"Closure of rectovaginal fistula; transperineal approach, with perineal body reconstruction, with or without levator plication","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":719.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0463","name":"Inj atropine (fresenius te)","description":"Injection, atropine sulfate (fresenius and therapeutically equivalent), 0.01 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1418","name":"Med rsn not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination because of a medical contraindication documented by clinician","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6211","name":"Bridge base metal cast","description":"Pontic-cast predominantly base metal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76018","name":"Mr safety implant elec prepj","description":"Mr safety implant electronics preparation under supervision of physician or other qualified health care professional, including mr-specific programming of pulse generator and/or transmitter to verify device integrity, protection of device internal circuitry from mr electromagnetic fields, and protec","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0256","name":"Alpha 1 proteinase inhibitor","description":"Injection, alpha 1 proteinase inhibitor (human), not otherwise specified, 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0461","name":"Testing for cracked tooth","description":"Testing for cracked tooth","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7049","name":"Epap nasal valve","description":"Expiratory positive airway pressure intranasal resistance valve","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4274","name":"Esano ac, per sq cm","description":"Esano ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1388","name":"Pt doc exm rec melmn","description":"Patients with documentation of an exam performed for recurrence of melanoma","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0673T","name":"Abltj b9 thyr ndul perq lasr","description":"Ablation, benign thyroid nodule(s), percutaneous, laser, including imaging guidance","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1458","name":"Pt died bef end meas pd","description":"Patient died prior to the end of the performance period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0532","name":"Take home supp nasal spray","description":"Take-home supply of nasal nalmefene hydrochloride; one carton of two, 2.7 mg per 0.1 ml nasal sprays (provision of the services by a medicare-enrolled opioid treatment program);( list separately in addition to each primary code)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0614U","name":"Iem pmd alys 4 nzm cplx page","description":"Iem pmd alys 4 nzm cplx page","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1431","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27075","name":"Resect hip tumor","description":"Radical resection of tumor; wing of ilium, 1 pubic or ischial ramus or symphysis pubis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2697.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85041","name":"Automated rbc count","description":"Blood count; red blood cell (rbc), automated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2799","name":"Inj, uzedy, 1 mg","description":"Injection, risperidone (uzedy), 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84393","name":"Tau phosphorylated ea","description":"Tau, phosphorylated (eg, ptau 181, ptau 217), each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4336","name":"Artecent c, per sq cm","description":"Artacent c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"Adju cgm supply allowance","description":"Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64655","name":"Revj/rplcmt bat mod sys lead","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; lead only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7284","name":"Exc biopsy of saliv glands","description":"Exc biopsy of saliv glands","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0288U","name":"Onc lung mrna quan pcr 11&3","description":"Onc lung mrna quan pcr 11&3","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4287","name":"Dermabind dl, per sq cm","description":"Dermabind dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10120","name":"Inc&rmvl fb subq tiss smpl","description":"Incision and removal of foreign body, subcutaneous tissues; simple","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":117.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62160","name":"Neuroendoscopy add-on","description":"Neuroendoscopy, intracranial, for placement or replacement of ventricular catheter and attachment to shunt system or external drainage (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4290","name":"Membrane wrap hydr per sq cm","description":"Membrane wrap-hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37299","name":"Revsc evsc imvt angio cpx ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5932","name":"Postsurgical obturator","description":"Obturator prosthesis definitive","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5152","name":"Inj, eculizumab-aeeb, 2 mg","description":"Injection, eculizumab-aeeb (bkemv), biosimilar, 2 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0747T","name":"Car ablt rad arrhyt dlvr rad","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; delivery of radiation therapy, arrhythmia","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1484","name":"No rpt hcv rna perf med rsn","description":"Patients who did not have a repeat hcv rna labs performed for medical reasons documented by clinician (e.g., patient with limited life expectancy, delay in treatment of hcv related to treatment of hiv, hbv, hepatocellular carcinoma, decompensated cirrhosis)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9220","name":"Indigotindisulfonate sod 1mg","description":"Injection, indigotindisulfonate sodium, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2781","name":"Inj, pegcetacoplan, 1mg","description":"Injection, pegcetacoplan, intravitreal, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33281","name":"Reposg phrnc nrv stim trnsvn","description":"Repositioning of phrenic nerve stimulator transvenous lead(s)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87627","name":"Jt spc pthgn&rx rsist gen26+","description":"Infectious agent detection by nucleic acid (dna or rna); joint space pathogens and drug resistance genes, multiplex amplified probe technique, 26 or more targets","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1362","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0730T","name":"Trabeculotomy lsr w/oct gdn","description":"Trabeculotomy by laser, including optical coherence tomography (oct) guidance","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0680","name":"Cr art clc art vlv clc w rpt","description":"Detection and quantification of coronary artery calcium and/or aortic valve calcification from algorithmic analysis of computed tomography of the chest with report","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49621","name":"Rpr parastomal hernia rdc","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; reducible","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1487","name":"Pt adm to hospice dur eval","description":"Patients in hospice in the year before or during the period of evaluation","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0690T","name":"Quan us tis charac w/dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained with diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0280U","name":"Hem vw factor&clgn iv bndg","description":"Hematology (von willebrand disease [vwd]), von willebrand factor (vwf) and collagen iv binding by enzyme-linked immunosorbent assays (elisa), plasma, report of collagen iv binding","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64596","name":"Ins/rplcmt prq eltrd ra pn 1","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; initial electrode array","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1287","name":"Calc bmi blw low param f/u","description":"Bmi is documented below normal parameters and a follow-up plan is documented","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0309U","name":"Crd cv ds aly 4 prtn plm alg","description":"Crd cv ds aly 4 prtn plm alg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0513","name":"Prolong prev svcs, first 30m","description":"Prolonged preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient contact beyond the usual service; first 30 minutes (list separately in addition to code for preventive service)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":62.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5947","name":"Mand implt sup fix","description":"Mand implt sup fix","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82488","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1811","name":"Fiasp for insulin pump use","description":"Insulin (fiasp) for administration through dme (i.e., insulin pump) per 50 units","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4402","name":"Xwrap 2.0 per sq cm","description":"Xwrap 2.0, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86258","name":"Dgp antibody each ig class","description":"Gliadin (deamidated) (dgp) antibody, each immunoglobulin (ig) class","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0567U","name":"Rare ds whl gen seq srs&lrs","description":"Rare ds whl gen seq srs&lrs","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0474U","name":"Hered pan ca gsap 88gene ngs","description":"Hered pan ca gsap 88gene ngs","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5878","name":"Dup of complt dent-mandib","description":"Dup of complt dent-mandib","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48500","name":"Surgery of pancreatic cyst","description":"Marsupialization of pancreatic cyst","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1099.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4225","name":"Amnio or derma tl, per sq cm","description":"Amniobind or dermabind tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4345","name":"Matrix hd allogrft per sq cm","description":"Matrix hd allograft dermis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86052","name":"Aquaporin-4 antb cba each","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; cell-based immunofluorescence assay (cba), each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0568U","name":"Neurol dementia bamyl ptau","description":"Neurol dementia bamyl ptau","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68841","name":"Insj rx elut implt lac canal","description":"Insertion of drug-eluting implant, including punctal dilation when performed, into lacrimal canaliculus, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1367","name":"Qual care ent disorder mvp","description":"Quality care for the treatment of ear, nose, and throat disorders mips value pathway","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1708","name":"Pfizer vacc admin 3rd dose","description":"Pfizer vacc admin 3rd dose","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9282","name":"Mitomycin intravesical inst","description":"Mitomycin, intravesical instillation, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36466","name":"Njx noncmpnd sclrsnt mlt vn","description":"Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate, inclusive of all imaging guidance and monitoring; multiple incompetent truncal veins (eg, great saphenous vein, accessory saphenous vein), same leg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":1463.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0581U","name":"Trnspl med antb nohla 39trgt","description":"Trnspl med antb nohla 39trgt","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0333U","name":"Onc lvr surveilanc hcc cfdna","description":"Onc lvr surveilanc hcc cfdna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30469","name":"Rpr nsl vlv collapse w/rmdlg","description":"Repair of nasal valve collapse with low energy, temperature-controlled (ie, radiofrequency) subcutaneous/submucosal remodeling","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1287","name":"Calc bmi blw low param f/u","description":"Bmi is documented below normal parameters and a follow-up plan is documented","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0822T","name":"Mntr psychdlc med cln staff","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; clinical staff under the direction of a physician or other qualified health care professional, concurrent with first physician or other qualified health care p","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1001T","name":"Autol musc cell therapy njx","description":"Autologous muscle cell therapy, injection of muscle progenitor cells into the external anal sphincter, including ultrasound guidance, when performed","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1002T","name":"Air displacmnt plethysmograp","description":"Air displacement plethysmography, whole-body composition assessment, with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73060","name":"X-ray exam of humerus","description":"Radiologic examination; humerus, minimum of 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1003T","name":"Arthrp 1st crp/mtcrpl prostc","description":"Arthroplasty, first carpometacarpal joint, with distal trapezial and proximal first metacarpal prosthetic replacement (eg, first carpometacarpal total joint)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21145","name":"Rcnstj mdfc lefort i 1 w/grf","description":"Reconstruction midface, lefort i; single piece, segment movement in any direction, requiring bone grafts (includes obtaining autografts)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1656.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15733","name":"Musc myoq/fscq flp h&n pedcl","description":"Muscle, myocutaneous, or fasciocutaneous flap; head and neck with named vascular pedicle (ie, buccinators, genioglossus, temporalis, masseter, sternocleidomastoid, levator scapulae)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1035.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66989","name":"Xcpsl ctrc rmvl cplx insj 1+","description":"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification), complex, requiring devices or techniques not generally used in routine cataract surgery (eg, iris expansion device,","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5934","name":"Mandibular flange prosthesis","description":"Mandibular resection prosthesis with guide flange","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9949","name":"Repair sleep apnea appliance","description":"Repair sleep apnea appliance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98009","name":"Synch audio-only new low 30","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 30 m","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9953","name":"Reline sleep apnea appliance","description":"Reline sleep apnea appliance","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9988","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99437","name":"Chrnc care mgmt phys ea addl","description":"Chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, or funct","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22838","name":"Rev rplc/rmv thrc vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracic vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2371","name":"Inj phenylephrine hcl 20 mcg","description":"Injection, phenylephrine hydrochloride, 20 micrograms","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4286","name":"Remove non-resorb barrier","description":"Remove non-resorb barrier","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9913","name":"Admin of neuromod","description":"Admin of neuromod","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1596","name":"Inj, glycopyrrolate, 0.1 mg","description":"Injection, glycopyrrolate, 0.1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6072","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (high noble metal)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6037","name":"Postop dsg cast chg handfing","description":"Immediate post-surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, partial hand including fingers","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1695.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27122","name":"Reconstruction of hip socket","description":"Acetabuloplasty; resection, femoral head (eg, girdlestone procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1303.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0788T","name":"Elec aly smp iins sp/sac nrv","description":"Electronic analysis with simple programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detecti","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24435","name":"Rpr non/mal hum with agrft","description":"Repair of nonunion or malunion, humerus; with iliac or other autograft (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9607","name":"Lutetium lu 177 vipivotide","description":"Lutetium lu 177 vipivotide tetraxetan, therapeutic, 1 millicurie","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53451","name":"Tprnl balo cntnc dev bi","description":"Periurethral transperineal adjustable balloon continence device; bilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5136","name":"Inj. denosumab-bbdz, 1 mg","description":"Injection, denosumab-bbdz (jubbonti/wyost), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0984T","name":"Iv img xtrc cere vsl oct 1st","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64473","name":"Lwr xtr fscl pln blk uni njx","description":"Lower extremity fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1470","name":"Hep b vac not recd med rsn","description":"Documentation of medical reason(s) for not administering hepatitis b vaccine (e.g., prior anaphylaxis due to the hepatitis b vaccine)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0916T","name":"Insj perm ccm-d sys pg only","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator only","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2956","name":"Indirect rest remov","description":"Indirect rest remov","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15600","name":"Delay flap trunk","description":"Delay of flap or sectioning of flap (division and inset); at trunk","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4016","name":"Neurosurgical ss","description":"Neurosurgical mips specialty set","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5153","name":"Inj, aflibercept-yszy, 1 mg","description":"Injection, aflibercept-yszy (opuviz), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1443","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2373","name":"Inj, immphentiv, 20 mcg","description":"Injection, phenylephrine hydrochloride (immphentiv), 20 micrograms","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0376U","name":"Onc prst8 ca img alys 128","description":"Onc prst8 ca img alys 128","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"Evaluation of wheezing","description":"Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1228","name":"Pt + hcv aby +vir w/ rx 3 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, has hcv treatment initiated within 3 months of the reactive hcv antibody test","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1324","name":"Pts intravitreal/pci","description":"Patients who had an intravitreal or periocular corticosteroid injection (e.g., triamcinolone, preservative-free triamcinolone, dexamethasone, dexamethasone intravitreal implant, or fluocinolone intravitreal implant)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87076","name":"Culture anaerobe ident each","description":"Culture, bacterial; anaerobic isolate, additional methods required for definitive identification, each isolate","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9244","name":"Office min sed drug enteral","description":"Office min sed drug enteral","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4387","name":"Neothelium ft per sq cm","description":"Neothelium ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99476","name":"Ped crit care age 2-5 subsq","description":"Subsequent inpatient pediatric critical care, per day, for the evaluation and management of a critically ill infant or young child, 2 through 5 years of age","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0280U","name":"Hem vw factor&clgn iv bndg","description":"Hematology (von willebrand disease [vwd]), von willebrand factor (vwf) and collagen iv binding by enzyme-linked immunosorbent assays (elisa), plasma, report of collagen iv binding","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82634","name":"Deoxycortisol","description":"Deoxycortisol, 11-","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4276","name":"Orion, per sq cm","description":"Orion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4224","name":"Hhf10-p per sq cm","description":"Human health factor 10 amniotic patch (hhf10-p), per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37267","name":"Revsc evsc fpvt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1218","name":"Pt copd symptoms","description":"Patient has copd symptoms (e.g., dyspnea, cough/sputum, wheezing)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35103","name":"Repair artery rupture aorta","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, abdominal aorta involving iliac vessels (common, hypogastric, external)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2769.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82375","name":"Assay carboxyhb quant","description":"Carboxyhemoglobin; quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0650","name":"Inj, levothyroxine nos 10mcg","description":"Injection, levothyroxine sodium, not otherwise specified, 10 mcg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1353","name":"Sealant repair per tooth","description":"Sealant repair per tooth","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1419","name":"Pt not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57305","name":"Repair rectum-vagina fistula","description":"Closure of rectovaginal fistula; abdominal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":967.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9999","name":"Doc sys rsn <3 colon","description":"Documentation of system reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., unable to locate previous colonoscopy report, patient cannot provide precise date or details from previous colonoscopy, previous colonoscopy report was incomplete)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4211","name":"Gingivectomy/plasty per toot","description":"Gingivectomy or gingivoplasty - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0892","name":"Argatroban dialysis (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1247","name":"Pt resp true best int","description":"Patient responded completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96202","name":"Mlt fam grp bhv train 1st 60","description":"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face with multiple sets of paren","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55709","name":"Bx prst8 tprnl us guided","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0526U","name":"Nefro rnl trnspl quan cxcl10","description":"Nefro rnl trnspl quan cxcl10","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1424","name":"Pulmonology care mvp","description":"Pulmonology care mips value pathway","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0285U","name":"Onc rsps radj cll fr dna tox","description":"Onc rsps radj cll fr dna tox","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4407","name":"Xwrap tribus per sq cm","description":"Xwrap tribus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0707","name":"Intraoral periap radio image","description":"Intraoral periap radio image","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0991T","name":"Cysto lo-nrg lithtrp&mcrsphr","description":"Cystourethroscopy, with low-energy lithotripsy and acoustically actuated microspheres, including imaging","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92551","name":"Pure tone hearing test air","description":"Screening test, pure tone, air only","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46600","name":"Diagnostic anoscopy spx","description":"Anoscopy; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":43.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7355","name":"Inj travoprost intra impl","description":"Injection, travoprost, intracameral implant, 1 microgram","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37262","name":"Iv lithotrp ivt w/in sm art","description":"Intravascular lithotripsy(ies), iliac vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98005","name":"Synch audio-video est low 20","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low medical decision making. when using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded.","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0751T","name":"Dgtz gls mcrscp sld level ii","description":"Digitization of glass microscope slides for level ii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63280","name":"Bx/exc idrl spine lesn crvl","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, cervical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2393.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0861T","name":"Rmvl pg wcs lv both compnt","description":"Removal of pulse generator for wireless cardiac stimulator for left ventricular pacing; both components (battery and transmitter)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0413U","name":"Onc hl neo opt gen mapg dna","description":"Onc hl neo opt gen mapg dna","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9800","name":"Gallium locametz 1 millicuri","description":"Gallium ga-68 gozetotide, diagnostic, (locametz), 1 millicurie","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0993T","name":"N-invas assmt car rsk w/ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat with concurrent computed tomography scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional (list s","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99341","name":"Home/res vst new sf mdm 15","description":"Home or residence visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 15 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":55.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76815","name":"Ob us limited fetus(s)","description":"Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9276","name":"Inj zanidatamab-hrii, 2 mg","description":"Injection, zanidatamab-hrii, 2 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85007","name":"Bl smear w/diff wbc count","description":"Blood count; blood smear, microscopic examination with manual differential wbc count","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1227","name":"Eb therapy prescribed","description":"Evidence-based therapy was prescribed","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21246","name":"Reconstruction of jaw","description":"Reconstruction of mandible or maxilla, subperiosteal implant; complete","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1024.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0690T","name":"Quan us tis charac w/dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained with diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1411","name":"1st ln ici no chemo","description":"Currently on first-line immune checkpoint inhibitors without chemotherapy","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92972","name":"Perq trluml coronry lithotrp","description":"Percutaneous transluminal coronary lithotripsy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1256","name":"Prior history of known cvd","description":"Prior history of known cvd","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74021","name":"Radex abdomen 3+ views","description":"Radiologic examination, abdomen; 3 or more views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1450","name":"Pt hos/pal care dur id/pf pd","description":"Patients who received hospice or palliative care service any time during denominator identification period or the measure assessment period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98977","name":"Rtm dev sply mscskl 16-30 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of musculoskeletal system, 16-30 days in a 30-day period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0495U","name":"Onc prst8 alys crcg plsm prt","description":"Onc prst8 alys crcg plsm prt","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85002","name":"Bleeding time test","description":"Bleeding time","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2468","name":"Inj, palonosetron (posfrea)","description":"Injection, palonosetron hydrochloride (posfrea), 25 micrograms","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21209","name":"Reduction of facial bones","description":"Osteoplasty, facial bones; reduction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78606","name":"Brain image w/flow 4 + views","description":"Brain imaging, minimum 4 static views; with vascular flow","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1248","name":"Pt resp true seen as person","description":"Patient responded completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0576U","name":"Trnsplj med lar quan ddcfdna","description":"Trnsplj med lar quan ddcfdna","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6614","name":"Onlay cst nbl mtl 2 surfaces","description":"Onlay - cast noble metal two surfaces","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72197","name":"Mri pelvis w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1388.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0520","name":"New pt-cg dyad dem mod cmplx","description":"Management of new patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0604U","name":"All&immunology crae 4bk pep","description":"All&immunology crae 4bk pep","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92920","name":"Prq trluml c angiop 1art&/br","description":"Percutaneous transluminal coronary angioplasty, single major coronary artery and/or its branch(es)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4379","name":"Amniodefend ft per sq cm","description":"Amniodefend ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0535U","name":"Pfas lc-ms/ms plsm/srm quan","description":"Pfas lc-ms/ms plsm/srm quan","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0964T","name":"I&cust prep jaw xpnsj 1arch","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; single arch, without mandibular advancement mechanism","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0652","name":"Inj, levothyroxine, hikma","description":"Injection, levothyroxine sodium (hikma), not therapeutically equivalent to j0650, 10 mcg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93897","name":"Emboli detcj wo iv mbubb njx","description":"Emboli detection without intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80061","name":"Lipid panel","description":"Lipid panel this panel must include the following: cholesterol, serum, total (82465) lipoprotein, direct measurement, high density cholesterol (hdl cholesterol) (83718) triglycerides (84478)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92579","name":"Visual audiometry (vra)","description":"Visual reinforcement audiometry (vra)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0569","name":"Subs psych care mng, subs mo","description":"Subsequent psychiatric collaborative care management, in a subsequent month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required elements: tracking ","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90801","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2003","name":"Inj, lidocaine hcl, 1 mg","description":"Injection, lidocaine hydrochloride, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0389","name":"Periopic image capture only","description":"Periopic image capture only","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0716T","name":"Car acous wavfrm rec cad rsk","description":"Cardiac acoustic waveform recording with automated analysis and generation of coronary artery disease risk score","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1330","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4413","name":"Cygnus solo per sq cm","description":"Cygnus solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0567U","name":"Rare ds whl gen seq srs&lrs","description":"Rare ds whl gen seq srs&lrs","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44156","name":"Removal of colon/ileostomy","description":"Colectomy, total, abdominal, with proctectomy; with continent ileostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2222.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0689","name":"Inj cefazolin sodium, baxter","description":"Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9129","name":"Photobio therpy-sub 15 mins","description":"Photobio therpy-sub 15 mins","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0539","name":"Initial care training 30 m","description":"Caregiver training in behavior management/modification for caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face; initial 30 minutes","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0728T","name":"Dx alys vstblr implt uni 1st","description":"Diagnostic analysis of vestibular implant, unilateral; with initial programming","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96203","name":"Mlt fam grp bhv train ea add","description":"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face with multiple sets of paren","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97003","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9936","name":"Clean occ guard","description":"Clean occ guard","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63286","name":"Bx/exc idrl imed lesn thrc","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, thoracic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2983.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4266","name":"Neostim per sq cm","description":"Neostim membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4420","name":"Nuform per sq cm","description":"Nuform, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"Breathing capacity test","description":"Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement(s), with or without maximal voluntary ventilation","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2802","name":"Inj, romiplostim 1 microgram","description":"Injection, romiplostim, 1 microgram","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25685","name":"Optx trns-scphprlnr fx dislc","description":"Open treatment of trans-scaphoperilunar type of fracture dislocation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":872.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0955T","name":"Tot impl amei removal","description":"Totally implantable active middle ear hearing implant; removal, including removal of sound processor and all implant components","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0789T","name":"Elec aly cpx iins sp/sac nrv","description":"Electronic analysis with complex programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detect","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33956","name":"Ecmo/ecls insj ctr cannula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; insertion of central cannula(e) by sternotomy or thoracotomy, 6 years and older","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1035.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87621","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6211","name":"Bridge base metal cast","description":"Pontic-cast predominantly base metal","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0548","name":"Phone/inter svs 21-30 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1292","name":"Pt 66+ frail inpt adv ill","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and an advanced illness diagnosis during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0881T","name":"Cryotherapy oral cavity","description":"Cryotherapy of the oral cavity using temperature regulated fluid cooling system, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0209","name":"Inj, sod thiosulfate (hope)","description":"Injection, sodium thiosulfate (hope), 100 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1301","name":"Pt recv tbco cess interv","description":"Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0992T","name":"N-invas assmt car rsk w/o ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat without concurrent computed tomography (ct) scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53453","name":"Tprnl balo cntnc dev rmvl ea","description":"Periurethral transperineal adjustable balloon continence device; removal, each balloon","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4324","name":"Amniotx, per sq cm","description":"Amniotx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0974T","name":"Slctv nzmtc dbrdmt t/a/l ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; each additional 100 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0764T","name":"Asstv alg ecg rsk asmt cncrt","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to concurrently performed electrocardiogram (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4289","name":"Revoshield+ amnio, per sq cm","description":"Revoshield + amniotic barrier, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4274","name":"Esano ac, per sq cm","description":"Esano ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9291","name":"Pres dig cog behav thera fda","description":"Prescription digital cognitive and/or behavioral therapy, fda cleared, per course of treatment","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2008","name":"Theragenesis, per sq cm","description":"Theragenesis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0377U","name":"Cv ds quan advsrm/plsm lprtn","description":"Cv ds quan advsrm/plsm lprtn","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1411","name":"1st ln ici no chemo","description":"Currently on first-line immune checkpoint inhibitors without chemotherapy","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3502","name":"Surg exp root surf premolar","description":"Surg exp root surf premolar","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64474","name":"Lwr xtr fscl pln blk uni nfs","description":"Lower extremity fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1336","name":"Pts eval ini xm 2 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 2 weeks","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0289U","name":"Neuro alzheimer mrna 24 gen","description":"Neuro alzheimer mrna 24 gen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0802","name":"Inj. (ani), up to 40 units","description":"Injection, corticotropin (ani), up to 40 units","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S4024","name":"Air polymer foam per study","description":"Air polymer-type a intrauterine foam, per study dose","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55712","name":"Bx prst8 tprnl mri-us 1st","description":"Biopsy, prostate, transperineal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84585","name":"Assay of urine vma","description":"Vanillylmandelic acid (vma), urine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0558","name":"Adv prim care mgmt lvl 3","description":"Advanced primary care management services for a patient that is a qualified medicare beneficiary with multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, which place the patient at significant risk of death, acute exacerbation/decompensat","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0481","name":"Electron microscopy diagnost","description":"Electron microscopy - diagnostic","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0502","name":"Other oral pathology procedu","description":"Other oral pathology procedures by report","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0235","name":"Inj, monoclon antibody, 1 mg","description":"Injection, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extraco","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28190","name":"Removal of foot foreign body","description":"Removal of foreign body, foot; subcutaneous","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4334","name":"Amnioplast 1, per sq cm","description":"Amnioplast 1, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9936","name":"Clean occ guard","description":"Clean occ guard","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9002","name":"Intra-vag motion sens biofk","description":"Intra-vaginal motion sensor system, provides biofeedback for pelvic floor muscle rehabilitation device","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0802T","name":"Tcat rmv&rpl2chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right at","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1098","name":"Articaine ophthalmi 8% 0.4ml","description":"Articaine ophthalmic, 8% solution, 0.4 ml","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1215","name":"Med rsn for no doc spiro","description":"Documentation of medical reason(s) for not documenting and reviewing spirometry results (e.g., patients with dementia or tracheostomy)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0426U","name":"Genome ultra-rapid seq alys","description":"Genome ultra-rapid seq alys","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1451","name":"Pt dx ppd dur id/pf pd","description":"Patients with an active diagnosis of pervasive developmental disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1272","name":"Pts kid transplt wtlst","description":"Patients observed on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0987T","name":"Iv img icr cere vsl oct ea","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2037","name":"G4derm plus/suprello, pr ml","description":"G4derm plus/suprello, per milliliter","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1304","name":"Inj tofersen intrathec 1 mg","description":"Injection, tofersen, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1422","name":"Gastroenterology care mvp","description":"Gastroenterology care mips value pathway","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49406","name":"Image cath fluid peri/retro","description":"Image-guided fluid collection drainage by catheter (eg, abscess, hematoma, seroma, lymphocele, cyst); peritoneal or retroperitoneal, percutaneous","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":964.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1373","name":"Mst rec gsa >=8 and <=9","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 8.0% and <= 9.0%","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0539U","name":"Onc sol tumor cfctdna 152gen","description":"Onc sol tumor cfctdna 152gen","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87812","name":"Sarscov2&inf typ a&b w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) and influenza virus types a and b","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2599","name":"Inj vasopressin (am reg) 1 u","description":"Injection, vasopressin (american regent), not therapeutically equivalent to j2598, 1 unit","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1307","name":"Inj, crovalimab-akkz, 10 mg","description":"Injection, crovalimab-akkz, 10 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69633","name":"Rebuild eardrum structures","description":"Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; with ossicular chain reconstruction and synthetic prosthesis (eg, partial ossicular replacement prosthesis [porp], total ossicular replacement prosthesis [torp])","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1177.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38228","name":"Car-t admn autologous","description":"Chimeric antigen receptor t-cell (car-t) therapy; car-t cell administration, autologous","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0797T","name":"Tcat ins 2chmbr ldls pm rv","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ventricular pace","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0826T","name":"Prgrmg evl ldls pm 1chmbr ip","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional, leadless pacemaker system in si","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83036","name":"Hemoglobin glycosylated a1c","description":"Hemoglobin; glycosylated (a1c)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1379","name":"10 yr fu no rec rsn not giv","description":"A 10 year follow-up interval for colonoscopy not recommended, reason not otherwise specified","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0269U","name":"Hem aut dm cgen trmbctpna 14","description":"Hematology (autosomal dominant congenital thrombocytopenia), genomic sequence analysis of 14 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4545","name":"Suppl accessor tibial stim","description":"Supplies and accessories for external tibial nerve stimulator (e.g., socks, gel pads, electrodes, etc.), needed for one month","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2001","name":"Suct pum ext mgmt sys","description":"Suction pump, home model, portable or stationary, electric, any type, for use with external urine and/or fecal management system","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9506","name":"Tc-99m graphite crucible","description":"Graphite crucible for preparation of technetium tc 99m-labeled carbon aerosol, one crucible","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1338","name":"Pt f/u 30-180 dys no + imprv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who did not demonstrate positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4406","name":"Xwrap fenestra per sq cm","description":"Xwrap fenestra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61556","name":"Incise skull/sutures","description":"Craniotomy for craniosynostosis; frontal or parietal bone flap","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1749.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0319U","name":"Neph rna pretrnspl perph bld","description":"Neph rna pretrnspl perph bld","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9615","name":"Urine specimen collect mult","description":"Catheterization for collection of specimen(s) (multiple patients)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0555","name":"Replacment pt electronic sys","description":"Provision of replacement patient electronics system (e.g., system pillow, handheld reader) for home pulmonary artery pressure monitoring","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50544","name":"Laparoscopy pyeloplasty","description":"Laparoscopy, surgical; pyeloplasty","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1413.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22513","name":"Perq vertebral augmentation","description":"Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (eg, kyphoplasty), 1 vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; thoracic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8612.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0616","name":"Inj metoprolol tartrate 1 mg","description":"Injection, metoprolol tartrate, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61050","name":"Remove brain canal fluid","description":"Cisternal or lateral cervical (c1-c2) puncture; without injection (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85044","name":"Manual reticulocyte count","description":"Blood count; reticulocyte, manual","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64642","name":"Chemodenerv 1 extremity 1-4","description":"Chemodenervation of one extremity; 1-4 muscle(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1448","name":"Pt dx pd bef end meas pd","description":"Patients with an active diagnosis of personality disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33241","name":"Remove pulse generator","description":"Removal of implantable defibrillator pulse generator only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90613","name":"Inf&sarscov2 vacc 40/0.4 im","description":"Influenza virus vaccine, quadrivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 40 mcg/0.4 ml dosage, for intramuscular use","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6560","name":"G stckng full/chap30-40 cust","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, custom, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26556","name":"Toe joint transfer","description":"Transfer, free toe joint, with microvascular anastomosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3666.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5938","name":"Resct proth max comp remov","description":"Resct proth max comp remov","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82274","name":"Assay test for blood fecal","description":"Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2372","name":"Inj, biorphen, 20 micrograms","description":"Injection, phenylephrine hydrochloride (biorphen), 20 micrograms","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1300","name":"Flu imm no admin doc rea","description":"Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5144","name":"Inj, idacio, 1 mg","description":"Injection, adalimumab-aacf (idacio), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0422","name":"Collect & prep genetic samp","description":"Collect & prep genetic samp","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0013","name":"Esketamine, nasal spray","description":"Esketamine, nasal spray, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5946","name":"Max implt sup fix","description":"Max implt sup fix","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3222","name":"Part pulp for apexogenesis","description":"Partial pulpotomy for apexogenesis - permanent tooth with incomplete root development","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1252","name":"Pts no cmplt hu survey","description":"Patients who did not complete at least one of the four patient experience hu survey items and return the hu survey within 60 days of the ambulatory palliative care visit","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6624","name":"Inlay titanium","description":"Inlay - titanium","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1434","name":"Orl chemo wthn 30 d post enc","description":"Patient on oral chemotherapy on or within 30 days after denominator eligible encounter","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1309","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0401U","name":"Crd c hrt ds 9 gen 12 vrnts","description":"Crd c hrt ds 9 gen 12 vrnts","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0036","name":"Pt/ptn decln assess","description":"Patient or care partner decline assessment","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1470","name":"Hep b vac not recd med rsn","description":"Documentation of medical reason(s) for not administering hepatitis b vaccine (e.g., prior anaphylaxis due to the hepatitis b vaccine)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0937T","name":"Xtrnl ecg rec>15d<30d","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; including recording, scanning analysis with report, review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76819","name":"Fetal biophys profil w/o nst","description":"Fetal biophysical profile; without non-stress testing","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2151","name":"Inj, mannitol, 250 mg","description":"Injection, mannitol, 250 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4400","name":"Polygon3 per sq cm","description":"Polygon3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":24.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0350U","name":"Rx metab/pcx dna 27 gen alys","description":"Rx metab/pcx dna 27 gen alys","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49186","name":"Opn exc/dstr ntra-abd 5 cm/<","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5 cm or less","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98977","name":"Rtm dev sply mscskl 16-30 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of musculoskeletal system, 16-30 days in a 30-day period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9323","name":"Inj pemetrexed ditromethamin","description":"Injection, pemetrexed ditromethamine, 10 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1440","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9025","name":"Plasma cryo redu path each","description":"Plasma, cryoprecipitate reduced, pathogen reduced, each unit","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1466","name":"Pt disc/lam proc same day","description":"Patient had a lumbar fusion on the same date as the discectomy/laminectomy procedure","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86141","name":"C-reactive protein hs","description":"C-reactive protein; high sensitivity (hscrp)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0736T","name":"Colonic lavage 35+l water","description":"Colonic lavage, 35 or more liters of water, gravity-fed, with induced defecation, including insertion of rectal catheter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76857","name":"Us exam pelvic limited","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64857","name":"Repair arm/leg nerve","description":"Suture of major peripheral nerve, arm or leg, except sciatic; without transposition","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1193.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17000","name":"Destruct premalg lesion","description":"Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (eg, actinic keratoses); first lesion","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":72.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2026","name":"Restrata minimatrix, 5 mg","description":"Restrata minimatrix, 5 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99395","name":"Prev visit est age 18-39","description":"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 18-39","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":82.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0995T","name":"Evasc dlvr a-wal stbl rx opn","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; open","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6105","name":"Remove implant body","description":"Remove implant body","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0255U","name":"Andrology infertility assmt","description":"Andrology (infertility), sperm-capacitation assessment of ganglioside gm1 distribution patterns, fluorescence microscopy, fresh or frozen specimen, reported as percentage of capacitated sperm and probability of generating a pregnancy score","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5157","name":"Inj, denosumab-bmwo, 1 mg","description":"Injection, denosumab-bmwo (stoboclo/osenvelt), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0044","name":"Pt mitral stenosis","description":"Patients with moderate or severe mitral stenosis","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87627","name":"Jt spc pthgn&rx rsist gen26+","description":"Infectious agent detection by nucleic acid (dna or rna); joint space pathogens and drug resistance genes, multiplex amplified probe technique, 26 or more targets","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4025","name":"Physical medicine ss","description":"Physical medicine mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1214","name":"Spiro results wth obs doc","description":"Spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and reviewed","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21556","name":"Exc neck tum deep < 5 cm","description":"Excision, tumor, soft tissue of neck or anterior thorax, subfascial (eg, intramuscular); less than 5 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":464.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55540","name":"Revise hernia & sperm veins","description":"Excision of varicocele or ligation of spermatic veins for varicocele; with hernia repair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":553.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0748T","name":"Njx stm cl prdct anl sft tis","description":"Injections of stem cell product into perianal perifistular soft tissue, including fistula preparation (eg, removal of setons, fistula curettage, closure of internal openings)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0375U","name":"Onc ovrn bchm asy 7 prtn alg","description":"Onc ovrn bchm asy 7 prtn alg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82947","name":"Assay glucose blood quant","description":"Glucose; quantitative, blood (except reagent strip)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4428","name":"Dermbnd sln sl+ slx sq cm","description":"Dermabind sl n or dermabind sl + or dermabind sl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J2504","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26990","name":"Drainage of pelvis lesion","description":"Incision and drainage, pelvis or hip joint area; deep abscess or hematoma","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":725.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0974T","name":"Slctv nzmtc dbrdmt t/a/l ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; each additional 100 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D8091","name":"Compre ortho treat w surg","description":"Compre ortho treat w surg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G3002","name":"Chronic pain mgmt 30 mins","description":"Chronic pain management and treatment, monthly bundle including, diagnosis; assessment and monitoring; administration of a validated pain rating scale or tool; the development, implementation, revision, and/or maintenance of a person-centered care plan that includes strengths, goals, clinical needs,","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0321U","name":"Iadna gu pthgn 20bct&fng org","description":"Iadna gu pthgn 20bct&fng org","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98976","name":"Rtm dev sply resp sys 16-30d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of respiratory system, 16-30 days in a 30-day period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94617","name":"Exercise tst brncspsm w/ecg","description":"Exercise test for bronchospasm, including pre- and post-spirometry and pulse oximetry; with electrocardiographic recording(s)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78586","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1398","name":"Bslne and  fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0752T","name":"Dgtz gls mcrscp sld lvl iii","description":"Digitization of glass microscope slides for level iii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87103","name":"Blood fungus culture","description":"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; blood","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0740T","name":"Rem auton alg nsln cal setup","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; initial set-up and patient education","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4426","name":"Dermbnd tl+, tlx per sq cm","description":"Dermabind tl + or dermabind tl x,  per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q4075","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59852","name":"Induced abortion 1+njx hyst","description":"Induced abortion, by 1 or more intra-amniotic injections (amniocentesis-injections), including hospital admission and visits, delivery of fetus and secundines; with hysterotomy (failed intra-amniotic injection)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":616.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0745T","name":"Car ablt rad arr n-invas loc","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; noninvasive arrhythmia localization and mapping of arrhythmia site (nidus), derived from anatomical image data (eg, ct, mri, or myocardial perfusion scan) and electrical data (eg, 12-lead ecg data), and identification of areas of avo","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0528","name":"Mgt est pt dem mod-hi cmplx","description":"Management of established patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1460","name":"Dx copd, cf, or arf","description":"Diagnosis for chronic obstructive pulmonary disease, emphysema, cystic fibrosis, or acute respiratory failure","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70480","name":"Ct orbit/ear/fossa w/o dye","description":"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6198","name":"Remove interim implant","description":"Remove interim implant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0589","name":"Inj daxibotulinumtoxina-lanm","description":"Injection, daxibotulinumtoxina-lanm, 1 unit","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37289","name":"Revsc evsc tpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37270","name":"Revsc evasc fpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0525","name":"Est pt-cg dyad dem mod cmplx","description":"Management of established patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61736","name":"Litt icr 1 traj 1 smpl les","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; single trajectory for 1 simple lesion","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53865","name":"Cysto insj dev ischmc rmdlg","description":"Cystourethroscopy with insertion of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0013","name":"Hiv prep counsel, clin staff","description":"Individual counseling for pre-exposure prophylaxis (prep) by clinical staff to prevent human immunodeficiency virus (hiv), includes: hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0868T","name":"Hi-res gastric ep mapping","description":"High-resolution gastric electrophysiology mapping with simultaneous patient-symptom profiling, with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53449","name":"Repair uro sphincter","description":"Repair of inflatable urethral/bladder neck sphincter, including pump, reservoir, and cuff","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":662.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6280","name":"Implt maint procd remv implt","description":"Implt maint procd remv implt","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0947T","name":"Mrgfus strtctc bl-br disrpj","description":"Magnetic resonance image guided low intensity focused ultrasound (mrgfus), stereotactic blood-brain barrier disruption using microbubble resonators to increase the concentration of blood-based biomarkers of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7972","name":"Surg redct fibrous tuberosit","description":"Surgical reduction of fibrous tuberosity","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53600","name":"Dilate urethra stricture","description":"Dilation of urethral stricture by passage of sound or urethral dilator, male; initial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4287","name":"Disp col sto bag breast milk","description":"Disposable collection and storage bag for breast milk, any size, any type, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1213","name":"No hx spiro prs spiro>=70%","description":"No history of spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) and present spirometry is >= 70%","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1473","name":"Pt func cap not allow impr","description":"Patient situations, at any point during the denominator identification period, where the patients functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools, such as delirium, dementia, intellectual disabilities, and pervasive and specific de","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51920","name":"Close bladder-uterus fistula","description":"Closure of vesicouterine fistula;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":823.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1335","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9612","name":"Inj, fluorescein, 1 mg","description":"Injection, fluorescein, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49594","name":"Rpr aa hrn 1st 3-10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1445","name":"Pp care visit by 12 weeks","description":"Postpartum care visit before or at 12 weeks of giving birth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0431U","name":"Gly rcptr alpha1 igg srm/csf","description":"Gly rcptr alpha1 igg srm/csf","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87154","name":"Cul typ id bld pthgn 6+ trgt","description":"Culture, typing; identification of blood pathogen and resistance typing, when performed, by nucleic acid (dna or rna) probe, multiplexed amplified probe technique including multiplex reverse transcription, when performed, per culture or isolate, 6 or more targets","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0502","name":"Other oral pathology procedu","description":"Other oral pathology procedures by report","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4326","name":"Woundplus, per sq cm","description":"Woundplus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33281","name":"Reposg phrnc nrv stim trnsvn","description":"Repositioning of phrenic nerve stimulator transvenous lead(s)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69840","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1096.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6604","name":"Cst bse mtl inlay 2 surfaces","description":"Inlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1227","name":"Eb therapy prescribed","description":"Evidence-based therapy was prescribed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1414","name":"Med rsn no pdl1 bef 1st ther","description":"Documentation of medical reason(s) for not performing the pd-l1 biomarker expression test prior to initiation of first-line immune checkpoint inhibitor therapy (e.g., patient is in an urgent or emergent situation where delay of treatment would jeopardize the patients health status; other medical rea","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37254","name":"Revsc evasc ivt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1500","name":"Neuropsychology mvp","description":"Neuropsychology mips value pathway","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0817T","name":"Opn insj/rplcmt ins ptn subf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41827","name":"Excision of gum lesion","description":"Excision of lesion or tumor (except listed above), dentoalveolar structures; with complex repair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53270","name":"Removal of urethra gland","description":"Excision or fulguration; skenes glands","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7514","name":"Mycophenol (myhibbin) 100 mg","description":"Mycophenolate mofetil (myhibbin), oral suspension, 100 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1247","name":"Pt resp true best int","description":"Patient responded completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1280","name":"Bilat mast/hx bi /unilat mas","description":"Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1791.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87475","name":"Lyme dis dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); borrelia burgdorferi, direct probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1412","name":"Inj roctavian ml 2x10^13vc g","description":"Injection, valoctocogene roxaparvovec-rvox, per ml, containing nominal 2 x 10^13 vector genomes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0518U","name":"Ther rx mntr 90+ pn&mtl hlth","description":"Ther rx mntr 90+ pn&mtl hlth","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1161","name":"Pt anphx due to dtp bef 13","description":"Patient had anaphylaxis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0388U","name":"Onc nonsm cll lng ca 37 gen","description":"Onc nonsm cll lng ca 37 gen","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6073","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (predominantly base metal)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1226","name":"Iop not doc","description":"Iop measurement not documented, reason not otherwise specified","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1409","name":"Recd gmln brca1/brca2 couns","description":"Patients who received germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4357","name":"Xwrap plus, per sq cm","description":"Xwrap plus, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34706","name":"Evasc rpr a-biiliac rpt","description":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-bi-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2396.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98986","name":"Rtm dev sply cbt 2-15 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of cognitive behavioral therapy, 2-15 days in a 30-day period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5157","name":"Inj, denosumab-bmwo, 1 mg","description":"Injection, denosumab-bmwo (stoboclo/osenvelt), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59852","name":"Induced abortion 1+njx hyst","description":"Induced abortion, by 1 or more intra-amniotic injections (amniocentesis-injections), including hospital admission and visits, delivery of fetus and secundines; with hysterotomy (failed intra-amniotic injection)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":625.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1259","name":"Pt stat doc <= 1 yr dialysis","description":"Patient status documented within the first year of initiating dialysis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81515","name":"Nfct ds bv&vaginitis dna alg","description":"Infectious disease, bacterial vaginosis and vaginitis, real-time pcr amplification of dna markers for atopobium vaginae, atopobium species, megasphaera type 1, and bacterial vaginosis associated bacteria-2 (bvab-2), utilizing vaginal-fluid specimens, algorithm reported as positive or negative for hi","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0379U","name":"Tgsap sl or neo dna523&rna55","description":"Tgsap sl or neo dna523&rna55","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1781","name":"Vac admin human pap dose 1","description":"Vac admin human pap dose 1","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4349","name":"Mantle dl matrix per sq cm","description":"Mantle dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81456","name":"So/hl 51/>gsap rna alys","description":"Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic sequence analysis panel, interrogation for sequence variants and copy number variants or rearrangements, or isoform expression or mrna expression levels, if performed; rna analysis","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1207","name":"Pt scrn sdoh","description":"Patient is screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0584U","name":"Neuro csf prion prtn qual","description":"Neuro csf prion prtn qual","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9998","name":"Inj ustekinumab-aekn, 1 mg","description":"Injection, ustekinumab-aekn (selarsdi), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4019","name":"Oncology/hema ss","description":"Oncology/hematology mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1806","name":"Inj esmolol hcl wg crit care","description":"Injection, esmolol hydrochloride (wg critical care), not therapeutically equivalent to j1805, 10 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80074","name":"Acute hepatitis panel","description":"Acute hepatitis panel this panel must include the following: hepatitis a antibody (haab), igm antibody (86709) hepatitis b core antibody (hbcab), igm antibody (86705) hepatitis b surface antigen (hbsag) (87340) hepatitis c antibody (86803)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0430U","name":"Gi malabs aat calpro pncrtc","description":"Gi malabs aat calpro pncrtc","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6074","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (noble metal)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85525","name":"Heparin neutralization","description":"Heparin neutralization","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0930T","name":"Ephys eval ccm-d ld 1st impl","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), at time of initial implantation or replacement with testing of cardiac contrac","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7171","name":"Inj, adzynma, 10 iu","description":"Injection, adamts13, recombinant-krhn, 10 iu","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01942","name":"Anes neuromd/ntrvrt lmbr/sac","description":"Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15854","name":"Removal sutr&stapl xreq anes","description":"Removal of sutures and staples not requiring anesthesia (list separately in addition to e/m code)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4007","name":"General surgery ss","description":"General surgery mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0960T","name":"Rpl s-sclp eltr ra rcvr&tlmt","description":"Replacement of sub-scalp implanted electrode array, receiver, and telemetry unit with tunneling of electrode for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2033","name":"Myriad morcells, 4 mg","description":"Myriad morcells, 4 milligrams","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01937","name":"Anes drg/aspir crv/thrc","description":"Anesthesia for percutaneous image-guided injection, drainage or aspiration procedures on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4007","name":"General surgery ss","description":"General surgery mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4321","name":"Renograft, per sq cm","description":"Renograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22310","name":"Closed tx vert fx w/o manj","description":"Closed treatment of vertebral body fracture(s), without manipulation, requiring and including casting or bracing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0908T","name":"Opn imp int nstm sys vgs nrv","description":"Open implantation of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0548","name":"Phone/inter svs 21-30 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0701T","name":"Molec fluor img sus nev ea","description":"Molecular fluorescent imaging of suspicious nevus; each additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01937","name":"Anes drg/aspir crv/thrc","description":"Anesthesia for percutaneous image-guided injection, drainage or aspiration procedures on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98975","name":"Rtm 1st set-up&pt educaj eqp","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); initial set-up and patient education on use of equipment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33279","name":"Rmvl phrnc nrv stim transvns","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s) only","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86940","name":"Hemolysins/agglutinins auto","description":"Hemolysins and agglutinins; auto, screen, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69960","name":"Release inner ear canal","description":"Decompression internal auditory canal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2192.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64913","name":"Nrv rpr w/nrv algrft ea addl","description":"Nerve repair; with nerve allograft, each additional strand (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76816","name":"Ob us follow-up per fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, follow-up (eg, re-evaluation of fetal size by measuring standard growth parameters and amniotic fluid volume, re-evaluation of organ system(s) suspected or confirmed to be abnormal on a previous scan), transabdominal approach, per fetu","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2031","name":"Mirodry, per sq cm","description":"Mirodry wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0013","name":"Esketamine, nasal spray","description":"Esketamine, nasal spray, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0917T","name":"Insj perm ccm-d sys 1 lead","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; single transvenous lead (pacing or defibrillation) only","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0523U","name":"Onc soltum dna ngs snv 22gen","description":"Onc soltum dna ngs snv 22gen","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37281","name":"Revsc evsc tpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43045","name":"Esophagotomy thrc rmvl fb","description":"Esophagotomy, thoracic approach, with removal of foreign body","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1493.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92629","name":"Eval hearing aid cand ea add","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0259U","name":"Neph ckd nuc mrs meas gfr","description":"Nephrology (chronic kidney disease), nuclear magnetic resonance spectroscopy measurement of myo-inositol, valine, and creatinine, algorithmically combined with cystatin c (by immunoassay) and demographic data to determine estimated glomerular filtration rate (gfr), serum, quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1307","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1257","name":"Cvd risk assess not perf","description":"Cvd risk assessment not performed or incomplete (e.g., cvd risk assessment was not documented), reason not otherwise specified","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2998","name":"Inj plasminogen tvmh 1mg","description":"Injection, plasminogen, human-tvmh, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0783T","name":"Tc auriculr neurostimulation","description":"Transcutaneous auricular neurostimulation, set-up, calibration, and patient education on use of equipment","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87070","name":"Culture othr specimn aerobic","description":"Culture, bacterial; any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98012","name":"Synch audio-only est sf 10","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0801","name":"3d dental scan direct","description":"3d dental scan direct","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33281","name":"Reposg phrnc nrv stim trnsvn","description":"Repositioning of phrenic nerve stimulator transvenous lead(s)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93596","name":"R&l hrt cath chd nml nt cnj","description":"Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); normal native connections","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27740","name":"Repair of leg epiphyses","description":"Arrest, epiphyseal (epiphysiodesis), any method, combined, proximal and distal tibia and fibula;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":864.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92544","name":"Optokinetic nystagmus test","description":"Optokinetic nystagmus test, bidirectional, foveal or peripheral stimulation, with recording","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1299","name":"Inj, eculizumab, 2 mg","description":"Injection, eculizumab, 2 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4332","name":"Axolotl dualgraft, per sq cm","description":"Axolotl dualgraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4436","name":"Renati ac membrane per sq cm","description":"Renati ac membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0712T","name":"N-nvs artl plaq alys quan","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess atherosclerotic plaque stability","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4377","name":"Trigraft ft per sq cm","description":"Trigraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2050","name":"Financial mgt waiver/diem","description":"Financial management, self-directed, waiver; per diem","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4390","name":"Ascendion per sq cm","description":"Ascendion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0019","name":"Comm hlth intg svs sdoh 60mn","description":"Community health integration services performed by certified or trained auxiliary personnel, including a community health worker, under the direction of a physician or other practitioner; 60 minutes per calendar month, in the following activities to address social determinants of health (sdoh) need(","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0685T","name":"Interrog dev eval isdss ip","description":"Interrogation device evaluation (in-person) with analysis, review and report by a physician or other qualified health care professional, including connection, recording and disconnection per patient encounter, permanent implantable synchronized diaphragmatic stimulation system for augmentation of ca","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83727","name":"Assay of lrh hormone","description":"Luteinizing releasing factor (lrh)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1381","name":"Pt sec strk wthin 5 days","description":"Patients with secondary stroke (e.g., a subsequent stroke that may occur with vasospasm in the setting of subarachnoid hemorrhage) within 5 days of the initial procedure","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0833T","name":"Dgtz gls mcrscp cytp oth prp","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; preparation, screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0018","name":"Crisis psychotherapy add 30m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); each additional 30 minutes (list separately in addition to code for primary service)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3291","name":"Tranexamic acid in sod chlor","description":"Injection, tranexamic acid in sodium chloride, 5 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69728","name":"Rmv ntr oi imp sk tc>=100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"X-ray exam chest 2 views","description":"Radiologic examination, chest; 2 views","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2038","name":"Skill train and dev/diem","description":"Skills training and development, per diem","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9075","name":"Inj, cyclophosphamide, nos","description":"Injection, cyclophosphamide, not otherwise specified, 5 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97009","name":"Mchnl sclp cool after chemo","description":"Mechanical scalp cooling; provided after discontinuation of chemotherapy, each 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"Adju cgm supply allowance","description":"Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74019","name":"Radex abdomen 2 views","description":"Radiologic examination, abdomen; 2 views","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1364","name":"Ascvd risk >=20pct","description":"Calculated 10-year ascvd risk score of >= 20 percent during the performance period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0369","name":"Max mri capture & interprete","description":"Max mri capture & interprete","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9607","name":"Lutetium lu 177 vipivotide","description":"Lutetium lu 177 vipivotide tetraxetan, therapeutic, 1 millicurie","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55867","name":"Laps surg prst8ect smpl stot","description":"Laparoscopy, surgical prostatectomy, simple subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy), includes robotic assistance, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4431","name":"Pma skin substitute, nos","description":"Pma skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99236","name":"Hosp ip/obs same date hi 85","description":"Hospital inpatient or observation care, for the evaluation and management of a patient including admission and discharge on the same date, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter f","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2544","name":"Dental onlay metl 4/more sur","description":"Onlay - metallic - four or more surfaces","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6191","name":"Semi precision abutment","description":"Semi precision abutment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0409U","name":"Onc sld tum dna 80 & rna 36","description":"Onc sld tum dna 80 & rna 36","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1440","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0237","name":"Inj, tocilizumab-anoh, hospi","description":"Injection, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2780","name":"Crown 3/4 cast hi noble met","description":"Crown - 3/4 cast high noble metal","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83876","name":"Assay myeloperoxidase","description":"Myeloperoxidase (mpo)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45126","name":"Pelvic exenteration","description":"Pelvic exenteration for colorectal malignancy, with proctectomy (with or without colostomy), with removal of bladder and ureteral transplantations, and/or hysterectomy, or cervicectomy, with or without removal of tube(s), with or without removal of ovary(s), or any combination thereof","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3021.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26502","name":"Hand tendon reconstruction","description":"Reconstruction of tendon pulley, each tendon; with tendon or fascial graft (includes obtaining graft) (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":938.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1809","name":"Inj, fosdenopterin, 0.1mg","description":"Injection, fosdenopterin, 0.1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0707","name":"Intraoral periap radio image","description":"Intraoral periap radio image","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9913","name":"Admin of neuromod","description":"Admin of neuromod","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0481U","name":"Idh1 idh2&tert promoter ngs","description":"Idh1 idh2&tert promoter ngs","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61686","name":"Intracranial vessel surgery","description":"Surgery of intracranial arteriovenous malformation; infratentorial, complex","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5344.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0803T","name":"Tcat rmv&rpl2chmb ldls pm rv","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1305","name":"Pneum vax admin 19+","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1370","name":"Inj, esomeprazole sod, 1 mg","description":"Injection, esomeprazole sodium, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96203","name":"Mlt fam grp bhv train ea add","description":"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face with multiple sets of paren","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0963T","name":"Anosc sbmcsl njx bulking agt","description":"Anoscopy with directed submucosal injection of bulking agent into anal canal","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43290","name":"Egd flx trnsorl dplmnt balo","description":"Esophagogastroduodenoscopy, flexible, transoral; with deployment of intragastric bariatric balloon","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29046","name":"Appl bdy cst sho to hip b th","description":"Application of body cast, shoulder to hips; including both thighs","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4398","name":"Summit ac per sq cm","description":"Summit ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0047","name":"Ped blunt hd traum","description":"Pediatric patient with minor blunt head trauma and pecarn prediction criteria are not assessed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86318","name":"Ia infectious agent antibody","description":"Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip);","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0421U","name":"Onc clrct scr sgl amp 8 rna","description":"Onc clrct scr sgl amp 8 rna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61892","name":"Rmv sk-mnt crnl nstm pg/rcvr","description":"Removal of skull-mounted cranial neurostimulator pulse generator or receiver with cranioplasty, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1306","name":"Injection, inclisiran, 1 mg","description":"Injection, inclisiran, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0601","name":"Sevelamer carbonate 20 mg","description":"Sevelamer carbonate (renvela or therapeutically equivalent), oral, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0393U","name":"Neu prksn msfl a-syncln prtn","description":"Neu prksn msfl a-syncln prtn","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61891","name":"Rev/rplcmt sk-mnt crnl nstm","description":"Revision or replacement of skull-mounted cranial neurostimulator pulse generator or receiver with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43286","name":"Esphg tot w/laps moblj","description":"Esophagectomy, total or near total, with laparoscopic mobilization of the abdominal and mediastinal esophagus and proximal gastrectomy, with laparoscopic pyloric drainage procedure if performed, with open cervical pharyngogastrostomy or esophagogastrostomy (ie, laparoscopic transhiatal esophagectomy","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3188.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11201","name":"Rmvl skin tags ea addl 10","description":"Removal of skin tags, multiple fibrocutaneous tags, any area; each additional 10 lesions, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":17.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0324","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0426","name":"Coll, analys of saliva","description":"Coll, analys of saliva","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9174","name":"Inj, docetaxel (beizray) 1mg","description":"Injection, docetaxel (beizray), 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1233","name":"Pt no hcv aby or result","description":"Patient does not receive hcv antibody test or patient does receive hcv antibody test but results not documented, reason not given","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0922T","name":"Rmvl perm ccm-d sys dual ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); dual (pacing and defibrillation) transvenous leads only","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1720","name":"Influenza vacc admin","description":"Influenza vacc admin","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0293U","name":"Psyc suicidal idea mrna 54","description":"Psyc suicidal idea mrna 54","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0863T","name":"Rlcj pg wcs lv trnsmtr only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; transmitter component only","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87494","name":"Chlmy trch&neisra gonor mult","description":"Infectious agent detection by nucleic acid (dna or rna); chlamydia trachomatis and neisseria gonorrhoeae, multiplex amplified probe technique","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93797","name":"Phys/qhp op car rhab wo ecg","description":"Physician or other qualified health care professional services for outpatient cardiac rehabilitation; without continuous ecg monitoring (per session)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1287","name":"Calc bmi blw low param f/u","description":"Bmi is documented below normal parameters and a follow-up plan is documented","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0796T","name":"Tcat ins 2chmbr ldls pm ra","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right atrial pacemaker","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2471","name":"Inj pantoprazole(hikma) 40mg","description":"Injection, pantoprazole (hikma), not therapeutically equivalent to j2470, 40 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0919T","name":"Rmvl perm ccm-d sys pg only","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); pulse generator only","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0909T","name":"Rplcmt int nstim sys vgs nrv","description":"Replacement of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4360","name":"Amchoplast fd per sq cm","description":"Amchoplast fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5127","name":"Inj, stimufend, 0.5 mg","description":"Injection, pegfilgrastim-fpgk (stimufend), biosimilar, 0.5 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4289","name":"Revoshield+ amnio, per sq cm","description":"Revoshield + amniotic barrier, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1370","name":"Inj, esomeprazole sod, 1 mg","description":"Injection, esomeprazole sodium, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"13153","name":"Cmplx rpr e/n/e/l addl 5cm/<","description":"Repair, complex, eyelids, nose, ears and/or lips; each additional 5 cm or less (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86036","name":"Anca screen each antibody","description":"Antineutrophil cytoplasmic antibody (anca); screen, each antibody","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2373","name":"Inj, immphentiv, 20 mcg","description":"Injection, phenylephrine hydrochloride (immphentiv), 20 micrograms","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97810","name":"Acup 1/> wo estim 1st 15 min","description":"Acupuncture, 1 or more needles; without electrical stimulation, initial 15 minutes of personal one-on-one contact with the patient","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":30.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0851T","name":"Dgtz gls mcrscp mphmtrc 1st","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6094","name":"Abut support crown titanium","description":"Abutment supported crown - (titanium)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7956","name":"Tiss regen edent resorb","description":"Tiss regen edent resorb","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0829T","name":"Dgtz gls mcrscp cytp conctrj","description":"Digitization of glass microscope slides for cytopathology, concentration technique, smears, and interpretation (eg, saccomanno technique) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0977T","name":"Upr gi bld detcj snr capsule","description":"Upper gastrointestinal blood detection, sensor capsule, with interpretation and report","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3387","name":"Inj elivaldogene autotemecel","description":"Injection, elivaldogene autotemcel, per treatment","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0735T","name":"Prep tum cav iort prim crnot","description":"Preparation of tumor cavity, with placement of a radiation therapy applicator for intraoperative radiation therapy (iort) concurrent with primary craniotomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2008","name":"Theragenesis, per sq cm","description":"Theragenesis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0440U","name":"Crd chd dna alys 10 snp 6dna","description":"Crd chd dna alys 10 snp 6dna","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6091","name":"Repl semi/precision attach","description":"Replacement of semi-precision or precision attachment (male or female component) of implant/abutment supported prosthesis per attachment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0235","name":"Inj, monoclon antibody, 1 mg","description":"Injection, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extraco","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1022T","name":"Prq tis dsplmt ntra-abdl/pel","description":"Percutaneous tissue displacement, any method, including imaging guidance; intra-abdominal/pelvic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2247","name":"Inj, micafungin (par pharm)","description":"Injection, micafungin sodium (par pharm) not thereapeutically equivalent to j2248, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81524","name":"Onc cns tum dna mthyl 10,000","description":"Oncology (central nervous system tumor), dna methylation analysis of at least 10,000 methylation sites, utilizing dna extracted from formalin-fixed tumor tissue, algorithm(s) reported as probability of matching a reference tumor family and class, and mgmt (o-6-methylguanine-dna methyltransferase) pr","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92014","name":"Compre oph exam est pt 1/>","description":"Ophthalmological services: medical examination and evaluation, with initiation or continuation of diagnostic and treatment program; comprehensive, established patient, 1 or more visits","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0256U","name":"Tma/tmao prfl ms/ms ur alg","description":"Trimethylamine/trimethylamine n-oxide (tma/tmao) profile, tandem mass spectrometry (ms/ms), urine, with algorithmic analysis and interpretive report","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25545","name":"Optx ulnar shft fx int fixj","description":"Open treatment of ulnar shaft fracture, includes internal fixation, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":825.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31365","name":"Removal of larynx","description":"Laryngectomy; total, with radical neck dissection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2082.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93598","name":"Car outp meas drg cath chd","description":"Cardiac output measurement(s), thermodilution or other indicator dilution method, performed during cardiac catheterization for the evaluation of congenital heart defects (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1204","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37257","name":"Revsc evsc ivt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0568","name":"Int psych care mng, 1 cal mo","description":"Initial psychiatric collaborative care management, in the first calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required elements: outrea","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31561","name":"Larynscop remve cart + scop","description":"Laryngoscopy, direct, operative, with arytenoidectomy; with operating microscope or telescope","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":434.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J2370","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1020T","name":"Raman spectroscopy 1+skn les","description":"Raman spectroscopy of 1 or more skin lesions, with probability score for malignant risk derived by algorithmic analysis of data from each lesion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1193","name":"Rpts w/ imp/con mmr/msi","description":"Surgical pathology reports that contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76830","name":"Transvaginal us non-ob","description":"Ultrasound, transvaginal","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4224","name":"Hhf10-p per sq cm","description":"Human health factor 10 amniotic patch (hhf10-p), per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2003","name":"Inj, lidocaine hcl, 1 mg","description":"Injection, lidocaine hydrochloride, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0686T","name":"Histotripsy mal hepatcel tis","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant hepatocellular tissue, including image guidance","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35663","name":"Bpg ilioiliac","description":"Bypass graft, with other than vein; ilioiliac","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1567.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1503","name":"Vascular surgery mvp","description":"Vascular surgery mips value pathway","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9563","name":"Ht inj immuno diem","description":"Home injectable therapy, immunotherapy, 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":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38760","name":"Remove groin lymph nodes","description":"Inguinofemoral lymphadenectomy, superficial, including cloquets node (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":926.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0981T","name":"Tcat impl wrls ivc snr","description":"Transcatheter implantation of wireless inferior vena cava sensor for long-term hemodynamic monitoring, including deployment of the sensor, radiological supervision and interpretation, right heart catheterization, and inferior vena cava venography, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61715","name":"Mrgfus strtctc ablt trgt icr","description":"Magnetic resonance image guided high intensity focused ultrasound (mrgfus), stereotactic ablation of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2998","name":"Inj plasminogen tvmh 1mg","description":"Injection, plasminogen, human-tvmh, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87521","name":"Hepatitis c probe&rvrs trnsc","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis c, amplified probe technique, includes reverse transcription when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0629U","name":"Nfct ds tb dna aly 1trgt pcr","description":"Nfct ds tb dna aly 1trgt pcr","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0562","name":"Complex simulation w/pet-ct","description":"Therapeutic radiology simulation-aided field setting; complex, including acquisition of pet and ct imaging data required for radiopharmaceutical-directed radiation therapy treatment planning (i.e., modeling)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99217","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0580U","name":"Bbrgdrferi antb detc 24rprtn","description":"Bbrgdrferi antb detc 24rprtn","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0940T","name":"Xtrnl ecg rec>15d<30d r&i","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0801T","name":"Tcat rmv&rpl 2chmbr ldls pm","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; dual-cha","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98976","name":"Rtm dev sply resp sys 16-30d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of respiratory system, 16-30 days in a 30-day period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1252","name":"Pts no cmplt hu survey","description":"Patients who did not complete at least one of the four patient experience hu survey items and return the hu survey within 60 days of the ambulatory palliative care visit","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1782","name":"Vac admin human pap dose 2","description":"Vac admin human pap dose 2","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0668","name":"Team remote e/m est pt 40 mn","description":"Team remote e/m est. pt 40mins","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6253","name":"Provisional pontic","description":"Provisional pontic","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0430U","name":"Gi malabs aat calpro pncrtc","description":"Gi malabs aat calpro pncrtc","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5143","name":"Inj adalimumab-adbm, 1 mg","description":"Injection, adalimumab-adbm, biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2642","name":"Dental onlay porcelin 2 surf","description":"Onlay - porcelain/ceramic - two surfaces","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1552","name":"Inj, alyglo, 500 mg","description":"Injection, immune globulin (alyglo), 500 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28635","name":"Treat toe dislocation","description":"Closed treatment of metatarsophalangeal joint dislocation; requiring anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5422","name":"Dentures adjust part mandbl","description":"Adjust partial denture - mandibular","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84830","name":"Ovulation tests","description":"Ovulation tests, by visual color comparison methods for human luteinizing hormone","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96547","name":"Intraop hipec px 1st 60 min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; first 60 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86363","name":"Mog-igg1 antb flo cytmtry ea","description":"Myelin oligodendrocyte glycoprotein (mog-igg1) antibody; flow cytometry (ie, fluorescence-activated cell sorting [facs]), each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0687T","name":"Tx amblyopia dev setup 1st","description":"Treatment of amblyopia using an online digital program; device supply, educational set-up, and initial session","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0891","name":"Argatroban nonesrd (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8610","name":"Methotrexate oral 2.5 mg","description":"Methotrexate; oral, 2.5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5135","name":"Inj, tyenne, 1 mg","description":"Injection, tocilizumab-aazg (tyenne), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0718T","name":"Adrc ther prtl rc tear njx","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; injection into supraspinatus tendon including ultrasound guidance, unilateral","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76641","name":"Ultrasound breast complete","description":"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0520","name":"New pt-cg dyad dem mod cmplx","description":"Management of new patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0953T","name":"Tot impl amei rev/rplc w/o","description":"Totally implantable active middle ear hearing implant; revision or replacement, without mastoidectomy and replacement of sound processor","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0848T","name":"Dgtz gls mcrscp ish 1st","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4313","name":"Dermabind fm, per sq cm","description":"Dermabind fm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0950T","name":"Abltj b9 prst8 tissue hifu","description":"Ablation of benign prostate tissue, transrectal, with high intensity-focused ultrasound (hifu), including ultrasound guidance","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0863T","name":"Rlcj pg wcs lv trnsmtr only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; transmitter component only","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1356","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1110","name":"Inj dihydroergotamine mesylt","description":"Injection, dihydroergotamine mesylate, per 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1177","name":"Pt recd pcv on/aft 19","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65114","name":"Remove eye/revise socket","description":"Exenteration of orbit (does not include skin graft), removal of orbital contents; with muscle or myocutaneous flap","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1555.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9225","name":"Vantas implant","description":"Histrelin implant (vantas), 50 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2524.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0938T","name":"Xtrnl ecg rec>15d<30d rec","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; recording (including connection and initial recording)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0426","name":"Inpt/ed teleconsult50","description":"Telehealth consultation, emergency department or initial inpatient, typically 50 minutes communicating with the patient via telehealth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9051","name":"Inj, bortezomib (maia)","description":"Injection, bortezomib (maia), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0556","name":"Adv prim care mgmt lvl 1","description":"Advanced primary care management services for a patient with one chronic condition [expected to last at least 12 months, or until the death of the patient, which place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline], or fewer, provided by clinical ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49621","name":"Rpr parastomal hernia rdc","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; reducible","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1353","name":"Sealant repair per tooth","description":"Sealant repair per tooth","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86376","name":"Microsomal antibody each","description":"Microsomal antibodies (eg, thyroid or liver-kidney), each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64659","name":"Rmvl bat modulj sys pg only","description":"Removal of baroreflex activation therapy (bat) modulation system; pulse generator only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33897","name":"Perq trluml angp nt/recr coa","description":"Percutaneous transluminal angioplasty of native or recurrent coarctation of the aorta","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64742","name":"Incision of facial nerve","description":"Transection or avulsion of; facial nerve, differential or complete","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":524.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6603","name":"Cst hgh nble mtl inlay >=3sr","description":"Inlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9936","name":"Clean occ guard","description":"Clean occ guard","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0530U","name":"Onc pan-sol tum ctdna 77 gen","description":"Onc pan-sol tum ctdna 77 gen","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5938","name":"Resct proth max comp remov","description":"Resct proth max comp remov","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0038","name":"Clin pt no ref","description":"Clinician determines patient does not require referral","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5155","name":"Inj, aflibercept-jbvf, 1 mg","description":"Injection, aflibercept-jbvf (yesafili), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1500","name":"Neuropsychology mvp","description":"Neuropsychology mips value pathway","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0976T","name":"Slctv nzmtc dbrdmt s/n/hf ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; each additional 100 sq cm (list separately in addition to code for p","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81001","name":"Urinalysis auto w/scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; automated, with microscopy","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0666","name":"Inj, bupivacaine liposome","description":"Injection, bupivacaine liposome, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1435","name":"Oral chemo in perf pd","description":"Patient on oral chemotherapy during the performance period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0706","name":"Intraoral occlus radio image","description":"Intraoral occlus radio image","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0479U","name":"Tau phosphorylated ptau217","description":"Tau phosphorylated ptau217","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72100","name":"X-ray exam l-s spine 2/3 vws","description":"Radiologic examination, spine, lumbosacral; 2 or 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9128","name":"Photobio therpy-first 15 min","description":"Photobio therpy-first 15 min","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1921","name":"Inj labetalol hcl hikma, 5mg","description":"Injection, labetalol hydrochloride (hikma), not therapeutically equivalent to j1920, 5 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92632","name":"Hearing aid slctn svc ea add","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6037","name":"Postop dsg cast chg handfing","description":"Immediate post-surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, partial hand including fingers","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1435","name":"Oral chemo in perf pd","description":"Patient on oral chemotherapy during the performance period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0849T","name":"Dgtz gls mcrscp ish ea adl 1","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9381","name":"Inj teplizumab mzwv 5 mcg","description":"Injection, teplizumab-mzwv, 5 mcg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1233","name":"Pt no hcv aby or result","description":"Patient does not receive hcv antibody test or patient does receive hcv antibody test but results not documented, reason not given","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1175","name":"Doc med rsn no hzv","description":"Documentation of medical reason(s) for not administering zoster vaccine (e.g., prior anaphylaxis due to the zoster vaccine)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92508","name":"Tx sp lang voice comm group","description":"Treatment of speech, language, voice, communication, and/or auditory processing disorder; group, 2 or more individuals","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1262","name":"Pts transplt bef dialysis","description":"Patients who had a transplant prior to initiation of dialysis","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0791T","name":"Motr cog vr gait train ea 15","description":"Motor-cognitive, semi-immersive virtual reality-facilitated gait training, each 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76818","name":"Fetal biophys profile w/nst","description":"Fetal biophysical profile; with non-stress testing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1284","name":"Pt 66+ snp or ltc pos > 90d","description":"Patients age 66 or older in institutional special needs plans (snp) or residing in long term care with pos code 32, 33, 34, 54, or 56 for more than 90 consecutive days during the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9129","name":"Photobio therpy-sub 15 mins","description":"Photobio therpy-sub 15 mins","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1485","name":"Neg viro resp hep c/qual rna","description":"Patients who did not achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7521","name":"Incision/drain abscess extra","description":"Incision and drainage of abscess - extraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93584","name":"Vngrph chd anom/persist svc","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; anomalous or persistent superior vena cava when it exists as a second contralateral superior vena cava, with native drainage to heart (list separately in addition to code for pri","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87496","name":"Cytomeg dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); cytomegalovirus, amplified probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4543","name":"Supply trans elec nerve stim","description":"Supplies for transcutaneous electrical nerve stimulator, for nerves in the auricular region, per month","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1249","name":"Pt resp true imprt to me","description":"Patient responded completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0729T","name":"Dx alys vstblr implt uni sbq","description":"Diagnostic analysis of vestibular implant, unilateral; with subsequent programming","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1213","name":"No hx spiro prs spiro>=70%","description":"No history of spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) and present spirometry is >= 70%","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1451","name":"Pt dx ppd dur id/pf pd","description":"Patients with an active diagnosis of pervasive developmental disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29836","name":"Elbow arthroscopy/surgery","description":"Arthroscopy, elbow, surgical; synovectomy, complete","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1484","name":"No rpt hcv rna perf med rsn","description":"Patients who did not have a repeat hcv rna labs performed for medical reasons documented by clinician (e.g., patient with limited life expectancy, delay in treatment of hcv related to treatment of hiv, hbv, hepatocellular carcinoma, decompensated cirrhosis)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23473","name":"Revis reconst shoulder joint","description":"Revision of total shoulder arthroplasty, including allograft when performed; humeral or glenoid component","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1993.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S4024","name":"Air polymer foam per study","description":"Air polymer-type a intrauterine foam, per study dose","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1028","name":"Take home supply 8mg per 0.1","description":"Take-home supply of nasal naloxone; 2-pack of 8mg per 0.1 ml nasal spray (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1098","name":"Articaine ophthalmi 8% 0.4ml","description":"Articaine ophthalmic, 8% solution, 0.4 ml","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33882","name":"Evasc rpr ta dplmt mltpc sys","description":"Endovascular repair of the thoracic aorta by deployment of a branched endograft multipiece system involving an aorto-aortic tube device with a fenestration for the left subclavian artery stent graft(s) and all aortic tube endograft extension(s) placed from the level of the left common carotid artery","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97533","name":"Sensory integration","description":"Sensory integrative techniques to enhance sensory processing and promote adaptive responses to environmental demands, direct (one-on-one) patient contact, each 15 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0414","name":"Lab process microbial spec","description":"Lab process microbial spec","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0923T","name":"Rmvl&rplcmt perm ccm-d pg","description":"Removal and replacement of permanent cardiac contractility modulation-defibrillation pulse generator only","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0032","name":"2+ antipsy schiz","description":"Two or more antipsychotic prescriptions ordered for patients who had a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder on or between january 1 of the year prior to the measurement period and the index prescription start date (ipsd) for antipsychotics","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75554","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":686.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67515","name":"Inject/treat eye socket","description":"Injection of medication or other substance into tenons capsule","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7174","name":"Injection fitusiran 0.04 mg","description":"Injection, fitusiran, 0.04 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2644","name":"Dental onlay porc 4/more sur","description":"Onlay - porcelain/ceramic - four or more surfaces","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0909T","name":"Rplcmt int nstim sys vgs nrv","description":"Replacement of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1255","name":"Pts w/ othr rsn vst,+prg tst","description":"Patients who have another reason for visiting the clinic [not prenatal or postpartum care] and have a positive pregnancy test but have not established the clinic as an ob provider (e.g., plan to terminate the pregnancy or seek prenatal services elsewhere)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1449","name":"Pt dx scz/pys bef end msr pd","description":"Patients with an active diagnosis of schizophrenia or psychotic disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2002","name":"Inj, lidocaine in d5w, 1 mg","description":"Injection, lidocaine hcl in 5% dextrose, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0664","name":"Team remote e/m new pt 60 mn","description":"Team remote e/m new pt 60mins","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88112","name":"Cytopath cell enhance tech","description":"Cytopathology, selective cellular enhancement technique with interpretation (eg, liquid based slide preparation method), except cervical or vaginal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0799","name":"Hiv prep, fda approved, noc","description":"Fda approved prescription drug, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv), not otherwise classified","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0613U","name":"Onc uc dna mthyltn&mut 6bmrk","description":"Onc uc dna mthyltn&mut 6bmrk","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4291","name":"Lamellas xt, per sq cm","description":"Lamellas xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1005T","name":"Elec alys s-scl eeg prgr 1st","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, first 15 minutes face-to-face time with physician or other qualified hea","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0805T","name":"Tcat s&ivc prstc vl impl prq","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); percutaneous femoral vein approach","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7023","name":"Mech allergen parti barrier","description":"Mechanical allergen particle barrier/inhalation filter, cream, nasal, topical","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0675","name":"Inj, carboprost, 0.1 mg","description":"Injection, carboprost tromethamine, 0.1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5143","name":"Inj adalimumab-adbm, 1 mg","description":"Injection, adalimumab-adbm, biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7300","name":"Rem anchorage dev w/o flap","description":"Rem anchorage dev w/o flap","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1308","name":"Inj, famotidine, 0.25 mg","description":"Injection, famotidine, 0.25 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5135","name":"Inj, tyenne, 1 mg","description":"Injection, tocilizumab-aazg (tyenne), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0607U","name":"Reprdtve med ema rtpcr 31bct","description":"Reprdtve med ema rtpcr 31bct","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93593","name":"R hrt cath chd nml nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; normal native connections","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0810T","name":"Subrta njx rx agt w/vtrc","description":"Subretinal injection of a pharmacologic agent, including vitrectomy and 1 or more retinotomies","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1227","name":"Eb therapy prescribed","description":"Evidence-based therapy was prescribed","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62223","name":"Establish brain cavity shunt","description":"Creation of shunt; ventriculo-peritoneal, -pleural, other terminus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1115.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4387","name":"Neothelium ft per sq cm","description":"Neothelium ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44405","name":"Colonoscopy w/dilation","description":"Colonoscopy through stoma; with transendoscopic balloon dilation","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":717.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":182.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96920","name":"Excimer lsr psriasis<250sqcm","description":"Excimer laser treatment for psoriasis; total area less than 250 sq cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78206","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76512","name":"Oph us dx b-scan","description":"Ophthalmic ultrasound, diagnostic; b-scan (with or without superimposed non-quantitative a-scan)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0681","name":"Inj ceftobipole medocarl 3mg","description":"Injection, ceftobiprole medocaril sodium, 3 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1025T","name":"Alt elec fld dos&dlv sim mdl","description":"Alternating electric fields dosimetry and delivery-simulation modeling, creation and selection of patient-specific array layouts, and placement verification","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6515","name":"Grad com wrap w str fu le cu","description":"Gradient compression wrap with adjustable straps, full leg, each, custom","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0140","name":"Nav srv peer sup 60 min pr m","description":"Principal illness navigation - peer support by certified or trained auxiliary personnel under the direction of a physician or other practitioner, including a certified peer specialist; 60 minutes per calendar month, in the following activities:  person-centered interview, performed to better underst","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7509","name":"Marsupialization odon cyst","description":"Marsupialization odon cyst","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0519","name":"New pt-cg dyad dem low cmplx","description":"Management of new patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64714","name":"Revise low back nerve(s)","description":"Neuroplasty, major peripheral nerve, arm or leg, open; lumbar plexus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2016","name":"Permeaderm b, per sq cm","description":"Permeaderm b, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86596","name":"Voltage-gtd ca chnl antb ea","description":"Voltage-gated calcium channel antibody, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4259","name":"Celera per sq cm","description":"Celera dual layer or celera dual membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93319","name":"3d echo img cgen car anomal","description":"3d echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac structure(s) (eg, cardiac chambers and valves, left atrial appendage, interatrial septum, interventricular","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0821T","name":"Mntr psychdlc med 2ndphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; second physician or other qualified health care professional, concurrent with first physician or other qualified health care professional, each hour (list sepa","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96116","name":"Nubhvl xm phys/qhp 1st hr","description":"Neurobehavioral status exam (clinical assessment of thinking, reasoning and judgment, [eg, acquired knowledge, attention, language, memory, planning and problem solving, and visual spatial abilities]), by physician or other qualified health care professional, both face-to-face time with the patient ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":76.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5135","name":"Inj, tyenne, 1 mg","description":"Injection, tocilizumab-aazg (tyenne), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0693T","name":"Compre ful bdy 3d mtn alys","description":"Comprehensive full body computer-based markerless 3d kinematic and kinetic motion analysis and report","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69637","name":"Rebuild eardrum structures","description":"Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic membrane repair); with ossicular chain reconstruction and synthetic prosthesis (eg, partial ossicular replacement prosthesis [porp], total ossicular replacement prosthesis [torp])","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1611.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87627","name":"Jt spc pthgn&rx rsist gen26+","description":"Infectious agent detection by nucleic acid (dna or rna); joint space pathogens and drug resistance genes, multiplex amplified probe technique, 26 or more targets","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1015T","name":"Rev/rmv lw esoph sphnc npg/r","description":"Revision or removal, lower esophageal sphincter neurostimulator pulse generator or receiver","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0913T","name":"Prq tcat ther rx ntrac balo1","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting), including mechanical dilation by nondrug-delivery balloon angioplasty, endoluminal imaging using intravascular ultrasound (ivus) or optical coherence tomography (oct) when per","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2989","name":"Excavate tooth non-restorabl","description":"Excavate tooth non-restorabl","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4286","name":"Nudyn sl or slw, per sq cm","description":"Nudyn sl or nudyn slw, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0518U","name":"Ther rx mntr 90+ pn&mtl hlth","description":"Ther rx mntr 90+ pn&mtl hlth","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4388","name":"Neothelium 4l per sq cm","description":"Neothelium 4l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64659","name":"Rmvl bat modulj sys pg only","description":"Removal of baroreflex activation therapy (bat) modulation system; pulse generator only","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95812","name":"Eeg 41-60 minutes","description":"Electroencephalogram (eeg) extended monitoring; 41-60 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35331","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; abdominal aorta","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1841.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4288","name":"Replacement breastpump valve","description":"Valve for breast pump, replacement","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2791","name":"Crown full cast base metal","description":"Crown-full cast predominantly base metal","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1006T","name":"Elec alys s-scl eeg prgrm ea","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, each additional 15 minutes face-to-face time with physician or other qua","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59015","name":"Chorion biopsy","description":"Chorionic villus sampling, any method","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97804","name":"Medical nutrition group","description":"Medical nutrition therapy; group (2 or more individual(s)), each 30 minutes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":18.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1748","name":"Inj, zymfentra, 10 mg","description":"Injection, infliximab-dyyb (zymfentra), 10 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96160","name":"Pt-focused hlth risk assmt","description":"Administration of patient-focused health risk assessment instrument (eg, health hazard appraisal) with scoring and documentation, per standardized instrument","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28208","name":"Repair of foot tendon","description":"Repair, tendon, extensor, foot; primary or secondary, each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0828T","name":"Dgtz gls mcrscp cytp smpl fl","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; simple filter method with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1248","name":"Pt resp true seen as person","description":"Patient responded completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0828T","name":"Dgtz gls mcrscp cytp smpl fl","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; simple filter method with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41805","name":"Removal foreign body gum","description":"Removal of embedded foreign body from dentoalveolar structures; soft tissues","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6597","name":"G comp bandage long stretch","description":"Gradient compression bandage roll, elastic long stretch, linear yard, any width, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0397","name":"Alcohol/subs interv >30 min","description":"Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and intervention, greater than 30 minutes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":60.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11044","name":"Dbrdmt bone 1st 20 sq cm/<","description":"Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed); first 20 sq cm or less","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85025","name":"Complete cbc w/auto diff wbc","description":"Blood count; complete (cbc), automated (hgb, hct, rbc, wbc and platelet count) and automated differential wbc count","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4356","name":"Abio mem abio hyd per sq cm","description":"Abiomend membrane and abiomend hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45110","name":"Removal of rectum","description":"Proctectomy; complete, combined abdominoperineal, with colostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1942.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9996","name":"Ustekinumab- ttwe sub cu inj","description":"Injection, ustekinumab-ttwe (pyzchiva), subcutaneous, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1262","name":"Pts transplt bef dialysis","description":"Patients who had a transplant prior to initiation of dialysis","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99305","name":"1st nf care moderate mdm 35","description":"Initial nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 35 minutes must be met or ex","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":158.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78201","name":"Liver imaging static only","description":"Liver imaging; static only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64902","name":"Nerve graft add-on","description":"Nerve graft, each additional nerve; multiple strands (cable) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":864.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88269","name":"Chromosome analys amniotic","description":"Chromosome analysis, in situ for amniotic fluid cells, count cells from 6-12 colonies, 1 karyotype, with banding","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88385","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86780","name":"Treponema pallidum","description":"Antibody; treponema pallidum","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0828T","name":"Dgtz gls mcrscp cytp smpl fl","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; simple filter method with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0973T","name":"Slctv nzmtc dbrdmt t/a/l 1st","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; first 100 sq cm","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55714","name":"Bx prst8 in-bore ct/mri 1","description":"Biopsy, prostate, in-bore ct- or mri-guided targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2033","name":"Myriad morcells, 4 mg","description":"Myriad morcells, 4 milligrams","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0311U","name":"Nfct ds bct quan antmcrb sc","description":"Nfct ds bct quan antmcrb sc","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87450","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J1480","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71040","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0046","name":"No mrs 90 days post stk","description":"Clinical follow-up and mrs score not assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0772T","name":"Vr px dissoc svc sm phy ea","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6113","name":"Imp/abut rem dent part mand","description":"Imp/abut rem dent part mand","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43220","name":"Esophagoscopy balloon <30mm","description":"Esophagoscopy, flexible, transoral; with transendoscopic balloon dilation (less than 30 mm diameter)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0521","name":"New pt-cg dyad dem hig cmplx","description":"Management of new patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89230","name":"Collect sweat for test","description":"Sweat collection by iontophoresis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0414","name":"Lab process microbial spec","description":"Lab process microbial spec","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1285","name":"Scrn mam perf rslts not doc","description":"Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed, reason not otherwise specified","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99396","name":"Prev visit est age 40-64","description":"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 40-64","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":91.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83529","name":"Asay of interleukin-6 (il-6)","description":"Interleukin-6 (il-6)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9939","name":"Placemnt removable appliance","description":"Placemnt removable appliance","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1098","name":"Articaine ophthalmi 8% 0.4ml","description":"Articaine ophthalmic, 8% solution, 0.4 ml","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33904","name":"Perq p-art revsc each addl","description":"Percutaneous pulmonary artery revascularization by stent placement, each additional vessel or separate lesion, normal or abnormal connections (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0588U","name":"Nfct ds bct/vir 32genes mrna","description":"Nfct ds bct/vir 32genes mrna","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21183","name":"Reconstruct cranial bone","description":"Reconstruction of orbital walls, rims, forehead, nasoethmoid complex following intra- and extracranial excision of benign tumor of cranial bone (eg, fibrous dysplasia), with multiple autografts (includes obtaining grafts); total area of bone grafting greater than 40 sq cm but less than 80 sq cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2716.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33280","name":"Rmvl phrnc nrv stim pg only","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator only","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0847T","name":"Dgtz gls mcrscp xm arch tiss","description":"Digitization of glass microscope slides for examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, kras mutational analysis) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86015","name":"Actin antibody each","description":"Actin (smooth muscle) antibody (asma), each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":12.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5811","name":"Denture interm cmplt mandbl","description":"Interim complete denture (mandibular)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76805","name":"Ob us >/= 14 wks sngl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88361","name":"Tumor immunohistochem/comput","description":"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; using computer-assisted technology","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4440","name":"Curamatrix per sq cm","description":"Curamatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"Basic vestibular evaluation","description":"Basic vestibular evaluation, includes spontaneous nystagmus test with eccentric gaze fixation nystagmus, with recording, positional nystagmus test, minimum of 4 positions, with recording, optokinetic nystagmus test, bidirectional foveal and peripheral stimulation, with recording, and oscillating tra","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93573","name":"Njx cath slct p-art angrp bi","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, bilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77437","name":"Surf radj ther supfc<=150kv","description":"Surface radiation therapy; superficial, delivery, </=150 kv, per fraction (eg, electronic brachytherapy)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9345","name":"Inj, retifanlimab-dlwr, 1 mg","description":"Injection, retifanlimab-dlwr, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0819T","name":"Revj/rmvl ins ptn subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15821","name":"Blepharp lwr eyelid fat pad","description":"Blepharoplasty, lower eyelid; with extensive herniated fat pad","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4262","name":"Dual layer impax, per sq cm","description":"Dual layer impax membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4329","name":"Singlay, per sq cm","description":"Singlay, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1374","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49186","name":"Opn exc/dstr ntra-abd 5 cm/<","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5 cm or less","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97002","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54240","name":"Penile plethysmography","description":"Penile plethysmography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1354","name":"Pt no suicd saf pln 120dy","description":"Patients who did not have a suicide safety plan initiated, reviewed, or updated or reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0548","name":"Phone/inter svs 21-30 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92568","name":"Acoustic refl threshold tst","description":"Acoustic reflex testing, threshold","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":13.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92629","name":"Eval hearing aid cand ea add","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0799","name":"Hiv prep, fda approved, noc","description":"Fda approved prescription drug, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv), not otherwise classified","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1445","name":"Pp care visit by 12 weeks","description":"Postpartum care visit before or at 12 weeks of giving birth","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0263U","name":"Neuro asd meas 16 c metblt","description":"Neurology (autism spectrum disorder [asd]), quantitative measurements of 16 central carbon metabolites (ie, a-ketoglutarate, alanine, lactate, phenylalanine, pyruvate, succinate, carnitine, citrate, fumarate, hypoxanthine, inosine, malate, s-sulfocysteine, taurine, urate, and xanthine), liquid chrom","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93150","name":"Therapy activation ipnss","description":"Therapy activation of implanted phrenic nerve stimulator system, including all interrogation and programming","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0424U","name":"Onc prst8 xom alys 53 sncrna","description":"Onc prst8 xom alys 53 sncrna","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27880","name":"Amputation of lower leg","description":"Amputation, leg, through tibia and fibula;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":934.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37266","name":"Rvsc evsc fpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21423","name":"Optx palatal/max fx comp","description":"Open treatment of palatal or maxillary fracture (lefort i type); complicated (comminuted or involving cranial nerve foramina), multiple approaches","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":948.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0618","name":"Inj, calcium chloride, 2 mg","description":"Injection, calcium chloride, 2 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90792","name":"Psych diag eval w/med srvcs","description":"Psychiatric diagnostic evaluation with medical services","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":173.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1347","name":"Pt pam incr 3 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 3 points in a 4 to 12 month period (passing)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98984","name":"Rtm dev sply resp sys 2-15 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of respiratory system, 2-15 days in a 30-day period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4389","name":"Neothelium 4l+ per sq cm","description":"Neothelium 4l+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20600","name":"Drain/inj joint/bursa w/o us","description":"Arthrocentesis, aspiration and/or injection, small joint or bursa (eg, fingers, toes); without ultrasound guidance","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":35.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5142","name":"Inj adalimumab-ryvk, 1 mg","description":"Injection, adalimumab-ryvk biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60502","name":"Re-explore parathyroids","description":"Parathyroidectomy or exploration of parathyroid(s); re-exploration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1434.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97813","name":"Acup 1/> w/estim 1st 15 min","description":"Acupuncture, 1 or more needles; with electrical stimulation, initial 15 minutes of personal one-on-one contact with the patient","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":37.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0906T","name":"Coms ther 1st appl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; first application, total wound(s) surface area less than or equal to 50 sq cm","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43611","name":"Excision of stomach lesion","description":"Excision, local; malignant tumor of stomach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1235.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0951T","name":"Tot impl amei 1st plmt","description":"Totally implantable active middle ear hearing implant; initial placement, including mastoidectomy, placement of and attachment to sound processor","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28309","name":"Incision of metatarsals","description":"Osteotomy, with or without lengthening, shortening or angular correction, metatarsal; multiple (eg, swanson type cavus foot procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4005","name":"Family medicine ss","description":"Family medicine mips specialty set","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86042","name":"Acetylcholn rcptr blckg antb","description":"Acetylcholine receptor (achr); blocking antibody","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4267","name":"Neostim dl per sq cm","description":"Neostim dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0461","name":"Testing for cracked tooth","description":"Testing for cracked tooth","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1171","name":"Pt recd 1 td/tdap 9yrs prior","description":"Patient received at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0349U","name":"Rx metab/pcx dna 27gen rx ia","description":"Rx metab/pcx dna 27gen rx ia","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15013","name":"Prepj skn cll ssp agrft 1st","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; first 25 sq cm or less of harvested skin","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4286","name":"Remove non-resorb barrier","description":"Remove non-resorb barrier","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7972","name":"Surg redct fibrous tuberosit","description":"Surgical reduction of fibrous tuberosity","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1276","name":"Calc bmi out nrm param nof/u","description":"Bmi documented outside normal parameters, no follow-up plan documented, no reason given","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69209","name":"Remove impacted ear wax uni","description":"Removal impacted cerumen using irrigation/lavage, unilateral","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3375","name":"Inj, vanco (tyzavan) 10mg","description":"Injection, vancomycin hydrochloride (tyzavan), not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77092","name":"Tbs i&r fx rsk qhp","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; interpretation and report on fracture-risk only by other qualified health care professional","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1574","name":"Inj, ganciclovir (exela)","description":"Injection, ganciclovir sodium (exela), not therapeutically equivalent to j1570, 500 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98984","name":"Rtm dev sply resp sys 2-15 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of respiratory system, 2-15 days in a 30-day period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7521","name":"Tacrolim granules oral susp","description":"Tacrolimus, granules, oral suspension, 0.1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96548","name":"Ntraop hipec px ea add 30min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6609","name":"G compression bandaging","description":"Gradient compression bandaging supply, not otherwise specified","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11621","name":"Exc s/n/h/f/g mal+mrg 0.6-1","description":"Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 0.6 to 1.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3387","name":"Inj elivaldogene autotemecel","description":"Injection, elivaldogene autotemcel, per treatment","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26553","name":"Single transfer toe-hand","description":"Transfer, toe-to-hand with microvascular anastomosis; other than great toe, single","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3106.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4332","name":"Axolotl dualgraft, per sq cm","description":"Axolotl dualgraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2018","name":"Permeaderm c, per sq cm","description":"Permeaderm c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1006T","name":"Elec alys s-scl eeg prgrm ea","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, each additional 15 minutes face-to-face time with physician or other qua","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0436U","name":"Onc lng plsm alys 388 prtn","description":"Onc lng plsm alys 388 prtn","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0440U","name":"Crd chd dna alys 10 snp 6dna","description":"Crd chd dna alys 10 snp 6dna","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1187","name":"Pt w/ esrd","description":"Patients with a diagnosis of end stage renal disease (esrd)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4285","name":"Nudyn dl or dl mesh pr sq cm","description":"Nudyn dl or nudyn dl mesh, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0713T","name":"N-nvs artl plaq alys rvw i&r","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data review, interpretation and report","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85007","name":"Bl smear w/diff wbc count","description":"Blood count; blood smear, microscopic examination with manual differential wbc count","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21181","name":"Rcnst cntrg b9 tum crnl xtrc","description":"Reconstruction by contouring of benign tumor of cranial bones (eg, fibrous dysplasia), extracranial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":844.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1215","name":"Med rsn for no doc spiro","description":"Documentation of medical reason(s) for not documenting and reviewing spirometry results (e.g., patients with dementia or tracheostomy)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0419U","name":"Nrpsyc gen seq vrnt aly 13","description":"Nrpsyc gen seq vrnt aly 13","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31243","name":"Nsl/sinus ndsc cryoabltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by cryoablation, posterior nasal nerve","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94626","name":"Phy/qhp op pulm rhb w/mntr","description":"Physician or other qualified health care professional services for outpatient pulmonary rehabilitation; with continuous oximetry monitoring (per session)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33213","name":"Insert pulse gen dual leads","description":"Insertion of pacemaker pulse generator only; with existing dual leads","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96547","name":"Intraop hipec px 1st 60 min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; first 60 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4211","name":"Gingivectomy/plasty per toot","description":"Gingivectomy or gingivoplasty - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0707","name":"Intraoral periap radio image","description":"Intraoral periap radio image","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0991T","name":"Cysto lo-nrg lithtrp&mcrsphr","description":"Cystourethroscopy, with low-energy lithotripsy and acoustically actuated microspheres, including imaging","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1374","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92553","name":"Audiometry air & bone","description":"Pure tone audiometry (threshold); air and bone","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0923T","name":"Rmvl&rplcmt perm ccm-d pg","description":"Removal and replacement of permanent cardiac contractility modulation-defibrillation pulse generator only","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96202","name":"Mlt fam grp bhv train 1st 60","description":"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face with multiple sets of paren","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54164","name":"Frenulotomy of penis","description":"Frenulotomy of penis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55709","name":"Bx prst8 tprnl us guided","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2175","name":"Meperidine hydrochl /100 mg","description":"Injection, meperidine hydrochloride, per 100 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7172","name":"Inj marstacim-hncq, 0.5 mg","description":"Injection, marstacimab-hncq, 0.5 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81005","name":"Urinalysis","description":"Urinalysis; qualitative or semiquantitative, except immunoassays","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1438","name":"Lst knwn well <=210 min","description":"Time last known well to hospital arrival less than or equal to 3.5 hours (<= 210 minutes)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0391","name":"Inj, artesunate, 1mg","description":"Injection, artesunate, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1821","name":"Ko elas w/ condyle pads otf","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, off the shelf","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2022","name":"Innovabrn/innovamatx xl sqcm","description":"Innovaburn or innovamatrix xl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27810","name":"Treatment of ankle fracture","description":"Closed treatment of bimalleolar ankle fracture (eg, lateral and medial malleoli, or lateral and posterior malleoli or medial and posterior malleoli); with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":506.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49188","name":"Opn exc/dst ntra-abd 10.1-20","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 10.1 to 20 cm","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64474","name":"Lwr xtr fscl pln blk uni nfs","description":"Lower extremity fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82627","name":"Dehydroepiandrosterone","description":"Dehydroepiandrosterone-sulfate (dhea-s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1610","name":"Glucagon hydrochloride/1 mg","description":"Injection, glucagon hydrochloride, per 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0851T","name":"Dgtz gls mcrscp mphmtrc 1st","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21196","name":"Reconst lwr jaw w/fixation","description":"Reconstruction of mandibular rami and/or body, sagittal split; with internal rigid fixation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1650.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33280","name":"Rmvl phrnc nrv stim pg only","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator only","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50948","name":"Laparo new ureter/bladder","description":"Laparoscopy, surgical; ureteroneocystostomy without cystoscopy and ureteral stent placement","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1433.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96203","name":"Mlt fam grp bhv train ea add","description":"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face with multiple sets of paren","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3263","name":"Inj, toripalimab-tpzi, 1 mg","description":"Injection, toripalimab-tpzi, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0776T","name":"Ther indctj ntrabrn hypthrm","description":"Therapeutic induction of intra-brain hypothermia, including placement of a mechanical temperature-controlled cooling device to the neck over carotids and head, including monitoring (eg, vital signs and sport concussion assessment tool 5 [scat5]), 30 minutes of treatment","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65280","name":"Repair of eye wound","description":"Repair of laceration; cornea and/or sclera, perforating, not involving uveal tissue","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93587","name":"Vngrph chd vnvn cltrl at/abv","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating at or above the heart (eg, from innominate vein) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1700","name":"Hydrocortisone acetate inj","description":"Injection, hydrocortisone acetate, up to 25 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0524","name":"Est pt-cg dyad dem low cmplx","description":"Management of established patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45349","name":"Sigmoidoscopy w/resection","description":"Sigmoidoscopy, flexible; with endoscopic mucosal resection","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93575","name":"Njx cath slct p angrph mapca","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary angiography of major aortopulmonary collateral arteries (mapcas) arising off the aorta or its systemic branches, during cardiac catheterization for congenital heart d","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67145","name":"Proph rta dtchmnt pc","description":"Prophylaxis of retinal detachment (eg, retinal break, lattice degeneration) without drainage; photocoagulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0727T","name":"Rmvl&rplcmt implt vstblr dev","description":"Removal and replacement of implanted vestibular device, unilateral","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0540U","name":"Trnsplj med quan dd-cfdna","description":"Trnsplj med quan dd-cfdna","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1338","name":"Pt f/u 30-180 dys no + imprv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who did not demonstrate positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0838T","name":"Dgtz gls mcrscp cslt sld els","description":"Digitization of glass microscope slides for consultation and report on referred slides prepared elsewhere (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0405U","name":"Onc pncrtc 59 mthltn blk mrk","description":"Onc pncrtc 59 mthltn blk mrk","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2003","name":"Inj, lidocaine hcl, 1 mg","description":"Injection, lidocaine hydrochloride, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4367","name":"Amniocore sl, per sq cm","description":"Amniocore sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0111","name":"Wet mounts/ w preparations","description":"Wet mounts, including preparations of vaginal, cervical or skin specimens","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81524","name":"Onc cns tum dna mthyl 10,000","description":"Oncology (central nervous system tumor), dna methylation analysis of at least 10,000 methylation sites, utilizing dna extracted from formalin-fixed tumor tissue, algorithm(s) reported as probability of matching a reference tumor family and class, and mgmt (o-6-methylguanine-dna methyltransferase) pr","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92521","name":"Evaluation of speech fluency","description":"Evaluation of speech fluency (eg, stuttering, cluttering)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3387","name":"Inj elivaldogene autotemecel","description":"Injection, elivaldogene autotemcel, per treatment","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0681","name":"Inj ceftobipole medocarl 3mg","description":"Injection, ceftobiprole medocaril sodium, 3 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0320U","name":"Neph rna psttrnspl perph bld","description":"Neph rna psttrnspl perph bld","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61892","name":"Rmv sk-mnt crnl nstm pg/rcvr","description":"Removal of skull-mounted cranial neurostimulator pulse generator or receiver with cranioplasty, when performed","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0549","name":"Phone/inter for treat>31m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0694T","name":"3d vol img&rcnstj brst/ax","description":"3-dimensional volumetric imaging and reconstruction of breast or axillary lymph node tissue, each excised specimen, 3-dimensional automatic specimen reorientation, interpretation and report, real-time intraoperative","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23655","name":"Cltx sho dslc w/mnpj w/anes","description":"Closed treatment of shoulder dislocation, with manipulation; requiring anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":427.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66991","name":"Xcapsl ctrc rmvl insj 1+","description":"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); with insertion of intraocular (eg, trabecular meshwork, supraciliary, suprachoroidal) anterior segment aqueous drai","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1214","name":"Spiro results wth obs doc","description":"Spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and reviewed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1400","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0299U","name":"Onc pan tum whl gen opt mapg","description":"Onc pan tum whl gen opt mapg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55868","name":"Lap srg prst8ct lymph nod bx","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with lymph node biopsy(ies) (limited pelvic lymphadenectomy)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2002","name":"Inj, lidocaine in d5w, 1 mg","description":"Injection, lidocaine hcl in 5% dextrose, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64582","name":"Opn mpltj hpglsl nstm ary pg","description":"Open implantation of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25115","name":"Remove wrist/forearm lesion","description":"Radical excision of bursa, synovia of wrist, or forearm tendon sheaths (eg, tenosynovitis, fungus, tbc, or other granulomas, rheumatoid arthritis); flexors","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1114.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4292","name":"Lamellas, per sq cm","description":"Lamellas, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73700","name":"Ct lower extremity w/o dye","description":"Computed tomography, lower extremity; without contrast material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50010","name":"Renal exploration","description":"Renal exploration, not necessitating other specific procedures","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":753.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88230","name":"Tissue culture lymphocyte","description":"Tissue culture for non-neoplastic disorders; lymphocyte","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4395","name":"Acelagraft per sq cm","description":"Acelagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1287","name":"Calc bmi blw low param f/u","description":"Bmi is documented below normal parameters and a follow-up plan is documented","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1200","name":"Diphenhydramine hcl injectio","description":"Injection, diphenhydramine hcl, up to 50 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0895T","name":"Connj lvr algrft prfu dev 1","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; initial 4 hours of monitoring time, including hourly physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78650","name":"Csf leakage imaging","description":"Cerebrospinal fluid leakage detection and localization","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70472","name":"Ct cere prfu alys c+w/ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed with concurrent ct or ct angiography of the same anatomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9319","name":"Inj romidepsin lyophil 0.1mg","description":"Injection, romidepsin, lyophilized, 0.1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0866T","name":"Quan mri alys brn w/dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion detection, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transmissio","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81191","name":"Ntrk1 translocation analysis","description":"Ntrk1 (neurotrophic receptor tyrosine kinase 1) (eg, solid tumors) translocation analysis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90612","name":"Inf&sarscov2 vacc 31.7/.32im","description":"Influenza virus vaccine, trivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 31.7 mcg/0.32 ml dosage, for intramuscular use","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87220","name":"Tissue exam for fungi","description":"Tissue examination by koh slide of samples from skin, hair, or nails for fungi or ectoparasite ova or mites (eg, scabies)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0878","name":"Daptomycin injection","description":"Injection, daptomycin, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0739T","name":"Abltj mal prst8 mag fld ndct","description":"Ablation of malignant prostate tissue by magnetic field induction, including all intraprocedural, transperineal needle/catheter placement for nanoparticle installation and intraprocedural temperature monitoring, thermal dosimetry, bladder irrigation, and magnetic field nanoparticle activation","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0848T","name":"Dgtz gls mcrscp ish 1st","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2777","name":"Inj, faricimab-svoa, 0.1mg","description":"Injection, faricimab-svoa, 0.1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85013","name":"Spun microhematocrit","description":"Blood count; spun microhematocrit","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91323","name":"Sarscov2 vac 10 mcg/0.2ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 10 mcg/0.2 ml dosage, for intramuscular use","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37256","name":"Revsc evasc ivt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5938","name":"Resct proth max comp remov","description":"Resct proth max comp remov","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1298","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0504U","name":"Nfct ds uti id 17 path orgs","description":"Nfct ds uti id 17 path orgs","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4031","name":"Radiation oncology ss","description":"Radiation oncology mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84490","name":"Assay of feces for trypsin","description":"Trypsin; feces, quantitative, 24-hour collection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87182","name":"Sc std carbapenemase nzm det","description":"Susceptibility studies, antimicrobial agent; carbapenemase enzyme detection (eg, klebsiella pneumoniae carbapenemase [kpc], new delhi metallo-beta-lactamase [ndm], verona integron-encoded metallo-beta-lactamase [vim]), multiplex immunoassay, qualitative, per isolate","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81523","name":"Onc brst mrna 70 cnt 31 gene","description":"Oncology (breast), mrna, next-generation sequencing gene expression profiling of 70 content genes and 31 housekeeping genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as index related to risk to distant metastasis","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9255","name":"Inj, methotrexate (accord)","description":"Injection, methotrexate (accord), not therapeutically equivalent to j9260, 50 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0256U","name":"Tma/tmao prfl ms/ms ur alg","description":"Trimethylamine/trimethylamine n-oxide (tma/tmao) profile, tandem mass spectrometry (ms/ms), urine, with algorithmic analysis and interpretive report","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4015","name":"Neurology ss","description":"Neurology mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24151","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1351.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33904","name":"Perq p-art revsc each addl","description":"Percutaneous pulmonary artery revascularization by stent placement, each additional vessel or separate lesion, normal or abnormal connections (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1354","name":"Pt no suicd saf pln 120dy","description":"Patients who did not have a suicide safety plan initiated, reviewed, or updated or reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38573","name":"Laps pelvic lymphadec","description":"Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy and peri-aortic lymph node sampling, peritoneal washings, peritoneal biopsy(ies), omentectomy, and diaphragmatic washings, including diaphragmatic and other serosal biopsy(ies), when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1297.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22838","name":"Rev rplc/rmv thrc vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracic vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0823T","name":"Tcat ins 1chmbr ldls pm ra","description":"Transcatheter insertion of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or programming), when","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0366U","name":"Onc bldr 10 prb recr bldr ca","description":"Onc bldr 10 prb recr bldr ca","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2151","name":"Inj, mannitol, 250 mg","description":"Injection, mannitol, 250 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0816T","name":"Opn insj/rplcmt ins ptn subq","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9026","name":"Cryo fib comp path redu each","description":"Cryoprecipitated fibrinogen complex, pathogen reduced, each unit","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86352","name":"Cell function assay w/stim","description":"Cellular function assay involving stimulation (eg, mitogen or antigen) and detection of biomarker (eg, atp)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4295","name":"Amnio tri-core, per sq cm","description":"Amnio tri-core amniotic, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90968","name":"Esrd svc pr day pt 2-11","description":"End-stage renal disease (esrd) related services for dialysis less than a full month of service, per day; for patients 2-11 years of age","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":20.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9073","name":"Inj cyclophos dr reddys 5 mg","description":"Injection, cyclophosphamide (dr. reddys), 5 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11976","name":"Remove contraceptive capsule","description":"Removal, implantable contraceptive capsules","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":76.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0752","name":"Hiv prep, oral lenacapavir","description":"Oral, lenacapavir, 300 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0955T","name":"Tot impl amei removal","description":"Totally implantable active middle ear hearing implant; removal, including removal of sound processor and all implant components","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68841","name":"Insj rx elut implt lac canal","description":"Insertion of drug-eluting implant, including punctal dilation when performed, into lacrimal canaliculus, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59426","name":"Antepartum care only","description":"Antepartum care only; 7 or more visits","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":846.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":1237.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86735","name":"Mumps antibody","description":"Antibody; mumps","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4344","name":"Tri membrane wrap, per sq cm","description":"Tri-membrane wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59409","name":"Obstetrical care","description":"Vaginal delivery only (with or without episiotomy and/or forceps);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"RenderingTaxonomy","value":["207V00000X","207VB0002X","207VE0102X","207VF0040X","207VG0400X","207VM0101X","207VX0000X","207VX0201X","363LX0001X"]},{"name":"Company Code","value":["01","20","42"]},{"name":"ClaimSpecialtyCode","value":["904","905","907","AMGY","APNOB","COLP","FPEM","GYNE","GYON","GYSU","MAFE","NPAG","NPGY","NPOB","OBEM","OBGY","OBHR","OBST","REND","URGY"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1733.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15011","name":"Hrv skn cll ssp agrft 1st 25","description":"Harvest of skin for skin cell suspension autograft; first 25 sq cm or less","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0498U","name":"Onc clrct ngs mut detc 43gen","description":"Onc clrct ngs mut detc 43gen","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29550","name":"Strapping of toes","description":"Strapping; toes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":10.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82962","name":"Glucose blood test","description":"Glucose, blood by glucose monitoring device(s) cleared by the fda specifically for home use","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1161","name":"Pt anphx due to dtp bef 13","description":"Patient had anaphylaxis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55707","name":"Bx prst8 trct us guided","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4356","name":"Abio mem abio hyd per sq cm","description":"Abiomend membrane and abiomend hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22819","name":"Kyphectomy 3 or more","description":"Kyphectomy, circumferential exposure of spine and resection of vertebral segment(s) (including body and posterior elements); 3 or more segments","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2937.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0535","name":"Pt navigat svs direct/ref","description":"Patient navigational services, provided directly or by referral; including helping the patient to navigate health systems and identify care providers and supportive services, to build patient self-advocacy and communication skills with care providers, and to promote patient-driven action plans and g","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0391U","name":"Onc sld tum dna&rna 437 gen","description":"Onc sld tum dna&rna 437 gen","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86000","name":"Agglutinins febrile antigen","description":"Agglutinins, febrile (eg, brucella, francisella, murine typhus, q fever, rocky mountain spotted fever, scrub typhus), each antigen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1497","name":"No doc fall med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56441","name":"Lysis of labial adhesions","description":"Lysis of labial adhesions","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1384","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23616","name":"Optx prx hmrl fx fix rpr rpl","description":"Open treatment of proximal humeral (surgical or anatomical neck) fracture, includes internal fixation, when performed, includes repair of tuberosity(s), when performed; with proximal humeral prosthetic replacement","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1777.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0938T","name":"Xtrnl ecg rec>15d<30d rec","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; recording (including connection and initial recording)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21462","name":"Optx mndblr fx w/ntrdntl","description":"Open treatment of mandibular fracture; with interdental fixation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1087.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4019","name":"Oncology/hema ss","description":"Oncology/hematology mips specialty set","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"X-ray exam chest 2 views","description":"Radiologic examination, chest; 2 views","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44378","name":"Small bowel endoscopy","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, including ileum; with control of bleeding (eg, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76827","name":"Echo exam of fetal heart","description":"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1806","name":"Inj esmolol hcl wg crit care","description":"Injection, esmolol hydrochloride (wg critical care), not therapeutically equivalent to j1805, 10 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1478","name":"Psychoactive sub abuse","description":"Psychoactive substance abuse","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57320","name":"Repair bladder-vagina lesion","description":"Closure of vesicovaginal fistula; vaginal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3472","name":"Surg rep root res premolar","description":"Surg rep root res premolar","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0548U","name":"Gfap cleia plasma","description":"Gfap cleia plasma","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1302","name":"Scrn mam perf rslts doc","description":"Screening, diagnostic, film digital or digital breast tomosynthesis (3d) mammography results documented and reviewed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33992","name":"Rmvl perq left heart vad","description":"Removal of percutaneous left heart ventricular assist device, arterial or arterial and venous cannula(s), at separate and distinct session from insertion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0600U","name":"Nfct ds wnd infctj 65orgs&30","description":"Nfct ds wnd infctj 65orgs&30","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0747T","name":"Car ablt rad arrhyt dlvr rad","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; delivery of radiation therapy, arrhythmia","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64466","name":"Thrc fascial pln blk uni njx","description":"Thoracic fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6634","name":"Onlay titanium","description":"Onlay - titanium","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90818","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4423","name":"Biolab tri wrap fl per sq cm","description":"Biolab tri-membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2029","name":"Mirotract matrix sheet","description":"Mirotract wound matrix sheet, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0138","name":"Inj acetaminoph 10mg/ibu 3mg","description":"Injection, acetaminophen 10 mg and ibuprofen 3 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6091","name":"Repl semi/precision attach","description":"Replacement of semi-precision or precision attachment (male or female component) of implant/abutment supported prosthesis per attachment","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1337","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6564","name":"G com stckng waist 40+ cust","description":"Gradient compression stocking, waist length, 40 mmhg or greater, custom, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5934","name":"Mandibular flange prosthesis","description":"Mandibular resection prosthesis with guide flange","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90853","name":"Group psychotherapy","description":"Group psychotherapy (other than of a multiple-family group)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4023","name":"Pathology ss","description":"Pathology mips specialty set","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0321U","name":"Iadna gu pthgn 20bct&fng org","description":"Iadna gu pthgn 20bct&fng org","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0487U","name":"Onc sol tum cfcdna tgsap 84","description":"Onc sol tum cfcdna tgsap 84","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4342","name":"Theramend, per sq cm","description":"Theramend, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0183","name":"Software meas of cardiac vol","description":"Quantitative software measurements of cardiac volume, cardiac chambers volumes and left ventricular wall mass derived from ct scan(s) data of the chest/heart (with or without contrast)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36425","name":"Venipuncture cutdown 1 yr/>","description":"Venipuncture, cutdown; age 1 or over","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87428","name":"Sarscov & inf vir a&b ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; severe acute respiratory syndrome coronavirus (eg, sars-cov, s","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27650","name":"Repair achilles tendon","description":"Repair, primary, open or percutaneous, ruptured achilles tendon;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":855.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4436","name":"Renati ac membrane per sq cm","description":"Renati ac membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49188","name":"Opn exc/dst ntra-abd 10.1-20","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 10.1 to 20 cm","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0613U","name":"Onc uc dna mthyltn&mut 6bmrk","description":"Onc uc dna mthyltn&mut 6bmrk","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55710","name":"Bx prst8 tprn us w/mri fus 1","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant) with mri-fusion-guidance biopsy, first targeted lesion","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1367","name":"Qual care ent disorder mvp","description":"Quality care for the treatment of ear, nose, and throat disorders mips value pathway","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7294","name":"Seg acet and eth estr yearly","description":"Segesterone acetate and ethinyl estradiol 0.15mg, 0.013mg per 24 hours; yearly vaginal system, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0681T","name":"Rlcj pulse gen only isdss","description":"Relocation of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing dual leads","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1552","name":"Inj, alyglo, 500 mg","description":"Injection, immune globulin (alyglo), 500 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4006","name":"Gastroenterology ss","description":"Gastro-enterology mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1232","name":"Pt hcv tst reactive result","description":"Patient receives hcv antibody test with reactive result","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33212","name":"Insert pulse gen sngl lead","description":"Insertion of pacemaker pulse generator only; with existing single lead","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":413.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1444","name":"Del < 39 weeks gest","description":"Delivery at < 39 weeks of gestation","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1282","name":"Pt scrn tbco id as non user","description":"Patient screened for tobacco use and identified as a tobacco non-user","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0917T","name":"Insj perm ccm-d sys 1 lead","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; single transvenous lead (pacing or defibrillation) only","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0906T","name":"Coms ther 1st appl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; first application, total wound(s) surface area less than or equal to 50 sq cm","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0463U","name":"Onc crvx mrna genxprsn 14bmk","description":"Onc crvx mrna genxprsn 14bmk","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9993","name":"Pall serv during meas","description":"Patient was provided palliative care services any time during the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9956","name":"Admin home sleep apnea test","description":"Admin home sleep apnea test","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9052","name":"Inj, carmustine (accord)","description":"Injection, carmustine (accord), not therapeutically equivalent to j9050, 100 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21600","name":"Partial removal of rib","description":"Excision of rib, partial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":616.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90695","name":"H5n8 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n8, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1812","name":"Ko elastic w/joints pre ots","description":"Knee orthosis, elastic with joints, prefabricated, off-the-shelf","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54420","name":"Revision of penis","description":"Corpora cavernosa-saphenous vein shunt (priapism operation), unilateral or bilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":778.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4369","name":"Amnioplast 3 per sq cm","description":"Amnioplast 3, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0310U","name":"Ped vsclts kd alys 3 bmrks","description":"Ped vsclts kd alys 3 bmrks","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5995","name":"Peri medicament w/seal, max","description":"Peri medicament w/seal, max","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1411","name":"Inj, hemgenix, per tx dose","description":"Injection, etranacogene dezaparvovec-drlb, per therapeutic dose","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1405","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27286","name":"Arthrd hip jt sbtrchc osteot","description":"Arthrodesis, hip joint (including obtaining graft); with subtrochanteric osteotomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1907.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3394","name":"Inj, lovotibeglogene autotem","description":"Injection, lovotibeglogene autotemcel, per treatment","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9988","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0941T","name":"Cysto flx ins&xpns urtl scaf","description":"Cystourethroscopy, flexible; with insertion and expansion of prostatic urethral scaffold using integrated cystoscopic visualization","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0374","name":"Tomo periapical image","description":"Tomo periapical image","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0617U","name":"Cv ascvd dna alys >20000","description":"Cv ascvd dna alys >20000","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43889","name":"Gstr rstcv px trnsorl esg","description":"Gastric restrictive procedure, transoral, endoscopic sleeve gastroplasty (esg), including argon plasma coagulation, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1185","name":"Imm ckpt inhib not hld no rx","description":"Documentation of immune checkpoint inhibitor therapy not held and/or corticosteroids or immunosuppressants prescribed or administered was not performed, reason not given","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0519U","name":"Ther rx mntr meds p/d/a 110+","description":"Ther rx mntr meds p/d/a 110+","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1210","name":">=2 same meds tbl4 not ord","description":"At least two orders for high-risk medications from the same drug class, (table 4), not ordered","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2051","name":"Support broker waiver/diem","description":"Supports brokerage, self-directed, waiver; per diem","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86363","name":"Mog-igg1 antb flo cytmtry ea","description":"Myelin oligodendrocyte glycoprotein (mog-igg1) antibody; flow cytometry (ie, fluorescence-activated cell sorting [facs]), each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3425","name":"Hydroxocobalamin im 10mcg","description":"Injection, hydroxocobalamin, intramuscular, 10 mcg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1411","name":"Inj, hemgenix, per tx dose","description":"Injection, etranacogene dezaparvovec-drlb, per therapeutic dose","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1310","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2794","name":"Crown-titanium","description":"Crown-titanium","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0475U","name":"Hered prst8 ca gsap 23 genes","description":"Hered prst8 ca gsap 23 genes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0563U","name":"Nfct ds pthgn-sna 11vir&4bct","description":"Nfct ds pthgn-sna 11vir&4bct","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9027","name":"Rbc o2 co2 reduced","description":"Red blood cells, leukocytes reduced, oxygen/ carbon dioxide reduced, each unit","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76815","name":"Ob us limited fetus(s)","description":"Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1433","name":"Oral chemo wthn 30 days enc","description":"Patient on oral chemotherapy on or within 30 days before denominator eligible encounter","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6612","name":"Onlay cst base mtl 2 surface","description":"Onlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1319","name":"Pts csp doc contact","description":"Patients who had documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67516","name":"Sprchoroidal spc njx rx agt","description":"Suprachoroidal space injection of pharmacologic agent (separate procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0272U","name":"Hem genetic bld do 51 genes","description":"Hematology (genetic bleeding disorders), genomic sequence analysis of 51 genes, blood, buccal swab, or amniotic fluid, comprehensive","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64821","name":"Sympathectomy radial artery","description":"Sympathectomy; radial artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":357.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0398U","name":"Gi baret esph dna mthyln aly","description":"Gi baret esph dna mthyln aly","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63304","name":"Remove vert idrl body crvcl","description":"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, cervical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2474.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4392","name":"Grafix duo per sq cm","description":"Grafix duo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44300","name":"Open bowel to skin","description":"Placement, enterostomy or cecostomy, tube open (eg, for feeding or decompression) (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":854.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85009","name":"Manual diff wbc count b-coat","description":"Blood count; manual differential wbc count, buffy coat","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69505","name":"Remove mastoid structures","description":"Mastoidectomy; modified radical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0341U","name":"Ftl aneup dna seq cmpr alys","description":"Ftl aneup dna seq cmpr alys","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1232","name":"Pt hcv tst reactive result","description":"Patient receives hcv antibody test with reactive result","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93573","name":"Njx cath slct p-art angrp bi","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, bilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22548","name":"Arthrd ant toral/xoral c1-c2","description":"Arthrodesis, anterior transoral or extraoral technique, clivus-c1-c2 (atlas-axis), with or without excision of odontoid process","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2168.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0543U","name":"Onc sol tum ngs dna 517 gens","description":"Onc sol tum ngs dna 517 gens","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61501","name":"Craniectomy f/osteomyelitis","description":"Craniectomy; for osteomyelitis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1240.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81462","name":"So gsap cll fr dna/dna&rna","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants and rearrangements","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0842T","name":"Dgtz gls mcrscp pth cslt ea","description":"Digitization of glass microscope slides for pathology consultation during surgery; each additional tissue block with frozen section(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4421","name":"Biolab wrap solo per sq cm","description":"Biolab membrane wrap solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37262","name":"Iv lithotrp ivt w/in sm art","description":"Intravascular lithotripsy(ies), iliac vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25660","name":"Cltx rdcrpl/ntrcrpl dislc 1+","description":"Closed treatment of radiocarpal or intercarpal dislocation, 1 or more bones, with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4253","name":"Zenith amniotic membrane psc","description":"Zenith amniotic membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21320","name":"Clsd tx nsl fx w/mnpj&stablj","description":"Closed treatment of nasal bone fracture with manipulation; with stabilization","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81005","name":"Urinalysis","description":"Urinalysis; qualitative or semiquantitative, except immunoassays","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64629","name":"Trml dstrj ios bvn ea addl","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; each additional vertebral body, lumbar or sacral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6253","name":"Provisional pontic","description":"Provisional pontic","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93586","name":"Vngrph chd coronary sinus","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; coronary sinus (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7214","name":"Altuviiio per factor viii iu","description":"Injection, factor viii/von willebrand factor complex, recombinant (altuviiio), per factor viii i.u.","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66710","name":"Ciliary transsleral therapy","description":"Ciliary body destruction; cyclophotocoagulation, transscleral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":391.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0581U","name":"Trnspl med antb nohla 39trgt","description":"Trnspl med antb nohla 39trgt","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9178","name":"Inj, epirubicin hcl, 2 mg","description":"Injection, epirubicin hcl, 2 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98984","name":"Rtm dev sply resp sys 2-15 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of respiratory system, 2-15 days in a 30-day period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99283","name":"Emergency dept visit low mdm","description":"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and low level of medical decision making","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90460","name":"Im admin 1st/only component","description":"Immunization administration through 18 years of age via any route of administration, with counseling by physician or other qualified health care professional; first or only component of each vaccine or toxoid administered","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6192","name":"Semi precision attachment","description":"Semi precision attachment","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6198","name":"Remove interim implant","description":"Remove interim implant","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0767T","name":"Tc mag stimj pn ea addl nrv","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; each additional nerve (list separat","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1412","name":"Met nsclc w/ egfr alk oth ab","description":"Patients with metastatic nsclc with epidermal growth factor receptor (egfr) mutations, alk genomic tumor aberrations, or other targetable genomic abnormalities with approved first-line targeted therapy, such as nsclc with ros1 rearrangement, braf v600e mutation, ntrk 1/2/3 gene fusion, met ex14 skip","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0668","name":"Team remote e/m est pt 40 mn","description":"Team remote e/m est. pt 40mins","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97037","name":"Appl modality 1+lllt po pain","description":"Application of a modality to 1 or more areas; low-level laser therapy (ie, nonthermal and non-ablative) for post-operative pain reduction","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4357","name":"Xwrap plus, per sq cm","description":"Xwrap plus, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26372","name":"Repair/graft hand tendon","description":"Repair or advancement of profundus tendon, with intact superficialis tendon; secondary with free graft (includes obtaining graft), each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1238.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1834","name":"Inj, isoniazid, 1 mg","description":"Injection, isoniazid, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2036","name":"Cohealyx col dml mx pr sq cm","description":"Cohealyx collagen dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0983T","name":"Rem mntr impl ivc snr phys","description":"Remote monitoring of an implanted inferior vena cava sensor for up to 30 days, including at least weekly downloads of inferior vena cava area recordings, interpretation(s), trend analysis, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90816","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1299","name":"Inj, eculizumab, 2 mg","description":"Injection, eculizumab, 2 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9342","name":"Inj thiotepa nos 1 mg","description":"Injection, thiotepa, not otherwise specified, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61715","name":"Mrgfus strtctc ablt trgt icr","description":"Magnetic resonance image guided high intensity focused ultrasound (mrgfus), stereotactic ablation of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87154","name":"Cul typ id bld pthgn 6+ trgt","description":"Culture, typing; identification of blood pathogen and resistance typing, when performed, by nucleic acid (dna or rna) probe, multiplexed amplified probe technique including multiplex reverse transcription, when performed, per culture or isolate, 6 or more targets","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4028","name":"Podiatry ss","description":"Podiatry mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97551","name":"Caregiver traing ea addl 15","description":"Caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patie","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2508","name":"Pegunigalsidase alfa-iwxj","description":"Injection, pegunigalsidase alfa-iwxj, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49615","name":"Rpr aa hrn rcr 3-10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, reducible","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78191","name":"Platelet survival study","description":"Platelet survival study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":413.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4379","name":"Amniodefend ft per sq cm","description":"Amniodefend ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64466","name":"Thrc fascial pln blk uni njx","description":"Thoracic fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83528","name":"Assay of intrinsic factor","description":"Intrinsic factor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9183","name":"Gemcitabine intravesical sys","description":"Gemcitabine intravesical system, 225 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0208","name":"Inj, pedmark, 100 mg","description":"Injection, sodium thiosulfate (pedmark), 100 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93897","name":"Emboli detcj wo iv mbubb njx","description":"Emboli detection without intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0739","name":"Rehab sys active assist rt","description":"Rehabilitation system with interactive interface providing active assistance in rehabilitation therapy, includes all components and accessories, motors, microprocessors, sensors","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1227","name":"Eb therapy prescribed","description":"Evidence-based therapy was prescribed","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2542","name":"Dental onlay metallic 2 surf","description":"Onlay-metallic-two surfaces","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97551","name":"Caregiver traing ea addl 15","description":"Caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patie","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0825T","name":"Tcat rmv&rpl1chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or prog","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"Endoskel posit rotat unit","description":"Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12015","name":"Rpr f/e/e/n/l/m 7.6-12.5 cm","description":"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 7.6 cm to 12.5 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7414","name":"Excision malig lesion>1.25cm","description":"Excision of malignant lesion greater than 1.25 cm","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0563U","name":"Nfct ds pthgn-sna 11vir&4bct","description":"Nfct ds pthgn-sna 11vir&4bct","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38525","name":"Biopsy/removal lymph nodes","description":"Biopsy or excision of lymph node(s); open, deep axillary node(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0249","name":"Tocilizumab for covid-19","description":"Injection, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97037","name":"Appl modality 1+lllt po pain","description":"Application of a modality to 1 or more areas; low-level laser therapy (ie, nonthermal and non-ablative) for post-operative pain reduction","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0827T","name":"Dgtz gls mcrscp cytp smears","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; smears with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86904","name":"Blood typing patient serum","description":"Blood typing, serologic; antigen screening for compatible unit using patient serum, per unit screened","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75960","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":816.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9275","name":"Inj cosibelimab-ipdl, 2 mg","description":"Injection, cosibelimab-ipdl, 2 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61875","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1212.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9600","name":"Porfimer sodium injection","description":"Injection, porfimer sodium, 75 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2285.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15171","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4395","name":"Acelagraft per sq cm","description":"Acelagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1014T","name":"Lap rv/rmv eso sph nstm eltr","description":"Laparoscopic revision or removal, lower esophageal sphincter neurostimulator electrodes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7961","name":"Buccal/labial frenectomy","description":"Buccal/labial frenectomy","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1014T","name":"Lap rv/rmv eso sph nstm eltr","description":"Laparoscopic revision or removal, lower esophageal sphincter neurostimulator electrodes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4371","name":"Neoguard per sq cm","description":"Neoguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0363U","name":"Onc urthl mrna 5 gen alg","description":"Onc urthl mrna 5 gen alg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5940","name":"Resct proth max part remov","description":"Resct proth max part remov","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0169","name":"Inj epinephrine (adrenalin)","description":"Injection, epinephrine (adrenalin), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0688T","name":"Tx amblyopia assmt w/report","description":"Treatment of amblyopia using an online digital program; assessment of patient performance and program data by physician or other qualified health care professional, with report, per calendar month","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84403","name":"Assay of total testosterone","description":"Testosterone; total","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0001","name":"Advancing cancer care mvp","description":"Advancing cancer care mips value pathways","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0109","name":"Diab manage trn ind/group","description":"Diabetes outpatient self-management training services, group session (2 or more), per 30 minutes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82962","name":"Glucose blood test","description":"Glucose, blood by glucose monitoring device(s) cleared by the fda specifically for home use","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41252","name":"Repair tongue laceration","description":"Repair of laceration of tongue, floor of mouth, over 2.6 cm or complex","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1463","name":"2 f/u wthn 180 day rx atmp","description":"Documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99494","name":"1st/sbsq psyc collab care","description":"Initial or subsequent psychiatric collaborative care management, each additional 30 minutes in a calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional (list separa","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":70.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6519","name":"Grad com garm noc night use","description":"Gradient compression garment, not otherwise specified, for nighttime use, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0539","name":"Initial care training 30 m","description":"Caregiver training in behavior management/modification for caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face; initial 30 minutes","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0603U","name":"Rx asy prsmv 77rx/metablt ur","description":"Rx asy prsmv 77rx/metablt ur","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90958","name":"Esrd srv 2-3 vsts p mo 12-19","description":"End-stage renal disease (esrd) related services monthly, for patients 12-19 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 2-3 face-to-face visits by a physician or other qualified health care professional per m","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":579.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6180","name":"Implnt maint proced","description":"Implnt maint proced","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0839T","name":"Dgtz gls mcrscp cslt mat prp","description":"Digitization of glass microscope slides for consultation and report on referred material requiring preparation of slides (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2779","name":"Inj, susvimo 0.1 mg","description":"Injection, ranibizumab, via intravitreal implant (susvimo), 0.1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76016","name":"Mr safety deter phys/qhp","description":"Mr safety determination by a physician or other qualified health care professional responsible for the safety of the mr procedure, including review of implant mr conditions for indicated mr examination, analysis of risk vs clinical benefit of performing mr examination, and determination of mr equipm","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22837","name":"Ant thrc vrt body tethrg 8+","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; 8 or more vertebral segments","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87626","name":"Hpv sep hi-rsk typ&pool rslt","description":"Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), separately reported high-risk types (eg, 16, 18, 31, 45, 51, 52) and high-risk pooled result(s)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98003","name":"Synch audio-video new hi 60","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high medical decision making. when using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0369","name":"Max mri capture & interprete","description":"Max mri capture & interprete","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44403","name":"Colonoscopy w/resection","description":"Colonoscopy through stoma; with endoscopic mucosal resection","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0681","name":"Inj ceftobipole medocarl 3mg","description":"Injection, ceftobiprole medocaril sodium, 3 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0478U","name":"Onc nsclc dna&rna dpcr 9 gen","description":"Onc nsclc dna&rna dpcr 9 gen","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1199","name":"Pt recg rrt","description":"Patients receiving rrt","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46600","name":"Diagnostic anoscopy spx","description":"Anoscopy; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":38.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21070","name":"Remove coronoid process","description":"Coronoidectomy (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":754.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1408","name":"Gmln brca bef dx ca","description":"Patients who have germline brca testing completed before diagnosis of epithelial ovarian, fallopian tube, or primary peritoneal cancer","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1322","name":"Pts 7wk inj, scrn iop =<25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop =<25 mm hg for injected eye","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0282U","name":"Rbc dna gntyp 12 bld grp gen","description":"Red blood cell antigen typing, dna, genotyping of 12 blood group system genes to predict 44 red blood cell antigen phenotypes","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1241","name":"Pt no resp seen as person","description":"Patient did not respond to the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0916T","name":"Insj perm ccm-d sys pg only","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator only","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0931T","name":"Ephys eval ccm-d ld separate","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), separate from initial implantation or replacement with testing of cardiac cont","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4288","name":"Dermabind ch, per sq cm","description":"Dermabind ch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0063","name":"Cardiology ss","description":"Cardiology mips specialty set","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2039","name":"Innovamatrix fd, per sq cm","description":"Innovamatrix fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0349U","name":"Rx metab/pcx dna 27gen rx ia","description":"Rx metab/pcx dna 27gen rx ia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64584","name":"Rmvl hpglsl nstim ary pg","description":"Removal of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64628","name":"Trml dstrj ios bvn 1st 2 l/s","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; first 2 vertebral bodies, lumbar or sacral","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3503","name":"Surg exp root surf molar","description":"Surg exp root surf molar","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5995","name":"Peri medicament w/seal, max","description":"Peri medicament w/seal, max","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1320","name":"Pts scrn + hrsn","description":"Patients who screened positive for at least 1 of the 5 hrsns","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1954","name":"Inj leu acet lutr dpt 7.5 mg","description":"Injection, leuprolide acetate for depot suspension (lutrate depot), 7.5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23670","name":"Optx sho dislc fx","description":"Open treatment of shoulder dislocation, with fracture of greater humeral tuberosity, includes internal fixation, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":735.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38222","name":"Dx bone marrow bx & aspir","description":"Diagnostic bone marrow; biopsy(ies) and aspiration(s)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":69.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1449","name":"Pt dx scz/pys bef end msr pd","description":"Patients with an active diagnosis of schizophrenia or psychotic disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4258","name":"Enverse, per sq cm","description":"Enverse, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2272","name":"Inj, morphine (fresenius)","description":"Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1809","name":"Inj, fosdenopterin, 0.1mg","description":"Injection, fosdenopterin, 0.1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0574U","name":"Mtb cfp-10 serum/plsm lc-ms","description":"Mtb cfp-10 serum/plsm lc-ms","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91124","name":"Rct snsatn tone&cmplianc std","description":"Rectal sensation, tone, and compliance study (eg, barostat)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9326","name":"Telisotuzumab vedotin-tllv","description":"Injection, telisotuzumab vedotin-tllv, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52443","name":"Cysto 1st trurl prst8 comis","description":"Cystourethroscopy with initial transurethral anterior prostate commissurotomy with a nondrug-coated balloon catheter followed by therapeutic drug delivery into the prostate by a drug-coated balloon catheter, including transrectal ultrasound and fluoroscopy, when performed","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9322","name":"Inj pemetrexed (bluepoint)","description":"Injection, pemetrexed (bluepoint), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4299","name":"Amniocore pro+, per sq cm","description":"Amniocore pro+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82271","name":"Occult blood other sources","description":"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; other sources","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38200","name":"Injection for spleen x-ray","description":"Injection procedure for splenoportography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90482","name":"Imm cnsl not admn sm 3<10","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; 3 minutes up to 10 minutes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2021","name":"Inj, linezolid (hospira)","description":"Injection, linezolid (hospira), not therapeutically equivalent to j2020, 200 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9602","name":"Fluorodopa f-18 diag per mci","description":"Fluorodopa f-18, diagnostic, per millicurie","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0308U","name":"Crd cad alys 3 prtn plsm alg","description":"Crd cad alys 3 prtn plsm alg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24341","name":"Rpr tdn/musc upr a/e each","description":"Repair, tendon or muscle, upper arm or elbow, each tendon or muscle, primary or secondary (excludes rotator cuff)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":786.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1359","name":"Indx suicd idea, no 0 scr","description":"Index assessment during the denominator period when the suicidal ideation and/or behavior symptoms or increased suicide risk by clinician determination occurs and a non-zero c-ssrs score is obtained","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1209","name":">=2 same hi-rsk med w/o diag","description":"At least two orders for high-risk medications from the same drug class, (table 4), without appropriate diagnoses","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32215","name":"Treat chest lining","description":"Pleural scarification for repeat pneumothorax","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":890.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81462","name":"So gsap cll fr dna/dna&rna","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants and rearrangements","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4390","name":"Ascendion per sq cm","description":"Ascendion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0738T","name":"Tx pln mag fld abltj prst8","description":"Treatment planning for magnetic field induction ablation of malignant prostate tissue, using data from previously performed magnetic resonance imaging (mri) examination","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0834T","name":"Dgtz gls mcrscp cytp oth xtn","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0985T","name":"Iv img xtrc cere vsl oct ea","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0431U","name":"Gly rcptr alpha1 igg srm/csf","description":"Gly rcptr alpha1 igg srm/csf","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0692T","name":"Therapeutic ultrafiltration","description":"Therapeutic ultrafiltration","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0236","name":"Intrav inf, mon anti, sec do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1329","name":"Pts act pvd 2 wks 8 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 8 weeks after initial acute pvd encounter","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34111","name":"Removal of arm artery clot","description":"Embolectomy or thrombectomy, with or without catheter; radial or ulnar artery, by arm incision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4296","name":"Rebound matrix, per sq cm","description":"Rebound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0762T","name":"Dgtz gls mcrscp sl imm ea m","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, each multiplex antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37282","name":"Rvsc evsc tpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0731T","name":"Augmnt ai-based fcl phnt a/r","description":"Augmentative ai-based facial phenotype analysis with report","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15260","name":"Fth/gft fr n/e/e/l 20 sqcm/<","description":"Full thickness graft, free, including direct closure of donor site, nose, ears, eyelids, and/or lips; 20 sq cm or less","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":863.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55713","name":"Bx prst8 in-bore ct/mri bx 1","description":"Biopsy, prostate, in-bore ct- or mri-guided (ie, sextant), with biopsy of additional targeted lesion(s), first targeted lesion","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0315U","name":"Onc cutan sq cll ca mrna 40","description":"Onc cutan sq cll ca mrna 40","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9256","name":"Inj, nipocalimab-aahu, 3 mg","description":"Injection, nipocalimab-aahu, 3 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5136","name":"Inj. denosumab-bbdz, 1 mg","description":"Injection, denosumab-bbdz (jubbonti/wyost), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81005","name":"Urinalysis","description":"Urinalysis; qualitative or semiquantitative, except immunoassays","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0922T","name":"Rmvl perm ccm-d sys dual ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); dual (pacing and defibrillation) transvenous leads only","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37299","name":"Revsc evsc imvt angio cpx ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1013T","name":"Lap srg imp/rpl eso nea&pg/r","description":"Laparoscopy, surgical, implantation or replacement of lower esophageal sphincter neurostimulator electrode array and neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver, including cruroplasty and/or electronic ","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0948T","name":"Rem interrog dev ccm phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system with interim analysis, review, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4413","name":"Cygnus solo per sq cm","description":"Cygnus solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33268","name":"Excl laa opn oth px any meth","description":"Exclusion of left atrial appendage, open, performed at the time of other sternotomy or thoracotomy procedure(s), any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69210","name":"Remove impacted ear wax uni","description":"Removal impacted cerumen requiring instrumentation, unilateral","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0349U","name":"Rx metab/pcx dna 27gen rx ia","description":"Rx metab/pcx dna 27gen rx ia","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0556U","name":"Nfct ds p-s dna&rna 12 trgts","description":"Nfct ds p-s dna&rna 12 trgts","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0235","name":"Intrav inf, mon anti, fir do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7300","name":"Rem anchorage dev w/o flap","description":"Rem anchorage dev w/o flap","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0578","name":"Inj brixadi, more than 7 day","description":"Injection, buprenorphine extended release (brixadi), greater than 7 days and up to 28 days of therapy","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9994","name":"Pall serv during meas","description":"Patient is using palliative care services any time during the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0415U","name":"Cv ds acs bld alg 5 yr score","description":"Cv ds acs bld alg 5 yr score","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86765","name":"Rubeola antibody","description":"Antibody; rubeola","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6252","name":"Bridge resin w/noble metal","description":"Pontic-resin with noble metal","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0422","name":"Collect & prep genetic samp","description":"Collect & prep genetic samp","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0431U","name":"Gly rcptr alpha1 igg srm/csf","description":"Gly rcptr alpha1 igg srm/csf","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"Add upp ext mec limb vol lam","description":"Addition to upper extremity prosthesis, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3150.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"X-ray exam chest 2 views","description":"Radiologic examination, chest; 2 views","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90483","name":"Imm cnsl not admn sm>10<20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 10 minutes up to 20 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6603","name":"Cst hgh nble mtl inlay >=3sr","description":"Inlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74021","name":"Radex abdomen 3+ views","description":"Radiologic examination, abdomen; 3 or more views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0651","name":"Inj, levothyroxine, freskabi","description":"Injection, levothyroxine sodium (fresenius kabi), not therapeutically equivalent to j0650, 10 mcg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2022","name":"Innovabrn/innovamatx xl sqcm","description":"Innovaburn or innovamatrix xl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64468","name":"Thrc fascial pln blk bi njx","description":"Thoracic fascial plane block, bilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":37.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0988T","name":"Opn ins/rplc ins ptn sbq&sbf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1454","name":"New cied","description":"New cied","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9324","name":"Inj, pemrydi rtu, 10 mg","description":"Injection, pemetrexed (pemrydi rtu), 10 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6594","name":"G comp bandge liner lwr extr","description":"Gradient compression bandaging supply, bandage liner, lower extremity, any size or length, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1413","name":"Pos pdl1 bef init ici tx","description":"Patients who had a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0830T","name":"Dgtz gls mcrscp cytp slctv","description":"Digitization of glass microscope slides for cytopathology, selective-cellular enhancement technique with interpretation (eg, liquid-based slide preparation method), except cervical or vaginal (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90951","name":"Esrd serv 4 visits p mo <2yr","description":"End-stage renal disease (esrd) related services monthly, for patients younger than 2 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 4 or more face-to-face visits by a physician or other qualified health care pro","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1317.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0575U","name":"Trnsplj med lar rtpcr 4genes","description":"Trnsplj med lar rtpcr 4genes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1224","name":"Iop dec <20% from base","description":"Intraocular pressure (iop) reduced by a value less than 20% from the pre-intervention level","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78608","name":"Brain imaging (pet)","description":"Brain imaging, positron emission tomography (pet); metabolic evaluation","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85660","name":"Rbc sickle cell test","description":"Sickling of rbc, reduction","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0879","name":"Difelikefalin, esrd on dialy","description":"Injection, difelikefalin, 0.1 microgram, (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49623","name":"Rmvl ninfct mesh hernia rpr","description":"Removal of total or near total non-infected mesh or other prosthesis at the time of initial or recurrent anterior abdominal hernia repair or parastomal hernia repair, any approach (ie, open, laparoscopic, robotic) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0438U","name":"Rx metab advrs vrnt alys 33","description":"Rx metab advrs vrnt alys 33","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6604","name":"Cst bse mtl inlay 2 surfaces","description":"Inlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1411","name":"1st ln ici no chemo","description":"Currently on first-line immune checkpoint inhibitors without chemotherapy","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0224","name":"Pemivibart infusion","description":"Intravenous infusion, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppr","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1401","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1456","name":"Pt had htx","description":"Patient had a heart transplant","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81462","name":"So gsap cll fr dna/dna&rna","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants and rearrangements","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6594","name":"G comp bandge liner lwr extr","description":"Gradient compression bandaging supply, bandage liner, lower extremity, any size or length, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33278","name":"Rmvl phrnc nrv stim sys","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; system, including pulse generator and lead(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":486.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0802","name":"Inj. (ani), up to 40 units","description":"Injection, corticotropin (ani), up to 40 units","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0804","name":"3d facial scan indirect","description":"3d facial scan indirect","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1243","name":"Pt othr thn true heard","description":"Patient provided a response other than completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42894","name":"Revision of pharyngeal walls","description":"Resection of pharyngeal wall requiring closure with myocutaneous or fasciocutaneous flap or free muscle, skin, or fascial flap with microvascular anastomosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2103.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78700","name":"Kidney imaging morphol","description":"Kidney imaging morphology;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0492U","name":"Onc sol tum ctc slctn pd-l1","description":"Onc sol tum ctc slctn pd-l1","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1359","name":"Indx suicd idea, no 0 scr","description":"Index assessment during the denominator period when the suicidal ideation and/or behavior symptoms or increased suicide risk by clinician determination occurs and a non-zero c-ssrs score is obtained","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58954","name":"Tah rad debulk/lymph remove","description":"Bilateral salpingo-oophorectomy with omentectomy, total abdominal hysterectomy and radical dissection for debulking; with pelvic lymphadenectomy and limited para-aortic lymphadenectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2435.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0815T","name":"Us rems b1 dns hips plvs/spi","description":"Ultrasound-based radiofrequency echographic multi-spectrometry (rems), bone-density study and fracture-risk assessment, 1 or more sites, hips, pelvis, or spine","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q0136","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75891","name":"Vein x-ray liver","description":"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82270","name":"Occult blood feces","description":"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (ie, patient was provided 3 cards or single triple card for consecutive collection)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1475","name":"Pt dx huntington","description":"Patients with diagnosis of huntingtons disease","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7521","name":"Incision/drain abscess extra","description":"Incision and drainage of abscess - extraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1306","name":"Pt anphx due to pneum","description":"Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2799","name":"Inj, uzedy, 1 mg","description":"Injection, risperidone (uzedy), 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58322","name":"Artificial insemination","description":"Artificial insemination; intra-uterine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99235","name":"Hosp ip/obs same date mod 70","description":"Hospital inpatient or observation care, for the evaluation and management of a patient including admission and discharge on the same date, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encount","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2393","name":"Post 3 srfc resinbased cmpst","description":"Resin-based composite - three surfaces posterior","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4333","name":"Ardeograft, per sq cm","description":"Ardeograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28120","name":"Part removal of ankle/heel","description":"Partial excision (craterization, saucerization, sequestrectomy, or diaphysectomy) bone (eg, osteomyelitis or bossing); talus or calcaneus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":480.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0235","name":"Intrav inf, mon anti, fir do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0533","name":"Buprenorphone inj weekly","description":"Medication assisted treatment, buprenorphine (injectable) administered on a weekly basis; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid tre","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0680T","name":"Insj/rplcmt pg only isdss","description":"Insertion or replacement of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing lead(s)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0548","name":"Phone/inter svs 21-30 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0918T","name":"Insj perm ccm-d sys dual ld","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; dual transvenous leads (pacing and defibrillation) only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2051","name":"Support broker waiver/diem","description":"Supports brokerage, self-directed, waiver; per diem","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0559U","name":"Onc brs quan elisa bf9ag srm","description":"Onc brs quan elisa bf9ag srm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0753T","name":"Dgtz gls mcrscp sld level iv","description":"Digitization of glass microscope slides for level iv, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2029","name":"Mirotract matrix sheet","description":"Mirotract wound matrix sheet, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0035","name":"Pt ed pos 23","description":"Patient has any emergency department encounter during the performance period with place of service indicator 23","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0235","name":"Intrav inf, mon anti, fir do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0872T","name":"Rplcmt ndwllg bldr&prtl cath","description":"Replacement of indwelling bladder and peritoneal catheters, including tunneling of catheter(s) and connection with previously implanted peritoneal ascites pump, including imaging and programming, when performed","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6608","name":"G com bandage tub protct pad","description":"Gradient compression bandaging supply, tubular protective absorption padded layer, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4211","name":"Gingivectomy/plasty per toot","description":"Gingivectomy or gingivoplasty - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0911T","name":"Elec aly nstm sys vgs nrv wo","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; without programming by physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6197","name":"Replace material prosthesis","description":"Replace material prosthesis","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27048","name":"Exc hip/pelv tum deep < 5 cm","description":"Excision, tumor, soft tissue of pelvis and hip area, subfascial (eg, intramuscular); less than 5 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0540U","name":"Trnsplj med quan dd-cfdna","description":"Trnsplj med quan dd-cfdna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4564","name":"Pessary, disposable any type","description":"Pessary, disposable, any type","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0502","name":"Other oral pathology procedu","description":"Other oral pathology procedures by report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0744","name":"Ciprofloxacin iv","description":"Injection, ciprofloxacin for intravenous infusion, 200 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71275","name":"Ct angiography chest","description":"Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":733.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31243","name":"Nsl/sinus ndsc cryoabltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by cryoablation, posterior nasal nerve","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0685T","name":"Interrog dev eval isdss ip","description":"Interrogation device evaluation (in-person) with analysis, review and report by a physician or other qualified health care professional, including connection, recording and disconnection per patient encounter, permanent implantable synchronized diaphragmatic stimulation system for augmentation of ca","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4429","name":"Dermbnd chn, chx per sq cm","description":"Dermabind ch n or dermabind ch x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61737","name":"Litt icr mlt trj mlt/cplx ls","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; multiple trajectories for multiple or complex lesion(s)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1737","name":"Inj meloxicam (azurity) 1mg","description":"Injection, meloxicam (azurity), 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49426","name":"Revise abdomen-venous shunt","description":"Revision of peritoneal-venous shunt","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":699.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99412","name":"Preventive counseling group","description":"Preventive medicine counseling and/or risk factor reduction intervention(s) provided to individuals in a group setting (separate procedure); approximately 60 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":29.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0019M","name":"Cv ds plasma alys prtn bmrk","description":"Cardiovascular disease, plasma, analysis of protein biomarkers by aptamer-based microarray and algorithm reported as 4-year likelihood of coronary event in high-risk populations","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2034","name":"Found drs solo, per sq cm","description":"Foundation drs solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4339","name":"Artacent vericlen, per sq cm","description":"Artacent vericlen, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64656","name":"Revj/rplcmt bat mod sys pg","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; pulse generator only","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1440","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31612","name":"Perq trchl pnxr ttrach aspir","description":"Tracheal puncture, percutaneous with transtracheal aspiration and/or injection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25301","name":"Fusion of tendons at wrist","description":"Tenodesis at wrist; extensors of fingers","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":809.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5827","name":"Endo knee shin single axis","description":"Endoskeletal knee-shin system, single axis, electromechanical swing and stance phase control, with or without shock absorption and stance extension damping","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0739T","name":"Abltj mal prst8 mag fld ndct","description":"Ablation of malignant prostate tissue by magnetic field induction, including all intraprocedural, transperineal needle/catheter placement for nanoparticle installation and intraprocedural temperature monitoring, thermal dosimetry, bladder irrigation, and magnetic field nanoparticle activation","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33900","name":"Perq p-art revsc 1 nm nt uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, unilateral","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0523U","name":"Onc soltum dna ngs snv 22gen","description":"Onc soltum dna ngs snv 22gen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6280","name":"Implt maint procd remv implt","description":"Implt maint procd remv implt","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4404","name":"Xwrap hydro plus per sq cm","description":"Xwrap hydro plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81463","name":"So gsap cl fr cpy nmbr&mcrst","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis, copy number variants, and microsatellite instability","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0340U","name":"Onc pan ca alys mrd plasma","description":"Onc pan ca alys mrd plasma","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0689T","name":"Quan us tis charac w/o dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained without diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97004","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4262","name":"Dual layer impax, per sq cm","description":"Dual layer impax membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0480","name":"Basiliximab","description":"Injection, basiliximab, 20 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1410.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4354","name":"Palingen dl-palingen dl-x","description":"Palingen dual-layer membrane and dual-layer palingen x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9953","name":"Reline sleep apnea appliance","description":"Reline sleep apnea appliance","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0665","name":"Team remote e/m est pt 10 mn","description":"Team remote e/m est. pt 10mins","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90846","name":"Family psytx w/o pt 50 min","description":"Family psychotherapy (without the patient present), 50 minutes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":106.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1357","name":"Pt w/red suic idea 120 days","description":"Patients who had a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1382","name":"Enc dur perf pd pos 11","description":"Patient encounter during the performance period with place of service code 11","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4412","name":"Choriofix per sq cm","description":"Choriofix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84431","name":"Thromboxane urine","description":"Thromboxane metabolite(s), including thromboxane if performed, urine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0521U","name":"Rf iga&igm ccp antb sr-a ia","description":"Rf iga&igm ccp antb sr-a ia","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1016T","name":"Elec alys npgs esoph intraop","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28070","name":"Removal of foot joint lining","description":"Synovectomy; intertarsal or tarsometatarsal joint, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5143","name":"Inj adalimumab-adbm, 1 mg","description":"Injection, adalimumab-adbm, biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76830","name":"Transvaginal us non-ob","description":"Ultrasound, transvaginal","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0275","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5155","name":"Inj, aflibercept-jbvf, 1 mg","description":"Injection, aflibercept-jbvf (yesafili), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81517","name":"Liver ds alys 3 bmrk srm alg","description":"Liver disease, analysis of 3 biomarkers (hyaluronic acid [ha], procollagen iii amino terminal peptide [piiinp], tissue inhibitor of metalloproteinase 1 [timp-1]), using immunoassays, utilizing serum, prognostic algorithm reported as a risk score and risk of liver fibrosis and liver-related clinical ","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0946T","name":"Ortho impl mvmt alys pair ct","description":"Orthopedic implant movement analysis using paired computed tomography (ct) examination of the target structure, including data acquisition, data preparation and transmission, interpretation and report (including ct scan of the joint or extremity performed with paired views)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0842T","name":"Dgtz gls mcrscp pth cslt ea","description":"Digitization of glass microscope slides for pathology consultation during surgery; each additional tissue block with frozen section(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1456","name":"Pt had htx","description":"Patient had a heart transplant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95920","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37296","name":"Revsc evasc imvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0043","name":"Pt mech pros ht valv","description":"Patients with mechanical prosthetic heart valve","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0533","name":"Buprenorphone inj weekly","description":"Medication assisted treatment, buprenorphine (injectable) administered on a weekly basis; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid tre","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35671","name":"Bpg pop-tibl/-prnl artery","description":"Bypass graft, with other than vein; popliteal-tibial or -peroneal artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1408.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0964T","name":"I&cust prep jaw xpnsj 1arch","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; single arch, without mandibular advancement mechanism","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93593","name":"R hrt cath chd nml nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; normal native connections","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0803","name":"3d facial scan direct","description":"3d facial scan direct","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0397","name":"Alcohol/subs interv >30 min","description":"Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and intervention, greater than 30 minutes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":75.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87110","name":"Chlamydia culture","description":"Culture, chlamydia, any source","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4395","name":"Acelagraft per sq cm","description":"Acelagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2252","name":"Inj midazolam in 0.8% nacl","description":"Injection, midazolam in 0.8% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98977","name":"Rtm dev sply mscskl 16-30 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of musculoskeletal system, 16-30 days in a 30-day period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40844","name":"Reconstruction of mouth","description":"Vestibuloplasty; entire arch","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1330.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4297","name":"Emerge matrix, per sq cm","description":"Emerge matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9998","name":"Doc med rsn <3 colon","description":"Documentation of medical reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., last colonoscopy incomplete, last colonoscopy had inadequate prep, piecemeal removal of adenomas, or sessile serrated polyps >= 20 mm in size, last colonoscopy found greater than 10 adenomas, lo","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2040","name":"Coord specialty care, month","description":"Coordinated specialty care, team-based, for first episode psychosis, per month","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0911","name":"Inst tauro 1.35mg/hep 100u","description":"Instillation, taurolidine 1.35 mg and heparin sodium 100 units (central venous catheter lock for adult patients receiving chronic hemodialysis)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1397","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4021","name":"Orthopedic surgery ss","description":"Orthopedic surgery mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1553","name":"Inj yimmugo 100 mg","description":"Injection, immune globulin (yimmugo), 100 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0879T","name":"Augmnt alys ch ct ild prep","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; radiological data preparation and transmission","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74190","name":"Peritoneogram rs&i","description":"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4388","name":"Neothelium 4l per sq cm","description":"Neothelium 4l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1375","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0250","name":"Adm tocilizu covid-19 2nd","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3472","name":"Surg rep root res premolar","description":"Surg rep root res premolar","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0969T","name":"Removal epicranial nstim sys","description":"Removal of epicranial neurostimulator system","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1285","name":"Scrn mam perf rslts not doc","description":"Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed, reason not otherwise specified","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59612","name":"Vbac delivery only","description":"Vaginal delivery only, after previous cesarean delivery (with or without episiotomy and/or forceps);","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":954.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6603","name":"Cst hgh nble mtl inlay >=3sr","description":"Inlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2277","name":"Inj, motixafortide, 0.25 mg","description":"Injection, motixafortide, 0.25 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1334","name":"Pts act pvd 2 wks 2 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 2 weeks after initial acute pvd encounter","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1169","name":"Doc med rsn no flu vax","description":"Documentation of medical reason(s) for not administering influenza vaccine (e.g., prior anaphylaxis due to the influenza vaccine)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1200","name":"Ace-i/arb rx","description":"Ace inhibitor (ace-i) or arb therapy prescribed during the measurement period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6526","name":"G com garmt full leg/ft nght","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73650","name":"X-ray exam of heel","description":"Radiologic examination; calcaneus, minimum of 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53866","name":"Cathj rmvl dev ischmc rmdlg","description":"Catheterization with removal of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9319","name":"Inj romidepsin lyophil 0.1mg","description":"Injection, romidepsin, lyophilized, 0.1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1373","name":"Mst rec gsa >=8 and <=9","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 8.0% and <= 9.0%","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92240","name":"Icg angiography i&r uni/bi","description":"Indocyanine-green angiography (includes multiframe imaging) with interpretation and report, unilateral or bilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1010T","name":"Cptr oph alys monoc eye mvmt","description":"Computerized ophthalmic analysis of monocular eye movements using retinal-based eye-tracking without spatial calibration, including fixation, microsaccades, drift, and horizontal saccades, when performed, unilateral or bilateral, with interpretation and report","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44050","name":"Reduce bowel obstruction","description":"Reduction of volvulus, intussusception, internal hernia, by laparotomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1421","name":"Dermatological care mvp","description":"Dermatological care mips value pathway","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69719","name":"Rplcm oi implt sk tc esp<100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0883T","name":"Intraop ther estim pn ue ea","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; each additional nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0852T","name":"Dgtz gls mcrscp mphmtrc ea 1","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1162","name":"Pt enceph due to dtp bef 13","description":"Patient had encephalitis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0496U","name":"Onc clrct cfdna 8/7 genes","description":"Onc clrct cfdna 8/7 genes","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43870","name":"Closure gastrostomy surgical","description":"Closure of gastrostomy, surgical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":688.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65730","name":"Corneal transplant","description":"Keratoplasty (corneal transplant); penetrating (except in aphakia or pseudophakia)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1195.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9049","name":"Inj, bortezomib, hospira","description":"Injection, bortezomib (hospira), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99214","name":"Office o/p est mod 30 min","description":"Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":95.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":156.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1028","name":"Take home supply 8mg per 0.1","description":"Take-home supply of nasal naloxone; 2-pack of 8mg per 0.1 ml nasal spray (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49617","name":"Rpr aa hrn rcr > 10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, reducible","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0961T","name":"Shortwave ifr radiation img","description":"Shortwave infrared radiation imaging, surgical pathology specimen, to assist gross examination for lymph node localization in fibroadipose tissue, per specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92641","name":"Hearing dev verif eacous aly","description":"Hearing device verification, electroacoustic analysis","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86816","name":"Hla typing dr/dq","description":"Hla typing; dr/dq, single antigen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28104","name":"Removal of foot lesion","description":"Excision or curettage of bone cyst or benign tumor, tarsal or metatarsal, except talus or calcaneus;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":440.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68320","name":"Revise/graft eyelid lining","description":"Conjunctivoplasty; with conjunctival graft or extensive rearrangement","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2356","name":"Inj tezepelumab-ekko, 1mg","description":"Injection, tezepelumab-ekko, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9273","name":"Inj tisotu vedotin-tftv, 1mg","description":"Injection, tisotumab vedotin-tftv, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0671T","name":"Insj ant sgm aq drg dev 1+","description":"Insertion of anterior segment aqueous drainage device into the trabecular meshwork, without external reservoir, and without concomitant cataract removal, one or more","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73610","name":"X-ray exam of ankle","description":"Radiologic examination, ankle; complete, minimum of 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94016","name":"Review patient spirometry","description":"Patient-initiated spirometric recording per 30-day period of time; review and interpretation only by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87880","name":"Strep a assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; streptococcus, group a","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9293","name":"Fertility cycl tracking soft","description":"Fertility cycle (contraception & conception) tracking software application, fda cleared, per month, includes accessories (e.g., thermometer)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0801","name":"Inj. acthar gel to 40 units","description":"Injection, corticotropin (acthar gel), up to 40 units","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1207","name":"Pt scrn sdoh","description":"Patient is screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9026","name":"Inj, tarlatamab-dlle, 1 mg","description":"Injection, tarlatamab-dlle, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0989T","name":"Revj/rmvl ins ptn subq&subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93595","name":"L hrt cath chd nm/abn nt cnj","description":"Left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone, normal or abnormal native connections","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"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":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0588U","name":"Nfct ds bct/vir 32genes mrna","description":"Nfct ds bct/vir 32genes mrna","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0684T","name":"Peri-px dev eval isdss ip","description":"Peri-procedural device evaluation (in-person) and programming of device system parameters before or after a surgery, procedure, or test with analysis, review, and report by a physician or other qualified health care professional, permanent implantable synchronized diaphragmatic stimulation system fo","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0996T","name":"Ins&sclr fix caps bag prosth","description":"Insertion and scleral fixation of a capsular bag prosthesis containing an intraocular lens prosthesis, with vitrectomy, including removal of crystalline lens or dislocated intraocular lens prosthesis, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84145","name":"Procalcitonin (pct)","description":"Procalcitonin (pct)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1296","name":"Calc bmi norm parameters","description":"Bmi is documented within normal parameters and no follow-up plan is required","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99327","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0954T","name":"Tot impl amei rplc snd proc","description":"Totally implantable active middle ear hearing implant; replacement of sound processor only, with attachment to existing transducers","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69209","name":"Remove impacted ear wax uni","description":"Removal impacted cerumen using irrigation/lavage, unilateral","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0411","name":"Hba1c in office testing","description":"Hba1c in office testing","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1783","name":"Vac admin human pap dose 3","description":"Vac admin human pap dose 3","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2542","name":"Dental onlay metallic 2 surf","description":"Onlay-metallic-two surfaces","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90638","name":"Vacc qirv mrna 60mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 60 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84460","name":"Alanine amino (alt) (sgpt)","description":"Transferase; alanine amino (alt) (sgpt)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3376","name":"Inj vancomycin (hikma) 10mg","description":"Injection, vancomycin hcl (hikma), not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74021","name":"Radex abdomen 3+ views","description":"Radiologic examination, abdomen; 3 or more views","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63047","name":"Lam facetec & foramot lumbar","description":"Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; lumbar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1273.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5146","name":"Inj, hercessi, 10 mg","description":"Injection, trastuzumab-strf (hercessi), biosimilar, 10 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1011T","name":"Pbm therapy of oral cavity","description":"Photobiomodulation (pbm) therapy of oral cavity, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86581","name":"Strptcs pneum antb serot ia","description":"Streptococcus pneumoniae antibody (igg), serotypes, multiplex immunoassay, quantitative","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4479","name":"Transanal irrigation, electr","description":"Electronic transanal irrigation system, includes electronic pump, water reservoir, tubing, and accessories, without catheter, any type","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99290","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1033","name":"Sv doula brth wrk per diem","description":"Services performed by a doula birth worker, per diem","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6612","name":"Onlay cst base mtl 2 surface","description":"Onlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37292","name":"Rvsc evsc tpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4412","name":"Choriofix per sq cm","description":"Choriofix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64654","name":"1st opn implt bat modulj sys","description":"Initial open implantation of baroreflex activation therapy (bat) modulation system, including lead placement onto the carotid sinus, lead tunnelling, connection to a pulse generator placed in a distant subcutaneous pocket (ie, total system), and intraoperative interrogation and programming","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6197","name":"Replace material prosthesis","description":"Replace material prosthesis","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1267","name":"Pt no act kid transplt wtlst","description":"Patients not observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33279","name":"Rmvl phrnc nrv stim transvns","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s) only","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64728","name":"Dcmprn median nrv carpl tunl","description":"Decompression; median nerve at the carpal tunnel, percutaneous, with intracarpal tunnel balloon dilation, including ultrasound guidance","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1234","name":"Pt hcv rctv aby f/u neg","description":"Patient has a reactive hcv antibody test, and has a follow up hcv viral test that does not detect hcv viremia","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0751T","name":"Dgtz gls mcrscp sld level ii","description":"Digitization of glass microscope slides for level ii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1484","name":"No rpt hcv rna perf med rsn","description":"Patients who did not have a repeat hcv rna labs performed for medical reasons documented by clinician (e.g., patient with limited life expectancy, delay in treatment of hcv related to treatment of hiv, hbv, hepatocellular carcinoma, decompensated cirrhosis)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37265","name":"Revsc evsc fpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0208","name":"Inj, pedmark, 100 mg","description":"Injection, sodium thiosulfate (pedmark), 100 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60661","name":"Abltj 1/+thyr ndul addl prq","description":"Ablation of 1 or more thyroid nodule(s), additional lobe, percutaneous, including imaging guidance, radiofrequency (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0785T","name":"Revj/rmvl nea spi w/nstim","description":"Revision or removal of neurostimulator electrode array, spinal, with integrated neurostimulator","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98985","name":"Rtm dev sply mscsk sys 2-15d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of musculoskeletal system, 2-15 days in a 30-day period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7353","name":"Anacaulase-bcdb 8.8% gel 1 g","description":"Anacaulase-bcdb, 8.8% gel, 1 gram","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44404","name":"Colonoscopy w/injection","description":"Colonoscopy through stoma; with directed submucosal injection(s), any substance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":550.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":178.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"Evoked auditory test limited","description":"Distortion product evoked otoacoustic emissions; limited evaluation (to confirm the presence or absence of hearing disorder, 3-6 frequencies) or transient evoked otoacoustic emissions, with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2601","name":"Inj, vasopressin (baxter)","description":"Injection, vasopressin (baxter), 1 unit","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9075","name":"Inj, cyclophosphamide, nos","description":"Injection, cyclophosphamide, not otherwise specified, 5 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4287","name":"Disp col sto bag breast milk","description":"Disposable collection and storage bag for breast milk, any size, any type, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77092","name":"Tbs i&r fx rsk qhp","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; interpretation and report on fracture-risk only by other qualified health care professional","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1708","name":"Pfizer vacc admin 3rd dose","description":"Pfizer vacc admin 3rd dose","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2277","name":"Inj, motixafortide, 0.25 mg","description":"Injection, motixafortide, 0.25 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4394","name":"Surgraft aca per sq cm","description":"Surgraft aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93584","name":"Vngrph chd anom/persist svc","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; anomalous or persistent superior vena cava when it exists as a second contralateral superior vena cava, with native drainage to heart (list separately in addition to code for pri","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9596","name":"Gallium illuccix 1 millicure","description":"Gallium ga-68 gozetotide, diagnostic, (illuccix), 1 millicurie","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28080","name":"Removal of foot lesion","description":"Excision, interdigital (morton) neuroma, single, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52305","name":"Cystoscopy and treatment","description":"Cystourethroscopy; with incision or resection of orifice of bladder diverticulum, single or multiple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0906T","name":"Coms ther 1st appl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; first application, total wound(s) surface area less than or equal to 50 sq cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78445","name":"Vascular flow imaging","description":"Non-cardiac vascular flow imaging (ie, angiography, venography)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0883T","name":"Intraop ther estim pn ue ea","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; each additional nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9345","name":"Inj, retifanlimab-dlwr, 1 mg","description":"Injection, retifanlimab-dlwr, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50135","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1234.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2006","name":"Novosorb synpath per sq cm","description":"Novosorb synpath dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1258","name":"Cvd risk assess perf","description":"Cvd risk assessment performed, have a documented calculated risk score","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0136","name":"Adm of pa/n assess 5-15 m","description":"Administration of a standardized, evidence-based assessment of physical activity and nutrition, 5-15 minutes, not more often than every 6 months","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0979T","name":"Sbmcsl crylys ther sft palt","description":"Submucosal cryolysis therapy; soft palate only","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0925T","name":"Rlcj skin pocket ccm-d pg","description":"Relocation of skin pocket for implanted cardiac contractility modulation-defibrillation pulse generator","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90958","name":"Esrd srv 2-3 vsts p mo 12-19","description":"End-stage renal disease (esrd) related services monthly, for patients 12-19 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 2-3 face-to-face visits by a physician or other qualified health care professional per m","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":589.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2313","name":"Inj, naloxone (zimhi) 0.01mg","description":"Injection, naloxone hydrochloride (zimhi), 0.01 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2007","name":"Restrata, per sq cm","description":"Restrata, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9293","name":"Fertility cycl tracking soft","description":"Fertility cycle (contraception & conception) tracking software application, fda cleared, per month, includes accessories (e.g., thermometer)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9246","name":"Mod sedation noniv-15 min","description":"Mod sedation noniv-15 min","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0355U","name":"Apol1 risk variants","description":"Apol1 risk variants","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0874T","name":"Rmvl pertl ascites pmp sys","description":"Removal of a peritoneal ascites pump system, including implanted peritoneal ascites pump and indwelling bladder and peritoneal catheters","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2183","name":"Inj meropenem (wg crit care)","description":"Injection, meropenem (wg critical care), not therapeutically equivalent to j2185, 100 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9326","name":"Telisotuzumab vedotin-tllv","description":"Injection, telisotuzumab vedotin-tllv, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4316","name":"Amchoplast, per sq cm","description":"Amchoplast, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2526","name":"Cntct lens blue violet","description":"Contact lens, hydrophilic, with blue-violet filter, per lens","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0991T","name":"Cysto lo-nrg lithtrp&mcrsphr","description":"Cystourethroscopy, with low-energy lithotripsy and acoustically actuated microspheres, including imaging","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1354","name":"Int caries med app per tooth","description":"Interim caries med app","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1202","name":"Pt rsn no ace-i/arb rx","description":"Documentation of patient reason(s) for not prescribing ace inhibitor or arb therapy during the measurement period, (e.g., patient declined, other patient reasons)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0374","name":"Tomo periapical image","description":"Tomo periapical image","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86316","name":"Immunoassay tumor other","description":"Immunoassay for tumor antigen, other antigen, quantitative (eg, ca 50, 72-4, 549), each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2976","name":"Band stabilization per tooth","description":"Band stabilization per tooth","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2272","name":"Inj, morphine (fresenius)","description":"Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1379","name":"10 yr fu no rec rsn not giv","description":"A 10 year follow-up interval for colonoscopy not recommended, reason not otherwise specified","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0316U","name":"B brgdrferi lyme ds ospa evl","description":"B brgdrferi lyme ds ospa evl","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1151","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP22","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2015","name":"Phoenix wnd mtrx, per sq cm","description":"Phoenix wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2272","name":"Inj, morphine (fresenius)","description":"Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52443","name":"Cysto 1st trurl prst8 comis","description":"Cystourethroscopy with initial transurethral anterior prostate commissurotomy with a nondrug-coated balloon catheter followed by therapeutic drug delivery into the prostate by a drug-coated balloon catheter, including transrectal ultrasound and fluoroscopy, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1353","name":"Sealant repair per tooth","description":"Sealant repair per tooth","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2526","name":"Cntct lens blue violet","description":"Contact lens, hydrophilic, with blue-violet filter, per lens","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0827T","name":"Dgtz gls mcrscp cytp smears","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; smears with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27358","name":"Remove femur lesion/fixation","description":"Excision or curettage of bone cyst or benign tumor of femur; with internal fixation (list in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":366.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0224","name":"Pemivibart infusion","description":"Intravenous infusion, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppr","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0741T","name":"Rem auton alg nsln data coll","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; provision of software, data collection, transmission, and storage, each 30 days","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4384","name":"Axolotl dual ult per sq cm","description":"Axolotl dualgraft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0302U","name":"Iadna brtnla ddpcr flwg liq","description":"Iadna brtnla ddpcr flwg liq","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1308","name":"Inj, famotidine, 0.25 mg","description":"Injection, famotidine, 0.25 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1231","name":"Pt hcv tst no reactive res","description":"Patient receives hcv antibody test with nonreactive result","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82955","name":"Assay of g6pd enzyme","description":"Glucose-6-phosphate dehydrogenase (g6pd); quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83901","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98976","name":"Rtm dev sply resp sys 16-30d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of respiratory system, 16-30 days in a 30-day period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66991","name":"Xcapsl ctrc rmvl insj 1+","description":"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); with insertion of intraocular (eg, trabecular meshwork, supraciliary, suprachoroidal) anterior segment aqueous drai","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3222","name":"Part pulp for apexogenesis","description":"Partial pulpotomy for apexogenesis - permanent tooth with incomplete root development","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0571","name":"Intraop nerve cryoablation","description":"Intraoperative nerve(s) cryoablation for post-surgical pain relief (list separately in addition to code for primary service)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0446U","name":"Ai ds sle alys 10 cytokine","description":"Ai ds sle alys 10 cytokine","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86053","name":"Aqaprn-4 antb flo cytmtry ea","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; flow cytometry (ie, fluorescence-activated cell sorting [facs]), each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43196","name":"Esophagoscp guide wire dilat","description":"Esophagoscopy, rigid, transoral; with insertion of guide wire followed by dilation over guide wire","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86015","name":"Actin antibody each","description":"Actin (smooth muscle) antibody (asma), each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59020","name":"Fetal contract stress test","description":"Fetal contraction stress test","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9256","name":"Inj, nipocalimab-aahu, 3 mg","description":"Injection, nipocalimab-aahu, 3 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41017","name":"Drainage of mouth lesion","description":"Extraoral incision and drainage of abscess, cyst, or hematoma of floor of mouth; submandibular","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":405.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4342","name":"Theramend, per sq cm","description":"Theramend, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0408U","name":"Iaad blk ac wv bsnsr sarscv2","description":"Iaad blk ac wv bsnsr sarscv2","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"U0002","name":"Covid-19 lab test non-cdc","description":"2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0811T","name":"Rem mlt day uroflow setup","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); set-up and patient education on use of equipment","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8006","name":"Grip glove replacement only","description":"Powered, cable driven grip assist glove, hand, finger, includes pressure sensors, glove replacement only","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49186","name":"Opn exc/dstr ntra-abd 5 cm/<","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5 cm or less","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6525","name":"G com garm lwrleg/ft ngt cus","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, custom, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0295U","name":"Onc brst dux carc 7 proteins","description":"Onc brst dux carc 7 proteins","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80504","name":"Path clin consltj mod 21-40","description":"Pathology clinical consultation; for a moderately complex clinical problem, with review of patients history and medical records and moderate level of medical decision making when using time for code selection, 21-40 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0721T","name":"Quan ct tiss charac w/o ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0874T","name":"Rmvl pertl ascites pmp sys","description":"Removal of a peritoneal ascites pump system, including implanted peritoneal ascites pump and indwelling bladder and peritoneal catheters","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81349","name":"Cytog alys chrml abnr lw-ps","description":"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and loss-of-heterozygosity variants, low-pass sequencing analysis","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96573","name":"Pdt dstr prmlg les phys/qhp","description":"Photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosensitizing drug(s) provided by a physician or other qualified health care professional, per day","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1398","name":"Bslne and  fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57456","name":"Endocerv curettage w/scope","description":"Colposcopy of the cervix including upper/adjacent vagina; with endocervical curettage","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":95.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J7343","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1355","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0335U","name":"Rare ds whl gen seq fetal","description":"Rare ds whl gen seq fetal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0676T","name":"Laps insj nw/rpcmt isdss ea","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional lead (list separately in addition to code for primary ","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0626U","name":"Neurol pd dna alys >20000","description":"Neurol pd dna alys >20000","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0411","name":"Hba1c in office testing","description":"Hba1c in office testing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0224","name":"Pemivibart infusion","description":"Intravenous infusion, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppr","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4431","name":"Pma skin substitute, nos","description":"Pma skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69210","name":"Remove impacted ear wax uni","description":"Removal impacted cerumen requiring instrumentation, unilateral","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":45.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37254","name":"Revsc evasc ivt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1299","name":"Inj, eculizumab, 2 mg","description":"Injection, eculizumab, 2 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6603","name":"G com bandge low dn foamchnl","description":"Gradient compression bandaging supply, low density channel foam sheet, per 250 square centimeters, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1009T","name":"Rem mntr s-sclp cont eeg sys","description":"Remote monitoring of a sub-scalp implanted continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83529","name":"Asay of interleukin-6 (il-6)","description":"Interleukin-6 (il-6)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27550","name":"Treat knee dislocation","description":"Closed treatment of knee dislocation; without anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93533","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2886.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0950T","name":"Abltj b9 prst8 tissue hifu","description":"Ablation of benign prostate tissue, transrectal, with high intensity-focused ultrasound (hifu), including ultrasound guidance","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0663","name":"Team remote e/m new pt 45 mn","description":"Team remote e/m new pt 45mins","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1812","name":"Inj. insulin (fiasp)","description":"Insulin (fiasp), per 5 units","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84578","name":"Test urine urobilinogen","description":"Urobilinogen, urine; qualitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0855T","name":"Dgtz gls mcrscp b1 marow smr","description":"Digitization of glass microscope slides for bone marrow, smear interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93146","name":"Interrog crtd sins bat ip w/","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45393","name":"Colonoscopy w/decompression","description":"Colonoscopy, flexible; with decompression (for pathologic distention) (eg, volvulus, megacolon), including placement of decompression tube, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7353","name":"Anacaulase-bcdb 8.8% gel 1 g","description":"Anacaulase-bcdb, 8.8% gel, 1 gram","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0051","name":"Traditional healing service","description":"Traditional healing service","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4290","name":"Membrane wrap hydr per sq cm","description":"Membrane wrap-hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82979","name":"Assay rbc glutathione","description":"Glutathione reductase, rbc","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0962T","name":"Asstv alg alys acous&ecg rec","description":"Assistive algorithmic analysis of acoustic and electrocardiogram recording for detection of cardiac dysfunction (eg, reduced ejection fraction, cardiac murmurs, atrial fibrillation), with review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0895T","name":"Connj lvr algrft prfu dev 1","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; initial 4 hours of monitoring time, including hourly physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0535","name":"Pt navigat svs direct/ref","description":"Patient navigational services, provided directly or by referral; including helping the patient to navigate health systems and identify care providers and supportive services, to build patient self-advocacy and communication skills with care providers, and to promote patient-driven action plans and g","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2508","name":"Pegunigalsidase alfa-iwxj","description":"Injection, pegunigalsidase alfa-iwxj, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49590","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83876","name":"Assay myeloperoxidase","description":"Myeloperoxidase (mpo)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33300","name":"Repair of heart wound","description":"Repair of cardiac wound; without bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1334.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1399","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0934T","name":"Rem mntr wrls l atr prs snr","description":"Remote monitoring of a wireless left atrial pressure sensor for up to 30 days, including data from daily uploads of left atrial pressure recordings, interpretation(s) and trend analysis, with adjustments to the diuretics plan, treatment paradigm thresholds, medications or lifestyle modifications, wh","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1415","name":"No pos pdl1 bef ici ther","description":"Patients who did not have a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0591U","name":"Onc prst8 ca 3prtns plsm srm","description":"Onc prst8 ca 3prtns plsm srm","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0237","name":"Inj, tocilizumab-anoh, hospi","description":"Injection, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0708T","name":"Id ca immntx prep & 1st njx","description":"Intradermal cancer immunotherapy; preparation and initial injection","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0323U","name":"Iadna cns pthgn next gen seq","description":"Iadna cns pthgn next gen seq","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4375","name":"Duograft ac per sq cm","description":"Duograft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11406","name":"Exc tr-ext b9+marg >4.0 cm","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter over 4.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4257","name":"Relese, per sq cm","description":"Relese, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1492","name":"No reported fall","description":"Patients who did not report a fall","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9610","name":"Xe129 xenon, diagnostic","description":"Xenon xe-129 hyperpolarized gas, diagnostic, per study dose","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87182","name":"Sc std carbapenemase nzm det","description":"Susceptibility studies, antimicrobial agent; carbapenemase enzyme detection (eg, klebsiella pneumoniae carbapenemase [kpc], new delhi metallo-beta-lactamase [ndm], verona integron-encoded metallo-beta-lactamase [vim]), multiplex immunoassay, qualitative, per isolate","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0548U","name":"Gfap cleia plasma","description":"Gfap cleia plasma","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0620U","name":"Onc hcc dna mthyln alys>5000","description":"Onc hcc dna mthyln alys>5000","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1748","name":"Inj, zymfentra, 10 mg","description":"Injection, infliximab-dyyb (zymfentra), 10 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86403","name":"Particle agglut antbdy scrn","description":"Particle agglutination; screen, each antibody","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0779T","name":"Gi myoelectrical actv study","description":"Gastrointestinal myoelectrical activity study, stomach through colon, with interpretation and report","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49617","name":"Rpr aa hrn rcr > 10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, reducible","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9249","name":"Inj, melphalan (apotex) 1 mg","description":"Injection, melphalan (apotex), 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4338","name":"Artacent velos, per sq cm","description":"Artacent velos, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1346","name":"No pam inc 6 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 6 points within a 4 to 12 month period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1420","name":"Complete ophthalmologic mvp","description":"Complete ophthalmologic care mips value pathway","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1353","name":"Sealant repair per tooth","description":"Sealant repair per tooth","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49613","name":"Rpr aa hrn rcr < 3 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, reducible","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81354","name":"Cytog alys chrml abnor ogm","description":"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of structural and copy number variants, optical genome mapping (ogm)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95975","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21243","name":"Reconstruction of jaw joint","description":"Arthroplasty, temporomandibular joint, with prosthetic joint replacement","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1885.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96912","name":"Photochemotherapy puva","description":"Photochemotherapy; psoralens and ultraviolet a (puva)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0691T","name":"Auto alys xst ct std vrt fx","description":"Automated analysis of an existing computed tomography study for vertebral fracture(s), including assessment of bone density when performed, data preparation, interpretation, and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0538","name":"Ascvd rsk mng clin stf pr mo","description":"Atherosclerotic cardiovascular disease (ascvd) risk management services; clinical staff time; per calendar month","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1256","name":"Prior history of known cvd","description":"Prior history of known cvd","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1192","name":"Pt w/ dx sq cell ca of esoph","description":"Patients with an existing diagnosis of squamous cell carcinoma of the esophagus","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30469","name":"Rpr nsl vlv collapse w/rmdlg","description":"Repair of nasal valve collapse with low energy, temperature-controlled (ie, radiofrequency) subcutaneous/submucosal remodeling","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9161","name":"Inj denileuk difti-cxdl 1mcg","description":"Injection, denileukin diftitox-cxdl, 1 mcg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55713","name":"Bx prst8 in-bore ct/mri bx 1","description":"Biopsy, prostate, in-bore ct- or mri-guided (ie, sextant), with biopsy of additional targeted lesion(s), first targeted lesion","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55867","name":"Laps surg prst8ect smpl stot","description":"Laparoscopy, surgical prostatectomy, simple subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy), includes robotic assistance, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98013","name":"Synch audio-only est low 20","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code select","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37258","name":"Revsc evasc ivt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82653","name":"El-1 fecal quantitative","description":"Elastase, pancreatic (el-1), fecal; quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":22.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92556","name":"Speech audiometry complete","description":"Speech audiometry threshold; with speech recognition","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J1564","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47100","name":"Wedge biopsy of liver","description":"Biopsy of liver, wedge","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0323U","name":"Iadna cns pthgn next gen seq","description":"Iadna cns pthgn next gen seq","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0620U","name":"Onc hcc dna mthyln alys>5000","description":"Onc hcc dna mthyln alys>5000","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0292U","name":"Psyc strs do mrna 72 genes","description":"Psyc strs do mrna 72 genes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9154","name":"Artificial saliva, 1 ml","description":"Artificial saliva, 1 ml","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2058","name":"Obecbtge autol up to 400 mil","description":"Obecabtagene autoleucel, 10 up to 400 million cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per infusion","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0238","name":"Intrav inf, toci, second dos","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0934T","name":"Rem mntr wrls l atr prs snr","description":"Remote monitoring of a wireless left atrial pressure sensor for up to 30 days, including data from daily uploads of left atrial pressure recordings, interpretation(s) and trend analysis, with adjustments to the diuretics plan, treatment paradigm thresholds, medications or lifestyle modifications, wh","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9275","name":"Inj cosibelimab-ipdl, 2 mg","description":"Injection, cosibelimab-ipdl, 2 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0538U","name":"Onc sol tum ngts ffpe 600gen","description":"Onc sol tum ngts ffpe 600gen","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0600U","name":"Nfct ds wnd infctj 65orgs&30","description":"Nfct ds wnd infctj 65orgs&30","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0961T","name":"Shortwave ifr radiation img","description":"Shortwave infrared radiation imaging, surgical pathology specimen, to assist gross examination for lymph node localization in fibroadipose tissue, per specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4037","name":"Urology ss","description":"Urology mips specialty set","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1358","name":"Pts no <suicd idea 120 dys","description":"Patients who did not have a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1468","name":"Hep b vaccine received","description":"Patient received recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4290","name":"Membrane wrap hydr per sq cm","description":"Membrane wrap-hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0318U","name":"Ped whl gen mthyltn alys 50+","description":"Ped whl gen mthyltn alys 50+","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1409","name":"Recd gmln brca1/brca2 couns","description":"Patients who received germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35485","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":638.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87913","name":"Nfct agt gntyp alys sarscov2","description":"Infectious agent genotype analysis by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), mutation identification in targeted region(s)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2014","name":"Omeza collag compl 100 mg","description":"Omeza collagen matrix or omeza complete matrix, per 100 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0549","name":"Phone/inter for treat>31m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G3002","name":"Chronic pain mgmt 30 mins","description":"Chronic pain management and treatment, monthly bundle including, diagnosis; assessment and monitoring; administration of a validated pain rating scale or tool; the development, implementation, revision, and/or maintenance of a person-centered care plan that includes strengths, goals, clinical needs,","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31611","name":"Constj trachesophgl fstl","description":"Construction of tracheoesophageal fistula and subsequent insertion of an alaryngeal speech prosthesis (eg, voice button, blom-singer prosthesis)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9246","name":"Mod sedation noniv-15 min","description":"Mod sedation noniv-15 min","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73020","name":"X-ray exam of shoulder","description":"Radiologic examination, shoulder; 1 view","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9318","name":"Inj romidepsin non-lyo 0.1mg","description":"Injection, romidepsin, non-lyophilized, 0.1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2777","name":"Inj, faricimab-svoa, 0.1mg","description":"Injection, faricimab-svoa, 0.1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99331","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4261","name":"Tag, per square centimeter","description":"Tag, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72270","name":"Myelogphy 2/> spine regions","description":"Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical), radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":392.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33276","name":"Insj phrnc nrv stim sys","description":"Insertion of phrenic nerve stimulator system (pulse generator and stimulating lead[s]), including vessel catheterization, all imaging guidance, and pulse generator initial analysis with diagnostic mode activation, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99382","name":"Init pm e/m new pat 1-4 yrs","description":"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; early childhood ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":136.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0679T","name":"Laps rmvl lead isdss","description":"Laparoscopic removal of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0558","name":"Adv prim care mgmt lvl 3","description":"Advanced primary care management services for a patient that is a qualified medicare beneficiary with multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, which place the patient at significant risk of death, acute exacerbation/decompensat","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0713T","name":"N-nvs artl plaq alys rvw i&r","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data review, interpretation and report","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99214","name":"Office o/p est mod 30 min","description":"Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":145.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0589","name":"Inj daxibotulinumtoxina-lanm","description":"Injection, daxibotulinumtoxina-lanm, 1 unit","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64584","name":"Rmvl hpglsl nstim ary pg","description":"Removal of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0447U","name":"Ai ds sle alys 11 cytokine","description":"Ai ds sle alys 11 cytokine","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0830T","name":"Dgtz gls mcrscp cytp slctv","description":"Digitization of glass microscope slides for cytopathology, selective-cellular enhancement technique with interpretation (eg, liquid-based slide preparation method), except cervical or vaginal (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1309","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1351","name":"Dental sealant per tooth","description":"Sealant-per tooth","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1852","name":"Ko double upright prefab ots","description":"Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":940.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1465","name":"F/u > 180 days after rx","description":"Patient follow up more than 180 days after treatment","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1851","name":"Ko single upright prefab ots","description":"Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0973T","name":"Slctv nzmtc dbrdmt t/a/l 1st","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; first 100 sq cm","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2036","name":"Cohealyx col dml mx pr sq cm","description":"Cohealyx collagen dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4278","name":"Epieffect, per sq cm","description":"Epieffect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9999","name":"Doc sys rsn <3 colon","description":"Documentation of system reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., unable to locate previous colonoscopy report, patient cannot provide precise date or details from previous colonoscopy, previous colonoscopy report was incomplete)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0957T","name":"Rev s-sclp eltr ra rcvr&tlmt","description":"Revision of sub-scalp implanted electrode array, receiver, and telemetry unit for electrode, when required, including imaging guidance","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4029","name":"Preventive medicine ss","description":"Preventive medicine mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86825","name":"Hla x-math non-cytotoxic","description":"Human leukocyte antigen (hla) crossmatch, non-cytotoxic (eg, using flow cytometry); first serum sample or dilution","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1191","name":"Hspc svc any time in meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0887T","name":"End-tidal ctrl inhaled anes","description":"End-tidal control of inhaled anesthetic agents and oxygen to assist anesthesia care delivery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1303","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1479","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53866","name":"Cathj rmvl dev ischmc rmdlg","description":"Catheterization with removal of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7412","name":"Excision benign lesion compl","description":"Excision of benign lesion complicated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0754T","name":"Dgtz gls mcrscp sld level v","description":"Digitization of glass microscope slides for level v, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24147","name":"Prtl exc bone olecrn process","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), olecranon process","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0586U","name":"Onc mrna gen xprsn 216 genes","description":"Onc mrna gen xprsn 216 genes","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27619","name":"Exc leg/ankle tum deep <5 cm","description":"Excision, tumor, soft tissue of leg or ankle area, subfascial (eg, intramuscular); less than 5 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":705.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0934T","name":"Rem mntr wrls l atr prs snr","description":"Remote monitoring of a wireless left atrial pressure sensor for up to 30 days, including data from daily uploads of left atrial pressure recordings, interpretation(s) and trend analysis, with adjustments to the diuretics plan, treatment paradigm thresholds, medications or lifestyle modifications, wh","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51040","name":"Incise & drain bladder","description":"Cystostomy, cystotomy with drainage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90847","name":"Family psytx w/pt 50 min","description":"Family psychotherapy (conjoint psychotherapy) (with patient present), 50 minutes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":118.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0331U","name":"Onc hl neo opt gen mapping","description":"Onc hl neo opt gen mapping","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0524U","name":"Ob pe sflt-1/plgf ia srm/pls","description":"Ob pe sflt-1/plgf ia srm/pls","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6602","name":"Cst hgh nble mtl inlay 2 srf","description":"Inlay - cast high noble metal two surfaces","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64659","name":"Rmvl bat modulj sys pg only","description":"Removal of baroreflex activation therapy (bat) modulation system; pulse generator only","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0992T","name":"N-invas assmt car rsk w/o ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat without concurrent computed tomography (ct) scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1217","name":"Sys rsn no doc spiro","description":"Documentation of system reason(s) for not documenting and reviewing spirometry results (e.g., spirometry equipment not available at the time of the encounter)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1283","name":"Pt scrn tbco and id as user","description":"Patient screened for tobacco use and identified as a tobacco user","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49614","name":"Rpr aa hrn rcr < 3 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0887T","name":"End-tidal ctrl inhaled anes","description":"End-tidal control of inhaled anesthetic agents and oxygen to assist anesthesia care delivery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1170","name":"Pt w/o flu vax 7/1-6/30","description":"Patient did not receive an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22837","name":"Ant thrc vrt body tethrg 8+","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; 8 or more vertebral segments","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34709","name":"Plmt xtn prosth evasc rpr","description":"Placement of extension prosthesis(es) distal to the common iliac artery(ies) or proximal to the renal artery(ies) for endovascular repair of infrarenal abdominal aortic or iliac aneurysm, false aneurysm, dissection, penetrating ulcer, including pre-procedure sizing and device selection, all nonselec","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":337.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0867T","name":"Tpla b9 prst8 hyprplsa>=50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume greater or equal to 50 ml","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0163","name":"Epinephrine in nacl (endo)","description":"Injection, epinephrine in sodium chloride (endo), 0.1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36660","name":"Insertion catheter artery","description":"Catheterization, umbilical artery, newborn, for diagnosis or therapy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1319","name":"Pts csp doc contact","description":"Patients who had documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98981","name":"Rtm tx mgmt ea addl 20 min","description":"Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least 1 real-time interactive communication with the patient or caregiver during the calendar month; each additional 20 minutes (list separately in","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1324","name":"Pts intravitreal/pci","description":"Patients who had an intravitreal or periocular corticosteroid injection (e.g., triamcinolone, preservative-free triamcinolone, dexamethasone, dexamethasone intravitreal implant, or fluocinolone intravitreal implant)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0019","name":"Comm hlth intg svs sdoh 60mn","description":"Community health integration services performed by certified or trained auxiliary personnel, including a community health worker, under the direction of a physician or other practitioner; 60 minutes per calendar month, in the following activities to address social determinants of health (sdoh) need(","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1409","name":"Recd gmln brca1/brca2 couns","description":"Patients who received germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1024T","name":"Perq tiss dsplmt soft tissue","description":"Percutaneous tissue displacement, any method, including imaging guidance; soft tissue (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61623","name":"Evasc temp balo artl occ h/n","description":"Endovascular temporary balloon arterial occlusion, head or neck (extracranial/intracranial) including selective catheterization of vessel to be occluded, positioning and inflation of occlusion balloon, concomitant neurological monitoring, and radiologic supervision and interpretation of all angiogra","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1190","name":"Doc khe not pef w/efgr/uacr","description":"Documentation of a kidney health evaluation was not performed or defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0904T","name":"Ecg alg 12 ld rdcd trcg only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; tracing only","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0738","name":"Hiv prep, inj, lenacapavir","description":"Injection, lenacapavir, 1 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","name":"Scoliosis orth sag/ cor","description":"Scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla to trochanter, includes all accessory pads, straps and interface, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1309.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0506","name":"Comp asses care plan ccm svc","description":"Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":42.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0988T","name":"Opn ins/rplc ins ptn sbq&sbf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0888T","name":"Histotripsy mal renal tissue","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant renal tissue, including imaging guidance","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99402","name":"Prev med cnsl indiv apprx 30","description":"Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 30 minutes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":44.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49596","name":"Rpr aa hrn 1st > 10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, incarcerated or strangulated","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55874","name":"Tprnl plmt biodegrdabl matrl","description":"Transperineal placement of biodegradable material, peri-prostatic, single or multiple injection(s), including image guidance, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":4052.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94370","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1194","name":"Med rsn no imp/con mmr/msi","description":"Documentation of medical reason(s) surgical pathology reports did not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both tests were not included (e.g., patient will not be treated with checkpoint inhibitor therap","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4348","name":"Sentry sl matrix per sq cm","description":"Sentry sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0616","name":"Inj metoprolol tartrate 1 mg","description":"Injection, metoprolol tartrate, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64657","name":"Rmvl bat modulj sys tot sys","description":"Removal of baroreflex activation therapy (bat) modulation system; total system, including lead and pulse generator","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88300","name":"Surgical path gross","description":"Level i - surgical pathology, gross examination only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49186","name":"Opn exc/dstr ntra-abd 5 cm/<","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5 cm or less","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64629","name":"Trml dstrj ios bvn ea addl","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; each additional vertebral body, lumbar or sacral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0967T","name":"Tranal ins tmp clrc anst dev","description":"Transanal insertion of endoluminal temporary colorectal anastomosis protection device, including vacuum anchoring component and flexible sheath connected to external vacuum source and monitoring system","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96574","name":"Dbrdmt prmlg les w/pdt","description":"Debridement of premalignant hyperkeratotic lesion(s) (ie, targeted curettage, abrasion) followed with photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosensitizing drug(s) provide","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98980","name":"Rtm tx mgmt 1st 20 min","description":"Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least 1 real-time interactive communication with the patient or caregiver during the calendar month; first 20 minutes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87493","name":"C diff amplified probe","description":"Infectious agent detection by nucleic acid (dna or rna); clostridium difficile, toxin gene(s), amplified probe technique","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2026","name":"Restrata minimatrix, 5 mg","description":"Restrata minimatrix, 5 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55200","name":"Incision of sperm duct","description":"Vasotomy, cannulization with or without incision of vas, unilateral or bilateral (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0952T","name":"Tot impl amei rev/rplc mstdc","description":"Totally implantable active middle ear hearing implant; revision or replacement, with mastoidectomy and replacement of sound processor","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9957","name":"Screening sleep disorders","description":"Screening sleep disorders","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72132","name":"Ct lumbar spine w/dye","description":"Computed tomography, lumbar spine; with contrast material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76857","name":"Us exam pelvic limited","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95165","name":"Antigen therapy services","description":"Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy; single or multiple antigens (specify number of doses)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9610","name":"Xe129 xenon, diagnostic","description":"Xenon xe-129 hyperpolarized gas, diagnostic, per study dose","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37203","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2791","name":"Crown full cast base metal","description":"Crown-full cast predominantly base metal","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0681","name":"App of non-sheet skin sub","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; first 25 sq cm or less of wound surface area","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1192","name":"Pt w/ dx sq cell ca of esoph","description":"Patients with an existing diagnosis of squamous cell carcinoma of the esophagus","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5938","name":"Resct proth max comp remov","description":"Resct proth max comp remov","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0969T","name":"Removal epicranial nstim sys","description":"Removal of epicranial neurostimulator system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99497","name":"Advncd care plan 30 min","description":"Advance care planning including the explanation and discussion of advance directives such as standard forms (with completion of such forms, when performed), by the physician or other qualified health care professional; first 30 minutes, face-to-face with the patient, family member(s), and/or surroga","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":99.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77437","name":"Surf radj ther supfc<=150kv","description":"Surface radiation therapy; superficial, delivery, </=150 kv, per fraction (eg, electronic brachytherapy)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93793","name":"Anticoag mgmt pt warfarin","description":"Anticoagulant management for a patient taking warfarin, must include review and interpretation of a new home, office, or lab international normalized ratio (inr) test result, patient instructions, dosage adjustment (as needed), and scheduling of additional test(s), when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1292","name":"Pt 66+ frail inpt adv ill","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and an advanced illness diagnosis during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0850T","name":"Dgtz gls mcrscp ish ea mult","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71260","name":"Ct thorax dx c+","description":"Computed tomography, thorax, diagnostic; with contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0561","name":"Temp tube delivery, unil","description":"Tympanostomy with local or topical anesthesia and insertion of a ventilating tube when performed with tympanostomy tube delivery device, unilateral (list separately in addition to 69433) (do not use in conjunction with 0583t)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1361","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6073","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (predominantly base metal)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3421","name":"Root surgery bicuspid","description":"Apicoectomy/periradicular surgery-bicuspid (first root)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0540U","name":"Trnsplj med quan dd-cfdna","description":"Trnsplj med quan dd-cfdna","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0834T","name":"Dgtz gls mcrscp cytp oth xtn","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80420","name":"Dexamethasone panel","description":"Dexamethasone suppression panel, 48 hour this panel must include the following: free cortisol, urine (82530 x 2) cortisol (82533 x 2) volume measurement for timed collection (81050 x 2)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99479","name":"Sbsq ic lbw inf 1,500-2,500","description":"Subsequent intensive care, per day, for the evaluation and management of the recovering low birth weight infant (present body weight of 1,500-2,500 grams)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0463U","name":"Onc crvx mrna genxprsn 14bmk","description":"Onc crvx mrna genxprsn 14bmk","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1182","name":"Not elg pre ex ibd/uc/crohn","description":"Patients not eligible due to pre-existing inflammatory bowel disease (ibd) (e.g., ulcerative colitis, crohns disease)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5133","name":"Inj, tofidence, 1 mg","description":"Injection, tocilizumab-bavi (tofidence), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82465","name":"Assay bld/serum cholesterol","description":"Cholesterol, serum or whole blood, total","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0877T","name":"Augmnt alys ch ct ild w/o ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0907T","name":"Coms ther ea addl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; each additional application, total wound(s) surface area less than or equal to 50 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97551","name":"Caregiver traing ea addl 15","description":"Caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patie","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1460","name":"Dx copd, cf, or arf","description":"Diagnosis for chronic obstructive pulmonary disease, emphysema, cystic fibrosis, or acute respiratory failure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86317","name":"Immunoassay infectious agent","description":"Immunoassay for infectious agent antibody, quantitative, not otherwise specified","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0861T","name":"Rmvl pg wcs lv both compnt","description":"Removal of pulse generator for wireless cardiac stimulator for left ventricular pacing; both components (battery and transmitter)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4435","name":"Renati membrane per sq cm","description":"Renati membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4329","name":"Singlay, per sq cm","description":"Singlay, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87913","name":"Nfct agt gntyp alys sarscov2","description":"Infectious agent genotype analysis by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), mutation identification in targeted region(s)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1229","name":"Pt w/ +hcv +vir ref win 1 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, is referred within 1 month of the reactive hcv antibody test to a clinician who treats hcv infection","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96922","name":"Excimer lsr psriasis>500sqcm","description":"Excimer laser treatment for psoriasis; over 500 sq cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7911","name":"Dental suture wound to 5 cm","description":"Complicated suture-up to 5 cm","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55877","name":"Abltj ire prst8 1+ tum perq","description":"Ablation, irreversible electroporation, prostate, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59025","name":"Fetal non-stress test","description":"Fetal non-stress test","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53451","name":"Tprnl balo cntnc dev bi","description":"Periurethral transperineal adjustable balloon continence device; bilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28088","name":"Excise foot tendon sheath","description":"Synovectomy, tendon sheath, foot; extensor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0342U","name":"Onc pncrtc ca mult ia eclia","description":"Onc pncrtc ca mult ia eclia","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31243","name":"Nsl/sinus ndsc cryoabltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by cryoablation, posterior nasal nerve","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3376","name":"Inj vancomycin (hikma) 10mg","description":"Injection, vancomycin hcl (hikma), not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0788T","name":"Elec aly smp iins sp/sac nrv","description":"Electronic analysis with simple programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detecti","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64469","name":"Thrc fascial pln blk bi nfs","description":"Thoracic fascial plane block, bilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1334","name":"Pts act pvd 2 wks 2 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 2 weeks after initial acute pvd encounter","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49591","name":"Rpr aa hrn 1st < 3 cm rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, reducible","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9298","name":"Inj nivol relatlimab 3mg/1mg","description":"Injection, nivolumab and relatlimab-rmbw, 3 mg/1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85576","name":"Blood platelet aggregation","description":"Platelet, aggregation (in vitro), each agent","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93574","name":"Njx cath slct pulm vn angrph","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary venous angiography of each distinct pulmonary vein during cardiac catheterization (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1306","name":"Pt anphx due to pneum","description":"Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7956","name":"Tiss regen edent resorb","description":"Tiss regen edent resorb","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0503U","name":"Neuro alz ds bamyl&tau prtn","description":"Neuro alz ds bamyl&tau prtn","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64876","name":"Repair nerve/shorten bone","description":"Suture of nerve; requiring shortening of bone of extremity (list separately in addition to code for nerve suture)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86403","name":"Particle agglut antbdy scrn","description":"Particle agglutination; screen, each antibody","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2032","name":"Myriad matrix, per sq cm","description":"Myriad matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0519U","name":"Ther rx mntr meds p/d/a 110+","description":"Ther rx mntr meds p/d/a 110+","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0741T","name":"Rem auton alg nsln data coll","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; provision of software, data collection, transmission, and storage, each 30 days","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3244","name":"Inj. tigecycline (accord)","description":"Injection, tigecycline (accord), not therapeutically equivalent to j3243, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1321","name":"Pts no 7wk inj,no iop,iop>25","description":"Patients who were not seen within 7 weeks following the date of injection for follow up or who did not have a documented iop or no plan of care documented if the iop was >25 mm hg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27702","name":"Reconstruct ankle joint","description":"Arthroplasty, ankle; with implant (total ankle)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1209.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85025","name":"Complete cbc w/auto diff wbc","description":"Blood count; complete (cbc), automated (hgb, hct, rbc, wbc and platelet count) and automated differential wbc count","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0398U","name":"Gi baret esph dna mthyln aly","description":"Gi baret esph dna mthyln aly","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36836","name":"Prq av fstl crtj uxtr 1 acs","description":"Percutaneous arteriovenous fistula creation, upper extremity, single access of both the peripheral artery and peripheral vein, including fistula maturation procedures (eg, transluminal balloon angioplasty, coil embolization) when performed, including all vascular access, imaging guidance and radiolo","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1275","name":"Pts hosp exl","description":"Patients determined to be in hospice were excluded from month of evaluation and the remainder of reporting period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6602","name":"G com bandge hgh dn foamroll","description":"Gradient compression bandaging supply, high density foam roll for bandage, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99418","name":"Prolng ip/obs e/m ea 15 min","description":"Prolonged inpatient or observation evaluation and management service(s) time with or without direct patient contact beyond the required time of the primary service when the primary service level has been selected using total time, each 15 minutes of total time (list separately in addition to the cod","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0905T","name":"Ecg alg 12 ld rdcd i&r only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; interpretation and report only","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80505","name":"Path clin consltj high 41-60","description":"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patients history and medical records and high level of medical decision making when using time for code selection, 41-60 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4009","name":"Hospitalists ss","description":"Hospitalists mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1000T","name":"Autol musc cell therapy admn","description":"Autologous muscle cell therapy, administration of muscle progenitor cells into the urethral sphincter, including cystoscopy and post-void residual ultrasound, when performed","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0958T","name":"Rmv s-sclp eltr ra rcvr&tlmt","description":"Removal of sub-scalp implanted electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0341U","name":"Ftl aneup dna seq cmpr alys","description":"Ftl aneup dna seq cmpr alys","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0221","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4316","name":"Amchoplast, per sq cm","description":"Amchoplast, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0417U","name":"Rare ds alys 335 nuc genes","description":"Rare ds alys 335 nuc genes","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77262","name":"Ther radiology tx plng intrm","description":"Therapeutic radiology treatment planning; intermediate","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95249","name":"Cont gluc mntr pt prov eqp","description":"Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; patient-provided equipment, sensor placement, hook-up, calibration of monitor, patient training, and printout of recording","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0996T","name":"Ins&sclr fix caps bag prosth","description":"Insertion and scleral fixation of a capsular bag prosthesis containing an intraocular lens prosthesis, with vitrectomy, including removal of crystalline lens or dislocated intraocular lens prosthesis, when performed","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5996","name":"Peri medicament w/seal, mand","description":"Peri medicament w/seal, mand","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4414","name":"Simplichor per sq cm","description":"Simplichor, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0597U","name":"Onc breast rna xprsn 329gens","description":"Onc breast rna xprsn 329gens","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0699","name":"Inj, cefiderocol, 10 mg","description":"Injection, cefiderocol, 10 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4417","name":"Alexiguard dl-t per sq cm","description":"Alexiguard dl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4308","name":"Sanopellis, per sq cm","description":"Sanopellis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4018","name":"Ob/gyn ss","description":"Obstetrics/gynecology mips specialty set","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9347","name":"Inj, tremelimumab-actl, 1 mg","description":"Injection, tremelimumab-actl, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0344U","name":"Hep nafld semiq evl 28 lipid","description":"Hep nafld semiq evl 28 lipid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0542U","name":"Nefro renal trnspl ur nmr 84","description":"Nefro renal trnspl ur nmr 84","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1266","name":"Pts admit snf","description":"Patients admitted to a skilled nursing facility (snf)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9021","name":"Inj, aspara, rylaze, 0.1 mg","description":"Injection, asparaginase, recombinant, (rylaze), 0.1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0374","name":"Tomo periapical image","description":"Tomo periapical image","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0295U","name":"Onc brst dux carc 7 proteins","description":"Onc brst dux carc 7 proteins","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99462","name":"Sbsq nb em per day hosp","description":"Subsequent hospital care, per day, for evaluation and management of normal newborn","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0974T","name":"Slctv nzmtc dbrdmt t/a/l ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; each additional 100 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37288","name":"Revsc evsc tpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0408U","name":"Iaad blk ac wv bsnsr sarscv2","description":"Iaad blk ac wv bsnsr sarscv2","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0842T","name":"Dgtz gls mcrscp pth cslt ea","description":"Digitization of glass microscope slides for pathology consultation during surgery; each additional tissue block with frozen section(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1250","name":"Pt resp true heard","description":"Patient responded as completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9949","name":"Repair sleep apnea appliance","description":"Repair sleep apnea appliance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38206","name":"Harvest auto stem cells","description":"Blood-derived hematopoietic progenitor cell harvesting for transplantation, per collection; autologous","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0062","name":"Audiology ss","description":"Audiology mips specialty set","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5158","name":"Inj, denosumab-bnht, 1 mg","description":"Injection, denosumab-bnht (bomyntra/conexxence), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36415","name":"Coll venous bld venipuncture","description":"Collection of venous blood by venipuncture","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2601","name":"Inj, vasopressin (baxter)","description":"Injection, vasopressin (baxter), 1 unit","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2050","name":"Financial mgt waiver/diem","description":"Financial management, self-directed, waiver; per diem","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1473","name":"Pt func cap not allow impr","description":"Patient situations, at any point during the denominator identification period, where the patients functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools, such as delirium, dementia, intellectual disabilities, and pervasive and specific de","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7957","name":"Tiss regen edent nonresorb","description":"Tiss regen edent nonresorb","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50405","name":"Revision of kidney/ureter","description":"Pyeloplasty (foley y-pyeloplasty), plastic operation on renal pelvis, with or without plastic operation on ureter, nephropexy, nephrostomy, pyelostomy, or ureteral splinting; complicated (congenital kidney abnormality, secondary pyeloplasty, solitary kidney, calycoplasty)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1511.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1952","name":"Leuprolide inj, camcevi, 1mg","description":"Leuprolide injectable, camcevi, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4365","name":"Amnio bur dl mem per sq cm","description":"Amnio burgeon dual-layer membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0780T","name":"Instlj fecal microbiota ssp","description":"Instillation of fecal microbiota suspension via rectal enema into lower gastrointestinal tract","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2561","name":"Inj, sezaby, 1 mg","description":"Injection, phenobarbital sodium (sezaby), 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0505U","name":"Nfct ds vag infctj id 32orgs","description":"Nfct ds vag infctj id 32orgs","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7911","name":"Dental suture wound to 5 cm","description":"Complicated suture-up to 5 cm","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63053","name":"Lam factc/frmt arthrd lum ea","description":"Laminectomy, facetectomy, or foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s] [eg, spinal or lateral recess stenosis]), during posterior interbody arthrodesis, lumbar; each additional vertebral segment (list separately in addition to code for","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1303","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5157","name":"Inj, denosumab-bmwo, 1 mg","description":"Injection, denosumab-bmwo (stoboclo/osenvelt), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1316","name":"Tobacco non-user","description":"Current tobacco non-user","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"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":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1203","name":"No rsn ace-i/arb rx","description":"Ace inhibitor or arb therapy not prescribed during the measurement period, reason not given","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0794T","name":"Pt spec alg rx-onc tx option","description":"Patient-specific, assistive, rules-based algorithm for ranking pharmaco-oncologic treatment options based on the patients tumor-specific cancer marker information obtained from prior molecular pathology, immunohistochemical, or other pathology results which have been previously interpreted and repor","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1161","name":"Pt anphx due to dtp bef 13","description":"Patient had anaphylaxis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43653","name":"Laparoscopy gastrostomy","description":"Laparoscopy, surgical; gastrostomy, without construction of gastric tube (eg, stamm procedure) (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":578.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":96.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7997","name":"Appliance removal","description":"Appliance removal (not by dentist who placed appliance) includes removal of archbar","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1377","name":"Fu colscop 10 yr doc w/ disc","description":"Recommended follow-up interval for repeat colonoscopy of 10 years documented  in colonoscopy report and communicated with patient","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q0168","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87340","name":"Hepatitis b surface ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; hepatitis b surface antigen (hbsag)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7521","name":"Incision/drain abscess extra","description":"Incision and drainage of abscess - extraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1365","name":"Hosp+pall care spec code 17","description":"Patient encounter during the performance period with hospice and palliative care specialty code 17","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2402","name":"Chloroprocaine (clorotekal)","description":"Injection, chloroprocaine hydrochloride (clorotekal), per 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51595","name":"Remove bladder/revise tract","description":"Cystectomy, complete, with ureteroileal conduit or sigmoid bladder, including intestine anastomosis; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2344.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4025","name":"Physical medicine ss","description":"Physical medicine mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0536U","name":"Rbcag ftl rhd pcr alys exon4","description":"Rbcag ftl rhd pcr alys exon4","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0533U","name":"Rx metab advrs gnotyp 16gens","description":"Rx metab advrs gnotyp 16gens","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0578","name":"Inj brixadi, more than 7 day","description":"Injection, buprenorphine extended release (brixadi), greater than 7 days and up to 28 days of therapy","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7521","name":"Incision/drain abscess extra","description":"Incision and drainage of abscess - extraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99426","name":"Prin care mgmt staff 1st 30","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0561","name":"Temp tube delivery, unil","description":"Tympanostomy with local or topical anesthesia and insertion of a ventilating tube when performed with tympanostomy tube delivery device, unilateral (list separately in addition to 69433) (do not use in conjunction with 0583t)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76857","name":"Us exam pelvic limited","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5411","name":"Dentures adjust cmplt mand","description":"Adjust complete denture - mandibular","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1443","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5143","name":"Inj adalimumab-adbm, 1 mg","description":"Injection, adalimumab-adbm, biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69719","name":"Rplcm oi implt sk tc esp<100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"Add upp ext mec limb vol lam","description":"Addition to upper extremity prosthesis, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0716T","name":"Car acous wavfrm rec cad rsk","description":"Cardiac acoustic waveform recording with automated analysis and generation of coronary artery disease risk score","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93573","name":"Njx cath slct p-art angrp bi","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, bilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0613U","name":"Onc uc dna mthyltn&mut 6bmrk","description":"Onc uc dna mthyltn&mut 6bmrk","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4545","name":"Suppl accessor tibial stim","description":"Supplies and accessories for external tibial nerve stimulator (e.g., socks, gel pads, electrodes, etc.), needed for one month","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4029","name":"Preventive medicine ss","description":"Preventive medicine mips specialty set","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2781","name":"Inj, pegcetacoplan, 1mg","description":"Injection, pegcetacoplan, intravitreal, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4331","name":"Axolotl graft, per sq cm","description":"Axolotl graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86777","name":"Toxoplasma antibody","description":"Antibody; toxoplasma","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0282U","name":"Rbc dna gntyp 12 bld grp gen","description":"Red blood cell antigen typing, dna, genotyping of 12 blood group system genes to predict 44 red blood cell antigen phenotypes","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47360","name":"Repair liver wound","description":"Management of liver hemorrhage; complex suture of liver wound or injury, with or without hepatic artery ligation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1858.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1203","name":"Inj, cipaglucosidase, 5 mg","description":"Injection, cipaglucosidase alfa-atga, 5 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37269","name":"Revsc evasc fpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82234","name":"Beta-amyloid 1-42 (abeta 42)","description":"Beta-amyloid; 1-42 (abeta 42)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1012T","name":"Mtrz ab ntrno trph scl/tr mw","description":"Motorized ab interno trephination of sclera (sclerostomy), or trabecular meshwork (trabeculostomy), 1 or more, including injection of antifibrotic agents, when performed","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34704","name":"Evasc rpr a-unilac ndgft rpt","description":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-uni-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in th","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1898.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81354","name":"Cytog alys chrml abnor ogm","description":"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of structural and copy number variants, optical genome mapping (ogm)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82810","name":"Blood gases o2 sat only","description":"Gases, blood, o2 saturation only, by direct measurement, except pulse oximetry","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0703","name":"Inj, cefepime hcl (b braun)","description":"Injection, cefepime hydrochloride (b braun), not therapeutically equivalent to maxipime, 500 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0624U","name":"Hep nash dna mthyl alys 5000","description":"Hep nash dna mthyl alys 5000","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0700T","name":"Molec fluor img sus nev 1st","description":"Molecular fluorescent imaging of suspicious nevus; first lesion","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4020","name":"Ophthalmology/optometry ss","description":"Ophthalmology/optometry mips specialty set","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66989","name":"Xcpsl ctrc rmvl cplx insj 1+","description":"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification), complex, requiring devices or techniques not generally used in routine cataract surgery (eg, iris expansion device,","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12031","name":"Intmd rpr s/a/t/ext 2.5 cm/<","description":"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 2.5 cm or less","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":143.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1005T","name":"Elec alys s-scl eeg prgr 1st","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, first 15 minutes face-to-face time with physician or other qualified hea","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49188","name":"Opn exc/dst ntra-abd 10.1-20","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 10.1 to 20 cm","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2390","name":"Ant resin-based cmpst crown","description":"Resin-based composite crown anterior","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64659","name":"Rmvl bat modulj sys pg only","description":"Removal of baroreflex activation therapy (bat) modulation system; pulse generator only","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1256","name":"Prior history of known cvd","description":"Prior history of known cvd","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0713T","name":"N-nvs artl plaq alys rvw i&r","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data review, interpretation and report","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92972","name":"Perq trluml coronry lithotrp","description":"Percutaneous transluminal coronary lithotripsy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6516","name":"Grad com wrap w strap foo cu","description":"Gradient compression wrap with adjustable straps, foot, each, custom","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0553","name":"Monthly tx for dmht 20mins","description":"First 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing information related to the use of","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0818T","name":"Revj/rmvl ins ptn subq","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0681","name":"Inj ceftobipole medocarl 3mg","description":"Injection, ceftobiprole medocaril sodium, 3 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0984T","name":"Iv img xtrc cere vsl oct 1st","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1252","name":"Pts no cmplt hu survey","description":"Patients who did not complete at least one of the four patient experience hu survey items and return the hu survey within 60 days of the ambulatory palliative care visit","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0525U","name":"Onc sphrd cell cul 11-rx pnl","description":"Onc sphrd cell cul 11-rx pnl","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20902","name":"Removal of bone for graft","description":"Bone graft, any donor area; major or large","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":719.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9292","name":"Pres dig visual therapy fda","description":"Prescription digital visual therapy, software-only, fda cleared, per course of treatment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0004","name":"Qual care neurologic cnd mvp","description":"Quality care for patients with neurological conditions mips value pathway","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4435","name":"Renati membrane per sq cm","description":"Renati membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0906T","name":"Coms ther 1st appl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; first application, total wound(s) surface area less than or equal to 50 sq cm","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97608","name":"Neg prs wnd ther ndme>50sqcm","description":"Negative pressure wound therapy, (eg, vacuum assisted drainage collection), utilizing disposable, non-durable medical equipment including provision of exudate management collection system, topical application(s), wound assessment, and instructions for ongoing care, per session; total wound(s) surfac","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":434.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":23.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98976","name":"Rtm dev sply resp sys 16-30d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of respiratory system, 16-30 days in a 30-day period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0541","name":"No pt prsnt train initial 30","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76987","name":"Dx intraop epicar car us chd","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; including placement and manipulation of transducer, image acquisition, interpretation and report","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1297","name":"Bmi not doc medrsn ptref","description":"Bmi not documented due to medical reason or patient refusal of height or weight measurement","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92945","name":"Prq trl rvs ch occ ant&rtrgr","description":"Percutaneous transluminal revascularization of chronic total occlusion, single coronary artery, coronary artery branch, or coronary artery bypass graft, and/or subtended major coronary artery branches of the bypass graft, any combination of intracoronary stent, atherectomy and angioplasty; combined ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65900","name":"Remove eye lesion","description":"Removal of epithelial downgrowth, anterior chamber of eye","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":968.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0048","name":"Pall serv during meas","description":"Patients who receive palliative care services any time during the intake period through the end of the measurement year","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1263","name":"Pts hosp dialysis dt","description":"Patients in hospice on their initiation of dialysis date or during the month of evaluation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77085","name":"Dxa bone density axl vrt fx","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4373","name":"Membrane wrp lt per sq cm","description":"Membrane wrap lite, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0046","name":"No mrs 90 days post stk","description":"Clinical follow-up and mrs score not assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83930","name":"Assay of blood osmolality","description":"Osmolality; blood","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0303U","name":"Hem rbc ads whl bld hypoxic","description":"Hem rbc ads whl bld hypoxic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95065","name":"Dir nsl mucous membrane test","description":"Direct nasal mucous membrane test","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36834","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":720.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0489U","name":"Ob sgnipt cfdna seq alys 1+","description":"Ob sgnipt cfdna seq alys 1+","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5944","name":"Max implt sup remv part","description":"Max implt sup remv part","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0421U","name":"Onc clrct scr sgl amp 8 rna","description":"Onc clrct scr sgl amp 8 rna","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0692T","name":"Therapeutic ultrafiltration","description":"Therapeutic ultrafiltration","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60650","name":"Laparoscopy adrenalectomy","description":"Laparoscopy, surgical, with adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1338.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86780","name":"Treponema pallidum","description":"Antibody; treponema pallidum","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J2322","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53080","name":"Drainage of urinary leakage","description":"Drainage of perineal urinary extravasation; uncomplicated (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4017","name":"Nutrition/dietician ss","description":"Nutrition/dietician mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0690T","name":"Quan us tis charac w/dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained with diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7671","name":"Alveolus open reduction","description":"Alveolus - open reduction may include stabilization of teeth","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0180","name":"Md certification hha patient","description":"Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initial ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0724T","name":"Qmrcp w/dx mri same anatomy","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained with diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in additio","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4377","name":"Trigraft ft per sq cm","description":"Trigraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1356","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4019","name":"Oncology/hema ss","description":"Oncology/hematology mips specialty set","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6037","name":"Postop dsg cast chg handfing","description":"Immediate post-surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, partial hand including fingers","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0959T","name":"Rmv/rplc magnet coil assem","description":"Removal or replacement of magnet from coil assembly that is connected to continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0560","name":"Safety plan interven","description":"Safety planning interventions, each 20 minutes personally performed by the billing practitioner, including assisting the patient in the identification of the following personalized elements of a safety plan: recognizing warning signs of an impending suicidal or substance use-related crisis; employin","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S4024","name":"Air polymer foam per study","description":"Air polymer-type a intrauterine foam, per study dose","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4409","name":"Amniomatrixf3x per sq cm","description":"Amniomatrixf3x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49618","name":"Rpr aa hrn rcr > 10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, incarcerated or strangulate","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6610","name":"G com stcking bk 18-30 custm","description":"Gradient compression stocking, below knee, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1376","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4036","name":"Urgent care ss","description":"Urgent care mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25375","name":"Revise radius & ulna","description":"Multiple osteotomies, with realignment on intramedullary rod (sofield type procedure); radius and ulna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1462.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33335","name":"Insert major vessel graft","description":"Insertion of graft, aorta or great vessels; with cardiopulmonary bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2126.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1446","name":"Pt died bef end meas pd","description":"Patients who died any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0846T","name":"Dgtz gls mcrscp imfluor ea","description":"Digitization of glass microscope slides for immunofluorescence, per specimen; each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6613","name":"Onlay cst base mtl >=3 surfa","description":"Onlay - cast predominantly base metal three or more surfaces","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33522","name":"Cabg artery-vein five","description":"Coronary artery bypass, using venous graft(s) and arterial graft(s); 5 venous grafts (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":765.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0267U","name":"Rare do id opt gen mapg&seq","description":"Rare constitutional and other heritable disorders, identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping and whole-genome sequencing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35602","name":"Bpg crtd-clat crtd","description":"Bypass graft, with other than vein; carotid-contralateral carotid","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78071","name":"Parathyrd planar w/wo subtrj","description":"Parathyroid planar imaging (including subtraction, when performed); with tomographic (spect)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7021","name":"Suppl and access lung expan","description":"Supplies and accessories for lung expansion airway clearance, continuous high frequency oscillation, and nebulization device (e.g., handset, nebulizer kit, biofilter)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0219","name":"Inj aval alfa-nqpt 4mg","description":"Injection, avalglucosidase alfa-ngpt, 4 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33895","name":"Evasc st rpr thrc/aa x crsg","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; not crossing major side branches","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55707","name":"Bx prst8 trct us guided","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2865","name":"Inj sulfameth/trim 5 mg/1 mg","description":"Injection, sulfamethoxazole 5 mg and trimethoprim 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4009","name":"Hospitalists ss","description":"Hospitalists mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0558U","name":"Onc clrct elisa bf7 ag serum","description":"Onc clrct elisa bf7 ag serum","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98011","name":"Synch audio-only new high 60","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 60 ","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0993T","name":"N-invas assmt car rsk w/ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat with concurrent computed tomography scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional (list s","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1033","name":"Sv doula brth wrk per diem","description":"Services performed by a doula birth worker, per diem","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0860T","name":"Ncntc ifr spctrsc scr pad","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), for screening for peripheral arterial disease, including provocative maneuvers, image acquisition, interpretation, and report, one or both lower extremities","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0742T","name":"Aqmbf spect xers/strs & rest","description":"Absolute quantitation of myocardial blood flow (aqmbf), single-photon emission computed tomography (spect), with exercise or pharmacologic stress, and at rest, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77333","name":"Radiation treatment aid(s)","description":"Treatment devices, design and construction; intermediate (multiple blocks, stents, bite blocks, special bolus)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0453U","name":"Onc clrct ca cfdna qpcr asy","description":"Onc clrct ca cfdna qpcr asy","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45341","name":"Sigmoidoscopy w/ultrasound","description":"Sigmoidoscopy, flexible; with endoscopic ultrasound examination","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2410","name":"Oxymorphone hcl injection","description":"Injection, oxymorphone hcl, up to 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5158","name":"Inj, denosumab-bnht, 1 mg","description":"Injection, denosumab-bnht (bomyntra/conexxence), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0943T","name":"Cysto flx rmvl urtl scaffold","description":"Cystourethroscopy, flexible; with removal of prostatic urethral scaffold","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1408","name":"Gmln brca bef dx ca","description":"Patients who have germline brca testing completed before diagnosis of epithelial ovarian, fallopian tube, or primary peritoneal cancer","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98003","name":"Synch audio-video new hi 60","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high medical decision making. when using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37284","name":"Revsc evasc tpvt st sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1310","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2679","name":"Inj fluphenazine hcl 1.25 mg","description":"Injection, fluphenazine hcl, 1.25 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64654","name":"1st opn implt bat modulj sys","description":"Initial open implantation of baroreflex activation therapy (bat) modulation system, including lead placement onto the carotid sinus, lead tunnelling, connection to a pulse generator placed in a distant subcutaneous pocket (ie, total system), and intraoperative interrogation and programming","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1168","name":"Pt recd flu vax 7/1-6/30","description":"Patient received an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"Breathing capacity test","description":"Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement(s), with or without maximal voluntary ventilation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0760T","name":"Dgtz gls mcrscp sl imm 1st","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69730","name":"Rplc oi implt sk tc esp>=100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4391","name":"Amnioplast double per sq cm","description":"Amnioplast double, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0600U","name":"Nfct ds wnd infctj 65orgs&30","description":"Nfct ds wnd infctj 65orgs&30","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4433","name":"361 hct/p skin subs, nos","description":"361 hct/p skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37274","name":"Rvsc evsc fpvt athrc cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9394","name":"Inj, fulvestrant (fresenius)","description":"Injection, fulvestrant (fresenius kabi) not therapeutically equivalent to j9395, 25 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9610","name":"Xe129 xenon, diagnostic","description":"Xenon xe-129 hyperpolarized gas, diagnostic, per study dose","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0294U","name":"Lngvty&mrtlty rsk mrna 18gen","description":"Lngvty&mrtlty rsk mrna 18gen","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0249","name":"Tocilizumab for covid-19","description":"Injection, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2281","name":"Inj moxifloxacin (fres kabi)","description":"Injection, moxifloxacin (fresenius kabi), not therapeutically equivalent to j2280, 100 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6074","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (noble metal)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23105","name":"Arthrotomy glenohumeral jt","description":"Arthrotomy; glenohumeral joint, with synovectomy, with or without biopsy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":766.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4425","name":"Revive tl per sq cm","description":"Revive tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29550","name":"Strapping of toes","description":"Strapping; toes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":9.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0795T","name":"Tcat ins 2chmbr ldls pm cmpl","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; complete system (ie, r","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81000","name":"Urinalysis nonauto w/scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; non-automated, with microscopy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9297","name":"Inj pemetrexed (sandoz) 10mg","description":"Injection, pemetrexed (sandoz), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35112","name":"Repair artery rupture spleen","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, splenic artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2050.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71047","name":"X-ray exam chest 3 views","description":"Radiologic examination, chest; 3 views","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9886","name":"In-person attendance g code","description":"Behavioral counseling for diabetes prevention, in-person, group, 60 minutes","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4344","name":"Tri membrane wrap, per sq cm","description":"Tri-membrane wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81002","name":"Urinalysis nonauto w/o scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; non-automated, without microscopy","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97551","name":"Caregiver traing ea addl 15","description":"Caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patie","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31294","name":"Nsl/sins ndsc surg on dcmprn","description":"Nasal/sinus endoscopy, surgical, with optic nerve decompression","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1484.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99292","name":"Critical care addl 30 min","description":"Critical care, evaluation and management of the critically ill or critically injured patient; each additional 30 minutes (list separately in addition to code for primary service)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":106.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4390","name":"Ascendion per sq cm","description":"Ascendion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0047","name":"Ped blunt hd traum","description":"Pediatric patient with minor blunt head trauma and pecarn prediction criteria are not assessed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0134","name":"Inj acetaminophen -fresenius","description":"Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0049","name":"Main hemo in-cntr","description":"With maintenance hemodialysis (in-center and home hd) for the complete reporting month","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0604U","name":"All&immunology crae 4bk pep","description":"All&immunology crae 4bk pep","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76801","name":"Ob us < 14 wks single fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1323","name":"Inj, elranatamab-bcmm, 1 mg","description":"Injection, elranatamab-bcmm, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"Ctlso a-p-l control custom","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32664","name":"Thoracoscopy w/ th nrv exc","description":"Thoracoscopy, surgical; with thoracic sympathectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1093.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0834T","name":"Dgtz gls mcrscp cytp oth xtn","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4377","name":"Trigraft ft per sq cm","description":"Trigraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0216","name":"Inj, alfentanil hcl, 500mcg","description":"Injection, alfentanil hydrochloride, 500 micrograms","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1291","name":"Pt 66+ frailty and med dem","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66989","name":"Xcpsl ctrc rmvl cplx insj 1+","description":"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification), complex, requiring devices or techniques not generally used in routine cataract surgery (eg, iris expansion device,","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63185","name":"Incise spine nrv half segmnt","description":"Laminectomy with rhizotomy; 1 or 2 segments","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1171.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0501U","name":"Onc clrc bld quan meas cfdna","description":"Onc clrc bld quan meas cfdna","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2780","name":"Crown 3/4 cast hi noble met","description":"Crown - 3/4 cast high noble metal","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37293","name":"Rvsc evsc tpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0890T","name":"Arhfcmrigtbs 1st tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including target assessment, initial motor threshold determination, neuronavigation, delivery and management, initial treatment day","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6608","name":"G com bandage tub protct pad","description":"Gradient compression bandaging supply, tubular protective absorption padded layer, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1312","name":"No pt tbco scrn rng","description":"Patient not screened for tobacco use","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5930","name":"Max guid prothes w/o flange","description":"Max guid prothes w/o flange","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1003T","name":"Arthrp 1st crp/mtcrpl prostc","description":"Arthroplasty, first carpometacarpal joint, with distal trapezial and proximal first metacarpal prosthetic replacement (eg, first carpometacarpal total joint)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4289","name":"Revoshield+ amnio, per sq cm","description":"Revoshield + amniotic barrier, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92628","name":"Eval hearing aid cand 1st 30","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0560","name":"Safety plan interven","description":"Safety planning interventions, each 20 minutes personally performed by the billing practitioner, including assisting the patient in the identification of the following personalized elements of a safety plan: recognizing warning signs of an impending suicidal or substance use-related crisis; employin","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1353","name":"Pts no cmplt suicd saf pln","description":"Patients who did not have a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J3150","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69730","name":"Rplc oi implt sk tc esp>=100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2770","name":"Quinupristin/dalfopristin","description":"Injection, quinupristin/dalfopristin, 500 mg (150/350)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64469","name":"Thrc fascial pln blk bi nfs","description":"Thoracic fascial plane block, bilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0663","name":"Team remote e/m new pt 45 mn","description":"Team remote e/m new pt 45mins","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1921","name":"Inj labetalol hcl hikma, 5mg","description":"Injection, labetalol hydrochloride (hikma), not therapeutically equivalent to j1920, 5 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0750T","name":"B1 str&fx rsk asmt dxrbmd1vw","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5143","name":"Inj adalimumab-adbm, 1 mg","description":"Injection, adalimumab-adbm, biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83918","name":"Organic acids total quant","description":"Organic acids; total, quantitative, each specimen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0943T","name":"Cysto flx rmvl urtl scaffold","description":"Cystourethroscopy, flexible; with removal of prostatic urethral scaffold","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6073","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (predominantly base metal)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0467U","name":"Onc bldr dna ngs 60gen&aneup","description":"Onc bldr dna ngs 60gen&aneup","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90802","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1255","name":"Pts w/ othr rsn vst,+prg tst","description":"Patients who have another reason for visiting the clinic [not prenatal or postpartum care] and have a positive pregnancy test but have not established the clinic as an ob provider (e.g., plan to terminate the pregnancy or seek prenatal services elsewhere)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J9170","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3502","name":"Surg exp root surf premolar","description":"Surg exp root surf premolar","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0822T","name":"Mntr psychdlc med cln staff","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; clinical staff under the direction of a physician or other qualified health care professional, concurrent with first physician or other qualified health care p","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27278","name":"Arthrd si jt plmt iartic dev","description":"Arthrodesis, sacroiliac joint, percutaneous or minimally invasive, with image guidance, includes obtaining bone graft when performed, unilateral; placement of intra-articular device(s), without cortical piercing","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35521","name":"Art byp grft axill-femoral","description":"Bypass graft, with vein; axillary-femoral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1567.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76017","name":"Mr sfty med physics xm cstmz","description":"Mr safety medical physics examination customization, planning and performance monitoring by medical physicist or mr safety expert, with review and analysis by physician or other qualified health care professional to prioritize and select views and imaging sequences, to tailor mr acquisition specific","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"Evaluation of wheezing","description":"Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4281","name":"Barrera slor dl per sq cm","description":"Barrera sl or barrera dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0608U","name":"Reprdtve med ema rtpcr 10bct","description":"Reprdtve med ema rtpcr 10bct","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49585","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":462.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0034","name":"Pall serv during meas","description":"Patients receiving palliative care during the measurement period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42140","name":"Excision of uvula","description":"Uvulectomy, excision of uvula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1713","name":"Pfizer vacc adm ped 1st dose","description":"Pfizer vacc adm ped 1st dose","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90481","name":"Admn sarscov2 vac ea add cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; each additional component administered (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"X-ray exam chest 2 views","description":"Radiologic examination, chest; 2 views","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6597","name":"G comp bandage long stretch","description":"Gradient compression bandage roll, elastic long stretch, linear yard, any width, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":1.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0340U","name":"Onc pan ca alys mrd plasma","description":"Onc pan ca alys mrd plasma","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2251","name":"Inj midazolam in 0.9% nacl","description":"Injection, midazolam in 0.9% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4433","name":"361 hct/p skin subs, nos","description":"361 hct/p skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74019","name":"Radex abdomen 2 views","description":"Radiologic examination, abdomen; 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1310","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36405","name":"Vnpnxr<3yrs phy/qhp scalp vn","description":"Venipuncture, younger than age 3 years, necessitating the skill of a physician or other qualified health care professional, not to be used for routine venipuncture; scalp vein","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":27.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"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":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93152","name":"Interrog&prgrmg ipnss polysm","description":"Interrogation and programming of implanted phrenic nerve stimulator system during polysomnography","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0614","name":"Inj, treosulfan, 50 mg","description":"Injection, treosulfan, 50 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1331","name":"Pts eval ini xm 8 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 8 weeks from initial exam","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99309","name":"Sbsq nf care moderate mdm 30","description":"Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":110.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4300","name":"Acesso tl, per sq cm","description":"Acesso tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1333","name":"Acute vitreous hemorrhage","description":"Acute vitreous hemorrhage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0559U","name":"Onc brs quan elisa bf9ag srm","description":"Onc brs quan elisa bf9ag srm","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5227","name":"Immed max part denture","description":"Immed max part denture","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93146","name":"Interrog crtd sins bat ip w/","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94250","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37290","name":"Revsc evsc tpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9244","name":"Office min sed drug enteral","description":"Office min sed drug enteral","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7111","name":"Extraction coronal remnants","description":"Extraction coronal remnants - deciduous tooth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4367","name":"Amniocore sl, per sq cm","description":"Amniocore sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9054","name":"Inj bortezomib boruzu 0.1 mg","description":"Injection, bortezomib (boruzu), 0.1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62148","name":"Retr bone flap to fix skull","description":"Incision and retrieval of subcutaneous cranial bone graft for cranioplasty (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0359U","name":"Onc prst8 ca alys all psa","description":"Onc prst8 ca alys all psa","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94618","name":"Pulmonary stress testing","description":"Pulmonary stress testing (eg, 6-minute walk test), including measurement of heart rate, oximetry, and oxygen titration, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0783T","name":"Tc auriculr neurostimulation","description":"Transcutaneous auricular neurostimulation, set-up, calibration, and patient education on use of equipment","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4419","name":"Biolab wrap flw lt per sq cm","description":"Biolab membrane wrap lite flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83525","name":"Assay of insulin","description":"Insulin; total","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32604","name":"Thoracoscopy wbx sac","description":"Thoracoscopy, diagnostic (separate procedure); pericardial sac, with biopsy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0529","name":"In home respite care, 4 hr u","description":"In-home respite care, 4-hour unit, for use in cmmi model","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1653","name":"Ho abduction static ots","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, off the shelf","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82652","name":"Vit d 1 25-dihydroxy","description":"Vitamin d; 1, 25 dihydroxy, includes fraction(s), if performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1310","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37277","name":"Rvsc evsc fpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9697","name":"Inj, magtrace per study dose","description":"Injection, carboxydextran-coated superparamagnetic iron oxide, per study dose","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0537","name":"Risk ascvd tst once pr 12 mo","description":"Administration of a standardized, evidence-based atherosclerotic cardiovascular disease (ascvd) risk assessment, 5-15 minutes, not more often than every 12 months","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98979","name":"Rtm tx mgmt 1st 10 min","description":"Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least 1 real-time interactive communication with the patient or caregiver during the calendar month; first 10 minutes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62180","name":"Establish brain cavity shunt","description":"Ventriculocisternostomy (torkildsen type operation)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1756.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1714","name":"Pfizer vacc adm ped 2nd dose","description":"Pfizer vacc adm ped 2nd dose","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1028","name":"Take home supply 8mg per 0.1","description":"Take-home supply of nasal naloxone; 2-pack of 8mg per 0.1 ml nasal spray (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0863T","name":"Rlcj pg wcs lv trnsmtr only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; transmitter component only","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9992","name":"Pall serv during meas","description":"Palliative care services used by patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3379","name":"Inj, valproate sod, 5 mg","description":"Injection, valproate sodium, 5 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6515","name":"Grad com wrap w str fu le cu","description":"Gradient compression wrap with adjustable straps, full leg, each, custom","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0821T","name":"Mntr psychdlc med 2ndphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; second physician or other qualified health care professional, concurrent with first physician or other qualified health care professional, each hour (list sepa","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98002","name":"Synch audio-video new mod 45","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate medical decision making. when using total time on the date of the encounter for code selection, 45 minutes must be met or exceeded.","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0680","name":"Cr art clc art vlv clc w rpt","description":"Detection and quantification of coronary artery calcium and/or aortic valve calcification from algorithmic analysis of computed tomography of the chest with report","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0760T","name":"Dgtz gls mcrscp sl imm 1st","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0283","name":"Inj, amiodarone (nexterone)","description":"Injection, amiodarone hydrochloride (nexterone), 30 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82271","name":"Occult blood other sources","description":"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; other sources","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3247","name":"Inj secukinumab intrav 1mg","description":"Injection, secukinumab, intravenous, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37255","name":"Revsc evasc ivt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4324","name":"Amniotx, per sq cm","description":"Amniotx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4212","name":"Gingivectomy/plasty rest","description":"Gingivectomy/plasty rest","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2711","name":"Inj neostigmin/glycopyrrolat","description":"Injection, neostigmine methylsulfate 0.1 mg and glycopyrrolate 0.02 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4410","name":"Amchomatrixdl per sq cm","description":"Amchomatrixdl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0773T","name":"Vr px dissoc svc oth phy 1st","description":"Virtual reality (vr) procedural dissociation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports; initial 15 min","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87493","name":"C diff amplified probe","description":"Infectious agent detection by nucleic acid (dna or rna); clostridium difficile, toxin gene(s), amplified probe technique","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95927","name":"Somatosensory testing","description":"Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in the trunk or head","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0485U","name":"Onc sol tum cfdna&rna ngs gm","description":"Onc sol tum cfdna&rna ngs gm","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0614","name":"Inj, treosulfan, 50 mg","description":"Injection, treosulfan, 50 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82234","name":"Beta-amyloid 1-42 (abeta 42)","description":"Beta-amyloid; 1-42 (abeta 42)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77080","name":"Dxa bone density axial","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61889","name":"Ins sk-mnt crnl nstm pg/rcvr","description":"Insertion of skull-mounted cranial neurostimulator pulse generator or receiver, including craniectomy or craniotomy, when performed, with direct or inductive coupling, with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1210","name":">=2 same meds tbl4 not ord","description":"At least two orders for high-risk medications from the same drug class, (table 4), not ordered","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6555","name":"G com stcking bk 40+ custm","description":"Gradient compression stocking, below knee, 40 mmhg or greater, custom, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1228","name":"Pt + hcv aby +vir w/ rx 3 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, has hcv treatment initiated within 3 months of the reactive hcv antibody test","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1022T","name":"Prq tis dsplmt ntra-abdl/pel","description":"Percutaneous tissue displacement, any method, including imaging guidance; intra-abdominal/pelvic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26040","name":"Release palm contracture","description":"Fasciotomy, palmar (eg, dupuytrens contracture); percutaneous","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55868","name":"Lap srg prst8ct lymph nod bx","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with lymph node biopsy(ies) (limited pelvic lymphadenectomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33217","name":"Insert 2 electrode pm-defib","description":"Insertion of 2 transvenous electrodes, permanent pacemaker or implantable defibrillator","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1457","name":"Dx asth dur crnt/prv perf pd","description":"Patient had a diagnosis of asthma with any contact during the current or prior performance period or had asthma present on an active problem list any time during the performance period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0375U","name":"Onc ovrn bchm asy 7 prtn alg","description":"Onc ovrn bchm asy 7 prtn alg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0948T","name":"Rem interrog dev ccm phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system with interim analysis, review, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4309","name":"Via matrix, per sq cm","description":"Via matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37262","name":"Iv lithotrp ivt w/in sm art","description":"Intravascular lithotripsy(ies), iliac vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64712","name":"Revision of sciatic nerve","description":"Neuroplasty, major peripheral nerve, arm or leg, open; sciatic nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":615.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1466","name":"Pt disc/lam proc same day","description":"Patient had a lumbar fusion on the same date as the discectomy/laminectomy procedure","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1435","name":"Oral chemo in perf pd","description":"Patient on oral chemotherapy during the performance period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64658","name":"Rmvl bat modul sys lead only","description":"Removal of baroreflex activation therapy (bat) modulation system; lead only","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0959T","name":"Rmv/rplc magnet coil assem","description":"Removal or replacement of magnet from coil assembly that is connected to continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33901","name":"Perq p-art revsc 1 nm nt bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, bilateral","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1202","name":"Pt rsn no ace-i/arb rx","description":"Documentation of patient reason(s) for not prescribing ace inhibitor or arb therapy during the measurement period, (e.g., patient declined, other patient reasons)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92642","name":"Hearing asstv dev fitg svc","description":"Hearing assistive device, supplemental technology fitting services (eg, personal frequency modulation [fm]/digital modulation [dm] system, remote microphone, alerting devices)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7509","name":"Marsupialization odon cyst","description":"Marsupialization odon cyst","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83055","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4433","name":"361 hct/p skin subs, nos","description":"361 hct/p skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5941","name":"Resct proth mand part remov","description":"Resct proth mand part remov","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2781","name":"Crown 3/4 cast base metal","description":"Crown - 3/4 cast predominantly base metal","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86702","name":"Hiv-2 antibody","description":"Antibody; hiv-2","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76394","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":895.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0467U","name":"Onc bldr dna ngs 60gen&aneup","description":"Onc bldr dna ngs 60gen&aneup","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35666","name":"Bpg fem-ant tib pst tib/prnl","description":"Bypass graft, with other than vein; femoral-anterior tibial, posterior tibial, or peroneal artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1611.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0982T","name":"Rem mntr impl ivc snr set-up","description":"Remote monitoring of implantable inferior vena cava sensor, physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate), initial set-up and patient education on use of equipment","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86036","name":"Anca screen each antibody","description":"Antineutrophil cytoplasmic antibody (anca); screen, each antibody","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0345U","name":"Psyc genom alys pnl 15 gen","description":"Psyc genom alys pnl 15 gen","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0686T","name":"Histotripsy mal hepatcel tis","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant hepatocellular tissue, including image guidance","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0590U","name":"Nfct ds bct&fngl dna 44 orgs","description":"Nfct ds bct&fngl dna 44 orgs","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52443","name":"Cysto 1st trurl prst8 comis","description":"Cystourethroscopy with initial transurethral anterior prostate commissurotomy with a nondrug-coated balloon catheter followed by therapeutic drug delivery into the prostate by a drug-coated balloon catheter, including transrectal ultrasound and fluoroscopy, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81457","name":"So neo gsap dna mcrstl ins","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis, microsatellite instability","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87594","name":"Pneumcysts jirovecii amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); pneumocystis jirovecii, amplified probe technique","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9003","name":"Leupro inj, camcevi etm, 1mg","description":"Leuprolide injectable (camcevi etm), 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0336U","name":"Rare ds whl gen seq bld/slv","description":"Rare ds whl gen seq bld/slv","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0371","name":"Sialoendoscopy capt & interp","description":"Sialoendoscopy capt & interp","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1809","name":"Inj, fosdenopterin, 0.1mg","description":"Injection, fosdenopterin, 0.1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2401","name":"Chloroprocaine hcl injection","description":"Injection, chloroprocaine hydrochloride, per 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86596","name":"Voltage-gtd ca chnl antb ea","description":"Voltage-gated calcium channel antibody, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6603","name":"G com bandge low dn foamchnl","description":"Gradient compression bandaging supply, low density channel foam sheet, per 250 square centimeters, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9607","name":"Lutetium lu 177 vipivotide","description":"Lutetium lu 177 vipivotide tetraxetan, therapeutic, 1 millicurie","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0249","name":"Adm tocilizu covid-19 1st","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9376","name":"Inj pozelimab-bbfg, 1 mg","description":"Injection, pozelimab-bbfg, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1337","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0378U","name":"Rfc1 repeat xpnsj vrnt alys","description":"Rfc1 repeat xpnsj vrnt alys","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1248","name":"Pt resp true seen as person","description":"Patient responded completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93735","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29830","name":"Elbow arthroscopy","description":"Arthroscopy, elbow, diagnostic, with or without synovial biopsy (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45331","name":"Sigmoidoscopy and biopsy","description":"Sigmoidoscopy, flexible; with biopsy, single or multiple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5946","name":"Max implt sup fix","description":"Max implt sup fix","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0596U","name":"Neuro alzds plsm 3dstnct isp","description":"Neuro alzds plsm 3dstnct isp","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21365","name":"Opn tx complx malar fx","description":"Open treatment of complicated (eg, comminuted or involving cranial nerve foramina) fracture(s) of malar area, including zygomatic arch and malar tripod; with internal fixation and multiple surgical approaches","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1232.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11730","name":"Avulsion nail plate simple 1","description":"Avulsion of nail plate, partial or complete, simple; single","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9332","name":"Inj efgartigimod 2mg","description":"Injection, efgartigimod alfa-fcab, 2mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0573U","name":"Onc pancreas 3bmrk pclf alg","description":"Onc pancreas 3bmrk pclf alg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4365","name":"Amnio bur dl mem per sq cm","description":"Amnio burgeon dual-layer membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1476","name":"Pt dx cog imp or ad","description":"Patients with diagnosis of cognitive impairment or alzheimers disease","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6584","name":"Grad com wrap w straps","description":"Gradient compression wrap with adjustable straps, not otherwise specified","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93594","name":"R hrt cath chd abnl nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; abnormal native connections","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0789T","name":"Elec aly cpx iins sp/sac nrv","description":"Electronic analysis with complex programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detect","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91125","name":"Anrct mano rct snsatn&balo","description":"Anorectal manometry, with rectal sensation and rectal balloon expulsion test, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9609","name":"F18 fdg, 15 millicuries","description":"Fludeoxyglucose f18 up to 15 millicuries","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0977T","name":"Upr gi bld detcj snr capsule","description":"Upper gastrointestinal blood detection, sensor capsule, with interpretation and report","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1939","name":"Inj, bumetanide, 0.5 mg","description":"Injection, bumetanide, 0.5 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0712T","name":"N-nvs artl plaq alys quan","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess atherosclerotic plaque stability","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7165","name":"Inj, human-lans, per i.u","description":"Injection, prothrombin complex concentrate, human-lans, per i.u. of factor ix activity","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0751T","name":"Dgtz gls mcrscp sld level ii","description":"Digitization of glass microscope slides for level ii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0802","name":"Inj. (ani), up to 40 units","description":"Injection, corticotropin (ani), up to 40 units","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4414","name":"Simplichor per sq cm","description":"Simplichor, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0757T","name":"Dgtz gls mcrscp sl spc grpii","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group ii, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistochemistry (list separately in addition to code for primary","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1471","name":"Ffs hep b not covered","description":"Documentation that patient is a medicare fee-for-service beneficiary and without additional supplementary insurance coverage for whom hep b vaccination is not reimbursable under current medicare part b coverage rules","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4280","name":"Xcell amnio matrix per sq cm","description":"Xcell amnio matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0752","name":"Hiv prep, oral lenacapavir","description":"Oral, lenacapavir, 300 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33963","name":"Ecmo/ecls repos perph cnula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; reposition of central cannula(e) by sternotomy or thoracotomy, birth through 5 years of age (includes fluoroscopic guidance, when performed)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0587U","name":"Ther rx mntr 60-150rx&metabl","description":"Ther rx mntr 60-150rx&metabl","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87281","name":"Pneumocystis carinii ag if","description":"Infectious agent antigen detection by immunofluorescent technique; pneumocystis carinii","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0918T","name":"Insj perm ccm-d sys dual ld","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; dual transvenous leads (pacing and defibrillation) only","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1434","name":"Inj, focinvez, 1mg","description":"Injection, fosaprepitant (focinvez), 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4438","name":"Adhesive clip ext ens contr","description":"Adhesive clip applied to the skin to secure external electrical nerve stimulator controller, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0163","name":"Epinephrine in nacl (endo)","description":"Injection, epinephrine in sodium chloride (endo), 0.1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1255","name":"Pts w/ othr rsn vst,+prg tst","description":"Patients who have another reason for visiting the clinic [not prenatal or postpartum care] and have a positive pregnancy test but have not established the clinic as an ob provider (e.g., plan to terminate the pregnancy or seek prenatal services elsewhere)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0962T","name":"Asstv alg alys acous&ecg rec","description":"Assistive algorithmic analysis of acoustic and electrocardiogram recording for detection of cardiac dysfunction (eg, reduced ejection fraction, cardiac murmurs, atrial fibrillation), with review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98011","name":"Synch audio-only new high 60","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 60 ","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0935T","name":"Cysto w/rnl pel symp dnrvtj","description":"Cystourethroscopy with renal pelvic sympathetic denervation, radiofrequency ablation, retrograde ureteral approach, including insertion of guide wire, selective placement of ureteral sheath(s) and multiple conformable electrodes, contrast injection(s), and fluoroscopy, bilateral","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4371","name":"Neoguard per sq cm","description":"Neoguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70471","name":"Cta h&n c+ w/noncontrast img","description":"Computed tomographic angiography (cta), head and neck, with contrast material(s), including noncontrast images, when performed, and image postprocessing","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83655","name":"Assay of lead","description":"Lead","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0751","name":"Hiv prep, ftc/taf 200/25mg","description":"Emtricitabine 200mg and tenofovir alafenamide 25mg, oral, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0607","name":"Lanthanum carbonate oral 5mg","description":"Lanthanum carbonate, oral, 5 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0044","name":"Pt mitral stenosis","description":"Patients with moderate or severe mitral stenosis","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0526","name":"Est pt-cg dyad dem hig cmplx","description":"Management of established patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6555","name":"G com stcking bk 40+ custm","description":"Gradient compression stocking, below knee, 40 mmhg or greater, custom, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90473","name":"Immune admin oral/nasal","description":"Immunization administration by intranasal or oral route; 1 vaccine (single or combination vaccine/toxoid)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":14.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99252","name":"Ip/obs consltj new/est sf 35","description":"Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 35 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":30.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87481","name":"Candida dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); candida species, amplified probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76987","name":"Dx intraop epicar car us chd","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; including placement and manipulation of transducer, image acquisition, interpretation and report","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1208","name":"Pt no scrn sdoh","description":"Patient is not screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6564","name":"G com stckng waist 40+ cust","description":"Gradient compression stocking, waist length, 40 mmhg or greater, custom, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0855T","name":"Dgtz gls mcrscp b1 marow smr","description":"Digitization of glass microscope slides for bone marrow, smear interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2780","name":"Crown 3/4 cast hi noble met","description":"Crown - 3/4 cast high noble metal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0999T","name":"Autol musc cell therapy hrvg","description":"Autologous muscle cell therapy, harvesting of muscle progenitor cells, including ultrasound guidance, when performed","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0165","name":"Inj epinephrine nos 0.1 mg","description":"Injection, epinephrine, not otherwise specified, 0.1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92567","name":"Tympanometry","description":"Tympanometry (impedance testing)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":9.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7172","name":"Inj marstacim-hncq, 0.5 mg","description":"Injection, marstacimab-hncq, 0.5 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0525","name":"Est pt-cg dyad dem mod cmplx","description":"Management of established patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25448","name":"Arthrp ntrcrpl/crp/mtcrp ssp","description":"Arthroplasty, intercarpal or carpometacarpal joints; suspension, including transfer or transplant of tendon, with interposition, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01939","name":"Anes nulyt agt crv/thrc","description":"Anesthesia for percutaneous image-guided destruction procedures by neurolytic agent on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6519","name":"Grad com garm noc night use","description":"Gradient compression garment, not otherwise specified, for nighttime use, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1269","name":"Recd esrd mcp lst day of mo","description":"Receiving esrd mcp dialysis services by the provider on the last day of the reporting month","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12020","name":"Tx supfc wnd dehsn smpl clsr","description":"Treatment of superficial wound dehiscence; simple closure","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":205.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0391","name":"Inj, artesunate, 1mg","description":"Injection, artesunate, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0739T","name":"Abltj mal prst8 mag fld ndct","description":"Ablation of malignant prostate tissue by magnetic field induction, including all intraprocedural, transperineal needle/catheter placement for nanoparticle installation and intraprocedural temperature monitoring, thermal dosimetry, bladder irrigation, and magnetic field nanoparticle activation","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34832","name":"Open aortofemor prosth repr","description":"Open repair of infrarenal aortic aneurysm or dissection, plus repair of associated arterial trauma, following unsuccessful endovascular repair; aorto-bifemoral prosthesis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2436.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99215","name":"Office o/p est hi 40 min","description":"Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 40 minutes must be met or ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":206.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99418","name":"Prolng ip/obs e/m ea 15 min","description":"Prolonged inpatient or observation evaluation and management service(s) time with or without direct patient contact beyond the required time of the primary service when the primary service level has been selected using total time, each 15 minutes of total time (list separately in addition to the cod","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9278","name":"Inj, carboplatin (avyxa)","description":"Injection, carboplatin (avyxa), 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0184","name":"Inj, amisulpride, 1 mg","description":"Injection, amisulpride, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1295","name":"Pt hx tot col or colon ca","description":"Patients with a diagnosis or past history of total colectomy or colorectal cancer","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1328","name":"Pts dx acute vitreous hem","description":"Patients with a diagnosis of acute vitreous hemorrhage","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87426","name":"Sarscov coronavirus ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; severe acute respiratory syndrome coronavirus (eg, sars-cov, s","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1384","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0711T","name":"N-nvs artl plaq alys dat prp","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data preparation and transmission","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9161","name":"Inj denileuk difti-cxdl 1mcg","description":"Injection, denileukin diftitox-cxdl, 1 mcg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2471","name":"Inj pantoprazole(hikma) 40mg","description":"Injection, pantoprazole (hikma), not therapeutically equivalent to j2470, 40 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6601","name":"G com bandge hgh dn foam pad","description":"Gradient compression bandaging supply, high density foam pad, any size or shape, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1469","name":"Hx of hep b, or pos bld test","description":"Patient has a history of hepatitis b illness or received a hepatitis b surface antigen, hepatitis b surface antibody, or total antibody to hepatitis b core antigen test with a positive result any time before or during the measurement period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0881","name":"Darbepoetin alfa, non-esrd","description":"Injection, darbepoetin alfa, 1 microgram (non-esrd use)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46760","name":"Repair of anal sphincter","description":"Sphincteroplasty, anal, for incontinence, adult; muscle transplant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1024.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1498","name":"Diagnostic radiology mvp","description":"Diagnostic radiology mips value pathway","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9997","name":"Ustekinumab-ttwe iv inj 1 mg","description":"Injection, ustekinumab-ttwe (pyzchiva), intravenous, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4014","name":"Nephrology ss","description":"Nephrology mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0844T","name":"Dgtz gls mcrscp cslt cyt ea","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), each additional site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J1540","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4299","name":"Amniocore pro+, per sq cm","description":"Amniocore pro+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9595","name":"Piflu f-18, dia 1 millicurie","description":"Piflufolastat f-18, diagnostic, 1 millicurie","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61880","name":"Revise/remove neuroelectrode","description":"Revision or removal of intracranial neurostimulator electrodes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":578.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1500","name":"Neuropsychology mvp","description":"Neuropsychology mips value pathway","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33413","name":"Replacement of aortic valve","description":"Replacement, aortic valve; by translocation of autologous pulmonary valve with allograft replacement of pulmonary valve (ross procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3180.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1160","name":"Pt anphx due to mengb bef 13","description":"Patient had anaphylaxis due to the meningococcal vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76019","name":"Mr safety implt pos&/immoblj","description":"Mr safety implant positioning and/or immobilization under supervision of physician or other qualified health care professional, including application of physical protections to secure implanted medical device from mr-induced translational or vibrational forces, magnetically induced functional change","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1426","name":"Injection, casimersen, 10 mg","description":"Injection, casimersen, 10 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1471","name":"Ffs hep b not covered","description":"Documentation that patient is a medicare fee-for-service beneficiary and without additional supplementary insurance coverage for whom hep b vaccination is not reimbursable under current medicare part b coverage rules","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4350","name":"Palisade dm matrix per sq cm","description":"Palisade dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65870","name":"Incise inner eye adhesions","description":"Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); anterior synechiae, except goniosynechiae","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":579.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87073","name":"Culture bacteria anaerobic","description":"Culture, bacterial; quantitative, anaerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4018","name":"Ob/gyn ss","description":"Obstetrics/gynecology mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0822T","name":"Mntr psychdlc med cln staff","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; clinical staff under the direction of a physician or other qualified health care professional, concurrent with first physician or other qualified health care p","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42600","name":"Closure of salivary fistula","description":"Closure salivary fistula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":419.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5137","name":"Inj, wezlana, sub cu, 1 mg","description":"Injection, ustekinumab-auub (wezlana), biosimilar, subcutaneous, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1275","name":"Pts hosp exl","description":"Patients determined to be in hospice were excluded from month of evaluation and the remainder of reporting period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7299","name":"Intraut copp cont (miudella)","description":"Intrauterine copper contraceptive (miudella)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1417","name":"Pt up to date cov","description":"Patients who are up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96116","name":"Nubhvl xm phys/qhp 1st hr","description":"Neurobehavioral status exam (clinical assessment of thinking, reasoning and judgment, [eg, acquired knowledge, attention, language, memory, planning and problem solving, and visual spatial abilities]), by physician or other qualified health care professional, both face-to-face time with the patient ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":46.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":79.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6049","name":"Scale implt peri-implt inflm","description":"Scale implt peri-implt inflm","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9026","name":"Inj, tarlatamab-dlle, 1 mg","description":"Injection, tarlatamab-dlle, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2598","name":"Inj, vasopressin, 1 unit","description":"Injection, vasopressin, 1 unit","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1195","name":"Rpt wo imp/con mmr/msi","description":"Surgical pathology reports that do not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both, reason not given","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37265","name":"Revsc evsc fpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1382","name":"Enc dur perf pd pos 11","description":"Patient encounter during the performance period with place of service code 11","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1502","name":"Podiatry mvp","description":"Podiatry mips value pathway","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0697T","name":"Quan mr tis wo mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained without diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, targ","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3401","name":"Vyjuvek 5x10^9pfu/ml, 0.1 ml","description":"Beremagene geperpavec-svdt for topical administration, containing nominal 5 x 10^9 pfu/ml vector genomes, per 0.1 ml","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5227","name":"Immed max part denture","description":"Immed max part denture","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1262","name":"Pts transplt bef dialysis","description":"Patients who had a transplant prior to initiation of dialysis","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67108","name":"Repair detached retina","description":"Repair of retinal detachment; with vitrectomy, any method, including, when performed, air or gas tamponade, focal endolaser photocoagulation, cryotherapy, drainage of subretinal fluid, scleral buckling, and/or removal of lens by same technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1596.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90791","name":"Psych diagnostic evaluation","description":"Psychiatric diagnostic evaluation","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":147.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0714T","name":"Tpla b9 prst8 hyprplsa<50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume less than 50 ml","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93722","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64655","name":"Revj/rplcmt bat mod sys lead","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; lead only","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0761T","name":"Dgtz gls mcrscp sl imm ea 1","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90684","name":"Pcv21 vaccine im","description":"Pneumococcal conjugate vaccine, 21 valent (pcv21), for intramuscular use","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37259","name":"Revsc evasc ivt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4275","name":"Esano aca, per sq cm","description":"Esano aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92288","name":"Scr dark adaptation meas i&r","description":"Screening dark adaptation measurement (eg, rod recovery intercept time), with interpretation and report","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4009","name":"Hospitalists ss","description":"Hospitalists mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96202","name":"Mlt fam grp bhv train 1st 60","description":"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face with multiple sets of paren","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6253","name":"Provisional pontic","description":"Provisional pontic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0706","name":"Intraoral occlus radio image","description":"Intraoral occlus radio image","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59840","name":"Induced abortion d&c","description":"Induced abortion, by dilation and curettage","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":219.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0751T","name":"Dgtz gls mcrscp sld level ii","description":"Digitization of glass microscope slides for level ii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1314","name":"Bmi not calculated","description":"Bmi not documented and no reason is given","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1019T","name":"Lymphovenous bypass per xtr","description":"Lymphovenous bypass, including robotic assistance, when performed, per extremity","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9947","name":"Sleep apnea appliance","description":"Sleep apnea appliance","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0671T","name":"Insj ant sgm aq drg dev 1+","description":"Insertion of anterior segment aqueous drainage device into the trabecular meshwork, without external reservoir, and without concomitant cataract removal, one or more","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3424","name":"Inj hydroxocobalamin iv 25mg","description":"Injection, hydroxocobalamin, intravenous, 25 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0917T","name":"Insj perm ccm-d sys 1 lead","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; single transvenous lead (pacing or defibrillation) only","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0030","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0866T","name":"Quan mri alys brn w/dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion detection, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transmissio","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37271","name":"Revsc evsc fpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1434","name":"Inj, focinvez, 1mg","description":"Injection, fosaprepitant (focinvez), 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1631","name":"Haloperidol decanoate inj","description":"Injection, haloperidol decanoate, per 50 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0399U","name":"Neuro cere folate defncy srm","description":"Neuro cere folate defncy srm","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0044","name":"Pt mitral stenosis","description":"Patients with moderate or severe mitral stenosis","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0970T","name":"Ablt b9 brst tum perq lsr ea","description":"Ablation, benign breast tumor (eg, fibroadenoma), percutaneous, laser, including imaging guidance when performed, each tumor","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0911T","name":"Elec aly nstm sys vgs nrv wo","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; without programming by physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96377","name":"Applicaton on-body injector","description":"Application of on-body injector (includes cannula insertion) for timed subcutaneous injection","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J1710","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4026","name":"Phys/occ therapy ss","description":"Physical therapy/occupational therapy mips specialty set","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96202","name":"Mlt fam grp bhv train 1st 60","description":"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face with multiple sets of paren","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5942","name":"Proth max implt sup remv","description":"Proth max implt sup remv","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4274","name":"Esano ac, per sq cm","description":"Esano ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88240","name":"Cell cryopreserve/storage","description":"Cryopreservation, freezing and storage of cells, each cell line","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2516","name":"Inj, pentamidine isethionate","description":"Injection, pentamidine isethionate, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1713","name":"Pfizer vacc adm ped 1st dose","description":"Pfizer vacc adm ped 1st dose","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0714T","name":"Tpla b9 prst8 hyprplsa<50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume less than 50 ml","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66184","name":"Revision of aqueous shunt","description":"Revision of aqueous shunt to extraocular equatorial plate reservoir; without graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93000","name":"Electrocardiogram complete","description":"Electrocardiogram, routine ecg with at least 12 leads; with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":15.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1488","name":"Dx dementia in msr timeframe","description":"Patients with a diagnosis for dementia in the year before or during the period of evaluation","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77437","name":"Surf radj ther supfc<=150kv","description":"Surface radiation therapy; superficial, delivery, </=150 kv, per fraction (eg, electronic brachytherapy)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9913","name":"Admin of neuromod","description":"Admin of neuromod","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98004","name":"Synch audio-video est sf 10","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 10 minutes must be met or e","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61698","name":"Brain aneurysm repr complx","description":"Surgery of complex intracranial aneurysm, intracranial approach; vertebrobasilar circulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4039.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0383U","name":"Tyrosinemia typ i mntr quan","description":"Tyrosinemia typ i mntr quan","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27086","name":"Remove hip foreign body","description":"Removal of foreign body, pelvis or hip; subcutaneous tissue","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0730T","name":"Trabeculotomy lsr w/oct gdn","description":"Trabeculotomy by laser, including optical coherence tomography (oct) guidance","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0155","name":"Dronabinol (syndros) 0.1 mg","description":"Dronabinol (syndros), 0.1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0465","name":"Autolog prp diab wound ulcer","description":"Autologous platelet rich plasma (prp) or other blood-derived product for diabetic chronic wounds/ulcers, using an fda-cleared device for this indication, (includes as applicable administration, dressings, phlebotomy, centrifugation or mixing, and all other preparatory procedures, per treatment)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4211","name":"Gingivectomy/plasty per toot","description":"Gingivectomy or gingivoplasty - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0235","name":"Inj, monoclon antibody, 1 mg","description":"Injection, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extraco","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1837","name":"Inj, posaconazole, 1 mg","description":"Injection, posaconazole, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92567","name":"Tympanometry","description":"Tympanometry (impedance testing)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":18.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4438","name":"Pretect per sq cm","description":"Pretect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76018","name":"Mr safety implant elec prepj","description":"Mr safety implant electronics preparation under supervision of physician or other qualified health care professional, including mr-specific programming of pulse generator and/or transmitter to verify device integrity, protection of device internal circuitry from mr electromagnetic fields, and protec","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3425","name":"Hydroxocobalamin im 10mcg","description":"Injection, hydroxocobalamin, intramuscular, 10 mcg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52597","name":"Trurl rbtc wtrjt rescj prst8","description":"Transurethral robotic-assisted waterjet resection of prostate, including intraoperative planning, ultrasound guidance, control of postoperative bleeding, complete, including vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0812T","name":"Rem mlt day uroflow dev sply","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); device supply with automated report generation, up to 10 days","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77301","name":"Radiotherapy dose plan imrt","description":"Intensity modulated radiotherapy plan, including dose-volume histograms for target and critical structure partial tolerance specifications","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1911.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0814T","name":"Prq njx biod osteo matrl fem","description":"Percutaneous injection of calcium-based biodegradable osteoconductive material, proximal femur, including imaging guidance, unilateral","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2427","name":"Inj, invega hafyera/trinza","description":"Injection, paliperidone palmitate extended release (invega hafyera, or invega trinza), 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5811","name":"Denture interm cmplt mandbl","description":"Interim complete denture (mandibular)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74340","name":"X-ray guide for gi tube","description":"Introduction of long gastrointestinal tube (eg, miller-abbott), including multiple fluoroscopies and images, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1445","name":"Pp care visit by 12 weeks","description":"Postpartum care visit before or at 12 weeks of giving birth","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61610","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2334.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0502","name":"Other oral pathology procedu","description":"Other oral pathology procedures by report","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0001","name":"Advancing cancer care mvp","description":"Advancing cancer care mips value pathways","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1478","name":"Psychoactive sub abuse","description":"Psychoactive substance abuse","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0452U","name":"Onc bldr mthyl penk lte-qmsp","description":"Onc bldr mthyl penk lte-qmsp","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96041","name":"Genetic counseling svc ea 30","description":"Medical genetics and genetic counseling services, each 30 minutes of total time provided by the genetic counselor on the date of the encounter","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1294","name":"Bp scrn perf rec interval","description":"Normal blood pressure reading documented, follow-up not required","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0368U","name":"Onc clrct ca mut&mthyltn mrk","description":"Onc clrct ca mut&mthyltn mrk","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97009","name":"Mchnl sclp cool after chemo","description":"Mechanical scalp cooling; provided after discontinuation of chemotherapy, each 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1370","name":"Rehab support msk care mvp","description":"Rehabilitative support for musculoskeletal care mips value pathway","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1384","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20610","name":"Drain/inj joint/bursa w/o us","description":"Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, subacromial bursa); without ultrasound guidance","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":79.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0271U","name":"Hem cgen neutropenia 23 gen","description":"Hematology (congenital neutropenia), genomic sequence analysis of 23 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33989","name":"Removal of left heart vent","description":"Removal of left heart vent by thoracic incision (eg, sternotomy, thoracotomy) for ecmo/ecls","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53454","name":"Tprnl balo cntnc dev adjmt","description":"Periurethral transperineal adjustable balloon continence device; percutaneous adjustment of balloon(s) fluid volume","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82270","name":"Occult blood feces","description":"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (ie, patient was provided 3 cards or single triple card for consecutive collection)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0744T","name":"Insj bioprostc vlv fem vn","description":"Insertion of bioprosthetic valve, open, femoral vein, including duplex ultrasound imaging guidance, when performed, including autogenous or nonautogenous patch graft (eg, polyester, eptfe, bovine pericardium), when performed","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9154","name":"Artificial saliva, 1 ml","description":"Artificial saliva, 1 ml","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27200","name":"Treat tail bone fracture","description":"Closed treatment of coccygeal fracture","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4038","name":"Vascular surgery ss","description":"Vascular surgery mips specialty set","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27096","name":"Inject sacroiliac joint","description":"Injection procedure for sacroiliac joint, anesthetic/steroid, with image guidance (fluoroscopy or ct) including arthrography when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0034","name":"Pall serv during meas","description":"Patients receiving palliative care during the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0532","name":"Take home supp nasal spray","description":"Take-home supply of nasal nalmefene hydrochloride; one carton of two, 2.7 mg per 0.1 ml nasal sprays (provision of the services by a medicare-enrolled opioid treatment program);( list separately in addition to each primary code)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9049","name":"Inj, bortezomib, hospira","description":"Injection, bortezomib (hospira), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77081","name":"Dxa bone density appendiculr","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2015","name":"Phoenix wnd mtrx, per sq cm","description":"Phoenix wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1293","name":"Calc bmi abv up param f/u","description":"Bmi is documented above normal parameters and a follow-up plan is documented","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45345","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64466","name":"Thrc fascial pln blk uni njx","description":"Thoracic fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4362","name":"Cygnus disk, per sq cm","description":"Cygnus disk, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1807","name":"Inj, ethacrynate sod, 1 mg","description":"Injection, ethacrynate sodium, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0926T","name":"Prgrmg dev eval ccm-d ip","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, including review and report, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0952T","name":"Tot impl amei rev/rplc mstdc","description":"Totally implantable active middle ear hearing implant; revision or replacement, with mastoidectomy and replacement of sound processor","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93005","name":"Electrocardiogram tracing","description":"Electrocardiogram, routine ecg with at least 12 leads; tracing only, without interpretation and report","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1185","name":"Imm ckpt inhib not hld no rx","description":"Documentation of immune checkpoint inhibitor therapy not held and/or corticosteroids or immunosuppressants prescribed or administered was not performed, reason not given","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4279","name":"Vendaje ac, per sq cm","description":"Vendaje ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37257","name":"Revsc evsc ivt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0960T","name":"Rpl s-sclp eltr ra rcvr&tlmt","description":"Replacement of sub-scalp implanted electrode array, receiver, and telemetry unit with tunneling of electrode for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9947","name":"Sleep apnea appliance","description":"Sleep apnea appliance","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0963T","name":"Anosc sbmcsl njx bulking agt","description":"Anoscopy with directed submucosal injection of bulking agent into anal canal","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5162","name":"Inj, denosumab-nxxp, 1 mg","description":"Injection, denosumab-nxxp (bildyos/bilprevda), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6280","name":"Implt maint procd remv implt","description":"Implt maint procd remv implt","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90837","name":"Psytx w pt 60 minutes","description":"Psychotherapy, 60 minutes with patient","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":176.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0506U","name":"Gi barretts esophgl cell 89","description":"Gi barretts esophgl cell 89","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4017","name":"Nutrition/dietician ss","description":"Nutrition/dietician mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24495","name":"Decompression fasct forearm","description":"Decompression fasciotomy, forearm, with brachial artery exploration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":823.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1360","name":"Suicd c-ssrs assessment","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4377","name":"Trigraft ft per sq cm","description":"Trigraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73721","name":"Mri jnt of lwr extre w/o dye","description":"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":643.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0401U","name":"Crd c hrt ds 9 gen 12 vrnts","description":"Crd c hrt ds 9 gen 12 vrnts","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7284","name":"Exc biopsy of saliv glands","description":"Exc biopsy of saliv glands","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7284","name":"Exc biopsy of saliv glands","description":"Exc biopsy of saliv glands","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87335","name":"E coli 0157 ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; escherichia coli 0157","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0297U","name":"Onc pan tum whl gen seq dna","description":"Onc pan tum whl gen seq dna","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92631","name":"Hearing aid slctn svc 1st 30","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4560","name":"Nmes disposable","description":"Neuromuscular electrical stimulator (nmes), disposable, replacement only","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93897","name":"Emboli detcj wo iv mbubb njx","description":"Emboli detection without intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9612","name":"Thera par drugs 2 or > admin","description":"Therapeutic parenteral drugs two or more administrations different medications","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9246","name":"Mod sedation noniv-15 min","description":"Mod sedation noniv-15 min","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0235","name":"Inj, monoclon antibody, 1 mg","description":"Injection, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extraco","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1160","name":"Pt anphx due to mengb bef 13","description":"Patient had anaphylaxis due to the meningococcal vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1206","name":"Isa not red 3pts/no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0561","name":"Temp tube delivery, unil","description":"Tympanostomy with local or topical anesthesia and insertion of a ventilating tube when performed with tympanostomy tube delivery device, unilateral (list separately in addition to 69433) (do not use in conjunction with 0583t)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32500","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1687.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9051","name":"Inj, bortezomib (maia)","description":"Injection, bortezomib (maia), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86825","name":"Hla x-math non-cytotoxic","description":"Human leukocyte antigen (hla) crossmatch, non-cytotoxic (eg, using flow cytometry); first serum sample or dilution","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4417","name":"Alexiguard dl-t per sq cm","description":"Alexiguard dl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9038","name":"Inj axatilimab-csfr 0.1 mg","description":"Injection, axatilimab-csfr, 0.1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0684T","name":"Peri-px dev eval isdss ip","description":"Peri-procedural device evaluation (in-person) and programming of device system parameters before or after a surgery, procedure, or test with analysis, review, and report by a physician or other qualified health care professional, permanent implantable synchronized diaphragmatic stimulation system fo","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37292","name":"Rvsc evsc tpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6553","name":"G com stcking bk 30-40 custm","description":"Gradient compression stocking, below knee, 30-40 mmhg, custom, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43772","name":"Lap rmvl gastr adj device","description":"Laparoscopy, surgical, gastric restrictive procedure; removal of adjustable gastric restrictive device component only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1040.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0615","name":"Calcium acetate, oral, 23 mg","description":"Calcium acetate, oral, 23 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9999","name":"Inj ustekinumab-aauz 1 mg","description":"Injection, ustekinumab-aauz (otulfi), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0566","name":"3d bn img algor drvd fr mri","description":"3d radiodensity-value bone imaging, algorithm derived, from previous magnetic resonance examination of the same anatomy","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0735T","name":"Prep tum cav iort prim crnot","description":"Preparation of tumor cavity, with placement of a radiation therapy applicator for intraoperative radiation therapy (iort) concurrent with primary craniotomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99475","name":"Ped crit care age 2-5 init","description":"Initial inpatient pediatric critical care, per day, for the evaluation and management of a critically ill infant or young child, 2 through 5 years of age","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9225","name":"Gen anes adv air-sub 15 min","description":"Gen anes adv air-sub 15 min","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2026","name":"Restrata minimatrix, 5 mg","description":"Restrata minimatrix, 5 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0531","name":"Fclty-based respite, 24 hr u","description":"Facility-based respite, 24-hour unit, for use in cmmi model","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0435U","name":"Onc chemo rx cytox csc 14 rx","description":"Onc chemo rx cytox csc 14 rx","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0347U","name":"Rx metab/pcx dna 16 gen alys","description":"Rx metab/pcx dna 16 gen alys","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9506","name":"Tc-99m graphite crucible","description":"Graphite crucible for preparation of technetium tc 99m-labeled carbon aerosol, one crucible","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0283","name":"Inj, amiodarone (nexterone)","description":"Injection, amiodarone hydrochloride (nexterone), 30 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9609","name":"F18 fdg, 15 millicuries","description":"Fludeoxyglucose f18 up to 15 millicuries","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0001","name":"Advancing cancer care mvp","description":"Advancing cancer care mips value pathways","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0031","name":"Pall serv during meas","description":"Palliative care services given to patient any time during the measurement period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25651","name":"Perq skel fix ulnar styld fx","description":"Percutaneous skeletal fixation of ulnar styloid fracture","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25915","name":"Amputation of forearm","description":"Krukenberg procedure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1787.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0627U","name":"Psyc scz dna alys >15000","description":"Psyc scz dna alys >15000","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0472U","name":"Ca vi psp&sp1 antb sjogren","description":"Ca vi psp&sp1 antb sjogren","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76984","name":"Dx intraop thoracic aorta us","description":"Ultrasound, intraoperative thoracic aorta (eg, epiaortic), diagnostic","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81418","name":"Rx metab gen seq alys pnl 6","description":"Drug metabolism (eg, pharmacogenomics) genomic sequence analysis panel, must include testing of at least 6 genes, including cyp2c19, cyp2d6, and cyp2d6 duplication/deletion analysis","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99478","name":"Sbsq ic vlbw inf<1,500 gm","description":"Subsequent intensive care, per day, for the evaluation and management of the recovering very low birth weight infant (present body weight less than 1,500 grams)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":130.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61864","name":"Implant neuroelectrde addl","description":"Twist drill, burr hole, craniotomy, or craniectomy with stereotactic implantation of neurostimulator electrode array in subcortical site (eg, thalamus, globus pallidus, subthalamic nucleus, periventricular, periaqueductal gray), without use of intraoperative microelectrode recording; each additional","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":642.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92627","name":"Eval aud funcj ea addl 15","description":"Evaluation of auditory function for surgically implanted device(s) candidacy or postoperative status of a surgically implanted device(s); each additional 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34712","name":"Tcat dlvr enhncd fixj dev","description":"Transcatheter delivery of enhanced fixation device(s) to the endograft (eg, anchor, screw, tack) and all associated radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":692.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2928","name":"Prefab porc/cer crown perm","description":"Prefab porc/cer crown perm","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86235","name":"Nuclear antigen antibody","description":"Extractable nuclear antigen, antibody to, any method (eg, nrnp, ss-a, ss-b, sm, rnp, sc170, j01), each antibody","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7299","name":"Intraut copp cont (miudella)","description":"Intrauterine copper contraceptive (miudella)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90631","name":"H5 vaccine pandemic im use","description":"Influenza virus vaccine (iiv), h5, pandemic formulation, split virus, adjuvanted, for intramuscular use","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91124","name":"Rct snsatn tone&cmplianc std","description":"Rectal sensation, tone, and compliance study (eg, barostat)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1477","name":"Dx delirium","description":"Diagnosis of delirium","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0463","name":"Inj atropine (fresenius te)","description":"Injection, atropine sulfate (fresenius and therapeutically equivalent), 0.01 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9026","name":"Cryo fib comp path redu each","description":"Cryoprecipitated fibrinogen complex, pathogen reduced, each unit","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1299","name":"Flu immunize order/admin","description":"Influenza immunization administered or previously received","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7308","name":"Aminolevulinic acid hcl top","description":"Aminolevulinic acid hcl for topical administration, 20%, single unit dosage form (354 mg)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5227","name":"Immed max part denture","description":"Immed max part denture","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80152","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4414","name":"Simplichor per sq cm","description":"Simplichor, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80299","name":"Quantitative assay drug","description":"Quantitation of therapeutic drug, not elsewhere specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90684","name":"Pcv21 vaccine im","description":"Pneumococcal conjugate vaccine, 21 valent (pcv21), for intramuscular use","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37609","name":"Ligation/bx temporal artery","description":"Ligation or biopsy, temporal artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0164","name":"Epinephrine in nacl (baxter)","description":"Injection, epinephrine in sodium chloride (baxter), 0.1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0755T","name":"Dgtz gls mcrscp sld level vi","description":"Digitization of glass microscope slides for level vi, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3404","name":"Inj zopapogene per ther dose","description":"Injection, zopapogene imadenovec-drba suspension, per therapeutic dose","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7485","name":"Surg reduct osseoustuberosit","description":"Surgical reduction of osseous tuberosity","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5099","name":"Inj ustekinumab-stba, 1 mg","description":"Injection, ustekinumab-stba (steqeyma), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87469","name":"Babesia microti amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); babesia microti, amplified probe technique","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31243","name":"Nsl/sinus ndsc cryoabltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by cryoablation, posterior nasal nerve","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4398","name":"Summit ac per sq cm","description":"Summit ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90823","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6598","name":"G comp bandage med stretch","description":"Gradient compression bandage roll, elastic medium stretch, per linear yard, any width, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59409","name":"Obstetrical care","description":"Vaginal delivery only (with or without episiotomy and/or forceps);","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0670","name":"Inj mepivacaine hcl/10 ml","description":"Injection, mepivacaine hydrochloride, per 10 ml","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37258","name":"Revsc evasc ivt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87075","name":"Cultr bacteria except blood","description":"Culture, bacterial; any source, except blood, anaerobic with isolation and presumptive identification of isolates","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55869","name":"Lap srg prst8ct bi pl lmphad","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2042","name":"Foundation drs+ solo, sq cm","description":"Foundation drs+ solo, per square centimeter","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1345","name":"Pt bsln pam, 2nd scr 4-12 mo","description":"Patients who had a baseline pam score and a second score within 4 to 12 month of baseline pam score","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5128","name":"Inj, cimerli, 0.1 mg","description":"Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0668","name":"Team remote e/m est pt 40 mn","description":"Team remote e/m est. pt 40mins","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0237","name":"Intrav inf, toci, first dose","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1343","name":"Pt pam lvl 4 base or srt lin","description":"Patients who are at pam level 4 at baseline or patients who are flagged with extreme straight line response sets on the pam or with excessive missing responses","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64597","name":"Ins/rplcm prq eltrd ra pn ea","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; each additional electrode array (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1489","name":"Pt status doc","description":"Patient status documented","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0731T","name":"Augmnt ai-based fcl phnt a/r","description":"Augmentative ai-based facial phenotype analysis with report","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0928T","name":"Rem interrog dev ccm-d phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system with interim analysis and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0295U","name":"Onc brst dux carc 7 proteins","description":"Onc brst dux carc 7 proteins","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86051","name":"Aquaporin-4 antb elisa","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; enzyme-linked immunosorbent immunoassay (elisa)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":11.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93574","name":"Njx cath slct pulm vn angrph","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary venous angiography of each distinct pulmonary vein during cardiac catheterization (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0816T","name":"Opn insj/rplcmt ins ptn subq","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0524U","name":"Ob pe sflt-1/plgf ia srm/pls","description":"Ob pe sflt-1/plgf ia srm/pls","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0387","name":"Comp image capture only","description":"Comp image capture only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4259","name":"Celera per sq cm","description":"Celera dual layer or celera dual membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1598","name":"Inj glycopyrrolate fres kabi","description":"Injection, glycopyrrolate (fresenius kabi), not therapeutically equivalent to j1596, 0.1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81025","name":"Urine pregnancy test","description":"Urine pregnancy test, by visual color comparison methods","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0626U","name":"Neurol pd dna alys >20000","description":"Neurol pd dna alys >20000","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90684","name":"Pcv21 vaccine im","description":"Pneumococcal conjugate vaccine, 21 valent (pcv21), for intramuscular use","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73070","name":"X-ray exam of elbow","description":"Radiologic examination, elbow; 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33894","name":"Evasc st rpr thrc/aa acrs br","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; across major side branches","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9296","name":"Inj pemetrexed (accord) 10mg","description":"Injection, pemetrexed (accord), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41110","name":"Excision of tongue lesion","description":"Excision of lesion of tongue without closure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36550","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95954","name":"Eeg monitoring/giving drugs","description":"Pharmacological or physical activation requiring physician or other qualified health care professional attendance during eeg recording of activation phase (eg, thiopental activation test)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6597","name":"G comp bandage long stretch","description":"Gradient compression bandage roll, elastic long stretch, linear yard, any width, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7671","name":"Alveolus open reduction","description":"Alveolus - open reduction may include stabilization of teeth","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69719","name":"Rplcm oi implt sk tc esp<100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94626","name":"Phy/qhp op pulm rhb w/mntr","description":"Physician or other qualified health care professional services for outpatient pulmonary rehabilitation; with continuous oximetry monitoring (per session)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0517U","name":"Ther rx mntr 80+ psyactiv rx","description":"Ther rx mntr 80+ psyactiv rx","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4370","name":"Aeroguard per sq cm","description":"Aeroguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0525","name":"Inj cefotetan disodium 10 mg","description":"Injection, cefotetan disodium, 10 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7961","name":"Buccal/labial frenectomy","description":"Buccal/labial frenectomy","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4287","name":"Dermabind dl, per sq cm","description":"Dermabind dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0872","name":"Daptomycin (xellia) unrefrig","description":"Injection, daptomycin (xellia), unrefrigerated, not therapeutically equivalent to j0878 or j0873, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4395","name":"Acelagraft per sq cm","description":"Acelagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0783T","name":"Tc auriculr neurostimulation","description":"Transcutaneous auricular neurostimulation, set-up, calibration, and patient education on use of equipment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1381","name":"Pt sec strk wthin 5 days","description":"Patients with secondary stroke (e.g., a subsequent stroke that may occur with vasospasm in the setting of subarachnoid hemorrhage) within 5 days of the initial procedure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12031","name":"Intmd rpr s/a/t/ext 2.5 cm/<","description":"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 2.5 cm or less","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":301.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1002T","name":"Air displacmnt plethysmograp","description":"Air displacement plethysmography, whole-body composition assessment, with interpretation and report","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0293U","name":"Psyc suicidal idea mrna 54","description":"Psyc suicidal idea mrna 54","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87076","name":"Culture anaerobe ident each","description":"Culture, bacterial; anaerobic isolate, additional methods required for definitive identification, each isolate","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1423","name":"Opt care urologic cnd mvp","description":"Optimal care for patients with urologic conditions mips value pathway","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40520","name":"Partial excision of lip","description":"Excision of lip; v-excision with primary direct linear closure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":419.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4372","name":"Amchoplast excl per sq cm","description":"Amchoplast excel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0593U","name":"Nfct ds gu pthgn dna 46trgt","description":"Nfct ds gu pthgn dna 46trgt","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84430","name":"Assay of thiocyanate","description":"Thiocyanate","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0684","name":"App non-sheet skin sb g addl","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area or part thereof, or each additional 1% o","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53865","name":"Cysto insj dev ischmc rmdlg","description":"Cystourethroscopy with insertion of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0774T","name":"Vr px dissoc svc oth phy ea","description":"Virtual reality (vr) procedural dissociation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports; each additiona","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1302","name":"Scrn mam perf rslts doc","description":"Screening, diagnostic, film digital or digital breast tomosynthesis (3d) mammography results documented and reviewed","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63194","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1550.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5944","name":"Max implt sup remv part","description":"Max implt sup remv part","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4318","name":"Fem urinary cup w/wo attch","description":"Female external urinary collection cup, with or without ring attachment, per day","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0591U","name":"Onc prst8 ca 3prtns plsm srm","description":"Onc prst8 ca 3prtns plsm srm","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1307","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1306","name":"Injection, inclisiran, 1 mg","description":"Injection, inclisiran, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7241","name":"Impact tooth rem bony w/comp","description":"Removal of impacted tooth-completely bony with unusual surgical complications","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0901T","name":"Plmt bone marrow smplg port","description":"Placement of bone marrow sampling port, including imaging guidance when performed","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1821","name":"Ko elas w/ condyle pads otf","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, off the shelf","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6038","name":"Multiax rotation attachment","description":"Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1376","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33505","name":"Repair artery w/tunnel","description":"Repair of anomalous coronary artery from pulmonary artery origin; with construction of intrapulmonary artery tunnel (takeuchi procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5611","name":"Rep resin part dent base man","description":"Rep resin part dent base man","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0339U","name":"Onc prst8 mrna hoxc6 & dlx1","description":"Onc prst8 mrna hoxc6 & dlx1","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0738","name":"Upper extremity rehab","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15297.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90638","name":"Vacc qirv mrna 60mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 60 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1290","name":"Pt not eli d/t act dig htn","description":"Patient not eligible due to active diagnosis of hypertension","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94625","name":"Phy/qhp op pulm rhb w/o mntr","description":"Physician or other qualified health care professional services for outpatient pulmonary rehabilitation; without continuous oximetry monitoring (per session)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5942","name":"Proth max implt sup remv","description":"Proth max implt sup remv","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43288","name":"Esphg thrsc moblj","description":"Esophagectomy, total or near total, with thoracoscopic mobilization of the upper, middle, and lower mediastinal esophagus, with separate laparoscopic proximal gastrectomy, with laparoscopic pyloric drainage procedure if performed, with open cervical pharyngogastrostomy or esophagogastrostomy (ie, th","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4045.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0379U","name":"Tgsap sl or neo dna523&rna55","description":"Tgsap sl or neo dna523&rna55","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93575","name":"Njx cath slct p angrph mapca","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary angiography of major aortopulmonary collateral arteries (mapcas) arising off the aorta or its systemic branches, during cardiac catheterization for congenital heart d","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1457","name":"Dx asth dur crnt/prv perf pd","description":"Patient had a diagnosis of asthma with any contact during the current or prior performance period or had asthma present on an active problem list any time during the performance period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1400","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1292","name":"Pt 66+ frail inpt adv ill","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and an advanced illness diagnosis during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0389U","name":"Ped fbrl kd ifi27&mcemp1 rna","description":"Ped fbrl kd ifi27&mcemp1 rna","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1217","name":"Sys rsn no doc spiro","description":"Documentation of system reason(s) for not documenting and reviewing spirometry results (e.g., spirometry equipment not available at the time of the encounter)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9245","name":"Admin mod sedation-enteral","description":"Admin mod sedation-enteral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0039","name":"Pt no ref, rn spec","description":"Patient not referred, reason not otherwise specified","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90638","name":"Vacc qirv mrna 60mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 60 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1225","name":"Iop dec>=20% from base","description":"Intraocular pressure (iop) reduced by a value of greater than or equal to 20% from the pre-intervention level","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57155","name":"Insert uteri tandem/ovoids","description":"Insertion of uterine tandem and/or vaginal ovoids for clinical brachytherapy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90613","name":"Inf&sarscov2 vacc 40/0.4 im","description":"Influenza virus vaccine, quadrivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 40 mcg/0.4 ml dosage, for intramuscular use","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5133","name":"Inj, tofidence, 1 mg","description":"Injection, tocilizumab-bavi (tofidence), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1182","name":"Not elg pre ex ibd/uc/crohn","description":"Patients not eligible due to pre-existing inflammatory bowel disease (ibd) (e.g., ulcerative colitis, crohns disease)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61618","name":"Repair dura","description":"Secondary repair of dura for cerebrospinal fluid leak, anterior, middle or posterior cranial fossa following surgery of the skull base; by free tissue graft (eg, pericranium, fascia, tensor fascia lata, adipose tissue, homologous or synthetic grafts)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1427.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4019","name":"Oncology/hema ss","description":"Oncology/hematology mips specialty set","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87210","name":"Smear wet mount saline/ink","description":"Smear, primary source with interpretation; wet mount for infectious agents (eg, saline, india ink, koh preps)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33904","name":"Perq p-art revsc each addl","description":"Percutaneous pulmonary artery revascularization by stent placement, each additional vessel or separate lesion, normal or abnormal connections (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47384","name":"Abltj ire liver 1+ tum perq","description":"Ablation, irreversible electroporation, liver, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1308","name":"Flu immunize no admin","description":"Influenza immunization was not administered, reason not given","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0577U","name":"Onc ovr serum alys 39 gps","description":"Onc ovr serum alys 39 gps","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7111","name":"Extraction coronal remnants","description":"Extraction coronal remnants - deciduous tooth","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6034","name":"Part hand finger distal amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s)/thumb, amputation at distal to metacarpal joint, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l669","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9063","name":"Inj, elahere, 1 mg","description":"Injection, mirvetuximab soravtansine-gynx, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0795T","name":"Tcat ins 2chmbr ldls pm cmpl","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; complete system (ie, r","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0298U","name":"Onc pan tum whl trns seq rna","description":"Onc pan tum whl trns seq rna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4225","name":"Amnio or derma tl, per sq cm","description":"Amniobind or dermabind tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34704","name":"Evasc rpr a-unilac ndgft rpt","description":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-uni-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in th","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2362.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93595","name":"L hrt cath chd nm/abn nt cnj","description":"Left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone, normal or abnormal native connections","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0996T","name":"Ins&sclr fix caps bag prosth","description":"Insertion and scleral fixation of a capsular bag prosthesis containing an intraocular lens prosthesis, with vitrectomy, including removal of crystalline lens or dislocated intraocular lens prosthesis, when performed","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53220","name":"Treatment of urethra lesion","description":"Excision or fulguration of carcinoma of urethra","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":494.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38571","name":"Laparoscopy lymphadenectomy","description":"Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":937.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64598","name":"Revj/rmvl nea pn w/int nstim","description":"Revision or removal of neurostimulator electrode array, peripheral nerve, with integrated neurostimulator","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0841T","name":"Dgtz gls mcrscp pth cslt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; first tissue block, with frozen section(s), single specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0257U","name":"Vlcad leuk nzm actv whl bld","description":"Very long chain acyl- coenzyme a (coa) dehydrogenase (vlcad), leukocyte enzyme activity, whole blood","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8005","name":"Grip glove w microprocessor","description":"Powered, cable driven grip assist glove, hand, finger, includes microprocessor, pressure sensors, all components and accessories, custom fitted","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0874T","name":"Rmvl pertl ascites pmp sys","description":"Removal of a peritoneal ascites pump system, including implanted peritoneal ascites pump and indwelling bladder and peritoneal catheters","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98977","name":"Rtm dev sply mscskl 16-30 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of musculoskeletal system, 16-30 days in a 30-day period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85004","name":"Automated diff wbc count","description":"Blood count; automated differential wbc count","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4290","name":"Membrane wrap hydr per sq cm","description":"Membrane wrap-hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55867","name":"Laps surg prst8ect smpl stot","description":"Laparoscopy, surgical prostatectomy, simple subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy), includes robotic assistance, when performed","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4366","name":"Dl amnio bur x-mem per sq cm","description":"Dual layer amnio burgeon x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0848T","name":"Dgtz gls mcrscp ish 1st","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40831","name":"Repair mouth laceration","description":"Closure of laceration, vestibule of mouth; over 2.5 cm or complex","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92631","name":"Hearing aid slctn svc 1st 30","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4479","name":"Transanal irrigation, electr","description":"Electronic transanal irrigation system, includes electronic pump, water reservoir, tubing, and accessories, without catheter, any type","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q0224","name":"Inj, pemivibart, 4500 mg","description":"Injection, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, and who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppressive ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64598","name":"Revj/rmvl nea pn w/int nstim","description":"Revision or removal of neurostimulator electrode array, peripheral nerve, with integrated neurostimulator","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33903","name":"Perq p-art revsc 1 abnor bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, bilateral","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4414","name":"Simplichor per sq cm","description":"Simplichor, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22860","name":"Tot disc arthrp 2ntrspc lmbr","description":"Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression); second interspace, lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4020","name":"Ophthalmology/optometry ss","description":"Ophthalmology/optometry mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1009T","name":"Rem mntr s-sclp cont eeg sys","description":"Remote monitoring of a sub-scalp implanted continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59414","name":"Deliver placenta","description":"Delivery of placenta (separate procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4405","name":"Xwrap fenestra plus sq cm","description":"Xwrap fenestra plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63032","name":"Lamot rpr anulr dfct 1 lmbr","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; with repair of annular defect by implantation of bone-anchored annular closure device, including all imaging guidance, 1 interspace, lumbar","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81441","name":"Ibmfs seq alys pnl 30 genes","description":"Inherited bone marrow failure syndromes (ibmfs) (eg, fanconi anemia, dyskeratosis congenita, diamond-blackfan anemia, shwachman-diamond syndrome, gata2 deficiency syndrome, congenital amegakaryocytic thrombocytopenia) sequence analysis panel, must include sequencing of at least 30 genes, including b","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1025T","name":"Alt elec fld dos&dlv sim mdl","description":"Alternating electric fields dosimetry and delivery-simulation modeling, creation and selection of patient-specific array layouts, and placement verification","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23440","name":"Remove/transplant tendon","description":"Resection or transplantation of long tendon of biceps","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":937.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0927T","name":"Interrog dev eval ccm-d ip","description":"Interrogation device evaluation (in person) with analysis, review, and report, including connection, recording, and disconnection, per patient encounter, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15610","name":"Delay flap arms/legs","description":"Delay of flap or sectioning of flap (division and inset); at scalp, arms, or legs","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":284.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6105","name":"Remove implant body","description":"Remove implant body","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0612","name":"Inj, calcium gluconate, nos","description":"Injection, calcium gluconate, not otherwise specified, 10 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76826","name":"Echo exam of fetal heart","description":"Echocardiography, fetal, cardiovascular system, real time with image documentation (2d), with or without m-mode recording; follow-up or repeat study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1837","name":"Inj, posaconazole, 1 mg","description":"Injection, posaconazole, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96372","name":"Ther/proph/diag inj sc/im","description":"Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0461U","name":"Onc rxgenom alys rtpcr 24gen","description":"Onc rxgenom alys rtpcr 24gen","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5783","name":"Add low ext mec limb vol lam","description":"Addition to lower extremity, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6515","name":"Grad com wrap w str fu le cu","description":"Gradient compression wrap with adjustable straps, full leg, each, custom","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4256","name":"Mlg complet, per sq cm","description":"Mlg-complete, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0370","name":"Max ultrasound capt & interp","description":"Max ultrasound capt & interp","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0136","name":"Adm of pa/n assess 5-15 m","description":"Administration of a standardized, evidence-based assessment of physical activity and nutrition, 5-15 minutes, not more often than every 6 months","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0662","name":"Team remote e/m new pt 30 mn","description":"Team remote e/m new pt 30 mins","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1576","name":"Inj, panzyga, 500 mg","description":"Injection, immune globulin (panzyga), intravenous, non-lyophilized (e.g., liquid), 500 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38226","name":"Car-t prep t lymphcyt f/trns","description":"Chimeric antigen receptor t-cell (car-t) therapy; preparation of blood-derived t lymphocytes for transportation (eg, cryopreservation, storage)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9939","name":"Placemnt removable appliance","description":"Placemnt removable appliance","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0821T","name":"Mntr psychdlc med 2ndphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; second physician or other qualified health care professional, concurrent with first physician or other qualified health care professional, each hour (list sepa","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75842","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86813","name":"Hla typing a b or c","description":"Hla typing; a, b, or c, multiple antigens","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0269U","name":"Hem aut dm cgen trmbctpna 14","description":"Hematology (autosomal dominant congenital thrombocytopenia), genomic sequence analysis of 14 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0469U","name":"Rare ds whl gen seq ftl samp","description":"Rare ds whl gen seq ftl samp","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7514","name":"Mycophenol (myhibbin) 100 mg","description":"Mycophenolate mofetil (myhibbin), oral suspension, 100 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0759T","name":"Dgtz gls mcrscp sl sp grpiii","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group iii, for enzyme constituents (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0721T","name":"Quan ct tiss charac w/o ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95907","name":"Nvr cndj tst 1-2 studies","description":"Nerve conduction studies; 1-2 studies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6191","name":"Semi precision abutment","description":"Semi precision abutment","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87467","name":"Hepatitis b surface ag quan","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; hepatitis b surface antigen (hbsag), quantitative","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77090","name":"Tbs techl prep&transmis data","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1466","name":"Pt disc/lam proc same day","description":"Patient had a lumbar fusion on the same date as the discectomy/laminectomy procedure","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4399","name":"Summit fx per sq cm","description":"Summit fx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0963T","name":"Anosc sbmcsl njx bulking agt","description":"Anoscopy with directed submucosal injection of bulking agent into anal canal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15016","name":"App skn cl ssp agrf t/a/l ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; each additional 480 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9602","name":"Fluorodopa f-18 diag per mci","description":"Fluorodopa f-18, diagnostic, per millicurie","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0286U","name":"Cep72 nudt15&tpmt gene alys","description":"Cep72 nudt15&tpmt gene alys","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0372U","name":"Nfct ds gu pthgn arg detcj","description":"Nfct ds gu pthgn arg detcj","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9004","name":"Va whole health partner serv","description":"Department of veterans affairs whole health partner services","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0484U","name":"Nfct ds mgen 23s rrna pt mut","description":"Nfct ds mgen 23s rrna pt mut","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4252","name":"Vendaje, per square centimet","description":"Vendaje, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1612","name":"Inj glucagon (gvoke) 0.01 mg","description":"Injection, glucagon (gvoke), 0.01 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0903T","name":"Ecg alg 12 lead reduced i&r","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; with interpretation and report","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93585","name":"Vngrph chd azygs/hemiazygs","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; azygos/hemiazygos venous system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93584","name":"Vngrph chd anom/persist svc","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; anomalous or persistent superior vena cava when it exists as a second contralateral superior vena cava, with native drainage to heart (list separately in addition to code for pri","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0616","name":"Inj metoprolol tartrate 1 mg","description":"Injection, metoprolol tartrate, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25251","name":"Removal of wrist prosthesis","description":"Removal of wrist prosthesis; complicated, including total wrist","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1320","name":"Pts scrn + hrsn","description":"Patients who screened positive for at least 1 of the 5 hrsns","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1218","name":"Pt copd symptoms","description":"Patient has copd symptoms (e.g., dyspnea, cough/sputum, wheezing)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82672","name":"Assay of estrogen","description":"Estrogens; total","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0327U","name":"Ftl aneuploidy trsmy dna seq","description":"Ftl aneuploidy trsmy dna seq","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0536U","name":"Rbcag ftl rhd pcr alys exon4","description":"Rbcag ftl rhd pcr alys exon4","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86727","name":"Lymph choriomeningitis ab","description":"Antibody; lymphocytic choriomeningitis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69730","name":"Rplc oi implt sk tc esp>=100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4318","name":"Fem urinary cup w/wo attch","description":"Female external urinary collection cup, with or without ring attachment, per day","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44372","name":"Small bowel endoscopy","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with placement of percutaneous jejunostomy tube","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86042","name":"Acetylcholn rcptr blckg antb","description":"Acetylcholine receptor (achr); blocking antibody","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93965","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97037","name":"Appl modality 1+lllt po pain","description":"Application of a modality to 1 or more areas; low-level laser therapy (ie, nonthermal and non-ablative) for post-operative pain reduction","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27860","name":"Fixation of ankle joint","description":"Manipulation of ankle under general anesthesia (includes application of traction or other fixation apparatus)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86580","name":"Tb intradermal test","description":"Skin test; tuberculosis, intradermal","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1481","name":"Pt in hosp/pal care who died","description":"Patients receiving hospice or palliative care or who died during the measurement period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1267","name":"Pt no act kid transplt wtlst","description":"Patients not observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90624","name":"Menb-4c&menacwy vacc im","description":"Meningococcal pentavalent vaccine, men b-4c recombinant proteins and outer membrane vesicle and conjugated men a, c, w, y-diphtheria toxoid carrier, for intramuscular use","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1351","name":"Dental sealant per tooth","description":"Sealant-per tooth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4393","name":"Surgraft ac per sq cm","description":"Surgraft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0750T","name":"B1 str&fx rsk asmt dxrbmd1vw","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25210","name":"Removal of wrist bone","description":"Carpectomy; 1 bone","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":623.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32606","name":"Thoracoscopy w/bx med space","description":"Thoracoscopy, diagnostic (separate procedure); mediastinal space, with biopsy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":577.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9048","name":"Inj, bortezomib freseniuskab","description":"Injection, bortezomib (fresenius kabi), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87811","name":"Sars-cov-2 covid19 w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19])","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1391","name":"All pt dx w/ rec mlnm","description":"All patients who were diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4353","name":"Xceed tl matrix per sq cm","description":"Xceed tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0544","name":"Post d/c phone follow up","description":"Post discharge telephonic follow-up contacts performed in conjunction with a discharge from the emergency department for behavioral health or other crisis encounter, 4 calls per calendar month","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64597","name":"Ins/rplcm prq eltrd ra pn ea","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; each additional electrode array (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7049","name":"Epap nasal valve","description":"Expiratory positive airway pressure intranasal resistance valve","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35681","name":"Composite byp grft pros&vein","description":"Bypass graft; composite, prosthetic and vein (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94770","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83884","name":"Assay neurflmnt light chain","description":"Neurofilament light chain (nfl)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7972","name":"Surg redct fibrous tuberosit","description":"Surgical reduction of fibrous tuberosity","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1307","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33276","name":"Insj phrnc nrv stim sys","description":"Insertion of phrenic nerve stimulator system (pulse generator and stimulating lead[s]), including vessel catheterization, all imaging guidance, and pulse generator initial analysis with diagnostic mode activation, when performed","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4397","name":"Summit aaa per sq cm","description":"Summit aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5932","name":"Postsurgical obturator","description":"Obturator prosthesis definitive","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4423","name":"Biolab tri wrap fl per sq cm","description":"Biolab tri-membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7956","name":"Tiss regen edent resorb","description":"Tiss regen edent resorb","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0048","name":"Pall serv during meas","description":"Patients who receive palliative care services any time during the intake period through the end of the measurement year","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4038","name":"Vascular surgery ss","description":"Vascular surgery mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55881","name":"Ablt trurl prst8 tis thrm us","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation;","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0521U","name":"Rf iga&igm ccp antb sr-a ia","description":"Rf iga&igm ccp antb sr-a ia","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1298","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4303","name":"Complete aa, per sq cm","description":"Complete aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92930","name":"Prq tcat plmt ntrac st 2+les","description":"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 2 or more distinct coronary lesions with 2 or more coronary stents deployed in 2 or more coronary segments, or a bifurcation lesion requiring ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87430","name":"Strep a ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; streptococcus, group a","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96542","name":"Chemotherapy injection","description":"Chemotherapy injection, subarachnoid or intraventricular via subcutaneous reservoir, single or multiple agents","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5992","name":"Low prosth foot shell repl","description":"All lower extremity prosthesis, foot shell for modular foot/non-solid ankle cushion heel (sach) replacement only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":127.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53865","name":"Cysto insj dev ischmc rmdlg","description":"Cystourethroscopy with insertion of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1352","name":"Suicd c-ssrs assessment, equ","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs or equivalent assessment","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83070","name":"Assay of hemosiderin qual","description":"Hemosiderin, qualitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0587U","name":"Ther rx mntr 60-150rx&metabl","description":"Ther rx mntr 60-150rx&metabl","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96366","name":"Ther/proph/diag iv inf addon","description":"Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); each additional hour (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1413","name":"Inj delandistrogene mox rokl","description":"Injection, delandistrogene moxeparvovec-rokl, per therapeutic dose","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4319","name":"Sanograft, per sq cm","description":"Sanograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1376","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0690T","name":"Quan us tis charac w/dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained with diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30905","name":"Control of nosebleed","description":"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; initial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0013","name":"Esketamine, nasal spray","description":"Esketamine, nasal spray, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1175","name":"Doc med rsn no hzv","description":"Documentation of medical reason(s) for not administering zoster vaccine (e.g., prior anaphylaxis due to the zoster vaccine)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1105","name":"Dexmedetomidine film, 1 mcg","description":"Dexmedetomidine, oral, 1 mcg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2006","name":"Novosorb synpath per sq cm","description":"Novosorb synpath dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0863T","name":"Rlcj pg wcs lv trnsmtr only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; transmitter component only","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2794","name":"Crown-titanium","description":"Crown-titanium","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0530","name":"Adult daycare center, 8 hr u","description":"Adult day center, 8-hour unit, for use in cmmi model","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84035","name":"Assay of phenylketones","description":"Phenylketones, qualitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0512U","name":"Onc prst8 alys dgtz img msi","description":"Onc prst8 alys dgtz img msi","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1227","name":"Eb therapy prescribed","description":"Evidence-based therapy was prescribed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1720","name":"Influenza vacc admin","description":"Influenza vacc admin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1464","name":"No record of f/u by 180 days","description":"No documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2055","name":"Idecabtagene vicleucel car","description":"Idecabtagene vicleucel, up to 510 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4312","name":"Acesso ac, per sq cm","description":"Acesso ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0297U","name":"Onc pan tum whl gen seq dna","description":"Onc pan tum whl gen seq dna","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28262","name":"Revision of foot and ankle","description":"Capsulotomy, midfoot; extensive, including posterior talotibial capsulotomy and tendon(s) lengthening (eg, resistant clubfoot deformity)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1332.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3394","name":"Inj, lovotibeglogene autotem","description":"Injection, lovotibeglogene autotemcel, per treatment","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55520","name":"Removal of sperm cord lesion","description":"Excision of lesion of spermatic cord (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81451","name":"Hl neo gsap 5-50 rna alys","description":"Hematolymphoid neoplasm or disorder, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants, and copy number variants or rearrangements, or isoform expression or mrna expression levels, if performed; rna analysis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0024","name":"Pin srv add 30 min pr m","description":"Principal illness navigation services, additional 30 minutes per calendar month (list separately in addition to g0023)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0874","name":"Inj, daptomycin (baxter)","description":"Injection, daptomycin (baxter), not therapeutically equivalent to j0878, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0618U","name":"Psyc bd dna mthyl alys>10000","description":"Psyc bd dna mthyl alys>10000","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4305","name":"Amer am ac tri-lay per sq cm","description":"American amnion ac tri-layer, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4300","name":"Acesso tl, per sq cm","description":"Acesso tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37298","name":"Revsc evsc imvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31375","name":"Partial removal of larynx","description":"Partial laryngectomy (hemilaryngectomy); laterovertical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1897.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33267","name":"Excl laa open any method","description":"Exclusion of left atrial appendage, open, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9331","name":"Inj sirolimus prot part 1 mg","description":"Injection, sirolimus protein-bound particles, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0684T","name":"Peri-px dev eval isdss ip","description":"Peri-procedural device evaluation (in-person) and programming of device system parameters before or after a surgery, procedure, or test with analysis, review, and report by a physician or other qualified health care professional, permanent implantable synchronized diaphragmatic stimulation system fo","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37255","name":"Revsc evasc ivt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67516","name":"Sprchoroidal spc njx rx agt","description":"Suprachoroidal space injection of pharmacologic agent (separate procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0377U","name":"Cv ds quan advsrm/plsm lprtn","description":"Cv ds quan advsrm/plsm lprtn","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1032","name":"Sv doula brth wrk per 15 min","description":"Services performed by a doula birth worker, per 15 minutes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82044","name":"Ur albumin semiquantitative","description":"Albumin; urine (eg, microalbumin), semiquantitative (eg, reagent strip assay)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0962T","name":"Asstv alg alys acous&ecg rec","description":"Assistive algorithmic analysis of acoustic and electrocardiogram recording for detection of cardiac dysfunction (eg, reduced ejection fraction, cardiac murmurs, atrial fibrillation), with review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37294","name":"Rvsc evsc tpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":195.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55715","name":"Bx prst8 ea add mri-us/ct/mr","description":"Biopsy, prostate, each additional, mri-ultrasound fusion or in-bore ct- or mri-guided targeted lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1467","name":"Pt dx lynch syn","description":"Patients with an existing diagnosis of lynch syndrome","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2781","name":"Crown 3/4 cast base metal","description":"Crown - 3/4 cast predominantly base metal","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0168","name":"Epinephrine (intl med sys)","description":"Injection, epinephrine (international medication systems), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1257","name":"Cvd risk assess not perf","description":"Cvd risk assessment not performed or incomplete (e.g., cvd risk assessment was not documented), reason not otherwise specified","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35400","name":"Angioscopy","description":"Angioscopy (noncoronary vessels or grafts) during therapeutic intervention (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1306","name":"Injection, inclisiran, 1 mg","description":"Injection, inclisiran, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37261","name":"Revsc evasc ivt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2526","name":"Cntct lens blue violet","description":"Contact lens, hydrophilic, with blue-violet filter, per lens","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0137","name":"Inj, acetaminophen (hikma)","description":"Injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1807","name":"Inj, ethacrynate sod, 1 mg","description":"Injection, ethacrynate sodium, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81195","name":"Cytog genom-wid alys hem mal","description":"Cytogenomic (genome-wide) analysis, hematologic malignancy, structural variants and copy number variants, optical genome mapping (ogm)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0909T","name":"Rplcmt int nstim sys vgs nrv","description":"Replacement of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61891","name":"Rev/rplcmt sk-mnt crnl nstm","description":"Revision or replacement of skull-mounted cranial neurostimulator pulse generator or receiver with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0459U","name":"Abeta42 & ttau eclia csf","description":"Abeta42 & ttau eclia csf","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5945","name":"Mand implt sup remv part","description":"Mand implt sup remv part","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0869T","name":"Njx b1 sub mtrl hw fixj aug","description":"Injection(s), bone-substitute material for bone and/or soft tissue hardware fixation augmentation, including intraoperative imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0614","name":"Inj, treosulfan, 50 mg","description":"Injection, treosulfan, 50 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81560","name":"Trnsplj pd lvr&bwl cd154+cll","description":"Transplantation medicine (allograft rejection, pediatric liver and small bowel), measurement of donor and third-party-induced cd154+t-cytotoxic memory cells, utilizing whole peripheral blood, algorithm reported as a rejection risk score","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0532U","name":"Rare ds whlgen&mitochdrl dna","description":"Rare ds whlgen&mitochdrl dna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1209","name":">=2 same hi-rsk med w/o diag","description":"At least two orders for high-risk medications from the same drug class, (table 4), without appropriate diagnoses","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86826","name":"Hla x-match noncytotoxc addl","description":"Human leukocyte antigen (hla) crossmatch, non-cytotoxic (eg, using flow cytometry); each additional serum sample or sample dilution (list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20822","name":"Replantation digit complete","description":"Replantation, digit, excluding thumb (includes distal tip to sublimis tendon insertion), complete amputation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2926.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49189","name":"Opn exc/dst ntra-abd 20.1-30","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 20.1 to 30 cm","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0618","name":"Inj, calcium chloride, 2 mg","description":"Injection, calcium chloride, 2 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1485","name":"Neg viro resp hep c/qual rna","description":"Patients who did not achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0385U","name":"Neph ckd alg rsk dbtc kdn ds","description":"Neph ckd alg rsk dbtc kdn ds","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0295U","name":"Onc brst dux carc 7 proteins","description":"Onc brst dux carc 7 proteins","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0447U","name":"Ai ds sle alys 11 cytokine","description":"Ai ds sle alys 11 cytokine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0680T","name":"Insj/rplcmt pg only isdss","description":"Insertion or replacement of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing lead(s)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37263","name":"Revsc evasc fpvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5128","name":"Inj, cimerli, 0.1 mg","description":"Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4350","name":"Palisade dm matrix per sq cm","description":"Palisade dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83876","name":"Assay myeloperoxidase","description":"Myeloperoxidase (mpo)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64728","name":"Dcmprn median nrv carpl tunl","description":"Decompression; median nerve at the carpal tunnel, percutaneous, with intracarpal tunnel balloon dilation, including ultrasound guidance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33690","name":"Banding pulmonary artery","description":"Banding of pulmonary artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1402.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19085","name":"Bx breast 1st lesion mr imag","description":"Biopsy, breast, with placement of breast localization device(s) (eg, clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; first lesion, including magnetic resonance guidance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0704T","name":"Rem tx amblyopia setup&edu","description":"Remote treatment of amblyopia using an eye tracking device; device supply with initial set-up and patient education on use of equipment","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1429","name":"Retinopathy in od, os, ou","description":"Retinal exam finding with evidence of retinopathy in left, right or both eyes with severity level documented","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2329","name":"Inj ublituximab-xiiy, 1 mg","description":"Injection, ublituximab-xiiy, 1mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1240","name":"Pt no resp best int","description":"Patient did not respond to the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0725T","name":"Vestibular dev impltj uni","description":"Vestibular device implantation, unilateral","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0391U","name":"Onc sld tum dna&rna 437 gen","description":"Onc sld tum dna&rna 437 gen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0570","name":"Buprenorphine implant 74.2mg","description":"Buprenorphine implant, 74.2 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0557U","name":"Nfct ds bv dna mrk vag fluid","description":"Nfct ds bv dna mrk vag fluid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0406U","name":"Onc lung flow cytmtry 5 mrk","description":"Onc lung flow cytmtry 5 mrk","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49622","name":"Rpr parastomal hrna ncr/strn","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99326","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9936","name":"Clean occ guard","description":"Clean occ guard","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4367","name":"Amniocore sl, per sq cm","description":"Amniocore sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76805","name":"Ob us >/= 14 wks sngl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0823T","name":"Tcat ins 1chmbr ldls pm ra","description":"Transcatheter insertion of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or programming), when","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0442U","name":"Nfct ds respir nfctj mxa&crp","description":"Nfct ds respir nfctj mxa&crp","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3247","name":"Inj secukinumab intrav 1mg","description":"Injection, secukinumab, intravenous, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0664","name":"Team remote e/m new pt 60 mn","description":"Team remote e/m new pt 60mins","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86706","name":"Hep b surface antibody","description":"Hepatitis b surface antibody (hbsab)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0953T","name":"Tot impl amei rev/rplc w/o","description":"Totally implantable active middle ear hearing implant; revision or replacement, without mastoidectomy and replacement of sound processor","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93150","name":"Therapy activation ipnss","description":"Therapy activation of implanted phrenic nerve stimulator system, including all interrogation and programming","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0343U","name":"Onc prst8 xom aly 442 sncrna","description":"Onc prst8 xom aly 442 sncrna","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0971T","name":"Ablt mal brst tum pq lsr uni","description":"Ablation, malignant breast tumor(s), percutaneous, laser, including imaging guidance when performed, unilateral","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64658","name":"Rmvl bat modul sys lead only","description":"Removal of baroreflex activation therapy (bat) modulation system; lead only","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0917T","name":"Insj perm ccm-d sys 1 lead","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; single transvenous lead (pacing or defibrillation) only","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77092","name":"Tbs i&r fx rsk qhp","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; interpretation and report on fracture-risk only by other qualified health care professional","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0408U","name":"Iaad blk ac wv bsnsr sarscv2","description":"Iaad blk ac wv bsnsr sarscv2","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6032","name":"Part handfng ultralite tcf/=","description":"Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9956","name":"Admin home sleep apnea test","description":"Admin home sleep apnea test","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0526U","name":"Nefro rnl trnspl quan cxcl10","description":"Nefro rnl trnspl quan cxcl10","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22600","name":"Arthrd pst tq 1ntrspc crv","description":"Arthrodesis, posterior or posterolateral technique, single interspace; cervical below c2 segment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90901","name":"Biofeedback train any meth","description":"Biofeedback training by any modality","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5140","name":"Inj adalimumab-fkjp, 1 mg","description":"Injection, adalimumab-fkjp, biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87880","name":"Strep a assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; streptococcus, group a","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1499","name":"Interventional radiology mvp","description":"Interventional radiology mips value pathway","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95115","name":"Immunotherapy one injection","description":"Professional services for allergen immunotherapy not including provision of allergenic extracts; single injection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9382","name":"Inj zenocutuzumab-zbco 1 mg","description":"Injection, zenocutuzumab-zbco, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0425U","name":"Genom rpd seq alys ea cmprtr","description":"Genom rpd seq alys ea cmprtr","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0801","name":"3d dental scan direct","description":"3d dental scan direct","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78492","name":"Myocrd img pet mlt rst&strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); multiple studies at rest and stress (exercise or pharmacologic)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1932","name":"Inj, lanreotide, (cipla) 1mg","description":"Injection, lanreotide, (cipla), 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86335","name":"Immunfix e-phorsis/urine/csf","description":"Immunofixation electrophoresis; other fluids with concentration (eg, urine, csf)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96548","name":"Ntraop hipec px ea add 30min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57061","name":"Destruction vag lesions smpl","description":"Destruction of vaginal lesion(s); simple (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1387","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0418U","name":"Onc brst aug alg aly whl sl8","description":"Onc brst aug alg aly whl sl8","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1298","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55100","name":"Drainage of scrotum abscess","description":"Drainage of scrotal wall abscess","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83013","name":"H pylori (c-13) breath","description":"Helicobacter pylori; breath test analysis for urease activity, non-radioactive isotope (eg, c-13)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1491","name":"Recd esrd mcp dur perf pd","description":"Receiving esrd mcp dialysis services by the provider during the performance period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1191","name":"Hspc svc any time in meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32002","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3432","name":"Guided tissue regeneration","description":"Guided tissue regeneration","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99470","name":"Rpm tx mgmt 1st 10 min","description":"Remote physiologic monitoring treatment management services, clinical staff/physician/other qualified health care professional time in a calendar month requiring 1 real-time interactive communication with the patient/caregiver during the calendar month; first 10 minutes","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81464","name":"So gsap cll fr mcrstl ins","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants, microsatellite instability, tumor mutation burden, and rearrangements","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33882","name":"Evasc rpr ta dplmt mltpc sys","description":"Endovascular repair of the thoracic aorta by deployment of a branched endograft multipiece system involving an aorto-aortic tube device with a fenestration for the left subclavian artery stent graft(s) and all aortic tube endograft extension(s) placed from the level of the left common carotid artery","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1314","name":"Bmi not calculated","description":"Bmi not documented and no reason is given","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9269","name":"Programable ingest capsule","description":"Programable, transient, orally ingested capsule, for use with external programmer, per month","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1322","name":"Pts 7wk inj, scrn iop =<25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop =<25 mm hg for injected eye","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1362","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86037","name":"Anca titer each antibody","description":"Antineutrophil cytoplasmic antibody (anca); titer, each antibody","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1202","name":"Pt rsn no ace-i/arb rx","description":"Documentation of patient reason(s) for not prescribing ace inhibitor or arb therapy during the measurement period, (e.g., patient declined, other patient reasons)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6515","name":"Grad com wrap w str fu le cu","description":"Gradient compression wrap with adjustable straps, full leg, each, custom","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5135","name":"Inj, tyenne, 1 mg","description":"Injection, tocilizumab-aazg (tyenne), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2799","name":"Inj, uzedy, 1 mg","description":"Injection, risperidone (uzedy), 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1206","name":"Isa not red 3pts/no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33411","name":"Replacement of aortic valve","description":"Replacement, aortic valve; with aortic annulus enlargement, noncoronary sinus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2711.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0250","name":"Md inr test revie inter mgmt","description":"Physician review, interpretation, and patient management of home inr testing for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria; testing not occurring more frequently than once a week; billing units of servic","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0621U","name":"Nfct ds lb dna alys>10000","description":"Nfct ds lb dna alys>10000","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0628U","name":"Nfro kdn ds genetic cond 449","description":"Nfro kdn ds genetic cond 449","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0138","name":"Inj acetaminoph 10mg/ibu 3mg","description":"Injection, acetaminophen 10 mg and ibuprofen 3 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7299","name":"Rem anchorage device w/flap","description":"Rem anchorage device w/flap","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9996","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"Add upp ext mec limb vol lam","description":"Addition to upper extremity prosthesis, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0671T","name":"Insj ant sgm aq drg dev 1+","description":"Insertion of anterior segment aqueous drainage device into the trabecular meshwork, without external reservoir, and without concomitant cataract removal, one or more","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21193","name":"Reconst lwr jaw w/o graft","description":"Reconstruction of mandibular rami, horizontal, vertical, c, or l osteotomy; without bone graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1443.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33280","name":"Rmvl phrnc nrv stim pg only","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator only","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37255","name":"Revsc evasc ivt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4394","name":"Surgraft aca per sq cm","description":"Surgraft aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67917","name":"Repair eyelid defect","description":"Repair of ectropion; extensive (eg, tarsal strip operations)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0394U","name":"Pfas 16 pfas compnd lc ms/ms","description":"Pfas 16 pfas compnd lc ms/ms","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20972","name":"Bone/skin graft metatarsal","description":"Free osteocutaneous flap with microvascular anastomosis; metatarsal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3071.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1431","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0944T","name":"3d cntr simula trgt lvr les","description":"3d contour simulation of target liver lesion(s) and margin(s) for image-guided percutaneous microwave ablation","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0893","name":"Inj, decitabine (sun pharma)","description":"Injection, decitabine (sun pharma), not therapeutically equivalent to j0894, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1072","name":"Inj, testosterone, azmiro","description":"Injection, testosterone cypionate (azmiro), 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1437","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1476","name":"Pt dx cog imp or ad","description":"Patients with diagnosis of cognitive impairment or alzheimers disease","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0859T","name":"Ncntc ifr spctrsc o/t pad ea","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), other than for screening for peripheral arterial disease, image acquisition, interpretation, and report; each additional anatomic site (list separately in addition to code ","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90482","name":"Imm cnsl not admn sm 3<10","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; 3 minutes up to 10 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1161","name":"Pt anphx due to dtp bef 13","description":"Patient had anaphylaxis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55868","name":"Lap srg prst8ct lymph nod bx","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with lymph node biopsy(ies) (limited pelvic lymphadenectomy)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7294","name":"Seg acet and eth estr yearly","description":"Segesterone acetate and ethinyl estradiol 0.15mg, 0.013mg per 24 hours; yearly vaginal system, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37280","name":"Revsc evsc tpvt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67334","name":"Revise eye muscle w/suture","description":"Strabismus surgery by posterior fixation suture technique, with or without muscle recession (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43228","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92945","name":"Prq trl rvs ch occ ant&rtrgr","description":"Percutaneous transluminal revascularization of chronic total occlusion, single coronary artery, coronary artery branch, or coronary artery bypass graft, and/or subtended major coronary artery branches of the bypass graft, any combination of intracoronary stent, atherectomy and angioplasty; combined ","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9249","name":"Inj, melphalan (apotex) 1 mg","description":"Injection, melphalan (apotex), 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9063","name":"Inj, elahere, 1 mg","description":"Injection, mirvetuximab soravtansine-gynx, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5141","name":"Inj adalimumab-aaty, 1 mg","description":"Injection, adalimumab-aaty, biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0499U","name":"Onc clrct&lng dna ngs 8gene","description":"Onc clrct&lng dna ngs 8gene","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86804","name":"Hep c ab test confirm","description":"Hepatitis c antibody; confirmatory test (eg, immunoblot)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0607U","name":"Reprdtve med ema rtpcr 31bct","description":"Reprdtve med ema rtpcr 31bct","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0931T","name":"Ephys eval ccm-d ld separate","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), separate from initial implantation or replacement with testing of cardiac cont","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0447","name":"Behavior counsel obesity 15m","description":"Face-to-face behavioral counseling for obesity, 15 minutes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":33.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9172","name":"Docetaxel (docivyx), 1 mg","description":"Injection, docetaxel (docivyx), 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55881","name":"Ablt trurl prst8 tis thrm us","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation;","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28530","name":"Treat sesamoid bone fracture","description":"Closed treatment of sesamoid fracture","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0671T","name":"Insj ant sgm aq drg dev 1+","description":"Insertion of anterior segment aqueous drainage device into the trabecular meshwork, without external reservoir, and without concomitant cataract removal, one or more","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1187","name":"Pt w/ esrd","description":"Patients with a diagnosis of end stage renal disease (esrd)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64628","name":"Trml dstrj ios bvn 1st 2 l/s","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; first 2 vertebral bodies, lumbar or sacral","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6107","name":"Tissue regen non-resorbable","description":"Tissue regen non-resorbable","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0525","name":"Inj cefotetan disodium 10 mg","description":"Injection, cefotetan disodium, 10 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0692T","name":"Therapeutic ultrafiltration","description":"Therapeutic ultrafiltration","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61737","name":"Litt icr mlt trj mlt/cplx ls","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; multiple trajectories for multiple or complex lesion(s)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0791T","name":"Motr cog vr gait train ea 15","description":"Motor-cognitive, semi-immersive virtual reality-facilitated gait training, each 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0405U","name":"Onc pncrtc 59 mthltn blk mrk","description":"Onc pncrtc 59 mthltn blk mrk","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0786T","name":"Insj/rplcmt prq ra sac nstim","description":"Insertion or replacement of percutaneous electrode array, sacral, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9611","name":"Flurpiridaz f18, diag, 1 mci","description":"Flurpiridaz f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1356","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19330","name":"Rmvl ruptured breast implant","description":"Removal of ruptured breast implant, including implant contents (eg, saline, silicone gel)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":675.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0284U","name":"Vw factor type 2n eval plsm","description":"Von willebrand factor (vwd), type 2n, factor viii and vwf binding evaluation, enzyme-linked immunosorbent assays (elisa), plasma","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1263","name":"Pts hosp dialysis dt","description":"Patients in hospice on their initiation of dialysis date or during the month of evaluation","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1681","name":"Ho bilateral hip abduction","description":"Hip orthosis, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37281","name":"Revsc evsc tpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2017","name":"Permeaderm glove, each","description":"Permeaderm glove, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1212","name":"Missing gsa not perf","description":"Glycemic status assessment (hba1c or gmi) level is missing, or was not performed during the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1261","name":"Pts on wtlist bef dialysis","description":"Patients that were on the kidney or kidney-pancreas waitlist prior to initiation of dialysis","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0136","name":"Adm of pa/n assess 5-15 m","description":"Administration of a standardized, evidence-based assessment of physical activity and nutrition, 5-15 minutes, not more often than every 6 months","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5811","name":"Denture interm cmplt mandbl","description":"Interim complete denture (mandibular)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0294U","name":"Lngvty&mrtlty rsk mrna 18gen","description":"Lngvty&mrtlty rsk mrna 18gen","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0872","name":"Daptomycin (xellia) unrefrig","description":"Injection, daptomycin (xellia), unrefrigerated, not therapeutically equivalent to j0878 or j0873, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50542","name":"Laparo ablate renal mass","description":"Laparoscopy, surgical; ablation of renal mass lesion(s), including intraoperative ultrasound guidance and monitoring, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1286.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76015","name":"Mr sfty mplt&/fb asmt stf ea","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3472","name":"Surg rep root res premolar","description":"Surg rep root res premolar","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0808T","name":"Pulm tiss vntj alys w/ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with computed tomography (ct) images taken for the purpose of pulmonary tissue ventilation analysis, including data preparation and transmission, quantificati","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0204","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0545","name":"Inherent visit to inpt","description":"Visit complexity inherent to hospital inpatient or observation care associated with a confirmed or suspected infectious disease by an infectious diseases specialist, including disease transmission risk assessment and mitigation, public health investigation, analysis, and testing, and complex antimic","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1293","name":"Calc bmi abv up param f/u","description":"Bmi is documented above normal parameters and a follow-up plan is documented","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0617U","name":"Cv ascvd dna alys >20000","description":"Cv ascvd dna alys >20000","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1001T","name":"Autol musc cell therapy njx","description":"Autologous muscle cell therapy, injection of muscle progenitor cells into the external anal sphincter, including ultrasound guidance, when performed","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0246","name":"Followup eval of foot pt lop","description":"Follow-up physician evaluation and management of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) to include at least the following: (1) a patient history, (2) a physical examination that includes: (a) visual inspection of the forefoot, hindfoot ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3387","name":"Inj elivaldogene autotemecel","description":"Injection, elivaldogene autotemcel, per treatment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0779T","name":"Gi myoelectrical actv study","description":"Gastrointestinal myoelectrical activity study, stomach through colon, with interpretation and report","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33269","name":"Excl laa thrscp any method","description":"Exclusion of left atrial appendage, thoracoscopic, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22860","name":"Tot disc arthrp 2ntrspc lmbr","description":"Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression); second interspace, lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31370","name":"Partial removal of larynx","description":"Partial laryngectomy (hemilaryngectomy); horizontal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2048.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0389U","name":"Ped fbrl kd ifi27&mcemp1 rna","description":"Ped fbrl kd ifi27&mcemp1 rna","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0791T","name":"Motr cog vr gait train ea 15","description":"Motor-cognitive, semi-immersive virtual reality-facilitated gait training, each 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0803","name":"3d facial scan direct","description":"3d facial scan direct","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0972T","name":"Asstv alg clsfctn burn hlg","description":"Assistive algorithmic classification of burn healing (ie, healing or nonhealing) by noninvasive multispectral imaging, including system set-up and acquisition, selection, and transmission of images, with automated generation of report","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0747T","name":"Car ablt rad arrhyt dlvr rad","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; delivery of radiation therapy, arrhythmia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0946T","name":"Ortho impl mvmt alys pair ct","description":"Orthopedic implant movement analysis using paired computed tomography (ct) examination of the target structure, including data acquisition, data preparation and transmission, interpretation and report (including ct scan of the joint or extremity performed with paired views)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0702","name":"2d cephal radio image","description":"2d cephal radio image","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4560","name":"Nmes disposable","description":"Neuromuscular electrical stimulator (nmes), disposable, replacement only","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5949","name":"Mand implt sup fix part","description":"Mand implt sup fix part","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0166","name":"Extrnl counterpulse, per tx","description":"External counterpulsation, per treatment session","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85041","name":"Automated rbc count","description":"Blood count; red blood cell (rbc), automated","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87525","name":"Hepatitis g dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis g, direct probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6601","name":"Porc/ceram inlay >= 3 surfac","description":"Inlay - porcelain/ceramic three or more surfaces","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1385","name":"Pt rsn not seen 2nd pam","description":"Documentation of patient reasons for patients who were not seen for the second pam survey (e.g., less than four months between baseline pam assessment and follow-up","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96445","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0341U","name":"Ftl aneup dna seq cmpr alys","description":"Ftl aneup dna seq cmpr alys","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54430","name":"Revision of penis","description":"Corpora cavernosa-corpus spongiosum shunt (priapism operation), unilateral or bilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92638","name":"Bhvl verif of amplification","description":"Behavioral verification of amplification including aided thresholds, functional gain, speech-in-noise, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0168","name":"Epinephrine (intl med sys)","description":"Injection, epinephrine (international medication systems), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0618U","name":"Psyc bd dna mthyl alys>10000","description":"Psyc bd dna mthyl alys>10000","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78594","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0527U","name":"Hsv 1&2 vzv amp prb tq pthgn","description":"Hsv 1&2 vzv amp prb tq pthgn","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86362","name":"Mog-igg1 antb cba each","description":"Myelin oligodendrocyte glycoprotein (mog-igg1) antibody; cell-based immunofluorescence assay (cba), each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0735T","name":"Prep tum cav iort prim crnot","description":"Preparation of tumor cavity, with placement of a radiation therapy applicator for intraoperative radiation therapy (iort) concurrent with primary craniotomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43326","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1425.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1331","name":"Pts eval ini xm 8 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 8 weeks from initial exam","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0334U","name":"Onc sld orgn tgsa dna 84/+","description":"Onc sld orgn tgsa dna 84/+","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0053","name":"Ht mental health and care","description":"Historical trauma (ht) mental health and clinical care for indigenous persons","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1170","name":"Pt w/o flu vax 7/1-6/30","description":"Patient did not receive an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36576","name":"Repair tunneled cv cath","description":"Repair of central venous access device, with subcutaneous port or pump, central or peripheral insertion site","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93575","name":"Njx cath slct p angrph mapca","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary angiography of major aortopulmonary collateral arteries (mapcas) arising off the aorta or its systemic branches, during cardiac catheterization for congenital heart d","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1205","name":"Isa reduced >=3","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0952T","name":"Tot impl amei rev/rplc mstdc","description":"Totally implantable active middle ear hearing implant; revision or replacement, with mastoidectomy and replacement of sound processor","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1351","name":"Pt cmplt suicd saf pln 120dy","description":"Patients who had a suicide safety plan initiated, reviewed, or updated and reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1318","name":"Pts no csp doc contact","description":"Patients who did not have documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening or documentation that there was no contact with a csp","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11420","name":"Exc h-f-nk-sp b9+marg 0.5/<","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 0.5 cm or less","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4545","name":"Suppl accessor tibial stim","description":"Supplies and accessories for external tibial nerve stimulator (e.g., socks, gel pads, electrodes, etc.), needed for one month","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4413","name":"Cygnus solo per sq cm","description":"Cygnus solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0740T","name":"Rem auton alg nsln cal setup","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; initial set-up and patient education","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20663","name":"Application halo femoral","description":"Application of halo, including removal; femoral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":512.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4241","name":"Gngvl flap w rootplan 1-3 th","description":"Gingival flap procedure including root planing - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99427","name":"Prin care mgmt staff ea addl","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0402","name":"Inj, abilify asimtufii, 1 mg","description":"Injection, aripiprazole (abilify asimtufii), 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0315U","name":"Onc cutan sq cll ca mrna 40","description":"Onc cutan sq cll ca mrna 40","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0539","name":"Initial care training 30 m","description":"Caregiver training in behavior management/modification for caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face; initial 30 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1013T","name":"Lap srg imp/rpl eso nea&pg/r","description":"Laparoscopy, surgical, implantation or replacement of lower esophageal sphincter neurostimulator electrode array and neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver, including cruroplasty and/or electronic ","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0462U","name":"Melatonin lvl tst slp std7/9","description":"Melatonin lvl tst slp std7/9","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1941","name":"Inj, furoscix, 20 mg","description":"Injection, furosemide (furoscix), 20 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5159","name":"Inj, denosumab-dssb, 1 mg","description":"Injection, denosumab-dssb (ospomyv/xbryk), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0726T","name":"Rmvl implt vstibular dev uni","description":"Removal of implanted vestibular device, unilateral","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9029","name":"Instill adstiladrin, tx dose","description":"Intravesical instillation, nadofaragene firadenovec-vncg, per therapeutic dose","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7173","name":"Inj. concizumab-mtci, 0.5 mg","description":"Injection, concizumab-mtci, 0.5 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4330","name":"Total, per sq cm","description":"Total, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0298U","name":"Onc pan tum whl trns seq rna","description":"Onc pan tum whl trns seq rna","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0701","name":"Inj. cefepime hcl (baxter)","description":"Injection, cefepime hydrochloride (baxter), not therapeutically equivalent to maxipime, 500 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2054","name":"Lisocabtagene mara car pos t","description":"Lisocabtagene maraleucel, up to 110 million autologous anti-cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0586U","name":"Onc mrna gen xprsn 216 genes","description":"Onc mrna gen xprsn 216 genes","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0330U","name":"Iadna vag pthgn panel 27 org","description":"Iadna vag pthgn panel 27 org","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64567","name":"Perq elec nrv field stimj cn","description":"Percutaneous electrical nerve field stimulation, cranial nerves, without implantation","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3391","name":"Inj, atidarsagene autotemcel","description":"Injection, atidarsagene autotemcel, per treatment","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27829","name":"Treat lower leg joint","description":"Open treatment of distal tibiofibular joint (syndesmosis) disruption, includes internal fixation, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":609.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1246","name":"Pt othr thn true imprt to me","description":"Patient provided a response other than completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0547U","name":"Neurflmnt lt chn cleia plsm","description":"Neurflmnt lt chn cleia plsm","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9072","name":"Inj cyclophos frindovyx 5 mg","description":"Injection, cyclophosphamide (frindovyx), 5 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4416","name":"Alexiguard tl-t per sq cm","description":"Alexiguard tl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"Sup/ext non-ins inf pump syr","description":"Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6081","name":"Scale & debride, single imp","description":"Scale & debride, single imp","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0249","name":"Adm tocilizu covid-19 1st","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50020","name":"Drg perirnl/renal absc open","description":"Drainage of perirenal or renal abscess, open","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31070","name":"Exploration of frontal sinus","description":"Sinusotomy frontal; external, simple (trephine operation)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0810T","name":"Subrta njx rx agt w/vtrc","description":"Subretinal injection of a pharmacologic agent, including vitrectomy and 1 or more retinotomies","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91124","name":"Rct snsatn tone&cmplianc std","description":"Rectal sensation, tone, and compliance study (eg, barostat)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4560","name":"Nmes disposable","description":"Neuromuscular electrical stimulator (nmes), disposable, replacement only","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0421U","name":"Onc clrct scr sgl amp 8 rna","description":"Onc clrct scr sgl amp 8 rna","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0461","name":"Testing for cracked tooth","description":"Testing for cracked tooth","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0662","name":"Team remote e/m new pt 30 mn","description":"Team remote e/m new pt 30 mins","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1277","name":"Colorectal ca screen doc rev","description":"Colorectal cancer screening results documented and reviewed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1222","name":"Glaucoma pln of care not doc","description":"Glaucoma plan of care not documented, reason not otherwise specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0872T","name":"Rplcmt ndwllg bldr&prtl cath","description":"Replacement of indwelling bladder and peritoneal catheters, including tunneling of catheter(s) and connection with previously implanted peritoneal ascites pump, including imaging and programming, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36420","name":"Venipuncture cutdown < 1 yr","description":"Venipuncture, cutdown; younger than age 1 year","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1235","name":"Doc pt hcv aby rna tst","description":"Documentation or patient report of hcv antibody test or hcv rna test which occurred prior to the performance period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64466","name":"Thrc fascial pln blk uni njx","description":"Thoracic fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1421","name":"Dermatological care mvp","description":"Dermatological care mips value pathway","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0819T","name":"Revj/rmvl ins ptn subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1301","name":"Immunization counseling","description":"Immunization counseling","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0925T","name":"Rlcj skin pocket ccm-d pg","description":"Relocation of skin pocket for implanted cardiac contractility modulation-defibrillation pulse generator","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86780","name":"Treponema pallidum","description":"Antibody; treponema pallidum","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2928","name":"Prefab porc/cer crown perm","description":"Prefab porc/cer crown perm","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0607","name":"Lanthanum carbonate oral 5mg","description":"Lanthanum carbonate, oral, 5 mg (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4010","name":"Infectious disease ss","description":"Infectious disease mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0782T","name":"Brnchsc rf dstrj plm nrv uni","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; unilateral mainstem bronchus","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8006","name":"Grip glove replacement only","description":"Powered, cable driven grip assist glove, hand, finger, includes pressure sensors, glove replacement only","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4278","name":"Epieffect, per sq cm","description":"Epieffect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4383","name":"Axolotl graft ult per sq cm","description":"Axolotl graft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4542","name":"Supp ext up limb tremor stim","description":"Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2782","name":"Crown 3/4 cast noble metal","description":"Crown - 3/4 cast noble metal","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45380","name":"Colonoscopy and biopsy","description":"Colonoscopy, flexible; with biopsy, single or multiple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":284.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7252","name":"Part extract for implant","description":"Part extract for implant","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1322","name":"Pts 7wk inj, scrn iop =<25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop =<25 mm hg for injected eye","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91113","name":"Gi trc img intral colon i&r","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57111","name":"Vagnc compl rmvl paravag tis","description":"Vaginectomy, complete removal of vaginal wall; with removal of paravaginal tissue (radical vaginectomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1901.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0966T","name":"I&cst prp jw xpn dl arch fxd","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, fixed hinge mechanism","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4325","name":"Acapatch, per sq cm","description":"Acapatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9255","name":"Inj, methotrexate (accord)","description":"Injection, methotrexate (accord), not therapeutically equivalent to j9260, 50 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34831","name":"Open aortoiliac prosth repr","description":"Open repair of infrarenal aortic aneurysm or dissection, plus repair of associated arterial trauma, following unsuccessful endovascular repair; aorto-bi-iliac prosthesis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2290.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4356","name":"Abio mem abio hyd per sq cm","description":"Abiomend membrane and abiomend hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0140","name":"Nav srv peer sup 60 min pr m","description":"Principal illness navigation - peer support by certified or trained auxiliary personnel under the direction of a physician or other practitioner, including a certified peer specialist; 60 minutes per calendar month, in the following activities:  person-centered interview, performed to better underst","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0473","name":"Micro exam prep & report","description":"Accession of tissue gross and microscopic examination preparation and transmission of written report","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0531","name":"Fclty-based respite, 24 hr u","description":"Facility-based respite, 24-hour unit, for use in cmmi model","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"Add upp ext mec limb vol lam","description":"Addition to upper extremity prosthesis, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59866","name":"Abortion (mpr)","description":"Multifetal pregnancy reduction(s) (mpr)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0024","name":"Pin srv add 30 min pr m","description":"Principal illness navigation services, additional 30 minutes per calendar month (list separately in addition to g0023)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45136","name":"Excise ileoanal reservior","description":"Excision of ileoanal reservoir with ileostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1878.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6603","name":"Cst hgh nble mtl inlay >=3sr","description":"Inlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0472","name":"Gross exam prep & report","description":"Accession of tissue gross examination preparation and transmission of written report","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66989","name":"Xcpsl ctrc rmvl cplx insj 1+","description":"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification), complex, requiring devices or techniques not generally used in routine cataract surgery (eg, iris expansion device,","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0879T","name":"Augmnt alys ch ct ild prep","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; radiological data preparation and transmission","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73706","name":"Ct angio lwr extr w/o&w/dye","description":"Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":664.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0734T","name":"Rem r-t mtn nrehab tx mgmt","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; treatment management services by a physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66986","name":"Exchange lens prosthesis","description":"Exchange of intraocular lens","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":972.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0868T","name":"Hi-res gastric ep mapping","description":"High-resolution gastric electrophysiology mapping with simultaneous patient-symptom profiling, with interpretation and report","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1016T","name":"Elec alys npgs esoph intraop","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0164","name":"Epinephrine in nacl (baxter)","description":"Injection, epinephrine in sodium chloride (baxter), 0.1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1286","name":"Bmi doc onl fup not cmpltd","description":"Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q0224","name":"Inj, pemivibart, 4500 mg","description":"Injection, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, and who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppressive ","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0589U","name":"Pfas24cmpnd hi-perf lc-ms/ms","description":"Pfas24cmpnd hi-perf lc-ms/ms","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49188","name":"Opn exc/dst ntra-abd 10.1-20","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 10.1 to 20 cm","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4001","name":"Diagnostic rad ss","description":"Diagnostic radiology mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31298","name":"Nsl/sins ndsc surg frnt&sphn","description":"Nasal/sinus endoscopy, surgical, with dilation (eg, balloon dilation); frontal and sphenoid sinus ostia","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":3242.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1220","name":"Dre wth interp rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; with evidence of retinopathy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0460U","name":"Onc whl bld/bucc rtpcr 24gen","description":"Onc whl bld/bucc rtpcr 24gen","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1329","name":"Pts act pvd 2 wks 8 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 8 weeks after initial acute pvd encounter","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78012","name":"Thyroid uptake measurement","description":"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29900","name":"Mcp joint arthroscopy dx","description":"Arthroscopy, metacarpophalangeal joint, diagnostic, includes synovial biopsy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":561.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57455","name":"Biopsy of cervix w/scope","description":"Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":185.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0745T","name":"Car ablt rad arr n-invas loc","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; noninvasive arrhythmia localization and mapping of arrhythmia site (nidus), derived from anatomical image data (eg, ct, mri, or myocardial perfusion scan) and electrical data (eg, 12-lead ecg data), and identification of areas of avo","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15836","name":"Exc excessive skin arm","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy); arm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":789.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86780","name":"Treponema pallidum","description":"Antibody; treponema pallidum","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6032","name":"Part handfng ultralite tcf/=","description":"Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0730T","name":"Trabeculotomy lsr w/oct gdn","description":"Trabeculotomy by laser, including optical coherence tomography (oct) guidance","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0371","name":"Sialoendoscopy capt & interp","description":"Sialoendoscopy capt & interp","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":1053.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7957","name":"Tiss regen edent nonresorb","description":"Tiss regen edent nonresorb","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52597","name":"Trurl rbtc wtrjt rescj prst8","description":"Transurethral robotic-assisted waterjet resection of prostate, including intraoperative planning, ultrasound guidance, control of postoperative bleeding, complete, including vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0320U","name":"Neph rna psttrnspl perph bld","description":"Neph rna psttrnspl perph bld","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4355","name":"Abio xpl abio xpl hy p sq cm","description":"Abiomend xplus membrane and abiomend xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6111","name":"Implnt/abut remov dent mand","description":"Implnt/abut remov dent mand","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8502","name":"Inj, aponvie, 1 mg","description":"Injection, aprepitant (aponvie), 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64628","name":"Trml dstrj ios bvn 1st 2 l/s","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; first 2 vertebral bodies, lumbar or sacral","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4271","name":"Complete ft per sq cm","description":"Complete ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0004","name":"Qual care neurologic cnd mvp","description":"Quality care for patients with neurological conditions mips value pathway","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4035","name":"Thoracic surgery ss","description":"Thoracic surgery mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1182","name":"Not elg pre ex ibd/uc/crohn","description":"Patients not eligible due to pre-existing inflammatory bowel disease (ibd) (e.g., ulcerative colitis, crohns disease)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0012","name":"Injection of hiv prep drug","description":"Injection of pre-exposure prophylaxis (prep) drug for hiv prevention, under skin or into muscle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0541","name":"No pt prsnt train initial 30","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98004","name":"Synch audio-video est sf 10","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 10 minutes must be met or e","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82286","name":"Assay of bradykinin","description":"Bradykinin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0731T","name":"Augmnt ai-based fcl phnt a/r","description":"Augmentative ai-based facial phenotype analysis with report","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76017","name":"Mr sfty med physics xm cstmz","description":"Mr safety medical physics examination customization, planning and performance monitoring by medical physicist or mr safety expert, with review and analysis by physician or other qualified health care professional to prioritize and select views and imaging sequences, to tailor mr acquisition specific","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0474U","name":"Hered pan ca gsap 88gene ngs","description":"Hered pan ca gsap 88gene ngs","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7961","name":"Buccal/labial frenectomy","description":"Buccal/labial frenectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5143","name":"Inj adalimumab-adbm, 1 mg","description":"Injection, adalimumab-adbm, biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70370","name":"Throat x-ray & fluoroscopy","description":"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0891","name":"Argatroban nonesrd (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44373","name":"Small bowel endoscopy","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with conversion of percutaneous gastrostomy tube to percutaneous jejunostomy tube","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94640","name":"Airway inhalation treatment","description":"Pressurized or nonpressurized inhalation treatment for acute airway obstruction for therapeutic purposes and/or for diagnostic purposes such as sputum induction with an aerosol generator, nebulizer, metered dose inhaler or intermittent positive pressure breathing (ippb) device","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9224","name":"Gen anes adv air-15 min","description":"Gen anes adv air-15 min","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1487","name":"Pt adm to hospice dur eval","description":"Patients in hospice in the year before or during the period of evaluation","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4257","name":"Relese, per sq cm","description":"Relese, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4323","name":"Alloply, per sq cm","description":"Alloply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9333","name":"Inj rozanolixizum-noli 1 mg","description":"Injection, rozanolixizumab-noli, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81349","name":"Cytog alys chrml abnr lw-ps","description":"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and loss-of-heterozygosity variants, low-pass sequencing analysis","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9052","name":"Inj, carmustine (accord)","description":"Injection, carmustine (accord), not therapeutically equivalent to j9050, 100 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92641","name":"Hearing dev verif eacous aly","description":"Hearing device verification, electroacoustic analysis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4416","name":"Alexiguard tl-t per sq cm","description":"Alexiguard tl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0574U","name":"Mtb cfp-10 serum/plsm lc-ms","description":"Mtb cfp-10 serum/plsm lc-ms","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99291","name":"Critical care first hour","description":"Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":212.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5153","name":"Inj, aflibercept-yszy, 1 mg","description":"Injection, aflibercept-yszy (opuviz), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85032","name":"Manual cell count each","description":"Blood count; manual cell count (erythrocyte, leukocyte, or platelet) each","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0444U","name":"Onc sld orgn neo tgsap 361","description":"Onc sld orgn neo tgsap 361","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35612","name":"Bpg subclavian-subclavian","description":"Bypass graft, with other than vein; subclavian-subclavian","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1147.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0527","name":"Mgt est pt dmentia low cmplx","description":"Management of established patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0569","name":"Subs psych care mng, subs mo","description":"Subsequent psychiatric collaborative care management, in a subsequent month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required elements: tracking ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5725","name":"Rebase hybrid prosthesis","description":"Rebase hybrid prosthesis","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0514U","name":"Gi ibd ia quan deter adl lvl","description":"Gi ibd ia quan deter adl lvl","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92641","name":"Hearing dev verif eacous aly","description":"Hearing device verification, electroacoustic analysis","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1232","name":"Pt hcv tst reactive result","description":"Patient receives hcv antibody test with reactive result","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6605","name":"G com bandage padded foam","description":"Gradient compression bandaging supply, padded foam, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0695T","name":"Bdy srf mpg pm/cvdfb tm impl","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of implant or replacement","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90695","name":"H5n8 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n8, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46601","name":"Diagnostic anoscopy","description":"Anoscopy; diagnostic, with high-resolution magnification (hra) (eg, colposcope, operating microscope) and chemical agent enhancement, including collection of specimen(s) by brushing or washing, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":158.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1319","name":"Pts csp doc contact","description":"Patients who had documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31240","name":"Nsl/sns ndsc cnch bull rescj","description":"Nasal/sinus endoscopy, surgical; with concha bullosa resection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0564U","name":"Nfct ds pthgn-sna 10vir&4bct","description":"Nfct ds pthgn-sna 10vir&4bct","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1011T","name":"Pbm therapy of oral cavity","description":"Photobiomodulation (pbm) therapy of oral cavity, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4272","name":"Esano a, per sq cm","description":"Esano a, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28264","name":"Release of midfoot joint","description":"Capsulotomy, midtarsal (eg, heyman type procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":868.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61720","name":"Incise skull/brain surgery","description":"Creation of lesion by stereotactic method, including burr hole(s) and localizing and recording techniques, single or multiple stages; globus pallidus or thalamus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1334.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64778","name":"Digit nerve surgery add-on","description":"Excision of neuroma; digital nerve, each additional digit (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0808T","name":"Pulm tiss vntj alys w/ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with computed tomography (ct) images taken for the purpose of pulmonary tissue ventilation analysis, including data preparation and transmission, quantificati","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0844T","name":"Dgtz gls mcrscp cslt cyt ea","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), each additional site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87593","name":"Orthopoxvirus amp prb each","description":"Infectious agent detection by nucleic acid (dna or rna); orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus), amplified probe technique, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92639","name":"Hearing aid meas verif","description":"Hearing-aid measurement, verification with probe-microphone (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0339U","name":"Onc prst8 mrna hoxc6 & dlx1","description":"Onc prst8 mrna hoxc6 & dlx1","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3472","name":"Surg rep root res premolar","description":"Surg rep root res premolar","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9100","name":"Cytarabine hcl 100 mg inj","description":"Injection, cytarabine, 100 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6114","name":"Implnt/abut fixed dent max","description":"Implnt/abut fixed dent max","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1416","name":"Pt rec hosp","description":"Patient received hospice services any time during the performance period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1477","name":"Dx delirium","description":"Diagnosis of delirium","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64654","name":"1st opn implt bat modulj sys","description":"Initial open implantation of baroreflex activation therapy (bat) modulation system, including lead placement onto the carotid sinus, lead tunnelling, connection to a pulse generator placed in a distant subcutaneous pocket (ie, total system), and intraoperative interrogation and programming","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0903T","name":"Ecg alg 12 lead reduced i&r","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; with interpretation and report","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0402","name":"Inj, abilify asimtufii, 1 mg","description":"Injection, aripiprazole (abilify asimtufii), 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1416","name":"Pt rec hosp","description":"Patient received hospice services any time during the performance period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64728","name":"Dcmprn median nrv carpl tunl","description":"Decompression; median nerve at the carpal tunnel, percutaneous, with intracarpal tunnel balloon dilation, including ultrasound guidance","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0265","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77317","name":"Brachytx isodose intermed","description":"Brachytherapy isodose plan; intermediate (calculation[s] made from 5 to 10 sources, or remote afterloading brachytherapy, 2-12 channels), includes basic dosimetry calculation(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4272","name":"Esano a, per sq cm","description":"Esano a, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9331","name":"Inj sirolimus prot part 1 mg","description":"Injection, sirolimus protein-bound particles, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4418","name":"Biolab wrap flow per sq cm","description":"Biolab membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2544","name":"Dental onlay metl 4/more sur","description":"Onlay - metallic - four or more surfaces","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2780","name":"Crown 3/4 cast hi noble met","description":"Crown - 3/4 cast high noble metal","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1164","name":"Inj diltiazem in 0.72% nacl","description":"Injection, diltiazem hydrochloride in 0.72% sodium chloride, 0.5 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0366U","name":"Onc bldr 10 prb recr bldr ca","description":"Onc bldr 10 prb recr bldr ca","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0300U","name":"Onc pan tum whl gen seq&opt","description":"Onc pan tum whl gen seq&opt","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99234","name":"Hosp ip/obs sm dt sf/low 45","description":"Hospital inpatient or observation care, for the evaluation and management of a patient including admission and discharge on the same date, which requires a medically appropriate history and/or examination and straightforward or low level of medical decision making. when using total time on the date ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1018T","name":"Elec alys npgs esoph sbsq w/","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67110","name":"Repair detached retina","description":"Repair of retinal detachment; by injection of air or other gas (eg, pneumatic retinopexy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":737.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81449","name":"So neo gsap 5-50 rna alys","description":"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; rna analysis","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99281","name":"Emr dpt vst mayx req phy/qhp","description":"Emergency department visit for the evaluation and management of a patient that may not require the presence of a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":10.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0799","name":"Hiv prep, fda approved, noc","description":"Fda approved prescription drug, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv), not otherwise classified","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27078","name":"Rsect hip tum incl femur","description":"Radical resection of tumor; ischial tuberosity and greater trochanter of femur","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1164.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28111","name":"Part removal of metatarsal","description":"Ostectomy, complete excision; first metatarsal head","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":421.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36585","name":"Replace picvad cath","description":"Replacement, complete, of a peripherally inserted central venous access device, with subcutaneous port, through same venous access","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4361","name":"Epixpress, per sq cm","description":"Epixpress, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1181","name":"Gr 2 or> dia or gr2 or> col","description":"Grade 2 or above diarrhea and/or grade 2 or above colitis","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1162","name":"Pt enceph due to dtp bef 13","description":"Patient had encephalitis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6032","name":"Part handfng ultralite tcf/=","description":"Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4318","name":"Fem urinary cup w/wo attch","description":"Female external urinary collection cup, with or without ring attachment, per day","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17263","name":"Dstrj mal les t/a/l 2.1-3.0","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), trunk, arms or legs; lesion diameter 2.1 to 3.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22522","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5098","name":"Inj ustekinumab-srlf, 1 mg","description":"Injection, ustekinumab-srlf (imuldosa), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1328","name":"Pts dx acute vitreous hem","description":"Patients with a diagnosis of acute vitreous hemorrhage","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0209","name":"Inj, sod thiosulfate (hope)","description":"Injection, sodium thiosulfate (hope), 100 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0623U","name":"Ai ms dna mthyl alys >5000","description":"Ai ms dna mthyl alys >5000","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1397","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31298","name":"Nsl/sins ndsc surg frnt&sphn","description":"Nasal/sinus endoscopy, surgical, with dilation (eg, balloon dilation); frontal and sphenoid sinus ostia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":3521.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1367","name":"Qual care ent disorder mvp","description":"Quality care for the treatment of ear, nose, and throat disorders mips value pathway","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9028","name":"Inj, nogapendekin pmln, 1mcg","description":"Injection, nogapendekin alfa inbakicept-pmln, for intravesical use, 1 microgram","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1404","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0457U","name":"Pfas 9 cmpnd lcms/ms pls/sr","description":"Pfas 9 cmpnd lcms/ms pls/sr","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1358","name":"Pts no <suicd idea 120 dys","description":"Patients who did not have a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0562","name":"Complex simulation w/pet-ct","description":"Therapeutic radiology simulation-aided field setting; complex, including acquisition of pet and ct imaging data required for radiopharmaceutical-directed radiation therapy treatment planning (i.e., modeling)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2427","name":"Inj, invega hafyera/trinza","description":"Injection, paliperidone palmitate extended release (invega hafyera, or invega trinza), 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87077","name":"Culture aerobic identify","description":"Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1488","name":"Dx dementia in msr timeframe","description":"Patients with a diagnosis for dementia in the year before or during the period of evaluation","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0457U","name":"Pfas 9 cmpnd lcms/ms pls/sr","description":"Pfas 9 cmpnd lcms/ms pls/sr","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0813T","name":"Egd vol adjmt bariatric balo","description":"Esophagogastroduodenoscopy, flexible, transoral, with volume adjustment of intragastric bariatric balloon","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0677T","name":"Laps repos lead isdss 1st ld","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first repositioned lead","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1286","name":"Bmi doc onl fup not cmpltd","description":"Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6089","name":"Access/retorq implant screw","description":"Access/retorq implant screw","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4372","name":"Amchoplast excl per sq cm","description":"Amchoplast excel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19367","name":"Brst rcnstj 1 pdcl tram flap","description":"Breast reconstruction; with single-pedicled transverse rectus abdominis myocutaneous (tram) flap","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2099.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0605U","name":"All&immunology hat tpsab1","description":"All&immunology hat tpsab1","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0498U","name":"Onc clrct ngs mut detc 43gen","description":"Onc clrct ngs mut detc 43gen","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0562U","name":"Onc sol tum tgsa 33gens snvs","description":"Onc sol tum tgsa 33gens snvs","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87542","name":"Legion pneumo dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); legionella pneumophila, quantification","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99495","name":"Transj care mgmt mod f2f 14d","description":"Transitional care management services with the following required elements: communication (direct contact, telephone, electronic) with the patient and/or caregiver within 2 business days of discharge at least moderate level of medical decision making during the service period face-to-face visit, wit","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":254.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87468","name":"Anaplsma phgcytophlm amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); anaplasma phagocytophilum, amplified probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6524","name":"G com garmnt lwr leg/ft nght","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4383","name":"Axolotl graft ult per sq cm","description":"Axolotl graft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1334","name":"Pts act pvd 2 wks 2 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 2 weeks after initial acute pvd encounter","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2402","name":"Chloroprocaine (clorotekal)","description":"Injection, chloroprocaine hydrochloride (clorotekal), per 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5149","name":"Inj, aflibercept-abzv, 1 mg","description":"Injection, aflibercept-abzv (enzeevu), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0914T","name":"Prq tcat thr rx ntrc bal sep","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting) performed on a separate target lesion from the target lesion treated with balloon angioplasty, coronary stent placement or coronary atherectomy, including mechanical dilation b","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":57.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7997","name":"Appliance removal","description":"Appliance removal (not by dentist who placed appliance) includes removal of archbar","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0557","name":"Adv prim care mgmt lvl 2","description":"Advanced primary care management services for a patient with multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, which place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline, provided by c","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01939","name":"Anes nulyt agt crv/thrc","description":"Anesthesia for percutaneous image-guided destruction procedures by neurolytic agent on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0919T","name":"Rmvl perm ccm-d sys pg only","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); pulse generator only","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3393","name":"Inj, betibeglogene autotemce","description":"Injection, betibeglogene autotemcel, per treatment","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1457","name":"Dx asth dur crnt/prv perf pd","description":"Patient had a diagnosis of asthma with any contact during the current or prior performance period or had asthma present on an active problem list any time during the performance period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0401U","name":"Crd c hrt ds 9 gen 12 vrnts","description":"Crd c hrt ds 9 gen 12 vrnts","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33904","name":"Perq p-art revsc each addl","description":"Percutaneous pulmonary artery revascularization by stent placement, each additional vessel or separate lesion, normal or abnormal connections (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9611","name":"Flurpiridaz f18, diag, 1 mci","description":"Flurpiridaz f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7165","name":"Inj, human-lans, per i.u","description":"Injection, prothrombin complex concentrate, human-lans, per i.u. of factor ix activity","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29425","name":"Appl short leg cast walking","description":"Application of short leg cast (below knee to toes); walking or ambulatory type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98005","name":"Synch audio-video est low 20","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low medical decision making. when using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded.","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43192","name":"Esophagoscp rig trnso inject","description":"Esophagoscopy, rigid, transoral; with directed submucosal injection(s), any substance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98979","name":"Rtm tx mgmt 1st 10 min","description":"Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least 1 real-time interactive communication with the patient or caregiver during the calendar month; first 10 minutes","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55869","name":"Lap srg prst8ct bi pl lmphad","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86280","name":"Hemagglutination inhibition","description":"Hemagglutination inhibition test (hai)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0803","name":"3d facial scan direct","description":"3d facial scan direct","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5940","name":"Resct proth max part remov","description":"Resct proth max part remov","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9291","name":"Pres dig cog behav thera fda","description":"Prescription digital cognitive and/or behavioral therapy, fda cleared, per course of treatment","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32402","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1275","name":"Pts hosp exl","description":"Patients determined to be in hospice were excluded from month of evaluation and the remainder of reporting period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1240","name":"Pt no resp best int","description":"Patient did not respond to the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1709","name":"Pfizer vaccine admin booster","description":"Pfizer vaccine admin booster","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0880T","name":"Augmnt alys ch ct ild i&r","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1720","name":"Influenza vacc admin","description":"Influenza vacc admin","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61543","name":"Removal of brain tissue","description":"Craniotomy with elevation of bone flap; for partial or subtotal (functional) hemispherectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2464.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"Motor &/ sens nrve cndj test","description":"Motor and/or sensory nerve conduction, using preconfigured electrode array(s), amplitude and latency/velocity study, each limb, includes f-wave study when performed, with interpretation and report","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27236","name":"Treat thigh fracture","description":"Open treatment of femoral fracture, proximal end, neck, internal fixation or prosthetic replacement","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1335.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1228","name":"Pt + hcv aby +vir w/ rx 3 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, has hcv treatment initiated within 3 months of the reactive hcv antibody test","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91113","name":"Gi trc img intral colon i&r","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0250","name":"Adm tocilizu covid-19 2nd","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4346","name":"Shelter dm matrix per sq cm","description":"Shelter dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0585U","name":"Tgsap so neo cfdna 521 genes","description":"Tgsap so neo cfdna 521 genes","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94618","name":"Pulmonary stress testing","description":"Pulmonary stress testing (eg, 6-minute walk test), including measurement of heart rate, oximetry, and oxygen titration, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0591U","name":"Onc prst8 ca 3prtns plsm srm","description":"Onc prst8 ca 3prtns plsm srm","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2016","name":"Permeaderm b, per sq cm","description":"Permeaderm b, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0518U","name":"Ther rx mntr 90+ pn&mtl hlth","description":"Ther rx mntr 90+ pn&mtl hlth","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70240","name":"X-ray exam pituitary saddle","description":"Radiologic examination, sella turcica","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90482","name":"Imm cnsl not admn sm 3<10","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; 3 minutes up to 10 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95070","name":"Inhlj brncl challenge tstg","description":"Inhalation bronchial challenge testing (not including necessary pulmonary function tests), with histamine, methacholine, or similar compounds","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0704T","name":"Rem tx amblyopia setup&edu","description":"Remote treatment of amblyopia using an eye tracking device; device supply with initial set-up and patient education on use of equipment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33277","name":"Insj phrnc nrv stim transvns","description":"Insertion of phrenic nerve stimulator transvenous sensing lead (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1175","name":"Doc med rsn no hzv","description":"Documentation of medical reason(s) for not administering zoster vaccine (e.g., prior anaphylaxis due to the zoster vaccine)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1360","name":"Suicd c-ssrs assessment","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1318","name":"Pts no csp doc contact","description":"Patients who did not have documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening or documentation that there was no contact with a csp","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0698T","name":"Quan mr tiss w/mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained with diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, target ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0216","name":"Inj, alfentanil hcl, 500mcg","description":"Injection, alfentanil hydrochloride, 500 micrograms","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2781","name":"Inj, pegcetacoplan, 1mg","description":"Injection, pegcetacoplan, intravitreal, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0498U","name":"Onc clrct ngs mut detc 43gen","description":"Onc clrct ngs mut detc 43gen","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2011","name":"Supra sdrm, per sq cm","description":"Supra sdrm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85170","name":"Blood clot retraction","description":"Clot retraction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49622","name":"Rpr parastomal hrna ncr/strn","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; incarcerated or strangulated","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1246","name":"Pt othr thn true imprt to me","description":"Patient provided a response other than completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64402","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6603","name":"G com bandge low dn foamchnl","description":"Gradient compression bandaging supply, low density channel foam sheet, per 250 square centimeters, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0874T","name":"Rmvl pertl ascites pmp sys","description":"Removal of a peritoneal ascites pump system, including implanted peritoneal ascites pump and indwelling bladder and peritoneal catheters","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0209","name":"Inj, sod thiosulfate (hope)","description":"Injection, sodium thiosulfate (hope), 100 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0495U","name":"Onc prst8 alys crcg plsm prt","description":"Onc prst8 alys crcg plsm prt","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1412","name":"Met nsclc w/ egfr alk oth ab","description":"Patients with metastatic nsclc with epidermal growth factor receptor (egfr) mutations, alk genomic tumor aberrations, or other targetable genomic abnormalities with approved first-line targeted therapy, such as nsclc with ros1 rearrangement, braf v600e mutation, ntrk 1/2/3 gene fusion, met ex14 skip","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33267","name":"Excl laa open any method","description":"Exclusion of left atrial appendage, open, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5657","name":"Add low ext man aut vol any","description":"Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4428","name":"Dermbnd sln sl+ slx sq cm","description":"Dermabind sl n or dermabind sl + or dermabind sl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99242","name":"Off/op consltj new/est sf 20","description":"Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":85.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82978","name":"Assay of glutathione","description":"Glutathione","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2644","name":"Dental onlay porc 4/more sur","description":"Onlay - porcelain/ceramic - four or more surfaces","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2956","name":"Indirect rest remov","description":"Indirect rest remov","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0002","name":"Opt care kidney hlth mvp","description":"Optimal care for kidney health mips value pathways","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3230","name":"Chlorpromazine hcl injection","description":"Injection, chlorpromazine hcl, up to 50 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4309","name":"Via matrix, per sq cm","description":"Via matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90837","name":"Psytx w pt 60 minutes","description":"Psychotherapy, 60 minutes with patient","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":134.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60660","name":"Abltj 1/+thyr ndul 1lobe prq","description":"Ablation of 1 or more thyroid nodule(s), one lobe or the isthmus, percutaneous, including imaging guidance, radiofrequency","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":166.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49613","name":"Rpr aa hrn rcr < 3 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, reducible","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69433","name":"Create eardrum opening","description":"Tympanostomy (requiring insertion of ventilating tube), local or topical anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1330","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66683","name":"Implantation iris prosthesis","description":"Implantation of iris prosthesis, including suture fixation and repair or removal of iris, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1407","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1939","name":"Inj, bumetanide, 0.5 mg","description":"Injection, bumetanide, 0.5 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35602","name":"Bpg crtd-clat crtd","description":"Bypass graft, with other than vein; carotid-contralateral carotid","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61708","name":"Revise circulation to head","description":"Surgery of aneurysm, vascular malformation or carotid-cavernous fistula; by intracranial electrothrombosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2311.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2040","name":"Coord specialty care, month","description":"Coordinated specialty care, team-based, for first episode psychosis, per month","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7259","name":"Nerve dissection","description":"Nerve dissection","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4013","name":"Mntal/behav/psych hlth ss","description":"Mental/behavioral and psychiatry mips specialty set","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1201","name":"Med rsn no ace-i/arb rx","description":"Documentation of medical reason(s) for not prescribing ace inhibitor (ace-i) or arb therapy during the measurement period (e.g., pregnancy, history of angioedema to ace-i, other allergy to ace-i and arb, hyperkalemia or history of hyperkalemia while on ace-i or arb therapy, acute kidney injury due t","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37186","name":"Sec art thrombectomy add-on","description":"Secondary percutaneous transluminal thrombectomy (eg, nonprimary mechanical, snare basket, suction technique), noncoronary, non-intracranial, arterial or arterial bypass graft, including fluoroscopic guidance and intraprocedural pharmacological thrombolytic injections, provided in conjunction with a","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1243","name":"Pt othr thn true heard","description":"Patient provided a response other than completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4388","name":"Neothelium 4l per sq cm","description":"Neothelium 4l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4403","name":"Xwrap dual plus per sq cm","description":"Xwrap dual plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0298U","name":"Onc pan tum whl trns seq rna","description":"Onc pan tum whl trns seq rna","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0446U","name":"Ai ds sle alys 10 cytokine","description":"Ai ds sle alys 10 cytokine","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0394U","name":"Pfas 16 pfas compnd lc ms/ms","description":"Pfas 16 pfas compnd lc ms/ms","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J1051","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6601","name":"G com bandge hgh dn foam pad","description":"Gradient compression bandaging supply, high density foam pad, any size or shape, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64582","name":"Opn mpltj hpglsl nstm ary pg","description":"Open implantation of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0559","name":"Unrelat prac follow up visit","description":"Post-operative follow-up visit complexity inherent to evaluation and management services addressing surgical procedure(s), provided by a physician or qualified health care professional who is not the practitioner who performed the procedure (or in the same group practice) and is of the same or of a ","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1480","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25922","name":"Amputate hand at wrist","description":"Disarticulation through wrist; secondary closure or scar revision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":711.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4318","name":"Fem urinary cup w/wo attch","description":"Female external urinary collection cup, with or without ring attachment, per day","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0338U","name":"Onc sld tum crcg tum cl slct","description":"Onc sld tum crcg tum cl slct","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9936","name":"Clean occ guard","description":"Clean occ guard","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0658","name":"Seg pneum comp 2 arm chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7100","name":"Dextran 40 infusion","description":"Infusion, dextran 40, 500 ml","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35508","name":"Art byp grft carotid-vertbrl","description":"Bypass graft, with vein; carotid-vertebral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1392.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37295","name":"Rvsc evsc tpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"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":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0482","name":"Direct immunofluorescence","description":"Direct immunofluorescence","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5149","name":"Inj, aflibercept-abzv, 1 mg","description":"Injection, aflibercept-abzv (enzeevu), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0843T","name":"Dgtz gls mcrscp cslt cyt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), initial site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3421","name":"Root surgery bicuspid","description":"Apicoectomy/periradicular surgery-bicuspid (first root)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2026","name":"Restrata minimatrix, 5 mg","description":"Restrata minimatrix, 5 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27070","name":"Part remove hip bone super","description":"Partial excision, wing of ilium, symphysis pubis, or greater trochanter of femur, (craterization, saucerization) (eg, osteomyelitis or bone abscess); superficial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":983.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":1015.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1321","name":"Couns for high risk sub use","description":"Couns for high risk sub use","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2371","name":"Inj phenylephrine hcl 20 mcg","description":"Injection, phenylephrine hydrochloride, 20 micrograms","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86692","name":"Hepatitis delta agent antbdy","description":"Antibody; hepatitis, delta agent","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21076","name":"Impres&prep surg obt prosth","description":"Impression and custom preparation; surgical obturator prosthesis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1150.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0463","name":"Inj atropine (fresenius te)","description":"Injection, atropine sulfate (fresenius and therapeutically equivalent), 0.01 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80506","name":"Path clin consltj prolng svc","description":"Pathology clinical consultation; prolonged service, each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9002","name":"Intra-vag motion sens biofk","description":"Intra-vaginal motion sensor system, provides biofeedback for pelvic floor muscle rehabilitation device","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4543","name":"Supply trans elec nerve stim","description":"Supplies for transcutaneous electrical nerve stimulator, for nerves in the auricular region, per month","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0462","name":"Atropine sulf, nte, 0.01 mg","description":"Injection, atropine sulfate, not therapeutically equivalent to j0461, 0.01 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1013T","name":"Lap srg imp/rpl eso nea&pg/r","description":"Laparoscopy, surgical, implantation or replacement of lower esophageal sphincter neurostimulator electrode array and neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver, including cruroplasty and/or electronic ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99425","name":"Prin care mgmt phys ea addl","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1169","name":"Doc med rsn no flu vax","description":"Documentation of medical reason(s) for not administering influenza vaccine (e.g., prior anaphylaxis due to the influenza vaccine)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9986","name":"Missed appointment","description":"Missed appointment","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1329","name":"Pts act pvd 2 wks 8 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 8 weeks after initial acute pvd encounter","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0873","name":"Inj daptomycin (xellia)","description":"Injection, daptomycin (xellia), not therapeutically equivalent to j0878 or j0872, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0578U","name":"Onc cutan mln rna qpcr 10gen","description":"Onc cutan mln rna qpcr 10gen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4284","name":"Dermabind sl, per sq cm","description":"Dermabind sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8612","name":"Oral methotrexate (xatmep)","description":"Methotrexate (xatmep), oral, 2.5 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50572","name":"Kidney endoscopy","description":"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without dilation of ureter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0457","name":"Injection, aztreonam, 100 mg","description":"Injection, aztreonam, 100 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36425","name":"Venipuncture cutdown 1 yr/>","description":"Venipuncture, cutdown; age 1 or over","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3921","name":"Decor or submerg erupt tooth","description":"Decor or submerg erupt tooth","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87523","name":"Hepatitis d quantification","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis d (delta), quantification, including reverse transcription, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4001","name":"Diagnostic rad ss","description":"Diagnostic radiology mips specialty set","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4385","name":"Apollo ft per sq cm","description":"Apollo ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15018","name":"App skn cll ssp f/n/g/hf ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 480 sq cm or part thereof (list separately in addition to code for prima","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64582","name":"Opn mpltj hpglsl nstm ary pg","description":"Open implantation of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7415","name":"Excision malig les complicat","description":"Excision of malignant lesion complicated","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4331","name":"Axolotl graft, per sq cm","description":"Axolotl graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0922T","name":"Rmvl perm ccm-d sys dual ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); dual (pacing and defibrillation) transvenous leads only","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99416","name":"Prolng clin staff svc ea add","description":"Prolonged clinical staff service (the service beyond the highest time in the range of total time of the service) during an evaluation and management service in the office or outpatient setting, direct patient contact with physician supervision; each additional 30 minutes (list separately in addition","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33993","name":"Reposg perq r/l hrt vad","description":"Repositioning of percutaneous right or left heart ventricular assist device with imaging guidance at separate and distinct session from insertion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82166","name":"Assay anti-mullerian horm","description":"Anti-mullerian hormone (amh)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0971T","name":"Ablt mal brst tum pq lsr uni","description":"Ablation, malignant breast tumor(s), percutaneous, laser, including imaging guidance when performed, unilateral","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0824T","name":"Tcat rmv 1chmbr ldls pm ra","description":"Transcatheter removal of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography), when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1405","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76015","name":"Mr sfty mplt&/fb asmt stf ea","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4283","name":"Biovance tri or 3l, sq cm","description":"Biovance tri-layer or biovance 3l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0601","name":"Sevelamer carbonate 20 mg","description":"Sevelamer carbonate (renvela or therapeutically equivalent), oral, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91323","name":"Sarscov2 vac 10 mcg/0.2ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 10 mcg/0.2 ml dosage, for intramuscular use","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5145","name":"Inj, abrilada, 1 mg","description":"Injection, adalimumab-afzb (abrilada), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0785T","name":"Revj/rmvl nea spi w/nstim","description":"Revision or removal of neurostimulator electrode array, spinal, with integrated neurostimulator","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91319","name":"Sarscv2 vac 10mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 10 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4293","name":"Acesso dl, per sq cm","description":"Acesso dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1452","name":"Pt dx dementia ever","description":"Patient ever had a diagnosis of dementia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1503","name":"Vascular surgery mvp","description":"Vascular surgery mips value pathway","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81459","name":"So neo gsap dna/dna&rna","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants, microsatellite instability, tumor mutation burden, and rearrangements","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76987","name":"Dx intraop epicar car us chd","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; including placement and manipulation of transducer, image acquisition, interpretation and report","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0789T","name":"Elec aly cpx iins sp/sac nrv","description":"Electronic analysis with complex programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detect","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0351U","name":"Nfct ds bct/viral trail ip10","description":"Nfct ds bct/viral trail ip10","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0627U","name":"Psyc scz dna alys >15000","description":"Psyc scz dna alys >15000","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2795","name":"Ropivacaine hcl injection","description":"Injection, ropivacaine hydrochloride, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1238","name":"Doc 2nd recom hzv 2-6 mo int","description":"Documentation that administration of second recombinant zoster vaccine could not occur during the performance period due to the recommended 2-6 month interval between doses (i.e, first dose received after october 31)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55870","name":"Electroejaculation","description":"Electroejaculation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2956","name":"Indirect rest remov","description":"Indirect rest remov","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4032","name":"Rheumatology ss","description":"Rheumatology mips specialty set","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0260U","name":"Rare ds id opt genome mapg","description":"Rare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9342","name":"Inj thiotepa nos 1 mg","description":"Injection, thiotepa, not otherwise specified, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1299","name":"Flu immunize order/admin","description":"Influenza immunization administered or previously received","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4036","name":"Urgent care ss","description":"Urgent care mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0138","name":"Inj acetaminoph 10mg/ibu 3mg","description":"Injection, acetaminophen 10 mg and ibuprofen 3 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69729","name":"Impl oi implt sk tc esp>=100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside of the mastoid and resulting in removal of greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0900T","name":"N-invas est aqmbf asstv cmr","description":"Noninvasive estimate of absolute quantitation of myocardial blood flow (aqmbf), derived from assistive algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health care profes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5859","name":"Knee-shin pro flex/ext cont","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, powered and programmable flexion/extension assist control, includes any type motor(s)","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17437.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0664","name":"Team remote e/m new pt 60 mn","description":"Team remote e/m new pt 60mins","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63053","name":"Lam factc/frmt arthrd lum ea","description":"Laminectomy, facetectomy, or foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s] [eg, spinal or lateral recess stenosis]), during posterior interbody arthrodesis, lumbar; each additional vertebral segment (list separately in addition to code for","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76801","name":"Ob us < 14 wks single fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0976T","name":"Slctv nzmtc dbrdmt s/n/hf ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; each additional 100 sq cm (list separately in addition to code for p","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6559","name":"G stckng full/chap18-30 cust","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0053","name":"Ht mental health and care","description":"Historical trauma (ht) mental health and clinical care for indigenous persons","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0996T","name":"Ins&sclr fix caps bag prosth","description":"Insertion and scleral fixation of a capsular bag prosthesis containing an intraocular lens prosthesis, with vitrectomy, including removal of crystalline lens or dislocated intraocular lens prosthesis, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0931T","name":"Ephys eval ccm-d ld separate","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), separate from initial implantation or replacement with testing of cardiac cont","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0457U","name":"Pfas 9 cmpnd lcms/ms pls/sr","description":"Pfas 9 cmpnd lcms/ms pls/sr","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1184","name":"Doc med rsn no cst/ist rx","description":"Documentation of medical reason(s) for not prescribing or administering corticosteroid or immunosuppressant treatment (e.g., allergy, intolerance, infectious etiology, pancreatic insufficiency, hyperthyroidism, prior bowel surgical interventions, celiac disease, receiving other medication, awaiting ","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82731","name":"Assay of fetal fibronectin","description":"Fetal fibronectin, cervicovaginal secretions, semi-quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3376","name":"Inj vancomycin (hikma) 10mg","description":"Injection, vancomycin hcl (hikma), not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1463","name":"2 f/u wthn 180 day rx atmp","description":"Documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35481","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":517.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0288U","name":"Onc lung mrna quan pcr 11&3","description":"Onc lung mrna quan pcr 11&3","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0424U","name":"Onc prst8 xom alys 53 sncrna","description":"Onc prst8 xom alys 53 sncrna","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3421","name":"Root surgery bicuspid","description":"Apicoectomy/periradicular surgery-bicuspid (first root)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9072","name":"Inj cyclophos frindovyx 5 mg","description":"Injection, cyclophosphamide (frindovyx), 5 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42215","name":"Reconstruct cleft palate","description":"Palatoplasty for cleft palate; major revision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":877.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4404","name":"Xwrap hydro plus per sq cm","description":"Xwrap hydro plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0781T","name":"Brnchsc rf dstrj pulm nrv bi","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; bilateral mainstem bronchi","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27458","name":"Osteot femur imed lngth dev","description":"Osteotomy(ies), femur, unilateral, with insertion of an externally controlled intramedullary lengthening device, including iliotibial band release when performed, imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0696T","name":"Bdy surf mapg pm/cvdfb f/up","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of follow-up interrogation or programming device evaluatio","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6605","name":"G com bandage padded foam","description":"Gradient compression bandaging supply, padded foam, per linear yard, any width, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36556","name":"Insert non-tunnel cv cath","description":"Insertion of non-tunneled centrally inserted central venous catheter; age 5 years or older","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1325","name":"Doc med rsn not seen","description":"Patients who were not seen for reasons documented by clinician for patient or medical reasons (e.g., inadequate time for follow-up, patients who received a prior intravitreal or periocular steroid injection within the last six (6) months and had a subsequent iop evaluation with iop <25mm hg within s","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87626","name":"Hpv sep hi-rsk typ&pool rslt","description":"Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), separately reported high-risk types (eg, 16, 18, 31, 45, 51, 52) and high-risk pooled result(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9938","name":"Fab removable appliance","description":"Fab removable appliance","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1261","name":"Pts on wtlist bef dialysis","description":"Patients that were on the kidney or kidney-pancreas waitlist prior to initiation of dialysis","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92623","name":"Dx aly aud oi snd prcsr each","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; each additional 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0224","name":"Pemivibart infusion","description":"Intravenous infusion, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppr","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5154","name":"Inj, omlyclo, 5 mg","description":"Injection, omalizumab-igec (omlyclo), biosimilar, 5 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4394","name":"Surgraft aca per sq cm","description":"Surgraft aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0970T","name":"Ablt b9 brst tum perq lsr ea","description":"Ablation, benign breast tumor (eg, fibroadenoma), percutaneous, laser, including imaging guidance when performed, each tumor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15730","name":"Mdfc flap w/prsrv vasc pedcl","description":"Midface flap (ie, zygomaticofacial flap) with preservation of vascular pedicle(s)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":840.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":1561.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1374","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0474","name":"Micro w exam of surg margins","description":"Accession of tissue gross and microscopic examination including assessment of surgical margins for presence of disease preparation and transmission of writte","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57410","name":"Pelvic examination","description":"Pelvic examination under anesthesia (other than local)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37264","name":"Revsc evasc fpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37271","name":"Revsc evsc fpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0367","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0701T","name":"Molec fluor img sus nev ea","description":"Molecular fluorescent imaging of suspicious nevus; each additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75710","name":"Artery x-rays arm/leg","description":"Angiography, extremity, unilateral, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":717.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4338","name":"Artacent velos, per sq cm","description":"Artacent velos, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5138","name":"Inj, wezlana, iv, 1 mg","description":"Injection, ustekinumab-auub (wezlana), biosimilar, intravenous, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90965","name":"Esrd home pt serv p mo 12-19","description":"End-stage renal disease (esrd) related services for home dialysis per full month, for patients 12-19 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3391","name":"Inj, atidarsagene autotemcel","description":"Injection, atidarsagene autotemcel, per treatment","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81002","name":"Urinalysis nonauto w/o scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; non-automated, without microscopy","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51925","name":"Hysterectomy/bladder repair","description":"Closure of vesicouterine fistula; with hysterectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1174.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9914","name":"Admin of dermal fill","description":"Admin of dermal fill","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4406","name":"Xwrap fenestra per sq cm","description":"Xwrap fenestra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33903","name":"Perq p-art revsc 1 abnor bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, bilateral","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0402U","name":"Nfct agt sti mult amp prb tq","description":"Nfct agt sti mult amp prb tq","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27675","name":"Repair lower leg tendons","description":"Repair, dislocating peroneal tendons; without fibular osteotomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":638.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1343","name":"Pt pam lvl 4 base or srt lin","description":"Patients who are at pam level 4 at baseline or patients who are flagged with extreme straight line response sets on the pam or with excessive missing responses","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99291","name":"Critical care first hour","description":"Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":84.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":228.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0820T","name":"Mntr psychdlc med 1stphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; first physician or other qualified health care professional, each hour","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0165","name":"Inj epinephrine nos 0.1 mg","description":"Injection, epinephrine, not otherwise specified, 0.1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0884T","name":"Esphgsc flx 1st tndsc dilat","description":"Esophagoscopy, flexible, transoral, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for esophageal stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1311","name":"Aphlx to vax bef enc","description":"Anaphylaxis due to the vaccine on or before the date of the encounter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0793T","name":"Prq tcat thrm ablt nrv p-art","description":"Percutaneous transcatheter thermal ablation of nerves innervating the pulmonary arteries, including right heart catheterization, pulmonary artery angiography, and all imaging guidance","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26449","name":"Release forearm/hand tendon","description":"Tenolysis, complex, extensor tendon, finger, including forearm, each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1108.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92632","name":"Hearing aid slctn svc ea add","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4271","name":"Home lancing/test cartridges","description":"Integrated lancing and blood sample testing cartridges for home blood glucose monitor, per 50 tests","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98984","name":"Rtm dev sply resp sys 2-15 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of respiratory system, 2-15 days in a 30-day period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0613","name":"Calcium glucon (wg critical)","description":"Injection, calcium gluconate (wg critical care), not therapeutically equivalent to j0612, 10 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0563U","name":"Nfct ds pthgn-sna 11vir&4bct","description":"Nfct ds pthgn-sna 11vir&4bct","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81464","name":"So gsap cll fr mcrstl ins","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants, microsatellite instability, tumor mutation burden, and rearrangements","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1805","name":"Inj, esmolol hcl, 10mg","description":"Injection, esmolol hydrochloride, 10 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01942","name":"Anes neuromd/ntrvrt lmbr/sac","description":"Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2055","name":"Idecabtagene vicleucel car","description":"Idecabtagene vicleucel, up to 510 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4560","name":"Nmes disposable","description":"Neuromuscular electrical stimulator (nmes), disposable, replacement only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1213","name":"No hx spiro prs spiro>=70%","description":"No history of spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) and present spirometry is >= 70%","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85246","name":"Clot factor viii vw antigen","description":"Clotting; factor viii, vw factor antigen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0164","name":"Epinephrine in nacl (baxter)","description":"Injection, epinephrine in sodium chloride (baxter), 0.1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0791T","name":"Motr cog vr gait train ea 15","description":"Motor-cognitive, semi-immersive virtual reality-facilitated gait training, each 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4308","name":"Sanopellis, per sq cm","description":"Sanopellis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55060","name":"Repair of hydrocele","description":"Repair of tunica vaginalis hydrocele (bottle type)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1003T","name":"Arthrp 1st crp/mtcrpl prostc","description":"Arthroplasty, first carpometacarpal joint, with distal trapezial and proximal first metacarpal prosthetic replacement (eg, first carpometacarpal total joint)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1180","name":"Pt imm ckpt inhib therapy","description":"Patients on immune checkpoint inhibitor therapy","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98975","name":"Rtm 1st set-up&pt educaj eqp","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); initial set-up and patient education on use of equipment","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25360","name":"Revision of ulna","description":"Osteotomy; ulna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1098.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4424","name":"Revive ft per sq cm","description":"Revive ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0402U","name":"Nfct agt sti mult amp prb tq","description":"Nfct agt sti mult amp prb tq","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0958T","name":"Rmv s-sclp eltr ra rcvr&tlmt","description":"Removal of sub-scalp implanted electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0299U","name":"Onc pan tum whl gen opt mapg","description":"Onc pan tum whl gen opt mapg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7472","name":"Removal of torus palatinus","description":"Removal of torus palatinus","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0713T","name":"N-nvs artl plaq alys rvw i&r","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data review, interpretation and report","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69720","name":"Release facial nerve","description":"Decompression facial nerve, intratemporal; lateral to geniculate ganglion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1353.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81515","name":"Nfct ds bv&vaginitis dna alg","description":"Infectious disease, bacterial vaginosis and vaginitis, real-time pcr amplification of dna markers for atopobium vaginae, atopobium species, megasphaera type 1, and bacterial vaginosis associated bacteria-2 (bvab-2), utilizing vaginal-fluid specimens, algorithm reported as positive or negative for hi","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0682","name":"App non-sheet skin sub add","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (list separately in addition to code for pri","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49407","name":"Image cath fluid trns/vgnl","description":"Image-guided fluid collection drainage by catheter (eg, abscess, hematoma, seroma, lymphocele, cyst); peritoneal or retroperitoneal, transvaginal or transrectal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":812.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0934T","name":"Rem mntr wrls l atr prs snr","description":"Remote monitoring of a wireless left atrial pressure sensor for up to 30 days, including data from daily uploads of left atrial pressure recordings, interpretation(s) and trend analysis, with adjustments to the diuretics plan, treatment paradigm thresholds, medications or lifestyle modifications, wh","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61215","name":"Ins subq rsvr pmp/nfs sys","description":"Insertion of subcutaneous reservoir, pump or continuous infusion system for connection to ventricular catheter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4268","name":"Surgraft ft per sq cm","description":"Surgraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2012","name":"Suprathel, per sq cm","description":"Suprathel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4005","name":"Family medicine ss","description":"Family medicine mips specialty set","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92920","name":"Prq trluml c angiop 1art&/br","description":"Percutaneous transluminal coronary angioplasty, single major coronary artery and/or its branch(es)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69727","name":"Rmv ntr oi imp sk tc esp<100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0437U","name":"Psyc anxiety do mrna 15 bmrk","description":"Psyc anxiety do mrna 15 bmrk","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9292","name":"Inj, pemetrexed dipotassium","description":"Injection, pemetrexed dipotassium, 10 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31643","name":"Diag bronchoscope/catheter","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with placement of catheter(s) for intracavitary radioelement application","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0960T","name":"Rpl s-sclp eltr ra rcvr&tlmt","description":"Replacement of sub-scalp implanted electrode array, receiver, and telemetry unit with tunneling of electrode for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0810T","name":"Subrta njx rx agt w/vtrc","description":"Subretinal injection of a pharmacologic agent, including vitrectomy and 1 or more retinotomies","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0491U","name":"Onc sol tum ctc slct er prtn","description":"Onc sol tum ctc slct er prtn","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7355","name":"Inj travoprost intra impl","description":"Injection, travoprost, intracameral implant, 1 microgram","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11200","name":"Rmvl skin tags up to&inc 15","description":"Removal of skin tags, multiple fibrocutaneous tags, any area; up to and including 15 lesions","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":66.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1425","name":"Surgical care mvp","description":"Surgical care mips value pathway","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0430U","name":"Gi malabs aat calpro pncrtc","description":"Gi malabs aat calpro pncrtc","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2601","name":"Inj, vasopressin (baxter)","description":"Injection, vasopressin (baxter), 1 unit","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1399","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26670","name":"Treat hand dislocation","description":"Closed treatment of carpometacarpal dislocation, other than thumb, with manipulation, each joint; without anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4256","name":"Mlg complet, per sq cm","description":"Mlg-complete, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49615","name":"Rpr aa hrn rcr 3-10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, reducible","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86041","name":"Acetylcholn rcptr bndng antb","description":"Acetylcholine receptor (achr); binding antibody","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0874","name":"Inj, daptomycin (baxter)","description":"Injection, daptomycin (baxter), not therapeutically equivalent to j0878, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5159","name":"Inj, denosumab-dssb, 1 mg","description":"Injection, denosumab-dssb (ospomyv/xbryk), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87913","name":"Nfct agt gntyp alys sarscov2","description":"Infectious agent genotype analysis by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), mutation identification in targeted region(s)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0707","name":"Intraoral periap radio image","description":"Intraoral periap radio image","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37284","name":"Revsc evasc tpvt st sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":365.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1933","name":"Afo rig ant tib tcf/= ots","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, off-the-shelf","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92002","name":"Intrm oph exam new patient","description":"Ophthalmological services: medical examination and evaluation with initiation of diagnostic and treatment program; intermediate, new patient","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1711","name":"Moderna vacc admin booster","description":"Moderna vacc admin booster","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0589U","name":"Pfas24cmpnd hi-perf lc-ms/ms","description":"Pfas24cmpnd hi-perf lc-ms/ms","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1445","name":"Pp care visit by 12 weeks","description":"Postpartum care visit before or at 12 weeks of giving birth","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87428","name":"Sarscov & inf vir a&b ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; severe acute respiratory syndrome coronavirus (eg, sars-cov, s","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80414","name":"Testosterone response panel","description":"Chorionic gonadotropin stimulation panel; testosterone response this panel must include the following: testosterone (84403 x 2 on 3 pooled blood samples)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1240","name":"Pt no resp best int","description":"Patient did not respond to the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0679T","name":"Laps rmvl lead isdss","description":"Laparoscopic removal of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76857","name":"Us exam pelvic limited","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0672T","name":"Ndovag cryg rf remdl tiss","description":"Endovaginal cryogen-cooled, monopolar radiofrequency remodeling of the tissues surrounding the female bladder neck and proximal urethra for urinary incontinence","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98975","name":"Rtm 1st set-up&pt educaj eqp","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); initial set-up and patient education on use of equipment","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4212","name":"Gingivectomy/plasty rest","description":"Gingivectomy/plasty rest","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1426","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1711","name":"Moderna vacc admin booster","description":"Moderna vacc admin booster","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4007","name":"General surgery ss","description":"General surgery mips specialty set","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"Endoskel posit rotat unit","description":"Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4545","name":"Suppl accessor tibial stim","description":"Supplies and accessories for external tibial nerve stimulator (e.g., socks, gel pads, electrodes, etc.), needed for one month","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34708","name":"Evasc rpr ilio-iliac rpt","description":"Endovascular repair of iliac artery by deployment of an ilio-iliac tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, and all endograft extension(s) proximally to the aortic bifurcation ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1781.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1272","name":"Pts kid transplt wtlst","description":"Patients observed on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64567","name":"Perq elec nrv field stimj cn","description":"Percutaneous electrical nerve field stimulation, cranial nerves, without implantation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1496","name":"No doc of fall or poc","description":"Patients that had a fall who did not have a plan of care for falls documented or do not have documentation of being assessed for falls","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4288","name":"Replacement breastpump valve","description":"Valve for breast pump, replacement","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4564","name":"Pessary, disposable any type","description":"Pessary, disposable, any type","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2525","name":"Cl, hydrophilic, dual focus","description":"Contact lens, hydrophilic, dual focus, per lens","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64788","name":"Remove skin nerve lesion","description":"Excision of neurofibroma or neurolemmoma; cutaneous nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1306","name":"Pt anphx due to pneum","description":"Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77615","name":"Hyperthermia ntrstl prb>5","description":"Hyperthermia generated by interstitial probe(s); more than 5 interstitial applicators","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2501","name":"Paricalcitol","description":"Injection, paricalcitol, 1 mcg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86756","name":"Respiratory virus antibody","description":"Antibody; respiratory syncytial virus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1352","name":"Suicd c-ssrs assessment, equ","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs or equivalent assessment","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76830","name":"Transvaginal us non-ob","description":"Ultrasound, transvaginal","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0822T","name":"Mntr psychdlc med cln staff","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; clinical staff under the direction of a physician or other qualified health care professional, concurrent with first physician or other qualified health care p","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0792T","name":"Appl slvr diamn fluoride 38%","description":"Application of silver diamine fluoride 38%, by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0560","name":"Safety plan interven","description":"Safety planning interventions, each 20 minutes personally performed by the billing practitioner, including assisting the patient in the identification of the following personalized elements of a safety plan: recognizing warning signs of an impending suicidal or substance use-related crisis; employin","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1243","name":"Pt othr thn true heard","description":"Patient provided a response other than completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99492","name":"1st psyc collab care mgmt","description":"Initial psychiatric collaborative care management, first 70 minutes in the first calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":91.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1152","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4375","name":"Duograft ac per sq cm","description":"Duograft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1449","name":"Inj eflapegrastim-xnst 0.1mg","description":"Injection, eflapegrastim-xnst, 0.1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"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":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12051","name":"Intmd rpr face/mm 2.5 cm/<","description":"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1480","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0677T","name":"Laps repos lead isdss 1st ld","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first repositioned lead","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2596","name":"Vasopressin (long grove) 1 u","description":"Injection, vasopressin (long grove), not therapeutically equivalent to j2598, 1 unit","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1490","name":"Pt status not doc","description":"Patient status not documented","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33924","name":"Remove pulmonary shunt","description":"Ligation and takedown of a systemic-to-pulmonary artery shunt, performed in conjunction with a congenital heart procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":364.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94664","name":"Demo&/eval pt use inhaler","description":"Demonstration and/or evaluation of patient utilization of an aerosol generator, nebulizer, metered dose inhaler or ippb device","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":24.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9948","name":"Adjust sleep apnea appliance","description":"Adjust sleep apnea appliance","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0792T","name":"Appl slvr diamn fluoride 38%","description":"Application of silver diamine fluoride 38%, by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15157","name":"Tis clt agrft f/s/n/h/f/g ea","description":"Tissue cultured skin autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7939","name":"Indexing for osteotomy","description":"Indexing for osteotomy","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2406","name":"Injection, oritavancin 10 mg","description":"Injection, oritavancin (kimyrsa), 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99470","name":"Rpm tx mgmt 1st 10 min","description":"Remote physiologic monitoring treatment management services, clinical staff/physician/other qualified health care professional time in a calendar month requiring 1 real-time interactive communication with the patient/caregiver during the calendar month; first 10 minutes","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99427","name":"Prin care mgmt staff ea addl","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0714T","name":"Tpla b9 prst8 hyprplsa<50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume less than 50 ml","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49615","name":"Rpr aa hrn rcr 3-10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, reducible","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71045","name":"X-ray exam chest 1 view","description":"Radiologic examination, chest; single view","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5411","name":"Dentures adjust cmplt mand","description":"Adjust complete denture - mandibular","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0533","name":"Buprenorphone inj weekly","description":"Medication assisted treatment, buprenorphine (injectable) administered on a weekly basis; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid tre","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4346","name":"Shelter dm matrix per sq cm","description":"Shelter dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9361","name":"Inj, efbemalenograstim alfa-","description":"Injection, efbemalenograstim alfa-vuxw, 0.5 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6191","name":"Semi precision abutment","description":"Semi precision abutment","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0267U","name":"Rare do id opt gen mapg&seq","description":"Rare constitutional and other heritable disorders, identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping and whole-genome sequencing","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2781","name":"Crown 3/4 cast base metal","description":"Crown - 3/4 cast predominantly base metal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0270","name":"Alprostadil for injection","description":"Injection, alprostadil, 1.25 mcg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9329","name":"Inj, tislelizumab-jsgr","description":"Injection, tislelizumab-jsgr, 1mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4258","name":"Enverse, per sq cm","description":"Enverse, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33710","name":"Repair of heart defects","description":"Repair sinus of valsalva fistula, with cardiopulmonary bypass; with repair of ventricular septal defect","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2157.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69716","name":"Impl oi implt sk tc esp<100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or resulting in removal of less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4251","name":"Vim, per square centimeter","description":"Vim, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0525","name":"Est pt-cg dyad dem mod cmplx","description":"Management of established patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1280","name":"Bilat mast/hx bi /unilat mas","description":"Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92543","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98004","name":"Synch audio-video est sf 10","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 10 minutes must be met or e","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1416","name":"Pt rec hosp","description":"Patient received hospice services any time during the performance period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9912","name":"Pre-visit patient screening","description":"Pre-visit patient screening","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0383U","name":"Tyrosinemia typ i mntr quan","description":"Tyrosinemia typ i mntr quan","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98978","name":"Rtm dev sply cbt 16-30 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of cognitive behavioral therapy, 16-30 days in a 30-day period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45915","name":"Remove rectal obstruction","description":"Removal of fecal impaction or foreign body (separate procedure) under anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0440U","name":"Crd chd dna alys 10 snp 6dna","description":"Crd chd dna alys 10 snp 6dna","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1023T","name":"Prq tis dsplmt intrathoracic","description":"Percutaneous tissue displacement, any method, including imaging guidance; intrathoracic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5422","name":"Dentures adjust part mandbl","description":"Adjust partial denture - mandibular","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1415","name":"No pos pdl1 bef ici ther","description":"Patients who did not have a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0017","name":"Crisis psychotherapy 60m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); first 60 minutes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4268","name":"Surgraft ft per sq cm","description":"Surgraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87523","name":"Hepatitis d quantification","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis d (delta), quantification, including reverse transcription, when performed","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1445","name":"Pp care visit by 12 weeks","description":"Postpartum care visit before or at 12 weeks of giving birth","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0981T","name":"Tcat impl wrls ivc snr","description":"Transcatheter implantation of wireless inferior vena cava sensor for long-term hemodynamic monitoring, including deployment of the sensor, radiological supervision and interpretation, right heart catheterization, and inferior vena cava venography, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0445U","name":"Abeta42 & ptau181 eclia csf","description":"Abeta42 & ptau181 eclia csf","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80185","name":"Assay of phenytoin total","description":"Phenytoin; total","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81458","name":"So gsap dna cpy nmbr&mcrstl","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis, copy number variants and microsatellite instability","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37266","name":"Rvsc evsc fpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80061","name":"Lipid panel","description":"Lipid panel this panel must include the following: cholesterol, serum, total (82465) lipoprotein, direct measurement, high density cholesterol (hdl cholesterol) (83718) triglycerides (84478)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90593","name":"Chikungunya vacc recomb im","description":"Chikungunya virus vaccine, recombinant, for intramuscular use","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99470","name":"Rpm tx mgmt 1st 10 min","description":"Remote physiologic monitoring treatment management services, clinical staff/physician/other qualified health care professional time in a calendar month requiring 1 real-time interactive communication with the patient/caregiver during the calendar month; first 10 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6605","name":"G com bandage padded foam","description":"Gradient compression bandaging supply, padded foam, per linear yard, any width, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0146","name":"Nav srv peer sup add 30 pr m","description":"Principal illness navigation - peer support, additional 30 minutes per calendar month (list separately in addition to g0140)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0602","name":"Sevelamer carbonate pdr 20mg","description":"Sevelamer carbonate (renvela or therapeutically equivalent), oral, powder, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31242","name":"Nsl/sinus ndsc rf abltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by radiofrequency ablation, posterior nasal nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":134.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0781T","name":"Brnchsc rf dstrj pulm nrv bi","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; bilateral mainstem bronchi","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78478","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9245","name":"Admin mod sedation-enteral","description":"Admin mod sedation-enteral","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11623","name":"Exc s/n/h/f/g mal+mrg 2.1-3","description":"Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 2.1 to 3.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80061","name":"Lipid panel","description":"Lipid panel this panel must include the following: cholesterol, serum, total (82465) lipoprotein, direct measurement, high density cholesterol (hdl cholesterol) (83718) triglycerides (84478)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3503","name":"Surg exp root surf molar","description":"Surg exp root surf molar","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64474","name":"Lwr xtr fscl pln blk uni nfs","description":"Lower extremity fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33694","name":"Cmp rpr tof wo plm atrs ptch","description":"Complete repair tetralogy of fallot without pulmonary atresia; with transannular patch","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2398.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64469","name":"Thrc fascial pln blk bi nfs","description":"Thoracic fascial plane block, bilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0140","name":"Nav srv peer sup 60 min pr m","description":"Principal illness navigation - peer support by certified or trained auxiliary personnel under the direction of a physician or other practitioner, including a certified peer specialist; 60 minutes per calendar month, in the following activities:  person-centered interview, performed to better underst","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82233","name":"Beta-amyloid 1-40 (abeta 40)","description":"Beta-amyloid; 1-40 (abeta 40)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1374","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1407","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31584","name":"Laryngoplasty fx rdctj fixj","description":"Laryngoplasty; with open reduction and fixation of (eg, plating) fracture, includes tracheostomy, if performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1773.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1411","name":"1st ln ici no chemo","description":"Currently on first-line immune checkpoint inhibitors without chemotherapy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27079","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1137.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78011","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78102","name":"Bone marrow imaging ltd","description":"Bone marrow imaging; limited area","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92541","name":"Spontaneous nystagmus test","description":"Spontaneous nystagmus test, including gaze and fixation nystagmus, with recording","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27832","name":"Treat lower leg dislocation","description":"Open treatment of proximal tibiofibular joint dislocation, includes internal fixation, when performed, or with excision of proximal fibula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":621.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0905T","name":"Ecg alg 12 ld rdcd i&r only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; interpretation and report only","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4314","name":"Reeva, per sq cm","description":"Reeva ft, per square cenitmeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92960","name":"Cardioversion electric ext","description":"Cardioversion, elective, electrical conversion of arrhythmia; external","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86480","name":"Tb test cell immun measure","description":"Tuberculosis test, cell mediated immunity antigen response measurement; gamma interferon","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69530","name":"Extensive mastoid surgery","description":"Petrous apicectomy including radical mastoidectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1910.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2001","name":"Suct pum ext mgmt sys","description":"Suction pump, home model, portable or stationary, electric, any type, for use with external urine and/or fecal management system","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9249","name":"Inj, melphalan (apotex) 1 mg","description":"Injection, melphalan (apotex), 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4340","name":"Simpligraft, per sq cm","description":"Simpligraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85240","name":"Clot factor viii ahg 1 stage","description":"Clotting; factor viii (ahg), 1-stage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64787","name":"Implant nerve end","description":"Implantation of nerve end into bone or muscle (list separately in addition to neuroma excision)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0601U","name":"Nfct ds pji alys 11 bmrks ia","description":"Nfct ds pji alys 11 bmrks ia","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87084","name":"Culture of specimen by kit","description":"Culture, presumptive, pathogenic organisms, screening only; with colony estimation from density chart","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0037","name":"Pt not able to participate","description":"On date of encounter, patient is not able to participate in assessment or screening, including non-verbal patients, delirious, severely aphasic, severely developmentally delayed, severe visual or hearing impairment and for those patients, no knowledgeable informant available","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"Ctlso a-p-l control custom","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0851T","name":"Dgtz gls mcrscp mphmtrc 1st","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52284","name":"Cysto rx balo cath urtl strx","description":"Cystourethroscopy, with mechanical urethral dilation and urethral therapeutic drug delivery by drug-coated balloon catheter for urethral stricture or stenosis, male, including fluoroscopy, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0315U","name":"Onc cutan sq cll ca mrna 40","description":"Onc cutan sq cll ca mrna 40","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23100","name":"Arthrotomy glenhumrl jt w/bx","description":"Arthrotomy, glenohumeral joint, including biopsy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":582.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37282","name":"Rvsc evsc tpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6252","name":"Bridge resin w/noble metal","description":"Pontic-resin with noble metal","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37268","name":"Revsc evasc fpvt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0530","name":"Adult daycare center, 8 hr u","description":"Adult day center, 8-hour unit, for use in cmmi model","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0570","name":"Care manage serv, pr cal mo","description":"Care management services for behavioral health conditions, directed by a physician or other qualified health care professional, per calendar month, with the following required elements: initial assessment or follow-up monitoring, including the use of applicable validated rating scales, behavioral he","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1472","name":"Hep b vaccine not received","description":"Patient did not receive recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37202","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1013T","name":"Lap srg imp/rpl eso nea&pg/r","description":"Laparoscopy, surgical, implantation or replacement of lower esophageal sphincter neurostimulator electrode array and neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver, including cruroplasty and/or electronic ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2008","name":"Theragenesis, per sq cm","description":"Theragenesis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5945","name":"Mand implt sup remv part","description":"Mand implt sup remv part","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1462","name":"Pt clin ind hd image","description":"Patients with clinical indications for imaging of the head","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4540","name":"Trans elec nerv periph nerv","description":"Distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86036","name":"Anca screen each antibody","description":"Antineutrophil cytoplasmic antibody (anca); screen, each antibody","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6280","name":"Implt maint procd remv implt","description":"Implt maint procd remv implt","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4351","name":"Enclose tl matrix, per sq cm","description":"Enclose tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3921","name":"Decor or submerg erupt tooth","description":"Decor or submerg erupt tooth","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4316","name":"Amchoplast, per sq cm","description":"Amchoplast, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0752","name":"Hiv prep, oral lenacapavir","description":"Oral, lenacapavir, 300 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1490","name":"Pt status not doc","description":"Patient status not documented","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2015","name":"Phoenix wnd mtrx, per sq cm","description":"Phoenix wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0389U","name":"Ped fbrl kd ifi27&mcemp1 rna","description":"Ped fbrl kd ifi27&mcemp1 rna","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58580","name":"Transcrv abltj utrn fibrd rf","description":"Transcervical ablation of uterine fibroid(s), including intraoperative ultrasound guidance and monitoring, radiofrequency","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6089","name":"Access/retorq implant screw","description":"Access/retorq implant screw","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0513U","name":"Onc prst8 alg alys msi&hrd","description":"Onc prst8 alg alys msi&hrd","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37287","name":"Revsc evasc tpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0702","name":"2d cephal radio image","description":"2d cephal radio image","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7962","name":"Lingual frenectomy","description":"Lingual frenectomy","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67900","name":"Repair brow defect","description":"Repair of brow ptosis (supraciliary, mid-forehead or coronal approach)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":523.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5227","name":"Immed max part denture","description":"Immed max part denture","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1499","name":"Interventional radiology mvp","description":"Interventional radiology mips value pathway","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4401","name":"Absolv3 per sq cm","description":"Absolv3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1378","name":"Med rsn no 10 yr fu colscope","description":"Documentation of medical reason(s) for not recommending a 10 year follow-up interval (e.g., inadequate prep, familial or personal history of colonic polyps, patient had no adenoma and age is >= 66 years old, or life expectancy < 10 years, other medical reasons)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90963","name":"Esrd home pt serv p mo <2yrs","description":"End-stage renal disease (esrd) related services for home dialysis per full month, for patients younger than 2 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":698.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"Ak 4 bar link hydl swg/stanc","description":"Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0939T","name":"Xtrnl ecg rec>15d<30d scan","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; scanning analysis with report","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1422","name":"Gastroenterology care mvp","description":"Gastroenterology care mips value pathway","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0863T","name":"Rlcj pg wcs lv trnsmtr only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; transmitter component only","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4271","name":"Home lancing/test cartridges","description":"Integrated lancing and blood sample testing cartridges for home blood glucose monitor, per 50 tests","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6609","name":"G compression bandaging","description":"Gradient compression bandaging supply, not otherwise specified","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86825","name":"Hla x-math non-cytotoxic","description":"Human leukocyte antigen (hla) crossmatch, non-cytotoxic (eg, using flow cytometry); first serum sample or dilution","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1241","name":"Pt no resp seen as person","description":"Patient did not respond to the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1432","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82746","name":"Assay of folic acid serum","description":"Folic acid; serum","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0138","name":"Iv cipaglucosidase alfa-atga","description":"Intravenous infusion of cipaglucosidase alfa-atga, including provider/supplier acquisition and clinical supervision of oral administration of miglustat in preparation of receipt of cipaglucosidase alfa-atga","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37259","name":"Revsc evasc ivt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10080","name":"I&d pilonidal cyst simple","description":"Incision and drainage of pilonidal cyst; simple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":319.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":124.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1783","name":"Vac admin human pap dose 3","description":"Vac admin human pap dose 3","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1388","name":"Pt doc exm rec melmn","description":"Patients with documentation of an exam performed for recurrence of melanoma","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0781T","name":"Brnchsc rf dstrj pulm nrv bi","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; bilateral mainstem bronchi","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37256","name":"Revsc evasc ivt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82668","name":"Assay of erythropoietin","description":"Erythropoietin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76830","name":"Transvaginal us non-ob","description":"Ultrasound, transvaginal","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q0172","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4400","name":"Polygon3 per sq cm","description":"Polygon3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71047","name":"X-ray exam chest 3 views","description":"Radiologic examination, chest; 3 views","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0601","name":"Sevelamer carbonate 20 mg","description":"Sevelamer carbonate (renvela or therapeutically equivalent), oral, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0664","name":"Team remote e/m new pt 60 mn","description":"Team remote e/m new pt 60mins","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37299","name":"Revsc evsc imvt angio cpx ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0041","name":"Pt/ptn decln referral","description":"Patient and/or care partner decline referral","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0476U","name":"Rx metab psyc 14gen&cyp2d6","description":"Rx metab psyc 14gen&cyp2d6","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15783","name":"Dermabrasion suprfl any site","description":"Dermabrasion; superficial, any site (eg, tattoo removal)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":391.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6253","name":"Provisional pontic","description":"Provisional pontic","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0603","name":"Sevelamer hydrochloride 20mg","description":"Sevelamer hydrochloride (renagel or therapeutically equivalent), oral, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38228","name":"Car-t admn autologous","description":"Chimeric antigen receptor t-cell (car-t) therapy; car-t cell administration, autologous","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30469","name":"Rpr nsl vlv collapse w/rmdlg","description":"Repair of nasal valve collapse with low energy, temperature-controlled (ie, radiofrequency) subcutaneous/submucosal remodeling","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55831","name":"Removal of prostate","description":"Prostatectomy (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy); retropubic, subtotal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1020.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90484","name":"Imm cnsl not admn sm>20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 20 minutes","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76987","name":"Dx intraop epicar car us chd","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; including placement and manipulation of transducer, image acquisition, interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4402","name":"Xwrap 2.0 per sq cm","description":"Xwrap 2.0, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2020","name":"Ac5 wound system","description":"Ac5 advanced wound system (ac5)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37259","name":"Revsc evasc ivt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6601","name":"G com bandge hgh dn foam pad","description":"Gradient compression bandaging supply, high density foam pad, any size or shape, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0567","name":"Screening hep c detect","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis c, screening, amplified probe technique","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3503","name":"Surg exp root surf molar","description":"Surg exp root surf molar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6214","name":"Pontic titanium","description":"Pontic - titanium","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1498","name":"Diagnostic radiology mvp","description":"Diagnostic radiology mips value pathway","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5943","name":"Proth mandib implt sup remv","description":"Proth mandib implt sup remv","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99403","name":"Prev med cnsl indiv apprx 45","description":"Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 45 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":100.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2030","name":"Miro3d fibers, per mg","description":"Miro3d fibers, per milligram","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0665","name":"Team remote e/m est pt 10 mn","description":"Team remote e/m est. pt 10mins","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0760T","name":"Dgtz gls mcrscp sl imm 1st","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57421","name":"Exam/biopsy of vag w/scope","description":"Colposcopy of the entire vagina, with cervix if present; with biopsy(s) of vagina/cervix","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":210.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1494","name":"Fall rep since last visit","description":"Patients that reported a fall since the last visit","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36224","name":"Place cath carotd art","description":"Selective catheter placement, internal carotid artery, unilateral, with angiography of the ipsilateral intracranial carotid circulation and all associated radiological supervision and interpretation, includes angiography of the extracranial carotid and cervicocerebral arch, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2141.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81003","name":"Urinalysis auto w/o scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; automated, without microscopy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9998","name":"Doc med rsn <3 colon","description":"Documentation of medical reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., last colonoscopy incomplete, last colonoscopy had inadequate prep, piecemeal removal of adenomas, or sessile serrated polyps >= 20 mm in size, last colonoscopy found greater than 10 adenomas, lo","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1306","name":"Injection, inclisiran, 1 mg","description":"Injection, inclisiran, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0372U","name":"Nfct ds gu pthgn arg detcj","description":"Nfct ds gu pthgn arg detcj","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0545","name":"Inherent visit to inpt","description":"Visit complexity inherent to hospital inpatient or observation care associated with a confirmed or suspected infectious disease by an infectious diseases specialist, including disease transmission risk assessment and mitigation, public health investigation, analysis, and testing, and complex antimic","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87564","name":"Mtb rifampin rst amp prb tq","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacterium tuberculosis, rifampin resistance, amplified probe technique","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0601","name":"Sevelamer carbonate 20 mg","description":"Sevelamer carbonate (renvela or therapeutically equivalent), oral, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0850T","name":"Dgtz gls mcrscp ish ea mult","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0542U","name":"Nefro renal trnspl ur nmr 84","description":"Nefro renal trnspl ur nmr 84","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49613","name":"Rpr aa hrn rcr < 3 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, reducible","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":611.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0853T","name":"Dgtz gls mcrscp mphmtrc ea m","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9607","name":"Lutetium lu 177 vipivotide","description":"Lutetium lu 177 vipivotide tetraxetan, therapeutic, 1 millicurie","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77438","name":"Surf rad thr orthvlt>150-500","description":"Surface radiation therapy; orthovoltage, delivery, >150-500 kv, per fraction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1354","name":"Int caries med app per tooth","description":"Interim caries med app","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1330","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99254","name":"Ip/obs cnsltj new/est mod 60","description":"Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1414","name":"Med rsn no pdl1 bef 1st ther","description":"Documentation of medical reason(s) for not performing the pd-l1 biomarker expression test prior to initiation of first-line immune checkpoint inhibitor therapy (e.g., patient is in an urgent or emergent situation where delay of treatment would jeopardize the patients health status; other medical rea","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0302U","name":"Iadna brtnla ddpcr flwg liq","description":"Iadna brtnla ddpcr flwg liq","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0793T","name":"Prq tcat thrm ablt nrv p-art","description":"Percutaneous transcatheter thermal ablation of nerves innervating the pulmonary arteries, including right heart catheterization, pulmonary artery angiography, and all imaging guidance","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0183","name":"Software meas of cardiac vol","description":"Quantitative software measurements of cardiac volume, cardiac chambers volumes and left ventricular wall mass derived from ct scan(s) data of the chest/heart (with or without contrast)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9986","name":"Missed appointment","description":"Missed appointment","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76987","name":"Dx intraop epicar car us chd","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; including placement and manipulation of transducer, image acquisition, interpretation and report","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1304","name":"No pneum vax admin 19+","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1451","name":"Pt dx ppd dur id/pf pd","description":"Patients with an active diagnosis of pervasive developmental disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1165","name":"Pt use hspc dur meas pd","description":"Patients who use hospice services any time during the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1335","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97036","name":"App mdlty 1+hubbrd tnk ea 15","description":"Application of a modality to 1 or more areas; hubbard tank, each 15 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0607","name":"Lanthanum carbonate oral 5mg","description":"Lanthanum carbonate, oral, 5 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0771T","name":"Vr px dissoc svc sm phy 1st","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15017","name":"App skn cll ssp f/n/g/hf 1st","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 480 sq cm or less","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12037","name":"Intmd rpr s/tr/ext >30.0 cm","description":"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); over 30.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15016","name":"App skn cl ssp agrf t/a/l ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; each additional 480 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2035","name":"Corpl p therac p allac p mg","description":"Corplex p or theracor p or allacor p, per milligram","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1230","name":"Pt hcv rctv aby no f/u tst","description":"Patient has a reactive hcv antibody test and does not have a follow up hcv viral test, or patient has a reactive hcv antibody test and has a follow up hcv viral test that detects hcv viremia and is not referred to a clinician who treats hcv infection within 1 month and does not have hcv treatment in","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60661","name":"Abltj 1/+thyr ndul addl prq","description":"Ablation of 1 or more thyroid nodule(s), additional lobe, percutaneous, including imaging guidance, radiofrequency (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0702","name":"2d cephal radio image","description":"2d cephal radio image","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64582","name":"Opn mpltj hpglsl nstm ary pg","description":"Open implantation of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42415","name":"Excise parotid gland/lesion","description":"Excision of parotid tumor or parotid gland; lateral lobe, with dissection and preservation of facial nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1297.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1479","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4284","name":"Dermabind sl, per sq cm","description":"Dermabind sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0443U","name":"Neurflmnt lt chn ultrsens ia","description":"Neurflmnt lt chn ultrsens ia","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49613","name":"Rpr aa hrn rcr < 3 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, reducible","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28270","name":"Release of foot contracture","description":"Capsulotomy; metatarsophalangeal joint, with or without tenorrhaphy, each joint (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9056","name":"Inj, vivimusta, 1 mg","description":"Injection, bendamustine hydrochloride (vivimusta), 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0497U","name":"Onc prst8 mrna rt-pcr 6 gene","description":"Onc prst8 mrna rt-pcr 6 gene","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21805","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":289.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1170","name":"Pt w/o flu vax 7/1-6/30","description":"Patient did not receive an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90832","name":"Psytx w pt 30 minutes","description":"Psychotherapy, 30 minutes with patient","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":25.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":94.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5157","name":"Inj, denosumab-bmwo, 1 mg","description":"Injection, denosumab-bmwo (stoboclo/osenvelt), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"U0002","name":"Covid-19 lab test non-cdc","description":"2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0447U","name":"Ai ds sle alys 11 cytokine","description":"Ai ds sle alys 11 cytokine","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98976","name":"Rtm dev sply resp sys 16-30d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of respiratory system, 16-30 days in a 30-day period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0515","name":"Sermorelin acetate injection","description":"Injection, sermorelin acetate, 1 microgram","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0463U","name":"Onc crvx mrna genxprsn 14bmk","description":"Onc crvx mrna genxprsn 14bmk","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0661","name":"Team remote e/m new pt 20 mn","description":"Team remote e/m new pt 20mins","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0045","name":"Mrs 90 days post stk","description":"Clinical follow-up and mrs score assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0038","name":"Clin pt no ref","description":"Clinician determines patient does not require referral","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7956","name":"Tiss regen edent resorb","description":"Tiss regen edent resorb","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2351","name":"Inj ocrelizumab 1mg hya-ocsq","description":"Injection, ocrelizumab, 1 mg and hyaluronidase-ocsq","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44010","name":"Incision of small bowel","description":"Duodenotomy, for exploration, biopsy(s), or foreign body removal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":871.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33902","name":"Perq p-art revsc 1 abnor uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, unilateral","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0306U","name":"Onc mrd nxt-gnrj alys 1st","description":"Onc mrd nxt-gnrj alys 1st","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0499U","name":"Onc clrct&lng dna ngs 8gene","description":"Onc clrct&lng dna ngs 8gene","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0620U","name":"Onc hcc dna mthyln alys>5000","description":"Onc hcc dna mthyln alys>5000","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53451","name":"Tprnl balo cntnc dev bi","description":"Periurethral transperineal adjustable balloon continence device; bilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1179","name":"No pcv recd","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine, on or after their 19th birthday and before or during measurement period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53850","name":"Prostatic microwave thermotx","description":"Transurethral destruction of prostate tissue; by microwave thermotherapy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57513","name":"Laser surgery of cervix","description":"Cautery of cervix; laser ablation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0558","name":"Adv prim care mgmt lvl 3","description":"Advanced primary care management services for a patient that is a qualified medicare beneficiary with multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, which place the patient at significant risk of death, acute exacerbation/decompensat","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1486","name":"Pt admitted to snf dur eval","description":"Patients admitted to a skilled nursing facility (snf) during the period of evaluation","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6594","name":"G comp bandge liner lwr extr","description":"Gradient compression bandaging supply, bandage liner, lower extremity, any size or length, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4322","name":"Splint intra-coronal","description":"Splint intra-coronal","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0287U","name":"Onc thyr dna&mrna 112 genes","description":"Onc thyr dna&mrna 112 genes","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98011","name":"Synch audio-only new high 60","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 60 ","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43235","name":"Egd diagnostic brush wash","description":"Esophagogastroduodenoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3375","name":"Inj, vanco (tyzavan) 10mg","description":"Injection, vancomycin hydrochloride (tyzavan), not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0406","name":"Inpt/tele follow up 15","description":"Follow-up inpatient consultation, limited, physicians typically spend 15 minutes communicating with the patient via telehealth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98942","name":"Chiropractic manj 5 regions","description":"Chiropractic manipulative treatment (cmt); spinal, 5 regions","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38228","name":"Car-t admn autologous","description":"Chimeric antigen receptor t-cell (car-t) therapy; car-t cell administration, autologous","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76857","name":"Us exam pelvic limited","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4296","name":"Rebound matrix, per sq cm","description":"Rebound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0387","name":"Comp image capture only","description":"Comp image capture only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1429","name":"Retinopathy in od, os, ou","description":"Retinal exam finding with evidence of retinopathy in left, right or both eyes with severity level documented","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1291","name":"Pt 66+ frailty and med dem","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0952T","name":"Tot impl amei rev/rplc mstdc","description":"Totally implantable active middle ear hearing implant; revision or replacement, with mastoidectomy and replacement of sound processor","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29807","name":"Sho arthrs srg rpr slap les","description":"Arthroscopy, shoulder, surgical; repair of slap lesion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1244.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0029","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0537","name":"Risk ascvd tst once pr 12 mo","description":"Administration of a standardized, evidence-based atherosclerotic cardiovascular disease (ascvd) risk assessment, 5-15 minutes, not more often than every 12 months","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1457","name":"Dx asth dur crnt/prv perf pd","description":"Patient had a diagnosis of asthma with any contact during the current or prior performance period or had asthma present on an active problem list any time during the performance period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0429U","name":"Hpv orop swab 14 hi-risk typ","description":"Hpv orop swab 14 hi-risk typ","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1499","name":"Interventional radiology mvp","description":"Interventional radiology mips value pathway","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q3025","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0350","name":"Oral/facial photo images","description":"Oral/facial photographic images","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0263U","name":"Neuro asd meas 16 c metblt","description":"Neurology (autism spectrum disorder [asd]), quantitative measurements of 16 central carbon metabolites (ie, a-ketoglutarate, alanine, lactate, phenylalanine, pyruvate, succinate, carnitine, citrate, fumarate, hypoxanthine, inosine, malate, s-sulfocysteine, taurine, urate, and xanthine), liquid chrom","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1299","name":"Inj, eculizumab, 2 mg","description":"Injection, eculizumab, 2 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93597","name":"R&l hrt cath chd abnl nt cnj","description":"Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); abnormal native connections","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1004T","name":"Elec alys s-scl eeg wo prgrm","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; without programming","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15758","name":"Free fascial flap microvasc","description":"Free fascial flap with microvascular anastomosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2728.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70473","name":"Ct cere prfu aly c+wo ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed without concurrent ct or ct angiography of the same anatomy","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0289U","name":"Neuro alzheimer mrna 24 gen","description":"Neuro alzheimer mrna 24 gen","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6113","name":"Imp/abut rem dent part mand","description":"Imp/abut rem dent part mand","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0740T","name":"Rem auton alg nsln cal setup","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; initial set-up and patient education","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1393","name":"Pr no dx rec mlnm","description":"Patients who were not diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7353","name":"Anacaulase-bcdb 8.8% gel 1 g","description":"Anacaulase-bcdb, 8.8% gel, 1 gram","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15853","name":"Removal sutr/stapl xreq anes","description":"Removal of sutures or staples not requiring anesthesia (list separately in addition to e/m code)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0629U","name":"Nfct ds tb dna aly 1trgt pcr","description":"Nfct ds tb dna aly 1trgt pcr","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94620","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4263","name":"Surgraft tl, per sq cm","description":"Surgraft tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83030","name":"Hemoglobin f fetal chemical","description":"Hemoglobin; f (fetal), chemical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27238","name":"Treat thigh fracture","description":"Closed treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; without manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":526.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0727T","name":"Rmvl&rplcmt implt vstblr dev","description":"Removal and replacement of implanted vestibular device, unilateral","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92637","name":"Hearing aid pst-fitg f-up ea","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0675T","name":"Laps insj nw/rpcmt isdss 1ld","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first lead","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0703","name":"Inj, cefepime hcl (b braun)","description":"Injection, cefepime hydrochloride (b braun), not therapeutically equivalent to maxipime, 500 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2024","name":"Resolve or xenopatch sq cm","description":"Resolve matrix or xenopatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0615U","name":"Bbrgdrferi ld antb detcj 26","description":"Bbrgdrferi ld antb detcj 26","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4364","name":"Am bur xp mem xpl hy p sq cm","description":"Amnio burgeon xplus membrane and xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63053","name":"Lam factc/frmt arthrd lum ea","description":"Laminectomy, facetectomy, or foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s] [eg, spinal or lateral recess stenosis]), during posterior interbody arthrodesis, lumbar; each additional vertebral segment (list separately in addition to code for","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0982T","name":"Rem mntr impl ivc snr set-up","description":"Remote monitoring of implantable inferior vena cava sensor, physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate), initial set-up and patient education on use of equipment","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1335","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0138","name":"Inj acetaminoph 10mg/ibu 3mg","description":"Injection, acetaminophen 10 mg and ibuprofen 3 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97551","name":"Caregiver traing ea addl 15","description":"Caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patie","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4354","name":"Palingen dl-palingen dl-x","description":"Palingen dual-layer membrane and dual-layer palingen x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0462U","name":"Melatonin lvl tst slp std7/9","description":"Melatonin lvl tst slp std7/9","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4438","name":"Adhesive clip ext ens contr","description":"Adhesive clip applied to the skin to secure external electrical nerve stimulator controller, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0566","name":"3d bn img algor drvd fr mri","description":"3d radiodensity-value bone imaging, algorithm derived, from previous magnetic resonance examination of the same anatomy","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0990T","name":"Trncrv inst biod hydrgl mtrl","description":"Transcervical instillation of biodegradable hydrogel materials, intrauterine","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4027","name":"Plastic surgery ss","description":"Plastic surgery mips specialty set","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4405","name":"Xwrap fenestra plus sq cm","description":"Xwrap fenestra plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1294","name":"Bp scrn perf rec interval","description":"Normal blood pressure reading documented, follow-up not required","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0541U","name":"Cv ds hdl rct cec lc-ms/ms 5","description":"Cv ds hdl rct cec lc-ms/ms 5","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4010","name":"Infectious disease ss","description":"Infectious disease mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0063","name":"Cardiology ss","description":"Cardiology mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9563","name":"Ht inj immuno diem","description":"Home injectable therapy, immunotherapy, 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":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0177","name":"Inj, aflibercept hd, 1 mg","description":"Injection, aflibercept hd, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0285U","name":"Onc rsps radj cll fr dna tox","description":"Onc rsps radj cll fr dna tox","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0702","name":"2d cephal radio image","description":"2d cephal radio image","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74475","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0336U","name":"Rare ds whl gen seq bld/slv","description":"Rare ds whl gen seq bld/slv","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0722T","name":"Quan ct tiss charac w/ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained with concurrent ct examination of any structure contained in the concurrently acquired diagnostic imaging dataset (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87494","name":"Chlmy trch&neisra gonor mult","description":"Infectious agent detection by nucleic acid (dna or rna); chlamydia trachomatis and neisseria gonorrhoeae, multiplex amplified probe technique","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59350","name":"Repair of uterus","description":"Hysterorrhaphy of ruptured uterus","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0785T","name":"Revj/rmvl nea spi w/nstim","description":"Revision or removal of neurostimulator electrode array, spinal, with integrated neurostimulator","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9248","name":"Inj melphalan (hepzato) 1 mg","description":"Injection, melphalan (hepzato), 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6193","name":"Replace implnt screw","description":"Replace implnt screw","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0595","name":"Butorphanol tartrate 1 mg","description":"Injection, butorphanol tartrate, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78103","name":"Bone marrow imaging mult","description":"Bone marrow imaging; multiple areas","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99213","name":"Office o/p est low 20 min","description":"Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 20 minutes must be met or e","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":21.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":109.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4303","name":"Complete aa, per sq cm","description":"Complete aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69719","name":"Rplcm oi implt sk tc esp<100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86226","name":"Dna antibody single strand","description":"Deoxyribonucleic acid (dna) antibody; single stranded","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0426","name":"Coll, analys of saliva","description":"Coll, analys of saliva","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0835T","name":"Dgtz gls mcrscp fna 1st ea","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4348","name":"Sentry sl matrix per sq cm","description":"Sentry sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2030","name":"Miro3d fibers, per mg","description":"Miro3d fibers, per milligram","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4365","name":"Amnio bur dl mem per sq cm","description":"Amnio burgeon dual-layer membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0038","name":"Clin pt no ref","description":"Clinician determines patient does not require referral","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0770T","name":"Vr technology assist therapy","description":"Virtual reality technology to assist therapy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99425","name":"Prin care mgmt phys ea addl","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0870","name":"Injection, imetelstat, 1 mg","description":"Injection, imetelstat, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37284","name":"Revsc evasc tpvt st sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0283U","name":"Vw factor type 2b eval plsm","description":"Von willebrand factor (vwf), type 2b, platelet-binding evaluation, radioimmunoassay, plasma","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0018","name":"Crisis psychotherapy add 30m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); each additional 30 minutes (list separately in addition to code for primary service)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1478","name":"Psychoactive sub abuse","description":"Psychoactive substance abuse","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0897T","name":"N-invas augmnt arrhyt alys","description":"Noninvasive augmentative arrhythmia analysis derived from quantitative computational cardiac arrhythmia simulations, based on selected intervals of interest from 12-lead electrocardiogram and uploaded clinical parameters, including uploading clinical parameters with interpretation and report","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1008T","name":"Rem mntr s-scl eeg sys setup","description":"Remote monitoring of sub-scalp implanted continuous bilateral electroencephalography monitoring system, device fitting, initial set-up, and patient education in wearing of system and use of equipment","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1321","name":"Couns for high risk sub use","description":"Couns for high risk sub use","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90460","name":"Im admin 1st/only component","description":"Immunization administration through 18 years of age via any route of administration, with counseling by physician or other qualified health care professional; first or only component of each vaccine or toxoid administered","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0771T","name":"Vr px dissoc svc sm phy 1st","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0316U","name":"B brgdrferi lyme ds ospa evl","description":"B brgdrferi lyme ds ospa evl","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0972T","name":"Asstv alg clsfctn burn hlg","description":"Assistive algorithmic classification of burn healing (ie, healing or nonhealing) by noninvasive multispectral imaging, including system set-up and acquisition, selection, and transmission of images, with automated generation of report","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4251","name":"Vim, per square centimeter","description":"Vim, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7353","name":"Anacaulase-bcdb 8.8% gel 1 g","description":"Anacaulase-bcdb, 8.8% gel, 1 gram","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35190","name":"Repair acq av fistula xtr","description":"Repair, acquired or traumatic arteriovenous fistula; extremities","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":940.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96900","name":"Actinotherapy uv light","description":"Actinotherapy (ultraviolet light)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0218","name":"Inj olipudase alfa-rpcp 1mg","description":"Injection, olipudase alfa-rpcp, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82948","name":"Reagent strip/blood glucose","description":"Glucose; blood, reagent strip","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96160","name":"Pt-focused hlth risk assmt","description":"Administration of patient-focused health risk assessment instrument (eg, health hazard appraisal) with scoring and documentation, per standardized instrument","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0257U","name":"Vlcad leuk nzm actv whl bld","description":"Very long chain acyl- coenzyme a (coa) dehydrogenase (vlcad), leukocyte enzyme activity, whole blood","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0312U","name":"Ai ds sle alys 8 igg autoant","description":"Ai ds sle alys 8 igg autoant","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":680.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1344","name":"No bsln/2nd pam score 4-12mo","description":"Patients who did not have a baseline pam score and/or a second score within 4 to 12 months of baseline pam score","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0854T","name":"Dgtz gls mcrscp bld smr prph","description":"Digitization of glass microscope slides for blood smear, peripheral, interpretation by physician with written report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7961","name":"Buccal/labial frenectomy","description":"Buccal/labial frenectomy","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1270","name":"Pts no kid transplt wtlst","description":"Patients not on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1307","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1032","name":"Sv doula brth wrk per 15 min","description":"Services performed by a doula birth worker, per 15 minutes","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4259","name":"Celera per sq cm","description":"Celera dual layer or celera dual membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9359","name":"Inj lon tesirin-lpyl 0.075mg","description":"Injection, loncastuximab tesirine-lpyl, 0.075 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33895","name":"Evasc st rpr thrc/aa x crsg","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; not crossing major side branches","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0445U","name":"Abeta42 & ptau181 eclia csf","description":"Abeta42 & ptau181 eclia csf","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93152","name":"Interrog&prgrmg ipnss polysm","description":"Interrogation and programming of implanted phrenic nerve stimulator system during polysomnography","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0955T","name":"Tot impl amei removal","description":"Totally implantable active middle ear hearing implant; removal, including removal of sound processor and all implant components","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0810T","name":"Subrta njx rx agt w/vtrc","description":"Subretinal injection of a pharmacologic agent, including vitrectomy and 1 or more retinotomies","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1317","name":"Pts counsl cpt opt out","description":"Patients who are counseled on connection with a csp and explicitly opt out","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21235","name":"Ear cartilage graft","description":"Graft; ear cartilage, autogenous, to nose or ear (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17250","name":"Chem caut of granltj tissue","description":"Chemical cauterization of granulation tissue (ie, proud flesh)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":105.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1398","name":"Bslne and  fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4400","name":"Polygon3 per sq cm","description":"Polygon3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4329","name":"Singlay, per sq cm","description":"Singlay, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2016","name":"Permeaderm b, per sq cm","description":"Permeaderm b, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0343U","name":"Onc prst8 xom aly 442 sncrna","description":"Onc prst8 xom aly 442 sncrna","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0892T","name":"Arhfcmrigtbs sbsq per tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent motor threshold redetermination with delivery and management, per treatment day","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0706","name":"Intraoral occlus radio image","description":"Intraoral occlus radio image","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4199","name":"Cygnus matrix, per sq cm","description":"Cygnus matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1207","name":"Pt scrn sdoh","description":"Patient is screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1230","name":"Pt hcv rctv aby no f/u tst","description":"Patient has a reactive hcv antibody test and does not have a follow up hcv viral test, or patient has a reactive hcv antibody test and has a follow up hcv viral test that detects hcv viremia and is not referred to a clinician who treats hcv infection within 1 month and does not have hcv treatment in","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0038","name":"Clin pt no ref","description":"Clinician determines patient does not require referral","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74241","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87468","name":"Anaplsma phgcytophlm amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); anaplasma phagocytophilum, amplified probe technique","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0943T","name":"Cysto flx rmvl urtl scaffold","description":"Cystourethroscopy, flexible; with removal of prostatic urethral scaffold","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69635","name":"Repair eardrum structures","description":"Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic membrane repair); without ossicular chain reconstruction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1411.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82520","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16000","name":"Initial treatment of burn(s)","description":"Initial treatment, first degree burn, when no more than local treatment is required","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":106.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":49.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2033","name":"Myriad morcells, 4 mg","description":"Myriad morcells, 4 milligrams","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0850T","name":"Dgtz gls mcrscp ish ea mult","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82938","name":"Gastrin test","description":"Gastrin after secretin stimulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33927","name":"Impltj tot rplcmt hrt sys","description":"Implantation of a total replacement heart system (artificial heart) with recipient cardiectomy","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2177.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1165","name":"Pt use hspc dur meas pd","description":"Patients who use hospice services any time during the measurement period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1171","name":"Pt recd 1 td/tdap 9yrs prior","description":"Patient received at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59050","name":"Fetal monitor w/report","description":"Fetal monitoring during labor by consulting physician (ie, non-attending physician) with written report; supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96548","name":"Ntraop hipec px ea add 30min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"Ctlso a-p-l control custom","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0013","name":"Hiv prep counsel, clin staff","description":"Individual counseling for pre-exposure prophylaxis (prep) by clinical staff to prevent human immunodeficiency virus (hiv), includes: hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74415","name":"Urography nfs drip&/bls w/nf","description":"Urography, infusion, drip technique and/or bolus technique; with nephrotomography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0892T","name":"Arhfcmrigtbs sbsq per tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent motor threshold redetermination with delivery and management, per treatment day","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0577","name":"Inj, brixadi, 7 days or less","description":"Injection, buprenorphine extended-release (brixadi), less than or equal to 7 days of therapy","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0603","name":"Sevelamer hydrochloride 20mg","description":"Sevelamer hydrochloride (renagel or therapeutically equivalent), oral, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5147","name":"Inj, aflibercept-ayyh, 1 mg","description":"Injection, aflibercept-ayyh (pavblu), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0583U","name":"Rare ds rpd whlgen cmptr dna","description":"Rare ds rpd whlgen cmptr dna","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0554U","name":"Repr med pga 24chrm te bx qc","description":"Repr med pga 24chrm te bx qc","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0990T","name":"Trncrv inst biod hydrgl mtrl","description":"Transcervical instillation of biodegradable hydrogel materials, intrauterine","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4432","name":"510(k) skin subs, nos","description":"510(k) skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4271","name":"Home lancing/test cartridges","description":"Integrated lancing and blood sample testing cartridges for home blood glucose monitor, per 50 tests","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0471U","name":"Onc clrc ca 35 vrn kras&nras","description":"Onc clrc ca 35 vrn kras&nras","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0301U","name":"Iadna bartonella ddpcr","description":"Iadna bartonella ddpcr","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37287","name":"Revsc evasc tpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9051","name":"Inj, bortezomib (maia)","description":"Injection, bortezomib (maia), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0043","name":"Pt mech pros ht valv","description":"Patients with mechanical prosthetic heart valve","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43843","name":"Gstr rstcv oth/thn v-band","description":"Gastric restrictive procedure, without gastric bypass, for morbid obesity; other than vertical-banded gastroplasty","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1284.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9953","name":"Reline sleep apnea appliance","description":"Reline sleep apnea appliance","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0602U","name":"Endocrin dm ins gen mthyltn","description":"Endocrin dm ins gen mthyltn","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23400","name":"Fixation of shoulder blade","description":"Scapulopexy (eg, sprengels deformity or for paralysis)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1179.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86225","name":"Dna antibody native","description":"Deoxyribonucleic acid (dna) antibody; native or double stranded","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1240","name":"Pt no resp best int","description":"Patient did not respond to the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0983T","name":"Rem mntr impl ivc snr phys","description":"Remote monitoring of an implanted inferior vena cava sensor for up to 30 days, including at least weekly downloads of inferior vena cava area recordings, interpretation(s), trend analysis, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7511","name":"Incision/drain abscess intra","description":"Incision and drainage of abscess - intraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66700","name":"Destruction ciliary body","description":"Ciliary body destruction; diathermy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0603","name":"Sevelamer hydrochloride 20mg","description":"Sevelamer hydrochloride (renagel or therapeutically equivalent), oral, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2598","name":"Inj, vasopressin, 1 unit","description":"Injection, vasopressin, 1 unit","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4324","name":"Amniotx, per sq cm","description":"Amniotx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64656","name":"Revj/rplcmt bat mod sys pg","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; pulse generator only","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87627","name":"Jt spc pthgn&rx rsist gen26+","description":"Infectious agent detection by nucleic acid (dna or rna); joint space pathogens and drug resistance genes, multiplex amplified probe technique, 26 or more targets","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP03","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9954","name":"Fab/del oral appliance thxpy","description":"Fab/del oral appliance thxpy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0236","name":"Intrav inf, mon anti, sec do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31233","name":"Nsl/sins ndsc dx max sinusc","description":"Nasal/sinus endoscopy, diagnostic; with maxillary sinusoscopy (via inferior meatus or canine fossa puncture)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9269","name":"Programable ingest capsule","description":"Programable, transient, orally ingested capsule, for use with external programmer, per month","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46942","name":"Treatment of anal fissure","description":"Curettage or cautery of anal fissure, including dilation of anal sphincter (separate procedure); subsequent","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0137","name":"Inten outpt svs,min 9 pr 7 d","description":"Intensive outpatient services; weekly bundle, minimum of 9 services over a 7 contiguous day period, which can include individual and group therapy with physicians or psychologists (or other mental health professionals to the extent authorized under state law); occupational therapy requiring the skil","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0538U","name":"Onc sol tum ngts ffpe 600gen","description":"Onc sol tum ngts ffpe 600gen","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J3280","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4282","name":"Cygnus dual per sq cm","description":"Cygnus dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95115","name":"Immunotherapy one injection","description":"Professional services for allergen immunotherapy not including provision of allergenic extracts; single injection","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90847","name":"Family psytx w/pt 50 min","description":"Family psychotherapy (conjoint psychotherapy) (with patient present), 50 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":118.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":110.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0594U","name":"Nfct ds sepsis pncrtc spc","description":"Nfct ds sepsis pncrtc spc","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93595","name":"L hrt cath chd nm/abn nt cnj","description":"Left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone, normal or abnormal native connections","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1424","name":"Pulmonology care mvp","description":"Pulmonology care mips value pathway","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1484","name":"No rpt hcv rna perf med rsn","description":"Patients who did not have a repeat hcv rna labs performed for medical reasons documented by clinician (e.g., patient with limited life expectancy, delay in treatment of hcv related to treatment of hiv, hbv, hepatocellular carcinoma, decompensated cirrhosis)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0046","name":"No mrs 90 days post stk","description":"Clinical follow-up and mrs score not assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1480","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4308","name":"Sanopellis, per sq cm","description":"Sanopellis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0037","name":"Pt not able to participate","description":"On date of encounter, patient is not able to participate in assessment or screening, including non-verbal patients, delirious, severely aphasic, severely developmentally delayed, severe visual or hearing impairment and for those patients, no knowledgeable informant available","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0441U","name":"Nfct ds bct fngl/viral semiq","description":"Nfct ds bct fngl/viral semiq","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0018","name":"Crisis psychotherapy add 30m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); each additional 30 minutes (list separately in addition to code for primary service)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1341","name":"Pt no f/u 30-180 dys","description":"Patients who did not have a follow-up assessment or did not have an assessment within 30 to 180 days after the index assessment during the performance period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5161","name":"Inj, denosumab-kyqq, 1 mg","description":"Injection, denosumab-kyqq (aukelso/bosaya), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1370","name":"Rehab support msk care mvp","description":"Rehabilitative support for musculoskeletal care mips value pathway","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0712T","name":"N-nvs artl plaq alys quan","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess atherosclerotic plaque stability","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0578U","name":"Onc cutan mln rna qpcr 10gen","description":"Onc cutan mln rna qpcr 10gen","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33978","name":"Remove ventricular device","description":"Removal of ventricular assist device; extracorporeal, biventricular","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1651.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1153","name":"Pt w/ dx osteo doe","description":"Patient with diagnosis of osteoporosis on date of encounter","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1319","name":"Pts csp doc contact","description":"Patients who had documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0836T","name":"Dgtz gls mcrscp fna ea addl","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64584","name":"Rmvl hpglsl nstim ary pg","description":"Removal of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0423","name":"Genetic test spec analysis","description":"Genetic test spec analysis","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2247","name":"Inj, micafungin (par pharm)","description":"Injection, micafungin sodium (par pharm) not thereapeutically equivalent to j2248, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99425","name":"Prin care mgmt phys ea addl","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0568","name":"Int psych care mng, 1 cal mo","description":"Initial psychiatric collaborative care management, in the first calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required elements: outrea","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9305","name":"Inj. pemetrexed nos 10mg","description":"Injection, pemetrexed, not otherwise specified, 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0453U","name":"Onc clrct ca cfdna qpcr asy","description":"Onc clrct ca cfdna qpcr asy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84145","name":"Procalcitonin (pct)","description":"Procalcitonin (pct)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1321","name":"Pts no 7wk inj,no iop,iop>25","description":"Patients who were not seen within 7 weeks following the date of injection for follow up or who did not have a documented iop or no plan of care documented if the iop was >25 mm hg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99462","name":"Sbsq nb em per day hosp","description":"Subsequent hospital care, per day, for evaluation and management of normal newborn","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":12.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58700","name":"Removal of fallopian tube","description":"Salpingectomy, complete or partial, unilateral or bilateral (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":871.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0024","name":"Pin srv add 30 min pr m","description":"Principal illness navigation services, additional 30 minutes per calendar month (list separately in addition to g0023)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1025T","name":"Alt elec fld dos&dlv sim mdl","description":"Alternating electric fields dosimetry and delivery-simulation modeling, creation and selection of patient-specific array layouts, and placement verification","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96547","name":"Intraop hipec px 1st 60 min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; first 60 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0116","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2040","name":"Coord specialty care, month","description":"Coordinated specialty care, team-based, for first episode psychosis, per month","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1019T","name":"Lymphovenous bypass per xtr","description":"Lymphovenous bypass, including robotic assistance, when performed, per extremity","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0469U","name":"Rare ds whl gen seq ftl samp","description":"Rare ds whl gen seq ftl samp","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0826T","name":"Prgrmg evl ldls pm 1chmbr ip","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional, leadless pacemaker system in si","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98008","name":"Synch audio-only new sf 15","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code sel","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1356","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0984T","name":"Iv img xtrc cere vsl oct 1st","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7356","name":"Inj foscarb/foslevodopa 5 mg","description":"Injection, foscarbidopa 0.25 mg/foslevodopa 5 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0852T","name":"Dgtz gls mcrscp mphmtrc ea 1","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0312U","name":"Ai ds sle alys 8 igg autoant","description":"Ai ds sle alys 8 igg autoant","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0694T","name":"3d vol img&rcnstj brst/ax","description":"3-dimensional volumetric imaging and reconstruction of breast or axillary lymph node tissue, each excised specimen, 3-dimensional automatic specimen reorientation, interpretation and report, real-time intraoperative","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37239","name":"Open/perq place stent ea add","description":"Transcatheter placement of an intravascular stent(s), open or percutaneous, including radiological supervision and interpretation and including angioplasty within the same vessel, when performed; each additional vein (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2288.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93224","name":"Xtrnl ecg rec up to 48 hrs","description":"External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage; includes recording, scanning analysis with report, review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":82.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86041","name":"Acetylcholn rcptr bndng antb","description":"Acetylcholine receptor (achr); binding antibody","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0976T","name":"Slctv nzmtc dbrdmt s/n/hf ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; each additional 100 sq cm (list separately in addition to code for p","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37256","name":"Revsc evasc ivt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75896","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1160.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2792","name":"Crown full cast noble metal","description":"Crown-full cast noble metal","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0396","name":"3d print of 3d surface scan","description":"3d print of 3d surface scan","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99281","name":"Emr dpt vst mayx req phy/qhp","description":"Emergency department visit for the evaluation and management of a patient that may not require the presence of a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1941","name":"Inj, furoscix, 20 mg","description":"Injection, furosemide (furoscix), 20 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15050","name":"Pinch graft up to 2 cm diam","description":"Pinch graft, single or multiple, to cover small ulcer, tip of digit, or other minimal open area (except on face), up to defect size 2 cm diameter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2272","name":"Inj, morphine (fresenius)","description":"Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93594","name":"R hrt cath chd abnl nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; abnormal native connections","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66940","name":"Extraction of lens","description":"Removal of lens material; extracapsular (other than 66840, 66850, 66852)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":752.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0382U","name":"Hyprphenylalninmia mntr quan","description":"Hyprphenylalninmia mntr quan","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91200","name":"Liver elastography","description":"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33903","name":"Perq p-art revsc 1 abnor bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, bilateral","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6036","name":"Prosthetic thumb mechanical","description":"Prosthetic thumb, mechanical, can include metacarpophalangeal (mcp), interphalangeal (ip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4288","name":"Dermabind ch, per sq cm","description":"Dermabind ch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1336","name":"Pts eval ini xm 2 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 2 weeks","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0271U","name":"Hem cgen neutropenia 23 gen","description":"Hematology (congenital neutropenia), genomic sequence analysis of 23 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67850","name":"Dstrj lesion lid margin <1cm","description":"Destruction of lesion of lid margin (up to 1 cm)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1285","name":"Scrn mam perf rslts not doc","description":"Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed, reason not otherwise specified","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0675T","name":"Laps insj nw/rpcmt isdss 1ld","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first lead","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1243","name":"Pt othr thn true heard","description":"Patient provided a response other than completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33814","name":"Obltrj a-pulm sep def w/byp","description":"Obliteration of aortopulmonary septal defect, with cardiopulmonary bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1897.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99424","name":"Prin care mgmt phys 1st 30","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49616","name":"Rpr aa hrn rcr 3-10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, incarcerated or strangulated","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3503","name":"Surg exp root surf molar","description":"Surg exp root surf molar","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1941","name":"Inj, furoscix, 20 mg","description":"Injection, furosemide (furoscix), 20 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37293","name":"Rvsc evsc tpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30465","name":"Repair nasal stenosis","description":"Repair of nasal vestibular stenosis (eg, spreader grafting, lateral nasal wall reconstruction)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1836","name":"Inj, metronidazole, 10 mg","description":"Injection, metronidazole, 10 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67516","name":"Sprchoroidal spc njx rx agt","description":"Suprachoroidal space injection of pharmacologic agent (separate procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0563U","name":"Nfct ds pthgn-sna 11vir&4bct","description":"Nfct ds pthgn-sna 11vir&4bct","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0930T","name":"Ephys eval ccm-d ld 1st impl","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), at time of initial implantation or replacement with testing of cardiac contrac","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9056","name":"Inj, vivimusta, 1 mg","description":"Injection, bendamustine hydrochloride (vivimusta), 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20605","name":"Drain/inj joint/bursa w/o us","description":"Arthrocentesis, aspiration and/or injection, intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa); without ultrasound guidance","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":65.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4017","name":"Nutrition/dietician ss","description":"Nutrition/dietician mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99312","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59841","name":"Induced abortion dilat&evac","description":"Induced abortion, by dilation and evacuation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":520.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":435.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":416.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1350","name":"Pt w/ suic saf pln init rev","description":"Patients who had a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76016","name":"Mr safety deter phys/qhp","description":"Mr safety determination by a physician or other qualified health care professional responsible for the safety of the mr procedure, including review of implant mr conditions for indicated mr examination, analysis of risk vs clinical benefit of performing mr examination, and determination of mr equipm","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3291","name":"Tranexamic acid in sod chlor","description":"Injection, tranexamic acid in sodium chloride, 5 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0502","name":"Other oral pathology procedu","description":"Other oral pathology procedures by report","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0395U","name":"Onc lng multiomics plsm alg","description":"Onc lng multiomics plsm alg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0537","name":"Risk ascvd tst once pr 12 mo","description":"Administration of a standardized, evidence-based atherosclerotic cardiovascular disease (ascvd) risk assessment, 5-15 minutes, not more often than every 12 months","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23410","name":"Repair rotator cuff acute","description":"Repair of ruptured musculotendinous cuff (eg, rotator cuff) open; acute","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1093.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1444","name":"Del < 39 weeks gest","description":"Delivery at < 39 weeks of gestation","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59622","name":"Attempted vbac after care","description":"Cesarean delivery only, following attempted vaginal delivery after previous cesarean delivery; including postpartum care","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1497.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6624","name":"Inlay titanium","description":"Inlay - titanium","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6595","name":"G comp bandge liner upr extr","description":"Gradient compression bandaging supply, bandage liner, upper extremity, any size or length, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86790","name":"Virus antibody nos","description":"Antibody; virus, not elsewhere specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1239","name":"Pt no resp heard","description":"Patient did not respond to the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1024T","name":"Perq tiss dsplmt soft tissue","description":"Percutaneous tissue displacement, any method, including imaging guidance; soft tissue (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29130","name":"Appl finger splint static","description":"Application of finger splint; static","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":27.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0444U","name":"Onc sld orgn neo tgsap 361","description":"Onc sld orgn neo tgsap 361","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22852","name":"Remove spine fixation device","description":"Removal of posterior segmental instrumentation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":812.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0467","name":"Tlso r fram soft pre ots","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated, off-the-shelf","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67340","name":"Revise eye muscle add-on","description":"Strabismus surgery involving exploration and/or repair of detached extraocular muscle(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0855T","name":"Dgtz gls mcrscp b1 marow smr","description":"Digitization of glass microscope slides for bone marrow, smear interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88344","name":"Imhchem/imcytchm ea mlt antb","description":"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58805","name":"Drainage of ovarian cyst(s)","description":"Drainage of ovarian cyst(s), unilateral or bilateral (separate procedure); abdominal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6603","name":"G com bandge low dn foamchnl","description":"Gradient compression bandaging supply, low density channel foam sheet, per 250 square centimeters, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":2.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1321","name":"Couns for high risk sub use","description":"Couns for high risk sub use","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0020M","name":"Onc cns alys 30000 dna loci","description":"Oncology (central nervous system), analysis of 30,000 dna methylation loci by methylation array, utilizing dna extracted from tumor tissue, diagnostic algorithm reported as probability of matching a reference tumor subclass","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86148","name":"Anti-phospholipid antibody","description":"Anti-phosphatidylserine (phospholipid) antibody","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78070","name":"Parathyroid planar imaging","description":"Parathyroid planar imaging (including subtraction, when performed);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0201","name":"Pne flu hepb cov home admin","description":"Administration of pneumococcal, influenza, hepatitis b, and/or covid-19 vaccine inside a patients home; reported only once per individual home per date of service when such vaccine administration(s) are performed at the patients home","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4321","name":"Renograft, per sq cm","description":"Renograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1494","name":"Fall rep since last visit","description":"Patients that reported a fall since the last visit","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90483","name":"Imm cnsl not admn sm>10<20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 10 minutes up to 20 minutes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20808","name":"Replantation hand complete","description":"Replantation, hand (includes hand through metacarpophalangeal joints), complete amputation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4959.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4037","name":"Urology ss","description":"Urology mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0907T","name":"Coms ther ea addl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; each additional application, total wound(s) surface area less than or equal to 50 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0458","name":"Aztreonam/avibactam 10 mg","description":"Injection, aztreonam/avibactam, 7.5 mg/2.5 mg (10 mg)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37275","name":"Rvsc evsc fpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66830","name":"Removal of lens lesion","description":"Removal of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid) with corneo-scleral section, with or without iridectomy (iridocapsulotomy, iridocapsulectomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":688.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55868","name":"Lap srg prst8ct lymph nod bx","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with lymph node biopsy(ies) (limited pelvic lymphadenectomy)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58820","name":"Drain ovary abscess open","description":"Drainage of ovarian abscess; vaginal approach, open","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2249","name":"Inj, remimazolam, 1 mg","description":"Injection, remimazolam, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85130","name":"Chromogenic substrate assay","description":"Chromogenic substrate assay","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92920","name":"Prq trluml c angiop 1art&/br","description":"Percutaneous transluminal coronary angioplasty, single major coronary artery and/or its branch(es)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1164","name":"Pt w/ dementia any time","description":"Patients with dementia any time during the patients history through the end of the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1221","name":"Dre w/o rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; without evidence of retinopathy","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0878T","name":"Augmnt alys ch ct ild w/ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained with concurrent ct examination of the same structure","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6214","name":"Pontic titanium","description":"Pontic - titanium","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0040","name":"Pt phys/occ therapy","description":"Patient already receiving physical/occupational/speech/recreational therapy during the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0777T","name":"R-t prs sensing edrl gdn sys","description":"Real-time pressure-sensing epidural guidance system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1377","name":"Fu colscop 10 yr doc w/ disc","description":"Recommended follow-up interval for repeat colonoscopy of 10 years documented  in colonoscopy report and communicated with patient","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1314","name":"Bmi not calculated","description":"Bmi not documented and no reason is given","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4283","name":"Biovance tri or 3l, sq cm","description":"Biovance tri-layer or biovance 3l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1416","name":"Pt rec hosp","description":"Patient received hospice services any time during the performance period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49592","name":"Rpr aa hrn 1st < 3 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, incarcerated or strangulated","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31231","name":"Nasal endoscopy dx","description":"Nasal endoscopy, diagnostic, unilateral or bilateral (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6193","name":"Replace implnt screw","description":"Replace implnt screw","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0786T","name":"Insj/rplcmt prq ra sac nstim","description":"Insertion or replacement of percutaneous electrode array, sacral, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43213","name":"Esophagoscopy retro balloon","description":"Esophagoscopy, flexible, transoral; with dilation of esophagus, by balloon or dilator, retrograde (includes fluoroscopic guidance, when performed)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1368.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4384","name":"Axolotl dual ult per sq cm","description":"Axolotl dualgraft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0013","name":"Esketamine, nasal spray","description":"Esketamine, nasal spray, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4321","name":"Renograft, per sq cm","description":"Renograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2044","name":"Biobrane glove, each","description":"Biobrane glove, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1306","name":"Injection, inclisiran, 1 mg","description":"Injection, inclisiran, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4334","name":"Amnioplast 1, per sq cm","description":"Amnioplast 1, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6091","name":"Repl semi/precision attach","description":"Replacement of semi-precision or precision attachment (male or female component) of implant/abutment supported prosthesis per attachment","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98980","name":"Rtm tx mgmt 1st 20 min","description":"Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least 1 real-time interactive communication with the patient or caregiver during the calendar month; first 20 minutes","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26011","name":"Drainage of finger abscess","description":"Drainage of finger abscess; complicated (eg, felon)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":564.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4251","name":"Vim, per square centimeter","description":"Vim, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82010","name":"Ketone bodys quan","description":"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77091","name":"Tbs techl calculation only","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical calculation only","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64469","name":"Thrc fascial pln blk bi nfs","description":"Thoracic fascial plane block, bilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98986","name":"Rtm dev sply cbt 2-15 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of cognitive behavioral therapy, 2-15 days in a 30-day period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0767T","name":"Tc mag stimj pn ea addl nrv","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; each additional nerve (list separat","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80188","name":"Assay of primidone","description":"Primidone","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3473","name":"Surg rep root res molar","description":"Surg rep root res molar","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1294","name":"Bp scrn perf rec interval","description":"Normal blood pressure reading documented, follow-up not required","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74329","name":"X-ray for pancreas endoscopy","description":"Endoscopic catheterization of the pancreatic ductal system, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95974","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"Ak 4 bar link hydl swg/stanc","description":"Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7534.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1288","name":"Doc rsn no hbp scrn or f/u","description":"Documented reason for not screening or recommending a follow-up for high blood pressure","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0583U","name":"Rare ds rpd whlgen cmptr dna","description":"Rare ds rpd whlgen cmptr dna","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4423","name":"Biolab tri wrap fl per sq cm","description":"Biolab tri-membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0867T","name":"Tpla b9 prst8 hyprplsa>=50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume greater or equal to 50 ml","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31243","name":"Nsl/sinus ndsc cryoabltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by cryoablation, posterior nasal nerve","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64658","name":"Rmvl bat modul sys lead only","description":"Removal of baroreflex activation therapy (bat) modulation system; lead only","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5859","name":"Knee-shin pro flex/ext cont","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, powered and programmable flexion/extension assist control, includes any type motor(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17437.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9947","name":"Sleep apnea appliance","description":"Sleep apnea appliance","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64469","name":"Thrc fascial pln blk bi nfs","description":"Thoracic fascial plane block, bilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33882","name":"Evasc rpr ta dplmt mltpc sys","description":"Endovascular repair of the thoracic aorta by deployment of a branched endograft multipiece system involving an aorto-aortic tube device with a fenestration for the left subclavian artery stent graft(s) and all aortic tube endograft extension(s) placed from the level of the left common carotid artery","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2023","name":"Innovamatrix pd, 1 mg","description":"Innovamatrix pd, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0944T","name":"3d cntr simula trgt lvr les","description":"3d contour simulation of target liver lesion(s) and margin(s) for image-guided percutaneous microwave ablation","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4105","name":"Enzyme cartridge enteral nut","description":"In-line cartridge containing digestive enzyme(s) for enteral feeding, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0948T","name":"Rem interrog dev ccm phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system with interim analysis, review, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9956","name":"Inj octafluoropropane mic,ml","description":"Injection, octafluoropropane microspheres, per ml","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4438","name":"Adhesive clip ext ens contr","description":"Adhesive clip applied to the skin to secure external electrical nerve stimulator controller, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1351","name":"Dental sealant per tooth","description":"Sealant-per tooth","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0523U","name":"Onc soltum dna ngs snv 22gen","description":"Onc soltum dna ngs snv 22gen","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9871","name":"Bhv couns dm prev, onln 60 m","description":"Behavioral counseling for diabetes prevention, online, 60 minutes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1807","name":"Inj, ethacrynate sod, 1 mg","description":"Injection, ethacrynate sodium, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48145","name":"Partial removal of pancreas","description":"Pancreatectomy, distal subtotal, with or without splenectomy; with pancreaticojejunostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1647.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87187","name":"Sc std microdil/agar mlc","description":"Susceptibility studies, antimicrobial agent; microdilution or agar dilution, minimum lethal concentration (mlc), each plate (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37278","name":"Rvsc evsc fpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98002","name":"Synch audio-video new mod 45","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate medical decision making. when using total time on the date of the encounter for code selection, 45 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37262","name":"Iv lithotrp ivt w/in sm art","description":"Intravascular lithotripsy(ies), iliac vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64656","name":"Revj/rplcmt bat mod sys pg","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; pulse generator only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0467","name":"Tlso r fram soft pre ots","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated, off-the-shelf","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0537","name":"Risk ascvd tst once pr 12 mo","description":"Administration of a standardized, evidence-based atherosclerotic cardiovascular disease (ascvd) risk assessment, 5-15 minutes, not more often than every 12 months","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4387","name":"Neothelium ft per sq cm","description":"Neothelium ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78608","name":"Brain imaging (pet)","description":"Brain imaging, positron emission tomography (pet); metabolic evaluation","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1726.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5152","name":"Inj, eculizumab-aeeb, 2 mg","description":"Injection, eculizumab-aeeb (bkemv), biosimilar, 2 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0029","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0216","name":"Inj, alfentanil hcl, 500mcg","description":"Injection, alfentanil hydrochloride, 500 micrograms","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5137","name":"Inj, wezlana, sub cu, 1 mg","description":"Injection, ustekinumab-auub (wezlana), biosimilar, subcutaneous, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9196","name":"Inj gemcitabine hcl (accord)","description":"Injection, gemcitabine hydrochloride (accord), not therapeutically equivalent to j9201, 200 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4274","name":"Esano ac, per sq cm","description":"Esano ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0513U","name":"Onc prst8 alg alys msi&hrd","description":"Onc prst8 alg alys msi&hrd","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34714","name":"Opn fem art expos cndt crtj","description":"Open femoral artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass, by groin incision, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"Ctlso a-p-l control custom","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0531","name":"Fclty-based respite, 24 hr u","description":"Facility-based respite, 24-hour unit, for use in cmmi model","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0940T","name":"Xtrnl ecg rec>15d<30d r&i","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4295","name":"Amnio tri-core, per sq cm","description":"Amnio tri-core amniotic, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72090","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6525","name":"G com garm lwrleg/ft ngt cus","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, custom, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76018","name":"Mr safety implant elec prepj","description":"Mr safety implant electronics preparation under supervision of physician or other qualified health care professional, including mr-specific programming of pulse generator and/or transmitter to verify device integrity, protection of device internal circuitry from mr electromagnetic fields, and protec","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71551","name":"Mri chest w/dye","description":"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); with contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15015","name":"App skn cl ssp agrft t/a/l 1","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; first 480 sq cm or less","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0338U","name":"Onc sld tum crcg tum cl slct","description":"Onc sld tum crcg tum cl slct","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5941","name":"Resct proth mand part remov","description":"Resct proth mand part remov","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0304U","name":"Hem rbc ads whl bld normoxic","description":"Hem rbc ads whl bld normoxic","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27590","name":"Amputate leg at thigh","description":"Amputation, thigh, through femur, any level;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0611U","name":"Onc lvr alys >1000 mr cfdna","description":"Onc lvr alys >1000 mr cfdna","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1025T","name":"Alt elec fld dos&dlv sim mdl","description":"Alternating electric fields dosimetry and delivery-simulation modeling, creation and selection of patient-specific array layouts, and placement verification","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0562U","name":"Onc sol tum tgsa 33gens snvs","description":"Onc sol tum tgsa 33gens snvs","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4296","name":"Rebound matrix, per sq cm","description":"Rebound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0493U","name":"Trnspl med quan dd-cfdna ngs","description":"Trnspl med quan dd-cfdna ngs","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87526","name":"Hepatitis g dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis g, amplified probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4345","name":"Matrix hd allogrft per sq cm","description":"Matrix hd allograft dermis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4314","name":"Reeva, per sq cm","description":"Reeva ft, per square cenitmeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43195","name":"Esophagoscopy rigid balloon","description":"Esophagoscopy, rigid, transoral; with balloon dilation (less than 30 mm diameter)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97535","name":"Self care mngment training","description":"Self-care/home management training (eg, activities of daily living (adl) and compensatory training, meal preparation, safety procedures, and instructions in use of assistive technology devices/adaptive equipment) direct one-on-one contact, each 15 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93897","name":"Emboli detcj wo iv mbubb njx","description":"Emboli detection without intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"Ak 4 bar link hydl swg/stanc","description":"Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21139","name":"Rdctj forehead cntrg&setback","description":"Reduction forehead; contouring and setback of anterior frontal sinus wall","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1196.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62164","name":"Remove brain tumor w/scope","description":"Neuroendoscopy, intracranial; with excision of brain tumor, including placement of external ventricular catheter for drainage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2179.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86231","name":"Ema each ig class","description":"Endomysial antibody (ema), each immunoglobulin (ig) class","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97001","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86366","name":"Muscle-specific kinase antb","description":"Muscle-specific kinase (musk) antibody","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1176","name":"No 2 hzv 10/2017-meas pd","description":"Patient did not receive two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5911","name":"Facial moulage sectional","description":"Facial moulage (sectional)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0764T","name":"Asstv alg ecg rsk asmt cncrt","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to concurrently performed electrocardiogram (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76014","name":"Mr sfty implt&/fb asmt stf 1","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1028","name":"Take home supply 8mg per 0.1","description":"Take-home supply of nasal naloxone; 2-pack of 8mg per 0.1 ml nasal spray (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0688","name":"Inj cefazolin sodium, hikma","description":"Injection, cefazolin sodium (hikma), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0796T","name":"Tcat ins 2chmbr ldls pm ra","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right atrial pacemaker","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85610","name":"Prothrombin time","description":"Prothrombin time;","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":3095.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0035","name":"Pt ed pos 23","description":"Patient has any emergency department encounter during the performance period with place of service indicator 23","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7023","name":"Mech allergen parti barrier","description":"Mechanical allergen particle barrier/inhalation filter, cream, nasal, topical","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1278","name":"Pre-htn or htn doc, f/u indc","description":"Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4035","name":"Thoracic surgery ss","description":"Thoracic surgery mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4273","name":"Esano aaa, per sq cm","description":"Esano aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4440","name":"Curamatrix per sq cm","description":"Curamatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9996","name":"Ustekinumab- ttwe sub cu inj","description":"Injection, ustekinumab-ttwe (pyzchiva), subcutaneous, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5421","name":"Dentures adjust part maxill","description":"Adjust partial denture - maxillary","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0399U","name":"Neuro cere folate defncy srm","description":"Neuro cere folate defncy srm","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0866T","name":"Quan mri alys brn w/dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion detection, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transmissio","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0847T","name":"Dgtz gls mcrscp xm arch tiss","description":"Digitization of glass microscope slides for examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, kras mutational analysis) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83916","name":"Oligoclonal bands","description":"Oligoclonal immune (oligoclonal bands)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1231","name":"Pt hcv tst no reactive res","description":"Patient receives hcv antibody test with nonreactive result","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15853","name":"Removal sutr/stapl xreq anes","description":"Removal of sutures or staples not requiring anesthesia (list separately in addition to e/m code)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4276","name":"Orion, per sq cm","description":"Orion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2277","name":"Inj, motixafortide, 0.25 mg","description":"Injection, motixafortide, 0.25 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1454","name":"New cied","description":"New cied","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0997T","name":"Precuneus mag stimj tx plng","description":"Precuneus magnetic stimulation; treatment planning using magnetic resonance imaging-guided neuronavigation to determine optimal location, dose, and intensity for magnetic stimulation therapy, derived from evoked potentials from single pulses of electromagnetic energy recorded by 64-channel electroen","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0415U","name":"Cv ds acs bld alg 5 yr score","description":"Cv ds acs bld alg 5 yr score","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1333","name":"Acute vitreous hemorrhage","description":"Acute vitreous hemorrhage","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1230","name":"Pt hcv rctv aby no f/u tst","description":"Patient has a reactive hcv antibody test and does not have a follow up hcv viral test, or patient has a reactive hcv antibody test and has a follow up hcv viral test that detects hcv viremia and is not referred to a clinician who treats hcv infection within 1 month and does not have hcv treatment in","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1216","name":"No spiro doc no res doc","description":"No spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and/or no spirometry performed with results documented during the encounter","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77318","name":"Brachytx isodose complex","description":"Brachytherapy isodose plan; complex (calculation[s] made from over 10 sources, or remote afterloading brachytherapy, over 12 channels), includes basic dosimetry calculation(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":397.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61891","name":"Rev/rplcmt sk-mnt crnl nstm","description":"Revision or replacement of skull-mounted cranial neurostimulator pulse generator or receiver with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0561U","name":"Onc mrd gsa cfdna subsequent","description":"Onc mrd gsa cfdna subsequent","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9321","name":"Inj epcoritamab-bysp 0.16 mg","description":"Injection, epcoritamab-bysp, 0.16 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0887T","name":"End-tidal ctrl inhaled anes","description":"End-tidal control of inhaled anesthetic agents and oxygen to assist anesthesia care delivery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90833","name":"Psytx w pt w e/m 30 min","description":"Psychotherapy, 30 minutes with patient when performed with an evaluation and management service (list separately in addition to the code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":90.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4329","name":"Singlay, per sq cm","description":"Singlay, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59622","name":"Attempted vbac after care","description":"Cesarean delivery only, following attempted vaginal delivery after previous cesarean delivery; including postpartum care","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1466.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1335","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"13132","name":"Cmplx rpr f/c/c/m/n/ax/g/h/f","description":"Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; 2.6 cm to 7.5 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96547","name":"Intraop hipec px 1st 60 min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; first 60 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4389","name":"Neothelium 4l+ per sq cm","description":"Neothelium 4l+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2394","name":"Post >=4srfc resinbase cmpst","description":"Resin-based composite - four or more surfaces posterior","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0023","name":"Pin service 60m per month","description":"Principal illness navigation services by certified or trained auxiliary personnel under the direction of a physician or other practitioner, including a patient navigator; 60 minutes per calendar month, in the following activities:  person-centered assessment, performed to better understand the indiv","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1230","name":"Pt hcv rctv aby no f/u tst","description":"Patient has a reactive hcv antibody test and does not have a follow up hcv viral test, or patient has a reactive hcv antibody test and has a follow up hcv viral test that detects hcv viremia and is not referred to a clinician who treats hcv infection within 1 month and does not have hcv treatment in","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4037","name":"Urology ss","description":"Urology mips specialty set","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0714T","name":"Tpla b9 prst8 hyprplsa<50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume less than 50 ml","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0546","name":"Phone/internet ehr assess","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty   whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patien","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2506","name":"Inj pegfilgrast ex bio 0.5mg","description":"Injection, pegfilgrastim, excludes biosimilar, 0.5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30469","name":"Rpr nsl vlv collapse w/rmdlg","description":"Repair of nasal valve collapse with low energy, temperature-controlled (ie, radiofrequency) subcutaneous/submucosal remodeling","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5157","name":"Inj, denosumab-bmwo, 1 mg","description":"Injection, denosumab-bmwo (stoboclo/osenvelt), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0536","name":"Peer recover support svs","description":"Peer recovery support services, provided directly or by referral; including leveraging knowledge of the condition or lived experience to provide support, mentorship, or inspiration to meet oud treatment and recovery goals; conducting a person-centered interview to understand the patients life story,","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1748","name":"Inj, zymfentra, 10 mg","description":"Injection, infliximab-dyyb (zymfentra), 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0565U","name":"Onc hcc ngs detc 6626epigalt","description":"Onc hcc ngs detc 6626epigalt","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1310","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0980T","name":"Sbmcsl crylys ther tng&tnsl","description":"Submucosal cryolysis therapy; base of tongue and lingual tonsil only","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0881T","name":"Cryotherapy oral cavity","description":"Cryotherapy of the oral cavity using temperature regulated fluid cooling system, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0384U","name":"Neph ckd rsk hi stg kdn ds","description":"Neph ckd rsk hi stg kdn ds","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1816.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1020T","name":"Raman spectroscopy 1+skn les","description":"Raman spectroscopy of 1 or more skin lesions, with probability score for malignant risk derived by algorithmic analysis of data from each lesion","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29821","name":"Sho arthrs srg compl synvct","description":"Arthroscopy, shoulder, surgical; synovectomy, complete","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":723.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0893T","name":"N-invas assmt bld oxygnation","description":"Noninvasive assessment of blood oxygenation, gas exchange efficiency, and cardiorespiratory status, with physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0106","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2045","name":"Novashield/novogen pr sq cm","description":"Novashield or novogen wound matrix, per square centimeter","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93152","name":"Interrog&prgrmg ipnss polysm","description":"Interrogation and programming of implanted phrenic nerve stimulator system during polysomnography","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1320","name":"Pts scrn + hrsn","description":"Patients who screened positive for at least 1 of the 5 hrsns","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2044","name":"Biobrane glove, each","description":"Biobrane glove, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44160","name":"Removal of colon","description":"Colectomy, partial, with removal of terminal ileum with ileocolostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1275.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9048","name":"Inj, bortezomib freseniuskab","description":"Injection, bortezomib (fresenius kabi), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0910T","name":"Rmvl int nstim sys vagus nrv","description":"Removal of integrated neurostimulation system, vagus nerve","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1441","name":"Init dx slp apn = 1st enc","description":"Encounter corresponds to initial diagnosis of sleep apnea or first contact with sleep apnea diagnosed patient","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22837","name":"Ant thrc vrt body tethrg 8+","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; 8 or more vertebral segments","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27187","name":"Reinforce hip bones","description":"Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate, femoral neck and proximal femur","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1196.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1407","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1200","name":"Ace-i/arb rx","description":"Ace inhibitor (ace-i) or arb therapy prescribed during the measurement period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40500","name":"Partial excision of lip","description":"Vermilionectomy (lip shave), with mucosal advancement","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":405.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81357","name":"U2af1 gene common variants","description":"U2af1 (u2 small nuclear rna auxiliary factor 1) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variants (eg, s34f, s34y, q157r, q157p)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50951","name":"Endoscopy of ureter","description":"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3471","name":"Surg rep root res anterior","description":"Surg rep root res anterior","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80158","name":"Drug assay cyclosporine","description":"Cyclosporine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57500","name":"Biopsy of cervix","description":"Biopsy of cervix, single or multiple, or local excision of lesion, with or without fulguration (separate procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":164.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64565","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1489","name":"Pt status doc","description":"Patient status documented","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0970T","name":"Ablt b9 brst tum perq lsr ea","description":"Ablation, benign breast tumor (eg, fibroadenoma), percutaneous, laser, including imaging guidance when performed, each tumor","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6559","name":"G stckng full/chap18-30 cust","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4420","name":"Nuform per sq cm","description":"Nuform, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9955","name":"Oral app thxpy titration vis","description":"Oral app thxpy titration vis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0791T","name":"Motr cog vr gait train ea 15","description":"Motor-cognitive, semi-immersive virtual reality-facilitated gait training, each 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82013","name":"Acetylcholinesterase assay","description":"Acetylcholinesterase","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9914","name":"Admin of dermal fill","description":"Admin of dermal fill","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1361","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99437","name":"Chrnc care mgmt phys ea addl","description":"Chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, or funct","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1297","name":"Bmi not doc medrsn ptref","description":"Bmi not documented due to medical reason or patient refusal of height or weight measurement","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17282","name":"Dstr mal ls f/e/e/n/l/m1.1-2","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 1.1 to 2.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33504","name":"Coronary artery graft","description":"Repair of anomalous coronary artery from pulmonary artery origin; by graft, with cardiopulmonary bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1780.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0959T","name":"Rmv/rplc magnet coil assem","description":"Removal or replacement of magnet from coil assembly that is connected to continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90593","name":"Chikungunya vacc recomb im","description":"Chikungunya virus vaccine, recombinant, for intramuscular use","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6105","name":"Remove implant body","description":"Remove implant body","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0724T","name":"Qmrcp w/dx mri same anatomy","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained with diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in additio","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99242","name":"Off/op consltj new/est sf 20","description":"Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":61.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33935","name":"Transplantation heart/lung","description":"Heart-lung transplant with recipient cardiectomy-pneumonectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4431.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0699T","name":"Njx pst chmbr eye medication","description":"Injection, posterior chamber of eye, medication","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0364U","name":"Onc hl neo gen seq alys alg","description":"Onc hl neo gen seq alys alg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4275","name":"Esano aca, per sq cm","description":"Esano aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7521","name":"Tacrolim granules oral susp","description":"Tacrolimus, granules, oral suspension, 0.1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6071","name":"Abutment supported retainer","description":"Abutment supported retainer for porcelain fused to metal fpd (noble metal)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1398","name":"Bslne and  fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4397","name":"Summit aaa per sq cm","description":"Summit aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33277","name":"Insj phrnc nrv stim transvns","description":"Insertion of phrenic nerve stimulator transvenous sensing lead (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59851","name":"Induced abortion 1+njx d&c","description":"Induced abortion, by 1 or more intra-amniotic injections (amniocentesis-injections), including hospital admission and visits, delivery of fetus and secundines; with dilation and curettage and/or evacuation","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77092","name":"Tbs i&r fx rsk qhp","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; interpretation and report on fracture-risk only by other qualified health care professional","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4340","name":"Simpligraft, per sq cm","description":"Simpligraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2035","name":"Corpl p therac p allac p mg","description":"Corplex p or theracor p or allacor p, per milligram","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0350","name":"Oral/facial photo images","description":"Oral/facial photographic images","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82270","name":"Occult blood feces","description":"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (ie, patient was provided 3 cards or single triple card for consecutive collection)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0140","name":"Nav srv peer sup 60 min pr m","description":"Principal illness navigation - peer support by certified or trained auxiliary personnel under the direction of a physician or other practitioner, including a certified peer specialist; 60 minutes per calendar month, in the following activities:  person-centered interview, performed to better underst","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87812","name":"Sarscov2&inf typ a&b w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) and influenza virus types a and b","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94760","name":"N-invas ear/pls oximetry 1","description":"Noninvasive ear or pulse oximetry for oxygen saturation; single determination","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1415","name":"No pos pdl1 bef ici ther","description":"Patients who did not have a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7471","name":"Rem exostosis any site","description":"Removal of lateral exostosis (maxilla or mandible)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0029","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29550","name":"Strapping of toes","description":"Strapping; toes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":10.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0908T","name":"Opn imp int nstm sys vgs nrv","description":"Open implantation of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1294","name":"Bp scrn perf rec interval","description":"Normal blood pressure reading documented, follow-up not required","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87154","name":"Cul typ id bld pthgn 6+ trgt","description":"Culture, typing; identification of blood pathogen and resistance typing, when performed, by nucleic acid (dna or rna) probe, multiplexed amplified probe technique including multiplex reverse transcription, when performed, per culture or isolate, 6 or more targets","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4354","name":"Palingen dl-palingen dl-x","description":"Palingen dual-layer membrane and dual-layer palingen x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67570","name":"Decompress optic nerve","description":"Optic nerve decompression (eg, incision or fenestration of optic nerve sheath)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1249.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1020T","name":"Raman spectroscopy 1+skn les","description":"Raman spectroscopy of 1 or more skin lesions, with probability score for malignant risk derived by algorithmic analysis of data from each lesion","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1422","name":"Gastroenterology care mvp","description":"Gastroenterology care mips value pathway","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0730T","name":"Trabeculotomy lsr w/oct gdn","description":"Trabeculotomy by laser, including optical coherence tomography (oct) guidance","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76017","name":"Mr sfty med physics xm cstmz","description":"Mr safety medical physics examination customization, planning and performance monitoring by medical physicist or mr safety expert, with review and analysis by physician or other qualified health care professional to prioritize and select views and imaging sequences, to tailor mr acquisition specific","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55712","name":"Bx prst8 tprnl mri-us 1st","description":"Biopsy, prostate, transperineal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33321","name":"Repair major vessel","description":"Suture repair of aorta or great vessels; with shunt bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1473.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0658","name":"Seg pneum comp 2 arm chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2036","name":"Cohealyx col dml mx pr sq cm","description":"Cohealyx collagen dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4270","name":"Complete sl per sq cm","description":"Complete sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1362","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0389U","name":"Ped fbrl kd ifi27&mcemp1 rna","description":"Ped fbrl kd ifi27&mcemp1 rna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0344U","name":"Hep nafld semiq evl 28 lipid","description":"Hep nafld semiq evl 28 lipid","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81005","name":"Urinalysis","description":"Urinalysis; qualitative or semiquantitative, except immunoassays","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0303U","name":"Hem rbc ads whl bld hypoxic","description":"Hem rbc ads whl bld hypoxic","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71130","name":"X-ray strenoclavic jt 3/>vws","description":"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33280","name":"Rmvl phrnc nrv stim pg only","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator only","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0687T","name":"Tx amblyopia dev setup 1st","description":"Treatment of amblyopia using an online digital program; device supply, educational set-up, and initial session","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5931","name":"Surgical obturator","description":"Obturator prosthesis surgical","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4408","name":"Xwrap hydro per sq cm","description":"Xwrap hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0236","name":"Intrav inf, mon anti, sec do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0516U","name":"Rx metab rxgenomic gnotyp 40","description":"Rx metab rxgenomic gnotyp 40","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87494","name":"Chlmy trch&neisra gonor mult","description":"Infectious agent detection by nucleic acid (dna or rna); chlamydia trachomatis and neisseria gonorrhoeae, multiplex amplified probe technique","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27156","name":"Revision of hip bones","description":"Osteotomy, iliac, acetabular or innominate bone; with femoral osteotomy and with open reduction of hip","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2036.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6584","name":"Grad com wrap w straps","description":"Gradient compression wrap with adjustable straps, not otherwise specified","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1488","name":"Dx dementia in msr timeframe","description":"Patients with a diagnosis for dementia in the year before or during the period of evaluation","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92288","name":"Scr dark adaptation meas i&r","description":"Screening dark adaptation measurement (eg, rod recovery intercept time), with interpretation and report","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9025","name":"Azacitidine injection","description":"Injection, azacitidine, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69200","name":"Clear outer ear canal","description":"Removal foreign body from external auditory canal; without general anesthesia","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":94.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0313U","name":"Onc pncrs dna&mrna seq 74","description":"Onc pncrs dna&mrna seq 74","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9912","name":"Pre-visit patient screening","description":"Pre-visit patient screening","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6612","name":"Onlay cst base mtl 2 surface","description":"Onlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82088","name":"Assay of aldosterone","description":"Aldosterone","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1809","name":"Inj, fosdenopterin, 0.1mg","description":"Injection, fosdenopterin, 0.1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4347","name":"Rampart dl matrix per sq cm","description":"Rampart dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4347","name":"Rampart dl matrix per sq cm","description":"Rampart dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4267","name":"Neostim dl per sq cm","description":"Neostim dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0555","name":"Replacment pt electronic sys","description":"Provision of replacement patient electronics system (e.g., system pillow, handheld reader) for home pulmonary artery pressure monitoring","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0524U","name":"Ob pe sflt-1/plgf ia srm/pls","description":"Ob pe sflt-1/plgf ia srm/pls","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4100","name":"Nosht skin sub fda clrd nos","description":"Non-sheet form skin substitute, fda cleared as a device, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0860T","name":"Ncntc ifr spctrsc scr pad","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), for screening for peripheral arterial disease, including provocative maneuvers, image acquisition, interpretation, and report, one or both lower extremities","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0968T","name":"Insj/rplcmt epcrnl nstim sys","description":"Insertion or replacement of epicranial neurostimulator system, including electrode array and pulse generator, with connection to electrode array","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17310","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1257","name":"Cvd risk assess not perf","description":"Cvd risk assessment not performed or incomplete (e.g., cvd risk assessment was not documented), reason not otherwise specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0556U","name":"Nfct ds p-s dna&rna 12 trgts","description":"Nfct ds p-s dna&rna 12 trgts","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26600","name":"Treat metacarpal fracture","description":"Closed treatment of metacarpal fracture, single; without manipulation, each bone","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91125","name":"Anrct mano rct snsatn&balo","description":"Anorectal manometry, with rectal sensation and rectal balloon expulsion test, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1456","name":"Pt had htx","description":"Patient had a heart transplant","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99402","name":"Prev med cnsl indiv apprx 30","description":"Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 30 minutes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":46.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1806","name":"Inj esmolol hcl wg crit care","description":"Injection, esmolol hydrochloride (wg critical care), not therapeutically equivalent to j1805, 10 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45300","name":"Proctosigmoidoscopy dx","description":"Proctosigmoidoscopy, rigid; diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1459","name":"Pt hosp/pal care dur perf pd","description":"Patient was in hospice or receiving palliative care services at any time during the performance period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0382U","name":"Hyprphenylalninmia mntr quan","description":"Hyprphenylalninmia mntr quan","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7473","name":"Remove torus mandibularis","description":"Removal of torus mandibularis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0063","name":"Cardiology ss","description":"Cardiology mips specialty set","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0137","name":"Inj, acetaminophen (hikma)","description":"Injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55869","name":"Lap srg prst8ct bi pl lmphad","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37254","name":"Revsc evasc ivt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2779","name":"Inj, susvimo 0.1 mg","description":"Injection, ranibizumab, via intravitreal implant (susvimo), 0.1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0841T","name":"Dgtz gls mcrscp pth cslt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; first tissue block, with frozen section(s), single specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67825","name":"Revise eyelashes","description":"Correction of trichiasis; epilation by other than forceps (eg, by electrosurgery, cryotherapy, laser surgery)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1410","name":"No gmln brca1/brca2 couns","description":"Patients who did not have germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37279","name":"Iv lithotrp fpvt w/in sm art","description":"Intravascular lithotripsy(ies), femoral and popliteal vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53440","name":"Male sling procedure","description":"Sling operation for correction of male urinary incontinence (eg, fascia or synthetic)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":898.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0619U","name":"Pulm copd dna alys >18000","description":"Pulm copd dna alys >18000","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0692T","name":"Therapeutic ultrafiltration","description":"Therapeutic ultrafiltration","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J9093","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81000","name":"Urinalysis nonauto w/scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; non-automated, with microscopy","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4386","name":"Acesso trifaca per sq cm","description":"Acesso trifaca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6094","name":"Abut support crown titanium","description":"Abutment supported crown - (titanium)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86800","name":"Thyroglobulin antibody","description":"Thyroglobulin antibody","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4418","name":"Biolab wrap flow per sq cm","description":"Biolab membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28585","name":"Repair foot dislocation","description":"Open treatment of talotarsal joint dislocation, includes internal fixation, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":683.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98006","name":"Synch audio-video est mod 30","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93896","name":"Vsrctv std tcd icr art compl","description":"Vasoreactivity study performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G3003","name":"Chronic pain mgmt addl 15m","description":"Each additional 15 minutes of chronic pain management and treatment by a physician or other qualified health care professional, per calendar month. (list separately in addition to code for g3002. when using g3003, 15 minutes must be met or exceeded.)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6111","name":"Implnt/abut remov dent mand","description":"Implnt/abut remov dent mand","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37256","name":"Revsc evasc ivt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0696T","name":"Bdy surf mapg pm/cvdfb f/up","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of follow-up interrogation or programming device evaluatio","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12057","name":"Intmd rpr face/mm >30.0 cm","description":"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; over 30.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0951T","name":"Tot impl amei 1st plmt","description":"Totally implantable active middle ear hearing implant; initial placement, including mastoidectomy, placement of and attachment to sound processor","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2032","name":"Myriad matrix, per sq cm","description":"Myriad matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0526","name":"Est pt-cg dyad dem hig cmplx","description":"Management of established patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9061","name":"Inj, amivantamab-vmjw","description":"Injection, amivantamab-vmjw, 2 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4361","name":"Epixpress, per sq cm","description":"Epixpress, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61736","name":"Litt icr 1 traj 1 smpl les","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; single trajectory for 1 simple lesion","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4403","name":"Xwrap dual plus per sq cm","description":"Xwrap dual plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86015","name":"Actin antibody each","description":"Actin (smooth muscle) antibody (asma), each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58580","name":"Transcrv abltj utrn fibrd rf","description":"Transcervical ablation of uterine fibroid(s), including intraoperative ultrasound guidance and monitoring, radiofrequency","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87181","name":"Sc std agar dilution per agt","description":"Susceptibility studies, antimicrobial agent; agar dilution method, per agent (eg, antibiotic gradient strip)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1446","name":"Pt died bef end meas pd","description":"Patients who died any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2007","name":"Restrata, per sq cm","description":"Restrata, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0828T","name":"Dgtz gls mcrscp cytp smpl fl","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; simple filter method with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0387U","name":"Onc mlnma ambra1&amlo","description":"Onc mlnma ambra1&amlo","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4298","name":"Amniocore pro, per sq cm","description":"Amniocore pro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4417","name":"Alexiguard dl-t per sq cm","description":"Alexiguard dl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4293","name":"Acesso dl, per sq cm","description":"Acesso dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64614","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0321U","name":"Iadna gu pthgn 20bct&fng org","description":"Iadna gu pthgn 20bct&fng org","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86231","name":"Ema each ig class","description":"Endomysial antibody (ema), each immunoglobulin (ig) class","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0904T","name":"Ecg alg 12 ld rdcd trcg only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; tracing only","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0234","name":"Intra inf, toci, second dos","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9998","name":"Inj ustekinumab-aekn, 1 mg","description":"Injection, ustekinumab-aekn (selarsdi), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4312","name":"Acesso ac, per sq cm","description":"Acesso ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1836","name":"Inj, metronidazole, 10 mg","description":"Injection, metronidazole, 10 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4326","name":"Woundplus, per sq cm","description":"Woundplus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0671T","name":"Insj ant sgm aq drg dev 1+","description":"Insertion of anterior segment aqueous drainage device into the trabecular meshwork, without external reservoir, and without concomitant cataract removal, one or more","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0250","name":"Adm tocilizu covid-19 2nd","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6049","name":"Scale implt peri-implt inflm","description":"Scale implt peri-implt inflm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1019T","name":"Lymphovenous bypass per xtr","description":"Lymphovenous bypass, including robotic assistance, when performed, per extremity","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0888T","name":"Histotripsy mal renal tissue","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant renal tissue, including imaging guidance","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83987","name":"Exhaled breath condensate","description":"Ph; exhaled breath condensate","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43233","name":"Egd balloon dil esoph30 mm/>","description":"Esophagogastroduodenoscopy, flexible, transoral; with dilation of esophagus with balloon (30 mm diameter or larger) (includes fluoroscopic guidance, when performed)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37256","name":"Revsc evasc ivt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0970T","name":"Ablt b9 brst tum perq lsr ea","description":"Ablation, benign breast tumor (eg, fibroadenoma), percutaneous, laser, including imaging guidance when performed, each tumor","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83499","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0595U","name":"Nfct ds tfp vctrbrn&zoonotic","description":"Nfct ds tfp vctrbrn&zoonotic","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82523","name":"Collagen crosslinks","description":"Collagen cross links, any method","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1290","name":"Pt not eli d/t act dig htn","description":"Patient not eligible due to active diagnosis of hypertension","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0997T","name":"Precuneus mag stimj tx plng","description":"Precuneus magnetic stimulation; treatment planning using magnetic resonance imaging-guided neuronavigation to determine optimal location, dose, and intensity for magnetic stimulation therapy, derived from evoked potentials from single pulses of electromagnetic energy recorded by 64-channel electroen","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9608","name":"Flotufolastat f18 diag 1 mci","description":"Flotufolastat f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67228","name":"Treatment x10sv retinopathy","description":"Treatment of extensive or progressive retinopathy (eg, diabetic retinopathy), photocoagulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":963.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1348","name":"Pam incr 6 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 6-points in a 4 to 12 month period (excellent)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78350","name":"Bone mineral single photon","description":"Bone density (bone mineral content) study, 1 or more sites; single photon absorptiometry","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1434","name":"Inj, focinvez, 1mg","description":"Injection, fosaprepitant (focinvez), 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0395U","name":"Onc lng multiomics plsm alg","description":"Onc lng multiomics plsm alg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52284","name":"Cysto rx balo cath urtl strx","description":"Cystourethroscopy, with mechanical urethral dilation and urethral therapeutic drug delivery by drug-coated balloon catheter for urethral stricture or stenosis, male, including fluoroscopy, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0713T","name":"N-nvs artl plaq alys rvw i&r","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data review, interpretation and report","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5914","name":"Auricular prosthesis","description":"Auricular prosthesis","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7023","name":"Mech allergen parti barrier","description":"Mechanical allergen particle barrier/inhalation filter, cream, nasal, topical","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90964","name":"Esrd home pt serv p mo 2-11","description":"End-stage renal disease (esrd) related services for home dialysis per full month, for patients 2-11 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":234.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0919T","name":"Rmvl perm ccm-d sys pg only","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); pulse generator only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4406","name":"Xwrap fenestra per sq cm","description":"Xwrap fenestra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1580","name":"Garamycin gentamicin inj","description":"Injection, garamycin, gentamicin, up to 80 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0601","name":"Sevelamer carbonate 20 mg","description":"Sevelamer carbonate (renvela or therapeutically equivalent), oral, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0867T","name":"Tpla b9 prst8 hyprplsa>=50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume greater or equal to 50 ml","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64655","name":"Revj/rplcmt bat mod sys lead","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; lead only","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1343.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27830","name":"Treat lower leg dislocation","description":"Closed treatment of proximal tibiofibular joint dislocation; without anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0762T","name":"Dgtz gls mcrscp sl imm ea m","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, each multiplex antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69424","name":"Remove ventilating tube","description":"Ventilating tube removal requiring general anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9074","name":"Inj, cyclophosphamd, sandoz","description":"Injection, cyclophosphamide (sandoz), 5 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1318","name":"Pts no csp doc contact","description":"Patients who did not have documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening or documentation that there was no contact with a csp","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0342U","name":"Onc pncrtc ca mult ia eclia","description":"Onc pncrtc ca mult ia eclia","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1019T","name":"Lymphovenous bypass per xtr","description":"Lymphovenous bypass, including robotic assistance, when performed, per extremity","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27604","name":"Drain lower leg bursa","description":"Incision and drainage, leg or ankle; infected bursa","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":415.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0501U","name":"Onc clrc bld quan meas cfdna","description":"Onc clrc bld quan meas cfdna","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6180","name":"Implnt maint proced","description":"Implnt maint proced","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0891T","name":"Arhfcmrigtbs sbsq tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent treatment day","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0893","name":"Inj, decitabine (sun pharma)","description":"Injection, decitabine (sun pharma), not therapeutically equivalent to j0894, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1455","name":"Rep/rev cied","description":"Replaced or revised cied","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7259","name":"Nerve dissection","description":"Nerve dissection","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57065","name":"Destruction vag lesion xtnsv","description":"Destruction of vaginal lesion(s); extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4279","name":"Vendaje ac, per sq cm","description":"Vendaje ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55715","name":"Bx prst8 ea add mri-us/ct/mr","description":"Biopsy, prostate, each additional, mri-ultrasound fusion or in-bore ct- or mri-guided targeted lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4010","name":"Infectious disease ss","description":"Infectious disease mips specialty set","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86817","name":"Hla typing dr/dq","description":"Hla typing; dr/dq, multiple antigens","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1330","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0339U","name":"Onc prst8 mrna hoxc6 & dlx1","description":"Onc prst8 mrna hoxc6 & dlx1","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0924T","name":"Rpos prv ccm-d trnsvns eltrd","description":"Repositioning of previously implanted cardiac contractility modulation-defibrillation transvenous electrode(s)/lead(s), including fluoroscopic guidance and programming of sensing and therapeutic parameters","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5098","name":"Inj ustekinumab-srlf, 1 mg","description":"Injection, ustekinumab-srlf (imuldosa), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"3080F","name":"Diast bp >= 90 mm hg","description":"Most recent diastolic blood pressure greater than or equal to 90 mm hg (htn, ckd, cad) (dm)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1199","name":"Pt recg rrt","description":"Patients receiving rrt","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0402","name":"Initial preventive exam","description":"Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":197.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9249","name":"Inj, melphalan (apotex) 1 mg","description":"Injection, melphalan (apotex), 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99232","name":"Sbsq hosp ip/obs moderate 35","description":"Subsequent hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 35 minut","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37290","name":"Revsc evsc tpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2021","name":"Inj, linezolid (hospira)","description":"Injection, linezolid (hospira), not therapeutically equivalent to j2020, 200 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5783","name":"Add low ext mec limb vol lam","description":"Addition to lower extremity, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1474","name":"Pt dx dementia","description":"Patients with diagnosis of dementia","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7997","name":"Appliance removal","description":"Appliance removal (not by dentist who placed appliance) includes removal of archbar","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4359","name":"Choriply, per sq cm","description":"Choriply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0577U","name":"Onc ovr serum alys 39 gps","description":"Onc ovr serum alys 39 gps","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0897T","name":"N-invas augmnt arrhyt alys","description":"Noninvasive augmentative arrhythmia analysis derived from quantitative computational cardiac arrhythmia simulations, based on selected intervals of interest from 12-lead electrocardiogram and uploaded clinical parameters, including uploading clinical parameters with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88154","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1025T","name":"Alt elec fld dos&dlv sim mdl","description":"Alternating electric fields dosimetry and delivery-simulation modeling, creation and selection of patient-specific array layouts, and placement verification","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4433","name":"361 hct/p skin subs, nos","description":"361 hct/p skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90759","name":"Hep b vac 3ag 10mcg 3 dos im","description":"Hepatitis b vaccine (hepb), 3-antigen (s, pre-s1, pre-s2), 10 mcg dosage, 3 dose schedule, for intramuscular use","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0759","name":"Inj, clevidipine, 1 mg","description":"Injection, clevidipine butyrate, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0989T","name":"Revj/rmvl ins ptn subq&subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69716","name":"Impl oi implt sk tc esp<100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or resulting in removal of less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36598","name":"Inj w/fluor eval cv device","description":"Contrast injection(s) for radiologic evaluation of existing central venous access device, including fluoroscopy, image documentation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0281","name":"Inj aminocaproic acid 1 gram","description":"Injection, aminocaproic acid, 1 gram","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D8091","name":"Compre ortho treat w surg","description":"Compre ortho treat w surg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0597U","name":"Onc breast rna xprsn 329gens","description":"Onc breast rna xprsn 329gens","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4007","name":"General surgery ss","description":"General surgery mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1164","name":"Inj diltiazem in 0.72% nacl","description":"Injection, diltiazem hydrochloride in 0.72% sodium chloride, 0.5 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0043","name":"Pt mech pros ht valv","description":"Patients with mechanical prosthetic heart valve","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0664","name":"Team remote e/m new pt 60 mn","description":"Team remote e/m new pt 60mins","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27278","name":"Arthrd si jt plmt iartic dev","description":"Arthrodesis, sacroiliac joint, percutaneous or minimally invasive, with image guidance, includes obtaining bone graft when performed, unilateral; placement of intra-articular device(s), without cortical piercing","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0453U","name":"Onc clrct ca cfdna qpcr asy","description":"Onc clrct ca cfdna qpcr asy","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1748","name":"Inj, zymfentra, 10 mg","description":"Injection, infliximab-dyyb (zymfentra), 10 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6603","name":"G com bandge low dn foamchnl","description":"Gradient compression bandaging supply, low density channel foam sheet, per 250 square centimeters, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0795T","name":"Tcat ins 2chmbr ldls pm cmpl","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; complete system (ie, r","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0477U","name":"Rx metab psy 14&cyp2d6 gn-rx","description":"Rx metab psy 14&cyp2d6 gn-rx","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0332U","name":"Onc pan tum gen prflg 8 dna","description":"Onc pan tum gen prflg 8 dna","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0347U","name":"Rx metab/pcx dna 16 gen alys","description":"Rx metab/pcx dna 16 gen alys","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90593","name":"Chikungunya vacc recomb im","description":"Chikungunya virus vaccine, recombinant, for intramuscular use","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6593","name":"Grad com accessory gmt_wrap","description":"Accessory for gradient compression garment or wrap with adjustable straps, not-otherwise specified","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0917T","name":"Insj perm ccm-d sys 1 lead","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; single transvenous lead (pacing or defibrillation) only","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2644","name":"Dental onlay porc 4/more sur","description":"Onlay - porcelain/ceramic - four or more surfaces","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0925T","name":"Rlcj skin pocket ccm-d pg","description":"Relocation of skin pocket for implanted cardiac contractility modulation-defibrillation pulse generator","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31820","name":"Closure of windpipe lesion","description":"Surgical closure tracheostomy or fistula; without plastic repair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87088","name":"Urine bacteria culture","description":"Culture, bacterial; with isolation and presumptive identification of each isolate, urine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":11.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31601","name":"Planned tracheostomy<2 yrs","description":"Tracheostomy, planned (separate procedure); younger than 2 years","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84307","name":"Assay of somatostatin","description":"Somatostatin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86037","name":"Anca titer each antibody","description":"Antineutrophil cytoplasmic antibody (anca); titer, each antibody","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64776","name":"Remove digit nerve lesion","description":"Excision of neuroma; digital nerve, 1 or both, same digit","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0784T","name":"Ins/rplmt eltrd ra spi nstim","description":"Insertion or replacement of percutaneous electrode array, spinal, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1186","name":"Pt w/ rx for hspc/plltv care","description":"Patients who have an order for or are receiving hospice or palliative care","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0897T","name":"N-invas augmnt arrhyt alys","description":"Noninvasive augmentative arrhythmia analysis derived from quantitative computational cardiac arrhythmia simulations, based on selected intervals of interest from 12-lead electrocardiogram and uploaded clinical parameters, including uploading clinical parameters with interpretation and report","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0958T","name":"Rmv s-sclp eltr ra rcvr&tlmt","description":"Removal of sub-scalp implanted electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54056","name":"Cryosurgery penis lesion(s)","description":"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; cryosurgery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0256U","name":"Tma/tmao prfl ms/ms ur alg","description":"Trimethylamine/trimethylamine n-oxide (tma/tmao) profile, tandem mass spectrometry (ms/ms), urine, with algorithmic analysis and interpretive report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97811","name":"Acup 1/> w/o estim ea add 15","description":"Acupuncture, 1 or more needles; without electrical stimulation, each additional 15 minutes of personal one-on-one contact with the patient, with insertion of needle(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":30.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0018","name":"Crisis psychotherapy add 30m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); each additional 30 minutes (list separately in addition to code for primary service)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1384","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0974T","name":"Slctv nzmtc dbrdmt t/a/l ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; each additional 100 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5996","name":"Peri medicament w/seal, mand","description":"Peri medicament w/seal, mand","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9002","name":"Intra-vag motion sens biofk","description":"Intra-vaginal motion sensor system, provides biofeedback for pelvic floor muscle rehabilitation device","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4009","name":"Hospitalists ss","description":"Hospitalists mips specialty set","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12032","name":"Intmd rpr s/a/t/ext 2.6-7.5","description":"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 2.6 cm to 7.5 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1445","name":"Pp care visit by 12 weeks","description":"Postpartum care visit before or at 12 weeks of giving birth","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96548","name":"Ntraop hipec px ea add 30min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0585U","name":"Tgsap so neo cfdna 521 genes","description":"Tgsap so neo cfdna 521 genes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94011","name":"Spirometry up to 2 yrs old","description":"Measurement of spirometric forced expiratory flows in an infant or child through 2 years of age","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0707T","name":"Njx b1 sub mtrl sbchdrl dfct","description":"Injection(s), bone-substitute material (eg, calcium phosphate) into subchondral bone defect (ie, bone marrow lesion, bone bruise, stress injury, microtrabecular fracture), including imaging guidance and arthroscopic assistance for joint visualization","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87564","name":"Mtb rifampin rst amp prb tq","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacterium tuberculosis, rifampin resistance, amplified probe technique","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37271","name":"Revsc evsc fpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0523","name":"Mgt nw pt dem mod-high cmplx","description":"Management of a new patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55877","name":"Abltj ire prst8 1+ tum perq","description":"Ablation, irreversible electroporation, prostate, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4339","name":"Artacent vericlen, per sq cm","description":"Artacent vericlen, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6594","name":"G comp bandge liner lwr extr","description":"Gradient compression bandaging supply, bandage liner, lower extremity, any size or length, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2393","name":"Post 3 srfc resinbased cmpst","description":"Resin-based composite - three surfaces posterior","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0870T","name":"Imp subq prtl ascts pmp sys","description":"Implantation of subcutaneous peritoneal ascites pump system, percutaneous, including pump-pocket creation, insertion of tunneled indwelling bladder and peritoneal catheters with pump connections, including all imaging and initial programming, when performed","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0545","name":"Inherent visit to inpt","description":"Visit complexity inherent to hospital inpatient or observation care associated with a confirmed or suspected infectious disease by an infectious diseases specialist, including disease transmission risk assessment and mitigation, public health investigation, analysis, and testing, and complex antimic","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0278U","name":"Hem gen thrombosis 12 genes","description":"Hematology (genetic thrombosis), genomic sequence analysis of 12 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9073","name":"Inj cyclophos dr reddys 5 mg","description":"Injection, cyclophosphamide (dr. reddys), 5 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0575U","name":"Trnsplj med lar rtpcr 4genes","description":"Trnsplj med lar rtpcr 4genes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1425","name":"Surgical care mvp","description":"Surgical care mips value pathway","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0879T","name":"Augmnt alys ch ct ild prep","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; radiological data preparation and transmission","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1430","name":"Ret exm ou no retinopthy doc","description":"Retinal exam finding without evidence of retinopathy in both eyes with severity level documented (in measurement year or in the prior year)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0049","name":"Main hemo in-cntr","description":"With maintenance hemodialysis (in-center and home hd) for the complete reporting month","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97009","name":"Mchnl sclp cool after chemo","description":"Mechanical scalp cooling; provided after discontinuation of chemotherapy, each 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70473","name":"Ct cere prfu aly c+wo ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed without concurrent ct or ct angiography of the same anatomy","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35132","name":"Repair artery rupture groin","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, iliac artery (common, hypogastric, external)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2085.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2017","name":"Permeaderm glove, each","description":"Permeaderm glove, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5138","name":"Inj, wezlana, iv, 1 mg","description":"Injection, ustekinumab-auub (wezlana), biosimilar, intravenous, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4564","name":"Pessary, disposable any type","description":"Pessary, disposable, any type","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0825T","name":"Tcat rmv&rpl1chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or prog","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0438","name":"Ppps, initial visit","description":"Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"Add upp ext mec limb vol lam","description":"Addition to upper extremity prosthesis, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64596","name":"Ins/rplcmt prq eltrd ra pn 1","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; initial electrode array","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0481","name":"Electron microscopy diagnost","description":"Electron microscopy - diagnostic","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1400","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0699","name":"Inj, cefiderocol, 10 mg","description":"Injection, cefiderocol, 10 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0334U","name":"Onc sld orgn tgsa dna 84/+","description":"Onc sld orgn tgsa dna 84/+","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0044","name":"Pt mitral stenosis","description":"Patients with moderate or severe mitral stenosis","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37275","name":"Rvsc evsc fpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4225","name":"Amnio or derma tl, per sq cm","description":"Amniobind or dermabind tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87076","name":"Culture anaerobe ident each","description":"Culture, bacterial; anaerobic isolate, additional methods required for definitive identification, each isolate","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33201","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":814.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96381","name":"Admn rsv monoc antb im njx","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4211","name":"Gingivectomy/plasty per toot","description":"Gingivectomy or gingivoplasty - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2252","name":"Inj midazolam in 0.8% nacl","description":"Injection, midazolam in 0.8% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6603","name":"Cst hgh nble mtl inlay >=3sr","description":"Inlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9072","name":"Inj cyclophos frindovyx 5 mg","description":"Injection, cyclophosphamide (frindovyx), 5 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48552","name":"Prep donor pancreas/venous","description":"Backbench reconstruction of cadaver donor pancreas allograft prior to transplantation, venous anastomosis, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6112","name":"Imp/abut rem dent part max","description":"Imp/abut rem dent part max","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0297U","name":"Onc pan tum whl gen seq dna","description":"Onc pan tum whl gen seq dna","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32151","name":"Remove lung foreign body","description":"Thoracotomy; with removal of intrapulmonary foreign body","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1083.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1499","name":"Interventional radiology mvp","description":"Interventional radiology mips value pathway","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0549","name":"Phone/inter for treat>31m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1496","name":"No doc of fall or poc","description":"Patients that had a fall who did not have a plan of care for falls documented or do not have documentation of being assessed for falls","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27486","name":"Revise/replace knee joint","description":"Revision of total knee arthroplasty, with or without allograft; 1 component","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1644.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1302","name":"Scrn mam perf rslts doc","description":"Screening, diagnostic, film digital or digital breast tomosynthesis (3d) mammography results documented and reviewed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24665","name":"Optx radial head/neck fx","description":"Open treatment of radial head or neck fracture, includes internal fixation or radial head excision, when performed;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":780.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9992","name":"Pall serv during meas","description":"Palliative care services used by patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0183","name":"Software meas of cardiac vol","description":"Quantitative software measurements of cardiac volume, cardiac chambers volumes and left ventricular wall mass derived from ct scan(s) data of the chest/heart (with or without contrast)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97552","name":"Group caregiver training","description":"Group caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0816T","name":"Opn insj/rplcmt ins ptn subq","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1324","name":"Pts intravitreal/pci","description":"Patients who had an intravitreal or periocular corticosteroid injection (e.g., triamcinolone, preservative-free triamcinolone, dexamethasone, dexamethasone intravitreal implant, or fluocinolone intravitreal implant)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0823T","name":"Tcat ins 1chmbr ldls pm ra","description":"Transcatheter insertion of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or programming), when","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81000","name":"Urinalysis nonauto w/scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; non-automated, with microscopy","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69670","name":"Remove mastoid air cells","description":"Mastoid obliteration (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63267","name":"Excise intrspinl lesion lmbr","description":"Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; lumbar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1539.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1306","name":"Pt anphx due to pneum","description":"Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92636","name":"Hearing aid post-fitg f-up 1","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1221","name":"Dre w/o rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; without evidence of retinopathy","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1348","name":"Pam incr 6 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 6-points in a 4 to 12 month period (excellent)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0315U","name":"Onc cutan sq cll ca mrna 40","description":"Onc cutan sq cll ca mrna 40","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92565","name":"Stenger test pure tone","description":"Stenger test, pure tone","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93573","name":"Njx cath slct p-art angrp bi","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, bilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0589","name":"Inj daxibotulinumtoxina-lanm","description":"Injection, daxibotulinumtoxina-lanm, 1 unit","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0668","name":"Instill, bupivac and meloxic","description":"Instillation, bupivacaine and meloxicam, 1 mg/0.03 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93541","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0360","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0672T","name":"Ndovag cryg rf remdl tiss","description":"Endovaginal cryogen-cooled, monopolar radiofrequency remodeling of the tissues surrounding the female bladder neck and proximal urethra for urinary incontinence","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0528U","name":"Lrt iad 18bct/8vir&7arg rna","description":"Lrt iad 18bct/8vir&7arg rna","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78491","name":"Myocrd img pet 1std rst/strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); single study, at rest or stress (exercise or pharmacologic)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86053","name":"Aqaprn-4 antb flo cytmtry ea","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; flow cytometry (ie, fluorescence-activated cell sorting [facs]), each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0699T","name":"Njx pst chmbr eye medication","description":"Injection, posterior chamber of eye, medication","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4440","name":"Curamatrix per sq cm","description":"Curamatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0283","name":"Inj, amiodarone (nexterone)","description":"Injection, amiodarone hydrochloride (nexterone), 30 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9051","name":"Inj, bortezomib (maia)","description":"Injection, bortezomib (maia), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76705","name":"Echo exam of abdomen","description":"Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0728T","name":"Dx alys vstblr implt uni 1st","description":"Diagnostic analysis of vestibular implant, unilateral; with initial programming","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7284","name":"Exc biopsy of saliv glands","description":"Exc biopsy of saliv glands","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85390","name":"Fibrinolysins screen i&r","description":"Fibrinolysins or coagulopathy screen, interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21450","name":"Cltx mndblr fx w/o mnpj","description":"Closed treatment of mandibular fracture; without manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26352","name":"Repair/graft hand tendon","description":"Repair or advancement, flexor tendon, not in zone 2 digital flexor tendon sheath (eg, no mans land); secondary with free graft (includes obtaining graft), each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1120.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1952","name":"Afo spiral prefab ots","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, off-the-shelf","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0455U","name":"Nfct agt sti mult amp prb ur","description":"Nfct agt sti mult amp prb ur","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0754T","name":"Dgtz gls mcrscp sld level v","description":"Digitization of glass microscope slides for level v, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"Home vent dual fnct incl all","description":"Home ventilator, dual-function respiratory device, also performs additional function of cough stimulation, includes all accessories, components and supplies for all functions","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0695T","name":"Bdy srf mpg pm/cvdfb tm impl","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of implant or replacement","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35500","name":"Harvest vein for bypass","description":"Harvest of upper extremity vein, 1 segment, for lower extremity or coronary artery bypass procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22860","name":"Tot disc arthrp 2ntrspc lmbr","description":"Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression); second interspace, lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33278","name":"Rmvl phrnc nrv stim sys","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; system, including pulse generator and lead(s)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2644","name":"Dental onlay porc 4/more sur","description":"Onlay - porcelain/ceramic - four or more surfaces","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0817T","name":"Opn insj/rplcmt ins ptn subf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93926","name":"Lower extremity study","description":"Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0571U","name":"Onc sol tum dna80&rna10g ngs","description":"Onc sol tum dna80&rna10g ngs","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1416","name":"Pt rec hosp","description":"Patient received hospice services any time during the performance period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76014","name":"Mr sfty implt&/fb asmt stf 1","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2976","name":"Band stabilization per tooth","description":"Band stabilization per tooth","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0760T","name":"Dgtz gls mcrscp sl imm 1st","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0513U","name":"Onc prst8 alg alys msi&hrd","description":"Onc prst8 alg alys msi&hrd","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0928T","name":"Rem interrog dev ccm-d phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system with interim analysis and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0893","name":"Inj, decitabine (sun pharma)","description":"Injection, decitabine (sun pharma), not therapeutically equivalent to j0894, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33900","name":"Perq p-art revsc 1 nm nt uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, unilateral","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1466","name":"Pt disc/lam proc same day","description":"Patient had a lumbar fusion on the same date as the discectomy/laminectomy procedure","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81002","name":"Urinalysis nonauto w/o scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; non-automated, without microscopy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49595","name":"Rpr aa hrn 1st > 10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, reducible","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0758T","name":"Dgtz gls mcrscp sl spc hchem","description":"Digitization of glass microscope slides for special stain, including interpretation and report, histochemical stain on frozen tissue block (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24343","name":"Repr elbow lat ligmnt w/tiss","description":"Repair lateral collateral ligament, elbow, with local tissue","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":832.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0705T","name":"Rem tx amblyopia tech sprt","description":"Remote treatment of amblyopia using an eye tracking device; surveillance center technical support including data transmission with analysis, with a minimum of 18 training hours, each 30 days","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1406","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1265","name":"Cms 2728 completed","description":"Cms medical evidence form 2728 for dialysis patients: initial form completed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4271","name":"Complete ft per sq cm","description":"Complete ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51590","name":"Remove bladder/revise tract","description":"Cystectomy, complete, with ureteroileal conduit or sigmoid bladder, including intestine anastomosis;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2071.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96120","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4251","name":"Vim, per square centimeter","description":"Vim, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4292","name":"Lamellas, per sq cm","description":"Lamellas, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4257","name":"Relese, per sq cm","description":"Relese, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0560U","name":"Onc mrd gsa cfdna baseline","description":"Onc mrd gsa cfdna baseline","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0944T","name":"3d cntr simula trgt lvr les","description":"3d contour simulation of target liver lesion(s) and margin(s) for image-guided percutaneous microwave ablation","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0757T","name":"Dgtz gls mcrscp sl spc grpii","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group ii, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistochemistry (list separately in addition to code for primary","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29105","name":"Application long arm splint","description":"Application of long arm splint (shoulder to hand)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4286","name":"Remove non-resorb barrier","description":"Remove non-resorb barrier","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81025","name":"Urine pregnancy test","description":"Urine pregnancy test, by visual color comparison methods","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6600","name":"G com bandge hgh dn foam sht","description":"Gradient compression bandaging supply, high density foam sheet, per 250 square centimeters, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1307","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0862T","name":"Rlcj pg wcs lv battery only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; battery component only","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0533","name":"Buprenorphone inj weekly","description":"Medication assisted treatment, buprenorphine (injectable) administered on a weekly basis; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid tre","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4252","name":"Vendaje, per square centimet","description":"Vendaje, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1551","name":"Inj cutaquig 100 mg","description":"Injection, immune globulin (cutaquig), 100 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9277","name":"Pembrolizumab 1mg berahyalur","description":"Injection, pembrolizumab, 1 mg and berahyaluronidase alfa-pmph","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4435","name":"Renati membrane per sq cm","description":"Renati membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82234","name":"Beta-amyloid 1-42 (abeta 42)","description":"Beta-amyloid; 1-42 (abeta 42)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4211","name":"Gingivectomy/plasty per toot","description":"Gingivectomy or gingivoplasty - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0495U","name":"Onc prst8 alys crcg plsm prt","description":"Onc prst8 alys crcg plsm prt","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0563","name":"Sbrt w/positron emission del","description":"Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance and real-time positron emissions-based delivery adjustments to 1 or more lesions, entire course not to exceed 5 fractions","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0556U","name":"Nfct ds p-s dna&rna 12 trgts","description":"Nfct ds p-s dna&rna 12 trgts","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2471","name":"Inj pantoprazole(hikma) 40mg","description":"Injection, pantoprazole (hikma), not therapeutically equivalent to j2470, 40 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0739","name":"Rehab sys active assist rt","description":"Rehabilitation system with interactive interface providing active assistance in rehabilitation therapy, includes all components and accessories, motors, microprocessors, sensors","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15976.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2044","name":"Biobrane glove, each","description":"Biobrane glove, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4294","name":"Amnio quad-core, per sq cm","description":"Amnio quad-core, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0472","name":"Gross exam prep & report","description":"Accession of tissue gross examination preparation and transmission of written report","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9289","name":"Inj nivolumab 2 mg hyaluron","description":"Injection, nivolumab, 2 mg and hyaluronidase-nvhy","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1472","name":"Hep b vaccine not received","description":"Patient did not receive recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87812","name":"Sarscov2&inf typ a&b w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) and influenza virus types a and b","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0605","name":"Antibody test pub hlth path","description":"Antibody test pub hlth path","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0542","name":"No pt prsnt train add 15","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4385","name":"Apollo ft per sq cm","description":"Apollo ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55801","name":"Removal of prostate","description":"Prostatectomy, perineal, subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1169.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0873","name":"Inj daptomycin (xellia)","description":"Injection, daptomycin (xellia), not therapeutically equivalent to j0878 or j0872, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59070","name":"Transabdom amnioinfus w/us","description":"Transabdominal amnioinfusion, including ultrasound guidance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93573","name":"Njx cath slct p-art angrp bi","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, bilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47361","name":"Repair liver wound","description":"Management of liver hemorrhage; exploration of hepatic wound, extensive debridement, coagulation and/or suture, with or without packing of liver","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3169.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1361","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4268","name":"Surgraft ft per sq cm","description":"Surgraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98004","name":"Synch audio-video est sf 10","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 10 minutes must be met or e","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0905T","name":"Ecg alg 12 ld rdcd i&r only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; interpretation and report only","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6089","name":"Access/retorq implant screw","description":"Access/retorq implant screw","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1814","name":"Inj. insulin (lyumjev)","description":"Insulin (lyumjev), per 5 units","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1448","name":"Pt dx pd bef end meas pd","description":"Patients with an active diagnosis of personality disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5930","name":"Max guid prothes w/o flange","description":"Max guid prothes w/o flange","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25611","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9029","name":"Instill adstiladrin, tx dose","description":"Intravesical instillation, nadofaragene firadenovec-vncg, per therapeutic dose","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1310","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64466","name":"Thrc fascial pln blk uni njx","description":"Thoracic fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0138","name":"Iv cipaglucosidase alfa-atga","description":"Intravenous infusion of cipaglucosidase alfa-atga, including provider/supplier acquisition and clinical supervision of oral administration of miglustat in preparation of receipt of cipaglucosidase alfa-atga","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0506","name":"Comp asses care plan ccm svc","description":"Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":42.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0463U","name":"Onc crvx mrna genxprsn 14bmk","description":"Onc crvx mrna genxprsn 14bmk","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1395","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1456","name":"Pt had htx","description":"Patient had a heart transplant","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6600","name":"G com bandge hgh dn foam sht","description":"Gradient compression bandaging supply, high density foam sheet, per 250 square centimeters, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":3.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92945","name":"Prq trl rvs ch occ ant&rtrgr","description":"Percutaneous transluminal revascularization of chronic total occlusion, single coronary artery, coronary artery branch, or coronary artery bypass graft, and/or subtended major coronary artery branches of the bypass graft, any combination of intracoronary stent, atherectomy and angioplasty; combined ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1471","name":"Ffs hep b not covered","description":"Documentation that patient is a medicare fee-for-service beneficiary and without additional supplementary insurance coverage for whom hep b vaccination is not reimbursable under current medicare part b coverage rules","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4384","name":"Axolotl dual ult per sq cm","description":"Axolotl dualgraft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4420","name":"Nuform per sq cm","description":"Nuform, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38222","name":"Dx bone marrow bx & aspir","description":"Diagnostic bone marrow; biopsy(ies) and aspiration(s)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":169.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76641","name":"Ultrasound breast complete","description":"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20692","name":"Appl mltpln uni ext fixj sys","description":"Application of a multiplane (pins or wires in more than 1 plane), unilateral, external fixation system (eg, ilizarov, monticelli type)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1162","name":"Pt enceph due to dtp bef 13","description":"Patient had encephalitis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1246","name":"Pt othr thn true imprt to me","description":"Patient provided a response other than completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6518","name":"Grad com wrap w strap arm cu","description":"Gradient compression wrap with adjustable straps, arm, each, custom","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1400","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54512","name":"Excise lesion testis","description":"Excision of extraparenchymal lesion of testis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":587.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0721T","name":"Quan ct tiss charac w/o ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4330","name":"Total, per sq cm","description":"Total, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91304","name":"Sarscov2 vac 5mcg/0.5ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, 5 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0953T","name":"Tot impl amei rev/rplc w/o","description":"Totally implantable active middle ear hearing implant; revision or replacement, without mastoidectomy and replacement of sound processor","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96202","name":"Mlt fam grp bhv train 1st 60","description":"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face with multiple sets of paren","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64584","name":"Rmvl hpglsl nstim ary pg","description":"Removal of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36483","name":"Endoven ther chem adhes sbsq","description":"Endovenous ablation therapy of incompetent vein, extremity, by transcatheter delivery of a chemical adhesive (eg, cyanoacrylate) remote from the access site, inclusive of all imaging guidance and monitoring, percutaneous; subsequent vein(s) treated in a single extremity, each through separate access","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":75.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90945","name":"Dialysis one evaluation","description":"Dialysis procedure other than hemodialysis (eg, peritoneal dialysis, hemofiltration, or other continuous renal replacement therapies), with single evaluation by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91113","name":"Gi trc img intral colon i&r","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2025","name":"Miro3d per cubic cm","description":"Miro3d, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0504U","name":"Nfct ds uti id 17 path orgs","description":"Nfct ds uti id 17 path orgs","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4020","name":"Ophthalmology/optometry ss","description":"Ophthalmology/optometry mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24931","name":"Amputate upper arm & implant","description":"Amputation, arm through humerus; with implant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37278","name":"Rvsc evsc fpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":145.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1267","name":"Pt no act kid transplt wtlst","description":"Patients not observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1372","name":"Mst rec gsa >=7 and<8","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 7.0% and < 8.0%","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93569","name":"Njx cth slct p-art angrp uni","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1261","name":"Pts on wtlist bef dialysis","description":"Patients that were on the kidney or kidney-pancreas waitlist prior to initiation of dialysis","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0542U","name":"Nefro renal trnspl ur nmr 84","description":"Nefro renal trnspl ur nmr 84","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67516","name":"Sprchoroidal spc njx rx agt","description":"Suprachoroidal space injection of pharmacologic agent (separate procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1375","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0816T","name":"Opn insj/rplcmt ins ptn subq","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"14020","name":"Tis trnfr s/a/l 10 sq cm/<","description":"Adjacent tissue transfer or rearrangement, scalp, arms and/or legs; defect 10 sq cm or less","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":620.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59020","name":"Fetal contract stress test","description":"Fetal contraction stress test","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0261U","name":"Onc clrct ca img alys w/ai","description":"Oncology (colorectal cancer), image analysis with artificial intelligence assessment of 4 histologic and immunohistochemical features (cd3 and cd8 within tumor-stroma border and tumor core), tissue, reported as immune response and recurrence-risk score","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1321","name":"Couns for high risk sub use","description":"Couns for high risk sub use","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87469","name":"Babesia microti amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); babesia microti, amplified probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37294","name":"Rvsc evsc tpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":437.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0528U","name":"Lrt iad 18bct/8vir&7arg rna","description":"Lrt iad 18bct/8vir&7arg rna","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9959","name":"Unspec sleep ap proc","description":"Unspec sleep ap proc","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93615","name":"Esophageal recording","description":"Esophageal recording of atrial electrogram with or without ventricular electrogram(s);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0583U","name":"Rare ds rpd whlgen cmptr dna","description":"Rare ds rpd whlgen cmptr dna","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2020","name":"Linezolid injection","description":"Injection, linezolid, 200 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9011","name":"Datopotamab deruxtecan, 1 mg","description":"Injection, datopotamab deruxtecan-dlnk, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0490U","name":"Onc cutan/uveal mlnma cd146","description":"Onc cutan/uveal mlnma cd146","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4015","name":"Neurology ss","description":"Neurology mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6526","name":"G com garmt full leg/ft nght","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43255","name":"Egd control bleeding any","description":"Esophagogastroduodenoscopy, flexible, transoral; with control of bleeding, any method","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84393","name":"Tau phosphorylated ea","description":"Tau, phosphorylated (eg, ptau 181, ptau 217), each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80061","name":"Lipid panel","description":"Lipid panel this panel must include the following: cholesterol, serum, total (82465) lipoprotein, direct measurement, high density cholesterol (hdl cholesterol) (83718) triglycerides (84478)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0614U","name":"Iem pmd alys 4 nzm cplx page","description":"Iem pmd alys 4 nzm cplx page","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5142","name":"Inj adalimumab-ryvk, 1 mg","description":"Injection, adalimumab-ryvk biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6564","name":"G com stckng waist 40+ cust","description":"Gradient compression stocking, waist length, 40 mmhg or greater, custom, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0455U","name":"Nfct agt sti mult amp prb ur","description":"Nfct agt sti mult amp prb ur","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27487","name":"Revise/replace knee joint","description":"Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2100.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1072","name":"Inj, testosterone, azmiro","description":"Injection, testosterone cypionate (azmiro), 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21275","name":"Revision orbitofacial bones","description":"Secondary revision of orbitocraniofacial reconstruction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":928.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0235","name":"Inj, monoclon antibody, 1 mg","description":"Injection, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extraco","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5134","name":"Inj, tyruko, 1 mg","description":"Injection, natalizumab-sztn (tyruko), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0531U","name":"Nfct ds afb&inv fng 673orgs","description":"Nfct ds afb&inv fng 673orgs","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81558","name":"Trnspl rej kdn mrna qpcr 139","description":"Transplantation medicine (allograft rejection, kidney), mrna, gene expression profiling by quantitative polymerase chain reaction (qpcr) of 139 genes, utilizing whole blood, algorithm reported as a binary categorization as transplant excellence, which indicates immune quiescence, or not transplant e","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44384","name":"Small bowel endoscopy","description":"Ileoscopy, through stoma; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0164A","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0275U","name":"Hem heprn nduc trmbctpna srm","description":"Hematology (heparin-induced thrombocytopenia) platelet antibody reactivity by flow cytometry, serum","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0727T","name":"Rmvl&rplcmt implt vstblr dev","description":"Removal and replacement of implanted vestibular device, unilateral","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33882","name":"Evasc rpr ta dplmt mltpc sys","description":"Endovascular repair of the thoracic aorta by deployment of a branched endograft multipiece system involving an aorto-aortic tube device with a fenestration for the left subclavian artery stent graft(s) and all aortic tube endograft extension(s) placed from the level of the left common carotid artery","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93598","name":"Car outp meas drg cath chd","description":"Cardiac output measurement(s), thermodilution or other indicator dilution method, performed during cardiac catheterization for the evaluation of congenital heart defects (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78491","name":"Myocrd img pet 1std rst/strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); single study, at rest or stress (exercise or pharmacologic)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0436U","name":"Onc lng plsm alys 388 prtn","description":"Onc lng plsm alys 388 prtn","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8502","name":"Inj, aponvie, 1 mg","description":"Injection, aprepitant (aponvie), 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1162","name":"Pt enceph due to dtp bef 13","description":"Patient had encephalitis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7415","name":"Excision malig les complicat","description":"Excision of malignant lesion complicated","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49613","name":"Rpr aa hrn rcr < 3 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, reducible","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99489","name":"Cplx chrnc care ea addl 30","description":"Complex chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":88.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4397","name":"Summit aaa per sq cm","description":"Summit aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1271","name":"Inj doxycycline hyclate 1 mg","description":"Injection, doxycycline hyclate, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85018","name":"Hemoglobin","description":"Blood count; hemoglobin (hgb)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37298","name":"Revsc evsc imvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0465U","name":"Onc urthl carc dna qmsp 2gen","description":"Onc urthl carc dna qmsp 2gen","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0958T","name":"Rmv s-sclp eltr ra rcvr&tlmt","description":"Removal of sub-scalp implanted electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0616","name":"Inj metoprolol tartrate 1 mg","description":"Injection, metoprolol tartrate, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4314","name":"Reeva, per sq cm","description":"Reeva ft, per square cenitmeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0972T","name":"Asstv alg clsfctn burn hlg","description":"Assistive algorithmic classification of burn healing (ie, healing or nonhealing) by noninvasive multispectral imaging, including system set-up and acquisition, selection, and transmission of images, with automated generation of report","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1000T","name":"Autol musc cell therapy admn","description":"Autologous muscle cell therapy, administration of muscle progenitor cells into the urethral sphincter, including cystoscopy and post-void residual ultrasound, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0312U","name":"Ai ds sle alys 8 igg autoant","description":"Ai ds sle alys 8 igg autoant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44403","name":"Colonoscopy w/resection","description":"Colonoscopy through stoma; with endoscopic mucosal resection","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86381","name":"Mitochondrial antibody each","description":"Mitochondrial antibody (eg, m2), each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26605","name":"Treat metacarpal fracture","description":"Closed treatment of metacarpal fracture, single; with manipulation, each bone","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31320","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37265","name":"Revsc evsc fpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":259.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85651","name":"Rbc sed rate nonautomated","description":"Sedimentation rate, erythrocyte; non-automated","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0555","name":"Replacment pt electronic sys","description":"Provision of replacement patient electronics system (e.g., system pillow, handheld reader) for home pulmonary artery pressure monitoring","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63740","name":"Install spinal shunt","description":"Creation of shunt, lumbar, subarachnoid-peritoneal, -pleural, or other; including laminectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4403","name":"Xwrap dual plus per sq cm","description":"Xwrap dual plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55868","name":"Lap srg prst8ct lymph nod bx","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with lymph node biopsy(ies) (limited pelvic lymphadenectomy)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1385","name":"Pt rsn not seen 2nd pam","description":"Documentation of patient reasons for patients who were not seen for the second pam survey (e.g., less than four months between baseline pam assessment and follow-up","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1160","name":"Pt anphx due to mengb bef 13","description":"Patient had anaphylaxis due to the meningococcal vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1270","name":"Pts no kid transplt wtlst","description":"Patients not on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6105","name":"Remove implant body","description":"Remove implant body","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0605","name":"Sucroferric oxyhydroxide 5mg","description":"Sucroferric oxyhydroxide, oral, 5 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1808","name":"Inj, folic acid, 0.1 mg","description":"Injection, folic acid, 0.1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4324","name":"Amniotx, per sq cm","description":"Amniotx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0564U","name":"Nfct ds pthgn-sna 10vir&4bct","description":"Nfct ds pthgn-sna 10vir&4bct","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0388U","name":"Onc nonsm cll lng ca 37 gen","description":"Onc nonsm cll lng ca 37 gen","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0820T","name":"Mntr psychdlc med 1stphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; first physician or other qualified health care professional, each hour","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33988","name":"Insertion of left heart vent","description":"Insertion of left heart vent by thoracic incision (eg, sternotomy, thoracotomy) for ecmo/ecls","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":883.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5811","name":"Denture interm cmplt mandbl","description":"Interim complete denture (mandibular)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60661","name":"Abltj 1/+thyr ndul addl prq","description":"Ablation of 1 or more thyroid nodule(s), additional lobe, percutaneous, including imaging guidance, radiofrequency (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76014","name":"Mr sfty implt&/fb asmt stf 1","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0534U","name":"Onc prst8 mirna snp 32 vrnt","description":"Onc prst8 mirna snp 32 vrnt","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0544","name":"Post d/c phone follow up","description":"Post discharge telephonic follow-up contacts performed in conjunction with a discharge from the emergency department for behavioral health or other crisis encounter, 4 calls per calendar month","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4323","name":"Splint extra-coronal","description":"Splint extra-coronal","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4352","name":"Overlay sl matrix, per sq cm","description":"Overlay sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4335","name":"Amnioplast 2, per sq cm","description":"Amnioplast 2, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0326U","name":"Trgt gen seq alys pnl 83+","description":"Trgt gen seq alys pnl 83+","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90785","name":"Psytx complex interactive","description":"Interactive complexity (list separately in addition to the code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":12.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0166","name":"Inj epinephrine (bpi)","description":"Injection, epinephrine (bpi), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0671T","name":"Insj ant sgm aq drg dev 1+","description":"Insertion of anterior segment aqueous drainage device into the trabecular meshwork, without external reservoir, and without concomitant cataract removal, one or more","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64584","name":"Rmvl hpglsl nstim ary pg","description":"Removal of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80196","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1211","name":"Gsa level>9.0%","description":"Most recent glycemic status assessment (hba1c or gmi) level > 9.0%","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J0215","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80422","name":"Glucagon tolerance panel","description":"Glucagon tolerance panel; for insulinoma this panel must include the following: glucose (82947 x 3) insulin (83525 x 3)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75724","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1246","name":"Pt othr thn true imprt to me","description":"Patient provided a response other than completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7298","name":"Remove screw retained plate","description":"Remove screw retained plate","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69436","name":"Create eardrum opening","description":"Tympanostomy (requiring insertion of ventilating tube), general anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1791.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92632","name":"Hearing aid slctn svc ea add","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0037","name":"Pt not able to participate","description":"On date of encounter, patient is not able to participate in assessment or screening, including non-verbal patients, delirious, severely aphasic, severely developmentally delayed, severe visual or hearing impairment and for those patients, no knowledgeable informant available","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0741","name":"Inj, cabote rilpivir 2mg 3mg","description":"Injection, cabotegravir and rilpivirine, 2mg/3mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4345","name":"Matrix hd allogrft per sq cm","description":"Matrix hd allograft dermis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0849T","name":"Dgtz gls mcrscp ish ea adl 1","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92928","name":"Prq tcat plmt ntrac st 1 les","description":"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 1 lesion involving 1 or more coronary segments","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4011","name":"Internal medicine ss","description":"Internal medicine mips specialty set","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9255","name":"Inj, methotrexate (accord)","description":"Injection, methotrexate (accord), not therapeutically equivalent to j9260, 50 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37265","name":"Revsc evsc fpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81462","name":"So gsap cll fr dna/dna&rna","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants and rearrangements","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0482","name":"Direct immunofluorescence","description":"Direct immunofluorescence","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0527U","name":"Hsv 1&2 vzv amp prb tq pthgn","description":"Hsv 1&2 vzv amp prb tq pthgn","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0685T","name":"Interrog dev eval isdss ip","description":"Interrogation device evaluation (in-person) with analysis, review and report by a physician or other qualified health care professional, including connection, recording and disconnection per patient encounter, permanent implantable synchronized diaphragmatic stimulation system for augmentation of ca","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64859","name":"Nerve surgery","description":"Suture of each additional major peripheral nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":321.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27625","name":"Remove ankle joint lining","description":"Arthrotomy, with synovectomy, ankle;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36821","name":"Av fusion direct any site","description":"Arteriovenous anastomosis, open; direct, any site (eg, cimino type) (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":663.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4378","name":"Renew ft matrix per sq cm","description":"Renew ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5914","name":"Auricular prosthesis","description":"Auricular prosthesis","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0900T","name":"N-invas est aqmbf asstv cmr","description":"Noninvasive estimate of absolute quantitation of myocardial blood flow (aqmbf), derived from assistive algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health care profes","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4212","name":"Gingivectomy/plasty rest","description":"Gingivectomy/plasty rest","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4306","name":"Americ amnion ac per sq cm","description":"American amnion ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0550","name":"Phone/inter for dx/treat >5m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a written report to the patients treating/r","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0472U","name":"Ca vi psp&sp1 antb sjogren","description":"Ca vi psp&sp1 antb sjogren","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0877T","name":"Augmnt alys ch ct ild w/o ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6198","name":"Remove interim implant","description":"Remove interim implant","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0388","name":"Bitewing image capture only","description":"Bitewing image capture only","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6113","name":"Imp/abut rem dent part mand","description":"Imp/abut rem dent part mand","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9608","name":"Flotufolastat f18 diag 1 mci","description":"Flotufolastat f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D8091","name":"Compre ortho treat w surg","description":"Compre ortho treat w surg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1813","name":"Lyumjev for insulin pump use","description":"Insulin (lyumjev) for administration through dme (i.e., insulin pump) per 50 units","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4355","name":"Abio xpl abio xpl hy p sq cm","description":"Abiomend xplus membrane and abiomend xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31586","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":887.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0605","name":"Sucroferric oxyhydroxide 5mg","description":"Sucroferric oxyhydroxide, oral, 5 mg (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72129","name":"Ct chest spine w/dye","description":"Computed tomography, thoracic spine; with contrast material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0017","name":"Crisis psychotherapy 60m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); first 60 minutes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21280","name":"Medial canthopexy","description":"Medial canthopexy (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0991T","name":"Cysto lo-nrg lithtrp&mcrsphr","description":"Cystourethroscopy, with low-energy lithotripsy and acoustically actuated microspheres, including imaging","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0538","name":"Ascvd rsk mng clin stf pr mo","description":"Atherosclerotic cardiovascular disease (ascvd) risk management services; clinical staff time; per calendar month","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J1567","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4014","name":"Nephrology ss","description":"Nephrology mips specialty set","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2781","name":"Crown 3/4 cast base metal","description":"Crown - 3/4 cast predominantly base metal","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6602","name":"Cst hgh nble mtl inlay 2 srf","description":"Inlay - cast high noble metal two surfaces","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1800","name":"Propranolol injection","description":"Injection, propranolol hcl, up to 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4438","name":"Adhesive clip ext ens contr","description":"Adhesive clip applied to the skin to secure external electrical nerve stimulator controller, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0115","name":"Post-coital mucous exam","description":"Post-coital direct, qualitative examinations of vaginal or cervical mucous","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76988","name":"Dx ntrop epcr us chd img acq","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; placement, manipulation of transducer, and image acquisition only","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9993","name":"Pall serv during meas","description":"Patient was provided palliative care services any time during the measurement period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1478","name":"Psychoactive sub abuse","description":"Psychoactive substance abuse","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15736","name":"Muscle-skin graft arm","description":"Muscle, myocutaneous, or fasciocutaneous flap; upper extremity","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1352.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25907","name":"Amputation follow-up surgery","description":"Amputation, forearm, through radius and ulna; secondary closure or scar revision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":951.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86036","name":"Anca screen each antibody","description":"Antineutrophil cytoplasmic antibody (anca); screen, each antibody","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1284","name":"Pt 66+ snp or ltc pos > 90d","description":"Patients age 66 or older in institutional special needs plans (snp) or residing in long term care with pos code 32, 33, 34, 54, or 56 for more than 90 consecutive days during the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0873T","name":"Revj subq prtl asct pmp sys","description":"Revision of a subcutaneously implanted peritoneal ascites pump system, any component (ascites pump, associated peritoneal catheter, associated bladder catheter), including imaging and programming, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0699","name":"Inj, cefiderocol, 10 mg","description":"Injection, cefiderocol, 10 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58323","name":"Sperm washing","description":"Sperm washing for artificial insemination","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9038","name":"Inj axatilimab-csfr 0.1 mg","description":"Injection, axatilimab-csfr, 0.1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11762","name":"Reconstruction of nail bed","description":"Reconstruction of nail bed with graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5948","name":"Max implt sup fix part","description":"Max implt sup fix part","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4423","name":"Biolab tri wrap fl per sq cm","description":"Biolab tri-membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5124","name":"Inj. byooviz, 0.1 mg","description":"Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0623U","name":"Ai ms dna mthyl alys >5000","description":"Ai ms dna mthyl alys >5000","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98001","name":"Synch audio-video new low 30","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0474","name":"Micro w exam of surg margins","description":"Accession of tissue gross and microscopic examination including assessment of surgical margins for presence of disease preparation and transmission of writte","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0168","name":"Epinephrine (intl med sys)","description":"Injection, epinephrine (international medication systems), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1782","name":"Vac admin human pap dose 2","description":"Vac admin human pap dose 2","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0491U","name":"Onc sol tum ctc slct er prtn","description":"Onc sol tum ctc slct er prtn","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J7616","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0306U","name":"Onc mrd nxt-gnrj alys 1st","description":"Onc mrd nxt-gnrj alys 1st","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0573U","name":"Onc pancreas 3bmrk pclf alg","description":"Onc pancreas 3bmrk pclf alg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4021","name":"Orthopedic surgery ss","description":"Orthopedic surgery mips specialty set","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1010T","name":"Cptr oph alys monoc eye mvmt","description":"Computerized ophthalmic analysis of monocular eye movements using retinal-based eye-tracking without spatial calibration, including fixation, microsaccades, drift, and horizontal saccades, when performed, unilateral or bilateral, with interpretation and report","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0400U","name":"Ob xpnd car scr 145 genes","description":"Ob xpnd car scr 145 genes","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4335","name":"Amnioplast 2, per sq cm","description":"Amnioplast 2, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1180","name":"Pt imm ckpt inhib therapy","description":"Patients on immune checkpoint inhibitor therapy","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66989","name":"Xcpsl ctrc rmvl cplx insj 1+","description":"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification), complex, requiring devices or techniques not generally used in routine cataract surgery (eg, iris expansion device,","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0687T","name":"Tx amblyopia dev setup 1st","description":"Treatment of amblyopia using an online digital program; device supply, educational set-up, and initial session","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0582U","name":"Rare ds rpd whlgen dna vrnts","description":"Rare ds rpd whlgen dna vrnts","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2038","name":"Skill train and dev/diem","description":"Skills training and development, per diem","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3374","name":"Inj, vancomycin (mylan) 10mg","description":"Injection, vancomycin hydrochloride (mylan) not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1175","name":"Doc med rsn no hzv","description":"Documentation of medical reason(s) for not administering zoster vaccine (e.g., prior anaphylaxis due to the zoster vaccine)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0522","name":"Mgt nw pt dementia low cmplx","description":"Management of a new patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4009","name":"Hospitalists ss","description":"Hospitalists mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4365","name":"Amnio bur dl mem per sq cm","description":"Amnio burgeon dual-layer membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0615U","name":"Bbrgdrferi ld antb detcj 26","description":"Bbrgdrferi ld antb detcj 26","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88147","name":"Cytopath c/v automated","description":"Cytopathology smears, cervical or vaginal; screening by automated system under physician supervision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1025","name":"Pt mnth 1 mcp prov","description":"Patient-months where there are more than one medicare capitated payment (mcp) provider listed for the month","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32854","name":"Lung transplant with bypass","description":"Lung transplant, double (bilateral sequential or en bloc); with cardiopulmonary bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4195.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99243","name":"Off/op cnsltj new/est low 30","description":"Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":97.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0047","name":"Ped blunt hd traum","description":"Pediatric patient with minor blunt head trauma and pecarn prediction criteria are not assessed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9603","name":"Inj, pafolacianine, 0.1 mg","description":"Injection, pafolacianine, 0.1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7601","name":"Ensifentrine inh 3 mg","description":"Ensifentrine, inhalation suspension, fda approved final product, non-compounded, administered through dme, unit dose form, 3 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90954","name":"Esrd serv 4 vsts p mo 2-11","description":"End-stage renal disease (esrd) related services monthly, for patients 2-11 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 4 or more face-to-face visits by a physician or other qualified health care professional ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":1172.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59830","name":"Treat uterus infection","description":"Treatment of septic abortion, completed surgically","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":488.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87181","name":"Sc std agar dilution per agt","description":"Susceptibility studies, antimicrobial agent; agar dilution method, per agent (eg, antibiotic gradient strip)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0491","name":"Oral dv nm mouthpc hw remote","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":105.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0978T","name":"Submucosal cryolysis therapy","description":"Submucosal cryolysis therapy; soft palate, base of tongue, and lingual tonsil","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2015","name":"Phoenix wnd mtrx, per sq cm","description":"Phoenix wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59136","name":"Treat ectopic pregnancy","description":"Surgical treatment of ectopic pregnancy; interstitial, uterine pregnancy with partial resection of uterus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1055.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60661","name":"Abltj 1/+thyr ndul addl prq","description":"Ablation of 1 or more thyroid nodule(s), additional lobe, percutaneous, including imaging guidance, radiofrequency (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0407U","name":"Neph dbtc ckd mult eclia alg","description":"Neph dbtc ckd mult eclia alg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9319","name":"Inj romidepsin lyophil 0.1mg","description":"Injection, romidepsin, lyophilized, 0.1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92572","name":"Staggered spondaic word test","description":"Staggered spondaic word test","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1302","name":"Scrn mam perf rslts doc","description":"Screening, diagnostic, film digital or digital breast tomosynthesis (3d) mammography results documented and reviewed","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6519","name":"Grad com garm noc night use","description":"Gradient compression garment, not otherwise specified, for nighttime use, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0022","name":"Comm hlth intg svs add 30 m","description":"Community health integration services, each additional 30 minutes per calendar month (list separately in addition to g0019)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33267","name":"Excl laa open any method","description":"Exclusion of left atrial appendage, open, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83013","name":"H pylori (c-13) breath","description":"Helicobacter pylori; breath test analysis for urease activity, non-radioactive isotope (eg, c-13)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1337","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63252","name":"Revise spine cord vsl thrlmb","description":"Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; thoracolumbar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3400.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0851T","name":"Dgtz gls mcrscp mphmtrc 1st","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0671T","name":"Insj ant sgm aq drg dev 1+","description":"Insertion of anterior segment aqueous drainage device into the trabecular meshwork, without external reservoir, and without concomitant cataract removal, one or more","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33840","name":"Exc coa w/direct anastomosis","description":"Excision of coarctation of aorta, with or without associated patent ductus arteriosus; with direct anastomosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1465.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55710","name":"Bx prst8 tprn us w/mri fus 1","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant) with mri-fusion-guidance biopsy, first targeted lesion","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81451","name":"Hl neo gsap 5-50 rna alys","description":"Hematolymphoid neoplasm or disorder, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants, and copy number variants or rearrangements, or isoform expression or mrna expression levels, if performed; rna analysis","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9291","name":"Pres dig cog behav thera fda","description":"Prescription digital cognitive and/or behavioral therapy, fda cleared, per course of treatment","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9332","name":"Inj efgartigimod 2mg","description":"Injection, efgartigimod alfa-fcab, 2mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0548","name":"Phone/inter svs 21-30 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4405","name":"Xwrap fenestra plus sq cm","description":"Xwrap fenestra plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0988T","name":"Opn ins/rplc ins ptn sbq&sbf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97552","name":"Group caregiver training","description":"Group caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6608","name":"G com bandage tub protct pad","description":"Gradient compression bandaging supply, tubular protective absorption padded layer, per linear yard, any width, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1354","name":"Int caries med app per tooth","description":"Interim caries med app","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12020","name":"Tx supfc wnd dehsn smpl clsr","description":"Treatment of superficial wound dehiscence; simple closure","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":170.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4344","name":"Tri membrane wrap, per sq cm","description":"Tri-membrane wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0742T","name":"Aqmbf spect xers/strs & rest","description":"Absolute quantitation of myocardial blood flow (aqmbf), single-photon emission computed tomography (spect), with exercise or pharmacologic stress, and at rest, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1748","name":"Inj, zymfentra, 10 mg","description":"Injection, infliximab-dyyb (zymfentra), 10 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0384U","name":"Neph ckd rsk hi stg kdn ds","description":"Neph ckd rsk hi stg kdn ds","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81464","name":"So gsap cll fr mcrstl ins","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants, microsatellite instability, tumor mutation burden, and rearrangements","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0262U","name":"Onc sld tum rt-pcr 7 gen","description":"Oncology (solid tumor), gene expression profiling by real-time rt-pcr of 7 gene pathways (er, ar, pi3k, mapk, hh, tgfb, notch), formalin-fixed paraffin-embedded (ffpe), algorithm reported as gene pathway activity score","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0483U","name":"Nfct ds ng gyra s91f pt mut","description":"Nfct ds ng gyra s91f pt mut","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4318","name":"E-graft, per sq cm","description":"E-graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97008","name":"Mchnl sclp cool prep plmt","description":"Mechanical scalp cooling; including hair preparation, individual cap placement, therapy initiation, and precooling period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6037","name":"Postop dsg cast chg handfing","description":"Immediate post-surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, partial hand including fingers","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0560","name":"Safety plan interven","description":"Safety planning interventions, each 20 minutes personally performed by the billing practitioner, including assisting the patient in the identification of the following personalized elements of a safety plan: recognizing warning signs of an impending suicidal or substance use-related crisis; employin","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1711","name":"Moderna vacc admin booster","description":"Moderna vacc admin booster","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76989","name":"Dx intraop epcar us chd i&r","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; interpretation and report only","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2711","name":"Inj neostigmin/glycopyrrolat","description":"Injection, neostigmine methylsulfate 0.1 mg and glycopyrrolate 0.02 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24310","name":"Tnot opn elbw to sho ea tdn","description":"Tenotomy, open, elbow to shoulder, each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":571.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0472","name":"Gross exam prep & report","description":"Accession of tissue gross examination preparation and transmission of written report","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3401","name":"Vyjuvek 5x10^9pfu/ml, 0.1 ml","description":"Beremagene geperpavec-svdt for topical administration, containing nominal 5 x 10^9 pfu/ml vector genomes, per 0.1 ml","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4021","name":"Orthopedic surgery ss","description":"Orthopedic surgery mips specialty set","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7414","name":"Excision malig lesion>1.25cm","description":"Excision of malignant lesion greater than 1.25 cm","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9297","name":"Inj pemetrexed (sandoz) 10mg","description":"Injection, pemetrexed (sandoz), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0710T","name":"N-invas artl plaq alys","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; including data preparation and transmission, quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess a","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0624U","name":"Hep nash dna mthyl alys 5000","description":"Hep nash dna mthyl alys 5000","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49622","name":"Rpr parastomal hrna ncr/strn","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1410","name":"No gmln brca1/brca2 couns","description":"Patients who did not have germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0917T","name":"Insj perm ccm-d sys 1 lead","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; single transvenous lead (pacing or defibrillation) only","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86381","name":"Mitochondrial antibody each","description":"Mitochondrial antibody (eg, m2), each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1236","name":"Baseline mrs > 2","description":"Baseline mrs > 2","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0568","name":"Int psych care mng, 1 cal mo","description":"Initial psychiatric collaborative care management, in the first calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required elements: outrea","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52443","name":"Cysto 1st trurl prst8 comis","description":"Cystourethroscopy with initial transurethral anterior prostate commissurotomy with a nondrug-coated balloon catheter followed by therapeutic drug delivery into the prostate by a drug-coated balloon catheter, including transrectal ultrasound and fluoroscopy, when performed","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87045","name":"Feces culture aerobic bact","description":"Culture, bacterial; stool, aerobic, with isolation and preliminary examination (eg, kia, lia), salmonella and shigella species","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49591","name":"Rpr aa hrn 1st < 3 cm rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, reducible","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1749","name":"Inj, iloprost, 0.1 mcg","description":"Injection, iloprost, 0.1 mcg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0018M","name":"Trnsplj rnl meas cd154+cll","description":"Transplantation medicine (allograft rejection, renal), measurement of donor and third-party-induced cd154+t-cytotoxic memory cells, utilizing whole peripheral blood, algorithm reported as a rejection risk score","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1390","name":"Pt no doc exm for rec","description":"Patients who do not have a documented exam performed for recurrence of melanoma or no documentation within the performance period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0854T","name":"Dgtz gls mcrscp bld smr prph","description":"Digitization of glass microscope slides for blood smear, peripheral, interpretation by physician with written report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0740T","name":"Rem auton alg nsln cal setup","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; initial set-up and patient education","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92622","name":"Dx aly aud oi snd prcsr 1st","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; first 60 minutes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6180","name":"Implnt maint proced","description":"Implnt maint proced","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":113.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1370","name":"Rehab support msk care mvp","description":"Rehabilitative support for musculoskeletal care mips value pathway","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10080","name":"I&d pilonidal cyst simple","description":"Incision and drainage of pilonidal cyst; simple","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":256.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99425","name":"Prin care mgmt phys ea addl","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9957","name":"Screening sleep disorders","description":"Screening sleep disorders","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6049","name":"Scale implt peri-implt inflm","description":"Scale implt peri-implt inflm","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9954","name":"Fab/del oral appliance thxpy","description":"Fab/del oral appliance thxpy","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0049","name":"Main hemo in-cntr","description":"With maintenance hemodialysis (in-center and home hd) for the complete reporting month","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37273","name":"Revsc evsc fpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4288","name":"Dermabind ch, per sq cm","description":"Dermabind ch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6517","name":"Grad com wrap w strap bn cus","description":"Gradient compression wrap with adjustable straps, below knee, each, custom","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4328","name":"Most, per sq cm","description":"Most, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0781T","name":"Brnchsc rf dstrj pulm nrv bi","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; bilateral mainstem bronchi","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90481","name":"Admn sarscov2 vac ea add cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; each additional component administered (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2246","name":"Inj, micafungin (baxter)","description":"Injection, micafungin in sodium (baxter), not therapeutically equivalent to j2248, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2356","name":"Inj tezepelumab-ekko, 1mg","description":"Injection, tezepelumab-ekko, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1394","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38381","name":"Thoracic duct procedure","description":"Suture and/or ligation of thoracic duct; thoracic approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82272","name":"Occult bld feces 1-3 tests","description":"Blood, occult, by peroxidase activity (eg, guaiac), qualitative, feces, 1-3 simultaneous determinations, performed for other than colorectal neoplasm screening","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0833T","name":"Dgtz gls mcrscp cytp oth prp","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; preparation, screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1162","name":"Pt enceph due to dtp bef 13","description":"Patient had encephalitis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5149","name":"Inj, aflibercept-abzv, 1 mg","description":"Injection, aflibercept-abzv (enzeevu), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2043","name":"Biobrane, per sq cm","description":"Biobrane, per square centimeter","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0891","name":"Argatroban nonesrd (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61619","name":"Repair dura","description":"Secondary repair of dura for cerebrospinal fluid leak, anterior, middle or posterior cranial fossa following surgery of the skull base; by local or regionalized vascularized pedicle flap or myocutaneous flap (including galea, temporalis, frontalis or occipitalis muscle)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1681.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76802","name":"Ob us < 14 wks addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67227","name":"Dstrj extensive retinopathy","description":"Destruction of extensive or progressive retinopathy (eg, diabetic retinopathy), cryotherapy, diathermy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0118","name":"Glaucoma scrn hgh risk direc","description":"Glaucoma screening for high risk patient furnished under the direct supervision of an optometrist or ophthalmologist","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0867T","name":"Tpla b9 prst8 hyprplsa>=50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume greater or equal to 50 ml","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77092","name":"Tbs i&r fx rsk qhp","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; interpretation and report on fracture-risk only by other qualified health care professional","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0917T","name":"Insj perm ccm-d sys 1 lead","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; single transvenous lead (pacing or defibrillation) only","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1248","name":"Pt resp true seen as person","description":"Patient responded completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0344","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1451","name":"Pt dx ppd dur id/pf pd","description":"Patients with an active diagnosis of pervasive developmental disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1311","name":"Aphlx to vax bef enc","description":"Anaphylaxis due to the vaccine on or before the date of the encounter","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2035","name":"Corpl p therac p allac p mg","description":"Corplex p or theracor p or allacor p, per milligram","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1308","name":"Inj, famotidine, 0.25 mg","description":"Injection, famotidine, 0.25 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9616","name":"Gallium gozellix 1 millicuri","description":"Gallium ga-68 gozetotide (gozellix), diagnostic, 1 millicurie","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0925T","name":"Rlcj skin pocket ccm-d pg","description":"Relocation of skin pocket for implanted cardiac contractility modulation-defibrillation pulse generator","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1017T","name":"Elec aly npgs esoph sbsq w/o","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9021","name":"Inj, aspara, rylaze, 0.1 mg","description":"Injection, asparaginase, recombinant, (rylaze), 0.1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37273","name":"Revsc evsc fpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0525","name":"Inj cefotetan disodium 10 mg","description":"Injection, cefotetan disodium, 10 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0418U","name":"Onc brst aug alg aly whl sl8","description":"Onc brst aug alg aly whl sl8","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1284","name":"Pt 66+ snp or ltc pos > 90d","description":"Patients age 66 or older in institutional special needs plans (snp) or residing in long term care with pos code 32, 33, 34, 54, or 56 for more than 90 consecutive days during the measurement period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87492","name":"Chlmyd trach dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); chlamydia trachomatis, quantification","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3222","name":"Part pulp for apexogenesis","description":"Partial pulpotomy for apexogenesis - permanent tooth with incomplete root development","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1330","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1010","name":"Inj, methylpred acetate 1 mg","description":"Injection, methylprednisolone acetate, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4397","name":"Summit aaa per sq cm","description":"Summit aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6094","name":"Abut support crown titanium","description":"Abutment supported crown - (titanium)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":674.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9064","name":"Inj, cabazitaxel (sandoz)","description":"Injection, cabazitaxel (sandoz), not therapeutically equivalent to j9043, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2781","name":"Inj, pegcetacoplan, 1mg","description":"Injection, pegcetacoplan, intravitreal, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30460","name":"Revision of nose","description":"Rhinoplasty for nasal deformity secondary to congenital cleft lip and/or palate, including columellar lengthening; tip only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":946.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73630","name":"X-ray exam of foot","description":"Radiologic examination, foot; complete, minimum of 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9914","name":"Admin of dermal fill","description":"Admin of dermal fill","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0803","name":"3d facial scan direct","description":"3d facial scan direct","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24301","name":"Musc/tdn transfer upr a/e 1","description":"Muscle or tendon transfer, any type, upper arm or elbow, single (excluding 24320-24331)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":908.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86886","name":"Coombs test indirect titer","description":"Antihuman globulin test (coombs test); indirect, each antibody titer","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1221","name":"Dre w/o rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; without evidence of retinopathy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1444","name":"Del < 39 weeks gest","description":"Delivery at < 39 weeks of gestation","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2247","name":"Inj, micafungin (par pharm)","description":"Injection, micafungin sodium (par pharm) not thereapeutically equivalent to j2248, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1202","name":"Miglustat oral 65 mg","description":"Miglustat, oral, 65 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1366","name":"Focus on womens health mvp","description":"Focusing on womens health mips value pathway","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15013","name":"Prepj skn cll ssp agrft 1st","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; first 25 sq cm or less of harvested skin","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1208","name":"Pt no scrn sdoh","description":"Patient is not screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1410","name":"No gmln brca1/brca2 couns","description":"Patients who did not have germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0583U","name":"Rare ds rpd whlgen cmptr dna","description":"Rare ds rpd whlgen cmptr dna","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0801T","name":"Tcat rmv&rpl 2chmbr ldls pm","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; dual-cha","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87564","name":"Mtb rifampin rst amp prb tq","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacterium tuberculosis, rifampin resistance, amplified probe technique","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87513","name":"H pylri clrthmcn rst amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); helicobacter pylori (h. pylori), clarithromycin resistance, amplified probe technique","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4258","name":"Enverse, per sq cm","description":"Enverse, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69719","name":"Rplcm oi implt sk tc esp<100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43267","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":467.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1244","name":"Pt othr thn true best int","description":"Patient provided a response other than completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44407","name":"Colonoscopy w/ndl aspir/bx","description":"Colonoscopy through stoma; with transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy(s), includes endoscopic ultrasound examination limited to the sigmoid, descending, transverse, or ascending colon and cecum and adjacent structures","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0526","name":"Est pt-cg dyad dem hig cmplx","description":"Management of established patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0260U","name":"Rare ds id opt genome mapg","description":"Rare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90813","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93585","name":"Vngrph chd azygs/hemiazygs","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; azygos/hemiazygos venous system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2791","name":"Crown full cast base metal","description":"Crown-full cast predominantly base metal","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3432","name":"Guided tissue regeneration","description":"Guided tissue regeneration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0668","name":"Team remote e/m est pt 40 mn","description":"Team remote e/m est. pt 40mins","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0472","name":"Gross exam prep & report","description":"Accession of tissue gross examination preparation and transmission of written report","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4273","name":"Esano aaa, per sq cm","description":"Esano aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0932T","name":"N-invs det hrt fail aug echo","description":"Noninvasive detection of heart failure derived from augmentative analysis of an echocardiogram that demonstrated preserved ejection fraction, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93594","name":"R hrt cath chd abnl nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; abnormal native connections","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7521","name":"Tacrolim granules oral susp","description":"Tacrolimus, granules, oral suspension, 0.1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0742T","name":"Aqmbf spect xers/strs & rest","description":"Absolute quantitation of myocardial blood flow (aqmbf), single-photon emission computed tomography (spect), with exercise or pharmacologic stress, and at rest, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90827","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0804T","name":"Prgrmg evl ldls pm 2chmbr ip","description":"Programming device evaluation (in person) with iterative adjustment of implantable device to test the function of device and to select optimal permanent programmed values, with analysis, review, and report, by a physician or other qualified health care professional, leadless pacemaker system in dual","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0062","name":"Audiology ss","description":"Audiology mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3373","name":"Inj, vancomycin hcl, 10 mg","description":"Injection, vancomycin hydrochloride, 10 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6604","name":"G com bandge low dn foam flt","description":"Gradient compression bandaging supply, low density flat foam sheet, per 250 square centimeters, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":1.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92631","name":"Hearing aid slctn svc 1st 30","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0286U","name":"Cep72 nudt15&tpmt gene alys","description":"Cep72 nudt15&tpmt gene alys","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4428","name":"Dermbnd sln sl+ slx sq cm","description":"Dermabind sl n or dermabind sl + or dermabind sl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4272","name":"Esano a, per sq cm","description":"Esano a, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0492U","name":"Onc sol tum ctc slctn pd-l1","description":"Onc sol tum ctc slctn pd-l1","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31613","name":"Tracheostoma revj simple","description":"Tracheostoma revision; simple, without flap rotation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1356","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0901","name":"Vadadustat oral 1mg for esrd","description":"Vadadustat, oral, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93660","name":"Tilt table evaluation","description":"Evaluation of cardiovascular function with tilt table evaluation, with continuous ecg monitoring and intermittent blood pressure monitoring, with or without pharmacological intervention","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2471","name":"Inj pantoprazole(hikma) 40mg","description":"Injection, pantoprazole (hikma), not therapeutically equivalent to j2470, 40 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1288","name":"Doc rsn no hbp scrn or f/u","description":"Documented reason for not screening or recommending a follow-up for high blood pressure","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8541","name":"Oral, hemady, 0.25 mg","description":"Dexamethasone (hemady), oral, 0.25 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6074","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (noble metal)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2007","name":"Restrata, per sq cm","description":"Restrata, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1181","name":"Gr 2 or> dia or gr2 or> col","description":"Grade 2 or above diarrhea and/or grade 2 or above colitis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0369","name":"Max mri capture & interprete","description":"Max mri capture & interprete","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19086","name":"Bx breast add lesion mr imag","description":"Biopsy, breast, with placement of breast localization device(s) (eg, clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; each additional lesion, including magnetic resonance guidance (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":895.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66160","name":"Glaucoma surgery","description":"Fistulization of sclera for glaucoma; sclerectomy with punch or scissors, with iridectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":930.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20957","name":"Mt bone graft microvasc","description":"Bone graft with microvascular anastomosis; metatarsal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3012.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37790","name":"Penile venous occlusion","description":"Penile venous occlusive procedure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0432U","name":"Klhl11 antb sr/csf asy qual","description":"Klhl11 antb sr/csf asy qual","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2643","name":"Dental onlay porcelin 3 surf","description":"Onlay - porcelain/ceramic - three surfaces","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64912","name":"Nrv rpr w/nrv algrft 1st","description":"Nerve repair; with nerve allograft, each nerve, first strand (cable)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":778.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0618","name":"Inj, calcium chloride, 2 mg","description":"Injection, calcium chloride, 2 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1454","name":"New cied","description":"New cied","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0503U","name":"Neuro alz ds bamyl&tau prtn","description":"Neuro alz ds bamyl&tau prtn","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0906T","name":"Coms ther 1st appl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; first application, total wound(s) surface area less than or equal to 50 sq cm","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2790","name":"Rho d immune globulin inj","description":"Injection, rho d immune globulin, human, full dose, 300 micrograms (1500 i.u.)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0560U","name":"Onc mrd gsa cfdna baseline","description":"Onc mrd gsa cfdna baseline","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0542U","name":"Nefro renal trnspl ur nmr 84","description":"Nefro renal trnspl ur nmr 84","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82270","name":"Occult blood feces","description":"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (ie, patient was provided 3 cards or single triple card for consecutive collection)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0742T","name":"Aqmbf spect xers/strs & rest","description":"Absolute quantitation of myocardial blood flow (aqmbf), single-photon emission computed tomography (spect), with exercise or pharmacologic stress, and at rest, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17108","name":"Dstr cut vsc prlf les>50sqcm","description":"Destruction of cutaneous vascular proliferative lesions (eg, laser technique); over 50.0 sq cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":952.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9291","name":"Pres dig cog behav thera fda","description":"Prescription digital cognitive and/or behavioral therapy, fda cleared, per course of treatment","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1364","name":"Ascvd risk >=20pct","description":"Calculated 10-year ascvd risk score of >= 20 percent during the performance period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35602","name":"Bpg crtd-clat crtd","description":"Bypass graft, with other than vein; carotid-contralateral carotid","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4408","name":"Xwrap hydro per sq cm","description":"Xwrap hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0257U","name":"Vlcad leuk nzm actv whl bld","description":"Very long chain acyl- coenzyme a (coa) dehydrogenase (vlcad), leukocyte enzyme activity, whole blood","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1275","name":"Pts hosp exl","description":"Patients determined to be in hospice were excluded from month of evaluation and the remainder of reporting period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47382","name":"Percut ablate liver rf","description":"Ablation, 1 or more liver tumor(s), percutaneous, radiofrequency","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":966.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33903","name":"Perq p-art revsc 1 abnor bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, bilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50541","name":"Laparo ablate renal cyst","description":"Laparoscopy, surgical; ablation of renal cysts","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7671","name":"Alveolus open reduction","description":"Alveolus - open reduction may include stabilization of teeth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0376U","name":"Onc prst8 ca img alys 128","description":"Onc prst8 ca img alys 128","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0541U","name":"Cv ds hdl rct cec lc-ms/ms 5","description":"Cv ds hdl rct cec lc-ms/ms 5","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0913T","name":"Prq tcat ther rx ntrac balo1","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting), including mechanical dilation by nondrug-delivery balloon angioplasty, endoluminal imaging using intravascular ultrasound (ivus) or optical coherence tomography (oct) when per","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4345","name":"Matrix hd allogrft per sq cm","description":"Matrix hd allograft dermis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21244","name":"Reconstruction of lower jaw","description":"Reconstruction of mandible, extraoral, with transosteal bone plate (eg, mandibular staple bone plate)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1141.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0046","name":"No mrs 90 days post stk","description":"Clinical follow-up and mrs score not assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45000","name":"Drainage of pelvic abscess","description":"Transrectal drainage of pelvic abscess","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":357.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2026","name":"Restrata minimatrix, 5 mg","description":"Restrata minimatrix, 5 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0605U","name":"All&immunology hat tpsab1","description":"All&immunology hat tpsab1","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61340","name":"Subtemporal cranial dcmprn","description":"Subtemporal cranial decompression (pseudotumor cerebri, slit ventricle syndrome)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1592.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99281","name":"Emr dpt vst mayx req phy/qhp","description":"Emergency department visit for the evaluation and management of a patient that may not require the presence of a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1413","name":"Inj delandistrogene mox rokl","description":"Injection, delandistrogene moxeparvovec-rokl, per therapeutic dose","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1003T","name":"Arthrp 1st crp/mtcrpl prostc","description":"Arthroplasty, first carpometacarpal joint, with distal trapezial and proximal first metacarpal prosthetic replacement (eg, first carpometacarpal total joint)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0233","name":"Intra inf, toci, first dose","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9615","name":"Inj, pegulicianine, 1 mg","description":"Injection, pegulicianine, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0478U","name":"Onc nsclc dna&rna dpcr 9 gen","description":"Onc nsclc dna&rna dpcr 9 gen","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37274","name":"Rvsc evsc fpvt athrc cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95919","name":"Quan puplmtry phy/qhp uni/bi","description":"Quantitative pupillometry with physician or other qualified health care professional interpretation and report, unilateral or bilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0913T","name":"Prq tcat ther rx ntrac balo1","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting), including mechanical dilation by nondrug-delivery balloon angioplasty, endoluminal imaging using intravascular ultrasound (ivus) or optical coherence tomography (oct) when per","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0498U","name":"Onc clrct ngs mut detc 43gen","description":"Onc clrct ngs mut detc 43gen","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0390U","name":"Ob pe kdr eng&rbp4 ia alg","description":"Ob pe kdr eng&rbp4 ia alg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1176","name":"No 2 hzv 10/2017-meas pd","description":"Patient did not receive two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0627U","name":"Psyc scz dna alys >15000","description":"Psyc scz dna alys >15000","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0949T","name":"Rem interrog dev ccm tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93319","name":"3d echo img cgen car anomal","description":"3d echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac structure(s) (eg, cardiac chambers and valves, left atrial appendage, interatrial septum, interventricular","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97113","name":"Aquatic therapy/exercises","description":"Therapeutic procedure, 1 or more areas, each 15 minutes; aquatic therapy with therapeutic exercises","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0491","name":"Inj anifrolumab-fnia 1mg","description":"Injection, anifrolumab-fnia, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0895T","name":"Connj lvr algrft prfu dev 1","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; initial 4 hours of monitoring time, including hourly physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary ","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0582U","name":"Rare ds rpd whlgen dna vrnts","description":"Rare ds rpd whlgen dna vrnts","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87594","name":"Pneumcysts jirovecii amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); pneumocystis jirovecii, amplified probe technique","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0942T","name":"Cysto flx rmv&rplc urtl scaf","description":"Cystourethroscopy, flexible; with removal and replacement of prostatic urethral scaffold","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5127","name":"Inj, stimufend, 0.5 mg","description":"Injection, pegfilgrastim-fpgk (stimufend), biosimilar, 0.5 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0570","name":"Care manage serv, pr cal mo","description":"Care management services for behavioral health conditions, directed by a physician or other qualified health care professional, per calendar month, with the following required elements: initial assessment or follow-up monitoring, including the use of applicable validated rating scales, behavioral he","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88187","name":"Flowcytometry/read 2-8","description":"Flow cytometry, interpretation; 2 to 8 markers","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0462","name":"Atropine sulf, nte, 0.01 mg","description":"Injection, atropine sulfate, not therapeutically equivalent to j0461, 0.01 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93896","name":"Vsrctv std tcd icr art compl","description":"Vasoreactivity study performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8612","name":"Oral methotrexate (xatmep)","description":"Methotrexate (xatmep), oral, 2.5 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3472","name":"Surg rep root res premolar","description":"Surg rep root res premolar","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97037","name":"Appl modality 1+lllt po pain","description":"Application of a modality to 1 or more areas; low-level laser therapy (ie, nonthermal and non-ablative) for post-operative pain reduction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1221","name":"Dre w/o rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; without evidence of retinopathy","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62270","name":"Dx lmbr spi pnxr","description":"Spinal puncture, lumbar, diagnostic;","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":63.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64656","name":"Revj/rplcmt bat mod sys pg","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; pulse generator only","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58410","name":"Suspension of uterus","description":"Uterine suspension, with or without shortening of round ligaments, with or without shortening of sacrouterine ligaments; with presacral sympathectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":917.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93631","name":"Ntraop epicar&endcar pac&map","description":"Intra-operative epicardial and endocardial pacing and mapping to localize the site of tachycardia or zone of slow conduction for surgical correction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":833.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0914T","name":"Prq tcat thr rx ntrc bal sep","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting) performed on a separate target lesion from the target lesion treated with balloon angioplasty, coronary stent placement or coronary atherectomy, including mechanical dilation b","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98985","name":"Rtm dev sply mscsk sys 2-15d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of musculoskeletal system, 2-15 days in a 30-day period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4268","name":"Surgraft ft per sq cm","description":"Surgraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43622","name":"Removal of stomach","description":"Gastrectomy, total; with formation of intestinal pouch, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2195.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69511","name":"Extensive mastoid surgery","description":"Mastoidectomy; radical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90845","name":"Psychoanalysis","description":"Psychoanalysis","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":119.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1461","name":"Pt dx chron hepc","description":"Patient diagnosis for chronic hepatitis c","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35654","name":"Bpg axillary-femoral-femoral","description":"Bypass graft, with other than vein; axillary-femoral-femoral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1749.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0838T","name":"Dgtz gls mcrscp cslt sld els","description":"Digitization of glass microscope slides for consultation and report on referred slides prepared elsewhere (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1467","name":"Pt dx lynch syn","description":"Patients with an existing diagnosis of lynch syndrome","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0975T","name":"Slctv nzmtc dbrdmt s/n/hf 1","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; first 100 sq cm","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92621","name":"Auditory function + 15 min","description":"Evaluation of central auditory function, with report; each additional 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0113","name":"Pinworm examinations","description":"Pinworm examinations","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4286","name":"Remove non-resorb barrier","description":"Remove non-resorb barrier","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92522","name":"Evaluate speech production","description":"Evaluation of speech sound production (eg, articulation, phonological process, apraxia, dysarthria);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26392","name":"Repair/graft hand tendon","description":"Removal of synthetic rod and insertion of flexor tendon graft, hand or finger (includes obtaining graft), each rod","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1316.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7997","name":"Appliance removal","description":"Appliance removal (not by dentist who placed appliance) includes removal of archbar","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4358","name":"Xwrap dual, per sq cm","description":"Xwrap dual, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87070","name":"Culture othr specimn aerobic","description":"Culture, bacterial; any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1283","name":"Pt scrn tbco and id as user","description":"Patient screened for tobacco use and identified as a tobacco user","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3263","name":"Inj, toripalimab-tpzi, 1 mg","description":"Injection, toripalimab-tpzi, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0533U","name":"Rx metab advrs gnotyp 16gens","description":"Rx metab advrs gnotyp 16gens","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53025","name":"Incision of urethra","description":"Meatotomy, cutting of meatus (separate procedure); infant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1379","name":"10 yr fu no rec rsn not giv","description":"A 10 year follow-up interval for colonoscopy not recommended, reason not otherwise specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4421","name":"Biolab wrap solo per sq cm","description":"Biolab membrane wrap solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0291U","name":"Psyc mood do mrna 144 genes","description":"Psyc mood do mrna 144 genes","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90964","name":"Esrd home pt serv p mo 2-11","description":"End-stage renal disease (esrd) related services for home dialysis per full month, for patients 2-11 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42420","name":"Excise parotid gland/lesion","description":"Excision of parotid tumor or parotid gland; total, with dissection and preservation of facial nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1492.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69719","name":"Rplcm oi implt sk tc esp<100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1309","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9220","name":"Indigotindisulfonate sod 1mg","description":"Injection, indigotindisulfonate sodium, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4278","name":"Epieffect, per sq cm","description":"Epieffect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0494U","name":"Rbc ag ftl rhd gene alys ngs","description":"Rbc ag ftl rhd gene alys ngs","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0516U","name":"Rx metab rxgenomic gnotyp 40","description":"Rx metab rxgenomic gnotyp 40","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1297","name":"Bmi not doc medrsn ptref","description":"Bmi not documented due to medical reason or patient refusal of height or weight measurement","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1489","name":"Pt status doc","description":"Patient status documented","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93319","name":"3d echo img cgen car anomal","description":"3d echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac structure(s) (eg, cardiac chambers and valves, left atrial appendage, interatrial septum, interventricular","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0730T","name":"Trabeculotomy lsr w/oct gdn","description":"Trabeculotomy by laser, including optical coherence tomography (oct) guidance","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1399","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9954","name":"Fab/del oral appliance thxpy","description":"Fab/del oral appliance thxpy","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2312","name":"Inj naloxone hcl nos, 0.01mg","description":"Injection, naloxone hydrochloride, not otherwise specified, 0.01 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1163","name":"Pt anphx due to hpv bef 13","description":"Patient had anaphylaxis due to the hpv vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0338U","name":"Onc sld tum crcg tum cl slct","description":"Onc sld tum crcg tum cl slct","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0238","name":"Oth resp proc, indiv","description":"Therapeutic procedures to improve respiratory function, other than described by g0237, one on one, face to face, per 15 minutes (includes monitoring)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0980T","name":"Sbmcsl crylys ther tng&tnsl","description":"Submucosal cryolysis therapy; base of tongue and lingual tonsil only","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0402","name":"Inj, abilify asimtufii, 1 mg","description":"Injection, aripiprazole (abilify asimtufii), 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87110","name":"Chlamydia culture","description":"Culture, chlamydia, any source","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0166","name":"Inj epinephrine (bpi)","description":"Injection, epinephrine (bpi), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46060","name":"I&d ischiorectal/ntrmrl absc","description":"Incision and drainage of ischiorectal or intramural abscess, with fistulectomy or fistulotomy, submuscular, with or without placement of seton","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":428.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6094","name":"Abut support crown titanium","description":"Abutment supported crown - (titanium)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73580","name":"Contrast x-ray of knee joint","description":"Radiologic examination, knee, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0787T","name":"Revj/rmvl nea sac w/nstim","description":"Revision or removal of neurostimulator electrode array, sacral, with integrated neurostimulator","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0891T","name":"Arhfcmrigtbs sbsq tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent treatment day","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1332","name":"Pts no eval ini xm no 2 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 2 weeks","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27265","name":"Treat hip dislocation","description":"Closed treatment of post hip arthroplasty dislocation; without anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":473.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0618","name":"Inj, calcium chloride, 2 mg","description":"Injection, calcium chloride, 2 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0932T","name":"N-invs det hrt fail aug echo","description":"Noninvasive detection of heart failure derived from augmentative analysis of an echocardiogram that demonstrated preserved ejection fraction, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45350","name":"Sgmdsc w/band ligation","description":"Sigmoidoscopy, flexible; with band ligation(s) (eg, hemorrhoids)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":707.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":88.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2036","name":"Cohealyx col dml mx pr sq cm","description":"Cohealyx collagen dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0793T","name":"Prq tcat thrm ablt nrv p-art","description":"Percutaneous transcatheter thermal ablation of nerves innervating the pulmonary arteries, including right heart catheterization, pulmonary artery angiography, and all imaging guidance","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0045","name":"Mrs 90 days post stk","description":"Clinical follow-up and mrs score assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22855","name":"Removal anterior instrmj","description":"Removal of anterior instrumentation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1300.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8541","name":"Oral, hemady, 0.25 mg","description":"Dexamethasone (hemady), oral, 0.25 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1359","name":"Indx suicd idea, no 0 scr","description":"Index assessment during the denominator period when the suicidal ideation and/or behavior symptoms or increased suicide risk by clinician determination occurs and a non-zero c-ssrs score is obtained","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0467U","name":"Onc bldr dna ngs 60gen&aneup","description":"Onc bldr dna ngs 60gen&aneup","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0752T","name":"Dgtz gls mcrscp sld lvl iii","description":"Digitization of glass microscope slides for level iii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0730T","name":"Trabeculotomy lsr w/oct gdn","description":"Trabeculotomy by laser, including optical coherence tomography (oct) guidance","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0586U","name":"Onc mrna gen xprsn 216 genes","description":"Onc mrna gen xprsn 216 genes","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69728","name":"Rmv ntr oi imp sk tc>=100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87166","name":"Dark field exam w/o collj","description":"Dark field examination, any source (eg, penile, vaginal, oral, skin); without collection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4543","name":"Supply trans elec nerve stim","description":"Supplies for transcutaneous electrical nerve stimulator, for nerves in the auricular region, per month","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9612","name":"Thera par drugs 2 or > admin","description":"Therapeutic parenteral drugs two or more administrations different medications","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3424","name":"Inj hydroxocobalamin iv 25mg","description":"Injection, hydroxocobalamin, intravenous, 25 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9988","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0272U","name":"Hem genetic bld do 51 genes","description":"Hematology (genetic bleeding disorders), genomic sequence analysis of 51 genes, blood, buccal swab, or amniotic fluid, comprehensive","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44406","name":"Colonoscopy w/ultrasound","description":"Colonoscopy through stoma; with endoscopic ultrasound examination, limited to the sigmoid, descending, transverse, or ascending colon and cecum and adjacent structures","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69728","name":"Rmv ntr oi imp sk tc>=100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1254","name":"Pts deceased prior hu surv","description":"Patients who were deceased when the hu survey reached them","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6093","name":"Recement supp part denture","description":"Recement implant/abutment supported fixed partial denture","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57550","name":"Removal of residual cervix","description":"Excision of cervical stump, vaginal approach;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3379","name":"Inj, valproate sod, 5 mg","description":"Injection, valproate sodium, 5 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0051","name":"Traditional healing service","description":"Traditional healing service","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0802T","name":"Tcat rmv&rpl2chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right at","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27324","name":"Biopsy thigh soft tissues","description":"Biopsy, soft tissue of thigh or knee area; deep (subfascial or intramuscular)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":446.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76818","name":"Fetal biophys profile w/nst","description":"Fetal biophysical profile; with non-stress testing","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98013","name":"Synch audio-only est low 20","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code select","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3424","name":"Inj hydroxocobalamin iv 25mg","description":"Injection, hydroxocobalamin, intravenous, 25 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4017","name":"Nutrition/dietician ss","description":"Nutrition/dietician mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22860","name":"Tot disc arthrp 2ntrspc lmbr","description":"Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression); second interspace, lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0604U","name":"All&immunology crae 4bk pep","description":"All&immunology crae 4bk pep","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3432","name":"Guided tissue regeneration","description":"Guided tissue regeneration","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2043","name":"Biobrane, per sq cm","description":"Biobrane, per square centimeter","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0567U","name":"Rare ds whl gen seq srs&lrs","description":"Rare ds whl gen seq srs&lrs","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0667","name":"Team remote e/m est pt 25 mn","description":"Team remote e/m est. pt 25mins","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0625U","name":"Endocrinol op dna alys>5000","description":"Endocrinol op dna alys>5000","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15819","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":786.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0879T","name":"Augmnt alys ch ct ild prep","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; radiological data preparation and transmission","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0674T","name":"Laps insj nw/rpcmt prm isdss","description":"Laparoscopic insertion of new or replacement of permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including an implantable pulse generator and diaphragmatic lead(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0328","name":"Fecal blood scrn immunoassay","description":"Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9996","name":"Ustekinumab- ttwe sub cu inj","description":"Injection, ustekinumab-ttwe (pyzchiva), subcutaneous, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50370","name":"Rmvl transplanted rnl algrft","description":"Removal of transplanted renal allograft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1004.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0868T","name":"Hi-res gastric ep mapping","description":"High-resolution gastric electrophysiology mapping with simultaneous patient-symptom profiling, with interpretation and report","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74280","name":"X-ray xm colon 2cntrst std","description":"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administered","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7939","name":"Indexing for osteotomy","description":"Indexing for osteotomy","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50548","name":"Laparo remove w/ureter","description":"Laparoscopy, surgical; nephrectomy with total ureterectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1536.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58546","name":"Laparo-myomectomy complex","description":"Laparoscopy, surgical, myomectomy, excision; 5 or more intramural myomas and/or intramural myomas with total weight greater than 250 g","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1343.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97552","name":"Group caregiver training","description":"Group caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0785T","name":"Revj/rmvl nea spi w/nstim","description":"Revision or removal of neurostimulator electrode array, spinal, with integrated neurostimulator","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1503","name":"Vascular surgery mvp","description":"Vascular surgery mips value pathway","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0184","name":"Inj, amisulpride, 1 mg","description":"Injection, amisulpride, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2393","name":"Post 3 srfc resinbased cmpst","description":"Resin-based composite - three surfaces posterior","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90593","name":"Chikungunya vacc recomb im","description":"Chikungunya virus vaccine, recombinant, for intramuscular use","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0466","name":"Home vent non-invasive inter","description":"Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81449","name":"So neo gsap 5-50 rna alys","description":"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; rna analysis","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0421U","name":"Onc clrct scr sgl amp 8 rna","description":"Onc clrct scr sgl amp 8 rna","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2026","name":"Restrata minimatrix, 5 mg","description":"Restrata minimatrix, 5 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36420","name":"Venipuncture cutdown < 1 yr","description":"Venipuncture, cutdown; younger than age 1 year","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0668","name":"Instill, bupivac and meloxic","description":"Instillation, bupivacaine and meloxicam, 1 mg/0.03 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0371U","name":"Iadna gu pthgn semiq dna16&1","description":"Iadna gu pthgn semiq dna16&1","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20600","name":"Drain/inj joint/bursa w/o us","description":"Arthrocentesis, aspiration and/or injection, small joint or bursa (eg, fingers, toes); without ultrasound guidance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":65.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":19.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52443","name":"Cysto 1st trurl prst8 comis","description":"Cystourethroscopy with initial transurethral anterior prostate commissurotomy with a nondrug-coated balloon catheter followed by therapeutic drug delivery into the prostate by a drug-coated balloon catheter, including transrectal ultrasound and fluoroscopy, when performed","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76393","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":664.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1293","name":"Calc bmi abv up param f/u","description":"Bmi is documented above normal parameters and a follow-up plan is documented","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0943T","name":"Cysto flx rmvl urtl scaffold","description":"Cystourethroscopy, flexible; with removal of prostatic urethral scaffold","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6081","name":"Scale & debride, single imp","description":"Scale & debride, single imp","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0155","name":"Dronabinol (syndros) 0.1 mg","description":"Dronabinol (syndros), 0.1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0155","name":"Dronabinol (syndros) 0.1 mg","description":"Dronabinol (syndros), 0.1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4380","name":"Advograft one per sq cm","description":"Advograft one, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1290","name":"Pt not eli d/t act dig htn","description":"Patient not eligible due to active diagnosis of hypertension","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86688","name":"Htlv-ii antibody","description":"Antibody; htlv-ii","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0660","name":"Team remote e/m new pt 10 mn","description":"Team remote e/m new pt 10mins","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1386","name":"Exc sx melmn or mlnm is","description":"Patients with an excisional surgery for melanoma or melanoma in situ in the past 5 years with an initial ajcc staging of 0, i, or ii at the start of the performance period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27509","name":"Treatment of thigh fracture","description":"Percutaneous skeletal fixation of femoral fracture, distal end, medial or lateral condyle, or supracondylar or transcondylar, with or without intercondylar extension, or distal femoral epiphyseal separation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44401","name":"Colonoscopy with ablation","description":"Colonoscopy through stoma; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre-and post-dilation and guide wire passage, when performed)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3038.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":239.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92137","name":"Cptrz oph img pst sg rta oct","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), posterior segment, with interpretation and report, unilateral or bilateral; retina, including oct angiography","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01941","name":"Anes neuromd/ntrvrt crv/thrc","description":"Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64657","name":"Rmvl bat modulj sys tot sys","description":"Removal of baroreflex activation therapy (bat) modulation system; total system, including lead and pulse generator","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0539","name":"Initial care training 30 m","description":"Caregiver training in behavior management/modification for caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face; initial 30 minutes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54800","name":"Biopsy of epididymis","description":"Biopsy of epididymis, needle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83885","name":"Assay of nickel","description":"Nickel","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2401","name":"Chloroprocaine hcl injection","description":"Injection, chloroprocaine hydrochloride, per 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0289U","name":"Neuro alzheimer mrna 24 gen","description":"Neuro alzheimer mrna 24 gen","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93278","name":"Ecg/signal-averaged","description":"Signal-averaged electrocardiography (saecg), with or without ecg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1404","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94012","name":"Spirmtry w/brnchdil inf-2 yr","description":"Measurement of spirometric forced expiratory flows, before and after bronchodilator, in an infant or child through 2 years of age","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0136","name":"Adm of pa/n assess 5-15 m","description":"Administration of a standardized, evidence-based assessment of physical activity and nutrition, 5-15 minutes, not more often than every 6 months","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0414","name":"Lab process microbial spec","description":"Lab process microbial spec","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58554","name":"Laparo-vag hyst w/t/o compl","description":"Laparoscopy, surgical, with vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1532.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1498","name":"Diagnostic radiology mvp","description":"Diagnostic radiology mips value pathway","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34702","name":"Evasc rpr a-ao ndgft rpt","description":"Endovascular repair of infrarenal aorta by deployment of an aorto-aortic tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the aorta from the level ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1758.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4252","name":"Vendaje, per square centimet","description":"Vendaje, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66150","name":"Glaucoma surgery","description":"Fistulization of sclera for glaucoma; trephination with iridectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":815.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0843T","name":"Dgtz gls mcrscp cslt cyt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), initial site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26725","name":"Treat finger fracture each","description":"Closed treatment of phalangeal shaft fracture, proximal or middle phalanx, finger or thumb; with manipulation, with or without skin or skeletal traction, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87220","name":"Tissue exam for fungi","description":"Tissue examination by koh slide of samples from skin, hair, or nails for fungi or ectoparasite ova or mites (eg, scabies)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0332U","name":"Onc pan tum gen prflg 8 dna","description":"Onc pan tum gen prflg 8 dna","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1266","name":"Pts admit snf","description":"Patients admitted to a skilled nursing facility (snf)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4340","name":"Simpligraft, per sq cm","description":"Simpligraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7521","name":"Incision/drain abscess extra","description":"Incision and drainage of abscess - extraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0437U","name":"Psyc anxiety do mrna 15 bmrk","description":"Psyc anxiety do mrna 15 bmrk","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4540","name":"Trans elec nerv periph nerv","description":"Distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5145","name":"Inj, abrilada, 1 mg","description":"Injection, adalimumab-afzb (abrilada), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76857","name":"Us exam pelvic limited","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87153","name":"Dna/rna sequencing","description":"Culture, typing; identification by nucleic acid sequencing method, each isolate (eg, sequencing of the 16s rrna gene)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0405","name":"Ekg interpret & report preve","description":"Electrocardiogram, routine ecg with 12 leads; interpretation and report only, performed as a screening for the initial preventive physical examination","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9296","name":"Inj pemetrexed (accord) 10mg","description":"Injection, pemetrexed (accord), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85651","name":"Rbc sed rate nonautomated","description":"Sedimentation rate, erythrocyte; non-automated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4019","name":"Oncology/hema ss","description":"Oncology/hematology mips specialty set","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1321","name":"Pts no 7wk inj,no iop,iop>25","description":"Patients who were not seen within 7 weeks following the date of injection for follow up or who did not have a documented iop or no plan of care documented if the iop was >25 mm hg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0765T","name":"Asstv alg ecg rsk asmt prev","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to previously performed electrocardiogram","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77439","name":"Surf rad thr img gdn us plmt","description":"Surface radiation therapy; superficial or orthovoltage, image guidance, ultrasound for placement of radiation therapy fields for treatment of cutaneous tumors, per course of treatment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1481","name":"Pt in hosp/pal care who died","description":"Patients receiving hospice or palliative care or who died during the measurement period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0861T","name":"Rmvl pg wcs lv both compnt","description":"Removal of pulse generator for wireless cardiac stimulator for left ventricular pacing; both components (battery and transmitter)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0546","name":"Phone/internet ehr assess","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty   whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patien","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2393","name":"Post 3 srfc resinbased cmpst","description":"Resin-based composite - three surfaces posterior","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49618","name":"Rpr aa hrn rcr > 10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, incarcerated or strangulate","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0699T","name":"Njx pst chmbr eye medication","description":"Injection, posterior chamber of eye, medication","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48001","name":"Placement of drain pancreas","description":"Placement of drains, peripancreatic, for acute pancreatitis; with cholecystostomy, gastrostomy, and jejunostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2398.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0891","name":"Argatroban nonesrd (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91321","name":"Sarscov2 vac 25 mcg/.25ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 25 mcg/0.25 ml dosage, for intramuscular use","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4392","name":"Grafix duo per sq cm","description":"Grafix duo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33211","name":"Insert card electrodes dual","description":"Insertion or replacement of temporary transvenous dual chamber pacing electrodes (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97552","name":"Group caregiver training","description":"Group caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0666","name":"Team remote e/m est pt 15 mn","description":"Team remote e/m est. pt 15mins","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52284","name":"Cysto rx balo cath urtl strx","description":"Cystourethroscopy, with mechanical urethral dilation and urethral therapeutic drug delivery by drug-coated balloon catheter for urethral stricture or stenosis, male, including fluoroscopy, when performed","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99480","name":"Sbsq ic inf pbw 2,501-5,000","description":"Subsequent intensive care, per day, for the evaluation and management of the recovering infant (present body weight of 2,501-5,000 grams)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9381","name":"Inj teplizumab mzwv 5 mcg","description":"Injection, teplizumab-mzwv, 5 mcg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4308","name":"Sanopellis, per sq cm","description":"Sanopellis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4439","name":"Instagraft per sq cm","description":"Instagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15756","name":"Free myo/skin flap microvasc","description":"Free muscle or myocutaneous flap with microvascular anastomosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2708.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1385","name":"Pt rsn not seen 2nd pam","description":"Documentation of patient reasons for patients who were not seen for the second pam survey (e.g., less than four months between baseline pam assessment and follow-up","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9323","name":"Inj pemetrexed ditromethamin","description":"Injection, pemetrexed ditromethamine, 10 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0549","name":"Phone/inter for treat>31m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0967T","name":"Tranal ins tmp clrc anst dev","description":"Transanal insertion of endoluminal temporary colorectal anastomosis protection device, including vacuum anchoring component and flexible sheath connected to external vacuum source and monitoring system","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0736","name":"Inj, clindamycin phosp 300mg","description":"Injection, clindamycin phosphate, 300 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37277","name":"Rvsc evsc fpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0411","name":"Hba1c in office testing","description":"Hba1c in office testing","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1442","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0537","name":"Risk ascvd tst once pr 12 mo","description":"Administration of a standardized, evidence-based atherosclerotic cardiovascular disease (ascvd) risk assessment, 5-15 minutes, not more often than every 12 months","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21386","name":"Opn tx orbit fx periorbital","description":"Open treatment of orbital floor blowout fracture; periorbital approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2471","name":"Inj pantoprazole(hikma) 40mg","description":"Injection, pantoprazole (hikma), not therapeutically equivalent to j2470, 40 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37283","name":"Rvsc evsc tpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31368","name":"Partial removal of larynx","description":"Laryngectomy; subtotal supraglottic, with radical neck dissection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2460.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1352","name":"Suicd c-ssrs assessment, equ","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs or equivalent assessment","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37295","name":"Rvsc evsc tpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36837","name":"Prq av fstl crt uxtr sep acs","description":"Percutaneous arteriovenous fistula creation, upper extremity, separate access sites of the peripheral artery and peripheral vein, including fistula maturation procedures (eg, transluminal balloon angioplasty, coil embolization) when performed, including all vascular access, imaging guidance and radi","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0738","name":"Hiv prep, inj, lenacapavir","description":"Injection, lenacapavir, 1 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4380","name":"Advograft one per sq cm","description":"Advograft one, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0949T","name":"Rem interrog dev ccm tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37265","name":"Revsc evsc fpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0971T","name":"Ablt mal brst tum pq lsr uni","description":"Ablation, malignant breast tumor(s), percutaneous, laser, including imaging guidance when performed, unilateral","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20690","name":"Appl unipln uni ext fixj sys","description":"Application of a uniplane (pins or wires in 1 plane), unilateral, external fixation system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0292U","name":"Psyc strs do mrna 72 genes","description":"Psyc strs do mrna 72 genes","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7042","name":"5% dextrose/normal saline","description":"5% dextrose/normal saline (500 ml = 1 unit)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0929T","name":"Rem interrog dev ccm-d tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0605","name":"Antibody test pub hlth path","description":"Antibody test pub hlth path","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43290","name":"Egd flx trnsorl dplmnt balo","description":"Esophagogastroduodenoscopy, flexible, transoral; with deployment of intragastric bariatric balloon","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45390","name":"Colonoscopy w/resection","description":"Colonoscopy, flexible; with endoscopic mucosal resection","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1448","name":"Pt dx pd bef end meas pd","description":"Patients with an active diagnosis of personality disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0268","name":"Removal of impacted wax md","description":"Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1481","name":"Pt in hosp/pal care who died","description":"Patients receiving hospice or palliative care or who died during the measurement period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5149","name":"Inj, aflibercept-abzv, 1 mg","description":"Injection, aflibercept-abzv (enzeevu), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4370","name":"Aeroguard per sq cm","description":"Aeroguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92639","name":"Hearing aid meas verif","description":"Hearing-aid measurement, verification with probe-microphone (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6034","name":"Part hand finger distal amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s)/thumb, amputation at distal to metacarpal joint, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l669","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":353.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0654","name":"Inj, liothyronine, 1 mcg","description":"Injection, liothyronine, 1 mcg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4271","name":"Home lancing/test cartridges","description":"Integrated lancing and blood sample testing cartridges for home blood glucose monitor, per 50 tests","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2045","name":"Novashield/novogen pr sq cm","description":"Novashield or novogen wound matrix, per square centimeter","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0545U","name":"Achr antb id imfluor livecll","description":"Achr antb id imfluor livecll","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1007T","name":"Eeg impl s-sclp eeg w/o vid","description":"Electroencephalogram from implanted sub-scalp continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75662","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":748.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4307","name":"American amnion, per sq cm","description":"American amnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0795T","name":"Tcat ins 2chmbr ldls pm cmpl","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; complete system (ie, r","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0388","name":"Bitewing image capture only","description":"Bitewing image capture only","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3501","name":"Surg exp root surf anterior","description":"Surg exp root surf anterior","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33464","name":"Valvuloplasty tricuspid","description":"Valvuloplasty, tricuspid valve; with ring insertion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2012.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6604","name":"Cst bse mtl inlay 2 surfaces","description":"Inlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0532","name":"Take home supp nasal spray","description":"Take-home supply of nasal nalmefene hydrochloride; one carton of two, 2.7 mg per 0.1 ml nasal sprays (provision of the services by a medicare-enrolled opioid treatment program);( list separately in addition to each primary code)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87494","name":"Chlmy trch&neisra gonor mult","description":"Infectious agent detection by nucleic acid (dna or rna); chlamydia trachomatis and neisseria gonorrhoeae, multiplex amplified probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0735T","name":"Prep tum cav iort prim crnot","description":"Preparation of tumor cavity, with placement of a radiation therapy applicator for intraoperative radiation therapy (iort) concurrent with primary craniotomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0907T","name":"Coms ther ea addl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; each additional application, total wound(s) surface area less than or equal to 50 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0137","name":"Inten outpt svs,min 9 pr 7 d","description":"Intensive outpatient services; weekly bundle, minimum of 9 services over a 7 contiguous day period, which can include individual and group therapy with physicians or psychologists (or other mental health professionals to the extent authorized under state law); occupational therapy requiring the skil","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49189","name":"Opn exc/dst ntra-abd 20.1-30","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 20.1 to 30 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":1239.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1392","name":"Pt rsn no exm or lst to fu","description":"Documentation of patient reasons for no examination, i.e., refusal of examination or lost to follow-up (documentation must include information that the clinician was unable to reach the patient by phone, mail or secure electronic mail - at least one method must be documented)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49617","name":"Rpr aa hrn rcr > 10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, reducible","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1247","name":"Pt resp true best int","description":"Patient responded completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6072","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (high noble metal)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2919","name":"Inj, methylpred sod succ 5mg","description":"Injection, methylprednisolone sodium succinate, 5 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78306","name":"Bone imaging whole body","description":"Bone and/or joint imaging; whole body","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93587","name":"Vngrph chd vnvn cltrl at/abv","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating at or above the heart (eg, from innominate vein) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86703","name":"Hiv-1/hiv-2 1 result antbdy","description":"Antibody; hiv-1 and hiv-2, single result","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99214","name":"Office o/p est mod 30 min","description":"Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":153.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2044","name":"Biobrane glove, each","description":"Biobrane glove, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4280","name":"Xcell amnio matrix per sq cm","description":"Xcell amnio matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92137","name":"Cptrz oph img pst sg rta oct","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), posterior segment, with interpretation and report, unilateral or bilateral; retina, including oct angiography","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27365","name":"Resect femur/knee tumor","description":"Radical resection of tumor, femur or knee","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1397.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4310","name":"Procenta, per 100 mg","description":"Procenta, per 100 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33509","name":"Ndsc hrv uxtr art 1 sgm cab","description":"Harvest of upper extremity artery, 1 segment, for coronary artery bypass procedure, endoscopic","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1006T","name":"Elec alys s-scl eeg prgrm ea","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, each additional 15 minutes face-to-face time with physician or other qua","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1470","name":"Hep b vac not recd med rsn","description":"Documentation of medical reason(s) for not administering hepatitis b vaccine (e.g., prior anaphylaxis due to the hepatitis b vaccine)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0856T","name":"Dgtz gls mcrscp electron mic","description":"Digitization of glass microscope slides for electron microscopy, diagnostic (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1464","name":"No record of f/u by 180 days","description":"No documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0762T","name":"Dgtz gls mcrscp sl imm ea m","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, each multiplex antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1206","name":"Isa not red 3pts/no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q9952","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7521","name":"Incision/drain abscess extra","description":"Incision and drainage of abscess - extraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1361","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1449","name":"Pt dx scz/pys bef end msr pd","description":"Patients with an active diagnosis of schizophrenia or psychotic disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55877","name":"Abltj ire prst8 1+ tum perq","description":"Ablation, irreversible electroporation, prostate, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0976T","name":"Slctv nzmtc dbrdmt s/n/hf ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; each additional 100 sq cm (list separately in addition to code for p","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77436","name":"Surf radj ther tx planning","description":"Surface radiation therapy; superficial or orthovoltage, treatment planning and simulation-aided field setting","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4258","name":"Enverse, per sq cm","description":"Enverse, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0286U","name":"Cep72 nudt15&tpmt gene alys","description":"Cep72 nudt15&tpmt gene alys","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4318","name":"E-graft, per sq cm","description":"E-graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0421U","name":"Onc clrct scr sgl amp 8 rna","description":"Onc clrct scr sgl amp 8 rna","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0681T","name":"Rlcj pulse gen only isdss","description":"Relocation of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing dual leads","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2041","name":"Foundation drs+ duo pr sq cm","description":"Foundation drs+ duo, per square centimeter","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2472","name":"Inj, pantoprazole sodium chl","description":"Injection, pantoprazole sodium in sodium chloride (baxter), 40 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5134","name":"Inj, tyruko, 1 mg","description":"Injection, natalizumab-sztn (tyruko), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0774T","name":"Vr px dissoc svc oth phy ea","description":"Virtual reality (vr) procedural dissociation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports; each additiona","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1318","name":"Pts no csp doc contact","description":"Patients who did not have documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening or documentation that there was no contact with a csp","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1462","name":"Pt clin ind hd image","description":"Patients with clinical indications for imaging of the head","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81515","name":"Nfct ds bv&vaginitis dna alg","description":"Infectious disease, bacterial vaginosis and vaginitis, real-time pcr amplification of dna markers for atopobium vaginae, atopobium species, megasphaera type 1, and bacterial vaginosis associated bacteria-2 (bvab-2), utilizing vaginal-fluid specimens, algorithm reported as positive or negative for hi","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85250","name":"Clot factor ix ptc/chrstmas","description":"Clotting; factor ix (ptc or christmas)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0589U","name":"Pfas24cmpnd hi-perf lc-ms/ms","description":"Pfas24cmpnd hi-perf lc-ms/ms","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0238","name":"Inj, tocilizumab-aazg, hospi","description":"Injection, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0558","name":"Adv prim care mgmt lvl 3","description":"Advanced primary care management services for a patient that is a qualified medicare beneficiary with multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, which place the patient at significant risk of death, acute exacerbation/decompensat","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1781","name":"Vac admin human pap dose 1","description":"Vac admin human pap dose 1","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90968","name":"Esrd svc pr day pt 2-11","description":"End-stage renal disease (esrd) related services for dialysis less than a full month of service, per day; for patients 2-11 years of age","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0422","name":"Collect & prep genetic samp","description":"Collect & prep genetic samp","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1165","name":"Phenytoin sodium injection","description":"Injection, phenytoin sodium, per 50 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70546","name":"Mr angiograph head w/o&w/dye","description":"Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1221.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0558","name":"Adv prim care mgmt lvl 3","description":"Advanced primary care management services for a patient that is a qualified medicare beneficiary with multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, which place the patient at significant risk of death, acute exacerbation/decompensat","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76101","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22114","name":"Remove part lumbar vertebra","description":"Partial excision of vertebral body, for intrinsic bony lesion, without decompression of spinal cord or nerve root(s), single vertebral segment; lumbar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1126.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9888","name":"5% wl maintnd from bsline wt","description":"Maintenance 5% wl from baseline weight in months 7-12","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0810T","name":"Subrta njx rx agt w/vtrc","description":"Subretinal injection of a pharmacologic agent, including vitrectomy and 1 or more retinotomies","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23515","name":"Optx clavicular fx w/int fix","description":"Open treatment of clavicular fracture, includes internal fixation, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1598","name":"Inj glycopyrrolate fres kabi","description":"Injection, glycopyrrolate (fresenius kabi), not therapeutically equivalent to j1596, 0.1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99459","name":"Pelvic examination","description":"Pelvic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0138","name":"Iv cipaglucosidase alfa-atga","description":"Intravenous infusion of cipaglucosidase alfa-atga, including provider/supplier acquisition and clinical supervision of oral administration of miglustat in preparation of receipt of cipaglucosidase alfa-atga","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0687","name":"Inj cefazolin (wg crit care)","description":"Injection, cefazolin sodium (wg critical care), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49596","name":"Rpr aa hrn 1st > 10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85032","name":"Manual cell count each","description":"Blood count; manual cell count (erythrocyte, leukocyte, or platelet) each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3911","name":"Intraorifice barrier","description":"Intraorifice barrier","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49595","name":"Rpr aa hrn 1st > 10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, reducible","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64474","name":"Lwr xtr fscl pln blk uni nfs","description":"Lower extremity fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36246","name":"Ins cath abd/l-ext art 2nd","description":"Selective catheter placement, arterial system; initial second order abdominal, pelvic, or lower extremity artery branch, within a vascular family","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0365U","name":"Onc bldr 10 prb bldr ca","description":"Onc bldr 10 prb bldr ca","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1001T","name":"Autol musc cell therapy njx","description":"Autologous muscle cell therapy, injection of muscle progenitor cells into the external anal sphincter, including ultrasound guidance, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0597U","name":"Onc breast rna xprsn 329gens","description":"Onc breast rna xprsn 329gens","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9939","name":"Placemnt removable appliance","description":"Placemnt removable appliance","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8541","name":"Oral, hemady, 0.25 mg","description":"Dexamethasone (hemady), oral, 0.25 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9255","name":"Inj, methotrexate (accord)","description":"Injection, methotrexate (accord), not therapeutically equivalent to j9260, 50 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9612","name":"Thera par drugs 2 or > admin","description":"Therapeutic parenteral drugs two or more administrations different medications","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4323","name":"Splint extra-coronal","description":"Splint extra-coronal","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0255U","name":"Andrology infertility assmt","description":"Andrology (infertility), sperm-capacitation assessment of ganglioside gm1 distribution patterns, fluorescence microscopy, fresh or frozen specimen, reported as percentage of capacitated sperm and probability of generating a pregnancy score","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86850","name":"Rbc antibody screen","description":"Antibody screen, rbc, each serum technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93896","name":"Vsrctv std tcd icr art compl","description":"Vasoreactivity study performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26530","name":"Revise knuckle joint","description":"Arthroplasty, metacarpophalangeal joint; each joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":632.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59614","name":"Vbac care after delivery","description":"Vaginal delivery only, after previous cesarean delivery (with or without episiotomy and/or forceps); including postpartum care","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1329.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55711","name":"Bx prst8 trct mri-us 1st","description":"Biopsy, prostate, transrectal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3299","name":"Inj xipere 1 mg","description":"Injection, triamcinolone acetonide (xipere), 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25491","name":"Prophylactic tx ulna","description":"Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate; ulna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0286U","name":"Cep72 nudt15&tpmt gene alys","description":"Cep72 nudt15&tpmt gene alys","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1431","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1611","name":"Inj glucagon hcl, fresenius","description":"Injection, glucagon hydrochloride (fresenius kabi), not therapeutically equivalent to j1610, per 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1216","name":"No spiro doc no res doc","description":"No spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and/or no spirometry performed with results documented during the encounter","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1386","name":"Exc sx melmn or mlnm is","description":"Patients with an excisional surgery for melanoma or melanoma in situ in the past 5 years with an initial ajcc staging of 0, i, or ii at the start of the performance period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1469","name":"Hx of hep b, or pos bld test","description":"Patient has a history of hepatitis b illness or received a hepatitis b surface antigen, hepatitis b surface antibody, or total antibody to hepatitis b core antigen test with a positive result any time before or during the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1032","name":"Sv doula brth wrk per 15 min","description":"Services performed by a doula birth worker, per 15 minutes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0052","name":"Mmip mental health and care","description":"Missing and murdered indigenous persons (mmip) mental health and clinical care","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2016","name":"Permeaderm b, per sq cm","description":"Permeaderm b, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0314U","name":"Onc cutan mlnma mrna 35 gene","description":"Onc cutan mlnma mrna 35 gene","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98984","name":"Rtm dev sply resp sys 2-15 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of respiratory system, 2-15 days in a 30-day period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26591","name":"Repair muscles of hand","description":"Repair, intrinsic muscles of hand, each muscle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":623.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1238","name":"Doc 2nd recom hzv 2-6 mo int","description":"Documentation that administration of second recombinant zoster vaccine could not occur during the performance period due to the recommended 2-6 month interval between doses (i.e, first dose received after october 31)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0019M","name":"Cv ds plasma alys prtn bmrk","description":"Cardiovascular disease, plasma, analysis of protein biomarkers by aptamer-based microarray and algorithm reported as 4-year likelihood of coronary event in high-risk populations","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9607","name":"Lutetium lu 177 vipivotide","description":"Lutetium lu 177 vipivotide tetraxetan, therapeutic, 1 millicurie","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9073","name":"Inj cyclophos dr reddys 5 mg","description":"Injection, cyclophosphamide (dr. reddys), 5 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2794","name":"Crown-titanium","description":"Crown-titanium","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64597","name":"Ins/rplcm prq eltrd ra pn ea","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; each additional electrode array (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q0224","name":"Inj, pemivibart, 4500 mg","description":"Injection, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, and who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppressive ","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82009","name":"Ketone bodys qual","description":"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); qualitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1268","name":"Pt ac stat kid trnsplt wtlst","description":"Patients observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5127","name":"Inj, stimufend, 0.5 mg","description":"Injection, pegfilgrastim-fpgk (stimufend), biosimilar, 0.5 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0521","name":"Supply fee hiv prep fda appr","description":"Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4303","name":"Complete aa, per sq cm","description":"Complete aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0705","name":"Extra oral post radio image","description":"Extra oral post radio image","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4032","name":"Rheumatology ss","description":"Rheumatology mips specialty set","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0260U","name":"Rare ds id opt genome mapg","description":"Rare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6074","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (noble metal)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31253","name":"Nsl/sins ndsc total","description":"Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior), including frontal sinus exploration, with removal of tissue from frontal sinus, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":473.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6106","name":"Tissue regen resorbable","description":"Tissue regen resorbable","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99235","name":"Hosp ip/obs same date mod 70","description":"Hospital inpatient or observation care, for the evaluation and management of a patient including admission and discharge on the same date, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encount","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":66.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98008","name":"Synch audio-only new sf 15","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code sel","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64597","name":"Ins/rplcm prq eltrd ra pn ea","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; each additional electrode array (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25448","name":"Arthrp ntrcrpl/crp/mtcrp ssp","description":"Arthroplasty, intercarpal or carpometacarpal joints; suspension, including transfer or transplant of tendon, with interposition, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0783T","name":"Tc auriculr neurostimulation","description":"Transcutaneous auricular neurostimulation, set-up, calibration, and patient education on use of equipment","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1215","name":"Med rsn for no doc spiro","description":"Documentation of medical reason(s) for not documenting and reviewing spirometry results (e.g., patients with dementia or tracheostomy)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1354","name":"Pt no suicd saf pln 120dy","description":"Patients who did not have a suicide safety plan initiated, reviewed, or updated or reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93596","name":"R&l hrt cath chd nml nt cnj","description":"Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); normal native connections","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15430","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6091","name":"Repl semi/precision attach","description":"Replacement of semi-precision or precision attachment (male or female component) of implant/abutment supported prosthesis per attachment","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0427U","name":"Monocyte dstrbj wdth whl bld","description":"Monocyte dstrbj wdth whl bld","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90840","name":"Psytx crisis ea addl 30 min","description":"Psychotherapy for crisis; each additional 30 minutes (list separately in addition to code for primary service)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":84.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9912","name":"Pre-visit patient screening","description":"Pre-visit patient screening","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12004","name":"Rpr s/n/ax/gen/trk7.6-12.5cm","description":"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 7.6 cm to 12.5 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":194.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":62.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0599U","name":"Onc pncrtc ca mult ia serum","description":"Onc pncrtc ca mult ia serum","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4008","name":"Geriatrics ss","description":"Geriatrics mips specialty set","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6559","name":"G stckng full/chap18-30 cust","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90947","name":"Dialysis repeated eval","description":"Dialysis procedure other than hemodialysis (eg, peritoneal dialysis, hemofiltration, or other continuous renal replacement therapies) requiring repeated evaluations by a physician or other qualified health care professional, with or without substantial revision of dialysis prescription","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27393","name":"Lengthening of thigh tendon","description":"Lengthening of hamstring tendon; single tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":607.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0487U","name":"Onc sol tum cfcdna tgsap 84","description":"Onc sol tum cfcdna tgsap 84","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4327","name":"Duoamnion, per sq cm","description":"Duoamnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1197","name":"Isa reduced >=3 fr ixv","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1430","name":"Ret exm ou no retinopthy doc","description":"Retinal exam finding without evidence of retinopathy in both eyes with severity level documented (in measurement year or in the prior year)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0652","name":"Inj, levothyroxine, hikma","description":"Injection, levothyroxine sodium (hikma), not therapeutically equivalent to j0650, 10 mcg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83921","name":"Organic acid single quant","description":"Organic acid, single, quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4308","name":"Sanopellis, per sq cm","description":"Sanopellis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0318U","name":"Ped whl gen mthyltn alys 50+","description":"Ped whl gen mthyltn alys 50+","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1023T","name":"Prq tis dsplmt intrathoracic","description":"Percutaneous tissue displacement, any method, including imaging guidance; intrathoracic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87493","name":"C diff amplified probe","description":"Infectious agent detection by nucleic acid (dna or rna); clostridium difficile, toxin gene(s), amplified probe technique","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6564","name":"G com stckng waist 40+ cust","description":"Gradient compression stocking, waist length, 40 mmhg or greater, custom, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32555","name":"Aspirate pleura w/ imaging","description":"Thoracentesis, needle or catheter, aspiration of the pleural space; with imaging guidance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":717.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0950T","name":"Abltj b9 prst8 tissue hifu","description":"Ablation of benign prostate tissue, transrectal, with high intensity-focused ultrasound (hifu), including ultrasound guidance","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93145","name":"Interrog crtd sins bat ip wo","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69700","name":"Close mastoid fistula","description":"Closure postauricular fistula, mastoid (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":818.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27532","name":"Treat knee fracture","description":"Closed treatment of tibial fracture, proximal (plateau); with or without manipulation, with skeletal traction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":686.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2033","name":"Myriad morcells, 4 mg","description":"Myriad morcells, 4 milligrams","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4347","name":"Rampart dl matrix per sq cm","description":"Rampart dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0882T","name":"Intraop ther estim pn ue 1st","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; initial nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2246","name":"Inj, micafungin (baxter)","description":"Injection, micafungin in sodium (baxter), not therapeutically equivalent to j2248, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0805T","name":"Tcat s&ivc prstc vl impl prq","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); percutaneous femoral vein approach","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56637","name":"Vlvctmy rad comp bi lymphad","description":"Vulvectomy, radical, complete; with bilateral inguinofemoral lymphadenectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1583.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23675","name":"Cltx sho dislc neck fx mnpj","description":"Closed treatment of shoulder dislocation, with surgical or anatomical neck fracture, with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":587.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95869","name":"Ndl emg thrc paraspinal musc","description":"Needle electromyography; thoracic paraspinal muscles (excluding t1 or t12)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0790T","name":"Revj rplcmt/rmvl vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracolumbar or lumbar vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67400","name":"Explore/biopsy eye socket","description":"Orbitotomy without bone flap (frontal or transconjunctival approach); for exploration, with or without biopsy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1163","name":"Pt anphx due to hpv bef 13","description":"Patient had anaphylaxis due to the hpv vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0746T","name":"Car ablt rad arr cnv loc map","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; conversion of arrhythmia localization and mapping of arrhythmia site (nidus) into a multidimensional radiation treatment plan","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4318","name":"E-graft, per sq cm","description":"E-graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0942T","name":"Cysto flx rmv&rplc urtl scaf","description":"Cystourethroscopy, flexible; with removal and replacement of prostatic urethral scaffold","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0543U","name":"Onc sol tum ngs dna 517 gens","description":"Onc sol tum ngs dna 517 gens","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0680T","name":"Insj/rplcmt pg only isdss","description":"Insertion or replacement of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing lead(s)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4275","name":"Esano aca, per sq cm","description":"Esano aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1489","name":"Pt status doc","description":"Patient status documented","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87594","name":"Pneumcysts jirovecii amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); pneumocystis jirovecii, amplified probe technique","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49189","name":"Opn exc/dst ntra-abd 20.1-30","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 20.1 to 30 cm","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7771","name":"Alveolus clsd reduc stblz te","description":"Alveolus closed reduction stabilization of teeth","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0462U","name":"Melatonin lvl tst slp std7/9","description":"Melatonin lvl tst slp std7/9","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0259U","name":"Neph ckd nuc mrs meas gfr","description":"Nephrology (chronic kidney disease), nuclear magnetic resonance spectroscopy measurement of myo-inositol, valine, and creatinine, algorithmically combined with cystatin c (by immunoassay) and demographic data to determine estimated glomerular filtration rate (gfr), serum, quantitative","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47500","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"Home vent dual fnct incl all","description":"Home ventilator, dual-function respiratory device, also performs additional function of cough stimulation, includes all accessories, components and supplies for all functions","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0856T","name":"Dgtz gls mcrscp electron mic","description":"Digitization of glass microscope slides for electron microscopy, diagnostic (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64582","name":"Opn mpltj hpglsl nstm ary pg","description":"Open implantation of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0889T","name":"Prsnlz trgt dvl arhfcmrigtbs","description":"Personalized target development for accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation derived from a structural and resting-state functional mri, including data preparation and transmission, generation of the target, motor threshold-starting location, neuro","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1393","name":"Pr no dx rec mlnm","description":"Patients who were not diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1427","name":"Doc med rsn bone scn","description":"Documentation of medical reason(s) for performing a bone scan (including documented pain related to prostate cancer, salvage therapy, other medical reasons)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58976","name":"Transfer of embryo","description":"Gamete, zygote, or embryo intrafallopian transfer, any method","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99295","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1077.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2777","name":"Inj, faricimab-svoa, 0.1mg","description":"Injection, faricimab-svoa, 0.1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59020","name":"Fetal contract stress test","description":"Fetal contraction stress test","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0956T","name":"Prt crn ch cr&tun elt s-sclp","description":"Partial craniectomy, channel creation, and tunneling of electrode for sub-scalp implantation of an electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0974T","name":"Slctv nzmtc dbrdmt t/a/l ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; each additional 100 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1397","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0571U","name":"Onc sol tum dna80&rna10g ngs","description":"Onc sol tum dna80&rna10g ngs","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0404","name":"Ekg tracing for initial prev","description":"Electrocardiogram, routine ecg with 12 leads; tracing only, without interpretation and report, performed as a screening for the initial preventive physical examination","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0945T","name":"Intraop assmt abnl tum tiss","description":"Intraoperative assessment for abnormal (tumor) tissue, in-vivo, following partial mastectomy (eg, lumpectomy) using computer-aided fluorescence imaging (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1330","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0962T","name":"Asstv alg alys acous&ecg rec","description":"Assistive algorithmic analysis of acoustic and electrocardiogram recording for detection of cardiac dysfunction (eg, reduced ejection fraction, cardiac murmurs, atrial fibrillation), with review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1414","name":"Med rsn no pdl1 bef 1st ther","description":"Documentation of medical reason(s) for not performing the pd-l1 biomarker expression test prior to initiation of first-line immune checkpoint inhibitor therapy (e.g., patient is in an urgent or emergent situation where delay of treatment would jeopardize the patients health status; other medical rea","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0113","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21175","name":"Rcnst bfrnt sp orb rm&lw fhd","description":"Reconstruction, bifrontal, superior-lateral orbital rims and lower forehead, advancement or alteration (eg, plagiocephaly, trigonocephaly, brachycephaly), with or without grafts (includes obtaining autografts)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2508.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97551","name":"Caregiver traing ea addl 15","description":"Caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patie","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9888","name":"5% wl maintnd from bsline wt","description":"Maintenance 5% wl from baseline weight in months 7-12","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1261","name":"Pts on wtlist bef dialysis","description":"Patients that were on the kidney or kidney-pancreas waitlist prior to initiation of dialysis","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9955","name":"Oral app thxpy titration vis","description":"Oral app thxpy titration vis","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0684T","name":"Peri-px dev eval isdss ip","description":"Peri-procedural device evaluation (in-person) and programming of device system parameters before or after a surgery, procedure, or test with analysis, review, and report by a physician or other qualified health care professional, permanent implantable synchronized diaphragmatic stimulation system fo","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4294","name":"Amnio quad-core, per sq cm","description":"Amnio quad-core, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43258","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92622","name":"Dx aly aud oi snd prcsr 1st","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; first 60 minutes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9394","name":"Inj, fulvestrant (fresenius)","description":"Injection, fulvestrant (fresenius kabi) not therapeutically equivalent to j9395, 25 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1351","name":"Dental sealant per tooth","description":"Sealant-per tooth","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0371U","name":"Iadna gu pthgn semiq dna16&1","description":"Iadna gu pthgn semiq dna16&1","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0676T","name":"Laps insj nw/rpcmt isdss ea","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional lead (list separately in addition to code for primary ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80503","name":"Path clin consltj sf 5-20","description":"Pathology clinical consultation; for a clinical problem, with limited review of patients history and medical records and straightforward medical decision making when using time for code selection, 5-20 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1952","name":"Leuprolide inj, camcevi, 1mg","description":"Leuprolide injectable, camcevi, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87252","name":"Virus inoculation tissue","description":"Virus isolation; tissue culture inoculation, observation, and presumptive identification by cytopathic effect","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9329","name":"Inj, tislelizumab-jsgr","description":"Injection, tislelizumab-jsgr, 1mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87210","name":"Smear wet mount saline/ink","description":"Smear, primary source with interpretation; wet mount for infectious agents (eg, saline, india ink, koh preps)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1435","name":"Oral chemo in perf pd","description":"Patient on oral chemotherapy during the performance period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9282","name":"Mitomycin intravesical inst","description":"Mitomycin, intravesical instillation, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9607","name":"Lutetium lu 177 vipivotide","description":"Lutetium lu 177 vipivotide tetraxetan, therapeutic, 1 millicurie","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7356","name":"Inj foscarb/foslevodopa 5 mg","description":"Injection, foscarbidopa 0.25 mg/foslevodopa 5 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0987T","name":"Iv img icr cere vsl oct ea","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7957","name":"Tiss regen edent nonresorb","description":"Tiss regen edent nonresorb","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0546U","name":"Ldns lrp4 antb imflr livecll","description":"Ldns lrp4 antb imflr livecll","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0551","name":"Phn/intr svs fr dx treat 30m","description":"Interprofessional telephone/internet/electronic health record referral service(s) provided by a treating/requesting practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, 30 minutes","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82374","name":"Assay blood carbon dioxide","description":"Carbon dioxide (bicarbonate)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0525U","name":"Onc sphrd cell cul 11-rx pnl","description":"Onc sphrd cell cul 11-rx pnl","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0940T","name":"Xtrnl ecg rec>15d<30d r&i","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52443","name":"Cysto 1st trurl prst8 comis","description":"Cystourethroscopy with initial transurethral anterior prostate commissurotomy with a nondrug-coated balloon catheter followed by therapeutic drug delivery into the prostate by a drug-coated balloon catheter, including transrectal ultrasound and fluoroscopy, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1303","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0569U","name":"Onc sol tum ngs tmm>20000dmr","description":"Onc sol tum ngs tmm>20000dmr","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0754T","name":"Dgtz gls mcrscp sld level v","description":"Digitization of glass microscope slides for level v, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19102","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63076","name":"Neck spine disk surgery","description":"Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; cervical, each additional interspace (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31242","name":"Nsl/sinus ndsc rf abltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by radiofrequency ablation, posterior nasal nerve","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49250","name":"Excision of umbilicus","description":"Umbilectomy, omphalectomy, excision of umbilicus (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":611.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64654","name":"1st opn implt bat modulj sys","description":"Initial open implantation of baroreflex activation therapy (bat) modulation system, including lead placement onto the carotid sinus, lead tunnelling, connection to a pulse generator placed in a distant subcutaneous pocket (ie, total system), and intraoperative interrogation and programming","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0512U","name":"Onc prst8 alys dgtz img msi","description":"Onc prst8 alys dgtz img msi","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0621U","name":"Nfct ds lb dna alys>10000","description":"Nfct ds lb dna alys>10000","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4376","name":"Duograft aa per sq cm","description":"Duograft aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0739","name":"Rehab sys active assist rt","description":"Rehabilitation system with interactive interface providing active assistance in rehabilitation therapy, includes all components and accessories, motors, microprocessors, sensors","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0750T","name":"B1 str&fx rsk asmt dxrbmd1vw","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90624","name":"Menb-4c&menacwy vacc im","description":"Meningococcal pentavalent vaccine, men b-4c recombinant proteins and outer membrane vesicle and conjugated men a, c, w, y-diphtheria toxoid carrier, for intramuscular use","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5421","name":"Dentures adjust part maxill","description":"Adjust partial denture - maxillary","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1436","name":"Etidronate disodium inj","description":"Injection, etidronate disodium, per 300 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5765","name":"Liner compl/partial rem dent","description":"Liner compl/partial rem dent","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96380","name":"Admn rsv monoc antb im cnsl","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection, with counseling by physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40530","name":"Partial removal of lip","description":"Resection of lip, more than one-fourth, without reconstruction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":473.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4280","name":"Xcell amnio matrix per sq cm","description":"Xcell amnio matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4366","name":"Dl amnio bur x-mem per sq cm","description":"Dual layer amnio burgeon x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0998T","name":"Precuneus mag stimj tx dlvr","description":"Precuneus magnetic stimulation; personalized treatment delivery of magnetic stimulation therapy to a prespecified target area derived from analysis of evoked potentials within the precuneus, utilizing magnetic resonance imaging-based neuronavigation, with management, per day","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0143","name":"Scr c/v cyto,thinlayer,rescr","description":"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with manual screening and rescreening by cytotechnologist under physician supervision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4297","name":"Emerge matrix, per sq cm","description":"Emerge matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36248","name":"Ins cath abd/l-ext art addl","description":"Selective catheter placement, arterial system; additional second order, third order, and beyond, abdominal, pelvic, or lower extremity artery branch, within a vascular family (list in addition to code for initial second or third order vessel as appropriate)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4032","name":"Rheumatology ss","description":"Rheumatology mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1242","name":"Pt no resp imprt to me","description":"Patient did not respond to the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87110","name":"Chlamydia culture","description":"Culture, chlamydia, any source","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24075","name":"Exc arm/elbow les sc < 3 cm","description":"Excision, tumor, soft tissue of upper arm or elbow area, subcutaneous; less than 3 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5914","name":"Auricular prosthesis","description":"Auricular prosthesis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4292","name":"Lamellas, per sq cm","description":"Lamellas, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0266","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5147","name":"Inj, aflibercept-ayyh, 1 mg","description":"Injection, aflibercept-ayyh (pavblu), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0045","name":"Mrs 90 days post stk","description":"Clinical follow-up and mrs score assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97007","name":"Mchnl sclp cool meas fitg","description":"Mechanical scalp cooling, including individual cap supply with head measurement, fitting, and patient education","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0480U","name":"Nfct ds csf metag ngs alys","description":"Nfct ds csf metag ngs alys","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82271","name":"Occult blood other sources","description":"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; other sources","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27278","name":"Arthrd si jt plmt iartic dev","description":"Arthrodesis, sacroiliac joint, percutaneous or minimally invasive, with image guidance, includes obtaining bone graft when performed, unilateral; placement of intra-articular device(s), without cortical piercing","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6604","name":"Cst bse mtl inlay 2 surfaces","description":"Inlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0010","name":"Eom meos payment","description":"Enhancing oncology model (eom) monthly enhanced oncology services (meos) payment for eom enhanced services","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0754T","name":"Dgtz gls mcrscp sld level v","description":"Digitization of glass microscope slides for level v, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0745T","name":"Car ablt rad arr n-invas loc","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; noninvasive arrhythmia localization and mapping of arrhythmia site (nidus), derived from anatomical image data (eg, ct, mri, or myocardial perfusion scan) and electrical data (eg, 12-lead ecg data), and identification of areas of avo","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1391","name":"All pt dx w/ rec mlnm","description":"All patients who were diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9986","name":"Missed appointment","description":"Missed appointment","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33894","name":"Evasc st rpr thrc/aa acrs br","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; across major side branches","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42950","name":"Reconstruction of throat","description":"Pharyngoplasty (plastic or reconstructive operation on pharynx)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":943.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1241","name":"Pt no resp seen as person","description":"Patient did not respond to the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1437","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1170","name":"Pt w/o flu vax 7/1-6/30","description":"Patient did not receive an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1490","name":"Pt status not doc","description":"Patient status not documented","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0654","name":"Inj, liothyronine, 1 mcg","description":"Injection, liothyronine, 1 mcg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1430","name":"Ret exm ou no retinopthy doc","description":"Retinal exam finding without evidence of retinopathy in both eyes with severity level documented (in measurement year or in the prior year)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1709","name":"Pfizer vaccine admin booster","description":"Pfizer vaccine admin booster","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0612U","name":"Onc lvr alys >1000 mr cfdna","description":"Onc lvr alys >1000 mr cfdna","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1961","name":"Inj lenacapavir (hiv tx) 1mg","description":"Injection, lenacapavir (only for use as hiv treatment), 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0880T","name":"Augmnt alys ch ct ild i&r","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90638","name":"Vacc qirv mrna 60mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 60 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4318","name":"E-graft, per sq cm","description":"E-graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1475","name":"Pt dx huntington","description":"Patients with diagnosis of huntingtons disease","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4409","name":"Amniomatrixf3x per sq cm","description":"Amniomatrixf3x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0141A","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9616","name":"Gallium gozellix 1 millicuri","description":"Gallium ga-68 gozetotide (gozellix), diagnostic, 1 millicurie","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0972T","name":"Asstv alg clsfctn burn hlg","description":"Assistive algorithmic classification of burn healing (ie, healing or nonhealing) by noninvasive multispectral imaging, including system set-up and acquisition, selection, and transmission of images, with automated generation of report","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4370","name":"Aeroguard per sq cm","description":"Aeroguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87220","name":"Tissue exam for fungi","description":"Tissue examination by koh slide of samples from skin, hair, or nails for fungi or ectoparasite ova or mites (eg, scabies)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0854T","name":"Dgtz gls mcrscp bld smr prph","description":"Digitization of glass microscope slides for blood smear, peripheral, interpretation by physician with written report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64598","name":"Revj/rmvl nea pn w/int nstim","description":"Revision or removal of neurostimulator electrode array, peripheral nerve, with integrated neurostimulator","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1464","name":"No record of f/u by 180 days","description":"No documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87536","name":"Hiv-1 quant&revrse trnscrpj","description":"Infectious agent detection by nucleic acid (dna or rna); hiv-1, quantification, includes reverse transcription when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7415","name":"Excision malig les complicat","description":"Excision of malignant lesion complicated","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54200","name":"Injection px peyronie ds","description":"Injection procedure for peyronie disease;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9394","name":"Inj, fulvestrant (fresenius)","description":"Injection, fulvestrant (fresenius kabi) not therapeutically equivalent to j9395, 25 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6253","name":"Provisional pontic","description":"Provisional pontic","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1168","name":"Pt recd flu vax 7/1-6/30","description":"Patient received an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3911","name":"Intraorifice barrier","description":"Intraorifice barrier","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53448","name":"Remov/replc ur sphinctr comp","description":"Removal and replacement of inflatable urethral/bladder neck sphincter including pump, reservoir, and cuff through an infected field at the same operative session including irrigation and debridement of infected tissue","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1384.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81418","name":"Rx metab gen seq alys pnl 6","description":"Drug metabolism (eg, pharmacogenomics) genomic sequence analysis panel, must include testing of at least 6 genes, including cyp2c19, cyp2d6, and cyp2d6 duplication/deletion analysis","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4439","name":"Instagraft per sq cm","description":"Instagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0431","name":"Diag tst detect mucos abnorm","description":"Adjunctive pre-diagnostic test that aids in detection of mucosal abnormalities including premalignant and malignant lesions not to include cytology or biopsy","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G3003","name":"Chronic pain mgmt addl 15m","description":"Each additional 15 minutes of chronic pain management and treatment by a physician or other qualified health care professional, per calendar month. (list separately in addition to code for g3002. when using g3003, 15 minutes must be met or exceeded.)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1406","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0350U","name":"Rx metab/pcx dna 27 gen alys","description":"Rx metab/pcx dna 27 gen alys","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4024","name":"Pediatrics ss","description":"Pediatrics mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4406","name":"Xwrap fenestra per sq cm","description":"Xwrap fenestra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28540","name":"Treat foot dislocation","description":"Closed treatment of tarsal bone dislocation, other than talotarsal; without anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9275","name":"Inj cosibelimab-ipdl, 2 mg","description":"Injection, cosibelimab-ipdl, 2 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0860T","name":"Ncntc ifr spctrsc scr pad","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), for screening for peripheral arterial disease, including provocative maneuvers, image acquisition, interpretation, and report, one or both lower extremities","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0927T","name":"Interrog dev eval ccm-d ip","description":"Interrogation device evaluation (in person) with analysis, review, and report, including connection, recording, and disconnection, per patient encounter, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0482","name":"Direct immunofluorescence","description":"Direct immunofluorescence","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2018","name":"Permeaderm c, per sq cm","description":"Permeaderm c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4386","name":"Acesso trifaca per sq cm","description":"Acesso trifaca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38227","name":"Car-t receipt&prepj admn","description":"Chimeric antigen receptor t-cell (car-t) therapy; receipt and preparation of car-t cells for administration","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55709","name":"Bx prst8 tprnl us guided","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6597","name":"G comp bandage long stretch","description":"Gradient compression bandage roll, elastic long stretch, linear yard, any width, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0525","name":"Est pt-cg dyad dem mod cmplx","description":"Management of established patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1484","name":"No rpt hcv rna perf med rsn","description":"Patients who did not have a repeat hcv rna labs performed for medical reasons documented by clinician (e.g., patient with limited life expectancy, delay in treatment of hcv related to treatment of hiv, hbv, hepatocellular carcinoma, decompensated cirrhosis)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9073","name":"Inj cyclophos dr reddys 5 mg","description":"Injection, cyclophosphamide (dr. reddys), 5 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0449U","name":"Car scr sev inh cond 5 genes","description":"Car scr sev inh cond 5 genes","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0755T","name":"Dgtz gls mcrscp sld level vi","description":"Digitization of glass microscope slides for level vi, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98007","name":"Synch audio-video est hi 40","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high medical decision making. when using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61524","name":"Removal of brain lesion","description":"Craniectomy, infratentorial or posterior fossa; for excision or fenestration of cyst","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2319.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0708T","name":"Id ca immntx prep & 1st njx","description":"Intradermal cancer immunotherapy; preparation and initial injection","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2468","name":"Inj, palonosetron (posfrea)","description":"Injection, palonosetron hydrochloride (posfrea), 25 micrograms","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1073","name":"Testosterone pellet 75 mg","description":"Testosterone pellet, implant, 75 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87593","name":"Orthopoxvirus amp prb each","description":"Infectious agent detection by nucleic acid (dna or rna); orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus), amplified probe technique, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4420","name":"Nuform per sq cm","description":"Nuform, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0446U","name":"Ai ds sle alys 10 cytokine","description":"Ai ds sle alys 10 cytokine","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87426","name":"Sarscov coronavirus ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; severe acute respiratory syndrome coronavirus (eg, sars-cov, s","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0814T","name":"Prq njx biod osteo matrl fem","description":"Percutaneous injection of calcium-based biodegradable osteoconductive material, proximal femur, including imaging guidance, unilateral","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0250","name":"Adm tocilizu covid-19 2nd","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64905","name":"Nerve pedicle transfer","description":"Nerve pedicle transfer; first stage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1103.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0390U","name":"Ob pe kdr eng&rbp4 ia alg","description":"Ob pe kdr eng&rbp4 ia alg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4287","name":"Dermabind dl, per sq cm","description":"Dermabind dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0527","name":"Mgt est pt dmentia low cmplx","description":"Management of established patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4429","name":"Dermbnd chn, chx per sq cm","description":"Dermabind ch n or dermabind ch x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4332","name":"Axolotl dualgraft, per sq cm","description":"Axolotl dualgraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4351","name":"Enclose tl matrix, per sq cm","description":"Enclose tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86654","name":"Encephaltis west eqne antbdy","description":"Antibody; encephalitis, western equine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0491U","name":"Onc sol tum ctc slct er prtn","description":"Onc sol tum ctc slct er prtn","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0684","name":"App non-sheet skin sb g addl","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area or part thereof, or each additional 1% o","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0062","name":"Audiology ss","description":"Audiology mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2313","name":"Inj, naloxone (zimhi) 0.01mg","description":"Injection, naloxone hydrochloride (zimhi), 0.01 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0359U","name":"Onc prst8 ca alys all psa","description":"Onc prst8 ca alys all psa","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6252","name":"Bridge resin w/noble metal","description":"Pontic-resin with noble metal","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4388","name":"Neothelium 4l per sq cm","description":"Neothelium 4l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64656","name":"Revj/rplcmt bat mod sys pg","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; pulse generator only","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5725","name":"Rebase hybrid prosthesis","description":"Rebase hybrid prosthesis","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2036","name":"Cohealyx col dml mx pr sq cm","description":"Cohealyx collagen dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9213","name":"Interferon alfa-2a inj","description":"Injection, interferon, alfa-2a, recombinant, 3 million units","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0708","name":"Intraoral bite radio image","description":"Intraoral bite radio image","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0013","name":"Hiv prep counsel, clin staff","description":"Individual counseling for pre-exposure prophylaxis (prep) by clinical staff to prevent human immunodeficiency virus (hiv), includes: hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1223","name":"Glaucoma plan of care doc","description":"Glaucoma plan of care documented","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0778T","name":"Smmg cncrnt appl imu snr","description":"Surface mechanomyography (smmg) with concurrent application of inertial measurement unit (imu) sensors for measurement of multi-joint range of motion, posture, gait, and muscle function","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0908T","name":"Opn imp int nstm sys vgs nrv","description":"Open implantation of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53454","name":"Tprnl balo cntnc dev adjmt","description":"Periurethral transperineal adjustable balloon continence device; percutaneous adjustment of balloon(s) fluid volume","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90832","name":"Psytx w pt 30 minutes","description":"Psychotherapy, 30 minutes with patient","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":72.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4315","name":"Regenelink amniotic mem allo","description":"Regenelink amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87593","name":"Orthopoxvirus amp prb each","description":"Infectious agent detection by nucleic acid (dna or rna); orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus), amplified probe technique, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99283","name":"Emergency dept visit low mdm","description":"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and low level of medical decision making","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41015","name":"Drainage of mouth lesion","description":"Extraoral incision and drainage of abscess, cyst, or hematoma of floor of mouth; sublingual","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91040","name":"Esoph balloon distension tst","description":"Esophageal balloon distension study, diagnostic, with provocation when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0521U","name":"Rf iga&igm ccp antb sr-a ia","description":"Rf iga&igm ccp antb sr-a ia","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65930","name":"Remove blood clot from eye","description":"Removal of blood clot, anterior segment of eye","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":651.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0964T","name":"I&cust prep jaw xpnsj 1arch","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; single arch, without mandibular advancement mechanism","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0238","name":"Intrav inf, toci, second dos","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57510","name":"Cauterization of cervix","description":"Cautery of cervix; electro or thermal","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":116.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99445","name":"Rem mntr physiol param 2-15","description":"Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate); device(s) supply with daily recording(s) or programmed alert(s) transmission, 2-15 days in a 30-day period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0899","name":"Argatroban dialysis, auromed","description":"Injection, argatroban (auromedics), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63053","name":"Lam factc/frmt arthrd lum ea","description":"Laminectomy, facetectomy, or foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s] [eg, spinal or lateral recess stenosis]), during posterior interbody arthrodesis, lumbar; each additional vertebral segment (list separately in addition to code for","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57540","name":"Removal of residual cervix","description":"Excision of cervical stump, abdominal approach;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":889.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6037","name":"Postop dsg cast chg handfing","description":"Immediate post-surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, partial hand including fingers","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0362U","name":"Onc pap thyr ca rna 82&10","description":"Onc pap thyr ca rna 82&10","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0962T","name":"Asstv alg alys acous&ecg rec","description":"Assistive algorithmic analysis of acoustic and electrocardiogram recording for detection of cardiac dysfunction (eg, reduced ejection fraction, cardiac murmurs, atrial fibrillation), with review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0892T","name":"Arhfcmrigtbs sbsq per tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent motor threshold redetermination with delivery and management, per treatment day","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35501","name":"Art byp grft ipsilat carotid","description":"Bypass graft, with vein; common carotid-ipsilateral internal carotid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1358.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99468","name":"Neonate crit care initial","description":"Initial inpatient neonatal critical care, per day, for the evaluation and management of a critically ill neonate, 28 days of age or younger","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":357.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":874.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49188","name":"Opn exc/dst ntra-abd 10.1-20","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 10.1 to 20 cm","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0839T","name":"Dgtz gls mcrscp cslt mat prp","description":"Digitization of glass microscope slides for consultation and report on referred material requiring preparation of slides (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78456","name":"Acute venous thrombus image","description":"Acute venous thrombosis imaging, peptide","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0261U","name":"Onc clrct ca img alys w/ai","description":"Oncology (colorectal cancer), image analysis with artificial intelligence assessment of 4 histologic and immunohistochemical features (cd3 and cd8 within tumor-stroma border and tumor core), tissue, reported as immune response and recurrence-risk score","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49596","name":"Rpr aa hrn 1st > 10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93010","name":"Electrocardiogram report","description":"Electrocardiogram, routine ecg with at least 12 leads; interpretation and report only","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1783","name":"Vac admin human pap dose 3","description":"Vac admin human pap dose 3","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2792","name":"Crown full cast noble metal","description":"Crown-full cast noble metal","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0384U","name":"Neph ckd rsk hi stg kdn ds","description":"Neph ckd rsk hi stg kdn ds","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1285","name":"Scrn mam perf rslts not doc","description":"Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed, reason not otherwise specified","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1376","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93595","name":"L hrt cath chd nm/abn nt cnj","description":"Left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone, normal or abnormal native connections","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0849T","name":"Dgtz gls mcrscp ish ea adl 1","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1268","name":"Pt ac stat kid trnsplt wtlst","description":"Patients observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5912","name":"Facial moulage complete","description":"Facial moulage (complete)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1026","name":"Pt hemo > 3mo","description":"The number of adult patient-months in the denominator who were on maintenance hemodialysis using a catheter continuously for three months or longer under the care of the same practitioner or group partner as of the last hemodialysis session of the reporting month","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0750T","name":"B1 str&fx rsk asmt dxrbmd1vw","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62292","name":"Njx chemonucleolysis lmbr","description":"Injection procedure for chemonucleolysis, including discography, intervertebral disc, single or multiple levels, lumbar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6553","name":"G com stcking bk 30-40 custm","description":"Gradient compression stocking, below knee, 30-40 mmhg, custom, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0457","name":"Injection, aztreonam, 100 mg","description":"Injection, aztreonam, 100 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76989","name":"Dx intraop epcar us chd i&r","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; interpretation and report only","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93587","name":"Vngrph chd vnvn cltrl at/abv","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating at or above the heart (eg, from innominate vein) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9225","name":"Gen anes adv air-sub 15 min","description":"Gen anes adv air-sub 15 min","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1353","name":"Sealant repair per tooth","description":"Sealant repair per tooth","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1436","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6113","name":"Imp/abut rem dent part mand","description":"Imp/abut rem dent part mand","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35452","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":462.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6614","name":"Onlay cst nbl mtl 2 surfaces","description":"Onlay - cast noble metal two surfaces","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24340","name":"Tenodesis biceps tdn at elbw","description":"Tenodesis of biceps tendon at elbow (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":741.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64657","name":"Rmvl bat modulj sys tot sys","description":"Removal of baroreflex activation therapy (bat) modulation system; total system, including lead and pulse generator","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0695T","name":"Bdy srf mpg pm/cvdfb tm impl","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of implant or replacement","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7962","name":"Lingual frenectomy","description":"Lingual frenectomy","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1318","name":"Pts no csp doc contact","description":"Patients who did not have documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening or documentation that there was no contact with a csp","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6609","name":"G compression bandaging","description":"Gradient compression bandaging supply, not otherwise specified","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86363","name":"Mog-igg1 antb flo cytmtry ea","description":"Myelin oligodendrocyte glycoprotein (mog-igg1) antibody; flow cytometry (ie, fluorescence-activated cell sorting [facs]), each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0274U","name":"Hem gen pltlt do 43 genes","description":"Hematology (genetic platelet disorders), genomic sequence analysis of 43 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33322","name":"Repair major blood vessel(s)","description":"Suture repair of aorta or great vessels; with cardiopulmonary bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1513.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1432","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81456","name":"So/hl 51/>gsap rna alys","description":"Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic sequence analysis panel, interrogation for sequence variants and copy number variants or rearrangements, or isoform expression or mrna expression levels, if performed; rna analysis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1351","name":"Dental sealant per tooth","description":"Sealant-per tooth","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21470","name":"Optx complicated mndblr fx","description":"Open treatment of complicated mandibular fracture by multiple surgical approaches including internal fixation, interdental fixation, and/or wiring of dentures or splints","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1323.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23200","name":"Radical rescj tumor clavicle","description":"Radical resection of tumor; clavicle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1023.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0276U","name":"Hem inh thrombocytopenia 23","description":"Hematology (inherited thrombocytopenia), genomic sequence analysis of 23 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0698T","name":"Quan mr tiss w/mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained with diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, target ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0932T","name":"N-invs det hrt fail aug echo","description":"Noninvasive detection of heart failure derived from augmentative analysis of an echocardiogram that demonstrated preserved ejection fraction, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30200","name":"Injection treatment of nose","description":"Injection into turbinate(s), therapeutic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98985","name":"Rtm dev sply mscsk sys 2-15d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of musculoskeletal system, 2-15 days in a 30-day period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4329","name":"Singlay, per sq cm","description":"Singlay, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83013","name":"H pylori (c-13) breath","description":"Helicobacter pylori; breath test analysis for urease activity, non-radioactive isotope (eg, c-13)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87494","name":"Chlmy trch&neisra gonor mult","description":"Infectious agent detection by nucleic acid (dna or rna); chlamydia trachomatis and neisseria gonorrhoeae, multiplex amplified probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1454","name":"New cied","description":"New cied","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64654","name":"1st opn implt bat modulj sys","description":"Initial open implantation of baroreflex activation therapy (bat) modulation system, including lead placement onto the carotid sinus, lead tunnelling, connection to a pulse generator placed in a distant subcutaneous pocket (ie, total system), and intraoperative interrogation and programming","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1326","name":"Inj, zolbetuximab-clzb, 2 mg","description":"Injection, zolbetuximab-clzb, 2 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0526","name":"Est pt-cg dyad dem hig cmplx","description":"Management of established patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68420","name":"I&d lacrimal sac","description":"Incision, drainage of lacrimal sac (dacryocystotomy or dacryocystostomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0747T","name":"Car ablt rad arrhyt dlvr rad","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; delivery of radiation therapy, arrhythmia","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20615","name":"Treatment of bone cyst","description":"Aspiration and injection for treatment of bone cyst","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4418","name":"Biolab wrap flow per sq cm","description":"Biolab membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4425","name":"Revive tl per sq cm","description":"Revive tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33225","name":"L ventric pacing lead add-on","description":"Insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at time of insertion of implantable defibrillator or pacemaker pulse generator (eg, for upgrade to dual chamber system) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":523.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98001","name":"Synch audio-video new low 30","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1303","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20824","name":"Replantation thumb complete","description":"Replantation, thumb (includes carpometacarpal joint to mp joint), complete amputation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3303.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33276","name":"Insj phrnc nrv stim sys","description":"Insertion of phrenic nerve stimulator system (pulse generator and stimulating lead[s]), including vessel catheterization, all imaging guidance, and pulse generator initial analysis with diagnostic mode activation, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9871","name":"Bhv couns dm prev, onln 60 m","description":"Behavioral counseling for diabetes prevention, online, 60 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0358U","name":"Neuro alys b-amyl 1-42&1-40","description":"Neuro alys b-amyl 1-42&1-40","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0018M","name":"Trnsplj rnl meas cd154+cll","description":"Transplantation medicine (allograft rejection, renal), measurement of donor and third-party-induced cd154+t-cytotoxic memory cells, utilizing whole peripheral blood, algorithm reported as a rejection risk score","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55000","name":"Drainage of hydrocele","description":"Puncture aspiration of hydrocele, tunica vaginalis, with or without injection of medication","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5124","name":"Inj. byooviz, 0.1 mg","description":"Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0558U","name":"Onc clrct elisa bf7 ag serum","description":"Onc clrct elisa bf7 ag serum","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1285","name":"Scrn mam perf rslts not doc","description":"Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed, reason not otherwise specified","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94013","name":"Meas lung vol thru 2 yrs","description":"Measurement of lung volumes (ie, functional residual capacity [frc], forced vital capacity [fvc], and expiratory reserve volume [erv]) in an infant or child through 2 years of age","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86581","name":"Strptcs pneum antb serot ia","description":"Streptococcus pneumoniae antibody (igg), serotypes, multiplex immunoassay, quantitative","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0736T","name":"Colonic lavage 35+l water","description":"Colonic lavage, 35 or more liters of water, gravity-fed, with induced defecation, including insertion of rectal catheter","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1006T","name":"Elec alys s-scl eeg prgrm ea","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, each additional 15 minutes face-to-face time with physician or other qua","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0986T","name":"Iv img icr cere vsl oct 1st","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87564","name":"Mtb rifampin rst amp prb tq","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacterium tuberculosis, rifampin resistance, amplified probe technique","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0002","name":"Opt care kidney hlth mvp","description":"Optimal care for kidney health mips value pathways","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99212","name":"Office o/p est sf 10 min","description":"Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 10 minutes must be met o","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":67.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92628","name":"Eval hearing aid cand 1st 30","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3389","name":"Topi adm prad zami per treat","description":"Topical administration, prademagene zamikeracel, per treatment","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0371U","name":"Iadna gu pthgn semiq dna16&1","description":"Iadna gu pthgn semiq dna16&1","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4309","name":"Via matrix, per sq cm","description":"Via matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98985","name":"Rtm dev sply mscsk sys 2-15d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of musculoskeletal system, 2-15 days in a 30-day period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1177","name":"Pt recd pcv on/aft 19","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0799","name":"Hiv prep, fda approved, noc","description":"Fda approved prescription drug, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv), not otherwise classified","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92639","name":"Hearing aid meas verif","description":"Hearing-aid measurement, verification with probe-microphone (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4432","name":"510(k) skin subs, nos","description":"510(k) skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1293","name":"Calc bmi abv up param f/u","description":"Bmi is documented above normal parameters and a follow-up plan is documented","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93152","name":"Interrog&prgrmg ipnss polysm","description":"Interrogation and programming of implanted phrenic nerve stimulator system during polysomnography","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0828T","name":"Dgtz gls mcrscp cytp smpl fl","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; simple filter method with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31390","name":"Removal of larynx & pharynx","description":"Pharyngolaryngectomy, with radical neck dissection; without reconstruction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2432.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5941","name":"Resct proth mand part remov","description":"Resct proth mand part remov","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0801T","name":"Tcat rmv&rpl 2chmbr ldls pm","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; dual-cha","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0048","name":"Pall serv during meas","description":"Patients who receive palliative care services any time during the intake period through the end of the measurement year","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1643","name":"Inj heparin, pfizer, 1000u","description":"Injection, heparin sodium (pfizer), not therapeutically equivalent to j1644, per 1000 units","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0899","name":"Argatroban dialysis, auromed","description":"Injection, argatroban (auromedics), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83919","name":"Organic acids qual each","description":"Organic acids; qualitative, each specimen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1254","name":"Pts deceased prior hu surv","description":"Patients who were deceased when the hu survey reached them","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0739T","name":"Abltj mal prst8 mag fld ndct","description":"Ablation of malignant prostate tissue by magnetic field induction, including all intraprocedural, transperineal needle/catheter placement for nanoparticle installation and intraprocedural temperature monitoring, thermal dosimetry, bladder irrigation, and magnetic field nanoparticle activation","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86363","name":"Mog-igg1 antb flo cytmtry ea","description":"Myelin oligodendrocyte glycoprotein (mog-igg1) antibody; flow cytometry (ie, fluorescence-activated cell sorting [facs]), each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5125","name":"Inj, releuko 1 mcg","description":"Injection, filgrastim-ayow, biosimilar, (releuko), 1 microgram","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82552","name":"Assay of cpk in blood","description":"Creatine kinase (ck), (cpk); isoenzymes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1229","name":"Pt w/ +hcv +vir ref win 1 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, is referred within 1 month of the reactive hcv antibody test to a clinician who treats hcv infection","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1321","name":"Couns for high risk sub use","description":"Couns for high risk sub use","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1501","name":"Pathology mvp","description":"Pathology mips value pathway","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96574","name":"Dbrdmt prmlg les w/pdt","description":"Debridement of premalignant hyperkeratotic lesion(s) (ie, targeted curettage, abrasion) followed with photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosensitizing drug(s) provide","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2516","name":"Inj, pentamidine isethionate","description":"Injection, pentamidine isethionate, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0677T","name":"Laps repos lead isdss 1st ld","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first repositioned lead","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0800T","name":"Tcat rmvl 2chmbr ldls pm rv","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right ventricular pacemaker component (when part of a dual-chamber leadless pacem","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0654","name":"Inj, liothyronine, 1 mcg","description":"Injection, liothyronine, 1 mcg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15018","name":"App skn cll ssp f/n/g/hf ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 480 sq cm or part thereof (list separately in addition to code for prima","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64470","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0524U","name":"Ob pe sflt-1/plgf ia srm/pls","description":"Ob pe sflt-1/plgf ia srm/pls","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0329U","name":"Onc neo xome&trns seq alys","description":"Onc neo xome&trns seq alys","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0677T","name":"Laps repos lead isdss 1st ld","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first repositioned lead","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29862","name":"Hip arthr0 w/debridement","description":"Arthroscopy, hip, surgical; with debridement/shaving of articular cartilage (chondroplasty), abrasion arthroplasty, and/or resection of labrum","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":916.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0566","name":"3d bn img algor drvd fr mri","description":"3d radiodensity-value bone imaging, algorithm derived, from previous magnetic resonance examination of the same anatomy","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1410","name":"No gmln brca1/brca2 couns","description":"Patients who did not have germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45910","name":"Dilation of rectal narrowing","description":"Dilation of rectal stricture (separate procedure) under anesthesia other than local","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0491U","name":"Onc sol tum ctc slct er prtn","description":"Onc sol tum ctc slct er prtn","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98978","name":"Rtm dev sply cbt 16-30 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of cognitive behavioral therapy, 16-30 days in a 30-day period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4320","name":"Pellograft, per sq cm","description":"Pellograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1781","name":"Vac admin human pap dose 1","description":"Vac admin human pap dose 1","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1313","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33977","name":"Remove ventricular device","description":"Removal of ventricular assist device; extracorporeal, single ventricle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1492.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0308U","name":"Crd cad alys 3 prtn plsm alg","description":"Crd cad alys 3 prtn plsm alg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0773T","name":"Vr px dissoc svc oth phy 1st","description":"Virtual reality (vr) procedural dissociation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports; initial 15 min","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92555","name":"Speech threshold audiometry","description":"Speech audiometry threshold;","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60220","name":"Partial removal of thyroid","description":"Total thyroid lobectomy, unilateral; with or without isthmusectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":861.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46285","name":"Remove anal fist 2 stage","description":"Surgical treatment of anal fistula (fistulectomy/fistulotomy); second stage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4380","name":"Advograft one per sq cm","description":"Advograft one, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0708","name":"Intraoral bite radio image","description":"Intraoral bite radio image","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0698T","name":"Quan mr tiss w/mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained with diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, target ","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6089","name":"Access/retorq implant screw","description":"Access/retorq implant screw","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70472","name":"Ct cere prfu alys c+w/ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed with concurrent ct or ct angiography of the same anatomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52284","name":"Cysto rx balo cath urtl strx","description":"Cystourethroscopy, with mechanical urethral dilation and urethral therapeutic drug delivery by drug-coated balloon catheter for urethral stricture or stenosis, male, including fluoroscopy, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4396","name":"Natalin per sq cm","description":"Natalin, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0370","name":"Max ultrasound capt & interp","description":"Max ultrasound capt & interp","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1243","name":"Pt othr thn true heard","description":"Patient provided a response other than completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90612","name":"Inf&sarscov2 vacc 31.7/.32im","description":"Influenza virus vaccine, trivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 31.7 mcg/0.32 ml dosage, for intramuscular use","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9063","name":"Inj, elahere, 1 mg","description":"Injection, mirvetuximab soravtansine-gynx, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1232","name":"Pt hcv tst reactive result","description":"Patient receives hcv antibody test with reactive result","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0738T","name":"Tx pln mag fld abltj prst8","description":"Treatment planning for magnetic field induction ablation of malignant prostate tissue, using data from previously performed magnetic resonance imaging (mri) examination","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87626","name":"Hpv sep hi-rsk typ&pool rslt","description":"Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), separately reported high-risk types (eg, 16, 18, 31, 45, 51, 52) and high-risk pooled result(s)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26010","name":"Drainage of finger abscess","description":"Drainage of finger abscess; simple","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":434.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":167.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5995","name":"Peri medicament w/seal, max","description":"Peri medicament w/seal, max","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4410","name":"Amchomatrixdl per sq cm","description":"Amchomatrixdl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1781","name":"Vac admin human pap dose 1","description":"Vac admin human pap dose 1","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2329","name":"Inj ublituximab-xiiy, 1 mg","description":"Injection, ublituximab-xiiy, 1mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0049","name":"Main hemo in-cntr","description":"With maintenance hemodialysis (in-center and home hd) for the complete reporting month","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6107","name":"Tissue regen non-resorbable","description":"Tissue regen non-resorbable","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4334","name":"Amnioplast 1, per sq cm","description":"Amnioplast 1, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0807T","name":"Pulm tiss vntj alys prev ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with previously acquired computed tomography (ct) images, including data preparation and transmission, quantification of pulmonary tissue ventilation, data re","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9056","name":"Inj, vivimusta, 1 mg","description":"Injection, bendamustine hydrochloride (vivimusta), 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6093","name":"Recement supp part denture","description":"Recement implant/abutment supported fixed partial denture","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3299","name":"Inj xipere 1 mg","description":"Injection, triamcinolone acetonide (xipere), 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21811","name":"Optx of rib fx w/fixj scope","description":"Open treatment of rib fracture(s) with internal fixation, includes thoracoscopic visualization when performed, unilateral; 1-3 ribs","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0992T","name":"N-invas assmt car rsk w/o ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat without concurrent computed tomography (ct) scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33280","name":"Rmvl phrnc nrv stim pg only","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator only","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6091","name":"Repl semi/precision attach","description":"Replacement of semi-precision or precision attachment (male or female component) of implant/abutment supported prosthesis per attachment","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0980T","name":"Sbmcsl crylys ther tng&tnsl","description":"Submucosal cryolysis therapy; base of tongue and lingual tonsil only","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1013T","name":"Lap srg imp/rpl eso nea&pg/r","description":"Laparoscopy, surgical, implantation or replacement of lower esophageal sphincter neurostimulator electrode array and neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver, including cruroplasty and/or electronic ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0819T","name":"Revj/rmvl ins ptn subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0560","name":"Safety plan interven","description":"Safety planning interventions, each 20 minutes personally performed by the billing practitioner, including assisting the patient in the identification of the following personalized elements of a safety plan: recognizing warning signs of an impending suicidal or substance use-related crisis; employin","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92551","name":"Pure tone hearing test air","description":"Screening test, pure tone, air only","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0772T","name":"Vr px dissoc svc sm phy ea","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4543","name":"Supply trans elec nerve stim","description":"Supplies for transcutaneous electrical nerve stimulator, for nerves in the auricular region, per month","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78170","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0453U","name":"Onc clrct ca cfdna qpcr asy","description":"Onc clrct ca cfdna qpcr asy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43610","name":"Excision of stomach lesion","description":"Excision, local; ulcer or benign tumor of stomach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1008.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99404","name":"Prev med cnsl indiv apprx 60","description":"Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 60 minutes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":81.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9244","name":"Office min sed drug enteral","description":"Office min sed drug enteral","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1225","name":"Iop dec>=20% from base","description":"Intraocular pressure (iop) reduced by a value of greater than or equal to 20% from the pre-intervention level","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1413","name":"Pos pdl1 bef init ici tx","description":"Patients who had a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99424","name":"Prin care mgmt phys 1st 30","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4431","name":"Pma skin substitute, nos","description":"Pma skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1441","name":"Init dx slp apn = 1st enc","description":"Encounter corresponds to initial diagnosis of sleep apnea or first contact with sleep apnea diagnosed patient","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0897T","name":"N-invas augmnt arrhyt alys","description":"Noninvasive augmentative arrhythmia analysis derived from quantitative computational cardiac arrhythmia simulations, based on selected intervals of interest from 12-lead electrocardiogram and uploaded clinical parameters, including uploading clinical parameters with interpretation and report","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0938T","name":"Xtrnl ecg rec>15d<30d rec","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; recording (including connection and initial recording)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2009","name":"Symphony, per sq cm","description":"Symphony, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6624","name":"Inlay titanium","description":"Inlay - titanium","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4412","name":"Choriofix per sq cm","description":"Choriofix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1184","name":"Doc med rsn no cst/ist rx","description":"Documentation of medical reason(s) for not prescribing or administering corticosteroid or immunosuppressant treatment (e.g., allergy, intolerance, infectious etiology, pancreatic insufficiency, hyperthyroidism, prior bowel surgical interventions, celiac disease, receiving other medication, awaiting ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9998","name":"Doc med rsn <3 colon","description":"Documentation of medical reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., last colonoscopy incomplete, last colonoscopy had inadequate prep, piecemeal removal of adenomas, or sessile serrated polyps >= 20 mm in size, last colonoscopy found greater than 10 adenomas, lo","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0722T","name":"Quan ct tiss charac w/ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained with concurrent ct examination of any structure contained in the concurrently acquired diagnostic imaging dataset (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9224","name":"Gen anes adv air-15 min","description":"Gen anes adv air-15 min","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0820T","name":"Mntr psychdlc med 1stphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; first physician or other qualified health care professional, each hour","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1464","name":"No record of f/u by 180 days","description":"No documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2542","name":"Dental onlay metallic 2 surf","description":"Onlay-metallic-two surfaces","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2402","name":"Chloroprocaine (clorotekal)","description":"Injection, chloroprocaine hydrochloride (clorotekal), per 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33370","name":"Tcat plmt&rmvl cepd perq","description":"Transcatheter placement and subsequent removal of cerebral embolic protection device(s), including arterial access, catheterization, imaging, and radiological supervision and interpretation, percutaneous (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2801","name":"Inj, rykindo, 0.5 mg","description":"Injection, risperidone (rykindo), 0.5 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0314U","name":"Onc cutan mlnma mrna 35 gene","description":"Onc cutan mlnma mrna 35 gene","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69220","name":"Clean out mastoid cavity","description":"Debridement, mastoidectomy cavity, simple (eg, routine cleaning)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0063","name":"Cardiology ss","description":"Cardiology mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0425","name":"Inpt/ed teleconsult30","description":"Telehealth consultation, emergency department or initial inpatient, typically 30 minutes communicating with the patient via telehealth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4325","name":"Acapatch, per sq cm","description":"Acapatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1355","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0600U","name":"Nfct ds wnd infctj 65orgs&30","description":"Nfct ds wnd infctj 65orgs&30","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3503","name":"Surg exp root surf molar","description":"Surg exp root surf molar","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26535","name":"Revise finger joint","description":"Arthroplasty, interphalangeal joint; each joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9074","name":"Inj, cyclophosphamd, sandoz","description":"Injection, cyclophosphamide (sandoz), 5 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27826","name":"Treat lower leg fracture","description":"Open treatment of fracture of weight bearing articular surface/portion of distal tibia (eg, pilon or tibial plafond), with internal fixation, when performed; of fibula only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":864.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93153","name":"Interrog w/o prgrmg ipnss","description":"Interrogation without programming of implanted phrenic nerve stimulator system","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4437","name":"Revival ac per sq cm","description":"Revival ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1417","name":"Pt up to date cov","description":"Patients who are up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80164","name":"Assay dipropylacetic acd tot","description":"Valproic acid (dipropylacetic acid); total","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1288","name":"Doc rsn no hbp scrn or f/u","description":"Documented reason for not screening or recommending a follow-up for high blood pressure","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92920","name":"Prq trluml c angiop 1art&/br","description":"Percutaneous transluminal coronary angioplasty, single major coronary artery and/or its branch(es)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4309","name":"Via matrix, per sq cm","description":"Via matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4011","name":"Internal medicine ss","description":"Internal medicine mips specialty set","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0910T","name":"Rmvl int nstim sys vagus nrv","description":"Removal of integrated neurostimulation system, vagus nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2394","name":"Post >=4srfc resinbase cmpst","description":"Resin-based composite - four or more surfaces posterior","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2782","name":"Crown 3/4 cast noble metal","description":"Crown - 3/4 cast noble metal","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6105","name":"Remove implant body","description":"Remove implant body","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3402","name":"Inj. remestemcel-l-rknd/ td","description":"Injection, remestemcel-l-rknd, per therapeutic dose","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5912","name":"Facial moulage complete","description":"Facial moulage (complete)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0551","name":"Phn/intr svs fr dx treat 30m","description":"Interprofessional telephone/internet/electronic health record referral service(s) provided by a treating/requesting practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, 30 minutes","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9056","name":"Inj, vivimusta, 1 mg","description":"Injection, bendamustine hydrochloride (vivimusta), 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1014T","name":"Lap rv/rmv eso sph nstm eltr","description":"Laparoscopic revision or removal, lower esophageal sphincter neurostimulator electrodes","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93150","name":"Therapy activation ipnss","description":"Therapy activation of implanted phrenic nerve stimulator system, including all interrogation and programming","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0041","name":"Pt/ptn decln referral","description":"Patient and/or care partner decline referral","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4351","name":"Enclose tl matrix, per sq cm","description":"Enclose tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82234","name":"Beta-amyloid 1-42 (abeta 42)","description":"Beta-amyloid; 1-42 (abeta 42)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4265","name":"Neostim tl per sq cm","description":"Neostim tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4199","name":"Cygnus matrix, per sq cm","description":"Cygnus matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0516","name":"Insert drug del implant, >=4","description":"Insertion of non-biodegradable drug delivery implants, 4 or more (services for subdermal rod implant)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":96.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1493","name":"No fall doc med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70490","name":"Ct soft tissue neck w/o dye","description":"Computed tomography, soft tissue neck; without contrast material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41112","name":"Excision of tongue lesion","description":"Excision of lesion of tongue with closure; anterior two-thirds","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90955","name":"Esrd srv 2-3 vsts p mo 2-11","description":"End-stage renal disease (esrd) related services monthly, for patients 2-11 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 2-3 face-to-face visits by a physician or other qualified health care professional per mo","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":611.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":231.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4270","name":"Complete sl per sq cm","description":"Complete sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64656","name":"Revj/rplcmt bat mod sys pg","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; pulse generator only","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81418","name":"Rx metab gen seq alys pnl 6","description":"Drug metabolism (eg, pharmacogenomics) genomic sequence analysis panel, must include testing of at least 6 genes, including cyp2c19, cyp2d6, and cyp2d6 duplication/deletion analysis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37286","name":"Revsc evasc tpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23331","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":705.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75552","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":671.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0311U","name":"Nfct ds bct quan antmcrb sc","description":"Nfct ds bct quan antmcrb sc","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3392","name":"Inj, exagamglogene autotem","description":"Injection, exagamglogene autotemcel, per treatment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74183","name":"Mri abd w/o cntr flwd cntr","description":"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1388.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6610","name":"G com stcking bk 18-30 custm","description":"Gradient compression stocking, below knee, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36482","name":"Endoven ther chem adhes 1st","description":"Endovenous ablation therapy of incompetent vein, extremity, by transcatheter delivery of a chemical adhesive (eg, cyanoacrylate) remote from the access site, inclusive of all imaging guidance and monitoring, percutaneous; first vein treated","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1925.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":183.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0583","name":"Bivalirudin","description":"Injection, bivalirudin, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4286","name":"Nudyn sl or slw, per sq cm","description":"Nudyn sl or nudyn slw, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49614","name":"Rpr aa hrn rcr < 3 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0414","name":"Lab process microbial spec","description":"Lab process microbial spec","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1004T","name":"Elec alys s-scl eeg wo prgrm","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; without programming","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98986","name":"Rtm dev sply cbt 2-15 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of cognitive behavioral therapy, 2-15 days in a 30-day period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1296","name":"Calc bmi norm parameters","description":"Bmi is documented within normal parameters and no follow-up plan is required","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0345U","name":"Psyc genom alys pnl 15 gen","description":"Psyc genom alys pnl 15 gen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0524","name":"Est pt-cg dyad dem low cmplx","description":"Management of established patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90695","name":"H5n8 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n8, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2561","name":"Inj, sezaby, 1 mg","description":"Injection, phenobarbital sodium (sezaby), 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90684","name":"Pcv21 vaccine im","description":"Pneumococcal conjugate vaccine, 21 valent (pcv21), for intramuscular use","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0526U","name":"Nefro rnl trnspl quan cxcl10","description":"Nefro rnl trnspl quan cxcl10","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32019","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11043","name":"Dbrdmt musc&/fsca 1st 20/<","description":"Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); first 20 sq cm or less","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":132.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0565U","name":"Onc hcc ngs detc 6626epigalt","description":"Onc hcc ngs detc 6626epigalt","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33897","name":"Perq trluml angp nt/recr coa","description":"Percutaneous transluminal angioplasty of native or recurrent coarctation of the aorta","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4545","name":"Suppl accessor tibial stim","description":"Supplies and accessories for external tibial nerve stimulator (e.g., socks, gel pads, electrodes, etc.), needed for one month","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0473U","name":"Onc sld tum bld/slv 648 gene","description":"Onc sld tum bld/slv 648 gene","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4280","name":"Xcell amnio matrix per sq cm","description":"Xcell amnio matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1281","name":"Bp scrn no perf at interval","description":"Blood pressure reading not documented, reason not given","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9054","name":"Inj bortezomib boruzu 0.1 mg","description":"Injection, bortezomib (boruzu), 0.1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0823T","name":"Tcat ins 1chmbr ldls pm ra","description":"Transcatheter insertion of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or programming), when","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3387","name":"Inj elivaldogene autotemecel","description":"Injection, elivaldogene autotemcel, per treatment","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0822T","name":"Mntr psychdlc med cln staff","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; clinical staff under the direction of a physician or other qualified health care professional, concurrent with first physician or other qualified health care p","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0531","name":"Fclty-based respite, 24 hr u","description":"Facility-based respite, 24-hour unit, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0466U","name":"Crd cad dna gwas 564856 snp","description":"Crd cad dna gwas 564856 snp","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37298","name":"Revsc evsc imvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26560","name":"Repair of web finger","description":"Repair of syndactyly (web finger) each web space; with skin flaps","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99490","name":"Chrnc care mgmt staff 1st 20","description":"Chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, or funct","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0439","name":"Ppps, subseq visit","description":"Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44201","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":701.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7511","name":"Incision/drain abscess intra","description":"Incision and drainage of abscess - intraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76828","name":"Echo exam of fetal heart","description":"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1452","name":"Pt dx dementia ever","description":"Patient ever had a diagnosis of dementia","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76988","name":"Dx ntrop epcr us chd img acq","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; placement, manipulation of transducer, and image acquisition only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0543","name":"Group train w/o patient","description":"Group caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient pre","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69728","name":"Rmv ntr oi imp sk tc>=100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1021T","name":"Active thrc irrigation spx","description":"Active thoracic irrigation (separate procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21335","name":"Open tx nose & septal fx","description":"Open treatment of nasal fracture; with concomitant open treatment of fractured septum","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":857.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1018T","name":"Elec alys npgs esoph sbsq w/","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6527","name":"G garmt full leg/ft nght cus","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, custom, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":1274.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86318","name":"Ia infectious agent antibody","description":"Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip);","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1495","name":"Fall w/ poc, no fall","description":"Patients that reported a fall occurred who had a plan of care for falls documented or patients that did not report a fall","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0929T","name":"Rem interrog dev ccm-d tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2427","name":"Inj, invega hafyera/trinza","description":"Injection, paliperidone palmitate extended release (invega hafyera, or invega trinza), 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84393","name":"Tau phosphorylated ea","description":"Tau, phosphorylated (eg, ptau 181, ptau 217), each","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80505","name":"Path clin consltj high 41-60","description":"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patients history and medical records and high level of medical decision making when using time for code selection, 41-60 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0985T","name":"Iv img xtrc cere vsl oct ea","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76802","name":"Ob us < 14 wks addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87280","name":"Respiratory syncytial ag if","description":"Infectious agent antigen detection by immunofluorescent technique; respiratory syncytial virus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99391","name":"Per pm reeval est pat infant","description":"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; infan","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":99.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0449U","name":"Car scr sev inh cond 5 genes","description":"Car scr sev inh cond 5 genes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37288","name":"Revsc evsc tpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9939","name":"Placemnt removable appliance","description":"Placemnt removable appliance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3473","name":"Surg rep root res molar","description":"Surg rep root res molar","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0369","name":"Max mri capture & interprete","description":"Max mri capture & interprete","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61150","name":"Bur hol/trph drg brn abs/cst","description":"Burr hole(s) or trephine; with drainage of brain abscess or cyst","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1491.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0862T","name":"Rlcj pg wcs lv battery only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; battery component only","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9056","name":"Inj, vivimusta, 1 mg","description":"Injection, bendamustine hydrochloride (vivimusta), 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0621U","name":"Nfct ds lb dna alys>10000","description":"Nfct ds lb dna alys>10000","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93587","name":"Vngrph chd vnvn cltrl at/abv","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating at or above the heart (eg, from innominate vein) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0573U","name":"Onc pancreas 3bmrk pclf alg","description":"Onc pancreas 3bmrk pclf alg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0982T","name":"Rem mntr impl ivc snr set-up","description":"Remote monitoring of implantable inferior vena cava sensor, physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate), initial set-up and patient education on use of equipment","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9556","name":"Ga67 gallium","description":"Gallium ga-67 citrate, diagnostic, per millicurie","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5144","name":"Inj, idacio, 1 mg","description":"Injection, adalimumab-aacf (idacio), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37298","name":"Revsc evsc imvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1206","name":"Isa not red 3pts/no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91113","name":"Gi trc img intral colon i&r","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1710","name":"Moderna vacc admin 3rd dose","description":"Moderna vacc admin 3rd dose","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37276","name":"Rvsc evsc fpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87913","name":"Nfct agt gntyp alys sarscov2","description":"Infectious agent genotype analysis by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), mutation identification in targeted region(s)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90812","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92060","name":"Sensorimotor examination","description":"Sensorimotor examination with multiple measurements of ocular deviation (eg, restrictive or paretic muscle with diplopia) with interpretation and report (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0845T","name":"Dgtz gls mcrscp imfluor 1st","description":"Digitization of glass microscope slides for immunofluorescence, per specimen; initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9996","name":"Ustekinumab- ttwe sub cu inj","description":"Injection, ustekinumab-ttwe (pyzchiva), subcutaneous, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1351","name":"Pt cmplt suicd saf pln 120dy","description":"Patients who had a suicide safety plan initiated, reviewed, or updated and reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82233","name":"Beta-amyloid 1-40 (abeta 40)","description":"Beta-amyloid; 1-40 (abeta 40)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29863","name":"Hip arthr0 w/synovectomy","description":"Arthroscopy, hip, surgical; with synovectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95819","name":"Eeg awake and asleep","description":"Electroencephalogram (eeg); including recording awake and asleep","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0011","name":"Hiv prep counsel, md 15-30m","description":"Individual counseling for pre-exposure prophylaxis (prep) by physician or qualified health care professional (qhp) to prevent human immunodeficiency virus (hiv), includes hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence, 15-30 minutes","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78014","name":"Thyroid imaging w/blood flow","description":"Thyroid imaging (including vascular flow, when performed); with single or multiple uptake(s) quantitative measurement(s) (including stimulation, suppression, or discharge, when performed)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99396","name":"Prev visit est age 40-64","description":"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 40-64","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":124.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1435","name":"Oral chemo in perf pd","description":"Patient on oral chemotherapy during the performance period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0535U","name":"Pfas lc-ms/ms plsm/srm quan","description":"Pfas lc-ms/ms plsm/srm quan","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0557U","name":"Nfct ds bv dna mrk vag fluid","description":"Nfct ds bv dna mrk vag fluid","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2023","name":"Innovamatrix pd, 1 mg","description":"Innovamatrix pd, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92632","name":"Hearing aid slctn svc ea add","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2038","name":"Skill train and dev/diem","description":"Skills training and development, per diem","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82166","name":"Assay anti-mullerian horm","description":"Anti-mullerian hormone (amh)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2643","name":"Dental onlay porcelin 3 surf","description":"Onlay - porcelain/ceramic - three surfaces","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0932T","name":"N-invs det hrt fail aug echo","description":"Noninvasive detection of heart failure derived from augmentative analysis of an echocardiogram that demonstrated preserved ejection fraction, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"13100","name":"Cmplx rpr trunk 1.1-2.5 cm","description":"Repair, complex, trunk; 1.1 cm to 2.5 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0612","name":"Inj, calcium gluconate, nos","description":"Injection, calcium gluconate, not otherwise specified, 10 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0909T","name":"Rplcmt int nstim sys vgs nrv","description":"Replacement of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0745T","name":"Car ablt rad arr n-invas loc","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; noninvasive arrhythmia localization and mapping of arrhythmia site (nidus), derived from anatomical image data (eg, ct, mri, or myocardial perfusion scan) and electrical data (eg, 12-lead ecg data), and identification of areas of avo","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1469","name":"Hx of hep b, or pos bld test","description":"Patient has a history of hepatitis b illness or received a hepatitis b surface antigen, hepatitis b surface antibody, or total antibody to hepatitis b core antigen test with a positive result any time before or during the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37268","name":"Revsc evasc fpvt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1214","name":"Spiro results wth obs doc","description":"Spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and reviewed","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4344","name":"Tri membrane wrap, per sq cm","description":"Tri-membrane wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74247","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2032","name":"Myriad matrix, per sq cm","description":"Myriad matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1180","name":"Pt imm ckpt inhib therapy","description":"Patients on immune checkpoint inhibitor therapy","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0974T","name":"Slctv nzmtc dbrdmt t/a/l ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; each additional 100 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56700","name":"Prtl hymnctmy/revj hymnl rng","description":"Partial hymenectomy or revision of hymenal ring","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0704T","name":"Rem tx amblyopia setup&edu","description":"Remote treatment of amblyopia using an eye tracking device; device supply with initial set-up and patient education on use of equipment","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9256","name":"Inj, nipocalimab-aahu, 3 mg","description":"Injection, nipocalimab-aahu, 3 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1352","name":"Suicd c-ssrs assessment, equ","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs or equivalent assessment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0981T","name":"Tcat impl wrls ivc snr","description":"Transcatheter implantation of wireless inferior vena cava sensor for long-term hemodynamic monitoring, including deployment of the sensor, radiological supervision and interpretation, right heart catheterization, and inferior vena cava venography, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4336","name":"Artecent c, per sq cm","description":"Artacent c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87077","name":"Culture aerobic identify","description":"Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1458","name":"Pt died bef end meas pd","description":"Patient died prior to the end of the performance period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50070","name":"Nl comp cgen kdn abnormality","description":"Nephrolithotomy; complicated by congenital kidney abnormality","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1305.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4261","name":"Tag, per square centimeter","description":"Tag, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92542","name":"Positional nystagmus test","description":"Positional nystagmus test, minimum of 4 positions, with recording","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0389U","name":"Ped fbrl kd ifi27&mcemp1 rna","description":"Ped fbrl kd ifi27&mcemp1 rna","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1281","name":"Bp scrn no perf at interval","description":"Blood pressure reading not documented, reason not given","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0712T","name":"N-nvs artl plaq alys quan","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess atherosclerotic plaque stability","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0815T","name":"Us rems b1 dns hips plvs/spi","description":"Ultrasound-based radiofrequency echographic multi-spectrometry (rems), bone-density study and fracture-risk assessment, 1 or more sites, hips, pelvis, or spine","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7284","name":"Exc biopsy of saliv glands","description":"Exc biopsy of saliv glands","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4281","name":"Barrera slor dl per sq cm","description":"Barrera sl or barrera dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93151","name":"Interrog&prgrmg ipnss","description":"Interrogation and programming (minimum one parameter) of implanted phrenic nerve stimulator system","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99383","name":"Prev visit new age 5-11","description":"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; late childhood (","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":119.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92635","name":"Hearing aid fitg svc ea addl","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; each additional 15 minutes (list separately in addition to code","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4333","name":"Ardeograft, per sq cm","description":"Ardeograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1358","name":"Pts no <suicd idea 120 dys","description":"Patients who did not have a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31243","name":"Nsl/sinus ndsc cryoabltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by cryoablation, posterior nasal nerve","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1434","name":"Orl chemo wthn 30 d post enc","description":"Patient on oral chemotherapy on or within 30 days after denominator eligible encounter","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0283U","name":"Vw factor type 2b eval plsm","description":"Von willebrand factor (vwf), type 2b, platelet-binding evaluation, radioimmunoassay, plasma","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1742","name":"Ibutilide fumarate injection","description":"Injection, ibutilide fumarate, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9563","name":"Ht inj immuno diem","description":"Home injectable therapy, immunotherapy, 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":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0829T","name":"Dgtz gls mcrscp cytp conctrj","description":"Digitization of glass microscope slides for cytopathology, concentration technique, smears, and interpretation (eg, saccomanno technique) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49593","name":"Rpr aa hrn 1st 3-10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, reducible","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6603","name":"G com bandge low dn foamchnl","description":"Gradient compression bandaging supply, low density channel foam sheet, per 250 square centimeters, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1448","name":"Pt dx pd bef end meas pd","description":"Patients with an active diagnosis of personality disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96202","name":"Mlt fam grp bhv train 1st 60","description":"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face with multiple sets of paren","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0705T","name":"Rem tx amblyopia tech sprt","description":"Remote treatment of amblyopia using an eye tracking device; surveillance center technical support including data transmission with analysis, with a minimum of 18 training hours, each 30 days","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0790T","name":"Revj rplcmt/rmvl vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracolumbar or lumbar vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1370","name":"Rehab support msk care mvp","description":"Rehabilitative support for musculoskeletal care mips value pathway","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9601","name":"Flortaucipir inj 1 millicuri","description":"Flortaucipir f 18 injection, diagnostic, 1 millicurie","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49616","name":"Rpr aa hrn rcr 3-10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, incarcerated or strangulated","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0032","name":"2+ antipsy schiz","description":"Two or more antipsychotic prescriptions ordered for patients who had a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder on or between january 1 of the year prior to the measurement period and the index prescription start date (ipsd) for antipsychotics","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7521","name":"Tacrolim granules oral susp","description":"Tacrolimus, granules, oral suspension, 0.1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2291","name":"Inj, nafcillin (baxter) 20mg","description":"Injection, nafcillin sodium (baxter), 20 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0817T","name":"Opn insj/rplcmt ins ptn subf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6593","name":"Grad com accessory gmt_wrap","description":"Accessory for gradient compression garment or wrap with adjustable straps, not-otherwise specified","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87495","name":"Cytomeg dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); cytomegalovirus, direct probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0936T","name":"Photobiomodulation ther rta","description":"Photobiomodulation therapy of retina, single session","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92941","name":"Prq trlml revsc tot occl ami","description":"Percutaneous transluminal revascularization of acute total/subtotal occlusion during acute myocardial infarction, any combination of intracoronary stent, atherectomy and angioplasty, including aspiration thrombectomy when performed, single major coronary artery and/or its branches or single bypass g","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":816.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85014","name":"Hematocrit","description":"Blood count; hematocrit (hct)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2291","name":"Inj, nafcillin (baxter) 20mg","description":"Injection, nafcillin sodium (baxter), 20 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2801","name":"Inj, rykindo, 0.5 mg","description":"Injection, risperidone (rykindo), 0.5 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46746","name":"Repair of cloacal anomaly","description":"Repair of cloacal anomaly by anorectovaginoplasty and urethroplasty, combined abdominal and sacroperineal approach;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4056.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64473","name":"Lwr xtr fscl pln blk uni njx","description":"Lower extremity fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7972","name":"Surg redct fibrous tuberosit","description":"Surgical reduction of fibrous tuberosity","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37256","name":"Revsc evasc ivt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76019","name":"Mr safety implt pos&/immoblj","description":"Mr safety implant positioning and/or immobilization under supervision of physician or other qualified health care professional, including application of physical protections to secure implanted medical device from mr-induced translational or vibrational forces, magnetically induced functional change","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92639","name":"Hearing aid meas verif","description":"Hearing-aid measurement, verification with probe-microphone (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49592","name":"Rpr aa hrn 1st < 3 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":266.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0527","name":"Mgt est pt dmentia low cmplx","description":"Management of established patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87478","name":"Borrelia miyamotoi amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); borrelia miyamotoi, amplified probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64738","name":"Incision of jaw nerve","description":"Transection or avulsion of; inferior alveolar nerve by osteotomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":523.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0208","name":"Inj, pedmark, 100 mg","description":"Injection, sodium thiosulfate (pedmark), 100 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63081","name":"Remove vert body dcmprn crvl","description":"Vertebral corpectomy (vertebral body resection), partial or complete, anterior approach with decompression of spinal cord and/or nerve root(s); cervical, single segment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2001.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1434","name":"Inj, focinvez, 1mg","description":"Injection, fosaprepitant (focinvez), 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27727","name":"Repair of lower leg","description":"Repair of congenital pseudarthrosis, tibia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1221.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4032","name":"Rheumatology ss","description":"Rheumatology mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2472","name":"Inj, pantoprazole sodium chl","description":"Injection, pantoprazole sodium in sodium chloride (baxter), 40 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1421","name":"Dermatological care mvp","description":"Dermatological care mips value pathway","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90473","name":"Immune admin oral/nasal","description":"Immunization administration by intranasal or oral route; 1 vaccine (single or combination vaccine/toxoid)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4005","name":"Family medicine ss","description":"Family medicine mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1455","name":"Rep/rev cied","description":"Replaced or revised cied","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0449U","name":"Car scr sev inh cond 5 genes","description":"Car scr sev inh cond 5 genes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1266","name":"Pts admit snf","description":"Patients admitted to a skilled nursing facility (snf)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3502","name":"Surg exp root surf premolar","description":"Surg exp root surf premolar","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0629U","name":"Nfct ds tb dna aly 1trgt pcr","description":"Nfct ds tb dna aly 1trgt pcr","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81007","name":"Urine screen for bacteria","description":"Urinalysis; bacteriuria screen, except by culture or dipstick","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0872","name":"Daptomycin (xellia) unrefrig","description":"Injection, daptomycin (xellia), unrefrigerated, not therapeutically equivalent to j0878 or j0873, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1288","name":"Doc rsn no hbp scrn or f/u","description":"Documented reason for not screening or recommending a follow-up for high blood pressure","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0706","name":"Intraoral occlus radio image","description":"Intraoral occlus radio image","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0956T","name":"Prt crn ch cr&tun elt s-sclp","description":"Partial craniectomy, channel creation, and tunneling of electrode for sub-scalp implantation of an electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0362U","name":"Onc pap thyr ca rna 82&10","description":"Onc pap thyr ca rna 82&10","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1488","name":"Dx dementia in msr timeframe","description":"Patients with a diagnosis for dementia in the year before or during the period of evaluation","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0962T","name":"Asstv alg alys acous&ecg rec","description":"Assistive algorithmic analysis of acoustic and electrocardiogram recording for detection of cardiac dysfunction (eg, reduced ejection fraction, cardiac murmurs, atrial fibrillation), with review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11046","name":"Dbrdmt musc&/fsca ea addl","description":"Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); each additional 20 sq cm, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":54.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37267","name":"Revsc evsc fpvt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1012T","name":"Mtrz ab ntrno trph scl/tr mw","description":"Motorized ab interno trephination of sclera (sclerostomy), or trabecular meshwork (trabeculostomy), 1 or more, including injection of antifibrotic agents, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49189","name":"Opn exc/dst ntra-abd 20.1-30","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 20.1 to 30 cm","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0459","name":"Telehealth inpt pharm mgmt","description":"Inpatient telehealth pharmacologic management, including prescription, use, and review of medication with no more than minimal medical psychotherapy","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0673T","name":"Abltj b9 thyr ndul perq lasr","description":"Ablation, benign thyroid nodule(s), percutaneous, laser, including imaging guidance","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0174","name":"Lecanemab-irmb, for iv inj","description":"Lecanemab-irmb, for intravenous injection, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0555U","name":"Repr med pga embryonic te qc","description":"Repr med pga embryonic te qc","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0974T","name":"Slctv nzmtc dbrdmt t/a/l ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; each additional 100 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92632","name":"Hearing aid slctn svc ea add","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6193","name":"Replace implnt screw","description":"Replace implnt screw","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J9375","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0683T","name":"Prgrmg dev eval isdss ip","description":"Programming device evaluation (in-person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional, permanent implantable synchroni","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81459","name":"So neo gsap dna/dna&rna","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants, microsatellite instability, tumor mutation burden, and rearrangements","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20205","name":"Deep muscle biopsy","description":"Biopsy, muscle; deep","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1282","name":"Pt scrn tbco id as non user","description":"Patient screened for tobacco use and identified as a tobacco non-user","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81458","name":"So gsap dna cpy nmbr&mcrstl","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis, copy number variants and microsatellite instability","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33861","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2945.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4311","name":"Acesso, per sq cm","description":"Acesso, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1670","name":"Tetanus immune globulin inj","description":"Injection, tetanus immune globulin, human, up to 250 units","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43497","name":"Transorl lwr esophgl myotomy","description":"Lower esophageal myotomy, transoral (ie, peroral endoscopic myotomy [poem])","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4435","name":"Renati membrane per sq cm","description":"Renati membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7514","name":"Mycophenol (myhibbin) 100 mg","description":"Mycophenolate mofetil (myhibbin), oral suspension, 100 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11604","name":"Exc tr-ext mal+marg 3.1-4 cm","description":"Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 3.1 to 4.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5948","name":"Max implt sup fix part","description":"Max implt sup fix part","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4199","name":"Cygnus matrix, per sq cm","description":"Cygnus matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92631","name":"Hearing aid slctn svc 1st 30","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0266U","name":"Unxpl cnst hrtbl do gn xprsn","description":"Unexplained constitutional or other heritable disorders or syndromes, tissue-specific gene expression by whole-transcriptome and next-generation sequencing, blood, formalin-fixed paraffin-embedded (ffpe) tissue or fresh frozen tissue, reported as presence or absence of splicing or expression changes","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0388","name":"Bitewing image capture only","description":"Bitewing image capture only","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0328U","name":"Drug assay 120+ rx&metablt","description":"Drug assay 120+ rx&metablt","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98010","name":"Synch audio-only new mod 45","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection,","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2427","name":"Inj, invega hafyera/trinza","description":"Injection, paliperidone palmitate extended release (invega hafyera, or invega trinza), 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95071","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4440","name":"Curamatrix per sq cm","description":"Curamatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7172","name":"Inj marstacim-hncq, 0.5 mg","description":"Injection, marstacimab-hncq, 0.5 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1196","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1231","name":"Pt hcv tst no reactive res","description":"Patient receives hcv antibody test with nonreactive result","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42890","name":"Limited pharyngectomy","description":"Limited pharyngectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1271.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26844","name":"Fusion/graft of hand joint","description":"Arthrodesis, carpometacarpal joint, digit, other than thumb, each; with autograft (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1080.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99255","name":"Ip/obs consltj new/est hi 80","description":"Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 80 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92575","name":"Sensorineural acuity lvl tst","description":"Sensorineural acuity level test","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1247","name":"Pt resp true best int","description":"Patient responded completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76801","name":"Ob us < 14 wks single fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77089","name":"Tbs dxa cal w/i&r fx risk","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; using dual x-ray absorptiometry (dxa) or other imaging data on gray-scale variogram, calculation, with interpretation and report on fracture-risk","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77761","name":"Apply intrcav radiat simple","description":"Intracavitary radiation source application; simple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0010","name":"Eom meos payment","description":"Enhancing oncology model (eom) monthly enhanced oncology services (meos) payment for eom enhanced services","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0953T","name":"Tot impl amei rev/rplc w/o","description":"Totally implantable active middle ear hearing implant; revision or replacement, without mastoidectomy and replacement of sound processor","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50391","name":"Instll rx agnt into rnal tub","description":"Instillation(s) of therapeutic agent into renal pelvis and/or ureter through established nephrostomy, pyelostomy or ureterostomy tube (eg, anticarcinogenic or antifungal agent)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1612","name":"Inj glucagon (gvoke) 0.01 mg","description":"Injection, glucagon (gvoke), 0.01 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9938","name":"Fab removable appliance","description":"Fab removable appliance","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4326","name":"Woundplus, per sq cm","description":"Woundplus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63011","name":"Remove spine lamina 1/2 scrl","description":"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), 1 or 2 vertebral segments; sacral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1203.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0281","name":"Inj aminocaproic acid 1 gram","description":"Injection, aminocaproic acid, 1 gram","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1269","name":"Recd esrd mcp lst day of mo","description":"Receiving esrd mcp dialysis services by the provider on the last day of the reporting month","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0916T","name":"Insj perm ccm-d sys pg only","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator only","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0692T","name":"Therapeutic ultrafiltration","description":"Therapeutic ultrafiltration","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9610","name":"Xe129 xenon, diagnostic","description":"Xenon xe-129 hyperpolarized gas, diagnostic, per study dose","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1421","name":"Dermatological care mvp","description":"Dermatological care mips value pathway","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2305","name":"Inj, nitroglycerin, 5 mg","description":"Injection, nitroglycerin, 5 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2919","name":"Inj, methylpred sod succ 5mg","description":"Injection, methylprednisolone sodium succinate, 5 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2055","name":"Idecabtagene vicleucel car","description":"Idecabtagene vicleucel, up to 510 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0892","name":"Argatroban dialysis (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0927T","name":"Interrog dev eval ccm-d ip","description":"Interrogation device evaluation (in person) with analysis, review, and report, including connection, recording, and disconnection, per patient encounter, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0845T","name":"Dgtz gls mcrscp imfluor 1st","description":"Digitization of glass microscope slides for immunofluorescence, per specimen; initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87084","name":"Culture of specimen by kit","description":"Culture, presumptive, pathogenic organisms, screening only; with colony estimation from density chart","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7261","name":"Primary closure sinus perf","description":"Primary closure of a sinus perforation","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6603","name":"G com bandge low dn foamchnl","description":"Gradient compression bandaging supply, low density channel foam sheet, per 250 square centimeters, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0966T","name":"I&cst prp jw xpn dl arch fxd","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, fixed hinge mechanism","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1749","name":"Inj, iloprost, 0.1 mcg","description":"Injection, iloprost, 0.1 mcg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83520","name":"Immunoassay quant nos nonab","description":"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, not otherwise specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74019","name":"Radex abdomen 2 views","description":"Radiologic examination, abdomen; 2 views","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87902","name":"Nfct agt gntyp alys hep c","description":"Infectious agent genotype analysis by nucleic acid (dna or rna); hepatitis c virus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1349","name":"No pam inc 3 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 3 points within a 4 to 12 month period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7521","name":"Incision/drain abscess extra","description":"Incision and drainage of abscess - extraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1442","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2428","name":"Inj, erzofri, 1 mg","description":"Injection, paliperidone palmitate extended release (erzofri), 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1189","name":"Doc khe pef w/efgr/uacr","description":"Documentation of a kidney health evaluation defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr) performed","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0852T","name":"Dgtz gls mcrscp mphmtrc ea 1","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11952","name":"Subq njx fil matrl 5.1-10cc","description":"Subcutaneous injection of filling material (eg, collagen); 5.1 to 10.0 cc","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01941","name":"Anes neuromd/ntrvrt crv/thrc","description":"Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37295","name":"Rvsc evsc tpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46275","name":"Remove anal fist inter","description":"Surgical treatment of anal fistula (fistulectomy/fistulotomy); intersphincteric","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59852","name":"Induced abortion 1+njx hyst","description":"Induced abortion, by 1 or more intra-amniotic injections (amniocentesis-injections), including hospital admission and visits, delivery of fetus and secundines; with hysterotomy (failed intra-amniotic injection)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":495.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0411","name":"Hba1c in office testing","description":"Hba1c in office testing","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5931","name":"Surgical obturator","description":"Obturator prosthesis surgical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5100","name":"Inj ustekinumab-kfce, 1 mg","description":"Injection, ustekinumab-kfce (yesintek), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0741T","name":"Rem auton alg nsln data coll","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; provision of software, data collection, transmission, and storage, each 30 days","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0864T","name":"Low ntsty eswt corpus cvrnsm","description":"Low-intensity extracorporeal shock wave therapy involving corpus cavernosum, low energy","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4335","name":"Amnioplast 2, per sq cm","description":"Amnioplast 2, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2777","name":"Inj, faricimab-svoa, 0.1mg","description":"Injection, faricimab-svoa, 0.1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1014T","name":"Lap rv/rmv eso sph nstm eltr","description":"Laparoscopic revision or removal, lower esophageal sphincter neurostimulator electrodes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82656","name":"El-1 fecal qual/semiq","description":"Elastase, pancreatic (el-1), fecal; qualitative or semi-quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4269","name":"Surgraft xt per sq cm","description":"Surgraft xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0766T","name":"Tc mag stimj pn 1st nerve","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; first nerve","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99283","name":"Emergency dept visit low mdm","description":"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and low level of medical decision making","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97550","name":"Caregiver traing 1st 30 min","description":"Caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patie","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91322","name":"Sarscov2 vac 50 mcg/0.5ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 50 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2024","name":"Resolve or xenopatch sq cm","description":"Resolve matrix or xenopatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64473","name":"Lwr xtr fscl pln blk uni njx","description":"Lower extremity fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0553U","name":"Repr med pga embry te strux","description":"Repr med pga embry te strux","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1955","name":"Inj levocarnitine per 1 gm","description":"Injection, levocarnitine, per 1 gm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0685T","name":"Interrog dev eval isdss ip","description":"Interrogation device evaluation (in-person) with analysis, review and report by a physician or other qualified health care professional, including connection, recording and disconnection per patient encounter, permanent implantable synchronized diaphragmatic stimulation system for augmentation of ca","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44407","name":"Colonoscopy w/ndl aspir/bx","description":"Colonoscopy through stoma; with transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy(s), includes endoscopic ultrasound examination limited to the sigmoid, descending, transverse, or ascending colon and cecum and adjacent structures","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0696T","name":"Bdy surf mapg pm/cvdfb f/up","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of follow-up interrogation or programming device evaluatio","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0601U","name":"Nfct ds pji alys 11 bmrks ia","description":"Nfct ds pji alys 11 bmrks ia","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0933T","name":"Tcat impl wrls l atr prs snr","description":"Transcatheter implantation of wireless left atrial pressure sensor for long-term left atrial pressure monitoring, including sensor calibration and deployment, right heart catheterization, transseptal puncture, imaging guidance, and radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0234","name":"Intra inf, toci, second dos","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86360","name":"T cell absolute count/ratio","description":"T cells; absolute cd4 and cd8 count, including ratio","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01938","name":"Anes drg/aspir lmbr/sac","description":"Anesthesia for percutaneous image-guided injection, drainage or aspiration procedures on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29897","name":"Ankle arthroscopy/surgery","description":"Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; debridement, limited","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":649.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23000","name":"Rmvl sbdltd clcreous dep opn","description":"Removal of subdeltoid calcareous deposits, open","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28300","name":"Incision of heel bone","description":"Osteotomy; calcaneus (eg, dwyer or chambers type procedure), with or without internal fixation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":823.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87076","name":"Culture anaerobe ident each","description":"Culture, bacterial; anaerobic isolate, additional methods required for definitive identification, each isolate","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1170F","name":"Fxnl status assessed","description":"Functional status assessed (coa) (ra)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0049","name":"Main hemo in-cntr","description":"With maintenance hemodialysis (in-center and home hd) for the complete reporting month","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45332","name":"Sigmoidoscopy w/fb removal","description":"Sigmoidoscopy, flexible; with removal of foreign body(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0780T","name":"Instlj fecal microbiota ssp","description":"Instillation of fecal microbiota suspension via rectal enema into lower gastrointestinal tract","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69726","name":"Rmv ntr oi implt skl prq esp","description":"Removal, entire osseointegrated implant, skull; with percutaneous attachment to external speech processor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33287","name":"Rmv&rplcmt phrnc nrv stim pg","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0575U","name":"Trnsplj med lar rtpcr 4genes","description":"Trnsplj med lar rtpcr 4genes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0756T","name":"Dgtz gls mcrscp sld spc grpi","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group i, for microorganisms (eg, acid fast, methenamine silver) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1354","name":"Pt no suicd saf pln 120dy","description":"Patients who did not have a suicide safety plan initiated, reviewed, or updated or reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1255","name":"Pts w/ othr rsn vst,+prg tst","description":"Patients who have another reason for visiting the clinic [not prenatal or postpartum care] and have a positive pregnancy test but have not established the clinic as an ob provider (e.g., plan to terminate the pregnancy or seek prenatal services elsewhere)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20220","name":"Bone biopsy trocar/ndl supfc","description":"Biopsy, bone, trocar, or needle; superficial (eg, ilium, sternum, spinous process, ribs)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1150","name":"Lvef <=40% or mod/sev l vsf","description":"Current or prior left ventricular ejection fraction (lvef) less than or equal to 40% or documentation of moderately or severely depressed left ventricular systolic function","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81025","name":"Urine pregnancy test","description":"Urine pregnancy test, by visual color comparison methods","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0566U","name":"Onc lng qpcr-bsd alys 13dmrs","description":"Onc lng qpcr-bsd alys 13dmrs","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1296","name":"Calc bmi norm parameters","description":"Bmi is documented within normal parameters and no follow-up plan is required","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0565U","name":"Onc hcc ngs detc 6626epigalt","description":"Onc hcc ngs detc 6626epigalt","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1485","name":"Neg viro resp hep c/qual rna","description":"Patients who did not achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43274","name":"Ercp duct stent placement","description":"Endoscopic retrograde cholangiopancreatography (ercp); with placement of endoscopic stent into biliary or pancreatic duct, including pre- and post-dilation and guide wire passage, when performed, including sphincterotomy, when performed, each stent","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1412","name":"Met nsclc w/ egfr alk oth ab","description":"Patients with metastatic nsclc with epidermal growth factor receptor (egfr) mutations, alk genomic tumor aberrations, or other targetable genomic abnormalities with approved first-line targeted therapy, such as nsclc with ros1 rearrangement, braf v600e mutation, ntrk 1/2/3 gene fusion, met ex14 skip","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61552","name":"Release of skull seams","description":"Craniectomy for craniosynostosis; multiple cranial sutures","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1293.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1403","name":"Bslne and fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0389U","name":"Ped fbrl kd ifi27&mcemp1 rna","description":"Ped fbrl kd ifi27&mcemp1 rna","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4416","name":"Alexiguard tl-t per sq cm","description":"Alexiguard tl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57270","name":"Repair of bowel pouch","description":"Repair of enterocele, abdominal approach (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":880.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8611","name":"Oral methotrexate (jylamvo)","description":"Methotrexate (jylamvo), oral, 2.5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42975","name":"Dise eval slp do brth flx dx","description":"Drug-induced sleep endoscopy, with dynamic evaluation of velum, pharynx, tongue base, and larynx for evaluation of sleep-disordered breathing, flexible, diagnostic","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1210","name":">=2 same meds tbl4 not ord","description":"At least two orders for high-risk medications from the same drug class, (table 4), not ordered","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94720","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92524","name":"Behavral qualit analys voice","description":"Behavioral and qualitative analysis of voice and resonance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70472","name":"Ct cere prfu alys c+w/ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed with concurrent ct or ct angiography of the same anatomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37273","name":"Revsc evsc fpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96041","name":"Genetic counseling svc ea 30","description":"Medical genetics and genetic counseling services, each 30 minutes of total time provided by the genetic counselor on the date of the encounter","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4033","name":"Skilled nursing facility ss","description":"Skilled nursing facility mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49591","name":"Rpr aa hrn 1st < 3 cm rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, reducible","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49592","name":"Rpr aa hrn 1st < 3 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9887","name":"Distance learning attendance","description":"Behavioral counseling for diabetes prevention, distance learning, 60 minutes","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1652","name":"Fondaparinux sodium","description":"Injection, fondaparinux sodium, 0.5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0423","name":"Genetic test spec analysis","description":"Genetic test spec analysis","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37261","name":"Revsc evasc ivt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70472","name":"Ct cere prfu alys c+w/ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed with concurrent ct or ct angiography of the same anatomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0945","name":"Brompheniramine maleate inj","description":"Injection, brompheniramine maleate, per 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1001T","name":"Autol musc cell therapy njx","description":"Autologous muscle cell therapy, injection of muscle progenitor cells into the external anal sphincter, including ultrasound guidance, when performed","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1194","name":"Med rsn no imp/con mmr/msi","description":"Documentation of medical reason(s) surgical pathology reports did not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both tests were not included (e.g., patient will not be treated with checkpoint inhibitor therap","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3392","name":"Inj, exagamglogene autotem","description":"Injection, exagamglogene autotemcel, per treatment","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0337U","name":"Onc plsm cell do&myeloma id","description":"Onc plsm cell do&myeloma id","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1204","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1334","name":"Pts act pvd 2 wks 2 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 2 weeks after initial acute pvd encounter","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61332","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2154.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9610","name":"Xe129 xenon, diagnostic","description":"Xenon xe-129 hyperpolarized gas, diagnostic, per study dose","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9275","name":"Inj cosibelimab-ipdl, 2 mg","description":"Injection, cosibelimab-ipdl, 2 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4224","name":"Supply insulin inf cath/wk","description":"Supplies for maintenance of insulin infusion catheter, per week","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0387","name":"Comp image capture only","description":"Comp image capture only","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92570","name":"Acoustic immitance testing","description":"Acoustic immittance testing, includes tympanometry (impedance testing), acoustic reflex threshold testing, and acoustic reflex decay testing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":26.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0426","name":"Coll, analys of saliva","description":"Coll, analys of saliva","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4468","name":"Exsuff belt incl all sup acc","description":"Exsufflation belt, includes all supplies and accessories","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33697","name":"Compl rpr tof w/pulm atresia","description":"Complete repair tetralogy of fallot with pulmonary atresia including construction of conduit from right ventricle to pulmonary artery and closure of ventricular septal defect","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2431.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1456","name":"Pt had htx","description":"Patient had a heart transplant","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68840","name":"Explore/irrigate tear ducts","description":"Probing of lacrimal canaliculi, with or without irrigation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0553","name":"Monthly tx for dmht 20mins","description":"First 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing information related to the use of","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9999","name":"Doc sys rsn <3 colon","description":"Documentation of system reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., unable to locate previous colonoscopy report, patient cannot provide precise date or details from previous colonoscopy, previous colonoscopy report was incomplete)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7471","name":"Rem exostosis any site","description":"Removal of lateral exostosis (maxilla or mandible)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1033","name":"Sv doula brth wrk per diem","description":"Services performed by a doula birth worker, per diem","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42720","name":"I&d absc phrngl ntraorl appr","description":"Incision and drainage abscess; retropharyngeal or parapharyngeal, intraoral approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0822T","name":"Mntr psychdlc med cln staff","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; clinical staff under the direction of a physician or other qualified health care professional, concurrent with first physician or other qualified health care p","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37263","name":"Revsc evasc fpvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27705","name":"Osteotomy tibia","description":"Osteotomy; tibia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":925.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0965T","name":"I&cst prp jw xpn dl arch non","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, non-fixed hinge mechanism","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29015","name":"Appl rissr jacket bdy w/head","description":"Application of risser jacket, localizer, body; including head","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1243","name":"Pt othr thn true heard","description":"Patient provided a response other than completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0434U","name":"Rx metab advrs vrnt alys 25","description":"Rx metab advrs vrnt alys 25","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0801T","name":"Tcat rmv&rpl 2chmbr ldls pm","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; dual-cha","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15017","name":"App skn cll ssp f/n/g/hf 1st","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 480 sq cm or less","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21127","name":"Augmentation mndblr b1 grf","description":"Augmentation, mandibular body or angle; with bone graft, onlay or interpositional (includes obtaining autograft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1002.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1206","name":"Isa not red 3pts/no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76802","name":"Ob us < 14 wks addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85651","name":"Rbc sed rate nonautomated","description":"Sedimentation rate, erythrocyte; non-automated","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9026","name":"Cryo fib comp path redu each","description":"Cryoprecipitated fibrinogen complex, pathogen reduced, each unit","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4380","name":"Advograft one per sq cm","description":"Advograft one, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0541U","name":"Cv ds hdl rct cec lc-ms/ms 5","description":"Cv ds hdl rct cec lc-ms/ms 5","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0737T","name":"Xenograft impltj artclr surf","description":"Xenograft implantation into the articular surface","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90997","name":"Hemoperfusion","description":"Hemoperfusion (eg, with activated charcoal or resin)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7415","name":"Excision malig les complicat","description":"Excision of malignant lesion complicated","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27848","name":"Treat ankle dislocation","description":"Open treatment of ankle dislocation, with or without percutaneous skeletal fixation; with repair or internal or external fixation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1042.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0542U","name":"Nefro renal trnspl ur nmr 84","description":"Nefro renal trnspl ur nmr 84","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q0224","name":"Inj, pemivibart, 4500 mg","description":"Injection, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, and who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppressive ","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0840T","name":"Dgtz gls mcrscp cslt compre","description":"Digitization of glass microscope slides for consultation, comprehensive, with review of records and specimens, with report on referred material (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92928","name":"Prq tcat plmt ntrac st 1 les","description":"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 1 lesion involving 1 or more coronary segments","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0527","name":"Mgt est pt dmentia low cmplx","description":"Management of established patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82166","name":"Assay anti-mullerian horm","description":"Anti-mullerian hormone (amh)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2679","name":"Inj fluphenazine hcl 1.25 mg","description":"Injection, fluphenazine hcl, 1.25 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0288U","name":"Onc lung mrna quan pcr 11&3","description":"Onc lung mrna quan pcr 11&3","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25690","name":"Cltx lunate dislc w/mnpj","description":"Closed treatment of lunate dislocation, with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":542.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0570U","name":"Neurol tbi alys gfap&uch-l1","description":"Neurol tbi alys gfap&uch-l1","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1299","name":"Inj, eculizumab, 2 mg","description":"Injection, eculizumab, 2 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0719T","name":"Pst vrt jt rplcmt lmbr 1 sgm","description":"Posterior vertebral joint replacement, including bilateral facetectomy, laminectomy, and radical discectomy, including imaging guidance, lumbar spine, single segment","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87626","name":"Hpv sep hi-rsk typ&pool rslt","description":"Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), separately reported high-risk types (eg, 16, 18, 31, 45, 51, 52) and high-risk pooled result(s)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97016","name":"Vasopneumatic device therapy","description":"Application of a modality to 1 or more areas; vasopneumatic devices","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86036","name":"Anca screen each antibody","description":"Antineutrophil cytoplasmic antibody (anca); screen, each antibody","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4390","name":"Ascendion per sq cm","description":"Ascendion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4330","name":"Total, per sq cm","description":"Total, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71552","name":"Mri chest w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1372.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98979","name":"Rtm tx mgmt 1st 10 min","description":"Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least 1 real-time interactive communication with the patient or caregiver during the calendar month; first 10 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1206","name":"Isa not red 3pts/no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4417","name":"Alexiguard dl-t per sq cm","description":"Alexiguard dl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0177","name":"Inj, aflibercept hd, 1 mg","description":"Injection, aflibercept hd, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4199","name":"Cygnus matrix, per sq cm","description":"Cygnus matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1283","name":"Pt scrn tbco and id as user","description":"Patient screened for tobacco use and identified as a tobacco user","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9871","name":"Bhv couns dm prev, onln 60 m","description":"Behavioral counseling for diabetes prevention, online, 60 minutes","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19324","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":526.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1681","name":"Ho bilateral hip abduction","description":"Hip orthosis, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0959T","name":"Rmv/rplc magnet coil assem","description":"Removal or replacement of magnet from coil assembly that is connected to continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31580","name":"Laryngoplasty laryngeal web","description":"Laryngoplasty; for laryngeal web, with indwelling keel or stent insertion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1328.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0579U","name":"Nfro dbtc ckd elisa apoa4","description":"Nfro dbtc ckd elisa apoa4","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0714T","name":"Tpla b9 prst8 hyprplsa<50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume less than 50 ml","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1494","name":"Fall rep since last visit","description":"Patients that reported a fall since the last visit","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7912","name":"Suture complicate wnd > 5 cm","description":"Complicated suture-greater than 5 cm","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36247","name":"Ins cath abd/l-ext art 3rd","description":"Selective catheter placement, arterial system; initial third order or more selective abdominal, pelvic, or lower extremity artery branch, within a vascular family","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0877T","name":"Augmnt alys ch ct ild w/o ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4426","name":"Dermbnd tl+, tlx per sq cm","description":"Dermabind tl + or dermabind tl x,  per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0603U","name":"Rx asy prsmv 77rx/metablt ur","description":"Rx asy prsmv 77rx/metablt ur","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85007","name":"Bl smear w/diff wbc count","description":"Blood count; blood smear, microscopic examination with manual differential wbc count","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0777T","name":"R-t prs sensing edrl gdn sys","description":"Real-time pressure-sensing epidural guidance system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78278","name":"Acute gi blood loss imaging","description":"Acute gastrointestinal blood loss imaging","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1402","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4271","name":"Complete ft per sq cm","description":"Complete ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4038","name":"Vascular surgery ss","description":"Vascular surgery mips specialty set","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1376","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2359","name":"Inj. olanzapine, 0.5mg","description":"Injection, olanzapine, 0.5 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5934","name":"Mandibular flange prosthesis","description":"Mandibular resection prosthesis with guide flange","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1460","name":"Dx copd, cf, or arf","description":"Diagnosis for chronic obstructive pulmonary disease, emphysema, cystic fibrosis, or acute respiratory failure","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33897","name":"Perq trluml angp nt/recr coa","description":"Percutaneous transluminal angioplasty of native or recurrent coarctation of the aorta","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1381","name":"Pt sec strk wthin 5 days","description":"Patients with secondary stroke (e.g., a subsequent stroke that may occur with vasospasm in the setting of subarachnoid hemorrhage) within 5 days of the initial procedure","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0989T","name":"Revj/rmvl ins ptn subq&subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75998","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0944T","name":"3d cntr simula trgt lvr les","description":"3d contour simulation of target liver lesion(s) and margin(s) for image-guided percutaneous microwave ablation","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7472","name":"Removal of torus palatinus","description":"Removal of torus palatinus","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43290","name":"Egd flx trnsorl dplmnt balo","description":"Esophagogastroduodenoscopy, flexible, transoral; with deployment of intragastric bariatric balloon","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76066","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1275","name":"Pts hosp exl","description":"Patients determined to be in hospice were excluded from month of evaluation and the remainder of reporting period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22900","name":"Exc abdl tum deep < 5 cm","description":"Excision, tumor, soft tissue of abdominal wall, subfascial (eg, intramuscular); less than 5 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78491","name":"Myocrd img pet 1std rst/strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); single study, at rest or stress (exercise or pharmacologic)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1145.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1493","name":"No fall doc med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6601","name":"G com bandge hgh dn foam pad","description":"Gradient compression bandaging supply, high density foam pad, any size or shape, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24675","name":"Cltx ulnar fx prox w/mnpj","description":"Closed treatment of ulnar fracture, proximal end (eg, olecranon or coronoid process[es]); with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1202","name":"Pt rsn no ace-i/arb rx","description":"Documentation of patient reason(s) for not prescribing ace inhibitor or arb therapy during the measurement period, (e.g., patient declined, other patient reasons)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0794T","name":"Pt spec alg rx-onc tx option","description":"Patient-specific, assistive, rules-based algorithm for ranking pharmaco-oncologic treatment options based on the patients tumor-specific cancer marker information obtained from prior molecular pathology, immunohistochemical, or other pathology results which have been previously interpreted and repor","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34825","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":861.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83987","name":"Exhaled breath condensate","description":"Ph; exhaled breath condensate","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93000","name":"Electrocardiogram complete","description":"Electrocardiogram, routine ecg with at least 12 leads; with interpretation and report","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9277","name":"Pembrolizumab 1mg berahyalur","description":"Injection, pembrolizumab, 1 mg and berahyaluronidase alfa-pmph","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49615","name":"Rpr aa hrn rcr 3-10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, reducible","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0575U","name":"Trnsplj med lar rtpcr 4genes","description":"Trnsplj med lar rtpcr 4genes","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0678T","name":"Laps repos lead isdss ea add","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional repositioned lead (list separately in addition to code for primary proce","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0483U","name":"Nfct ds ng gyra s91f pt mut","description":"Nfct ds ng gyra s91f pt mut","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33916","name":"Surgery of great vessel","description":"Pulmonary endarterectomy, with or without embolectomy, with cardiopulmonary bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1826.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2516","name":"Inj, pentamidine isethionate","description":"Injection, pentamidine isethionate, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0664","name":"Team remote e/m new pt 60 mn","description":"Team remote e/m new pt 60mins","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33422","name":"Revision of mitral valve","description":"Valvotomy, mitral valve; open heart, with cardiopulmonary bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1949.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0918T","name":"Insj perm ccm-d sys dual ld","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; dual transvenous leads (pacing and defibrillation) only","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0899","name":"Argatroban dialysis, auromed","description":"Injection, argatroban (auromedics), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1292","name":"Pt 66+ frail inpt adv ill","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and an advanced illness diagnosis during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4388","name":"Neothelium 4l per sq cm","description":"Neothelium 4l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1202","name":"Miglustat oral 65 mg","description":"Miglustat, oral, 65 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0524","name":"Est pt-cg dyad dem low cmplx","description":"Management of established patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9563","name":"Ht inj immuno diem","description":"Home injectable therapy, immunotherapy, 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":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0707","name":"Intraoral periap radio image","description":"Intraoral periap radio image","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91022","name":"Duodenal motility study","description":"Duodenal motility (manometric) study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1329","name":"Pts act pvd 2 wks 8 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 8 weeks after initial acute pvd encounter","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87077","name":"Culture aerobic identify","description":"Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0876T","name":"Duplex scan hemo fstl lmtd","description":"Duplex scan of hemodialysis fistula, computer-aided, limited (volume flow, diameter, and depth, including only body of fistula)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6561","name":"G stockng full/chap 40+ cust","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, custom, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1193","name":"Rpts w/ imp/con mmr/msi","description":"Surgical pathology reports that contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1414","name":"Inj, beqvez, per tx dose","description":"Injection, fidanacogene elaparvovec-dzkt, per therapeutic dose","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1406","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1305","name":"Inj, evinacumab-dgnb, 5mg","description":"Injection, evinacumab-dgnb, 5mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28297","name":"Cor hlx vlgs jt arthrd","description":"Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with first metatarsal and medial cuneiform joint arthrodesis, any method","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87084","name":"Culture of specimen by kit","description":"Culture, presumptive, pathogenic organisms, screening only; with colony estimation from density chart","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64655","name":"Revj/rplcmt bat mod sys lead","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; lead only","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0846T","name":"Dgtz gls mcrscp imfluor ea","description":"Digitization of glass microscope slides for immunofluorescence, per specimen; each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1309","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91320","name":"Sarscv2 vac 30mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 30 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1478","name":"Psychoactive sub abuse","description":"Psychoactive substance abuse","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0693T","name":"Compre ful bdy 3d mtn alys","description":"Comprehensive full body computer-based markerless 3d kinematic and kinetic motion analysis and report","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0268U","name":"Hem ahus gen seq alys 15 gen","description":"Hematology (atypical hemolytic uremic syndrome [ahus]), genomic sequence analysis of 15 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1576","name":"Inj, panzyga, 500 mg","description":"Injection, immune globulin (panzyga), intravenous, non-lyophilized (e.g., liquid), 500 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0375U","name":"Onc ovrn bchm asy 7 prtn alg","description":"Onc ovrn bchm asy 7 prtn alg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33268","name":"Excl laa opn oth px any meth","description":"Exclusion of left atrial appendage, open, performed at the time of other sternotomy or thoracotomy procedure(s), any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0206","name":"Inj allopurinol sodium 1 mg","description":"Injection, allopurinol sodium, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1370","name":"Inj, esomeprazole sod, 1 mg","description":"Injection, esomeprazole sodium, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1332","name":"Pts no eval ini xm no 2 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 2 weeks","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0850T","name":"Dgtz gls mcrscp ish ea mult","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0955T","name":"Tot impl amei removal","description":"Totally implantable active middle ear hearing implant; removal, including removal of sound processor and all implant components","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0515U","name":"Gi ibd ia quan deter ifx lvl","description":"Gi ibd ia quan deter ifx lvl","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37268","name":"Revsc evasc fpvt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0377U","name":"Cv ds quan advsrm/plsm lprtn","description":"Cv ds quan advsrm/plsm lprtn","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0625U","name":"Endocrinol op dna alys>5000","description":"Endocrinol op dna alys>5000","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9939","name":"Placemnt removable appliance","description":"Placemnt removable appliance","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0033","name":"2+ benzo seiz","description":"Two or more benzodiazepine prescriptions ordered for patients who had a diagnosis of seizure disorders, rapid eye movement sleep behavior disorder, benzodiazepine withdrawal, ethanol withdrawal, or severe generalized anxiety disorder on or between january 1 of the year prior to the measurement perio","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37293","name":"Rvsc evsc tpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1244","name":"Pt othr thn true best int","description":"Patient provided a response other than completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31515","name":"Laryngoscopy for aspiration","description":"Laryngoscopy direct, with or without tracheoscopy; for aspiration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9298","name":"Inj nivol relatlimab 3mg/1mg","description":"Injection, nivolumab and relatlimab-rmbw, 3 mg/1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0737T","name":"Xenograft impltj artclr surf","description":"Xenograft implantation into the articular surface","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1597","name":"Inj glycopyrrolate, glyrx-pf","description":"Injection, glycopyrrolate (glyrx-pf), 0.1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8005","name":"Grip glove w microprocessor","description":"Powered, cable driven grip assist glove, hand, finger, includes microprocessor, pressure sensors, all components and accessories, custom fitted","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8612","name":"Oral methotrexate (xatmep)","description":"Methotrexate (xatmep), oral, 2.5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0283U","name":"Vw factor type 2b eval plsm","description":"Von willebrand factor (vwf), type 2b, platelet-binding evaluation, radioimmunoassay, plasma","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3244","name":"Inj. tigecycline (accord)","description":"Injection, tigecycline (accord), not therapeutically equivalent to j3243, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0556U","name":"Nfct ds p-s dna&rna 12 trgts","description":"Nfct ds p-s dna&rna 12 trgts","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4003","name":"Emergency med ss","description":"Emergency medicine mips specialty set","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1611","name":"Inj glucagon hcl, fresenius","description":"Injection, glucagon hydrochloride (fresenius kabi), not therapeutically equivalent to j1610, per 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0626U","name":"Neurol pd dna alys >20000","description":"Neurol pd dna alys >20000","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7294","name":"Seg acet and eth estr yearly","description":"Segesterone acetate and ethinyl estradiol 0.15mg, 0.013mg per 24 hours; yearly vaginal system, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20606","name":"Drain/inj joint/bursa w/us","description":"Arthrocentesis, aspiration and/or injection, intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa); with ultrasound guidance, with permanent recording and reporting","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1468","name":"Hep b vaccine received","description":"Patient received recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44404","name":"Colonoscopy w/injection","description":"Colonoscopy through stoma; with directed submucosal injection(s), any substance","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":506.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37275","name":"Rvsc evsc fpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2041","name":"Coord special care encounter","description":"Coordinated specialty care, team-based, for first episode psychosis, per encounter","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5153","name":"Inj, aflibercept-yszy, 1 mg","description":"Injection, aflibercept-yszy (opuviz), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28288","name":"Partial removal of foot bone","description":"Ostectomy, partial, exostectomy or condylectomy, metatarsal head, each metatarsal head","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0672T","name":"Ndovag cryg rf remdl tiss","description":"Endovaginal cryogen-cooled, monopolar radiofrequency remodeling of the tissues surrounding the female bladder neck and proximal urethra for urinary incontinence","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0166","name":"Inj epinephrine (bpi)","description":"Injection, epinephrine (bpi), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7298","name":"Remove screw retained plate","description":"Remove screw retained plate","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1286","name":"Bmi doc onl fup not cmpltd","description":"Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0043","name":"Pt mech pros ht valv","description":"Patients with mechanical prosthetic heart valve","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72196","name":"Mri pelvis w/dye","description":"Magnetic resonance (eg, proton) imaging, pelvis; with contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6035","name":"Prosthetic digit mechanical","description":"Single prosthetic digit, mechanical, can include metacarpophalangeal (mcp), proximal interphalangeal (pip), and/or distal interphalangeal (dip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52443","name":"Cysto 1st trurl prst8 comis","description":"Cystourethroscopy with initial transurethral anterior prostate commissurotomy with a nondrug-coated balloon catheter followed by therapeutic drug delivery into the prostate by a drug-coated balloon catheter, including transrectal ultrasound and fluoroscopy, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15854","name":"Removal sutr&stapl xreq anes","description":"Removal of sutures and staples not requiring anesthesia (list separately in addition to e/m code)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0825T","name":"Tcat rmv&rpl1chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or prog","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4345","name":"Matrix hd allogrft per sq cm","description":"Matrix hd allograft dermis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0332U","name":"Onc pan tum gen prflg 8 dna","description":"Onc pan tum gen prflg 8 dna","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59610","name":"Vbac delivery","description":"Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care, after previous cesarean delivery","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2710.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0998T","name":"Precuneus mag stimj tx dlvr","description":"Precuneus magnetic stimulation; personalized treatment delivery of magnetic stimulation therapy to a prespecified target area derived from analysis of evoked potentials within the precuneus, utilizing magnetic resonance imaging-based neuronavigation, with management, per day","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0706T","name":"Rem tx amblyopia i&r phy/qhp","description":"Remote treatment of amblyopia using an eye tracking device; interpretation and report by physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0900T","name":"N-invas est aqmbf asstv cmr","description":"Noninvasive estimate of absolute quantitation of myocardial blood flow (aqmbf), derived from assistive algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health care profes","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58580","name":"Transcrv abltj utrn fibrd rf","description":"Transcervical ablation of uterine fibroid(s), including intraoperative ultrasound guidance and monitoring, radiofrequency","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90966","name":"Esrd home pt serv p mo 20+","description":"End-stage renal disease (esrd) related services for home dialysis per full month, for patients 20 years of age and older","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76984","name":"Dx intraop thoracic aorta us","description":"Ultrasound, intraoperative thoracic aorta (eg, epiaortic), diagnostic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1490","name":"Pt status not doc","description":"Patient status not documented","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01941","name":"Anes neuromd/ntrvrt crv/thrc","description":"Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9994","name":"Pall serv during meas","description":"Patient is using palliative care services any time during the measurement period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21029","name":"Contour of face bone lesion","description":"Removal by contouring of benign tumor of facial bone (eg, fibrous dysplasia)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1394","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9272","name":"Inj, dostarlimab-gxly, 10 mg","description":"Injection, dostarlimab-gxly, 10 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0748T","name":"Njx stm cl prdct anl sft tis","description":"Injections of stem cell product into perianal perifistular soft tissue, including fistula preparation (eg, removal of setons, fistula curettage, closure of internal openings)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1377","name":"Fu colscop 10 yr doc w/ disc","description":"Recommended follow-up interval for repeat colonoscopy of 10 years documented  in colonoscopy report and communicated with patient","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0444U","name":"Onc sld orgn neo tgsap 361","description":"Onc sld orgn neo tgsap 361","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71550","name":"Mri chest w/o dye","description":"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":653.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0726T","name":"Rmvl implt vstibular dev uni","description":"Removal of implanted vestibular device, unilateral","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0040","name":"Pt phys/occ therapy","description":"Patient already receiving physical/occupational/speech/recreational therapy during the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38242","name":"Transplt allo lymphocytes","description":"Allogeneic lymphocyte infusions","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69601","name":"Revj mstdc rsltg compl mstdc","description":"Revision mastoidectomy; resulting in complete mastoidectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1209.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8502","name":"Inj, aponvie, 1 mg","description":"Injection, aprepitant (aponvie), 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2644","name":"Dental onlay porc 4/more sur","description":"Onlay - porcelain/ceramic - four or more surfaces","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37261","name":"Revsc evasc ivt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90483","name":"Imm cnsl not admn sm>10<20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 10 minutes up to 20 minutes","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1151","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1167","name":"Hspc dur meas pd","description":"In hospice or using hospice services during the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6516","name":"Grad com wrap w strap foo cu","description":"Gradient compression wrap with adjustable straps, foot, each, custom","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7956","name":"Tiss regen edent resorb","description":"Tiss regen edent resorb","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0986T","name":"Iv img icr cere vsl oct 1st","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11201","name":"Rmvl skin tags ea addl 10","description":"Removal of skin tags, multiple fibrocutaneous tags, any area; each additional 10 lesions, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":20.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5125","name":"Inj, releuko 1 mcg","description":"Injection, filgrastim-ayow, biosimilar, (releuko), 1 microgram","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0560","name":"Safety plan interven","description":"Safety planning interventions, each 20 minutes personally performed by the billing practitioner, including assisting the patient in the identification of the following personalized elements of a safety plan: recognizing warning signs of an impending suicidal or substance use-related crisis; employin","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0784T","name":"Ins/rplmt eltrd ra spi nstim","description":"Insertion or replacement of percutaneous electrode array, spinal, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1012T","name":"Mtrz ab ntrno trph scl/tr mw","description":"Motorized ab interno trephination of sclera (sclerostomy), or trabecular meshwork (trabeculostomy), 1 or more, including injection of antifibrotic agents, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0753T","name":"Dgtz gls mcrscp sld level iv","description":"Digitization of glass microscope slides for level iv, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0402","name":"Inj, abilify asimtufii, 1 mg","description":"Injection, aripiprazole (abilify asimtufii), 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3472","name":"Surg rep root res premolar","description":"Surg rep root res premolar","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0650","name":"Inj, levothyroxine nos 10mcg","description":"Injection, levothyroxine sodium, not otherwise specified, 10 mcg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7356","name":"Inj foscarb/foslevodopa 5 mg","description":"Injection, foscarbidopa 0.25 mg/foslevodopa 5 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54150","name":"Circumcision w/regionl block","description":"Circumcision, using clamp or other device with regional dorsal penile or ring block","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":81.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87449","name":"Nos each organism ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; not otherwise specified, each organism","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90759","name":"Hep b vac 3ag 10mcg 3 dos im","description":"Hepatitis b vaccine (hepb), 3-antigen (s, pre-s1, pre-s2), 10 mcg dosage, 3 dose schedule, for intramuscular use","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68505","name":"Partial removal tear gland","description":"Excision of lacrimal gland (dacryoadenectomy), except for tumor; partial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":988.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0555","name":"Replacment pt electronic sys","description":"Provision of replacement patient electronics system (e.g., system pillow, handheld reader) for home pulmonary artery pressure monitoring","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1181","name":"Gr 2 or> dia or gr2 or> col","description":"Grade 2 or above diarrhea and/or grade 2 or above colitis","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0854T","name":"Dgtz gls mcrscp bld smr prph","description":"Digitization of glass microscope slides for blood smear, peripheral, interpretation by physician with written report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7174","name":"Injection fitusiran 0.04 mg","description":"Injection, fitusiran, 0.04 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72285","name":"Discography cerv/thor spine","description":"Discography, cervical or thoracic, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94618","name":"Pulmonary stress testing","description":"Pulmonary stress testing (eg, 6-minute walk test), including measurement of heart rate, oximetry, and oxygen titration, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0009","name":"Admin pneumococcal vaccine","description":"Administration of pneumococcal vaccine","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0749T","name":"B1 str&fx rsk assmt dxr-bmd","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2037","name":"G4derm plus/suprello, pr ml","description":"G4derm plus/suprello, per milliliter","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0615","name":"Calcium acetate, oral, 23 mg","description":"Calcium acetate, oral, 23 mg (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88107","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86327","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1338","name":"Pt f/u 30-180 dys no + imprv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who did not demonstrate positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0071A","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11101","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0155","name":"Dronabinol (syndros) 0.1 mg","description":"Dronabinol (syndros), 0.1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0556U","name":"Nfct ds p-s dna&rna 12 trgts","description":"Nfct ds p-s dna&rna 12 trgts","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0855T","name":"Dgtz gls mcrscp b1 marow smr","description":"Digitization of glass microscope slides for bone marrow, smear interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33641","name":"Repair heart septum defect","description":"Repair atrial septal defect, secundum, with cardiopulmonary bypass, with or without patch","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1526.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7411","name":"Excision benign lesion>1.25c","description":"Excision of benign lesion greater than 1.25 cm","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1304","name":"Inj tofersen intrathec 1 mg","description":"Injection, tofersen, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1344","name":"No bsln/2nd pam score 4-12mo","description":"Patients who did not have a baseline pam score and/or a second score within 4 to 12 months of baseline pam score","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0538U","name":"Onc sol tum ngts ffpe 600gen","description":"Onc sol tum ngts ffpe 600gen","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87158","name":"Culture typing added method","description":"Culture, typing; other methods","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0051","name":"Traditional healing service","description":"Traditional healing service","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2024","name":"Resolve or xenopatch sq cm","description":"Resolve matrix or xenopatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1433","name":"Oral chemo wthn 30 days enc","description":"Patient on oral chemotherapy on or within 30 days before denominator eligible encounter","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57292","name":"Construct vagina with graft","description":"Construction of artificial vagina; with graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":963.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0289U","name":"Neuro alzheimer mrna 24 gen","description":"Neuro alzheimer mrna 24 gen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0556U","name":"Nfct ds p-s dna&rna 12 trgts","description":"Nfct ds p-s dna&rna 12 trgts","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83009","name":"H pylori (c-13) blood","description":"Helicobacter pylori, blood test analysis for urease activity, non-radioactive isotope (eg, c-13)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4015","name":"Neurology ss","description":"Neurology mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1384","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0675","name":"Inj, carboprost, 0.1 mg","description":"Injection, carboprost tromethamine, 0.1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5612","name":"Rep resin part dent base max","description":"Rep resin part dent base max","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46936","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1193","name":"Rpts w/ imp/con mmr/msi","description":"Surgical pathology reports that contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2027","name":"Matriderm per sq cm","description":"Matriderm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58563","name":"Hysteroscopy ablation","description":"Hysteroscopy, surgical; with endometrial ablation (eg, endometrial resection, electrosurgical ablation, thermoablation)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0709","name":"Intraoral cmplt radio images","description":"Intraoral cmplt radio images","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57420","name":"Exam of vagina w/scope","description":"Colposcopy of the entire vagina, with cervix if present;","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":92.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2015","name":"Phoenix wnd mtrx, per sq cm","description":"Phoenix wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0854T","name":"Dgtz gls mcrscp bld smr prph","description":"Digitization of glass microscope slides for blood smear, peripheral, interpretation by physician with written report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0275U","name":"Hem heprn nduc trmbctpna srm","description":"Hematology (heparin-induced thrombocytopenia) platelet antibody reactivity by flow cytometry, serum","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2035","name":"Corpl p therac p allac p mg","description":"Corplex p or theracor p or allacor p, per milligram","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4403","name":"Xwrap dual plus per sq cm","description":"Xwrap dual plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0980T","name":"Sbmcsl crylys ther tng&tnsl","description":"Submucosal cryolysis therapy; base of tongue and lingual tonsil only","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97009","name":"Mchnl sclp cool after chemo","description":"Mechanical scalp cooling; provided after discontinuation of chemotherapy, each 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0339U","name":"Onc prst8 mrna hoxc6 & dlx1","description":"Onc prst8 mrna hoxc6 & dlx1","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1367","name":"Qual care ent disorder mvp","description":"Quality care for the treatment of ear, nose, and throat disorders mips value pathway","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31830","name":"Revise windpipe scar","description":"Revision of tracheostomy scar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1225","name":"Iop dec>=20% from base","description":"Intraocular pressure (iop) reduced by a value of greater than or equal to 20% from the pre-intervention level","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98979","name":"Rtm tx mgmt 1st 10 min","description":"Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least 1 real-time interactive communication with the patient or caregiver during the calendar month; first 10 minutes","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0611U","name":"Onc lvr alys >1000 mr cfdna","description":"Onc lvr alys >1000 mr cfdna","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1011T","name":"Pbm therapy of oral cavity","description":"Photobiomodulation (pbm) therapy of oral cavity, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1491","name":"Recd esrd mcp dur perf pd","description":"Receiving esrd mcp dialysis services by the provider during the performance period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4392","name":"Grafix duo per sq cm","description":"Grafix duo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0996T","name":"Ins&sclr fix caps bag prosth","description":"Insertion and scleral fixation of a capsular bag prosthesis containing an intraocular lens prosthesis, with vitrectomy, including removal of crystalline lens or dislocated intraocular lens prosthesis, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1015T","name":"Rev/rmv lw esoph sphnc npg/r","description":"Revision or removal, lower esophageal sphincter neurostimulator pulse generator or receiver","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82465","name":"Assay bld/serum cholesterol","description":"Cholesterol, serum or whole blood, total","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26115","name":"Exc hand les sc < 1.5 cm","description":"Excision, tumor or vascular malformation, soft tissue of hand or finger, subcutaneous; less than 1.5 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0531U","name":"Nfct ds afb&inv fng 673orgs","description":"Nfct ds afb&inv fng 673orgs","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0781T","name":"Brnchsc rf dstrj pulm nrv bi","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; bilateral mainstem bronchi","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37296","name":"Revsc evasc imvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0531","name":"Fclty-based respite, 24 hr u","description":"Facility-based respite, 24-hour unit, for use in cmmi model","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"14041","name":"Tis trnfr f/c/c/m/n/a/g/h/f","description":"Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; defect 10.1 sq cm to 30.0 sq cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":928.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0400U","name":"Ob xpnd car scr 145 genes","description":"Ob xpnd car scr 145 genes","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5135","name":"Inj, tyenne, 1 mg","description":"Injection, tocilizumab-aazg (tyenne), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32100","name":"Exploration of chest","description":"Thoracotomy; with exploration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1132.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37269","name":"Revsc evasc fpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0534","name":"Coordinated care/or referral","description":"Coordinated care and/or referral services, such as to adequate and accessible community resources to address unmet health-related social needs, including harm reduction interventions and recovery support services a patient needs and wishes to pursue, which significantly limit the ability to diagnose","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0613","name":"Calcium glucon (wg critical)","description":"Injection, calcium gluconate (wg critical care), not therapeutically equivalent to j0612, 10 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4005","name":"Family medicine ss","description":"Family medicine mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6081","name":"Scale & debride, single imp","description":"Scale & debride, single imp","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2780","name":"Crown 3/4 cast hi noble met","description":"Crown - 3/4 cast high noble metal","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"Adju cgm supply allowance","description":"Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26650","name":"Treat thumb fracture","description":"Percutaneous skeletal fixation of carpometacarpal fracture dislocation, thumb (bennett fracture), with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1350","name":"Pt w/ suic saf pln init rev","description":"Patients who had a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0331U","name":"Onc hl neo opt gen mapping","description":"Onc hl neo opt gen mapping","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49618","name":"Rpr aa hrn rcr > 10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, incarcerated or strangulate","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99467","name":"Ped crit care transport addl","description":"Critical care face-to-face services, during an interfacility transport of critically ill or critically injured pediatric patient, 24 months of age or younger; each additional 30 minutes (list separately in addition to code for primary service)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0013","name":"Esketamine, nasal spray","description":"Esketamine, nasal spray, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99291","name":"Critical care first hour","description":"Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":351.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0724T","name":"Qmrcp w/dx mri same anatomy","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained with diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in additio","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0884T","name":"Esphgsc flx 1st tndsc dilat","description":"Esophagoscopy, flexible, transoral, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for esophageal stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7413","name":"Excision malig lesion<=1.25c","description":"Excision of malignant lesion up to 1.25 cm","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27400","name":"Revise thigh muscles/tendons","description":"Transfer, tendon or muscle, hamstrings to femur (eg, eggers type procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":798.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2799","name":"Inj, uzedy, 1 mg","description":"Injection, risperidone (uzedy), 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0843T","name":"Dgtz gls mcrscp cslt cyt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), initial site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81458","name":"So gsap dna cpy nmbr&mcrstl","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis, copy number variants and microsatellite instability","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7411","name":"Excision benign lesion>1.25c","description":"Excision of benign lesion greater than 1.25 cm","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0569","name":"Subs psych care mng, subs mo","description":"Subsequent psychiatric collaborative care management, in a subsequent month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required elements: tracking ","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0517","name":"Remove drug implant","description":"Removal of non-biodegradable drug delivery implants, 4 or more (services for subdermal implants)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":94.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67405","name":"Explore/drain eye socket","description":"Orbitotomy without bone flap (frontal or transconjunctival approach); with drainage only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":818.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37292","name":"Rvsc evsc tpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1178","name":"Doc med rsn no pcv","description":"Documentation of medical reason(s) for not administering pneumococcal vaccine (e.g., prior anaphylaxis due to the pneumococcal vaccine)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15156","name":"Tis clt agrft f/s/n/h/f/g ad","description":"Tissue cultured skin autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; additional 1 sq cm to 75 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53452","name":"Tprnl balo cntnc dev uni","description":"Periurethral transperineal adjustable balloon continence device; unilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4351","name":"Enclose tl matrix, per sq cm","description":"Enclose tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0368","name":"Cone beam ct interprete tmj","description":"Cone beam ct interprete tmj","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1461","name":"Pt dx chron hepc","description":"Patient diagnosis for chronic hepatitis c","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4036","name":"Urgent care ss","description":"Urgent care mips specialty set","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82649","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93896","name":"Vsrctv std tcd icr art compl","description":"Vasoreactivity study performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43291","name":"Egd flx trnsorl rmvl balo","description":"Esophagogastroduodenoscopy, flexible, transoral; with removal of intragastric bariatric balloon(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9994","name":"Pall serv during meas","description":"Patient is using palliative care services any time during the measurement period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6609","name":"G compression bandaging","description":"Gradient compression bandaging supply, not otherwise specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5158","name":"Inj, denosumab-bnht, 1 mg","description":"Injection, denosumab-bnht (bomyntra/conexxence), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1282","name":"Pt scrn tbco id as non user","description":"Patient screened for tobacco use and identified as a tobacco non-user","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0201","name":"Pne flu hepb cov home admin","description":"Administration of pneumococcal, influenza, hepatitis b, and/or covid-19 vaccine inside a patients home; reported only once per individual home per date of service when such vaccine administration(s) are performed at the patients home","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1821","name":"Ko elas w/ condyle pads otf","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, off the shelf","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37288","name":"Revsc evsc tpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7261","name":"Primary closure sinus perf","description":"Primary closure of a sinus perforation","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1343","name":"Pt pam lvl 4 base or srt lin","description":"Patients who are at pam level 4 at baseline or patients who are flagged with extreme straight line response sets on the pam or with excessive missing responses","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9321","name":"Inj epcoritamab-bysp 0.16 mg","description":"Injection, epcoritamab-bysp, 0.16 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1405","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1426","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76802","name":"Ob us < 14 wks addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1425","name":"Surgical care mvp","description":"Surgical care mips value pathway","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99341","name":"Home/res vst new sf mdm 15","description":"Home or residence visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 15 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0538","name":"Ascvd rsk mng clin stf pr mo","description":"Atherosclerotic cardiovascular disease (ascvd) risk management services; clinical staff time; per calendar month","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90382","name":"Rsv monoc antb seasn .7ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose, 0.7 ml, for intramuscular use","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27130","name":"Total hip arthroplasty","description":"Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1678.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4031","name":"Radiation oncology ss","description":"Radiation oncology mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9021","name":"Inj, aspara, rylaze, 0.1 mg","description":"Injection, asparaginase, recombinant, (rylaze), 0.1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9393","name":"Inj, fulvestrant (teva)","description":"Injection, fulvestrant (teva), not therapeutically equivalent to j9395, 25 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5148","name":"Inj, nyposi 1 mcg","description":"Injection, filgrastim-txid (nypozi), biosimilar, 1 microgram","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0563","name":"Sbrt w/positron emission del","description":"Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance and real-time positron emissions-based delivery adjustments to 1 or more lesions, entire course not to exceed 5 fractions","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0816T","name":"Opn insj/rplcmt ins ptn subq","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15013","name":"Prepj skn cll ssp agrft 1st","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; first 25 sq cm or less of harvested skin","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66820","name":"Incision secondary cataract","description":"Discission of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid); stab incision technique (ziegler or wheeler knife)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78491","name":"Myocrd img pet 1std rst/strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); single study, at rest or stress (exercise or pharmacologic)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4287","name":"Disp col sto bag breast milk","description":"Disposable collection and storage bag for breast milk, any size, any type, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33276","name":"Insj phrnc nrv stim sys","description":"Insertion of phrenic nerve stimulator system (pulse generator and stimulating lead[s]), including vessel catheterization, all imaging guidance, and pulse generator initial analysis with diagnostic mode activation, when performed","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82947","name":"Assay glucose blood quant","description":"Glucose; quantitative, blood (except reagent strip)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0857T","name":"Opto-acoustic img breast uni","description":"Opto-acoustic imaging, breast, unilateral, including axilla when performed, real-time with image documentation, augmentative analysis and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92977","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":417.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4347","name":"Rampart dl matrix per sq cm","description":"Rampart dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4326","name":"Woundplus, per sq cm","description":"Woundplus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92982","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24066","name":"Biopsy arm/elbow soft tissue","description":"Biopsy, soft tissue of upper arm or elbow area; deep (subfascial or intramuscular)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78492","name":"Myocrd img pet mlt rst&strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); multiple studies at rest and stress (exercise or pharmacologic)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1444.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4270","name":"Complete sl per sq cm","description":"Complete sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76825","name":"Echo exam of fetal heart","description":"Echocardiography, fetal, cardiovascular system, real time with image documentation (2d), with or without m-mode recording;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1342","name":"Pts died perf per","description":"Patients who died during the performance period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85025","name":"Complete cbc w/auto diff wbc","description":"Blood count; complete (cbc), automated (hgb, hct, rbc, wbc and platelet count) and automated differential wbc count","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97008","name":"Mchnl sclp cool prep plmt","description":"Mechanical scalp cooling; including hair preparation, individual cap placement, therapy initiation, and precooling period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0339U","name":"Onc prst8 mrna hoxc6 & dlx1","description":"Onc prst8 mrna hoxc6 & dlx1","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54408","name":"Repair multi-comp penis pros","description":"Repair of component(s) of a multi-component, inflatable penile prosthesis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":847.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1394","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0740T","name":"Rem auton alg nsln cal setup","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; initial set-up and patient education","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0899","name":"Argatroban dialysis, auromed","description":"Injection, argatroban (auromedics), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0481U","name":"Idh1 idh2&tert promoter ngs","description":"Idh1 idh2&tert promoter ngs","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99483","name":"Assmt & care pln pt cog imp","description":"Assessment of and care planning for a patient with cognitive impairment, requiring an independent historian, in the office or other outpatient, home or domiciliary or rest home, with all of the following required elements: cognition-focused evaluation including a pertinent history and examination, m","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":338.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":191.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4018","name":"Ob/gyn ss","description":"Obstetrics/gynecology mips specialty set","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0750T","name":"B1 str&fx rsk asmt dxrbmd1vw","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0925T","name":"Rlcj skin pocket ccm-d pg","description":"Relocation of skin pocket for implanted cardiac contractility modulation-defibrillation pulse generator","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64596","name":"Ins/rplcmt prq eltrd ra pn 1","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; initial electrode array","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20604","name":"Drain/inj joint/bursa w/us","description":"Arthrocentesis, aspiration and/or injection, small joint or bursa (eg, fingers, toes); with ultrasound guidance, with permanent recording and reporting","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83701","name":"Lipoprotein bld hr fraction","description":"Lipoprotein, blood; high resolution fractionation and quantitation of lipoproteins including lipoprotein subclasses when performed (eg, electrophoresis, ultracentrifugation)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0947T","name":"Mrgfus strtctc bl-br disrpj","description":"Magnetic resonance image guided low intensity focused ultrasound (mrgfus), stereotactic blood-brain barrier disruption using microbubble resonators to increase the concentration of blood-based biomarkers of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9196","name":"Inj gemcitabine hcl (accord)","description":"Injection, gemcitabine hydrochloride (accord), not therapeutically equivalent to j9201, 200 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6028","name":"Part hand finger metacar amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s) /thumb, amputation at metacarpal level, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4406","name":"Xwrap fenestra per sq cm","description":"Xwrap fenestra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44025","name":"Incision of large bowel","description":"Colotomy, for exploration, biopsy(s), or foreign body removal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":982.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98006","name":"Synch audio-video est mod 30","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87210","name":"Smear wet mount saline/ink","description":"Smear, primary source with interpretation; wet mount for infectious agents (eg, saline, india ink, koh preps)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93896","name":"Vsrctv std tcd icr art compl","description":"Vasoreactivity study performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98002","name":"Synch audio-video new mod 45","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate medical decision making. when using total time on the date of the encounter for code selection, 45 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4409","name":"Amniomatrixf3x per sq cm","description":"Amniomatrixf3x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1449","name":"Pt dx scz/pys bef end msr pd","description":"Patients with an active diagnosis of schizophrenia or psychotic disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1013T","name":"Lap srg imp/rpl eso nea&pg/r","description":"Laparoscopy, surgical, implantation or replacement of lower esophageal sphincter neurostimulator electrode array and neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver, including cruroplasty and/or electronic ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4292","name":"Lamellas, per sq cm","description":"Lamellas, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85041","name":"Automated rbc count","description":"Blood count; red blood cell (rbc), automated","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61154","name":"Burr hole w/evac&/drg hmtma","description":"Burr hole(s) with evacuation and/or drainage of hematoma, extradural or subdural","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1331.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43458","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4340","name":"Simpligraft, per sq cm","description":"Simpligraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49186","name":"Opn exc/dstr ntra-abd 5 cm/<","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5 cm or less","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77781","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1143.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9247","name":"Mod sedation noniv-sub15min","description":"Mod sedation noniv-sub15min","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1421","name":"Dermatological care mvp","description":"Dermatological care mips value pathway","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4317","name":"Vitograft, per sq cm","description":"Vitograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70355","name":"Panoramic x-ray of jaws","description":"Orthopantogram (eg, panoramic x-ray)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0731T","name":"Augmnt ai-based fcl phnt a/r","description":"Augmentative ai-based facial phenotype analysis with report","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31200","name":"Removal of ethmoid sinus","description":"Ethmoidectomy; intranasal, anterior","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":661.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1325","name":"Doc med rsn not seen","description":"Patients who were not seen for reasons documented by clinician for patient or medical reasons (e.g., inadequate time for follow-up, patients who received a prior intravitreal or periocular steroid injection within the last six (6) months and had a subsequent iop evaluation with iop <25mm hg within s","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0773T","name":"Vr px dissoc svc oth phy 1st","description":"Virtual reality (vr) procedural dissociation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports; initial 15 min","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81195","name":"Cytog genom-wid alys hem mal","description":"Cytogenomic (genome-wide) analysis, hematologic malignancy, structural variants and copy number variants, optical genome mapping (ogm)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0663","name":"Team remote e/m new pt 45 mn","description":"Team remote e/m new pt 45mins","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1597","name":"Inj glycopyrrolate, glyrx-pf","description":"Injection, glycopyrrolate (glyrx-pf), 0.1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25448","name":"Arthrp ntrcrpl/crp/mtcrp ssp","description":"Arthroplasty, intercarpal or carpometacarpal joints; suspension, including transfer or transplant of tendon, with interposition, when performed","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0870T","name":"Imp subq prtl ascts pmp sys","description":"Implantation of subcutaneous peritoneal ascites pump system, percutaneous, including pump-pocket creation, insertion of tunneled indwelling bladder and peritoneal catheters with pump connections, including all imaging and initial programming, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0459U","name":"Abeta42 & ttau eclia csf","description":"Abeta42 & ttau eclia csf","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0571","name":"Intraop nerve cryoablation","description":"Intraoperative nerve(s) cryoablation for post-surgical pain relief (list separately in addition to code for primary service)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0201","name":"Pne flu hepb cov home admin","description":"Administration of pneumococcal, influenza, hepatitis b, and/or covid-19 vaccine inside a patients home; reported only once per individual home per date of service when such vaccine administration(s) are performed at the patients home","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5942","name":"Proth max implt sup remv","description":"Proth max implt sup remv","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90847","name":"Family psytx w/pt 50 min","description":"Family psychotherapy (conjoint psychotherapy) (with patient present), 50 minutes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":110.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25275","name":"Repair forearm tendon sheath","description":"Repair, tendon sheath, extensor, forearm and/or wrist, with free graft (includes obtaining graft) (eg, for extensor carpi ulnaris subluxation)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":793.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31575","name":"Diagnostic laryngoscopy","description":"Laryngoscopy, flexible; diagnostic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55868","name":"Lap srg prst8ct lymph nod bx","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with lymph node biopsy(ies) (limited pelvic lymphadenectomy)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6107","name":"Tissue regen non-resorbable","description":"Tissue regen non-resorbable","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9997","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6180","name":"Implnt maint proced","description":"Implnt maint proced","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1304","name":"No pneum vax admin 19+","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43290","name":"Egd flx trnsorl dplmnt balo","description":"Esophagogastroduodenoscopy, flexible, transoral; with deployment of intragastric bariatric balloon","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81463","name":"So gsap cl fr cpy nmbr&mcrst","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis, copy number variants, and microsatellite instability","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9998","name":"Inj ustekinumab-aekn, 1 mg","description":"Injection, ustekinumab-aekn (selarsdi), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2404","name":"Inj, nicardipine 0.1 mg","description":"Injection, nicardipine, 0.1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1462","name":"Pt clin ind hd image","description":"Patients with clinical indications for imaging of the head","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32815","name":"Close bronchial fistula","description":"Open closure of major bronchial fistula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1673.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6191","name":"Semi precision abutment","description":"Semi precision abutment","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87493","name":"C diff amplified probe","description":"Infectious agent detection by nucleic acid (dna or rna); clostridium difficile, toxin gene(s), amplified probe technique","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49613","name":"Rpr aa hrn rcr < 3 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, reducible","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0704T","name":"Rem tx amblyopia setup&edu","description":"Remote treatment of amblyopia using an eye tracking device; device supply with initial set-up and patient education on use of equipment","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4027","name":"Plastic surgery ss","description":"Plastic surgery mips specialty set","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72202","name":"X-ray exam si joints 3/> vws","description":"Radiologic examination, sacroiliac joints; 3 or more views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98004","name":"Synch audio-video est sf 10","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 10 minutes must be met or e","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1501","name":"Pathology mvp","description":"Pathology mips value pathway","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44360","name":"Small bowel endoscopy","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7412","name":"Excision benign lesion compl","description":"Excision of benign lesion complicated","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1292","name":"Pt 66+ frail inpt adv ill","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and an advanced illness diagnosis during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1408","name":"Gmln brca bef dx ca","description":"Patients who have germline brca testing completed before diagnosis of epithelial ovarian, fallopian tube, or primary peritoneal cancer","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4003","name":"Emergency med ss","description":"Emergency medicine mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0798T","name":"Tcat rmv 2chmbr ldls pm cmpl","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; complete system (ie, right atrial and right ventricular pacemaker components)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2679","name":"Inj fluphenazine hcl 1.25 mg","description":"Injection, fluphenazine hcl, 1.25 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5912","name":"Facial moulage complete","description":"Facial moulage (complete)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4364","name":"Am bur xp mem xpl hy p sq cm","description":"Amnio burgeon xplus membrane and xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0328U","name":"Drug assay 120+ rx&metablt","description":"Drug assay 120+ rx&metablt","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75964","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":453.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1304","name":"No pneum vax admin 19+","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66989","name":"Xcpsl ctrc rmvl cplx insj 1+","description":"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification), complex, requiring devices or techniques not generally used in routine cataract surgery (eg, iris expansion device,","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98009","name":"Synch audio-only new low 30","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 30 m","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1218","name":"Pt copd symptoms","description":"Patient has copd symptoms (e.g., dyspnea, cough/sputum, wheezing)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83500","name":"Assay free hydroxyproline","description":"Hydroxyproline; free","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99305","name":"1st nf care moderate mdm 35","description":"Initial nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 35 minutes must be met or ex","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":136.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":44.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35276","name":"Rpr blvs gr ot/t vn ntrth wo","description":"Repair blood vessel with graft other than vein; intrathoracic, without bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1737.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1821","name":"Ko elas w/ condyle pads otf","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, off the shelf","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4383","name":"Axolotl graft ult per sq cm","description":"Axolotl graft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0052","name":"Mmip mental health and care","description":"Missing and murdered indigenous persons (mmip) mental health and clinical care","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33401","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1845.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2031","name":"Mirodry, per sq cm","description":"Mirodry wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0525","name":"Est pt-cg dyad dem mod cmplx","description":"Management of established patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1377","name":"Fu colscop 10 yr doc w/ disc","description":"Recommended follow-up interval for repeat colonoscopy of 10 years documented  in colonoscopy report and communicated with patient","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0555U","name":"Repr med pga embryonic te qc","description":"Repr med pga embryonic te qc","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0503U","name":"Neuro alz ds bamyl&tau prtn","description":"Neuro alz ds bamyl&tau prtn","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1287","name":"Calc bmi blw low param f/u","description":"Bmi is documented below normal parameters and a follow-up plan is documented","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11950","name":"Subq njx filling matrl 1cc/<","description":"Subcutaneous injection of filling material (eg, collagen); 1 cc or less","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0823T","name":"Tcat ins 1chmbr ldls pm ra","description":"Transcatheter insertion of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or programming), when","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66985","name":"Insert lens prosthesis","description":"Insertion of intraocular lens prosthesis (secondary implant), not associated with concurrent cataract removal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":719.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6602","name":"G com bandge hgh dn foamroll","description":"Gradient compression bandaging supply, high density foam roll for bandage, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1305","name":"Inj, evinacumab-dgnb, 5mg","description":"Injection, evinacumab-dgnb, 5mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1371","name":"Mst rec gsa<7","description":"Most recent glycemic status assessment (hba1c or gmi) level < 7.0%","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6192","name":"Semi precision attachment","description":"Semi precision attachment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9026","name":"Inj, tarlatamab-dlle, 1 mg","description":"Injection, tarlatamab-dlle, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7511","name":"Incision/drain abscess intra","description":"Incision and drainage of abscess - intraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5124","name":"Inj. byooviz, 0.1 mg","description":"Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6559","name":"G stckng full/chap18-30 cust","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0263U","name":"Neuro asd meas 16 c metblt","description":"Neurology (autism spectrum disorder [asd]), quantitative measurements of 16 central carbon metabolites (ie, a-ketoglutarate, alanine, lactate, phenylalanine, pyruvate, succinate, carnitine, citrate, fumarate, hypoxanthine, inosine, malate, s-sulfocysteine, taurine, urate, and xanthine), liquid chrom","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6114","name":"Implnt/abut fixed dent max","description":"Implnt/abut fixed dent max","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47721","name":"Fuse upper gi structures","description":"Cholecystoenterostomy; with gastroenterostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1344.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0569U","name":"Onc sol tum ngs tmm>20000dmr","description":"Onc sol tum ngs tmm>20000dmr","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0431","name":"Diag tst detect mucos abnorm","description":"Adjunctive pre-diagnostic test that aids in detection of mucosal abnormalities including premalignant and malignant lesions not to include cytology or biopsy","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4013","name":"Mntal/behav/psych hlth ss","description":"Mental/behavioral and psychiatry mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28234","name":"Incision of foot tendon","description":"Tenotomy, open, extensor, foot or toe, each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36475","name":"Endovenous rf 1st vein","description":"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; first vein treated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1289","name":"No pt tbco cess interv rng","description":"Patient identified as tobacco user did not receive tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7912","name":"Suture complicate wnd > 5 cm","description":"Complicated suture-greater than 5 cm","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1227","name":"Eb therapy prescribed","description":"Evidence-based therapy was prescribed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69719","name":"Rplcm oi implt sk tc esp<100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0572U","name":"Onc prst8 httl qfish whl bld","description":"Onc prst8 httl qfish whl bld","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0542U","name":"Nefro renal trnspl ur nmr 84","description":"Nefro renal trnspl ur nmr 84","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21495","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":663.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1292","name":"Pt 66+ frail inpt adv ill","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and an advanced illness diagnosis during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0264U","name":"Rare ds id opt genome mapg","description":"Rare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1003T","name":"Arthrp 1st crp/mtcrpl prostc","description":"Arthroplasty, first carpometacarpal joint, with distal trapezial and proximal first metacarpal prosthetic replacement (eg, first carpometacarpal total joint)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1183","name":"Doc imm ckpt inhib hld","description":"Documentation of immune checkpoint inhibitor therapy held and corticosteroids or immunosuppressants prescribed or administered","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38720","name":"Removal of lymph nodes neck","description":"Cervical lymphadenectomy (complete)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1079.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2372","name":"Inj, biorphen, 20 micrograms","description":"Injection, phenylephrine hydrochloride (biorphen), 20 micrograms","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"13101","name":"Cmplx rpr trunk 2.6-7.5 cm","description":"Repair, complex, trunk; 2.6 cm to 7.5 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":304.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55882","name":"Ablt trurl prst8 tis trnsdcr","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation; with insertion of transurethral ultrasound transducer for delivery of thermal ultrasound, including suprapubic tube placement and placement of ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6564","name":"G com stckng waist 40+ cust","description":"Gradient compression stocking, waist length, 40 mmhg or greater, custom, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50384","name":"Remove ureter stent percut","description":"Removal (via snare/capture) of internally dwelling ureteral stent via percutaneous approach, including radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3374","name":"Inj, vancomycin (mylan) 10mg","description":"Injection, vancomycin hydrochloride (mylan) not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0751","name":"Hiv prep, ftc/taf 200/25mg","description":"Emtricitabine 200mg and tenofovir alafenamide 25mg, oral, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78264","name":"Gastric emptying img study","description":"Gastric emptying imaging study (eg, solid, liquid, or both);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0803T","name":"Tcat rmv&rpl2chmb ldls pm rv","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ve","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4435","name":"Renati membrane per sq cm","description":"Renati membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0498U","name":"Onc clrct ngs mut detc 43gen","description":"Onc clrct ngs mut detc 43gen","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1501","name":"Pathology mvp","description":"Pathology mips value pathway","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5914","name":"Auricular prosthesis","description":"Auricular prosthesis","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0002","name":"Opt care kidney hlth mvp","description":"Optimal care for kidney health mips value pathways","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43401","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1544.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3392","name":"Inj, exagamglogene autotem","description":"Injection, exagamglogene autotemcel, per treatment","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61737","name":"Litt icr mlt trj mlt/cplx ls","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; multiple trajectories for multiple or complex lesion(s)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10060","name":"I&d abscess simple/single","description":"Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); simple or single","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":96.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0789T","name":"Elec aly cpx iins sp/sac nrv","description":"Electronic analysis with complex programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detect","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9603","name":"Inj, pafolacianine, 0.1 mg","description":"Injection, pafolacianine, 0.1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6515","name":"Grad com wrap w str fu le cu","description":"Gradient compression wrap with adjustable straps, full leg, each, custom","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64772","name":"Incision of spinal nerve","description":"Transection or avulsion of other spinal nerve, extradural","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":612.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0661","name":"Team remote e/m new pt 20 mn","description":"Team remote e/m new pt 20mins","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0543U","name":"Onc sol tum ngs dna 517 gens","description":"Onc sol tum ngs dna 517 gens","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31293","name":"Nsl/sins ndsc med&inf dcmprn","description":"Nasal/sinus endoscopy, surgical, with orbital decompression; medial and inferior wall","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1284.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1164","name":"Pt w/ dementia any time","description":"Patients with dementia any time during the patients history through the end of the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55881","name":"Ablt trurl prst8 tis thrm us","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation;","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1487","name":"Pt adm to hospice dur eval","description":"Patients in hospice in the year before or during the period of evaluation","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9999","name":"Inj ustekinumab-aauz 1 mg","description":"Injection, ustekinumab-aauz (otulfi), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1488","name":"Dx dementia in msr timeframe","description":"Patients with a diagnosis for dementia in the year before or during the period of evaluation","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26590","name":"Repair finger deformity","description":"Repair macrodactylia, each digit","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1574.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4419","name":"Biolab wrap flw lt per sq cm","description":"Biolab membrane wrap lite flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0013","name":"Hiv prep counsel, clin staff","description":"Individual counseling for pre-exposure prophylaxis (prep) by clinical staff to prevent human immunodeficiency virus (hiv), includes: hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0875T","name":"Prgrm subq prtl asct pmp sys","description":"Programming of subcutaneously implanted peritoneal ascites pump system by physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1370","name":"Rehab support msk care mvp","description":"Rehabilitative support for musculoskeletal care mips value pathway","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0569","name":"Subs psych care mng, subs mo","description":"Subsequent psychiatric collaborative care management, in a subsequent month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required elements: tracking ","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0676T","name":"Laps insj nw/rpcmt isdss ea","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional lead (list separately in addition to code for primary ","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96381","name":"Admn rsv monoc antb im njx","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96380","name":"Admn rsv monoc antb im cnsl","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection, with counseling by physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94625","name":"Phy/qhp op pulm rhb w/o mntr","description":"Physician or other qualified health care professional services for outpatient pulmonary rehabilitation; without continuous oximetry monitoring (per session)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4259","name":"Celera per sq cm","description":"Celera dual layer or celera dual membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36837","name":"Prq av fstl crt uxtr sep acs","description":"Percutaneous arteriovenous fistula creation, upper extremity, separate access sites of the peripheral artery and peripheral vein, including fistula maturation procedures (eg, transluminal balloon angioplasty, coil embolization) when performed, including all vascular access, imaging guidance and radi","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64410","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4032","name":"Rheumatology ss","description":"Rheumatology mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0624U","name":"Hep nash dna mthyl alys 5000","description":"Hep nash dna mthyl alys 5000","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4440","name":"Curamatrix per sq cm","description":"Curamatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1350","name":"Pt w/ suic saf pln init rev","description":"Patients who had a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0842T","name":"Dgtz gls mcrscp pth cslt ea","description":"Digitization of glass microscope slides for pathology consultation during surgery; each additional tissue block with frozen section(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6624","name":"Inlay titanium","description":"Inlay - titanium","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4283","name":"Biovance tri or 3l, sq cm","description":"Biovance tri-layer or biovance 3l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87493","name":"C diff amplified probe","description":"Infectious agent detection by nucleic acid (dna or rna); clostridium difficile, toxin gene(s), amplified probe technique","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5161","name":"Inj, denosumab-kyqq, 1 mg","description":"Injection, denosumab-kyqq (aukelso/bosaya), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87181","name":"Sc std agar dilution per agt","description":"Susceptibility studies, antimicrobial agent; agar dilution method, per agent (eg, antibiotic gradient strip)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82376","name":"Assay carboxyhb qual","description":"Carboxyhemoglobin; qualitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1783","name":"Vac admin human pap dose 3","description":"Vac admin human pap dose 3","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0819T","name":"Revj/rmvl ins ptn subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99487","name":"Cplx chrnc care 1st 60 min","description":"Complex chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":87.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2471","name":"Inj pantoprazole(hikma) 40mg","description":"Injection, pantoprazole (hikma), not therapeutically equivalent to j2470, 40 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65130","name":"Insert ocular implant","description":"Insertion of ocular implant secondary; after evisceration, in scleral shell","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4405","name":"Xwrap fenestra plus sq cm","description":"Xwrap fenestra plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1406","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84145","name":"Procalcitonin (pct)","description":"Procalcitonin (pct)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37264","name":"Revsc evasc fpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2791","name":"Crown full cast base metal","description":"Crown-full cast predominantly base metal","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0296U","name":"Onc orl&/orop ca 20 mlc feat","description":"Onc orl&/orop ca 20 mlc feat","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6038","name":"Multiax rotation attachment","description":"Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27713","name":"Osteot tibia imed lngth dev","description":"Osteotomy(ies), tibia, including fibula when performed, unilateral, with insertion of an externally controlled intramedullary lengthening device, including imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0846T","name":"Dgtz gls mcrscp imfluor ea","description":"Digitization of glass microscope slides for immunofluorescence, per specimen; each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0924T","name":"Rpos prv ccm-d trnsvns eltrd","description":"Repositioning of previously implanted cardiac contractility modulation-defibrillation transvenous electrode(s)/lead(s), including fluoroscopic guidance and programming of sensing and therapeutic parameters","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0937T","name":"Xtrnl ecg rec>15d<30d","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; including recording, scanning analysis with report, review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9601","name":"Inj linvoseltamab-gcpt 1 mg","description":"Injection, linvoseltamab-gcpt, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81457","name":"So neo gsap dna mcrstl ins","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis, microsatellite instability","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4372","name":"Amchoplast excl per sq cm","description":"Amchoplast excel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52284","name":"Cysto rx balo cath urtl strx","description":"Cystourethroscopy, with mechanical urethral dilation and urethral therapeutic drug delivery by drug-coated balloon catheter for urethral stricture or stenosis, male, including fluoroscopy, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84393","name":"Tau phosphorylated ea","description":"Tau, phosphorylated (eg, ptau 181, ptau 217), each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0664","name":"Team remote e/m new pt 60 mn","description":"Team remote e/m new pt 60mins","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0976T","name":"Slctv nzmtc dbrdmt s/n/hf ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; each additional 100 sq cm (list separately in addition to code for p","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1302","name":"Inj, sutimlimab-jome, 10 mg","description":"Injection, sutimlimab-jome, 10 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0547U","name":"Neurflmnt lt chn cleia plsm","description":"Neurflmnt lt chn cleia plsm","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1372","name":"Mst rec gsa >=7 and<8","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 7.0% and < 8.0%","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0778T","name":"Smmg cncrnt appl imu snr","description":"Surface mechanomyography (smmg) with concurrent application of inertial measurement unit (imu) sensors for measurement of multi-joint range of motion, posture, gait, and muscle function","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1288","name":"Doc rsn no hbp scrn or f/u","description":"Documented reason for not screening or recommending a follow-up for high blood pressure","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4418","name":"Biolab wrap flow per sq cm","description":"Biolab membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78608","name":"Brain imaging (pet)","description":"Brain imaging, positron emission tomography (pet); metabolic evaluation","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0706","name":"Intraoral occlus radio image","description":"Intraoral occlus radio image","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1479","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1200","name":"Ace-i/arb rx","description":"Ace inhibitor (ace-i) or arb therapy prescribed during the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1313","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2055","name":"Idecabtagene vicleucel car","description":"Idecabtagene vicleucel, up to 510 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0892","name":"Argatroban dialysis (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93150","name":"Therapy activation ipnss","description":"Therapy activation of implanted phrenic nerve stimulator system, including all interrogation and programming","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6610","name":"G com stcking bk 18-30 custm","description":"Gradient compression stocking, below knee, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1327","name":"Pts no eval ini xm no 8 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 8 weeks","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6192","name":"Semi precision attachment","description":"Semi precision attachment","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9318","name":"Inj romidepsin non-lyo 0.1mg","description":"Injection, romidepsin, non-lyophilized, 0.1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0753T","name":"Dgtz gls mcrscp sld level iv","description":"Digitization of glass microscope slides for level iv, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88331","name":"Path consltj surg 1 blk 1spc","description":"Pathology consultation during surgery; first tissue block, with frozen section(s), single specimen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2976","name":"Band stabilization per tooth","description":"Band stabilization per tooth","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0780T","name":"Instlj fecal microbiota ssp","description":"Instillation of fecal microbiota suspension via rectal enema into lower gastrointestinal tract","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0502","name":"Other oral pathology procedu","description":"Other oral pathology procedures by report","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96380","name":"Admn rsv monoc antb im cnsl","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection, with counseling by physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0046","name":"No mrs 90 days post stk","description":"Clinical follow-up and mrs score not assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0696T","name":"Bdy surf mapg pm/cvdfb f/up","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of follow-up interrogation or programming device evaluatio","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0753T","name":"Dgtz gls mcrscp sld level iv","description":"Digitization of glass microscope slides for level iv, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76818","name":"Fetal biophys profile w/nst","description":"Fetal biophysical profile; with non-stress testing","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1192","name":"Pt w/ dx sq cell ca of esoph","description":"Patients with an existing diagnosis of squamous cell carcinoma of the esophagus","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0521","name":"New pt-cg dyad dem hig cmplx","description":"Management of new patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98926","name":"Osteopath manj 3-4 regions","description":"Osteopathic manipulative treatment (omt); 3-4 body regions involved","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":44.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99350","name":"Home/res vst est high mdm 60","description":"Home or residence visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0570U","name":"Neurol tbi alys gfap&uch-l1","description":"Neurol tbi alys gfap&uch-l1","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"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":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58600","name":"Division of fallopian tube","description":"Ligation or transection of fallopian tube(s), abdominal or vaginal approach, unilateral or bilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":428.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1326","name":"Inj, zolbetuximab-clzb, 2 mg","description":"Injection, zolbetuximab-clzb, 2 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58562","name":"Hysteroscopy remove fb","description":"Hysteroscopy, surgical; with removal of impacted foreign body","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4261","name":"Tag, per square centimeter","description":"Tag, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64416","name":"Njx aa&/strd brch pl nfs img","description":"Injection(s), anesthetic agent(s) and/or steroid; brachial plexus, continuous infusion by catheter (including catheter placement), including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59620","name":"Attempted vbac delivery only","description":"Cesarean delivery only, following attempted vaginal delivery after previous cesarean delivery;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"RenderingTaxonomy","value":["207V00000X","207VB0002X","207VE0102X","207VF0040X","207VG0400X","207VM0101X","207VX0000X","207VX0201X","363LX0001X"]},{"name":"Company Code","value":["01","20","42"]},{"name":"ClaimSpecialtyCode","value":["904","905","907","AMGY","APNOB","COLP","FPEM","GYNE","GYON","GYSU","MAFE","NPAG","NPGY","NPOB","OBEM","OBGY","OBHR","OBST","REND","URGY"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1733.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0682T","name":"Removal pulse gen only isdss","description":"Removal of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1370","name":"Inj, esomeprazole sod, 1 mg","description":"Injection, esomeprazole sodium, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86001","name":"Allergen specific igg","description":"Allergen specific igg quantitative or semiquantitative, each allergen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2642","name":"Dental onlay porcelin 2 surf","description":"Onlay - porcelain/ceramic - two surfaces","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0539","name":"Initial care training 30 m","description":"Caregiver training in behavior management/modification for caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face; initial 30 minutes","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2644","name":"Dental onlay porc 4/more sur","description":"Onlay - porcelain/ceramic - four or more surfaces","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5227","name":"Immed max part denture","description":"Immed max part denture","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78270","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77436","name":"Surf radj ther tx planning","description":"Surface radiation therapy; superficial or orthovoltage, treatment planning and simulation-aided field setting","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0557","name":"Adv prim care mgmt lvl 2","description":"Advanced primary care management services for a patient with multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, which place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline, provided by c","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0661","name":"Team remote e/m new pt 20 mn","description":"Team remote e/m new pt 20mins","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68400","name":"I&d lacrimal gland","description":"Incision, drainage of lacrimal gland","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55710","name":"Bx prst8 tprn us w/mri fus 1","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant) with mri-fusion-guidance biopsy, first targeted lesion","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3809","name":"Whfo w/o joints pre ots","description":"Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4368","name":"Amchothick per sq cm","description":"Amchothick, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0910T","name":"Rmvl int nstim sys vagus nrv","description":"Removal of integrated neurostimulation system, vagus nerve","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83700","name":"Lipopro bld electrophoretic","description":"Lipoprotein, blood; electrophoretic separation and quantitation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0461","name":"Testing for cracked tooth","description":"Testing for cracked tooth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87150","name":"Dna/rna amplified probe","description":"Culture, typing; identification by nucleic acid (dna or rna) probe, amplified probe technique, per culture or isolate, each organism probed","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2359","name":"Inj. olanzapine, 0.5mg","description":"Injection, olanzapine, 0.5 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0957T","name":"Rev s-sclp eltr ra rcvr&tlmt","description":"Revision of sub-scalp implanted electrode array, receiver, and telemetry unit for electrode, when required, including imaging guidance","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11423","name":"Exc h-f-nk-sp b9+marg 2.1-3","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 2.1 to 3.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1611","name":"Inj glucagon hcl, fresenius","description":"Injection, glucagon hydrochloride (fresenius kabi), not therapeutically equivalent to j1610, per 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0732T","name":"Immntx admn electroporatn im","description":"Immunotherapy administration with electroporation, intramuscular","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99233","name":"Sbsq hosp ip/obs high 50","description":"Subsequent hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 50 minutes m","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99252","name":"Ip/obs consltj new/est sf 35","description":"Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 35 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9323","name":"Inj pemetrexed ditromethamin","description":"Injection, pemetrexed ditromethamine, 10 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7252","name":"Part extract for implant","description":"Part extract for implant","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0560U","name":"Onc mrd gsa cfdna baseline","description":"Onc mrd gsa cfdna baseline","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4288","name":"Replacement breastpump valve","description":"Valve for breast pump, replacement","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96547","name":"Intraop hipec px 1st 60 min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; first 60 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1245","name":"Pt othr thn true person","description":"Patient provided a response other than completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3299","name":"Inj xipere 1 mg","description":"Injection, triamcinolone acetonide (xipere), 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0863T","name":"Rlcj pg wcs lv trnsmtr only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; transmitter component only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90481","name":"Admn sarscov2 vac ea add cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; each additional component administered (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0502","name":"Other oral pathology procedu","description":"Other oral pathology procedures by report","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0852T","name":"Dgtz gls mcrscp mphmtrc ea 1","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0553","name":"Monthly tx for dmht 20mins","description":"First 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing information related to the use of","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43262","name":"Endo cholangiopancreatograph","description":"Endoscopic retrograde cholangiopancreatography (ercp); with sphincterotomy/papillotomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97139","name":"Unlisted therapeutic px","description":"Unlisted therapeutic procedure (specify)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0673T","name":"Abltj b9 thyr ndul perq lasr","description":"Ablation, benign thyroid nodule(s), percutaneous, laser, including imaging guidance","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67218","name":"Treatment of retinal lesion","description":"Destruction of localized lesion of retina (eg, macular edema, tumors), 1 or more sessions; radiation by implantation of source (includes removal of source)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1388.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1176","name":"No 2 hzv 10/2017-meas pd","description":"Patient did not receive two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1263","name":"Pts hosp dialysis dt","description":"Patients in hospice on their initiation of dialysis date or during the month of evaluation","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"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":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1021T","name":"Active thrc irrigation spx","description":"Active thoracic irrigation (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90951","name":"Esrd serv 4 visits p mo <2yr","description":"End-stage renal disease (esrd) related services monthly, for patients younger than 2 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 4 or more face-to-face visits by a physician or other qualified health care pro","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1317.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2312","name":"Inj naloxone hcl nos, 0.01mg","description":"Injection, naloxone hydrochloride, not otherwise specified, 0.01 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33246","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1499.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0950T","name":"Abltj b9 prst8 tissue hifu","description":"Ablation of benign prostate tissue, transrectal, with high intensity-focused ultrasound (hifu), including ultrasound guidance","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0614U","name":"Iem pmd alys 4 nzm cplx page","description":"Iem pmd alys 4 nzm cplx page","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99407","name":"Behav chng smoking > 10 min","description":"Smoking and tobacco use cessation counseling visit; intensive, greater than 10 minutes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":32.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46607","name":"Diagnostic anoscopy & biopsy","description":"Anoscopy; with high-resolution magnification (hra) (eg, colposcope, operating microscope) and chemical agent enhancement, with biopsy, single or multiple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":132.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92623","name":"Dx aly aud oi snd prcsr each","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; each additional 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6049","name":"Scale implt peri-implt inflm","description":"Scale implt peri-implt inflm","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33269","name":"Excl laa thrscp any method","description":"Exclusion of left atrial appendage, thoracoscopic, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34706","name":"Evasc rpr a-biiliac rpt","description":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-bi-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1930.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7356","name":"Inj foscarb/foslevodopa 5 mg","description":"Injection, foscarbidopa 0.25 mg/foslevodopa 5 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1456","name":"Pt had htx","description":"Patient had a heart transplant","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0474","name":"Micro w exam of surg margins","description":"Accession of tissue gross and microscopic examination including assessment of surgical margins for presence of disease preparation and transmission of writte","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G8510","name":"Scr dep neg, no plan reqd","description":"Screening for depression is documented as negative, a follow-up plan is not required","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["HD"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0387","name":"Comp image capture only","description":"Comp image capture only","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93145","name":"Interrog crtd sins bat ip wo","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2026","name":"Restrata minimatrix, 5 mg","description":"Restrata minimatrix, 5 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0926T","name":"Prgrmg dev eval ccm-d ip","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, including review and report, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54900","name":"Fusion of spermatic ducts","description":"Epididymovasostomy, anastomosis of epididymis to vas deferens; unilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":869.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0350U","name":"Rx metab/pcx dna 27 gen alys","description":"Rx metab/pcx dna 27 gen alys","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96548","name":"Ntraop hipec px ea add 30min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0183","name":"Software meas of cardiac vol","description":"Quantitative software measurements of cardiac volume, cardiac chambers volumes and left ventricular wall mass derived from ct scan(s) data of the chest/heart (with or without contrast)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54401","name":"Insert self-contd prosthesis","description":"Insertion of penile prosthesis; inflatable (self-contained)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":735.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6214","name":"Pontic titanium","description":"Pontic - titanium","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0279U","name":"Hem vw factor&clgn iii bndg","description":"Hematology (von willebrand disease [vwd]), von willebrand factor (vwf) and collagen iii binding by enzyme-linked immunosorbent assays (elisa), plasma, report of collagen iii binding","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0554","name":"Add 20 m of monthly tx","description":"Each additional 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing data generated from the","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4013","name":"Mntal/behav/psych hlth ss","description":"Mental/behavioral and psychiatry mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6113","name":"Imp/abut rem dent part mand","description":"Imp/abut rem dent part mand","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66989","name":"Xcpsl ctrc rmvl cplx insj 1+","description":"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification), complex, requiring devices or techniques not generally used in routine cataract surgery (eg, iris expansion device,","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1179","name":"No pcv recd","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine, on or after their 19th birthday and before or during measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64550","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1502","name":"Podiatry mvp","description":"Podiatry mips value pathway","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69440","name":"Exploration of middle ear","description":"Middle ear exploration through postauricular or ear canal incision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":765.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0526","name":"Est pt-cg dyad dem hig cmplx","description":"Management of established patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17284","name":"Dstr mal ls f/e/e/n/l/m3.1-4","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 3.1 to 4.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57200","name":"Repair of vagina","description":"Colporrhaphy, suture of injury of vagina (nonobstetrical)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1015T","name":"Rev/rmv lw esoph sphnc npg/r","description":"Revision or removal, lower esophageal sphincter neurostimulator pulse generator or receiver","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1449","name":"Inj eflapegrastim-xnst 0.1mg","description":"Injection, eflapegrastim-xnst, 0.1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6198","name":"Remove interim implant","description":"Remove interim implant","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0018","name":"Crisis psychotherapy add 30m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); each additional 30 minutes (list separately in addition to code for primary service)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6527","name":"G garmt full leg/ft nght cus","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, custom, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2041","name":"Foundation drs+ duo pr sq cm","description":"Foundation drs+ duo, per square centimeter","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37195","name":"Thrombolytic therapy stroke","description":"Thrombolysis, cerebral, by intravenous infusion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40845","name":"Reconstruction of mouth","description":"Vestibuloplasty; complex (including ridge extension, muscle repositioning)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1513.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0934T","name":"Rem mntr wrls l atr prs snr","description":"Remote monitoring of a wireless left atrial pressure sensor for up to 30 days, including data from daily uploads of left atrial pressure recordings, interpretation(s) and trend analysis, with adjustments to the diuretics plan, treatment paradigm thresholds, medications or lifestyle modifications, wh","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98007","name":"Synch audio-video est hi 40","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high medical decision making. when using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded.","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0338U","name":"Onc sld tum crcg tum cl slct","description":"Onc sld tum crcg tum cl slct","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32000","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2033","name":"Myriad morcells, 4 mg","description":"Myriad morcells, 4 milligrams","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90593","name":"Chikungunya vacc recomb im","description":"Chikungunya virus vaccine, recombinant, for intramuscular use","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2045","name":"Novashield/novogen pr sq cm","description":"Novashield or novogen wound matrix, per square centimeter","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54530","name":"Removal of testis","description":"Orchiectomy, radical, for tumor; inguinal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1279","name":"Pre-htn/htn, no f/u, not gvn","description":"Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55712","name":"Bx prst8 tprnl mri-us 1st","description":"Biopsy, prostate, transperineal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1424","name":"Pulmonology care mvp","description":"Pulmonology care mips value pathway","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19081","name":"Bx breast 1st lesion strtctc","description":"Biopsy, breast, with placement of breast localization device(s) (eg, clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; first lesion, including stereotactic guidance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":744.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4037","name":"Urology ss","description":"Urology mips specialty set","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9607","name":"Lutetium lu 177 vipivotide","description":"Lutetium lu 177 vipivotide tetraxetan, therapeutic, 1 millicurie","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92979","name":"Endoluminl ivus oct c ea","description":"Endoluminal imaging of coronary vessel or graft using intravascular ultrasound (ivus) or optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention including imaging supervision, interpretation and report; each additional vessel (list separately in addition to co","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4000","name":"Dermatology ss","description":"Dermatology mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1433","name":"Oral chemo wthn 30 days enc","description":"Patient on oral chemotherapy on or within 30 days before denominator eligible encounter","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93152","name":"Interrog&prgrmg ipnss polysm","description":"Interrogation and programming of implanted phrenic nerve stimulator system during polysomnography","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99459","name":"Pelvic examination","description":"Pelvic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99283","name":"Emergency dept visit low mdm","description":"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and low level of medical decision making","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5141","name":"Inj adalimumab-aaty, 1 mg","description":"Injection, adalimumab-aaty, biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0177","name":"Inj, aflibercept hd, 1 mg","description":"Injection, aflibercept hd, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4411","name":"Amniomatrixf4x per sq cm","description":"Amniomatrixf4x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4417","name":"Alexiguard dl-t per sq cm","description":"Alexiguard dl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53454","name":"Tprnl balo cntnc dev adjmt","description":"Periurethral transperineal adjustable balloon continence device; percutaneous adjustment of balloon(s) fluid volume","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6072","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (high noble metal)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2794","name":"Crown-titanium","description":"Crown-titanium","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0182","name":"Hospice care supervision","description":"Physician supervision of a patient under a medicare-approved hospice (patient not present) requiring complex and multidisciplinary care modalities involving regular physician development and/or revision of care plans, review of subsequent reports of patient status, review of laboratory and other stu","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4391","name":"Amnioplast double per sq cm","description":"Amnioplast double, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9183","name":"Gemcitabine intravesical sys","description":"Gemcitabine intravesical system, 225 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4344","name":"Tri membrane wrap, per sq cm","description":"Tri-membrane wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17003","name":"Destruct premalg les 2-14","description":"Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (eg, actinic keratoses); second through 14 lesions, each (list separately in addition to code for first lesion)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":7.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25442","name":"Arthrp w/prostc dstl ulna","description":"Arthroplasty with prosthetic replacement; distal ulna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":964.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2060","name":"Lorazepam injection","description":"Injection, lorazepam, 2 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1301","name":"Pt recv tbco cess interv","description":"Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0053","name":"Ht mental health and care","description":"Historical trauma (ht) mental health and clinical care for indigenous persons","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98985","name":"Rtm dev sply mscsk sys 2-15d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of musculoskeletal system, 2-15 days in a 30-day period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1021T","name":"Active thrc irrigation spx","description":"Active thoracic irrigation (separate procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88374","name":"M/phmtrc alys ishquant/semiq","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each multiplex probe stain procedure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0018","name":"Crisis psychotherapy add 30m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); each additional 30 minutes (list separately in addition to code for primary service)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1653","name":"Ho abduction static ots","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, off the shelf","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0978T","name":"Submucosal cryolysis therapy","description":"Submucosal cryolysis therapy; soft palate, base of tongue, and lingual tonsil","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1008T","name":"Rem mntr s-scl eeg sys setup","description":"Remote monitoring of sub-scalp implanted continuous bilateral electroencephalography monitoring system, device fitting, initial set-up, and patient education in wearing of system and use of equipment","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59821","name":"Treatment of miscarriage","description":"Treatment of missed abortion, completed surgically; second trimester","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":499.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1187","name":"Pt w/ esrd","description":"Patients with a diagnosis of end stage renal disease (esrd)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1494","name":"Fall rep since last visit","description":"Patients that reported a fall since the last visit","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4402","name":"Xwrap 2.0 per sq cm","description":"Xwrap 2.0, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0770T","name":"Vr technology assist therapy","description":"Virtual reality technology to assist therapy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9225","name":"Gen anes adv air-sub 15 min","description":"Gen anes adv air-sub 15 min","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55450","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15012","name":"Hrv skn cll ssp agrft ea add","description":"Harvest of skin for skin cell suspension autograft; each additional 25 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54340","name":"Rpr hypspad comp simple","description":"Repair of hypospadias complication(s) (ie, fistula, stricture, diverticula); by closure, incision, or excision, simple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":641.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0884T","name":"Esphgsc flx 1st tndsc dilat","description":"Esophagoscopy, flexible, transoral, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for esophageal stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70491","name":"Ct soft tissue neck w/dye","description":"Computed tomography, soft tissue neck; with contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0856T","name":"Dgtz gls mcrscp electron mic","description":"Digitization of glass microscope slides for electron microscopy, diagnostic (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0661","name":"Team remote e/m new pt 20 mn","description":"Team remote e/m new pt 20mins","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0326U","name":"Trgt gen seq alys pnl 83+","description":"Trgt gen seq alys pnl 83+","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1004T","name":"Elec alys s-scl eeg wo prgrm","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; without programming","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55821","name":"Removal of prostate","description":"Prostatectomy (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy); suprapubic, subtotal, 1 or 2 stages","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":936.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53866","name":"Cathj rmvl dev ischmc rmdlg","description":"Catheterization with removal of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0425U","name":"Genom rpd seq alys ea cmprtr","description":"Genom rpd seq alys ea cmprtr","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1321","name":"Couns for high risk sub use","description":"Couns for high risk sub use","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4286","name":"Remove non-resorb barrier","description":"Remove non-resorb barrier","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86231","name":"Ema each ig class","description":"Endomysial antibody (ema), each immunoglobulin (ig) class","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0856T","name":"Dgtz gls mcrscp electron mic","description":"Digitization of glass microscope slides for electron microscopy, diagnostic (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95115","name":"Immunotherapy one injection","description":"Professional services for allergen immunotherapy not including provision of allergenic extracts; single injection","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3471","name":"Surg rep root res anterior","description":"Surg rep root res anterior","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4409","name":"Amniomatrixf3x per sq cm","description":"Amniomatrixf3x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2543","name":"Dental onlay metallic 3 surf","description":"Onlay - metallic - three surfaces","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2029","name":"Mirotract matrix sheet","description":"Mirotract wound matrix sheet, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93898","name":"Ven-artl shunt det mbubb njx","description":"Venous-arterial shunt detection with intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55877","name":"Abltj ire prst8 1+ tum perq","description":"Ablation, irreversible electroporation, prostate, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9939","name":"Placemnt removable appliance","description":"Placemnt removable appliance","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92315","name":"C-lens fitg tech aphakia 1","description":"Prescription of optical and physical characteristics of contact lens, with medical supervision of adaptation and direction of fitting by independent technician; corneal lens for aphakia, 1 eye","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0891T","name":"Arhfcmrigtbs sbsq tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent treatment day","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1228","name":"Pt + hcv aby +vir w/ rx 3 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, has hcv treatment initiated within 3 months of the reactive hcv antibody test","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1338","name":"Pt f/u 30-180 dys no + imprv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who did not demonstrate positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33240","name":"Insrt pulse gen w/singl lead","description":"Insertion of implantable defibrillator pulse generator only; with existing single lead","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":557.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6035","name":"Prosthetic digit mechanical","description":"Single prosthetic digit, mechanical, can include metacarpophalangeal (mcp), proximal interphalangeal (pip), and/or distal interphalangeal (dip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":1502.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7356","name":"Inj foscarb/foslevodopa 5 mg","description":"Injection, foscarbidopa 0.25 mg/foslevodopa 5 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4295","name":"Amnio tri-core, per sq cm","description":"Amnio tri-core amniotic, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0394U","name":"Pfas 16 pfas compnd lc ms/ms","description":"Pfas 16 pfas compnd lc ms/ms","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6212","name":"Bridge noble metal cast","description":"Pontic-cast noble metal","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4331","name":"Axolotl graft, per sq cm","description":"Axolotl graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0362U","name":"Onc pap thyr ca rna 82&10","description":"Onc pap thyr ca rna 82&10","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30469","name":"Rpr nsl vlv collapse w/rmdlg","description":"Repair of nasal valve collapse with low energy, temperature-controlled (ie, radiofrequency) subcutaneous/submucosal remodeling","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55110","name":"Explore scrotum","description":"Scrotal exploration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1359","name":"Indx suicd idea, no 0 scr","description":"Index assessment during the denominator period when the suicidal ideation and/or behavior symptoms or increased suicide risk by clinician determination occurs and a non-zero c-ssrs score is obtained","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6612","name":"Onlay cst base mtl 2 surface","description":"Onlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67516","name":"Sprchoroidal spc njx rx agt","description":"Suprachoroidal space injection of pharmacologic agent (separate procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0219","name":"Inj aval alfa-nqpt 4mg","description":"Injection, avalglucosidase alfa-ngpt, 4 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9073","name":"Inj cyclophos dr reddys 5 mg","description":"Injection, cyclophosphamide (dr. reddys), 5 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0275U","name":"Hem heprn nduc trmbctpna srm","description":"Hematology (heparin-induced thrombocytopenia) platelet antibody reactivity by flow cytometry, serum","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25230","name":"Partial removal of radius","description":"Radial styloidectomy (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":557.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26474","name":"Fusion of finger tendons","description":"Tenodesis; of distal joint, each joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":810.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0284U","name":"Vw factor type 2n eval plsm","description":"Von willebrand factor (vwd), type 2n, factor viii and vwf binding evaluation, enzyme-linked immunosorbent assays (elisa), plasma","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G3003","name":"Chronic pain mgmt addl 15m","description":"Each additional 15 minutes of chronic pain management and treatment by a physician or other qualified health care professional, per calendar month. (list separately in addition to code for g3002. when using g3003, 15 minutes must be met or exceeded.)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0828T","name":"Dgtz gls mcrscp cytp smpl fl","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; simple filter method with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0738","name":"Upper extremity rehab","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0867T","name":"Tpla b9 prst8 hyprplsa>=50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume greater or equal to 50 ml","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0983T","name":"Rem mntr impl ivc snr phys","description":"Remote monitoring of an implanted inferior vena cava sensor for up to 30 days, including at least weekly downloads of inferior vena cava area recordings, interpretation(s), trend analysis, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87626","name":"Hpv sep hi-rsk typ&pool rslt","description":"Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), separately reported high-risk types (eg, 16, 18, 31, 45, 51, 52) and high-risk pooled result(s)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86596","name":"Voltage-gtd ca chnl antb ea","description":"Voltage-gated calcium channel antibody, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0519U","name":"Ther rx mntr meds p/d/a 110+","description":"Ther rx mntr meds p/d/a 110+","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82600","name":"Assay of cyanide","description":"Cyanide","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4282","name":"Cygnus dual per sq cm","description":"Cygnus dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36455","name":"Bld exchange truj oth thn nb","description":"Exchange transfusion, blood; other than newborn","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17272","name":"Dstr mal les s/n/h/f/g 1.1-2","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia; lesion diameter 1.1 to 2.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1358","name":"Pts no <suicd idea 120 dys","description":"Patients who did not have a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9278","name":"Inj, carboplatin (avyxa)","description":"Injection, carboplatin (avyxa), 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7189","name":"Factor viia recomb novoseven","description":"Factor viia (antihemophilic factor, recombinant), (novoseven rt), 1 microgram","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6634","name":"Onlay titanium","description":"Onlay - titanium","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0491","name":"Oral dv nm mouthpc hw remote","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0582","name":"Bivalirudin (endo) 1 mg","description":"Injection, bivalirudin (endo), not therapeutically equivalent to j0583, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0696T","name":"Bdy surf mapg pm/cvdfb f/up","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of follow-up interrogation or programming device evaluatio","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0773T","name":"Vr px dissoc svc oth phy 1st","description":"Virtual reality (vr) procedural dissociation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports; initial 15 min","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0165","name":"Inj epinephrine nos 0.1 mg","description":"Injection, epinephrine, not otherwise specified, 0.1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37270","name":"Revsc evasc fpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59051","name":"Fetal monitor/interpret only","description":"Fetal monitoring during labor by consulting physician (ie, non-attending physician) with written report; interpretation only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4369","name":"Amnioplast 3 per sq cm","description":"Amnioplast 3, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9075","name":"Inj, cyclophosphamide, nos","description":"Injection, cyclophosphamide, not otherwise specified, 5 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2058","name":"Obecbtge autol up to 400 mil","description":"Obecabtagene autoleucel, 10 up to 400 million cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per infusion","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0838T","name":"Dgtz gls mcrscp cslt sld els","description":"Digitization of glass microscope slides for consultation and report on referred slides prepared elsewhere (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64655","name":"Revj/rplcmt bat mod sys lead","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; lead only","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0864T","name":"Low ntsty eswt corpus cvrnsm","description":"Low-intensity extracorporeal shock wave therapy involving corpus cavernosum, low energy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2998","name":"Inj plasminogen tvmh 1mg","description":"Injection, plasminogen, human-tvmh, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7414","name":"Excision malig lesion>1.25cm","description":"Excision of malignant lesion greater than 1.25 cm","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1295","name":"Pt hx tot col or colon ca","description":"Patients with a diagnosis or past history of total colectomy or colorectal cancer","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0699","name":"Inj, cefiderocol, 10 mg","description":"Injection, cefiderocol, 10 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55711","name":"Bx prst8 trct mri-us 1st","description":"Biopsy, prostate, transrectal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2794","name":"Crown-titanium","description":"Crown-titanium","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61105","name":"Tdh sdrl/ventr pnxr","description":"Twist drill hole for subdural or ventricular puncture","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":481.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0757T","name":"Dgtz gls mcrscp sl spc grpii","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group ii, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistochemistry (list separately in addition to code for primary","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5946","name":"Max implt sup fix","description":"Max implt sup fix","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90624","name":"Menb-4c&menacwy vacc im","description":"Meningococcal pentavalent vaccine, men b-4c recombinant proteins and outer membrane vesicle and conjugated men a, c, w, y-diphtheria toxoid carrier, for intramuscular use","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90638","name":"Vacc qirv mrna 60mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 60 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33472","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1699.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8612","name":"Oral methotrexate (xatmep)","description":"Methotrexate (xatmep), oral, 2.5 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21268","name":"Revise eye sockets","description":"Orbital repositioning, periorbital osteotomies, unilateral, with bone grafts; combined intra- and extracranial approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2196.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86243","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5725","name":"Rebase hybrid prosthesis","description":"Rebase hybrid prosthesis","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44402","name":"Colonoscopy w/stent plcmt","description":"Colonoscopy through stoma; with endoscopic stent placement (including pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81457","name":"So neo gsap dna mcrstl ins","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis, microsatellite instability","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52352","name":"Cystouretero w/stone remove","description":"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with removal or manipulation of calculus (ureteral catheterization is included)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4030","name":"Pulmonology ss","description":"Pulmonology mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99384","name":"Prev visit new age 12-17","description":"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; adolescent (age ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":148.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0821T","name":"Mntr psychdlc med 2ndphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; second physician or other qualified health care professional, concurrent with first physician or other qualified health care professional, each hour (list sepa","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0712T","name":"N-nvs artl plaq alys quan","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess atherosclerotic plaque stability","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0978T","name":"Submucosal cryolysis therapy","description":"Submucosal cryolysis therapy; soft palate, base of tongue, and lingual tonsil","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9563","name":"P32 na phosphate","description":"Sodium phosphate p-32, therapeutic, per millicurie","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44377","name":"Small bowel endoscopy/biopsy","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, including ileum; with biopsy, single or multiple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99348","name":"Home/res vst est low mdm 30","description":"Home or residence visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4291","name":"Lamellas xt, per sq cm","description":"Lamellas xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97814","name":"Acup 1/> w/estim ea addl 15","description":"Acupuncture, 1 or more needles; with electrical stimulation, each additional 15 minutes of personal one-on-one contact with the patient, with insertion of needle(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":23.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15793","name":"Chemical peel nonfacial drm","description":"Chemical peel, nonfacial; dermal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":374.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86704","name":"Hep b core antibody total","description":"Hepatitis b core antibody (hbcab); total","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59412","name":"Antepartum manipulation","description":"External cephalic version, with or without tocolysis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":134.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1749","name":"Inj, iloprost, 0.1 mcg","description":"Injection, iloprost, 0.1 mcg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4366","name":"Dl amnio bur x-mem per sq cm","description":"Dual layer amnio burgeon x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50500","name":"Repair of kidney wound","description":"Nephrorrhaphy, suture of kidney wound or injury","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1322.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37255","name":"Revsc evasc ivt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87594","name":"Pneumcysts jirovecii amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); pneumocystis jirovecii, amplified probe technique","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2372","name":"Inj, biorphen, 20 micrograms","description":"Injection, phenylephrine hydrochloride (biorphen), 20 micrograms","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0539","name":"Initial care training 30 m","description":"Caregiver training in behavior management/modification for caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face; initial 30 minutes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0019M","name":"Cv ds plasma alys prtn bmrk","description":"Cardiovascular disease, plasma, analysis of protein biomarkers by aptamer-based microarray and algorithm reported as 4-year likelihood of coronary event in high-risk populations","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0736","name":"Inj, clindamycin phosp 300mg","description":"Injection, clindamycin phosphate, 300 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9393","name":"Inj, fulvestrant (teva)","description":"Injection, fulvestrant (teva), not therapeutically equivalent to j9395, 25 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6526","name":"G com garmt full leg/ft nght","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76815","name":"Ob us limited fetus(s)","description":"Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0706","name":"Intraoral occlus radio image","description":"Intraoral occlus radio image","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87564","name":"Mtb rifampin rst amp prb tq","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacterium tuberculosis, rifampin resistance, amplified probe technique","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9506","name":"Tc-99m graphite crucible","description":"Graphite crucible for preparation of technetium tc 99m-labeled carbon aerosol, one crucible","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4280","name":"Xcell amnio matrix per sq cm","description":"Xcell amnio matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44120","name":"Removal of small intestine","description":"Enterectomy, resection of small intestine; single resection and anastomosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1169.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44380","name":"Small bowel endoscopy br/wa","description":"Ileoscopy, through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59020","name":"Fetal contract stress test","description":"Fetal contraction stress test","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64596","name":"Ins/rplcmt prq eltrd ra pn 1","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; initial electrode array","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0347U","name":"Rx metab/pcx dna 16 gen alys","description":"Rx metab/pcx dna 16 gen alys","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4411","name":"Amniomatrixf4x per sq cm","description":"Amniomatrixf4x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0684","name":"App non-sheet skin sb g addl","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area or part thereof, or each additional 1% o","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4314","name":"Reeva, per sq cm","description":"Reeva ft, per square cenitmeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7957","name":"Tiss regen edent nonresorb","description":"Tiss regen edent nonresorb","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87426","name":"Sarscov coronavirus ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; severe acute respiratory syndrome coronavirus (eg, sars-cov, s","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1218","name":"Pt copd symptoms","description":"Patient has copd symptoms (e.g., dyspnea, cough/sputum, wheezing)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1451","name":"Fomepizole, 15 mg","description":"Injection, fomepizole, 15 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0674T","name":"Laps insj nw/rpcmt prm isdss","description":"Laparoscopic insertion of new or replacement of permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including an implantable pulse generator and diaphragmatic lead(s)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37283","name":"Rvsc evsc tpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1339","name":"Pts f/u 30-180 dys + improv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who demonstrated positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0049","name":"Main hemo in-cntr","description":"With maintenance hemodialysis (in-center and home hd) for the complete reporting month","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98981","name":"Rtm tx mgmt ea addl 20 min","description":"Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least 1 real-time interactive communication with the patient or caregiver during the calendar month; each additional 20 minutes (list separately in","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77091","name":"Tbs techl calculation only","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical calculation only","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3389","name":"Topi adm prad zami per treat","description":"Topical administration, prademagene zamikeracel, per treatment","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98012","name":"Synch audio-only est sf 10","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0909T","name":"Rplcmt int nstim sys vgs nrv","description":"Replacement of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0957T","name":"Rev s-sclp eltr ra rcvr&tlmt","description":"Revision of sub-scalp implanted electrode array, receiver, and telemetry unit for electrode, when required, including imaging guidance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50125","name":"Pyelotomy w/drg pyelostomy","description":"Pyelotomy; with drainage, pyelostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1093.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0814T","name":"Prq njx biod osteo matrl fem","description":"Percutaneous injection of calcium-based biodegradable osteoconductive material, proximal femur, including imaging guidance, unilateral","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1440","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1404","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72120","name":"X-ray bend only l-s spine","description":"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9341","name":"Inj thiotepa (tepylute) 1 mg","description":"Injection, thiotepa (tepylute), 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0707","name":"Intraoral periap radio image","description":"Intraoral periap radio image","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89060","name":"Exam synovial fluid crystals","description":"Crystal identification by light microscopy with or without polarizing lens analysis, tissue or any body fluid (except urine)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66682","name":"Repair iris & ciliary body","description":"Suture of iris, ciliary body (separate procedure) with retrieval of suture through small incision (eg, mccannel suture)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":587.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4004","name":"Endocrinology ss","description":"Endocrinology mips specialty set","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0429U","name":"Hpv orop swab 14 hi-risk typ","description":"Hpv orop swab 14 hi-risk typ","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37274","name":"Rvsc evsc fpvt athrc cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0322U","name":"Neuro asd meas 14 acyl carn","description":"Neuro asd meas 14 acyl carn","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7911","name":"Dental suture wound to 5 cm","description":"Complicated suture-up to 5 cm","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9326","name":"Telisotuzumab vedotin-tllv","description":"Injection, telisotuzumab vedotin-tllv, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0684","name":"App non-sheet skin sb g addl","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area or part thereof, or each additional 1% o","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33267","name":"Excl laa open any method","description":"Exclusion of left atrial appendage, open, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2040","name":"Microlyte painguard pr sq cm","description":"Microlyte painguard, per square centimeter","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0592U","name":"Onc hl neo dna tgs 417 genes","description":"Onc hl neo dna tgs 417 genes","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4002","name":"Ep cardio ss","description":"Electrophysiology cardiac specialist mips specialty set","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1190","name":"Doc khe not pef w/efgr/uacr","description":"Documentation of a kidney health evaluation was not performed or defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0709","name":"Intraoral cmplt radio images","description":"Intraoral cmplt radio images","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62284","name":"Injection for myelogram","description":"Injection procedure for myelography and/or computed tomography, lumbar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0382U","name":"Hyprphenylalninmia mntr quan","description":"Hyprphenylalninmia mntr quan","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22860","name":"Tot disc arthrp 2ntrspc lmbr","description":"Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression); second interspace, lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0533","name":"Buprenorphone inj weekly","description":"Medication assisted treatment, buprenorphine (injectable) administered on a weekly basis; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid tre","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1472","name":"Hep b vaccine not received","description":"Patient did not receive recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0465U","name":"Onc urthl carc dna qmsp 2gen","description":"Onc urthl carc dna qmsp 2gen","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7911","name":"Dental suture wound to 5 cm","description":"Complicated suture-up to 5 cm","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0696T","name":"Bdy surf mapg pm/cvdfb f/up","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of follow-up interrogation or programming device evaluatio","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0264U","name":"Rare ds id opt genome mapg","description":"Rare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55714","name":"Bx prst8 in-bore ct/mri 1","description":"Biopsy, prostate, in-bore ct- or mri-guided targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55877","name":"Abltj ire prst8 1+ tum perq","description":"Ablation, irreversible electroporation, prostate, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1386","name":"Exc sx melmn or mlnm is","description":"Patients with an excisional surgery for melanoma or melanoma in situ in the past 5 years with an initial ajcc staging of 0, i, or ii at the start of the performance period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0878T","name":"Augmnt alys ch ct ild w/ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained with concurrent ct examination of the same structure","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0589U","name":"Pfas24cmpnd hi-perf lc-ms/ms","description":"Pfas24cmpnd hi-perf lc-ms/ms","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0514U","name":"Gi ibd ia quan deter adl lvl","description":"Gi ibd ia quan deter adl lvl","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0561U","name":"Onc mrd gsa cfdna subsequent","description":"Onc mrd gsa cfdna subsequent","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6624","name":"Inlay titanium","description":"Inlay - titanium","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1720","name":"Hydrocortisone sodium succ i","description":"Injection, hydrocortisone sodium succinate, up to 100 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0562U","name":"Onc sol tum tgsa 33gens snvs","description":"Onc sol tum tgsa 33gens snvs","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0415U","name":"Cv ds acs bld alg 5 yr score","description":"Cv ds acs bld alg 5 yr score","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0627U","name":"Psyc scz dna alys >15000","description":"Psyc scz dna alys >15000","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37281","name":"Revsc evsc tpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":77.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98975","name":"Rtm 1st set-up&pt educaj eqp","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); initial set-up and patient education on use of equipment","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0443","name":"Brief alcohol misuse counsel","description":"Brief face-to-face behavioral counseling for alcohol misuse, 15 minutes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":25.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1212","name":"Missing gsa not perf","description":"Glycemic status assessment (hba1c or gmi) level is missing, or was not performed during the measurement period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0330U","name":"Iadna vag pthgn panel 27 org","description":"Iadna vag pthgn panel 27 org","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77620","name":"Hyperthermia gen intrcv prb","description":"Hyperthermia generated by intracavitary probe(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1152","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1012T","name":"Mtrz ab ntrno trph scl/tr mw","description":"Motorized ab interno trephination of sclera (sclerostomy), or trabecular meshwork (trabeculostomy), 1 or more, including injection of antifibrotic agents, when performed","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33900","name":"Perq p-art revsc 1 nm nt uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, unilateral","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87428","name":"Sarscov & inf vir a&b ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; severe acute respiratory syndrome coronavirus (eg, sars-cov, s","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37274","name":"Rvsc evsc fpvt athrc cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1470","name":"Hep b vac not recd med rsn","description":"Documentation of medical reason(s) for not administering hepatitis b vaccine (e.g., prior anaphylaxis due to the hepatitis b vaccine)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5949","name":"Mand implt sup fix part","description":"Mand implt sup fix part","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0923T","name":"Rmvl&rplcmt perm ccm-d pg","description":"Removal and replacement of permanent cardiac contractility modulation-defibrillation pulse generator only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0851T","name":"Dgtz gls mcrscp mphmtrc 1st","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44370","name":"Small bowel endoscopy/stent","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with transendoscopic stent placement (includes predilation)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9076","name":"Inj, cyclophos (baxter) 5mg","description":"Injection, cyclophosphamide (baxter), 5 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0941T","name":"Cysto flx ins&xpns urtl scaf","description":"Cystourethroscopy, flexible; with insertion and expansion of prostatic urethral scaffold using integrated cystoscopic visualization","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1015T","name":"Rev/rmv lw esoph sphnc npg/r","description":"Revision or removal, lower esophageal sphincter neurostimulator pulse generator or receiver","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8005","name":"Grip glove w microprocessor","description":"Powered, cable driven grip assist glove, hand, finger, includes microprocessor, pressure sensors, all components and accessories, custom fitted","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1341","name":"Pt no f/u 30-180 dys","description":"Patients who did not have a follow-up assessment or did not have an assessment within 30 to 180 days after the index assessment during the performance period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90484","name":"Imm cnsl not admn sm>20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 20 minutes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1008T","name":"Rem mntr s-scl eeg sys setup","description":"Remote monitoring of sub-scalp implanted continuous bilateral electroencephalography monitoring system, device fitting, initial set-up, and patient education in wearing of system and use of equipment","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0738","name":"Hiv prep, inj, lenacapavir","description":"Injection, lenacapavir, 1 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31292","name":"Nsl/sins ndsc med/inf dcmprn","description":"Nasal/sinus endoscopy, surgical, with orbital decompression; medial or inferior wall","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1183.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9294","name":"Biofeed dig cog behav tx fda","description":"Prescription digital cognitive and/or behavioral therapy, biofeedback, fda cleared, per course of treatment","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1203","name":"Inj, cipaglucosidase, 5 mg","description":"Injection, cipaglucosidase alfa-atga, 5 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0458","name":"Aztreonam/avibactam 10 mg","description":"Injection, aztreonam/avibactam, 7.5 mg/2.5 mg (10 mg)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44363","name":"Small bowel endoscopy","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with removal of foreign body(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4286","name":"Nudyn sl or slw, per sq cm","description":"Nudyn sl or nudyn slw, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0701T","name":"Molec fluor img sus nev ea","description":"Molecular fluorescent imaging of suspicious nevus; each additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1351","name":"Dental sealant per tooth","description":"Sealant-per tooth","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1736","name":"Inj meloxicam (delova) 1mg","description":"Injection, meloxicam (delova), 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99437","name":"Chrnc care mgmt phys ea addl","description":"Chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, or funct","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6611","name":"Onlay cst hgh nbl mtl >=3srf","description":"Onlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42960","name":"Control throat bleeding","description":"Control oropharyngeal hemorrhage, primary or secondary (eg, post-tonsillectomy); simple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0438U","name":"Rx metab advrs vrnt alys 33","description":"Rx metab advrs vrnt alys 33","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4410","name":"Amchomatrixdl per sq cm","description":"Amchomatrixdl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0295U","name":"Onc brst dux carc 7 proteins","description":"Onc brst dux carc 7 proteins","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99498","name":"Advncd care plan addl 30 min","description":"Advance care planning including the explanation and discussion of advance directives such as standard forms (with completion of such forms, when performed), by the physician or other qualified health care professional; each additional 30 minutes (list separately in addition to code for primary proce","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":87.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5126","name":"Inj alymsys 10 mg","description":"Injection, bevacizumab-maly, biosimilar, (alymsys), 10 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68841","name":"Insj rx elut implt lac canal","description":"Insertion of drug-eluting implant, including punctal dilation when performed, into lacrimal canaliculus, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0492U","name":"Onc sol tum ctc slctn pd-l1","description":"Onc sol tum ctc slctn pd-l1","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3432","name":"Guided tissue regeneration","description":"Guided tissue regeneration","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1230","name":"Pt hcv rctv aby no f/u tst","description":"Patient has a reactive hcv antibody test and does not have a follow up hcv viral test, or patient has a reactive hcv antibody test and has a follow up hcv viral test that detects hcv viremia and is not referred to a clinician who treats hcv infection within 1 month and does not have hcv treatment in","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34715","name":"Opn ax/subcla art expos","description":"Open axillary/subclavian artery exposure for delivery of endovascular prosthesis by infraclavicular or supraclavicular incision, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0521U","name":"Rf iga&igm ccp antb sr-a ia","description":"Rf iga&igm ccp antb sr-a ia","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4306","name":"Americ amnion ac per sq cm","description":"American amnion ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0487U","name":"Onc sol tum cfcdna tgsap 84","description":"Onc sol tum cfcdna tgsap 84","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87110","name":"Chlamydia culture","description":"Culture, chlamydia, any source","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5157","name":"Inj, denosumab-bmwo, 1 mg","description":"Injection, denosumab-bmwo (stoboclo/osenvelt), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1720","name":"Influenza vacc admin","description":"Influenza vacc admin","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71035","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1611","name":"Inj glucagon hcl, fresenius","description":"Injection, glucagon hydrochloride (fresenius kabi), not therapeutically equivalent to j1610, per 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5154","name":"Inj, omlyclo, 5 mg","description":"Injection, omalizumab-igec (omlyclo), biosimilar, 5 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7021","name":"Suppl and access lung expan","description":"Supplies and accessories for lung expansion airway clearance, continuous high frequency oscillation, and nebulization device (e.g., handset, nebulizer kit, biofilter)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98981","name":"Rtm tx mgmt ea addl 20 min","description":"Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least 1 real-time interactive communication with the patient or caregiver during the calendar month; each additional 20 minutes (list separately in","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74021","name":"Radex abdomen 3+ views","description":"Radiologic examination, abdomen; 3 or more views","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0510U","name":"Onc pncrtc ca alg alys 16gen","description":"Onc pncrtc ca alg alys 16gen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33281","name":"Reposg phrnc nrv stim trnsvn","description":"Repositioning of phrenic nerve stimulator transvenous lead(s)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63303","name":"Remov vert xdrl bdy lmbr/sac","description":"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, lumbar or sacral by transperitoneal or retroperitoneal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2337.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9318","name":"Inj romidepsin non-lyo 0.1mg","description":"Injection, romidepsin, non-lyophilized, 0.1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4251","name":"Vim, per square centimeter","description":"Vim, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27713","name":"Osteot tibia imed lngth dev","description":"Osteotomy(ies), tibia, including fibula when performed, unilateral, with insertion of an externally controlled intramedullary lengthening device, including imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4010","name":"Infectious disease ss","description":"Infectious disease mips specialty set","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80506","name":"Path clin consltj prolng svc","description":"Pathology clinical consultation; prolonged service, each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9947","name":"Sleep apnea appliance","description":"Sleep apnea appliance","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2599","name":"Inj vasopressin (am reg) 1 u","description":"Injection, vasopressin (american regent), not therapeutically equivalent to j2598, 1 unit","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92641","name":"Hearing dev verif eacous aly","description":"Hearing device verification, electroacoustic analysis","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0934T","name":"Rem mntr wrls l atr prs snr","description":"Remote monitoring of a wireless left atrial pressure sensor for up to 30 days, including data from daily uploads of left atrial pressure recordings, interpretation(s) and trend analysis, with adjustments to the diuretics plan, treatment paradigm thresholds, medications or lifestyle modifications, wh","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3222","name":"Part pulp for apexogenesis","description":"Partial pulpotomy for apexogenesis - permanent tooth with incomplete root development","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0993T","name":"N-invas assmt car rsk w/ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat with concurrent computed tomography scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional (list s","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57820","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5941","name":"Resct proth mand part remov","description":"Resct proth mand part remov","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87350","name":"Hepatitis be ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; hepatitis be antigen (hbeag)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0880T","name":"Augmnt alys ch ct ild i&r","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76856","name":"Us exam pelvic complete","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"Non-adju cgm supply allow","description":"Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49189","name":"Opn exc/dst ntra-abd 20.1-30","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 20.1 to 30 cm","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93598","name":"Car outp meas drg cath chd","description":"Cardiac output measurement(s), thermodilution or other indicator dilution method, performed during cardiac catheterization for the evaluation of congenital heart defects (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86784","name":"Trichinella antibody","description":"Antibody; trichinella","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90834","name":"Psytx w pt 45 minutes","description":"Psychotherapy, 45 minutes with patient","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":37.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":98.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22843","name":"Insert spine fixation device","description":"Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 7 to 12 vertebral segments (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1045.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87493","name":"C diff amplified probe","description":"Infectious agent detection by nucleic acid (dna or rna); clostridium difficile, toxin gene(s), amplified probe technique","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0530U","name":"Onc pan-sol tum ctdna 77 gen","description":"Onc pan-sol tum ctdna 77 gen","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6516","name":"Grad com wrap w strap foo cu","description":"Gradient compression wrap with adjustable straps, foot, each, custom","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1499","name":"Interventional radiology mvp","description":"Interventional radiology mips value pathway","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57510","name":"Cauterization of cervix","description":"Cautery of cervix; electro or thermal","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":155.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58673","name":"Laparoscopy salpingostomy","description":"Laparoscopy, surgical; with salpingostomy (salpingoneostomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":978.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1353","name":"Pts no cmplt suicd saf pln","description":"Patients who did not have a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4275","name":"Esano aca, per sq cm","description":"Esano aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90624","name":"Menb-4c&menacwy vacc im","description":"Meningococcal pentavalent vaccine, men b-4c recombinant proteins and outer membrane vesicle and conjugated men a, c, w, y-diphtheria toxoid carrier, for intramuscular use","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27448","name":"Incision of thigh","description":"Osteotomy, femur, shaft or supracondylar; without fixation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37266","name":"Rvsc evsc fpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0955T","name":"Tot impl amei removal","description":"Totally implantable active middle ear hearing implant; removal, including removal of sound processor and all implant components","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4031","name":"Radiation oncology ss","description":"Radiation oncology mips specialty set","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9612","name":"Inj, fluorescein, 1 mg","description":"Injection, fluorescein, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2390","name":"Ant resin-based cmpst crown","description":"Resin-based composite crown anterior","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0850T","name":"Dgtz gls mcrscp ish ea mult","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96547","name":"Intraop hipec px 1st 60 min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; first 60 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49613","name":"Rpr aa hrn rcr < 3 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, reducible","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5156","name":"Inj, tocilizumab-anoh, 1 mg","description":"Injection, tocilizumab-anoh (avtozma), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31243","name":"Nsl/sinus ndsc cryoabltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by cryoablation, posterior nasal nerve","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45190","name":"Destruction rectal tumor","description":"Destruction of rectal tumor (eg, electrodesiccation, electrosurgery, laser ablation, laser resection, cryosurgery) transanal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":686.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9128","name":"Photobio therpy-first 15 min","description":"Photobio therpy-first 15 min","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0808T","name":"Pulm tiss vntj alys w/ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with computed tomography (ct) images taken for the purpose of pulmonary tissue ventilation analysis, including data preparation and transmission, quantificati","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75577","name":"Quan&char c athrosclrtc plaq","description":"Quantification and characterization of coronary atherosclerotic plaque to assess severity of coronary disease, derived from augmentative software analysis of the data set from a coronary computed tomographic angiography, with interpretation and report by a physician or other qualified health care pr","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4212","name":"Gingivectomy/plasty rest","description":"Gingivectomy/plasty rest","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37285","name":"Revsc evasc tpvt st sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1202","name":"Pt rsn no ace-i/arb rx","description":"Documentation of patient reason(s) for not prescribing ace inhibitor or arb therapy during the measurement period, (e.g., patient declined, other patient reasons)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7509","name":"Marsupialization odon cyst","description":"Marsupialization odon cyst","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87484","name":"Ehrlicha chaffeensis amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); ehrlichia chaffeensis, amplified probe technique","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40842","name":"Reconstruction of mouth","description":"Vestibuloplasty; posterior, unilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":748.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52597","name":"Trurl rbtc wtrjt rescj prst8","description":"Transurethral robotic-assisted waterjet resection of prostate, including intraoperative planning, ultrasound guidance, control of postoperative bleeding, complete, including vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy, when performed","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4317","name":"Vitograft, per sq cm","description":"Vitograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3291","name":"Tranexamic acid in sod chlor","description":"Injection, tranexamic acid in sodium chloride, 5 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0650","name":"Inj, levothyroxine nos 10mcg","description":"Injection, levothyroxine sodium, not otherwise specified, 10 mcg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98016","name":"Brief comunicaj tech-bsd svc","description":"Brief communication technology-based service (eg, virtual check-in) by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related evaluation and management service provided within the p","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1460","name":"Dx copd, cf, or arf","description":"Diagnosis for chronic obstructive pulmonary disease, emphysema, cystic fibrosis, or acute respiratory failure","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6611","name":"Grad com wrap w strap ak cus","description":"Gradient compression wrap with adjustable straps, above knee, each, custom","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1438","name":"Lst knwn well <=210 min","description":"Time last known well to hospital arrival less than or equal to 3.5 hours (<= 210 minutes)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50840","name":"Replace ureter by bowel","description":"Replacement of all or part of ureter by intestine segment, including intestine anastomosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1308.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4399","name":"Summit fx per sq cm","description":"Summit fx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98011","name":"Synch audio-only new high 60","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 60 ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9376","name":"Inj pozelimab-bbfg, 1 mg","description":"Injection, pozelimab-bbfg, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5909","name":"Max guid prothes w/ flange","description":"Max guid prothes w/ flange","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0370","name":"Max ultrasound capt & interp","description":"Max ultrasound capt & interp","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1478","name":"Psychoactive sub abuse","description":"Psychoactive substance abuse","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0018M","name":"Trnsplj rnl meas cd154+cll","description":"Transplantation medicine (allograft rejection, renal), measurement of donor and third-party-induced cd154+t-cytotoxic memory cells, utilizing whole peripheral blood, algorithm reported as a rejection risk score","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2028","name":"Micromatrix flex per mg","description":"Micromatrix flex, per mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1821","name":"Ko elas w/ condyle pads otf","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, off the shelf","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G8431","name":"Pos clin depres scrn f/u doc","description":"Screening for depression is documented as being positive and a follow-up plan is documented","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5909","name":"Max guid prothes w/ flange","description":"Max guid prothes w/ flange","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4286","name":"Nudyn sl or slw, per sq cm","description":"Nudyn sl or nudyn slw, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96041","name":"Genetic counseling svc ea 30","description":"Medical genetics and genetic counseling services, each 30 minutes of total time provided by the genetic counselor on the date of the encounter","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0807T","name":"Pulm tiss vntj alys prev ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with previously acquired computed tomography (ct) images, including data preparation and transmission, quantification of pulmonary tissue ventilation, data re","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9994","name":"Pall serv during meas","description":"Patient is using palliative care services any time during the measurement period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4363","name":"Am bur mem hydro per sq cm","description":"Amnio burgeon membrane and hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34713","name":"Perq access & clsr fem art","description":"Percutaneous access and closure of femoral artery for delivery of endograft through a large sheath (12 french or larger), including ultrasound guidance, when performed, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0904T","name":"Ecg alg 12 ld rdcd trcg only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; tracing only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9275","name":"Inj cosibelimab-ipdl, 2 mg","description":"Injection, cosibelimab-ipdl, 2 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5128","name":"Inj, cimerli, 0.1 mg","description":"Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93798","name":"Phys/qhp op car rhab w/ecg","description":"Physician or other qualified health care professional services for outpatient cardiac rehabilitation; with continuous ecg monitoring (per session)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33897","name":"Perq trluml angp nt/recr coa","description":"Percutaneous transluminal angioplasty of native or recurrent coarctation of the aorta","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69726","name":"Rmv ntr oi implt skl prq esp","description":"Removal, entire osseointegrated implant, skull; with percutaneous attachment to external speech processor","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1311","name":"Aphlx to vax bef enc","description":"Anaphylaxis due to the vaccine on or before the date of the encounter","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93573","name":"Njx cath slct p-art angrp bi","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, bilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9602","name":"Fluorodopa f-18 diag per mci","description":"Fluorodopa f-18, diagnostic, per millicurie","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3389","name":"Topi adm prad zami per treat","description":"Topical administration, prademagene zamikeracel, per treatment","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4263","name":"Surgraft tl, per sq cm","description":"Surgraft tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1394","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15576","name":"Pedicle e/n/e/l/ntroral","description":"Formation of direct or tubed pedicle, with or without transfer; eyelids, nose, ears, lips, or intraoral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":737.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8005","name":"Grip glove w microprocessor","description":"Powered, cable driven grip assist glove, hand, finger, includes microprocessor, pressure sensors, all components and accessories, custom fitted","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0608","name":"Lanthanum carbonate pwdr 5mg","description":"Lanthanum carbonate, oral, powder, 5 mg, not therapeutically equivalent to j0607 (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0343U","name":"Onc prst8 xom aly 442 sncrna","description":"Onc prst8 xom aly 442 sncrna","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40840","name":"Reconstruction of mouth","description":"Vestibuloplasty; anterior","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":755.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6193","name":"Replace implnt screw","description":"Replace implnt screw","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45388","name":"Colonoscopy w/ablation","description":"Colonoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":2906.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4359","name":"Choriply, per sq cm","description":"Choriply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28630","name":"Treat toe dislocation","description":"Closed treatment of metatarsophalangeal joint dislocation; without anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0368U","name":"Onc clrct ca mut&mthyltn mrk","description":"Onc clrct ca mut&mthyltn mrk","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0487U","name":"Onc sol tum cfcdna tgsap 84","description":"Onc sol tum cfcdna tgsap 84","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1372","name":"Mst rec gsa >=7 and<8","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 7.0% and < 8.0%","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0839T","name":"Dgtz gls mcrscp cslt mat prp","description":"Digitization of glass microscope slides for consultation and report on referred material requiring preparation of slides (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0568U","name":"Neurol dementia bamyl ptau","description":"Neurol dementia bamyl ptau","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0559U","name":"Onc brs quan elisa bf9ag srm","description":"Onc brs quan elisa bf9ag srm","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4014","name":"Nephrology ss","description":"Nephrology mips specialty set","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2013","name":"Innovamatrix fs, per sq cm","description":"Innovamatrix fs, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4003","name":"Emergency med ss","description":"Emergency medicine mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1105","name":"Dexmedetomidine film, 1 mcg","description":"Dexmedetomidine, oral, 1 mcg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61609","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84120","name":"Assay of urine porphyrins","description":"Porphyrins, urine; quantitation and fractionation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0903T","name":"Ecg alg 12 lead reduced i&r","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; with interpretation and report","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50280","name":"Exc/unroofing cyst kidney","description":"Excision or unroofing of cyst(s) of kidney","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1170","name":"Pt w/o flu vax 7/1-6/30","description":"Patient did not receive an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37209","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0018","name":"Crisis psychotherapy add 30m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); each additional 30 minutes (list separately in addition to code for primary service)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2468","name":"Inj, palonosetron (posfrea)","description":"Injection, palonosetron hydrochloride (posfrea), 25 micrograms","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0403U","name":"Onc prst8 mrna 18 gen dre ur","description":"Onc prst8 mrna 18 gen dre ur","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0517U","name":"Ther rx mntr 80+ psyactiv rx","description":"Ther rx mntr 80+ psyactiv rx","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0752","name":"Hiv prep, oral lenacapavir","description":"Oral, lenacapavir, 300 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33506","name":"Repair artery translocation","description":"Repair of anomalous coronary artery from pulmonary artery origin; by translocation from pulmonary artery to aorta","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2435.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1318","name":"Pts no csp doc contact","description":"Patients who did not have documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening or documentation that there was no contact with a csp","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0423","name":"Genetic test spec analysis","description":"Genetic test spec analysis","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1171","name":"Pt recd 1 td/tdap 9yrs prior","description":"Patient received at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0237","name":"Intrav inf, toci, first dose","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0939T","name":"Xtrnl ecg rec>15d<30d scan","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; scanning analysis with report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1437","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0509","name":"Crit care telehea consult 50","description":"Telehealth consultation, critical care, subsequent, physicians typically spend 50 minutes communicating with the patient and providers via telehealth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1234","name":"Pt hcv rctv aby f/u neg","description":"Patient has a reactive hcv antibody test, and has a follow up hcv viral test that does not detect hcv viremia","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1290","name":"Pt not eli d/t act dig htn","description":"Patient not eligible due to active diagnosis of hypertension","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6608","name":"G com bandage tub protct pad","description":"Gradient compression bandaging supply, tubular protective absorption padded layer, per linear yard, any width, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1419","name":"Pt not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0680T","name":"Insj/rplcmt pg only isdss","description":"Insertion or replacement of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing lead(s)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9616","name":"Gallium gozellix 1 millicuri","description":"Gallium ga-68 gozetotide (gozellix), diagnostic, 1 millicurie","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49593","name":"Rpr aa hrn 1st 3-10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, reducible","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93307","name":"Tte w/o doppler complete","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, complete, without spectral or color doppler echocardiography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1340","name":"Indx whodas 2.0 or sds","description":"Index assessment completed using the 12-item whodas 2.0 or sds during the denominator identification period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22860","name":"Tot disc arthrp 2ntrspc lmbr","description":"Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression); second interspace, lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0876T","name":"Duplex scan hemo fstl lmtd","description":"Duplex scan of hemodialysis fistula, computer-aided, limited (volume flow, diameter, and depth, including only body of fistula)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1493","name":"No fall doc med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4390","name":"Ascendion per sq cm","description":"Ascendion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9914","name":"Admin of dermal fill","description":"Admin of dermal fill","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61791","name":"Treat trigeminal tract","description":"Creation of lesion by stereotactic method, percutaneous, by neurolytic agent (eg, alcohol, thermal, electrical, radiofrequency); trigeminal medullary tract","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1221.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0001","name":"Advancing cancer care mvp","description":"Advancing cancer care mips value pathways","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0917T","name":"Insj perm ccm-d sys 1 lead","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; single transvenous lead (pacing or defibrillation) only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44145","name":"Partial removal of colon","description":"Colectomy, partial; with coloproctostomy (low pelvic anastomosis)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1797.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4286","name":"Nudyn sl or slw, per sq cm","description":"Nudyn sl or nudyn slw, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4025","name":"Physical medicine ss","description":"Physical medicine mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0875T","name":"Prgrm subq prtl asct pmp sys","description":"Programming of subcutaneously implanted peritoneal ascites pump system by physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9376","name":"Inj pozelimab-bbfg, 1 mg","description":"Injection, pozelimab-bbfg, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92288","name":"Scr dark adaptation meas i&r","description":"Screening dark adaptation measurement (eg, rod recovery intercept time), with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1370","name":"Inj, esomeprazole sod, 1 mg","description":"Injection, esomeprazole sodium, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0965T","name":"I&cst prp jw xpn dl arch non","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, non-fixed hinge mechanism","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0682","name":"App non-sheet skin sub add","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (list separately in addition to code for pri","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93236","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98007","name":"Synch audio-video est hi 40","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high medical decision making. when using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded.","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1254","name":"Pts deceased prior hu surv","description":"Patients who were deceased when the hu survey reached them","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0999T","name":"Autol musc cell therapy hrvg","description":"Autologous muscle cell therapy, harvesting of muscle progenitor cells, including ultrasound guidance, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31649","name":"Bronchial valve remov addl","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with removal of bronchial valve(s), each additional lobe (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0911T","name":"Elec aly nstm sys vgs nrv wo","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; without programming by physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9268","name":"Programmer orally ingest cap","description":"Programmer for transient, orally ingested capsule","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52647","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":682.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92641","name":"Hearing dev verif eacous aly","description":"Hearing device verification, electroacoustic analysis","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22836","name":"Ant thrc vrt body tethrg <7","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; up to 7 vertebral segments","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2021","name":"Neomatrix per sq cm","description":"Neomatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9393","name":"Inj, fulvestrant (teva)","description":"Injection, fulvestrant (teva), not therapeutically equivalent to j9395, 25 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33277","name":"Insj phrnc nrv stim transvns","description":"Insertion of phrenic nerve stimulator transvenous sensing lead (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33535","name":"Cabg arterial three","description":"Coronary artery bypass, using arterial graft(s); 3 coronary arterial grafts","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2587.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9061","name":"Inj, amivantamab-vmjw","description":"Injection, amivantamab-vmjw, 2 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86215","name":"Deoxyribonuclease antibody","description":"Deoxyribonuclease, antibody","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92570","name":"Acoustic immitance testing","description":"Acoustic immittance testing, includes tympanometry (impedance testing), acoustic reflex threshold testing, and acoustic reflex decay testing","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":25.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0920T","name":"Rmvl perm ccm-d sys 1 pac ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous pacing lead only","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44210","name":"Laparo total proctocolectomy","description":"Laparoscopy, surgical; colectomy, total, abdominal, without proctectomy, with ileostomy or ileoproctostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1922.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4378","name":"Renew ft matrix per sq cm","description":"Renew ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0372U","name":"Nfct ds gu pthgn arg detcj","description":"Nfct ds gu pthgn arg detcj","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4396","name":"Natalin per sq cm","description":"Natalin, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4405","name":"Xwrap fenestra plus sq cm","description":"Xwrap fenestra plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0805T","name":"Tcat s&ivc prstc vl impl prq","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); percutaneous femoral vein approach","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0571","name":"Intraop nerve cryoablation","description":"Intraoperative nerve(s) cryoablation for post-surgical pain relief (list separately in addition to code for primary service)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2001","name":"Suct pum ext mgmt sys","description":"Suction pump, home model, portable or stationary, electric, any type, for use with external urine and/or fecal management system","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0627U","name":"Psyc scz dna alys >15000","description":"Psyc scz dna alys >15000","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1497","name":"No doc fall med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50686","name":"Measure ureter pressure","description":"Manometric studies through ureterostomy or indwelling ureteral catheter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92283","name":"Extnd color vision xm","description":"Color vision examination, extended, eg, anomaloscope or equivalent","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1339","name":"Pts f/u 30-180 dys + improv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who demonstrated positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4297","name":"Emerge matrix, per sq cm","description":"Emerge matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76770","name":"Us exam abdo back wall comp","description":"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0504U","name":"Nfct ds uti id 17 path orgs","description":"Nfct ds uti id 17 path orgs","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4008","name":"Geriatrics ss","description":"Geriatrics mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1249","name":"Pt resp true imprt to me","description":"Patient responded completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0272U","name":"Hem genetic bld do 51 genes","description":"Hematology (genetic bleeding disorders), genomic sequence analysis of 51 genes, blood, buccal swab, or amniotic fluid, comprehensive","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55707","name":"Bx prst8 trct us guided","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2014","name":"Omeza collag compl 100 mg","description":"Omeza collagen matrix or omeza complete matrix, per 100 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47300","name":"Surgery for liver lesion","description":"Marsupialization of cyst or abscess of liver","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1081.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1447","name":"Pt dx bd bef end meas pd","description":"Patients with an active diagnosis of bipolar disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7214","name":"Altuviiio per factor viii iu","description":"Injection, factor viii/von willebrand factor complex, recombinant (altuviiio), per factor viii i.u.","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93898","name":"Ven-artl shunt det mbubb njx","description":"Venous-arterial shunt detection with intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0741T","name":"Rem auton alg nsln data coll","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; provision of software, data collection, transmission, and storage, each 30 days","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9948","name":"Adjust sleep apnea appliance","description":"Adjust sleep apnea appliance","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1836","name":"Inj, metronidazole, 10 mg","description":"Injection, metronidazole, 10 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3291","name":"Tranexamic acid in sod chlor","description":"Injection, tranexamic acid in sodium chloride, 5 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0540","name":"Train for caregiver add 15","description":"Caregiver training in behavior management/modification for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face; each additional 15 minutes","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7353","name":"Anacaulase-bcdb 8.8% gel 1 g","description":"Anacaulase-bcdb, 8.8% gel, 1 gram","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0361","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0453U","name":"Onc clrct ca cfdna qpcr asy","description":"Onc clrct ca cfdna qpcr asy","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6034","name":"Part hand finger distal amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s)/thumb, amputation at distal to metacarpal joint, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l669","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77777","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":659.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0018","name":"Crisis psychotherapy add 30m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); each additional 30 minutes (list separately in addition to code for primary service)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0978T","name":"Submucosal cryolysis therapy","description":"Submucosal cryolysis therapy; soft palate, base of tongue, and lingual tonsil","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0610U","name":"Nfct ds antmcr sc phenotypic","description":"Nfct ds antmcr sc phenotypic","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1215","name":"Med rsn for no doc spiro","description":"Documentation of medical reason(s) for not documenting and reviewing spirometry results (e.g., patients with dementia or tracheostomy)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4342","name":"Theramend, per sq cm","description":"Theramend, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4375","name":"Duograft ac per sq cm","description":"Duograft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33249","name":"Insj/rplcmt defib w/lead(s)","description":"Insertion or replacement of permanent implantable defibrillator system, with transvenous lead(s), single or dual chamber","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1028.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1260","name":"Pt not doc <= 1 yr dialysis","description":"Patient status not documented within the first year of initiating dialysis","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0414U","name":"Onc lng aug alg aly whl sld8","description":"Onc lng aug alg aly whl sld8","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71047","name":"X-ray exam chest 3 views","description":"Radiologic examination, chest; 3 views","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55812","name":"Extensive prostate surgery","description":"Prostatectomy, perineal radical; with lymph node biopsy(s) (limited pelvic lymphadenectomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1766.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88341","name":"Imhchem/imcytchm ea add antb","description":"Immunohistochemistry or immunocytochemistry, per specimen; each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0594U","name":"Nfct ds sepsis pncrtc spc","description":"Nfct ds sepsis pncrtc spc","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0300U","name":"Onc pan tum whl gen seq&opt","description":"Onc pan tum whl gen seq&opt","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0381U","name":"Maple syrup ur ds mntr quan","description":"Maple syrup ur ds mntr quan","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23660","name":"Optx acute shoulder dislc","description":"Open treatment of acute shoulder dislocation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":692.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9061","name":"Inj, amivantamab-vmjw","description":"Injection, amivantamab-vmjw, 2 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87070","name":"Culture othr specimn aerobic","description":"Culture, bacterial; any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1413","name":"Inj delandistrogene mox rokl","description":"Injection, delandistrogene moxeparvovec-rokl, per therapeutic dose","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8522","name":"Capecitabine, oral, 50 mg","description":"Capecitabine, oral, 50 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0166","name":"Inj epinephrine (bpi)","description":"Injection, epinephrine (bpi), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0959T","name":"Rmv/rplc magnet coil assem","description":"Removal or replacement of magnet from coil assembly that is connected to continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96160","name":"Pt-focused hlth risk assmt","description":"Administration of patient-focused health risk assessment instrument (eg, health hazard appraisal) with scoring and documentation, per standardized instrument","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74018","name":"Radex abdomen 1 view","description":"Radiologic examination, abdomen; 1 view","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0726T","name":"Rmvl implt vstibular dev uni","description":"Removal of implanted vestibular device, unilateral","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86812","name":"Hla typing a b or c","description":"Hla typing; a, b, or c (eg, a10, b7, b27), single antigen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90472","name":"Immunization admin each add","description":"Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); each additional vaccine (single or combination vaccine/toxoid) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48150","name":"Partial removal of pancreas","description":"Pancreatectomy, proximal subtotal with total duodenectomy, partial gastrectomy, choledochoenterostomy and gastrojejunostomy (whipple-type procedure); with pancreatojejunostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3281.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74440","name":"X-ray male genital tract","description":"Vasography, vesiculography, or epididymography, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9331","name":"Inj sirolimus prot part 1 mg","description":"Injection, sirolimus protein-bound particles, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6518","name":"Grad com wrap w strap arm cu","description":"Gradient compression wrap with adjustable straps, arm, each, custom","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"Ctlso a-p-l control custom","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3222","name":"Part pulp for apexogenesis","description":"Partial pulpotomy for apexogenesis - permanent tooth with incomplete root development","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5909","name":"Max guid prothes w/ flange","description":"Max guid prothes w/ flange","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0530U","name":"Onc pan-sol tum ctdna 77 gen","description":"Onc pan-sol tum ctdna 77 gen","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97007","name":"Mchnl sclp cool meas fitg","description":"Mechanical scalp cooling, including individual cap supply with head measurement, fitting, and patient education","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0746T","name":"Car ablt rad arr cnv loc map","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; conversion of arrhythmia localization and mapping of arrhythmia site (nidus) into a multidimensional radiation treatment plan","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0902T","name":"Qtc ntrvl augmnt alg aly ecg","description":"Qtc interval derived by augmentative algorithmic analysis of input from an external, patient-activated mobile ecg device","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0530","name":"Adult daycare center, 8 hr u","description":"Adult day center, 8-hour unit, for use in cmmi model","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1495","name":"Fall w/ poc, no fall","description":"Patients that reported a fall occurred who had a plan of care for falls documented or patients that did not report a fall","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1259","name":"Pt stat doc <= 1 yr dialysis","description":"Patient status documented within the first year of initiating dialysis","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0447U","name":"Ai ds sle alys 11 cytokine","description":"Ai ds sle alys 11 cytokine","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0576U","name":"Trnsplj med lar quan ddcfdna","description":"Trnsplj med lar quan ddcfdna","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1489","name":"Pt status doc","description":"Patient status documented","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":2.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6613","name":"Onlay cst base mtl >=3 surfa","description":"Onlay - cast predominantly base metal three or more surfaces","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0964T","name":"I&cust prep jaw xpnsj 1arch","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; single arch, without mandibular advancement mechanism","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1016T","name":"Elec alys npgs esoph intraop","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25448","name":"Arthrp ntrcrpl/crp/mtcrp ssp","description":"Arthroplasty, intercarpal or carpometacarpal joints; suspension, including transfer or transplant of tendon, with interposition, when performed","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89051","name":"Body fluid cell count","description":"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; with differential count","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0356U","name":"Onc orop 17 dna ddpcr alg","description":"Onc orop 17 dna ddpcr alg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78491","name":"Myocrd img pet 1std rst/strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); single study, at rest or stress (exercise or pharmacologic)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49616","name":"Rpr aa hrn rcr 3-10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0281","name":"Inj aminocaproic acid 1 gram","description":"Injection, aminocaproic acid, 1 gram","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","date_of_service":"2026-06-05","zip":"10985","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99480","name":"Sbsq ic inf pbw 2,501-5,000","description":"Subsequent intensive care, per day, for the evaluation and management of the recovering infant (present body weight of 2,501-5,000 grams)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1952","name":"Afo spiral prefab ots","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, off-the-shelf","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23520","name":"Cltx strnclav dislc w/o mnpj","description":"Closed treatment of sternoclavicular dislocation; without manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0516","name":"Insert drug del implant, >=4","description":"Insertion of non-biodegradable drug delivery implants, 4 or more (services for subdermal rod implant)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":189.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0911","name":"Inst tauro 1.35mg/hep 100u","description":"Instillation, taurolidine 1.35 mg and heparin sodium 100 units (central venous catheter lock for adult patients receiving chronic hemodialysis)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1370","name":"Inj, esomeprazole sod, 1 mg","description":"Injection, esomeprazole sodium, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1285","name":"Scrn mam perf rslts not doc","description":"Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed, reason not otherwise specified","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0805T","name":"Tcat s&ivc prstc vl impl prq","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); percutaneous femoral vein approach","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26477","name":"Tendon shortening","description":"Shortening of tendon, extensor, hand or finger, each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":791.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28010","name":"Incision of toe tendon","description":"Tenotomy, percutaneous, toe; single tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91321","name":"Sarscov2 vac 25 mcg/.25ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 25 mcg/0.25 ml dosage, for intramuscular use","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1209","name":">=2 same hi-rsk med w/o diag","description":"At least two orders for high-risk medications from the same drug class, (table 4), without appropriate diagnoses","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70471","name":"Cta h&n c+ w/noncontrast img","description":"Computed tomographic angiography (cta), head and neck, with contrast material(s), including noncontrast images, when performed, and image postprocessing","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0337U","name":"Onc plsm cell do&myeloma id","description":"Onc plsm cell do&myeloma id","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0508","name":"Crit care telehea consult 60","description":"Telehealth consultation, critical care, initial , physicians typically spend 60 minutes communicating with the patient and providers via telehealth","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2799","name":"Inj, uzedy, 1 mg","description":"Injection, risperidone (uzedy), 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7252","name":"Part extract for implant","description":"Part extract for implant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0802","name":"3d dental scan indirect","description":"3d dental scan indirect","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20816","name":"Replantation digit complete","description":"Replantation, digit, excluding thumb (includes metacarpophalangeal joint to insertion of flexor sublimis tendon), complete amputation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3357.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1198","name":"Isa not red 3pts /no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0321U","name":"Iadna gu pthgn 20bct&fng org","description":"Iadna gu pthgn 20bct&fng org","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0062","name":"Audiology ss","description":"Audiology mips specialty set","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93146","name":"Interrog crtd sins bat ip w/","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6600","name":"G com bandge hgh dn foam sht","description":"Gradient compression bandaging supply, high density foam sheet, per 250 square centimeters, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2393","name":"Post 3 srfc resinbased cmpst","description":"Resin-based composite - three surfaces posterior","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1403","name":"Bslne and fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59200","name":"Insert cervical dilator","description":"Insertion of cervical dilator (eg, laminaria, prostaglandin) (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":58.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":74.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1171","name":"Pt recd 1 td/tdap 9yrs prior","description":"Patient received at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9957","name":"Screening sleep disorders","description":"Screening sleep disorders","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47384","name":"Abltj ire liver 1+ tum perq","description":"Ablation, irreversible electroporation, liver, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0505U","name":"Nfct ds vag infctj id 32orgs","description":"Nfct ds vag infctj id 32orgs","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9506","name":"Tc-99m graphite crucible","description":"Graphite crucible for preparation of technetium tc 99m-labeled carbon aerosol, one crucible","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1714","name":"Pfizer vacc adm ped 2nd dose","description":"Pfizer vacc adm ped 2nd dose","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1231","name":"Pt hcv tst no reactive res","description":"Patient receives hcv antibody test with nonreactive result","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0792T","name":"Appl slvr diamn fluoride 38%","description":"Application of silver diamine fluoride 38%, by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4402","name":"Xwrap 2.0 per sq cm","description":"Xwrap 2.0, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27440","name":"Revision of knee joint","description":"Arthroplasty, knee, tibial plateau;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":827.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95782","name":"Polysom <6 yrs 4/> paramtrs","description":"Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1334.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1488","name":"Dx dementia in msr timeframe","description":"Patients with a diagnosis for dementia in the year before or during the period of evaluation","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0494U","name":"Rbc ag ftl rhd gene alys ngs","description":"Rbc ag ftl rhd gene alys ngs","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0773T","name":"Vr px dissoc svc oth phy 1st","description":"Virtual reality (vr) procedural dissociation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports; initial 15 min","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1446","name":"Pt died bef end meas pd","description":"Patients who died any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4267","name":"Neostim dl per sq cm","description":"Neostim dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4437","name":"Revival ac per sq cm","description":"Revival ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0918T","name":"Insj perm ccm-d sys dual ld","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; dual transvenous leads (pacing and defibrillation) only","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0477U","name":"Rx metab psy 14&cyp2d6 gn-rx","description":"Rx metab psy 14&cyp2d6 gn-rx","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59821","name":"Treatment of miscarriage","description":"Treatment of missed abortion, completed surgically; second trimester","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":503.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":406.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0237","name":"Inj, tocilizumab-anoh, hospi","description":"Injection, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9174","name":"Inj, docetaxel (beizray) 1mg","description":"Injection, docetaxel (beizray), 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93505","name":"Endomyocardial biopsy","description":"Endomyocardial biopsy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1211","name":"Gsa level>9.0%","description":"Most recent glycemic status assessment (hba1c or gmi) level > 9.0%","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0301U","name":"Iadna bartonella ddpcr","description":"Iadna bartonella ddpcr","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93569","name":"Njx cth slct p-art angrp uni","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2394","name":"Post >=4srfc resinbase cmpst","description":"Resin-based composite - four or more surfaces posterior","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0937T","name":"Xtrnl ecg rec>15d<30d","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; including recording, scanning analysis with report, review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19294","name":"Prepj tum cav iort prtl mast","description":"Preparation of tumor cavity, with placement of a radiation therapy applicator for intraoperative radiation therapy (iort) concurrent with partial mastectomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35142","name":"Repair artery rupture thigh","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, common femoral artery (profunda femoris, superficial femoral)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1653.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99307","name":"Sbsq nf care sf mdm 10","description":"Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 10 minutes must be met or e","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":41.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0414","name":"Lab process microbial spec","description":"Lab process microbial spec","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0558","name":"Adv prim care mgmt lvl 3","description":"Advanced primary care management services for a patient that is a qualified medicare beneficiary with multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, which place the patient at significant risk of death, acute exacerbation/decompensat","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5099","name":"Inj ustekinumab-stba, 1 mg","description":"Injection, ustekinumab-stba (steqeyma), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37289","name":"Revsc evsc tpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0803","name":"3d facial scan direct","description":"3d facial scan direct","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0966T","name":"I&cst prp jw xpn dl arch fxd","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, fixed hinge mechanism","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99469","name":"Neonate crit care subsq","description":"Subsequent inpatient neonatal critical care, per day, for the evaluation and management of a critically ill neonate, 28 days of age or younger","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":377.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70473","name":"Ct cere prfu aly c+wo ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed without concurrent ct or ct angiography of the same anatomy","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0366U","name":"Onc bldr 10 prb recr bldr ca","description":"Onc bldr 10 prb recr bldr ca","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93793","name":"Anticoag mgmt pt warfarin","description":"Anticoagulant management for a patient taking warfarin, must include review and interpretation of a new home, office, or lab international normalized ratio (inr) test result, patient instructions, dosage adjustment (as needed), and scheduling of additional test(s), when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0238","name":"Intrav inf, toci, second dos","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1438","name":"Lst knwn well <=210 min","description":"Time last known well to hospital arrival less than or equal to 3.5 hours (<= 210 minutes)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80048","name":"Basic metabolic pnl total ca","description":"Basic metabolic panel (calcium, total) this panel must include the following: calcium, total (82310) carbon dioxide (bicarbonate) (82374) chloride (82435) creatinine (82565) glucose (82947) potassium (84132) sodium (84295) urea nitrogen (bun) (84520)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0281","name":"Inj aminocaproic acid 1 gram","description":"Injection, aminocaproic acid, 1 gram","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2056","name":"Ciltacabtagene car-pos t","description":"Ciltacabtagene autoleucel, up to 100 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0848T","name":"Dgtz gls mcrscp ish 1st","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15018","name":"App skn cll ssp f/n/g/hf ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 480 sq cm or part thereof (list separately in addition to code for prima","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93585","name":"Vngrph chd azygs/hemiazygs","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; azygos/hemiazygos venous system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4288","name":"Replacement breastpump valve","description":"Valve for breast pump, replacement","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0255U","name":"Andrology infertility assmt","description":"Andrology (infertility), sperm-capacitation assessment of ganglioside gm1 distribution patterns, fluorescence microscopy, fresh or frozen specimen, reported as percentage of capacitated sperm and probability of generating a pregnancy score","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0561","name":"Temp tube delivery, unil","description":"Tympanostomy with local or topical anesthesia and insertion of a ventilating tube when performed with tympanostomy tube delivery device, unilateral (list separately in addition to 69433) (do not use in conjunction with 0583t)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2183","name":"Inj meropenem (wg crit care)","description":"Injection, meropenem (wg critical care), not therapeutically equivalent to j2185, 100 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0938T","name":"Xtrnl ecg rec>15d<30d rec","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; recording (including connection and initial recording)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6198","name":"Remove interim implant","description":"Remove interim implant","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7771","name":"Alveolus clsd reduc stblz te","description":"Alveolus closed reduction stabilization of teeth","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52597","name":"Trurl rbtc wtrjt rescj prst8","description":"Transurethral robotic-assisted waterjet resection of prostate, including intraoperative planning, ultrasound guidance, control of postoperative bleeding, complete, including vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy, when performed","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0523","name":"Mgt nw pt dem mod-high cmplx","description":"Management of a new patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27087","name":"Remove hip foreign body","description":"Removal of foreign body, pelvis or hip; deep (subfascial or intramuscular)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1380","name":"Estradiol valerate 10 mg inj","description":"Injection, estradiol valerate, up to 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4327","name":"Duoamnion, per sq cm","description":"Duoamnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0999T","name":"Autol musc cell therapy hrvg","description":"Autologous muscle cell therapy, harvesting of muscle progenitor cells, including ultrasound guidance, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55877","name":"Abltj ire prst8 1+ tum perq","description":"Ablation, irreversible electroporation, prostate, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98929","name":"Osteopath manj 9-10 regions","description":"Osteopathic manipulative treatment (omt); 9-10 body regions involved","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":91.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4302","name":"Complete aca, per sq cm","description":"Complete aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0700T","name":"Molec fluor img sus nev 1st","description":"Molecular fluorescent imaging of suspicious nevus; first lesion","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6111","name":"Implnt/abut remov dent mand","description":"Implnt/abut remov dent mand","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1025T","name":"Alt elec fld dos&dlv sim mdl","description":"Alternating electric fields dosimetry and delivery-simulation modeling, creation and selection of patient-specific array layouts, and placement verification","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62230","name":"Replace/revise brain shunt","description":"Replacement or revision of cerebrospinal fluid shunt, obstructed valve, or distal catheter in shunt system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9026","name":"Cryo fib comp path redu each","description":"Cryoprecipitated fibrinogen complex, pathogen reduced, each unit","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0540","name":"Train for caregiver add 15","description":"Caregiver training in behavior management/modification for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face; each additional 15 minutes","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4315","name":"Regenelink amniotic mem allo","description":"Regenelink amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1233","name":"Pt no hcv aby or result","description":"Patient does not receive hcv antibody test or patient does receive hcv antibody test but results not documented, reason not given","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75600","name":"Contrast exam thoracic aorta","description":"Aortography, thoracic, without serialography, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2017","name":"Permeaderm glove, each","description":"Permeaderm glove, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9296","name":"Inj pemetrexed (accord) 10mg","description":"Injection, pemetrexed (accord), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1443","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58561","name":"Hysteroscopy remove myoma","description":"Hysteroscopy, surgical; with removal of leiomyomata","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":687.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9886","name":"In-person attendance g code","description":"Behavioral counseling for diabetes prevention, in-person, group, 60 minutes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1379","name":"10 yr fu no rec rsn not giv","description":"A 10 year follow-up interval for colonoscopy not recommended, reason not otherwise specified","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0520","name":"New pt-cg dyad dem mod cmplx","description":"Management of new patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q2008","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4436","name":"Renati ac membrane per sq cm","description":"Renati ac membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81515","name":"Nfct ds bv&vaginitis dna alg","description":"Infectious disease, bacterial vaginosis and vaginitis, real-time pcr amplification of dna markers for atopobium vaginae, atopobium species, megasphaera type 1, and bacterial vaginosis associated bacteria-2 (bvab-2), utilizing vaginal-fluid specimens, algorithm reported as positive or negative for hi","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95910","name":"Nrv cndj test 7-8 studies","description":"Nerve conduction studies; 7-8 studies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0022","name":"Comm hlth intg svs add 30 m","description":"Community health integration services, each additional 30 minutes per calendar month (list separately in addition to g0019)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15015","name":"App skn cl ssp agrft t/a/l 1","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; first 480 sq cm or less","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1373","name":"Mst rec gsa >=8 and <=9","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 8.0% and <= 9.0%","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37270","name":"Revsc evasc fpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5422","name":"Dentures adjust part mandbl","description":"Adjust partial denture - mandibular","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20969","name":"Bone/skin graft microvasc","description":"Free osteocutaneous flap with microvascular anastomosis; other than iliac crest, metatarsal, or great toe","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3367.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92520","name":"Laryngeal function studies","description":"Laryngeal function studies (ie, aerodynamic testing and acoustic testing)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0511U","name":"Onc sol tum 3dmicroenvir 36+","description":"Onc sol tum 3dmicroenvir 36+","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4301","name":"Activate matrix, per sq cm","description":"Activate matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9800","name":"Gallium locametz 1 millicuri","description":"Gallium ga-68 gozetotide, diagnostic, (locametz), 1 millicurie","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5143","name":"Inj adalimumab-adbm, 1 mg","description":"Injection, adalimumab-adbm, biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4457","name":"Enema tube any type repl","description":"Enema tube, with or without adapter, any type, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0571","name":"Intraop nerve cryoablation","description":"Intraoperative nerve(s) cryoablation for post-surgical pain relief (list separately in addition to code for primary service)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27713","name":"Osteot tibia imed lngth dev","description":"Osteotomy(ies), tibia, including fibula when performed, unilateral, with insertion of an externally controlled intramedullary lengthening device, including imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0517U","name":"Ther rx mntr 80+ psyactiv rx","description":"Ther rx mntr 80+ psyactiv rx","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86317","name":"Immunoassay infectious agent","description":"Immunoassay for infectious agent antibody, quantitative, not otherwise specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1364","name":"Ascvd risk >=20pct","description":"Calculated 10-year ascvd risk score of >= 20 percent during the performance period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2022","name":"Innovabrn/innovamatx xl sqcm","description":"Innovaburn or innovamatrix xl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1380","name":"2 rx in perf pd any com meds","description":"Filled at least two prescriptions during the performance period for any combination of the qualifying oral antipsychotic medications listed under denominator note or the long-acting injectable antipsychotic medications listed under denominator note","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J9140","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93574","name":"Njx cath slct pulm vn angrph","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary venous angiography of each distinct pulmonary vein during cardiac catheterization (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0402","name":"Inj, abilify asimtufii, 1 mg","description":"Injection, aripiprazole (abilify asimtufii), 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78491","name":"Myocrd img pet 1std rst/strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); single study, at rest or stress (exercise or pharmacologic)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83887","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38380","name":"Thoracic duct procedure","description":"Suture and/or ligation of thoracic duct; cervical approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":625.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5124","name":"Inj. byooviz, 0.1 mg","description":"Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0305U","name":"Hem rbc fnclty&dfrm shr strs","description":"Hem rbc fnclty&dfrm shr strs","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0414","name":"Lab process microbial spec","description":"Lab process microbial spec","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53452","name":"Tprnl balo cntnc dev uni","description":"Periurethral transperineal adjustable balloon continence device; unilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1921","name":"Inj labetalol hcl hikma, 5mg","description":"Injection, labetalol hydrochloride (hikma), not therapeutically equivalent to j1920, 5 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6613","name":"Onlay cst base mtl >=3 surfa","description":"Onlay - cast predominantly base metal three or more surfaces","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37281","name":"Revsc evsc tpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5725","name":"Rebase hybrid prosthesis","description":"Rebase hybrid prosthesis","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26863","name":"Fuse/graft added joint","description":"Arthrodesis, interphalangeal joint, with or without internal fixation; with autograft (includes obtaining graft), each additional joint (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2782","name":"Crown 3/4 cast noble metal","description":"Crown - 3/4 cast noble metal","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4365","name":"Amnio bur dl mem per sq cm","description":"Amnio burgeon dual-layer membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0238","name":"Intrav inf, toci, second dos","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1347","name":"Pt pam incr 3 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 3 points in a 4 to 12 month period (passing)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1199","name":"Pt recg rrt","description":"Patients receiving rrt","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4355","name":"Abio xpl abio xpl hy p sq cm","description":"Abiomend xplus membrane and abiomend xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4361","name":"Epixpress, per sq cm","description":"Epixpress, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37261","name":"Revsc evasc ivt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72110","name":"X-ray exam l-2 spine 4/>vws","description":"Radiologic examination, spine, lumbosacral; minimum of 4 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43752","name":"Nasal/orogastric w/tube plmt","description":"Naso- or oro-gastric tube placement, requiring physicians skill and fluoroscopic guidance (includes fluoroscopy, image documentation and report)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9948","name":"Adjust sleep apnea appliance","description":"Adjust sleep apnea appliance","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0463","name":"Inj atropine (fresenius te)","description":"Injection, atropine sulfate (fresenius and therapeutically equivalent), 0.01 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1369","name":"Qualcare mental hlth/sud mvp","description":"Quality care in mental health and substance use disorders mips value pathway","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9054","name":"Inj bortezomib boruzu 0.1 mg","description":"Injection, bortezomib (boruzu), 0.1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7601","name":"Ensifentrine inh 3 mg","description":"Ensifentrine, inhalation suspension, fda approved final product, non-compounded, administered through dme, unit dose form, 3 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67830","name":"Revise eyelashes","description":"Correction of trichiasis; incision of lid margin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0483U","name":"Nfct ds ng gyra s91f pt mut","description":"Nfct ds ng gyra s91f pt mut","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1747","name":"Inj, spesolimab-sbzo, 1 mg","description":"Injection, spesolimab-sbzo, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4298","name":"Amniocore pro, per sq cm","description":"Amniocore pro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0609U","name":"Onc prostate ia tot&free psa","description":"Onc prostate ia tot&free psa","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28636","name":"Treat toe dislocation","description":"Percutaneous skeletal fixation of metatarsophalangeal joint dislocation, with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4404","name":"Xwrap hydro plus per sq cm","description":"Xwrap hydro plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0405U","name":"Onc pncrtc 59 mthltn blk mrk","description":"Onc pncrtc 59 mthltn blk mrk","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25077","name":"Resect forearm/wrist tum<3cm","description":"Radical resection of tumor (eg, sarcoma), soft tissue of forearm and/or wrist area; less than 3 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1063.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99285","name":"Emergency dept visit hi mdm","description":"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93610","name":"Intra-atrial pacing","description":"Intra-atrial pacing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0920T","name":"Rmvl perm ccm-d sys 1 pac ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous pacing lead only","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35516","name":"Art byp grft subclav-axilary","description":"Bypass graft, with vein; subclavian-axillary","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1137.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0554U","name":"Repr med pga 24chrm te bx qc","description":"Repr med pga 24chrm te bx qc","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73701","name":"Ct lower extremity w/dye","description":"Computed tomography, lower extremity; with contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2040","name":"Microlyte painguard pr sq cm","description":"Microlyte painguard, per square centimeter","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5133","name":"Inj, tofidence, 1 mg","description":"Injection, tocilizumab-bavi (tofidence), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0787T","name":"Revj/rmvl nea sac w/nstim","description":"Revision or removal of neurostimulator electrode array, sacral, with integrated neurostimulator","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1790","name":"Droperidol injection","description":"Injection, droperidol, up to 5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4415","name":"Alexiguard st-l per sq cm","description":"Alexiguard sl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1169","name":"Doc med rsn no flu vax","description":"Documentation of medical reason(s) for not administering influenza vaccine (e.g., prior anaphylaxis due to the influenza vaccine)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92622","name":"Dx aly aud oi snd prcsr 1st","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; first 60 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1226","name":"Iop not doc","description":"Iop measurement not documented, reason not otherwise specified","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74018","name":"Radex abdomen 1 view","description":"Radiologic examination, abdomen; 1 view","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0679T","name":"Laps rmvl lead isdss","description":"Laparoscopic removal of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30124","name":"Removal of nose lesion","description":"Excision dermoid cyst, nose; simple, skin, subcutaneous","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77439","name":"Surf rad thr img gdn us plmt","description":"Surface radiation therapy; superficial or orthovoltage, image guidance, ultrasound for placement of radiation therapy fields for treatment of cutaneous tumors, per course of treatment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86362","name":"Mog-igg1 antb cba each","description":"Myelin oligodendrocyte glycoprotein (mog-igg1) antibody; cell-based immunofluorescence assay (cba), each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49592","name":"Rpr aa hrn 1st < 3 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99464","name":"Attendance at delivery","description":"Attendance at delivery (when requested by the delivering physician or other qualified health care professional) and initial stabilization of newborn","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":70.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0542","name":"No pt prsnt train add 15","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22808","name":"Arthrd ant dfrm 2-3 vrt sgm","description":"Arthrodesis, anterior, for spinal deformity, with or without cast; 2 to 3 vertebral segments","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2159.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0946T","name":"Ortho impl mvmt alys pair ct","description":"Orthopedic implant movement analysis using paired computed tomography (ct) examination of the target structure, including data acquisition, data preparation and transmission, interpretation and report (including ct scan of the joint or extremity performed with paired views)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0500U","name":"Autoinflam ds vexas synd dna","description":"Autoinflam ds vexas synd dna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1331","name":"Pts eval ini xm 8 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 8 weeks from initial exam","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46744","name":"Repair of cloacal anomaly","description":"Repair of cloacal anomaly by anorectovaginoplasty and urethroplasty, sacroperineal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3552.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84393","name":"Tau phosphorylated ea","description":"Tau, phosphorylated (eg, ptau 181, ptau 217), each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0571U","name":"Onc sol tum dna80&rna10g ngs","description":"Onc sol tum dna80&rna10g ngs","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87532","name":"Hhv-6 dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); herpes virus-6, amplified probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4265","name":"Neostim tl per sq cm","description":"Neostim tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0875T","name":"Prgrm subq prtl asct pmp sys","description":"Programming of subcutaneously implanted peritoneal ascites pump system by physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0683T","name":"Prgrmg dev eval isdss ip","description":"Programming device evaluation (in-person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional, permanent implantable synchroni","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5934","name":"Mandibular flange prosthesis","description":"Mandibular resection prosthesis with guide flange","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7355","name":"Inj travoprost intra impl","description":"Injection, travoprost, intracameral implant, 1 microgram","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90483","name":"Imm cnsl not admn sm>10<20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 10 minutes up to 20 minutes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22224","name":"Osteot dsc ant 1vrt sgm lmbr","description":"Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; lumbar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1353","name":"Pts no cmplt suicd saf pln","description":"Patients who did not have a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52284","name":"Cysto rx balo cath urtl strx","description":"Cystourethroscopy, with mechanical urethral dilation and urethral therapeutic drug delivery by drug-coated balloon catheter for urethral stricture or stenosis, male, including fluoroscopy, when performed","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1347","name":"Pt pam incr 3 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 3 points in a 4 to 12 month period (passing)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1202","name":"Miglustat oral 65 mg","description":"Miglustat, oral, 65 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1010T","name":"Cptr oph alys monoc eye mvmt","description":"Computerized ophthalmic analysis of monocular eye movements using retinal-based eye-tracking without spatial calibration, including fixation, microsaccades, drift, and horizontal saccades, when performed, unilateral or bilateral, with interpretation and report","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69300","name":"Revise external ear","description":"Otoplasty, protruding ear, with or without size reduction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":506.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0688","name":"Inj cefazolin sodium, hikma","description":"Injection, cefazolin sodium (hikma), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33280","name":"Rmvl phrnc nrv stim pg only","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator only","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0555","name":"Replacment pt electronic sys","description":"Provision of replacement patient electronics system (e.g., system pillow, handheld reader) for home pulmonary artery pressure monitoring","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0567U","name":"Rare ds whl gen seq srs&lrs","description":"Rare ds whl gen seq srs&lrs","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0961T","name":"Shortwave ifr radiation img","description":"Shortwave infrared radiation imaging, surgical pathology specimen, to assist gross examination for lymph node localization in fibroadipose tissue, per specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31720","name":"Clearance of airways","description":"Catheter aspiration (separate procedure); nasotracheal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99254","name":"Ip/obs cnsltj new/est mod 60","description":"Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1783","name":"Vac admin human pap dose 3","description":"Vac admin human pap dose 3","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22860","name":"Tot disc arthrp 2ntrspc lmbr","description":"Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression); second interspace, lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0765T","name":"Asstv alg ecg rsk asmt prev","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to previously performed electrocardiogram","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16000","name":"Initial treatment of burn(s)","description":"Initial treatment, first degree burn, when no more than local treatment is required","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":85.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5227","name":"Immed max part denture","description":"Immed max part denture","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25448","name":"Arthrp ntrcrpl/crp/mtcrp ssp","description":"Arthroplasty, intercarpal or carpometacarpal joints; suspension, including transfer or transplant of tendon, with interposition, when performed","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49596","name":"Rpr aa hrn 1st > 10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0910T","name":"Rmvl int nstim sys vagus nrv","description":"Removal of integrated neurostimulation system, vagus nerve","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6604","name":"G com bandge low dn foam flt","description":"Gradient compression bandaging supply, low density flat foam sheet, per 250 square centimeters, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0622U","name":"Psyc mdd dna alys >20000","description":"Psyc mdd dna alys >20000","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0618","name":"Inj, calcium chloride, 2 mg","description":"Injection, calcium chloride, 2 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80173","name":"Assay of haloperidol","description":"Haloperidol","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76020","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87564","name":"Mtb rifampin rst amp prb tq","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacterium tuberculosis, rifampin resistance, amplified probe technique","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21208","name":"Augmentation of facial bones","description":"Osteoplasty, facial bones; augmentation (autograft, allograft, or prosthetic implant)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":943.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69905","name":"Remove inner ear","description":"Labyrinthectomy; transcanal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1058.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2402","name":"Chloroprocaine (clorotekal)","description":"Injection, chloroprocaine hydrochloride (clorotekal), per 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0529","name":"In home respite care, 4 hr u","description":"In-home respite care, 4-hour unit, for use in cmmi model","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12034","name":"Intmd rpr s/tr/ext 7.6-12.5","description":"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 7.6 cm to 12.5 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S4024","name":"Air polymer foam per study","description":"Air polymer-type a intrauterine foam, per study dose","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59409","name":"Obstetrical care","description":"Vaginal delivery only (with or without episiotomy and/or forceps);","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":676.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1184","name":"Doc med rsn no cst/ist rx","description":"Documentation of medical reason(s) for not prescribing or administering corticosteroid or immunosuppressant treatment (e.g., allergy, intolerance, infectious etiology, pancreatic insufficiency, hyperthyroidism, prior bowel surgical interventions, celiac disease, receiving other medication, awaiting ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33140","name":"Heart revascularize (tmr)","description":"Transmyocardial laser revascularization, by thoracotomy; (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1514.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5143","name":"Inj adalimumab-adbm, 1 mg","description":"Injection, adalimumab-adbm, biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0537","name":"Risk ascvd tst once pr 12 mo","description":"Administration of a standardized, evidence-based atherosclerotic cardiovascular disease (ascvd) risk assessment, 5-15 minutes, not more often than every 12 months","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97542","name":"Wheelchair mngment training","description":"Wheelchair management (eg, assessment, fitting, training), each 15 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82615","name":"Test for urine cystines","description":"Cystine and homocystine, urine, qualitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9256","name":"Inj, nipocalimab-aahu, 3 mg","description":"Injection, nipocalimab-aahu, 3 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1502","name":"Podiatry mvp","description":"Podiatry mips value pathway","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4010","name":"Infectious disease ss","description":"Infectious disease mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0921T","name":"Rmvl perm ccm-d sys 1 dfb ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous defibrillation lead only","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0595U","name":"Nfct ds tfp vctrbrn&zoonotic","description":"Nfct ds tfp vctrbrn&zoonotic","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4437","name":"Revival ac per sq cm","description":"Revival ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69716","name":"Impl oi implt sk tc esp<100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or resulting in removal of less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4333","name":"Ardeograft, per sq cm","description":"Ardeograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89220","name":"Sputum specimen collection","description":"Sputum, obtaining specimen, aerosol induced technique (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J9095","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99204","name":"Office o/p new mod 45 min","description":"Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 45 minutes must be met or excee","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":190.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0601","name":"Sevelamer carbonate 20 mg","description":"Sevelamer carbonate (renvela or therapeutically equivalent), oral, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9289","name":"Inj nivolumab 2 mg hyaluron","description":"Injection, nivolumab, 2 mg and hyaluronidase-nvhy","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92628","name":"Eval hearing aid cand 1st 30","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0854T","name":"Dgtz gls mcrscp bld smr prph","description":"Digitization of glass microscope slides for blood smear, peripheral, interpretation by physician with written report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80500","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0870T","name":"Imp subq prtl ascts pmp sys","description":"Implantation of subcutaneous peritoneal ascites pump system, percutaneous, including pump-pocket creation, insertion of tunneled indwelling bladder and peritoneal catheters with pump connections, including all imaging and initial programming, when performed","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2781","name":"Crown 3/4 cast base metal","description":"Crown - 3/4 cast predominantly base metal","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87660","name":"Trichomonas vagin dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); trichomonas vaginalis, direct probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37281","name":"Revsc evsc tpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62200","name":"Establish brain cavity shunt","description":"Ventriculocisternostomy, third ventricle;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1558.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9996","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1469","name":"Hx of hep b, or pos bld test","description":"Patient has a history of hepatitis b illness or received a hepatitis b surface antigen, hepatitis b surface antibody, or total antibody to hepatitis b core antigen test with a positive result any time before or during the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21086","name":"Impres&prep auricular prosth","description":"Impression and custom preparation; auricular prosthesis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2180.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81161","name":"Dmd dup/delet analysis","description":"Dmd (dystrophin) (eg, duchenne/becker muscular dystrophy) deletion analysis, and duplication analysis, if performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0796T","name":"Tcat ins 2chmbr ldls pm ra","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right atrial pacemaker","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1413","name":"Pos pdl1 bef init ici tx","description":"Patients who had a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0281","name":"Inj aminocaproic acid 1 gram","description":"Injection, aminocaproic acid, 1 gram","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4256","name":"Mlg complet, per sq cm","description":"Mlg-complete, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83012","name":"Assay of haptoglobins","description":"Haptoglobin; phenotypes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1811","name":"Fiasp for insulin pump use","description":"Insulin (fiasp) for administration through dme (i.e., insulin pump) per 50 units","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83912","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0681","name":"Inj ceftobipole medocarl 3mg","description":"Injection, ceftobiprole medocaril sodium, 3 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1326","name":"Inj, zolbetuximab-clzb, 2 mg","description":"Injection, zolbetuximab-clzb, 2 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0962T","name":"Asstv alg alys acous&ecg rec","description":"Assistive algorithmic analysis of acoustic and electrocardiogram recording for detection of cardiac dysfunction (eg, reduced ejection fraction, cardiac murmurs, atrial fibrillation), with review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0559U","name":"Onc brs quan elisa bf9ag srm","description":"Onc brs quan elisa bf9ag srm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9347","name":"Inj, tremelimumab-actl, 1 mg","description":"Injection, tremelimumab-actl, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29847","name":"Wrist arthroscopy/surgery","description":"Arthroscopy, wrist, surgical; internal fixation for fracture or instability","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7939","name":"Indexing for osteotomy","description":"Indexing for osteotomy","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17000","name":"Destruct premalg lesion","description":"Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (eg, actinic keratoses); first lesion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":55.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":24.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2029","name":"Mirotract matrix sheet","description":"Mirotract wound matrix sheet, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0737T","name":"Xenograft impltj artclr surf","description":"Xenograft implantation into the articular surface","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1151","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0488U","name":"Ob fetal ag nipt cfdna alys","description":"Ob fetal ag nipt cfdna alys","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21081","name":"Impres&prep mndbl res prosth","description":"Impression and custom preparation; mandibular resection prosthesis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1972.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4457","name":"Enema tube any type repl","description":"Enema tube, with or without adapter, any type, replacement only, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1474","name":"Pt dx dementia","description":"Patients with diagnosis of dementia","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0821T","name":"Mntr psychdlc med 2ndphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; second physician or other qualified health care professional, concurrent with first physician or other qualified health care professional, each hour (list sepa","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1258","name":"Cvd risk assess perf","description":"Cvd risk assessment performed, have a documented calculated risk score","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1456","name":"Inj, fosaprepitant (teva)","description":"Injection, fosaprepitant (teva), not therapeutically equivalent to j1453, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99387","name":"Init pm e/m new pat 65+ yrs","description":"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; 65 years and old","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":117.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49596","name":"Rpr aa hrn 1st > 10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, incarcerated or strangulated","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9051","name":"Inj, bortezomib (maia)","description":"Injection, bortezomib (maia), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91200","name":"Liver elastography","description":"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6251","name":"Bridge resin base metal","description":"Pontic-resin with predominantly base metal","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0694T","name":"3d vol img&rcnstj brst/ax","description":"3-dimensional volumetric imaging and reconstruction of breast or axillary lymph node tissue, each excised specimen, 3-dimensional automatic specimen reorientation, interpretation and report, real-time intraoperative","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1165","name":"Pt use hspc dur meas pd","description":"Patients who use hospice services any time during the measurement period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63052","name":"Lam facetc/frmt arthrd lum 1","description":"Laminectomy, facetectomy, or foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s] [eg, spinal or lateral recess stenosis]), during posterior interbody arthrodesis, lumbar; single vertebral segment (list separately in addition to code for primary ","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5161","name":"Inj, denosumab-kyqq, 1 mg","description":"Injection, denosumab-kyqq (aukelso/bosaya), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0375U","name":"Onc ovrn bchm asy 7 prtn alg","description":"Onc ovrn bchm asy 7 prtn alg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69727","name":"Rmv ntr oi imp sk tc esp<100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0283","name":"Inj, amiodarone (nexterone)","description":"Injection, amiodarone hydrochloride (nexterone), 30 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42160","name":"Treatment mouth roof lesion","description":"Destruction of lesion, palate or uvula (thermal, cryo or chemical)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1337.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0601","name":"Sevelamer carbonate 20 mg","description":"Sevelamer carbonate (renvela or therapeutically equivalent), oral, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1475","name":"Pt dx huntington","description":"Patients with diagnosis of huntingtons disease","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5228","name":"Immed mand part denture","description":"Immed mand part denture","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0547","name":"Phone/internet svs 11-20 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15933","name":"Exc sac pr ulc prim str ostc","description":"Excision, sacral pressure ulcer, with primary suture; with ostectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":912.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1653","name":"Ho abduction static ots","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, off the shelf","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0494U","name":"Rbc ag ftl rhd gene alys ngs","description":"Rbc ag ftl rhd gene alys ngs","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0109","name":"Diab manage trn ind/group","description":"Diabetes outpatient self-management training services, group session (2 or more), per 30 minutes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0914T","name":"Prq tcat thr rx ntrc bal sep","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting) performed on a separate target lesion from the target lesion treated with balloon angioplasty, coronary stent placement or coronary atherectomy, including mechanical dilation b","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9601","name":"Flortaucipir inj 1 millicuri","description":"Flortaucipir f 18 injection, diagnostic, 1 millicurie","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1791.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0696T","name":"Bdy surf mapg pm/cvdfb f/up","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of follow-up interrogation or programming device evaluatio","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4251","name":"Vim, per square centimeter","description":"Vim, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9938","name":"Fab removable appliance","description":"Fab removable appliance","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4416","name":"Alexiguard tl-t per sq cm","description":"Alexiguard tl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0164","name":"Epinephrine in nacl (baxter)","description":"Injection, epinephrine in sodium chloride (baxter), 0.1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0725T","name":"Vestibular dev impltj uni","description":"Vestibular device implantation, unilateral","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37289","name":"Revsc evsc tpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0709","name":"Intraoral cmplt radio images","description":"Intraoral cmplt radio images","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24101","name":"Arthrt elbw jt expl bx rmvl","description":"Arthrotomy, elbow; with joint exploration, with or without biopsy, with or without removal of loose or foreign body","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2267","name":"Inj, mirikizumab-mrkz, 1 mg","description":"Injection, mirikizumab-mrkz, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1269","name":"Recd esrd mcp lst day of mo","description":"Receiving esrd mcp dialysis services by the provider on the last day of the reporting month","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1368","name":"Prev trt inf d/o hiv/hep mvp","description":"Prevention and treatment of infectious disorders including hepatitis c and hiv mips value pathway","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55715","name":"Bx prst8 ea add mri-us/ct/mr","description":"Biopsy, prostate, each additional, mri-ultrasound fusion or in-bore ct- or mri-guided targeted lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28285","name":"Repair of hammertoe","description":"Correction, hammertoe (eg, interphalangeal fusion, partial or total phalangectomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0800T","name":"Tcat rmvl 2chmbr ldls pm rv","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right ventricular pacemaker component (when part of a dual-chamber leadless pacem","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0389U","name":"Ped fbrl kd ifi27&mcemp1 rna","description":"Ped fbrl kd ifi27&mcemp1 rna","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7956","name":"Tiss regen edent resorb","description":"Tiss regen edent resorb","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0474","name":"Micro w exam of surg margins","description":"Accession of tissue gross and microscopic examination including assessment of surgical margins for presence of disease preparation and transmission of writte","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66635","name":"Removal of iris","description":"Iridectomy, with corneoscleral or corneal section; optical (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":547.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0046","name":"No mrs 90 days post stk","description":"Clinical follow-up and mrs score not assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60661","name":"Abltj 1/+thyr ndul addl prq","description":"Ablation of 1 or more thyroid nodule(s), additional lobe, percutaneous, including imaging guidance, radiofrequency (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46200","name":"Removal of anal fissure","description":"Fissurectomy, including sphincterotomy, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86231","name":"Ema each ig class","description":"Endomysial antibody (ema), each immunoglobulin (ig) class","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41005","name":"Drainage of mouth lesion","description":"Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; sublingual, superficial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1325","name":"Doc med rsn not seen","description":"Patients who were not seen for reasons documented by clinician for patient or medical reasons (e.g., inadequate time for follow-up, patients who received a prior intravitreal or periocular steroid injection within the last six (6) months and had a subsequent iop evaluation with iop <25mm hg within s","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7049","name":"Epap nasal valve","description":"Expiratory positive airway pressure intranasal resistance valve","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0248","name":"Inj, remdesivir, 1 mg","description":"Injection, remdesivir, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86258","name":"Dgp antibody each ig class","description":"Gliadin (deamidated) (dgp) antibody, each immunoglobulin (ig) class","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0658","name":"Seg pneum comp 2 arm chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36580","name":"Replace cvad cath","description":"Replacement, complete, of a non-tunneled centrally inserted central venous catheter, without subcutaneous port or pump, through same venous access","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27227","name":"Treat hip fracture(s)","description":"Open treatment of acetabular fracture(s) involving anterior or posterior (one) column, or a fracture running transversely across the acetabulum, with internal fixation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1948.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6598","name":"G comp bandage med stretch","description":"Gradient compression bandage roll, elastic medium stretch, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4333","name":"Ardeograft, per sq cm","description":"Ardeograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87478","name":"Borrelia miyamotoi amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); borrelia miyamotoi, amplified probe technique","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0501U","name":"Onc clrc bld quan meas cfdna","description":"Onc clrc bld quan meas cfdna","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58200","name":"Extensive hysterectomy","description":"Total abdominal hysterectomy, including partial vaginectomy, with para-aortic and pelvic lymph node sampling, with or without removal of tube(s), with or without removal of ovary(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1513.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4437","name":"Revival ac per sq cm","description":"Revival ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0471U","name":"Onc clrc ca 35 vrn kras&nras","description":"Onc clrc ca 35 vrn kras&nras","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4258","name":"Enverse, per sq cm","description":"Enverse, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31367","name":"Partial removal of larynx","description":"Laryngectomy; subtotal supraglottic, without radical neck dissection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2049.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0607","name":"Lanthanum carbonate oral 5mg","description":"Lanthanum carbonate, oral, 5 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0938T","name":"Xtrnl ecg rec>15d<30d rec","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; recording (including connection and initial recording)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64468","name":"Thrc fascial pln blk bi njx","description":"Thoracic fascial plane block, bilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85384","name":"Fibrinogen activity","description":"Fibrinogen; activity","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9359","name":"Inj lon tesirin-lpyl 0.075mg","description":"Injection, loncastuximab tesirine-lpyl, 0.075 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"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":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0174","name":"Lecanemab-irmb, for iv inj","description":"Lecanemab-irmb, for intravenous injection, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1283","name":"Pt scrn tbco and id as user","description":"Patient screened for tobacco use and identified as a tobacco user","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2327","name":"Inj risankizumab-rzaa 1 mg","description":"Injection, risankizumab-rzaa, intravenous, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1431","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0610U","name":"Nfct ds antmcr sc phenotypic","description":"Nfct ds antmcr sc phenotypic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93152","name":"Interrog&prgrmg ipnss polysm","description":"Interrogation and programming of implanted phrenic nerve stimulator system during polysomnography","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61514","name":"Crnec treph exc brn abs sttl","description":"Craniectomy, trephination, bone flap craniotomy; for excision of brain abscess, supratentorial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2128.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0928T","name":"Rem interrog dev ccm-d phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system with interim analysis and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99285","name":"Emergency dept visit hi mdm","description":"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":163.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7173","name":"Inj. concizumab-mtci, 0.5 mg","description":"Injection, concizumab-mtci, 0.5 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0295U","name":"Onc brst dux carc 7 proteins","description":"Onc brst dux carc 7 proteins","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1414","name":"Med rsn no pdl1 bef 1st ther","description":"Documentation of medical reason(s) for not performing the pd-l1 biomarker expression test prior to initiation of first-line immune checkpoint inhibitor therapy (e.g., patient is in an urgent or emergent situation where delay of treatment would jeopardize the patients health status; other medical rea","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0415U","name":"Cv ds acs bld alg 5 yr score","description":"Cv ds acs bld alg 5 yr score","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1469","name":"Hx of hep b, or pos bld test","description":"Patient has a history of hepatitis b illness or received a hepatitis b surface antigen, hepatitis b surface antibody, or total antibody to hepatitis b core antigen test with a positive result any time before or during the measurement period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4005","name":"Family medicine ss","description":"Family medicine mips specialty set","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93153","name":"Interrog w/o prgrmg ipnss","description":"Interrogation without programming of implanted phrenic nerve stimulator system","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8679","name":"Imp neurosti pls gn any type","description":"Implantable neurostimulator, pulse generator, any type","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10028.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99466","name":"Ped crit care transport","description":"Critical care face-to-face services, during an interfacility transport of critically ill or critically injured pediatric patient, 24 months of age or younger; first 30-74 minutes of hands-on care during transport","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0040","name":"Pt phys/occ therapy","description":"Patient already receiving physical/occupational/speech/recreational therapy during the measurement period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9269","name":"Programable ingest capsule","description":"Programable, transient, orally ingested capsule, for use with external programmer, per month","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0829T","name":"Dgtz gls mcrscp cytp conctrj","description":"Digitization of glass microscope slides for cytopathology, concentration technique, smears, and interpretation (eg, saccomanno technique) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0300U","name":"Onc pan tum whl gen seq&opt","description":"Onc pan tum whl gen seq&opt","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33370","name":"Tcat plmt&rmvl cepd perq","description":"Transcatheter placement and subsequent removal of cerebral embolic protection device(s), including arterial access, catheterization, imaging, and radiological supervision and interpretation, percutaneous (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33851","name":"Exc coa rpr l subcl art/prst","description":"Excision of coarctation of aorta, with or without associated patent ductus arteriosus; repair using either left subclavian artery or prosthetic material as gusset for enlargement","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1578.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90695","name":"H5n8 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n8, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0680","name":"Cr art clc art vlv clc w rpt","description":"Detection and quantification of coronary artery calcium and/or aortic valve calcification from algorithmic analysis of computed tomography of the chest with report","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94618","name":"Pulmonary stress testing","description":"Pulmonary stress testing (eg, 6-minute walk test), including measurement of heart rate, oximetry, and oxygen titration, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6603","name":"Cst hgh nble mtl inlay >=3sr","description":"Inlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0935T","name":"Cysto w/rnl pel symp dnrvtj","description":"Cystourethroscopy with renal pelvic sympathetic denervation, radiofrequency ablation, retrograde ureteral approach, including insertion of guide wire, selective placement of ureteral sheath(s) and multiple conformable electrodes, contrast injection(s), and fluoroscopy, bilateral","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5943","name":"Proth mandib implt sup remv","description":"Proth mandib implt sup remv","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4438","name":"Adhesive clip ext ens contr","description":"Adhesive clip applied to the skin to secure external electrical nerve stimulator controller, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90481","name":"Admn sarscov2 vac ea add cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; each additional component administered (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0526","name":"Est pt-cg dyad dem hig cmplx","description":"Management of established patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37617","name":"Ligation major artery abd","description":"Ligation, major artery (eg, post-traumatic, rupture); abdomen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1523.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4224","name":"Hhf10-p per sq cm","description":"Human health factor 10 amniotic patch (hhf10-p), per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91304","name":"Sarscov2 vac 5mcg/0.5ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, 5 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0561","name":"Temp tube delivery, unil","description":"Tympanostomy with local or topical anesthesia and insertion of a ventilating tube when performed with tympanostomy tube delivery device, unilateral (list separately in addition to 69433) (do not use in conjunction with 0583t)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5877","name":"Dup of complt dent-maxill","description":"Dup of complt dent-maxill","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0826T","name":"Prgrmg evl ldls pm 1chmbr ip","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional, leadless pacemaker system in si","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1287","name":"Calc bmi blw low param f/u","description":"Bmi is documented below normal parameters and a follow-up plan is documented","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0579U","name":"Nfro dbtc ckd elisa apoa4","description":"Nfro dbtc ckd elisa apoa4","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0736T","name":"Colonic lavage 35+l water","description":"Colonic lavage, 35 or more liters of water, gravity-fed, with induced defecation, including insertion of rectal catheter","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":310.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0829T","name":"Dgtz gls mcrscp cytp conctrj","description":"Digitization of glass microscope slides for cytopathology, concentration technique, smears, and interpretation (eg, saccomanno technique) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0338U","name":"Onc sld tum crcg tum cl slct","description":"Onc sld tum crcg tum cl slct","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37296","name":"Revsc evasc imvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0183","name":"Software meas of cardiac vol","description":"Quantitative software measurements of cardiac volume, cardiac chambers volumes and left ventricular wall mass derived from ct scan(s) data of the chest/heart (with or without contrast)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5124","name":"Inj. byooviz, 0.1 mg","description":"Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0588U","name":"Nfct ds bct/vir 32genes mrna","description":"Nfct ds bct/vir 32genes mrna","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92638","name":"Bhvl verif of amplification","description":"Behavioral verification of amplification including aided thresholds, functional gain, speech-in-noise, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4540","name":"Trans elec nerv periph nerv","description":"Distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0258U","name":"Ai psor mrna 50-100 gen alg","description":"Autoimmune (psoriasis), mrna, next-generation sequencing, gene expression profiling of 50-100 genes, skin- surface collection using adhesive patch, algorithm reported as likelihood of response to psoriasis biologics","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99354","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77316","name":"Brachytx isodose plan simple","description":"Brachytherapy isodose plan; simple (calculation[s] made from 1 to 4 sources, or remote afterloading brachytherapy, 1 channel), includes basic dosimetry calculation(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59614","name":"Vbac care after delivery","description":"Vaginal delivery only, after previous cesarean delivery (with or without episiotomy and/or forceps); including postpartum care","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1158.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4257","name":"Relese, per sq cm","description":"Relese, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0742T","name":"Aqmbf spect xers/strs & rest","description":"Absolute quantitation of myocardial blood flow (aqmbf), single-photon emission computed tomography (spect), with exercise or pharmacologic stress, and at rest, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81348","name":"Srsf2 gene common variants","description":"Srsf2 (serine and arginine-rich splicing factor 2) (eg, myelodysplastic syndrome, acute myeloid leukemia) gene analysis, common variants (eg, p95h, p95l)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"Breathing capacity test","description":"Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement(s), with or without maximal voluntary ventilation","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2406","name":"Injection, oritavancin 10 mg","description":"Injection, oritavancin (kimyrsa), 10 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59020","name":"Fetal contract stress test","description":"Fetal contraction stress test","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1326","name":"Pts dx hypotony","description":"Patients with a diagnosis of hypotony","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76092","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1000T","name":"Autol musc cell therapy admn","description":"Autologous muscle cell therapy, administration of muscle progenitor cells into the urethral sphincter, including cystoscopy and post-void residual ultrasound, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0810T","name":"Subrta njx rx agt w/vtrc","description":"Subretinal injection of a pharmacologic agent, including vitrectomy and 1 or more retinotomies","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1217","name":"Sys rsn no doc spiro","description":"Documentation of system reason(s) for not documenting and reviewing spirometry results (e.g., spirometry equipment not available at the time of the encounter)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37295","name":"Rvsc evsc tpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9959","name":"Unspec sleep ap proc","description":"Unspec sleep ap proc","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47384","name":"Abltj ire liver 1+ tum perq","description":"Ablation, irreversible electroporation, liver, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4259","name":"Celera per sq cm","description":"Celera dual layer or celera dual membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9573","name":"Inj, gadopiclenol, 1 ml","description":"Injection, gadopiclenol, 1 ml","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4397","name":"Summit aaa per sq cm","description":"Summit aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3486","name":"Ziprasidone mesylate","description":"Injection, ziprasidone mesylate, 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37297","name":"Revsc evasc imvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0665","name":"Team remote e/m est pt 10 mn","description":"Team remote e/m est. pt 10mins","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0771T","name":"Vr px dissoc svc sm phy 1st","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0476U","name":"Rx metab psyc 14gen&cyp2d6","description":"Rx metab psyc 14gen&cyp2d6","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0482U","name":"Ob pe biochem asy sfit1&pigf","description":"Ob pe biochem asy sfit1&pigf","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99271","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1188","name":"Pt w/ ckd stg 5","description":"Patients with a diagnosis of chronic kidney disease (ckd) stage 5","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2989","name":"Excavate tooth non-restorabl","description":"Excavate tooth non-restorabl","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4340","name":"Simpligraft, per sq cm","description":"Simpligraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86850","name":"Rbc antibody screen","description":"Antibody screen, rbc, each serum technique","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0539","name":"Initial care training 30 m","description":"Caregiver training in behavior management/modification for caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face; initial 30 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2544","name":"Dental onlay metl 4/more sur","description":"Onlay - metallic - four or more surfaces","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4420","name":"Nuform per sq cm","description":"Nuform, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1199","name":"Pt recg rrt","description":"Patients receiving rrt","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85014","name":"Hematocrit","description":"Blood count; hematocrit (hct)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4388","name":"Neothelium 4l per sq cm","description":"Neothelium 4l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5765","name":"Liner compl/partial rem dent","description":"Liner compl/partial rem dent","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0444U","name":"Onc sld orgn neo tgsap 361","description":"Onc sld orgn neo tgsap 361","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9345","name":"Inj, retifanlimab-dlwr, 1 mg","description":"Injection, retifanlimab-dlwr, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0793T","name":"Prq tcat thrm ablt nrv p-art","description":"Percutaneous transcatheter thermal ablation of nerves innervating the pulmonary arteries, including right heart catheterization, pulmonary artery angiography, and all imaging guidance","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0864T","name":"Low ntsty eswt corpus cvrnsm","description":"Low-intensity extracorporeal shock wave therapy involving corpus cavernosum, low energy","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0140","name":"Nav srv peer sup 60 min pr m","description":"Principal illness navigation - peer support by certified or trained auxiliary personnel under the direction of a physician or other practitioner, including a certified peer specialist; 60 minutes per calendar month, in the following activities:  person-centered interview, performed to better underst","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29750","name":"Wedging of clubfoot cast","description":"Wedging of clubfoot cast","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1272","name":"Pts kid transplt wtlst","description":"Patients observed on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0818T","name":"Revj/rmvl ins ptn subq","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0534","name":"Coordinated care/or referral","description":"Coordinated care and/or referral services, such as to adequate and accessible community resources to address unmet health-related social needs, including harm reduction interventions and recovery support services a patient needs and wishes to pursue, which significantly limit the ability to diagnose","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82962","name":"Glucose blood test","description":"Glucose, blood by glucose monitoring device(s) cleared by the fda specifically for home use","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86305","name":"Human epididymis protein 4","description":"Human epididymis protein 4 (he4)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6105","name":"Remove implant body","description":"Remove implant body","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1246","name":"Pt othr thn true imprt to me","description":"Patient provided a response other than completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0592U","name":"Onc hl neo dna tgs 417 genes","description":"Onc hl neo dna tgs 417 genes","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17004","name":"Destroy premal lesions 15/>","description":"Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (eg, actinic keratoses), 15 or more lesions","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":79.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1150","name":"Lvef <=40% or mod/sev l vsf","description":"Current or prior left ventricular ejection fraction (lvef) less than or equal to 40% or documentation of moderately or severely depressed left ventricular systolic function","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1325","name":"Doc med rsn not seen","description":"Patients who were not seen for reasons documented by clinician for patient or medical reasons (e.g., inadequate time for follow-up, patients who received a prior intravitreal or periocular steroid injection within the last six (6) months and had a subsequent iop evaluation with iop <25mm hg within s","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1256","name":"Prior history of known cvd","description":"Prior history of known cvd","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43855","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1776.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","name":"Gait mod systm rhym auditory","description":"Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8839.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0963T","name":"Anosc sbmcsl njx bulking agt","description":"Anoscopy with directed submucosal injection of bulking agent into anal canal","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59812","name":"Treatment of miscarriage","description":"Treatment of incomplete abortion, any trimester, completed surgically","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":391.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":304.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9595","name":"Piflu f-18, dia 1 millicurie","description":"Piflufolastat f-18, diagnostic, 1 millicurie","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32540","name":"Removal of lung lesion","description":"Extrapleural enucleation of empyema (empyemectomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1187.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0887T","name":"End-tidal ctrl inhaled anes","description":"End-tidal control of inhaled anesthetic agents and oxygen to assist anesthesia care delivery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0898","name":"Argatroban nonesrd (auromed)","description":"Injection, argatroban (auromedics), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49560","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":812.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0567U","name":"Rare ds whl gen seq srs&lrs","description":"Rare ds whl gen seq srs&lrs","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0440U","name":"Crd chd dna alys 10 snp 6dna","description":"Crd chd dna alys 10 snp 6dna","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26820","name":"Thumb fusion with graft","description":"Fusion in opposition, thumb, with autogenous graft (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1052.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4356","name":"Abio mem abio hyd per sq cm","description":"Abiomend membrane and abiomend hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1202","name":"Pt rsn no ace-i/arb rx","description":"Documentation of patient reason(s) for not prescribing ace inhibitor or arb therapy during the measurement period, (e.g., patient declined, other patient reasons)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6559","name":"G stckng full/chap18-30 cust","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0389","name":"Periopic image capture only","description":"Periopic image capture only","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0238","name":"Intrav inf, toci, second dos","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0620U","name":"Onc hcc dna mthyln alys>5000","description":"Onc hcc dna mthyln alys>5000","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"Limited visual field xm","description":"Visual field examination, unilateral or bilateral, with interpretation and report; limited examination (eg, tangent screen, autoplot, arc perimeter, or single stimulus level automated test, such as octopus 3 or 7 equivalent)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86366","name":"Muscle-specific kinase antb","description":"Muscle-specific kinase (musk) antibody","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1477","name":"Dx delirium","description":"Diagnosis of delirium","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0896T","name":"Connj lvr algrft prfu dev ea","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; each additional hour, including physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary bicarbonate, lactate ","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4392","name":"Grafix duo per sq cm","description":"Grafix duo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0310U","name":"Ped vsclts kd alys 3 bmrks","description":"Ped vsclts kd alys 3 bmrks","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37290","name":"Revsc evsc tpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01937","name":"Anes drg/aspir crv/thrc","description":"Anesthesia for percutaneous image-guided injection, drainage or aspiration procedures on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2515","name":"Pentobarbital sodium inj","description":"Injection, pentobarbital sodium, per 50 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0790T","name":"Revj rplcmt/rmvl vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracolumbar or lumbar vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45114","name":"Partial removal of rectum","description":"Proctectomy, partial, with anastomosis; abdominal and transsacral approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1841.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74019","name":"Radex abdomen 2 views","description":"Radiologic examination, abdomen; 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57421","name":"Exam/biopsy of vag w/scope","description":"Colposcopy of the entire vagina, with cervix if present; with biopsy(s) of vagina/cervix","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":210.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4369","name":"Amnioplast 3 per sq cm","description":"Amnioplast 3, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7111","name":"Extraction coronal remnants","description":"Extraction coronal remnants - deciduous tooth","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0541","name":"No pt prsnt train initial 30","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7214","name":"Altuviiio per factor viii iu","description":"Injection, factor viii/von willebrand factor complex, recombinant (altuviiio), per factor viii i.u.","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1354","name":"Pt no suicd saf pln 120dy","description":"Patients who did not have a suicide safety plan initiated, reviewed, or updated or reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12014","name":"Rpr f/e/e/n/l/m 5.1-7.5 cm","description":"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 5.1 cm to 7.5 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92622","name":"Dx aly aud oi snd prcsr 1st","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; first 60 minutes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99494","name":"1st/sbsq psyc collab care","description":"Initial or subsequent psychiatric collaborative care management, each additional 30 minutes in a calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional (list separa","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":35.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6106","name":"Tissue regen resorbable","description":"Tissue regen resorbable","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0044","name":"Pt mitral stenosis","description":"Patients with moderate or severe mitral stenosis","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58580","name":"Transcrv abltj utrn fibrd rf","description":"Transcervical ablation of uterine fibroid(s), including intraoperative ultrasound guidance and monitoring, radiofrequency","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7049","name":"Epap nasal valve","description":"Expiratory positive airway pressure intranasal resistance valve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0209","name":"Inj, sod thiosulfate (hope)","description":"Injection, sodium thiosulfate (hope), 100 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35321","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; axillary-brachial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1146.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0592U","name":"Onc hl neo dna tgs 417 genes","description":"Onc hl neo dna tgs 417 genes","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2781","name":"Inj, pegcetacoplan, 1mg","description":"Injection, pegcetacoplan, intravitreal, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0540U","name":"Trnsplj med quan dd-cfdna","description":"Trnsplj med quan dd-cfdna","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0179","name":"Md recertification hha pt","description":"Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initi","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98011","name":"Synch audio-only new high 60","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 60 ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67500","name":"Inject/treat eye socket","description":"Retrobulbar injection; medication (separate procedure, does not include supply of medication)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98977","name":"Rtm dev sply mscskl 16-30 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of musculoskeletal system, 16-30 days in a 30-day period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0486U","name":"Onc pan sol tum ngs cfctdna","description":"Onc pan sol tum ngs cfctdna","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76802","name":"Ob us < 14 wks addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1939","name":"Inj, bumetanide, 0.5 mg","description":"Injection, bumetanide, 0.5 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0262U","name":"Onc sld tum rt-pcr 7 gen","description":"Oncology (solid tumor), gene expression profiling by real-time rt-pcr of 7 gene pathways (er, ar, pi3k, mapk, hh, tgfb, notch), formalin-fixed paraffin-embedded (ffpe), algorithm reported as gene pathway activity score","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77439","name":"Surf rad thr img gdn us plmt","description":"Surface radiation therapy; superficial or orthovoltage, image guidance, ultrasound for placement of radiation therapy fields for treatment of cutaneous tumors, per course of treatment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5765","name":"Liner compl/partial rem dent","description":"Liner compl/partial rem dent","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0834T","name":"Dgtz gls mcrscp cytp oth xtn","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0388U","name":"Onc nonsm cll lng ca 37 gen","description":"Onc nonsm cll lng ca 37 gen","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0559U","name":"Onc brs quan elisa bf9ag srm","description":"Onc brs quan elisa bf9ag srm","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1020T","name":"Raman spectroscopy 1+skn les","description":"Raman spectroscopy of 1 or more skin lesions, with probability score for malignant risk derived by algorithmic analysis of data from each lesion","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96417","name":"Chemo iv infus each addl seq","description":"Chemotherapy administration, intravenous infusion technique; each additional sequential infusion (different substance/drug), up to 1 hour (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0591U","name":"Onc prst8 ca 3prtns plsm srm","description":"Onc prst8 ca 3prtns plsm srm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0741T","name":"Rem auton alg nsln data coll","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; provision of software, data collection, transmission, and storage, each 30 days","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33281","name":"Reposg phrnc nrv stim trnsvn","description":"Repositioning of phrenic nerve stimulator transvenous lead(s)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9011","name":"Datopotamab deruxtecan, 1 mg","description":"Injection, datopotamab deruxtecan-dlnk, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1346","name":"No pam inc 6 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 6 points within a 4 to 12 month period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41520","name":"Reconstruction tongue fold","description":"Frenoplasty (surgical revision of frenum, eg, with z-plasty)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6092","name":"Recement supp crown","description":"Recement implant/abutment supported crown","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4278","name":"Epieffect, per sq cm","description":"Epieffect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1271","name":"Pts dem any time/dur mo","description":"Patients with dementia at any time prior to or during the month","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35600","name":"Open hrv uxtr art 1 sgm cab","description":"Harvest of upper extremity artery, 1 segment, for coronary artery bypass procedure, open","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4033","name":"Skilled nursing facility ss","description":"Skilled nursing facility mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98002","name":"Synch audio-video new mod 45","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate medical decision making. when using total time on the date of the encounter for code selection, 45 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1159","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0502U","name":"Hpv e6/e7 mrk hi-rsk typ crv","description":"Hpv e6/e7 mrk hi-rsk typ crv","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55881","name":"Ablt trurl prst8 tis thrm us","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation;","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99437","name":"Chrnc care mgmt phys ea addl","description":"Chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, or funct","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9323","name":"Inj pemetrexed ditromethamin","description":"Injection, pemetrexed ditromethamine, 10 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0546U","name":"Ldns lrp4 antb imflr livecll","description":"Ldns lrp4 antb imflr livecll","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67516","name":"Sprchoroidal spc njx rx agt","description":"Suprachoroidal space injection of pharmacologic agent (separate procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1262","name":"Pts transplt bef dialysis","description":"Patients who had a transplant prior to initiation of dialysis","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4387","name":"Neothelium ft per sq cm","description":"Neothelium ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0038","name":"Clin pt no ref","description":"Clinician determines patient does not require referral","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0784T","name":"Ins/rplmt eltrd ra spi nstim","description":"Insertion or replacement of percutaneous electrode array, spinal, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29838","name":"Elbow arthroscopy/surgery","description":"Arthroscopy, elbow, surgical; debridement, extensive","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":725.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9871","name":"Bhv couns dm prev, onln 60 m","description":"Behavioral counseling for diabetes prevention, online, 60 minutes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6111","name":"Implnt/abut remov dent mand","description":"Implnt/abut remov dent mand","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0998T","name":"Precuneus mag stimj tx dlvr","description":"Precuneus magnetic stimulation; personalized treatment delivery of magnetic stimulation therapy to a prespecified target area derived from analysis of evoked potentials within the precuneus, utilizing magnetic resonance imaging-based neuronavigation, with management, per day","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15017","name":"App skn cll ssp f/n/g/hf 1st","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 480 sq cm or less","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4257","name":"Relese, per sq cm","description":"Relese, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1326","name":"Inj, zolbetuximab-clzb, 2 mg","description":"Injection, zolbetuximab-clzb, 2 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0709T","name":"Id ca immntx each addl njx","description":"Intradermal cancer immunotherapy; each additional injection (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43889","name":"Gstr rstcv px trnsorl esg","description":"Gastric restrictive procedure, transoral, endoscopic sleeve gastroplasty (esg), including argon plasma coagulation, when performed","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49320","name":"Diag laparo separate proc","description":"Laparoscopy, abdomen, peritoneum, and omentum, diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":373.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9321","name":"Inj epcoritamab-bysp 0.16 mg","description":"Injection, epcoritamab-bysp, 0.16 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0335U","name":"Rare ds whl gen seq fetal","description":"Rare ds whl gen seq fetal","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91320","name":"Sarscv2 vac 30mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 30 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1941","name":"Inj, furoscix, 20 mg","description":"Injection, furosemide (furoscix), 20 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0728T","name":"Dx alys vstblr implt uni 1st","description":"Diagnostic analysis of vestibular implant, unilateral; with initial programming","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32853","name":"Lung transplant double","description":"Lung transplant, double (bilateral sequential or en bloc); without cardiopulmonary bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3904.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55707","name":"Bx prst8 trct us guided","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21720","name":"Revision of neck muscle","description":"Division of sternocleidomastoid for torticollis, open operation; without cast application","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":405.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4270","name":"Complete sl per sq cm","description":"Complete sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92631","name":"Hearing aid slctn svc 1st 30","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2033","name":"Myriad morcells, 4 mg","description":"Myriad morcells, 4 milligrams","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88106","name":"Cytopath fl nongyn filter","description":"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82272","name":"Occult bld feces 1-3 tests","description":"Blood, occult, by peroxidase activity (eg, guaiac), qualitative, feces, 1-3 simultaneous determinations, performed for other than colorectal neoplasm screening","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0552U","name":"Repr med pga gdo te bx locus","description":"Repr med pga gdo te bx locus","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7519","name":"Inj. mycophenolate mofetil","description":"Injection, mycophenolate mofetil, 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97009","name":"Mchnl sclp cool after chemo","description":"Mechanical scalp cooling; provided after discontinuation of chemotherapy, each 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1713","name":"Pfizer vacc adm ped 1st dose","description":"Pfizer vacc adm ped 1st dose","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20955","name":"Fibula bone graft microvasc","description":"Bone graft with microvascular anastomosis; fibula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3062.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64582","name":"Opn mpltj hpglsl nstm ary pg","description":"Open implantation of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9156","name":"Oral mucoadhesive per 1 ml","description":"Oral mucoadhesive, any type (liquid, gel, paste, etc.), per 1 ml","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0978T","name":"Submucosal cryolysis therapy","description":"Submucosal cryolysis therapy; soft palate, base of tongue, and lingual tonsil","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0772T","name":"Vr px dissoc svc sm phy ea","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92137","name":"Cptrz oph img pst sg rta oct","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), posterior segment, with interpretation and report, unilateral or bilateral; retina, including oct angiography","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32220","name":"Release of lung","description":"Decortication, pulmonary (separate procedure); total","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1814.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0183","name":"Software meas of cardiac vol","description":"Quantitative software measurements of cardiac volume, cardiac chambers volumes and left ventricular wall mass derived from ct scan(s) data of the chest/heart (with or without contrast)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49496","name":"Rpr ing hernia baby blocked","description":"Repair, initial inguinal hernia, full term infant younger than age 6 months, or preterm infant older than 50 weeks postconception age and younger than age 6 months at the time of surgery, with or without hydrocelectomy; incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":629.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92137","name":"Cptrz oph img pst sg rta oct","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), posterior segment, with interpretation and report, unilateral or bilateral; retina, including oct angiography","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29800","name":"Jaw arthroscopy/surgery","description":"Arthroscopy, temporomandibular joint, diagnostic, with or without synovial biopsy (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":658.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1737","name":"Inj meloxicam (azurity) 1mg","description":"Injection, meloxicam (azurity), 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1805","name":"Inj, esmolol hcl, 10mg","description":"Injection, esmolol hydrochloride, 10 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90637","name":"Vacc qirv mrna 30mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 30 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91124","name":"Rct snsatn tone&cmplianc std","description":"Rectal sensation, tone, and compliance study (eg, barostat)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6596","name":"G comp bandge conform gauze","description":"Gradient compression bandaging supply, conforming gauze, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":0.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53452","name":"Tprnl balo cntnc dev uni","description":"Periurethral transperineal adjustable balloon continence device; unilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9029","name":"Instill adstiladrin, tx dose","description":"Intravesical instillation, nadofaragene firadenovec-vncg, per therapeutic dose","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7261","name":"Primary closure sinus perf","description":"Primary closure of a sinus perforation","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0041","name":"Pt/ptn decln referral","description":"Patient and/or care partner decline referral","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0612","name":"Inj, calcium gluconate, nos","description":"Injection, calcium gluconate, not otherwise specified, 10 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1366","name":"Focus on womens health mvp","description":"Focusing on womens health mips value pathway","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0458U","name":"Onc brst ca s100 a8&a9 elisa","description":"Onc brst ca s100 a8&a9 elisa","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42510","name":"Parotid duct diversion","description":"Parotid duct diversion, bilateral (wilke type procedure); with ligation of both submandibular (whartons) ducts","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":745.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3010","name":"Fentanyl citrate injection","description":"Injection, fentanyl citrate, 0.1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0754T","name":"Dgtz gls mcrscp sld level v","description":"Digitization of glass microscope slides for level v, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85260","name":"Clot factor x stuart-power","description":"Clotting; factor x (stuart-prower)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4308","name":"Sanopellis, per sq cm","description":"Sanopellis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88304","name":"Tissue exam by pathologist","description":"Level iii - surgical pathology, gross and microscopic examination abortion, induced abscess aneurysm - arterial/ventricular anus, tag appendix, other than incidental artery, atheromatous plaque bartholins gland cyst bone fragment(s), other than pathologic fracture bursa/synovial cyst carpal tunnel t","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4411","name":"Amniomatrixf4x per sq cm","description":"Amniomatrixf4x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0354","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4372","name":"Amchoplast excl per sq cm","description":"Amchoplast excel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2007","name":"Restrata, per sq cm","description":"Restrata, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51500","name":"Removal of bladder cyst","description":"Excision of urachal cyst or sinus, with or without umbilical hernia repair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0278U","name":"Hem gen thrombosis 12 genes","description":"Hematology (genetic thrombosis), genomic sequence analysis of 12 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0750T","name":"B1 str&fx rsk asmt dxrbmd1vw","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0946T","name":"Ortho impl mvmt alys pair ct","description":"Orthopedic implant movement analysis using paired computed tomography (ct) examination of the target structure, including data acquisition, data preparation and transmission, interpretation and report (including ct scan of the joint or extremity performed with paired views)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58120","name":"Dilation and curettage","description":"Dilation and curettage, diagnostic and/or therapeutic (nonobstetrical)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1450","name":"Pt hos/pal care dur id/pf pd","description":"Patients who received hospice or palliative care service any time during denominator identification period or the measure assessment period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70320","name":"Full mouth x-ray of teeth","description":"Radiologic examination, teeth; complete, full mouth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0797T","name":"Tcat ins 2chmbr ldls pm rv","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ventricular pace","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1237","name":"Pt rsn no scrn","description":"Patient reason for not screening for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety (e.g., patient declined or other patient reasons)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4378","name":"Renew ft matrix per sq cm","description":"Renew ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29130","name":"Appl finger splint static","description":"Application of finger splint; static","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":29.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1218","name":"Pt copd symptoms","description":"Patient has copd symptoms (e.g., dyspnea, cough/sputum, wheezing)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5421","name":"Dentures adjust part maxill","description":"Adjust partial denture - maxillary","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0497U","name":"Onc prst8 mrna rt-pcr 6 gene","description":"Onc prst8 mrna rt-pcr 6 gene","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"13150","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP21","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0330U","name":"Iadna vag pthgn panel 27 org","description":"Iadna vag pthgn panel 27 org","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4357","name":"Xwrap plus, per sq cm","description":"Xwrap plus, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0408U","name":"Iaad blk ac wv bsnsr sarscv2","description":"Iaad blk ac wv bsnsr sarscv2","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71045","name":"X-ray exam chest 1 view","description":"Radiologic examination, chest; single view","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4297","name":"Emerge matrix, per sq cm","description":"Emerge matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0043","name":"Pt mech pros ht valv","description":"Patients with mechanical prosthetic heart valve","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1412","name":"Inj roctavian ml 2x10^13vc g","description":"Injection, valoctocogene roxaparvovec-rvox, per ml, containing nominal 2 x 10^13 vector genomes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7259","name":"Nerve dissection","description":"Nerve dissection","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1345","name":"Pt bsln pam, 2nd scr 4-12 mo","description":"Patients who had a baseline pam score and a second score within 4 to 12 month of baseline pam score","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9563","name":"Ht inj immuno diem","description":"Home injectable therapy, immunotherapy, 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":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21493","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0567U","name":"Rare ds whl gen seq srs&lrs","description":"Rare ds whl gen seq srs&lrs","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0044","name":"Pt mitral stenosis","description":"Patients with moderate or severe mitral stenosis","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64782","name":"Remove limb nerve lesion","description":"Excision of neuroma; hand or foot, except digital nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2057","name":"Afamitresgene autoleucel","description":"Afamitresgene autoleucel, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0523U","name":"Onc soltum dna ngs snv 22gen","description":"Onc soltum dna ngs snv 22gen","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5149","name":"Inj, aflibercept-abzv, 1 mg","description":"Injection, aflibercept-abzv (enzeevu), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0704T","name":"Rem tx amblyopia setup&edu","description":"Remote treatment of amblyopia using an eye tracking device; device supply with initial set-up and patient education on use of equipment","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1235","name":"Doc pt hcv aby rna tst","description":"Documentation or patient report of hcv antibody test or hcv rna test which occurred prior to the performance period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1954","name":"Inj leu acet lutr dpt 7.5 mg","description":"Injection, leuprolide acetate for depot suspension (lutrate depot), 7.5 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37254","name":"Revsc evasc ivt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4560","name":"Nmes disposable","description":"Neuromuscular electrical stimulator (nmes), disposable, replacement only","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25107","name":"Remove wrist joint cartilage","description":"Arthrotomy, distal radioulnar joint including repair of triangular cartilage, complex","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":724.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3394","name":"Inj, lovotibeglogene autotem","description":"Injection, lovotibeglogene autotemcel, per treatment","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0747T","name":"Car ablt rad arrhyt dlvr rad","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; delivery of radiation therapy, arrhythmia","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1024T","name":"Perq tiss dsplmt soft tissue","description":"Percutaneous tissue displacement, any method, including imaging guidance; soft tissue (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87210","name":"Smear wet mount saline/ink","description":"Smear, primary source with interpretation; wet mount for infectious agents (eg, saline, india ink, koh preps)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29125","name":"Appl short arm splint static","description":"Application of short arm splint (forearm to hand); static","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31605","name":"Emer tracheostomy cthyr mem","description":"Tracheostomy, emergency procedure; cricothyroid membrane","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4399","name":"Summit fx per sq cm","description":"Summit fx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6604","name":"G com bandge low dn foam flt","description":"Gradient compression bandaging supply, low density flat foam sheet, per 250 square centimeters, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0731T","name":"Augmnt ai-based fcl phnt a/r","description":"Augmentative ai-based facial phenotype analysis with report","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1299","name":"Inj, eculizumab, 2 mg","description":"Injection, eculizumab, 2 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0744T","name":"Insj bioprostc vlv fem vn","description":"Insertion of bioprosthetic valve, open, femoral vein, including duplex ultrasound imaging guidance, when performed, including autogenous or nonautogenous patch graft (eg, polyester, eptfe, bovine pericardium), when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3055","name":"Inj talquetamab-tgvs 0.25 mg","description":"Injection, talquetamab-tgvs, 0.25 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0689T","name":"Quan us tis charac w/o dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained without diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1805","name":"Inj, esmolol hcl, 10mg","description":"Injection, esmolol hydrochloride, 10 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49002","name":"Reopening of abdomen","description":"Reopening of recent laparotomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":751.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92137","name":"Cptrz oph img pst sg rta oct","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), posterior segment, with interpretation and report, unilateral or bilateral; retina, including oct angiography","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83013","name":"H pylori (c-13) breath","description":"Helicobacter pylori; breath test analysis for urease activity, non-radioactive isotope (eg, c-13)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0683","name":"App of non-sheet skin sub g","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0420U","name":"Onc urthl mrna xprsn 6 snp","description":"Onc urthl mrna xprsn 6 snp","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63050","name":"Cervical laminoplsty 2/> seg","description":"Laminoplasty, cervical, with decompression of the spinal cord, 2 or more vertebral segments;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1715.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0733T","name":"Rem r-t mtn nrehab ther sply","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; supply and technical support, per 30 days","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0874","name":"Inj, daptomycin (baxter)","description":"Injection, daptomycin (baxter), not therapeutically equivalent to j0878, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2016","name":"Permeaderm b, per sq cm","description":"Permeaderm b, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22860","name":"Tot disc arthrp 2ntrspc lmbr","description":"Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression); second interspace, lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84311","name":"Spectrophotometry","description":"Spectrophotometry, analyte not elsewhere specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73725","name":"Mr ang lwr ext w or w/o dye","description":"Magnetic resonance angiography, lower extremity, with or without contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7300","name":"Rem anchorage dev w/o flap","description":"Rem anchorage dev w/o flap","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12005","name":"Rpr s/n/a/gen/trk12.6-20.0cm","description":"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 12.6 cm to 20.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4410","name":"Amchomatrixdl per sq cm","description":"Amchomatrixdl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77321","name":"Special teletx port plan","description":"Special teletherapy port plan, particles, hemibody, total body","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2249","name":"Inj, remimazolam, 1 mg","description":"Injection, remimazolam, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8005","name":"Grip glove w microprocessor","description":"Powered, cable driven grip assist glove, hand, finger, includes microprocessor, pressure sensors, all components and accessories, custom fitted","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21935","name":"Resect back tum < 5 cm","description":"Radical resection of tumor (eg, sarcoma), soft tissue of back or flank; less than 5 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1343.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55708","name":"Bx prst8 trct us w/mri fus 1","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant) with mri-fusion-guidance, first targeted lesion","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76015","name":"Mr sfty mplt&/fb asmt stf ea","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0709T","name":"Id ca immntx each addl njx","description":"Intradermal cancer immunotherapy; each additional injection (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0793T","name":"Prq tcat thrm ablt nrv p-art","description":"Percutaneous transcatheter thermal ablation of nerves innervating the pulmonary arteries, including right heart catheterization, pulmonary artery angiography, and all imaging guidance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3263","name":"Inj, toripalimab-tpzi, 1 mg","description":"Injection, toripalimab-tpzi, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96547","name":"Intraop hipec px 1st 60 min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; first 60 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37255","name":"Revsc evasc ivt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5137","name":"Inj, wezlana, sub cu, 1 mg","description":"Injection, ustekinumab-auub (wezlana), biosimilar, subcutaneous, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2794","name":"Crown-titanium","description":"Crown-titanium","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1409","name":"Recd gmln brca1/brca2 couns","description":"Patients who received germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4276","name":"Orion, per sq cm","description":"Orion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0583U","name":"Rare ds rpd whlgen cmptr dna","description":"Rare ds rpd whlgen cmptr dna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81457","name":"So neo gsap dna mcrstl ins","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis, microsatellite instability","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0536","name":"Peer recover support svs","description":"Peer recovery support services, provided directly or by referral; including leveraging knowledge of the condition or lived experience to provide support, mentorship, or inspiration to meet oud treatment and recovery goals; conducting a person-centered interview to understand the patients life story,","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0919T","name":"Rmvl perm ccm-d sys pg only","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); pulse generator only","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1167","name":"Hspc dur meas pd","description":"In hospice or using hospice services during the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1473","name":"Pt func cap not allow impr","description":"Patient situations, at any point during the denominator identification period, where the patients functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools, such as delirium, dementia, intellectual disabilities, and pervasive and specific de","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0042","name":"Ref to therapy","description":"Referral to physical, occupational, speech, or recreational therapy","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37266","name":"Rvsc evsc fpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0584U","name":"Neuro csf prion prtn qual","description":"Neuro csf prion prtn qual","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33287","name":"Rmv&rplcmt phrnc nrv stim pg","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40816","name":"Excision of mouth lesion","description":"Excision of lesion of mucosa and submucosa, vestibule of mouth; complex, with excision of underlying muscle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":366.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93152","name":"Interrog&prgrmg ipnss polysm","description":"Interrogation and programming of implanted phrenic nerve stimulator system during polysomnography","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6031","name":"Rep interface handfng molded","description":"Replacement socket/interface, partial hand including fingers, molded to patient model, for use with or without external power","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":1602.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1444","name":"Del < 39 weeks gest","description":"Delivery at < 39 weeks of gestation","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4342","name":"Theramend, per sq cm","description":"Theramend, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0267U","name":"Rare do id opt gen mapg&seq","description":"Rare constitutional and other heritable disorders, identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping and whole-genome sequencing","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6584","name":"Grad com wrap w straps","description":"Gradient compression wrap with adjustable straps, not otherwise specified","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74018","name":"Radex abdomen 1 view","description":"Radiologic examination, abdomen; 1 view","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0605","name":"Sucroferric oxyhydroxide 5mg","description":"Sucroferric oxyhydroxide, oral, 5 mg (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0727T","name":"Rmvl&rplcmt implt vstblr dev","description":"Removal and replacement of implanted vestibular device, unilateral","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84431","name":"Thromboxane urine","description":"Thromboxane metabolite(s), including thromboxane if performed, urine","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83014","name":"H pylori drug admin","description":"Helicobacter pylori; drug administration","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9333","name":"Inj rozanolixizum-noli 1 mg","description":"Injection, rozanolixizumab-noli, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2054","name":"Lisocabtagene mara car pos t","description":"Lisocabtagene maraleucel, up to 110 million autologous anti-cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88104","name":"Cytopath fl nongyn smears","description":"Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1492","name":"No reported fall","description":"Patients who did not report a fall","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0500U","name":"Autoinflam ds vexas synd dna","description":"Autoinflam ds vexas synd dna","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81464","name":"So gsap cll fr mcrstl ins","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants, microsatellite instability, tumor mutation burden, and rearrangements","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1806","name":"Inj esmolol hcl wg crit care","description":"Injection, esmolol hydrochloride (wg critical care), not therapeutically equivalent to j1805, 10 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0757T","name":"Dgtz gls mcrscp sl spc grpii","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group ii, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistochemistry (list separately in addition to code for primary","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4322","name":"Splint intra-coronal","description":"Splint intra-coronal","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0676T","name":"Laps insj nw/rpcmt isdss ea","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional lead (list separately in addition to code for primary ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0703","name":"2d oral/facial photo image","description":"2d oral/facial photo image","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0937T","name":"Xtrnl ecg rec>15d<30d","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; including recording, scanning analysis with report, review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5411","name":"Dentures adjust cmplt mand","description":"Adjust complete denture - mandibular","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68130","name":"Exc les conjunctiva adj scl","description":"Excision of lesion, conjunctiva; with adjacent sclera","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91321","name":"Sarscov2 vac 25 mcg/.25ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 25 mcg/0.25 ml dosage, for intramuscular use","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93586","name":"Vngrph chd coronary sinus","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; coronary sinus (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1361","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0844T","name":"Dgtz gls mcrscp cslt cyt ea","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), each additional site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64468","name":"Thrc fascial pln blk bi njx","description":"Thoracic fascial plane block, bilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9255","name":"Inj, methotrexate (accord)","description":"Injection, methotrexate (accord), not therapeutically equivalent to j9260, 50 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67027","name":"Implant eye drug system","description":"Implantation of intravitreal drug delivery system (eg, ganciclovir implant), includes concomitant removal of vitreous","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":855.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0547","name":"Phone/internet svs 11-20 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37212","name":"Thrombolytic venous therapy","description":"Transcatheter therapy, venous infusion for thrombolysis, any method, including radiological supervision and interpretation, initial treatment day","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0011","name":"Hiv prep counsel, md 15-30m","description":"Individual counseling for pre-exposure prophylaxis (prep) by physician or qualified health care professional (qhp) to prevent human immunodeficiency virus (hiv), includes hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence, 15-30 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21215","name":"Lower jaw bone graft","description":"Graft, bone; mandible (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":983.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3411","name":"Thiamine hcl 100 mg","description":"Injection, thiamine hcl, 100 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0307U","name":"Onc mrd nxt-gnrj alys sbsq","description":"Onc mrd nxt-gnrj alys sbsq","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92568","name":"Acoustic refl threshold tst","description":"Acoustic reflex testing, threshold","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":17.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0695T","name":"Bdy srf mpg pm/cvdfb tm impl","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of implant or replacement","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0268","name":"Removal of impacted wax md","description":"Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0739T","name":"Abltj mal prst8 mag fld ndct","description":"Ablation of malignant prostate tissue by magnetic field induction, including all intraprocedural, transperineal needle/catheter placement for nanoparticle installation and intraprocedural temperature monitoring, thermal dosimetry, bladder irrigation, and magnetic field nanoparticle activation","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4310","name":"Procenta, per 100 mg","description":"Procenta, per 100 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77089","name":"Tbs dxa cal w/i&r fx risk","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; using dual x-ray absorptiometry (dxa) or other imaging data on gray-scale variogram, calculation, with interpretation and report on fracture-risk","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0542","name":"No pt prsnt train add 15","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5147","name":"Inj, aflibercept-ayyh, 1 mg","description":"Injection, aflibercept-ayyh (pavblu), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64596","name":"Ins/rplcmt prq eltrd ra pn 1","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; initial electrode array","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81523","name":"Onc brst mrna 70 cnt 31 gene","description":"Oncology (breast), mrna, next-generation sequencing gene expression profiling of 70 content genes and 31 housekeeping genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as index related to risk to distant metastasis","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6214","name":"Pontic titanium","description":"Pontic - titanium","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0582","name":"Bivalirudin (endo) 1 mg","description":"Injection, bivalirudin (endo), not therapeutically equivalent to j0583, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86363","name":"Mog-igg1 antb flo cytmtry ea","description":"Myelin oligodendrocyte glycoprotein (mog-igg1) antibody; flow cytometry (ie, fluorescence-activated cell sorting [facs]), each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J1752","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98006","name":"Synch audio-video est mod 30","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6593","name":"Grad com accessory gmt_wrap","description":"Accessory for gradient compression garment or wrap with adjustable straps, not-otherwise specified","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0542U","name":"Nefro renal trnspl ur nmr 84","description":"Nefro renal trnspl ur nmr 84","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0782T","name":"Brnchsc rf dstrj plm nrv uni","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; unilateral mainstem bronchus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0602U","name":"Endocrin dm ins gen mthyltn","description":"Endocrin dm ins gen mthyltn","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9026","name":"Cryo fib comp path redu each","description":"Cryoprecipitated fibrinogen complex, pathogen reduced, each unit","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0347U","name":"Rx metab/pcx dna 16 gen alys","description":"Rx metab/pcx dna 16 gen alys","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21497","name":"Interdental wirg oth/thn fx","description":"Interdental wiring, for condition other than fracture","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76645","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1329","name":"Pts act pvd 2 wks 8 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 8 weeks after initial acute pvd encounter","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0053","name":"Ht mental health and care","description":"Historical trauma (ht) mental health and clinical care for indigenous persons","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0167","name":"Inj epinephrine (hospira)","description":"Injection, epinephrine (hospira), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0791T","name":"Motr cog vr gait train ea 15","description":"Motor-cognitive, semi-immersive virtual reality-facilitated gait training, each 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34706","name":"Evasc rpr a-biiliac rpt","description":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-bi-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2502.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1419","name":"Pt not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0532","name":"Take home supp nasal spray","description":"Take-home supply of nasal nalmefene hydrochloride; one carton of two, 2.7 mg per 0.1 ml nasal sprays (provision of the services by a medicare-enrolled opioid treatment program);( list separately in addition to each primary code)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4427","name":"Dermbnd dln dl+ dlx sq cm","description":"Dermabind dl n or dermabind dl + or dermabind dl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87075","name":"Cultr bacteria except blood","description":"Culture, bacterial; any source, except blood, anaerobic with isolation and presumptive identification of isolates","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66172","name":"Incision of eye","description":"Fistulization of sclera for glaucoma; trabeculectomy ab externo with scarring from previous ocular surgery or trauma (includes injection of antifibrotic agents)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1382.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0555U","name":"Repr med pga embryonic te qc","description":"Repr med pga embryonic te qc","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9616","name":"Gallium gozellix 1 millicuri","description":"Gallium ga-68 gozetotide (gozellix), diagnostic, 1 millicurie","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6595","name":"G comp bandge liner upr extr","description":"Gradient compression bandaging supply, bandage liner, upper extremity, any size or length, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0899","name":"Argatroban dialysis, auromed","description":"Injection, argatroban (auromedics), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90759","name":"Hep b vac 3ag 10mcg 3 dos im","description":"Hepatitis b vaccine (hepb), 3-antigen (s, pre-s1, pre-s2), 10 mcg dosage, 3 dose schedule, for intramuscular use","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43215","name":"Esophagoscopy flex remove fb","description":"Esophagoscopy, flexible, transoral; with removal of foreign body(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31257","name":"Nsl/sins ndsc tot w/sphendt","description":"Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior), including sphenoidotomy","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":426.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1397","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4393","name":"Surgraft ac per sq cm","description":"Surgraft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"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":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0601U","name":"Nfct ds pji alys 11 bmrks ia","description":"Nfct ds pji alys 11 bmrks ia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0847T","name":"Dgtz gls mcrscp xm arch tiss","description":"Digitization of glass microscope slides for examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, kras mutational analysis) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91124","name":"Rct snsatn tone&cmplianc std","description":"Rectal sensation, tone, and compliance study (eg, barostat)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69740","name":"Repair facial nerve","description":"Suture facial nerve, intratemporal, with or without graft or decompression; lateral to geniculate ganglion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1369.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90624","name":"Menb-4c&menacwy vacc im","description":"Meningococcal pentavalent vaccine, men b-4c recombinant proteins and outer membrane vesicle and conjugated men a, c, w, y-diphtheria toxoid carrier, for intramuscular use","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4432","name":"510(k) skin subs, nos","description":"510(k) skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1098","name":"Articaine ophthalmi 8% 0.4ml","description":"Articaine ophthalmic, 8% solution, 0.4 ml","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1414","name":"Inj, beqvez, per tx dose","description":"Injection, fidanacogene elaparvovec-dzkt, per therapeutic dose","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0667","name":"Team remote e/m est pt 25 mn","description":"Team remote e/m est. pt 25mins","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4334","name":"Amnioplast 1, per sq cm","description":"Amnioplast 1, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73600","name":"X-ray exam of ankle","description":"Radiologic examination, ankle; 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1281","name":"Bp scrn no perf at interval","description":"Blood pressure reading not documented, reason not given","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99426","name":"Prin care mgmt staff 1st 30","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6197","name":"Replace material prosthesis","description":"Replace material prosthesis","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1381","name":"Pt sec strk wthin 5 days","description":"Patients with secondary stroke (e.g., a subsequent stroke that may occur with vasospasm in the setting of subarachnoid hemorrhage) within 5 days of the initial procedure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"13102","name":"Cmplx rpr trunk addl 5cm/<","description":"Repair, complex, trunk; each additional 5 cm or less (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0481","name":"Electron microscopy diagnost","description":"Electron microscopy - diagnostic","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67516","name":"Sprchoroidal spc njx rx agt","description":"Suprachoroidal space injection of pharmacologic agent (separate procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2781","name":"Inj, pegcetacoplan, 1mg","description":"Injection, pegcetacoplan, intravitreal, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0691T","name":"Auto alys xst ct std vrt fx","description":"Automated analysis of an existing computed tomography study for vertebral fracture(s), including assessment of bone density when performed, data preparation, interpretation, and report","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1301","name":"Pt recv tbco cess interv","description":"Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65155","name":"Reinsert ocular implant","description":"Reinsertion of ocular implant; with use of foreign material for reinforcement and/or attachment of muscles to implant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":884.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0327U","name":"Ftl aneuploidy trsmy dna seq","description":"Ftl aneuploidy trsmy dna seq","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49555","name":"Rerepair fem hernia reduce","description":"Repair recurrent femoral hernia; reducible","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":646.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1597","name":"Inj glycopyrrolate, glyrx-pf","description":"Injection, glycopyrrolate (glyrx-pf), 0.1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1020T","name":"Raman spectroscopy 1+skn les","description":"Raman spectroscopy of 1 or more skin lesions, with probability score for malignant risk derived by algorithmic analysis of data from each lesion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1010","name":"Inj, methylpred acetate 1 mg","description":"Injection, methylprednisolone acetate, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0431U","name":"Gly rcptr alpha1 igg srm/csf","description":"Gly rcptr alpha1 igg srm/csf","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0601U","name":"Nfct ds pji alys 11 bmrks ia","description":"Nfct ds pji alys 11 bmrks ia","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0602U","name":"Endocrin dm ins gen mthyltn","description":"Endocrin dm ins gen mthyltn","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0934T","name":"Rem mntr wrls l atr prs snr","description":"Remote monitoring of a wireless left atrial pressure sensor for up to 30 days, including data from daily uploads of left atrial pressure recordings, interpretation(s) and trend analysis, with adjustments to the diuretics plan, treatment paradigm thresholds, medications or lifestyle modifications, wh","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86053","name":"Aqaprn-4 antb flo cytmtry ea","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; flow cytometry (ie, fluorescence-activated cell sorting [facs]), each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4329","name":"Singlay, per sq cm","description":"Singlay, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21502","name":"I&d dp abs/hmtm nck rib ostc","description":"Incision and drainage, deep abscess or hematoma, soft tissues of neck or thorax; with partial rib ostectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":622.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5912","name":"Facial moulage complete","description":"Facial moulage (complete)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95249","name":"Cont gluc mntr pt prov eqp","description":"Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; patient-provided equipment, sensor placement, hook-up, calibration of monitor, patient training, and printout of recording","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0571U","name":"Onc sol tum dna80&rna10g ngs","description":"Onc sol tum dna80&rna10g ngs","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1293","name":"Calc bmi abv up param f/u","description":"Bmi is documented above normal parameters and a follow-up plan is documented","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1485","name":"Neg viro resp hep c/qual rna","description":"Patients who did not achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2313","name":"Inj, naloxone (zimhi) 0.01mg","description":"Injection, naloxone hydrochloride (zimhi), 0.01 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60605","name":"Remove carotid body lesion","description":"Excision of carotid body tumor; with excision of carotid artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1566.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93572","name":"Iv dop vel&/press c flo ea","description":"Intravascular doppler velocity and/or pressure derived coronary flow reserve measurement (coronary vessel or graft) during coronary angiography including pharmacologically induced stress, when performed; each additional vessel (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0264U","name":"Rare ds id opt genome mapg","description":"Rare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0666","name":"Team remote e/m est pt 15 mn","description":"Team remote e/m est. pt 15mins","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0466U","name":"Crd cad dna gwas 564856 snp","description":"Crd cad dna gwas 564856 snp","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0694T","name":"3d vol img&rcnstj brst/ax","description":"3-dimensional volumetric imaging and reconstruction of breast or axillary lymph node tissue, each excised specimen, 3-dimensional automatic specimen reorientation, interpretation and report, real-time intraoperative","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5127","name":"Inj, stimufend, 0.5 mg","description":"Injection, pegfilgrastim-fpgk (stimufend), biosimilar, 0.5 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27381","name":"Repair/graft kneecap tendon","description":"Suture of infrapatellar tendon; secondary reconstruction, including fascial or tendon graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":969.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1299","name":"Flu immunize order/admin","description":"Influenza immunization administered or previously received","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33903","name":"Perq p-art revsc 1 abnor bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, bilateral","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81349","name":"Cytog alys chrml abnr lw-ps","description":"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and loss-of-heterozygosity variants, low-pass sequencing analysis","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9573","name":"Inj, gadopiclenol, 1 ml","description":"Injection, gadopiclenol, 1 ml","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72191","name":"Ct angiograph pelv w/o&w/dye","description":"Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1208","name":"Pt no scrn sdoh","description":"Patient is not screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4283","name":"Biovance tri or 3l, sq cm","description":"Biovance tri-layer or biovance 3l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36837","name":"Prq av fstl crt uxtr sep acs","description":"Percutaneous arteriovenous fistula creation, upper extremity, separate access sites of the peripheral artery and peripheral vein, including fistula maturation procedures (eg, transluminal balloon angioplasty, coil embolization) when performed, including all vascular access, imaging guidance and radi","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0569","name":"Subs psych care mng, subs mo","description":"Subsequent psychiatric collaborative care management, in a subsequent month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required elements: tracking ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0676T","name":"Laps insj nw/rpcmt isdss ea","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional lead (list separately in addition to code for primary ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1275","name":"Pts hosp exl","description":"Patients determined to be in hospice were excluded from month of evaluation and the remainder of reporting period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86340","name":"Intrinsic factor antibody","description":"Intrinsic factor antibodies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53866","name":"Cathj rmvl dev ischmc rmdlg","description":"Catheterization with removal of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0307","name":"Cbc without platelet","description":"Complete (cbc), automated (hgb, hct, rbc, wbc; without platelet count)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1329","name":"Pts act pvd 2 wks 8 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 8 weeks after initial acute pvd encounter","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0690T","name":"Quan us tis charac w/dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained with diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43194","name":"Esophagoscp rig trnso rem fb","description":"Esophagoscopy, rigid, transoral; with removal of foreign body(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99465","name":"Nb resuscitation","description":"Delivery/birthing room resuscitation, provision of positive pressure ventilation and/or chest compressions in the presence of acute inadequate ventilation and/or cardiac output","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":59.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6072","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (high noble metal)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0675T","name":"Laps insj nw/rpcmt isdss 1ld","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first lead","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1018T","name":"Elec alys npgs esoph sbsq w/","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92641","name":"Hearing dev verif eacous aly","description":"Hearing device verification, electroacoustic analysis","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2038","name":"Marigen pacto, per sq cm","description":"Marigen pacto, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5947","name":"Mand implt sup fix","description":"Mand implt sup fix","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9046","name":"Inj, bortezomib, dr. reddys","description":"Injection, bortezomib (dr. reddys), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0258U","name":"Ai psor mrna 50-100 gen alg","description":"Autoimmune (psoriasis), mrna, next-generation sequencing, gene expression profiling of 50-100 genes, skin- surface collection using adhesive patch, algorithm reported as likelihood of response to psoriasis biologics","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73200","name":"Ct upper extremity w/o dye","description":"Computed tomography, upper extremity; without contrast material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0368","name":"Cone beam ct interprete tmj","description":"Cone beam ct interprete tmj","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0338U","name":"Onc sld tum crcg tum cl slct","description":"Onc sld tum crcg tum cl slct","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31030","name":"Exploration maxillary sinus","description":"Sinusotomy, maxillary (antrotomy); radical (caldwell-luc) without removal of antrochoanal polyps","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15011","name":"Hrv skn cll ssp agrft 1st 25","description":"Harvest of skin for skin cell suspension autograft; first 25 sq cm or less","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9563","name":"Ht inj immuno diem","description":"Home injectable therapy, immunotherapy, 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":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0308U","name":"Crd cad alys 3 prtn plsm alg","description":"Crd cad alys 3 prtn plsm alg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0882T","name":"Intraop ther estim pn ue 1st","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; initial nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73085","name":"Contrast x-ray of elbow","description":"Radiologic examination, elbow, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1008T","name":"Rem mntr s-scl eeg sys setup","description":"Remote monitoring of sub-scalp implanted continuous bilateral electroencephalography monitoring system, device fitting, initial set-up, and patient education in wearing of system and use of equipment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81451","name":"Hl neo gsap 5-50 rna alys","description":"Hematolymphoid neoplasm or disorder, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants, and copy number variants or rearrangements, or isoform expression or mrna expression levels, if performed; rna analysis","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0846T","name":"Dgtz gls mcrscp imfluor ea","description":"Digitization of glass microscope slides for immunofluorescence, per specimen; each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0731T","name":"Augmnt ai-based fcl phnt a/r","description":"Augmentative ai-based facial phenotype analysis with report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0912T","name":"Elec alys nstim sys vgs smpl","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; with simple programming by physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3402","name":"Inj. remestemcel-l-rknd/ td","description":"Injection, remestemcel-l-rknd, per therapeutic dose","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90635","name":"H5n1 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n1, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9244","name":"Office min sed drug enteral","description":"Office min sed drug enteral","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4288","name":"Replacement breastpump valve","description":"Valve for breast pump, replacement","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9027","name":"Rbc o2 co2 reduced","description":"Red blood cells, leukocytes reduced, oxygen/ carbon dioxide reduced, each unit","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23020","name":"Capsular contracture release","description":"Capsular contracture release (eg, sever type procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":823.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76805","name":"Ob us >/= 14 wks sngl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4029","name":"Preventive medicine ss","description":"Preventive medicine mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1308","name":"Flu immunize no admin","description":"Influenza immunization was not administered, reason not given","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1228","name":"Pt + hcv aby +vir w/ rx 3 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, has hcv treatment initiated within 3 months of the reactive hcv antibody test","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1330","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01940","name":"Anes nulyt agt lmbr/sac","description":"Anesthesia for percutaneous image-guided destruction procedures by neurolytic agent on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1941","name":"Inj, furoscix, 20 mg","description":"Injection, furosemide (furoscix), 20 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7519","name":"Inj. mycophenolate mofetil","description":"Injection, mycophenolate mofetil, 10 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0986T","name":"Iv img icr cere vsl oct 1st","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0491U","name":"Onc sol tum ctc slct er prtn","description":"Onc sol tum ctc slct er prtn","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5945","name":"Mand implt sup remv part","description":"Mand implt sup remv part","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0606U","name":"Hem red cll memb do rbc oge","description":"Hem red cll memb do rbc oge","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49593","name":"Rpr aa hrn 1st 3-10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, reducible","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0268","name":"Removal of impacted wax md","description":"Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0734T","name":"Rem r-t mtn nrehab tx mgmt","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; treatment management services by a physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4367","name":"Amniocore sl, per sq cm","description":"Amniocore sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6611","name":"Grad com wrap w strap ak cus","description":"Gradient compression wrap with adjustable straps, above knee, each, custom","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2020","name":"Ac5 wound system","description":"Ac5 advanced wound system (ac5)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80504","name":"Path clin consltj mod 21-40","description":"Pathology clinical consultation; for a moderately complex clinical problem, with review of patients history and medical records and moderate level of medical decision making when using time for code selection, 21-40 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0661","name":"Team remote e/m new pt 20 mn","description":"Team remote e/m new pt 20mins","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0953T","name":"Tot impl amei rev/rplc w/o","description":"Totally implantable active middle ear hearing implant; revision or replacement, without mastoidectomy and replacement of sound processor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33897","name":"Perq trluml angp nt/recr coa","description":"Percutaneous transluminal angioplasty of native or recurrent coarctation of the aorta","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83632","name":"Placental lactogen","description":"Lactogen, human placental (hpl) human chorionic somatomammotropin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6634","name":"Onlay titanium","description":"Onlay - titanium","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4386","name":"Acesso trifaca per sq cm","description":"Acesso trifaca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0934T","name":"Rem mntr wrls l atr prs snr","description":"Remote monitoring of a wireless left atrial pressure sensor for up to 30 days, including data from daily uploads of left atrial pressure recordings, interpretation(s) and trend analysis, with adjustments to the diuretics plan, treatment paradigm thresholds, medications or lifestyle modifications, wh","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90613","name":"Inf&sarscov2 vacc 40/0.4 im","description":"Influenza virus vaccine, quadrivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 40 mcg/0.4 ml dosage, for intramuscular use","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6593","name":"Grad com accessory gmt_wrap","description":"Accessory for gradient compression garment or wrap with adjustable straps, not-otherwise specified","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4388","name":"Neothelium 4l per sq cm","description":"Neothelium 4l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32994","name":"Ablate pulm tumor perq crybl","description":"Ablation therapy for reduction or eradication of 1 or more pulmonary tumor(s) including pleura or chest wall when involved by tumor extension, percutaneous, including imaging guidance when performed, unilateral; cryoablation","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4323.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":368.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0575U","name":"Trnsplj med lar rtpcr 4genes","description":"Trnsplj med lar rtpcr 4genes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1220","name":"Dre wth interp rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; with evidence of retinopathy","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6519","name":"Grad com garm noc night use","description":"Gradient compression garment, not otherwise specified, for nighttime use, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0234","name":"Intra inf, toci, second dos","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0322U","name":"Neuro asd meas 14 acyl carn","description":"Neuro asd meas 14 acyl carn","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20979","name":"Lw ntsty us stimj bone healg","description":"Low intensity ultrasound stimulation to aid bone healing, noninvasive (nonoperative)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37281","name":"Revsc evsc tpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1403","name":"Bslne and fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44406","name":"Colonoscopy w/ultrasound","description":"Colonoscopy through stoma; with endoscopic ultrasound examination, limited to the sigmoid, descending, transverse, or ascending colon and cecum and adjacent structures","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0113A","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0960T","name":"Rpl s-sclp eltr ra rcvr&tlmt","description":"Replacement of sub-scalp implanted electrode array, receiver, and telemetry unit with tunneling of electrode for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47801","name":"Placement bile duct support","description":"Placement of choledochal stent","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1077.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7414","name":"Excision malig lesion>1.25cm","description":"Excision of malignant lesion greater than 1.25 cm","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4299","name":"Amniocore pro+, per sq cm","description":"Amniocore pro+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0926T","name":"Prgrmg dev eval ccm-d ip","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, including review and report, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0934T","name":"Rem mntr wrls l atr prs snr","description":"Remote monitoring of a wireless left atrial pressure sensor for up to 30 days, including data from daily uploads of left atrial pressure recordings, interpretation(s) and trend analysis, with adjustments to the diuretics plan, treatment paradigm thresholds, medications or lifestyle modifications, wh","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80506","name":"Path clin consltj prolng svc","description":"Pathology clinical consultation; prolonged service, each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1497","name":"No doc fall med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0458","name":"Aztreonam/avibactam 10 mg","description":"Injection, aztreonam/avibactam, 7.5 mg/2.5 mg (10 mg)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5949","name":"Mand implt sup fix part","description":"Mand implt sup fix part","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61107","name":"Tdh pnxr implt ventr cath","description":"Twist drill hole(s) for subdural, intracerebral, or ventricular puncture; for implanting ventricular catheter, pressure recording device, or other intracerebral monitoring device","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":405.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0703","name":"2d oral/facial photo image","description":"2d oral/facial photo image","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J2321","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7518","name":"Mycophenolic acid","description":"Mycophenolic acid, oral, 180 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19285","name":"Perq dev breast 1st us imag","description":"Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; first lesion, including ultrasound guidance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32120","name":"Re-exploration of chest","description":"Thoracotomy; for postoperative complications","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":910.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1301","name":"Pt recv tbco cess interv","description":"Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0913T","name":"Prq tcat ther rx ntrac balo1","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting), including mechanical dilation by nondrug-delivery balloon angioplasty, endoluminal imaging using intravascular ultrasound (ivus) or optical coherence tomography (oct) when per","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0939T","name":"Xtrnl ecg rec>15d<30d scan","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; scanning analysis with report","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1335","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0519U","name":"Ther rx mntr meds p/d/a 110+","description":"Ther rx mntr meds p/d/a 110+","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0542U","name":"Nefro renal trnspl ur nmr 84","description":"Nefro renal trnspl ur nmr 84","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33216","name":"Insert 1 electrode pm-defib","description":"Insertion of a single transvenous electrode, permanent pacemaker or implantable defibrillator","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1343","name":"Pt pam lvl 4 base or srt lin","description":"Patients who are at pam level 4 at baseline or patients who are flagged with extreme straight line response sets on the pam or with excessive missing responses","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2506","name":"Inj pegfilgrast ex bio 0.5mg","description":"Injection, pegfilgrastim, excludes biosimilar, 0.5 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97810","name":"Acup 1/> wo estim 1st 15 min","description":"Acupuncture, 1 or more needles; without electrical stimulation, initial 15 minutes of personal one-on-one contact with the patient","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":51.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0426","name":"Coll, analys of saliva","description":"Coll, analys of saliva","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67101","name":"Repair detached retina crtx","description":"Repair of retinal detachment, including drainage of subretinal fluid when performed; cryotherapy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1317","name":"Pts counsl cpt opt out","description":"Patients who are counseled on connection with a csp and explicitly opt out","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0341U","name":"Ftl aneup dna seq cmpr alys","description":"Ftl aneup dna seq cmpr alys","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3299","name":"Inj xipere 1 mg","description":"Injection, triamcinolone acetonide (xipere), 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2027","name":"Matriderm per sq cm","description":"Matriderm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63090","name":"Remove vert body dcmprn lmbr","description":"Vertebral corpectomy (vertebral body resection), partial or complete, transperitoneal or retroperitoneal approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic, lumbar, or sacral; single segment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2173.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73000","name":"X-ray exam of collar bone","description":"Radiologic examination; clavicle, complete","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1461","name":"Pt dx chron hepc","description":"Patient diagnosis for chronic hepatitis c","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4384","name":"Axolotl dual ult per sq cm","description":"Axolotl dualgraft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0481U","name":"Idh1 idh2&tert promoter ngs","description":"Idh1 idh2&tert promoter ngs","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1019T","name":"Lymphovenous bypass per xtr","description":"Lymphovenous bypass, including robotic assistance, when performed, per extremity","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1293","name":"Calc bmi abv up param f/u","description":"Bmi is documented above normal parameters and a follow-up plan is documented","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01938","name":"Anes drg/aspir lmbr/sac","description":"Anesthesia for percutaneous image-guided injection, drainage or aspiration procedures on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43259","name":"Egd us exam duodenum/jejunum","description":"Esophagogastroduodenoscopy, flexible, transoral; with endoscopic ultrasound examination, including the esophagus, stomach, and either the duodenum or a surgically altered stomach where the jejunum is examined distal to the anastomosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95149","name":"Antigen therapy services","description":"Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy (specify number of doses); 5 single stinging insect venoms","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0249","name":"Tocilizumab for covid-19","description":"Injection, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9607","name":"Lutetium lu 177 vipivotide","description":"Lutetium lu 177 vipivotide tetraxetan, therapeutic, 1 millicurie","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0511U","name":"Onc sol tum 3dmicroenvir 36+","description":"Onc sol tum 3dmicroenvir 36+","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9998","name":"Inj ustekinumab-aekn, 1 mg","description":"Injection, ustekinumab-aekn (selarsdi), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4401","name":"Absolv3 per sq cm","description":"Absolv3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0972T","name":"Asstv alg clsfctn burn hlg","description":"Assistive algorithmic classification of burn healing (ie, healing or nonhealing) by noninvasive multispectral imaging, including system set-up and acquisition, selection, and transmission of images, with automated generation of report","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0367U","name":"Onc bldr 10 flwg trurl rescj","description":"Onc bldr 10 flwg trurl rescj","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0765T","name":"Asstv alg ecg rsk asmt prev","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to previously performed electrocardiogram","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98016","name":"Brief comunicaj tech-bsd svc","description":"Brief communication technology-based service (eg, virtual check-in) by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related evaluation and management service provided within the p","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4021","name":"Orthopedic surgery ss","description":"Orthopedic surgery mips specialty set","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99468","name":"Neonate crit care initial","description":"Initial inpatient neonatal critical care, per day, for the evaluation and management of a critically ill neonate, 28 days of age or younger","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":826.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5930","name":"Max guid prothes w/o flange","description":"Max guid prothes w/o flange","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0250","name":"Md inr test revie inter mgmt","description":"Physician review, interpretation, and patient management of home inr testing for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria; testing not occurring more frequently than once a week; billing units of servic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59857","name":"Induced ab 1+vag supp hyst","description":"Induced abortion, by 1 or more vaginal suppositories (eg, prostaglandin) with or without cervical dilation (eg, laminaria), including hospital admission and visits, delivery of fetus and secundines; with hysterotomy (failed medical evacuation)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0137","name":"Inj, acetaminophen (hikma)","description":"Injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2056","name":"Ciltacabtagene car-pos t","description":"Ciltacabtagene autoleucel, up to 100 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90631","name":"H5 vaccine pandemic im use","description":"Influenza virus vaccine (iiv), h5, pandemic formulation, split virus, adjuvanted, for intramuscular use","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1429","name":"Retinopathy in od, os, ou","description":"Retinal exam finding with evidence of retinopathy in left, right or both eyes with severity level documented","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0577","name":"Inj, brixadi, 7 days or less","description":"Injection, buprenorphine extended-release (brixadi), less than or equal to 7 days of therapy","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0787T","name":"Revj/rmvl nea sac w/nstim","description":"Revision or removal of neurostimulator electrode array, sacral, with integrated neurostimulator","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1336","name":"Pts eval ini xm 2 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 2 weeks","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90472","name":"Immunization admin each add","description":"Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); each additional vaccine (single or combination vaccine/toxoid) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9999","name":"Doc sys rsn <3 colon","description":"Documentation of system reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., unable to locate previous colonoscopy report, patient cannot provide precise date or details from previous colonoscopy, previous colonoscopy report was incomplete)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75658","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":728.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36216","name":"Place catheter in artery","description":"Selective catheter placement, arterial system; initial second order thoracic or brachiocephalic branch, within a vascular family","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55713","name":"Bx prst8 in-bore ct/mri bx 1","description":"Biopsy, prostate, in-bore ct- or mri-guided (ie, sextant), with biopsy of additional targeted lesion(s), first targeted lesion","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0513U","name":"Onc prst8 alg alys msi&hrd","description":"Onc prst8 alg alys msi&hrd","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2470","name":"Inj pantoprazole sodium 40mg","description":"Injection, pantoprazole sodium, 40 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20950","name":"Mntr intrstitial fluid press","description":"Monitoring of interstitial fluid pressure (includes insertion of device, eg, wick catheter technique, needle manometer technique) in detection of muscle compartment syndrome","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0483","name":"Indirect immunofluorescence","description":"Indirect immunofluorescence","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0734T","name":"Rem r-t mtn nrehab tx mgmt","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; treatment management services by a physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6071","name":"Abutment supported retainer","description":"Abutment supported retainer for porcelain fused to metal fpd (noble metal)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98980","name":"Rtm tx mgmt 1st 20 min","description":"Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least 1 real-time interactive communication with the patient or caregiver during the calendar month; first 20 minutes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37263","name":"Revsc evasc fpvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22860","name":"Tot disc arthrp 2ntrspc lmbr","description":"Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression); second interspace, lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1398","name":"Bslne and  fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0927T","name":"Interrog dev eval ccm-d ip","description":"Interrogation device evaluation (in person) with analysis, review, and report, including connection, recording, and disconnection, per patient encounter, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2780","name":"Crown 3/4 cast hi noble met","description":"Crown - 3/4 cast high noble metal","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0399U","name":"Neuro cere folate defncy srm","description":"Neuro cere folate defncy srm","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0940T","name":"Xtrnl ecg rec>15d<30d r&i","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70473","name":"Ct cere prfu aly c+wo ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed without concurrent ct or ct angiography of the same anatomy","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44211","name":"Lap colectomy w/proctectomy","description":"Laparoscopy, surgical; colectomy, total, abdominal, with proctectomy, with ileoanal anastomosis, creation of ileal reservoir (s or j), with loop ileostomy, includes rectal mucosectomy, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2387.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87812","name":"Sarscov2&inf typ a&b w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) and influenza virus types a and b","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72130","name":"Ct chest spine w/o & w/dye","description":"Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":530.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90382","name":"Rsv monoc antb seasn .7ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose, 0.7 ml, for intramuscular use","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9292","name":"Inj, pemetrexed dipotassium","description":"Injection, pemetrexed dipotassium, 10 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5783","name":"Add low ext mec limb vol lam","description":"Addition to lower extremity, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0278U","name":"Hem gen thrombosis 12 genes","description":"Hematology (genetic thrombosis), genomic sequence analysis of 12 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0465","name":"Autolog prp diab wound ulcer","description":"Autologous platelet rich plasma (prp) or other blood-derived product for diabetic chronic wounds/ulcers, using an fda-cleared device for this indication, (includes as applicable administration, dressings, phlebotomy, centrifugation or mixing, and all other preparatory procedures, per treatment)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2043","name":"Biobrane, per sq cm","description":"Biobrane, per square centimeter","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5126","name":"Inj alymsys 10 mg","description":"Injection, bevacizumab-maly, biosimilar, (alymsys), 10 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60001","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0787T","name":"Revj/rmvl nea sac w/nstim","description":"Revision or removal of neurostimulator electrode array, sacral, with integrated neurostimulator","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49000","name":"Exploration of abdomen","description":"Exploratory laparotomy, exploratory celiotomy with or without biopsy(s) (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":826.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3431","name":"Biological materials","description":"Biological materials","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5145","name":"Inj, abrilada, 1 mg","description":"Injection, adalimumab-afzb (abrilada), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92316","name":"C-lens fitg tech aphakia ou","description":"Prescription of optical and physical characteristics of contact lens, with medical supervision of adaptation and direction of fitting by independent technician; corneal lens for aphakia, both eyes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1010","name":"Inj, methylpred acetate 1 mg","description":"Injection, methylprednisolone acetate, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73723","name":"Mri joint lwr extr w/o&w/dye","description":"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1377.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5914","name":"Auricular prosthesis","description":"Auricular prosthesis","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0678T","name":"Laps repos lead isdss ea add","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional repositioned lead (list separately in addition to code for primary proce","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49593","name":"Rpr aa hrn 1st 3-10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, reducible","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1434","name":"Orl chemo wthn 30 d post enc","description":"Patient on oral chemotherapy on or within 30 days after denominator eligible encounter","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33902","name":"Perq p-art revsc 1 abnor uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, unilateral","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4272","name":"Esano a, per sq cm","description":"Esano a, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2267","name":"Inj, mirikizumab-mrkz, 1 mg","description":"Injection, mirikizumab-mrkz, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0914T","name":"Prq tcat thr rx ntrc bal sep","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting) performed on a separate target lesion from the target lesion treated with balloon angioplasty, coronary stent placement or coronary atherectomy, including mechanical dilation b","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0585U","name":"Tgsap so neo cfdna 521 genes","description":"Tgsap so neo cfdna 521 genes","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0481","name":"Electron microscopy diagnost","description":"Electron microscopy - diagnostic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4334","name":"Amnioplast 1, per sq cm","description":"Amnioplast 1, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55882","name":"Ablt trurl prst8 tis trnsdcr","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation; with insertion of transurethral ultrasound transducer for delivery of thermal ultrasound, including suprapubic tube placement and placement of ","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0978T","name":"Submucosal cryolysis therapy","description":"Submucosal cryolysis therapy; soft palate, base of tongue, and lingual tonsil","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2018","name":"Permeaderm c, per sq cm","description":"Permeaderm c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2991","name":"App of hydroxyapatite","description":"App of hydroxyapatite","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0333U","name":"Onc lvr surveilanc hcc cfdna","description":"Onc lvr surveilanc hcc cfdna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1293","name":"Calc bmi abv up param f/u","description":"Bmi is documented above normal parameters and a follow-up plan is documented","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5099","name":"Inj ustekinumab-stba, 1 mg","description":"Injection, ustekinumab-stba (steqeyma), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0358","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0011A","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0485U","name":"Onc sol tum cfdna&rna ngs gm","description":"Onc sol tum cfdna&rna ngs gm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84449","name":"Assay of transcortin","description":"Transcortin (cortisol binding globulin)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76987","name":"Dx intraop epicar car us chd","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; including placement and manipulation of transducer, image acquisition, interpretation and report","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1072","name":"Inj, testosterone, azmiro","description":"Injection, testosterone cypionate (azmiro), 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0975T","name":"Slctv nzmtc dbrdmt s/n/hf 1","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; first 100 sq cm","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6092","name":"Recement supp crown","description":"Recement implant/abutment supported crown","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86480","name":"Tb test cell immun measure","description":"Tuberculosis test, cell mediated immunity antigen response measurement; gamma interferon","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0138","name":"Iv cipaglucosidase alfa-atga","description":"Intravenous infusion of cipaglucosidase alfa-atga, including provider/supplier acquisition and clinical supervision of oral administration of miglustat in preparation of receipt of cipaglucosidase alfa-atga","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4313","name":"Dermabind fm, per sq cm","description":"Dermabind fm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23335","name":"Shoulder prosthesis removal","description":"Removal of prosthesis, includes debridement and synovectomy when performed; humeral and glenoid components (eg, total shoulder)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1396.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0803","name":"3d facial scan direct","description":"3d facial scan direct","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9249","name":"Inj, melphalan (apotex) 1 mg","description":"Injection, melphalan (apotex), 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4398","name":"Summit ac per sq cm","description":"Summit ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4212","name":"Gingivectomy/plasty rest","description":"Gingivectomy/plasty rest","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1478","name":"Psychoactive sub abuse","description":"Psychoactive substance abuse","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86060","name":"Antistreptolysin o titer","description":"Antistreptolysin 0; titer","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4416","name":"Alexiguard tl-t per sq cm","description":"Alexiguard tl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0373","name":"Tomo bitewing image","description":"Tomo bitewing image","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9052","name":"Inj, carmustine (accord)","description":"Injection, carmustine (accord), not therapeutically equivalent to j9050, 100 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4290","name":"Membrane wrap hydr per sq cm","description":"Membrane wrap-hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87181","name":"Sc std agar dilution per agt","description":"Susceptibility studies, antimicrobial agent; agar dilution method, per agent (eg, antibiotic gradient strip)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90631","name":"H5 vaccine pandemic im use","description":"Influenza virus vaccine (iiv), h5, pandemic formulation, split virus, adjuvanted, for intramuscular use","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9025","name":"Plasma cryo redu path each","description":"Plasma, cryoprecipitate reduced, pathogen reduced, each unit","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27447","name":"Total knee arthroplasty","description":"Arthroplasty, knee, condyle and plateau; medial and lateral compartments with or without patella resurfacing (total knee arthroplasty)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1815.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5160","name":"Inj, jobevne, 10 mg","description":"Injection, bevacizumab-nwgd (jobevne), biosimilar, 10 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0587U","name":"Ther rx mntr 60-150rx&metabl","description":"Ther rx mntr 60-150rx&metabl","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80172","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4331","name":"Axolotl graft, per sq cm","description":"Axolotl graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61314","name":"Crnec/crnot ittl xdrl/sdrl","description":"Craniectomy or craniotomy for evacuation of hematoma, infratentorial; extradural or subdural","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2010.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9997","name":"Ustekinumab-ttwe iv inj 1 mg","description":"Injection, ustekinumab-ttwe (pyzchiva), intravenous, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2543","name":"Dental onlay metallic 3 surf","description":"Onlay - metallic - three surfaces","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8611","name":"Oral methotrexate (jylamvo)","description":"Methotrexate (jylamvo), oral, 2.5 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4296","name":"Rebound matrix, per sq cm","description":"Rebound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9002","name":"Intra-vag motion sens biofk","description":"Intra-vaginal motion sensor system, provides biofeedback for pelvic floor muscle rehabilitation device","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7049","name":"Epap nasal valve","description":"Expiratory positive airway pressure intranasal resistance valve","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76984","name":"Dx intraop thoracic aorta us","description":"Ultrasound, intraoperative thoracic aorta (eg, epiaortic), diagnostic","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3501","name":"Surg exp root surf anterior","description":"Surg exp root surf anterior","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0731T","name":"Augmnt ai-based fcl phnt a/r","description":"Augmentative ai-based facial phenotype analysis with report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0964T","name":"I&cust prep jaw xpnsj 1arch","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; single arch, without mandibular advancement mechanism","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4315","name":"Regenelink amniotic mem allo","description":"Regenelink amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71045","name":"X-ray exam chest 1 view","description":"Radiologic examination, chest; single view","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3911","name":"Intraorifice barrier","description":"Intraorifice barrier","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0804T","name":"Prgrmg evl ldls pm 2chmbr ip","description":"Programming device evaluation (in person) with iterative adjustment of implantable device to test the function of device and to select optimal permanent programmed values, with analysis, review, and report, by a physician or other qualified health care professional, leadless pacemaker system in dual","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37259","name":"Revsc evasc ivt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15330","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20610","name":"Drain/inj joint/bursa w/o us","description":"Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, subacromial bursa); without ultrasound guidance","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":65.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46601","name":"Diagnostic anoscopy","description":"Anoscopy; diagnostic, with high-resolution magnification (hra) (eg, colposcope, operating microscope) and chemical agent enhancement, including collection of specimen(s) by brushing or washing, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":195.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37298","name":"Revsc evsc imvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":333.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0336U","name":"Rare ds whl gen seq bld/slv","description":"Rare ds whl gen seq bld/slv","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4289","name":"Revoshield+ amnio, per sq cm","description":"Revoshield + amniotic barrier, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0271U","name":"Hem cgen neutropenia 23 gen","description":"Hematology (congenital neutropenia), genomic sequence analysis of 23 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81457","name":"So neo gsap dna mcrstl ins","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis, microsatellite instability","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0684","name":"App non-sheet skin sb g addl","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area or part thereof, or each additional 1% o","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33277","name":"Insj phrnc nrv stim transvns","description":"Insertion of phrenic nerve stimulator transvenous sensing lead (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1242","name":"Pt no resp imprt to me","description":"Patient did not respond to the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61521","name":"Removal of brain lesion","description":"Craniectomy for excision of brain tumor, infratentorial or posterior fossa; midline tumor at base of skull","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3657.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1366","name":"Focus on womens health mvp","description":"Focusing on womens health mips value pathway","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2029","name":"Mirotract matrix sheet","description":"Mirotract wound matrix sheet, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58145","name":"Myomectomy vag method","description":"Myomectomy, excision of fibroid tumor(s) of uterus, 1 to 4 intramural myoma(s) with total weight of 250 g or less and/or removal of surface myomas; vaginal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":617.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0275U","name":"Hem heprn nduc trmbctpna srm","description":"Hematology (heparin-induced thrombocytopenia) platelet antibody reactivity by flow cytometry, serum","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01941","name":"Anes neuromd/ntrvrt crv/thrc","description":"Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0954T","name":"Tot impl amei rplc snd proc","description":"Totally implantable active middle ear hearing implant; replacement of sound processor only, with attachment to existing transducers","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11471","name":"Exc skn h/p/p/u complex","description":"Excision of skin and subcutaneous tissue for hidradenitis, perianal, perineal, or umbilical; with complex repair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1273","name":"Pts snf 1 yr dialysis","description":"Patients who were admitted to a skilled nursing facility (snf) within one year of dialysis initiation according to the cms-2728 form","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2329","name":"Inj ublituximab-xiiy, 1 mg","description":"Injection, ublituximab-xiiy, 1mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6196","name":"Remv of ind rest on implt","description":"Remv of ind rest on implt","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4294","name":"Amnio quad-core, per sq cm","description":"Amnio quad-core, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0355U","name":"Apol1 risk variants","description":"Apol1 risk variants","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1305","name":"Pneum vax admin 19+","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4347","name":"Rampart dl matrix per sq cm","description":"Rampart dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4015","name":"Neurology ss","description":"Neurology mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9334","name":"Inj efgart-alfa 2mg hya-qvfc","description":"Injection, efgartigimod alfa, 2 mg and hyaluronidase-qvfc","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0932T","name":"N-invs det hrt fail aug echo","description":"Noninvasive detection of heart failure derived from augmentative analysis of an echocardiogram that demonstrated preserved ejection fraction, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0535","name":"Pt navigat svs direct/ref","description":"Patient navigational services, provided directly or by referral; including helping the patient to navigate health systems and identify care providers and supportive services, to build patient self-advocacy and communication skills with care providers, and to promote patient-driven action plans and g","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1053.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4241","name":"Gngvl flap w rootplan 1-3 th","description":"Gingival flap procedure including root planing - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0464U","name":"Onc clrct scr qrtsa dna mrk","description":"Onc clrct scr qrtsa dna mrk","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12021","name":"Tx supfc wnd dehsn w/packing","description":"Treatment of superficial wound dehiscence; with packing","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":128.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9154","name":"Artificial saliva, 1 ml","description":"Artificial saliva, 1 ml","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15018","name":"App skn cll ssp f/n/g/hf ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 480 sq cm or part thereof (list separately in addition to code for prima","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0683","name":"App of non-sheet skin sub g","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20605","name":"Drain/inj joint/bursa w/o us","description":"Arthrocentesis, aspiration and/or injection, intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa); without ultrasound guidance","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":30.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7631","name":"Cromolyn sodium noncomp unit","description":"Cromolyn sodium, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per 10 milligrams","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4419","name":"Biolab wrap flw lt per sq cm","description":"Biolab membrane wrap lite flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3921","name":"Decor or submerg erupt tooth","description":"Decor or submerg erupt tooth","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0521","name":"New pt-cg dyad dem hig cmplx","description":"Management of new patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42820","name":"Remove tonsils and adenoids","description":"Tonsillectomy and adenoidectomy; younger than age 12","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86780","name":"Treponema pallidum","description":"Antibody; treponema pallidum","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96381","name":"Admn rsv monoc antb im njx","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61892","name":"Rmv sk-mnt crnl nstm pg/rcvr","description":"Removal of skull-mounted cranial neurostimulator pulse generator or receiver with cranioplasty, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":702.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25448","name":"Arthrp ntrcrpl/crp/mtcrp ssp","description":"Arthroplasty, intercarpal or carpometacarpal joints; suspension, including transfer or transplant of tendon, with interposition, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1438","name":"Lst knwn well <=210 min","description":"Time last known well to hospital arrival less than or equal to 3.5 hours (<= 210 minutes)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0996T","name":"Ins&sclr fix caps bag prosth","description":"Insertion and scleral fixation of a capsular bag prosthesis containing an intraocular lens prosthesis, with vitrectomy, including removal of crystalline lens or dislocated intraocular lens prosthesis, when performed","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95060","name":"Oph mucous membrane tests","description":"Ophthalmic mucous membrane tests","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27290","name":"Amputation of leg at hip","description":"Interpelviabdominal amputation (hindquarter amputation)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1833.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1442","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0376U","name":"Onc prst8 ca img alys 128","description":"Onc prst8 ca img alys 128","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0710T","name":"N-invas artl plaq alys","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; including data preparation and transmission, quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess a","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10120","name":"Inc&rmvl fb subq tiss smpl","description":"Incision and removal of foreign body, subcutaneous tissues; simple","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":110.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63660","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":473.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4303","name":"Complete aa, per sq cm","description":"Complete aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92609","name":"Use of speech device service","description":"Therapeutic services for the use of speech-generating device, including programming and modification","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2998","name":"Inj plasminogen tvmh 1mg","description":"Injection, plasminogen, human-tvmh, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0348U","name":"Rx metab/pcx dna 25 gen alys","description":"Rx metab/pcx dna 25 gen alys","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87070","name":"Culture othr specimn aerobic","description":"Culture, bacterial; any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9015","name":"Aldesleukin injection","description":"Injection, aldesleukin, per single use vial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":672.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9174","name":"Inj, docetaxel (beizray) 1mg","description":"Injection, docetaxel (beizray), 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1460","name":"Dx copd, cf, or arf","description":"Diagnosis for chronic obstructive pulmonary disease, emphysema, cystic fibrosis, or acute respiratory failure","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99253","name":"Ip/obs cnsltj new/est low 45","description":"Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 45 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2004","name":"Inj, lidocaine w epinephrine","description":"Injection, lidocaine hcl with epinephrine, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0474","name":"Micro w exam of surg margins","description":"Accession of tissue gross and microscopic examination including assessment of surgical margins for presence of disease preparation and transmission of writte","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5765","name":"Liner compl/partial rem dent","description":"Liner compl/partial rem dent","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44700","name":"Suspend bowel w/prosthesis","description":"Exclusion of small intestine from pelvis by mesh or other prosthesis, or native tissue (eg, bladder or omentum)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1087.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4435","name":"Renati membrane per sq cm","description":"Renati membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0854T","name":"Dgtz gls mcrscp bld smr prph","description":"Digitization of glass microscope slides for blood smear, peripheral, interpretation by physician with written report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2804","name":"Inj, rifampin, 1 mg","description":"Injection, rifampin, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0556U","name":"Nfct ds p-s dna&rna 12 trgts","description":"Nfct ds p-s dna&rna 12 trgts","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6608","name":"G com bandage tub protct pad","description":"Gradient compression bandaging supply, tubular protective absorption padded layer, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4021","name":"Orthopedic surgery ss","description":"Orthopedic surgery mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9174","name":"Inj, docetaxel (beizray) 1mg","description":"Injection, docetaxel (beizray), 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5945","name":"Mand implt sup remv part","description":"Mand implt sup remv part","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97550","name":"Caregiver traing 1st 30 min","description":"Caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patie","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8611","name":"Oral methotrexate (jylamvo)","description":"Methotrexate (jylamvo), oral, 2.5 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4286","name":"Nudyn sl or slw, per sq cm","description":"Nudyn sl or nudyn slw, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0947T","name":"Mrgfus strtctc bl-br disrpj","description":"Magnetic resonance image guided low intensity focused ultrasound (mrgfus), stereotactic blood-brain barrier disruption using microbubble resonators to increase the concentration of blood-based biomarkers of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4019","name":"Oncology/hema ss","description":"Oncology/hematology mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0332U","name":"Onc pan tum gen prflg 8 dna","description":"Onc pan tum gen prflg 8 dna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0696T","name":"Bdy surf mapg pm/cvdfb f/up","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of follow-up interrogation or programming device evaluatio","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0062","name":"Audiology ss","description":"Audiology mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0875T","name":"Prgrm subq prtl asct pmp sys","description":"Programming of subcutaneously implanted peritoneal ascites pump system by physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59020","name":"Fetal contract stress test","description":"Fetal contraction stress test","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90624","name":"Menb-4c&menacwy vacc im","description":"Meningococcal pentavalent vaccine, men b-4c recombinant proteins and outer membrane vesicle and conjugated men a, c, w, y-diphtheria toxoid carrier, for intramuscular use","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4391","name":"Amnioplast double per sq cm","description":"Amnioplast double, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90951","name":"Esrd serv 4 visits p mo <2yr","description":"End-stage renal disease (esrd) related services monthly, for patients younger than 2 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 4 or more face-to-face visits by a physician or other qualified health care pro","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1261.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66183","name":"Insert ant drainage device","description":"Insertion of anterior segment aqueous drainage device, without extraocular reservoir, external approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1165.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0290U","name":"Pain mgmt mrna gen xprsn 36","description":"Pain mgmt mrna gen xprsn 36","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80505","name":"Path clin consltj high 41-60","description":"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patients history and medical records and high level of medical decision making when using time for code selection, 41-60 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0883T","name":"Intraop ther estim pn ue ea","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; each additional nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0870","name":"Injection, imetelstat, 1 mg","description":"Injection, imetelstat, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0920T","name":"Rmvl perm ccm-d sys 1 pac ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous pacing lead only","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21445","name":"Optx mndblr/max alv ridge fx","description":"Open treatment of mandibular or maxillary alveolar ridge fracture (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1277","name":"Colorectal ca screen doc rev","description":"Colorectal cancer screening results documented and reviewed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1299","name":"Flu immunize order/admin","description":"Influenza immunization administered or previously received","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4320","name":"Pellograft, per sq cm","description":"Pellograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0234","name":"Intra inf, toci, second dos","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0330U","name":"Iadna vag pthgn panel 27 org","description":"Iadna vag pthgn panel 27 org","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99395","name":"Prev visit est age 18-39","description":"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 18-39","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":79.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0557","name":"Adv prim care mgmt lvl 2","description":"Advanced primary care management services for a patient with multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, which place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline, provided by c","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92639","name":"Hearing aid meas verif","description":"Hearing-aid measurement, verification with probe-microphone (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4326","name":"Woundplus, per sq cm","description":"Woundplus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0081A","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1442","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29131","name":"Appl finger splint dynamic","description":"Application of finger splint; dynamic","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":35.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1001T","name":"Autol musc cell therapy njx","description":"Autologous muscle cell therapy, injection of muscle progenitor cells into the external anal sphincter, including ultrasound guidance, when performed","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9938","name":"Fab removable appliance","description":"Fab removable appliance","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92638","name":"Bhvl verif of amplification","description":"Behavioral verification of amplification including aided thresholds, functional gain, speech-in-noise, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7415","name":"Excision malig les complicat","description":"Excision of malignant lesion complicated","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2038","name":"Marigen pacto, per sq cm","description":"Marigen pacto, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0300U","name":"Onc pan tum whl gen seq&opt","description":"Onc pan tum whl gen seq&opt","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1365","name":"Hosp+pall care spec code 17","description":"Patient encounter during the performance period with hospice and palliative care specialty code 17","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3387","name":"Inj elivaldogene autotemecel","description":"Injection, elivaldogene autotemcel, per treatment","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0943T","name":"Cysto flx rmvl urtl scaffold","description":"Cystourethroscopy, flexible; with removal of prostatic urethral scaffold","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78469","name":"Heart infarct image (3d)","description":"Myocardial imaging, infarct avid, planar; tomographic spect with or without quantification","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5150","name":"Inj, aflibercept-mrbb, 1 mg","description":"Injection, aflibercept-mrbb (ahzantive), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62140","name":"Crnop skull defect<5 cm diam","description":"Cranioplasty for skull defect; up to 5 cm diameter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1158.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7939","name":"Indexing for osteotomy","description":"Indexing for osteotomy","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45330","name":"Diagnostic sigmoidoscopy","description":"Sigmoidoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":204.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0943T","name":"Cysto flx rmvl urtl scaffold","description":"Cystourethroscopy, flexible; with removal of prostatic urethral scaffold","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33511","name":"Cabg vein two","description":"Coronary artery bypass, vein only; 2 coronary venous grafts","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2317.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6191","name":"Semi precision abutment","description":"Semi precision abutment","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1203","name":"No rsn ace-i/arb rx","description":"Ace inhibitor or arb therapy not prescribed during the measurement period, reason not given","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27827","name":"Treat lower leg fracture","description":"Open treatment of fracture of weight bearing articular surface/portion of distal tibia (eg, pilon or tibial plafond), with internal fixation, when performed; of tibia only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1337.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0925T","name":"Rlcj skin pocket ccm-d pg","description":"Relocation of skin pocket for implanted cardiac contractility modulation-defibrillation pulse generator","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1499","name":"Interventional radiology mvp","description":"Interventional radiology mips value pathway","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4309","name":"Via matrix, per sq cm","description":"Via matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36819","name":"Av fuse uppr arm basilic","description":"Arteriovenous anastomosis, open; by upper arm basilic vein transposition","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":997.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1455","name":"Rep/rev cied","description":"Replaced or revised cied","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92284","name":"Dx dark adaptation exam i&r","description":"Diagnostic dark adaptation examination (eg, rod and cone sensitivities, rod-cone breakpoint), with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2001","name":"Suct pum ext mgmt sys","description":"Suction pump, home model, portable or stationary, electric, any type, for use with external urine and/or fecal management system","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J9300","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2203.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92637","name":"Hearing aid pst-fitg f-up ea","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0309U","name":"Crd cv ds aly 4 prtn plm alg","description":"Crd cv ds aly 4 prtn plm alg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82465","name":"Assay bld/serum cholesterol","description":"Cholesterol, serum or whole blood, total","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1002T","name":"Air displacmnt plethysmograp","description":"Air displacement plethysmography, whole-body composition assessment, with interpretation and report","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0514U","name":"Gi ibd ia quan deter adl lvl","description":"Gi ibd ia quan deter adl lvl","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0755T","name":"Dgtz gls mcrscp sld level vi","description":"Digitization of glass microscope slides for level vi, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0877T","name":"Augmnt alys ch ct ild w/o ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0906T","name":"Coms ther 1st appl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; first application, total wound(s) surface area less than or equal to 50 sq cm","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0249","name":"Adm tocilizu covid-19 1st","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0763T","name":"Dgtz gls mcrscp mphmtrc alys","description":"Digitization of glass microscope slides for morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure, manual (list separately in addition to code for primary proced","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4028","name":"Podiatry ss","description":"Podiatry mips specialty set","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1171","name":"Pt recd 1 td/tdap 9yrs prior","description":"Patient received at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1200","name":"Ace-i/arb rx","description":"Ace inhibitor (ace-i) or arb therapy prescribed during the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0566U","name":"Onc lng qpcr-bsd alys 13dmrs","description":"Onc lng qpcr-bsd alys 13dmrs","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9615","name":"Inj, pegulicianine, 1 mg","description":"Injection, pegulicianine, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33130","name":"Rescj external cardiac tumor","description":"Resection of external cardiac tumor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1537.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43350","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1133.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83013","name":"H pylori (c-13) breath","description":"Helicobacter pylori; breath test analysis for urease activity, non-radioactive isotope (eg, c-13)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0599U","name":"Onc pncrtc ca mult ia serum","description":"Onc pncrtc ca mult ia serum","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4286","name":"Nudyn sl or slw, per sq cm","description":"Nudyn sl or nudyn slw, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9075","name":"Inj, cyclophosphamide, nos","description":"Injection, cyclophosphamide, not otherwise specified, 5 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1464","name":"No record of f/u by 180 days","description":"No documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1344","name":"No bsln/2nd pam score 4-12mo","description":"Patients who did not have a baseline pam score and/or a second score within 4 to 12 months of baseline pam score","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69727","name":"Rmv ntr oi imp sk tc esp<100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64583","name":"Rev/rplct hpglsl nstm ary pg","description":"Revision or replacement of hypoglossal nerve neurostimulator array and distal respiratory sensor electrode or electrode array, including connection to existing pulse generator","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2007","name":"Restrata, per sq cm","description":"Restrata, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9298","name":"Inj nivol relatlimab 3mg/1mg","description":"Injection, nivolumab and relatlimab-rmbw, 3 mg/1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1405","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59620","name":"Attempted vbac delivery only","description":"Cesarean delivery only, following attempted vaginal delivery after previous cesarean delivery;","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":793.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1332","name":"Pts no eval ini xm no 2 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 2 weeks","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69728","name":"Rmv ntr oi imp sk tc>=100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0515U","name":"Gi ibd ia quan deter ifx lvl","description":"Gi ibd ia quan deter ifx lvl","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11976","name":"Remove contraceptive capsule","description":"Removal, implantable contraceptive capsules","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":169.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1300","name":"Flu imm no admin doc rea","description":"Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81451","name":"Hl neo gsap 5-50 rna alys","description":"Hematolymphoid neoplasm or disorder, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants, and copy number variants or rearrangements, or isoform expression or mrna expression levels, if performed; rna analysis","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5939","name":"Resct proth mand comp remov","description":"Resct proth mand comp remov","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0700T","name":"Molec fluor img sus nev 1st","description":"Molecular fluorescent imaging of suspicious nevus; first lesion","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0916T","name":"Insj perm ccm-d sys pg only","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator only","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64704","name":"Revise hand/foot nerve","description":"Neuroplasty; nerve of hand or foot","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42665","name":"Ligation of salivary duct","description":"Ligation salivary duct, intraoral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1280","name":"Bilat mast/hx bi /unilat mas","description":"Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0035","name":"Pt ed pos 23","description":"Patient has any emergency department encounter during the performance period with place of service indicator 23","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0867T","name":"Tpla b9 prst8 hyprplsa>=50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume greater or equal to 50 ml","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1207","name":"Pt scrn sdoh","description":"Patient is screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78075","name":"Adrenal cortex & medulla img","description":"Adrenal imaging, cortex and/or medulla","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64654","name":"1st opn implt bat modulj sys","description":"Initial open implantation of baroreflex activation therapy (bat) modulation system, including lead placement onto the carotid sinus, lead tunnelling, connection to a pulse generator placed in a distant subcutaneous pocket (ie, total system), and intraoperative interrogation and programming","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7957","name":"Tiss regen edent nonresorb","description":"Tiss regen edent nonresorb","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0621U","name":"Nfct ds lb dna alys>10000","description":"Nfct ds lb dna alys>10000","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1204","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9324","name":"Inj, pemrydi rtu, 10 mg","description":"Injection, pemetrexed (pemrydi rtu), 10 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44152","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1907.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0680T","name":"Insj/rplcmt pg only isdss","description":"Insertion or replacement of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing lead(s)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0502U","name":"Hpv e6/e7 mrk hi-rsk typ crv","description":"Hpv e6/e7 mrk hi-rsk typ crv","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2210","name":"Methylergonovin maleate inj","description":"Injection, methylergonovine maleate, up to 0.2 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1073","name":"Testosterone pellet 75 mg","description":"Testosterone pellet, implant, 75 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4394","name":"Surgraft aca per sq cm","description":"Surgraft aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55708","name":"Bx prst8 trct us w/mri fus 1","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant) with mri-fusion-guidance, first targeted lesion","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1296","name":"Calc bmi norm parameters","description":"Bmi is documented within normal parameters and no follow-up plan is required","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4290","name":"Membrane wrap hydr per sq cm","description":"Membrane wrap-hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0418U","name":"Onc brst aug alg aly whl sl8","description":"Onc brst aug alg aly whl sl8","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6193","name":"Replace implnt screw","description":"Replace implnt screw","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1073","name":"Testosterone pellet 75 mg","description":"Testosterone pellet, implant, 75 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0822T","name":"Mntr psychdlc med cln staff","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; clinical staff under the direction of a physician or other qualified health care professional, concurrent with first physician or other qualified health care p","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46706","name":"Repr of anal fistula w/glue","description":"Repair of anal fistula with fibrin glue","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0349U","name":"Rx metab/pcx dna 27gen rx ia","description":"Rx metab/pcx dna 27gen rx ia","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19294","name":"Prepj tum cav iort prtl mast","description":"Preparation of tumor cavity, with placement of a radiation therapy applicator for intraoperative radiation therapy (iort) concurrent with partial mastectomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2440","name":"Papaverin hcl injection","description":"Injection, papaverine hcl, up to 60 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0663","name":"Team remote e/m new pt 45 mn","description":"Team remote e/m new pt 45mins","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1308","name":"Flu immunize no admin","description":"Influenza immunization was not administered, reason not given","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0668","name":"Instill, bupivac and meloxic","description":"Instillation, bupivacaine and meloxicam, 1 mg/0.03 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0788T","name":"Elec aly smp iins sp/sac nrv","description":"Electronic analysis with simple programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detecti","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64467","name":"Thrc fascial pln blk uni nfs","description":"Thoracic fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34702","name":"Evasc rpr a-ao ndgft rpt","description":"Endovascular repair of infrarenal aorta by deployment of an aorto-aortic tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the aorta from the level ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1863.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76989","name":"Dx intraop epcar us chd i&r","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; interpretation and report only","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87913","name":"Nfct agt gntyp alys sarscov2","description":"Infectious agent genotype analysis by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), mutation identification in targeted region(s)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4438","name":"Adhesive clip ext ens contr","description":"Adhesive clip applied to the skin to secure external electrical nerve stimulator controller, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":1.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4353","name":"Xceed tl matrix per sq cm","description":"Xceed tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1500","name":"Neuropsychology mvp","description":"Neuropsychology mips value pathway","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37262","name":"Iv lithotrp ivt w/in sm art","description":"Intravascular lithotripsy(ies), iliac vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47712","name":"Excision of bile duct tumor","description":"Excision of bile duct tumor, with or without primary repair of bile duct; intrahepatic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2069.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1426","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99401","name":"Prev med cnsl indiv apprx 15","description":"Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 15 minutes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":22.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2029","name":"Mirotract matrix sheet","description":"Mirotract wound matrix sheet, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1411","name":"Inj, hemgenix, per tx dose","description":"Injection, etranacogene dezaparvovec-drlb, per therapeutic dose","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0835T","name":"Dgtz gls mcrscp fna 1st ea","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86705","name":"Hep b core antibody igm","description":"Hepatitis b core antibody (hbcab); igm antibody","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1225","name":"Iop dec>=20% from base","description":"Intraocular pressure (iop) reduced by a value of greater than or equal to 20% from the pre-intervention level","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50380","name":"Rnl autotrnsplj rimpltj kdn","description":"Renal autotransplantation, reimplantation of kidney","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1572.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":558.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9573","name":"Inj, gadopiclenol, 1 ml","description":"Injection, gadopiclenol, 1 ml","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1837","name":"Inj, posaconazole, 1 mg","description":"Injection, posaconazole, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0705","name":"Extra oral post radio image","description":"Extra oral post radio image","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5138","name":"Inj, wezlana, iv, 1 mg","description":"Injection, ustekinumab-auub (wezlana), biosimilar, intravenous, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98001","name":"Synch audio-video new low 30","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0305U","name":"Hem rbc fnclty&dfrm shr strs","description":"Hem rbc fnclty&dfrm shr strs","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0336U","name":"Rare ds whl gen seq bld/slv","description":"Rare ds whl gen seq bld/slv","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45116","name":"Partial removal of rectum","description":"Proctectomy, partial, with anastomosis; transsacral approach only (kraske type)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1663.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40805","name":"Removal foreign body mouth","description":"Removal of embedded foreign body, vestibule of mouth; complicated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1370","name":"Inj, esomeprazole sod, 1 mg","description":"Injection, esomeprazole sodium, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67120","name":"Remove eye implant material","description":"Removal of implanted material, posterior segment; extraocular","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92636","name":"Hearing aid post-fitg f-up 1","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65093","name":"Revise eye with implant","description":"Evisceration of ocular contents; with implant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":717.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J1620","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9912","name":"Pre-visit patient screening","description":"Pre-visit patient screening","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96116","name":"Nubhvl xm phys/qhp 1st hr","description":"Neurobehavioral status exam (clinical assessment of thinking, reasoning and judgment, [eg, acquired knowledge, attention, language, memory, planning and problem solving, and visual spatial abilities]), by physician or other qualified health care professional, both face-to-face time with the patient ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":78.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86596","name":"Voltage-gtd ca chnl antb ea","description":"Voltage-gated calcium channel antibody, each","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2040","name":"Coord specialty care, month","description":"Coordinated specialty care, team-based, for first episode psychosis, per month","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98927","name":"Osteopath manj 5-6 regions","description":"Osteopathic manipulative treatment (omt); 5-6 body regions involved","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":68.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9939","name":"Placemnt removable appliance","description":"Placemnt removable appliance","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98975","name":"Rtm 1st set-up&pt educaj eqp","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); initial set-up and patient education on use of equipment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4023","name":"Pathology ss","description":"Pathology mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0687","name":"Inj cefazolin (wg crit care)","description":"Injection, cefazolin sodium (wg critical care), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1308","name":"Flu immunize no admin","description":"Influenza immunization was not administered, reason not given","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92629","name":"Eval hearing aid cand ea add","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51600","name":"Injection for bladder x-ray","description":"Injection procedure for cystography or voiding urethrocystography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35522","name":"Art byp grft axill-brachial","description":"Bypass graft, with vein; axillary-brachial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1482.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44602","name":"Suture small intestine","description":"Suture of small intestine (enterorrhaphy) for perforated ulcer, diverticulum, wound, injury or rupture; single perforation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1088.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0404U","name":"Onc brst semiq meas thym kn","description":"Onc brst semiq meas thym kn","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0759T","name":"Dgtz gls mcrscp sl sp grpiii","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group iii, for enzyme constituents (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2544","name":"Dental onlay metl 4/more sur","description":"Onlay - metallic - four or more surfaces","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0284U","name":"Vw factor type 2n eval plsm","description":"Von willebrand factor (vwd), type 2n, factor viii and vwf binding evaluation, enzyme-linked immunosorbent assays (elisa), plasma","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83858","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82465","name":"Assay bld/serum cholesterol","description":"Cholesterol, serum or whole blood, total","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D8671","name":"Periodic orth treat w surg","description":"Periodic orth treat w surg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0684T","name":"Peri-px dev eval isdss ip","description":"Peri-procedural device evaluation (in-person) and programming of device system parameters before or after a surgery, procedure, or test with analysis, review, and report by a physician or other qualified health care professional, permanent implantable synchronized diaphragmatic stimulation system fo","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76017","name":"Mr sfty med physics xm cstmz","description":"Mr safety medical physics examination customization, planning and performance monitoring by medical physicist or mr safety expert, with review and analysis by physician or other qualified health care professional to prioritize and select views and imaging sequences, to tailor mr acquisition specific","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1805","name":"Inj, esmolol hcl, 10mg","description":"Injection, esmolol hydrochloride, 10 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0331U","name":"Onc hl neo opt gen mapping","description":"Onc hl neo opt gen mapping","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0341U","name":"Ftl aneup dna seq cmpr alys","description":"Ftl aneup dna seq cmpr alys","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6091","name":"Repl semi/precision attach","description":"Replacement of semi-precision or precision attachment (male or female component) of implant/abutment supported prosthesis per attachment","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0349U","name":"Rx metab/pcx dna 27gen rx ia","description":"Rx metab/pcx dna 27gen rx ia","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81349","name":"Cytog alys chrml abnr lw-ps","description":"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and loss-of-heterozygosity variants, low-pass sequencing analysis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17110","name":"Destruction b9 les up to 14","description":"Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), of benign lesions other than skin tags or cutaneous vascular proliferative lesions; up to 14 lesions","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":71.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0473","name":"Micro exam prep & report","description":"Accession of tissue gross and microscopic examination preparation and transmission of written report","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0766T","name":"Tc mag stimj pn 1st nerve","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; first nerve","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0548U","name":"Gfap cleia plasma","description":"Gfap cleia plasma","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9156","name":"Oral mucoadhesive per 1 ml","description":"Oral mucoadhesive, any type (liquid, gel, paste, etc.), per 1 ml","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9959","name":"Unspec sleep ap proc","description":"Unspec sleep ap proc","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6516","name":"Grad com wrap w strap foo cu","description":"Gradient compression wrap with adjustable straps, foot, each, custom","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92945","name":"Prq trl rvs ch occ ant&rtrgr","description":"Percutaneous transluminal revascularization of chronic total occlusion, single coronary artery, coronary artery branch, or coronary artery bypass graft, and/or subtended major coronary artery branches of the bypass graft, any combination of intracoronary stent, atherectomy and angioplasty; combined ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9595","name":"Piflu f-18, dia 1 millicurie","description":"Piflufolastat f-18, diagnostic, 1 millicurie","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5725","name":"Rebase hybrid prosthesis","description":"Rebase hybrid prosthesis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98975","name":"Rtm 1st set-up&pt educaj eqp","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); initial set-up and patient education on use of equipment","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0486U","name":"Onc pan sol tum ngs cfctdna","description":"Onc pan sol tum ngs cfctdna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94667","name":"Mnpj chest wall 1st","description":"Manipulation chest wall, such as cupping, percussing, and vibration to facilitate lung function; initial demonstration and/or evaluation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2051","name":"Support broker waiver/diem","description":"Supports brokerage, self-directed, waiver; per diem","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2183","name":"Inj meropenem (wg crit care)","description":"Injection, meropenem (wg critical care), not therapeutically equivalent to j2185, 100 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81007","name":"Urine screen for bacteria","description":"Urinalysis; bacteriuria screen, except by culture or dipstick","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1171","name":"Inj, hydromorphone, 0.1 mg","description":"Injection, hydromorphone, 0.1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0743T","name":"B1 str & fx rsk vrt fx assmt","description":"Bone strength and fracture risk using finite element analysis of functional data and bone mineral density (bmd), with concurrent vertebral fracture assessment, utilizing data from a computed tomography scan, retrieval and transmission of the scan data, measurement of bone strength and bmd and classi","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1452","name":"Pt dx dementia ever","description":"Patient ever had a diagnosis of dementia","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1310","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24620","name":"Cltx monteggia fx dislc elbw","description":"Closed treatment of monteggia type of fracture dislocation at elbow (fracture proximal end of ulna with dislocation of radial head), with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":649.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63744","name":"Revision of spinal shunt","description":"Replacement, irrigation or revision of lumbosubarachnoid shunt","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":695.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86022","name":"Platelet antibodies","description":"Antibody identification; platelet antibodies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0517U","name":"Ther rx mntr 80+ psyactiv rx","description":"Ther rx mntr 80+ psyactiv rx","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1286","name":"Bmi doc onl fup not cmpltd","description":"Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90635","name":"H5n1 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n1, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1013T","name":"Lap srg imp/rpl eso nea&pg/r","description":"Laparoscopy, surgical, implantation or replacement of lower esophageal sphincter neurostimulator electrode array and neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver, including cruroplasty and/or electronic ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37261","name":"Revsc evasc ivt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2448.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4369","name":"Amnioplast 3 per sq cm","description":"Amnioplast 3, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5099","name":"Inj ustekinumab-stba, 1 mg","description":"Injection, ustekinumab-stba (steqeyma), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98010","name":"Synch audio-only new mod 45","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection,","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1220","name":"Dre wth interp rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; with evidence of retinopathy","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0512U","name":"Onc prst8 alys dgtz img msi","description":"Onc prst8 alys dgtz img msi","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0033","name":"2+ benzo seiz","description":"Two or more benzodiazepine prescriptions ordered for patients who had a diagnosis of seizure disorders, rapid eye movement sleep behavior disorder, benzodiazepine withdrawal, ethanol withdrawal, or severe generalized anxiety disorder on or between january 1 of the year prior to the measurement perio","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61616","name":"Resect/excise lesion skull","description":"Resection or excision of neoplastic, vascular or infectious lesion of base of posterior cranial fossa, jugular foramen, foramen magnum, or c1-c3 vertebral bodies; intradural, including dural repair, with or without graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3646.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1464","name":"No record of f/u by 180 days","description":"No documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1405","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64728","name":"Dcmprn median nrv carpl tunl","description":"Decompression; median nerve at the carpal tunnel, percutaneous, with intracarpal tunnel balloon dilation, including ultrasound guidance","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7671","name":"Alveolus open reduction","description":"Alveolus - open reduction may include stabilization of teeth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0342","name":"Laparoscopy islet cell trans","description":"Laparoscopy for islet cell transplant, includes portal vein catheterization and infusion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":831.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4340","name":"Simpligraft, per sq cm","description":"Simpligraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86162","name":"Complement total (ch50)","description":"Complement; total hemolytic (ch50)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87564","name":"Mtb rifampin rst amp prb tq","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacterium tuberculosis, rifampin resistance, amplified probe technique","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92629","name":"Eval hearing aid cand ea add","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9953","name":"Reline sleep apnea appliance","description":"Reline sleep apnea appliance","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0848T","name":"Dgtz gls mcrscp ish 1st","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0458U","name":"Onc brst ca s100 a8&a9 elisa","description":"Onc brst ca s100 a8&a9 elisa","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0695T","name":"Bdy srf mpg pm/cvdfb tm impl","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of implant or replacement","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17111","name":"Destruction b9 lesions 15/>","description":"Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), of benign lesions other than skin tags or cutaneous vascular proliferative lesions; 15 or more lesions","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0803","name":"3d facial scan direct","description":"3d facial scan direct","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0052","name":"Mmip mental health and care","description":"Missing and murdered indigenous persons (mmip) mental health and clinical care","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4331","name":"Axolotl graft, per sq cm","description":"Axolotl graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1003T","name":"Arthrp 1st crp/mtcrpl prostc","description":"Arthroplasty, first carpometacarpal joint, with distal trapezial and proximal first metacarpal prosthetic replacement (eg, first carpometacarpal total joint)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9318","name":"Inj romidepsin non-lyo 0.1mg","description":"Injection, romidepsin, non-lyophilized, 0.1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1362","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0666","name":"Team remote e/m est pt 15 mn","description":"Team remote e/m est. pt 15mins","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0362U","name":"Onc pap thyr ca rna 82&10","description":"Onc pap thyr ca rna 82&10","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4352","name":"Overlay sl matrix, per sq cm","description":"Overlay sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0731T","name":"Augmnt ai-based fcl phnt a/r","description":"Augmentative ai-based facial phenotype analysis with report","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72080","name":"X-ray exam thoracolmb 2/> vw","description":"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4023","name":"Pathology ss","description":"Pathology mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9997","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86753","name":"Protozoa antibody nos","description":"Antibody; protozoa, not elsewhere specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1443","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4372","name":"Amchoplast excl per sq cm","description":"Amchoplast excel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0439U","name":"Crd chd dna alys 5 snp 3 dna","description":"Crd chd dna alys 5 snp 3 dna","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15014","name":"Prepj skn cll ssp agrft ea","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; each additional 25 sq cm of harvested skin or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0523","name":"Mgt nw pt dem mod-high cmplx","description":"Management of a new patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1177","name":"Pt recd pcv on/aft 19","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15810","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1375","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98006","name":"Synch audio-video est mod 30","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1163","name":"Inj, diltiazem hcl, 0.5 mg","description":"Injection, diltiazem hydrochloride, 0.5 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61563","name":"Excision of skull tumor","description":"Excision, intra and extracranial, benign tumor of cranial bone (eg, fibrous dysplasia); without optic nerve decompression","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2153.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0931T","name":"Ephys eval ccm-d ld separate","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), separate from initial implantation or replacement with testing of cardiac cont","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9612","name":"Catheterize for urine spec","description":"Catheterization for collection of specimen, single patient, all places of service","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0340U","name":"Onc pan ca alys mrd plasma","description":"Onc pan ca alys mrd plasma","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20838","name":"Replantation foot complete","description":"Replantation, foot, complete amputation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2805.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1331","name":"Pts eval ini xm 8 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 8 weeks from initial exam","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0863T","name":"Rlcj pg wcs lv trnsmtr only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; transmitter component only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6074","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (noble metal)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0956T","name":"Prt crn ch cr&tun elt s-sclp","description":"Partial craniectomy, channel creation, and tunneling of electrode for sub-scalp implantation of an electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4032","name":"Rheumatology ss","description":"Rheumatology mips specialty set","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0271U","name":"Hem cgen neutropenia 23 gen","description":"Hematology (congenital neutropenia), genomic sequence analysis of 23 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7413","name":"Excision malig lesion<=1.25c","description":"Excision of malignant lesion up to 1.25 cm","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0225","name":"Inj, vutrisiran, 1 mg","description":"Injection, vutrisiran, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0281U","name":"Hem vwd propeptide ag lvl","description":"Hematology (von willebrand disease [vwd]), von willebrand propeptide, enzyme-linked immunosorbent assays (elisa), plasma, diagnostic report of von willebrand factor (vwf) propeptide antigen level","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5156","name":"Inj, tocilizumab-anoh, 1 mg","description":"Injection, tocilizumab-anoh (avtozma), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0490U","name":"Onc cutan/uveal mlnma cd146","description":"Onc cutan/uveal mlnma cd146","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1445","name":"Pp care visit by 12 weeks","description":"Postpartum care visit before or at 12 weeks of giving birth","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99403","name":"Prev med cnsl indiv apprx 45","description":"Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 45 minutes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":99.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01941","name":"Anes neuromd/ntrvrt crv/thrc","description":"Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0489U","name":"Ob sgnipt cfdna seq alys 1+","description":"Ob sgnipt cfdna seq alys 1+","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99213","name":"Office o/p est low 20 min","description":"Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 20 minutes must be met or e","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":108.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1807","name":"Inj, ethacrynate sod, 1 mg","description":"Injection, ethacrynate sodium, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49622","name":"Rpr parastomal hrna ncr/strn","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":509.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0580U","name":"Bbrgdrferi antb detc 24rprtn","description":"Bbrgdrferi antb detc 24rprtn","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1249","name":"Pt resp true imprt to me","description":"Patient responded completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0318U","name":"Ped whl gen mthyltn alys 50+","description":"Ped whl gen mthyltn alys 50+","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3911","name":"Intraorifice barrier","description":"Intraorifice barrier","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0466U","name":"Crd cad dna gwas 564856 snp","description":"Crd cad dna gwas 564856 snp","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0301U","name":"Iadna bartonella ddpcr","description":"Iadna bartonella ddpcr","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0519U","name":"Ther rx mntr meds p/d/a 110+","description":"Ther rx mntr meds p/d/a 110+","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15300","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2561","name":"Inj, sezaby, 1 mg","description":"Injection, phenobarbital sodium (sezaby), 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76830","name":"Transvaginal us non-ob","description":"Ultrasound, transvaginal","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37278","name":"Rvsc evsc fpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1240","name":"Pt no resp best int","description":"Patient did not respond to the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27592","name":"Amputate leg at thigh","description":"Amputation, thigh, through femur, any level; open, circular (guillotine)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":795.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7671","name":"Alveolus open reduction","description":"Alveolus - open reduction may include stabilization of teeth","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69209","name":"Remove impacted ear wax uni","description":"Removal impacted cerumen using irrigation/lavage, unilateral","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92945","name":"Prq trl rvs ch occ ant&rtrgr","description":"Percutaneous transluminal revascularization of chronic total occlusion, single coronary artery, coronary artery branch, or coronary artery bypass graft, and/or subtended major coronary artery branches of the bypass graft, any combination of intracoronary stent, atherectomy and angioplasty; combined ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92588","name":"Evoked auditory tst complete","description":"Distortion product evoked otoacoustic emissions; comprehensive diagnostic evaluation (quantitative analysis of outer hair cell function by cochlear mapping, minimum of 12 frequencies), with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0562","name":"Complex simulation w/pet-ct","description":"Therapeutic radiology simulation-aided field setting; complex, including acquisition of pet and ct imaging data required for radiopharmaceutical-directed radiation therapy treatment planning (i.e., modeling)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4345","name":"Matrix hd allogrft per sq cm","description":"Matrix hd allograft dermis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0128","name":"Corf skilled nursing service","description":"Direct (face-to-face with patient) skilled nursing services of a registered nurse provided in a comprehensive outpatient rehabilitation facility, each 10 minutes beyond the first 5 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80504","name":"Path clin consltj mod 21-40","description":"Pathology clinical consultation; for a moderately complex clinical problem, with review of patients history and medical records and moderate level of medical decision making when using time for code selection, 21-40 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0298U","name":"Onc pan tum whl trns seq rna","description":"Onc pan tum whl trns seq rna","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0622U","name":"Psyc mdd dna alys >20000","description":"Psyc mdd dna alys >20000","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85032","name":"Manual cell count each","description":"Blood count; manual cell count (erythrocyte, leukocyte, or platelet) each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37273","name":"Revsc evsc fpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0404U","name":"Onc brst semiq meas thym kn","description":"Onc brst semiq meas thym kn","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86825","name":"Hla x-math non-cytotoxic","description":"Human leukocyte antigen (hla) crossmatch, non-cytotoxic (eg, using flow cytometry); first serum sample or dilution","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1344","name":"No bsln/2nd pam score 4-12mo","description":"Patients who did not have a baseline pam score and/or a second score within 4 to 12 months of baseline pam score","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5765","name":"Liner compl/partial rem dent","description":"Liner compl/partial rem dent","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5411","name":"Dentures adjust cmplt mand","description":"Adjust complete denture - mandibular","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2015","name":"Phoenix wnd mtrx, per sq cm","description":"Phoenix wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3055","name":"Inj talquetamab-tgvs 0.25 mg","description":"Injection, talquetamab-tgvs, 0.25 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63052","name":"Lam facetc/frmt arthrd lum 1","description":"Laminectomy, facetectomy, or foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s] [eg, spinal or lateral recess stenosis]), during posterior interbody arthrodesis, lumbar; single vertebral segment (list separately in addition to code for primary ","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4276","name":"Orion, per sq cm","description":"Orion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1164","name":"Inj diltiazem in 0.72% nacl","description":"Injection, diltiazem hydrochloride in 0.72% sodium chloride, 0.5 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0376U","name":"Onc prst8 ca img alys 128","description":"Onc prst8 ca img alys 128","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11045","name":"Dbrdmt subq tiss each addl","description":"Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); each additional 20 sq cm, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":6.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":49.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64598","name":"Revj/rmvl nea pn w/int nstim","description":"Revision or removal of neurostimulator electrode array, peripheral nerve, with integrated neurostimulator","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80220","name":"Drug asy hydroxychloroquine","description":"Hydroxychloroquine","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0839T","name":"Dgtz gls mcrscp cslt mat prp","description":"Digitization of glass microscope slides for consultation and report on referred material requiring preparation of slides (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0950T","name":"Abltj b9 prst8 tissue hifu","description":"Ablation of benign prostate tissue, transrectal, with high intensity-focused ultrasound (hifu), including ultrasound guidance","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24346","name":"Reconstruct elbow med ligmnt","description":"Reconstruction medial collateral ligament, elbow, with tendon graft (includes harvesting of graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1261.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6624","name":"Inlay titanium","description":"Inlay - titanium","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4377","name":"Trigraft ft per sq cm","description":"Trigraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81451","name":"Hl neo gsap 5-50 rna alys","description":"Hematolymphoid neoplasm or disorder, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants, and copy number variants or rearrangements, or isoform expression or mrna expression levels, if performed; rna analysis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0376U","name":"Onc prst8 ca img alys 128","description":"Onc prst8 ca img alys 128","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0497U","name":"Onc prst8 mrna rt-pcr 6 gene","description":"Onc prst8 mrna rt-pcr 6 gene","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0625U","name":"Endocrinol op dna alys>5000","description":"Endocrinol op dna alys>5000","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62362","name":"Implant spine infusion pump","description":"Implantation or replacement of device for intrathecal or epidural drug infusion; programmable pump, including preparation of pump, with or without programming","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":569.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0937T","name":"Xtrnl ecg rec>15d<30d","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; including recording, scanning analysis with report, review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5141","name":"Inj adalimumab-aaty, 1 mg","description":"Injection, adalimumab-aaty, biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1496","name":"No doc of fall or poc","description":"Patients that had a fall who did not have a plan of care for falls documented or do not have documentation of being assessed for falls","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0039","name":"Pt no ref, rn spec","description":"Patient not referred, reason not otherwise specified","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23195","name":"Resection humeral head","description":"Resection, humeral head","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":878.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0942T","name":"Cysto flx rmv&rplc urtl scaf","description":"Cystourethroscopy, flexible; with removal and replacement of prostatic urethral scaffold","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1291","name":"Pt 66+ frailty and med dem","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1295","name":"Pt hx tot col or colon ca","description":"Patients with a diagnosis or past history of total colectomy or colorectal cancer","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69727","name":"Rmv ntr oi imp sk tc esp<100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0304U","name":"Hem rbc ads whl bld normoxic","description":"Hem rbc ads whl bld normoxic","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0183","name":"Software meas of cardiac vol","description":"Quantitative software measurements of cardiac volume, cardiac chambers volumes and left ventricular wall mass derived from ct scan(s) data of the chest/heart (with or without contrast)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4338","name":"Artacent velos, per sq cm","description":"Artacent velos, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0334U","name":"Onc sld orgn tgsa dna 84/+","description":"Onc sld orgn tgsa dna 84/+","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1163","name":"Pt anphx due to hpv bef 13","description":"Patient had anaphylaxis due to the hpv vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83013","name":"H pylori (c-13) breath","description":"Helicobacter pylori; breath test analysis for urease activity, non-radioactive isotope (eg, c-13)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98978","name":"Rtm dev sply cbt 16-30 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of cognitive behavioral therapy, 16-30 days in a 30-day period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5996","name":"Peri medicament w/seal, mand","description":"Peri medicament w/seal, mand","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4429","name":"Dermbnd chn, chx per sq cm","description":"Dermabind ch n or dermabind ch x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1269","name":"Recd esrd mcp lst day of mo","description":"Receiving esrd mcp dialysis services by the provider on the last day of the reporting month","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27465","name":"Shortening of thigh bone","description":"Osteoplasty, femur; shortening (excluding 64876)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1212.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1272","name":"Pts kid transplt wtlst","description":"Patients observed on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9247","name":"Mod sedation noniv-sub15min","description":"Mod sedation noniv-sub15min","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1362","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0722T","name":"Quan ct tiss charac w/ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained with concurrent ct examination of any structure contained in the concurrently acquired diagnostic imaging dataset (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0568U","name":"Neurol dementia bamyl ptau","description":"Neurol dementia bamyl ptau","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87086","name":"Urine culture/colony count","description":"Culture, bacterial; quantitative colony count, urine","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2007","name":"Restrata, per sq cm","description":"Restrata, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0422","name":"Collect & prep genetic samp","description":"Collect & prep genetic samp","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0265U","name":"Rar do whl gn&mtcdrl dna als","description":"Rare constitutional and other heritable disorders, whole- genome and mitochondrial dna sequence analysis, blood, frozen and formalin-fixed paraffin-embedded (ffpe) tissue, saliva, buccal swabs or cell lines, identification of single nucleotide and copy number variants","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27226","name":"Treat hip wall fracture","description":"Open treatment of posterior or anterior acetabular wall fracture, with internal fixation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1138.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63052","name":"Lam facetc/frmt arthrd lum 1","description":"Laminectomy, facetectomy, or foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s] [eg, spinal or lateral recess stenosis]), during posterior interbody arthrodesis, lumbar; single vertebral segment (list separately in addition to code for primary ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1263","name":"Pts hosp dialysis dt","description":"Patients in hospice on their initiation of dialysis date or during the month of evaluation","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0909T","name":"Rplcmt int nstim sys vgs nrv","description":"Replacement of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78491","name":"Myocrd img pet 1std rst/strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); single study, at rest or stress (exercise or pharmacologic)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1401.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4379","name":"Amniodefend ft per sq cm","description":"Amniodefend ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0494U","name":"Rbc ag ftl rhd gene alys ngs","description":"Rbc ag ftl rhd gene alys ngs","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0913T","name":"Prq tcat ther rx ntrac balo1","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting), including mechanical dilation by nondrug-delivery balloon angioplasty, endoluminal imaging using intravascular ultrasound (ivus) or optical coherence tomography (oct) when per","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64473","name":"Lwr xtr fscl pln blk uni njx","description":"Lower extremity fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32655","name":"Thoracoscopy resect bullae","description":"Thoracoscopy, surgical; with resection-plication of bullae, includes any pleural procedure when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":995.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99381","name":"Init pm e/m new pat infant","description":"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; infant (age youn","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":62.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4259","name":"Celera per sq cm","description":"Celera dual layer or celera dual membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0422U","name":"Onc pan solid tum alys dna","description":"Onc pan solid tum alys dna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0947T","name":"Mrgfus strtctc bl-br disrpj","description":"Magnetic resonance image guided low intensity focused ultrasound (mrgfus), stereotactic blood-brain barrier disruption using microbubble resonators to increase the concentration of blood-based biomarkers of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1150","name":"Lvef <=40% or mod/sev l vsf","description":"Current or prior left ventricular ejection fraction (lvef) less than or equal to 40% or documentation of moderately or severely depressed left ventricular systolic function","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0881T","name":"Cryotherapy oral cavity","description":"Cryotherapy of the oral cavity using temperature regulated fluid cooling system, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6212","name":"Bridge noble metal cast","description":"Pontic-cast noble metal","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4307","name":"American amnion, per sq cm","description":"American amnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6089","name":"Access/retorq implant screw","description":"Access/retorq implant screw","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54840","name":"Remove epididymis lesion","description":"Excision of spermatocele, with or without epididymectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2313","name":"Inj, naloxone (zimhi) 0.01mg","description":"Injection, naloxone hydrochloride (zimhi), 0.01 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71048","name":"X-ray exam chest 4+ views","description":"Radiologic examination, chest; 4 or more views","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8611","name":"Oral methotrexate (jylamvo)","description":"Methotrexate (jylamvo), oral, 2.5 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0598U","name":"Gi ibs igg antb 18food items","description":"Gi ibs igg antb 18food items","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31725","name":"Clearance of airways","description":"Catheter aspiration (separate procedure); tracheobronchial with fiberscope, bedside","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43889","name":"Gstr rstcv px trnsorl esg","description":"Gastric restrictive procedure, transoral, endoscopic sleeve gastroplasty (esg), including argon plasma coagulation, when performed","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9956","name":"Admin home sleep apnea test","description":"Admin home sleep apnea test","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0703","name":"2d oral/facial photo image","description":"2d oral/facial photo image","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1309","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"Basic vestibular evaluation","description":"Basic vestibular evaluation, includes spontaneous nystagmus test with eccentric gaze fixation nystagmus, with recording, positional nystagmus test, minimum of 4 positions, with recording, optokinetic nystagmus test, bidirectional foveal and peripheral stimulation, with recording, and oscillating tra","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1446","name":"Pt died bef end meas pd","description":"Patients who died any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0957T","name":"Rev s-sclp eltr ra rcvr&tlmt","description":"Revision of sub-scalp implanted electrode array, receiver, and telemetry unit for electrode, when required, including imaging guidance","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S4024","name":"Air polymer foam per study","description":"Air polymer-type a intrauterine foam, per study dose","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80432","name":"Insulin suppression panel","description":"Insulin-induced c-peptide suppression panel this panel must include the following: insulin (83525) c-peptide (84681 x 5) glucose (82947 x 5)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0614U","name":"Iem pmd alys 4 nzm cplx page","description":"Iem pmd alys 4 nzm cplx page","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98016","name":"Brief comunicaj tech-bsd svc","description":"Brief communication technology-based service (eg, virtual check-in) by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related evaluation and management service provided within the p","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2472","name":"Inj, pantoprazole sodium chl","description":"Injection, pantoprazole sodium in sodium chloride (baxter), 40 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4351","name":"Enclose tl matrix, per sq cm","description":"Enclose tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4406","name":"Xwrap fenestra per sq cm","description":"Xwrap fenestra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1952","name":"Leuprolide inj, camcevi, 1mg","description":"Leuprolide injectable, camcevi, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1313","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0946T","name":"Ortho impl mvmt alys pair ct","description":"Orthopedic implant movement analysis using paired computed tomography (ct) examination of the target structure, including data acquisition, data preparation and transmission, interpretation and report (including ct scan of the joint or extremity performed with paired views)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0532","name":"Take home supp nasal spray","description":"Take-home supply of nasal nalmefene hydrochloride; one carton of two, 2.7 mg per 0.1 ml nasal sprays (provision of the services by a medicare-enrolled opioid treatment program);( list separately in addition to each primary code)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1499","name":"Interventional radiology mvp","description":"Interventional radiology mips value pathway","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49613","name":"Rpr aa hrn rcr < 3 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, reducible","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4437","name":"Revival ac per sq cm","description":"Revival ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2018","name":"Permeaderm c, per sq cm","description":"Permeaderm c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1461","name":"Pt dx chron hepc","description":"Patient diagnosis for chronic hepatitis c","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0682T","name":"Removal pulse gen only isdss","description":"Removal of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93010","name":"Electrocardiogram report","description":"Electrocardiogram, routine ecg with at least 12 leads; interpretation and report only","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66991","name":"Xcapsl ctrc rmvl insj 1+","description":"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); with insertion of intraocular (eg, trabecular meshwork, supraciliary, suprachoroidal) anterior segment aqueous drai","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4270","name":"Complete sl per sq cm","description":"Complete sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6032","name":"Part handfng ultralite tcf/=","description":"Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1296","name":"Calc bmi norm parameters","description":"Bmi is documented within normal parameters and no follow-up plan is required","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0473U","name":"Onc sld tum bld/slv 648 gene","description":"Onc sld tum bld/slv 648 gene","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0136","name":"Inj, acetaminophen (b braun)","description":"Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93595","name":"L hrt cath chd nm/abn nt cnj","description":"Left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone, normal or abnormal native connections","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0498U","name":"Onc clrct ngs mut detc 43gen","description":"Onc clrct ngs mut detc 43gen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2267","name":"Inj, mirikizumab-mrkz, 1 mg","description":"Injection, mirikizumab-mrkz, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2041","name":"Coord special care encounter","description":"Coordinated specialty care, team-based, for first episode psychosis, per encounter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1398","name":"Bslne and  fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15016","name":"App skn cl ssp agrf t/a/l ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; each additional 480 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D8091","name":"Compre ortho treat w surg","description":"Compre ortho treat w surg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6611","name":"Grad com wrap w strap ak cus","description":"Gradient compression wrap with adjustable straps, above knee, each, custom","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1349","name":"No pam inc 3 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 3 points within a 4 to 12 month period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75680","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":747.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0968T","name":"Insj/rplcmt epcrnl nstim sys","description":"Insertion or replacement of epicranial neurostimulator system, including electrode array and pulse generator, with connection to electrode array","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76810","name":"Ob us >/= 14 wks addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2359","name":"Inj. olanzapine, 0.5mg","description":"Injection, olanzapine, 0.5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59160","name":"D & c after delivery","description":"Curettage, postpartum","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":182.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9954","name":"Fab/del oral appliance thxpy","description":"Fab/del oral appliance thxpy","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2021","name":"Inj, linezolid (hospira)","description":"Injection, linezolid (hospira), not therapeutically equivalent to j2020, 200 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49595","name":"Rpr aa hrn 1st > 10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, reducible","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76818","name":"Fetal biophys profile w/nst","description":"Fetal biophysical profile; with non-stress testing","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1330","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6211","name":"Bridge base metal cast","description":"Pontic-cast predominantly base metal","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5949","name":"Mand implt sup fix part","description":"Mand implt sup fix part","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1387","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1259","name":"Pt stat doc <= 1 yr dialysis","description":"Patient status documented within the first year of initiating dialysis","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0654","name":"Inj, liothyronine, 1 mcg","description":"Injection, liothyronine, 1 mcg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87469","name":"Babesia microti amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); babesia microti, amplified probe technique","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43312","name":"Repair esophagus and fistula","description":"Esophagoplasty (plastic repair or reconstruction), thoracic approach; with repair of tracheoesophageal fistula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1978.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0412U","name":"Beta amyloid ab42/40 imprcip","description":"Beta amyloid ab42/40 imprcip","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0930T","name":"Ephys eval ccm-d ld 1st impl","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), at time of initial implantation or replacement with testing of cardiac contrac","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1233","name":"Pt no hcv aby or result","description":"Patient does not receive hcv antibody test or patient does receive hcv antibody test but results not documented, reason not given","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0600U","name":"Nfct ds wnd infctj 65orgs&30","description":"Nfct ds wnd infctj 65orgs&30","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9888","name":"5% wl maintnd from bsline wt","description":"Maintenance 5% wl from baseline weight in months 7-12","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77417","name":"Ther radiology port image(s)","description":"Therapeutic radiology port image(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2050","name":"Financial mgt waiver/diem","description":"Financial management, self-directed, waiver; per diem","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4015","name":"Neurology ss","description":"Neurology mips specialty set","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31243","name":"Nsl/sinus ndsc cryoabltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by cryoablation, posterior nasal nerve","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92972","name":"Perq trluml coronry lithotrp","description":"Percutaneous transluminal coronary lithotripsy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32994","name":"Ablate pulm tumor perq crybl","description":"Ablation therapy for reduction or eradication of 1 or more pulmonary tumor(s) including pleura or chest wall when involved by tumor extension, percutaneous, including imaging guidance when performed, unilateral; cryoablation","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5345.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":424.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1377","name":"Fu colscop 10 yr doc w/ disc","description":"Recommended follow-up interval for repeat colonoscopy of 10 years documented  in colonoscopy report and communicated with patient","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8541","name":"Oral, hemady, 0.25 mg","description":"Dexamethasone (hemady), oral, 0.25 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6605","name":"G com bandage padded foam","description":"Gradient compression bandaging supply, padded foam, per linear yard, any width, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7521","name":"Tacrolim granules oral susp","description":"Tacrolimus, granules, oral suspension, 0.1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4396","name":"Natalin per sq cm","description":"Natalin, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49188","name":"Opn exc/dst ntra-abd 10.1-20","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 10.1 to 20 cm","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31081","name":"Removal of frontal sinus","description":"Sinusotomy frontal; obliterative, without osteoplastic flap, coronal incision (includes ablation)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1348.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4341","name":"Simplimax, per sq cm","description":"Simplimax, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5151","name":"Inj, eculizumab-aagh, 2 mg","description":"Injection, eculizumab-aagh (epysqli), biosimilar, 2 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0409U","name":"Onc sld tum dna 80 & rna 36","description":"Onc sld tum dna 80 & rna 36","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19294","name":"Prepj tum cav iort prtl mast","description":"Preparation of tumor cavity, with placement of a radiation therapy applicator for intraoperative radiation therapy (iort) concurrent with partial mastectomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4260","name":"Signature apatch, per sq cm","description":"Signature apatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2030","name":"Miro3d fibers, per mg","description":"Miro3d fibers, per milligram","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0593U","name":"Nfct ds gu pthgn dna 46trgt","description":"Nfct ds gu pthgn dna 46trgt","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8522","name":"Capecitabine, oral, 50 mg","description":"Capecitabine, oral, 50 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9052","name":"Inj, carmustine (accord)","description":"Injection, carmustine (accord), not therapeutically equivalent to j9050, 100 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86850","name":"Rbc antibody screen","description":"Antibody screen, rbc, each serum technique","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1026","name":"Pt hemo > 3mo","description":"The number of adult patient-months in the denominator who were on maintenance hemodialysis using a catheter continuously for three months or longer under the care of the same practitioner or group partner as of the last hemodialysis session of the reporting month","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0139","name":"Inj, adalimumab, 1 mg","description":"Injection, adalimumab, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1952","name":"Leuprolide inj, camcevi, 1mg","description":"Leuprolide injectable, camcevi, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0611U","name":"Onc lvr alys >1000 mr cfdna","description":"Onc lvr alys >1000 mr cfdna","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1186","name":"Pt w/ rx for hspc/plltv care","description":"Patients who have an order for or are receiving hospice or palliative care","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1001T","name":"Autol musc cell therapy njx","description":"Autologous muscle cell therapy, injection of muscle progenitor cells into the external anal sphincter, including ultrasound guidance, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33516","name":"Cabg vein six or more","description":"Coronary artery bypass, vein only; 6 or more coronary venous grafts","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2645.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84144","name":"Assay of progesterone","description":"Progesterone","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1340","name":"Indx whodas 2.0 or sds","description":"Index assessment completed using the 12-item whodas 2.0 or sds during the denominator identification period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3431","name":"Biological materials","description":"Biological materials","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25905","name":"Amputation of forearm","description":"Amputation, forearm, through radius and ulna; open, circular (guillotine)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1048.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9610","name":"Xe129 xenon, diagnostic","description":"Xenon xe-129 hyperpolarized gas, diagnostic, per study dose","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32405","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77406","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23350","name":"Injection for shoulder x-ray","description":"Injection procedure for shoulder arthrography or enhanced ct/mri shoulder arthrography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4269","name":"Surgraft xt per sq cm","description":"Surgraft xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69726","name":"Rmv ntr oi implt skl prq esp","description":"Removal, entire osseointegrated implant, skull; with percutaneous attachment to external speech processor","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0966T","name":"I&cst prp jw xpn dl arch fxd","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, fixed hinge mechanism","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2030","name":"Miro3d fibers, per mg","description":"Miro3d fibers, per milligram","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1472","name":"Hep b vaccine not received","description":"Patient did not receive recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49614","name":"Rpr aa hrn rcr < 3 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29055","name":"Appl cast shoulder spica","description":"Application, cast; shoulder spica","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0052","name":"Mmip mental health and care","description":"Missing and murdered indigenous persons (mmip) mental health and clinical care","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93585","name":"Vngrph chd azygs/hemiazygs","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; azygos/hemiazygos venous system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0689T","name":"Quan us tis charac w/o dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained without diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0542U","name":"Nefro renal trnspl ur nmr 84","description":"Nefro renal trnspl ur nmr 84","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5145","name":"Inj, abrilada, 1 mg","description":"Injection, adalimumab-afzb (abrilada), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57511","name":"Cryocautery of cervix","description":"Cautery of cervix; cryocautery, initial or repeat","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":220.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":151.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0960T","name":"Rpl s-sclp eltr ra rcvr&tlmt","description":"Replacement of sub-scalp implanted electrode array, receiver, and telemetry unit with tunneling of electrode for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37276","name":"Rvsc evsc fpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4270","name":"Complete sl per sq cm","description":"Complete sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7295","name":"Eth estr and eton monthly","description":"Ethinyl estradiol and etonogestrel 0.015mg, 0.12mg per 24 hours; monthly vaginal ring, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1357","name":"Pt w/red suic idea 120 days","description":"Patients who had a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62331","name":"Dcmprn prq rmv lig flv addl","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; additional interspace(s), lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0515U","name":"Gi ibd ia quan deter ifx lvl","description":"Gi ibd ia quan deter ifx lvl","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87153","name":"Dna/rna sequencing","description":"Culture, typing; identification by nucleic acid sequencing method, each isolate (eg, sequencing of the 16s rrna gene)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0858T","name":"Ext trnscranl mag stimj meas","description":"Externally applied transcranial magnetic stimulation with concomitant measurement of evoked cortical potentials with automated report","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0910T","name":"Rmvl int nstim sys vagus nrv","description":"Removal of integrated neurostimulation system, vagus nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22220","name":"Osteot dsc ant 1 vrt sgm crv","description":"Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; cervical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1850.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1713","name":"Pfizer vacc adm ped 1st dose","description":"Pfizer vacc adm ped 1st dose","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0891","name":"Argatroban nonesrd (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27594","name":"Amputation follow-up surgery","description":"Amputation, thigh, through femur, any level; secondary closure or scar revision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":593.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76801","name":"Ob us < 14 wks single fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0041","name":"Pt/ptn decln referral","description":"Patient and/or care partner decline referral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3402","name":"Inj. remestemcel-l-rknd/ td","description":"Injection, remestemcel-l-rknd, per therapeutic dose","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75966","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":890.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82947","name":"Assay glucose blood quant","description":"Glucose; quantitative, blood (except reagent strip)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0426","name":"Coll, analys of saliva","description":"Coll, analys of saliva","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1266","name":"Pts admit snf","description":"Patients admitted to a skilled nursing facility (snf)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15170","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1408","name":"Gmln brca bef dx ca","description":"Patients who have germline brca testing completed before diagnosis of epithelial ovarian, fallopian tube, or primary peritoneal cancer","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4329","name":"Singlay, per sq cm","description":"Singlay, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4253","name":"Zenith amniotic membrane psc","description":"Zenith amniotic membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98004","name":"Synch audio-video est sf 10","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 10 minutes must be met or e","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3473","name":"Surg rep root res molar","description":"Surg rep root res molar","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1462","name":"Pt clin ind hd image","description":"Patients with clinical indications for imaging of the head","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0703","name":"Inj, cefepime hcl (b braun)","description":"Injection, cefepime hydrochloride (b braun), not therapeutically equivalent to maxipime, 500 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91100","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1247","name":"Pt resp true best int","description":"Patient responded completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0049","name":"Main hemo in-cntr","description":"With maintenance hemodialysis (in-center and home hd) for the complete reporting month","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0300U","name":"Onc pan tum whl gen seq&opt","description":"Onc pan tum whl gen seq&opt","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1173","name":"Pt no rec td/tdap 9yrs prior","description":"Patient did not receive at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0940T","name":"Xtrnl ecg rec>15d<30d r&i","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1476","name":"Pt dx cog imp or ad","description":"Patients with diagnosis of cognitive impairment or alzheimers disease","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92920","name":"Prq trluml c angiop 1art&/br","description":"Percutaneous transluminal coronary angioplasty, single major coronary artery and/or its branch(es)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0888T","name":"Histotripsy mal renal tissue","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant renal tissue, including imaging guidance","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99255","name":"Ip/obs consltj new/est hi 80","description":"Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 80 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87594","name":"Pneumcysts jirovecii amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); pneumocystis jirovecii, amplified probe technique","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9345","name":"Inj, retifanlimab-dlwr, 1 mg","description":"Injection, retifanlimab-dlwr, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1211","name":"Gsa level>9.0%","description":"Most recent glycemic status assessment (hba1c or gmi) level > 9.0%","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0691T","name":"Auto alys xst ct std vrt fx","description":"Automated analysis of an existing computed tomography study for vertebral fracture(s), including assessment of bone density when performed, data preparation, interpretation, and report","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85660","name":"Rbc sickle cell test","description":"Sickling of rbc, reduction","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5149","name":"Inj, aflibercept-abzv, 1 mg","description":"Injection, aflibercept-abzv (enzeevu), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37215","name":"Transcath stent cca w/eps","description":"Transcatheter placement of intravascular stent(s), cervical carotid artery, open or percutaneous, including angioplasty, when performed, and radiological supervision and interpretation; with distal embolic protection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1261.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70120","name":"X-ray exam of mastoids","description":"Radiologic examination, mastoids; less than 3 views per side","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0921T","name":"Rmvl perm ccm-d sys 1 dfb ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous defibrillation lead only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0607U","name":"Reprdtve med ema rtpcr 31bct","description":"Reprdtve med ema rtpcr 31bct","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0765T","name":"Asstv alg ecg rsk asmt prev","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to previously performed electrocardiogram","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1502","name":"Podiatry mvp","description":"Podiatry mips value pathway","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98977","name":"Rtm dev sply mscskl 16-30 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of musculoskeletal system, 16-30 days in a 30-day period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0476","name":"Baclofen intrathecal trial","description":"Injection, baclofen, 50 mcg for intrathecal trial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1315","name":"Crc no doc no rsn","description":"Colorectal cancer screening results were not documented and reviewed; reason not otherwise specified","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4320","name":"Pellograft, per sq cm","description":"Pellograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5947","name":"Mand implt sup fix","description":"Mand implt sup fix","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1598","name":"Inj glycopyrrolate fres kabi","description":"Injection, glycopyrrolate (fresenius kabi), not therapeutically equivalent to j1596, 0.1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1268","name":"Pt ac stat kid trnsplt wtlst","description":"Patients observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5227","name":"Immed max part denture","description":"Immed max part denture","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4271","name":"Complete ft per sq cm","description":"Complete ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0734T","name":"Rem r-t mtn nrehab tx mgmt","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; treatment management services by a physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1223","name":"Glaucoma plan of care doc","description":"Glaucoma plan of care documented","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0743T","name":"B1 str & fx rsk vrt fx assmt","description":"Bone strength and fracture risk using finite element analysis of functional data and bone mineral density (bmd), with concurrent vertebral fracture assessment, utilizing data from a computed tomography scan, retrieval and transmission of the scan data, measurement of bone strength and bmd and classi","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1228","name":"Pt + hcv aby +vir w/ rx 3 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, has hcv treatment initiated within 3 months of the reactive hcv antibody test","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1164","name":"Inj diltiazem in 0.72% nacl","description":"Injection, diltiazem hydrochloride in 0.72% sodium chloride, 0.5 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9601","name":"Inj linvoseltamab-gcpt 1 mg","description":"Injection, linvoseltamab-gcpt, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52597","name":"Trurl rbtc wtrjt rescj prst8","description":"Transurethral robotic-assisted waterjet resection of prostate, including intraoperative planning, ultrasound guidance, control of postoperative bleeding, complete, including vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy, when performed","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95919","name":"Quan puplmtry phy/qhp uni/bi","description":"Quantitative pupillometry with physician or other qualified health care professional interpretation and report, unilateral or bilateral","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0947T","name":"Mrgfus strtctc bl-br disrpj","description":"Magnetic resonance image guided low intensity focused ultrasound (mrgfus), stereotactic blood-brain barrier disruption using microbubble resonators to increase the concentration of blood-based biomarkers of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0835T","name":"Dgtz gls mcrscp fna 1st ea","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96548","name":"Ntraop hipec px ea add 30min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59510","name":"Cesarean delivery","description":"Routine obstetric care including antepartum care, cesarean delivery, and postpartum care","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2310.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1488","name":"Dx dementia in msr timeframe","description":"Patients with a diagnosis for dementia in the year before or during the period of evaluation","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1833","name":"Ko adj jnt pos r sup pre ots","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":503.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1342","name":"Pts died perf per","description":"Patients who died during the performance period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0224","name":"Pemivibart infusion","description":"Intravenous infusion, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppr","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4019","name":"Oncology/hema ss","description":"Oncology/hematology mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0447","name":"Behavior counsel obesity 15m","description":"Face-to-face behavioral counseling for obesity, 15 minutes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":36.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4386","name":"Acesso trifaca per sq cm","description":"Acesso trifaca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6561","name":"G stockng full/chap 40+ cust","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, custom, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52597","name":"Trurl rbtc wtrjt rescj prst8","description":"Transurethral robotic-assisted waterjet resection of prostate, including intraoperative planning, ultrasound guidance, control of postoperative bleeding, complete, including vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy, when performed","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25443","name":"Arthrp prostc dstl scph crpl","description":"Arthroplasty with prosthetic replacement; scaphoid carpal (navicular)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4295","name":"Amnio tri-core, per sq cm","description":"Amnio tri-core amniotic, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44397","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2801","name":"Inj, rykindo, 0.5 mg","description":"Injection, risperidone (rykindo), 0.5 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1025T","name":"Alt elec fld dos&dlv sim mdl","description":"Alternating electric fields dosimetry and delivery-simulation modeling, creation and selection of patient-specific array layouts, and placement verification","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86632","name":"Chlamydia igm antibody","description":"Antibody; chlamydia, igm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0550","name":"Phone/inter for dx/treat >5m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a written report to the patients treating/r","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85007","name":"Bl smear w/diff wbc count","description":"Blood count; blood smear, microscopic examination with manual differential wbc count","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4287","name":"Disp col sto bag breast milk","description":"Disposable collection and storage bag for breast milk, any size, any type, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0372","name":"Tomo comp series images","description":"Tomo comp series images","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4288","name":"Dermabind ch, per sq cm","description":"Dermabind ch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66020","name":"Injection treatment of eye","description":"Injection, anterior chamber of eye (separate procedure); air or liquid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80505","name":"Path clin consltj high 41-60","description":"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patients history and medical records and high level of medical decision making when using time for code selection, 41-60 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1300","name":"Flu imm no admin doc rea","description":"Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0031","name":"Pall serv during meas","description":"Palliative care services given to patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35636","name":"Bpg splenorenal","description":"Bypass graft, with other than vein; splenorenal (splenic to renal arterial anastomosis)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2047.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39561","name":"Resect diaphragm complex","description":"Resection, diaphragm; with complex repair (eg, prosthetic material, local muscle flap)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1309.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7023","name":"Mech allergen parti barrier","description":"Mechanical allergen particle barrier/inhalation filter, cream, nasal, topical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1244","name":"Pt othr thn true best int","description":"Patient provided a response other than completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0955T","name":"Tot impl amei removal","description":"Totally implantable active middle ear hearing implant; removal, including removal of sound processor and all implant components","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0430U","name":"Gi malabs aat calpro pncrtc","description":"Gi malabs aat calpro pncrtc","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1598","name":"Inj glycopyrrolate fres kabi","description":"Injection, glycopyrrolate (fresenius kabi), not therapeutically equivalent to j1596, 0.1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1358","name":"Pts no <suicd idea 120 dys","description":"Patients who did not have a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4273","name":"Esano aaa, per sq cm","description":"Esano aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0037","name":"Pt not able to participate","description":"On date of encounter, patient is not able to participate in assessment or screening, including non-verbal patients, delirious, severely aphasic, severely developmentally delayed, severe visual or hearing impairment and for those patients, no knowledgeable informant available","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0925T","name":"Rlcj skin pocket ccm-d pg","description":"Relocation of skin pocket for implanted cardiac contractility modulation-defibrillation pulse generator","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0168","name":"Epinephrine (intl med sys)","description":"Injection, epinephrine (international medication systems), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1337","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45347","name":"Sigmoidoscopy w/plcmt stent","description":"Sigmoidoscopy, flexible; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64628","name":"Trml dstrj ios bvn 1st 2 l/s","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; first 2 vertebral bodies, lumbar or sacral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86305","name":"Human epididymis protein 4","description":"Human epididymis protein 4 (he4)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0617U","name":"Cv ascvd dna alys >20000","description":"Cv ascvd dna alys >20000","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1343","name":"Pt pam lvl 4 base or srt lin","description":"Patients who are at pam level 4 at baseline or patients who are flagged with extreme straight line response sets on the pam or with excessive missing responses","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42870","name":"Excision of lingual tonsil","description":"Excision or destruction lingual tonsil, any method (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":657.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7413","name":"Excision malig lesion<=1.25c","description":"Excision of malignant lesion up to 1.25 cm","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0387","name":"Comp image capture only","description":"Comp image capture only","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1186","name":"Pt w/ rx for hspc/plltv care","description":"Patients who have an order for or are receiving hospice or palliative care","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67316","name":"Revise two eye muscles","description":"Strabismus surgery, recession or resection procedure; 2 or more vertical muscles (excluding superior oblique)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":780.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37287","name":"Revsc evasc tpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1736","name":"Inj meloxicam (delova) 1mg","description":"Injection, meloxicam (delova), 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0355U","name":"Apol1 risk variants","description":"Apol1 risk variants","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4406","name":"Xwrap fenestra per sq cm","description":"Xwrap fenestra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2035","name":"Corpl p therac p allac p mg","description":"Corplex p or theracor p or allacor p, per milligram","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7284","name":"Exc biopsy of saliv glands","description":"Exc biopsy of saliv glands","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1360","name":"Suicd c-ssrs assessment","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0545U","name":"Achr antb id imfluor livecll","description":"Achr antb id imfluor livecll","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0999T","name":"Autol musc cell therapy hrvg","description":"Autologous muscle cell therapy, harvesting of muscle progenitor cells, including ultrasound guidance, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2041","name":"Coord special care encounter","description":"Coordinated specialty care, team-based, for first episode psychosis, per encounter","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86023","name":"Immunoglobulin assay","description":"Antibody identification; platelet associated immunoglobulin assay","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2356","name":"Inj tezepelumab-ekko, 1mg","description":"Injection, tezepelumab-ekko, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2012","name":"Suprathel, per sq cm","description":"Suprathel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0235","name":"Inj, monoclon antibody, 1 mg","description":"Injection, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extraco","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1394","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0289","name":"Amphotericin b liposome inj","description":"Injection, amphotericin b liposome, 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0857T","name":"Opto-acoustic img breast uni","description":"Opto-acoustic imaging, breast, unilateral, including axilla when performed, real-time with image documentation, augmentative analysis and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83518","name":"Immunoassay dipstick","description":"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, single step method (eg, reagent strip)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6601","name":"Porc/ceram inlay >= 3 surfac","description":"Inlay - porcelain/ceramic three or more surfaces","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98009","name":"Synch audio-only new low 30","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 30 m","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4024","name":"Pediatrics ss","description":"Pediatrics mips specialty set","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60660","name":"Abltj 1/+thyr ndul 1lobe prq","description":"Ablation of 1 or more thyroid nodule(s), one lobe or the isthmus, percutaneous, including imaging guidance, radiofrequency","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0047","name":"Ped blunt hd traum","description":"Pediatric patient with minor blunt head trauma and pecarn prediction criteria are not assessed","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0987T","name":"Iv img icr cere vsl oct ea","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63032","name":"Lamot rpr anulr dfct 1 lmbr","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; with repair of annular defect by implantation of bone-anchored annular closure device, including all imaging guidance, 1 interspace, lumbar","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93587","name":"Vngrph chd vnvn cltrl at/abv","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating at or above the heart (eg, from innominate vein) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99242","name":"Off/op consltj new/est sf 20","description":"Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":86.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":62.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0533U","name":"Rx metab advrs gnotyp 16gens","description":"Rx metab advrs gnotyp 16gens","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92635","name":"Hearing aid fitg svc ea addl","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; each additional 15 minutes (list separately in addition to code","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0365U","name":"Onc bldr 10 prb bldr ca","description":"Onc bldr 10 prb bldr ca","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0952T","name":"Tot impl amei rev/rplc mstdc","description":"Totally implantable active middle ear hearing implant; revision or replacement, with mastoidectomy and replacement of sound processor","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21813","name":"Treatment of rib fracture","description":"Open treatment of rib fracture(s) with internal fixation, includes thoracoscopic visualization when performed, unilateral; 7 or more ribs","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":981.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2730","name":"Pralidoxime chloride inj","description":"Injection, pralidoxime chloride, up to 1 gm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2184","name":"Inj, meropenem (b. braun)","description":"Injection, meropenem (b. braun), not therapeutically equivalent to j2185, 100 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86744","name":"Nocardia antibody","description":"Antibody; nocardia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5421","name":"Dentures adjust part maxill","description":"Adjust partial denture - maxillary","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1337","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0183","name":"Software meas of cardiac vol","description":"Quantitative software measurements of cardiac volume, cardiac chambers volumes and left ventricular wall mass derived from ct scan(s) data of the chest/heart (with or without contrast)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33902","name":"Perq p-art revsc 1 abnor uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, unilateral","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0272U","name":"Hem genetic bld do 51 genes","description":"Hematology (genetic bleeding disorders), genomic sequence analysis of 51 genes, blood, buccal swab, or amniotic fluid, comprehensive","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74305","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0356U","name":"Onc orop 17 dna ddpcr alg","description":"Onc orop 17 dna ddpcr alg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35642","name":"Bpg carotid-vertebral","description":"Bypass graft, with other than vein; carotid-vertebral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1289.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4269","name":"Surgraft xt per sq cm","description":"Surgraft xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33895","name":"Evasc st rpr thrc/aa x crsg","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; not crossing major side branches","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0359U","name":"Onc prst8 ca alys all psa","description":"Onc prst8 ca alys all psa","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4427","name":"Dermbnd dln dl+ dlx sq cm","description":"Dermabind dl n or dermabind dl + or dermabind dl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1432","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0595U","name":"Nfct ds tfp vctrbrn&zoonotic","description":"Nfct ds tfp vctrbrn&zoonotic","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2281","name":"Inj moxifloxacin (fres kabi)","description":"Injection, moxifloxacin (fresenius kabi), not therapeutically equivalent to j2280, 100 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7957","name":"Tiss regen edent nonresorb","description":"Tiss regen edent nonresorb","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"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":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4364","name":"Am bur xp mem xpl hy p sq cm","description":"Amnio burgeon xplus membrane and xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0175","name":"Inj, donanemab-azbt, 2 mg","description":"Injection, donanemab-azbt, 2 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1033","name":"Sv doula brth wrk per diem","description":"Services performed by a doula birth worker, per diem","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41800","name":"Drainage of gum lesion","description":"Drainage of abscess, cyst, hematoma from dentoalveolar structures","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1418","name":"Med rsn not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination because of a medical contraindication documented by clinician","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0681","name":"App of non-sheet skin sub","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; first 25 sq cm or less of wound surface area","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65410","name":"Biopsy of cornea","description":"Biopsy of cornea","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0423U","name":"Psyc genomic alys pnl 26 gen","description":"Psyc genomic alys pnl 26 gen","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9282","name":"Mitomycin intravesical inst","description":"Mitomycin, intravesical instillation, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28220","name":"Release of foot tendon","description":"Tenolysis, flexor, foot; single tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0738","name":"Upper extremity rehab","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1203","name":"No rsn ace-i/arb rx","description":"Ace inhibitor or arb therapy not prescribed during the measurement period, reason not given","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1333","name":"Acute vitreous hemorrhage","description":"Acute vitreous hemorrhage","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1414","name":"Inj, beqvez, per tx dose","description":"Injection, fidanacogene elaparvovec-dzkt, per therapeutic dose","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36405","name":"Vnpnxr<3yrs phy/qhp scalp vn","description":"Venipuncture, younger than age 3 years, necessitating the skill of a physician or other qualified health care professional, not to be used for routine venipuncture; scalp vein","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":13.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81451","name":"Hl neo gsap 5-50 rna alys","description":"Hematolymphoid neoplasm or disorder, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants, and copy number variants or rearrangements, or isoform expression or mrna expression levels, if performed; rna analysis","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4272","name":"Esano a, per sq cm","description":"Esano a, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87181","name":"Sc std agar dilution per agt","description":"Susceptibility studies, antimicrobial agent; agar dilution method, per agent (eg, antibiotic gradient strip)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0317U","name":"Onc lung ca 4-prb fish assay","description":"Onc lung ca 4-prb fish assay","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4319","name":"Sanograft, per sq cm","description":"Sanograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77336","name":"Radiation physics consult","description":"Continuing medical physics consultation, including assessment of treatment parameters, quality assurance of dose delivery, and review of patient treatment documentation in support of the radiation oncologist, reported per week of therapy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25535","name":"Cltx ulnar shft fx w/mnpj","description":"Closed treatment of ulnar shaft fracture; with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98977","name":"Rtm dev sply mscskl 16-30 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of musculoskeletal system, 16-30 days in a 30-day period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62270","name":"Dx lmbr spi pnxr","description":"Spinal puncture, lumbar, diagnostic;","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":192.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0919T","name":"Rmvl perm ccm-d sys pg only","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); pulse generator only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16015","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2221","name":"Ank mcrop plant & dorsi flex","description":"Addition to lower extremity orthosis, ankle system, microprocessor-controlled feature plantarflexion and/or dorsiflexion, includes power source","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1167","name":"Hspc dur meas pd","description":"In hospice or using hospice services during the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81001","name":"Urinalysis auto w/scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; automated, with microscopy","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55869","name":"Lap srg prst8ct bi pl lmphad","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2010","name":"Apis, per square centimeter","description":"Apis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3471","name":"Surg rep root res anterior","description":"Surg rep root res anterior","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0566U","name":"Onc lng qpcr-bsd alys 13dmrs","description":"Onc lng qpcr-bsd alys 13dmrs","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0514U","name":"Gi ibd ia quan deter adl lvl","description":"Gi ibd ia quan deter adl lvl","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53865","name":"Cysto insj dev ischmc rmdlg","description":"Cystourethroscopy with insertion of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1848","name":"Ko dbl upright w/air pre ots","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated, off-the-shelf","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":689.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1306","name":"Pt anphx due to pneum","description":"Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0234","name":"Intra inf, toci, second dos","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2794","name":"Crown-titanium","description":"Crown-titanium","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35226","name":"Repair blood vessel dir lxtr","description":"Repair blood vessel, direct; lower extremity","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1072.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81195","name":"Cytog genom-wid alys hem mal","description":"Cytogenomic (genome-wide) analysis, hematologic malignancy, structural variants and copy number variants, optical genome mapping (ogm)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1236","name":"Baseline mrs > 2","description":"Baseline mrs > 2","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0812T","name":"Rem mlt day uroflow dev sply","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); device supply with automated report generation, up to 10 days","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0404U","name":"Onc brst semiq meas thym kn","description":"Onc brst semiq meas thym kn","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26516","name":"Fusion of knuckle joint","description":"Capsulodesis, metacarpophalangeal joint; single digit","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":946.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0837T","name":"Dgtz gls mcrscp fna i&r","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; interpretation and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0627U","name":"Psyc scz dna alys >15000","description":"Psyc scz dna alys >15000","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9156","name":"Oral mucoadhesive per 1 ml","description":"Oral mucoadhesive, any type (liquid, gel, paste, etc.), per 1 ml","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1454","name":"New cied","description":"New cied","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1473","name":"Pt func cap not allow impr","description":"Patient situations, at any point during the denominator identification period, where the patients functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools, such as delirium, dementia, intellectual disabilities, and pervasive and specific de","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4361","name":"Epixpress, per sq cm","description":"Epixpress, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15018","name":"App skn cll ssp f/n/g/hf ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 480 sq cm or part thereof (list separately in addition to code for prima","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3379","name":"Inj, valproate sod, 5 mg","description":"Injection, valproate sodium, 5 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2021","name":"Neomatrix per sq cm","description":"Neomatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0905T","name":"Ecg alg 12 ld rdcd i&r only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; interpretation and report only","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1265","name":"Cms 2728 completed","description":"Cms medical evidence form 2728 for dialysis patients: initial form completed","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9612","name":"Thera par drugs 2 or > admin","description":"Therapeutic parenteral drugs two or more administrations different medications","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9322","name":"Inj pemetrexed (bluepoint)","description":"Injection, pemetrexed (bluepoint), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76519","name":"Echo exam of eye","description":"Ophthalmic biometry by ultrasound echography, a-scan; with intraocular lens power calculation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0310U","name":"Ped vsclts kd alys 3 bmrks","description":"Ped vsclts kd alys 3 bmrks","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25600","name":"Cltx dst rdl fx/ephys sep wo","description":"Closed treatment of distal radial fracture (eg, colles or smith type) or epiphyseal separation, includes closed treatment of fracture of ulnar styloid, when performed; without manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6611","name":"Onlay cst hgh nbl mtl >=3srf","description":"Onlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88162","name":"Cytopath smear other source","description":"Cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54112","name":"Treat penis lesion graft","description":"Excision of penile plaque (peyronie disease); with graft greater than 5 cm in length","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1037.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1806","name":"Inj esmolol hcl wg crit care","description":"Injection, esmolol hydrochloride (wg critical care), not therapeutically equivalent to j1805, 10 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1300","name":"Flu imm no admin doc rea","description":"Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0978T","name":"Submucosal cryolysis therapy","description":"Submucosal cryolysis therapy; soft palate, base of tongue, and lingual tonsil","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1234","name":"Pt hcv rctv aby f/u neg","description":"Patient has a reactive hcv antibody test, and has a follow up hcv viral test that does not detect hcv viremia","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82962","name":"Glucose blood test","description":"Glucose, blood by glucose monitoring device(s) cleared by the fda specifically for home use","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4258","name":"Enverse, per sq cm","description":"Enverse, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5947","name":"Mand implt sup fix","description":"Mand implt sup fix","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0865T","name":"Quan mri alys brn w/o dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion identification, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transm","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77401","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4280","name":"Xcell amnio matrix per sq cm","description":"Xcell amnio matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90460","name":"Im admin 1st/only component","description":"Immunization administration through 18 years of age via any route of administration, with counseling by physician or other qualified health care professional; first or only component of each vaccine or toxoid administered","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":27.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01940","name":"Anes nulyt agt lmbr/sac","description":"Anesthesia for percutaneous image-guided destruction procedures by neurolytic agent on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73720","name":"Mri lwr extremity w/o&w/dye","description":"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1377.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1202","name":"Pt rsn no ace-i/arb rx","description":"Documentation of patient reason(s) for not prescribing ace inhibitor or arb therapy during the measurement period, (e.g., patient declined, other patient reasons)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0589","name":"Inj daxibotulinumtoxina-lanm","description":"Injection, daxibotulinumtoxina-lanm, 1 unit","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0912T","name":"Elec alys nstim sys vgs smpl","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; with simple programming by physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1267","name":"Pt no act kid transplt wtlst","description":"Patients not observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1492","name":"No reported fall","description":"Patients who did not report a fall","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4288","name":"Dermabind ch, per sq cm","description":"Dermabind ch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93897","name":"Emboli detcj wo iv mbubb njx","description":"Emboli detection without intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4002","name":"Ep cardio ss","description":"Electrophysiology cardiac specialist mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0582U","name":"Rare ds rpd whlgen dna vrnts","description":"Rare ds rpd whlgen dna vrnts","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0787T","name":"Revj/rmvl nea sac w/nstim","description":"Revision or removal of neurostimulator electrode array, sacral, with integrated neurostimulator","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33276","name":"Insj phrnc nrv stim sys","description":"Insertion of phrenic nerve stimulator system (pulse generator and stimulating lead[s]), including vessel catheterization, all imaging guidance, and pulse generator initial analysis with diagnostic mode activation, when performed","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0608U","name":"Reprdtve med ema rtpcr 10bct","description":"Reprdtve med ema rtpcr 10bct","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9154","name":"Artificial saliva, 1 ml","description":"Artificial saliva, 1 ml","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74019","name":"Radex abdomen 2 views","description":"Radiologic examination, abdomen; 2 views","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0394U","name":"Pfas 16 pfas compnd lc ms/ms","description":"Pfas 16 pfas compnd lc ms/ms","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4282","name":"Cygnus dual per sq cm","description":"Cygnus dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87086","name":"Urine culture/colony count","description":"Culture, bacterial; quantitative colony count, urine","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0535","name":"Pt navigat svs direct/ref","description":"Patient navigational services, provided directly or by referral; including helping the patient to navigate health systems and identify care providers and supportive services, to build patient self-advocacy and communication skills with care providers, and to promote patient-driven action plans and g","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0514U","name":"Gi ibd ia quan deter adl lvl","description":"Gi ibd ia quan deter adl lvl","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9324","name":"Inj, pemrydi rtu, 10 mg","description":"Injection, pemetrexed (pemrydi rtu), 10 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0687","name":"Inj cefazolin (wg crit care)","description":"Injection, cefazolin sodium (wg critical care), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0773T","name":"Vr px dissoc svc oth phy 1st","description":"Virtual reality (vr) procedural dissociation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports; initial 15 min","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0905T","name":"Ecg alg 12 ld rdcd i&r only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; interpretation and report only","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1473","name":"Pt func cap not allow impr","description":"Patient situations, at any point during the denominator identification period, where the patients functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools, such as delirium, dementia, intellectual disabilities, and pervasive and specific de","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9071","name":"Inj cyclophosphamd auromedic","description":"Injection, cyclophosphamide (auromedics), 5 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0692T","name":"Therapeutic ultrafiltration","description":"Therapeutic ultrafiltration","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11422","name":"Exc h-f-nk-sp b9+marg 1.1-2","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 1.1 to 2.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0831T","name":"Dgtz gls mcrscp cytp c/v","description":"Digitization of glass microscope slides for cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2184","name":"Inj, meropenem (b. braun)","description":"Injection, meropenem (b. braun), not therapeutically equivalent to j2185, 100 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0292U","name":"Psyc strs do mrna 72 genes","description":"Psyc strs do mrna 72 genes","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16020","name":"Dress/debrid p-thick burn s","description":"Dressings and/or debridement of partial-thickness burns, initial or subsequent; small (less than 5% total body surface area)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":107.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0439U","name":"Crd chd dna alys 5 snp 3 dna","description":"Crd chd dna alys 5 snp 3 dna","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2351","name":"Inj ocrelizumab 1mg hya-ocsq","description":"Injection, ocrelizumab, 1 mg and hyaluronidase-ocsq","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0878T","name":"Augmnt alys ch ct ild w/ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained with concurrent ct examination of the same structure","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1500","name":"Neuropsychology mvp","description":"Neuropsychology mips value pathway","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2956","name":"Indirect rest remov","description":"Indirect rest remov","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7173","name":"Inj. concizumab-mtci, 0.5 mg","description":"Injection, concizumab-mtci, 0.5 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60660","name":"Abltj 1/+thyr ndul 1lobe prq","description":"Ablation of 1 or more thyroid nodule(s), one lobe or the isthmus, percutaneous, including imaging guidance, radiofrequency","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1311","name":"Aphlx to vax bef enc","description":"Anaphylaxis due to the vaccine on or before the date of the encounter","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64657","name":"Rmvl bat modulj sys tot sys","description":"Removal of baroreflex activation therapy (bat) modulation system; total system, including lead and pulse generator","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64466","name":"Thrc fascial pln blk uni njx","description":"Thoracic fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64722","name":"Decompression unspec nerve","description":"Decompression; unspecified nerve(s) (specify)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":369.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28600","name":"Treat foot dislocation","description":"Closed treatment of tarsometatarsal joint dislocation; without anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0773T","name":"Vr px dissoc svc oth phy 1st","description":"Virtual reality (vr) procedural dissociation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports; initial 15 min","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5127","name":"Inj, stimufend, 0.5 mg","description":"Injection, pegfilgrastim-fpgk (stimufend), biosimilar, 0.5 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1019T","name":"Lymphovenous bypass per xtr","description":"Lymphovenous bypass, including robotic assistance, when performed, per extremity","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75984","name":"Xray control catheter change","description":"Change of percutaneous tube or drainage catheter with contrast monitoring (eg, genitourinary system, abscess), radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0856T","name":"Dgtz gls mcrscp electron mic","description":"Digitization of glass microscope slides for electron microscopy, diagnostic (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0884T","name":"Esphgsc flx 1st tndsc dilat","description":"Esophagoscopy, flexible, transoral, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for esophageal stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5940","name":"Resct proth max part remov","description":"Resct proth max part remov","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86805","name":"Lymphocytotoxicity assay","description":"Lymphocytotoxicity assay, visual crossmatch; with titration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1022T","name":"Prq tis dsplmt ntra-abdl/pel","description":"Percutaneous tissue displacement, any method, including imaging guidance; intra-abdominal/pelvic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1485","name":"Neg viro resp hep c/qual rna","description":"Patients who did not achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4375","name":"Duograft ac per sq cm","description":"Duograft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1206","name":"Isa not red 3pts/no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7298","name":"Remove screw retained plate","description":"Remove screw retained plate","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63102","name":"Remove vert body dcmprn lmbr","description":"Vertebral corpectomy (vertebral body resection), partial or complete, lateral extracavitary approach with decompression of spinal cord and/or nerve root(s) (eg, for tumor or retropulsed bone fragments); lumbar, single segment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2576.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1281","name":"Bp scrn no perf at interval","description":"Blood pressure reading not documented, reason not given","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95813","name":"Eeg extnd mntr 61-119 min","description":"Electroencephalogram (eeg) extended monitoring; 61-119 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0529","name":"In home respite care, 4 hr u","description":"In-home respite care, 4-hour unit, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66991","name":"Xcapsl ctrc rmvl insj 1+","description":"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); with insertion of intraocular (eg, trabecular meshwork, supraciliary, suprachoroidal) anterior segment aqueous drai","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9948","name":"Adjust sleep apnea appliance","description":"Adjust sleep apnea appliance","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1304","name":"No pneum vax admin 19+","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3394","name":"Inj, lovotibeglogene autotem","description":"Injection, lovotibeglogene autotemcel, per treatment","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3368.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0836T","name":"Dgtz gls mcrscp fna ea addl","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1386","name":"Exc sx melmn or mlnm is","description":"Patients with an excisional surgery for melanoma or melanoma in situ in the past 5 years with an initial ajcc staging of 0, i, or ii at the start of the performance period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4316","name":"Amchoplast, per sq cm","description":"Amchoplast, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69210","name":"Remove impacted ear wax uni","description":"Removal impacted cerumen requiring instrumentation, unilateral","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4258","name":"Enverse, per sq cm","description":"Enverse, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1202","name":"Miglustat oral 65 mg","description":"Miglustat, oral, 65 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1168","name":"Pt recd flu vax 7/1-6/30","description":"Patient received an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9292","name":"Pres dig visual therapy fda","description":"Prescription digital visual therapy, software-only, fda cleared, per course of treatment","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2801","name":"Inj, rykindo, 0.5 mg","description":"Injection, risperidone (rykindo), 0.5 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9936","name":"Clean occ guard","description":"Clean occ guard","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0841T","name":"Dgtz gls mcrscp pth cslt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; first tissue block, with frozen section(s), single specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4266","name":"Neostim per sq cm","description":"Neostim membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0383U","name":"Tyrosinemia typ i mntr quan","description":"Tyrosinemia typ i mntr quan","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0333U","name":"Onc lvr surveilanc hcc cfdna","description":"Onc lvr surveilanc hcc cfdna","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1448","name":"Injection, trilaciclib, 1mg","description":"Injection, trilaciclib, 1mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92970","name":"Cardioassist internal","description":"Cardioassist-method of circulatory assist; internal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81349","name":"Cytog alys chrml abnr lw-ps","description":"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and loss-of-heterozygosity variants, low-pass sequencing analysis","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0554","name":"Add 20 m of monthly tx","description":"Each additional 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing data generated from the","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61702","name":"Inner skull vessel surgery","description":"Surgery of simple intracranial aneurysm, intracranial approach; vertebrobasilar circulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3888.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0675T","name":"Laps insj nw/rpcmt isdss 1ld","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first lead","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93743","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6515","name":"Grad com wrap w str fu le cu","description":"Gradient compression wrap with adjustable straps, full leg, each, custom","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68371","name":"Harvest eye tissue alograft","description":"Harvesting conjunctival allograft, living donor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":453.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4005","name":"Family medicine ss","description":"Family medicine mips specialty set","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1240","name":"Pt no resp best int","description":"Patient did not respond to the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81441","name":"Ibmfs seq alys pnl 30 genes","description":"Inherited bone marrow failure syndromes (ibmfs) (eg, fanconi anemia, dyskeratosis congenita, diamond-blackfan anemia, shwachman-diamond syndrome, gata2 deficiency syndrome, congenital amegakaryocytic thrombocytopenia) sequence analysis panel, must include sequencing of at least 30 genes, including b","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1172","name":"Doc med rsn no td/tdap","description":"Documentation of medical reason(s) for not administering td or tdap vaccine (e.g., prior anaphylaxis due to the td or tdap vaccine or history of encephalopathy within seven days after a previous dose of a td-containing vaccine)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97037","name":"Appl modality 1+lllt po pain","description":"Application of a modality to 1 or more areas; low-level laser therapy (ie, nonthermal and non-ablative) for post-operative pain reduction","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63052","name":"Lam facetc/frmt arthrd lum 1","description":"Laminectomy, facetectomy, or foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s] [eg, spinal or lateral recess stenosis]), during posterior interbody arthrodesis, lumbar; single vertebral segment (list separately in addition to code for primary ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1151","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3401","name":"Vyjuvek 5x10^9pfu/ml, 0.1 ml","description":"Beremagene geperpavec-svdt for topical administration, containing nominal 5 x 10^9 pfu/ml vector genomes, per 0.1 ml","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4269","name":"Surgraft xt per sq cm","description":"Surgraft xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59852","name":"Induced abortion 1+njx hyst","description":"Induced abortion, by 1 or more intra-amniotic injections (amniocentesis-injections), including hospital admission and visits, delivery of fetus and secundines; with hysterotomy (failed intra-amniotic injection)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9002","name":"Intra-vag motion sens biofk","description":"Intra-vaginal motion sensor system, provides biofeedback for pelvic floor muscle rehabilitation device","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5125","name":"Inj, releuko 1 mcg","description":"Injection, filgrastim-ayow, biosimilar, (releuko), 1 microgram","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27816","name":"Treatment of ankle fracture","description":"Closed treatment of trimalleolar ankle fracture; without manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92928","name":"Prq tcat plmt ntrac st 1 les","description":"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 1 lesion involving 1 or more coronary segments","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":728.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0258U","name":"Ai psor mrna 50-100 gen alg","description":"Autoimmune (psoriasis), mrna, next-generation sequencing, gene expression profiling of 50-100 genes, skin- surface collection using adhesive patch, algorithm reported as likelihood of response to psoriasis biologics","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92972","name":"Perq trluml coronry lithotrp","description":"Percutaneous transluminal coronary lithotripsy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0382U","name":"Hyprphenylalninmia mntr quan","description":"Hyprphenylalninmia mntr quan","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99309","name":"Sbsq nf care moderate mdm 30","description":"Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":110.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0266U","name":"Unxpl cnst hrtbl do gn xprsn","description":"Unexplained constitutional or other heritable disorders or syndromes, tissue-specific gene expression by whole-transcriptome and next-generation sequencing, blood, formalin-fixed paraffin-embedded (ffpe) tissue or fresh frozen tissue, reported as presence or absence of splicing or expression changes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8612","name":"Oral methotrexate (xatmep)","description":"Methotrexate (xatmep), oral, 2.5 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76988","name":"Dx ntrop epcr us chd img acq","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; placement, manipulation of transducer, and image acquisition only","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1375","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1368","name":"Prev trt inf d/o hiv/hep mvp","description":"Prevention and treatment of infectious disorders including hepatitis c and hiv mips value pathway","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0387U","name":"Onc mlnma ambra1&amlo","description":"Onc mlnma ambra1&amlo","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1196","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76988","name":"Dx ntrop epcr us chd img acq","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; placement, manipulation of transducer, and image acquisition only","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J1840","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86231","name":"Ema each ig class","description":"Endomysial antibody (ema), each immunoglobulin (ig) class","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1285","name":"Scrn mam perf rslts not doc","description":"Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed, reason not otherwise specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0034","name":"Pall serv during meas","description":"Patients receiving palliative care during the measurement period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0083A","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2001","name":"Suct pum ext mgmt sys","description":"Suction pump, home model, portable or stationary, electric, any type, for use with external urine and/or fecal management system","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15017","name":"App skn cll ssp f/n/g/hf 1st","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 480 sq cm or less","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0671T","name":"Insj ant sgm aq drg dev 1+","description":"Insertion of anterior segment aqueous drainage device into the trabecular meshwork, without external reservoir, and without concomitant cataract removal, one or more","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6197","name":"Replace material prosthesis","description":"Replace material prosthesis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59020","name":"Fetal contract stress test","description":"Fetal contraction stress test","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78608","name":"Brain imaging (pet)","description":"Brain imaging, positron emission tomography (pet); metabolic evaluation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6516","name":"Grad com wrap w strap foo cu","description":"Gradient compression wrap with adjustable straps, foot, each, custom","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0702","name":"2d cephal radio image","description":"2d cephal radio image","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82166","name":"Assay anti-mullerian horm","description":"Anti-mullerian hormone (amh)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0916T","name":"Insj perm ccm-d sys pg only","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator only","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17276","name":"Dstr mal les s/n/h/f/g >4.0","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia; lesion diameter over 4.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6114","name":"Implnt/abut fixed dent max","description":"Implnt/abut fixed dent max","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81459","name":"So neo gsap dna/dna&rna","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants, microsatellite instability, tumor mutation burden, and rearrangements","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4367","name":"Amniocore sl, per sq cm","description":"Amniocore sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0258U","name":"Ai psor mrna 50-100 gen alg","description":"Autoimmune (psoriasis), mrna, next-generation sequencing, gene expression profiling of 50-100 genes, skin- surface collection using adhesive patch, algorithm reported as likelihood of response to psoriasis biologics","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92638","name":"Bhvl verif of amplification","description":"Behavioral verification of amplification including aided thresholds, functional gain, speech-in-noise, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37285","name":"Revsc evasc tpvt st sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58293","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1622.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7261","name":"Primary closure sinus perf","description":"Primary closure of a sinus perforation","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9027","name":"Rbc o2 co2 reduced","description":"Red blood cells, leukocytes reduced, oxygen/ carbon dioxide reduced, each unit","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0861T","name":"Rmvl pg wcs lv both compnt","description":"Removal of pulse generator for wireless cardiac stimulator for left ventricular pacing; both components (battery and transmitter)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4360","name":"Amchoplast fd per sq cm","description":"Amchoplast fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1220","name":"Dre wth interp rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; with evidence of retinopathy","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45309","name":"Proctosigmoidoscopy removal","description":"Proctosigmoidoscopy, rigid; with removal of single tumor, polyp, or other lesion by snare technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1403","name":"Bslne and fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0968T","name":"Insj/rplcmt epcrnl nstim sys","description":"Insertion or replacement of epicranial neurostimulator system, including electrode array and pulse generator, with connection to electrode array","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28515","name":"Treatment of toe fracture","description":"Closed treatment of fracture, phalanx or phalanges, other than great toe; with manipulation, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6603","name":"G com bandge low dn foamchnl","description":"Gradient compression bandaging supply, low density channel foam sheet, per 250 square centimeters, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":2.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4016","name":"Neurosurgical ss","description":"Neurosurgical mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86052","name":"Aquaporin-4 antb cba each","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; cell-based immunofluorescence assay (cba), each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0791T","name":"Motr cog vr gait train ea 15","description":"Motor-cognitive, semi-immersive virtual reality-facilitated gait training, each 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9697","name":"Inj, magtrace per study dose","description":"Injection, carboxydextran-coated superparamagnetic iron oxide, per study dose","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1483","name":"Neg quan hep c or qual rna","description":"Patients who achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0709T","name":"Id ca immntx each addl njx","description":"Intradermal cancer immunotherapy; each additional injection (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83935","name":"Assay of urine osmolality","description":"Osmolality; urine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94014","name":"Patient recorded spirometry","description":"Patient-initiated spirometric recording per 30-day period of time; includes reinforced education, transmission of spirometric tracing, data capture, analysis of transmitted data, periodic recalibration and review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":59.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0751","name":"Hiv prep, ftc/taf 200/25mg","description":"Emtricitabine 200mg and tenofovir alafenamide 25mg, oral, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6073","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (predominantly base metal)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0840T","name":"Dgtz gls mcrscp cslt compre","description":"Digitization of glass microscope slides for consultation, comprehensive, with review of records and specimens, with report on referred material (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1409","name":"Recd gmln brca1/brca2 couns","description":"Patients who received germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31505","name":"Diagnostic laryngoscopy","description":"Laryngoscopy, indirect; diagnostic (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0053","name":"Ht mental health and care","description":"Historical trauma (ht) mental health and clinical care for indigenous persons","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58671","name":"Laparoscopy tubal block","description":"Laparoscopy, surgical; with occlusion of oviducts by device (eg, band, clip, or falope ring)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":426.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5911","name":"Facial moulage sectional","description":"Facial moulage (sectional)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0996T","name":"Ins&sclr fix caps bag prosth","description":"Insertion and scleral fixation of a capsular bag prosthesis containing an intraocular lens prosthesis, with vitrectomy, including removal of crystalline lens or dislocated intraocular lens prosthesis, when performed","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0968T","name":"Insj/rplcmt epcrnl nstim sys","description":"Insertion or replacement of epicranial neurostimulator system, including electrode array and pulse generator, with connection to electrode array","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26525","name":"Release finger contracture","description":"Capsulectomy or capsulotomy; interphalangeal joint, each joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":938.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4397","name":"Summit aaa per sq cm","description":"Summit aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9685","name":"Acute nursing facility care","description":"Physician service or other qualified health care professional for the evaluation and management of a beneficiarys acute change in condition in a nursing facility. this service is for a demonstration project","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82465","name":"Assay bld/serum cholesterol","description":"Cholesterol, serum or whole blood, total","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3471","name":"Surg rep root res anterior","description":"Surg rep root res anterior","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55711","name":"Bx prst8 trct mri-us 1st","description":"Biopsy, prostate, transrectal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1950","name":"Leuprolide acetate /3.75 mg","description":"Injection, leuprolide acetate (for depot suspension), per 3.75 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0661","name":"Team remote e/m new pt 20 mn","description":"Team remote e/m new pt 20mins","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3921","name":"Decor or submerg erupt tooth","description":"Decor or submerg erupt tooth","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2794","name":"Crown-titanium","description":"Crown-titanium","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2253","name":"Inj midazolam (seizalam)","description":"Injection, midazolam (seizalam), 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36620","name":"Insertion catheter artery","description":"Arterial catheterization or cannulation for sampling, monitoring or transfusion (separate procedure); percutaneous","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9174","name":"Inj, docetaxel (beizray) 1mg","description":"Injection, docetaxel (beizray), 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1341","name":"Pt no f/u 30-180 dys","description":"Patients who did not have a follow-up assessment or did not have an assessment within 30 to 180 days after the index assessment during the performance period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2009","name":"Symphony, per sq cm","description":"Symphony, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7198","name":"Anti-inhibitor","description":"Anti-inhibitor, per i.u.","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81007","name":"Urine screen for bacteria","description":"Urinalysis; bacteriuria screen, except by culture or dipstick","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1466","name":"Pt disc/lam proc same day","description":"Patient had a lumbar fusion on the same date as the discectomy/laminectomy procedure","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0516U","name":"Rx metab rxgenomic gnotyp 40","description":"Rx metab rxgenomic gnotyp 40","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87469","name":"Babesia microti amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); babesia microti, amplified probe technique","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2329","name":"Inj ublituximab-xiiy, 1 mg","description":"Injection, ublituximab-xiiy, 1mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0175","name":"Perphenazine 4mg oral","description":"Perphenazine, 4 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1932","name":"Inj, lanreotide, (cipla) 1mg","description":"Injection, lanreotide, (cipla), 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0771T","name":"Vr px dissoc svc sm phy 1st","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25248","name":"Remove forearm foreign body","description":"Exploration with removal of deep foreign body, forearm or wrist","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":661.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0499U","name":"Onc clrct&lng dna ngs 8gene","description":"Onc clrct&lng dna ngs 8gene","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84150","name":"Assay of prostaglandin","description":"Prostaglandin, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15016","name":"App skn cl ssp agrf t/a/l ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; each additional 480 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36832","name":"Av fistula revision open","description":"Revision, open, arteriovenous fistula; without thrombectomy, autogenous or nonautogenous dialysis graft (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":744.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86701","name":"Hiv-1antibody","description":"Antibody; hiv-1","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1814","name":"Inj. insulin (lyumjev)","description":"Insulin (lyumjev), per 5 units","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9294","name":"Inj pemetrexed, hospira 10mg","description":"Injection, pemetrexed (hospira), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0730T","name":"Trabeculotomy lsr w/oct gdn","description":"Trabeculotomy by laser, including optical coherence tomography (oct) guidance","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0367U","name":"Onc bldr 10 flwg trurl rescj","description":"Onc bldr 10 flwg trurl rescj","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2054","name":"Lisocabtagene mara car pos t","description":"Lisocabtagene maraleucel, up to 110 million autologous anti-cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1004T","name":"Elec alys s-scl eeg wo prgrm","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; without programming","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78492","name":"Myocrd img pet mlt rst&strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); multiple studies at rest and stress (exercise or pharmacologic)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0824T","name":"Tcat rmv 1chmbr ldls pm ra","description":"Transcatheter removal of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography), when performed","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0587U","name":"Ther rx mntr 60-150rx&metabl","description":"Ther rx mntr 60-150rx&metabl","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0594U","name":"Nfct ds sepsis pncrtc spc","description":"Nfct ds sepsis pncrtc spc","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9074","name":"Inj, cyclophosphamd, sandoz","description":"Injection, cyclophosphamide (sandoz), 5 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90624","name":"Menb-4c&menacwy vacc im","description":"Meningococcal pentavalent vaccine, men b-4c recombinant proteins and outer membrane vesicle and conjugated men a, c, w, y-diphtheria toxoid carrier, for intramuscular use","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3403","name":"Revakinagene, per implant","description":"Revakinagene taroretcel-lwey, per implant","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1354","name":"Pt no suicd saf pln 120dy","description":"Patients who did not have a suicide safety plan initiated, reviewed, or updated or reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49587","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92526","name":"Oral function therapy","description":"Treatment of swallowing dysfunction and/or oral function for feeding","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1748","name":"Inj, zymfentra, 10 mg","description":"Injection, infliximab-dyyb (zymfentra), 10 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4100","name":"Nosht skin sub fda clrd nos","description":"Non-sheet form skin substitute, fda cleared as a device, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2252","name":"Inj midazolam in 0.8% nacl","description":"Injection, midazolam in 0.8% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0368","name":"Cone beam ct interprete tmj","description":"Cone beam ct interprete tmj","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0372","name":"Tomo comp series images","description":"Tomo comp series images","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4002","name":"Ep cardio ss","description":"Electrophysiology cardiac specialist mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01942","name":"Anes neuromd/ntrvrt lmbr/sac","description":"Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4034","name":"Speech language path ss","description":"Speech language pathology mips specialty set","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":611.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0455U","name":"Nfct agt sti mult amp prb ur","description":"Nfct agt sti mult amp prb ur","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1371","name":"Mst rec gsa<7","description":"Most recent glycemic status assessment (hba1c or gmi) level < 7.0%","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9992","name":"Pall serv during meas","description":"Palliative care services used by patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76015","name":"Mr sfty mplt&/fb asmt stf ea","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1178","name":"Doc med rsn no pcv","description":"Documentation of medical reason(s) for not administering pneumococcal vaccine (e.g., prior anaphylaxis due to the pneumococcal vaccine)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50546","name":"Laparoscopic nephrectomy","description":"Laparoscopy, surgical; nephrectomy, including partial ureterectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1328.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5155","name":"Inj, aflibercept-jbvf, 1 mg","description":"Injection, aflibercept-jbvf (yesafili), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1249","name":"Pt resp true imprt to me","description":"Patient responded completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0598U","name":"Gi ibs igg antb 18food items","description":"Gi ibs igg antb 18food items","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1105","name":"Dexmedetomidine film, 1 mcg","description":"Dexmedetomidine, oral, 1 mcg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1376","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37276","name":"Rvsc evsc fpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37616","name":"Ligation major artery chest","description":"Ligation, major artery (eg, post-traumatic, rupture); chest","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1204.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0923T","name":"Rmvl&rplcmt perm ccm-d pg","description":"Removal and replacement of permanent cardiac contractility modulation-defibrillation pulse generator only","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24136","name":"Sequestrectomy radial h/n","description":"Sequestrectomy (eg, for osteomyelitis or bone abscess), radial head or neck","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":760.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0711T","name":"N-nvs artl plaq alys dat prp","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data preparation and transmission","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42227","name":"Lengthening of palate","description":"Lengthening of palate, with island flap","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1193.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62143","name":"Rpl b1 flp/prostc plate skl","description":"Replacement of bone flap or prosthetic plate of skull","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1124.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1306","name":"Pt anphx due to pneum","description":"Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1009T","name":"Rem mntr s-sclp cont eeg sys","description":"Remote monitoring of a sub-scalp implanted continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6553","name":"G com stcking bk 30-40 custm","description":"Gradient compression stocking, below knee, 30-40 mmhg, custom, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85027","name":"Complete cbc automated","description":"Blood count; complete (cbc), automated (hgb, hct, rbc, wbc and platelet count)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0317U","name":"Onc lung ca 4-prb fish assay","description":"Onc lung ca 4-prb fish assay","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99252","name":"Ip/obs consltj new/est sf 35","description":"Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 35 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0249","name":"Tocilizumab for covid-19","description":"Injection, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6094","name":"Abut support crown titanium","description":"Abutment supported crown - (titanium)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1395","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4388","name":"Neothelium 4l per sq cm","description":"Neothelium 4l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1188","name":"Pt w/ ckd stg 5","description":"Patients with a diagnosis of chronic kidney disease (ckd) stage 5","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1234","name":"Pt hcv rctv aby f/u neg","description":"Patient has a reactive hcv antibody test, and has a follow up hcv viral test that does not detect hcv viremia","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0287U","name":"Onc thyr dna&mrna 112 genes","description":"Onc thyr dna&mrna 112 genes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0395U","name":"Onc lng multiomics plsm alg","description":"Onc lng multiomics plsm alg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4031","name":"Radiation oncology ss","description":"Radiation oncology mips specialty set","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0592U","name":"Onc hl neo dna tgs 417 genes","description":"Onc hl neo dna tgs 417 genes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31640","name":"Bronchoscopy w/tumor excise","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with excision of tumor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0965T","name":"I&cst prp jw xpn dl arch non","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, non-fixed hinge mechanism","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0333U","name":"Onc lvr surveilanc hcc cfdna","description":"Onc lvr surveilanc hcc cfdna","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1300","name":"Flu imm no admin doc rea","description":"Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0630U","name":"Onc brst mrna gen prflg 80","description":"Onc brst mrna gen prflg 80","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1002T","name":"Air displacmnt plethysmograp","description":"Air displacement plethysmography, whole-body composition assessment, with interpretation and report","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3263","name":"Inj, toripalimab-tpzi, 1 mg","description":"Injection, toripalimab-tpzi, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4266","name":"Neostim per sq cm","description":"Neostim membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0706","name":"Intraoral occlus radio image","description":"Intraoral occlus radio image","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1380","name":"2 rx in perf pd any com meds","description":"Filled at least two prescriptions during the performance period for any combination of the qualifying oral antipsychotic medications listed under denominator note or the long-acting injectable antipsychotic medications listed under denominator note","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59025","name":"Fetal non-stress test","description":"Fetal non-stress test","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97008","name":"Mchnl sclp cool prep plmt","description":"Mechanical scalp cooling; including hair preparation, individual cap placement, therapy initiation, and precooling period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4545","name":"Suppl accessor tibial stim","description":"Supplies and accessories for external tibial nerve stimulator (e.g., socks, gel pads, electrodes, etc.), needed for one month","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1332","name":"Pts no eval ini xm no 2 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 2 weeks","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4013","name":"Mntal/behav/psych hlth ss","description":"Mental/behavioral and psychiatry mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0701","name":"Inj. cefepime hcl (baxter)","description":"Injection, cefepime hydrochloride (baxter), not therapeutically equivalent to maxipime, 500 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4407","name":"Xwrap tribus per sq cm","description":"Xwrap tribus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69205","name":"Clear outer ear canal","description":"Removal foreign body from external auditory canal; with general anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46600","name":"Diagnostic anoscopy spx","description":"Anoscopy; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":46.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3432","name":"Guided tissue regeneration","description":"Guided tissue regeneration","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0238","name":"Intrav inf, toci, second dos","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83010","name":"Assay of haptoglobin quant","description":"Haptoglobin; quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15013","name":"Prepj skn cll ssp agrft 1st","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; first 25 sq cm or less of harvested skin","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2777","name":"Inj, faricimab-svoa, 0.1mg","description":"Injection, faricimab-svoa, 0.1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4287","name":"Dermabind dl, per sq cm","description":"Dermabind dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2540","name":"Penicillin g potassium inj","description":"Injection, penicillin g potassium, up to 600,000 units","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1164","name":"Inj diltiazem in 0.72% nacl","description":"Injection, diltiazem hydrochloride in 0.72% sodium chloride, 0.5 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6036","name":"Prosthetic thumb mechanical","description":"Prosthetic thumb, mechanical, can include metacarpophalangeal (mcp), interphalangeal (ip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":1502.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1206","name":"Isa not red 3pts/no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64415","name":"Njx aa&/strd brch plxs img","description":"Injection(s), anesthetic agent(s) and/or steroid; brachial plexus, including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0388","name":"Bitewing image capture only","description":"Bitewing image capture only","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0013","name":"Esketamine, nasal spray","description":"Esketamine, nasal spray, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37275","name":"Rvsc evsc fpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4422","name":"Ac wrap per sq cm","description":"A/c wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9959","name":"Unspec sleep ap proc","description":"Unspec sleep ap proc","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20501","name":"Njx sinus tract diagnostic","description":"Injection of sinus tract; diagnostic (sinogram)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0593U","name":"Nfct ds gu pthgn dna 46trgt","description":"Nfct ds gu pthgn dna 46trgt","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1191","name":"Hspc svc any time in meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4407","name":"Xwrap tribus per sq cm","description":"Xwrap tribus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6198","name":"Remove interim implant","description":"Remove interim implant","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10080","name":"I&d pilonidal cyst simple","description":"Incision and drainage of pilonidal cyst; simple","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":121.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82271","name":"Occult blood other sources","description":"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; other sources","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97008","name":"Mchnl sclp cool prep plmt","description":"Mechanical scalp cooling; including hair preparation, individual cap placement, therapy initiation, and precooling period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87523","name":"Hepatitis d quantification","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis d (delta), quantification, including reverse transcription, when performed","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0010","name":"Eom meos payment","description":"Enhancing oncology model (eom) monthly enhanced oncology services (meos) payment for eom enhanced services","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0966T","name":"I&cst prp jw xpn dl arch fxd","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, fixed hinge mechanism","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99425","name":"Prin care mgmt phys ea addl","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95907","name":"Nvr cndj tst 1-2 studies","description":"Nerve conduction studies; 1-2 studies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1392","name":"Pt rsn no exm or lst to fu","description":"Documentation of patient reasons for no examination, i.e., refusal of examination or lost to follow-up (documentation must include information that the clinician was unable to reach the patient by phone, mail or secure electronic mail - at least one method must be documented)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91105","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4353","name":"Xceed tl matrix per sq cm","description":"Xceed tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9938","name":"Fab removable appliance","description":"Fab removable appliance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0463U","name":"Onc crvx mrna genxprsn 14bmk","description":"Onc crvx mrna genxprsn 14bmk","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8006","name":"Grip glove replacement only","description":"Powered, cable driven grip assist glove, hand, finger, includes pressure sensors, glove replacement only","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25170","name":"Resect radius/ulnar tumor","description":"Radical resection of tumor, radius or ulna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1285.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4413","name":"Cygnus solo per sq cm","description":"Cygnus solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97552","name":"Group caregiver training","description":"Group caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9506","name":"Tc-99m graphite crucible","description":"Graphite crucible for preparation of technetium tc 99m-labeled carbon aerosol, one crucible","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33288","name":"Rmv&rplcmt phrnc nrv stim ld","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0891T","name":"Arhfcmrigtbs sbsq tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent treatment day","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4286","name":"Remove non-resorb barrier","description":"Remove non-resorb barrier","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0739","name":"Hiv prep, inj, cabotegravir","description":"Injection, cabotegravir, 1mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24100","name":"Arthrt elbw synovial bx only","description":"Arthrotomy, elbow; with synovial biopsy only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":467.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6601","name":"Porc/ceram inlay >= 3 surfac","description":"Inlay - porcelain/ceramic three or more surfaces","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0785T","name":"Revj/rmvl nea spi w/nstim","description":"Revision or removal of neurostimulator electrode array, spinal, with integrated neurostimulator","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0367U","name":"Onc bldr 10 flwg trurl rescj","description":"Onc bldr 10 flwg trurl rescj","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2037","name":"G4derm plus/suprello, pr ml","description":"G4derm plus/suprello, per milliliter","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25652","name":"Optx ulnar styloid fracture","description":"Open treatment of ulnar styloid fracture","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":721.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43497","name":"Transorl lwr esophgl myotomy","description":"Lower esophageal myotomy, transoral (ie, peroral endoscopic myotomy [poem])","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1432","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1304","name":"No pneum vax admin 19+","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4436","name":"Renati ac membrane per sq cm","description":"Renati ac membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5137","name":"Inj, wezlana, sub cu, 1 mg","description":"Injection, ustekinumab-auub (wezlana), biosimilar, subcutaneous, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4376","name":"Duograft aa per sq cm","description":"Duograft aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43820","name":"Gastrojejunostomy wo vagotmy","description":"Gastrojejunostomy; without vagotomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1058.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0688T","name":"Tx amblyopia assmt w/report","description":"Treatment of amblyopia using an online digital program; assessment of patient performance and program data by physician or other qualified health care professional, with report, per calendar month","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0894T","name":"Cannulation liver allograft","description":"Cannulation of the liver allograft in preparation for connection to the normothermic perfusion device and decannulation of the liver allograft following normothermic perfusion","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1237","name":"Pt rsn no scrn","description":"Patient reason for not screening for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety (e.g., patient declined or other patient reasons)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31288","name":"Nasal/sinus endoscopy surg","description":"Nasal/sinus endoscopy, surgical, with sphenoidotomy; with removal of tissue from the sphenoid sinus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5157","name":"Inj, denosumab-bmwo, 1 mg","description":"Injection, denosumab-bmwo (stoboclo/osenvelt), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1322","name":"Pts 7wk inj, scrn iop =<25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop =<25 mm hg for injected eye","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0532","name":"Take home supp nasal spray","description":"Take-home supply of nasal nalmefene hydrochloride; one carton of two, 2.7 mg per 0.1 ml nasal sprays (provision of the services by a medicare-enrolled opioid treatment program);( list separately in addition to each primary code)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37275","name":"Rvsc evsc fpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9955","name":"Oral app thxpy titration vis","description":"Oral app thxpy titration vis","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0687","name":"Inj cefazolin (wg crit care)","description":"Injection, cefazolin sodium (wg critical care), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87086","name":"Urine culture/colony count","description":"Culture, bacterial; quantitative colony count, urine","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38101","name":"Removal of spleen partial","description":"Splenectomy; partial (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1059.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38228","name":"Car-t admn autologous","description":"Chimeric antigen receptor t-cell (car-t) therapy; car-t cell administration, autologous","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6634","name":"Onlay titanium","description":"Onlay - titanium","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69727","name":"Rmv ntr oi imp sk tc esp<100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4319","name":"Sanograft, per sq cm","description":"Sanograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0402U","name":"Nfct agt sti mult amp prb tq","description":"Nfct agt sti mult amp prb tq","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2976","name":"Band stabilization per tooth","description":"Band stabilization per tooth","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76818","name":"Fetal biophys profile w/nst","description":"Fetal biophysical profile; with non-stress testing","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87591","name":"N.gonorrhoeae dna amp prob","description":"Infectious agent detection by nucleic acid (dna or rna); neisseria gonorrhoeae, amplified probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0943T","name":"Cysto flx rmvl urtl scaffold","description":"Cystourethroscopy, flexible; with removal of prostatic urethral scaffold","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49595","name":"Rpr aa hrn 1st > 10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, reducible","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0024","name":"Pin srv add 30 min pr m","description":"Principal illness navigation services, additional 30 minutes per calendar month (list separately in addition to g0023)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57112","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1949.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0718T","name":"Adrc ther prtl rc tear njx","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; injection into supraspinatus tendon including ultrasound guidance, unilateral","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2009","name":"Symphony, per sq cm","description":"Symphony, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78481","name":"Heart first pass single","description":"Cardiac blood pool imaging (planar), first pass technique; single study, at rest or with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantification","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0764T","name":"Asstv alg ecg rsk asmt cncrt","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to concurrently performed electrocardiogram (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90482","name":"Imm cnsl not admn sm 3<10","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; 3 minutes up to 10 minutes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0868T","name":"Hi-res gastric ep mapping","description":"High-resolution gastric electrophysiology mapping with simultaneous patient-symptom profiling, with interpretation and report","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0022","name":"Comm hlth intg svs add 30 m","description":"Community health integration services, each additional 30 minutes per calendar month (list separately in addition to g0019)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90970","name":"Esrd svc pr day pt 20+","description":"End-stage renal disease (esrd) related services for dialysis less than a full month of service, per day; for patients 20 years of age and older","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1379","name":"10 yr fu no rec rsn not giv","description":"A 10 year follow-up interval for colonoscopy not recommended, reason not otherwise specified","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0742T","name":"Aqmbf spect xers/strs & rest","description":"Absolute quantitation of myocardial blood flow (aqmbf), single-photon emission computed tomography (spect), with exercise or pharmacologic stress, and at rest, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64583","name":"Rev/rplct hpglsl nstm ary pg","description":"Revision or replacement of hypoglossal nerve neurostimulator array and distal respiratory sensor electrode or electrode array, including connection to existing pulse generator","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0884T","name":"Esphgsc flx 1st tndsc dilat","description":"Esophagoscopy, flexible, transoral, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for esophageal stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30540","name":"Rpr choanal atresia ntranasl","description":"Repair choanal atresia; intranasal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33276","name":"Insj phrnc nrv stim sys","description":"Insertion of phrenic nerve stimulator system (pulse generator and stimulating lead[s]), including vessel catheterization, all imaging guidance, and pulse generator initial analysis with diagnostic mode activation, when performed","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77305","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0894T","name":"Cannulation liver allograft","description":"Cannulation of the liver allograft in preparation for connection to the normothermic perfusion device and decannulation of the liver allograft following normothermic perfusion","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2028","name":"Micromatrix flex per mg","description":"Micromatrix flex, per mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0920T","name":"Rmvl perm ccm-d sys 1 pac ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous pacing lead only","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0743T","name":"B1 str & fx rsk vrt fx assmt","description":"Bone strength and fracture risk using finite element analysis of functional data and bone mineral density (bmd), with concurrent vertebral fracture assessment, utilizing data from a computed tomography scan, retrieval and transmission of the scan data, measurement of bone strength and bmd and classi","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0267U","name":"Rare do id opt gen mapg&seq","description":"Rare constitutional and other heritable disorders, identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping and whole-genome sequencing","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9276","name":"Inj zanidatamab-hrii, 2 mg","description":"Injection, zanidatamab-hrii, 2 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29879","name":"Arthrs kne srg abrasj arthrp","description":"Arthroscopy, knee, surgical; abrasion arthroplasty (includes chondroplasty where necessary) or multiple drilling or microfracture","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"X-ray exam chest 2 views","description":"Radiologic examination, chest; 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":38.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2031","name":"Mirodry, per sq cm","description":"Mirodry wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0496U","name":"Onc clrct cfdna 8/7 genes","description":"Onc clrct cfdna 8/7 genes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3263","name":"Inj, toripalimab-tpzi, 1 mg","description":"Injection, toripalimab-tpzi, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43497","name":"Transorl lwr esophgl myotomy","description":"Lower esophageal myotomy, transoral (ie, peroral endoscopic myotomy [poem])","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0564U","name":"Nfct ds pthgn-sna 10vir&4bct","description":"Nfct ds pthgn-sna 10vir&4bct","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1021T","name":"Active thrc irrigation spx","description":"Active thoracic irrigation (separate procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45308","name":"Proctosigmoidoscopy removal","description":"Proctosigmoidoscopy, rigid; with removal of single tumor, polyp, or other lesion by hot biopsy forceps or bipolar cautery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92642","name":"Hearing asstv dev fitg svc","description":"Hearing assistive device, supplemental technology fitting services (eg, personal frequency modulation [fm]/digital modulation [dm] system, remote microphone, alerting devices)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82542","name":"Col chromotography qual/quan","description":"Column chromatography, includes mass spectrometry, if performed (eg, hplc, lc, lc/ms, lc/ms-ms, gc, gc/ms-ms, gc/ms, hplc/ms), non-drug analyte(s) not elsewhere specified, qualitative or quantitative, each specimen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61526","name":"Removal of brain lesion","description":"Craniectomy, bone flap craniotomy, transtemporal (mastoid) for excision of cerebellopontine angle tumor;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3968.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4382","name":"Advograft dual per sq cm","description":"Advograft dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0919T","name":"Rmvl perm ccm-d sys pg only","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); pulse generator only","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4291","name":"Lamellas xt, per sq cm","description":"Lamellas xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5158","name":"Inj, denosumab-bnht, 1 mg","description":"Injection, denosumab-bnht (bomyntra/conexxence), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9347","name":"Inj, tremelimumab-actl, 1 mg","description":"Injection, tremelimumab-actl, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6038","name":"Multiax rotation attachment","description":"Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15014","name":"Prepj skn cll ssp agrft ea","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; each additional 25 sq cm of harvested skin or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0681T","name":"Rlcj pulse gen only isdss","description":"Relocation of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing dual leads","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37272","name":"Revsc evsc fpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":97.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":501.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0835T","name":"Dgtz gls mcrscp fna 1st ea","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4385","name":"Apollo ft per sq cm","description":"Apollo ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0992T","name":"N-invas assmt car rsk w/o ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat without concurrent computed tomography (ct) scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91055","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4363","name":"Am bur mem hydro per sq cm","description":"Amnio burgeon membrane and hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0891T","name":"Arhfcmrigtbs sbsq tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent treatment day","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0309U","name":"Crd cv ds aly 4 prtn plm alg","description":"Crd cv ds aly 4 prtn plm alg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4033","name":"Skilled nursing facility ss","description":"Skilled nursing facility mips specialty set","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G3002","name":"Chronic pain mgmt 30 mins","description":"Chronic pain management and treatment, monthly bundle including, diagnosis; assessment and monitoring; administration of a validated pain rating scale or tool; the development, implementation, revision, and/or maintenance of a person-centered care plan that includes strengths, goals, clinical needs,","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5144","name":"Inj, idacio, 1 mg","description":"Injection, adalimumab-aacf (idacio), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55882","name":"Ablt trurl prst8 tis trnsdcr","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation; with insertion of transurethral ultrasound transducer for delivery of thermal ultrasound, including suprapubic tube placement and placement of ","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0736T","name":"Colonic lavage 35+l water","description":"Colonic lavage, 35 or more liters of water, gravity-fed, with induced defecation, including insertion of rectal catheter","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5996","name":"Peri medicament w/seal, mand","description":"Peri medicament w/seal, mand","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1253","name":"Pts hu surv no amb plltv","description":"Patients who respond on the patient experience hu survey that they did not receive care by the listed ambulatory palliative care provider in the last 60 days (disavowal)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6191","name":"Semi precision abutment","description":"Semi precision abutment","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1383","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0311U","name":"Nfct ds bct quan antmcrb sc","description":"Nfct ds bct quan antmcrb sc","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93584","name":"Vngrph chd anom/persist svc","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; anomalous or persistent superior vena cava when it exists as a second contralateral superior vena cava, with native drainage to heart (list separately in addition to code for pri","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0556","name":"Adv prim care mgmt lvl 1","description":"Advanced primary care management services for a patient with one chronic condition [expected to last at least 12 months, or until the death of the patient, which place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline], or fewer, provided by clinical ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4564","name":"Pessary, disposable any type","description":"Pessary, disposable, any type","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0612","name":"Inj, calcium gluconate, nos","description":"Injection, calcium gluconate, not otherwise specified, 10 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1160","name":"Pt anphx due to mengb bef 13","description":"Patient had anaphylaxis due to the meningococcal vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1159","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81449","name":"So neo gsap 5-50 rna alys","description":"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; rna analysis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1278","name":"Pre-htn or htn doc, f/u indc","description":"Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1961","name":"Inj lenacapavir (hiv tx) 1mg","description":"Injection, lenacapavir (only for use as hiv treatment), 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76984","name":"Dx intraop thoracic aorta us","description":"Ultrasound, intraoperative thoracic aorta (eg, epiaortic), diagnostic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4034","name":"Speech language path ss","description":"Speech language pathology mips specialty set","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0235","name":"Inj, monoclon antibody, 1 mg","description":"Injection, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extraco","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22510","name":"Perq cervicothoracic inject","description":"Percutaneous vertebroplasty (bone biopsy included when performed), 1 vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance; cervicothoracic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2026.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25263","name":"Repair forearm tendon/muscle","description":"Repair, tendon or muscle, flexor, forearm and/or wrist; secondary, single, each tendon or muscle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1027.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2033","name":"Myriad morcells, 4 mg","description":"Myriad morcells, 4 milligrams","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1473","name":"Pt func cap not allow impr","description":"Patient situations, at any point during the denominator identification period, where the patients functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools, such as delirium, dementia, intellectual disabilities, and pervasive and specific de","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0554","name":"Add 20 m of monthly tx","description":"Each additional 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing data generated from the","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3393","name":"Inj, betibeglogene autotemce","description":"Injection, betibeglogene autotemcel, per treatment","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97504","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0817T","name":"Opn insj/rplcmt ins ptn subf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9596","name":"Gallium illuccix 1 millicure","description":"Gallium ga-68 gozetotide, diagnostic, (illuccix), 1 millicurie","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42975","name":"Dise eval slp do brth flx dx","description":"Drug-induced sleep endoscopy, with dynamic evaluation of velum, pharynx, tongue base, and larynx for evaluation of sleep-disordered breathing, flexible, diagnostic","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0705","name":"Extra oral post radio image","description":"Extra oral post radio image","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33276","name":"Insj phrnc nrv stim sys","description":"Insertion of phrenic nerve stimulator system (pulse generator and stimulating lead[s]), including vessel catheterization, all imaging guidance, and pulse generator initial analysis with diagnostic mode activation, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1954","name":"Inj leu acet lutr dpt 7.5 mg","description":"Injection, leuprolide acetate for depot suspension (lutrate depot), 7.5 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1428","name":"Bilateral absence of eyes","description":"Patients who have bilateral absence of eyes any time during the patients history through the end of the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0439U","name":"Crd chd dna alys 5 snp 3 dna","description":"Crd chd dna alys 5 snp 3 dna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99393","name":"Prev visit est age 5-11","description":"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; late ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":70.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83014","name":"H pylori drug admin","description":"Helicobacter pylori; drug administration","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49187","name":"Opn exc/dstr ntra-abd 5.1-10","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5.1 to 10 cm","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66984","name":"Xcapsl ctrc rmvl w/o ecp","description":"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); without endoscopic cyclophotocoagulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":794.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0268U","name":"Hem ahus gen seq alys 15 gen","description":"Hematology (atypical hemolytic uremic syndrome [ahus]), genomic sequence analysis of 15 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91113","name":"Gi trc img intral colon i&r","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92638","name":"Bhvl verif of amplification","description":"Behavioral verification of amplification including aided thresholds, functional gain, speech-in-noise, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1419","name":"Pt not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86826","name":"Hla x-match noncytotoxc addl","description":"Human leukocyte antigen (hla) crossmatch, non-cytotoxic (eg, using flow cytometry); each additional serum sample or sample dilution (list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0535","name":"Pt navigat svs direct/ref","description":"Patient navigational services, provided directly or by referral; including helping the patient to navigate health systems and identify care providers and supportive services, to build patient self-advocacy and communication skills with care providers, and to promote patient-driven action plans and g","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99467","name":"Ped crit care transport addl","description":"Critical care face-to-face services, during an interfacility transport of critically ill or critically injured pediatric patient, 24 months of age or younger; each additional 30 minutes (list separately in addition to code for primary service)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0802","name":"3d dental scan indirect","description":"3d dental scan indirect","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5765","name":"Liner compl/partial rem dent","description":"Liner compl/partial rem dent","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4294","name":"Amnio quad-core, per sq cm","description":"Amnio quad-core, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0750T","name":"B1 str&fx rsk asmt dxrbmd1vw","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1098","name":"Articaine ophthalmi 8% 0.4ml","description":"Articaine ophthalmic, 8% solution, 0.4 ml","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6191","name":"Semi precision abutment","description":"Semi precision abutment","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0136","name":"Inj, acetaminophen (b braun)","description":"Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0037","name":"Pt not able to participate","description":"On date of encounter, patient is not able to participate in assessment or screening, including non-verbal patients, delirious, severely aphasic, severely developmentally delayed, severe visual or hearing impairment and for those patients, no knowledgeable informant available","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2021","name":"Inj, linezolid (hospira)","description":"Injection, linezolid (hospira), not therapeutically equivalent to j2020, 200 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0853T","name":"Dgtz gls mcrscp mphmtrc ea m","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2329","name":"Inj ublituximab-xiiy, 1 mg","description":"Injection, ublituximab-xiiy, 1mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0521","name":"Supply fee hiv prep fda appr","description":"Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33268","name":"Excl laa opn oth px any meth","description":"Exclusion of left atrial appendage, open, performed at the time of other sternotomy or thoracotomy procedure(s), any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0564U","name":"Nfct ds pthgn-sna 10vir&4bct","description":"Nfct ds pthgn-sna 10vir&4bct","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4351","name":"Enclose tl matrix, per sq cm","description":"Enclose tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1174","name":"Pt w/ 2 hzv 10/2017 - mp","description":"Patient received at least two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1308","name":"Flu immunize no admin","description":"Influenza immunization was not administered, reason not given","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2040","name":"Microlyte painguard pr sq cm","description":"Microlyte painguard, per square centimeter","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9615","name":"Inj, pegulicianine, 1 mg","description":"Injection, pegulicianine, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93595","name":"L hrt cath chd nm/abn nt cnj","description":"Left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone, normal or abnormal native connections","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4276","name":"Orion, per sq cm","description":"Orion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0936T","name":"Photobiomodulation ther rta","description":"Photobiomodulation therapy of retina, single session","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45350","name":"Sgmdsc w/band ligation","description":"Sigmoidoscopy, flexible; with band ligation(s) (eg, hemorrhoids)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":874.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":103.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1748","name":"Inj, zymfentra, 10 mg","description":"Injection, infliximab-dyyb (zymfentra), 10 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1709","name":"Pfizer vaccine admin booster","description":"Pfizer vaccine admin booster","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4313","name":"Dermabind fm, per sq cm","description":"Dermabind fm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6527","name":"G garmt full leg/ft nght cus","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, custom, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62270","name":"Dx lmbr spi pnxr","description":"Spinal puncture, lumbar, diagnostic;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":71.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":197.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0360U","name":"Onc lung elisa 7 autoant alg","description":"Onc lung elisa 7 autoant alg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0310U","name":"Ped vsclts kd alys 3 bmrks","description":"Ped vsclts kd alys 3 bmrks","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0602","name":"Sevelamer carbonate pdr 20mg","description":"Sevelamer carbonate (renvela or therapeutically equivalent), oral, powder, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1454","name":"New cied","description":"New cied","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78725","name":"Kidney function study","description":"Kidney function study, non-imaging radioisotopic study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4354","name":"Palingen dl-palingen dl-x","description":"Palingen dual-layer membrane and dual-layer palingen x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2045","name":"Novashield/novogen pr sq cm","description":"Novashield or novogen wound matrix, per square centimeter","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49187","name":"Opn exc/dstr ntra-abd 5.1-10","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5.1 to 10 cm","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1932","name":"Inj, lanreotide, (cipla) 1mg","description":"Injection, lanreotide, (cipla), 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70470","name":"Ct head/brain w/o & w/dye","description":"Computed tomography, head or brain; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":439.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0788T","name":"Elec aly smp iins sp/sac nrv","description":"Electronic analysis with simple programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detecti","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0603U","name":"Rx asy prsmv 77rx/metablt ur","description":"Rx asy prsmv 77rx/metablt ur","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4335","name":"Amnioplast 2, per sq cm","description":"Amnioplast 2, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1224","name":"Iop dec <20% from base","description":"Intraocular pressure (iop) reduced by a value less than 20% from the pre-intervention level","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64654","name":"1st opn implt bat modulj sys","description":"Initial open implantation of baroreflex activation therapy (bat) modulation system, including lead placement onto the carotid sinus, lead tunnelling, connection to a pulse generator placed in a distant subcutaneous pocket (ie, total system), and intraoperative interrogation and programming","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1302","name":"Scrn mam perf rslts doc","description":"Screening, diagnostic, film digital or digital breast tomosynthesis (3d) mammography results documented and reviewed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0717T","name":"Adrc ther prtl rc tear","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; adipose tissue harvesting, isolation and preparation of harvested cells, including incubation with cell dissociation enzymes, filtration, washing, and concentration of adrcs","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1317","name":"Pts counsl cpt opt out","description":"Patients who are counseled on connection with a csp and explicitly opt out","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37283","name":"Rvsc evsc tpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0641","name":"Lo rig pos pnl l1-l5 pre ots","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76810","name":"Ob us >/= 14 wks addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0605","name":"Sucroferric oxyhydroxide 5mg","description":"Sucroferric oxyhydroxide, oral, 5 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27220","name":"Treat hip socket fracture","description":"Closed treatment of acetabulum (hip socket) fracture(s); without manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":588.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0524U","name":"Ob pe sflt-1/plgf ia srm/pls","description":"Ob pe sflt-1/plgf ia srm/pls","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0922T","name":"Rmvl perm ccm-d sys dual ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); dual (pacing and defibrillation) transvenous leads only","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2001","name":"Suct pum ext mgmt sys","description":"Suction pump, home model, portable or stationary, electric, any type, for use with external urine and/or fecal management system","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64790","name":"Removal of nerve lesion","description":"Excision of neurofibroma or neurolemmoma; major peripheral nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":933.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85660","name":"Rbc sickle cell test","description":"Sickling of rbc, reduction","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6036","name":"Prosthetic thumb mechanical","description":"Prosthetic thumb, mechanical, can include metacarpophalangeal (mcp), interphalangeal (ip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1351","name":"Pt cmplt suicd saf pln 120dy","description":"Patients who had a suicide safety plan initiated, reviewed, or updated and reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1321","name":"Pts no 7wk inj,no iop,iop>25","description":"Patients who were not seen within 7 weeks following the date of injection for follow up or who did not have a documented iop or no plan of care documented if the iop was >25 mm hg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0180","name":"Md certification hha patient","description":"Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initial ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1503","name":"Vascular surgery mvp","description":"Vascular surgery mips value pathway","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0570","name":"Care manage serv, pr cal mo","description":"Care management services for behavioral health conditions, directed by a physician or other qualified health care professional, per calendar month, with the following required elements: initial assessment or follow-up monitoring, including the use of applicable validated rating scales, behavioral he","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4263","name":"Surgraft tl, per sq cm","description":"Surgraft tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0422U","name":"Onc pan solid tum alys dna","description":"Onc pan solid tum alys dna","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0843T","name":"Dgtz gls mcrscp cslt cyt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), initial site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33964","name":"Ecmo/ecls repos perph cnula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; reposition central cannula(e) by sternotomy or thoracotomy, 6 years and older (includes fluoroscopic guidance, when performed)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":725.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2033","name":"Myriad morcells, 4 mg","description":"Myriad morcells, 4 milligrams","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86053","name":"Aqaprn-4 antb flo cytmtry ea","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; flow cytometry (ie, fluorescence-activated cell sorting [facs]), each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1297","name":"Bmi not doc medrsn ptref","description":"Bmi not documented due to medical reason or patient refusal of height or weight measurement","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0487U","name":"Onc sol tum cfcdna tgsap 84","description":"Onc sol tum cfcdna tgsap 84","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6700","name":"Ue add ext power myoel","description":"Upper extremity addition, external powered feature, myoelectronic control module, additional emg inputs, pattern-recognition decoding intent movement","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29510.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0968T","name":"Insj/rplcmt epcrnl nstim sys","description":"Insertion or replacement of epicranial neurostimulator system, including electrode array and pulse generator, with connection to electrode array","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0793T","name":"Prq tcat thrm ablt nrv p-art","description":"Percutaneous transcatheter thermal ablation of nerves innervating the pulmonary arteries, including right heart catheterization, pulmonary artery angiography, and all imaging guidance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92972","name":"Perq trluml coronry lithotrp","description":"Percutaneous transluminal coronary lithotripsy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3431","name":"Biological materials","description":"Biological materials","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76805","name":"Ob us >/= 14 wks sngl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81007","name":"Urine screen for bacteria","description":"Urinalysis; bacteriuria screen, except by culture or dipstick","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76805","name":"Ob us >/= 14 wks sngl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0894T","name":"Cannulation liver allograft","description":"Cannulation of the liver allograft in preparation for connection to the normothermic perfusion device and decannulation of the liver allograft following normothermic perfusion","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5783","name":"Add low ext mec limb vol lam","description":"Addition to lower extremity, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0763T","name":"Dgtz gls mcrscp mphmtrc alys","description":"Digitization of glass microscope slides for morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure, manual (list separately in addition to code for primary proced","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55710","name":"Bx prst8 tprn us w/mri fus 1","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant) with mri-fusion-guidance biopsy, first targeted lesion","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99459","name":"Pelvic examination","description":"Pelvic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56606","name":"Biopsy of vulva/perineum","description":"Biopsy of vulva or perineum (separate procedure); each separate additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0180","name":"Md certification hha patient","description":"Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initial ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0778T","name":"Smmg cncrnt appl imu snr","description":"Surface mechanomyography (smmg) with concurrent application of inertial measurement unit (imu) sensors for measurement of multi-joint range of motion, posture, gait, and muscle function","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0937T","name":"Xtrnl ecg rec>15d<30d","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; including recording, scanning analysis with report, review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1012T","name":"Mtrz ab ntrno trph scl/tr mw","description":"Motorized ab interno trephination of sclera (sclerostomy), or trabecular meshwork (trabeculostomy), 1 or more, including injection of antifibrotic agents, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37280","name":"Revsc evsc tpvt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1364","name":"Ascvd risk >=20pct","description":"Calculated 10-year ascvd risk score of >= 20 percent during the performance period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1171","name":"Pt recd 1 td/tdap 9yrs prior","description":"Patient received at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1322","name":"Pts 7wk inj, scrn iop =<25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop =<25 mm hg for injected eye","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0201","name":"Pne flu hepb cov home admin","description":"Administration of pneumococcal, influenza, hepatitis b, and/or covid-19 vaccine inside a patients home; reported only once per individual home per date of service when such vaccine administration(s) are performed at the patients home","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15301","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4364","name":"Am bur xp mem xpl hy p sq cm","description":"Amnio burgeon xplus membrane and xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0701","name":"Inj. cefepime hcl (baxter)","description":"Injection, cefepime hydrochloride (baxter), not therapeutically equivalent to maxipime, 500 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0753T","name":"Dgtz gls mcrscp sld level iv","description":"Digitization of glass microscope slides for level iv, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34707","name":"Evasc rpr ilio-iliac ndgft","description":"Endovascular repair of iliac artery by deployment of an ilio-iliac tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, and all endograft extension(s) proximally to the aortic bifurcation ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7252","name":"Part extract for implant","description":"Part extract for implant","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6598","name":"G comp bandage med stretch","description":"Gradient compression bandage roll, elastic medium stretch, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93896","name":"Vsrctv std tcd icr art compl","description":"Vasoreactivity study performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6525","name":"G com garm lwrleg/ft ngt cus","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, custom, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1380","name":"2 rx in perf pd any com meds","description":"Filled at least two prescriptions during the performance period for any combination of the qualifying oral antipsychotic medications listed under denominator note or the long-acting injectable antipsychotic medications listed under denominator note","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0063","name":"Cardiology ss","description":"Cardiology mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25447","name":"Arthrp ntrcrp/crp/mtcr ntrps","description":"Arthroplasty, intercarpal or carpometacarpal joints; interposition (eg, tendon)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":938.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0726T","name":"Rmvl implt vstibular dev uni","description":"Removal of implanted vestibular device, unilateral","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0821T","name":"Mntr psychdlc med 2ndphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; second physician or other qualified health care professional, concurrent with first physician or other qualified health care professional, each hour (list sepa","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61889","name":"Ins sk-mnt crnl nstm pg/rcvr","description":"Insertion of skull-mounted cranial neurostimulator pulse generator or receiver, including craniectomy or craniotomy, when performed, with direct or inductive coupling, with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4288","name":"Replacement breastpump valve","description":"Valve for breast pump, replacement","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45112","name":"Removal of rectum","description":"Proctectomy, combined abdominoperineal, pull-through procedure (eg, colo-anal anastomosis)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2017.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1645","name":"Dalteparin sodium","description":"Injection, dalteparin sodium, per 2500 iu","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0432U","name":"Klhl11 antb sr/csf asy qual","description":"Klhl11 antb sr/csf asy qual","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0938T","name":"Xtrnl ecg rec>15d<30d rec","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; recording (including connection and initial recording)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86612","name":"Blastomyces antibody","description":"Antibody; blastomyces","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9912","name":"Pre-visit patient screening","description":"Pre-visit patient screening","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0873T","name":"Revj subq prtl asct pmp sys","description":"Revision of a subcutaneously implanted peritoneal ascites pump system, any component (ascites pump, associated peritoneal catheter, associated bladder catheter), including imaging and programming, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31648","name":"Bronchial valve remov init","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with removal of bronchial valve(s), initial lobe","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0091A","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4427","name":"Dermbnd dln dl+ dlx sq cm","description":"Dermabind dl n or dermabind dl + or dermabind dl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49650","name":"Lap ing hernia repair init","description":"Laparoscopy, surgical; repair initial inguinal hernia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4431","name":"Pma skin substitute, nos","description":"Pma skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1327","name":"Pts no eval ini xm no 8 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 8 weeks","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66683","name":"Implantation iris prosthesis","description":"Implantation of iris prosthesis, including suture fixation and repair or removal of iris, when performed","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0695T","name":"Bdy srf mpg pm/cvdfb tm impl","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of implant or replacement","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1443","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0423U","name":"Psyc genomic alys pnl 26 gen","description":"Psyc genomic alys pnl 26 gen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4373","name":"Membrane wrp lt per sq cm","description":"Membrane wrap lite, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0604U","name":"All&immunology crae 4bk pep","description":"All&immunology crae 4bk pep","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0746T","name":"Car ablt rad arr cnv loc map","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; conversion of arrhythmia localization and mapping of arrhythmia site (nidus) into a multidimensional radiation treatment plan","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2024","name":"Resolve or xenopatch sq cm","description":"Resolve matrix or xenopatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0588U","name":"Nfct ds bct/vir 32genes mrna","description":"Nfct ds bct/vir 32genes mrna","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95147","name":"Antigen therapy services","description":"Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy (specify number of doses); 3 single stinging insect venoms","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99383","name":"Prev visit new age 5-11","description":"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; late childhood (","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":81.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99484","name":"Care mgmt svc bhvl hlth cond","description":"Care management services for behavioral health conditions, at least 20 minutes of clinical staff time, directed by a physician or other qualified health care professional, per calendar month, with the following required elements: initial assessment or follow-up monitoring, including the use of appli","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":41.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83521","name":"Ig light chains free each","description":"Immunoglobulin light chains (ie, kappa, lambda), free, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0558U","name":"Onc clrct elisa bf7 ag serum","description":"Onc clrct elisa bf7 ag serum","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1681","name":"Ho bilateral hip abduction","description":"Hip orthosis, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1159","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1424","name":"Pulmonology care mvp","description":"Pulmonology care mips value pathway","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9361","name":"Inj, efbemalenograstim alfa-","description":"Injection, efbemalenograstim alfa-vuxw, 0.5 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0738","name":"Upper extremity rehab","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20396.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85230","name":"Clot factor vii proconvertin","description":"Clotting; factor vii (proconvertin, stable factor)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0899T","name":"N-invas deter aqmbf aug cmr","description":"Noninvasive determination of absolute quantitation of myocardial blood flow (aqmbf), derived from augmentative algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health car","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49615","name":"Rpr aa hrn rcr 3-10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, reducible","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58150","name":"Total hysterectomy","description":"Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1092.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0370","name":"Max ultrasound capt & interp","description":"Max ultrasound capt & interp","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4036","name":"Urgent care ss","description":"Urgent care mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0549U","name":"Onc urthl dna mthyltd rt pcr","description":"Onc urthl dna mthyltd rt pcr","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0803T","name":"Tcat rmv&rpl2chmb ldls pm rv","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ve","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0464U","name":"Onc clrct scr qrtsa dna mrk","description":"Onc clrct scr qrtsa dna mrk","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50830","name":"Revise urine flow","description":"Urinary undiversion (eg, taking down of ureteroileal conduit, ureterosigmoidostomy or ureteroenterostomy with ureteroureterostomy or ureteroneocystostomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1996.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84394","name":"Total tau","description":"Tau, total (ttau)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7023","name":"Mech allergen parti barrier","description":"Mechanical allergen particle barrier/inhalation filter, cream, nasal, topical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0977T","name":"Upr gi bld detcj snr capsule","description":"Upper gastrointestinal blood detection, sensor capsule, with interpretation and report","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21360","name":"Opn tx dprsd malar fracture","description":"Open treatment of depressed malar fracture, including zygomatic arch and malar tripod","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":592.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37278","name":"Rvsc evsc fpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1164","name":"Pt w/ dementia any time","description":"Patients with dementia any time during the patients history through the end of the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0817T","name":"Opn insj/rplcmt ins ptn subf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28298","name":"Cor hlx vlgs prx phlx osteot","description":"Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with proximal phalanx osteotomy, any method","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":629.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1391","name":"All pt dx w/ rec mlnm","description":"All patients who were diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0033","name":"2+ benzo seiz","description":"Two or more benzodiazepine prescriptions ordered for patients who had a diagnosis of seizure disorders, rapid eye movement sleep behavior disorder, benzodiazepine withdrawal, ethanol withdrawal, or severe generalized anxiety disorder on or between january 1 of the year prior to the measurement perio","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q9946","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0801","name":"Inj. acthar gel to 40 units","description":"Injection, corticotropin (acthar gel), up to 40 units","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55713","name":"Bx prst8 in-bore ct/mri bx 1","description":"Biopsy, prostate, in-bore ct- or mri-guided (ie, sextant), with biopsy of additional targeted lesion(s), first targeted lesion","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0155","name":"Dronabinol (syndros) 0.1 mg","description":"Dronabinol (syndros), 0.1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49615","name":"Rpr aa hrn rcr 3-10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, reducible","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1479","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4349","name":"Mantle dl matrix per sq cm","description":"Mantle dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81464","name":"So gsap cll fr mcrstl ins","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants, microsatellite instability, tumor mutation burden, and rearrangements","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7521","name":"Incision/drain abscess extra","description":"Incision and drainage of abscess - extraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1813","name":"Lyumjev for insulin pump use","description":"Insulin (lyumjev) for administration through dme (i.e., insulin pump) per 50 units","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0909T","name":"Rplcmt int nstim sys vgs nrv","description":"Replacement of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2012","name":"Suprathel, per sq cm","description":"Suprathel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0261U","name":"Onc clrct ca img alys w/ai","description":"Oncology (colorectal cancer), image analysis with artificial intelligence assessment of 4 histologic and immunohistochemical features (cd3 and cd8 within tumor-stroma border and tumor core), tissue, reported as immune response and recurrence-risk score","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93612","name":"Intraventricular pacing","description":"Intraventricular pacing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60200","name":"Remove thyroid lesion","description":"Excision of cyst or adenoma of thyroid, or transection of isthmus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0795T","name":"Tcat ins 2chmbr ldls pm cmpl","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; complete system (ie, r","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61580","name":"Craniofacial approach skull","description":"Craniofacial approach to anterior cranial fossa; extradural, including lateral rhinotomy, ethmoidectomy, sphenoidectomy, without maxillectomy or orbital exenteration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2669.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7174","name":"Injection fitusiran 0.04 mg","description":"Injection, fitusiran, 0.04 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81418","name":"Rx metab gen seq alys pnl 6","description":"Drug metabolism (eg, pharmacogenomics) genomic sequence analysis panel, must include testing of at least 6 genes, including cyp2c19, cyp2d6, and cyp2d6 duplication/deletion analysis","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80506","name":"Path clin consltj prolng svc","description":"Pathology clinical consultation; prolonged service, each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0761T","name":"Dgtz gls mcrscp sl imm ea 1","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1455","name":"Rep/rev cied","description":"Replaced or revised cied","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1418","name":"Med rsn not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination because of a medical contraindication documented by clinician","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88167","name":"Cytopath tbs c/v select","description":"Cytopathology, slides, cervical or vaginal (the bethesda system); with manual screening and computer-assisted rescreening using cell selection and review under physician supervision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47384","name":"Abltj ire liver 1+ tum perq","description":"Ablation, irreversible electroporation, liver, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4280","name":"Xcell amnio matrix per sq cm","description":"Xcell amnio matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0983T","name":"Rem mntr impl ivc snr phys","description":"Remote monitoring of an implanted inferior vena cava sensor for up to 30 days, including at least weekly downloads of inferior vena cava area recordings, interpretation(s), trend analysis, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7771","name":"Alveolus clsd reduc stblz te","description":"Alveolus closed reduction stabilization of teeth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64597","name":"Ins/rplcm prq eltrd ra pn ea","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; each additional electrode array (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0488U","name":"Ob fetal ag nipt cfdna alys","description":"Ob fetal ag nipt cfdna alys","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76857","name":"Us exam pelvic limited","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86052","name":"Aquaporin-4 antb cba each","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; cell-based immunofluorescence assay (cba), each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1179","name":"No pcv recd","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine, on or after their 19th birthday and before or during measurement period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90964","name":"Esrd home pt serv p mo 2-11","description":"End-stage renal disease (esrd) related services for home dialysis per full month, for patients 2-11 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98002","name":"Synch audio-video new mod 45","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate medical decision making. when using total time on the date of the encounter for code selection, 45 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1272","name":"Pts kid transplt wtlst","description":"Patients observed on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7354","name":"Cantharidin top, applicator","description":"Cantharidin for topical administration, 0.7%, single unit dose applicator (3.2 mg)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99205","name":"Office o/p new hi 60 min","description":"Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.","date_of_service":"2026-06-05","other_properties":[{"name":"BillingTaxonomy","value":["207V00000X","207VB0002X","207VE0102X","207VF0040X","207VG0400X","207VM0101X","207VX0000X","207VX0201X","363LX0001X"]},{"name":"RenderingTaxonomy","value":["207V00000X","207VB0002X","207VE0102X","207VF0040X","207VG0400X","207VM0101X","207VX0000X","207VX0201X","363LX0001X"]},{"name":"ClaimSpecialtyCode","value":["904","905","907","AMGY","APNOB","COLP","FPEM","GYNE","GYON","GYSU","MAFE","NPAG","NPGY","NPOB","OBEM","OBGY","OBHR","OBST","REND","URGY"]},{"name":"CumulativeFixedFeeAmount","value":["N"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TH"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TH"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54700","name":"I&d epdidyms tstis&/scrot sp","description":"Incision and drainage of epididymis, testis and/or scrotal space (eg, abscess or hematoma)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0320U","name":"Neph rna psttrnspl perph bld","description":"Neph rna psttrnspl perph bld","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37291","name":"Revsc evsc tpvt athr cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98013","name":"Synch audio-only est low 20","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code select","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6081","name":"Scale & debride, single imp","description":"Scale & debride, single imp","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0776T","name":"Ther indctj ntrabrn hypthrm","description":"Therapeutic induction of intra-brain hypothermia, including placement of a mechanical temperature-controlled cooling device to the neck over carotids and head, including monitoring (eg, vital signs and sport concussion assessment tool 5 [scat5]), 30 minutes of treatment","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58560","name":"Hysteroscopy resect septum","description":"Hysteroscopy, surgical; with division or resection of intrauterine septum (any method)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62005","name":"Treat skull fracture","description":"Elevation of depressed skull fracture; compound or comminuted, extradural","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1323.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2010","name":"Apis, per square centimeter","description":"Apis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0491U","name":"Onc sol tum ctc slct er prtn","description":"Onc sol tum ctc slct er prtn","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0042","name":"Ref to therapy","description":"Referral to physical, occupational, speech, or recreational therapy","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0950T","name":"Abltj b9 prst8 tissue hifu","description":"Ablation of benign prostate tissue, transrectal, with high intensity-focused ultrasound (hifu), including ultrasound guidance","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0828T","name":"Dgtz gls mcrscp cytp smpl fl","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; simple filter method with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2393","name":"Post 3 srfc resinbased cmpst","description":"Resin-based composite - three surfaces posterior","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7252","name":"Part extract for implant","description":"Part extract for implant","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4012","name":"Interventional rad ss","description":"Interventional radiology mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1197","name":"Isa reduced >=3 fr ixv","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0987T","name":"Iv img icr cere vsl oct ea","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0473","name":"Micro exam prep & report","description":"Accession of tissue gross and microscopic examination preparation and transmission of written report","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0772T","name":"Vr px dissoc svc sm phy ea","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9011","name":"Datopotamab deruxtecan, 1 mg","description":"Injection, datopotamab deruxtecan-dlnk, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1295","name":"Pt hx tot col or colon ca","description":"Patients with a diagnosis or past history of total colectomy or colorectal cancer","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9074","name":"Inj, cyclophosphamd, sandoz","description":"Injection, cyclophosphamide (sandoz), 5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61715","name":"Mrgfus strtctc ablt trgt icr","description":"Magnetic resonance image guided high intensity focused ultrasound (mrgfus), stereotactic ablation of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0818T","name":"Revj/rmvl ins ptn subq","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82239","name":"Bile acids total","description":"Bile acids; total","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0489U","name":"Ob sgnipt cfdna seq alys 1+","description":"Ob sgnipt cfdna seq alys 1+","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2036","name":"Cohealyx col dml mx pr sq cm","description":"Cohealyx collagen dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1273","name":"Pts snf 1 yr dialysis","description":"Patients who were admitted to a skilled nursing facility (snf) within one year of dialysis initiation according to the cms-2728 form","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1317","name":"Pts counsl cpt opt out","description":"Patients who are counseled on connection with a csp and explicitly opt out","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50785","name":"Reimplant ureter in bladder","description":"Ureteroneocystostomy; with vesico-psoas hitch or bladder flap","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1326.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45520","name":"Treatment of rectal prolapse","description":"Perirectal injection of sclerosing solution for prolapse","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6610","name":"G com stcking bk 18-30 custm","description":"Gradient compression stocking, below knee, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3055","name":"Inj talquetamab-tgvs 0.25 mg","description":"Injection, talquetamab-tgvs, 0.25 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4402","name":"Xwrap 2.0 per sq cm","description":"Xwrap 2.0, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81456","name":"So/hl 51/>gsap rna alys","description":"Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic sequence analysis panel, interrogation for sequence variants and copy number variants or rearrangements, or isoform expression or mrna expression levels, if performed; rna analysis","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0946T","name":"Ortho impl mvmt alys pair ct","description":"Orthopedic implant movement analysis using paired computed tomography (ct) examination of the target structure, including data acquisition, data preparation and transmission, interpretation and report (including ct scan of the joint or extremity performed with paired views)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81560","name":"Trnsplj pd lvr&bwl cd154+cll","description":"Transplantation medicine (allograft rejection, pediatric liver and small bowel), measurement of donor and third-party-induced cd154+t-cytotoxic memory cells, utilizing whole peripheral blood, algorithm reported as a rejection risk score","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85014","name":"Hematocrit","description":"Blood count; hematocrit (hct)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4224","name":"Hhf10-p per sq cm","description":"Human health factor 10 amniotic patch (hhf10-p), per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0443U","name":"Neurflmnt lt chn ultrsens ia","description":"Neurflmnt lt chn ultrsens ia","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82975","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0383U","name":"Tyrosinemia typ i mntr quan","description":"Tyrosinemia typ i mntr quan","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0548U","name":"Gfap cleia plasma","description":"Gfap cleia plasma","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62121","name":"Incise skull repair","description":"Craniotomy for repair of encephalocele, skull base","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1882.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1387","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21435","name":"Optx crnfc sep comp int&/xtr","description":"Open treatment of craniofacial separation (lefort iii type); complicated, utilizing internal and/or external fixation techniques (eg, head cap, halo device, and/or intermaxillary fixation)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1433.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0044","name":"Pt mitral stenosis","description":"Patients with moderate or severe mitral stenosis","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38227","name":"Car-t receipt&prepj admn","description":"Chimeric antigen receptor t-cell (car-t) therapy; receipt and preparation of car-t cells for administration","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0544","name":"Post d/c phone follow up","description":"Post discharge telephonic follow-up contacts performed in conjunction with a discharge from the emergency department for behavioral health or other crisis encounter, 4 calls per calendar month","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2183","name":"Inj meropenem (wg crit care)","description":"Injection, meropenem (wg critical care), not therapeutically equivalent to j2185, 100 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99480","name":"Sbsq ic inf pbw 2,501-5,000","description":"Subsequent intensive care, per day, for the evaluation and management of the recovering infant (present body weight of 2,501-5,000 grams)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3389","name":"Topi adm prad zami per treat","description":"Topical administration, prademagene zamikeracel, per treatment","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0892T","name":"Arhfcmrigtbs sbsq per tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent motor threshold redetermination with delivery and management, per treatment day","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0756T","name":"Dgtz gls mcrscp sld spc grpi","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group i, for microorganisms (eg, acid fast, methenamine silver) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99425","name":"Prin care mgmt phys ea addl","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0216","name":"Inj, alfentanil hcl, 500mcg","description":"Injection, alfentanil hydrochloride, 500 micrograms","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54065","name":"Destruction penis lesion(s)","description":"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0837T","name":"Dgtz gls mcrscp fna i&r","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; interpretation and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49593","name":"Rpr aa hrn 1st 3-10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, reducible","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0675T","name":"Laps insj nw/rpcmt isdss 1ld","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first lead","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37257","name":"Revsc evsc ivt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0893T","name":"N-invas assmt bld oxygnation","description":"Noninvasive assessment of blood oxygenation, gas exchange efficiency, and cardiorespiratory status, with physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0473","name":"Micro exam prep & report","description":"Accession of tissue gross and microscopic examination preparation and transmission of written report","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2249","name":"Inj, remimazolam, 1 mg","description":"Injection, remimazolam, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0820T","name":"Mntr psychdlc med 1stphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; first physician or other qualified health care professional, each hour","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1007T","name":"Eeg impl s-sclp eeg w/o vid","description":"Electroencephalogram from implanted sub-scalp continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0971T","name":"Ablt mal brst tum pq lsr uni","description":"Ablation, malignant breast tumor(s), percutaneous, laser, including imaging guidance when performed, unilateral","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4440","name":"Curamatrix per sq cm","description":"Curamatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0807T","name":"Pulm tiss vntj alys prev ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with previously acquired computed tomography (ct) images, including data preparation and transmission, quantification of pulmonary tissue ventilation, data re","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5944","name":"Max implt sup remv part","description":"Max implt sup remv part","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0378U","name":"Rfc1 repeat xpnsj vrnt alys","description":"Rfc1 repeat xpnsj vrnt alys","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92628","name":"Eval hearing aid cand 1st 30","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37261","name":"Revsc evasc ivt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98980","name":"Rtm tx mgmt 1st 20 min","description":"Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least 1 real-time interactive communication with the patient or caregiver during the calendar month; first 20 minutes","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1273","name":"Pts snf 1 yr dialysis","description":"Patients who were admitted to a skilled nursing facility (snf) within one year of dialysis initiation according to the cms-2728 form","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81005","name":"Urinalysis","description":"Urinalysis; qualitative or semiquantitative, except immunoassays","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1301","name":"Pt recv tbco cess interv","description":"Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28496","name":"Treat big toe fracture","description":"Percutaneous skeletal fixation of fracture great toe, phalanx or phalanges, with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0808T","name":"Pulm tiss vntj alys w/ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with computed tomography (ct) images taken for the purpose of pulmonary tissue ventilation analysis, including data preparation and transmission, quantificati","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83013","name":"H pylori (c-13) breath","description":"Helicobacter pylori; breath test analysis for urease activity, non-radioactive isotope (eg, c-13)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0556U","name":"Nfct ds p-s dna&rna 12 trgts","description":"Nfct ds p-s dna&rna 12 trgts","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92930","name":"Prq tcat plmt ntrac st 2+les","description":"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 2 or more distinct coronary lesions with 2 or more coronary stents deployed in 2 or more coronary segments, or a bifurcation lesion requiring ","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1271","name":"Pts dem any time/dur mo","description":"Patients with dementia at any time prior to or during the month","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33987","name":"Artery expos/graft artery","description":"Arterial exposure with creation of graft conduit (eg, chimney graft) to facilitate arterial perfusion for ecmo/ecls (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":338.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20500","name":"Njx sinus tract therapeutic","description":"Injection of sinus tract; therapeutic (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93596","name":"R&l hrt cath chd nml nt cnj","description":"Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); normal native connections","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7172","name":"Inj marstacim-hncq, 0.5 mg","description":"Injection, marstacimab-hncq, 0.5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5150","name":"Inj, aflibercept-mrbb, 1 mg","description":"Injection, aflibercept-mrbb (ahzantive), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1373","name":"Mst rec gsa >=8 and <=9","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 8.0% and <= 9.0%","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4393","name":"Surgraft ac per sq cm","description":"Surgraft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4020","name":"Ophthalmology/optometry ss","description":"Ophthalmology/optometry mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2054","name":"Lisocabtagene mara car pos t","description":"Lisocabtagene maraleucel, up to 110 million autologous anti-cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83873","name":"Assay of csf protein","description":"Myelin basic protein, cerebrospinal fluid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8006","name":"Grip glove replacement only","description":"Powered, cable driven grip assist glove, hand, finger, includes pressure sensors, glove replacement only","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64659","name":"Rmvl bat modulj sys pg only","description":"Removal of baroreflex activation therapy (bat) modulation system; pulse generator only","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0281U","name":"Hem vwd propeptide ag lvl","description":"Hematology (von willebrand disease [vwd]), von willebrand propeptide, enzyme-linked immunosorbent assays (elisa), plasma, diagnostic report of von willebrand factor (vwf) propeptide antigen level","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1487","name":"Pt adm to hospice dur eval","description":"Patients in hospice in the year before or during the period of evaluation","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49190","name":"Opn exc/dstr ntra-abd >30 cm","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); greater than 30 cm","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0477U","name":"Rx metab psy 14&cyp2d6 gn-rx","description":"Rx metab psy 14&cyp2d6 gn-rx","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23150","name":"Removal of humerus lesion","description":"Excision or curettage of bone cyst or benign tumor of proximal humerus;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":758.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0712T","name":"N-nvs artl plaq alys quan","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess atherosclerotic plaque stability","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33281","name":"Reposg phrnc nrv stim trnsvn","description":"Repositioning of phrenic nerve stimulator transvenous lead(s)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1407","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0950T","name":"Abltj b9 prst8 tissue hifu","description":"Ablation of benign prostate tissue, transrectal, with high intensity-focused ultrasound (hifu), including ultrasound guidance","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0776T","name":"Ther indctj ntrabrn hypthrm","description":"Therapeutic induction of intra-brain hypothermia, including placement of a mechanical temperature-controlled cooling device to the neck over carotids and head, including monitoring (eg, vital signs and sport concussion assessment tool 5 [scat5]), 30 minutes of treatment","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0684T","name":"Peri-px dev eval isdss ip","description":"Peri-procedural device evaluation (in-person) and programming of device system parameters before or after a surgery, procedure, or test with analysis, review, and report by a physician or other qualified health care professional, permanent implantable synchronized diaphragmatic stimulation system fo","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99304","name":"1st nf care sf/low mdm 25","description":"Initial nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward or low level of medical decision making. when using total time on the date of the encounter for code selection, 25 minutes mus","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":78.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15838","name":"Exc excsv submental fat pad","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy); submental fat pad","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":617.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23065","name":"Biopsy shoulder tissues","description":"Biopsy, soft tissue of shoulder area; superficial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0235","name":"Inj, monoclon antibody, 1 mg","description":"Injection, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extraco","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0627U","name":"Psyc scz dna alys >15000","description":"Psyc scz dna alys >15000","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0300U","name":"Onc pan tum whl gen seq&opt","description":"Onc pan tum whl gen seq&opt","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43497","name":"Transorl lwr esophgl myotomy","description":"Lower esophageal myotomy, transoral (ie, peroral endoscopic myotomy [poem])","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9999","name":"Doc sys rsn <3 colon","description":"Documentation of system reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., unable to locate previous colonoscopy report, patient cannot provide precise date or details from previous colonoscopy, previous colonoscopy report was incomplete)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55708","name":"Bx prst8 trct us w/mri fus 1","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant) with mri-fusion-guidance, first targeted lesion","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30469","name":"Rpr nsl vlv collapse w/rmdlg","description":"Repair of nasal valve collapse with low energy, temperature-controlled (ie, radiofrequency) subcutaneous/submucosal remodeling","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0700T","name":"Molec fluor img sus nev 1st","description":"Molecular fluorescent imaging of suspicious nevus; first lesion","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0470U","name":"Onc orop detcj mrd 8 dna hpv","description":"Onc orop detcj mrd 8 dna hpv","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66683","name":"Implantation iris prosthesis","description":"Implantation of iris prosthesis, including suture fixation and repair or removal of iris, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4408","name":"Xwrap hydro per sq cm","description":"Xwrap hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP16","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2470","name":"Inj pantoprazole sodium 40mg","description":"Injection, pantoprazole sodium, 40 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4414","name":"Simplichor per sq cm","description":"Simplichor, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9268","name":"Programmer orally ingest cap","description":"Programmer for transient, orally ingested capsule","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33970","name":"Aortic circulation assist","description":"Insertion of intra-aortic balloon assist device through the femoral artery, open approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35526","name":"Art byp grft aor/carot/innom","description":"Bypass graft, with vein; aortosubclavian, aortoinnominate, or aortocarotid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2044.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5949","name":"Mand implt sup fix part","description":"Mand implt sup fix part","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74021","name":"Radex abdomen 3+ views","description":"Radiologic examination, abdomen; 3 or more views","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98984","name":"Rtm dev sply resp sys 2-15 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of respiratory system, 2-15 days in a 30-day period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4543","name":"Supply trans elec nerve stim","description":"Supplies for transcutaneous electrical nerve stimulator, for nerves in the auricular region, per month","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2006","name":"Novosorb synpath per sq cm","description":"Novosorb synpath dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"Rec cath any transanal, each","description":"Rectal catheter with or without balloon, for use with any type transanal irrigation system, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99309","name":"Sbsq nf care moderate mdm 30","description":"Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":122.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4020","name":"Ophthalmology/optometry ss","description":"Ophthalmology/optometry mips specialty set","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76802","name":"Ob us < 14 wks addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1008T","name":"Rem mntr s-scl eeg sys setup","description":"Remote monitoring of sub-scalp implanted continuous bilateral electroencephalography monitoring system, device fitting, initial set-up, and patient education in wearing of system and use of equipment","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0981T","name":"Tcat impl wrls ivc snr","description":"Transcatheter implantation of wireless inferior vena cava sensor for long-term hemodynamic monitoring, including deployment of the sensor, radiological supervision and interpretation, right heart catheterization, and inferior vena cava venography, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6603","name":"Cst hgh nble mtl inlay >=3sr","description":"Inlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27278","name":"Arthrd si jt plmt iartic dev","description":"Arthrodesis, sacroiliac joint, percutaneous or minimally invasive, with image guidance, includes obtaining bone graft when performed, unilateral; placement of intra-articular device(s), without cortical piercing","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0680T","name":"Insj/rplcmt pg only isdss","description":"Insertion or replacement of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing lead(s)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2643","name":"Dental onlay porcelin 3 surf","description":"Onlay - porcelain/ceramic - three surfaces","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92288","name":"Scr dark adaptation meas i&r","description":"Screening dark adaptation measurement (eg, rod recovery intercept time), with interpretation and report","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0391","name":"Inj, artesunate, 1mg","description":"Injection, artesunate, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15951","name":"Exc trchntr pr ulc ostc","description":"Excision, trochanteric pressure ulcer, with primary suture; with ostectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1181","name":"Gr 2 or> dia or gr2 or> col","description":"Grade 2 or above diarrhea and/or grade 2 or above colitis","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69805","name":"Explore inner ear","description":"Endolymphatic sac operation; without shunt","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0438U","name":"Rx metab advrs vrnt alys 33","description":"Rx metab advrs vrnt alys 33","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4333","name":"Ardeograft, per sq cm","description":"Ardeograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1483","name":"Neg quan hep c or qual rna","description":"Patients who achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90481","name":"Admn sarscov2 vac ea add cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; each additional component administered (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1315","name":"Crc no doc no rsn","description":"Colorectal cancer screening results were not documented and reviewed; reason not otherwise specified","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4429","name":"Dermbnd chn, chx per sq cm","description":"Dermabind ch n or dermabind ch x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93588","name":"Vngrph chd vnvn cltrl below","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating below the heart (eg, from the inferior vena cava) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37262","name":"Iv lithotrp ivt w/in sm art","description":"Intravascular lithotripsy(ies), iliac vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61460","name":"Crnec sopl sctj 1+crnl nrv","description":"Craniectomy, suboccipital; for section of 1 or more cranial nerves","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2323.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4287","name":"Dermabind dl, per sq cm","description":"Dermabind dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0492U","name":"Onc sol tum ctc slctn pd-l1","description":"Onc sol tum ctc slctn pd-l1","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1342","name":"Pts died perf per","description":"Patients who died during the performance period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96381","name":"Admn rsv monoc antb im njx","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87812","name":"Sarscov2&inf typ a&b w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) and influenza virus types a and b","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11982","name":"Remove drug implant device","description":"Removal, non-biodegradable drug delivery implant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0396","name":"3d print of 3d surface scan","description":"3d print of 3d surface scan","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4258","name":"Enverse, per sq cm","description":"Enverse, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0926T","name":"Prgrmg dev eval ccm-d ip","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, including review and report, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94617","name":"Exercise tst brncspsm w/ecg","description":"Exercise test for bronchospasm, including pre- and post-spirometry and pulse oximetry; with electrocardiographic recording(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1373","name":"Mst rec gsa >=8 and <=9","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 8.0% and <= 9.0%","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0929T","name":"Rem interrog dev ccm-d tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1223","name":"Glaucoma plan of care doc","description":"Glaucoma plan of care documented","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27713","name":"Osteot tibia imed lngth dev","description":"Osteotomy(ies), tibia, including fibula when performed, unilateral, with insertion of an externally controlled intramedullary lengthening device, including imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4014","name":"Nephrology ss","description":"Nephrology mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0537","name":"Risk ascvd tst once pr 12 mo","description":"Administration of a standardized, evidence-based atherosclerotic cardiovascular disease (ascvd) risk assessment, 5-15 minutes, not more often than every 12 months","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89330","name":"Evaluation cervical mucus","description":"Sperm evaluation; cervical mucus penetration test, with or without spinnbarkeit test","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5154","name":"Inj, omlyclo, 5 mg","description":"Injection, omalizumab-igec (omlyclo), biosimilar, 5 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0184","name":"Inj, amisulpride, 1 mg","description":"Injection, amisulpride, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21812","name":"Treatment of rib fracture","description":"Open treatment of rib fracture(s) with internal fixation, includes thoracoscopic visualization when performed, unilateral; 4-6 ribs","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":721.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86581","name":"Strptcs pneum antb serot ia","description":"Streptococcus pneumoniae antibody (igg), serotypes, multiplex immunoassay, quantitative","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1344","name":"No bsln/2nd pam score 4-12mo","description":"Patients who did not have a baseline pam score and/or a second score within 4 to 12 months of baseline pam score","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4293","name":"Acesso dl, per sq cm","description":"Acesso dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4409","name":"Amniomatrixf3x per sq cm","description":"Amniomatrixf3x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0988T","name":"Opn ins/rplc ins ptn sbq&sbf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0108","name":"Diab manage trn  per indiv","description":"Diabetes outpatient self-management training services, individual, per 30 minutes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6516","name":"Grad com wrap w strap foo cu","description":"Gradient compression wrap with adjustable straps, foot, each, custom","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0867T","name":"Tpla b9 prst8 hyprplsa>=50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume greater or equal to 50 ml","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2016","name":"Permeaderm b, per sq cm","description":"Permeaderm b, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0545","name":"Inherent visit to inpt","description":"Visit complexity inherent to hospital inpatient or observation care associated with a confirmed or suspected infectious disease by an infectious diseases specialist, including disease transmission risk assessment and mitigation, public health investigation, analysis, and testing, and complex antimic","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4346","name":"Shelter dm matrix per sq cm","description":"Shelter dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90483","name":"Imm cnsl not admn sm>10<20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 10 minutes up to 20 minutes","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4416","name":"Alexiguard tl-t per sq cm","description":"Alexiguard tl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0387","name":"Comp image capture only","description":"Comp image capture only","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29893","name":"Endoscopic plantr fasciotomy","description":"Endoscopic plantar fasciotomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1003T","name":"Arthrp 1st crp/mtcrpl prostc","description":"Arthroplasty, first carpometacarpal joint, with distal trapezial and proximal first metacarpal prosthetic replacement (eg, first carpometacarpal total joint)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5783","name":"Add low ext mec limb vol lam","description":"Addition to lower extremity, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0600","name":"Edetate calcium disodium inj","description":"Injection, edetate calcium disodium, up to 1000 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61737","name":"Litt icr mlt trj mlt/cplx ls","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; multiple trajectories for multiple or complex lesion(s)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22837","name":"Ant thrc vrt body tethrg 8+","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; 8 or more vertebral segments","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1318","name":"Pts no csp doc contact","description":"Patients who did not have documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening or documentation that there was no contact with a csp","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52315","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from urethra or bladder (separate procedure); complicated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":321.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1212","name":"Missing gsa not perf","description":"Glycemic status assessment (hba1c or gmi) level is missing, or was not performed during the measurement period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98977","name":"Rtm dev sply mscskl 16-30 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of musculoskeletal system, 16-30 days in a 30-day period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52640","name":"Relieve bladder contracture","description":"Transurethral resection; of postoperative bladder neck contracture","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":439.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35541","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1816.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4002","name":"Ep cardio ss","description":"Electrophysiology cardiac specialist mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J1550","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1368","name":"Prev trt inf d/o hiv/hep mvp","description":"Prevention and treatment of infectious disorders including hepatitis c and hiv mips value pathway","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93526","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2923.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1350","name":"Pt w/ suic saf pln init rev","description":"Patients who had a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0533U","name":"Rx metab advrs gnotyp 16gens","description":"Rx metab advrs gnotyp 16gens","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0358U","name":"Neuro alys b-amyl 1-42&1-40","description":"Neuro alys b-amyl 1-42&1-40","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0870T","name":"Imp subq prtl ascts pmp sys","description":"Implantation of subcutaneous peritoneal ascites pump system, percutaneous, including pump-pocket creation, insertion of tunneled indwelling bladder and peritoneal catheters with pump connections, including all imaging and initial programming, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60520","name":"Removal of thymus gland","description":"Thymectomy, partial or total; transcervical approach (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1217.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70330","name":"X-ray exam of jaw joints","description":"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76802","name":"Ob us < 14 wks addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0403","name":"Ekg for initial prevent exam","description":"Electrocardiogram, routine ecg with 12 leads; performed as a screening for the initial preventive physical examination with interpretation and report","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0422U","name":"Onc pan solid tum alys dna","description":"Onc pan solid tum alys dna","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4268","name":"Surgraft ft per sq cm","description":"Surgraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0758T","name":"Dgtz gls mcrscp sl spc hchem","description":"Digitization of glass microscope slides for special stain, including interpretation and report, histochemical stain on frozen tissue block (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6614","name":"Onlay cst nbl mtl 2 surfaces","description":"Onlay - cast noble metal two surfaces","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0699T","name":"Njx pst chmbr eye medication","description":"Injection, posterior chamber of eye, medication","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34714","name":"Opn fem art expos cndt crtj","description":"Open femoral artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass, by groin incision, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0566","name":"3d bn img algor drvd fr mri","description":"3d radiodensity-value bone imaging, algorithm derived, from previous magnetic resonance examination of the same anatomy","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1211","name":"Gsa level>9.0%","description":"Most recent glycemic status assessment (hba1c or gmi) level > 9.0%","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4257","name":"Relese, per sq cm","description":"Relese, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0613U","name":"Onc uc dna mthyltn&mut 6bmrk","description":"Onc uc dna mthyltn&mut 6bmrk","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64467","name":"Thrc fascial pln blk uni nfs","description":"Thoracic fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96100","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0419U","name":"Nrpsyc gen seq vrnt aly 13","description":"Nrpsyc gen seq vrnt aly 13","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0562","name":"Complex simulation w/pet-ct","description":"Therapeutic radiology simulation-aided field setting; complex, including acquisition of pet and ct imaging data required for radiopharmaceutical-directed radiation therapy treatment planning (i.e., modeling)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0362U","name":"Onc pap thyr ca rna 82&10","description":"Onc pap thyr ca rna 82&10","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1477","name":"Dx delirium","description":"Diagnosis of delirium","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21501","name":"I&d dp absc/hmtma sft ts nck","description":"Incision and drainage, deep abscess or hematoma, soft tissues of neck or thorax;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6092","name":"Recement supp crown","description":"Recement implant/abutment supported crown","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0973T","name":"Slctv nzmtc dbrdmt t/a/l 1st","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; first 100 sq cm","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4330","name":"Total, per sq cm","description":"Total, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69728","name":"Rmv ntr oi imp sk tc>=100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3432","name":"Guided tissue regeneration","description":"Guided tissue regeneration","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9331","name":"Inj sirolimus prot part 1 mg","description":"Injection, sirolimus protein-bound particles, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69716","name":"Impl oi implt sk tc esp<100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or resulting in removal of less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1269","name":"Recd esrd mcp lst day of mo","description":"Receiving esrd mcp dialysis services by the provider on the last day of the reporting month","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0702","name":"2d cephal radio image","description":"2d cephal radio image","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47563","name":"Laparo cholecystectomy/graph","description":"Laparoscopy, surgical; cholecystectomy with cholangiography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":838.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1018T","name":"Elec alys npgs esoph sbsq w/","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9949","name":"Repair sleep apnea appliance","description":"Repair sleep apnea appliance","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81025","name":"Urine pregnancy test","description":"Urine pregnancy test, by visual color comparison methods","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9220","name":"Indigotindisulfonate sod 1mg","description":"Injection, indigotindisulfonate sodium, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1711","name":"Moderna vacc admin booster","description":"Moderna vacc admin booster","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4404","name":"Xwrap hydro plus per sq cm","description":"Xwrap hydro plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64467","name":"Thrc fascial pln blk uni nfs","description":"Thoracic fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0336U","name":"Rare ds whl gen seq bld/slv","description":"Rare ds whl gen seq bld/slv","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29025","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15361","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0315U","name":"Onc cutan sq cll ca mrna 40","description":"Onc cutan sq cll ca mrna 40","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0495U","name":"Onc prst8 alys crcg plsm prt","description":"Onc prst8 alys crcg plsm prt","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0841T","name":"Dgtz gls mcrscp pth cslt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; first tissue block, with frozen section(s), single specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2804","name":"Inj, rifampin, 1 mg","description":"Injection, rifampin, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1367","name":"Qual care ent disorder mvp","description":"Quality care for the treatment of ear, nose, and throat disorders mips value pathway","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4311","name":"Acesso, per sq cm","description":"Acesso, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52287","name":"Cystoscopy chemodenervation","description":"Cystourethroscopy, with injection(s) for chemodenervation of the bladder","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0913T","name":"Prq tcat ther rx ntrac balo1","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting), including mechanical dilation by nondrug-delivery balloon angioplasty, endoluminal imaging using intravascular ultrasound (ivus) or optical coherence tomography (oct) when per","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0945T","name":"Intraop assmt abnl tum tiss","description":"Intraoperative assessment for abnormal (tumor) tissue, in-vivo, following partial mastectomy (eg, lumpectomy) using computer-aided fluorescence imaging (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0899T","name":"N-invas deter aqmbf aug cmr","description":"Noninvasive determination of absolute quantitation of myocardial blood flow (aqmbf), derived from augmentative algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health car","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0586U","name":"Onc mrna gen xprsn 216 genes","description":"Onc mrna gen xprsn 216 genes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0239","name":"Oth resp proc, group","description":"Therapeutic procedures to improve respiratory function or increase strength or endurance of respiratory muscles, two or more individuals (includes monitoring)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74250","name":"X-ray xm sm int 1cntrst std","description":"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85460","name":"Hemoglobin fetal","description":"Hemoglobin or rbcs, fetal, for fetomaternal hemorrhage; differential lysis (kleihauer-betke)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0511U","name":"Onc sol tum 3dmicroenvir 36+","description":"Onc sol tum 3dmicroenvir 36+","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":674.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1450","name":"Fluconazole","description":"Injection fluconazole, 200 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1368","name":"Prev trt inf d/o hiv/hep mvp","description":"Prevention and treatment of infectious disorders including hepatitis c and hiv mips value pathway","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0798T","name":"Tcat rmv 2chmbr ldls pm cmpl","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; complete system (ie, right atrial and right ventricular pacemaker components)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0568","name":"Int psych care mng, 1 cal mo","description":"Initial psychiatric collaborative care management, in the first calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required elements: outrea","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0898T","name":"N-invas prst8 cancer est map","description":"Noninvasive prostate cancer estimation map, derived from augmentative analysis of image-guided fusion biopsy and pathology, including visualization of margin volume and location, with margin determination and physician interpretation and report","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37296","name":"Revsc evasc imvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0049","name":"Main hemo in-cntr","description":"With maintenance hemodialysis (in-center and home hd) for the complete reporting month","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9347","name":"Inj, tremelimumab-actl, 1 mg","description":"Injection, tremelimumab-actl, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4352","name":"Overlay sl matrix, per sq cm","description":"Overlay sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0493U","name":"Trnspl med quan dd-cfdna ngs","description":"Trnspl med quan dd-cfdna ngs","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53865","name":"Cysto insj dev ischmc rmdlg","description":"Cystourethroscopy with insertion of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0613","name":"Calcium glucon (wg critical)","description":"Injection, calcium gluconate (wg critical care), not therapeutically equivalent to j0612, 10 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0757T","name":"Dgtz gls mcrscp sl spc grpii","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group ii, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistochemistry (list separately in addition to code for primary","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7294","name":"Seg acet and eth estr yearly","description":"Segesterone acetate and ethinyl estradiol 0.15mg, 0.013mg per 24 hours; yearly vaginal system, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9278","name":"Inj, carboplatin (avyxa)","description":"Injection, carboplatin (avyxa), 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1333","name":"Acute vitreous hemorrhage","description":"Acute vitreous hemorrhage","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66179","name":"Aqueous shunt eye w/o graft","description":"Aqueous shunt to extraocular equatorial plate reservoir, external approach; without graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83876","name":"Assay myeloperoxidase","description":"Myeloperoxidase (mpo)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6515","name":"Grad com wrap w str fu le cu","description":"Gradient compression wrap with adjustable straps, full leg, each, custom","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51605","name":"Preparation for bladder xray","description":"Injection procedure and placement of chain for contrast and/or chain urethrocystography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4432","name":"510(k) skin subs, nos","description":"510(k) skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2019","name":"Kerecis marigen shld sq cm","description":"Kerecis omega3 marigen shield, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24300","name":"Mnpj elbow under anes","description":"Manipulation, elbow, under anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0803T","name":"Tcat rmv&rpl2chmb ldls pm rv","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ve","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9912","name":"Pre-visit patient screening","description":"Pre-visit patient screening","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0878T","name":"Augmnt alys ch ct ild w/ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained with concurrent ct examination of the same structure","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0488U","name":"Ob fetal ag nipt cfdna alys","description":"Ob fetal ag nipt cfdna alys","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9573","name":"Inj, gadopiclenol, 1 ml","description":"Injection, gadopiclenol, 1 ml","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0846T","name":"Dgtz gls mcrscp imfluor ea","description":"Digitization of glass microscope slides for immunofluorescence, per specimen; each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4281","name":"Barrera slor dl per sq cm","description":"Barrera sl or barrera dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15018","name":"App skn cll ssp f/n/g/hf ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 480 sq cm or part thereof (list separately in addition to code for prima","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2788","name":"Rho d immune globulin 50 mcg","description":"Injection, rho d immune globulin, human, minidose, 50 micrograms (250 i.u.)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0460U","name":"Onc whl bld/bucc rtpcr 24gen","description":"Onc whl bld/bucc rtpcr 24gen","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3473","name":"Surg rep root res molar","description":"Surg rep root res molar","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1226","name":"Iop not doc","description":"Iop measurement not documented, reason not otherwise specified","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86381","name":"Mitochondrial antibody each","description":"Mitochondrial antibody (eg, m2), each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0584U","name":"Neuro csf prion prtn qual","description":"Neuro csf prion prtn qual","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90836","name":"Psytx w pt w e/m 45 min","description":"Psychotherapy, 45 minutes with patient when performed with an evaluation and management service (list separately in addition to the code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":34.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":91.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4022","name":"Otolaryngology ss","description":"Otolaryngology mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54680","name":"Relocation of testis(es)","description":"Transplantation of testis(es) to thigh (because of scrotal destruction)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":880.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4390","name":"Ascendion per sq cm","description":"Ascendion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0365U","name":"Onc bldr 10 prb bldr ca","description":"Onc bldr 10 prb bldr ca","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99461","name":"Init nb em per day non-fac","description":"Initial care, per day, for evaluation and management of normal newborn infant seen in other than hospital or birthing center","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":90.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55713","name":"Bx prst8 in-bore ct/mri bx 1","description":"Biopsy, prostate, in-bore ct- or mri-guided (ie, sextant), with biopsy of additional targeted lesion(s), first targeted lesion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":99.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85097","name":"Bone marrow interpretation","description":"Bone marrow, smear interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0177","name":"Inj, aflibercept hd, 1 mg","description":"Injection, aflibercept hd, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12004","name":"Rpr s/n/ax/gen/trk7.6-12.5cm","description":"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 7.6 cm to 12.5 cm","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":176.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81000","name":"Urinalysis nonauto w/scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; non-automated, with microscopy","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1339","name":"Pts f/u 30-180 dys + improv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who demonstrated positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33925","name":"Rpr pul art unifocal w/o cpb","description":"Repair of pulmonary artery arborization anomalies by unifocalization; without cardiopulmonary bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2200.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4310","name":"Procenta, per 100 mg","description":"Procenta, per 100 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0217","name":"Inj velmanase alfa-tycv 1 mg","description":"Injection, velmanase alfa-tycv, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21920","name":"Biopsy soft tissue of back","description":"Biopsy, soft tissue of back or flank; superficial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0562","name":"Complex simulation w/pet-ct","description":"Therapeutic radiology simulation-aided field setting; complex, including acquisition of pet and ct imaging data required for radiopharmaceutical-directed radiation therapy treatment planning (i.e., modeling)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76815","name":"Ob us limited fetus(s)","description":"Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1266","name":"Pts admit snf","description":"Patients admitted to a skilled nursing facility (snf)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82948","name":"Reagent strip/blood glucose","description":"Glucose; blood, reagent strip","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2928","name":"Prefab porc/cer crown perm","description":"Prefab porc/cer crown perm","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7939","name":"Indexing for osteotomy","description":"Indexing for osteotomy","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0643","name":"Lso sag ctr rigi pos pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0751T","name":"Dgtz gls mcrscp sld level ii","description":"Digitization of glass microscope slides for level ii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9273","name":"Inj tisotu vedotin-tftv, 1mg","description":"Injection, tisotumab vedotin-tftv, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3246","name":"Tirofiban hcl","description":"Injection, tirofiban hcl, 0.25 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0831T","name":"Dgtz gls mcrscp cytp c/v","description":"Digitization of glass microscope slides for cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93153","name":"Interrog w/o prgrmg ipnss","description":"Interrogation without programming of implanted phrenic nerve stimulator system","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0423","name":"Genetic test spec analysis","description":"Genetic test spec analysis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95910","name":"Nrv cndj test 7-8 studies","description":"Nerve conduction studies; 7-8 studies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0417U","name":"Rare ds alys 335 nuc genes","description":"Rare ds alys 335 nuc genes","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0329U","name":"Onc neo xome&trns seq alys","description":"Onc neo xome&trns seq alys","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43286","name":"Esphg tot w/laps moblj","description":"Esophagectomy, total or near total, with laparoscopic mobilization of the abdominal and mediastinal esophagus and proximal gastrectomy, with laparoscopic pyloric drainage procedure if performed, with open cervical pharyngogastrostomy or esophagogastrostomy (ie, laparoscopic transhiatal esophagectomy","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3441.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37262","name":"Iv lithotrp ivt w/in sm art","description":"Intravascular lithotripsy(ies), iliac vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64561","name":"Implant neuroelectrodes","description":"Percutaneous implantation of neurostimulator electrode array; sacral nerve (transforaminal placement) including image guidance, if performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0368","name":"Cone beam ct interprete tmj","description":"Cone beam ct interprete tmj","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0201","name":"Pne flu hepb cov home admin","description":"Administration of pneumococcal, influenza, hepatitis b, and/or covid-19 vaccine inside a patients home; reported only once per individual home per date of service when such vaccine administration(s) are performed at the patients home","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4404","name":"Xwrap hydro plus per sq cm","description":"Xwrap hydro plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9292","name":"Inj, pemetrexed dipotassium","description":"Injection, pemetrexed dipotassium, 10 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91124","name":"Rct snsatn tone&cmplianc std","description":"Rectal sensation, tone, and compliance study (eg, barostat)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37276","name":"Rvsc evsc fpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0249","name":"Adm tocilizu covid-19 1st","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1357","name":"Pt w/red suic idea 120 days","description":"Patients who had a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1747","name":"Inj, spesolimab-sbzo, 1 mg","description":"Injection, spesolimab-sbzo, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1329","name":"Pts act pvd 2 wks 8 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 8 weeks after initial acute pvd encounter","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1237","name":"Pt rsn no scrn","description":"Patient reason for not screening for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety (e.g., patient declined or other patient reasons)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4285","name":"Nudyn dl or dl mesh pr sq cm","description":"Nudyn dl or nudyn dl mesh, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0682","name":"App non-sheet skin sub add","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (list separately in addition to code for pri","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84207","name":"Assay of vitamin b-6","description":"Pyridoxal phosphate (vitamin b-6)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25448","name":"Arthrp ntrcrpl/crp/mtcrp ssp","description":"Arthroplasty, intercarpal or carpometacarpal joints; suspension, including transfer or transplant of tendon, with interposition, when performed","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45540","name":"Correct rectal prolapse","description":"Proctopexy (eg, for prolapse); abdominal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87562","name":"M.avium-intra dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacteria avium-intracellulare, quantification","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25695","name":"Optx lunate dislocation","description":"Open treatment of lunate dislocation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":764.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64728","name":"Dcmprn median nrv carpl tunl","description":"Decompression; median nerve at the carpal tunnel, percutaneous, with intracarpal tunnel balloon dilation, including ultrasound guidance","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0737","name":"Inj, clindamycin (baxter)","description":"Injection, clindamycin phosphate (baxter), not therapeutically equivalent to j0736, 300 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0739","name":"Hiv prep, inj, cabotegravir","description":"Injection, cabotegravir, 1mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47001","name":"Ndl biopsy lvr tm oth maj px","description":"Biopsy of liver, needle; when done for indicated purpose at time of other major procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4322","name":"Splint intra-coronal","description":"Splint intra-coronal","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0762T","name":"Dgtz gls mcrscp sl imm ea m","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, each multiplex antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99495","name":"Transj care mgmt mod f2f 14d","description":"Transitional care management services with the following required elements: communication (direct contact, telephone, electronic) with the patient and/or caregiver within 2 business days of discharge at least moderate level of medical decision making during the service period face-to-face visit, wit","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":119.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2012","name":"Suprathel, per sq cm","description":"Suprathel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61626","name":"Tcat perm occls/embol noncns","description":"Transcatheter permanent occlusion or embolization (eg, for tumor destruction, to achieve hemostasis, to occlude a vascular malformation), including all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention, percutaneous,","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1203","name":"Inj, cipaglucosidase, 5 mg","description":"Injection, cipaglucosidase alfa-atga, 5 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0490U","name":"Onc cutan/uveal mlnma cd146","description":"Onc cutan/uveal mlnma cd146","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7299","name":"Rem anchorage device w/flap","description":"Rem anchorage device w/flap","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8605","name":"Inj bulking agent anal canal","description":"Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, anal canal, 1 ml, includes shipping and necessary supplies","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":860.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3373","name":"Inj, vancomycin hcl, 10 mg","description":"Injection, vancomycin hydrochloride, 10 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1490","name":"Pt status not doc","description":"Patient status not documented","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1266","name":"Pts admit snf","description":"Patients admitted to a skilled nursing facility (snf)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63053","name":"Lam factc/frmt arthrd lum ea","description":"Laminectomy, facetectomy, or foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s] [eg, spinal or lateral recess stenosis]), during posterior interbody arthrodesis, lumbar; each additional vertebral segment (list separately in addition to code for","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0614U","name":"Iem pmd alys 4 nzm cplx page","description":"Iem pmd alys 4 nzm cplx page","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33273","name":"Repos prev impltbl subq dfb","description":"Repositioning of previously implanted subcutaneous implantable defibrillator electrode","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":465.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0899T","name":"N-invas deter aqmbf aug cmr","description":"Noninvasive determination of absolute quantitation of myocardial blood flow (aqmbf), derived from augmentative algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health car","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90838","name":"Psytx w pt w e/m 60 min","description":"Psychotherapy, 60 minutes with patient when performed with an evaluation and management service (list separately in addition to the code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":133.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0377U","name":"Cv ds quan advsrm/plsm lprtn","description":"Cv ds quan advsrm/plsm lprtn","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0539U","name":"Onc sol tumor cfctdna 152gen","description":"Onc sol tumor cfctdna 152gen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80220","name":"Drug asy hydroxychloroquine","description":"Hydroxychloroquine","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3240","name":"Thyrotropin injection","description":"Injection, thyrotropin alpha, 0.9 mg, provided in 1.1 mg vial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":699.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2023","name":"Innovamatrix pd, 1 mg","description":"Innovamatrix pd, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0770T","name":"Vr technology assist therapy","description":"Virtual reality technology to assist therapy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0578","name":"Inj brixadi, more than 7 day","description":"Injection, buprenorphine extended release (brixadi), greater than 7 days and up to 28 days of therapy","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1203","name":"No rsn ace-i/arb rx","description":"Ace inhibitor or arb therapy not prescribed during the measurement period, reason not given","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4347","name":"Rampart dl matrix per sq cm","description":"Rampart dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":357.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0465U","name":"Onc urthl carc dna qmsp 2gen","description":"Onc urthl carc dna qmsp 2gen","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0858T","name":"Ext trnscranl mag stimj meas","description":"Externally applied transcranial magnetic stimulation with concomitant measurement of evoked cortical potentials with automated report","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3392","name":"Inj, exagamglogene autotem","description":"Injection, exagamglogene autotemcel, per treatment","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0557U","name":"Nfct ds bv dna mrk vag fluid","description":"Nfct ds bv dna mrk vag fluid","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5783","name":"Add low ext mec limb vol lam","description":"Addition to lower extremity, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0753T","name":"Dgtz gls mcrscp sld level iv","description":"Digitization of glass microscope slides for level iv, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90484","name":"Imm cnsl not admn sm>20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 20 minutes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44403","name":"Colonoscopy w/resection","description":"Colonoscopy through stoma; with endoscopic mucosal resection","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36861","name":"Cannula declotting","description":"External cannula declotting (separate procedure); with balloon catheter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1277","name":"Colorectal ca screen doc rev","description":"Colorectal cancer screening results documented and reviewed","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49186","name":"Opn exc/dstr ntra-abd 5 cm/<","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5 cm or less","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J1490","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90481","name":"Admn sarscov2 vac ea add cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; each additional component administered (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80156","name":"Assay carbamazepine total","description":"Carbamazepine; total","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86403","name":"Particle agglut antbdy scrn","description":"Particle agglutination; screen, each antibody","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91319","name":"Sarscv2 vac 10mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 10 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0730T","name":"Trabeculotomy lsr w/oct gdn","description":"Trabeculotomy by laser, including optical coherence tomography (oct) guidance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2791","name":"Crown full cast base metal","description":"Crown-full cast predominantly base metal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97803","name":"Med nutrition indiv subseq","description":"Medical nutrition therapy; re-assessment and intervention, individual, face-to-face with the patient, each 15 minutes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":35.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77090","name":"Tbs techl prep&transmis data","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9061","name":"Inj, amivantamab-vmjw","description":"Injection, amivantamab-vmjw, 2 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0958T","name":"Rmv s-sclp eltr ra rcvr&tlmt","description":"Removal of sub-scalp implanted electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0921T","name":"Rmvl perm ccm-d sys 1 dfb ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous defibrillation lead only","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26517","name":"Fusion of knuckle joints","description":"Capsulodesis, metacarpophalangeal joint; 2 digits","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1096.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1782","name":"Vac admin human pap dose 2","description":"Vac admin human pap dose 2","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80220","name":"Drug asy hydroxychloroquine","description":"Hydroxychloroquine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2014","name":"Omeza collag compl 100 mg","description":"Omeza collagen matrix or omeza complete matrix, per 100 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81456","name":"So/hl 51/>gsap rna alys","description":"Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic sequence analysis panel, interrogation for sequence variants and copy number variants or rearrangements, or isoform expression or mrna expression levels, if performed; rna analysis","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31661","name":"Bronch thermoplsty 2/> lobes","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial thermoplasty, 2 or more lobes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1299","name":"Inj, eculizumab, 2 mg","description":"Injection, eculizumab, 2 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83857","name":"Assay of methemalbumin","description":"Methemalbumin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0528","name":"Mgt est pt dem mod-hi cmplx","description":"Management of established patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37280","name":"Revsc evsc tpvt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1426","name":"Injection, casimersen, 10 mg","description":"Injection, casimersen, 10 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9268","name":"Programmer orally ingest cap","description":"Programmer for transient, orally ingested capsule","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5099","name":"Inj ustekinumab-stba, 1 mg","description":"Injection, ustekinumab-stba (steqeyma), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5127","name":"Inj, stimufend, 0.5 mg","description":"Injection, pegfilgrastim-fpgk (stimufend), biosimilar, 0.5 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5136","name":"Inj. denosumab-bbdz, 1 mg","description":"Injection, denosumab-bbdz (jubbonti/wyost), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81354","name":"Cytog alys chrml abnor ogm","description":"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of structural and copy number variants, optical genome mapping (ogm)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0458","name":"Aztreonam/avibactam 10 mg","description":"Injection, aztreonam/avibactam, 7.5 mg/2.5 mg (10 mg)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0821T","name":"Mntr psychdlc med 2ndphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; second physician or other qualified health care professional, concurrent with first physician or other qualified health care professional, each hour (list sepa","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2040","name":"Coord specialty care, month","description":"Coordinated specialty care, team-based, for first episode psychosis, per month","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0936T","name":"Photobiomodulation ther rta","description":"Photobiomodulation therapy of retina, single session","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1002T","name":"Air displacmnt plethysmograp","description":"Air displacement plethysmography, whole-body composition assessment, with interpretation and report","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0455","name":"Tlso flex trnk sj-t9 pre ots","description":"Tlso, flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, pref","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1392","name":"Pt rsn no exm or lst to fu","description":"Documentation of patient reasons for no examination, i.e., refusal of examination or lost to follow-up (documentation must include information that the clinician was unable to reach the patient by phone, mail or secure electronic mail - at least one method must be documented)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1290","name":"Pt not eli d/t act dig htn","description":"Patient not eligible due to active diagnosis of hypertension","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84235","name":"Assay of endocrine hormone","description":"Receptor assay; endocrine, other than estrogen or progesterone (specify hormone)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1370","name":"Rehab support msk care mvp","description":"Rehabilitative support for musculoskeletal care mips value pathway","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93584","name":"Vngrph chd anom/persist svc","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; anomalous or persistent superior vena cava when it exists as a second contralateral superior vena cava, with native drainage to heart (list separately in addition to code for pri","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23600","name":"Cltx prox humrl fx w/o mnpj","description":"Closed treatment of proximal humeral (surgical or anatomical neck) fracture; without manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0310U","name":"Ped vsclts kd alys 3 bmrks","description":"Ped vsclts kd alys 3 bmrks","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0169","name":"Inj epinephrine (adrenalin)","description":"Injection, epinephrine (adrenalin), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26418","name":"Repair finger tendon","description":"Repair, extensor tendon, finger, primary or secondary; without free graft, each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":804.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24145","name":"Prtl exc bone radial h/n","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), radial head or neck","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":774.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36522","name":"Photopheresis","description":"Photopheresis, extracorporeal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99460","name":"Init nb em per day hosp","description":"Initial hospital or birthing center care, per day, for evaluation and management of normal newborn infant","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93151","name":"Interrog&prgrmg ipnss","description":"Interrogation and programming (minimum one parameter) of implanted phrenic nerve stimulator system","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0870T","name":"Imp subq prtl ascts pmp sys","description":"Implantation of subcutaneous peritoneal ascites pump system, percutaneous, including pump-pocket creation, insertion of tunneled indwelling bladder and peritoneal catheters with pump connections, including all imaging and initial programming, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51065","name":"Remove ureter calculus","description":"Cystotomy, with calculus basket extraction and/or ultrasonic or electrohydraulic fragmentation of ureteral calculus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":607.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21408","name":"Opn tx orbit fx w/bone grft","description":"Open treatment of fracture of orbit, except blowout; with bone grafting (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7601","name":"Ensifentrine inh 3 mg","description":"Ensifentrine, inhalation suspension, fda approved final product, non-compounded, administered through dme, unit dose form, 3 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2031","name":"Mirodry, per sq cm","description":"Mirodry wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0872","name":"Daptomycin (xellia) unrefrig","description":"Injection, daptomycin (xellia), unrefrigerated, not therapeutically equivalent to j0878 or j0873, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"13152","name":"Cmplx rpr e/n/e/l 2.6-7.5 cm","description":"Repair, complex, eyelids, nose, ears and/or lips; 2.6 cm to 7.5 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":476.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82024","name":"Assay of acth","description":"Adrenocorticotropic hormone (acth)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33533","name":"Cabg arterial single","description":"Coronary artery bypass, using arterial graft(s); single arterial graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2286.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49189","name":"Opn exc/dst ntra-abd 20.1-30","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 20.1 to 30 cm","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54326","name":"Reconstruction of urethra","description":"1-stage distal hypospadias repair (with or without chordee or circumcision); with urethroplasty by local skin flaps and mobilization of urethra","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1078.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0573U","name":"Onc pancreas 3bmrk pclf alg","description":"Onc pancreas 3bmrk pclf alg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9997","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2351","name":"Inj ocrelizumab 1mg hya-ocsq","description":"Injection, ocrelizumab, 1 mg and hyaluronidase-ocsq","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88373","name":"M/phmtrc alys ishquant/semiq","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1311","name":"Aphlx to vax bef enc","description":"Anaphylaxis due to the vaccine on or before the date of the encounter","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7413","name":"Excision malig lesion<=1.25c","description":"Excision of malignant lesion up to 1.25 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64628","name":"Trml dstrj ios bvn 1st 2 l/s","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; first 2 vertebral bodies, lumbar or sacral","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0480U","name":"Nfct ds csf metag ngs alys","description":"Nfct ds csf metag ngs alys","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0019M","name":"Cv ds plasma alys prtn bmrk","description":"Cardiovascular disease, plasma, analysis of protein biomarkers by aptamer-based microarray and algorithm reported as 4-year likelihood of coronary event in high-risk populations","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52597","name":"Trurl rbtc wtrjt rescj prst8","description":"Transurethral robotic-assisted waterjet resection of prostate, including intraoperative planning, ultrasound guidance, control of postoperative bleeding, complete, including vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G3003","name":"Chronic pain mgmt addl 15m","description":"Each additional 15 minutes of chronic pain management and treatment by a physician or other qualified health care professional, per calendar month. (list separately in addition to code for g3002. when using g3003, 15 minutes must be met or exceeded.)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81449","name":"So neo gsap 5-50 rna alys","description":"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; rna analysis","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74363","name":"X-ray bile duct dilation","description":"Percutaneous transhepatic dilation of biliary duct stricture with or without placement of stent, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":366.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4297","name":"Emerge matrix, per sq cm","description":"Emerge matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70481","name":"Ct orbit/ear/fossa w/dye","description":"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0796T","name":"Tcat ins 2chmbr ldls pm ra","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right atrial pacemaker","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86585","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6113","name":"Imp/abut rem dent part mand","description":"Imp/abut rem dent part mand","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83529","name":"Asay of interleukin-6 (il-6)","description":"Interleukin-6 (il-6)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62330","name":"Dcmprn prq rmv lig flv 1lmbr","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; one interspace, lumbar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":257.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0554","name":"Add 20 m of monthly tx","description":"Each additional 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing data generated from the","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0778T","name":"Smmg cncrnt appl imu snr","description":"Surface mechanomyography (smmg) with concurrent application of inertial measurement unit (imu) sensors for measurement of multi-joint range of motion, posture, gait, and muscle function","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33284","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86664","name":"Epstein-barr nuclear antigen","description":"Antibody; epstein-barr (eb) virus, nuclear antigen (ebna)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82671","name":"Assay of estrogens","description":"Estrogens; fractionated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45349","name":"Sigmoidoscopy w/resection","description":"Sigmoidoscopy, flexible; with endoscopic mucosal resection","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0858T","name":"Ext trnscranl mag stimj meas","description":"Externally applied transcranial magnetic stimulation with concomitant measurement of evoked cortical potentials with automated report","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61737","name":"Litt icr mlt trj mlt/cplx ls","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; multiple trajectories for multiple or complex lesion(s)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99223","name":"1st hosp ip/obs high 75","description":"Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 75 minutes must","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"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":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0883T","name":"Intraop ther estim pn ue ea","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; each additional nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93593","name":"R hrt cath chd nml nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; normal native connections","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1222","name":"Glaucoma pln of care not doc","description":"Glaucoma plan of care not documented, reason not otherwise specified","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54500","name":"Biopsy of testis","description":"Biopsy of testis, needle (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4349","name":"Mantle dl matrix per sq cm","description":"Mantle dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0427U","name":"Monocyte dstrbj wdth whl bld","description":"Monocyte dstrbj wdth whl bld","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1813","name":"Lyumjev for insulin pump use","description":"Insulin (lyumjev) for administration through dme (i.e., insulin pump) per 50 units","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3379","name":"Inj, valproate sod, 5 mg","description":"Injection, valproate sodium, 5 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1233","name":"Pt no hcv aby or result","description":"Patient does not receive hcv antibody test or patient does receive hcv antibody test but results not documented, reason not given","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4436","name":"Renati ac membrane per sq cm","description":"Renati ac membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0678T","name":"Laps repos lead isdss ea add","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional repositioned lead (list separately in addition to code for primary proce","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4270","name":"Complete sl per sq cm","description":"Complete sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1412","name":"Met nsclc w/ egfr alk oth ab","description":"Patients with metastatic nsclc with epidermal growth factor receptor (egfr) mutations, alk genomic tumor aberrations, or other targetable genomic abnormalities with approved first-line targeted therapy, such as nsclc with ros1 rearrangement, braf v600e mutation, ntrk 1/2/3 gene fusion, met ex14 skip","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0400U","name":"Ob xpnd car scr 145 genes","description":"Ob xpnd car scr 145 genes","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0494U","name":"Rbc ag ftl rhd gene alys ngs","description":"Rbc ag ftl rhd gene alys ngs","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0717T","name":"Adrc ther prtl rc tear","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; adipose tissue harvesting, isolation and preparation of harvested cells, including incubation with cell dissociation enzymes, filtration, washing, and concentration of adrcs","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5914","name":"Auricular prosthesis","description":"Auricular prosthesis","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1933","name":"Afo rig ant tib tcf/= ots","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, off-the-shelf","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64658","name":"Rmvl bat modul sys lead only","description":"Removal of baroreflex activation therapy (bat) modulation system; lead only","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1338","name":"Pt f/u 30-180 dys no + imprv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who did not demonstrate positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1305","name":"Inj, evinacumab-dgnb, 5mg","description":"Injection, evinacumab-dgnb, 5mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4199","name":"Cygnus matrix, per sq cm","description":"Cygnus matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0901","name":"Vadadustat oral 1mg for esrd","description":"Vadadustat, oral, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1475","name":"Pt dx huntington","description":"Patients with diagnosis of huntingtons disease","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65275","name":"Repair of eye wound","description":"Repair of laceration; cornea, nonperforating, with or without removal foreign body","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4419","name":"Biolab wrap flw lt per sq cm","description":"Biolab membrane wrap lite flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0995T","name":"Evasc dlvr a-wal stbl rx opn","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; open","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0759T","name":"Dgtz gls mcrscp sl sp grpiii","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group iii, for enzyme constituents (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1370","name":"Rehab support msk care mvp","description":"Rehabilitative support for musculoskeletal care mips value pathway","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5611","name":"Rep resin part dent base man","description":"Rep resin part dent base man","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0762T","name":"Dgtz gls mcrscp sl imm ea m","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, each multiplex antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81459","name":"So neo gsap dna/dna&rna","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants, microsatellite instability, tumor mutation burden, and rearrangements","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1183","name":"Doc imm ckpt inhib hld","description":"Documentation of immune checkpoint inhibitor therapy held and corticosteroids or immunosuppressants prescribed or administered","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5159","name":"Inj, denosumab-dssb, 1 mg","description":"Injection, denosumab-dssb (ospomyv/xbryk), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0721T","name":"Quan ct tiss charac w/o ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64659","name":"Rmvl bat modulj sys pg only","description":"Removal of baroreflex activation therapy (bat) modulation system; pulse generator only","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1477","name":"Dx delirium","description":"Diagnosis of delirium","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7300","name":"Rem anchorage dev w/o flap","description":"Rem anchorage dev w/o flap","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6036","name":"Prosthetic thumb mechanical","description":"Prosthetic thumb, mechanical, can include metacarpophalangeal (mcp), interphalangeal (ip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0853T","name":"Dgtz gls mcrscp mphmtrc ea m","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19281","name":"Perq device breast 1st imag","description":"Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; first lesion, including mammographic guidance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42210","name":"Reconstruct cleft palate","description":"Palatoplasty for cleft palate, with closure of alveolar ridge; with bone graft to alveolar ridge (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1276.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4282","name":"Cygnus dual per sq cm","description":"Cygnus dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0526U","name":"Nefro rnl trnspl quan cxcl10","description":"Nefro rnl trnspl quan cxcl10","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1576","name":"Inj, panzyga, 500 mg","description":"Injection, immune globulin (panzyga), intravenous, non-lyophilized (e.g., liquid), 500 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7473","name":"Remove torus mandibularis","description":"Removal of torus mandibularis","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0667","name":"Team remote e/m est pt 25 mn","description":"Team remote e/m est. pt 25mins","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67875","name":"Closure of eyelid by suture","description":"Temporary closure of eyelids by suture (eg, frost suture)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3222","name":"Part pulp for apexogenesis","description":"Partial pulpotomy for apexogenesis - permanent tooth with incomplete root development","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0976T","name":"Slctv nzmtc dbrdmt s/n/hf ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; each additional 100 sq cm (list separately in addition to code for p","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6211","name":"Bridge base metal cast","description":"Pontic-cast predominantly base metal","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29901","name":"Mcp joint arthroscopy surg","description":"Arthroscopy, metacarpophalangeal joint, surgical; with debridement","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":617.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1198","name":"Isa not red 3pts /no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6092","name":"Recement supp crown","description":"Recement implant/abutment supported crown","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59855","name":"Induced abortion 1+vag supp","description":"Induced abortion, by 1 or more vaginal suppositories (eg, prostaglandin) with or without cervical dilation (eg, laminaria), including hospital admission and visits, delivery of fetus and secundines;","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":456.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0264U","name":"Rare ds id opt genome mapg","description":"Rare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0480U","name":"Nfct ds csf metag ngs alys","description":"Nfct ds csf metag ngs alys","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1437","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0922T","name":"Rmvl perm ccm-d sys dual ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); dual (pacing and defibrillation) transvenous leads only","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92597","name":"Oral speech device eval","description":"Evaluation for use and/or fitting of voice prosthetic device to supplement oral speech","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4252","name":"Vendaje, per square centimet","description":"Vendaje, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0861T","name":"Rmvl pg wcs lv both compnt","description":"Removal of pulse generator for wireless cardiac stimulator for left ventricular pacing; both components (battery and transmitter)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59612","name":"Vbac delivery only","description":"Vaginal delivery only, after previous cesarean delivery (with or without episiotomy and/or forceps);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1026.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":1134.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1398","name":"Bslne and  fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1380","name":"2 rx in perf pd any com meds","description":"Filled at least two prescriptions during the performance period for any combination of the qualifying oral antipsychotic medications listed under denominator note or the long-acting injectable antipsychotic medications listed under denominator note","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5421","name":"Dentures adjust part maxill","description":"Adjust partial denture - maxillary","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1275","name":"Pts hosp exl","description":"Patients determined to be in hospice were excluded from month of evaluation and the remainder of reporting period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1447","name":"Pt dx bd bef end meas pd","description":"Patients with an active diagnosis of bipolar disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96361","name":"Hydrate iv infusion add-on","description":"Intravenous infusion, hydration; each additional hour (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1015T","name":"Rev/rmv lw esoph sphnc npg/r","description":"Revision or removal, lower esophageal sphincter neurostimulator pulse generator or receiver","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0689","name":"Inj cefazolin sodium, baxter","description":"Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74018","name":"Radex abdomen 1 view","description":"Radiologic examination, abdomen; 1 view","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0576U","name":"Trnsplj med lar quan ddcfdna","description":"Trnsplj med lar quan ddcfdna","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2032","name":"Myriad matrix, per sq cm","description":"Myriad matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0874T","name":"Rmvl pertl ascites pmp sys","description":"Removal of a peritoneal ascites pump system, including implanted peritoneal ascites pump and indwelling bladder and peritoneal catheters","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0922T","name":"Rmvl perm ccm-d sys dual ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); dual (pacing and defibrillation) transvenous leads only","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4332","name":"Axolotl dualgraft, per sq cm","description":"Axolotl dualgraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0876T","name":"Duplex scan hemo fstl lmtd","description":"Duplex scan of hemodialysis fistula, computer-aided, limited (volume flow, diameter, and depth, including only body of fistula)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84433","name":"Asy thiopurin s-mthyltrnsfrs","description":"Thiopurine s-methyltransferase (tpmt)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81458","name":"So gsap dna cpy nmbr&mcrstl","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis, copy number variants and microsatellite instability","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0559U","name":"Onc brs quan elisa bf9ag srm","description":"Onc brs quan elisa bf9ag srm","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35546","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1789.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4021","name":"Orthopedic surgery ss","description":"Orthopedic surgery mips specialty set","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2246","name":"Inj, micafungin (baxter)","description":"Injection, micafungin in sodium (baxter), not therapeutically equivalent to j2248, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1280","name":"Bilat mast/hx bi /unilat mas","description":"Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77089","name":"Tbs dxa cal w/i&r fx risk","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; using dual x-ray absorptiometry (dxa) or other imaging data on gray-scale variogram, calculation, with interpretation and report on fracture-risk","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1342","name":"Pts died perf per","description":"Patients who died during the performance period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","name":"Gait mod systm rhym auditory","description":"Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0284U","name":"Vw factor type 2n eval plsm","description":"Von willebrand factor (vwd), type 2n, factor viii and vwf binding evaluation, enzyme-linked immunosorbent assays (elisa), plasma","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1370","name":"Rehab support msk care mvp","description":"Rehabilitative support for musculoskeletal care mips value pathway","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4035","name":"Thoracic surgery ss","description":"Thoracic surgery mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4293","name":"Acesso dl, per sq cm","description":"Acesso dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82384","name":"Assay three catecholamines","description":"Catecholamines; fractionated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0373","name":"Tomo bitewing image","description":"Tomo bitewing image","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0340U","name":"Onc pan ca alys mrd plasma","description":"Onc pan ca alys mrd plasma","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66920","name":"Extraction of lens","description":"Removal of lens material; intracapsular","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":735.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92553","name":"Audiometry air & bone","description":"Pure tone audiometry (threshold); air and bone","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19140","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4352","name":"Overlay sl matrix, per sq cm","description":"Overlay sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0706T","name":"Rem tx amblyopia i&r phy/qhp","description":"Remote treatment of amblyopia using an eye tracking device; interpretation and report by physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86318","name":"Ia infectious agent antibody","description":"Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip);","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0666","name":"Inj, bupivacaine liposome","description":"Injection, bupivacaine liposome, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5811","name":"Denture interm cmplt mandbl","description":"Interim complete denture (mandibular)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1486","name":"Pt admitted to snf dur eval","description":"Patients admitted to a skilled nursing facility (snf) during the period of evaluation","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0508","name":"Crit care telehea consult 60","description":"Telehealth consultation, critical care, initial , physicians typically spend 60 minutes communicating with the patient and providers via telehealth","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0741T","name":"Rem auton alg nsln data coll","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; provision of software, data collection, transmission, and storage, each 30 days","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15851","name":"Removal sutr/staple req anes","description":"Removal of sutures or staples requiring anesthesia (ie, general anesthesia, moderate sedation)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87593","name":"Orthopoxvirus amp prb each","description":"Infectious agent detection by nucleic acid (dna or rna); orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus), amplified probe technique, each","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9156","name":"Oral mucoadhesive per 1 ml","description":"Oral mucoadhesive, any type (liquid, gel, paste, etc.), per 1 ml","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87513","name":"H pylri clrthmcn rst amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); helicobacter pylori (h. pylori), clarithromycin resistance, amplified probe technique","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1444","name":"Del < 39 weeks gest","description":"Delivery at < 39 weeks of gestation","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1190","name":"Doc khe not pef w/efgr/uacr","description":"Documentation of a kidney health evaluation was not performed or defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76096","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0052","name":"Mmip mental health and care","description":"Missing and murdered indigenous persons (mmip) mental health and clinical care","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81523","name":"Onc brst mrna 70 cnt 31 gene","description":"Oncology (breast), mrna, next-generation sequencing gene expression profiling of 70 content genes and 31 housekeeping genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as index related to risk to distant metastasis","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0461","name":"Testing for cracked tooth","description":"Testing for cracked tooth","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0701","name":"Pano radio image","description":"Pano radio image","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0426","name":"Coll, analys of saliva","description":"Coll, analys of saliva","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1425","name":"Surgical care mvp","description":"Surgical care mips value pathway","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5158","name":"Inj, denosumab-bnht, 1 mg","description":"Injection, denosumab-bnht (bomyntra/conexxence), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15950","name":"Exc trchntr pr ulc prim sutr","description":"Excision, trochanteric pressure ulcer, with primary suture;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":630.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24600","name":"Tx clsd elbow dislc w/o anes","description":"Treatment of closed elbow dislocation; without anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":369.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0258U","name":"Ai psor mrna 50-100 gen alg","description":"Autoimmune (psoriasis), mrna, next-generation sequencing, gene expression profiling of 50-100 genes, skin- surface collection using adhesive patch, algorithm reported as likelihood of response to psoriasis biologics","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4354","name":"Palingen dl-palingen dl-x","description":"Palingen dual-layer membrane and dual-layer palingen x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5912","name":"Facial moulage complete","description":"Facial moulage (complete)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4543","name":"Supply trans elec nerve stim","description":"Supplies for transcutaneous electrical nerve stimulator, for nerves in the auricular region, per month","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4291","name":"Lamellas xt, per sq cm","description":"Lamellas xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0719T","name":"Pst vrt jt rplcmt lmbr 1 sgm","description":"Posterior vertebral joint replacement, including bilateral facetectomy, laminectomy, and radical discectomy, including imaging guidance, lumbar spine, single segment","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0403U","name":"Onc prst8 mrna 18 gen dre ur","description":"Onc prst8 mrna 18 gen dre ur","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2026","name":"Restrata minimatrix, 5 mg","description":"Restrata minimatrix, 5 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4231","name":"Ana crown exp 1-3 per quad","description":"Anatomical crown exposure - one to three teeth per quadrant","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4429","name":"Dermbnd chn, chx per sq cm","description":"Dermabind ch n or dermabind ch x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0498U","name":"Onc clrct ngs mut detc 43gen","description":"Onc clrct ngs mut detc 43gen","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0495U","name":"Onc prst8 alys crcg plsm prt","description":"Onc prst8 alys crcg plsm prt","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32810","name":"Close chest after drainage","description":"Closure of chest wall following open flap drainage for empyema (clagett type procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1010.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0855T","name":"Dgtz gls mcrscp b1 marow smr","description":"Digitization of glass microscope slides for bone marrow, smear interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25620","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":786.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0770T","name":"Vr technology assist therapy","description":"Virtual reality technology to assist therapy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82387","name":"Assay of cathepsin-d","description":"Cathepsin-d","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4435","name":"Renati membrane per sq cm","description":"Renati membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64728","name":"Dcmprn median nrv carpl tunl","description":"Decompression; median nerve at the carpal tunnel, percutaneous, with intracarpal tunnel balloon dilation, including ultrasound guidance","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0934T","name":"Rem mntr wrls l atr prs snr","description":"Remote monitoring of a wireless left atrial pressure sensor for up to 30 days, including data from daily uploads of left atrial pressure recordings, interpretation(s) and trend analysis, with adjustments to the diuretics plan, treatment paradigm thresholds, medications or lifestyle modifications, wh","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0596U","name":"Neuro alzds plsm 3dstnct isp","description":"Neuro alzds plsm 3dstnct isp","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1023T","name":"Prq tis dsplmt intrathoracic","description":"Percutaneous tissue displacement, any method, including imaging guidance; intrathoracic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0543","name":"Group train w/o patient","description":"Group caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient pre","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0438","name":"Ppps, initial visit","description":"Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0532U","name":"Rare ds whlgen&mitochdrl dna","description":"Rare ds whlgen&mitochdrl dna","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76810","name":"Ob us >/= 14 wks addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76936","name":"Echo guide for artery repair","description":"Ultrasound guided compression repair of arterial pseudoaneurysm or arteriovenous fistulae (includes diagnostic ultrasound evaluation, compression of lesion and imaging)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20939","name":"Bone marrow aspir bone grfg","description":"Bone marrow aspiration for bone grafting, spine surgery only, through separate skin or fascial incision (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1434","name":"Inj, focinvez, 1mg","description":"Injection, fosaprepitant (focinvez), 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87493","name":"C diff amplified probe","description":"Infectious agent detection by nucleic acid (dna or rna); clostridium difficile, toxin gene(s), amplified probe technique","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2016","name":"Permeaderm b, per sq cm","description":"Permeaderm b, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2183","name":"Inj meropenem (wg crit care)","description":"Injection, meropenem (wg critical care), not therapeutically equivalent to j2185, 100 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5153","name":"Inj, aflibercept-yszy, 1 mg","description":"Injection, aflibercept-yszy (opuviz), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1387","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97803","name":"Med nutrition indiv subseq","description":"Medical nutrition therapy; re-assessment and intervention, individual, face-to-face with the patient, each 15 minutes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":34.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1423","name":"Opt care urologic cnd mvp","description":"Optimal care for patients with urologic conditions mips value pathway","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0804T","name":"Prgrmg evl ldls pm 2chmbr ip","description":"Programming device evaluation (in person) with iterative adjustment of implantable device to test the function of device and to select optimal permanent programmed values, with analysis, review, and report, by a physician or other qualified health care professional, leadless pacemaker system in dual","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49593","name":"Rpr aa hrn 1st 3-10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, reducible","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98009","name":"Synch audio-only new low 30","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 30 m","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0397","name":"Alcohol/subs interv >30 min","description":"Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and intervention, greater than 30 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":76.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1250","name":"Pt resp true heard","description":"Patient responded as completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4564","name":"Pessary, disposable any type","description":"Pessary, disposable, any type","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G3003","name":"Chronic pain mgmt addl 15m","description":"Each additional 15 minutes of chronic pain management and treatment by a physician or other qualified health care professional, per calendar month. (list separately in addition to code for g3002. when using g3003, 15 minutes must be met or exceeded.)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93575","name":"Njx cath slct p angrph mapca","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary angiography of major aortopulmonary collateral arteries (mapcas) arising off the aorta or its systemic branches, during cardiac catheterization for congenital heart d","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5783","name":"Add low ext mec limb vol lam","description":"Addition to lower extremity, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0265U","name":"Rar do whl gn&mtcdrl dna als","description":"Rare constitutional and other heritable disorders, whole- genome and mitochondrial dna sequence analysis, blood, frozen and formalin-fixed paraffin-embedded (ffpe) tissue, saliva, buccal swabs or cell lines, identification of single nucleotide and copy number variants","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0709T","name":"Id ca immntx each addl njx","description":"Intradermal cancer immunotherapy; each additional injection (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1809","name":"Inj, fosdenopterin, 0.1mg","description":"Injection, fosdenopterin, 0.1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64612","name":"Destroy nerve face muscle","description":"Chemodenervation of muscle(s); muscle(s) innervated by facial nerve, unilateral (eg, for blepharospasm, hemifacial spasm)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86171","name":"Complement fixation each","description":"Complement fixation tests, each antigen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1781","name":"Vac admin human pap dose 1","description":"Vac admin human pap dose 1","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2371","name":"Inj phenylephrine hcl 20 mcg","description":"Injection, phenylephrine hydrochloride, 20 micrograms","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4005","name":"Family medicine ss","description":"Family medicine mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0280U","name":"Hem vw factor&clgn iv bndg","description":"Hematology (von willebrand disease [vwd]), von willebrand factor (vwf) and collagen iv binding by enzyme-linked immunosorbent assays (elisa), plasma, report of collagen iv binding","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5949","name":"Mand implt sup fix part","description":"Mand implt sup fix part","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69726","name":"Rmv ntr oi implt skl prq esp","description":"Removal, entire osseointegrated implant, skull; with percutaneous attachment to external speech processor","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4274","name":"Esano ac, per sq cm","description":"Esano ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93005","name":"Electrocardiogram tracing","description":"Electrocardiogram, routine ecg with at least 12 leads; tracing only, without interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":8.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4303","name":"Complete aa, per sq cm","description":"Complete aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2598","name":"Inj, vasopressin, 1 unit","description":"Injection, vasopressin, 1 unit","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96000","name":"Motion analysis video/3d","description":"Comprehensive computer-based motion analysis by video-taping and 3d kinematics;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G3002","name":"Chronic pain mgmt 30 mins","description":"Chronic pain management and treatment, monthly bundle including, diagnosis; assessment and monitoring; administration of a validated pain rating scale or tool; the development, implementation, revision, and/or maintenance of a person-centered care plan that includes strengths, goals, clinical needs,","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82270","name":"Occult blood feces","description":"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (ie, patient was provided 3 cards or single triple card for consecutive collection)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59425","name":"Antepartum care only","description":"Antepartum care only; 4-6 visits","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":674.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":461.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45393","name":"Colonoscopy w/decompression","description":"Colonoscopy, flexible; with decompression (for pathologic distention) (eg, volvulus, megacolon), including placement of decompression tube, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4342","name":"Theramend, per sq cm","description":"Theramend, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0364U","name":"Onc hl neo gen seq alys alg","description":"Onc hl neo gen seq alys alg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0676T","name":"Laps insj nw/rpcmt isdss ea","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional lead (list separately in addition to code for primary ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1373","name":"Mst rec gsa >=8 and <=9","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 8.0% and <= 9.0%","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0524U","name":"Ob pe sflt-1/plgf ia srm/pls","description":"Ob pe sflt-1/plgf ia srm/pls","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9247","name":"Mod sedation noniv-sub15min","description":"Mod sedation noniv-sub15min","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92980","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90759","name":"Hep b vac 3ag 10mcg 3 dos im","description":"Hepatitis b vaccine (hepb), 3-antigen (s, pre-s1, pre-s2), 10 mcg dosage, 3 dose schedule, for intramuscular use","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9246","name":"Mod sedation noniv-15 min","description":"Mod sedation noniv-15 min","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0815T","name":"Us rems b1 dns hips plvs/spi","description":"Ultrasound-based radiofrequency echographic multi-spectrometry (rems), bone-density study and fracture-risk assessment, 1 or more sites, hips, pelvis, or spine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15012","name":"Hrv skn cll ssp agrft ea add","description":"Harvest of skin for skin cell suspension autograft; each additional 25 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9268","name":"Programmer orally ingest cap","description":"Programmer for transient, orally ingested capsule","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0954T","name":"Tot impl amei rplc snd proc","description":"Totally implantable active middle ear hearing implant; replacement of sound processor only, with attachment to existing transducers","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9998","name":"Inj ustekinumab-aekn, 1 mg","description":"Injection, ustekinumab-aekn (selarsdi), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86305","name":"Human epididymis protein 4","description":"Human epididymis protein 4 (he4)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S4024","name":"Air polymer foam per study","description":"Air polymer-type a intrauterine foam, per study dose","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6028","name":"Part hand finger metacar amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s) /thumb, amputation at metacarpal level, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4025","name":"Physical medicine ss","description":"Physical medicine mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33468","name":"Revision of tricuspid valve","description":"Tricuspid valve repositioning and plication for ebstein anomaly","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2135.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9324","name":"Inj, pemrydi rtu, 10 mg","description":"Injection, pemetrexed (pemrydi rtu), 10 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97009","name":"Mchnl sclp cool after chemo","description":"Mechanical scalp cooling; provided after discontinuation of chemotherapy, each 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4369","name":"Amnioplast 3 per sq cm","description":"Amnioplast 3, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4224","name":"Hhf10-p per sq cm","description":"Human health factor 10 amniotic patch (hhf10-p), per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37282","name":"Rvsc evsc tpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6028","name":"Part hand finger metacar amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s) /thumb, amputation at metacarpal level, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0890T","name":"Arhfcmrigtbs 1st tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including target assessment, initial motor threshold determination, neuronavigation, delivery and management, initial treatment day","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86015","name":"Actin antibody each","description":"Actin (smooth muscle) antibody (asma), each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52284","name":"Cysto rx balo cath urtl strx","description":"Cystourethroscopy, with mechanical urethral dilation and urethral therapeutic drug delivery by drug-coated balloon catheter for urethral stricture or stenosis, male, including fluoroscopy, when performed","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0851T","name":"Dgtz gls mcrscp mphmtrc 1st","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0618U","name":"Psyc bd dna mthyl alys>10000","description":"Psyc bd dna mthyl alys>10000","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0698T","name":"Quan mr tiss w/mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained with diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, target ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9063","name":"Inj, elahere, 1 mg","description":"Injection, mirvetuximab soravtansine-gynx, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0255U","name":"Andrology infertility assmt","description":"Andrology (infertility), sperm-capacitation assessment of ganglioside gm1 distribution patterns, fluorescence microscopy, fresh or frozen specimen, reported as percentage of capacitated sperm and probability of generating a pregnancy score","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2008","name":"Theragenesis, per sq cm","description":"Theragenesis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4273","name":"Esano aaa, per sq cm","description":"Esano aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7165","name":"Inj, human-lans, per i.u","description":"Injection, prothrombin complex concentrate, human-lans, per i.u. of factor ix activity","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0281U","name":"Hem vwd propeptide ag lvl","description":"Hematology (von willebrand disease [vwd]), von willebrand propeptide, enzyme-linked immunosorbent assays (elisa), plasma, diagnostic report of von willebrand factor (vwf) propeptide antigen level","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7173","name":"Inj. concizumab-mtci, 0.5 mg","description":"Injection, concizumab-mtci, 0.5 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1025T","name":"Alt elec fld dos&dlv sim mdl","description":"Alternating electric fields dosimetry and delivery-simulation modeling, creation and selection of patient-specific array layouts, and placement verification","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0620U","name":"Onc hcc dna mthyln alys>5000","description":"Onc hcc dna mthyln alys>5000","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96571","name":"Photodynamic tx addl 15 min","description":"Photodynamic therapy by endoscopic application of light to ablate abnormal tissue via activation of photosensitive drug(s); each additional 15 minutes (list separately in addition to code for endoscopy or bronchoscopy procedures of lung and gastrointestinal tract)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1321","name":"Couns for high risk sub use","description":"Couns for high risk sub use","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":24.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0650","name":"Inj, levothyroxine nos 10mcg","description":"Injection, levothyroxine sodium, not otherwise specified, 10 mcg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1329","name":"Pts act pvd 2 wks 8 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 8 weeks after initial acute pvd encounter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2044","name":"Biobrane glove, each","description":"Biobrane glove, each","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0731T","name":"Augmnt ai-based fcl phnt a/r","description":"Augmentative ai-based facial phenotype analysis with report","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0673T","name":"Abltj b9 thyr ndul perq lasr","description":"Ablation, benign thyroid nodule(s), percutaneous, laser, including imaging guidance","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9432","name":"Med food non inborn err meta","description":"Medical foods for non-inborn errors of metabolism","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J9091","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1169","name":"Doc med rsn no flu vax","description":"Documentation of medical reason(s) for not administering influenza vaccine (e.g., prior anaphylaxis due to the influenza vaccine)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59414","name":"Deliver placenta","description":"Delivery of placenta (separate procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86305","name":"Human epididymis protein 4","description":"Human epididymis protein 4 (he4)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0611U","name":"Onc lvr alys >1000 mr cfdna","description":"Onc lvr alys >1000 mr cfdna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1334","name":"Pts act pvd 2 wks 2 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 2 weeks after initial acute pvd encounter","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4397","name":"Summit aaa per sq cm","description":"Summit aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90695","name":"H5n8 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n8, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0980T","name":"Sbmcsl crylys ther tng&tnsl","description":"Submucosal cryolysis therapy; base of tongue and lingual tonsil only","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7299","name":"Rem anchorage device w/flap","description":"Rem anchorage device w/flap","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0833T","name":"Dgtz gls mcrscp cytp oth prp","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; preparation, screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1253","name":"Pts hu surv no amb plltv","description":"Patients who respond on the patient experience hu survey that they did not receive care by the listed ambulatory palliative care provider in the last 60 days (disavowal)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0463","name":"Inj atropine (fresenius te)","description":"Injection, atropine sulfate (fresenius and therapeutically equivalent), 0.01 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7601","name":"Ensifentrine inh 3 mg","description":"Ensifentrine, inhalation suspension, fda approved final product, non-compounded, administered through dme, unit dose form, 3 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0985T","name":"Iv img xtrc cere vsl oct ea","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D8671","name":"Periodic orth treat w surg","description":"Periodic orth treat w surg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9993","name":"Pall serv during meas","description":"Patient was provided palliative care services any time during the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0166","name":"Granisetron hcl 1 mg oral","description":"Granisetron hydrochloride, 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 24 hour dosage regimen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0139","name":"Inj, adalimumab, 1 mg","description":"Injection, adalimumab, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2252","name":"Inj midazolam in 0.8% nacl","description":"Injection, midazolam in 0.8% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0388","name":"Bitewing image capture only","description":"Bitewing image capture only","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2781","name":"Crown 3/4 cast base metal","description":"Crown - 3/4 cast predominantly base metal","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4399","name":"Summit fx per sq cm","description":"Summit fx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4424","name":"Revive ft per sq cm","description":"Revive ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0575U","name":"Trnsplj med lar rtpcr 4genes","description":"Trnsplj med lar rtpcr 4genes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2781","name":"Inj, pegcetacoplan, 1mg","description":"Injection, pegcetacoplan, intravitreal, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87182","name":"Sc std carbapenemase nzm det","description":"Susceptibility studies, antimicrobial agent; carbapenemase enzyme detection (eg, klebsiella pneumoniae carbapenemase [kpc], new delhi metallo-beta-lactamase [ndm], verona integron-encoded metallo-beta-lactamase [vim]), multiplex immunoassay, qualitative, per isolate","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2525","name":"Cl, hydrophilic, dual focus","description":"Contact lens, hydrophilic, dual focus, per lens","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0331U","name":"Onc hl neo opt gen mapping","description":"Onc hl neo opt gen mapping","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92564","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0661","name":"Team remote e/m new pt 20 mn","description":"Team remote e/m new pt 20mins","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2428","name":"Inj, erzofri, 1 mg","description":"Injection, paliperidone palmitate extended release (erzofri), 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9357","name":"Valrubicin injection","description":"Injection, valrubicin, intravesical, 200 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":369.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1192","name":"Pt w/ dx sq cell ca of esoph","description":"Patients with an existing diagnosis of squamous cell carcinoma of the esophagus","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31242","name":"Nsl/sinus ndsc rf abltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by radiofrequency ablation, posterior nasal nerve","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4271","name":"Home lancing/test cartridges","description":"Integrated lancing and blood sample testing cartridges for home blood glucose monitor, per 50 tests","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01942","name":"Anes neuromd/ntrvrt lmbr/sac","description":"Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4351","name":"Enclose tl matrix, per sq cm","description":"Enclose tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0865T","name":"Quan mri alys brn w/o dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion identification, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transm","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16025","name":"Dress/debrid p-thick burn m","description":"Dressings and/or debridement of partial-thickness burns, initial or subsequent; medium (eg, whole face or whole extremity, or 5% to 10% total body surface area)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":116.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33702","name":"Repair of heart defects","description":"Repair sinus of valsalva fistula, with cardiopulmonary bypass;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1913.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0861T","name":"Rmvl pg wcs lv both compnt","description":"Removal of pulse generator for wireless cardiac stimulator for left ventricular pacing; both components (battery and transmitter)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4276","name":"Orion, per sq cm","description":"Orion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0704T","name":"Rem tx amblyopia setup&edu","description":"Remote treatment of amblyopia using an eye tracking device; device supply with initial set-up and patient education on use of equipment","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82947","name":"Assay glucose blood quant","description":"Glucose; quantitative, blood (except reagent strip)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2782","name":"Crown 3/4 cast noble metal","description":"Crown - 3/4 cast noble metal","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0473U","name":"Onc sld tum bld/slv 648 gene","description":"Onc sld tum bld/slv 648 gene","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1032","name":"Sv doula brth wrk per 15 min","description":"Services performed by a doula birth worker, per 15 minutes","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0806T","name":"Tcat s&ivc prstc vl impl opn","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); open femoral vein approach","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57511","name":"Cryocautery of cervix","description":"Cautery of cervix; cryocautery, initial or repeat","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":219.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0798T","name":"Tcat rmv 2chmbr ldls pm cmpl","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; complete system (ie, right atrial and right ventricular pacemaker components)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0674T","name":"Laps insj nw/rpcmt prm isdss","description":"Laparoscopic insertion of new or replacement of permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including an implantable pulse generator and diaphragmatic lead(s)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0268","name":"Removal of impacted wax md","description":"Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0048","name":"Pall serv during meas","description":"Patients who receive palliative care services any time during the intake period through the end of the measurement year","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98014","name":"Synch audio-only est mod 30","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code s","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90482","name":"Imm cnsl not admn sm 3<10","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; 3 minutes up to 10 minutes","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1353","name":"Pts no cmplt suicd saf pln","description":"Patients who did not have a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1961","name":"Inj lenacapavir (hiv tx) 1mg","description":"Injection, lenacapavir (only for use as hiv treatment), 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4301","name":"Activate matrix, per sq cm","description":"Activate matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1254","name":"Pts deceased prior hu surv","description":"Patients who were deceased when the hu survey reached them","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1361","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2023","name":"Innovamatrix pd, 1 mg","description":"Innovamatrix pd, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0449U","name":"Car scr sev inh cond 5 genes","description":"Car scr sev inh cond 5 genes","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9289","name":"Inj nivolumab 2 mg hyaluron","description":"Injection, nivolumab, 2 mg and hyaluronidase-nvhy","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0613U","name":"Onc uc dna mthyltn&mut 6bmrk","description":"Onc uc dna mthyltn&mut 6bmrk","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0623U","name":"Ai ms dna mthyl alys >5000","description":"Ai ms dna mthyl alys >5000","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83655","name":"Assay of lead","description":"Lead","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9076","name":"Inj, cyclophos (baxter) 5mg","description":"Injection, cyclophosphamide (baxter), 5 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1210","name":">=2 same meds tbl4 not ord","description":"At least two orders for high-risk medications from the same drug class, (table 4), not ordered","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1241","name":"Pt no resp seen as person","description":"Patient did not respond to the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0546U","name":"Ldns lrp4 antb imflr livecll","description":"Ldns lrp4 antb imflr livecll","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4439","name":"Instagraft per sq cm","description":"Instagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0453U","name":"Onc clrct ca cfdna qpcr asy","description":"Onc clrct ca cfdna qpcr asy","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0484","name":"Consult slides prep elsewher","description":"Consultation on slides prepared elsewhere","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2018","name":"Permeaderm c, per sq cm","description":"Permeaderm c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9332","name":"Inj efgartigimod 2mg","description":"Injection, efgartigimod alfa-fcab, 2mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76016","name":"Mr safety deter phys/qhp","description":"Mr safety determination by a physician or other qualified health care professional responsible for the safety of the mr procedure, including review of implant mr conditions for indicated mr examination, analysis of risk vs clinical benefit of performing mr examination, and determination of mr equipm","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9291","name":"Pres dig cog behav thera fda","description":"Prescription digital cognitive and/or behavioral therapy, fda cleared, per course of treatment","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0698T","name":"Quan mr tiss w/mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained with diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, target ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4382","name":"Advograft dual per sq cm","description":"Advograft dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5146","name":"Inj, hercessi, 10 mg","description":"Injection, trastuzumab-strf (hercessi), biosimilar, 10 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0919T","name":"Rmvl perm ccm-d sys pg only","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); pulse generator only","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8560","name":"Etoposide oral 50 mg","description":"Etoposide; oral, 50 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45338","name":"Sigmoidoscopy w/tumr remove","description":"Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37275","name":"Rvsc evsc fpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0012","name":"Injection of hiv prep drug","description":"Injection of pre-exposure prophylaxis (prep) drug for hiv prevention, under skin or into muscle","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0536U","name":"Rbcag ftl rhd pcr alys exon4","description":"Rbcag ftl rhd pcr alys exon4","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4416","name":"Alexiguard tl-t per sq cm","description":"Alexiguard tl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9011","name":"Datopotamab deruxtecan, 1 mg","description":"Injection, datopotamab deruxtecan-dlnk, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0010","name":"Eom meos payment","description":"Enhancing oncology model (eom) monthly enhanced oncology services (meos) payment for eom enhanced services","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21615","name":"Excision 1st &/cervical rib","description":"Excision first and/or cervical rib;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":814.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6611","name":"Onlay cst hgh nbl mtl >=3srf","description":"Onlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90612","name":"Inf&sarscov2 vacc 31.7/.32im","description":"Influenza virus vaccine, trivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 31.7 mcg/0.32 ml dosage, for intramuscular use","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5912","name":"Facial moulage complete","description":"Facial moulage (complete)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0392U","name":"Rx metab genrx ia 16 genes","description":"Rx metab genrx ia 16 genes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0420U","name":"Onc urthl mrna xprsn 6 snp","description":"Onc urthl mrna xprsn 6 snp","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5126","name":"Inj alymsys 10 mg","description":"Injection, bevacizumab-maly, biosimilar, (alymsys), 10 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96372","name":"Ther/proph/diag inj sc/im","description":"Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1269","name":"Recd esrd mcp lst day of mo","description":"Receiving esrd mcp dialysis services by the provider on the last day of the reporting month","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0928T","name":"Rem interrog dev ccm-d phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system with interim analysis and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0208","name":"Inj, pedmark, 100 mg","description":"Injection, sodium thiosulfate (pedmark), 100 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0002","name":"Opt care kidney hlth mvp","description":"Optimal care for kidney health mips value pathways","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2057","name":"Afamitresgene autoleucel","description":"Afamitresgene autoleucel, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2390","name":"Ant resin-based cmpst crown","description":"Resin-based composite crown anterior","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34710","name":"Dlyd plmt xtn prosth 1st vsl","description":"Delayed placement of distal or proximal extension prosthesis for endovascular repair of infrarenal abdominal aortic or iliac aneurysm, false aneurysm, dissection, endoleak, or endograft migration, including pre-procedure sizing and device selection, all nonselective catheterization(s), all associate","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":780.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0867T","name":"Tpla b9 prst8 hyprplsa>=50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume greater or equal to 50 ml","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0990T","name":"Trncrv inst biod hydrgl mtrl","description":"Transcervical instillation of biodegradable hydrogel materials, intrauterine","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0347U","name":"Rx metab/pcx dna 16 gen alys","description":"Rx metab/pcx dna 16 gen alys","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6604","name":"G com bandge low dn foam flt","description":"Gradient compression bandaging supply, low density flat foam sheet, per 250 square centimeters, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10081","name":"I&d pilonidal cyst comp","description":"Incision and drainage of pilonidal cyst; complicated","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":440.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7912","name":"Suture complicate wnd > 5 cm","description":"Complicated suture-greater than 5 cm","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92637","name":"Hearing aid pst-fitg f-up ea","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4029","name":"Preventive medicine ss","description":"Preventive medicine mips specialty set","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6590","name":"Urinary cath disp suc pump","description":"External urinary catheters; disposable, with wicking material, for use with suction pump, per month","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0759T","name":"Dgtz gls mcrscp sl sp grpiii","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group iii, for enzyme constituents (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9292","name":"Pres dig visual therapy fda","description":"Prescription digital visual therapy, software-only, fda cleared, per course of treatment","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45500","name":"Repair of rectum","description":"Proctoplasty; for stenosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76014","name":"Mr sfty implt&/fb asmt stf 1","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0605","name":"Antibody test pub hlth path","description":"Antibody test pub hlth path","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9996","name":"Ustekinumab- ttwe sub cu inj","description":"Injection, ustekinumab-ttwe (pyzchiva), subcutaneous, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37237","name":"Open/perq place stent ea add","description":"Transcatheter placement of an intravascular stent(s) (except lower extremity artery(s) for occlusive disease, cervical carotid, extracranial vertebral or intrathoracic carotid, intracranial, or coronary), open or percutaneous, including radiological supervision and interpretation and including all a","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1360.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0268","name":"Removal of impacted wax md","description":"Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5126","name":"Inj alymsys 10 mg","description":"Injection, bevacizumab-maly, biosimilar, (alymsys), 10 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6074","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (noble metal)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86053","name":"Aqaprn-4 antb flo cytmtry ea","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; flow cytometry (ie, fluorescence-activated cell sorting [facs]), each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0985T","name":"Iv img xtrc cere vsl oct ea","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6191","name":"Semi precision abutment","description":"Semi precision abutment","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27047","name":"Exc hip/pelvis les sc < 3 cm","description":"Excision, tumor, soft tissue of pelvis and hip area, subcutaneous; less than 3 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45393","name":"Colonoscopy w/decompression","description":"Colonoscopy, flexible; with decompression (for pathologic distention) (eg, volvulus, megacolon), including placement of decompression tube, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87183","name":"Sc std carbapenem resist gen","description":"Susceptibility studies, antimicrobial agent; carbapenem resistance genes (eg, blakpc, blandm, blavim, blaoxa-48, blaimp), amplified probe technique, per isolate","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0377U","name":"Cv ds quan advsrm/plsm lprtn","description":"Cv ds quan advsrm/plsm lprtn","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2406","name":"Injection, oritavancin 10 mg","description":"Injection, oritavancin (kimyrsa), 10 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5422","name":"Dentures adjust part mandbl","description":"Adjust partial denture - mandibular","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90471","name":"Immunization admin","description":"Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); 1 vaccine (single or combination vaccine/toxoid)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4263","name":"Surgraft tl, per sq cm","description":"Surgraft tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0047","name":"Ped blunt hd traum","description":"Pediatric patient with minor blunt head trauma and pecarn prediction criteria are not assessed","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1494","name":"Fall rep since last visit","description":"Patients that reported a fall since the last visit","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64792","name":"Removal of nerve lesion","description":"Excision of neurofibroma or neurolemmoma; extensive (including malignant type)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6599","name":"G comp bandage short stretch","description":"Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96381","name":"Admn rsv monoc antb im njx","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99308","name":"Sbsq nf care low mdm 20","description":"Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 20 minutes must be met or exce","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":88.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33900","name":"Perq p-art revsc 1 nm nt uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, unilateral","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7415","name":"Excision malig les complicat","description":"Excision of malignant lesion complicated","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4425","name":"Revive tl per sq cm","description":"Revive tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1382","name":"Enc dur perf pd pos 11","description":"Patient encounter during the performance period with place of service code 11","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98984","name":"Rtm dev sply resp sys 2-15 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of respiratory system, 2-15 days in a 30-day period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1291","name":"Pt 66+ frailty and med dem","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1393","name":"Pr no dx rec mlnm","description":"Patients who were not diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4399","name":"Summit fx per sq cm","description":"Summit fx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0502U","name":"Hpv e6/e7 mrk hi-rsk typ crv","description":"Hpv e6/e7 mrk hi-rsk typ crv","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"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":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4353","name":"Xceed tl matrix per sq cm","description":"Xceed tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5934","name":"Mandibular flange prosthesis","description":"Mandibular resection prosthesis with guide flange","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0686T","name":"Histotripsy mal hepatcel tis","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant hepatocellular tissue, including image guidance","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4022","name":"Otolaryngology ss","description":"Otolaryngology mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0483U","name":"Nfct ds ng gyra s91f pt mut","description":"Nfct ds ng gyra s91f pt mut","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47384","name":"Abltj ire liver 1+ tum perq","description":"Ablation, irreversible electroporation, liver, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4319","name":"Sanograft, per sq cm","description":"Sanograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76017","name":"Mr sfty med physics xm cstmz","description":"Mr safety medical physics examination customization, planning and performance monitoring by medical physicist or mr safety expert, with review and analysis by physician or other qualified health care professional to prioritize and select views and imaging sequences, to tailor mr acquisition specific","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0464U","name":"Onc clrct scr qrtsa dna mrk","description":"Onc clrct scr qrtsa dna mrk","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55715","name":"Bx prst8 ea add mri-us/ct/mr","description":"Biopsy, prostate, each additional, mri-ultrasound fusion or in-bore ct- or mri-guided targeted lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4366","name":"Dl amnio bur x-mem per sq cm","description":"Dual layer amnio burgeon x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55715","name":"Bx prst8 ea add mri-us/ct/mr","description":"Biopsy, prostate, each additional, mri-ultrasound fusion or in-bore ct- or mri-guided targeted lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50600","name":"Exploration of ureter","description":"Ureterotomy with exploration or drainage (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0537","name":"Risk ascvd tst once pr 12 mo","description":"Administration of a standardized, evidence-based atherosclerotic cardiovascular disease (ascvd) risk assessment, 5-15 minutes, not more often than every 12 months","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0883T","name":"Intraop ther estim pn ue ea","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; each additional nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0849T","name":"Dgtz gls mcrscp ish ea adl 1","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49900","name":"Repair of abdominal wall","description":"Suture, secondary, of abdominal wall for evisceration or dehiscence","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":895.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2506","name":"Inj pegfilgrast ex bio 0.5mg","description":"Injection, pegfilgrastim, excludes biosimilar, 0.5 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70472","name":"Ct cere prfu alys c+w/ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed with concurrent ct or ct angiography of the same anatomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92639","name":"Hearing aid meas verif","description":"Hearing-aid measurement, verification with probe-microphone (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4359","name":"Choriply, per sq cm","description":"Choriply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4403","name":"Xwrap dual plus per sq cm","description":"Xwrap dual plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87650","name":"Strep a dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); streptococcus, group a, direct probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0803T","name":"Tcat rmv&rpl2chmb ldls pm rv","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ve","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6602","name":"Cst hgh nble mtl inlay 2 srf","description":"Inlay - cast high noble metal two surfaces","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1399","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0684","name":"App non-sheet skin sb g addl","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area or part thereof, or each additional 1% o","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37282","name":"Rvsc evsc tpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1161","name":"Pt anphx due to dtp bef 13","description":"Patient had anaphylaxis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2051","name":"Support broker waiver/diem","description":"Supports brokerage, self-directed, waiver; per diem","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9244","name":"Office min sed drug enteral","description":"Office min sed drug enteral","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0823T","name":"Tcat ins 1chmbr ldls pm ra","description":"Transcatheter insertion of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or programming), when","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0870","name":"Injection, imetelstat, 1 mg","description":"Injection, imetelstat, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2009","name":"Symphony, per sq cm","description":"Symphony, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2373","name":"Inj, immphentiv, 20 mcg","description":"Injection, phenylephrine hydrochloride (immphentiv), 20 micrograms","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0969T","name":"Removal epicranial nstim sys","description":"Removal of epicranial neurostimulator system","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85660","name":"Rbc sickle cell test","description":"Sickling of rbc, reduction","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0625U","name":"Endocrinol op dna alys>5000","description":"Endocrinol op dna alys>5000","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38205","name":"Harvest allogeneic stem cell","description":"Blood-derived hematopoietic progenitor cell harvesting for transplantation, per collection; allogeneic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1386","name":"Exc sx melmn or mlnm is","description":"Patients with an excisional surgery for melanoma or melanoma in situ in the past 5 years with an initial ajcc staging of 0, i, or ii at the start of the performance period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1225","name":"Iop dec>=20% from base","description":"Intraocular pressure (iop) reduced by a value of greater than or equal to 20% from the pre-intervention level","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32657","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1047.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50760","name":"Ureteroureterostomy","description":"Ureteroureterostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1213.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0423","name":"Genetic test spec analysis","description":"Genetic test spec analysis","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26536","name":"Revise/implant finger joint","description":"Arthroplasty, interphalangeal joint; with prosthetic implant, each joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0549U","name":"Onc urthl dna mthyltd rt pcr","description":"Onc urthl dna mthyltd rt pcr","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86366","name":"Muscle-specific kinase antb","description":"Muscle-specific kinase (musk) antibody","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82726","name":"Long chain fatty acids","description":"Very long chain fatty acids","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0395U","name":"Onc lng multiomics plsm alg","description":"Onc lng multiomics plsm alg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61889","name":"Ins sk-mnt crnl nstm pg/rcvr","description":"Insertion of skull-mounted cranial neurostimulator pulse generator or receiver, including craniectomy or craniotomy, when performed, with direct or inductive coupling, with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7295","name":"Eth estr and eton monthly","description":"Ethinyl estradiol and etonogestrel 0.015mg, 0.12mg per 24 hours; monthly vaginal ring, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52441","name":"Cysto insj trnsprstc 1 implt","description":"Cystourethroscopy, with insertion of permanent adjustable transprostatic implant; single implant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1466.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37286","name":"Revsc evasc tpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2644","name":"Dental onlay porc 4/more sur","description":"Onlay - porcelain/ceramic - four or more surfaces","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0672T","name":"Ndovag cryg rf remdl tiss","description":"Endovaginal cryogen-cooled, monopolar radiofrequency remodeling of the tissues surrounding the female bladder neck and proximal urethra for urinary incontinence","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88386","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":427.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9255","name":"Inj, methotrexate (accord)","description":"Injection, methotrexate (accord), not therapeutically equivalent to j9260, 50 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58550","name":"Laparo-asst vag hysterectomy","description":"Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 g or less;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1033.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75746","name":"Artery x-rays lung","description":"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J7341","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4325","name":"Acapatch, per sq cm","description":"Acapatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0898","name":"Argatroban nonesrd (auromed)","description":"Injection, argatroban (auromedics), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94626","name":"Phy/qhp op pulm rhb w/mntr","description":"Physician or other qualified health care professional services for outpatient pulmonary rehabilitation; with continuous oximetry monitoring (per session)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1714","name":"Pfizer vacc adm ped 2nd dose","description":"Pfizer vacc adm ped 2nd dose","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0695T","name":"Bdy srf mpg pm/cvdfb tm impl","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of implant or replacement","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23530","name":"Optx strnclav dislc aqt/chrn","description":"Open treatment of sternoclavicular dislocation, acute or chronic;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":658.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98003","name":"Synch audio-video new hi 60","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high medical decision making. when using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0260U","name":"Rare ds id opt genome mapg","description":"Rare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90473","name":"Immune admin oral/nasal","description":"Immunization administration by intranasal or oral route; 1 vaccine (single or combination vaccine/toxoid)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0305U","name":"Hem rbc fnclty&dfrm shr strs","description":"Hem rbc fnclty&dfrm shr strs","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54150","name":"Circumcision w/regionl block","description":"Circumcision, using clamp or other device with regional dorsal penile or ring block","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":94.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0802","name":"3d dental scan indirect","description":"3d dental scan indirect","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4291","name":"Lamellas xt, per sq cm","description":"Lamellas xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0558U","name":"Onc clrct elisa bf7 ag serum","description":"Onc clrct elisa bf7 ag serum","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98925","name":"Osteopath manj 1-2 regions","description":"Osteopathic manipulative treatment (omt); 1-2 body regions involved","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":21.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0857T","name":"Opto-acoustic img breast uni","description":"Opto-acoustic imaging, breast, unilateral, including axilla when performed, real-time with image documentation, augmentative analysis and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9274","name":"Inj, tebentafusp-tebn, 1 mcg","description":"Injection, tebentafusp-tebn, 1 microgram","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75577","name":"Quan&char c athrosclrtc plaq","description":"Quantification and characterization of coronary atherosclerotic plaque to assess severity of coronary disease, derived from augmentative software analysis of the data set from a coronary computed tomographic angiography, with interpretation and report by a physician or other qualified health care pr","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98001","name":"Synch audio-video new low 30","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0483","name":"Indirect immunofluorescence","description":"Indirect immunofluorescence","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"Evoked auditory test limited","description":"Distortion product evoked otoacoustic emissions; limited evaluation (to confirm the presence or absence of hearing disorder, 3-6 frequencies) or transient evoked otoacoustic emissions, with interpretation and report","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0344U","name":"Hep nafld semiq evl 28 lipid","description":"Hep nafld semiq evl 28 lipid","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33276","name":"Insj phrnc nrv stim sys","description":"Insertion of phrenic nerve stimulator system (pulse generator and stimulating lead[s]), including vessel catheterization, all imaging guidance, and pulse generator initial analysis with diagnostic mode activation, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":488.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1360","name":"Suicd c-ssrs assessment","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9130","name":"Dacarbazine 100 mg inj","description":"Dacarbazine, 100 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5137","name":"Inj, wezlana, sub cu, 1 mg","description":"Injection, ustekinumab-auub (wezlana), biosimilar, subcutaneous, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J7344","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4540","name":"Trans elec nerv periph nerv","description":"Distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9957","name":"Screening sleep disorders","description":"Screening sleep disorders","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87478","name":"Borrelia miyamotoi amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); borrelia miyamotoi, amplified probe technique","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9332","name":"Inj efgartigimod 2mg","description":"Injection, efgartigimod alfa-fcab, 2mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47130","name":"Partial removal of liver","description":"Hepatectomy, resection of liver; total right lobectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3602.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15013","name":"Prepj skn cll ssp agrft 1st","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; first 25 sq cm or less of harvested skin","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31242","name":"Nsl/sinus ndsc rf abltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by radiofrequency ablation, posterior nasal nerve","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0751","name":"Hiv prep, ftc/taf 200/25mg","description":"Emtricitabine 200mg and tenofovir alafenamide 25mg, oral, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0479U","name":"Tau phosphorylated ptau217","description":"Tau phosphorylated ptau217","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85013","name":"Spun microhematocrit","description":"Blood count; spun microhematocrit","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0414U","name":"Onc lng aug alg aly whl sld8","description":"Onc lng aug alg aly whl sld8","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15854","name":"Removal sutr&stapl xreq anes","description":"Removal of sutures and staples not requiring anesthesia (list separately in addition to e/m code)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4404","name":"Xwrap hydro plus per sq cm","description":"Xwrap hydro plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4301","name":"Activate matrix, per sq cm","description":"Activate matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4436","name":"Renati ac membrane per sq cm","description":"Renati ac membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1420","name":"Complete ophthalmologic mvp","description":"Complete ophthalmologic care mips value pathway","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1612","name":"Inj glucagon (gvoke) 0.01 mg","description":"Injection, glucagon (gvoke), 0.01 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49621","name":"Rpr parastomal hernia rdc","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; reducible","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50780","name":"Reimplant ureter in bladder","description":"Ureteroneocystostomy; anastomosis of single ureter to bladder","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1203.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93010","name":"Electrocardiogram report","description":"Electrocardiogram, routine ecg with at least 12 leads; interpretation and report only","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6212","name":"Bridge noble metal cast","description":"Pontic-cast noble metal","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44407","name":"Colonoscopy w/ndl aspir/bx","description":"Colonoscopy through stoma; with transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy(s), includes endoscopic ultrasound examination limited to the sigmoid, descending, transverse, or ascending colon and cecum and adjacent structures","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0331U","name":"Onc hl neo opt gen mapping","description":"Onc hl neo opt gen mapping","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0486U","name":"Onc pan sol tum ngs cfctdna","description":"Onc pan sol tum ngs cfctdna","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1714","name":"Pfizer vacc adm ped 2nd dose","description":"Pfizer vacc adm ped 2nd dose","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0910T","name":"Rmvl int nstim sys vagus nrv","description":"Removal of integrated neurostimulation system, vagus nerve","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54405","name":"Insert multi-comp penis pros","description":"Insertion of multi-component, inflatable penile prosthesis, including placement of pump, cylinders, and reservoir","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":886.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0897T","name":"N-invas augmnt arrhyt alys","description":"Noninvasive augmentative arrhythmia analysis derived from quantitative computational cardiac arrhythmia simulations, based on selected intervals of interest from 12-lead electrocardiogram and uploaded clinical parameters, including uploading clinical parameters with interpretation and report","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1326","name":"Pts dx hypotony","description":"Patients with a diagnosis of hypotony","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4340","name":"Simpligraft, per sq cm","description":"Simpligraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0412U","name":"Beta amyloid ab42/40 imprcip","description":"Beta amyloid ab42/40 imprcip","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6596","name":"G comp bandge conform gauze","description":"Gradient compression bandaging supply, conforming gauze, per linear yard, any width, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4022","name":"Otolaryngology ss","description":"Otolaryngology mips specialty set","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0264U","name":"Rare ds id opt genome mapg","description":"Rare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0810T","name":"Subrta njx rx agt w/vtrc","description":"Subretinal injection of a pharmacologic agent, including vitrectomy and 1 or more retinotomies","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6564","name":"G com stckng waist 40+ cust","description":"Gradient compression stocking, waist length, 40 mmhg or greater, custom, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5948","name":"Max implt sup fix part","description":"Max implt sup fix part","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1238","name":"Doc 2nd recom hzv 2-6 mo int","description":"Documentation that administration of second recombinant zoster vaccine could not occur during the performance period due to the recommended 2-6 month interval between doses (i.e, first dose received after october 31)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1491","name":"Recd esrd mcp dur perf pd","description":"Receiving esrd mcp dialysis services by the provider during the performance period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0525","name":"Est pt-cg dyad dem mod cmplx","description":"Management of established patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0813T","name":"Egd vol adjmt bariatric balo","description":"Esophagogastroduodenoscopy, flexible, transoral, with volume adjustment of intragastric bariatric balloon","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90593","name":"Chikungunya vacc recomb im","description":"Chikungunya virus vaccine, recombinant, for intramuscular use","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0559","name":"Unrelat prac follow up visit","description":"Post-operative follow-up visit complexity inherent to evaluation and management services addressing surgical procedure(s), provided by a physician or qualified health care professional who is not the practitioner who performed the procedure (or in the same group practice) and is of the same or of a ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4021","name":"Orthopedic surgery ss","description":"Orthopedic surgery mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5136","name":"Inj. denosumab-bbdz, 1 mg","description":"Injection, denosumab-bbdz (jubbonti/wyost), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93584","name":"Vngrph chd anom/persist svc","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; anomalous or persistent superior vena cava when it exists as a second contralateral superior vena cava, with native drainage to heart (list separately in addition to code for pri","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6602","name":"Cst hgh nble mtl inlay 2 srf","description":"Inlay - cast high noble metal two surfaces","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4347","name":"Rampart dl matrix per sq cm","description":"Rampart dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1456","name":"Pt had htx","description":"Patient had a heart transplant","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84583","name":"Assay of urine urobilinogen","description":"Urobilinogen, urine; semiquantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0474U","name":"Hered pan ca gsap 88gene ngs","description":"Hered pan ca gsap 88gene ngs","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55550","name":"Laparo ligate spermatic vein","description":"Laparoscopy, surgical, with ligation of spermatic veins for varicocele","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7241","name":"Impact tooth rem bony w/comp","description":"Removal of impacted tooth-completely bony with unusual surgical complications","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1152","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0412U","name":"Beta amyloid ab42/40 imprcip","description":"Beta amyloid ab42/40 imprcip","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2011","name":"Supra sdrm, per sq cm","description":"Supra sdrm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76819","name":"Fetal biophys profil w/o nst","description":"Fetal biophysical profile; without non-stress testing","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0467","name":"Home vent multi-function","description":"Home ventilator, multi-function respiratory device, also performs any or all of the additional functions of oxygen concentration, drug nebulization, aspiration, and cough stimulation, includes all accessories, components and supplies for all functions","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":916.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9326","name":"Telisotuzumab vedotin-tllv","description":"Injection, telisotuzumab vedotin-tllv, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6280","name":"Implt maint procd remv implt","description":"Implt maint procd remv implt","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3291","name":"Tranexamic acid in sod chlor","description":"Injection, tranexamic acid in sodium chloride, 5 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4320","name":"Pellograft, per sq cm","description":"Pellograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0844T","name":"Dgtz gls mcrscp cslt cyt ea","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), each additional site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2782","name":"Crown 3/4 cast noble metal","description":"Crown - 3/4 cast noble metal","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9027","name":"Rbc o2 co2 reduced","description":"Red blood cells, leukocytes reduced, oxygen/ carbon dioxide reduced, each unit","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0031","name":"Pall serv during meas","description":"Palliative care services given to patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93595","name":"L hrt cath chd nm/abn nt cnj","description":"Left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone, normal or abnormal native connections","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1188","name":"Pt w/ ckd stg 5","description":"Patients with a diagnosis of chronic kidney disease (ckd) stage 5","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0522","name":"Mgt nw pt dementia low cmplx","description":"Management of a new patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9255","name":"Inj, methotrexate (accord)","description":"Injection, methotrexate (accord), not therapeutically equivalent to j9260, 50 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1300","name":"Flu imm no admin doc rea","description":"Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99475","name":"Ped crit care age 2-5 init","description":"Initial inpatient pediatric critical care, per day, for the evaluation and management of a critically ill infant or young child, 2 through 5 years of age","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6049","name":"Scale implt peri-implt inflm","description":"Scale implt peri-implt inflm","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1033","name":"Sv doula brth wrk per diem","description":"Services performed by a doula birth worker, per diem","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4293","name":"Acesso dl, per sq cm","description":"Acesso dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95933","name":"Blink reflex test","description":"Orbicularis oculi (blink) reflex, by electrodiagnostic testing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5146","name":"Inj, hercessi, 10 mg","description":"Injection, trastuzumab-strf (hercessi), biosimilar, 10 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4429","name":"Dermbnd chn, chx per sq cm","description":"Dermabind ch n or dermabind ch x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0795T","name":"Tcat ins 2chmbr ldls pm cmpl","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; complete system (ie, r","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2015","name":"Phoenix wnd mtrx, per sq cm","description":"Phoenix wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27712","name":"Osteot mlt relignmt imed rod","description":"Osteotomy; multiple, with realignment on intramedullary rod (eg, sofield type procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1252.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9342","name":"Inj thiotepa nos 1 mg","description":"Injection, thiotepa, not otherwise specified, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"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":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0296U","name":"Onc orl&/orop ca 20 mlc feat","description":"Onc orl&/orop ca 20 mlc feat","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1171","name":"Inj, hydromorphone, 0.1 mg","description":"Injection, hydromorphone, 0.1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33952","name":"Ecmo/ecls insj prph cannula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; insertion of peripheral (arterial and/or venous) cannula(e), percutaneous, 6 years and older (includes fluoroscopic guidance, when performed)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":433.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6613","name":"Onlay cst base mtl >=3 surfa","description":"Onlay - cast predominantly base metal three or more surfaces","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0445U","name":"Abeta42 & ptau181 eclia csf","description":"Abeta42 & ptau181 eclia csf","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0630U","name":"Onc brst mrna gen prflg 80","description":"Onc brst mrna gen prflg 80","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15011","name":"Hrv skn cll ssp agrft 1st 25","description":"Harvest of skin for skin cell suspension autograft; first 25 sq cm or less","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20550","name":"Njx 1 tendon sheath/ligament","description":"Injection(s); single tendon sheath, or ligament, aponeurosis (eg, plantar fascia)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":35.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0802","name":"3d dental scan indirect","description":"3d dental scan indirect","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0799T","name":"Tcat rmvl 2chmbr ldls pm ra","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right atrial pacemaker component","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0919T","name":"Rmvl perm ccm-d sys pg only","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); pulse generator only","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0256U","name":"Tma/tmao prfl ms/ms ur alg","description":"Trimethylamine/trimethylamine n-oxide (tma/tmao) profile, tandem mass spectrometry (ms/ms), urine, with algorithmic analysis and interpretive report","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90613","name":"Inf&sarscov2 vacc 40/0.4 im","description":"Influenza virus vaccine, quadrivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 40 mcg/0.4 ml dosage, for intramuscular use","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90833","name":"Psytx w pt w e/m 30 min","description":"Psychotherapy, 30 minutes with patient when performed with an evaluation and management service (list separately in addition to the code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":71.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82947","name":"Assay glucose blood quant","description":"Glucose; quantitative, blood (except reagent strip)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1200","name":"Ace-i/arb rx","description":"Ace inhibitor (ace-i) or arb therapy prescribed during the measurement period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66180","name":"Aqueous shunt eye w/graft","description":"Aqueous shunt to extraocular equatorial plate reservoir, external approach; with graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1147.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9291","name":"Pres dig cog behav thera fda","description":"Prescription digital cognitive and/or behavioral therapy, fda cleared, per course of treatment","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4385","name":"Apollo ft per sq cm","description":"Apollo ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21930","name":"Exc back les sc < 3 cm","description":"Excision, tumor, soft tissue of back or flank, subcutaneous; less than 3 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9128","name":"Photobio therpy-first 15 min","description":"Photobio therpy-first 15 min","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0988T","name":"Opn ins/rplc ins ptn sbq&sbf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2029","name":"Mirotract matrix sheet","description":"Mirotract wound matrix sheet, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1484","name":"No rpt hcv rna perf med rsn","description":"Patients who did not have a repeat hcv rna labs performed for medical reasons documented by clinician (e.g., patient with limited life expectancy, delay in treatment of hcv related to treatment of hiv, hbv, hepatocellular carcinoma, decompensated cirrhosis)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6107","name":"Tissue regen non-resorbable","description":"Tissue regen non-resorbable","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0534U","name":"Onc prst8 mirna snp 32 vrnt","description":"Onc prst8 mirna snp 32 vrnt","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1433","name":"Oral chemo wthn 30 days enc","description":"Patient on oral chemotherapy on or within 30 days before denominator eligible encounter","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0928T","name":"Rem interrog dev ccm-d phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system with interim analysis and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0807T","name":"Pulm tiss vntj alys prev ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with previously acquired computed tomography (ct) images, including data preparation and transmission, quantification of pulmonary tissue ventilation, data re","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32660","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1293.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0454U","name":"U rare ds id opt genome mapg","description":"U rare ds id opt genome mapg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0711T","name":"N-nvs artl plaq alys dat prp","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data preparation and transmission","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4282","name":"Cygnus dual per sq cm","description":"Cygnus dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","name":"Scoliosis orth sag/ cor","description":"Scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla to trochanter, includes all accessory pads, straps and interface, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual ","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6519","name":"Grad com garm noc night use","description":"Gradient compression garment, not otherwise specified, for nighttime use, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9293","name":"Fertility cycl tracking soft","description":"Fertility cycle (contraception & conception) tracking software application, fda cleared, per month, includes accessories (e.g., thermometer)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0737","name":"Inj, clindamycin (baxter)","description":"Injection, clindamycin phosphate (baxter), not therapeutically equivalent to j0736, 300 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0140","name":"Nav srv peer sup 60 min pr m","description":"Principal illness navigation - peer support by certified or trained auxiliary personnel under the direction of a physician or other practitioner, including a certified peer specialist; 60 minutes per calendar month, in the following activities:  person-centered interview, performed to better underst","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88373","name":"M/phmtrc alys ishquant/semiq","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0528U","name":"Lrt iad 18bct/8vir&7arg rna","description":"Lrt iad 18bct/8vir&7arg rna","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0902T","name":"Qtc ntrvl augmnt alg aly ecg","description":"Qtc interval derived by augmentative algorithmic analysis of input from an external, patient-activated mobile ecg device","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4269","name":"Surgraft xt per sq cm","description":"Surgraft xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38227","name":"Car-t receipt&prepj admn","description":"Chimeric antigen receptor t-cell (car-t) therapy; receipt and preparation of car-t cells for administration","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1349","name":"No pam inc 3 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 3 points within a 4 to 12 month period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1299","name":"Flu immunize order/admin","description":"Influenza immunization administered or previously received","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4303","name":"Complete aa, per sq cm","description":"Complete aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53451","name":"Tprnl balo cntnc dev bi","description":"Periurethral transperineal adjustable balloon continence device; bilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0782T","name":"Brnchsc rf dstrj plm nrv uni","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; unilateral mainstem bronchus","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1001T","name":"Autol musc cell therapy njx","description":"Autologous muscle cell therapy, injection of muscle progenitor cells into the external anal sphincter, including ultrasound guidance, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0660","name":"Team remote e/m new pt 10 mn","description":"Team remote e/m new pt 10mins","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32820","name":"Reconstruct injured chest","description":"Major reconstruction, chest wall (posttraumatic)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1614.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9959","name":"Unspec sleep ap proc","description":"Unspec sleep ap proc","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61598","name":"Transpetrosal approach/skull","description":"Transpetrosal approach to posterior cranial fossa, clivus or foramen magnum, including ligation of superior petrosal sinus and/or sigmoid sinus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2828.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0029","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1208","name":"Pt no scrn sdoh","description":"Patient is not screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0501U","name":"Onc clrc bld quan meas cfdna","description":"Onc clrc bld quan meas cfdna","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0689T","name":"Quan us tis charac w/o dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained without diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1348","name":"Pam incr 6 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 6-points in a 4 to 12 month period (excellent)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15014","name":"Prepj skn cll ssp agrft ea","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; each additional 25 sq cm of harvested skin or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76872","name":"Us transrectal","description":"Ultrasound, transrectal;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93597","name":"R&l hrt cath chd abnl nt cnj","description":"Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); abnormal native connections","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86043","name":"Acetylcholn rcptr modlg antb","description":"Acetylcholine receptor (achr); modulating antibody","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90613","name":"Inf&sarscov2 vacc 40/0.4 im","description":"Influenza virus vaccine, quadrivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 40 mcg/0.4 ml dosage, for intramuscular use","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37254","name":"Revsc evasc ivt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1317","name":"Pts counsl cpt opt out","description":"Patients who are counseled on connection with a csp and explicitly opt out","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0557U","name":"Nfct ds bv dna mrk vag fluid","description":"Nfct ds bv dna mrk vag fluid","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77089","name":"Tbs dxa cal w/i&r fx risk","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; using dual x-ray absorptiometry (dxa) or other imaging data on gray-scale variogram, calculation, with interpretation and report on fracture-risk","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"Motor &/ sens nrve cndj test","description":"Motor and/or sensory nerve conduction, using preconfigured electrode array(s), amplitude and latency/velocity study, each limb, includes f-wave study when performed, with interpretation and report","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0843T","name":"Dgtz gls mcrscp cslt cyt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), initial site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22810","name":"Arthrd ant dfrm 4-7 vrt sgm","description":"Arthrodesis, anterior, for spinal deformity, with or without cast; 4 to 7 vertebral segments","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2417.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7957","name":"Tiss regen edent nonresorb","description":"Tiss regen edent nonresorb","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0013","name":"Hiv prep counsel, clin staff","description":"Individual counseling for pre-exposure prophylaxis (prep) by clinical staff to prevent human immunodeficiency virus (hiv), includes: hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27076","name":"Resect hip tum incl acetabul","description":"Radical resection of tumor; ilium, including acetabulum, both pubic rami, or ischium and acetabulum","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1826.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1270","name":"Pts no kid transplt wtlst","description":"Patients not on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4427","name":"Dermbnd dln dl+ dlx sq cm","description":"Dermabind dl n or dermabind dl + or dermabind dl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4438","name":"Pretect per sq cm","description":"Pretect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0992T","name":"N-invas assmt car rsk w/o ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat without concurrent computed tomography (ct) scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27610","name":"Explore/treat ankle joint","description":"Arthrotomy, ankle, including exploration, drainage, or removal of foreign body","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":763.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0891T","name":"Arhfcmrigtbs sbsq tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent treatment day","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25449","name":"Revj arthrp wrist joint","description":"Revision of arthroplasty, including removal of implant, wrist joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1240.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0415U","name":"Cv ds acs bld alg 5 yr score","description":"Cv ds acs bld alg 5 yr score","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1355","name":"Caries med app per tooth","description":"Caries med app per tooth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0177","name":"Inj, aflibercept hd, 1 mg","description":"Injection, aflibercept hd, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11400","name":"Exc tr-ext b9+marg 0.5 cm<","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 0.5 cm or less","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":148.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6613","name":"Onlay cst base mtl >=3 surfa","description":"Onlay - cast predominantly base metal three or more surfaces","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0937T","name":"Xtrnl ecg rec>15d<30d","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; including recording, scanning analysis with report, review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0334U","name":"Onc sld orgn tgsa dna 84/+","description":"Onc sld orgn tgsa dna 84/+","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0949T","name":"Rem interrog dev ccm tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1347","name":"Pt pam incr 3 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 3 points in a 4 to 12 month period (passing)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80201","name":"Assay of topiramate","description":"Topiramate","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1212","name":"Missing gsa not perf","description":"Glycemic status assessment (hba1c or gmi) level is missing, or was not performed during the measurement period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0211","name":"Inj, nithiodote, 3mg / 125mg","description":"Injection, sodium nitrite 3 mg and sodium thiosulfate 125 mg (nithiodote)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4286","name":"Remove non-resorb barrier","description":"Remove non-resorb barrier","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1251","name":"Pts proxy cmplt hu surv","description":"Patients for whom a proxy completed the entire hu survey on their behalf for any reason (no patient involvement)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47384","name":"Abltj ire liver 1+ tum perq","description":"Ablation, irreversible electroporation, liver, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0592U","name":"Onc hl neo dna tgs 417 genes","description":"Onc hl neo dna tgs 417 genes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2865","name":"Inj sulfameth/trim 5 mg/1 mg","description":"Injection, sulfamethoxazole 5 mg and trimethoprim 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37291","name":"Revsc evsc tpvt athr cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90791","name":"Psych diagnostic evaluation","description":"Psychiatric diagnostic evaluation","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":183.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0041","name":"Pt/ptn decln referral","description":"Patient and/or care partner decline referral","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2472","name":"Inj, pantoprazole sodium chl","description":"Injection, pantoprazole sodium in sodium chloride (baxter), 40 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0991T","name":"Cysto lo-nrg lithtrp&mcrsphr","description":"Cystourethroscopy, with low-energy lithotripsy and acoustically actuated microspheres, including imaging","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1424","name":"Pulmonology care mvp","description":"Pulmonology care mips value pathway","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1017T","name":"Elec aly npgs esoph sbsq w/o","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4006","name":"Gastroenterology ss","description":"Gastro-enterology mips specialty set","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7300","name":"Rem anchorage dev w/o flap","description":"Rem anchorage dev w/o flap","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0136","name":"Inj, acetaminophen (b braun)","description":"Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0666","name":"Team remote e/m est pt 15 mn","description":"Team remote e/m est. pt 15mins","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6526","name":"G com garmt full leg/ft nght","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":693.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0654","name":"Inj, liothyronine, 1 mcg","description":"Injection, liothyronine, 1 mcg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0968T","name":"Insj/rplcmt epcrnl nstim sys","description":"Insertion or replacement of epicranial neurostimulator system, including electrode array and pulse generator, with connection to electrode array","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9174","name":"Inj, docetaxel (beizray) 1mg","description":"Injection, docetaxel (beizray), 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21282","name":"Lateral canthopexy","description":"Lateral canthopexy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9936","name":"Clean occ guard","description":"Clean occ guard","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","name":"Scoliosis orth sag/ cor","description":"Scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla to trochanter, includes all accessory pads, straps and interface, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual ","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4023","name":"Pathology ss","description":"Pathology mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33513","name":"Cabg vein four","description":"Coronary artery bypass, vein only; 4 coronary venous grafts","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2449.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92551","name":"Pure tone hearing test air","description":"Screening test, pure tone, air only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3473","name":"Surg rep root res molar","description":"Surg rep root res molar","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"Breathing capacity test","description":"Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement(s), with or without maximal voluntary ventilation","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1781","name":"Vac admin human pap dose 1","description":"Vac admin human pap dose 1","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37264","name":"Revsc evasc fpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4199","name":"Cygnus matrix, per sq cm","description":"Cygnus matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0794T","name":"Pt spec alg rx-onc tx option","description":"Patient-specific, assistive, rules-based algorithm for ranking pharmaco-oncologic treatment options based on the patients tumor-specific cancer marker information obtained from prior molecular pathology, immunohistochemical, or other pathology results which have been previously interpreted and repor","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83876","name":"Assay myeloperoxidase","description":"Myeloperoxidase (mpo)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0903T","name":"Ecg alg 12 lead reduced i&r","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; with interpretation and report","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1570","name":"Ganciclovir sodium injection","description":"Injection, ganciclovir sodium, 500 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81005","name":"Urinalysis","description":"Urinalysis; qualitative or semiquantitative, except immunoassays","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86780","name":"Treponema pallidum","description":"Antibody; treponema pallidum","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1481","name":"Pt in hosp/pal care who died","description":"Patients receiving hospice or palliative care or who died during the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5152","name":"Inj, eculizumab-aeeb, 2 mg","description":"Injection, eculizumab-aeeb (bkemv), biosimilar, 2 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83695","name":"Assay of lipoprotein(a)","description":"Lipoprotein (a)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1360","name":"Suicd c-ssrs assessment","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1391","name":"All pt dx w/ rec mlnm","description":"All patients who were diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49553","name":"Rpr fem hernia init blocked","description":"Repair initial femoral hernia, any age; incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37271","name":"Revsc evsc fpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0387U","name":"Onc mlnma ambra1&amlo","description":"Onc mlnma ambra1&amlo","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0436U","name":"Onc lng plsm alys 388 prtn","description":"Onc lng plsm alys 388 prtn","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81194","name":"Ntrk translocation analysis","description":"Ntrk (neurotrophic receptor tyrosine kinase 1, 2, and 3) (eg, solid tumors) translocation analysis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":518.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0739","name":"Hiv prep, inj, cabotegravir","description":"Injection, cabotegravir, 1mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0794T","name":"Pt spec alg rx-onc tx option","description":"Patient-specific, assistive, rules-based algorithm for ranking pharmaco-oncologic treatment options based on the patients tumor-specific cancer marker information obtained from prior molecular pathology, immunohistochemical, or other pathology results which have been previously interpreted and repor","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1336","name":"Pts eval ini xm 2 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 2 weeks","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76014","name":"Mr sfty implt&/fb asmt stf 1","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0925T","name":"Rlcj skin pocket ccm-d pg","description":"Relocation of skin pocket for implanted cardiac contractility modulation-defibrillation pulse generator","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27626","name":"Remove ankle joint lining","description":"Arthrotomy, with synovectomy, ankle; including tenosynovectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":788.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4350","name":"Palisade dm matrix per sq cm","description":"Palisade dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15335","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4409","name":"Amniomatrixf3x per sq cm","description":"Amniomatrixf3x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1807","name":"Inj, ethacrynate sod, 1 mg","description":"Injection, ethacrynate sodium, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","name":"Gait mod systm rhym auditory","description":"Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77090","name":"Tbs techl prep&transmis data","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99386","name":"Prev visit new age 40-64","description":"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; 40-64 years","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":167.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4323","name":"Alloply, per sq cm","description":"Alloply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44110","name":"Excise intestine lesion(s)","description":"Excision of 1 or more lesions of small or large intestine not requiring anastomosis, exteriorization, or fistulization; single enterotomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":826.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6212","name":"Bridge noble metal cast","description":"Pontic-cast noble metal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57452","name":"Exam of cervix w/scope","description":"Colposcopy of the cervix including upper/adjacent vagina;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":97.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":108.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9248","name":"Inj melphalan (hepzato) 1 mg","description":"Injection, melphalan (hepzato), 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35860","name":"Explore limb vessels","description":"Exploration for postoperative hemorrhage, thrombosis or infection; extremity","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":467.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5909","name":"Max guid prothes w/ flange","description":"Max guid prothes w/ flange","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9154","name":"Artificial saliva, 1 ml","description":"Artificial saliva, 1 ml","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0510U","name":"Onc pncrtc ca alg alys 16gen","description":"Onc pncrtc ca alg alys 16gen","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4285","name":"Nudyn dl or dl mesh pr sq cm","description":"Nudyn dl or nudyn dl mesh, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0654","name":"Inj, liothyronine, 1 mcg","description":"Injection, liothyronine, 1 mcg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1329","name":"Pts act pvd 2 wks 8 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 8 weeks after initial acute pvd encounter","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0162","name":"Inj epinephrine (fresenius)","description":"Injection, epinephrine (fresenius), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1229","name":"Pt w/ +hcv +vir ref win 1 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, is referred within 1 month of the reactive hcv antibody test to a clinician who treats hcv infection","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4468","name":"Exsuff belt incl all sup acc","description":"Exsufflation belt, includes all supplies and accessories","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5933","name":"Refitting of obturator","description":"Obturator prosthesis modification","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86231","name":"Ema each ig class","description":"Endomysial antibody (ema), each immunoglobulin (ig) class","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96401","name":"Chemo anti-neopl sq/im","description":"Chemotherapy administration, subcutaneous or intramuscular; non-hormonal anti-neoplastic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90482","name":"Imm cnsl not admn sm 3<10","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; 3 minutes up to 10 minutes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0363U","name":"Onc urthl mrna 5 gen alg","description":"Onc urthl mrna 5 gen alg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4368","name":"Amchothick per sq cm","description":"Amchothick, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9602","name":"Fluorodopa f-18 diag per mci","description":"Fluorodopa f-18, diagnostic, per millicurie","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6214","name":"Pontic titanium","description":"Pontic - titanium","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82575","name":"Creatinine clearance test","description":"Creatinine; clearance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1297","name":"Bmi not doc medrsn ptref","description":"Bmi not documented due to medical reason or patient refusal of height or weight measurement","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53865","name":"Cysto insj dev ischmc rmdlg","description":"Cystourethroscopy with insertion of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6611","name":"Grad com wrap w strap ak cus","description":"Gradient compression wrap with adjustable straps, above knee, each, custom","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1000T","name":"Autol musc cell therapy admn","description":"Autologous muscle cell therapy, administration of muscle progenitor cells into the urethral sphincter, including cystoscopy and post-void residual ultrasound, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0983T","name":"Rem mntr impl ivc snr phys","description":"Remote monitoring of an implanted inferior vena cava sensor for up to 30 days, including at least weekly downloads of inferior vena cava area recordings, interpretation(s), trend analysis, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0873T","name":"Revj subq prtl asct pmp sys","description":"Revision of a subcutaneously implanted peritoneal ascites pump system, any component (ascites pump, associated peritoneal catheter, associated bladder catheter), including imaging and programming, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24354","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":627.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0578","name":"Inj brixadi, more than 7 day","description":"Injection, buprenorphine extended release (brixadi), greater than 7 days and up to 28 days of therapy","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28222","name":"Release of foot tendons","description":"Tenolysis, flexor, foot; multiple tendons","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55868","name":"Lap srg prst8ct lymph nod bx","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with lymph node biopsy(ies) (limited pelvic lymphadenectomy)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1361","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9609","name":"F18 fdg, 15 millicuries","description":"Fludeoxyglucose f18 up to 15 millicuries","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93652","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4428","name":"Dermbnd sln sl+ slx sq cm","description":"Dermabind sl n or dermabind sl + or dermabind sl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0728T","name":"Dx alys vstblr implt uni 1st","description":"Diagnostic analysis of vestibular implant, unilateral; with initial programming","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2008","name":"Theragenesis, per sq cm","description":"Theragenesis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69719","name":"Rplcm oi implt sk tc esp<100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9887","name":"Distance learning attendance","description":"Behavioral counseling for diabetes prevention, distance learning, 60 minutes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1249","name":"Pt resp true imprt to me","description":"Patient responded completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1284","name":"Pt 66+ snp or ltc pos > 90d","description":"Patients age 66 or older in institutional special needs plans (snp) or residing in long term care with pos code 32, 33, 34, 54, or 56 for more than 90 consecutive days during the measurement period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1416","name":"Pt rec hosp","description":"Patient received hospice services any time during the performance period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87468","name":"Anaplsma phgcytophlm amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); anaplasma phagocytophilum, amplified probe technique","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4322","name":"Splint intra-coronal","description":"Splint intra-coronal","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4410","name":"Amchomatrixdl per sq cm","description":"Amchomatrixdl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0457","name":"Injection, aztreonam, 100 mg","description":"Injection, aztreonam, 100 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0313U","name":"Onc pncrs dna&mrna seq 74","description":"Onc pncrs dna&mrna seq 74","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0739T","name":"Abltj mal prst8 mag fld ndct","description":"Ablation of malignant prostate tissue by magnetic field induction, including all intraprocedural, transperineal needle/catheter placement for nanoparticle installation and intraprocedural temperature monitoring, thermal dosimetry, bladder irrigation, and magnetic field nanoparticle activation","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66991","name":"Xcapsl ctrc rmvl insj 1+","description":"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); with insertion of intraocular (eg, trabecular meshwork, supraciliary, suprachoroidal) anterior segment aqueous drai","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3404","name":"Inj zopapogene per ther dose","description":"Injection, zopapogene imadenovec-drba suspension, per therapeutic dose","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4391","name":"Amnioplast double per sq cm","description":"Amnioplast double, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0747T","name":"Car ablt rad arrhyt dlvr rad","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; delivery of radiation therapy, arrhythmia","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0672T","name":"Ndovag cryg rf remdl tiss","description":"Endovaginal cryogen-cooled, monopolar radiofrequency remodeling of the tissues surrounding the female bladder neck and proximal urethra for urinary incontinence","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0127","name":"Trim nail(s)","description":"Trimming of dystrophic nails, any number","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3376","name":"Inj vancomycin (hikma) 10mg","description":"Injection, vancomycin hcl (hikma), not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29902","name":"Mcp joint arthroscopy surg","description":"Arthroscopy, metacarpophalangeal joint, surgical; with reduction of displaced ulnar collateral ligament (eg, stener lesion)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":658.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88273","name":"Cytogenetics 10-30","description":"Molecular cytogenetics; chromosomal in situ hybridization, analyze 10-30 cells (eg, for microdeletions)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7912","name":"Suture complicate wnd > 5 cm","description":"Complicated suture-greater than 5 cm","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9296","name":"Inj pemetrexed (accord) 10mg","description":"Injection, pemetrexed (accord), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2031","name":"Mirodry, per sq cm","description":"Mirodry wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9602","name":"Fluorodopa f-18 diag per mci","description":"Fluorodopa f-18, diagnostic, per millicurie","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5913","name":"Nasal prosthesis","description":"Nasal prosthesis","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1483","name":"Neg quan hep c or qual rna","description":"Patients who achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2023","name":"Innovamatrix pd, 1 mg","description":"Innovamatrix pd, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4342","name":"Theramend, per sq cm","description":"Theramend, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0608","name":"Lanthanum carbonate pwdr 5mg","description":"Lanthanum carbonate, oral, powder, 5 mg, not therapeutically equivalent to j0607 (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0788T","name":"Elec aly smp iins sp/sac nrv","description":"Electronic analysis with simple programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detecti","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2042","name":"Foundation drs+ solo, sq cm","description":"Foundation drs+ solo, per square centimeter","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4332","name":"Axolotl dualgraft, per sq cm","description":"Axolotl dualgraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80220","name":"Drug asy hydroxychloroquine","description":"Hydroxychloroquine","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0750T","name":"B1 str&fx rsk asmt dxrbmd1vw","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0206","name":"Inj allopurinol sodium 1 mg","description":"Injection, allopurinol sodium, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4289","name":"Revoshield+ amnio, per sq cm","description":"Revoshield + amniotic barrier, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5657","name":"Add low ext man aut vol any","description":"Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0301U","name":"Iadna bartonella ddpcr","description":"Iadna bartonella ddpcr","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7509","name":"Marsupialization odon cyst","description":"Marsupialization odon cyst","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1237","name":"Pt rsn no scrn","description":"Patient reason for not screening for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety (e.g., patient declined or other patient reasons)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1961","name":"Inj lenacapavir (hiv tx) 1mg","description":"Injection, lenacapavir (only for use as hiv treatment), 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4383","name":"Axolotl graft ult per sq cm","description":"Axolotl graft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0283U","name":"Vw factor type 2b eval plsm","description":"Von willebrand factor (vwf), type 2b, platelet-binding evaluation, radioimmunoassay, plasma","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1246","name":"Pt othr thn true imprt to me","description":"Patient provided a response other than completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99411","name":"Preventive counseling group","description":"Preventive medicine counseling and/or risk factor reduction intervention(s) provided to individuals in a group setting (separate procedure); approximately 30 minutes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":23.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1811","name":"Fiasp for insulin pump use","description":"Insulin (fiasp) for administration through dme (i.e., insulin pump) per 50 units","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0860T","name":"Ncntc ifr spctrsc scr pad","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), for screening for peripheral arterial disease, including provocative maneuvers, image acquisition, interpretation, and report, one or both lower extremities","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0283","name":"Inj, amiodarone (nexterone)","description":"Injection, amiodarone hydrochloride (nexterone), 30 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1304","name":"Inj tofersen intrathec 1 mg","description":"Injection, tofersen, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1417","name":"Pt up to date cov","description":"Patients who are up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6074","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (noble metal)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1459","name":"Pt hosp/pal care dur perf pd","description":"Patient was in hospice or receiving palliative care services at any time during the performance period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1003T","name":"Arthrp 1st crp/mtcrpl prostc","description":"Arthroplasty, first carpometacarpal joint, with distal trapezial and proximal first metacarpal prosthetic replacement (eg, first carpometacarpal total joint)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6515","name":"Grad com wrap w str fu le cu","description":"Gradient compression wrap with adjustable straps, full leg, each, custom","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49610","name":"Repair umbilical lesion","description":"Repair of omphalocele (gross type operation); first stage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0320U","name":"Neph rna psttrnspl perph bld","description":"Neph rna psttrnspl perph bld","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4425","name":"Revive tl per sq cm","description":"Revive tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9948","name":"Adjust sleep apnea appliance","description":"Adjust sleep apnea appliance","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0041","name":"Pt/ptn decln referral","description":"Patient and/or care partner decline referral","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1427","name":"Doc med rsn bone scn","description":"Documentation of medical reason(s) for performing a bone scan (including documented pain related to prostate cancer, salvage therapy, other medical reasons)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4355","name":"Abio xpl abio xpl hy p sq cm","description":"Abiomend xplus membrane and abiomend xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0002","name":"Opt care kidney hlth mvp","description":"Optimal care for kidney health mips value pathways","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0981T","name":"Tcat impl wrls ivc snr","description":"Transcatheter implantation of wireless inferior vena cava sensor for long-term hemodynamic monitoring, including deployment of the sensor, radiological supervision and interpretation, right heart catheterization, and inferior vena cava venography, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25370","name":"Revise radius or ulna","description":"Multiple osteotomies, with realignment on intramedullary rod (sofield type procedure); radius or ulna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1460.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73615","name":"Contrast x-ray of ankle","description":"Radiologic examination, ankle, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93152","name":"Interrog&prgrmg ipnss polysm","description":"Interrogation and programming of implanted phrenic nerve stimulator system during polysomnography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":78.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95852","name":"Range of motion measurements","description":"Range of motion measurements and report (separate procedure); hand, with or without comparison with normal side","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0603U","name":"Rx asy prsmv 77rx/metablt ur","description":"Rx asy prsmv 77rx/metablt ur","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91113","name":"Gi trc img intral colon i&r","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1249","name":"Pt resp true imprt to me","description":"Patient responded completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0939T","name":"Xtrnl ecg rec>15d<30d scan","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; scanning analysis with report","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2644","name":"Dental onlay porc 4/more sur","description":"Onlay - porcelain/ceramic - four or more surfaces","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15012","name":"Hrv skn cll ssp agrft ea add","description":"Harvest of skin for skin cell suspension autograft; each additional 25 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0961T","name":"Shortwave ifr radiation img","description":"Shortwave infrared radiation imaging, surgical pathology specimen, to assist gross examination for lymph node localization in fibroadipose tissue, per specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4280","name":"Xcell amnio matrix per sq cm","description":"Xcell amnio matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0553U","name":"Repr med pga embry te strux","description":"Repr med pga embry te strux","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0539","name":"Initial care training 30 m","description":"Caregiver training in behavior management/modification for caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face; initial 30 minutes","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1235","name":"Doc pt hcv aby rna tst","description":"Documentation or patient report of hcv antibody test or hcv rna test which occurred prior to the performance period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0932T","name":"N-invs det hrt fail aug echo","description":"Noninvasive detection of heart failure derived from augmentative analysis of an echocardiogram that demonstrated preserved ejection fraction, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4008","name":"Geriatrics ss","description":"Geriatrics mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0598U","name":"Gi ibs igg antb 18food items","description":"Gi ibs igg antb 18food items","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98976","name":"Rtm dev sply resp sys 16-30d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of respiratory system, 16-30 days in a 30-day period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4260","name":"Signature apatch, per sq cm","description":"Signature apatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5227","name":"Immed max part denture","description":"Immed max part denture","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0534","name":"Coordinated care/or referral","description":"Coordinated care and/or referral services, such as to adequate and accessible community resources to address unmet health-related social needs, including harm reduction interventions and recovery support services a patient needs and wishes to pursue, which significantly limit the ability to diagnose","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1423","name":"Opt care urologic cnd mvp","description":"Optimal care for patients with urologic conditions mips value pathway","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5811","name":"Denture interm cmplt mandbl","description":"Interim complete denture (mandibular)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0032","name":"2+ antipsy schiz","description":"Two or more antipsychotic prescriptions ordered for patients who had a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder on or between january 1 of the year prior to the measurement period and the index prescription start date (ipsd) for antipsychotics","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90638","name":"Vacc qirv mrna 60mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 60 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1225","name":"Iop dec>=20% from base","description":"Intraocular pressure (iop) reduced by a value of greater than or equal to 20% from the pre-intervention level","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1434","name":"Orl chemo wthn 30 d post enc","description":"Patient on oral chemotherapy on or within 30 days after denominator eligible encounter","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0680","name":"Cr art clc art vlv clc w rpt","description":"Detection and quantification of coronary artery calcium and/or aortic valve calcification from algorithmic analysis of computed tomography of the chest with report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85060","name":"Blood smear interpretation","description":"Blood smear, peripheral, interpretation by physician with written report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0393U","name":"Neu prksn msfl a-syncln prtn","description":"Neu prksn msfl a-syncln prtn","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0820T","name":"Mntr psychdlc med 1stphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; first physician or other qualified health care professional, each hour","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38228","name":"Car-t admn autologous","description":"Chimeric antigen receptor t-cell (car-t) therapy; car-t cell administration, autologous","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57230","name":"Repair of urethral lesion","description":"Plastic repair of urethrocele","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":426.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1105","name":"Dexmedetomidine film, 1 mcg","description":"Dexmedetomidine, oral, 1 mcg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0668","name":"Instill, bupivac and meloxic","description":"Instillation, bupivacaine and meloxicam, 1 mg/0.03 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98975","name":"Rtm 1st set-up&pt educaj eqp","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); initial set-up and patient education on use of equipment","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9914","name":"Admin of dermal fill","description":"Admin of dermal fill","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4359","name":"Choriply, per sq cm","description":"Choriply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0816T","name":"Opn insj/rplcmt ins ptn subq","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9076","name":"Inj, cyclophos (baxter) 5mg","description":"Injection, cyclophosphamide (baxter), 5 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0790T","name":"Revj rplcmt/rmvl vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracolumbar or lumbar vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1374","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84540","name":"Assay of urine/urea-n","description":"Urea nitrogen, urine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0965T","name":"I&cst prp jw xpn dl arch non","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, non-fixed hinge mechanism","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0208","name":"Inj, pedmark, 100 mg","description":"Injection, sodium thiosulfate (pedmark), 100 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0411","name":"Hba1c in office testing","description":"Hba1c in office testing","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5949","name":"Mand implt sup fix part","description":"Mand implt sup fix part","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0565U","name":"Onc hcc ngs detc 6626epigalt","description":"Onc hcc ngs detc 6626epigalt","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1009T","name":"Rem mntr s-sclp cont eeg sys","description":"Remote monitoring of a sub-scalp implanted continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9432","name":"Med food non inborn err meta","description":"Medical foods for non-inborn errors of metabolism","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85013","name":"Spun microhematocrit","description":"Blood count; spun microhematocrit","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2329","name":"Inj ublituximab-xiiy, 1 mg","description":"Injection, ublituximab-xiiy, 1mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0689","name":"Inj cefazolin sodium, baxter","description":"Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9220","name":"Indigotindisulfonate sod 1mg","description":"Injection, indigotindisulfonate sodium, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44403","name":"Colonoscopy w/resection","description":"Colonoscopy through stoma; with endoscopic mucosal resection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"13151","name":"Cmplx rpr e/n/e/l 1.1-2.5 cm","description":"Repair, complex, eyelids, nose, ears and/or lips; 1.1 cm to 2.5 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3222","name":"Part pulp for apexogenesis","description":"Partial pulpotomy for apexogenesis - permanent tooth with incomplete root development","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37265","name":"Revsc evsc fpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99397","name":"Per pm reeval est pat 65+ yr","description":"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 65 ye","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":149.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0499U","name":"Onc clrct&lng dna ngs 8gene","description":"Onc clrct&lng dna ngs 8gene","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4253","name":"Zenith amniotic membrane psc","description":"Zenith amniotic membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0889T","name":"Prsnlz trgt dvl arhfcmrigtbs","description":"Personalized target development for accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation derived from a structural and resting-state functional mri, including data preparation and transmission, generation of the target, motor threshold-starting location, neuro","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0971T","name":"Ablt mal brst tum pq lsr uni","description":"Ablation, malignant breast tumor(s), percutaneous, laser, including imaging guidance when performed, unilateral","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9293","name":"Fertility cycl tracking soft","description":"Fertility cycle (contraception & conception) tracking software application, fda cleared, per month, includes accessories (e.g., thermometer)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52400","name":"Cysto cgen post urtl valves","description":"Cystourethroscopy with incision, fulguration, or resection of congenital posterior urethral valves, or congenital obstructive hypertrophic mucosal folds","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":614.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96380","name":"Admn rsv monoc antb im cnsl","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection, with counseling by physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92953","name":"Temporary external pacing","description":"Temporary transcutaneous pacing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0289U","name":"Neuro alzheimer mrna 24 gen","description":"Neuro alzheimer mrna 24 gen","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0104","name":"Ca screen;flexi sigmoidscope","description":"Colorectal cancer screening; flexible sigmoidoscopy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1304","name":"Inj tofersen intrathec 1 mg","description":"Injection, tofersen, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2506","name":"Inj pegfilgrast ex bio 0.5mg","description":"Injection, pegfilgrastim, excludes biosimilar, 0.5 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80503","name":"Path clin consltj sf 5-20","description":"Pathology clinical consultation; for a clinical problem, with limited review of patients history and medical records and straightforward medical decision making when using time for code selection, 5-20 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62331","name":"Dcmprn prq rmv lig flv addl","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; additional interspace(s), lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86185","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0675","name":"Inj, carboprost, 0.1 mg","description":"Injection, carboprost tromethamine, 0.1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0320U","name":"Neph rna psttrnspl perph bld","description":"Neph rna psttrnspl perph bld","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70472","name":"Ct cere prfu alys c+w/ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed with concurrent ct or ct angiography of the same anatomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1000T","name":"Autol musc cell therapy admn","description":"Autologous muscle cell therapy, administration of muscle progenitor cells into the urethral sphincter, including cystoscopy and post-void residual ultrasound, when performed","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4428","name":"Dermbnd sln sl+ slx sq cm","description":"Dermabind sl n or dermabind sl + or dermabind sl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2371","name":"Inj phenylephrine hcl 20 mcg","description":"Injection, phenylephrine hydrochloride, 20 micrograms","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1402","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4406","name":"Xwrap fenestra per sq cm","description":"Xwrap fenestra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92100","name":"Serial tonometry","description":"Serial tonometry (separate procedure) with multiple measurements of intraocular pressure over an extended time period with interpretation and report, same day (eg, diurnal curve or medical treatment of acute elevation of intraocular pressure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83876","name":"Assay myeloperoxidase","description":"Myeloperoxidase (mpo)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3425","name":"Hydroxocobalamin im 10mcg","description":"Injection, hydroxocobalamin, intramuscular, 10 mcg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22860","name":"Tot disc arthrp 2ntrspc lmbr","description":"Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression); second interspace, lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2782","name":"Crown 3/4 cast noble metal","description":"Crown - 3/4 cast noble metal","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55714","name":"Bx prst8 in-bore ct/mri 1","description":"Biopsy, prostate, in-bore ct- or mri-guided targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87493","name":"C diff amplified probe","description":"Infectious agent detection by nucleic acid (dna or rna); clostridium difficile, toxin gene(s), amplified probe technique","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0507U","name":"Onc ovr dna whole gen w/5hmc","description":"Onc ovr dna whole gen w/5hmc","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4421","name":"Biolab wrap solo per sq cm","description":"Biolab membrane wrap solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39540","name":"Repair of diaphragm hernia","description":"Repair, diaphragmatic hernia (other than neonatal), traumatic; acute","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":951.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0761T","name":"Dgtz gls mcrscp sl imm ea 1","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0549U","name":"Onc urthl dna mthyltd rt pcr","description":"Onc urthl dna mthyltd rt pcr","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0323U","name":"Iadna cns pthgn next gen seq","description":"Iadna cns pthgn next gen seq","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1808","name":"Inj, folic acid, 0.1 mg","description":"Injection, folic acid, 0.1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85014","name":"Hematocrit","description":"Blood count; hematocrit (hct)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33269","name":"Excl laa thrscp any method","description":"Exclusion of left atrial appendage, thoracoscopic, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2394","name":"Post >=4srfc resinbase cmpst","description":"Resin-based composite - four or more surfaces posterior","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0911","name":"Inst tauro 1.35mg/hep 100u","description":"Instillation, taurolidine 1.35 mg and heparin sodium 100 units (central venous catheter lock for adult patients receiving chronic hemodialysis)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1351","name":"Dental sealant per tooth","description":"Sealant-per tooth","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1387","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85025","name":"Complete cbc w/auto diff wbc","description":"Blood count; complete (cbc), automated (hgb, hct, rbc, wbc and platelet count) and automated differential wbc count","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6624","name":"Inlay titanium","description":"Inlay - titanium","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92604","name":"Reprogram cochlear implt 7/>","description":"Diagnostic analysis of cochlear implant, age 7 years or older; subsequent reprogramming","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4393","name":"Surgraft ac per sq cm","description":"Surgraft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54150","name":"Circumcision w/regionl block","description":"Circumcision, using clamp or other device with regional dorsal penile or ring block","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":97.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":178.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0779T","name":"Gi myoelectrical actv study","description":"Gastrointestinal myoelectrical activity study, stomach through colon, with interpretation and report","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70350","name":"X-ray head for orthodontia","description":"Cephalogram, orthodontic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99476","name":"Ped crit care age 2-5 subsq","description":"Subsequent inpatient pediatric critical care, per day, for the evaluation and management of a critically ill infant or young child, 2 through 5 years of age","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9247","name":"Mod sedation noniv-sub15min","description":"Mod sedation noniv-sub15min","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q0224","name":"Inj, pemivibart, 4500 mg","description":"Injection, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, and who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppressive ","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37700","name":"Ligation&div long saph vein","description":"Ligation and division of long saphenous vein at saphenofemoral junction, or distal interruptions","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0861T","name":"Rmvl pg wcs lv both compnt","description":"Removal of pulse generator for wireless cardiac stimulator for left ventricular pacing; both components (battery and transmitter)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84525","name":"Urea nitrogen semi-quant","description":"Urea nitrogen; semiquantitative (eg, reagent strip test)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91034","name":"Gastroesophageal reflux test","description":"Esophagus, gastroesophageal reflux test; with nasal catheter ph electrode(s) placement, recording, analysis and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0330U","name":"Iadna vag pthgn panel 27 org","description":"Iadna vag pthgn panel 27 org","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53452","name":"Tprnl balo cntnc dev uni","description":"Periurethral transperineal adjustable balloon continence device; unilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0526U","name":"Nefro rnl trnspl quan cxcl10","description":"Nefro rnl trnspl quan cxcl10","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1349","name":"No pam inc 3 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 3 points within a 4 to 12 month period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2014","name":"Omeza collag compl 100 mg","description":"Omeza collagen matrix or omeza complete matrix, per 100 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2596","name":"Vasopressin (long grove) 1 u","description":"Injection, vasopressin (long grove), not therapeutically equivalent to j2598, 1 unit","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52443","name":"Cysto 1st trurl prst8 comis","description":"Cystourethroscopy with initial transurethral anterior prostate commissurotomy with a nondrug-coated balloon catheter followed by therapeutic drug delivery into the prostate by a drug-coated balloon catheter, including transrectal ultrasound and fluoroscopy, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86053","name":"Aqaprn-4 antb flo cytmtry ea","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; flow cytometry (ie, fluorescence-activated cell sorting [facs]), each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"Basic vestibular evaluation","description":"Basic vestibular evaluation, includes spontaneous nystagmus test with eccentric gaze fixation nystagmus, with recording, positional nystagmus test, minimum of 4 positions, with recording, optokinetic nystagmus test, bidirectional foveal and peripheral stimulation, with recording, and oscillating tra","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2249","name":"Inj, remimazolam, 1 mg","description":"Injection, remimazolam, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1465","name":"F/u > 180 days after rx","description":"Patient follow up more than 180 days after treatment","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1428","name":"Bilateral absence of eyes","description":"Patients who have bilateral absence of eyes any time during the patients history through the end of the measurement period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0818T","name":"Revj/rmvl ins ptn subq","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0342U","name":"Onc pncrtc ca mult ia eclia","description":"Onc pncrtc ca mult ia eclia","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0665","name":"Inj, bupivacaine, nos, 0.5mg","description":"Injection, bupivicaine, not otherwise specified, 0.5 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7509","name":"Marsupialization odon cyst","description":"Marsupialization odon cyst","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1222","name":"Glaucoma pln of care not doc","description":"Glaucoma plan of care not documented, reason not otherwise specified","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42975","name":"Dise eval slp do brth flx dx","description":"Drug-induced sleep endoscopy, with dynamic evaluation of velum, pharynx, tongue base, and larynx for evaluation of sleep-disordered breathing, flexible, diagnostic","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1098","name":"Articaine ophthalmi 8% 0.4ml","description":"Articaine ophthalmic, 8% solution, 0.4 ml","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0432U","name":"Klhl11 antb sr/csf asy qual","description":"Klhl11 antb sr/csf asy qual","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43600","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2792","name":"Crown full cast noble metal","description":"Crown-full cast noble metal","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6192","name":"Semi precision attachment","description":"Semi precision attachment","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70545","name":"Mr angiography head w/dye","description":"Magnetic resonance angiography, head; with contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":647.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87181","name":"Sc std agar dilution per agt","description":"Susceptibility studies, antimicrobial agent; agar dilution method, per agent (eg, antibiotic gradient strip)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0423","name":"Genetic test spec analysis","description":"Genetic test spec analysis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51992","name":"Laparo sling operation","description":"Laparoscopy, surgical; sling operation for stress incontinence (eg, fascia or synthetic)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":954.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99469","name":"Neonate crit care subsq","description":"Subsequent inpatient neonatal critical care, per day, for the evaluation and management of a critically ill neonate, 28 days of age or younger","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4436","name":"Renati ac membrane per sq cm","description":"Renati ac membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27295","name":"Amputation of leg at hip","description":"Disarticulation of hip","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1485.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5942","name":"Proth max implt sup remv","description":"Proth max implt sup remv","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1159","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4336","name":"Artecent c, per sq cm","description":"Artacent c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85557","name":"Rbc osmotic fragility","description":"Osmotic fragility, rbc; incubated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6597","name":"G comp bandage long stretch","description":"Gradient compression bandage roll, elastic long stretch, linear yard, any width, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0402","name":"Inj, abilify asimtufii, 1 mg","description":"Injection, aripiprazole (abilify asimtufii), 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4259","name":"Celera per sq cm","description":"Celera dual layer or celera dual membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4340","name":"Simpligraft, per sq cm","description":"Simpligraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0137","name":"Inj, acetaminophen (hikma)","description":"Injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1150","name":"Lvef <=40% or mod/sev l vsf","description":"Current or prior left ventricular ejection fraction (lvef) less than or equal to 40% or documentation of moderately or severely depressed left ventricular systolic function","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87812","name":"Sarscov2&inf typ a&b w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) and influenza virus types a and b","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0392U","name":"Rx metab genrx ia 16 genes","description":"Rx metab genrx ia 16 genes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0687T","name":"Tx amblyopia dev setup 1st","description":"Treatment of amblyopia using an online digital program; device supply, educational set-up, and initial session","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87880","name":"Strep a assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; streptococcus, group a","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0874T","name":"Rmvl pertl ascites pmp sys","description":"Removal of a peritoneal ascites pump system, including implanted peritoneal ascites pump and indwelling bladder and peritoneal catheters","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7252","name":"Part extract for implant","description":"Part extract for implant","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23650","name":"Cltx sho dslc w/mnpj wo anes","description":"Closed treatment of shoulder dislocation, with manipulation; without anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6553","name":"G com stcking bk 30-40 custm","description":"Gradient compression stocking, below knee, 30-40 mmhg, custom, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":226.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7259","name":"Nerve dissection","description":"Nerve dissection","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33966","name":"Ecmo/ecls rmvl prph cannula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; removal of peripheral (arterial and/or venous) cannula(e), percutaneous, 6 years and older","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0444U","name":"Onc sld orgn neo tgsap 361","description":"Onc sld orgn neo tgsap 361","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98007","name":"Synch audio-video est hi 40","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high medical decision making. when using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded.","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-06-05","zip":"10985","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0958T","name":"Rmv s-sclp eltr ra rcvr&tlmt","description":"Removal of sub-scalp implanted electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87493","name":"C diff amplified probe","description":"Infectious agent detection by nucleic acid (dna or rna); clostridium difficile, toxin gene(s), amplified probe technique","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0890T","name":"Arhfcmrigtbs 1st tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including target assessment, initial motor threshold determination, neuronavigation, delivery and management, initial treatment day","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4267","name":"Neostim dl per sq cm","description":"Neostim dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4322","name":"Splint intra-coronal","description":"Splint intra-coronal","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5125","name":"Inj, releuko 1 mcg","description":"Injection, filgrastim-ayow, biosimilar, (releuko), 1 microgram","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1379","name":"10 yr fu no rec rsn not giv","description":"A 10 year follow-up interval for colonoscopy not recommended, reason not otherwise specified","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37258","name":"Revsc evasc ivt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0833T","name":"Dgtz gls mcrscp cytp oth prp","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; preparation, screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52318","name":"Remove bladder stone","description":"Litholapaxy: crushing or fragmentation of calculus by any means in bladder and removal of fragments; complicated or large (over 2.5 cm)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":561.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2470","name":"Inj pantoprazole sodium 40mg","description":"Injection, pantoprazole sodium, 40 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4273","name":"Esano aaa, per sq cm","description":"Esano aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2291","name":"Inj, nafcillin (baxter) 20mg","description":"Injection, nafcillin sodium (baxter), 20 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0801","name":"3d dental scan direct","description":"3d dental scan direct","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0808T","name":"Pulm tiss vntj alys w/ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with computed tomography (ct) images taken for the purpose of pulmonary tissue ventilation analysis, including data preparation and transmission, quantificati","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0447U","name":"Ai ds sle alys 11 cytokine","description":"Ai ds sle alys 11 cytokine","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0817T","name":"Opn insj/rplcmt ins ptn subf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25151","name":"Partial removal of radius","description":"Partial excision (craterization, saucerization, or diaphysectomy) of bone (eg, for osteomyelitis); radius","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0881T","name":"Cryotherapy oral cavity","description":"Cryotherapy of the oral cavity using temperature regulated fluid cooling system, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0140","name":"Nav srv peer sup 60 min pr m","description":"Principal illness navigation - peer support by certified or trained auxiliary personnel under the direction of a physician or other practitioner, including a certified peer specialist; 60 minutes per calendar month, in the following activities:  person-centered interview, performed to better underst","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72114","name":"X-ray exam l-s spine bending","description":"Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0599U","name":"Onc pncrtc ca mult ia serum","description":"Onc pncrtc ca mult ia serum","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99223","name":"1st hosp ip/obs high 75","description":"Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 75 minutes must","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0606U","name":"Hem red cll memb do rbc oge","description":"Hem red cll memb do rbc oge","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4438","name":"Pretect per sq cm","description":"Pretect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1402","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4284","name":"Dermabind sl, per sq cm","description":"Dermabind sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21330","name":"Open tx nose fx w/skele fixj","description":"Open treatment of nasal fracture; complicated, with internal and/or external skeletal fixation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":720.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0557U","name":"Nfct ds bv dna mrk vag fluid","description":"Nfct ds bv dna mrk vag fluid","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0853T","name":"Dgtz gls mcrscp mphmtrc ea m","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1374","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1354","name":"Int caries med app per tooth","description":"Interim caries med app","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6196","name":"Remv of ind rest on implt","description":"Remv of ind rest on implt","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0281U","name":"Hem vwd propeptide ag lvl","description":"Hematology (von willebrand disease [vwd]), von willebrand propeptide, enzyme-linked immunosorbent assays (elisa), plasma, diagnostic report of von willebrand factor (vwf) propeptide antigen level","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0729T","name":"Dx alys vstblr implt uni sbq","description":"Diagnostic analysis of vestibular implant, unilateral; with subsequent programming","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2711","name":"Inj neostigmin/glycopyrrolat","description":"Injection, neostigmine methylsulfate 0.1 mg and glycopyrrolate 0.02 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1305","name":"Pneum vax admin 19+","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4379","name":"Amniodefend ft per sq cm","description":"Amniodefend ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0596U","name":"Neuro alzds plsm 3dstnct isp","description":"Neuro alzds plsm 3dstnct isp","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90832","name":"Psytx w pt 30 minutes","description":"Psychotherapy, 30 minutes with patient","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":93.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1460","name":"Dx copd, cf, or arf","description":"Diagnosis for chronic obstructive pulmonary disease, emphysema, cystic fibrosis, or acute respiratory failure","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0404U","name":"Onc brst semiq meas thym kn","description":"Onc brst semiq meas thym kn","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0367U","name":"Onc bldr 10 flwg trurl rescj","description":"Onc bldr 10 flwg trurl rescj","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1226","name":"Iop not doc","description":"Iop measurement not documented, reason not otherwise specified","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2051","name":"Support broker waiver/diem","description":"Supports brokerage, self-directed, waiver; per diem","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7972","name":"Surg redct fibrous tuberosit","description":"Surgical reduction of fibrous tuberosity","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5877","name":"Dup of complt dent-maxill","description":"Dup of complt dent-maxill","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4346","name":"Shelter dm matrix per sq cm","description":"Shelter dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15115","name":"Epdrm agrft f/s/n/h/f/g/m 1","description":"Epidermal autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq cm or less, or 1% of body area of infants and children","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":826.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90483","name":"Imm cnsl not admn sm>10<20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 10 minutes up to 20 minutes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6094","name":"Abut support crown titanium","description":"Abutment supported crown - (titanium)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31656","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77091","name":"Tbs techl calculation only","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical calculation only","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0721T","name":"Quan ct tiss charac w/o ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72148","name":"Mri lumbar spine w/o dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4322","name":"Caregraft, per sq cm","description":"Caregraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1022T","name":"Prq tis dsplmt ntra-abdl/pel","description":"Percutaneous tissue displacement, any method, including imaging guidance; intra-abdominal/pelvic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0033","name":"2+ benzo seiz","description":"Two or more benzodiazepine prescriptions ordered for patients who had a diagnosis of seizure disorders, rapid eye movement sleep behavior disorder, benzodiazepine withdrawal, ethanol withdrawal, or severe generalized anxiety disorder on or between january 1 of the year prior to the measurement perio","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9004","name":"Va whole health partner serv","description":"Department of veterans affairs whole health partner services","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76811","name":"Ob us detailed sngl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; single or first gestation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7259","name":"Nerve dissection","description":"Nerve dissection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87210","name":"Smear wet mount saline/ink","description":"Smear, primary source with interpretation; wet mount for infectious agents (eg, saline, india ink, koh preps)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0893","name":"Inj, decitabine (sun pharma)","description":"Injection, decitabine (sun pharma), not therapeutically equivalent to j0894, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0601","name":"Sevelamer carbonate 20 mg","description":"Sevelamer carbonate (renvela or therapeutically equivalent), oral, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90805","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81001","name":"Urinalysis auto w/scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; automated, with microscopy","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0447U","name":"Ai ds sle alys 11 cytokine","description":"Ai ds sle alys 11 cytokine","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0542","name":"No pt prsnt train add 15","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5150","name":"Inj, aflibercept-mrbb, 1 mg","description":"Injection, aflibercept-mrbb (ahzantive), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4350","name":"Palisade dm matrix per sq cm","description":"Palisade dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6600","name":"G com bandge hgh dn foam sht","description":"Gradient compression bandaging supply, high density foam sheet, per 250 square centimeters, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0734T","name":"Rem r-t mtn nrehab tx mgmt","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; treatment management services by a physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1257","name":"Cvd risk assess not perf","description":"Cvd risk assessment not performed or incomplete (e.g., cvd risk assessment was not documented), reason not otherwise specified","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9026","name":"Cryo fib comp path redu each","description":"Cryoprecipitated fibrinogen complex, pathogen reduced, each unit","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7962","name":"Lingual frenectomy","description":"Lingual frenectomy","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37277","name":"Rvsc evsc fpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42500","name":"Repair salivary duct","description":"Plastic repair of salivary duct, sialodochoplasty; primary or simple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6526","name":"G com garmt full leg/ft nght","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33277","name":"Insj phrnc nrv stim transvns","description":"Insertion of phrenic nerve stimulator transvenous sensing lead (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0364U","name":"Onc hl neo gen seq alys alg","description":"Onc hl neo gen seq alys alg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9615","name":"Inj, pegulicianine, 1 mg","description":"Injection, pegulicianine, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1487","name":"Pt adm to hospice dur eval","description":"Patients in hospice in the year before or during the period of evaluation","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9615","name":"Inj, pegulicianine, 1 mg","description":"Injection, pegulicianine, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99445","name":"Rem mntr physiol param 2-15","description":"Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate); device(s) supply with daily recording(s) or programmed alert(s) transmission, 2-15 days in a 30-day period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4438","name":"Pretect per sq cm","description":"Pretect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0048","name":"Pall serv during meas","description":"Patients who receive palliative care services any time during the intake period through the end of the measurement year","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5931","name":"Surgical obturator","description":"Obturator prosthesis surgical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0435U","name":"Onc chemo rx cytox csc 14 rx","description":"Onc chemo rx cytox csc 14 rx","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0857T","name":"Opto-acoustic img breast uni","description":"Opto-acoustic imaging, breast, unilateral, including axilla when performed, real-time with image documentation, augmentative analysis and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0976T","name":"Slctv nzmtc dbrdmt s/n/hf ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; each additional 100 sq cm (list separately in addition to code for p","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28805","name":"Amputation thru metatarsal","description":"Amputation, foot; transmetatarsal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":686.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93586","name":"Vngrph chd coronary sinus","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; coronary sinus (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86063","name":"Antistreptolysin o screen","description":"Antistreptolysin 0; screen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93587","name":"Vngrph chd vnvn cltrl at/abv","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating at or above the heart (eg, from innominate vein) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3263","name":"Inj, toripalimab-tpzi, 1 mg","description":"Injection, toripalimab-tpzi, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2004","name":"Inj, lidocaine w epinephrine","description":"Injection, lidocaine hcl with epinephrine, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"Ak 4 bar link hydl swg/stanc","description":"Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77089","name":"Tbs dxa cal w/i&r fx risk","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; using dual x-ray absorptiometry (dxa) or other imaging data on gray-scale variogram, calculation, with interpretation and report on fracture-risk","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7298","name":"Remove screw retained plate","description":"Remove screw retained plate","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93594","name":"R hrt cath chd abnl nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; abnormal native connections","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1213","name":"No hx spiro prs spiro>=70%","description":"No history of spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) and present spirometry is >= 70%","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1161","name":"Pt anphx due to dtp bef 13","description":"Patient had anaphylaxis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58752","name":"Revise ovarian tube(s)","description":"Tubouterine implantation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1048.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81463","name":"So gsap cl fr cpy nmbr&mcrst","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis, copy number variants, and microsatellite instability","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0756T","name":"Dgtz gls mcrscp sld spc grpi","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group i, for microorganisms (eg, acid fast, methenamine silver) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2329","name":"Inj ublituximab-xiiy, 1 mg","description":"Injection, ublituximab-xiiy, 1mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93569","name":"Njx cth slct p-art angrp uni","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4297","name":"Emerge matrix, per sq cm","description":"Emerge matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1781","name":"Vac admin human pap dose 1","description":"Vac admin human pap dose 1","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38228","name":"Car-t admn autologous","description":"Chimeric antigen receptor t-cell (car-t) therapy; car-t cell administration, autologous","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0272U","name":"Hem genetic bld do 51 genes","description":"Hematology (genetic bleeding disorders), genomic sequence analysis of 51 genes, blood, buccal swab, or amniotic fluid, comprehensive","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6094","name":"Abut support crown titanium","description":"Abutment supported crown - (titanium)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1496","name":"No doc of fall or poc","description":"Patients that had a fall who did not have a plan of care for falls documented or do not have documentation of being assessed for falls","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1271","name":"Inj doxycycline hyclate 1 mg","description":"Injection, doxycycline hyclate, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1941","name":"Inj, furoscix, 20 mg","description":"Injection, furosemide (furoscix), 20 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6074","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (noble metal)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90586","name":"Bcg vaccine intravesical","description":"Bacillus calmette-guerin vaccine (bcg) for bladder cancer, live, for intravesical use","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7294","name":"Seg acet and eth estr yearly","description":"Segesterone acetate and ethinyl estradiol 0.15mg, 0.013mg per 24 hours; yearly vaginal system, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0201","name":"Pne flu hepb cov home admin","description":"Administration of pneumococcal, influenza, hepatitis b, and/or covid-19 vaccine inside a patients home; reported only once per individual home per date of service when such vaccine administration(s) are performed at the patients home","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0234","name":"Intra inf, toci, second dos","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47384","name":"Abltj ire liver 1+ tum perq","description":"Ablation, irreversible electroporation, liver, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67516","name":"Sprchoroidal spc njx rx agt","description":"Suprachoroidal space injection of pharmacologic agent (separate procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37280","name":"Revsc evsc tpvt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6093","name":"Recement supp part denture","description":"Recement implant/abutment supported fixed partial denture","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55707","name":"Bx prst8 trct us guided","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0042","name":"Ref to therapy","description":"Referral to physical, occupational, speech, or recreational therapy","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1456","name":"Pt had htx","description":"Patient had a heart transplant","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6197","name":"Replace material prosthesis","description":"Replace material prosthesis","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1151","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49617","name":"Rpr aa hrn rcr > 10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, reducible","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27786","name":"Treatment of ankle fracture","description":"Closed treatment of distal fibular fracture (lateral malleolus); without manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2642","name":"Dental onlay porcelin 2 surf","description":"Onlay - porcelain/ceramic - two surfaces","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1199","name":"Pt recg rrt","description":"Patients receiving rrt","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1334","name":"Pts act pvd 2 wks 2 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 2 weeks after initial acute pvd encounter","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0406U","name":"Onc lung flow cytmtry 5 mrk","description":"Onc lung flow cytmtry 5 mrk","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3391","name":"Inj, atidarsagene autotemcel","description":"Injection, atidarsagene autotemcel, per treatment","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58670","name":"Laparoscopy tubal cautery","description":"Laparoscopy, surgical; with fulguration of oviducts (with or without transection)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":426.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0409U","name":"Onc sld tum dna 80 & rna 36","description":"Onc sld tum dna 80 & rna 36","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90481","name":"Admn sarscov2 vac ea add cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; each additional component administered (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85032","name":"Manual cell count each","description":"Blood count; manual cell count (erythrocyte, leukocyte, or platelet) each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":6.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94012","name":"Spirmtry w/brnchdil inf-2 yr","description":"Measurement of spirometric forced expiratory flows, before and after bronchodilator, in an infant or child through 2 years of age","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4393","name":"Surgraft ac per sq cm","description":"Surgraft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2029","name":"Mirotract matrix sheet","description":"Mirotract wound matrix sheet, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0609","name":"Ferric citrate orl 3 mg iron","description":"Ferric citrate, oral, 3 mg ferric iron, (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1351","name":"Dental sealant per tooth","description":"Sealant-per tooth","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2056","name":"Ciltacabtagene car-pos t","description":"Ciltacabtagene autoleucel, up to 100 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77600","name":"Hyperthermia ext gen supfc","description":"Hyperthermia, externally generated; superficial (ie, heating to a depth of 4 cm or less)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82272","name":"Occult bld feces 1-3 tests","description":"Blood, occult, by peroxidase activity (eg, guaiac), qualitative, feces, 1-3 simultaneous determinations, performed for other than colorectal neoplasm screening","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34715","name":"Opn ax/subcla art expos","description":"Open axillary/subclavian artery exposure for delivery of endovascular prosthesis by infraclavicular or supraclavicular incision, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1447","name":"Pt dx bd bef end meas pd","description":"Patients with an active diagnosis of bipolar disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0166","name":"Inj epinephrine (bpi)","description":"Injection, epinephrine (bpi), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0602U","name":"Endocrin dm ins gen mthyltn","description":"Endocrin dm ins gen mthyltn","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91321","name":"Sarscov2 vac 25 mcg/.25ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 25 mcg/0.25 ml dosage, for intramuscular use","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0235","name":"Intrav inf, mon anti, fir do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0528","name":"Mgt est pt dem mod-hi cmplx","description":"Management of established patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0138","name":"Inj acetaminoph 10mg/ibu 3mg","description":"Injection, acetaminophen 10 mg and ibuprofen 3 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83069","name":"Hemoglobin urine","description":"Hemoglobin; urine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0606U","name":"Hem red cll memb do rbc oge","description":"Hem red cll memb do rbc oge","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2014","name":"Omeza collag compl 100 mg","description":"Omeza collagen matrix or omeza complete matrix, per 100 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90635","name":"H5n1 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n1, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69209","name":"Remove impacted ear wax uni","description":"Removal impacted cerumen using irrigation/lavage, unilateral","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93151","name":"Interrog&prgrmg ipnss","description":"Interrogation and programming (minimum one parameter) of implanted phrenic nerve stimulator system","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1257","name":"Cvd risk assess not perf","description":"Cvd risk assessment not performed or incomplete (e.g., cvd risk assessment was not documented), reason not otherwise specified","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0885T","name":"Colsc flx 1st tndsc dilat","description":"Colonoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0804T","name":"Prgrmg evl ldls pm 2chmbr ip","description":"Programming device evaluation (in person) with iterative adjustment of implantable device to test the function of device and to select optimal permanent programmed values, with analysis, review, and report, by a physician or other qualified health care professional, leadless pacemaker system in dual","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64616","name":"Chemodenerv musc neck dyston","description":"Chemodenervation of muscle(s); neck muscle(s), excluding muscles of the larynx, unilateral (eg, for cervical dystonia, spasmodic torticollis)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96548","name":"Ntraop hipec px ea add 30min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3473","name":"Surg rep root res molar","description":"Surg rep root res molar","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0996T","name":"Ins&sclr fix caps bag prosth","description":"Insertion and scleral fixation of a capsular bag prosthesis containing an intraocular lens prosthesis, with vitrectomy, including removal of crystalline lens or dislocated intraocular lens prosthesis, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0555","name":"Replacment pt electronic sys","description":"Provision of replacement patient electronics system (e.g., system pillow, handheld reader) for home pulmonary artery pressure monitoring","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2009","name":"Symphony, per sq cm","description":"Symphony, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9052","name":"Inj, carmustine (accord)","description":"Injection, carmustine (accord), not therapeutically equivalent to j9050, 100 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1486","name":"Pt admitted to snf dur eval","description":"Patients admitted to a skilled nursing facility (snf) during the period of evaluation","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1424","name":"Pulmonology care mvp","description":"Pulmonology care mips value pathway","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4261","name":"Tag, per square centimeter","description":"Tag, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7030","name":"Normal saline solution infus","description":"Infusion, normal saline solution , 1000 cc","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0393U","name":"Neu prksn msfl a-syncln prtn","description":"Neu prksn msfl a-syncln prtn","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0894T","name":"Cannulation liver allograft","description":"Cannulation of the liver allograft in preparation for connection to the normothermic perfusion device and decannulation of the liver allograft following normothermic perfusion","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61889","name":"Ins sk-mnt crnl nstm pg/rcvr","description":"Insertion of skull-mounted cranial neurostimulator pulse generator or receiver, including craniectomy or craniotomy, when performed, with direct or inductive coupling, with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1189","name":"Doc khe pef w/efgr/uacr","description":"Documentation of a kidney health evaluation defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr) performed","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77091","name":"Tbs techl calculation only","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical calculation only","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2246","name":"Inj, micafungin (baxter)","description":"Injection, micafungin in sodium (baxter), not therapeutically equivalent to j2248, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16010","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9938","name":"Fab removable appliance","description":"Fab removable appliance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0549","name":"Phone/inter for treat>31m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6597","name":"G comp bandage long stretch","description":"Gradient compression bandage roll, elastic long stretch, linear yard, any width, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28725","name":"Arthrodesis subtalar","description":"Arthrodesis; subtalar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7472","name":"Removal of torus palatinus","description":"Removal of torus palatinus","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44139","name":"Mobilization of colon","description":"Mobilization (take-down) of splenic flexure performed in conjunction with partial colectomy (list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2865","name":"Inj sulfameth/trim 5 mg/1 mg","description":"Injection, sulfamethoxazole 5 mg and trimethoprim 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37277","name":"Rvsc evsc fpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9913","name":"Admin of neuromod","description":"Admin of neuromod","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77080","name":"Dxa bone density axial","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5827","name":"Endo knee shin single axis","description":"Endoskeletal knee-shin system, single axis, electromechanical swing and stance phase control, with or without shock absorption and stance extension damping","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5422","name":"Dentures adjust part mandbl","description":"Adjust partial denture - mandibular","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61892","name":"Rmv sk-mnt crnl nstm pg/rcvr","description":"Removal of skull-mounted cranial neurostimulator pulse generator or receiver with cranioplasty, when performed","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1229","name":"Pt w/ +hcv +vir ref win 1 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, is referred within 1 month of the reactive hcv antibody test to a clinician who treats hcv infection","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4405","name":"Xwrap fenestra plus sq cm","description":"Xwrap fenestra plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4416","name":"Alexiguard tl-t per sq cm","description":"Alexiguard tl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0350","name":"Oral/facial photo images","description":"Oral/facial photographic images","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0250","name":"Adm tocilizu covid-19 2nd","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98981","name":"Rtm tx mgmt ea addl 20 min","description":"Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least 1 real-time interactive communication with the patient or caregiver during the calendar month; each additional 20 minutes (list separately in","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2249","name":"Inj, remimazolam, 1 mg","description":"Injection, remimazolam, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0705","name":"Extra oral post radio image","description":"Extra oral post radio image","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0745T","name":"Car ablt rad arr n-invas loc","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; noninvasive arrhythmia localization and mapping of arrhythmia site (nidus), derived from anatomical image data (eg, ct, mri, or myocardial perfusion scan) and electrical data (eg, 12-lead ecg data), and identification of areas of avo","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0834T","name":"Dgtz gls mcrscp cytp oth xtn","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84431","name":"Thromboxane urine","description":"Thromboxane metabolite(s), including thromboxane if performed, urine","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0877T","name":"Augmnt alys ch ct ild w/o ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0263U","name":"Neuro asd meas 16 c metblt","description":"Neurology (autism spectrum disorder [asd]), quantitative measurements of 16 central carbon metabolites (ie, a-ketoglutarate, alanine, lactate, phenylalanine, pyruvate, succinate, carnitine, citrate, fumarate, hypoxanthine, inosine, malate, s-sulfocysteine, taurine, urate, and xanthine), liquid chrom","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0137","name":"Inten outpt svs,min 9 pr 7 d","description":"Intensive outpatient services; weekly bundle, minimum of 9 services over a 7 contiguous day period, which can include individual and group therapy with physicians or psychologists (or other mental health professionals to the extent authorized under state law); occupational therapy requiring the skil","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9293","name":"Fertility cycl tracking soft","description":"Fertility cycle (contraception & conception) tracking software application, fda cleared, per month, includes accessories (e.g., thermometer)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4384","name":"Axolotl dual ult per sq cm","description":"Axolotl dualgraft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24640","name":"Cltx rdl head sublxtj nrsemd","description":"Closed treatment of radial head subluxation in child, nursemaid elbow, with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":39.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":120.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4302","name":"Complete aca, per sq cm","description":"Complete aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29520","name":"Strapping of hip","description":"Strapping; hip","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4299","name":"Amniocore pro+, per sq cm","description":"Amniocore pro+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37296","name":"Revsc evasc imvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0389","name":"Periopic image capture only","description":"Periopic image capture only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6613","name":"Onlay cst base mtl >=3 surfa","description":"Onlay - cast predominantly base metal three or more surfaces","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0529U","name":"Hem vte snp f2&f5 gen leiden","description":"Hem vte snp f2&f5 gen leiden","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0950T","name":"Abltj b9 prst8 tissue hifu","description":"Ablation of benign prostate tissue, transrectal, with high intensity-focused ultrasound (hifu), including ultrasound guidance","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28260","name":"Release of midfoot joint","description":"Capsulotomy, midfoot; medial release only (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":635.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0616U","name":"Neurol dementia alys >30000","description":"Neurol dementia alys >30000","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1001T","name":"Autol musc cell therapy njx","description":"Autologous muscle cell therapy, injection of muscle progenitor cells into the external anal sphincter, including ultrasound guidance, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0534","name":"Coordinated care/or referral","description":"Coordinated care and/or referral services, such as to adequate and accessible community resources to address unmet health-related social needs, including harm reduction interventions and recovery support services a patient needs and wishes to pursue, which significantly limit the ability to diagnose","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75989","name":"Abscess drainage under x-ray","description":"Radiological guidance (ie, fluoroscopy, ultrasound, or computed tomography), for percutaneous drainage (eg, abscess, specimen collection), with placement of catheter, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28293","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9004","name":"Va whole health partner serv","description":"Department of veterans affairs whole health partner services","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01940","name":"Anes nulyt agt lmbr/sac","description":"Anesthesia for percutaneous image-guided destruction procedures by neurolytic agent on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7191","name":"Factor viii (porcine)","description":"Factor viii (antihemophilic factor (porcine)), per i.u.","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0534","name":"Coordinated care/or referral","description":"Coordinated care and/or referral services, such as to adequate and accessible community resources to address unmet health-related social needs, including harm reduction interventions and recovery support services a patient needs and wishes to pursue, which significantly limit the ability to diagnose","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84402","name":"Assay of free testosterone","description":"Testosterone; free","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0168","name":"Epinephrine (intl med sys)","description":"Injection, epinephrine (international medication systems), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27067","name":"Remove/graft hip bone lesion","description":"Excision of bone cyst or benign tumor, wing of ilium, symphysis pubis, or greater trochanter of femur; with autograft requiring separate incision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1189.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1167","name":"Hspc dur meas pd","description":"In hospice or using hospice services during the measurement period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0328U","name":"Drug assay 120+ rx&metablt","description":"Drug assay 120+ rx&metablt","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9025","name":"Plasma cryo redu path each","description":"Plasma, cryoprecipitate reduced, pathogen reduced, each unit","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82947","name":"Assay glucose blood quant","description":"Glucose; quantitative, blood (except reagent strip)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6034","name":"Part hand finger distal amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s)/thumb, amputation at distal to metacarpal joint, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l669","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5162","name":"Inj, denosumab-nxxp, 1 mg","description":"Injection, denosumab-nxxp (bildyos/bilprevda), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0530U","name":"Onc pan-sol tum ctdna 77 gen","description":"Onc pan-sol tum ctdna 77 gen","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0339U","name":"Onc prst8 mrna hoxc6 & dlx1","description":"Onc prst8 mrna hoxc6 & dlx1","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1811","name":"Fiasp for insulin pump use","description":"Insulin (fiasp) for administration through dme (i.e., insulin pump) per 50 units","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0675","name":"Inj, carboprost, 0.1 mg","description":"Injection, carboprost tromethamine, 0.1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33897","name":"Perq trluml angp nt/recr coa","description":"Percutaneous transluminal angioplasty of native or recurrent coarctation of the aorta","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01940","name":"Anes nulyt agt lmbr/sac","description":"Anesthesia for percutaneous image-guided destruction procedures by neurolytic agent on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86701","name":"Hiv-1antibody","description":"Antibody; hiv-1","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15331","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2403","name":"Chloroprocaine opht gel, 1mg","description":"Chloroprocaine hcl ophthalmic, 3% gel, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28272","name":"Release of toe joint each","description":"Capsulotomy; interphalangeal joint, each joint (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28286","name":"Repair of hammertoe","description":"Correction, cock-up fifth toe, with plastic skin closure (eg, ruiz-mora type procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":377.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1489","name":"Pt status doc","description":"Patient status documented","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46607","name":"Diagnostic anoscopy & biopsy","description":"Anoscopy; with high-resolution magnification (hra) (eg, colposcope, operating microscope) and chemical agent enhancement, with biopsy, single or multiple","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":128.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0976T","name":"Slctv nzmtc dbrdmt s/n/hf ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; each additional 100 sq cm (list separately in addition to code for p","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86038","name":"Antinuclear antibodies","description":"Antinuclear antibodies (ana);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30220","name":"Insert nasal septal button","description":"Insertion, nasal septal prosthesis (button)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82962","name":"Glucose blood test","description":"Glucose, blood by glucose monitoring device(s) cleared by the fda specifically for home use","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78007","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0388","name":"Bitewing image capture only","description":"Bitewing image capture only","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5158","name":"Inj, denosumab-bnht, 1 mg","description":"Injection, denosumab-bnht (bomyntra/conexxence), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0990T","name":"Trncrv inst biod hydrgl mtrl","description":"Transcervical instillation of biodegradable hydrogel materials, intrauterine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"Rec cath any transanal, each","description":"Rectal catheter with or without balloon, for use with any type transanal irrigation system, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4199","name":"Cygnus matrix, per sq cm","description":"Cygnus matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3299","name":"Inj xipere 1 mg","description":"Injection, triamcinolone acetonide (xipere), 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1163","name":"Inj, diltiazem hcl, 0.5 mg","description":"Injection, diltiazem hydrochloride, 0.5 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9215","name":"Interferon alfa-n3 inj","description":"Injection, interferon, alfa-n3, (human leukocyte derived), 250,000 iu","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4264","name":"Cocoon membrane, per sq cm","description":"Cocoon membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0811T","name":"Rem mlt day uroflow setup","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); set-up and patient education on use of equipment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8541","name":"Oral, hemady, 0.25 mg","description":"Dexamethasone (hemady), oral, 0.25 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0504U","name":"Nfct ds uti id 17 path orgs","description":"Nfct ds uti id 17 path orgs","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0614U","name":"Iem pmd alys 4 nzm cplx page","description":"Iem pmd alys 4 nzm cplx page","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0713T","name":"N-nvs artl plaq alys rvw i&r","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data review, interpretation and report","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0752T","name":"Dgtz gls mcrscp sld lvl iii","description":"Digitization of glass microscope slides for level iii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0544","name":"Post d/c phone follow up","description":"Post discharge telephonic follow-up contacts performed in conjunction with a discharge from the emergency department for behavioral health or other crisis encounter, 4 calls per calendar month","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71111","name":"X-ray exam ribs/chest4/> vws","description":"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0581U","name":"Trnspl med antb nohla 39trgt","description":"Trnspl med antb nohla 39trgt","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93584","name":"Vngrph chd anom/persist svc","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; anomalous or persistent superior vena cava when it exists as a second contralateral superior vena cava, with native drainage to heart (list separately in addition to code for pri","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6607","name":"G com bandage tub protct lyr","description":"Gradient compression bandaging supply, tubular protective absorption layer, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49190","name":"Opn exc/dstr ntra-abd >30 cm","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); greater than 30 cm","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0155","name":"Dronabinol (syndros) 0.1 mg","description":"Dronabinol (syndros), 0.1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0452U","name":"Onc bldr mthyl penk lte-qmsp","description":"Onc bldr mthyl penk lte-qmsp","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2006","name":"Novosorb synpath per sq cm","description":"Novosorb synpath dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5100","name":"Inj ustekinumab-kfce, 1 mg","description":"Injection, ustekinumab-kfce (yesintek), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81523","name":"Onc brst mrna 70 cnt 31 gene","description":"Oncology (breast), mrna, next-generation sequencing gene expression profiling of 70 content genes and 31 housekeeping genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as index related to risk to distant metastasis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0546","name":"Phone/internet ehr assess","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty   whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patien","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86053","name":"Aqaprn-4 antb flo cytmtry ea","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; flow cytometry (ie, fluorescence-activated cell sorting [facs]), each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1236","name":"Baseline mrs > 2","description":"Baseline mrs > 2","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0455U","name":"Nfct agt sti mult amp prb ur","description":"Nfct agt sti mult amp prb ur","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93657","name":"Tx l/r atrial fib addl","description":"Additional linear or focal intracardiac catheter ablation of the left or right atrium for treatment of atrial fibrillation remaining after completion of pulmonary vein isolation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0383U","name":"Tyrosinemia typ i mntr quan","description":"Tyrosinemia typ i mntr quan","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1170","name":"Pt w/o flu vax 7/1-6/30","description":"Patient did not receive an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9298","name":"Inj nivol relatlimab 3mg/1mg","description":"Injection, nivolumab and relatlimab-rmbw, 3 mg/1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"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":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37291","name":"Revsc evsc tpvt athr cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0473","name":"Micro exam prep & report","description":"Accession of tissue gross and microscopic examination preparation and transmission of written report","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1205","name":"Isa reduced >=3","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1321","name":"Couns for high risk sub use","description":"Couns for high risk sub use","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55869","name":"Lap srg prst8ct bi pl lmphad","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":711.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1439","name":"Sig ocu cond imp surg out","description":"Significant ocular conditions that impact the visual outcome of surgery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1454","name":"New cied","description":"New cied","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1713","name":"Pfizer vacc adm ped 1st dose","description":"Pfizer vacc adm ped 1st dose","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86079","name":"Phys blood bank serv authrj","description":"Blood bank physician services; authorization for deviation from standard blood banking procedures (eg, use of outdated blood, transfusion of rh incompatible units), with written report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7295","name":"Eth estr and eton monthly","description":"Ethinyl estradiol and etonogestrel 0.015mg, 0.12mg per 24 hours; monthly vaginal ring, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4329","name":"Singlay, per sq cm","description":"Singlay, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58300","name":"Insert intrauterine device","description":"Insertion of intrauterine device (iud)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":50.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":123.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93588","name":"Vngrph chd vnvn cltrl below","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating below the heart (eg, from the inferior vena cava) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4382","name":"Advograft dual per sq cm","description":"Advograft dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12045","name":"Intmd rpr n-hf/genit12.6-20","description":"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 12.6 cm to 20.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86480","name":"Tb test cell immun measure","description":"Tuberculosis test, cell mediated immunity antigen response measurement; gamma interferon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2008","name":"Theragenesis, per sq cm","description":"Theragenesis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0818T","name":"Revj/rmvl ins ptn subq","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21300","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4337","name":"Artecent trident, per sq cm","description":"Artacent trident, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4306","name":"Americ amnion ac per sq cm","description":"American amnion ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01940","name":"Anes nulyt agt lmbr/sac","description":"Anesthesia for percutaneous image-guided destruction procedures by neurolytic agent on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0864T","name":"Low ntsty eswt corpus cvrnsm","description":"Low-intensity extracorporeal shock wave therapy involving corpus cavernosum, low energy","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76989","name":"Dx intraop epcar us chd i&r","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; interpretation and report only","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7023","name":"Mech allergen parti barrier","description":"Mechanical allergen particle barrier/inhalation filter, cream, nasal, topical","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0424U","name":"Onc prst8 xom alys 53 sncrna","description":"Onc prst8 xom alys 53 sncrna","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1413","name":"Inj delandistrogene mox rokl","description":"Injection, delandistrogene moxeparvovec-rokl, per therapeutic dose","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9050","name":"Carmustine injection","description":"Injection, carmustine, 100 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0703","name":"Inj, cefepime hcl (b braun)","description":"Injection, cefepime hydrochloride (b braun), not therapeutically equivalent to maxipime, 500 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0474","name":"Micro w exam of surg margins","description":"Accession of tissue gross and microscopic examination including assessment of surgical margins for presence of disease preparation and transmission of writte","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45388","name":"Colonoscopy w/ablation","description":"Colonoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":3083.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7521","name":"Tacrolim granules oral susp","description":"Tacrolimus, granules, oral suspension, 0.1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0525U","name":"Onc sphrd cell cul 11-rx pnl","description":"Onc sphrd cell cul 11-rx pnl","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0461","name":"Testing for cracked tooth","description":"Testing for cracked tooth","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1807","name":"Inj, ethacrynate sod, 1 mg","description":"Injection, ethacrynate sodium, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0541U","name":"Cv ds hdl rct cec lc-ms/ms 5","description":"Cv ds hdl rct cec lc-ms/ms 5","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4352","name":"Overlay sl matrix, per sq cm","description":"Overlay sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2561","name":"Inj, sezaby, 1 mg","description":"Injection, phenobarbital sodium (sezaby), 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6198","name":"Remove interim implant","description":"Remove interim implant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98984","name":"Rtm dev sply resp sys 2-15 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of respiratory system, 2-15 days in a 30-day period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0674T","name":"Laps insj nw/rpcmt prm isdss","description":"Laparoscopic insertion of new or replacement of permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including an implantable pulse generator and diaphragmatic lead(s)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6516","name":"Grad com wrap w strap foo cu","description":"Gradient compression wrap with adjustable straps, foot, each, custom","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1187","name":"Pt w/ esrd","description":"Patients with a diagnosis of end stage renal disease (esrd)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87150","name":"Dna/rna amplified probe","description":"Culture, typing; identification by nucleic acid (dna or rna) probe, amplified probe technique, per culture or isolate, each organism probed","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2272","name":"Inj, morphine (fresenius)","description":"Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6197","name":"Replace material prosthesis","description":"Replace material prosthesis","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0560U","name":"Onc mrd gsa cfdna baseline","description":"Onc mrd gsa cfdna baseline","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1379","name":"10 yr fu no rec rsn not giv","description":"A 10 year follow-up interval for colonoscopy not recommended, reason not otherwise specified","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0877T","name":"Augmnt alys ch ct ild w/o ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6252","name":"Bridge resin w/noble metal","description":"Pontic-resin with noble metal","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96203","name":"Mlt fam grp bhv train ea add","description":"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face with multiple sets of paren","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0913T","name":"Prq tcat ther rx ntrac balo1","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting), including mechanical dilation by nondrug-delivery balloon angioplasty, endoluminal imaging using intravascular ultrasound (ivus) or optical coherence tomography (oct) when per","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2782","name":"Inj avacincaptad pegol 0.1mg","description":"Injection, avacincaptad pegol, 0.1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0570U","name":"Neurol tbi alys gfap&uch-l1","description":"Neurol tbi alys gfap&uch-l1","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52282","name":"Cystoscopy implant stent","description":"Cystourethroscopy, with insertion of permanent urethral stent","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":395.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37293","name":"Rvsc evsc tpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0560U","name":"Onc mrd gsa cfdna baseline","description":"Onc mrd gsa cfdna baseline","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37298","name":"Revsc evsc imvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61615","name":"Resect/excise lesion skull","description":"Resection or excision of neoplastic, vascular or infectious lesion of base of posterior cranial fossa, jugular foramen, foramen magnum, or c1-c3 vertebral bodies; extradural","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2690.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"Basic vestibular evaluation","description":"Basic vestibular evaluation, includes spontaneous nystagmus test with eccentric gaze fixation nystagmus, with recording, positional nystagmus test, minimum of 4 positions, with recording, optokinetic nystagmus test, bidirectional foveal and peripheral stimulation, with recording, and oscillating tra","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33882","name":"Evasc rpr ta dplmt mltpc sys","description":"Endovascular repair of the thoracic aorta by deployment of a branched endograft multipiece system involving an aorto-aortic tube device with a fenestration for the left subclavian artery stent graft(s) and all aortic tube endograft extension(s) placed from the level of the left common carotid artery","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2027","name":"Matriderm per sq cm","description":"Matriderm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4289","name":"Revoshield+ amnio, per sq cm","description":"Revoshield + amniotic barrier, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28011","name":"Incision of toe tendons","description":"Tenotomy, percutaneous, toe; multiple tendons","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":364.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4267","name":"Neostim dl per sq cm","description":"Neostim dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87551","name":"Mycobacteria dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacteria species, amplified probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5227","name":"Immed max part denture","description":"Immed max part denture","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43889","name":"Gstr rstcv px trnsorl esg","description":"Gastric restrictive procedure, transoral, endoscopic sleeve gastroplasty (esg), including argon plasma coagulation, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4424","name":"Revive ft per sq cm","description":"Revive ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0882T","name":"Intraop ther estim pn ue 1st","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; initial nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9128","name":"Photobio therpy-first 15 min","description":"Photobio therpy-first 15 min","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0518U","name":"Ther rx mntr 90+ pn&mtl hlth","description":"Ther rx mntr 90+ pn&mtl hlth","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6526","name":"G com garmt full leg/ft nght","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1436","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51700","name":"Irrigation of bladder","description":"Bladder irrigation, simple, lavage and/or instillation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9289","name":"Inj nivolumab 2 mg hyaluron","description":"Injection, nivolumab, 2 mg and hyaluronidase-nvhy","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4038","name":"Vascular surgery ss","description":"Vascular surgery mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6092","name":"Recement supp crown","description":"Recement implant/abutment supported crown","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33900","name":"Perq p-art revsc 1 nm nt uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, unilateral","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0701","name":"Pano radio image","description":"Pano radio image","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J0380","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66990","name":"Ophthalmic endoscope add-on","description":"Use of ophthalmic endoscope (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2019","name":"Kerecis marigen shld sq cm","description":"Kerecis omega3 marigen shield, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0496U","name":"Onc clrct cfdna 8/7 genes","description":"Onc clrct cfdna 8/7 genes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47380","name":"Open ablate liver tumor rf","description":"Ablation, open, of 1 or more liver tumor(s); radiofrequency","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1559.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42825","name":"Removal of tonsils","description":"Tonsillectomy, primary or secondary; younger than age 12","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90969","name":"Esrd svc pr day pt 12-19","description":"End-stage renal disease (esrd) related services for dialysis less than a full month of service, per day; for patients 12-19 years of age","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4279","name":"Vendaje ac, per sq cm","description":"Vendaje ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G3002","name":"Chronic pain mgmt 30 mins","description":"Chronic pain management and treatment, monthly bundle including, diagnosis; assessment and monitoring; administration of a validated pain rating scale or tool; the development, implementation, revision, and/or maintenance of a person-centered care plan that includes strengths, goals, clinical needs,","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0413U","name":"Onc hl neo opt gen mapg dna","description":"Onc hl neo opt gen mapg dna","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0837T","name":"Dgtz gls mcrscp fna i&r","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; interpretation and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7962","name":"Lingual frenectomy","description":"Lingual frenectomy","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1296","name":"Calc bmi norm parameters","description":"Bmi is documented within normal parameters and no follow-up plan is required","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1737","name":"Inj meloxicam (azurity) 1mg","description":"Injection, meloxicam (azurity), 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4257","name":"Relese, per sq cm","description":"Relese, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4314","name":"Reeva, per sq cm","description":"Reeva ft, per square cenitmeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0282U","name":"Rbc dna gntyp 12 bld grp gen","description":"Red blood cell antigen typing, dna, genotyping of 12 blood group system genes to predict 44 red blood cell antigen phenotypes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87626","name":"Hpv sep hi-rsk typ&pool rslt","description":"Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), separately reported high-risk types (eg, 16, 18, 31, 45, 51, 52) and high-risk pooled result(s)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0323U","name":"Iadna cns pthgn next gen seq","description":"Iadna cns pthgn next gen seq","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0713T","name":"N-nvs artl plaq alys rvw i&r","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data review, interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1438","name":"Lst knwn well <=210 min","description":"Time last known well to hospital arrival less than or equal to 3.5 hours (<= 210 minutes)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86053","name":"Aqaprn-4 antb flo cytmtry ea","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; flow cytometry (ie, fluorescence-activated cell sorting [facs]), each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1343","name":"Pt pam lvl 4 base or srt lin","description":"Patients who are at pam level 4 at baseline or patients who are flagged with extreme straight line response sets on the pam or with excessive missing responses","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0542","name":"No pt prsnt train add 15","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31622","name":"Dx bronchoscope/wash","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; diagnostic, with cell washing, when performed (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92288","name":"Scr dark adaptation meas i&r","description":"Screening dark adaptation measurement (eg, rod recovery intercept time), with interpretation and report","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2013","name":"Innovamatrix fs, per sq cm","description":"Innovamatrix fs, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1195","name":"Rpt wo imp/con mmr/msi","description":"Surgical pathology reports that do not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both, reason not given","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7509","name":"Marsupialization odon cyst","description":"Marsupialization odon cyst","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81418","name":"Rx metab gen seq alys pnl 6","description":"Drug metabolism (eg, pharmacogenomics) genomic sequence analysis panel, must include testing of at least 6 genes, including cyp2c19, cyp2d6, and cyp2d6 duplication/deletion analysis","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0944T","name":"3d cntr simula trgt lvr les","description":"3d contour simulation of target liver lesion(s) and margin(s) for image-guided percutaneous microwave ablation","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0063","name":"Cardiology ss","description":"Cardiology mips specialty set","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4362","name":"Cygnus disk, per sq cm","description":"Cygnus disk, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99291","name":"Critical care first hour","description":"Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":297.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0860T","name":"Ncntc ifr spctrsc scr pad","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), for screening for peripheral arterial disease, including provocative maneuvers, image acquisition, interpretation, and report, one or both lower extremities","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0163","name":"Epinephrine in nacl (endo)","description":"Injection, epinephrine in sodium chloride (endo), 0.1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9319","name":"Inj romidepsin lyophil 0.1mg","description":"Injection, romidepsin, lyophilized, 0.1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2956","name":"Indirect rest remov","description":"Indirect rest remov","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3432","name":"Guided tissue regeneration","description":"Guided tissue regeneration","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23931","name":"I&d upr a/e bursa","description":"Incision and drainage, upper arm or elbow area; bursa","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1374","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1574","name":"Inj, ganciclovir (exela)","description":"Injection, ganciclovir sodium (exela), not therapeutically equivalent to j1570, 500 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11305","name":"Shave skin lesion 0.5 cm/<","description":"Shaving of epidermal or dermal lesion, single lesion, scalp, neck, hands, feet, genitalia; lesion diameter 0.5 cm or less","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":37.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":17.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0752","name":"Hiv prep, oral lenacapavir","description":"Oral, lenacapavir, 300 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10081","name":"I&d pilonidal cyst comp","description":"Incision and drainage of pilonidal cyst; complicated","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":193.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4411","name":"Amniomatrixf4x per sq cm","description":"Amniomatrixf4x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9294","name":"Biofeed dig cog behav tx fda","description":"Prescription digital cognitive and/or behavioral therapy, biofeedback, fda cleared, per course of treatment","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85009","name":"Manual diff wbc count b-coat","description":"Blood count; manual differential wbc count, buffy coat","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1394","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0249","name":"Adm tocilizu covid-19 1st","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0955T","name":"Tot impl amei removal","description":"Totally implantable active middle ear hearing implant; removal, including removal of sound processor and all implant components","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55868","name":"Lap srg prst8ct lymph nod bx","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with lymph node biopsy(ies) (limited pelvic lymphadenectomy)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0034","name":"Pall serv during meas","description":"Patients receiving palliative care during the measurement period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1273","name":"Pts snf 1 yr dialysis","description":"Patients who were admitted to a skilled nursing facility (snf) within one year of dialysis initiation according to the cms-2728 form","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9333","name":"Inj rozanolixizum-noli 1 mg","description":"Injection, rozanolixizumab-noli, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92945","name":"Prq trl rvs ch occ ant&rtrgr","description":"Percutaneous transluminal revascularization of chronic total occlusion, single coronary artery, coronary artery branch, or coronary artery bypass graft, and/or subtended major coronary artery branches of the bypass graft, any combination of intracoronary stent, atherectomy and angioplasty; combined ","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6251","name":"Bridge resin base metal","description":"Pontic-resin with predominantly base metal","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1430","name":"Ret exm ou no retinopthy doc","description":"Retinal exam finding without evidence of retinopathy in both eyes with severity level documented (in measurement year or in the prior year)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0956T","name":"Prt crn ch cr&tun elt s-sclp","description":"Partial craniectomy, channel creation, and tunneling of electrode for sub-scalp implantation of an electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93594","name":"R hrt cath chd abnl nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; abnormal native connections","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1482","name":"Pos quan hep c or qual rna","description":"Positive/detectable hepatitis c virus quantitative or qualitative rna test result during the denominator identification period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0431","name":"Diag tst detect mucos abnorm","description":"Adjunctive pre-diagnostic test that aids in detection of mucosal abnormalities including premalignant and malignant lesions not to include cytology or biopsy","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61322","name":"Crnec/crnot dcmprv w/o lobec","description":"Craniectomy or craniotomy, decompressive, with or without duraplasty, for treatment of intracranial hypertension, without evacuation of associated intraparenchymal hematoma; without lobectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2425.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88323","name":"Consltj&reprt matrl prep sld","description":"Consultation and report on referred material requiring preparation of slides","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0913T","name":"Prq tcat ther rx ntrac balo1","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting), including mechanical dilation by nondrug-delivery balloon angioplasty, endoluminal imaging using intravascular ultrasound (ivus) or optical coherence tomography (oct) when per","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0799T","name":"Tcat rmvl 2chmbr ldls pm ra","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right atrial pacemaker component","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6553","name":"G com stcking bk 30-40 custm","description":"Gradient compression stocking, below knee, 30-40 mmhg, custom, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49616","name":"Rpr aa hrn rcr 3-10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, incarcerated or strangulated","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9994","name":"Pall serv during meas","description":"Patient is using palliative care services any time during the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0183","name":"Software meas of cardiac vol","description":"Quantitative software measurements of cardiac volume, cardiac chambers volumes and left ventricular wall mass derived from ct scan(s) data of the chest/heart (with or without contrast)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1483","name":"Neg quan hep c or qual rna","description":"Patients who achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4100","name":"Nosht skin sub fda clrd nos","description":"Non-sheet form skin substitute, fda cleared as a device, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0820T","name":"Mntr psychdlc med 1stphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; first physician or other qualified health care professional, each hour","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4284","name":"Dermabind sl, per sq cm","description":"Dermabind sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93146","name":"Interrog crtd sins bat ip w/","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0784T","name":"Ins/rplmt eltrd ra spi nstim","description":"Insertion or replacement of percutaneous electrode array, spinal, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53460","name":"Revision of urethra","description":"Urethromeatoplasty, with partial excision of distal urethral segment (richardson type procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":497.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37273","name":"Revsc evsc fpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49621","name":"Rpr parastomal hernia rdc","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; reducible","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9381","name":"Inj teplizumab mzwv 5 mcg","description":"Injection, teplizumab-mzwv, 5 mcg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86043","name":"Acetylcholn rcptr modlg antb","description":"Acetylcholine receptor (achr); modulating antibody","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99328","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85014","name":"Hematocrit","description":"Blood count; hematocrit (hct)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2151","name":"Inj, mannitol, 250 mg","description":"Injection, mannitol, 250 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0174","name":"Lecanemab-irmb, for iv inj","description":"Lecanemab-irmb, for intravenous injection, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93153","name":"Interrog w/o prgrmg ipnss","description":"Interrogation without programming of implanted phrenic nerve stimulator system","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9172","name":"Docetaxel (docivyx), 1 mg","description":"Injection, docetaxel (docivyx), 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0589U","name":"Pfas24cmpnd hi-perf lc-ms/ms","description":"Pfas24cmpnd hi-perf lc-ms/ms","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1272","name":"Pts kid transplt wtlst","description":"Patients observed on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0376U","name":"Onc prst8 ca img alys 128","description":"Onc prst8 ca img alys 128","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35556","name":"Art byp grft fem-popliteal","description":"Bypass graft, with vein; femoral-popliteal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1544.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4274","name":"Esano ac, per sq cm","description":"Esano ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0879T","name":"Augmnt alys ch ct ild prep","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; radiological data preparation and transmission","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9298","name":"Inj nivol relatlimab 3mg/1mg","description":"Injection, nivolumab and relatlimab-rmbw, 3 mg/1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90969","name":"Esrd svc pr day pt 12-19","description":"End-stage renal disease (esrd) related services for dialysis less than a full month of service, per day; for patients 12-19 years of age","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95782","name":"Polysom <6 yrs 4/> paramtrs","description":"Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4022","name":"Otolaryngology ss","description":"Otolaryngology mips specialty set","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81418","name":"Rx metab gen seq alys pnl 6","description":"Drug metabolism (eg, pharmacogenomics) genomic sequence analysis panel, must include testing of at least 6 genes, including cyp2c19, cyp2d6, and cyp2d6 duplication/deletion analysis","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33902","name":"Perq p-art revsc 1 abnor uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, unilateral","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1238","name":"Doc 2nd recom hzv 2-6 mo int","description":"Documentation that administration of second recombinant zoster vaccine could not occur during the performance period due to the recommended 2-6 month interval between doses (i.e, first dose received after october 31)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0136","name":"Inj, acetaminophen (b braun)","description":"Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0962T","name":"Asstv alg alys acous&ecg rec","description":"Assistive algorithmic analysis of acoustic and electrocardiogram recording for detection of cardiac dysfunction (eg, reduced ejection fraction, cardiac murmurs, atrial fibrillation), with review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1413","name":"Pos pdl1 bef init ici tx","description":"Patients who had a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24925","name":"Amputation follow-up surgery","description":"Amputation, arm through humerus; secondary closure or scar revision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":652.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4341","name":"Simplimax, per sq cm","description":"Simplimax, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4426","name":"Dermbnd tl+, tlx per sq cm","description":"Dermabind tl + or dermabind tl x,  per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93593","name":"R hrt cath chd nml nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; normal native connections","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1434","name":"Orl chemo wthn 30 d post enc","description":"Patient on oral chemotherapy on or within 30 days after denominator eligible encounter","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1174","name":"Pt w/ 2 hzv 10/2017 - mp","description":"Patient received at least two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9294","name":"Biofeed dig cog behav tx fda","description":"Prescription digital cognitive and/or behavioral therapy, biofeedback, fda cleared, per course of treatment","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1239","name":"Pt no resp heard","description":"Patient did not respond to the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82653","name":"El-1 fecal quantitative","description":"Elastase, pancreatic (el-1), fecal; quantitative","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9994","name":"Pall serv during meas","description":"Patient is using palliative care services any time during the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88377","name":"M/phmtrc alys ishquant/semiq","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each multiplex probe stain procedure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1216","name":"No spiro doc no res doc","description":"No spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and/or no spirometry performed with results documented during the encounter","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6107","name":"Tissue regen non-resorbable","description":"Tissue regen non-resorbable","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91000","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27882","name":"Amputation of lower leg","description":"Amputation, leg, through tibia and fibula; open, circular (guillotine)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":756.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0333U","name":"Onc lvr surveilanc hcc cfdna","description":"Onc lvr surveilanc hcc cfdna","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4036","name":"Urgent care ss","description":"Urgent care mips specialty set","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0842T","name":"Dgtz gls mcrscp pth cslt ea","description":"Digitization of glass microscope slides for pathology consultation during surgery; each additional tissue block with frozen section(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7509","name":"Marsupialization odon cyst","description":"Marsupialization odon cyst","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93734","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0546","name":"Phone/internet ehr assess","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty   whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patien","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4318","name":"E-graft, per sq cm","description":"E-graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66683","name":"Implantation iris prosthesis","description":"Implantation of iris prosthesis, including suture fixation and repair or removal of iris, when performed","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0047","name":"Ped blunt hd traum","description":"Pediatric patient with minor blunt head trauma and pecarn prediction criteria are not assessed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53451","name":"Tprnl balo cntnc dev bi","description":"Periurethral transperineal adjustable balloon continence device; bilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55710","name":"Bx prst8 tprn us w/mri fus 1","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant) with mri-fusion-guidance biopsy, first targeted lesion","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5941","name":"Resct proth mand part remov","description":"Resct proth mand part remov","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0296","name":"Visit to determ ldct elig","description":"Counseling visit to discuss need for lung cancer screening using low dose ct scan (ldct) (service is for eligibility determination and shared decision making)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":30.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1282","name":"Pt scrn tbco id as non user","description":"Patient screened for tobacco use and identified as a tobacco non-user","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84512","name":"Assay of troponin qual","description":"Troponin, qualitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0602U","name":"Endocrin dm ins gen mthyltn","description":"Endocrin dm ins gen mthyltn","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35082","name":"Repair artery rupture aorta","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, abdominal aorta","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2637.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4479","name":"Transanal irrigation, electr","description":"Electronic transanal irrigation system, includes electronic pump, water reservoir, tubing, and accessories, without catheter, any type","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95827","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0362U","name":"Onc pap thyr ca rna 82&10","description":"Onc pap thyr ca rna 82&10","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0461","name":"Testing for cracked tooth","description":"Testing for cracked tooth","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1484","name":"No rpt hcv rna perf med rsn","description":"Patients who did not have a repeat hcv rna labs performed for medical reasons documented by clinician (e.g., patient with limited life expectancy, delay in treatment of hcv related to treatment of hiv, hbv, hepatocellular carcinoma, decompensated cirrhosis)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43101","name":"Excision of esophagus lesion","description":"Excision of lesion, esophagus, with primary repair; thoracic or abdominal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1180.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90593","name":"Chikungunya vacc recomb im","description":"Chikungunya virus vaccine, recombinant, for intramuscular use","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4412","name":"Choriofix per sq cm","description":"Choriofix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81456","name":"So/hl 51/>gsap rna alys","description":"Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic sequence analysis panel, interrogation for sequence variants and copy number variants or rearrangements, or isoform expression or mrna expression levels, if performed; rna analysis","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0736T","name":"Colonic lavage 35+l water","description":"Colonic lavage, 35 or more liters of water, gravity-fed, with induced defecation, including insertion of rectal catheter","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0822T","name":"Mntr psychdlc med cln staff","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; clinical staff under the direction of a physician or other qualified health care professional, concurrent with first physician or other qualified health care p","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1359","name":"Indx suicd idea, no 0 scr","description":"Index assessment during the denominator period when the suicidal ideation and/or behavior symptoms or increased suicide risk by clinician determination occurs and a non-zero c-ssrs score is obtained","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5141","name":"Inj adalimumab-aaty, 1 mg","description":"Injection, adalimumab-aaty, biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1302","name":"Inj, sutimlimab-jome, 10 mg","description":"Injection, sutimlimab-jome, 10 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52284","name":"Cysto rx balo cath urtl strx","description":"Cystourethroscopy, with mechanical urethral dilation and urethral therapeutic drug delivery by drug-coated balloon catheter for urethral stricture or stenosis, male, including fluoroscopy, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0723T","name":"Qmrcp w/o dx mri sm anat ses","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained without diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) during the same session","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4000","name":"Dermatology ss","description":"Dermatology mips specialty set","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3473","name":"Surg rep root res molar","description":"Surg rep root res molar","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99342","name":"Home/res vst new low mdm 30","description":"Home or residence visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0387U","name":"Onc mlnma ambra1&amlo","description":"Onc mlnma ambra1&amlo","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78610","name":"Brain flow imaging only","description":"Brain imaging, vascular flow only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0803","name":"3d facial scan direct","description":"3d facial scan direct","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22210","name":"Incis 1 vertebral seg cerv","description":"Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; cervical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2056.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0786T","name":"Insj/rplcmt prq ra sac nstim","description":"Insertion or replacement of percutaneous electrode array, sacral, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98977","name":"Rtm dev sply mscskl 16-30 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of musculoskeletal system, 16-30 days in a 30-day period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0491","name":"Oral dv nm mouthpc hw remote","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86701","name":"Hiv-1antibody","description":"Antibody; hiv-1","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1396","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64567","name":"Perq elec nrv field stimj cn","description":"Percutaneous electrical nerve field stimulation, cranial nerves, without implantation","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90382","name":"Rsv monoc antb seasn .7ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose, 0.7 ml, for intramuscular use","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6211","name":"Bridge base metal cast","description":"Pontic-cast predominantly base metal","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78195","name":"Lymph system imaging","description":"Lymphatics and lymph nodes imaging","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34702","name":"Evasc rpr a-ao ndgft rpt","description":"Endovascular repair of infrarenal aorta by deployment of an aorto-aortic tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the aorta from the level ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1989.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1418","name":"Med rsn not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination because of a medical contraindication documented by clinician","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34714","name":"Opn fem art expos cndt crtj","description":"Open femoral artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass, by groin incision, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0392U","name":"Rx metab genrx ia 16 genes","description":"Rx metab genrx ia 16 genes","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0678T","name":"Laps repos lead isdss ea add","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional repositioned lead (list separately in addition to code for primary proce","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1348","name":"Pam incr 6 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 6-points in a 4 to 12 month period (excellent)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86352","name":"Cell function assay w/stim","description":"Cellular function assay involving stimulation (eg, mitogen or antigen) and detection of biomarker (eg, atp)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6081","name":"Scale & debride, single imp","description":"Scale & debride, single imp","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6555","name":"G com stcking bk 40+ custm","description":"Gradient compression stocking, below knee, 40 mmhg or greater, custom, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"Home vent dual fnct incl all","description":"Home ventilator, dual-function respiratory device, also performs additional function of cough stimulation, includes all accessories, components and supplies for all functions","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0211","name":"Inj, nithiodote, 3mg / 125mg","description":"Injection, sodium nitrite 3 mg and sodium thiosulfate 125 mg (nithiodote)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24802","name":"Arthrd elbow jt autog graft","description":"Arthrodesis, elbow joint; with autogenous graft (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0950T","name":"Abltj b9 prst8 tissue hifu","description":"Ablation of benign prostate tissue, transrectal, with high intensity-focused ultrasound (hifu), including ultrasound guidance","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3472","name":"Surg rep root res premolar","description":"Surg rep root res premolar","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0729T","name":"Dx alys vstblr implt uni sbq","description":"Diagnostic analysis of vestibular implant, unilateral; with subsequent programming","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55714","name":"Bx prst8 in-bore ct/mri 1","description":"Biopsy, prostate, in-bore ct- or mri-guided targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35602","name":"Bpg crtd-clat crtd","description":"Bypass graft, with other than vein; carotid-contralateral carotid","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43860","name":"Revj gstr/jj anast w/o vgtmy","description":"Revision of gastrojejunal anastomosis (gastrojejunostomy) with reconstruction, with or without partial gastrectomy or intestine resection; without vagotomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1700.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4367","name":"Amniocore sl, per sq cm","description":"Amniocore sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5227","name":"Immed max part denture","description":"Immed max part denture","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0908T","name":"Opn imp int nstm sys vgs nrv","description":"Open implantation of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0470","name":"Dimecaprol injection","description":"Injection, dimercaprol, per 100 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92642","name":"Hearing asstv dev fitg svc","description":"Hearing assistive device, supplemental technology fitting services (eg, personal frequency modulation [fm]/digital modulation [dm] system, remote microphone, alerting devices)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1336","name":"Pts eval ini xm 2 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 2 weeks","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37293","name":"Rvsc evsc tpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1174","name":"Pt w/ 2 hzv 10/2017 - mp","description":"Patient received at least two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73092","name":"X-ray exam of arm infant","description":"Radiologic examination; upper extremity, infant, minimum of 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4413","name":"Cygnus solo per sq cm","description":"Cygnus solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4286","name":"Nudyn sl or slw, per sq cm","description":"Nudyn sl or nudyn slw, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25066","name":"Biopsy forearm soft tissues","description":"Biopsy, soft tissue of forearm and/or wrist; deep (subfascial or intramuscular)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78491","name":"Myocrd img pet 1std rst/strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); single study, at rest or stress (exercise or pharmacologic)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55867","name":"Laps surg prst8ect smpl stot","description":"Laparoscopy, surgical prostatectomy, simple subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy), includes robotic assistance, when performed","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1192","name":"Pt w/ dx sq cell ca of esoph","description":"Patients with an existing diagnosis of squamous cell carcinoma of the esophagus","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2989","name":"Excavate tooth non-restorabl","description":"Excavate tooth non-restorabl","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0739","name":"Rehab sys active assist rt","description":"Rehabilitation system with interactive interface providing active assistance in rehabilitation therapy, includes all components and accessories, motors, microprocessors, sensors","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1364","name":"Ascvd risk >=20pct","description":"Calculated 10-year ascvd risk score of >= 20 percent during the performance period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64901","name":"Nerve graft add-on","description":"Nerve graft, each additional nerve; single strand (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":754.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0722T","name":"Quan ct tiss charac w/ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained with concurrent ct examination of any structure contained in the concurrently acquired diagnostic imaging dataset (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99418","name":"Prolng ip/obs e/m ea 15 min","description":"Prolonged inpatient or observation evaluation and management service(s) time with or without direct patient contact beyond the required time of the primary service when the primary service level has been selected using total time, each 15 minutes of total time (list separately in addition to the cod","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1392","name":"Pt rsn no exm or lst to fu","description":"Documentation of patient reasons for no examination, i.e., refusal of examination or lost to follow-up (documentation must include information that the clinician was unable to reach the patient by phone, mail or secure electronic mail - at least one method must be documented)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9603","name":"Inj, pafolacianine, 0.1 mg","description":"Injection, pafolacianine, 0.1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51741","name":"Electro-uroflowmetry first","description":"Complex uroflowmetry (eg, calibrated electronic equipment)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4018","name":"Ob/gyn ss","description":"Obstetrics/gynecology mips specialty set","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4408","name":"Xwrap hydro per sq cm","description":"Xwrap hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4021","name":"Orthopedic surgery ss","description":"Orthopedic surgery mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0836T","name":"Dgtz gls mcrscp fna ea addl","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29886","name":"Arthrs knee surg drlg od les","description":"Arthroscopy, knee, surgical; drilling for intact osteochondritis dissecans lesion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4334","name":"Amnioplast 1, per sq cm","description":"Amnioplast 1, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1409","name":"Recd gmln brca1/brca2 couns","description":"Patients who received germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4320","name":"Pellograft, per sq cm","description":"Pellograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92623","name":"Dx aly aud oi snd prcsr each","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; each additional 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0722T","name":"Quan ct tiss charac w/ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained with concurrent ct examination of any structure contained in the concurrently acquired diagnostic imaging dataset (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1357","name":"Pt w/red suic idea 120 days","description":"Patients who had a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26230","name":"Partial removal of hand bone","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis); metacarpal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":604.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9376","name":"Inj pozelimab-bbfg, 1 mg","description":"Injection, pozelimab-bbfg, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4314","name":"Reeva, per sq cm","description":"Reeva ft, per square cenitmeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0923T","name":"Rmvl&rplcmt perm ccm-d pg","description":"Removal and replacement of permanent cardiac contractility modulation-defibrillation pulse generator only","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49596","name":"Rpr aa hrn 1st > 10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, incarcerated or strangulated","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6593","name":"Grad com accessory gmt_wrap","description":"Accessory for gradient compression garment or wrap with adjustable straps, not-otherwise specified","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1226","name":"Iop not doc","description":"Iop measurement not documented, reason not otherwise specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35697","name":"Reimplant artery each","description":"Reimplantation, visceral artery to infrarenal aortic prosthesis, each artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9601","name":"Flortaucipir inj 1 millicuri","description":"Flortaucipir f 18 injection, diagnostic, 1 millicurie","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0798T","name":"Tcat rmv 2chmbr ldls pm cmpl","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; complete system (ie, right atrial and right ventricular pacemaker components)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1281","name":"Bp scrn no perf at interval","description":"Blood pressure reading not documented, reason not given","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76856","name":"Us exam pelvic complete","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53454","name":"Tprnl balo cntnc dev adjmt","description":"Periurethral transperineal adjustable balloon continence device; percutaneous adjustment of balloon(s) fluid volume","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5146","name":"Inj, hercessi, 10 mg","description":"Injection, trastuzumab-strf (hercessi), biosimilar, 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0280U","name":"Hem vw factor&clgn iv bndg","description":"Hematology (von willebrand disease [vwd]), von willebrand factor (vwf) and collagen iv binding by enzyme-linked immunosorbent assays (elisa), plasma, report of collagen iv binding","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0429U","name":"Hpv orop swab 14 hi-risk typ","description":"Hpv orop swab 14 hi-risk typ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93586","name":"Vngrph chd coronary sinus","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; coronary sinus (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90612","name":"Inf&sarscov2 vacc 31.7/.32im","description":"Influenza virus vaccine, trivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 31.7 mcg/0.32 ml dosage, for intramuscular use","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21110","name":"Interdental fixation","description":"Application of interdental fixation device for conditions other than fracture or dislocation, includes removal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":653.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1151","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64567","name":"Perq elec nrv field stimj cn","description":"Percutaneous electrical nerve field stimulation, cranial nerves, without implantation","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27600","name":"Decompression of lower leg","description":"Decompression fasciotomy, leg; anterior and/or lateral compartments only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6524","name":"G com garmnt lwr leg/ft nght","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0167","name":"Inj epinephrine (hospira)","description":"Injection, epinephrine (hospira), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0589","name":"Inj daxibotulinumtoxina-lanm","description":"Injection, daxibotulinumtoxina-lanm, 1 unit","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0548","name":"Phone/inter svs 21-30 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2050","name":"Financial mgt waiver/diem","description":"Financial management, self-directed, waiver; per diem","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0989T","name":"Revj/rmvl ins ptn subq&subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1232","name":"Pt hcv tst reactive result","description":"Patient receives hcv antibody test with reactive result","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1299","name":"Flu immunize order/admin","description":"Influenza immunization administered or previously received","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85651","name":"Rbc sed rate nonautomated","description":"Sedimentation rate, erythrocyte; non-automated","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49618","name":"Rpr aa hrn rcr > 10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, incarcerated or strangulate","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0755T","name":"Dgtz gls mcrscp sld level vi","description":"Digitization of glass microscope slides for level vi, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37214","name":"Cessj therapy cath removal","description":"Transcatheter therapy, arterial or venous infusion for thrombolysis other than coronary, any method, including radiological supervision and interpretation, continued treatment on subsequent day during course of thrombolytic therapy, including follow-up catheter contrast injection, position change, o","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1188","name":"Pt w/ ckd stg 5","description":"Patients with a diagnosis of chronic kidney disease (ckd) stage 5","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69729","name":"Impl oi implt sk tc esp>=100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside of the mastoid and resulting in removal of greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2018","name":"Permeaderm c, per sq cm","description":"Permeaderm c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6624","name":"Inlay titanium","description":"Inlay - titanium","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1229","name":"Pt w/ +hcv +vir ref win 1 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, is referred within 1 month of the reactive hcv antibody test to a clinician who treats hcv infection","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0309U","name":"Crd cv ds aly 4 prtn plm alg","description":"Crd cv ds aly 4 prtn plm alg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1313","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6518","name":"Grad com wrap w strap arm cu","description":"Gradient compression wrap with adjustable straps, arm, each, custom","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0566","name":"3d bn img algor drvd fr mri","description":"3d radiodensity-value bone imaging, algorithm derived, from previous magnetic resonance examination of the same anatomy","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1372","name":"Mst rec gsa >=7 and<8","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 7.0% and < 8.0%","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1017T","name":"Elec aly npgs esoph sbsq w/o","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1486","name":"Pt admitted to snf dur eval","description":"Patients admitted to a skilled nursing facility (snf) during the period of evaluation","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5100","name":"Inj ustekinumab-kfce, 1 mg","description":"Injection, ustekinumab-kfce (yesintek), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9359","name":"Inj lon tesirin-lpyl 0.075mg","description":"Injection, loncastuximab tesirine-lpyl, 0.075 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1183","name":"Doc imm ckpt inhib hld","description":"Documentation of immune checkpoint inhibitor therapy held and corticosteroids or immunosuppressants prescribed or administered","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4353","name":"Xceed tl matrix per sq cm","description":"Xceed tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58146","name":"Myomectomy abdom complex","description":"Myomectomy, excision of fibroid tumor(s) of uterus, 5 or more intramural myomas and/or intramural myomas with total weight greater than 250 g, abdominal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1347.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15018","name":"App skn cll ssp f/n/g/hf ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 480 sq cm or part thereof (list separately in addition to code for prima","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0391U","name":"Onc sld tum dna&rna 437 gen","description":"Onc sld tum dna&rna 437 gen","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0523U","name":"Onc soltum dna ngs snv 22gen","description":"Onc soltum dna ngs snv 22gen","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9936","name":"Clean occ guard","description":"Clean occ guard","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7412","name":"Excision benign lesion compl","description":"Excision of benign lesion complicated","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63308","name":"Remove vertebral body add-on","description":"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; each additional segment (list separately in addition to codes for single segment)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5932","name":"Postsurgical obturator","description":"Obturator prosthesis definitive","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0660","name":"Team remote e/m new pt 10 mn","description":"Team remote e/m new pt 10mins","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0870","name":"Injection, imetelstat, 1 mg","description":"Injection, imetelstat, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2058","name":"Obecbtge autol up to 400 mil","description":"Obecabtagene autoleucel, 10 up to 400 million cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per infusion","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23156","name":"Removal of humerus lesion","description":"Excision or curettage of bone cyst or benign tumor of proximal humerus; with allograft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":803.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46607","name":"Diagnostic anoscopy & biopsy","description":"Anoscopy; with high-resolution magnification (hra) (eg, colposcope, operating microscope) and chemical agent enhancement, with biopsy, single or multiple","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":220.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":108.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0808T","name":"Pulm tiss vntj alys w/ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with computed tomography (ct) images taken for the purpose of pulmonary tissue ventilation analysis, including data preparation and transmission, quantificati","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82658","name":"Enzyme cell activity ra","description":"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; radioactive substrate, each specimen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2010","name":"Lincomycin injection","description":"Injection, lincomycin hcl, up to 300 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26485","name":"Transplant palm tendon","description":"Transfer or transplant of tendon, palmar; without free tendon graft, each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1122.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G8431","name":"Pos clin depres scrn f/u doc","description":"Screening for depression is documented as being positive and a follow-up plan is documented","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["HD"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9886","name":"In-person attendance g code","description":"Behavioral counseling for diabetes prevention, in-person, group, 60 minutes","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96910","name":"Photchmtx tar&uvb/ptrltm&uvb","description":"Photochemotherapy; tar and ultraviolet b (goeckerman treatment) or petrolatum and ultraviolet b","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52597","name":"Trurl rbtc wtrjt rescj prst8","description":"Transurethral robotic-assisted waterjet resection of prostate, including intraoperative planning, ultrasound guidance, control of postoperative bleeding, complete, including vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy, when performed","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1399","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0763T","name":"Dgtz gls mcrscp mphmtrc alys","description":"Digitization of glass microscope slides for morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure, manual (list separately in addition to code for primary proced","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0733T","name":"Rem r-t mtn nrehab ther sply","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; supply and technical support, per 30 days","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1231","name":"Pt hcv tst no reactive res","description":"Patient receives hcv antibody test with nonreactive result","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34201","name":"Removal of artery clot","description":"Embolectomy or thrombectomy, with or without catheter; femoropopliteal, aortoiliac artery, by leg incision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4100","name":"Nosht skin sub fda clrd nos","description":"Non-sheet form skin substitute, fda cleared as a device, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q0178","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9011","name":"Datopotamab deruxtecan, 1 mg","description":"Injection, datopotamab deruxtecan-dlnk, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0606U","name":"Hem red cll memb do rbc oge","description":"Hem red cll memb do rbc oge","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1737","name":"Inj meloxicam (azurity) 1mg","description":"Injection, meloxicam (azurity), 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0367U","name":"Onc bldr 10 flwg trurl rescj","description":"Onc bldr 10 flwg trurl rescj","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95908","name":"Nrv cndj tst 3-4 studies","description":"Nerve conduction studies; 3-4 studies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9999","name":"Doc sys rsn <3 colon","description":"Documentation of system reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., unable to locate previous colonoscopy report, patient cannot provide precise date or details from previous colonoscopy, previous colonoscopy report was incomplete)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0778T","name":"Smmg cncrnt appl imu snr","description":"Surface mechanomyography (smmg) with concurrent application of inertial measurement unit (imu) sensors for measurement of multi-joint range of motion, posture, gait, and muscle function","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0046","name":"No mrs 90 days post stk","description":"Clinical follow-up and mrs score not assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4306","name":"Americ amnion ac per sq cm","description":"American amnion ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0950T","name":"Abltj b9 prst8 tissue hifu","description":"Ablation of benign prostate tissue, transrectal, with high intensity-focused ultrasound (hifu), including ultrasound guidance","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5931","name":"Surgical obturator","description":"Obturator prosthesis surgical","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0023","name":"Pin service 60m per month","description":"Principal illness navigation services by certified or trained auxiliary personnel under the direction of a physician or other practitioner, including a patient navigator; 60 minutes per calendar month, in the following activities:  person-centered assessment, performed to better understand the indiv","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1347","name":"Pt pam incr 3 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 3 points in a 4 to 12 month period (passing)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2012","name":"Suprathel, per sq cm","description":"Suprathel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1194","name":"Med rsn no imp/con mmr/msi","description":"Documentation of medical reason(s) surgical pathology reports did not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both tests were not included (e.g., patient will not be treated with checkpoint inhibitor therap","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0827T","name":"Dgtz gls mcrscp cytp smears","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; smears with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0833T","name":"Dgtz gls mcrscp cytp oth prp","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; preparation, screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9393","name":"Inj, fulvestrant (teva)","description":"Injection, fulvestrant (teva), not therapeutically equivalent to j9395, 25 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87084","name":"Culture of specimen by kit","description":"Culture, presumptive, pathogenic organisms, screening only; with colony estimation from density chart","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0036","name":"Pt/ptn decln assess","description":"Patient or care partner decline assessment","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4030","name":"Pulmonology ss","description":"Pulmonology mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2543","name":"Dental onlay metallic 3 surf","description":"Onlay - metallic - three surfaces","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86628","name":"Candida antibody","description":"Antibody; candida","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4438","name":"Adhesive clip ext ens contr","description":"Adhesive clip applied to the skin to secure external electrical nerve stimulator controller, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0900T","name":"N-invas est aqmbf asstv cmr","description":"Noninvasive estimate of absolute quantitation of myocardial blood flow (aqmbf), derived from assistive algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health care profes","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33370","name":"Tcat plmt&rmvl cepd perq","description":"Transcatheter placement and subsequent removal of cerebral embolic protection device(s), including arterial access, catheterization, imaging, and radiological supervision and interpretation, percutaneous (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0722T","name":"Quan ct tiss charac w/ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained with concurrent ct examination of any structure contained in the concurrently acquired diagnostic imaging dataset (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93594","name":"R hrt cath chd abnl nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; abnormal native connections","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0900T","name":"N-invas est aqmbf asstv cmr","description":"Noninvasive estimate of absolute quantitation of myocardial blood flow (aqmbf), derived from assistive algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health care profes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34716","name":"Opn ax/subcla art expos cndt","description":"Open axillary/subclavian artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass, by infraclavicular or supraclavicular incision, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":394.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4275","name":"Esano aca, per sq cm","description":"Esano aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0477U","name":"Rx metab psy 14&cyp2d6 gn-rx","description":"Rx metab psy 14&cyp2d6 gn-rx","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0921T","name":"Rmvl perm ccm-d sys 1 dfb ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous defibrillation lead only","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0766T","name":"Tc mag stimj pn 1st nerve","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; first nerve","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1019T","name":"Lymphovenous bypass per xtr","description":"Lymphovenous bypass, including robotic assistance, when performed, per extremity","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99387","name":"Init pm e/m new pat 65+ yrs","description":"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; 65 years and old","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":120.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":193.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0035","name":"Pt ed pos 23","description":"Patient has any emergency department encounter during the performance period with place of service indicator 23","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0828T","name":"Dgtz gls mcrscp cytp smpl fl","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; simple filter method with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44020","name":"Explore small intestine","description":"Enterotomy, small intestine, other than duodenum; for exploration, biopsy(s), or foreign body removal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":966.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4368","name":"Amchothick per sq cm","description":"Amchothick, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66991","name":"Xcapsl ctrc rmvl insj 1+","description":"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); with insertion of intraocular (eg, trabecular meshwork, supraciliary, suprachoroidal) anterior segment aqueous drai","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36483","name":"Endoven ther chem adhes sbsq","description":"Endovenous ablation therapy of incompetent vein, extremity, by transcatheter delivery of a chemical adhesive (eg, cyanoacrylate) remote from the access site, inclusive of all imaging guidance and monitoring, percutaneous; subsequent vein(s) treated in a single extremity, each through separate access","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":169.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43226","name":"Esoph endoscopy dilation","description":"Esophagoscopy, flexible, transoral; with insertion of guide wire followed by passage of dilator(s) over guide wire","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0679T","name":"Laps rmvl lead isdss","description":"Laparoscopic removal of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37280","name":"Revsc evsc tpvt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9949","name":"Repair sleep apnea appliance","description":"Repair sleep apnea appliance","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1417","name":"Pt up to date cov","description":"Patients who are up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1210","name":">=2 same meds tbl4 not ord","description":"At least two orders for high-risk medications from the same drug class, (table 4), not ordered","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1422","name":"Gastroenterology care mvp","description":"Gastroenterology care mips value pathway","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4306","name":"Americ amnion ac per sq cm","description":"American amnion ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0491","name":"Inj anifrolumab-fnia 1mg","description":"Injection, anifrolumab-fnia, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98004","name":"Synch audio-video est sf 10","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 10 minutes must be met or e","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1454","name":"New cied","description":"New cied","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1331","name":"Pts eval ini xm 8 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 8 weeks from initial exam","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21154","name":"Rcnstj mdfc lefort iii w/o i","description":"Reconstruction midface, lefort iii (extracranial), any type, requiring bone grafts (includes obtaining autografts); without lefort i","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2499.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1160","name":"Pt anphx due to mengb bef 13","description":"Patient had anaphylaxis due to the meningococcal vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0663","name":"Team remote e/m new pt 45 mn","description":"Team remote e/m new pt 45mins","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0580U","name":"Bbrgdrferi antb detc 24rprtn","description":"Bbrgdrferi antb detc 24rprtn","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4545","name":"Suppl accessor tibial stim","description":"Supplies and accessories for external tibial nerve stimulator (e.g., socks, gel pads, electrodes, etc.), needed for one month","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0318","name":"Prolong home eval add 15m","description":"Prolonged home or residence evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the date of the primary service); each additional 15 minutes by the physician or qualified healthcare professional, with or without","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0913T","name":"Prq tcat ther rx ntrac balo1","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting), including mechanical dilation by nondrug-delivery balloon angioplasty, endoluminal imaging using intravascular ultrasound (ivus) or optical coherence tomography (oct) when per","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1498","name":"Diagnostic radiology mvp","description":"Diagnostic radiology mips value pathway","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75902","name":"Remove cva lumen obstruct","description":"Mechanical removal of intraluminal (intracatheter) obstructive material from central venous device through device lumen, radiologic supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0756T","name":"Dgtz gls mcrscp sld spc grpi","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group i, for microorganisms (eg, acid fast, methenamine silver) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0698T","name":"Quan mr tiss w/mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained with diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, target ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93272","name":"Ecg/review interpret only","description":"External patient and, when performed, auto activated electrocardiographic rhythm derived event recording with symptom-related memory loop with remote download capability up to 30 days, 24-hour attended monitoring; review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39530","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0699T","name":"Njx pst chmbr eye medication","description":"Injection, posterior chamber of eye, medication","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0035","name":"Pt ed pos 23","description":"Patient has any emergency department encounter during the performance period with place of service indicator 23","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97009","name":"Mchnl sclp cool after chemo","description":"Mechanical scalp cooling; provided after discontinuation of chemotherapy, each 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31710","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4265","name":"Neostim tl per sq cm","description":"Neostim tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0978T","name":"Submucosal cryolysis therapy","description":"Submucosal cryolysis therapy; soft palate, base of tongue, and lingual tonsil","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1235","name":"Doc pt hcv aby rna tst","description":"Documentation or patient report of hcv antibody test or hcv rna test which occurred prior to the performance period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0915T","name":"Insj perm ccm-d sys pg&eltrd","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator and dual transvenous electrodes/leads (pacing and defibrillation)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90807","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90957","name":"Esrd srv 4 vsts p mo 12-19","description":"End-stage renal disease (esrd) related services monthly, for patients 12-19 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 4 or more face-to-face visits by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":850.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0294U","name":"Lngvty&mrtlty rsk mrna 18gen","description":"Lngvty&mrtlty rsk mrna 18gen","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9887","name":"Distance learning attendance","description":"Behavioral counseling for diabetes prevention, distance learning, 60 minutes","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0668","name":"Team remote e/m est pt 40 mn","description":"Team remote e/m est. pt 40mins","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0051","name":"Traditional healing service","description":"Traditional healing service","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1467","name":"Pt dx lynch syn","description":"Patients with an existing diagnosis of lynch syndrome","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1233","name":"Pt no hcv aby or result","description":"Patient does not receive hcv antibody test or patient does receive hcv antibody test but results not documented, reason not given","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45330","name":"Diagnostic sigmoidoscopy","description":"Sigmoidoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":63.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":29.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1316","name":"Tobacco non-user","description":"Current tobacco non-user","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87182","name":"Sc std carbapenemase nzm det","description":"Susceptibility studies, antimicrobial agent; carbapenemase enzyme detection (eg, klebsiella pneumoniae carbapenemase [kpc], new delhi metallo-beta-lactamase [ndm], verona integron-encoded metallo-beta-lactamase [vim]), multiplex immunoassay, qualitative, per isolate","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87468","name":"Anaplsma phgcytophlm amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); anaplasma phagocytophilum, amplified probe technique","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1837","name":"Inj, posaconazole, 1 mg","description":"Injection, posaconazole, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1411","name":"1st ln ici no chemo","description":"Currently on first-line immune checkpoint inhibitors without chemotherapy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4422","name":"Ac wrap per sq cm","description":"A/c wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1169","name":"Doc med rsn no flu vax","description":"Documentation of medical reason(s) for not administering influenza vaccine (e.g., prior anaphylaxis due to the influenza vaccine)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0718T","name":"Adrc ther prtl rc tear njx","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; injection into supraspinatus tendon including ultrasound guidance, unilateral","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1311","name":"Aphlx to vax bef enc","description":"Anaphylaxis due to the vaccine on or before the date of the encounter","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0371U","name":"Iadna gu pthgn semiq dna16&1","description":"Iadna gu pthgn semiq dna16&1","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92634","name":"Hearing aid fitg svc 1st 60","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; first 60 minutes","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4100","name":"Nosht skin sub fda clrd nos","description":"Non-sheet form skin substitute, fda cleared as a device, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94668","name":"Mnpj chest wall sbsq","description":"Manipulation chest wall, such as cupping, percussing, and vibration to facilitate lung function; subsequent","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0889T","name":"Prsnlz trgt dvl arhfcmrigtbs","description":"Personalized target development for accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation derived from a structural and resting-state functional mri, including data preparation and transmission, generation of the target, motor threshold-starting location, neuro","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23106","name":"Arthrotomy strnclav joint","description":"Arthrotomy; sternoclavicular joint, with synovectomy, with or without biopsy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":578.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9292","name":"Pres dig visual therapy fda","description":"Prescription digital visual therapy, software-only, fda cleared, per course of treatment","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0529","name":"In home respite care, 4 hr u","description":"In-home respite care, 4-hour unit, for use in cmmi model","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99412","name":"Preventive counseling group","description":"Preventive medicine counseling and/or risk factor reduction intervention(s) provided to individuals in a group setting (separate procedure); approximately 60 minutes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7411","name":"Excision benign lesion>1.25c","description":"Excision of benign lesion greater than 1.25 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69728","name":"Rmv ntr oi imp sk tc>=100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0475U","name":"Hered prst8 ca gsap 23 genes","description":"Hered prst8 ca gsap 23 genes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0914T","name":"Prq tcat thr rx ntrc bal sep","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting) performed on a separate target lesion from the target lesion treated with balloon angioplasty, coronary stent placement or coronary atherectomy, including mechanical dilation b","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0348U","name":"Rx metab/pcx dna 25 gen alys","description":"Rx metab/pcx dna 25 gen alys","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76380","name":"Cat scan follow-up study","description":"Computed tomography, limited or localized follow-up study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37279","name":"Iv lithotrp fpvt w/in sm art","description":"Intravascular lithotripsy(ies), femoral and popliteal vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9054","name":"Inj bortezomib boruzu 0.1 mg","description":"Injection, bortezomib (boruzu), 0.1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0942T","name":"Cysto flx rmv&rplc urtl scaf","description":"Cystourethroscopy, flexible; with removal and replacement of prostatic urethral scaffold","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4429","name":"Dermbnd chn, chx per sq cm","description":"Dermabind ch n or dermabind ch x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0922T","name":"Rmvl perm ccm-d sys dual ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); dual (pacing and defibrillation) transvenous leads only","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1305","name":"Inj, evinacumab-dgnb, 5mg","description":"Injection, evinacumab-dgnb, 5mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0882T","name":"Intraop ther estim pn ue 1st","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; initial nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4372","name":"Amchoplast excl per sq cm","description":"Amchoplast excel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0785T","name":"Revj/rmvl nea spi w/nstim","description":"Revision or removal of neurostimulator electrode array, spinal, with integrated neurostimulator","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37287","name":"Revsc evasc tpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82274","name":"Assay test for blood fecal","description":"Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1228","name":"Pt + hcv aby +vir w/ rx 3 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, has hcv treatment initiated within 3 months of the reactive hcv antibody test","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37295","name":"Rvsc evsc tpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5159","name":"Inj, denosumab-dssb, 1 mg","description":"Injection, denosumab-dssb (ospomyv/xbryk), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59410","name":"Obstetrical care","description":"Vaginal delivery only (with or without episiotomy and/or forceps); including postpartum care","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1126.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4337","name":"Artecent trident, per sq cm","description":"Artacent trident, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1125F","name":"Amnt pain noted pain prsnt","description":"Pain severity quantified; pain present (coa) (onc)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4312","name":"Acesso ac, per sq cm","description":"Acesso ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"U0002","name":"Covid-19 lab test non-cdc","description":"2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9326","name":"Telisotuzumab vedotin-tllv","description":"Injection, telisotuzumab vedotin-tllv, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0545","name":"Inherent visit to inpt","description":"Visit complexity inherent to hospital inpatient or observation care associated with a confirmed or suspected infectious disease by an infectious diseases specialist, including disease transmission risk assessment and mitigation, public health investigation, analysis, and testing, and complex antimic","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0540U","name":"Trnsplj med quan dd-cfdna","description":"Trnsplj med quan dd-cfdna","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37292","name":"Rvsc evsc tpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0511U","name":"Onc sol tum 3dmicroenvir 36+","description":"Onc sol tum 3dmicroenvir 36+","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4468","name":"Exsuff belt incl all sup acc","description":"Exsufflation belt, includes all supplies and accessories","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0967T","name":"Tranal ins tmp clrc anst dev","description":"Transanal insertion of endoluminal temporary colorectal anastomosis protection device, including vacuum anchoring component and flexible sheath connected to external vacuum source and monitoring system","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25675","name":"Cltx dstl rad/uln dislc mnpj","description":"Closed treatment of distal radioulnar dislocation with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81001","name":"Urinalysis auto w/scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; automated, with microscopy","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37281","name":"Revsc evsc tpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37296","name":"Revsc evasc imvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0315U","name":"Onc cutan sq cll ca mrna 40","description":"Onc cutan sq cll ca mrna 40","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96202","name":"Mlt fam grp bhv train 1st 60","description":"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face with multiple sets of paren","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4432","name":"510(k) skin subs, nos","description":"510(k) skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0490U","name":"Onc cutan/uveal mlnma cd146","description":"Onc cutan/uveal mlnma cd146","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0737","name":"Inj, clindamycin (baxter)","description":"Injection, clindamycin phosphate (baxter), not therapeutically equivalent to j0736, 300 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61020","name":"Remove brain cavity fluid","description":"Ventricular puncture through previous burr hole, fontanelle, suture, or implanted ventricular catheter/reservoir; without injection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93898","name":"Ven-artl shunt det mbubb njx","description":"Venous-arterial shunt detection with intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6527","name":"G garmt full leg/ft nght cus","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, custom, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90638","name":"Vacc qirv mrna 60mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 60 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99426","name":"Prin care mgmt staff 1st 30","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1216","name":"No spiro doc no res doc","description":"No spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and/or no spirometry performed with results documented during the encounter","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5140","name":"Inj adalimumab-fkjp, 1 mg","description":"Injection, adalimumab-fkjp, biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2025","name":"Miro3d per cubic cm","description":"Miro3d, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0414","name":"Lab process microbial spec","description":"Lab process microbial spec","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1821","name":"Ko elas w/ condyle pads otf","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, off the shelf","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22838","name":"Rev rplc/rmv thrc vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracic vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1392","name":"Pt rsn no exm or lst to fu","description":"Documentation of patient reasons for no examination, i.e., refusal of examination or lost to follow-up (documentation must include information that the clinician was unable to reach the patient by phone, mail or secure electronic mail - at least one method must be documented)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28100","name":"Removal of ankle/heel lesion","description":"Excision or curettage of bone cyst or benign tumor, talus or calcaneus;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":506.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5411","name":"Dentures adjust cmplt mand","description":"Adjust complete denture - mandibular","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0303U","name":"Hem rbc ads whl bld hypoxic","description":"Hem rbc ads whl bld hypoxic","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2516","name":"Inj, pentamidine isethionate","description":"Injection, pentamidine isethionate, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5938","name":"Resct proth max comp remov","description":"Resct proth max comp remov","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0833T","name":"Dgtz gls mcrscp cytp oth prp","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; preparation, screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1291","name":"Pt 66+ frailty and med dem","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1343.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0826T","name":"Prgrmg evl ldls pm 1chmbr ip","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional, leadless pacemaker system in si","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0563","name":"Sbrt w/positron emission del","description":"Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance and real-time positron emissions-based delivery adjustments to 1 or more lesions, entire course not to exceed 5 fractions","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0500U","name":"Autoinflam ds vexas synd dna","description":"Autoinflam ds vexas synd dna","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7353","name":"Anacaulase-bcdb 8.8% gel 1 g","description":"Anacaulase-bcdb, 8.8% gel, 1 gram","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0013","name":"Esketamine, nasal spray","description":"Esketamine, nasal spray, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87512","name":"Gardner vag dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); gardnerella vaginalis, quantification","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78587","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0040","name":"Pt phys/occ therapy","description":"Patient already receiving physical/occupational/speech/recreational therapy during the measurement period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4344","name":"Tri membrane wrap, per sq cm","description":"Tri-membrane wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4440","name":"Curamatrix per sq cm","description":"Curamatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0814T","name":"Prq njx biod osteo matrl fem","description":"Percutaneous injection of calcium-based biodegradable osteoconductive material, proximal femur, including imaging guidance, unilateral","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0847T","name":"Dgtz gls mcrscp xm arch tiss","description":"Digitization of glass microscope slides for examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, kras mutational analysis) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4335","name":"Amnioplast 2, per sq cm","description":"Amnioplast 2, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0465","name":"Autolog prp diab wound ulcer","description":"Autologous platelet rich plasma (prp) or other blood-derived product for diabetic chronic wounds/ulcers, using an fda-cleared device for this indication, (includes as applicable administration, dressings, phlebotomy, centrifugation or mixing, and all other preparatory procedures, per treatment)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1271","name":"Inj doxycycline hyclate 1 mg","description":"Injection, doxycycline hyclate, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4426","name":"Dermbnd tl+, tlx per sq cm","description":"Dermabind tl + or dermabind tl x,  per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6089","name":"Access/retorq implant screw","description":"Access/retorq implant screw","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64874","name":"Repair & revise nerve add-on","description":"Suture of nerve; requiring extensive mobilization, or transposition of nerve (list separately in addition to code for nerve suture)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1368","name":"Prev trt inf d/o hiv/hep mvp","description":"Prevention and treatment of infectious disorders including hepatitis c and hiv mips value pathway","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88160","name":"Cytopath smear other source","description":"Cytopathology, smears, any other source; screening and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1346","name":"No pam inc 6 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 6 points within a 4 to 12 month period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0355U","name":"Apol1 risk variants","description":"Apol1 risk variants","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15014","name":"Prepj skn cll ssp agrft ea","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; each additional 25 sq cm of harvested skin or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5140","name":"Inj adalimumab-fkjp, 1 mg","description":"Injection, adalimumab-fkjp, biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33600","name":"Closure of valve","description":"Closure of atrioventricular valve (mitral or tricuspid) by suture or patch","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2080.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67966","name":"Revision of eyelid","description":"Excision and repair of eyelid, involving lid margin, tarsus, conjunctiva, canthus, or full thickness, may include preparation for skin graft or pedicle flap with adjacent tissue transfer or rearrangement; over one-fourth of lid margin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55714","name":"Bx prst8 in-bore ct/mri 1","description":"Biopsy, prostate, in-bore ct- or mri-guided targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7165","name":"Inj, human-lans, per i.u","description":"Injection, prothrombin complex concentrate, human-lans, per i.u. of factor ix activity","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87390","name":"Hiv-1 ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; hiv-1","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4017","name":"Nutrition/dietician ss","description":"Nutrition/dietician mips specialty set","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9276","name":"Inj zanidatamab-hrii, 2 mg","description":"Injection, zanidatamab-hrii, 2 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0462U","name":"Melatonin lvl tst slp std7/9","description":"Melatonin lvl tst slp std7/9","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77092","name":"Tbs i&r fx rsk qhp","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; interpretation and report on fracture-risk only by other qualified health care professional","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1465","name":"F/u > 180 days after rx","description":"Patient follow up more than 180 days after treatment","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1105","name":"Dexmedetomidine film, 1 mcg","description":"Dexmedetomidine, oral, 1 mcg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4016","name":"Neurosurgical ss","description":"Neurosurgical mips specialty set","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0697T","name":"Quan mr tis wo mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained without diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, targ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0391U","name":"Onc sld tum dna&rna 437 gen","description":"Onc sld tum dna&rna 437 gen","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99464","name":"Attendance at delivery","description":"Attendance at delivery (when requested by the delivering physician or other qualified health care professional) and initial stabilization of newborn","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4011","name":"Internal medicine ss","description":"Internal medicine mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0579U","name":"Nfro dbtc ckd elisa apoa4","description":"Nfro dbtc ckd elisa apoa4","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64468","name":"Thrc fascial pln blk bi njx","description":"Thoracic fascial plane block, bilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J2503","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1054.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1355","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6596","name":"G comp bandge conform gauze","description":"Gradient compression bandaging supply, conforming gauze, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81005","name":"Urinalysis","description":"Urinalysis; qualitative or semiquantitative, except immunoassays","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2402","name":"Chloroprocaine (clorotekal)","description":"Injection, chloroprocaine hydrochloride (clorotekal), per 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76857","name":"Us exam pelvic limited","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50630","name":"Removal of ureter stone","description":"Ureterolithotomy; lower one-third of ureter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55815","name":"Extensive prostate surgery","description":"Prostatectomy, perineal radical; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric and obturator nodes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1937.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4468","name":"Exsuff belt incl all sup acc","description":"Exsufflation belt, includes all supplies and accessories","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6593","name":"Grad com accessory gmt_wrap","description":"Accessory for gradient compression garment or wrap with adjustable straps, not-otherwise specified","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3375","name":"Inj, vanco (tyzavan) 10mg","description":"Injection, vancomycin hydrochloride (tyzavan), not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0794T","name":"Pt spec alg rx-onc tx option","description":"Patient-specific, assistive, rules-based algorithm for ranking pharmaco-oncologic treatment options based on the patients tumor-specific cancer marker information obtained from prior molecular pathology, immunohistochemical, or other pathology results which have been previously interpreted and repor","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92920","name":"Prq trluml c angiop 1art&/br","description":"Percutaneous transluminal coronary angioplasty, single major coronary artery and/or its branch(es)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0035","name":"Pt ed pos 23","description":"Patient has any emergency department encounter during the performance period with place of service indicator 23","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9886","name":"In-person attendance g code","description":"Behavioral counseling for diabetes prevention, in-person, group, 60 minutes","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9074","name":"Inj, cyclophosphamd, sandoz","description":"Injection, cyclophosphamide (sandoz), 5 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7298","name":"Remove screw retained plate","description":"Remove screw retained plate","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38226","name":"Car-t prep t lymphcyt f/trns","description":"Chimeric antigen receptor t-cell (car-t) therapy; preparation of blood-derived t lymphocytes for transportation (eg, cryopreservation, storage)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22520","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":698.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1432","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0741","name":"Inj, cabote rilpivir 2mg 3mg","description":"Injection, cabotegravir and rilpivirine, 2mg/3mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0001","name":"Advancing cancer care mvp","description":"Advancing cancer care mips value pathways","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98980","name":"Rtm tx mgmt 1st 20 min","description":"Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least 1 real-time interactive communication with the patient or caregiver during the calendar month; first 20 minutes","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1250","name":"Pt resp true heard","description":"Patient responded as completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87265","name":"Pertussis ag if","description":"Infectious agent antigen detection by immunofluorescent technique; bordetella pertussis/parapertussis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0501U","name":"Onc clrc bld quan meas cfdna","description":"Onc clrc bld quan meas cfdna","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37284","name":"Revsc evasc tpvt st sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0313U","name":"Onc pncrs dna&mrna seq 74","description":"Onc pncrs dna&mrna seq 74","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47785","name":"Fuse bile ducts and bowel","description":"Anastomosis, roux-en-y, of intrahepatic biliary ducts and gastrointestinal tract","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2138.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87913","name":"Nfct agt gntyp alys sarscov2","description":"Infectious agent genotype analysis by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), mutation identification in targeted region(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2804","name":"Inj, rifampin, 1 mg","description":"Injection, rifampin, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4307","name":"American amnion, per sq cm","description":"American amnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0298U","name":"Onc pan tum whl trns seq rna","description":"Onc pan tum whl trns seq rna","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58559","name":"Hysteroscopy lysis","description":"Hysteroscopy, surgical; with lysis of intrauterine adhesions (any method)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":427.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2043","name":"Biobrane, per sq cm","description":"Biobrane, per square centimeter","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53452","name":"Tprnl balo cntnc dev uni","description":"Periurethral transperineal adjustable balloon continence device; unilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1322","name":"Pts 7wk inj, scrn iop =<25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop =<25 mm hg for injected eye","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0503U","name":"Neuro alz ds bamyl&tau prtn","description":"Neuro alz ds bamyl&tau prtn","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0701","name":"Pano radio image","description":"Pano radio image","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49424","name":"Assess cyst contrast inject","description":"Contrast injection for assessment of abscess or cyst via previously placed drainage catheter or tube (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62330","name":"Dcmprn prq rmv lig flv 1lmbr","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; one interspace, lumbar","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9612","name":"Inj, fluorescein, 1 mg","description":"Injection, fluorescein, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1327","name":"Pts no eval ini xm no 8 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 8 weeks","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27713","name":"Osteot tibia imed lngth dev","description":"Osteotomy(ies), tibia, including fibula when performed, unilateral, with insertion of an externally controlled intramedullary lengthening device, including imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4231","name":"Ana crown exp 1-3 per quad","description":"Anatomical crown exposure - one to three teeth per quadrant","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0168","name":"Epinephrine (intl med sys)","description":"Injection, epinephrine (international medication systems), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4333","name":"Ardeograft, per sq cm","description":"Ardeograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2561","name":"Inj, sezaby, 1 mg","description":"Injection, phenobarbital sodium (sezaby), 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0491","name":"Inj anifrolumab-fnia 1mg","description":"Injection, anifrolumab-fnia, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0912T","name":"Elec alys nstim sys vgs smpl","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; with simple programming by physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0953T","name":"Tot impl amei rev/rplc w/o","description":"Totally implantable active middle ear hearing implant; revision or replacement, without mastoidectomy and replacement of sound processor","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29892","name":"Arthrs aid rpr od les/tib fx","description":"Arthroscopically aided repair of large osteochondritis dissecans lesion, talar dome fracture, or tibial plafond fracture, with or without internal fixation (includes arthroscopy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":827.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1213","name":"No hx spiro prs spiro>=70%","description":"No history of spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) and present spirometry is >= 70%","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92550","name":"Tympanometry & reflex thresh","description":"Tympanometry and reflex threshold measurements","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0711T","name":"N-nvs artl plaq alys dat prp","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data preparation and transmission","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0897T","name":"N-invas augmnt arrhyt alys","description":"Noninvasive augmentative arrhythmia analysis derived from quantitative computational cardiac arrhythmia simulations, based on selected intervals of interest from 12-lead electrocardiogram and uploaded clinical parameters, including uploading clinical parameters with interpretation and report","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92634","name":"Hearing aid fitg svc 1st 60","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; first 60 minutes","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4020","name":"Ophthalmology/optometry ss","description":"Ophthalmology/optometry mips specialty set","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9601","name":"Inj linvoseltamab-gcpt 1 mg","description":"Injection, linvoseltamab-gcpt, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4322","name":"Splint intra-coronal","description":"Splint intra-coronal","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43510","name":"Surgical opening of stomach","description":"Gastrotomy; with esophageal dilation and insertion of permanent intraluminal tube (eg, celestin or mousseaux-barbin)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":939.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7172","name":"Inj marstacim-hncq, 0.5 mg","description":"Injection, marstacimab-hncq, 0.5 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32124","name":"Explore chest free adhesions","description":"Thoracotomy; with open intrapleural pneumonolysis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":981.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0031","name":"Pall serv during meas","description":"Palliative care services given to patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66991","name":"Xcapsl ctrc rmvl insj 1+","description":"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); with insertion of intraocular (eg, trabecular meshwork, supraciliary, suprachoroidal) anterior segment aqueous drai","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4000","name":"Dermatology ss","description":"Dermatology mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78605","name":"Brain image 4+ views","description":"Brain imaging, minimum 4 static views;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0405U","name":"Onc pncrtc 59 mthltn blk mrk","description":"Onc pncrtc 59 mthltn blk mrk","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25830","name":"Arthrd dst rad/ul jt sgm rsc","description":"Arthrodesis, distal radioulnar joint with segmental resection of ulna, with or without bone graft (eg, sauve-kapandji procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0702","name":"2d cephal radio image","description":"2d cephal radio image","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4357","name":"Xwrap plus, per sq cm","description":"Xwrap plus, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0850T","name":"Dgtz gls mcrscp ish ea mult","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0738","name":"Upper extremity rehab","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64598","name":"Revj/rmvl nea pn w/int nstim","description":"Revision or removal of neurostimulator electrode array, peripheral nerve, with integrated neurostimulator","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0420U","name":"Onc urthl mrna xprsn 6 snp","description":"Onc urthl mrna xprsn 6 snp","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0693T","name":"Compre ful bdy 3d mtn alys","description":"Comprehensive full body computer-based markerless 3d kinematic and kinetic motion analysis and report","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0553","name":"Monthly tx for dmht 20mins","description":"First 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing information related to the use of","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0483","name":"Indirect immunofluorescence","description":"Indirect immunofluorescence","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J9340","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5152","name":"Inj, eculizumab-aeeb, 2 mg","description":"Injection, eculizumab-aeeb (bkemv), biosimilar, 2 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4359","name":"Choriply, per sq cm","description":"Choriply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64629","name":"Trml dstrj ios bvn ea addl","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; each additional vertebral body, lumbar or sacral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"Rec cath any transanal, each","description":"Rectal catheter with or without balloon, for use with any type transanal irrigation system, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0952T","name":"Tot impl amei rev/rplc mstdc","description":"Totally implantable active middle ear hearing implant; revision or replacement, with mastoidectomy and replacement of sound processor","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1258","name":"Cvd risk assess perf","description":"Cvd risk assessment performed, have a documented calculated risk score","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78271","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0807T","name":"Pulm tiss vntj alys prev ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with previously acquired computed tomography (ct) images, including data preparation and transmission, quantification of pulmonary tissue ventilation, data re","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4252","name":"Vendaje, per square centimet","description":"Vendaje, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0767T","name":"Tc mag stimj pn ea addl nrv","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; each additional nerve (list separat","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0605","name":"Sucroferric oxyhydroxide 5mg","description":"Sucroferric oxyhydroxide, oral, 5 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1161","name":"Pt anphx due to dtp bef 13","description":"Patient had anaphylaxis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62330","name":"Dcmprn prq rmv lig flv 1lmbr","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; one interspace, lumbar","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1413","name":"Pos pdl1 bef init ici tx","description":"Patients who had a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0362U","name":"Onc pap thyr ca rna 82&10","description":"Onc pap thyr ca rna 82&10","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6559","name":"G stckng full/chap18-30 cust","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81456","name":"So/hl 51/>gsap rna alys","description":"Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic sequence analysis panel, interrogation for sequence variants and copy number variants or rearrangements, or isoform expression or mrna expression levels, if performed; rna analysis","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4252","name":"Vendaje, per square centimet","description":"Vendaje, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62310","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0885T","name":"Colsc flx 1st tndsc dilat","description":"Colonoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4305","name":"Amer am ac tri-lay per sq cm","description":"American amnion ac tri-layer, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0779T","name":"Gi myoelectrical actv study","description":"Gastrointestinal myoelectrical activity study, stomach through colon, with interpretation and report","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4256","name":"Mlg complet, per sq cm","description":"Mlg-complete, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4479","name":"Transanal irrigation, electr","description":"Electronic transanal irrigation system, includes electronic pump, water reservoir, tubing, and accessories, without catheter, any type","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34703","name":"Evasc rpr a-unilac ndgft","description":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-uni-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in th","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1337.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0408U","name":"Iaad blk ac wv bsnsr sarscv2","description":"Iaad blk ac wv bsnsr sarscv2","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3375","name":"Inj, vanco (tyzavan) 10mg","description":"Injection, vancomycin hydrochloride (tyzavan), not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0708T","name":"Id ca immntx prep & 1st njx","description":"Intradermal cancer immunotherapy; preparation and initial injection","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0235","name":"Inj, monoclon antibody, 1 mg","description":"Injection, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extraco","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61889","name":"Ins sk-mnt crnl nstm pg/rcvr","description":"Insertion of skull-mounted cranial neurostimulator pulse generator or receiver, including craniectomy or craniotomy, when performed, with direct or inductive coupling, with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47570","name":"Laparo cholecystoenterostomy","description":"Laparoscopy, surgical; cholecystoenterostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":871.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0956T","name":"Prt crn ch cr&tun elt s-sclp","description":"Partial craniectomy, channel creation, and tunneling of electrode for sub-scalp implantation of an electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9432","name":"Med food non inborn err meta","description":"Medical foods for non-inborn errors of metabolism","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99426","name":"Prin care mgmt staff 1st 30","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0679T","name":"Laps rmvl lead isdss","description":"Laparoscopic removal of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34705","name":"Evac rpr a-biiliac ndgft","description":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-bi-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1484.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82540","name":"Assay of creatine","description":"Creatine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0890T","name":"Arhfcmrigtbs 1st tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including target assessment, initial motor threshold determination, neuronavigation, delivery and management, initial treatment day","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82705","name":"Fats/lipids feces qual","description":"Fat or lipids, feces; qualitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1177","name":"Pt recd pcv on/aft 19","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9071","name":"Inj cyclophosphamd auromedic","description":"Injection, cyclophosphamide (auromedics), 5 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86294","name":"Immunoassay tumor qual","description":"Immunoassay for tumor antigen, qualitative or semiquantitative (eg, bladder tumor antigen)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71048","name":"X-ray exam chest 4+ views","description":"Radiologic examination, chest; 4 or more views","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1304","name":"Inj tofersen intrathec 1 mg","description":"Injection, tofersen, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0942T","name":"Cysto flx rmv&rplc urtl scaf","description":"Cystourethroscopy, flexible; with removal and replacement of prostatic urethral scaffold","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7912","name":"Suture complicate wnd > 5 cm","description":"Complicated suture-greater than 5 cm","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37258","name":"Revsc evasc ivt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1258","name":"Cvd risk assess perf","description":"Cvd risk assessment performed, have a documented calculated risk score","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0430U","name":"Gi malabs aat calpro pncrtc","description":"Gi malabs aat calpro pncrtc","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9225","name":"Gen anes adv air-sub 15 min","description":"Gen anes adv air-sub 15 min","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0689","name":"Inj cefazolin sodium, baxter","description":"Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90481","name":"Admn sarscov2 vac ea add cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; each additional component administered (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0681","name":"Inj ceftobipole medocarl 3mg","description":"Injection, ceftobiprole medocaril sodium, 3 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90824","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91319","name":"Sarscv2 vac 10mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 10 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67961","name":"Revision of eyelid","description":"Excision and repair of eyelid, involving lid margin, tarsus, conjunctiva, canthus, or full thickness, may include preparation for skin graft or pedicle flap with adjacent tissue transfer or rearrangement; up to one-fourth of lid margin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4296","name":"Rebound matrix, per sq cm","description":"Rebound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0020M","name":"Onc cns alys 30000 dna loci","description":"Oncology (central nervous system), analysis of 30,000 dna methylation loci by methylation array, utilizing dna extracted from tumor tissue, diagnostic algorithm reported as probability of matching a reference tumor subclass","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2007","name":"Restrata, per sq cm","description":"Restrata, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4404","name":"Xwrap hydro plus per sq cm","description":"Xwrap hydro plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82306","name":"Vitamin d 25 hydroxy","description":"Vitamin d; 25 hydroxy, includes fraction(s), if performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99459","name":"Pelvic examination","description":"Pelvic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2401","name":"Chloroprocaine hcl injection","description":"Injection, chloroprocaine hydrochloride, per 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5149","name":"Inj, aflibercept-abzv, 1 mg","description":"Injection, aflibercept-abzv (enzeevu), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4286","name":"Remove non-resorb barrier","description":"Remove non-resorb barrier","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1267","name":"Pt no act kid transplt wtlst","description":"Patients not observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9341","name":"Inj thiotepa (tepylute) 1 mg","description":"Injection, thiotepa (tepylute), 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0601","name":"Sevelamer carbonate 20 mg","description":"Sevelamer carbonate (renvela or therapeutically equivalent), oral, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0997T","name":"Precuneus mag stimj tx plng","description":"Precuneus magnetic stimulation; treatment planning using magnetic resonance imaging-guided neuronavigation to determine optimal location, dose, and intensity for magnetic stimulation therapy, derived from evoked potentials from single pulses of electromagnetic energy recorded by 64-channel electroen","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20939","name":"Bone marrow aspir bone grfg","description":"Bone marrow aspiration for bone grafting, spine surgery only, through separate skin or fascial incision (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4268","name":"Surgraft ft per sq cm","description":"Surgraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0351U","name":"Nfct ds bct/viral trail ip10","description":"Nfct ds bct/viral trail ip10","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6114","name":"Implnt/abut fixed dent max","description":"Implnt/abut fixed dent max","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0345U","name":"Psyc genom alys pnl 15 gen","description":"Psyc genom alys pnl 15 gen","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25628","name":"Optx carpl scphd fx int fixj","description":"Open treatment of carpal scaphoid (navicular) fracture, includes internal fixation, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":805.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27386","name":"Repair/graft of thigh muscle","description":"Suture of quadriceps or hamstring muscle rupture; secondary reconstruction, including fascial or tendon graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1002.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0047","name":"Ped blunt hd traum","description":"Pediatric patient with minor blunt head trauma and pecarn prediction criteria are not assessed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29899","name":"Ankle arthroscopy/surgery","description":"Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; with ankle arthrodesis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1223.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0869T","name":"Njx b1 sub mtrl hw fixj aug","description":"Injection(s), bone-substitute material for bone and/or soft tissue hardware fixation augmentation, including intraoperative imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99342","name":"Home/res vst new low mdm 30","description":"Home or residence visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75840","name":"Vein x-ray adrenal gland","description":"Venography, adrenal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":717.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96203","name":"Mlt fam grp bhv train ea add","description":"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face with multiple sets of paren","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0766T","name":"Tc mag stimj pn 1st nerve","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; first nerve","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4011","name":"Internal medicine ss","description":"Internal medicine mips specialty set","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4024","name":"Pediatrics ss","description":"Pediatrics mips specialty set","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0225","name":"Inj, vutrisiran, 1 mg","description":"Injection, vutrisiran, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4309","name":"Via matrix, per sq cm","description":"Via matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4369","name":"Amnioplast 3 per sq cm","description":"Amnioplast 3, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0565U","name":"Onc hcc ngs detc 6626epigalt","description":"Onc hcc ngs detc 6626epigalt","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9601","name":"Inj linvoseltamab-gcpt 1 mg","description":"Injection, linvoseltamab-gcpt, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99463","name":"Same day nb discharge","description":"Initial hospital or birthing center care, per day, for evaluation and management of normal newborn infant admitted and discharged on the same date","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61737","name":"Litt icr mlt trj mlt/cplx ls","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; multiple trajectories for multiple or complex lesion(s)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1503","name":"Vascular surgery mvp","description":"Vascular surgery mips value pathway","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0265U","name":"Rar do whl gn&mtcdrl dna als","description":"Rare constitutional and other heritable disorders, whole- genome and mitochondrial dna sequence analysis, blood, frozen and formalin-fixed paraffin-embedded (ffpe) tissue, saliva, buccal swabs or cell lines, identification of single nucleotide and copy number variants","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22612","name":"Arthrd pst tq 1ntrspc lumbar","description":"Arthrodesis, posterior or posterolateral technique, single interspace; lumbar (with lateral transverse technique, when performed)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21172","name":"Rcnst supr-lat orb rm&lw fhd","description":"Reconstruction superior-lateral orbital rim and lower forehead, advancement or alteration, with or without grafts (includes obtaining autografts)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2012.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82166","name":"Assay anti-mullerian horm","description":"Anti-mullerian hormone (amh)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1444","name":"Del < 39 weeks gest","description":"Delivery at < 39 weeks of gestation","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42815","name":"Excision of neck cyst","description":"Excision branchial cleft cyst, vestige, or fistula, extending beneath subcutaneous tissues and/or into pharynx","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7412","name":"Excision benign lesion compl","description":"Excision of benign lesion complicated","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2401","name":"Chloroprocaine hcl injection","description":"Injection, chloroprocaine hydrochloride, per 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87469","name":"Babesia microti amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); babesia microti, amplified probe technique","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9075","name":"Inj, cyclophosphamide, nos","description":"Injection, cyclophosphamide, not otherwise specified, 5 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87154","name":"Cul typ id bld pthgn 6+ trgt","description":"Culture, typing; identification of blood pathogen and resistance typing, when performed, by nucleic acid (dna or rna) probe, multiplexed amplified probe technique including multiplex reverse transcription, when performed, per culture or isolate, 6 or more targets","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4357","name":"Xwrap plus, per sq cm","description":"Xwrap plus, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9998","name":"Doc med rsn <3 colon","description":"Documentation of medical reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., last colonoscopy incomplete, last colonoscopy had inadequate prep, piecemeal removal of adenomas, or sessile serrated polyps >= 20 mm in size, last colonoscopy found greater than 10 adenomas, lo","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0582U","name":"Rare ds rpd whlgen dna vrnts","description":"Rare ds rpd whlgen dna vrnts","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77789","name":"Apply surf ldr radionuclide","description":"Surface application of low dose rate radionuclide source","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37254","name":"Revsc evasc ivt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9334","name":"Inj efgart-alfa 2mg hya-qvfc","description":"Injection, efgartigimod alfa, 2 mg and hyaluronidase-qvfc","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2055","name":"Idecabtagene vicleucel car","description":"Idecabtagene vicleucel, up to 510 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1465","name":"F/u > 180 days after rx","description":"Patient follow up more than 180 days after treatment","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3387","name":"Inj elivaldogene autotemecel","description":"Injection, elivaldogene autotemcel, per treatment","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92225","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37263","name":"Revsc evasc fpvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2051","name":"Support broker waiver/diem","description":"Supports brokerage, self-directed, waiver; per diem","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87183","name":"Sc std carbapenem resist gen","description":"Susceptibility studies, antimicrobial agent; carbapenem resistance genes (eg, blakpc, blandm, blavim, blaoxa-48, blaimp), amplified probe technique, per isolate","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4334","name":"Amnioplast 1, per sq cm","description":"Amnioplast 1, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5125","name":"Inj, releuko 1 mcg","description":"Injection, filgrastim-ayow, biosimilar, (releuko), 1 microgram","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4336","name":"Artecent c, per sq cm","description":"Artacent c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64654","name":"1st opn implt bat modulj sys","description":"Initial open implantation of baroreflex activation therapy (bat) modulation system, including lead placement onto the carotid sinus, lead tunnelling, connection to a pulse generator placed in a distant subcutaneous pocket (ie, total system), and intraoperative interrogation and programming","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4440","name":"Curamatrix per sq cm","description":"Curamatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5943","name":"Proth mandib implt sup remv","description":"Proth mandib implt sup remv","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0757T","name":"Dgtz gls mcrscp sl spc grpii","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group ii, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistochemistry (list separately in addition to code for primary","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9611","name":"Flurpiridaz f18, diag, 1 mci","description":"Flurpiridaz f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4322","name":"Splint intra-coronal","description":"Splint intra-coronal","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35152","name":"Repair ruptd popliteal art","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, popliteal artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1813.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93150","name":"Therapy activation ipnss","description":"Therapy activation of implanted phrenic nerve stimulator system, including all interrogation and programming","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77063","name":"Breast tomosynthesis bi","description":"Screening digital breast tomosynthesis, bilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92622","name":"Dx aly aud oi snd prcsr 1st","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; first 60 minutes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5942","name":"Proth max implt sup remv","description":"Proth max implt sup remv","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87428","name":"Sarscov & inf vir a&b ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; severe acute respiratory syndrome coronavirus (eg, sars-cov, s","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0523U","name":"Onc soltum dna ngs snv 22gen","description":"Onc soltum dna ngs snv 22gen","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43290","name":"Egd flx trnsorl dplmnt balo","description":"Esophagogastroduodenoscopy, flexible, transoral; with deployment of intragastric bariatric balloon","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9393","name":"Inj, fulvestrant (teva)","description":"Injection, fulvestrant (teva), not therapeutically equivalent to j9395, 25 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1350","name":"Pt w/ suic saf pln init rev","description":"Patients who had a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0542","name":"No pt prsnt train add 15","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64597","name":"Ins/rplcm prq eltrd ra pn ea","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; each additional electrode array (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9256","name":"Inj, nipocalimab-aahu, 3 mg","description":"Injection, nipocalimab-aahu, 3 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0431","name":"Diag tst detect mucos abnorm","description":"Adjunctive pre-diagnostic test that aids in detection of mucosal abnormalities including premalignant and malignant lesions not to include cytology or biopsy","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90960","name":"Esrd srv 4 visits p mo 20+","description":"End-stage renal disease (esrd) related services monthly, for patients 20 years of age and older; with 4 or more face-to-face visits by a physician or other qualified health care professional per month","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":398.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1010","name":"Inj, methylpred acetate 1 mg","description":"Injection, methylprednisolone acetate, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1225","name":"Iop dec>=20% from base","description":"Intraocular pressure (iop) reduced by a value of greater than or equal to 20% from the pre-intervention level","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0571","name":"Intraop nerve cryoablation","description":"Intraoperative nerve(s) cryoablation for post-surgical pain relief (list separately in addition to code for primary service)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0926T","name":"Prgrmg dev eval ccm-d ip","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, including review and report, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1247","name":"Pt resp true best int","description":"Patient responded completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0889T","name":"Prsnlz trgt dvl arhfcmrigtbs","description":"Personalized target development for accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation derived from a structural and resting-state functional mri, including data preparation and transmission, generation of the target, motor threshold-starting location, neuro","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27762","name":"Cltx med ankle fx w/mnpj","description":"Closed treatment of medial malleolus fracture; with manipulation, with or without skin or skeletal traction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":518.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9612","name":"Thera par drugs 2 or > admin","description":"Therapeutic parenteral drugs two or more administrations different medications","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0838T","name":"Dgtz gls mcrscp cslt sld els","description":"Digitization of glass microscope slides for consultation and report on referred slides prepared elsewhere (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82565","name":"Assay of creatinine","description":"Creatinine; blood","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15015","name":"App skn cl ssp agrft t/a/l 1","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; first 480 sq cm or less","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1303","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80505","name":"Path clin consltj high 41-60","description":"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patients history and medical records and high level of medical decision making when using time for code selection, 41-60 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1422","name":"Gastroenterology care mvp","description":"Gastroenterology care mips value pathway","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9292","name":"Inj, pemetrexed dipotassium","description":"Injection, pemetrexed dipotassium, 10 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44406","name":"Colonoscopy w/ultrasound","description":"Colonoscopy through stoma; with endoscopic ultrasound examination, limited to the sigmoid, descending, transverse, or ascending colon and cecum and adjacent structures","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3501","name":"Surg exp root surf anterior","description":"Surg exp root surf anterior","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46611","name":"Anoscopy","description":"Anoscopy; with removal of single tumor, polyp, or other lesion by snare technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0595U","name":"Nfct ds tfp vctrbrn&zoonotic","description":"Nfct ds tfp vctrbrn&zoonotic","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2267","name":"Inj, mirikizumab-mrkz, 1 mg","description":"Injection, mirikizumab-mrkz, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25295","name":"Release wrist/forearm tendon","description":"Tenolysis, flexor or extensor tendon, forearm and/or wrist, single, each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":913.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"14000","name":"Tis trnfr trunk 10 sq cm/<","description":"Adjacent tissue transfer or rearrangement, trunk; defect 10 sq cm or less","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0856T","name":"Dgtz gls mcrscp electron mic","description":"Digitization of glass microscope slides for electron microscopy, diagnostic (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0536U","name":"Rbcag ftl rhd pcr alys exon4","description":"Rbcag ftl rhd pcr alys exon4","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81560","name":"Trnsplj pd lvr&bwl cd154+cll","description":"Transplantation medicine (allograft rejection, pediatric liver and small bowel), measurement of donor and third-party-induced cd154+t-cytotoxic memory cells, utilizing whole peripheral blood, algorithm reported as a rejection risk score","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7521","name":"Incision/drain abscess extra","description":"Incision and drainage of abscess - extraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0642","name":"Lo sag ri an/pos pnl pre ots","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52597","name":"Trurl rbtc wtrjt rescj prst8","description":"Transurethral robotic-assisted waterjet resection of prostate, including intraoperative planning, ultrasound guidance, control of postoperative bleeding, complete, including vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy, when performed","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0265U","name":"Rar do whl gn&mtcdrl dna als","description":"Rare constitutional and other heritable disorders, whole- genome and mitochondrial dna sequence analysis, blood, frozen and formalin-fixed paraffin-embedded (ffpe) tissue, saliva, buccal swabs or cell lines, identification of single nucleotide and copy number variants","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"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":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87182","name":"Sc std carbapenemase nzm det","description":"Susceptibility studies, antimicrobial agent; carbapenemase enzyme detection (eg, klebsiella pneumoniae carbapenemase [kpc], new delhi metallo-beta-lactamase [ndm], verona integron-encoded metallo-beta-lactamase [vim]), multiplex immunoassay, qualitative, per isolate","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0309","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":791.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0608","name":"Lanthanum carbonate pwdr 5mg","description":"Lanthanum carbonate, oral, powder, 5 mg, not therapeutically equivalent to j0607 (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4019","name":"Oncology/hema ss","description":"Oncology/hematology mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0558U","name":"Onc clrct elisa bf7 ag serum","description":"Onc clrct elisa bf7 ag serum","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0236","name":"Intrav inf, mon anti, sec do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99395","name":"Prev visit est age 18-39","description":"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 18-39","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":139.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":84.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0716T","name":"Car acous wavfrm rec cad rsk","description":"Cardiac acoustic waveform recording with automated analysis and generation of coronary artery disease risk score","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0018M","name":"Trnsplj rnl meas cd154+cll","description":"Transplantation medicine (allograft rejection, renal), measurement of donor and third-party-induced cd154+t-cytotoxic memory cells, utilizing whole peripheral blood, algorithm reported as a rejection risk score","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1248","name":"Pt resp true seen as person","description":"Patient responded completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92623","name":"Dx aly aud oi snd prcsr each","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; each additional 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1837","name":"Inj, posaconazole, 1 mg","description":"Injection, posaconazole, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3379","name":"Inj, valproate sod, 5 mg","description":"Injection, valproate sodium, 5 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1391","name":"All pt dx w/ rec mlnm","description":"All patients who were diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92557","name":"Comprehensive hearing test","description":"Comprehensive audiometry threshold evaluation and speech recognition (92553 and 92556 combined)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":40.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4279","name":"Vendaje ac, per sq cm","description":"Vendaje ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3472","name":"Ovine, 1000 usp units","description":"Injection, hyaluronidase, ovine, preservative free, per 1000 usp units","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1236","name":"Baseline mrs > 2","description":"Baseline mrs > 2","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97550","name":"Caregiver traing 1st 30 min","description":"Caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patie","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0529","name":"In home respite care, 4 hr u","description":"In-home respite care, 4-hour unit, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78262","name":"Gastroesophageal reflux std","description":"Gastroesophageal reflux study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":259.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80061","name":"Lipid panel","description":"Lipid panel this panel must include the following: cholesterol, serum, total (82465) lipoprotein, direct measurement, high density cholesterol (hdl cholesterol) (83718) triglycerides (84478)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0209","name":"Inj, sod thiosulfate (hope)","description":"Injection, sodium thiosulfate (hope), 100 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4325","name":"Acapatch, per sq cm","description":"Acapatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69209","name":"Remove impacted ear wax uni","description":"Removal impacted cerumen using irrigation/lavage, unilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4300","name":"Acesso tl, per sq cm","description":"Acesso tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0356U","name":"Onc orop 17 dna ddpcr alg","description":"Onc orop 17 dna ddpcr alg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9939","name":"Placemnt removable appliance","description":"Placemnt removable appliance","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91020","name":"Gastric motility studies","description":"Gastric motility (manometric) studies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0733T","name":"Rem r-t mtn nrehab ther sply","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; supply and technical support, per 30 days","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0092","name":"Set up port xray equipment","description":"Set-up portable x-ray equipment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74018","name":"Radex abdomen 1 view","description":"Radiologic examination, abdomen; 1 view","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"Adju cgm supply allowance","description":"Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KF"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1805","name":"Inj, esmolol hcl, 10mg","description":"Injection, esmolol hydrochloride, 10 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0892","name":"Argatroban dialysis (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9161","name":"Inj denileuk difti-cxdl 1mcg","description":"Injection, denileukin diftitox-cxdl, 1 mcg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0019M","name":"Cv ds plasma alys prtn bmrk","description":"Cardiovascular disease, plasma, analysis of protein biomarkers by aptamer-based microarray and algorithm reported as 4-year likelihood of coronary event in high-risk populations","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01937","name":"Anes drg/aspir crv/thrc","description":"Anesthesia for percutaneous image-guided injection, drainage or aspiration procedures on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77090","name":"Tbs techl prep&transmis data","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90593","name":"Chikungunya vacc recomb im","description":"Chikungunya virus vaccine, recombinant, for intramuscular use","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77782","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1192.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92601","name":"Cochlear implt f/up exam <7","description":"Diagnostic analysis of cochlear implant, patient younger than 7 years of age; with programming","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0557","name":"Adv prim care mgmt lvl 2","description":"Advanced primary care management services for a patient with multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, which place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline, provided by c","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9209","name":"Mesna injection","description":"Injection, mesna, 200 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0803T","name":"Tcat rmv&rpl2chmb ldls pm rv","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ve","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1198","name":"Isa not red 3pts /no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10121","name":"Inc&rmvl fb subq tiss comp","description":"Incision and removal of foreign body, subcutaneous tissues; complicated","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":195.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1339","name":"Pts f/u 30-180 dys + improv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who demonstrated positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0275U","name":"Hem heprn nduc trmbctpna srm","description":"Hematology (heparin-induced thrombocytopenia) platelet antibody reactivity by flow cytometry, serum","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20900","name":"Removal of bone for graft","description":"Bone graft, any donor area; minor or small (eg, dowel or button)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":558.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29445","name":"Appl rigid tot cntc leg cast","description":"Application of rigid total contact leg cast","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0757T","name":"Dgtz gls mcrscp sl spc grpii","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group ii, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistochemistry (list separately in addition to code for primary","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4005","name":"Family medicine ss","description":"Family medicine mips specialty set","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0041","name":"Pt/ptn decln referral","description":"Patient and/or care partner decline referral","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2781","name":"Crown 3/4 cast base metal","description":"Crown - 3/4 cast predominantly base metal","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1306","name":"Injection, inclisiran, 1 mg","description":"Injection, inclisiran, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93145","name":"Interrog crtd sins bat ip wo","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2801","name":"Inj, rykindo, 0.5 mg","description":"Injection, risperidone (rykindo), 0.5 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50382","name":"Change ureter stent percut","description":"Removal (via snare/capture) and replacement of internally dwelling ureteral stent via percutaneous approach, including radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1325","name":"Doc med rsn not seen","description":"Patients who were not seen for reasons documented by clinician for patient or medical reasons (e.g., inadequate time for follow-up, patients who received a prior intravitreal or periocular steroid injection within the last six (6) months and had a subsequent iop evaluation with iop <25mm hg within s","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43771","name":"Lap revise gastr adj device","description":"Laparoscopy, surgical, gastric restrictive procedure; revision of adjustable gastric restrictive device component only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1366.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99307","name":"Sbsq nf care sf mdm 10","description":"Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 10 minutes must be met or e","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":48.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":15.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0708T","name":"Id ca immntx prep & 1st njx","description":"Intradermal cancer immunotherapy; preparation and initial injection","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91124","name":"Rct snsatn tone&cmplianc std","description":"Rectal sensation, tone, and compliance study (eg, barostat)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":670.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3503","name":"Surg exp root surf molar","description":"Surg exp root surf molar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10140","name":"I&d hmtma seroma/fluid collj","description":"Incision and drainage of hematoma, seroma or fluid collection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83876","name":"Assay myeloperoxidase","description":"Myeloperoxidase (mpo)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0233","name":"Intra inf, toci, first dose","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0438U","name":"Rx metab advrs vrnt alys 33","description":"Rx metab advrs vrnt alys 33","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0918T","name":"Insj perm ccm-d sys dual ld","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; dual transvenous leads (pacing and defibrillation) only","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0697T","name":"Quan mr tis wo mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained without diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, targ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1431","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"Breathing capacity test","description":"Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement(s), with or without maximal voluntary ventilation","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4314","name":"Reeva, per sq cm","description":"Reeva ft, per square cenitmeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1253","name":"Pts hu surv no amb plltv","description":"Patients who respond on the patient experience hu survey that they did not receive care by the listed ambulatory palliative care provider in the last 60 days (disavowal)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","name":"Gait mod systm rhym auditory","description":"Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0572U","name":"Onc prst8 httl qfish whl bld","description":"Onc prst8 httl qfish whl bld","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1416","name":"Pt rec hosp","description":"Patient received hospice services any time during the performance period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0314U","name":"Onc cutan mlnma mrna 35 gene","description":"Onc cutan mlnma mrna 35 gene","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4367","name":"Amniocore sl, per sq cm","description":"Amniocore sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1410","name":"No gmln brca1/brca2 couns","description":"Patients who did not have germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0265U","name":"Rar do whl gn&mtcdrl dna als","description":"Rare constitutional and other heritable disorders, whole- genome and mitochondrial dna sequence analysis, blood, frozen and formalin-fixed paraffin-embedded (ffpe) tissue, saliva, buccal swabs or cell lines, identification of single nucleotide and copy number variants","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4425","name":"Revive tl per sq cm","description":"Revive tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7957","name":"Tiss regen edent nonresorb","description":"Tiss regen edent nonresorb","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1493","name":"No fall doc med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34803","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1588.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4370","name":"Aeroguard per sq cm","description":"Aeroguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1456","name":"Pt had htx","description":"Patient had a heart transplant","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61870","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1323.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1413","name":"Inj delandistrogene mox rokl","description":"Injection, delandistrogene moxeparvovec-rokl, per therapeutic dose","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0224","name":"Pemivibart infusion","description":"Intravenous infusion, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppr","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0018","name":"Crisis psychotherapy add 30m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); each additional 30 minutes (list separately in addition to code for primary service)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3389","name":"Topi adm prad zami per treat","description":"Topical administration, prademagene zamikeracel, per treatment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4392","name":"Grafix duo per sq cm","description":"Grafix duo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50327","name":"Prep renal graft/venous","description":"Backbench reconstruction of cadaver or living donor renal allograft prior to transplantation; venous anastomosis, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0155","name":"Dronabinol (syndros) 0.1 mg","description":"Dronabinol (syndros), 0.1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9955","name":"Oral app thxpy titration vis","description":"Oral app thxpy titration vis","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1355","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1411","name":"1st ln ici no chemo","description":"Currently on first-line immune checkpoint inhibitors without chemotherapy","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4428","name":"Dermbnd sln sl+ slx sq cm","description":"Dermabind sl n or dermabind sl + or dermabind sl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12004","name":"Rpr s/n/ax/gen/trk7.6-12.5cm","description":"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 7.6 cm to 12.5 cm","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":188.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77080","name":"Dxa bone density axial","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]},{"negotiated_type":"negotiated","negotiated_rate":54.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25415","name":"Repair radius & ulna","description":"Repair of nonunion or malunion, radius and ulna; without graft (eg, compression technique)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1472.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37298","name":"Revsc evsc imvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0260U","name":"Rare ds id opt genome mapg","description":"Rare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44386","name":"Endoscopy bowel pouch/biop","description":"Endoscopic evaluation of small intestinal pouch (eg, kock pouch, ileal reservoir [s or j]); with biopsy, single or multiple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33521","name":"Cabg artery-vein four","description":"Coronary artery bypass, using venous graft(s) and arterial graft(s); 4 venous grafts (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":615.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0682","name":"App non-sheet skin sub add","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (list separately in addition to code for pri","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2037","name":"G4derm plus/suprello, pr ml","description":"G4derm plus/suprello, per milliliter","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87428","name":"Sarscov & inf vir a&b ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; severe acute respiratory syndrome coronavirus (eg, sars-cov, s","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9954","name":"Fab/del oral appliance thxpy","description":"Fab/del oral appliance thxpy","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0672T","name":"Ndovag cryg rf remdl tiss","description":"Endovaginal cryogen-cooled, monopolar radiofrequency remodeling of the tissues surrounding the female bladder neck and proximal urethra for urinary incontinence","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92326","name":"Replacement of contact lens","description":"Replacement of contact lens","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37293","name":"Rvsc evsc tpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4409","name":"Amniomatrixf3x per sq cm","description":"Amniomatrixf3x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98013","name":"Synch audio-only est low 20","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code select","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7241","name":"Impact tooth rem bony w/comp","description":"Removal of impacted tooth-completely bony with unusual surgical complications","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3247","name":"Inj secukinumab intrav 1mg","description":"Injection, secukinumab, intravenous, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0286U","name":"Cep72 nudt15&tpmt gene alys","description":"Cep72 nudt15&tpmt gene alys","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0184","name":"Inj, amisulpride, 1 mg","description":"Injection, amisulpride, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4370","name":"Aeroguard per sq cm","description":"Aeroguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20962","name":"Other bone graft microvasc","description":"Bone graft with microvascular anastomosis; other than fibula, iliac crest, or metatarsal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3264.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1452","name":"Pt dx dementia ever","description":"Patient ever had a diagnosis of dementia","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15040","name":"Harvest cultured skin graft","description":"Harvest of skin for tissue cultured skin autograft, 100 sq cm or less","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0366U","name":"Onc bldr 10 prb recr bldr ca","description":"Onc bldr 10 prb recr bldr ca","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63276","name":"Bx/exc xdrl spine lesn thrc","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, thoracic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1975.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84393","name":"Tau phosphorylated ea","description":"Tau, phosphorylated (eg, ptau 181, ptau 217), each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83570","name":"Assay of idh enzyme","description":"Isocitric dehydrogenase (idh)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4397","name":"Summit aaa per sq cm","description":"Summit aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37281","name":"Revsc evsc tpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0523","name":"Mgt nw pt dem mod-high cmplx","description":"Management of a new patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27499","name":"Decompression of thigh/knee","description":"Decompression fasciotomy, thigh and/or knee, multiple compartments; with debridement of nonviable muscle and/or nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4412","name":"Choriofix per sq cm","description":"Choriofix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35820","name":"Explore chest vessels","description":"Exploration for postoperative hemorrhage, thrombosis or infection; chest","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":987.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2313","name":"Inj, naloxone (zimhi) 0.01mg","description":"Injection, naloxone hydrochloride (zimhi), 0.01 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77437","name":"Surf radj ther supfc<=150kv","description":"Surface radiation therapy; superficial, delivery, </=150 kv, per fraction (eg, electronic brachytherapy)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76988","name":"Dx ntrop epcr us chd img acq","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; placement, manipulation of transducer, and image acquisition only","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90635","name":"H5n1 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n1, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2057","name":"Afamitresgene autoleucel","description":"Afamitresgene autoleucel, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4321","name":"Renograft, per sq cm","description":"Renograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1271","name":"Inj doxycycline hyclate 1 mg","description":"Injection, doxycycline hyclate, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10080","name":"I&d pilonidal cyst simple","description":"Incision and drainage of pilonidal cyst; simple","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":293.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37722","name":"Lig div&strpg long saph vein","description":"Ligation, division, and stripping, long (greater) saphenous veins from saphenofemoral junction to knee or below","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":583.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2030","name":"Miro3d fibers, per mg","description":"Miro3d fibers, per milligram","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6560","name":"G stckng full/chap30-40 cust","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, custom, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4428","name":"Dermbnd sln sl+ slx sq cm","description":"Dermabind sl n or dermabind sl + or dermabind sl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44314","name":"Revision of ileostomy","description":"Revision of ileostomy; complicated (reconstruction in-depth) (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1035.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0706","name":"Intraoral occlus radio image","description":"Intraoral occlus radio image","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28294","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":643.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56630","name":"Vulvectomy radical partial","description":"Vulvectomy, radical, partial;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":922.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0864T","name":"Low ntsty eswt corpus cvrnsm","description":"Low-intensity extracorporeal shock wave therapy involving corpus cavernosum, low energy","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27090","name":"Removal of hip prosthesis","description":"Removal of hip prosthesis; (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":997.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"Motor &/ sens nrve cndj test","description":"Motor and/or sensory nerve conduction, using preconfigured electrode array(s), amplitude and latency/velocity study, each limb, includes f-wave study when performed, with interpretation and report","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1297","name":"Bmi not doc medrsn ptref","description":"Bmi not documented due to medical reason or patient refusal of height or weight measurement","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1376","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0601U","name":"Nfct ds pji alys 11 bmrks ia","description":"Nfct ds pji alys 11 bmrks ia","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92928","name":"Prq tcat plmt ntrac st 1 les","description":"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 1 lesion involving 1 or more coronary segments","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1191","name":"Hspc svc any time in meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0406U","name":"Onc lung flow cytmtry 5 mrk","description":"Onc lung flow cytmtry 5 mrk","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80051","name":"Electrolyte panel","description":"Electrolyte panel this panel must include the following: carbon dioxide (bicarbonate) (82374) chloride (82435) potassium (84132) sodium (84295)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1205","name":"Isa reduced >=3","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64473","name":"Lwr xtr fscl pln blk uni njx","description":"Lower extremity fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0676T","name":"Laps insj nw/rpcmt isdss ea","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional lead (list separately in addition to code for primary ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4007","name":"General surgery ss","description":"General surgery mips specialty set","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0225","name":"Inj, vutrisiran, 1 mg","description":"Injection, vutrisiran, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0377U","name":"Cv ds quan advsrm/plsm lprtn","description":"Cv ds quan advsrm/plsm lprtn","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5136","name":"Inj. denosumab-bbdz, 1 mg","description":"Injection, denosumab-bbdz (jubbonti/wyost), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0849T","name":"Dgtz gls mcrscp ish ea adl 1","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5911","name":"Facial moulage sectional","description":"Facial moulage (sectional)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6602","name":"Cst hgh nble mtl inlay 2 srf","description":"Inlay - cast high noble metal two surfaces","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1236","name":"Baseline mrs > 2","description":"Baseline mrs > 2","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1333","name":"Acute vitreous hemorrhage","description":"Acute vitreous hemorrhage","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92623","name":"Dx aly aud oi snd prcsr each","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; each additional 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43135","name":"Removal of esophagus pouch","description":"Diverticulectomy of hypopharynx or esophagus, with or without myotomy; thoracic approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1187.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1400","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0315U","name":"Onc cutan sq cll ca mrna 40","description":"Onc cutan sq cll ca mrna 40","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0883T","name":"Intraop ther estim pn ue ea","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; each additional nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1596","name":"Inj, glycopyrrolate, 0.1 mg","description":"Injection, glycopyrrolate, 0.1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46280","name":"Remove anal fist complex","description":"Surgical treatment of anal fistula (fistulectomy/fistulotomy); transsphincteric, suprasphincteric, extrasphincteric or multiple, including placement of seton, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":440.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0599U","name":"Onc pncrtc ca mult ia serum","description":"Onc pncrtc ca mult ia serum","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2023","name":"Innovamatrix pd, 1 mg","description":"Innovamatrix pd, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9072","name":"Inj cyclophos frindovyx 5 mg","description":"Injection, cyclophosphamide (frindovyx), 5 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1336","name":"Pts eval ini xm 2 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 2 weeks","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76071","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1161","name":"Pt anphx due to dtp bef 13","description":"Patient had anaphylaxis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0729T","name":"Dx alys vstblr implt uni sbq","description":"Diagnostic analysis of vestibular implant, unilateral; with subsequent programming","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87426","name":"Sarscov coronavirus ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; severe acute respiratory syndrome coronavirus (eg, sars-cov, s","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0534","name":"Coordinated care/or referral","description":"Coordinated care and/or referral services, such as to adequate and accessible community resources to address unmet health-related social needs, including harm reduction interventions and recovery support services a patient needs and wishes to pursue, which significantly limit the ability to diagnose","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0541U","name":"Cv ds hdl rct cec lc-ms/ms 5","description":"Cv ds hdl rct cec lc-ms/ms 5","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2038","name":"Skill train and dev/diem","description":"Skills training and development, per diem","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2025","name":"Miro3d per cubic cm","description":"Miro3d, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0665","name":"Inj, bupivacaine, nos, 0.5mg","description":"Injection, bupivicaine, not otherwise specified, 0.5 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96161","name":"Caregiver health risk assmt","description":"Administration of caregiver-focused health risk assessment instrument (eg, depression inventory) for the benefit of the patient, with scoring and documentation, per standardized instrument","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4026","name":"Phys/occ therapy ss","description":"Physical therapy/occupational therapy mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36226","name":"Place cath vertebral art","description":"Selective catheter placement, vertebral artery, unilateral, with angiography of the ipsilateral vertebral circulation and all associated radiological supervision and interpretation, includes angiography of the cervicocerebral arch, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2184.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78609","name":"Brain imaging (pet)","description":"Brain imaging, positron emission tomography (pet); perfusion evaluation","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80504","name":"Path clin consltj mod 21-40","description":"Pathology clinical consultation; for a moderately complex clinical problem, with review of patients history and medical records and moderate level of medical decision making when using time for code selection, 21-40 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27758","name":"Treatment of tibia fracture","description":"Open treatment of tibial shaft fracture (with or without fibular fracture), with plate/screws, with or without cerclage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1043.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1013T","name":"Lap srg imp/rpl eso nea&pg/r","description":"Laparoscopy, surgical, implantation or replacement of lower esophageal sphincter neurostimulator electrode array and neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver, including cruroplasty and/or electronic ","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83051","name":"Hemoglobin plasma","description":"Hemoglobin; plasma","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0588U","name":"Nfct ds bct/vir 32genes mrna","description":"Nfct ds bct/vir 32genes mrna","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0683T","name":"Prgrmg dev eval isdss ip","description":"Programming device evaluation (in-person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional, permanent implantable synchroni","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0541U","name":"Cv ds hdl rct cec lc-ms/ms 5","description":"Cv ds hdl rct cec lc-ms/ms 5","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0865T","name":"Quan mri alys brn w/o dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion identification, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transm","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J9031","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0936T","name":"Photobiomodulation ther rta","description":"Photobiomodulation therapy of retina, single session","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92642","name":"Hearing asstv dev fitg svc","description":"Hearing assistive device, supplemental technology fitting services (eg, personal frequency modulation [fm]/digital modulation [dm] system, remote microphone, alerting devices)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53444","name":"Insert tandem cuff","description":"Insertion of tandem cuff (dual cuff)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":882.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0540U","name":"Trnsplj med quan dd-cfdna","description":"Trnsplj med quan dd-cfdna","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0796T","name":"Tcat ins 2chmbr ldls pm ra","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right atrial pacemaker","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0367U","name":"Onc bldr 10 flwg trurl rescj","description":"Onc bldr 10 flwg trurl rescj","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"Ctlso a-p-l control custom","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51721","name":"Ins trurl ablt trnsdc thr us","description":"Insertion of transurethral ablation transducer for delivery of thermal ultrasound for prostate tissue ablation, including suprapubic tube placement during the same session and placement of an endorectal cooling device, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95115","name":"Immunotherapy one injection","description":"Professional services for allergen immunotherapy not including provision of allergenic extracts; single injection","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9046","name":"Inj, bortezomib, dr. reddys","description":"Injection, bortezomib (dr. reddys), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80192","name":"Assay of procainamide","description":"Procainamide; with metabolites (eg, n-acetyl procainamide)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76642","name":"Ultrasound breast limited","description":"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9286","name":"Inj glofitamab gxbm, 2.5 mg","description":"Injection, glofitamab-gxbm, 2.5 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81441","name":"Ibmfs seq alys pnl 30 genes","description":"Inherited bone marrow failure syndromes (ibmfs) (eg, fanconi anemia, dyskeratosis congenita, diamond-blackfan anemia, shwachman-diamond syndrome, gata2 deficiency syndrome, congenital amegakaryocytic thrombocytopenia) sequence analysis panel, must include sequencing of at least 30 genes, including b","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0023","name":"Pin service 60m per month","description":"Principal illness navigation services by certified or trained auxiliary personnel under the direction of a physician or other practitioner, including a patient navigator; 60 minutes per calendar month, in the following activities:  person-centered assessment, performed to better understand the indiv","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0944T","name":"3d cntr simula trgt lvr les","description":"3d contour simulation of target liver lesion(s) and margin(s) for image-guided percutaneous microwave ablation","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0035","name":"Pt ed pos 23","description":"Patient has any emergency department encounter during the performance period with place of service indicator 23","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87627","name":"Jt spc pthgn&rx rsist gen26+","description":"Infectious agent detection by nucleic acid (dna or rna); joint space pathogens and drug resistance genes, multiplex amplified probe technique, 26 or more targets","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61891","name":"Rev/rplcmt sk-mnt crnl nstm","description":"Revision or replacement of skull-mounted cranial neurostimulator pulse generator or receiver with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27766","name":"Optx medial ankle fx","description":"Open treatment of medial malleolus fracture, includes internal fixation, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":777.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1812","name":"Inj. insulin (fiasp)","description":"Insulin (fiasp), per 5 units","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9025","name":"Plasma cryo redu path each","description":"Plasma, cryoprecipitate reduced, pathogen reduced, each unit","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6613","name":"Onlay cst base mtl >=3 surfa","description":"Onlay - cast predominantly base metal three or more surfaces","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4384","name":"Axolotl dual ult per sq cm","description":"Axolotl dualgraft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1213","name":"No hx spiro prs spiro>=70%","description":"No history of spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) and present spirometry is >= 70%","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7252","name":"Part extract for implant","description":"Part extract for implant","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87153","name":"Dna/rna sequencing","description":"Culture, typing; identification by nucleic acid sequencing method, each isolate (eg, sequencing of the 16s rrna gene)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0321U","name":"Iadna gu pthgn 20bct&fng org","description":"Iadna gu pthgn 20bct&fng org","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3431","name":"Biological materials","description":"Biological materials","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0658","name":"Seg pneum comp 2 arm chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1343.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1421","name":"Dermatological care mvp","description":"Dermatological care mips value pathway","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33279","name":"Rmvl phrnc nrv stim transvns","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s) only","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0968T","name":"Insj/rplcmt epcrnl nstim sys","description":"Insertion or replacement of epicranial neurostimulator system, including electrode array and pulse generator, with connection to electrode array","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4005","name":"Family medicine ss","description":"Family medicine mips specialty set","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98007","name":"Synch audio-video est hi 40","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high medical decision making. when using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0986T","name":"Iv img icr cere vsl oct 1st","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4318","name":"Fem urinary cup w/wo attch","description":"Female external urinary collection cup, with or without ring attachment, per day","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4332","name":"Axolotl dualgraft, per sq cm","description":"Axolotl dualgraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1386","name":"Exc sx melmn or mlnm is","description":"Patients with an excisional surgery for melanoma or melanoma in situ in the past 5 years with an initial ajcc staging of 0, i, or ii at the start of the performance period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0804","name":"3d facial scan indirect","description":"3d facial scan indirect","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1411","name":"1st ln ici no chemo","description":"Currently on first-line immune checkpoint inhibitors without chemotherapy","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37286","name":"Revsc evasc tpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0738","name":"Hiv prep, inj, lenacapavir","description":"Injection, lenacapavir, 1 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9277","name":"Pembrolizumab 1mg berahyalur","description":"Injection, pembrolizumab, 1 mg and berahyaluronidase alfa-pmph","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99381","name":"Init pm e/m new pat infant","description":"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; infant (age youn","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":122.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0533U","name":"Rx metab advrs gnotyp 16gens","description":"Rx metab advrs gnotyp 16gens","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97550","name":"Caregiver traing 1st 30 min","description":"Caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patie","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1234","name":"Pt hcv rctv aby f/u neg","description":"Patient has a reactive hcv antibody test, and has a follow up hcv viral test that does not detect hcv viremia","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1426","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8522","name":"Capecitabine, oral, 50 mg","description":"Capecitabine, oral, 50 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5142","name":"Inj adalimumab-ryvk, 1 mg","description":"Injection, adalimumab-ryvk biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0330U","name":"Iadna vag pthgn panel 27 org","description":"Iadna vag pthgn panel 27 org","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1245","name":"Pt othr thn true person","description":"Patient provided a response other than completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9004","name":"Va whole health partner serv","description":"Department of veterans affairs whole health partner services","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5140","name":"Inj adalimumab-fkjp, 1 mg","description":"Injection, adalimumab-fkjp, biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87880","name":"Strep a assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; streptococcus, group a","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22838","name":"Rev rplc/rmv thrc vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracic vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0612U","name":"Onc lvr alys >1000 mr cfdna","description":"Onc lvr alys >1000 mr cfdna","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0250","name":"Adm tocilizu covid-19 2nd","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0737T","name":"Xenograft impltj artclr surf","description":"Xenograft implantation into the articular surface","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86780","name":"Treponema pallidum","description":"Antibody; treponema pallidum","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1170","name":"Pt w/o flu vax 7/1-6/30","description":"Patient did not receive an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0269U","name":"Hem aut dm cgen trmbctpna 14","description":"Hematology (autosomal dominant congenital thrombocytopenia), genomic sequence analysis of 14 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1202","name":"Miglustat oral 65 mg","description":"Miglustat, oral, 65 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1487","name":"Pt adm to hospice dur eval","description":"Patients in hospice in the year before or during the period of evaluation","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0927T","name":"Interrog dev eval ccm-d ip","description":"Interrogation device evaluation (in person) with analysis, review, and report, including connection, recording, and disconnection, per patient encounter, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4423","name":"Biolab tri wrap fl per sq cm","description":"Biolab tri-membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0532U","name":"Rare ds whlgen&mitochdrl dna","description":"Rare ds whlgen&mitochdrl dna","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21325","name":"Open tx nose fx uncomplicatd","description":"Open treatment of nasal fracture; uncomplicated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":585.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99387","name":"Init pm e/m new pat 65+ yrs","description":"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; 65 years and old","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":113.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4457","name":"Enema tube any type repl","description":"Enema tube, with or without adapter, any type, replacement only, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2598","name":"Inj, vasopressin, 1 unit","description":"Injection, vasopressin, 1 unit","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37294","name":"Rvsc evsc tpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4376","name":"Duograft aa per sq cm","description":"Duograft aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0973T","name":"Slctv nzmtc dbrdmt t/a/l 1st","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; first 100 sq cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0527","name":"Mgt est pt dmentia low cmplx","description":"Management of established patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46211","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0598U","name":"Gi ibs igg antb 18food items","description":"Gi ibs igg antb 18food items","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"Add upp ext mec limb vol lam","description":"Addition to upper extremity prosthesis, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4334","name":"Amnioplast 1, per sq cm","description":"Amnioplast 1, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4334","name":"Amnioplast 1, per sq cm","description":"Amnioplast 1, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0887T","name":"End-tidal ctrl inhaled anes","description":"End-tidal control of inhaled anesthetic agents and oxygen to assist anesthesia care delivery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0524","name":"Est pt-cg dyad dem low cmplx","description":"Management of established patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1280","name":"Bilat mast/hx bi /unilat mas","description":"Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0331U","name":"Onc hl neo opt gen mapping","description":"Onc hl neo opt gen mapping","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37283","name":"Rvsc evsc tpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61770","name":"Incise skull for treatment","description":"Stereotactic localization, including burr hole(s), with insertion of catheter(s) or probe(s) for placement of radiation source","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1685.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52443","name":"Cysto 1st trurl prst8 comis","description":"Cystourethroscopy with initial transurethral anterior prostate commissurotomy with a nondrug-coated balloon catheter followed by therapeutic drug delivery into the prostate by a drug-coated balloon catheter, including transrectal ultrasound and fluoroscopy, when performed","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64629","name":"Trml dstrj ios bvn ea addl","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; each additional vertebral body, lumbar or sacral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0018","name":"Crisis psychotherapy add 30m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); each additional 30 minutes (list separately in addition to code for primary service)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0206","name":"Inj allopurinol sodium 1 mg","description":"Injection, allopurinol sodium, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5992","name":"Low prosth foot shell repl","description":"All lower extremity prosthesis, foot shell for modular foot/non-solid ankle cushion heel (sach) replacement only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0801T","name":"Tcat rmv&rpl 2chmbr ldls pm","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; dual-cha","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4024","name":"Pediatrics ss","description":"Pediatrics mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37263","name":"Revsc evasc fpvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0856T","name":"Dgtz gls mcrscp electron mic","description":"Digitization of glass microscope slides for electron microscopy, diagnostic (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2544","name":"Dental onlay metl 4/more sur","description":"Onlay - metallic - four or more surfaces","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83987","name":"Exhaled breath condensate","description":"Ph; exhaled breath condensate","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0877","name":"Inj, daptomycin (hospira)","description":"Injection, daptomycin (hospira), not therapeutically equivalent to j0878, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1429","name":"Retinopathy in od, os, ou","description":"Retinal exam finding with evidence of retinopathy in left, right or both eyes with severity level documented","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0621U","name":"Nfct ds lb dna alys>10000","description":"Nfct ds lb dna alys>10000","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1191","name":"Hspc svc any time in meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6611","name":"Onlay cst hgh nbl mtl >=3srf","description":"Onlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87150","name":"Dna/rna amplified probe","description":"Culture, typing; identification by nucleic acid (dna or rna) probe, amplified probe technique, per culture or isolate, each organism probed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87469","name":"Babesia microti amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); babesia microti, amplified probe technique","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2800","name":"Methocarbamol injection","description":"Injection, methocarbamol, up to 10 ml","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1434","name":"Orl chemo wthn 30 d post enc","description":"Patient on oral chemotherapy on or within 30 days after denominator eligible encounter","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0566","name":"3d bn img algor drvd fr mri","description":"3d radiodensity-value bone imaging, algorithm derived, from previous magnetic resonance examination of the same anatomy","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0621U","name":"Nfct ds lb dna alys>10000","description":"Nfct ds lb dna alys>10000","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52443","name":"Cysto 1st trurl prst8 comis","description":"Cystourethroscopy with initial transurethral anterior prostate commissurotomy with a nondrug-coated balloon catheter followed by therapeutic drug delivery into the prostate by a drug-coated balloon catheter, including transrectal ultrasound and fluoroscopy, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0571U","name":"Onc sol tum dna80&rna10g ngs","description":"Onc sol tum dna80&rna10g ngs","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75961","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":792.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1195","name":"Rpt wo imp/con mmr/msi","description":"Surgical pathology reports that do not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both, reason not given","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0480U","name":"Nfct ds csf metag ngs alys","description":"Nfct ds csf metag ngs alys","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95957","name":"Eeg digital analysis","description":"Digital analysis of electroencephalogram (eeg) (eg, for epileptic spike analysis)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36478","name":"Endovenous laser 1st vein","description":"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, laser; first vein treated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1396","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36482","name":"Endoven ther chem adhes 1st","description":"Endovenous ablation therapy of incompetent vein, extremity, by transcatheter delivery of a chemical adhesive (eg, cyanoacrylate) remote from the access site, inclusive of all imaging guidance and monitoring, percutaneous; first vein treated","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":1811.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0754T","name":"Dgtz gls mcrscp sld level v","description":"Digitization of glass microscope slides for level v, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1416","name":"Pt rec hosp","description":"Patient received hospice services any time during the performance period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1921","name":"Inj labetalol hcl hikma, 5mg","description":"Injection, labetalol hydrochloride (hikma), not therapeutically equivalent to j1920, 5 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22836","name":"Ant thrc vrt body tethrg <7","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; up to 7 vertebral segments","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1272","name":"Pts kid transplt wtlst","description":"Patients observed on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0743T","name":"B1 str & fx rsk vrt fx assmt","description":"Bone strength and fracture risk using finite element analysis of functional data and bone mineral density (bmd), with concurrent vertebral fracture assessment, utilizing data from a computed tomography scan, retrieval and transmission of the scan data, measurement of bone strength and bmd and classi","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49595","name":"Rpr aa hrn 1st > 10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, reducible","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1228","name":"Pt + hcv aby +vir w/ rx 3 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, has hcv treatment initiated within 3 months of the reactive hcv antibody test","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64469","name":"Thrc fascial pln blk bi nfs","description":"Thoracic fascial plane block, bilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5941","name":"Resct proth mand part remov","description":"Resct proth mand part remov","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6604","name":"Cst bse mtl inlay 2 surfaces","description":"Inlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7413","name":"Excision malig lesion<=1.25c","description":"Excision of malignant lesion up to 1.25 cm","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0539","name":"Initial care training 30 m","description":"Caregiver training in behavior management/modification for caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face; initial 30 minutes","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0579U","name":"Nfro dbtc ckd elisa apoa4","description":"Nfro dbtc ckd elisa apoa4","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4389","name":"Neothelium 4l+ per sq cm","description":"Neothelium 4l+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4336","name":"Artecent c, per sq cm","description":"Artacent c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1369","name":"Qualcare mental hlth/sud mvp","description":"Quality care in mental health and substance use disorders mips value pathway","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1736","name":"Inj meloxicam (delova) 1mg","description":"Injection, meloxicam (delova), 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0623U","name":"Ai ms dna mthyl alys >5000","description":"Ai ms dna mthyl alys >5000","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69719","name":"Rplcm oi implt sk tc esp<100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4342","name":"Theramend, per sq cm","description":"Theramend, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21295","name":"Revision of jaw muscle/bone","description":"Reduction of masseter muscle and bone (eg, for treatment of benign masseteric hypertrophy); extraoral approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43497","name":"Transorl lwr esophgl myotomy","description":"Lower esophageal myotomy, transoral (ie, peroral endoscopic myotomy [poem])","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0372U","name":"Nfct ds gu pthgn arg detcj","description":"Nfct ds gu pthgn arg detcj","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16030","name":"Dress/debrid p-thick burn l","description":"Dressings and/or debridement of partial-thickness burns, initial or subsequent; large (eg, more than 1 extremity, or greater than 10% total body surface area)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":116.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0667","name":"Team remote e/m est pt 25 mn","description":"Team remote e/m est. pt 25mins","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0368","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91038","name":"Esoph imped funct test > 1hr","description":"Esophageal function test, gastroesophageal reflux test with nasal catheter intraluminal impedance electrode(s) placement, recording, analysis and interpretation; prolonged (greater than 1 hour, up to 24 hours)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4284","name":"Dermabind sl, per sq cm","description":"Dermabind sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4404","name":"Xwrap hydro plus per sq cm","description":"Xwrap hydro plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0936T","name":"Photobiomodulation ther rta","description":"Photobiomodulation therapy of retina, single session","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19366","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1625.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87077","name":"Culture aerobic identify","description":"Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81560","name":"Trnsplj pd lvr&bwl cd154+cll","description":"Transplantation medicine (allograft rejection, pediatric liver and small bowel), measurement of donor and third-party-induced cd154+t-cytotoxic memory cells, utilizing whole peripheral blood, algorithm reported as a rejection risk score","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1449","name":"Pt dx scz/pys bef end msr pd","description":"Patients with an active diagnosis of schizophrenia or psychotic disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90839","name":"Psytx crisis initial 60 min","description":"Psychotherapy for crisis; first 60 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":139.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4307","name":"American amnion, per sq cm","description":"American amnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30110","name":"Removal of nose polyp(s)","description":"Excision, nasal polyp(s), simple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4268","name":"Surgraft ft per sq cm","description":"Surgraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0472U","name":"Ca vi psp&sp1 antb sjogren","description":"Ca vi psp&sp1 antb sjogren","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64728","name":"Dcmprn median nrv carpl tunl","description":"Decompression; median nerve at the carpal tunnel, percutaneous, with intracarpal tunnel balloon dilation, including ultrasound guidance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1186","name":"Pt w/ rx for hspc/plltv care","description":"Patients who have an order for or are receiving hospice or palliative care","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9026","name":"Cryo fib comp path redu each","description":"Cryoprecipitated fibrinogen complex, pathogen reduced, each unit","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q0187","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1043.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86015","name":"Actin antibody each","description":"Actin (smooth muscle) antibody (asma), each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57109","name":"Vagnc bi total pel lymphadec","description":"Vaginectomy, partial removal of vaginal wall; with removal of paravaginal tissue (radical vaginectomy) with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1834.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1202","name":"Miglustat oral 65 mg","description":"Miglustat, oral, 65 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5783","name":"Add low ext mec limb vol lam","description":"Addition to lower extremity, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0776T","name":"Ther indctj ntrabrn hypthrm","description":"Therapeutic induction of intra-brain hypothermia, including placement of a mechanical temperature-controlled cooling device to the neck over carotids and head, including monitoring (eg, vital signs and sport concussion assessment tool 5 [scat5]), 30 minutes of treatment","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9244","name":"Office min sed drug enteral","description":"Office min sed drug enteral","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0017","name":"Crisis psychotherapy 60m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); first 60 minutes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4266","name":"Neostim per sq cm","description":"Neostim membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0047","name":"Ped blunt hd traum","description":"Pediatric patient with minor blunt head trauma and pecarn prediction criteria are not assessed","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9954","name":"Fab/del oral appliance thxpy","description":"Fab/del oral appliance thxpy","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1262","name":"Pts transplt bef dialysis","description":"Patients who had a transplant prior to initiation of dialysis","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0993T","name":"N-invas assmt car rsk w/ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat with concurrent computed tomography scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional (list s","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90484","name":"Imm cnsl not admn sm>20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 20 minutes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82233","name":"Beta-amyloid 1-40 (abeta 40)","description":"Beta-amyloid; 1-40 (abeta 40)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37264","name":"Revsc evasc fpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1480","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0593U","name":"Nfct ds gu pthgn dna 46trgt","description":"Nfct ds gu pthgn dna 46trgt","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47560","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81515","name":"Nfct ds bv&vaginitis dna alg","description":"Infectious disease, bacterial vaginosis and vaginitis, real-time pcr amplification of dna markers for atopobium vaginae, atopobium species, megasphaera type 1, and bacterial vaginosis associated bacteria-2 (bvab-2), utilizing vaginal-fluid specimens, algorithm reported as positive or negative for hi","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G3002","name":"Chronic pain mgmt 30 mins","description":"Chronic pain management and treatment, monthly bundle including, diagnosis; assessment and monitoring; administration of a validated pain rating scale or tool; the development, implementation, revision, and/or maintenance of a person-centered care plan that includes strengths, goals, clinical needs,","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1418","name":"Med rsn not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination because of a medical contraindication documented by clinician","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4439","name":"Instagraft per sq cm","description":"Instagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5147","name":"Inj, aflibercept-ayyh, 1 mg","description":"Injection, aflibercept-ayyh (pavblu), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1171","name":"Inj, hydromorphone, 0.1 mg","description":"Injection, hydromorphone, 0.1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9024","name":"Inj atezolizumb 5mg hya-tqjs","description":"Injection, atezolizumab, 5 mg and hyaluronidase-tqjs","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0995T","name":"Evasc dlvr a-wal stbl rx opn","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; open","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0321U","name":"Iadna gu pthgn 20bct&fng org","description":"Iadna gu pthgn 20bct&fng org","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76810","name":"Ob us >/= 14 wks addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0879","name":"Difelikefalin, esrd on dialy","description":"Injection, difelikefalin, 0.1 microgram, (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42826","name":"Removal of tonsils","description":"Tonsillectomy, primary or secondary; age 12 or over","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0519","name":"New pt-cg dyad dem low cmplx","description":"Management of new patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75665","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":728.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6594","name":"G comp bandge liner lwr extr","description":"Gradient compression bandaging supply, bandage liner, lower extremity, any size or length, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90382","name":"Rsv monoc antb seasn .7ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose, 0.7 ml, for intramuscular use","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0721T","name":"Quan ct tiss charac w/o ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2034","name":"Found drs solo, per sq cm","description":"Foundation drs solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87254","name":"Virus inoculation shell via","description":"Virus isolation; centrifuge enhanced (shell vial) technique, includes identification with immunofluorescence stain, each virus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1323","name":"Pts 7wk inj, scrn iop >25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop >25 mm hg and a plan of care was documented","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0766T","name":"Tc mag stimj pn 1st nerve","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; first nerve","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0355U","name":"Apol1 risk variants","description":"Apol1 risk variants","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62117","name":"Reduction of skull defect","description":"Reduction of craniomegalic skull (eg, treated hydrocephalus); requiring craniotomy and reconstruction with or without bone graft (includes obtaining grafts)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2107.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2029","name":"Mirotract matrix sheet","description":"Mirotract wound matrix sheet, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57283","name":"Colpopexy intraperitoneal","description":"Colpopexy, vaginal; intra-peritoneal approach (uterosacral, levator myorrhaphy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":788.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94011","name":"Spirometry up to 2 yrs old","description":"Measurement of spirometric forced expiratory flows in an infant or child through 2 years of age","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9506","name":"Tc-99m graphite crucible","description":"Graphite crucible for preparation of technetium tc 99m-labeled carbon aerosol, one crucible","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1194","name":"Med rsn no imp/con mmr/msi","description":"Documentation of medical reason(s) surgical pathology reports did not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both tests were not included (e.g., patient will not be treated with checkpoint inhibitor therap","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93898","name":"Ven-artl shunt det mbubb njx","description":"Venous-arterial shunt detection with intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1258","name":"Cvd risk assess perf","description":"Cvd risk assessment performed, have a documented calculated risk score","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0546","name":"Phone/internet ehr assess","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty   whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patien","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0620U","name":"Onc hcc dna mthyln alys>5000","description":"Onc hcc dna mthyln alys>5000","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5421","name":"Dentures adjust part maxill","description":"Adjust partial denture - maxillary","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76802","name":"Ob us < 14 wks addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4322","name":"Caregraft, per sq cm","description":"Caregraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0404U","name":"Onc brst semiq meas thym kn","description":"Onc brst semiq meas thym kn","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49495","name":"Rpr ing hernia baby reduc","description":"Repair, initial inguinal hernia, full term infant younger than age 6 months, or preterm infant older than 50 weeks postconception age and younger than age 6 months at the time of surgery, with or without hydrocelectomy; reducible","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":427.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1681","name":"Ho bilateral hip abduction","description":"Hip orthosis, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1347","name":"Pt pam incr 3 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 3 points in a 4 to 12 month period (passing)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0703","name":"2d oral/facial photo image","description":"2d oral/facial photo image","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27508","name":"Treatment of thigh fracture","description":"Closed treatment of femoral fracture, distal end, medial or lateral condyle, without manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5911","name":"Facial moulage sectional","description":"Facial moulage (sectional)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0760T","name":"Dgtz gls mcrscp sl imm 1st","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37281","name":"Revsc evsc tpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4289","name":"Revoshield+ amnio, per sq cm","description":"Revoshield + amniotic barrier, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75982","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87590","name":"N.gonorrhoeae dna dir prob","description":"Infectious agent detection by nucleic acid (dna or rna); neisseria gonorrhoeae, direct probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0052","name":"Mmip mental health and care","description":"Missing and murdered indigenous persons (mmip) mental health and clinical care","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4275","name":"Esano aca, per sq cm","description":"Esano aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53866","name":"Cathj rmvl dev ischmc rmdlg","description":"Catheterization with removal of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2596","name":"Vasopressin (long grove) 1 u","description":"Injection, vasopressin (long grove), not therapeutically equivalent to j2598, 1 unit","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":103.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1576","name":"Inj, panzyga, 500 mg","description":"Injection, immune globulin (panzyga), intravenous, non-lyophilized (e.g., liquid), 500 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36569","name":"Insj picc 5 yr+ w/o imaging","description":"Insertion of peripherally inserted central venous catheter (picc), without subcutaneous port or pump, without imaging guidance; age 5 years or older","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1437","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4305","name":"Amer am ac tri-lay per sq cm","description":"American amnion ac tri-layer, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0959T","name":"Rmv/rplc magnet coil assem","description":"Removal or replacement of magnet from coil assembly that is connected to continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3472","name":"Surg rep root res premolar","description":"Surg rep root res premolar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1309","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2781","name":"Crown 3/4 cast base metal","description":"Crown - 3/4 cast predominantly base metal","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0799","name":"Hiv prep, fda approved, noc","description":"Fda approved prescription drug, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv), not otherwise classified","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11901","name":"Inject skin lesions >7","description":"Injection, intralesional; more than 7 lesions","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2017","name":"Permeaderm glove, each","description":"Permeaderm glove, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0137","name":"Inj, acetaminophen (hikma)","description":"Injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0868T","name":"Hi-res gastric ep mapping","description":"High-resolution gastric electrophysiology mapping with simultaneous patient-symptom profiling, with interpretation and report","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0630U","name":"Onc brst mrna gen prflg 80","description":"Onc brst mrna gen prflg 80","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0469U","name":"Rare ds whl gen seq ftl samp","description":"Rare ds whl gen seq ftl samp","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0461U","name":"Onc rxgenom alys rtpcr 24gen","description":"Onc rxgenom alys rtpcr 24gen","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2272","name":"Inj, morphine (fresenius)","description":"Injection, morphine sulfate (fresenius kabi), not therapeutically equivalent to j2270, up to 10 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63048","name":"Lam facetec &foramot ea addl","description":"Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; each additional vertebral segment, cervical, thoracic, or lumbar (list separately in addition t","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9324","name":"Inj, pemrydi rtu, 10 mg","description":"Injection, pemetrexed (pemrydi rtu), 10 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0680T","name":"Insj/rplcmt pg only isdss","description":"Insertion or replacement of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing lead(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0818T","name":"Revj/rmvl ins ptn subq","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0871T","name":"Rplcmt subq prtl ascites pmp","description":"Replacement of a subcutaneous peritoneal ascites pump, including reconnection between pump and indwelling bladder and peritoneal catheters, including initial programming and imaging, when performed","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0736","name":"Inj, clindamycin phosp 300mg","description":"Injection, clindamycin phosphate, 300 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27006","name":"Tenotomy abductor&/xtnsr hip","description":"Tenotomy, abductors and/or extensor(s) of hip, open (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":884.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1420","name":"Complete ophthalmologic mvp","description":"Complete ophthalmologic care mips value pathway","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0179","name":"Md recertification hha pt","description":"Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initi","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90593","name":"Chikungunya vacc recomb im","description":"Chikungunya virus vaccine, recombinant, for intramuscular use","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1359","name":"Indx suicd idea, no 0 scr","description":"Index assessment during the denominator period when the suicidal ideation and/or behavior symptoms or increased suicide risk by clinician determination occurs and a non-zero c-ssrs score is obtained","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87478","name":"Borrelia miyamotoi amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); borrelia miyamotoi, amplified probe technique","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0569U","name":"Onc sol tum ngs tmm>20000dmr","description":"Onc sol tum ngs tmm>20000dmr","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0878T","name":"Augmnt alys ch ct ild w/ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained with concurrent ct examination of the same structure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86793","name":"Yersinia antibody","description":"Antibody; yersinia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6517","name":"Grad com wrap w strap bn cus","description":"Gradient compression wrap with adjustable straps, below knee, each, custom","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0531U","name":"Nfct ds afb&inv fng 673orgs","description":"Nfct ds afb&inv fng 673orgs","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12054","name":"Intmd rpr face/mm 7.6-12.5cm","description":"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 7.6 cm to 12.5 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78491","name":"Myocrd img pet 1std rst/strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); single study, at rest or stress (exercise or pharmacologic)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0994T","name":"Evasc dlvr a-wal stbl rx prq","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; percutaneous","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42326","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1394","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99427","name":"Prin care mgmt staff ea addl","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53621","name":"Dilate urethra stricture","description":"Dilation of urethral stricture by passage of filiform and follower, male; subsequent","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3394","name":"Inj, lovotibeglogene autotem","description":"Injection, lovotibeglogene autotemcel, per treatment","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0951T","name":"Tot impl amei 1st plmt","description":"Totally implantable active middle ear hearing implant; initial placement, including mastoidectomy, placement of and attachment to sound processor","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71045","name":"X-ray exam chest 1 view","description":"Radiologic examination, chest; single view","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9563","name":"Ht inj immuno diem","description":"Home injectable therapy, immunotherapy, 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":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45541","name":"Correct rectal prolapse","description":"Proctopexy (eg, for prolapse); perineal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37285","name":"Revsc evasc tpvt st sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q4080","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43886","name":"Gstr rstcv px opn revj port","description":"Gastric restrictive procedure, open; revision of subcutaneous port component only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9986","name":"Missed appointment","description":"Missed appointment","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37277","name":"Rvsc evsc fpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9322","name":"Inj pemetrexed (bluepoint)","description":"Injection, pemetrexed (bluepoint), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0682T","name":"Removal pulse gen only isdss","description":"Removal of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1203","name":"No rsn ace-i/arb rx","description":"Ace inhibitor or arb therapy not prescribed during the measurement period, reason not given","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0553U","name":"Repr med pga embry te strux","description":"Repr med pga embry te strux","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0009","name":"Admin pneumococcal vaccine","description":"Administration of pneumococcal vaccine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62330","name":"Dcmprn prq rmv lig flv 1lmbr","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; one interspace, lumbar","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1245","name":"Pt othr thn true person","description":"Patient provided a response other than completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38573","name":"Laps pelvic lymphadec","description":"Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy and peri-aortic lymph node sampling, peritoneal washings, peritoneal biopsy(ies), omentectomy, and diaphragmatic washings, including diaphragmatic and other serosal biopsy(ies), when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1024.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81558","name":"Trnspl rej kdn mrna qpcr 139","description":"Transplantation medicine (allograft rejection, kidney), mrna, gene expression profiling by quantitative polymerase chain reaction (qpcr) of 139 genes, utilizing whole blood, algorithm reported as a binary categorization as transplant excellence, which indicates immune quiescence, or not transplant e","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74150","name":"Ct abdomen w/o contrast","description":"Computed tomography, abdomen; without contrast material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4348","name":"Sentry sl matrix per sq cm","description":"Sentry sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0774T","name":"Vr px dissoc svc oth phy ea","description":"Virtual reality (vr) procedural dissociation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports; each additiona","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0292U","name":"Psyc strs do mrna 72 genes","description":"Psyc strs do mrna 72 genes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24320","name":"Tenoplasty elbow to sho 1","description":"Tenoplasty, with muscle transfer, with or without free graft, elbow to shoulder, single (seddon-brookes type procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99292","name":"Critical care addl 30 min","description":"Critical care, evaluation and management of the critically ill or critically injured patient; each additional 30 minutes (list separately in addition to code for primary service)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":97.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4314","name":"Reeva, per sq cm","description":"Reeva ft, per square cenitmeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0372U","name":"Nfct ds gu pthgn arg detcj","description":"Nfct ds gu pthgn arg detcj","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44381","name":"Small bowel endoscopy br/wa","description":"Ileoscopy, through stoma; with transendoscopic balloon dilation","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":1014.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1276","name":"Calc bmi out nrm param nof/u","description":"Bmi documented outside normal parameters, no follow-up plan documented, no reason given","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9038","name":"Inj axatilimab-csfr 0.1 mg","description":"Injection, axatilimab-csfr, 0.1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0795T","name":"Tcat ins 2chmbr ldls pm cmpl","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; complete system (ie, r","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4432","name":"510(k) skin subs, nos","description":"510(k) skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1015T","name":"Rev/rmv lw esoph sphnc npg/r","description":"Revision or removal, lower esophageal sphincter neurostimulator pulse generator or receiver","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3404","name":"Inj zopapogene per ther dose","description":"Injection, zopapogene imadenovec-drba suspension, per therapeutic dose","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0729T","name":"Dx alys vstblr implt uni sbq","description":"Diagnostic analysis of vestibular implant, unilateral; with subsequent programming","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44381","name":"Small bowel endoscopy br/wa","description":"Ileoscopy, through stoma; with transendoscopic balloon dilation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1267.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":90.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45395","name":"Lap removal of rectum","description":"Laparoscopy, surgical; proctectomy, complete, combined abdominoperineal, with colostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2125.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"Motor &/ sens nrve cndj test","description":"Motor and/or sensory nerve conduction, using preconfigured electrode array(s), amplitude and latency/velocity study, each limb, includes f-wave study when performed, with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33976","name":"Implant ventricular device","description":"Insertion of ventricular assist device; extracorporeal, biventricular","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1501.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75898","name":"Follow-up angiography","description":"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4270","name":"Complete sl per sq cm","description":"Complete sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0773T","name":"Vr px dissoc svc oth phy 1st","description":"Virtual reality (vr) procedural dissociation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports; initial 15 min","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3431","name":"Biological materials","description":"Biological materials","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9936","name":"Clean occ guard","description":"Clean occ guard","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29220","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1482","name":"Pos quan hep c or qual rna","description":"Positive/detectable hepatitis c virus quantitative or qualitative rna test result during the denominator identification period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4309","name":"Via matrix, per sq cm","description":"Via matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28546","name":"Treat foot dislocation","description":"Percutaneous skeletal fixation of tarsal bone dislocation, other than talotarsal, with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":373.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35682","name":"Composite byp grft 2 veins","description":"Bypass graft; autogenous composite, 2 segments of veins from 2 locations (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9957","name":"Inj perflutren lip micros,ml","description":"Injection, perflutren lipid microspheres, per ml","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81517","name":"Liver ds alys 3 bmrk srm alg","description":"Liver disease, analysis of 3 biomarkers (hyaluronic acid [ha], procollagen iii amino terminal peptide [piiinp], tissue inhibitor of metalloproteinase 1 [timp-1]), using immunoassays, utilizing serum, prognostic algorithm reported as a risk score and risk of liver fibrosis and liver-related clinical ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2544","name":"Dental onlay metl 4/more sur","description":"Onlay - metallic - four or more surfaces","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98929","name":"Osteopath manj 9-10 regions","description":"Osteopathic manipulative treatment (omt); 9-10 body regions involved","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":96.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85415","name":"Fibrinolytic plasminogen","description":"Fibrinolytic factors and inhibitors; plasminogen activator","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36406","name":"Vnpnxr<3yrs phy/qhp other vn","description":"Venipuncture, younger than age 3 years, necessitating the skill of a physician or other qualified health care professional, not to be used for routine venipuncture; other vein","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":21.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0259U","name":"Neph ckd nuc mrs meas gfr","description":"Nephrology (chronic kidney disease), nuclear magnetic resonance spectroscopy measurement of myo-inositol, valine, and creatinine, algorithmically combined with cystatin c (by immunoassay) and demographic data to determine estimated glomerular filtration rate (gfr), serum, quantitative","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9183","name":"Gemcitabine intravesical sys","description":"Gemcitabine intravesical system, 225 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86305","name":"Human epididymis protein 4","description":"Human epididymis protein 4 (he4)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0808T","name":"Pulm tiss vntj alys w/ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with computed tomography (ct) images taken for the purpose of pulmonary tissue ventilation analysis, including data preparation and transmission, quantificati","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9319","name":"Inj romidepsin lyophil 0.1mg","description":"Injection, romidepsin, lyophilized, 0.1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87523","name":"Hepatitis d quantification","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis d (delta), quantification, including reverse transcription, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0546U","name":"Ldns lrp4 antb imflr livecll","description":"Ldns lrp4 antb imflr livecll","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6196","name":"Remv of ind rest on implt","description":"Remv of ind rest on implt","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1482","name":"Pos quan hep c or qual rna","description":"Positive/detectable hepatitis c virus quantitative or qualitative rna test result during the denominator identification period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0280U","name":"Hem vw factor&clgn iv bndg","description":"Hematology (von willebrand disease [vwd]), von willebrand factor (vwf) and collagen iv binding by enzyme-linked immunosorbent assays (elisa), plasma, report of collagen iv binding","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37267","name":"Revsc evsc fpvt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5611","name":"Rep resin part dent base man","description":"Rep resin part dent base man","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9938","name":"Fab removable appliance","description":"Fab removable appliance","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0893T","name":"N-invas assmt bld oxygnation","description":"Noninvasive assessment of blood oxygenation, gas exchange efficiency, and cardiorespiratory status, with physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46607","name":"Diagnostic anoscopy & biopsy","description":"Anoscopy; with high-resolution magnification (hra) (eg, colposcope, operating microscope) and chemical agent enhancement, with biopsy, single or multiple","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":121.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0525U","name":"Onc sphrd cell cul 11-rx pnl","description":"Onc sphrd cell cul 11-rx pnl","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-06-05","zip":"10985","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6106","name":"Tissue regen resorbable","description":"Tissue regen resorbable","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5124","name":"Inj. byooviz, 0.1 mg","description":"Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0165","name":"Inj epinephrine nos 0.1 mg","description":"Injection, epinephrine, not otherwise specified, 0.1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4281","name":"Barrera slor dl per sq cm","description":"Barrera sl or barrera dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21557","name":"Resect neck thorax tumor<5cm","description":"Radical resection of tumor (eg, sarcoma), soft tissue of neck or anterior thorax; less than 5 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":686.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9993","name":"Pall serv during meas","description":"Patient was provided palliative care services any time during the measurement period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95972","name":"Alys cplx sp/pn npgt w/prgrm","description":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg, contact group[s], interleaving, amplitude, pulse width, frequency [hz], on/off cycling, burst, magnet mode, dose lockout, patient selectable parameters, responsive neurostimulation, detection algorithms, closed loop pa","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0568U","name":"Neurol dementia bamyl ptau","description":"Neurol dementia bamyl ptau","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78492","name":"Myocrd img pet mlt rst&strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); multiple studies at rest and stress (exercise or pharmacologic)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1145.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1224","name":"Iop dec <20% from base","description":"Intraocular pressure (iop) reduced by a value less than 20% from the pre-intervention level","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1416","name":"Pt rec hosp","description":"Patient received hospice services any time during the performance period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2401","name":"Chloroprocaine hcl injection","description":"Injection, chloroprocaine hydrochloride, per 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1470","name":"Hep b vac not recd med rsn","description":"Documentation of medical reason(s) for not administering hepatitis b vaccine (e.g., prior anaphylaxis due to the hepatitis b vaccine)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83907","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32851","name":"Lung transplant single","description":"Lung transplant, single; without cardiopulmonary bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3238.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0376U","name":"Onc prst8 ca img alys 128","description":"Onc prst8 ca img alys 128","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0039","name":"Pt no ref, rn spec","description":"Patient not referred, reason not otherwise specified","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0012","name":"Injection of hiv prep drug","description":"Injection of pre-exposure prophylaxis (prep) drug for hiv prevention, under skin or into muscle","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62302","name":"Myelography lumbar injection","description":"Myelography via lumbar injection, including radiological supervision and interpretation; cervical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85651","name":"Rbc sed rate nonautomated","description":"Sedimentation rate, erythrocyte; non-automated","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6212","name":"Bridge noble metal cast","description":"Pontic-cast noble metal","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2356","name":"Inj tezepelumab-ekko, 1mg","description":"Injection, tezepelumab-ekko, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4225","name":"Amnio or derma tl, per sq cm","description":"Amniobind or dermabind tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55881","name":"Ablt trurl prst8 tis thrm us","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation;","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29305","name":"Appl hip spica cast 1 leg","description":"Application of hip spica cast; 1 leg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37296","name":"Revsc evasc imvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4346","name":"Shelter dm matrix per sq cm","description":"Shelter dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0650","name":"Lso sc r ant/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, inclu","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1105.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2058","name":"Obecbtge autol up to 400 mil","description":"Obecabtagene autoleucel, 10 up to 400 million cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per infusion","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0819T","name":"Revj/rmvl ins ptn subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76965","name":"Echo guidance radiotherapy","description":"Ultrasonic guidance for interstitial radioelement application","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":366.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"14350","name":"Filleted finger/toe flap","description":"Filleted finger or toe flap, including preparation of recipient site","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":817.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99239","name":"Hosp ip/obs dschrg mgmt >30","description":"Hospital inpatient or observation discharge day management; more than 30 minutes on the date of the encounter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":121.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80430","name":"Growth hormone panel","description":"Growth hormone suppression panel (glucose administration) this panel must include the following: glucose (82947 x 3) human growth hormone (hgh) (83003 x 4)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4407","name":"Xwrap tribus per sq cm","description":"Xwrap tribus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1172","name":"Doc med rsn no td/tdap","description":"Documentation of medical reason(s) for not administering td or tdap vaccine (e.g., prior anaphylaxis due to the td or tdap vaccine or history of encephalopathy within seven days after a previous dose of a td-containing vaccine)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92641","name":"Hearing dev verif eacous aly","description":"Hearing device verification, electroacoustic analysis","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9064","name":"Inj, cabazitaxel (sandoz)","description":"Injection, cabazitaxel (sandoz), not therapeutically equivalent to j9043, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1921","name":"Inj labetalol hcl hikma, 5mg","description":"Injection, labetalol hydrochloride (hikma), not therapeutically equivalent to j1920, 5 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1336","name":"Pts eval ini xm 2 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 2 weeks","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2021","name":"Neomatrix per sq cm","description":"Neomatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87484","name":"Ehrlicha chaffeensis amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); ehrlichia chaffeensis, amplified probe technique","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96041","name":"Genetic counseling svc ea 30","description":"Medical genetics and genetic counseling services, each 30 minutes of total time provided by the genetic counselor on the date of the encounter","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0759","name":"Inj, clevidipine, 1 mg","description":"Injection, clevidipine butyrate, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28043","name":"Exc foot/toe tum sc < 1.5 cm","description":"Excision, tumor, soft tissue of foot or toe, subcutaneous; less than 1.5 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0766T","name":"Tc mag stimj pn 1st nerve","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; first nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1236","name":"Baseline mrs > 2","description":"Baseline mrs > 2","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4324","name":"Amniotx, per sq cm","description":"Amniotx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"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":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65125","name":"Revise ocular implant","description":"Modification of ocular implant with placement or replacement of pegs (eg, drilling receptacle for prosthesis appendage) (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":310.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70548","name":"Mr angiography neck w/dye","description":"Magnetic resonance angiography, neck; with contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":647.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5909","name":"Max guid prothes w/ flange","description":"Max guid prothes w/ flange","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0439U","name":"Crd chd dna alys 5 snp 3 dna","description":"Crd chd dna alys 5 snp 3 dna","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4389","name":"Neothelium 4l+ per sq cm","description":"Neothelium 4l+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1255","name":"Pts w/ othr rsn vst,+prg tst","description":"Patients who have another reason for visiting the clinic [not prenatal or postpartum care] and have a positive pregnancy test but have not established the clinic as an ob provider (e.g., plan to terminate the pregnancy or seek prenatal services elsewhere)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24587","name":"Optx partclr fx&/dslc elbw w","description":"Open treatment of periarticular fracture and/or dislocation of the elbow (fracture distal humerus and proximal ulna and/or proximal radius); with implant arthroplasty","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1306.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86382","name":"Neutralization test viral","description":"Neutralization test, viral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5141","name":"Inj adalimumab-aaty, 1 mg","description":"Injection, adalimumab-aaty, biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63078","name":"Spine disk surgery thorax","description":"Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; thoracic, each additional interspace (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69726","name":"Rmv ntr oi implt skl prq esp","description":"Removal, entire osseointegrated implant, skull; with percutaneous attachment to external speech processor","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0972T","name":"Asstv alg clsfctn burn hlg","description":"Assistive algorithmic classification of burn healing (ie, healing or nonhealing) by noninvasive multispectral imaging, including system set-up and acquisition, selection, and transmission of images, with automated generation of report","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37264","name":"Revsc evasc fpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77089","name":"Tbs dxa cal w/i&r fx risk","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; using dual x-ray absorptiometry (dxa) or other imaging data on gray-scale variogram, calculation, with interpretation and report on fracture-risk","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9601","name":"Inj linvoseltamab-gcpt 1 mg","description":"Injection, linvoseltamab-gcpt, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0333U","name":"Onc lvr surveilanc hcc cfdna","description":"Onc lvr surveilanc hcc cfdna","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58270","name":"Vag hyst w/enterocele repair","description":"Vaginal hysterectomy, for uterus 250 g or less; with repair of enterocele","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1025.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0602","name":"Sevelamer carbonate pdr 20mg","description":"Sevelamer carbonate (renvela or therapeutically equivalent), oral, powder, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84600","name":"Assay of volatiles","description":"Volatiles (eg, acetic anhydride, diethylether)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78492","name":"Myocrd img pet mlt rst&strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); multiple studies at rest and stress (exercise or pharmacologic)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45005","name":"Drainage of rectal abscess","description":"Incision and drainage of submucosal abscess, rectum","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93025","name":"Microvolt t-wave assess","description":"Microvolt t-wave alternans for assessment of ventricular arrhythmias","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4321","name":"Renograft, per sq cm","description":"Renograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76880","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64583","name":"Rev/rplct hpglsl nstm ary pg","description":"Revision or replacement of hypoglossal nerve neurostimulator array and distal respiratory sensor electrode or electrode array, including connection to existing pulse generator","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0801","name":"3d dental scan direct","description":"3d dental scan direct","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0011","name":"Hiv prep counsel, md 15-30m","description":"Individual counseling for pre-exposure prophylaxis (prep) by physician or qualified health care professional (qhp) to prevent human immunodeficiency virus (hiv), includes hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence, 15-30 minutes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6191","name":"Semi precision abutment","description":"Semi precision abutment","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0330U","name":"Iadna vag pthgn panel 27 org","description":"Iadna vag pthgn panel 27 org","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0549","name":"Phone/inter for treat>31m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0837T","name":"Dgtz gls mcrscp fna i&r","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; interpretation and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92562","name":"Loudness balance test","description":"Loudness balance test, alternate binaural or monaural","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76988","name":"Dx ntrop epcr us chd img acq","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; placement, manipulation of transducer, and image acquisition only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4427","name":"Dermbnd dln dl+ dlx sq cm","description":"Dermabind dl n or dermabind dl + or dermabind dl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73718","name":"Mri lower extremity w/o dye","description":"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":643.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53453","name":"Tprnl balo cntnc dev rmvl ea","description":"Periurethral transperineal adjustable balloon continence device; removal, each balloon","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4406","name":"Xwrap fenestra per sq cm","description":"Xwrap fenestra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2390","name":"Ant resin-based cmpst crown","description":"Resin-based composite crown anterior","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95115","name":"Immunotherapy one injection","description":"Professional services for allergen immunotherapy not including provision of allergenic extracts; single injection","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1307","name":"Inj, crovalimab-akkz, 10 mg","description":"Injection, crovalimab-akkz, 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4038","name":"Vascular surgery ss","description":"Vascular surgery mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53453","name":"Tprnl balo cntnc dev rmvl ea","description":"Periurethral transperineal adjustable balloon continence device; removal, each balloon","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3401","name":"Vyjuvek 5x10^9pfu/ml, 0.1 ml","description":"Beremagene geperpavec-svdt for topical administration, containing nominal 5 x 10^9 pfu/ml vector genomes, per 0.1 ml","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27598","name":"Amputate lower leg at knee","description":"Disarticulation at knee","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":867.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0139","name":"Inj, adalimumab, 1 mg","description":"Injection, adalimumab, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0444","name":"Depression screen annual","description":"Annual depression screening, 5 to 15 minutes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":17.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27356","name":"Remove femur lesion/graft","description":"Excision or curettage of bone cyst or benign tumor of femur; with allograft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":865.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86042","name":"Acetylcholn rcptr blckg antb","description":"Acetylcholine receptor (achr); blocking antibody","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0351U","name":"Nfct ds bct/viral trail ip10","description":"Nfct ds bct/viral trail ip10","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17250","name":"Chem caut of granltj tissue","description":"Chemical cauterization of granulation tissue (ie, proud flesh)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":104.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0680","name":"Cr art clc art vlv clc w rpt","description":"Detection and quantification of coronary artery calcium and/or aortic valve calcification from algorithmic analysis of computed tomography of the chest with report","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0216","name":"Inj, alfentanil hcl, 500mcg","description":"Injection, alfentanil hydrochloride, 500 micrograms","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0603U","name":"Rx asy prsmv 77rx/metablt ur","description":"Rx asy prsmv 77rx/metablt ur","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0834T","name":"Dgtz gls mcrscp cytp oth xtn","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0305U","name":"Hem rbc fnclty&dfrm shr strs","description":"Hem rbc fnclty&dfrm shr strs","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9345","name":"Inj, retifanlimab-dlwr, 1 mg","description":"Injection, retifanlimab-dlwr, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33900","name":"Perq p-art revsc 1 nm nt uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, unilateral","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2919","name":"Inj, methylpred sod succ 5mg","description":"Injection, methylprednisolone sodium succinate, 5 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4318","name":"Fem urinary cup w/wo attch","description":"Female external urinary collection cup, with or without ring attachment, per day","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80506","name":"Path clin consltj prolng svc","description":"Pathology clinical consultation; prolonged service, each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23680","name":"Optx sho dislc neck fx fixj","description":"Open treatment of shoulder dislocation, with surgical or anatomical neck fracture, includes internal fixation, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":907.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0741T","name":"Rem auton alg nsln data coll","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; provision of software, data collection, transmission, and storage, each 30 days","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4313","name":"Dermabind fm, per sq cm","description":"Dermabind fm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2003","name":"Inj, lidocaine hcl, 1 mg","description":"Injection, lidocaine hydrochloride, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69405","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4360","name":"Amchoplast fd per sq cm","description":"Amchoplast fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81523","name":"Onc brst mrna 70 cnt 31 gene","description":"Oncology (breast), mrna, next-generation sequencing gene expression profiling of 70 content genes and 31 housekeeping genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as index related to risk to distant metastasis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0216","name":"Inj, alfentanil hcl, 500mcg","description":"Injection, alfentanil hydrochloride, 500 micrograms","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9697","name":"Inj, magtrace per study dose","description":"Injection, carboxydextran-coated superparamagnetic iron oxide, per study dose","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78740","name":"Ureteral reflux study","description":"Ureteral reflux study (radiopharmaceutical voiding cystogram)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1020T","name":"Raman spectroscopy 1+skn les","description":"Raman spectroscopy of 1 or more skin lesions, with probability score for malignant risk derived by algorithmic analysis of data from each lesion","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99282","name":"Emergency dept visit sf mdm","description":"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward medical decision making","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0578U","name":"Onc cutan mln rna qpcr 10gen","description":"Onc cutan mln rna qpcr 10gen","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9603","name":"Inj, pafolacianine, 0.1 mg","description":"Injection, pafolacianine, 0.1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3247","name":"Inj secukinumab intrav 1mg","description":"Injection, secukinumab, intravenous, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91323","name":"Sarscov2 vac 10 mcg/0.2ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 10 mcg/0.2 ml dosage, for intramuscular use","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37292","name":"Rvsc evsc tpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37262","name":"Iv lithotrp ivt w/in sm art","description":"Intravascular lithotripsy(ies), iliac vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":73.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0585U","name":"Tgsap so neo cfdna 521 genes","description":"Tgsap so neo cfdna 521 genes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82271","name":"Occult blood other sources","description":"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; other sources","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81463","name":"So gsap cl fr cpy nmbr&mcrst","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis, copy number variants, and microsatellite instability","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76016","name":"Mr safety deter phys/qhp","description":"Mr safety determination by a physician or other qualified health care professional responsible for the safety of the mr procedure, including review of implant mr conditions for indicated mr examination, analysis of risk vs clinical benefit of performing mr examination, and determination of mr equipm","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99437","name":"Chrnc care mgmt phys ea addl","description":"Chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, or funct","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80502","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33222","name":"Relocation pocket pacemaker","description":"Relocation of skin pocket for pacemaker","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":433.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1282","name":"Pt scrn tbco id as non user","description":"Patient screened for tobacco use and identified as a tobacco non-user","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0517U","name":"Ther rx mntr 80+ psyactiv rx","description":"Ther rx mntr 80+ psyactiv rx","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5909","name":"Max guid prothes w/ flange","description":"Max guid prothes w/ flange","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0942T","name":"Cysto flx rmv&rplc urtl scaf","description":"Cystourethroscopy, flexible; with removal and replacement of prostatic urethral scaffold","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1303","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0331U","name":"Onc hl neo opt gen mapping","description":"Onc hl neo opt gen mapping","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0774T","name":"Vr px dissoc svc oth phy ea","description":"Virtual reality (vr) procedural dissociation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports; each additiona","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0834T","name":"Dgtz gls mcrscp cytp oth xtn","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80190","name":"Assay of procainamide","description":"Procainamide;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87088","name":"Urine bacteria culture","description":"Culture, bacterial; with isolation and presumptive identification of each isolate, urine","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37267","name":"Revsc evsc fpvt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9052","name":"Inj, carmustine (accord)","description":"Injection, carmustine (accord), not therapeutically equivalent to j9050, 100 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0524","name":"Est pt-cg dyad dem low cmplx","description":"Management of established patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4012","name":"Interventional rad ss","description":"Interventional radiology mips specialty set","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1283","name":"Pt scrn tbco and id as user","description":"Patient screened for tobacco use and identified as a tobacco user","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1598","name":"Inj glycopyrrolate fres kabi","description":"Injection, glycopyrrolate (fresenius kabi), not therapeutically equivalent to j1596, 0.1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4303","name":"Complete aa, per sq cm","description":"Complete aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1195","name":"Rpt wo imp/con mmr/msi","description":"Surgical pathology reports that do not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both, reason not given","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73040","name":"Contrast x-ray of shoulder","description":"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71015","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1837","name":"Inj, posaconazole, 1 mg","description":"Injection, posaconazole, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5125","name":"Inj, releuko 1 mcg","description":"Injection, filgrastim-ayow, biosimilar, (releuko), 1 microgram","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0518","name":"Remove w insert drug implant","description":"Removal with reinsertion, non-biodegradable drug delivery implants, 4 or more (services for subdermal implants)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":361.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0975T","name":"Slctv nzmtc dbrdmt s/n/hf 1","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; first 100 sq cm","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1375","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56625","name":"Vulvectomy simple complete","description":"Vulvectomy simple; complete","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":659.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0134","name":"Inj acetaminophen -fresenius","description":"Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0522","name":"Mgt nw pt dementia low cmplx","description":"Management of a new patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0609U","name":"Onc prostate ia tot&free psa","description":"Onc prostate ia tot&free psa","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4328","name":"Most, per sq cm","description":"Most, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0590U","name":"Nfct ds bct&fngl dna 44 orgs","description":"Nfct ds bct&fngl dna 44 orgs","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55869","name":"Lap srg prst8ct bi pl lmphad","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4326","name":"Woundplus, per sq cm","description":"Woundplus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0030","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0859T","name":"Ncntc ifr spctrsc o/t pad ea","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), other than for screening for peripheral arterial disease, image acquisition, interpretation, and report; each additional anatomic site (list separately in addition to code ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10030","name":"Img gid flu coll drg sft tis","description":"Image-guided fluid collection drainage by catheter (eg, abscess, hematoma, seroma, lymphocele, cyst), soft tissue (eg, extremity, abdominal wall, neck), percutaneous","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":863.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82270","name":"Occult blood feces","description":"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (ie, patient was provided 3 cards or single triple card for consecutive collection)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0414","name":"Lab process microbial spec","description":"Lab process microbial spec","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1366","name":"Focus on womens health mvp","description":"Focusing on womens health mips value pathway","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1501","name":"Pathology mvp","description":"Pathology mips value pathway","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4335","name":"Amnioplast 2, per sq cm","description":"Amnioplast 2, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5878","name":"Dup of complt dent-mandib","description":"Dup of complt dent-mandib","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84484","name":"Assay of troponin quant","description":"Troponin, quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62258","name":"Replace brain cavity shunt","description":"Removal of complete cerebrospinal fluid shunt system; with replacement by similar or other shunt at same operation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1242.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4100","name":"Nosht skin sub fda clrd nos","description":"Non-sheet form skin substitute, fda cleared as a device, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2055","name":"Idecabtagene vicleucel car","description":"Idecabtagene vicleucel, up to 510 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1252","name":"Pts no cmplt hu survey","description":"Patients who did not complete at least one of the four patient experience hu survey items and return the hu survey within 60 days of the ambulatory palliative care visit","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0703","name":"Inj, cefepime hcl (b braun)","description":"Injection, cefepime hydrochloride (b braun), not therapeutically equivalent to maxipime, 500 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0705","name":"Extra oral post radio image","description":"Extra oral post radio image","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1355","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4028","name":"Podiatry ss","description":"Podiatry mips specialty set","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1007T","name":"Eeg impl s-sclp eeg w/o vid","description":"Electroencephalogram from implanted sub-scalp continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53454","name":"Tprnl balo cntnc dev adjmt","description":"Periurethral transperineal adjustable balloon continence device; percutaneous adjustment of balloon(s) fluid volume","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1355","name":"Caries med app per tooth","description":"Caries med app per tooth","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0512U","name":"Onc prst8 alys dgtz img msi","description":"Onc prst8 alys dgtz img msi","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0303U","name":"Hem rbc ads whl bld hypoxic","description":"Hem rbc ads whl bld hypoxic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0578U","name":"Onc cutan mln rna qpcr 10gen","description":"Onc cutan mln rna qpcr 10gen","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30117","name":"Removal of intranasal lesion","description":"Excision or destruction (eg, laser), intranasal lesion; internal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":366.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92137","name":"Cptrz oph img pst sg rta oct","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), posterior segment, with interpretation and report, unilateral or bilateral; retina, including oct angiography","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0472","name":"Gross exam prep & report","description":"Accession of tissue gross examination preparation and transmission of written report","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87626","name":"Hpv sep hi-rsk typ&pool rslt","description":"Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), separately reported high-risk types (eg, 16, 18, 31, 45, 51, 52) and high-risk pooled result(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0172A","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52443","name":"Cysto 1st trurl prst8 comis","description":"Cystourethroscopy with initial transurethral anterior prostate commissurotomy with a nondrug-coated balloon catheter followed by therapeutic drug delivery into the prostate by a drug-coated balloon catheter, including transrectal ultrasound and fluoroscopy, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6624","name":"Inlay titanium","description":"Inlay - titanium","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0870","name":"Injection, imetelstat, 1 mg","description":"Injection, imetelstat, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21336","name":"Open tx septal fx w/wo stabj","description":"Open treatment of nasal septal fracture, with or without stabilization","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":728.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77422","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0492U","name":"Onc sol tum ctc slctn pd-l1","description":"Onc sol tum ctc slctn pd-l1","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0313","name":"Immunize couns < 21yr 6-30 m","description":"Immunization counseling by a physician or other qualified health care professional when  the vaccine(s) is not administered on the same date of service for ages under 21, 16-30 mins time (this code is used for medicaid billing purposes)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":426.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0484","name":"Consult slides prep elsewher","description":"Consultation on slides prepared elsewhere","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0235","name":"Inj, monoclon antibody, 1 mg","description":"Injection, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extraco","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1305","name":"Inj, evinacumab-dgnb, 5mg","description":"Injection, evinacumab-dgnb, 5mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1446","name":"Pt died bef end meas pd","description":"Patients who died any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2390","name":"Ant resin-based cmpst crown","description":"Resin-based composite crown anterior","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9332","name":"Inj efgartigimod 2mg","description":"Injection, efgartigimod alfa-fcab, 2mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0516U","name":"Rx metab rxgenomic gnotyp 40","description":"Rx metab rxgenomic gnotyp 40","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1348","name":"Pam incr 6 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 6-points in a 4 to 12 month period (excellent)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0469","name":"Tlso rig fram pelvic pre ots","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal and coronal ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":337.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0745","name":"Inj codeine phosphate /30 mg","description":"Injection, codeine phosphate, per 30 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1227","name":"Eb therapy prescribed","description":"Evidence-based therapy was prescribed","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0041","name":"Pt/ptn decln referral","description":"Patient and/or care partner decline referral","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4402","name":"Xwrap 2.0 per sq cm","description":"Xwrap 2.0, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89105","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0609U","name":"Onc prostate ia tot&free psa","description":"Onc prostate ia tot&free psa","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9999","name":"Doc sys rsn <3 colon","description":"Documentation of system reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., unable to locate previous colonoscopy report, patient cannot provide precise date or details from previous colonoscopy, previous colonoscopy report was incomplete)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1433","name":"Oral chemo wthn 30 days enc","description":"Patient on oral chemotherapy on or within 30 days before denominator eligible encounter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93319","name":"3d echo img cgen car anomal","description":"3d echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac structure(s) (eg, cardiac chambers and valves, left atrial appendage, interatrial septum, interventricular","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0264U","name":"Rare ds id opt genome mapg","description":"Rare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9272","name":"Inj, dostarlimab-gxly, 10 mg","description":"Injection, dostarlimab-gxly, 10 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0543","name":"Group train w/o patient","description":"Group caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient pre","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1175","name":"Doc med rsn no hzv","description":"Documentation of medical reason(s) for not administering zoster vaccine (e.g., prior anaphylaxis due to the zoster vaccine)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1452","name":"Pt dx dementia ever","description":"Patient ever had a diagnosis of dementia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1180","name":"Pt imm ckpt inhib therapy","description":"Patients on immune checkpoint inhibitor therapy","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1355","name":"Caries med app per tooth","description":"Caries med app per tooth","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0930T","name":"Ephys eval ccm-d ld 1st impl","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), at time of initial implantation or replacement with testing of cardiac contrac","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7961","name":"Buccal/labial frenectomy","description":"Buccal/labial frenectomy","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87077","name":"Culture aerobic identify","description":"Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1309","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0004","name":"Qual care neurologic cnd mvp","description":"Quality care for patients with neurological conditions mips value pathway","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0910T","name":"Rmvl int nstim sys vagus nrv","description":"Removal of integrated neurostimulation system, vagus nerve","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1243","name":"Pt othr thn true heard","description":"Patient provided a response other than completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5098","name":"Inj ustekinumab-srlf, 1 mg","description":"Injection, ustekinumab-srlf (imuldosa), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0604U","name":"All&immunology crae 4bk pep","description":"All&immunology crae 4bk pep","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0612U","name":"Onc lvr alys >1000 mr cfdna","description":"Onc lvr alys >1000 mr cfdna","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97811","name":"Acup 1/> w/o estim ea add 15","description":"Acupuncture, 1 or more needles; without electrical stimulation, each additional 15 minutes of personal one-on-one contact with the patient, with insertion of needle(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":32.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1194","name":"Med rsn no imp/con mmr/msi","description":"Documentation of medical reason(s) surgical pathology reports did not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both tests were not included (e.g., patient will not be treated with checkpoint inhibitor therap","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","name":"Gait mod systm rhym auditory","description":"Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11786.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98928","name":"Osteopath manj 7-8 regions","description":"Osteopathic manipulative treatment (omt); 7-8 body regions involved","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":55.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63032","name":"Lamot rpr anulr dfct 1 lmbr","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; with repair of annular defect by implantation of bone-anchored annular closure device, including all imaging guidance, 1 interspace, lumbar","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4010","name":"Infectious disease ss","description":"Infectious disease mips specialty set","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1312","name":"No pt tbco scrn rng","description":"Patient not screened for tobacco use","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2598","name":"Inj, vasopressin, 1 unit","description":"Injection, vasopressin, 1 unit","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93145","name":"Interrog crtd sins bat ip wo","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2040","name":"Coord specialty care, month","description":"Coordinated specialty care, team-based, for first episode psychosis, per month","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2329","name":"Inj ublituximab-xiiy, 1 mg","description":"Injection, ublituximab-xiiy, 1mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0782T","name":"Brnchsc rf dstrj plm nrv uni","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; unilateral mainstem bronchus","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90472","name":"Immunization admin each add","description":"Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); each additional vaccine (single or combination vaccine/toxoid) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98009","name":"Synch audio-only new low 30","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 30 m","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0826T","name":"Prgrmg evl ldls pm 1chmbr ip","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional, leadless pacemaker system in si","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1310","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0249","name":"Adm tocilizu covid-19 1st","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1415","name":"No pos pdl1 bef ici ther","description":"Patients who did not have a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81001","name":"Urinalysis auto w/scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; automated, with microscopy","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0328U","name":"Drug assay 120+ rx&metablt","description":"Drug assay 120+ rx&metablt","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7299","name":"Rem anchorage device w/flap","description":"Rem anchorage device w/flap","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1184","name":"Doc med rsn no cst/ist rx","description":"Documentation of medical reason(s) for not prescribing or administering corticosteroid or immunosuppressant treatment (e.g., allergy, intolerance, infectious etiology, pancreatic insufficiency, hyperthyroidism, prior bowel surgical interventions, celiac disease, receiving other medication, awaiting ","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6091","name":"Repl semi/precision attach","description":"Replacement of semi-precision or precision attachment (male or female component) of implant/abutment supported prosthesis per attachment","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71048","name":"X-ray exam chest 4+ views","description":"Radiologic examination, chest; 4 or more views","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4308","name":"Sanopellis, per sq cm","description":"Sanopellis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0821T","name":"Mntr psychdlc med 2ndphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; second physician or other qualified health care professional, concurrent with first physician or other qualified health care professional, each hour (list sepa","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1306","name":"Injection, inclisiran, 1 mg","description":"Injection, inclisiran, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4018","name":"Ob/gyn ss","description":"Obstetrics/gynecology mips specialty set","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35602","name":"Bpg crtd-clat crtd","description":"Bypass graft, with other than vein; carotid-contralateral carotid","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99425","name":"Prin care mgmt phys ea addl","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6193","name":"Replace implnt screw","description":"Replace implnt screw","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43291","name":"Egd flx trnsorl rmvl balo","description":"Esophagogastroduodenoscopy, flexible, transoral; with removal of intragastric bariatric balloon(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":86.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96203","name":"Mlt fam grp bhv train ea add","description":"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face with multiple sets of paren","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"Adju cgm supply allowance","description":"Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1204","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1363","name":"Pts no f/u 120 dys","description":"Patients who did not have a follow-up assessment within 120 days of the index assessment","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98976","name":"Rtm dev sply resp sys 16-30d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of respiratory system, 16-30 days in a 30-day period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29200","name":"Strapping thorax","description":"Strapping; thorax","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2711","name":"Inj neostigmin/glycopyrrolat","description":"Injection, neostigmine methylsulfate 0.1 mg and glycopyrrolate 0.02 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3299","name":"Inj xipere 1 mg","description":"Injection, triamcinolone acetonide (xipere), 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0515","name":"Inj benztropine mesylate","description":"Injection, benztropine mesylate, per 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6180","name":"Implnt maint proced","description":"Implnt maint proced","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68525","name":"Biopsy of tear sac","description":"Biopsy of lacrimal sac","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4317","name":"Vitograft, per sq cm","description":"Vitograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0833T","name":"Dgtz gls mcrscp cytp oth prp","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; preparation, screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70473","name":"Ct cere prfu aly c+wo ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed without concurrent ct or ct angiography of the same anatomy","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3376","name":"Inj vancomycin (hikma) 10mg","description":"Injection, vancomycin hcl (hikma), not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7284","name":"Exc biopsy of saliv glands","description":"Exc biopsy of saliv glands","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4316","name":"Amchoplast, per sq cm","description":"Amchoplast, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85380","name":"Fibrin degradj d-dimer","description":"Fibrin degradation products, d-dimer; ultrasensitive (eg, for evaluation for venous thromboembolism), qualitative or semiquantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9996","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0449U","name":"Car scr sev inh cond 5 genes","description":"Car scr sev inh cond 5 genes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2760","name":"Phentolaine mesylate inj","description":"Injection, phentolamine mesylate, up to 5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15781","name":"Dermabrasion segmental face","description":"Dermabrasion; segmental, face","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":474.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3501","name":"Surg exp root surf anterior","description":"Surg exp root surf anterior","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0705T","name":"Rem tx amblyopia tech sprt","description":"Remote treatment of amblyopia using an eye tracking device; surveillance center technical support including data transmission with analysis, with a minimum of 18 training hours, each 30 days","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0900T","name":"N-invas est aqmbf asstv cmr","description":"Noninvasive estimate of absolute quantitation of myocardial blood flow (aqmbf), derived from assistive algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health care profes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0323U","name":"Iadna cns pthgn next gen seq","description":"Iadna cns pthgn next gen seq","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9381","name":"Inj teplizumab mzwv 5 mcg","description":"Injection, teplizumab-mzwv, 5 mcg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0454U","name":"U rare ds id opt genome mapg","description":"U rare ds id opt genome mapg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0375U","name":"Onc ovrn bchm asy 7 prtn alg","description":"Onc ovrn bchm asy 7 prtn alg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92288","name":"Scr dark adaptation meas i&r","description":"Screening dark adaptation measurement (eg, rod recovery intercept time), with interpretation and report","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1000T","name":"Autol musc cell therapy admn","description":"Autologous muscle cell therapy, administration of muscle progenitor cells into the urethral sphincter, including cystoscopy and post-void residual ultrasound, when performed","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57289","name":"Repair bladder & vagina","description":"Pereyra procedure, including anterior colporrhaphy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":835.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2928","name":"Prefab porc/cer crown perm","description":"Prefab porc/cer crown perm","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37268","name":"Revsc evasc fpvt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49622","name":"Rpr parastomal hrna ncr/strn","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; incarcerated or strangulated","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4019","name":"Oncology/hema ss","description":"Oncology/hematology mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98979","name":"Rtm tx mgmt 1st 10 min","description":"Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least 1 real-time interactive communication with the patient or caregiver during the calendar month; first 10 minutes","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0551","name":"Phn/intr svs fr dx treat 30m","description":"Interprofessional telephone/internet/electronic health record referral service(s) provided by a treating/requesting practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, 30 minutes","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4019","name":"Oncology/hema ss","description":"Oncology/hematology mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6114","name":"Implnt/abut fixed dent max","description":"Implnt/abut fixed dent max","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1225","name":"Iop dec>=20% from base","description":"Intraocular pressure (iop) reduced by a value of greater than or equal to 20% from the pre-intervention level","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5995","name":"Peri medicament w/seal, max","description":"Peri medicament w/seal, max","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59025","name":"Fetal non-stress test","description":"Fetal non-stress test","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98000","name":"Synch audio-video new sf 15","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 15 minutes must be met or exceeded.","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9506","name":"Tc-99m graphite crucible","description":"Graphite crucible for preparation of technetium tc 99m-labeled carbon aerosol, one crucible","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0572U","name":"Onc prst8 httl qfish whl bld","description":"Onc prst8 httl qfish whl bld","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2045","name":"Novashield/novogen pr sq cm","description":"Novashield or novogen wound matrix, per square centimeter","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0580U","name":"Bbrgdrferi antb detc 24rprtn","description":"Bbrgdrferi antb detc 24rprtn","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J7130","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81001","name":"Urinalysis auto w/scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; automated, with microscopy","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4274","name":"Esano ac, per sq cm","description":"Esano ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61591","name":"Infratemporal approach/skull","description":"Infratemporal post-auricular approach to middle cranial fossa (internal auditory meatus, petrous apex, tentorium, cavernous sinus, parasellar area, infratemporal fossa) including mastoidectomy, resection of sigmoid sinus, with or without decompression and/or mobilization of contents of auditory cana","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3538.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42975","name":"Dise eval slp do brth flx dx","description":"Drug-induced sleep endoscopy, with dynamic evaluation of velum, pharynx, tongue base, and larynx for evaluation of sleep-disordered breathing, flexible, diagnostic","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0776T","name":"Ther indctj ntrabrn hypthrm","description":"Therapeutic induction of intra-brain hypothermia, including placement of a mechanical temperature-controlled cooling device to the neck over carotids and head, including monitoring (eg, vital signs and sport concussion assessment tool 5 [scat5]), 30 minutes of treatment","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0949T","name":"Rem interrog dev ccm tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1462","name":"Pt clin ind hd image","description":"Patients with clinical indications for imaging of the head","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26675","name":"Treat hand dislocation","description":"Closed treatment of carpometacarpal dislocation, other than thumb, with manipulation, each joint; requiring anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":451.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3402","name":"Inj. remestemcel-l-rknd/ td","description":"Injection, remestemcel-l-rknd, per therapeutic dose","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0754T","name":"Dgtz gls mcrscp sld level v","description":"Digitization of glass microscope slides for level v, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37255","name":"Revsc evasc ivt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0873","name":"Inj daptomycin (xellia)","description":"Injection, daptomycin (xellia), not therapeutically equivalent to j0878 or j0872, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0224","name":"Pemivibart infusion","description":"Intravenous infusion, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppr","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1454","name":"New cied","description":"New cied","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76801","name":"Ob us < 14 wks single fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2313","name":"Inj, naloxone (zimhi) 0.01mg","description":"Injection, naloxone hydrochloride (zimhi), 0.01 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0827T","name":"Dgtz gls mcrscp cytp smears","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; smears with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87182","name":"Sc std carbapenemase nzm det","description":"Susceptibility studies, antimicrobial agent; carbapenemase enzyme detection (eg, klebsiella pneumoniae carbapenemase [kpc], new delhi metallo-beta-lactamase [ndm], verona integron-encoded metallo-beta-lactamase [vim]), multiplex immunoassay, qualitative, per isolate","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33903","name":"Perq p-art revsc 1 abnor bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, bilateral","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1398","name":"Bslne and  fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6604","name":"Cst bse mtl inlay 2 surfaces","description":"Inlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0762T","name":"Dgtz gls mcrscp sl imm ea m","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, each multiplex antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0396","name":"3d print of 3d surface scan","description":"3d print of 3d surface scan","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86036","name":"Anca screen each antibody","description":"Antineutrophil cytoplasmic antibody (anca); screen, each antibody","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":12.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1201","name":"Med rsn no ace-i/arb rx","description":"Documentation of medical reason(s) for not prescribing ace inhibitor (ace-i) or arb therapy during the measurement period (e.g., pregnancy, history of angioedema to ace-i, other allergy to ace-i and arb, hyperkalemia or history of hyperkalemia while on ace-i or arb therapy, acute kidney injury due t","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37241","name":"Vasc embolize/occlude venous","description":"Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; venous, other than hemorrhage (eg, congenital or acquired venous malformations, venous and capillary hemangiomas","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5087.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92557","name":"Comprehensive hearing test","description":"Comprehensive audiometry threshold evaluation and speech recognition (92553 and 92556 combined)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":25.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76019","name":"Mr safety implt pos&/immoblj","description":"Mr safety implant positioning and/or immobilization under supervision of physician or other qualified health care professional, including application of physical protections to secure implanted medical device from mr-induced translational or vibrational forces, magnetically induced functional change","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5938","name":"Resct proth max comp remov","description":"Resct proth max comp remov","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4317","name":"Vitograft, per sq cm","description":"Vitograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0823T","name":"Tcat ins 1chmbr ldls pm ra","description":"Transcatheter insertion of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or programming), when","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2599","name":"Inj vasopressin (am reg) 1 u","description":"Injection, vasopressin (american regent), not therapeutically equivalent to j2598, 1 unit","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0804T","name":"Prgrmg evl ldls pm 2chmbr ip","description":"Programming device evaluation (in person) with iterative adjustment of implantable device to test the function of device and to select optimal permanent programmed values, with analysis, review, and report, by a physician or other qualified health care professional, leadless pacemaker system in dual","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1023T","name":"Prq tis dsplmt intrathoracic","description":"Percutaneous tissue displacement, any method, including imaging guidance; intrathoracic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0609","name":"Ferric citrate orl 3 mg iron","description":"Ferric citrate, oral, 3 mg ferric iron, (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2004","name":"Inj, lidocaine w epinephrine","description":"Injection, lidocaine hcl with epinephrine, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0479U","name":"Tau phosphorylated ptau217","description":"Tau phosphorylated ptau217","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0676T","name":"Laps insj nw/rpcmt isdss ea","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional lead (list separately in addition to code for primary ","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0304U","name":"Hem rbc ads whl bld normoxic","description":"Hem rbc ads whl bld normoxic","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1018T","name":"Elec alys npgs esoph sbsq w/","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1012T","name":"Mtrz ab ntrno trph scl/tr mw","description":"Motorized ab interno trephination of sclera (sclerostomy), or trabecular meshwork (trabeculostomy), 1 or more, including injection of antifibrotic agents, when performed","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0957T","name":"Rev s-sclp eltr ra rcvr&tlmt","description":"Revision of sub-scalp implanted electrode array, receiver, and telemetry unit for electrode, when required, including imaging guidance","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67516","name":"Sprchoroidal spc njx rx agt","description":"Suprachoroidal space injection of pharmacologic agent (separate procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4298","name":"Amniocore pro, per sq cm","description":"Amniocore pro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0539U","name":"Onc sol tumor cfctdna 152gen","description":"Onc sol tumor cfctdna 152gen","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0754T","name":"Dgtz gls mcrscp sld level v","description":"Digitization of glass microscope slides for level v, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6197","name":"Replace material prosthesis","description":"Replace material prosthesis","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0139","name":"Inj, adalimumab, 1 mg","description":"Injection, adalimumab, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2184","name":"Inj, meropenem (b. braun)","description":"Injection, meropenem (b. braun), not therapeutically equivalent to j2185, 100 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7356","name":"Inj foscarb/foslevodopa 5 mg","description":"Injection, foscarbidopa 0.25 mg/foslevodopa 5 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85018","name":"Hemoglobin","description":"Blood count; hemoglobin (hgb)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38115","name":"Repair of ruptured spleen","description":"Repair of ruptured spleen (splenorrhaphy) with or without partial splenectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1088.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64467","name":"Thrc fascial pln blk uni nfs","description":"Thoracic fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4225","name":"Amnio or derma tl, per sq cm","description":"Amniobind or dermabind tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0490U","name":"Onc cutan/uveal mlnma cd146","description":"Onc cutan/uveal mlnma cd146","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57500","name":"Biopsy of cervix","description":"Biopsy of cervix, single or multiple, or local excision of lesion, with or without fulguration (separate procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":143.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90966","name":"Esrd home pt serv p mo 20+","description":"End-stage renal disease (esrd) related services for home dialysis per full month, for patients 20 years of age and older","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33279","name":"Rmvl phrnc nrv stim transvns","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s) only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76801","name":"Ob us < 14 wks single fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6028","name":"Part hand finger metacar amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s) /thumb, amputation at metacarpal level, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":1766.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37274","name":"Rvsc evsc fpvt athrc cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4003","name":"Emergency med ss","description":"Emergency medicine mips specialty set","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1301","name":"Immunization counseling","description":"Immunization counseling","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21015","name":"Resect face/scalp tum < 2 cm","description":"Radical resection of tumor (eg, sarcoma), soft tissue of face or scalp; less than 2 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":498.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1466","name":"Pt disc/lam proc same day","description":"Patient had a lumbar fusion on the same date as the discectomy/laminectomy procedure","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28445","name":"Optx talus fracture","description":"Open treatment of talus fracture, includes internal fixation, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1328.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0401U","name":"Crd c hrt ds 9 gen 12 vrnts","description":"Crd c hrt ds 9 gen 12 vrnts","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4307","name":"American amnion, per sq cm","description":"American amnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9612","name":"Thera par drugs 2 or > admin","description":"Therapeutic parenteral drugs two or more administrations different medications","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0737","name":"Inj, clindamycin (baxter)","description":"Injection, clindamycin phosphate (baxter), not therapeutically equivalent to j0736, 300 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0685T","name":"Interrog dev eval isdss ip","description":"Interrogation device evaluation (in-person) with analysis, review and report by a physician or other qualified health care professional, including connection, recording and disconnection per patient encounter, permanent implantable synchronized diaphragmatic stimulation system for augmentation of ca","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4438","name":"Pretect per sq cm","description":"Pretect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0330U","name":"Iadna vag pthgn panel 27 org","description":"Iadna vag pthgn panel 27 org","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1291","name":"Pt 66+ frailty and med dem","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6094","name":"Abut support crown titanium","description":"Abutment supported crown - (titanium)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9957","name":"Screening sleep disorders","description":"Screening sleep disorders","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4231","name":"Ana crown exp 1-3 per quad","description":"Anatomical crown exposure - one to three teeth per quadrant","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1941","name":"Inj, furoscix, 20 mg","description":"Injection, furosemide (furoscix), 20 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1336","name":"Pts eval ini xm 2 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 2 weeks","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0566","name":"3d bn img algor drvd fr mri","description":"3d radiodensity-value bone imaging, algorithm derived, from previous magnetic resonance examination of the same anatomy","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5877","name":"Dup of complt dent-maxill","description":"Dup of complt dent-maxill","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1933","name":"Afo rig ant tib tcf/= ots","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, off-the-shelf","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0465","name":"Home vent invasive interface","description":"Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":731.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87152","name":"Culture type pulse field gel","description":"Culture, typing; identification by pulse field gel typing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37272","name":"Revsc evsc fpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5827","name":"Endo knee shin single axis","description":"Endoskeletal knee-shin system, single axis, electromechanical swing and stance phase control, with or without shock absorption and stance extension damping","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0434U","name":"Rx metab advrs vrnt alys 25","description":"Rx metab advrs vrnt alys 25","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70482","name":"Ct orbit/ear/fossa w/o&w/dye","description":"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2051","name":"Support broker waiver/diem","description":"Supports brokerage, self-directed, waiver; per diem","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95783","name":"Polysom <6 yrs cpap/bilvl","description":"Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bi-level ventilation, attended by a technologist","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1397.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0322U","name":"Neuro asd meas 14 acyl carn","description":"Neuro asd meas 14 acyl carn","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1426","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4291","name":"Lamellas xt, per sq cm","description":"Lamellas xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4396","name":"Natalin per sq cm","description":"Natalin, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0391","name":"Inj, artesunate, 1mg","description":"Injection, artesunate, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76818","name":"Fetal biophys profile w/nst","description":"Fetal biophysical profile; with non-stress testing","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20605","name":"Drain/inj joint/bursa w/o us","description":"Arthrocentesis, aspiration and/or injection, intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa); without ultrasound guidance","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":36.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0801","name":"3d dental scan direct","description":"3d dental scan direct","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0487U","name":"Onc sol tum cfcdna tgsap 84","description":"Onc sol tum cfcdna tgsap 84","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64412","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0351U","name":"Nfct ds bct/viral trail ip10","description":"Nfct ds bct/viral trail ip10","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27443","name":"Revision of knee joint","description":"Arthroplasty, femoral condyles or tibial plateau(s), knee; with debridement and partial synovectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":983.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93588","name":"Vngrph chd vnvn cltrl below","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating below the heart (eg, from the inferior vena cava) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2428","name":"Inj, erzofri, 1 mg","description":"Injection, paliperidone palmitate extended release (erzofri), 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25909","name":"Amputation follow-up surgery","description":"Amputation, forearm, through radius and ulna; re-amputation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1041.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9608","name":"Flotufolastat f18 diag 1 mci","description":"Flotufolastat f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0263U","name":"Neuro asd meas 16 c metblt","description":"Neurology (autism spectrum disorder [asd]), quantitative measurements of 16 central carbon metabolites (ie, a-ketoglutarate, alanine, lactate, phenylalanine, pyruvate, succinate, carnitine, citrate, fumarate, hypoxanthine, inosine, malate, s-sulfocysteine, taurine, urate, and xanthine), liquid chrom","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27475","name":"Surgery to stop leg growth","description":"Arrest, epiphyseal, any method (eg, epiphysiodesis); distal femur","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":784.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9381","name":"Inj teplizumab mzwv 5 mcg","description":"Injection, teplizumab-mzwv, 5 mcg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0838T","name":"Dgtz gls mcrscp cslt sld els","description":"Digitization of glass microscope slides for consultation and report on referred slides prepared elsewhere (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0621U","name":"Nfct ds lb dna alys>10000","description":"Nfct ds lb dna alys>10000","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65810","name":"Drainage of eye","description":"Paracentesis of anterior chamber of eye (separate procedure); with removal of vitreous and/or discission of anterior hyaloid membrane, with or without air injection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0526","name":"Est pt-cg dyad dem hig cmplx","description":"Management of established patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0516","name":"Insert drug del implant, >=4","description":"Insertion of non-biodegradable drug delivery implants, 4 or more (services for subdermal rod implant)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":199.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"Limited visual field xm","description":"Visual field examination, unilateral or bilateral, with interpretation and report; limited examination (eg, tangent screen, autoplot, arc perimeter, or single stimulus level automated test, such as octopus 3 or 7 equivalent)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59612","name":"Vbac delivery only","description":"Vaginal delivery only, after previous cesarean delivery (with or without episiotomy and/or forceps);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"RenderingTaxonomy","value":["207V00000X","207VB0002X","207VE0102X","207VF0040X","207VG0400X","207VM0101X","207VX0000X","207VX0201X","363LX0001X"]},{"name":"Company Code","value":["01","20","42"]},{"name":"ClaimSpecialtyCode","value":["904","905","907","AMGY","APNOB","COLP","FPEM","GYNE","GYON","GYSU","MAFE","NPAG","NPGY","NPOB","OBEM","OBGY","OBHR","OBST","REND","URGY"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1733.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0480U","name":"Nfct ds csf metag ngs alys","description":"Nfct ds csf metag ngs alys","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26011","name":"Drainage of finger abscess","description":"Drainage of finger abscess; complicated (eg, felon)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":491.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5939","name":"Resct proth mand comp remov","description":"Resct proth mand comp remov","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68850","name":"Injection for tear sac x-ray","description":"Injection of contrast medium for dacryocystography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0899T","name":"N-invas deter aqmbf aug cmr","description":"Noninvasive determination of absolute quantitation of myocardial blood flow (aqmbf), derived from augmentative algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health car","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2252","name":"Inj midazolam in 0.8% nacl","description":"Injection, midazolam in 0.8% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0587U","name":"Ther rx mntr 60-150rx&metabl","description":"Ther rx mntr 60-150rx&metabl","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86750","name":"Malaria antibody","description":"Antibody; plasmodium (malaria)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1199","name":"Pt recg rrt","description":"Patients receiving rrt","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0959T","name":"Rmv/rplc magnet coil assem","description":"Removal or replacement of magnet from coil assembly that is connected to continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0280U","name":"Hem vw factor&clgn iv bndg","description":"Hematology (von willebrand disease [vwd]), von willebrand factor (vwf) and collagen iv binding by enzyme-linked immunosorbent assays (elisa), plasma, report of collagen iv binding","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0169","name":"Inj epinephrine (adrenalin)","description":"Injection, epinephrine (adrenalin), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6553","name":"G com stcking bk 30-40 custm","description":"Gradient compression stocking, below knee, 30-40 mmhg, custom, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93598","name":"Car outp meas drg cath chd","description":"Cardiac output measurement(s), thermodilution or other indicator dilution method, performed during cardiac catheterization for the evaluation of congenital heart defects (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1028","name":"Take home supply 8mg per 0.1","description":"Take-home supply of nasal naloxone; 2-pack of 8mg per 0.1 ml nasal spray (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0771T","name":"Vr px dissoc svc sm phy 1st","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90963","name":"Esrd home pt serv p mo <2yrs","description":"End-stage renal disease (esrd) related services for home dialysis per full month, for patients younger than 2 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2372","name":"Inj, biorphen, 20 micrograms","description":"Injection, phenylephrine hydrochloride (biorphen), 20 micrograms","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50555","name":"Kidney endoscopy & biopsy","description":"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0317U","name":"Onc lung ca 4-prb fish assay","description":"Onc lung ca 4-prb fish assay","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9063","name":"Inj, elahere, 1 mg","description":"Injection, mirvetuximab soravtansine-gynx, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1301","name":"Pt recv tbco cess interv","description":"Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7411","name":"Excision benign lesion>1.25c","description":"Excision of benign lesion greater than 1.25 cm","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0707T","name":"Njx b1 sub mtrl sbchdrl dfct","description":"Injection(s), bone-substitute material (eg, calcium phosphate) into subchondral bone defect (ie, bone marrow lesion, bone bruise, stress injury, microtrabecular fracture), including imaging guidance and arthroscopic assistance for joint visualization","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1332","name":"Pts no eval ini xm no 2 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 2 weeks","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5949","name":"Mand implt sup fix part","description":"Mand implt sup fix part","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0174","name":"Lecanemab-irmb, for iv inj","description":"Lecanemab-irmb, for intravenous injection, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4431","name":"Pma skin substitute, nos","description":"Pma skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7252","name":"Part extract for implant","description":"Part extract for implant","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0724T","name":"Qmrcp w/dx mri same anatomy","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained with diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in additio","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69200","name":"Clear outer ear canal","description":"Removal foreign body from external auditory canal; without general anesthesia","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":44.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0547","name":"Phone/internet svs 11-20 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6107","name":"Tissue regen non-resorbable","description":"Tissue regen non-resorbable","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10081","name":"I&d pilonidal cyst comp","description":"Incision and drainage of pilonidal cyst; complicated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":452.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":201.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1022T","name":"Prq tis dsplmt ntra-abdl/pel","description":"Percutaneous tissue displacement, any method, including imaging guidance; intra-abdominal/pelvic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98008","name":"Synch audio-only new sf 15","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code sel","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1307","name":"Inj, crovalimab-akkz, 10 mg","description":"Injection, crovalimab-akkz, 10 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4326","name":"Woundplus, per sq cm","description":"Woundplus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76370","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36837","name":"Prq av fstl crt uxtr sep acs","description":"Percutaneous arteriovenous fistula creation, upper extremity, separate access sites of the peripheral artery and peripheral vein, including fistula maturation procedures (eg, transluminal balloon angioplasty, coil embolization) when performed, including all vascular access, imaging guidance and radi","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0036","name":"Pt/ptn decln assess","description":"Patient or care partner decline assessment","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0063","name":"Cardiology ss","description":"Cardiology mips specialty set","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4309","name":"Via matrix, per sq cm","description":"Via matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1453","name":"Preop vis acu > 20/40","description":"Patients with a pre-operative visual acuity better than 20/40","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61891","name":"Rev/rplcmt sk-mnt crnl nstm","description":"Revision or replacement of skull-mounted cranial neurostimulator pulse generator or receiver with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0525U","name":"Onc sphrd cell cul 11-rx pnl","description":"Onc sphrd cell cul 11-rx pnl","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98975","name":"Rtm 1st set-up&pt educaj eqp","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); initial set-up and patient education on use of equipment","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0051A","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4491.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0307U","name":"Onc mrd nxt-gnrj alys sbsq","description":"Onc mrd nxt-gnrj alys sbsq","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1230","name":"Pt hcv rctv aby no f/u tst","description":"Patient has a reactive hcv antibody test and does not have a follow up hcv viral test, or patient has a reactive hcv antibody test and has a follow up hcv viral test that detects hcv viremia and is not referred to a clinician who treats hcv infection within 1 month and does not have hcv treatment in","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4354","name":"Palingen dl-palingen dl-x","description":"Palingen dual-layer membrane and dual-layer palingen x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83902","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64582","name":"Opn mpltj hpglsl nstm ary pg","description":"Open implantation of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2183","name":"Inj meropenem (wg crit care)","description":"Injection, meropenem (wg critical care), not therapeutically equivalent to j2185, 100 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61736","name":"Litt icr 1 traj 1 smpl les","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; single trajectory for 1 simple lesion","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9948","name":"Adjust sleep apnea appliance","description":"Adjust sleep apnea appliance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0785T","name":"Revj/rmvl nea spi w/nstim","description":"Revision or removal of neurostimulator electrode array, spinal, with integrated neurostimulator","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0237","name":"Inj, tocilizumab-anoh, hospi","description":"Injection, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0953T","name":"Tot impl amei rev/rplc w/o","description":"Totally implantable active middle ear hearing implant; revision or replacement, without mastoidectomy and replacement of sound processor","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99425","name":"Prin care mgmt phys ea addl","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1403","name":"Bslne and fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4015","name":"Neurology ss","description":"Neurology mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1171","name":"Pt recd 1 td/tdap 9yrs prior","description":"Patient received at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"Basic vestibular evaluation","description":"Basic vestibular evaluation, includes spontaneous nystagmus test with eccentric gaze fixation nystagmus, with recording, positional nystagmus test, minimum of 4 positions, with recording, optokinetic nystagmus test, bidirectional foveal and peripheral stimulation, with recording, and oscillating tra","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0481","name":"Electron microscopy diagnost","description":"Electron microscopy - diagnostic","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4031","name":"Radiation oncology ss","description":"Radiation oncology mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4408","name":"Xwrap hydro per sq cm","description":"Xwrap hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0292U","name":"Psyc strs do mrna 72 genes","description":"Psyc strs do mrna 72 genes","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4362","name":"Cygnus disk, per sq cm","description":"Cygnus disk, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33894","name":"Evasc st rpr thrc/aa acrs br","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; across major side branches","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6612","name":"Onlay cst base mtl 2 surface","description":"Onlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9506","name":"Tc-99m graphite crucible","description":"Graphite crucible for preparation of technetium tc 99m-labeled carbon aerosol, one crucible","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4269","name":"Surgraft xt per sq cm","description":"Surgraft xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86015","name":"Actin antibody each","description":"Actin (smooth muscle) antibody (asma), each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4009","name":"Hospitalists ss","description":"Hospitalists mips specialty set","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0280U","name":"Hem vw factor&clgn iv bndg","description":"Hematology (von willebrand disease [vwd]), von willebrand factor (vwf) and collagen iv binding by enzyme-linked immunosorbent assays (elisa), plasma, report of collagen iv binding","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84394","name":"Total tau","description":"Tau, total (ttau)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6526","name":"G com garmt full leg/ft nght","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0786T","name":"Insj/rplcmt prq ra sac nstim","description":"Insertion or replacement of percutaneous electrode array, sacral, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0869T","name":"Njx b1 sub mtrl hw fixj aug","description":"Injection(s), bone-substitute material for bone and/or soft tissue hardware fixation augmentation, including intraoperative imaging guidance, when performed","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0855T","name":"Dgtz gls mcrscp b1 marow smr","description":"Digitization of glass microscope slides for bone marrow, smear interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1425","name":"Surgical care mvp","description":"Surgical care mips value pathway","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90613","name":"Inf&sarscov2 vacc 40/0.4 im","description":"Influenza virus vaccine, quadrivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 40 mcg/0.4 ml dosage, for intramuscular use","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1709","name":"Pfizer vaccine admin booster","description":"Pfizer vaccine admin booster","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7021","name":"Suppl and access lung expan","description":"Supplies and accessories for lung expansion airway clearance, continuous high frequency oscillation, and nebulization device (e.g., handset, nebulizer kit, biofilter)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4304","name":"Grafix plus, per sq cm","description":"Grafix plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15101","name":"Splt agrft t/a/l ea addl 100","description":"Split-thickness autograft, trunk, arms, legs; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1373","name":"Mst rec gsa >=8 and <=9","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 8.0% and <= 9.0%","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86041","name":"Acetylcholn rcptr bndng antb","description":"Acetylcholine receptor (achr); binding antibody","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2305","name":"Inj, nitroglycerin, 5 mg","description":"Injection, nitroglycerin, 5 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1457","name":"Dx asth dur crnt/prv perf pd","description":"Patient had a diagnosis of asthma with any contact during the current or prior performance period or had asthma present on an active problem list any time during the performance period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1159","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1184","name":"Doc med rsn no cst/ist rx","description":"Documentation of medical reason(s) for not prescribing or administering corticosteroid or immunosuppressant treatment (e.g., allergy, intolerance, infectious etiology, pancreatic insufficiency, hyperthyroidism, prior bowel surgical interventions, celiac disease, receiving other medication, awaiting ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2427","name":"Inj, invega hafyera/trinza","description":"Injection, paliperidone palmitate extended release (invega hafyera, or invega trinza), 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69729","name":"Impl oi implt sk tc esp>=100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside of the mastoid and resulting in removal of greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3911","name":"Intraorifice barrier","description":"Intraorifice barrier","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4363","name":"Am bur mem hydro per sq cm","description":"Amnio burgeon membrane and hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96203","name":"Mlt fam grp bhv train ea add","description":"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face with multiple sets of paren","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1457","name":"Dx asth dur crnt/prv perf pd","description":"Patient had a diagnosis of asthma with any contact during the current or prior performance period or had asthma present on an active problem list any time during the performance period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2393","name":"Post 3 srfc resinbased cmpst","description":"Resin-based composite - three surfaces posterior","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0875T","name":"Prgrm subq prtl asct pmp sys","description":"Programming of subcutaneously implanted peritoneal ascites pump system by physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64583","name":"Rev/rplct hpglsl nstm ary pg","description":"Revision or replacement of hypoglossal nerve neurostimulator array and distal respiratory sensor electrode or electrode array, including connection to existing pulse generator","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6280","name":"Implt maint procd remv implt","description":"Implt maint procd remv implt","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1318","name":"Pts no csp doc contact","description":"Patients who did not have documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening or documentation that there was no contact with a csp","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4354","name":"Palingen dl-palingen dl-x","description":"Palingen dual-layer membrane and dual-layer palingen x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2372","name":"Inj, biorphen, 20 micrograms","description":"Injection, phenylephrine hydrochloride (biorphen), 20 micrograms","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99386","name":"Prev visit new age 40-64","description":"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; 40-64 years","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":45.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":178.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81456","name":"So/hl 51/>gsap rna alys","description":"Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic sequence analysis panel, interrogation for sequence variants and copy number variants or rearrangements, or isoform expression or mrna expression levels, if performed; rna analysis","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61536","name":"Removal of brain lesion","description":"Craniotomy with elevation of bone flap; for excision of cerebral epileptogenic focus, with electrocorticography during surgery (includes removal of electrode array)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2961.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2058","name":"Obecbtge autol up to 400 mil","description":"Obecabtagene autoleucel, 10 up to 400 million cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per infusion","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0990T","name":"Trncrv inst biod hydrgl mtrl","description":"Transcervical instillation of biodegradable hydrogel materials, intrauterine","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2010","name":"Apis, per square centimeter","description":"Apis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5100","name":"Inj ustekinumab-kfce, 1 mg","description":"Injection, ustekinumab-kfce (yesintek), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0036","name":"Pt/ptn decln assess","description":"Patient or care partner decline assessment","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73542","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0624U","name":"Hep nash dna mthyl alys 5000","description":"Hep nash dna mthyl alys 5000","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0703","name":"2d oral/facial photo image","description":"2d oral/facial photo image","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33894","name":"Evasc st rpr thrc/aa acrs br","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; across major side branches","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34711","name":"Dlyd plmt xtn prosth ea addl","description":"Delayed placement of distal or proximal extension prosthesis for endovascular repair of infrarenal abdominal aortic or iliac aneurysm, false aneurysm, dissection, endoleak, or endograft migration, including pre-procedure sizing and device selection, all nonselective catheterization(s), all associate","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76883","name":"Us nrv&acc strux 1xtr compre","description":"Ultrasound, nerve(s) and accompanying structures throughout their entire anatomic course in one extremity, comprehensive, including real-time cine imaging with image documentation, per extremity","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4428","name":"Dermbnd sln sl+ slx sq cm","description":"Dermabind sl n or dermabind sl + or dermabind sl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4564","name":"Pessary, disposable any type","description":"Pessary, disposable, any type","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81523","name":"Onc brst mrna 70 cnt 31 gene","description":"Oncology (breast), mrna, next-generation sequencing gene expression profiling of 70 content genes and 31 housekeeping genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as index related to risk to distant metastasis","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1395","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57556","name":"Remove cervix repair bowel","description":"Excision of cervical stump, vaginal approach; with repair of enterocele","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7354","name":"Cantharidin top, applicator","description":"Cantharidin for topical administration, 0.7%, single unit dose applicator (3.2 mg)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0297U","name":"Onc pan tum whl gen seq dna","description":"Onc pan tum whl gen seq dna","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64823","name":"Sympathectomy supfc palmar","description":"Sympathectomy; superficial palmar arch","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":910.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9003","name":"Leupro inj, camcevi etm, 1mg","description":"Leuprolide injectable (camcevi etm), 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4323","name":"Alloply, per sq cm","description":"Alloply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1011T","name":"Pbm therapy of oral cavity","description":"Photobiomodulation (pbm) therapy of oral cavity, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86403","name":"Particle agglut antbdy scrn","description":"Particle agglutination; screen, each antibody","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4311","name":"Acesso, per sq cm","description":"Acesso, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30160","name":"Rhinectomy total","description":"Rhinectomy; total","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":935.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78491","name":"Myocrd img pet 1std rst/strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); single study, at rest or stress (exercise or pharmacologic)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1522.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1347","name":"Pt pam incr 3 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 3 points in a 4 to 12 month period (passing)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0558","name":"Adv prim care mgmt lvl 3","description":"Advanced primary care management services for a patient that is a qualified medicare beneficiary with multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, which place the patient at significant risk of death, acute exacerbation/decompensat","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0559","name":"Unrelat prac follow up visit","description":"Post-operative follow-up visit complexity inherent to evaluation and management services addressing surgical procedure(s), provided by a physician or qualified health care professional who is not the practitioner who performed the procedure (or in the same group practice) and is of the same or of a ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90483","name":"Imm cnsl not admn sm>10<20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 10 minutes up to 20 minutes","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0446","name":"Intens behave ther cardio dx","description":"Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":33.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1241","name":"Pt no resp seen as person","description":"Patient did not respond to the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"Breathing capacity test","description":"Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement(s), with or without maximal voluntary ventilation","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99425","name":"Prin care mgmt phys ea addl","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G3002","name":"Chronic pain mgmt 30 mins","description":"Chronic pain management and treatment, monthly bundle including, diagnosis; assessment and monitoring; administration of a validated pain rating scale or tool; the development, implementation, revision, and/or maintenance of a person-centered care plan that includes strengths, goals, clinical needs,","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0560","name":"Safety plan interven","description":"Safety planning interventions, each 20 minutes personally performed by the billing practitioner, including assisting the patient in the identification of the following personalized elements of a safety plan: recognizing warning signs of an impending suicidal or substance use-related crisis; employin","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16030","name":"Dress/debrid p-thick burn l","description":"Dressings and/or debridement of partial-thickness burns, initial or subsequent; large (eg, more than 1 extremity, or greater than 10% total body surface area)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":147.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":62.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76989","name":"Dx intraop epcar us chd i&r","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; interpretation and report only","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44408","name":"Colonoscopy w/decompression","description":"Colonoscopy through stoma; with decompression (for pathologic distention) (eg, volvulus, megacolon), including placement of decompression tube, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87088","name":"Urine bacteria culture","description":"Culture, bacterial; with isolation and presumptive identification of each isolate, urine","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4329","name":"Singlay, per sq cm","description":"Singlay, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4001","name":"Diagnostic rad ss","description":"Diagnostic radiology mips specialty set","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4564","name":"Pessary, disposable any type","description":"Pessary, disposable, any type","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23170","name":"Sequestrectomy clavicle","description":"Sequestrectomy (eg, for osteomyelitis or bone abscess), clavicle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":635.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1000T","name":"Autol musc cell therapy admn","description":"Autologous muscle cell therapy, administration of muscle progenitor cells into the urethral sphincter, including cystoscopy and post-void residual ultrasound, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29580","name":"Strapping unna boot","description":"Strapping; unna boot","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":26.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0804","name":"3d facial scan indirect","description":"3d facial scan indirect","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37607","name":"Lig/banding angioacs av fstl","description":"Ligation or banding of angioaccess arteriovenous fistula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":474.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0343U","name":"Onc prst8 xom aly 442 sncrna","description":"Onc prst8 xom aly 442 sncrna","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4436","name":"Renati ac membrane per sq cm","description":"Renati ac membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7956","name":"Tiss regen edent resorb","description":"Tiss regen edent resorb","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0209","name":"Inj, sod thiosulfate (hope)","description":"Injection, sodium thiosulfate (hope), 100 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1202","name":"Miglustat oral 65 mg","description":"Miglustat, oral, 65 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51725","name":"Simple cystometrogram","description":"Simple cystometrogram (cmg) (eg, spinal manometer)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92635","name":"Hearing aid fitg svc ea addl","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; each additional 15 minutes (list separately in addition to code","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5611","name":"Rep resin part dent base man","description":"Rep resin part dent base man","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4540","name":"Trans elec nerv periph nerv","description":"Distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0238","name":"Intrav inf, toci, second dos","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83876","name":"Assay myeloperoxidase","description":"Myeloperoxidase (mpo)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0832T","name":"Dgtz gls mcrscp cytp oth scr","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0360U","name":"Onc lung elisa 7 autoant alg","description":"Onc lung elisa 7 autoant alg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4378","name":"Renew ft matrix per sq cm","description":"Renew ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21436","name":"Optx crnfcl sep comp mlt int","description":"Open treatment of craniofacial separation (lefort iii type); complicated, multiple surgical approaches, internal fixation, with bone grafting (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2205.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0609","name":"Ferric citrate orl 3 mg iron","description":"Ferric citrate, oral, 3 mg ferric iron, (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96381","name":"Admn rsv monoc antb im njx","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0561U","name":"Onc mrd gsa cfdna subsequent","description":"Onc mrd gsa cfdna subsequent","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0863T","name":"Rlcj pg wcs lv trnsmtr only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; transmitter component only","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51772","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":345.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0530U","name":"Onc pan-sol tum ctdna 77 gen","description":"Onc pan-sol tum ctdna 77 gen","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6111","name":"Implnt/abut remov dent mand","description":"Implnt/abut remov dent mand","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33243","name":"Remove eltrd/thoracotomy","description":"Removal of single or dual chamber implantable defibrillator electrode(s); by thoracotomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1643","name":"Inj heparin, pfizer, 1000u","description":"Injection, heparin sodium (pfizer), not therapeutically equivalent to j1644, per 1000 units","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87426","name":"Sarscov coronavirus ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; severe acute respiratory syndrome coronavirus (eg, sars-cov, s","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6114","name":"Implnt/abut fixed dent max","description":"Implnt/abut fixed dent max","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4387","name":"Non-pneum walk boot pre ots","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96380","name":"Admn rsv monoc antb im cnsl","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection, with counseling by physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5996","name":"Peri medicament w/seal, mand","description":"Peri medicament w/seal, mand","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77438","name":"Surf rad thr orthvlt>150-500","description":"Surface radiation therapy; orthovoltage, delivery, >150-500 kv, per fraction","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0820T","name":"Mntr psychdlc med 1stphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; first physician or other qualified health care professional, each hour","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87088","name":"Urine bacteria culture","description":"Culture, bacterial; with isolation and presumptive identification of each isolate, urine","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36581","name":"Replace tunneled cv cath","description":"Replacement, complete, of a tunneled centrally inserted central venous catheter, without subcutaneous port or pump, through same venous access","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22837","name":"Ant thrc vrt body tethrg 8+","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; 8 or more vertebral segments","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27397","name":"Transplants of thigh tendons","description":"Transplant or transfer (with muscle redirection or rerouting), thigh (eg, extensor to flexor); multiple tendons","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1008.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0371U","name":"Iadna gu pthgn semiq dna16&1","description":"Iadna gu pthgn semiq dna16&1","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55708","name":"Bx prst8 trct us w/mri fus 1","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant) with mri-fusion-guidance, first targeted lesion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":90.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93569","name":"Njx cth slct p-art angrp uni","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0441U","name":"Nfct ds bct fngl/viral semiq","description":"Nfct ds bct fngl/viral semiq","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97608","name":"Neg prs wnd ther ndme>50sqcm","description":"Negative pressure wound therapy, (eg, vacuum assisted drainage collection), utilizing disposable, non-durable medical equipment including provision of exudate management collection system, topical application(s), wound assessment, and instructions for ongoing care, per session; total wound(s) surfac","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":460.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1427","name":"Doc med rsn bone scn","description":"Documentation of medical reason(s) for performing a bone scan (including documented pain related to prostate cancer, salvage therapy, other medical reasons)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5422","name":"Dentures adjust part mandbl","description":"Adjust partial denture - mandibular","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2003","name":"Inj, lidocaine hcl, 1 mg","description":"Injection, lidocaine hydrochloride, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0343U","name":"Onc prst8 xom aly 442 sncrna","description":"Onc prst8 xom aly 442 sncrna","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0614","name":"Inj, treosulfan, 50 mg","description":"Injection, treosulfan, 50 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0857T","name":"Opto-acoustic img breast uni","description":"Opto-acoustic imaging, breast, unilateral, including axilla when performed, real-time with image documentation, augmentative analysis and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72072","name":"X-ray exam thorac spine 3vws","description":"Radiologic examination, spine; thoracic, 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5130","name":"Inj, fylnetra, 0.5 mg","description":"Injection, pegfilgrastim-pbbk (fylnetra), biosimilar, 0.5 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37266","name":"Rvsc evsc fpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9293","name":"Fertility cycl tracking soft","description":"Fertility cycle (contraception & conception) tracking software application, fda cleared, per month, includes accessories (e.g., thermometer)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99285","name":"Emergency dept visit hi mdm","description":"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67902","name":"Repair eyelid defect","description":"Repair of blepharoptosis; frontalis muscle technique with autologous fascial sling (includes obtaining fascia)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":574.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2779","name":"Inj, susvimo 0.1 mg","description":"Injection, ranibizumab, via intravitreal implant (susvimo), 0.1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0364U","name":"Onc hl neo gen seq alys alg","description":"Onc hl neo gen seq alys alg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0041","name":"Pt/ptn decln referral","description":"Patient and/or care partner decline referral","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49617","name":"Rpr aa hrn rcr > 10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, reducible","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82482","name":"Assay rbc cholinesterase","description":"Cholinesterase; rbc","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97762","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0366U","name":"Onc bldr 10 prb recr bldr ca","description":"Onc bldr 10 prb recr bldr ca","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0840T","name":"Dgtz gls mcrscp cslt compre","description":"Digitization of glass microscope slides for consultation, comprehensive, with review of records and specimens, with report on referred material (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27713","name":"Osteot tibia imed lngth dev","description":"Osteotomy(ies), tibia, including fibula when performed, unilateral, with insertion of an externally controlled intramedullary lengthening device, including imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0869T","name":"Njx b1 sub mtrl hw fixj aug","description":"Injection(s), bone-substitute material for bone and/or soft tissue hardware fixation augmentation, including intraoperative imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9323","name":"Inj pemetrexed ditromethamin","description":"Injection, pemetrexed ditromethamine, 10 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4338","name":"Artacent velos, per sq cm","description":"Artacent velos, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1230","name":"Pt hcv rctv aby no f/u tst","description":"Patient has a reactive hcv antibody test and does not have a follow up hcv viral test, or patient has a reactive hcv antibody test and has a follow up hcv viral test that detects hcv viremia and is not referred to a clinician who treats hcv infection within 1 month and does not have hcv treatment in","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33895","name":"Evasc st rpr thrc/aa x crsg","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; not crossing major side branches","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0665","name":"Inj, bupivacaine, nos, 0.5mg","description":"Injection, bupivicaine, not otherwise specified, 0.5 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99349","name":"Home/res vst est mod mdm 40","description":"Home or residence visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 40 minutes must be met or excee","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1364","name":"Ascvd risk >=20pct","description":"Calculated 10-year ascvd risk score of >= 20 percent during the performance period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37256","name":"Revsc evasc ivt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0716T","name":"Car acous wavfrm rec cad rsk","description":"Cardiac acoustic waveform recording with automated analysis and generation of coronary artery disease risk score","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92622","name":"Dx aly aud oi snd prcsr 1st","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; first 60 minutes","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45349","name":"Sigmoidoscopy w/resection","description":"Sigmoidoscopy, flexible; with endoscopic mucosal resection","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0625U","name":"Endocrinol op dna alys>5000","description":"Endocrinol op dna alys>5000","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0707T","name":"Njx b1 sub mtrl sbchdrl dfct","description":"Injection(s), bone-substitute material (eg, calcium phosphate) into subchondral bone defect (ie, bone marrow lesion, bone bruise, stress injury, microtrabecular fracture), including imaging guidance and arthroscopic assistance for joint visualization","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0681","name":"Inj ceftobipole medocarl 3mg","description":"Injection, ceftobiprole medocaril sodium, 3 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45135","name":"Excision of rectal prolapse","description":"Excision of rectal procidentia, with anastomosis; abdominal and perineal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1335.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83014","name":"H pylori drug admin","description":"Helicobacter pylori; drug administration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5143","name":"Inj adalimumab-adbm, 1 mg","description":"Injection, adalimumab-adbm, biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32960","name":"Therapeutic pneumothorax","description":"Pneumothorax, therapeutic, intrapleural injection of air","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1327","name":"Pts no eval ini xm no 8 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 8 weeks","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99469","name":"Neonate crit care subsq","description":"Subsequent inpatient neonatal critical care, per day, for the evaluation and management of a critically ill neonate, 28 days of age or younger","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7294","name":"Seg acet and eth estr yearly","description":"Segesterone acetate and ethinyl estradiol 0.15mg, 0.013mg per 24 hours; yearly vaginal system, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5149","name":"Inj, aflibercept-abzv, 1 mg","description":"Injection, aflibercept-abzv (enzeevu), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0368","name":"Cone beam ct interprete tmj","description":"Cone beam ct interprete tmj","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1160","name":"Pt anphx due to mengb bef 13","description":"Patient had anaphylaxis due to the meningococcal vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1327","name":"Pts no eval ini xm no 8 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 8 weeks","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1263","name":"Pts hosp dialysis dt","description":"Patients in hospice on their initiation of dialysis date or during the month of evaluation","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0322U","name":"Neuro asd meas 14 acyl carn","description":"Neuro asd meas 14 acyl carn","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0759T","name":"Dgtz gls mcrscp sl sp grpiii","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group iii, for enzyme constituents (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1470","name":"Hep b vac not recd med rsn","description":"Documentation of medical reason(s) for not administering hepatitis b vaccine (e.g., prior anaphylaxis due to the hepatitis b vaccine)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2249","name":"Inj, remimazolam, 1 mg","description":"Injection, remimazolam, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0800T","name":"Tcat rmvl 2chmbr ldls pm rv","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right ventricular pacemaker component (when part of a dual-chamber leadless pacem","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91304","name":"Sarscov2 vac 5mcg/0.5ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, 5 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2007","name":"Restrata, per sq cm","description":"Restrata, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4026","name":"Phys/occ therapy ss","description":"Physical therapy/occupational therapy mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37299","name":"Revsc evsc imvt angio cpx ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1257","name":"Cvd risk assess not perf","description":"Cvd risk assessment not performed or incomplete (e.g., cvd risk assessment was not documented), reason not otherwise specified","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19361","name":"Brst rcnstj latsms drsi flap","description":"Breast reconstruction; with latissimus dorsi flap","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1562.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0531U","name":"Nfct ds afb&inv fng 673orgs","description":"Nfct ds afb&inv fng 673orgs","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"Ak 4 bar link hydl swg/stanc","description":"Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":7534.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1429","name":"Retinopathy in od, os, ou","description":"Retinal exam finding with evidence of retinopathy in left, right or both eyes with severity level documented","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1178","name":"Doc med rsn no pcv","description":"Documentation of medical reason(s) for not administering pneumococcal vaccine (e.g., prior anaphylaxis due to the pneumococcal vaccine)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78492","name":"Myocrd img pet mlt rst&strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); multiple studies at rest and stress (exercise or pharmacologic)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1326.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1245","name":"Pt othr thn true person","description":"Patient provided a response other than completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1014T","name":"Lap rv/rmv eso sph nstm eltr","description":"Laparoscopic revision or removal, lower esophageal sphincter neurostimulator electrodes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0270U","name":"Hem cgen coagj do 20 genes","description":"Hematology (congenital coagulation disorders), genomic sequence analysis of 20 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4457","name":"Enema tube any type repl","description":"Enema tube, with or without adapter, any type, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0237","name":"Inj, tocilizumab-anoh, hospi","description":"Injection, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1387","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1320","name":"Pts scrn + hrsn","description":"Patients who screened positive for at least 1 of the 5 hrsns","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4011","name":"Internal medicine ss","description":"Internal medicine mips specialty set","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99461","name":"Init nb em per day non-fac","description":"Initial care, per day, for evaluation and management of normal newborn infant seen in other than hospital or birthing center","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":105.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0883T","name":"Intraop ther estim pn ue ea","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; each additional nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2058","name":"Obecbtge autol up to 400 mil","description":"Obecabtagene autoleucel, 10 up to 400 million cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per infusion","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0545","name":"Inherent visit to inpt","description":"Visit complexity inherent to hospital inpatient or observation care associated with a confirmed or suspected infectious disease by an infectious diseases specialist, including disease transmission risk assessment and mitigation, public health investigation, analysis, and testing, and complex antimic","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2037","name":"G4derm plus/suprello, pr ml","description":"G4derm plus/suprello, per milliliter","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78760","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0166","name":"Inj epinephrine (bpi)","description":"Injection, epinephrine (bpi), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66991","name":"Xcapsl ctrc rmvl insj 1+","description":"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); with insertion of intraocular (eg, trabecular meshwork, supraciliary, suprachoroidal) anterior segment aqueous drai","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0389U","name":"Ped fbrl kd ifi27&mcemp1 rna","description":"Ped fbrl kd ifi27&mcemp1 rna","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0018M","name":"Trnsplj rnl meas cd154+cll","description":"Transplantation medicine (allograft rejection, renal), measurement of donor and third-party-induced cd154+t-cytotoxic memory cells, utilizing whole peripheral blood, algorithm reported as a rejection risk score","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85610","name":"Prothrombin time","description":"Prothrombin time;","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4353","name":"Xceed tl matrix per sq cm","description":"Xceed tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0856T","name":"Dgtz gls mcrscp electron mic","description":"Digitization of glass microscope slides for electron microscopy, diagnostic (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1299","name":"Inj, eculizumab, 2 mg","description":"Injection, eculizumab, 2 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3403","name":"Revakinagene, per implant","description":"Revakinagene taroretcel-lwey, per implant","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99472","name":"Ped critical care subsq","description":"Subsequent inpatient pediatric critical care, per day, for the evaluation and management of a critically ill infant or young child, 29 days through 24 months of age","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":389.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0484U","name":"Nfct ds mgen 23s rrna pt mut","description":"Nfct ds mgen 23s rrna pt mut","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5765","name":"Liner compl/partial rem dent","description":"Liner compl/partial rem dent","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61517","name":"Implt brn intrcv chemotx agt","description":"Implantation of brain intracavitary chemotherapy agent (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63075","name":"Neck spine disk surgery","description":"Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; cervical, single interspace","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1661.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4383","name":"Axolotl graft ult per sq cm","description":"Axolotl graft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4148","name":"Enteral feed elastomer daily","description":"Enteral feeding supply kit; elastomeric control fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0726T","name":"Rmvl implt vstibular dev uni","description":"Removal of implanted vestibular device, unilateral","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82271","name":"Occult blood other sources","description":"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; other sources","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93145","name":"Interrog crtd sins bat ip wo","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0391U","name":"Onc sld tum dna&rna 437 gen","description":"Onc sld tum dna&rna 437 gen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3387","name":"Inj elivaldogene autotemecel","description":"Injection, elivaldogene autotemcel, per treatment","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31513","name":"Injection into vocal cord","description":"Laryngoscopy, indirect; with vocal cord injection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0707","name":"Intraoral periap radio image","description":"Intraoral periap radio image","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0967T","name":"Tranal ins tmp clrc anst dev","description":"Transanal insertion of endoluminal temporary colorectal anastomosis protection device, including vacuum anchoring component and flexible sheath connected to external vacuum source and monitoring system","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55869","name":"Lap srg prst8ct bi pl lmphad","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52343","name":"Cysto w/renal stricture tx","description":"Cystourethroscopy; with treatment of intra-renal stricture (eg, balloon dilation, laser, electrocautery, and incision)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J0760","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0535U","name":"Pfas lc-ms/ms plsm/srm quan","description":"Pfas lc-ms/ms plsm/srm quan","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4267","name":"Neostim dl per sq cm","description":"Neostim dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0562","name":"Complex simulation w/pet-ct","description":"Therapeutic radiology simulation-aided field setting; complex, including acquisition of pet and ct imaging data required for radiopharmaceutical-directed radiation therapy treatment planning (i.e., modeling)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4389","name":"Neothelium 4l+ per sq cm","description":"Neothelium 4l+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0238","name":"Inj, tocilizumab-aazg, hospi","description":"Injection, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1462","name":"Pt clin ind hd image","description":"Patients with clinical indications for imaging of the head","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0567U","name":"Rare ds whl gen seq srs&lrs","description":"Rare ds whl gen seq srs&lrs","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1551","name":"Inj cutaquig 100 mg","description":"Injection, immune globulin (cutaquig), 100 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15922","name":"Exc coccygl pr ulc flap clsr","description":"Excision, coccygeal pressure ulcer, with coccygectomy; with flap closure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":837.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0414","name":"Lab process microbial spec","description":"Lab process microbial spec","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92620","name":"Auditory function 60 min","description":"Evaluation of central auditory function, with report; initial 60 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99394","name":"Prev visit est age 12-17","description":"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; adole","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":128.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81195","name":"Cytog genom-wid alys hem mal","description":"Cytogenomic (genome-wide) analysis, hematologic malignancy, structural variants and copy number variants, optical genome mapping (ogm)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0753T","name":"Dgtz gls mcrscp sld level iv","description":"Digitization of glass microscope slides for level iv, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15241","name":"Fth/gft f/c/c/m/n/a/g/h/f ea","description":"Full thickness graft, free, including direct closure of donor site, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet; each additional 20 sq cm, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90484","name":"Imm cnsl not admn sm>20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 20 minutes","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0553","name":"Monthly tx for dmht 20mins","description":"First 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing information related to the use of","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9046","name":"Inj, bortezomib, dr. reddys","description":"Injection, bortezomib (dr. reddys), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6611","name":"Grad com wrap w strap ak cus","description":"Gradient compression wrap with adjustable straps, above knee, each, custom","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0910T","name":"Rmvl int nstim sys vagus nrv","description":"Removal of integrated neurostimulation system, vagus nerve","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2022","name":"Innovabrn/innovamatx xl sqcm","description":"Innovaburn or innovamatrix xl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0370","name":"Max ultrasound capt & interp","description":"Max ultrasound capt & interp","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28476","name":"Prq skel fix metar fx w/mnpj","description":"Percutaneous skeletal fixation of metatarsal fracture, with manipulation, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0873T","name":"Revj subq prtl asct pmp sys","description":"Revision of a subcutaneously implanted peritoneal ascites pump system, any component (ascites pump, associated peritoneal catheter, associated bladder catheter), including imaging and programming, when performed","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27886","name":"Amputation follow-up surgery","description":"Amputation, leg, through tibia and fibula; re-amputation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":779.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3247","name":"Inj secukinumab intrav 1mg","description":"Injection, secukinumab, intravenous, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1204","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87186","name":"Sc std microdil/agar dil","description":"Susceptibility studies, antimicrobial agent; microdilution or agar dilution (minimum inhibitory concentration [mic] or breakpoint), each multi-antimicrobial, per plate","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0505U","name":"Nfct ds vag infctj id 32orgs","description":"Nfct ds vag infctj id 32orgs","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33919","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2843.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4389","name":"Neothelium 4l+ per sq cm","description":"Neothelium 4l+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4356","name":"Abio mem abio hyd per sq cm","description":"Abiomend membrane and abiomend hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0477U","name":"Rx metab psy 14&cyp2d6 gn-rx","description":"Rx metab psy 14&cyp2d6 gn-rx","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1490","name":"Pt status not doc","description":"Patient status not documented","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9026","name":"Inj, tarlatamab-dlle, 1 mg","description":"Injection, tarlatamab-dlle, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64584","name":"Rmvl hpglsl nstim ary pg","description":"Removal of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11042","name":"Dbrdmt subq tis 1st 20sqcm/<","description":"Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":63.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47400","name":"Incision of liver duct","description":"Hepaticotomy or hepaticostomy with exploration, drainage, or removal of calculus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2157.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86364","name":"Tiss trnsgltmnase ea ig clas","description":"Tissue transglutaminase, each immunoglobulin (ig) class","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","name":"Gait mod systm rhym auditory","description":"Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0668","name":"Team remote e/m est pt 40 mn","description":"Team remote e/m est. pt 40mins","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2506","name":"Inj pegfilgrast ex bio 0.5mg","description":"Injection, pegfilgrastim, excludes biosimilar, 0.5 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0371U","name":"Iadna gu pthgn semiq dna16&1","description":"Iadna gu pthgn semiq dna16&1","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3391","name":"Inj, atidarsagene autotemcel","description":"Injection, atidarsagene autotemcel, per treatment","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68530","name":"Clearance of tear duct","description":"Removal of foreign body or dacryolith, lacrimal passages","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6603","name":"G com bandge low dn foamchnl","description":"Gradient compression bandaging supply, low density channel foam sheet, per 250 square centimeters, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53452","name":"Tprnl balo cntnc dev uni","description":"Periurethral transperineal adjustable balloon continence device; unilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78806","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1497","name":"No doc fall med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5934","name":"Mandibular flange prosthesis","description":"Mandibular resection prosthesis with guide flange","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1293","name":"Calc bmi abv up param f/u","description":"Bmi is documented above normal parameters and a follow-up plan is documented","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4405","name":"Xwrap fenestra plus sq cm","description":"Xwrap fenestra plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5657","name":"Add low ext man aut vol any","description":"Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69631","name":"Repair eardrum structures","description":"Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; without ossicular chain reconstruction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":987.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1348","name":"Pam incr 6 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 6-points in a 4 to 12 month period (excellent)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"13160","name":"Sec clsr surg wnd/dehsn xtn","description":"Secondary closure of surgical wound or dehiscence, extensive or complicated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":864.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92570","name":"Acoustic immitance testing","description":"Acoustic immittance testing, includes tympanometry (impedance testing), acoustic reflex threshold testing, and acoustic reflex decay testing","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":33.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28062","name":"Removal of foot fascia","description":"Fasciectomy, plantar fascia; radical (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":510.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37284","name":"Revsc evasc tpvt st sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4296","name":"Rebound matrix, per sq cm","description":"Rebound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0511U","name":"Onc sol tum 3dmicroenvir 36+","description":"Onc sol tum 3dmicroenvir 36+","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1024T","name":"Perq tiss dsplmt soft tissue","description":"Percutaneous tissue displacement, any method, including imaging guidance; soft tissue (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20670","name":"Removal implant superficial","description":"Removal of implant; superficial (eg, buried wire, pin or rod) (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0738T","name":"Tx pln mag fld abltj prst8","description":"Treatment planning for magnetic field induction ablation of malignant prostate tissue, using data from previously performed magnetic resonance imaging (mri) examination","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37297","name":"Revsc evasc imvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37259","name":"Revsc evasc ivt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0238","name":"Inj, tocilizumab-aazg, hospi","description":"Injection, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2011","name":"Supra sdrm, per sq cm","description":"Supra sdrm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9074","name":"Inj, cyclophosphamd, sandoz","description":"Injection, cyclophosphamide (sandoz), 5 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0630U","name":"Onc brst mrna gen prflg 80","description":"Onc brst mrna gen prflg 80","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2371","name":"Inj phenylephrine hcl 20 mcg","description":"Injection, phenylephrine hydrochloride, 20 micrograms","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49593","name":"Rpr aa hrn 1st 3-10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, reducible","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27457","name":"Realignment of knee","description":"Osteotomy, proximal tibia, including fibular excision or osteotomy (includes correction of genu varus [bowleg] or genu valgus [knock-knee]); after epiphyseal closure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1172.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0794T","name":"Pt spec alg rx-onc tx option","description":"Patient-specific, assistive, rules-based algorithm for ranking pharmaco-oncologic treatment options based on the patients tumor-specific cancer marker information obtained from prior molecular pathology, immunohistochemical, or other pathology results which have been previously interpreted and repor","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"Rec cath any transanal, each","description":"Rectal catheter with or without balloon, for use with any type transanal irrigation system, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96420","name":"Chemo ia push tecnique","description":"Chemotherapy administration, intra-arterial; push technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0548","name":"Phone/inter svs 21-30 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31253","name":"Nsl/sins ndsc total","description":"Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior), including frontal sinus exploration, with removal of tissue from frontal sinus, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":477.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0013","name":"Hiv prep counsel, clin staff","description":"Individual counseling for pre-exposure prophylaxis (prep) by clinical staff to prevent human immunodeficiency virus (hiv), includes: hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33883","name":"Delayed plmt prox xtn prosth","description":"Delayed placement of proximal extension prosthesis(es) not involving coverage of the left subclavian artery origin, after endovascular repair of the thoracic aorta, including pre-procedure sizing and device selection, nonselective catheterization(s), all associated radiological supervision and inter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1386.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0687","name":"Inj cefazolin (wg crit care)","description":"Injection, cefazolin sodium (wg critical care), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1152","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35141","name":"Repair defect of artery","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, common femoral artery (profunda femoris, superficial femoral)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1420.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1681","name":"Ho bilateral hip abduction","description":"Hip orthosis, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1164","name":"Pt w/ dementia any time","description":"Patients with dementia any time during the patients history through the end of the measurement period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57282","name":"Colpopexy extraperitoneal","description":"Colpopexy, vaginal; extra-peritoneal approach (sacrospinous, iliococcygeus)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1812","name":"Inj. insulin (fiasp)","description":"Insulin (fiasp), per 5 units","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0593U","name":"Nfct ds gu pthgn dna 46trgt","description":"Nfct ds gu pthgn dna 46trgt","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2919","name":"Inj, methylpred sod succ 5mg","description":"Injection, methylprednisolone sodium succinate, 5 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9211","name":"Idarubicin hcl injection","description":"Injection, idarubicin hydrochloride, 5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4002","name":"Ep cardio ss","description":"Electrophysiology cardiac specialist mips specialty set","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11642","name":"Exc f/e/e/n/l mal+mrg 1.1-2","description":"Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 1.1 to 2.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9154","name":"Artificial saliva, 1 ml","description":"Artificial saliva, 1 ml","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6598","name":"G comp bandage med stretch","description":"Gradient compression bandage roll, elastic medium stretch, per linear yard, any width, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28315","name":"Removal of sesamoid bone","description":"Sesamoidectomy, first toe (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":397.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8502","name":"Inj, aponvie, 1 mg","description":"Injection, aprepitant (aponvie), 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1186","name":"Pt w/ rx for hspc/plltv care","description":"Patients who have an order for or are receiving hospice or palliative care","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93585","name":"Vngrph chd azygs/hemiazygs","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; azygos/hemiazygos venous system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77439","name":"Surf rad thr img gdn us plmt","description":"Surface radiation therapy; superficial or orthovoltage, image guidance, ultrasound for placement of radiation therapy fields for treatment of cutaneous tumors, per course of treatment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0473U","name":"Onc sld tum bld/slv 648 gene","description":"Onc sld tum bld/slv 648 gene","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1269","name":"Recd esrd mcp lst day of mo","description":"Receiving esrd mcp dialysis services by the provider on the last day of the reporting month","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83065","name":"Hemoglobin thermolabile","description":"Hemoglobin; thermolabile","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4322","name":"Splint intra-coronal","description":"Splint intra-coronal","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2471","name":"Inj pantoprazole(hikma) 40mg","description":"Injection, pantoprazole (hikma), not therapeutically equivalent to j2470, 40 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9602","name":"Fluorodopa f-18 diag per mci","description":"Fluorodopa f-18, diagnostic, per millicurie","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1406","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0555","name":"Replacment pt electronic sys","description":"Provision of replacement patient electronics system (e.g., system pillow, handheld reader) for home pulmonary artery pressure monitoring","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0699T","name":"Njx pst chmbr eye medication","description":"Injection, posterior chamber of eye, medication","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27458","name":"Osteot femur imed lngth dev","description":"Osteotomy(ies), femur, unilateral, with insertion of an externally controlled intramedullary lengthening device, including iliotibial band release when performed, imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49572","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":495.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0327U","name":"Ftl aneuploidy trsmy dna seq","description":"Ftl aneuploidy trsmy dna seq","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99463","name":"Same day nb discharge","description":"Initial hospital or birthing center care, per day, for evaluation and management of normal newborn infant admitted and discharged on the same date","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9612","name":"Inj, fluorescein, 1 mg","description":"Injection, fluorescein, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0719T","name":"Pst vrt jt rplcmt lmbr 1 sgm","description":"Posterior vertebral joint replacement, including bilateral facetectomy, laminectomy, and radical discectomy, including imaging guidance, lumbar spine, single segment","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J0800","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6590","name":"Urinary cath disp suc pump","description":"External urinary catheters; disposable, with wicking material, for use with suction pump, per month","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9129","name":"Photobio therpy-sub 15 mins","description":"Photobio therpy-sub 15 mins","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0234","name":"Intra inf, toci, second dos","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q0170","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q0224","name":"Inj, pemivibart, 4500 mg","description":"Injection, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, and who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppressive ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59030","name":"Fetal scalp blood sampling","description":"Fetal scalp blood sampling","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9054","name":"Inj bortezomib boruzu 0.1 mg","description":"Injection, bortezomib (boruzu), 0.1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30915","name":"Ligation nasal sinus artery","description":"Ligation arteries; ethmoidal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":649.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1221","name":"Dre w/o rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; without evidence of retinopathy","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1284","name":"Pt 66+ snp or ltc pos > 90d","description":"Patients age 66 or older in institutional special needs plans (snp) or residing in long term care with pos code 32, 33, 34, 54, or 56 for more than 90 consecutive days during the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20551","name":"Njx 1 tendon origin/insj","description":"Injection(s); single tendon origin/insertion","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":69.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22844","name":"Insert spine fixation device","description":"Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 13 or more vertebral segments (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1291.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15733","name":"Musc myoq/fscq flp h&n pedcl","description":"Muscle, myocutaneous, or fasciocutaneous flap; head and neck with named vascular pedicle (ie, buccinators, genioglossus, temporalis, masseter, sternocleidomastoid, levator scapulae)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":978.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1008T","name":"Rem mntr s-scl eeg sys setup","description":"Remote monitoring of sub-scalp implanted continuous bilateral electroencephalography monitoring system, device fitting, initial set-up, and patient education in wearing of system and use of equipment","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1400","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64802","name":"Sympathectomy cervical","description":"Sympathectomy, cervical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":699.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99316","name":"Nf dschrg mgmt 30 min+","description":"Nursing facility discharge management; more than 30 minutes total time on the date of the encounter","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":130.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01942","name":"Anes neuromd/ntrvrt lmbr/sac","description":"Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93151","name":"Interrog&prgrmg ipnss","description":"Interrogation and programming (minimum one parameter) of implanted phrenic nerve stimulator system","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47553","name":"Biliary endoscopy thru skin","description":"Biliary endoscopy, percutaneous via t-tube or other tract; with biopsy, single or multiple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37213","name":"Thromblytic art/ven therapy","description":"Transcatheter therapy, arterial or venous infusion for thrombolysis other than coronary, any method, including radiological supervision and interpretation, continued treatment on subsequent day during course of thrombolytic therapy, including follow-up catheter contrast injection, position change, o","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37288","name":"Revsc evsc tpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0505U","name":"Nfct ds vag infctj id 32orgs","description":"Nfct ds vag infctj id 32orgs","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61889","name":"Ins sk-mnt crnl nstm pg/rcvr","description":"Insertion of skull-mounted cranial neurostimulator pulse generator or receiver, including craniectomy or craniotomy, when performed, with direct or inductive coupling, with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51798","name":"Us urine capacity measure","description":"Measurement of post-voiding residual urine and/or bladder capacity by ultrasound, non-imaging","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1404","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0920T","name":"Rmvl perm ccm-d sys 1 pac ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous pacing lead only","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0557","name":"Adv prim care mgmt lvl 2","description":"Advanced primary care management services for a patient with multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, which place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline, provided by c","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92930","name":"Prq tcat plmt ntrac st 2+les","description":"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 2 or more distinct coronary lesions with 2 or more coronary stents deployed in 2 or more coronary segments, or a bifurcation lesion requiring ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61544","name":"Remove & treat brain lesion","description":"Craniotomy with elevation of bone flap; for excision or coagulation of choroid plexus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2086.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45391","name":"Colonoscopy w/endoscope us","description":"Colonoscopy, flexible; with endoscopic ultrasound examination limited to the rectum, sigmoid, descending, transverse, or ascending colon and cecum, and adjacent structures","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0108","name":"Diab manage trn  per indiv","description":"Diabetes outpatient self-management training services, individual, per 30 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":63.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0446U","name":"Ai ds sle alys 10 cytokine","description":"Ai ds sle alys 10 cytokine","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41826","name":"Excision of gum lesion","description":"Excision of lesion or tumor (except listed above), dentoalveolar structures; with simple repair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1423","name":"Opt care urologic cnd mvp","description":"Optimal care for patients with urologic conditions mips value pathway","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1431","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55711","name":"Bx prst8 trct mri-us 1st","description":"Biopsy, prostate, transrectal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9602","name":"Fluorodopa f-18 diag per mci","description":"Fluorodopa f-18, diagnostic, per millicurie","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0961T","name":"Shortwave ifr radiation img","description":"Shortwave infrared radiation imaging, surgical pathology specimen, to assist gross examination for lymph node localization in fibroadipose tissue, per specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2034","name":"Found drs solo, per sq cm","description":"Foundation drs solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1736","name":"Inj meloxicam (delova) 1mg","description":"Injection, meloxicam (delova), 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0542U","name":"Nefro renal trnspl ur nmr 84","description":"Nefro renal trnspl ur nmr 84","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27001","name":"Tenotomy adductor hip open","description":"Tenotomy, adductor of hip, open","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":653.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0825T","name":"Tcat rmv&rpl1chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or prog","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0981T","name":"Tcat impl wrls ivc snr","description":"Transcatheter implantation of wireless inferior vena cava sensor for long-term hemodynamic monitoring, including deployment of the sensor, radiological supervision and interpretation, right heart catheterization, and inferior vena cava venography, when performed","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1220","name":"Dre wth interp rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; with evidence of retinopathy","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99415","name":"Prolng clin staff svc 1st hr","description":"Prolonged clinical staff service (the service beyond the highest time in the range of total time of the service) during an evaluation and management service in the office or outpatient setting, direct patient contact with physician supervision; first hour (list separately in addition to code for out","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15155","name":"Tis cltr agrft f/s/n/h/f/g 1","description":"Tissue cultured skin autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 25 sq cm or less","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":768.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6561","name":"G stockng full/chap 40+ cust","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, custom, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23130","name":"Acromp/acromionectomy prtl","description":"Acromioplasty or acromionectomy, partial, with or without coracoacromial ligament release","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1012T","name":"Mtrz ab ntrno trph scl/tr mw","description":"Motorized ab interno trephination of sclera (sclerostomy), or trabecular meshwork (trabeculostomy), 1 or more, including injection of antifibrotic agents, when performed","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2428","name":"Inj, erzofri, 1 mg","description":"Injection, paliperidone palmitate extended release (erzofri), 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1021T","name":"Active thrc irrigation spx","description":"Active thoracic irrigation (separate procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69554","name":"Exc aurl glomus tum extended","description":"Excision aural glomus tumor; extended (extratemporal)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2980.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2253","name":"Inj midazolam (seizalam)","description":"Injection, midazolam (seizalam), 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1470","name":"Hep b vac not recd med rsn","description":"Documentation of medical reason(s) for not administering hepatitis b vaccine (e.g., prior anaphylaxis due to the hepatitis b vaccine)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0155","name":"Dronabinol (syndros) 0.1 mg","description":"Dronabinol (syndros), 0.1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74019","name":"Radex abdomen 2 views","description":"Radiologic examination, abdomen; 2 views","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98979","name":"Rtm tx mgmt 1st 10 min","description":"Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least 1 real-time interactive communication with the patient or caregiver during the calendar month; first 10 minutes","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0109","name":"Diab manage trn ind/group","description":"Diabetes outpatient self-management training services, group session (2 or more), per 30 minutes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33882","name":"Evasc rpr ta dplmt mltpc sys","description":"Endovascular repair of the thoracic aorta by deployment of a branched endograft multipiece system involving an aorto-aortic tube device with a fenestration for the left subclavian artery stent graft(s) and all aortic tube endograft extension(s) placed from the level of the left common carotid artery","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1381","name":"Pt sec strk wthin 5 days","description":"Patients with secondary stroke (e.g., a subsequent stroke that may occur with vasospasm in the setting of subarachnoid hemorrhage) within 5 days of the initial procedure","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0577U","name":"Onc ovr serum alys 39 gps","description":"Onc ovr serum alys 39 gps","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83036","name":"Hemoglobin glycosylated a1c","description":"Hemoglobin; glycosylated (a1c)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0330U","name":"Iadna vag pthgn panel 27 org","description":"Iadna vag pthgn panel 27 org","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37273","name":"Revsc evsc fpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1190","name":"Doc khe not pef w/efgr/uacr","description":"Documentation of a kidney health evaluation was not performed or defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0780T","name":"Instlj fecal microbiota ssp","description":"Instillation of fecal microbiota suspension via rectal enema into lower gastrointestinal tract","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86480","name":"Tb test cell immun measure","description":"Tuberculosis test, cell mediated immunity antigen response measurement; gamma interferon","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0039","name":"Pt no ref, rn spec","description":"Patient not referred, reason not otherwise specified","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37294","name":"Rvsc evsc tpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56405","name":"I&d vulva/perineal abscess","description":"Incision and drainage of vulva or perineal abscess","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5140","name":"Inj adalimumab-fkjp, 1 mg","description":"Injection, adalimumab-fkjp, biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7472","name":"Removal of torus palatinus","description":"Removal of torus palatinus","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0608","name":"Lanthanum carbonate pwdr 5mg","description":"Lanthanum carbonate, oral, powder, 5 mg, not therapeutically equivalent to j0607 (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1325","name":"Doc med rsn not seen","description":"Patients who were not seen for reasons documented by clinician for patient or medical reasons (e.g., inadequate time for follow-up, patients who received a prior intravitreal or periocular steroid injection within the last six (6) months and had a subsequent iop evaluation with iop <25mm hg within s","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64728","name":"Dcmprn median nrv carpl tunl","description":"Decompression; median nerve at the carpal tunnel, percutaneous, with intracarpal tunnel balloon dilation, including ultrasound guidance","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0299U","name":"Onc pan tum whl gen opt mapg","description":"Onc pan tum whl gen opt mapg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4421","name":"Biolab wrap solo per sq cm","description":"Biolab membrane wrap solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0497U","name":"Onc prst8 mrna rt-pcr 6 gene","description":"Onc prst8 mrna rt-pcr 6 gene","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0868T","name":"Hi-res gastric ep mapping","description":"High-resolution gastric electrophysiology mapping with simultaneous patient-symptom profiling, with interpretation and report","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0557","name":"Adv prim care mgmt lvl 2","description":"Advanced primary care management services for a patient with multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, which place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline, provided by c","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1181","name":"Gr 2 or> dia or gr2 or> col","description":"Grade 2 or above diarrhea and/or grade 2 or above colitis","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0547","name":"Phone/internet svs 11-20 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1026","name":"Pt hemo > 3mo","description":"The number of adult patient-months in the denominator who were on maintenance hemodialysis using a catheter continuously for three months or longer under the care of the same practitioner or group partner as of the last hemodialysis session of the reporting month","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1420","name":"Complete ophthalmologic mvp","description":"Complete ophthalmologic care mips value pathway","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1437","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4403","name":"Xwrap dual plus per sq cm","description":"Xwrap dual plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67908","name":"Repair eyelid defect","description":"Repair of blepharoptosis; conjunctivo-tarso-mullers muscle-levator resection (eg, fasanella-servat type)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":481.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0585U","name":"Tgsap so neo cfdna 521 genes","description":"Tgsap so neo cfdna 521 genes","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6564","name":"G com stckng waist 40+ cust","description":"Gradient compression stocking, waist length, 40 mmhg or greater, custom, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72195","name":"Mri pelvis w/o dye","description":"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0839T","name":"Dgtz gls mcrscp cslt mat prp","description":"Digitization of glass microscope slides for consultation and report on referred material requiring preparation of slides (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77081","name":"Dxa bone density appendiculr","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0976T","name":"Slctv nzmtc dbrdmt s/n/hf ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; each additional 100 sq cm (list separately in addition to code for p","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0718T","name":"Adrc ther prtl rc tear njx","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; injection into supraspinatus tendon including ultrasound guidance, unilateral","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7473","name":"Remove torus mandibularis","description":"Removal of torus mandibularis","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0924T","name":"Rpos prv ccm-d trnsvns eltrd","description":"Repositioning of previously implanted cardiac contractility modulation-defibrillation transvenous electrode(s)/lead(s), including fluoroscopic guidance and programming of sensing and therapeutic parameters","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4308","name":"Sanopellis, per sq cm","description":"Sanopellis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90814","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2015","name":"Phoenix wnd mtrx, per sq cm","description":"Phoenix wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4000","name":"Dermatology ss","description":"Dermatology mips specialty set","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49622","name":"Rpr parastomal hrna ncr/strn","description":"Repair of parastomal hernia, any approach (ie, open, laparoscopic, robotic), initial or recurrent, including implantation of mesh or other prosthesis, when performed; incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0555","name":"Replacment pt electronic sys","description":"Provision of replacement patient electronics system (e.g., system pillow, handheld reader) for home pulmonary artery pressure monitoring","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96548","name":"Ntraop hipec px ea add 30min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4033","name":"Skilled nursing facility ss","description":"Skilled nursing facility mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0375U","name":"Onc ovrn bchm asy 7 prtn alg","description":"Onc ovrn bchm asy 7 prtn alg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78492","name":"Myocrd img pet mlt rst&strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); multiple studies at rest and stress (exercise or pharmacologic)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1565.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99203","name":"Office o/p new low 30 min","description":"Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":126.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1330","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80220","name":"Drug asy hydroxychloroquine","description":"Hydroxychloroquine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9342","name":"Inj thiotepa nos 1 mg","description":"Injection, thiotepa, not otherwise specified, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0882T","name":"Intraop ther estim pn ue 1st","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; initial nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9291","name":"Pres dig cog behav thera fda","description":"Prescription digital cognitive and/or behavioral therapy, fda cleared, per course of treatment","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6604","name":"Cst bse mtl inlay 2 surfaces","description":"Inlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87328","name":"Cryptosporidium ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; cryptosporidium","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76873","name":"Echograp trans r pros study","description":"Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0507U","name":"Onc ovr dna whole gen w/5hmc","description":"Onc ovr dna whole gen w/5hmc","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1399","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84080","name":"Assay alkaline phosphatases","description":"Phosphatase, alkaline; isoenzymes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85009","name":"Manual diff wbc count b-coat","description":"Blood count; manual differential wbc count, buffy coat","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99284","name":"Emergency dept visit mod mdm","description":"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":112.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0997T","name":"Precuneus mag stimj tx plng","description":"Precuneus magnetic stimulation; treatment planning using magnetic resonance imaging-guided neuronavigation to determine optimal location, dose, and intensity for magnetic stimulation therapy, derived from evoked potentials from single pulses of electromagnetic energy recorded by 64-channel electroen","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78492","name":"Myocrd img pet mlt rst&strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); multiple studies at rest and stress (exercise or pharmacologic)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1209","name":">=2 same hi-rsk med w/o diag","description":"At least two orders for high-risk medications from the same drug class, (table 4), without appropriate diagnoses","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9071","name":"Inj cyclophosphamd auromedic","description":"Injection, cyclophosphamide (auromedics), 5 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4317","name":"Vitograft, per sq cm","description":"Vitograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0211","name":"Inj, nithiodote, 3mg / 125mg","description":"Injection, sodium nitrite 3 mg and sodium thiosulfate 125 mg (nithiodote)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63032","name":"Lamot rpr anulr dfct 1 lmbr","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; with repair of annular defect by implantation of bone-anchored annular closure device, including all imaging guidance, 1 interspace, lumbar","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0844T","name":"Dgtz gls mcrscp cslt cyt ea","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), each additional site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26433","name":"Repair finger tendon","description":"Repair of extensor tendon, distal insertion, primary or secondary; without graft (eg, mallet finger)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":748.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33267","name":"Excl laa open any method","description":"Exclusion of left atrial appendage, open, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6601","name":"Porc/ceram inlay >= 3 surfac","description":"Inlay - porcelain/ceramic three or more surfaces","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56633","name":"Vulvectomy radical complete","description":"Vulvectomy, radical, complete;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1203.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1458","name":"Pt died bef end meas pd","description":"Patient died prior to the end of the performance period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4020","name":"Ophthalmology/optometry ss","description":"Ophthalmology/optometry mips specialty set","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0705","name":"Extra oral post radio image","description":"Extra oral post radio image","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11446","name":"Exc face-mm b9+marg >4 cm","description":"Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter over 4.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85009","name":"Manual diff wbc count b-coat","description":"Blood count; manual differential wbc count, buffy coat","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":5.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64656","name":"Revj/rplcmt bat mod sys pg","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; pulse generator only","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1400","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0108","name":"Diab manage trn  per indiv","description":"Diabetes outpatient self-management training services, individual, per 30 minutes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1380","name":"2 rx in perf pd any com meds","description":"Filled at least two prescriptions during the performance period for any combination of the qualifying oral antipsychotic medications listed under denominator note or the long-acting injectable antipsychotic medications listed under denominator note","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1476","name":"Pt dx cog imp or ad","description":"Patients with diagnosis of cognitive impairment or alzheimers disease","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0546","name":"Phone/internet ehr assess","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty   whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patien","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1016T","name":"Elec alys npgs esoph intraop","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97530","name":"Therapeutic activities","description":"Therapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve functional performance), each 15 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0986T","name":"Iv img icr cere vsl oct 1st","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1009T","name":"Rem mntr s-sclp cont eeg sys","description":"Remote monitoring of a sub-scalp implanted continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5931","name":"Surgical obturator","description":"Obturator prosthesis surgical","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1417","name":"Pt up to date cov","description":"Patients who are up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4033","name":"Skilled nursing facility ss","description":"Skilled nursing facility mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99460","name":"Init nb em per day hosp","description":"Initial hospital or birthing center care, per day, for evaluation and management of normal newborn infant","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29710","name":"Rmvl/bivlv sho/hip spica","description":"Removal or bivalving; shoulder or hip spica, minerva, or risser jacket, etc.","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9603","name":"Inj, pafolacianine, 0.1 mg","description":"Injection, pafolacianine, 0.1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0483","name":"Indirect immunofluorescence","description":"Indirect immunofluorescence","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0924T","name":"Rpos prv ccm-d trnsvns eltrd","description":"Repositioning of previously implanted cardiac contractility modulation-defibrillation transvenous electrode(s)/lead(s), including fluoroscopic guidance and programming of sensing and therapeutic parameters","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0943T","name":"Cysto flx rmvl urtl scaffold","description":"Cystourethroscopy, flexible; with removal of prostatic urethral scaffold","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1814","name":"Inj. insulin (lyumjev)","description":"Insulin (lyumjev), per 5 units","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81458","name":"So gsap dna cpy nmbr&mcrstl","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis, copy number variants and microsatellite instability","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77438","name":"Surf rad thr orthvlt>150-500","description":"Surface radiation therapy; orthovoltage, delivery, >150-500 kv, per fraction","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1438","name":"Lst knwn well <=210 min","description":"Time last known well to hospital arrival less than or equal to 3.5 hours (<= 210 minutes)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4422","name":"Ac wrap per sq cm","description":"A/c wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55714","name":"Bx prst8 in-bore ct/mri 1","description":"Biopsy, prostate, in-bore ct- or mri-guided targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5783","name":"Add low ext mec limb vol lam","description":"Addition to lower extremity, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0938T","name":"Xtrnl ecg rec>15d<30d rec","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; recording (including connection and initial recording)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53452","name":"Tprnl balo cntnc dev uni","description":"Periurethral transperineal adjustable balloon continence device; unilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0290U","name":"Pain mgmt mrna gen xprsn 36","description":"Pain mgmt mrna gen xprsn 36","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27641","name":"Partial removal of fibula","description":"Partial excision (craterization, saucerization, or diaphysectomy), bone (eg, osteomyelitis); fibula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":869.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0811T","name":"Rem mlt day uroflow setup","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); set-up and patient education on use of equipment","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9992","name":"Pall serv during meas","description":"Palliative care services used by patient any time during the measurement period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90638","name":"Vacc qirv mrna 60mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 60 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63052","name":"Lam facetc/frmt arthrd lum 1","description":"Laminectomy, facetectomy, or foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s] [eg, spinal or lateral recess stenosis]), during posterior interbody arthrodesis, lumbar; single vertebral segment (list separately in addition to code for primary ","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0614","name":"Inj, treosulfan, 50 mg","description":"Injection, treosulfan, 50 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0411U","name":"Psyc genom alys pnl 15 gen","description":"Psyc genom alys pnl 15 gen","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0414U","name":"Onc lng aug alg aly whl sld8","description":"Onc lng aug alg aly whl sld8","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97608","name":"Neg prs wnd ther ndme>50sqcm","description":"Negative pressure wound therapy, (eg, vacuum assisted drainage collection), utilizing disposable, non-durable medical equipment including provision of exudate management collection system, topical application(s), wound assessment, and instructions for ongoing care, per session; total wound(s) surfac","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":377.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":20.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51570","name":"Removal of bladder","description":"Cystectomy, complete; (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1563.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7188","name":"Factor viii recomb obizur","description":"Injection, factor viii (antihemophilic factor, recombinant), (obizur), per i.u.","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68335","name":"Revise/graft eyelid lining","description":"Repair of symblepharon; with free graft conjunctiva or buccal mucous membrane (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1371","name":"Mst rec gsa<7","description":"Most recent glycemic status assessment (hba1c or gmi) level < 7.0%","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0557","name":"Adv prim care mgmt lvl 2","description":"Advanced primary care management services for a patient with multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, which place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline, provided by c","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0424U","name":"Onc prst8 xom alys 53 sncrna","description":"Onc prst8 xom alys 53 sncrna","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4325","name":"Acapatch, per sq cm","description":"Acapatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6112","name":"Imp/abut rem dent part max","description":"Imp/abut rem dent part max","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42426","name":"Excise parotid gland/lesion","description":"Excision of parotid tumor or parotid gland; total, with unilateral radical neck dissection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1602.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0002","name":"Opt care kidney hlth mvp","description":"Optimal care for kidney health mips value pathways","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1354","name":"Int caries med app per tooth","description":"Interim caries med app","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86337","name":"Insulin antibodies","description":"Insulin antibodies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1485","name":"Neg viro resp hep c/qual rna","description":"Patients who did not achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90613","name":"Inf&sarscov2 vacc 40/0.4 im","description":"Influenza virus vaccine, quadrivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 40 mcg/0.4 ml dosage, for intramuscular use","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9393","name":"Inj, fulvestrant (teva)","description":"Injection, fulvestrant (teva), not therapeutically equivalent to j9395, 25 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47701","name":"Bile duct revision","description":"Portoenterostomy (eg, kasai procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1912.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4407","name":"Xwrap tribus per sq cm","description":"Xwrap tribus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0287U","name":"Onc thyr dna&mrna 112 genes","description":"Onc thyr dna&mrna 112 genes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0365U","name":"Onc bldr 10 prb bldr ca","description":"Onc bldr 10 prb bldr ca","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76883","name":"Us nrv&acc strux 1xtr compre","description":"Ultrasound, nerve(s) and accompanying structures throughout their entire anatomic course in one extremity, comprehensive, including real-time cine imaging with image documentation, per extremity","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35602","name":"Bpg crtd-clat crtd","description":"Bypass graft, with other than vein; carotid-contralateral carotid","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49616","name":"Rpr aa hrn rcr 3-10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1574","name":"Inj, ganciclovir (exela)","description":"Injection, ganciclovir sodium (exela), not therapeutically equivalent to j1570, 500 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30520","name":"Repair of nasal septum","description":"Septoplasty or submucous resection, with or without cartilage scoring, contouring or replacement with graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":579.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0580U","name":"Bbrgdrferi antb detc 24rprtn","description":"Bbrgdrferi antb detc 24rprtn","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0791T","name":"Motr cog vr gait train ea 15","description":"Motor-cognitive, semi-immersive virtual reality-facilitated gait training, each 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1220","name":"Dre wth interp rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; with evidence of retinopathy","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7473","name":"Remove torus mandibularis","description":"Removal of torus mandibularis","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90612","name":"Inf&sarscov2 vacc 31.7/.32im","description":"Influenza virus vaccine, trivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 31.7 mcg/0.32 ml dosage, for intramuscular use","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0390U","name":"Ob pe kdr eng&rbp4 ia alg","description":"Ob pe kdr eng&rbp4 ia alg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85014","name":"Hematocrit","description":"Blood count; hematocrit (hct)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37257","name":"Revsc evsc ivt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68841","name":"Insj rx elut implt lac canal","description":"Insertion of drug-eluting implant, including punctal dilation when performed, into lacrimal canaliculus, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":17.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0184","name":"Inj, amisulpride, 1 mg","description":"Injection, amisulpride, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1187","name":"Pt w/ esrd","description":"Patients with a diagnosis of end stage renal disease (esrd)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95961","name":"Electrode stimulation brain","description":"Functional cortical and subcortical mapping by stimulation and/or recording of electrodes on brain surface, or of depth electrodes, to provoke seizures or identify vital brain structures; initial hour of attendance by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0350","name":"Oral/facial photo images","description":"Oral/facial photographic images","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1503","name":"Vascular surgery mvp","description":"Vascular surgery mips value pathway","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80504","name":"Path clin consltj mod 21-40","description":"Pathology clinical consultation; for a moderately complex clinical problem, with review of patients history and medical records and moderate level of medical decision making when using time for code selection, 21-40 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54690","name":"Laparoscopy orchiectomy","description":"Laparoscopy, surgical; orchiectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":744.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0391U","name":"Onc sld tum dna&rna 437 gen","description":"Onc sld tum dna&rna 437 gen","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0541","name":"No pt prsnt train initial 30","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93150","name":"Therapy activation ipnss","description":"Therapy activation of implanted phrenic nerve stimulator system, including all interrogation and programming","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1954","name":"Inj leu acet lutr dpt 7.5 mg","description":"Injection, leuprolide acetate for depot suspension (lutrate depot), 7.5 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9376","name":"Inj pozelimab-bbfg, 1 mg","description":"Injection, pozelimab-bbfg, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1441","name":"Init dx slp apn = 1st enc","description":"Encounter corresponds to initial diagnosis of sleep apnea or first contact with sleep apnea diagnosed patient","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75577","name":"Quan&char c athrosclrtc plaq","description":"Quantification and characterization of coronary atherosclerotic plaque to assess severity of coronary disease, derived from augmentative software analysis of the data set from a coronary computed tomographic angiography, with interpretation and report by a physician or other qualified health care pr","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7961","name":"Buccal/labial frenectomy","description":"Buccal/labial frenectomy","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0971T","name":"Ablt mal brst tum pq lsr uni","description":"Ablation, malignant breast tumor(s), percutaneous, laser, including imaging guidance when performed, unilateral","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0538U","name":"Onc sol tum ngts ffpe 600gen","description":"Onc sol tum ngts ffpe 600gen","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9172","name":"Docetaxel (docivyx), 1 mg","description":"Injection, docetaxel (docivyx), 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15853","name":"Removal sutr/stapl xreq anes","description":"Removal of sutures or staples not requiring anesthesia (list separately in addition to e/m code)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0675","name":"Inj, carboprost, 0.1 mg","description":"Injection, carboprost tromethamine, 0.1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0586U","name":"Onc mrna gen xprsn 216 genes","description":"Onc mrna gen xprsn 216 genes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9318","name":"Inj romidepsin non-lyo 0.1mg","description":"Injection, romidepsin, non-lyophilized, 0.1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64474","name":"Lwr xtr fscl pln blk uni nfs","description":"Lower extremity fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11311","name":"Shave skin lesion 0.6-1.0 cm","description":"Shaving of epidermal or dermal lesion, single lesion, face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 0.6 to 1.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99305","name":"1st nf care moderate mdm 35","description":"Initial nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 35 minutes must be met or ex","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":116.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0694T","name":"3d vol img&rcnstj brst/ax","description":"3-dimensional volumetric imaging and reconstruction of breast or axillary lymph node tissue, each excised specimen, 3-dimensional automatic specimen reorientation, interpretation and report, real-time intraoperative","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30920","name":"Ligation upper jaw artery","description":"Ligation arteries; internal maxillary artery, transantral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":878.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7413","name":"Excision malig lesion<=1.25c","description":"Excision of malignant lesion up to 1.25 cm","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4360","name":"Amchoplast fd per sq cm","description":"Amchoplast fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43243","name":"Egd injection varices","description":"Esophagogastroduodenoscopy, flexible, transoral; with injection sclerosis of esophageal/gastric varices","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0431","name":"Diag tst detect mucos abnorm","description":"Adjunctive pre-diagnostic test that aids in detection of mucosal abnormalities including premalignant and malignant lesions not to include cytology or biopsy","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0487U","name":"Onc sol tum cfcdna tgsap 84","description":"Onc sol tum cfcdna tgsap 84","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"14021","name":"Tis trnfr s/a/l 10.1-30 sqcm","description":"Adjacent tissue transfer or rearrangement, scalp, arms and/or legs; defect 10.1 sq cm to 30.0 sq cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":856.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70473","name":"Ct cere prfu aly c+wo ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed without concurrent ct or ct angiography of the same anatomy","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5129","name":"Inj, vegzelma, 10 mg","description":"Injection, bevacizumab-adcd (vegzelma), biosimilar, 10 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0668","name":"Instill, bupivac and meloxic","description":"Instillation, bupivacaine and meloxicam, 1 mg/0.03 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4288","name":"Dermabind ch, per sq cm","description":"Dermabind ch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1237","name":"Pt rsn no scrn","description":"Patient reason for not screening for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety (e.g., patient declined or other patient reasons)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0062","name":"Audiology ss","description":"Audiology mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75722","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":717.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3376","name":"Inj vancomycin (hikma) 10mg","description":"Injection, vancomycin hcl (hikma), not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36836","name":"Prq av fstl crtj uxtr 1 acs","description":"Percutaneous arteriovenous fistula creation, upper extremity, single access of both the peripheral artery and peripheral vein, including fistula maturation procedures (eg, transluminal balloon angioplasty, coil embolization) when performed, including all vascular access, imaging guidance and radiolo","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0588U","name":"Nfct ds bct/vir 32genes mrna","description":"Nfct ds bct/vir 32genes mrna","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0615U","name":"Bbrgdrferi ld antb detcj 26","description":"Bbrgdrferi ld antb detcj 26","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4418","name":"Biolab wrap flow per sq cm","description":"Biolab membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0600U","name":"Nfct ds wnd infctj 65orgs&30","description":"Nfct ds wnd infctj 65orgs&30","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64596","name":"Ins/rplcmt prq eltrd ra pn 1","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; initial electrode array","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0939T","name":"Xtrnl ecg rec>15d<30d scan","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; scanning analysis with report","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27000","name":"Tenotomy adductor hip perq","description":"Tenotomy, adductor of hip, percutaneous (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":543.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3503","name":"Surg exp root surf molar","description":"Surg exp root surf molar","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63710","name":"Graft repair of spine defect","description":"Dural graft, spinal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1223.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9161","name":"Inj denileuk difti-cxdl 1mcg","description":"Injection, denileukin diftitox-cxdl, 1 mcg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78120","name":"Red cell mass single","description":"Red cell volume determination (separate procedure); single sampling","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0499U","name":"Onc clrct&lng dna ngs 8gene","description":"Onc clrct&lng dna ngs 8gene","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35476","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1196","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90382","name":"Rsv monoc antb seasn .7ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose, 0.7 ml, for intramuscular use","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1309","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4417","name":"Alexiguard dl-t per sq cm","description":"Alexiguard dl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0424U","name":"Onc prst8 xom alys 53 sncrna","description":"Onc prst8 xom alys 53 sncrna","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0915T","name":"Insj perm ccm-d sys pg&eltrd","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator and dual transvenous electrodes/leads (pacing and defibrillation)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32141","name":"Remove/treat lung lesions","description":"Thoracotomy; with resection-plication of bullae, includes any pleural procedure when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1057.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1459","name":"Pt hosp/pal care dur perf pd","description":"Patient was in hospice or receiving palliative care services at any time during the performance period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98976","name":"Rtm dev sply resp sys 16-30d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of respiratory system, 16-30 days in a 30-day period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24470","name":"Hemiepiphyseal arrest","description":"Hemiepiphyseal arrest (eg, cubitus varus or valgus, distal humerus)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":821.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0566","name":"3d bn img algor drvd fr mri","description":"3d radiodensity-value bone imaging, algorithm derived, from previous magnetic resonance examination of the same anatomy","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1343","name":"Pt pam lvl 4 base or srt lin","description":"Patients who are at pam level 4 at baseline or patients who are flagged with extreme straight line response sets on the pam or with excessive missing responses","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1499","name":"Interventional radiology mvp","description":"Interventional radiology mips value pathway","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6091","name":"Repl semi/precision attach","description":"Replacement of semi-precision or precision attachment (male or female component) of implant/abutment supported prosthesis per attachment","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0803T","name":"Tcat rmv&rpl2chmb ldls pm rv","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ve","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0036","name":"Pt/ptn decln assess","description":"Patient or care partner decline assessment","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36575","name":"Repair tunneled cv cath","description":"Repair of tunneled or non-tunneled central venous access catheter, without subcutaneous port or pump, central or peripheral insertion site","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37260","name":"Revsc evasc ivt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4287","name":"Disp col sto bag breast milk","description":"Disposable collection and storage bag for breast milk, any size, any type, each","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3244","name":"Inj. tigecycline (accord)","description":"Injection, tigecycline (accord), not therapeutically equivalent to j3243, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32140","name":"Removal of lung lesion(s)","description":"Thoracotomy; with cyst(s) removal, includes pleural procedure when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1059.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0666","name":"Team remote e/m est pt 15 mn","description":"Team remote e/m est. pt 15mins","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99289","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1262","name":"Pts transplt bef dialysis","description":"Patients who had a transplant prior to initiation of dialysis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1354","name":"Int caries med app per tooth","description":"Interim caries med app","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0977T","name":"Upr gi bld detcj snr capsule","description":"Upper gastrointestinal blood detection, sensor capsule, with interpretation and report","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4017","name":"Nutrition/dietician ss","description":"Nutrition/dietician mips specialty set","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1208","name":"Pt no scrn sdoh","description":"Patient is not screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0439U","name":"Crd chd dna alys 5 snp 3 dna","description":"Crd chd dna alys 5 snp 3 dna","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0337U","name":"Onc plsm cell do&myeloma id","description":"Onc plsm cell do&myeloma id","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2792","name":"Crown full cast noble metal","description":"Crown-full cast noble metal","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"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":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0829T","name":"Dgtz gls mcrscp cytp conctrj","description":"Digitization of glass microscope slides for cytopathology, concentration technique, smears, and interpretation (eg, saccomanno technique) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9322","name":"Inj pemetrexed (bluepoint)","description":"Injection, pemetrexed (bluepoint), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0017","name":"Crisis psychotherapy 60m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); first 60 minutes","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51721","name":"Ins trurl ablt trnsdc thr us","description":"Insertion of transurethral ablation transducer for delivery of thermal ultrasound for prostate tissue ablation, including suprapubic tube placement during the same session and placement of an endorectal cooling device, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9994","name":"Pall serv during meas","description":"Patient is using palliative care services any time during the measurement period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40812","name":"Excise/repair mouth lesion","description":"Excision of lesion of mucosa and submucosa, vestibule of mouth; with simple repair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0905T","name":"Ecg alg 12 ld rdcd i&r only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; interpretation and report only","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87075","name":"Cultr bacteria except blood","description":"Culture, bacterial; any source, except blood, anaerobic with isolation and presumptive identification of isolates","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":13.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90593","name":"Chikungunya vacc recomb im","description":"Chikungunya virus vaccine, recombinant, for intramuscular use","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93150","name":"Therapy activation ipnss","description":"Therapy activation of implanted phrenic nerve stimulator system, including all interrogation and programming","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20551","name":"Njx 1 tendon origin/insj","description":"Injection(s); single tendon origin/insertion","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":35.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66225","name":"Repair/graft eye lesion","description":"Repair of scleral staphyloma with graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":898.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9291","name":"Pres dig cog behav thera fda","description":"Prescription digital cognitive and/or behavioral therapy, fda cleared, per course of treatment","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2781","name":"Inj, pegcetacoplan, 1mg","description":"Injection, pegcetacoplan, intravitreal, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1340","name":"Indx whodas 2.0 or sds","description":"Index assessment completed using the 12-item whodas 2.0 or sds during the denominator identification period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9249","name":"Inj, melphalan (apotex) 1 mg","description":"Injection, melphalan (apotex), 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0951T","name":"Tot impl amei 1st plmt","description":"Totally implantable active middle ear hearing implant; initial placement, including mastoidectomy, placement of and attachment to sound processor","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4337","name":"Artecent trident, per sq cm","description":"Artacent trident, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0929T","name":"Rem interrog dev ccm-d tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92516","name":"Facial nerve function test","description":"Facial nerve function studies (eg, electroneuronography)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1349","name":"No pam inc 3 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 3 points within a 4 to 12 month period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1335","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2976","name":"Band stabilization per tooth","description":"Band stabilization per tooth","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4479","name":"Transanal irrigation, electr","description":"Electronic transanal irrigation system, includes electronic pump, water reservoir, tubing, and accessories, without catheter, any type","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2039","name":"Innovamatrix fd, per sq cm","description":"Innovamatrix fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1326","name":"Pts dx hypotony","description":"Patients with a diagnosis of hypotony","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6553","name":"G com stcking bk 30-40 custm","description":"Gradient compression stocking, below knee, 30-40 mmhg, custom, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2543","name":"Dental onlay metallic 3 surf","description":"Onlay - metallic - three surfaces","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58760","name":"Fimbrioplasty","description":"Fimbrioplasty","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":968.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9289","name":"Inj nivolumab 2 mg hyaluron","description":"Injection, nivolumab, 2 mg and hyaluronidase-nvhy","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0138","name":"Iv cipaglucosidase alfa-atga","description":"Intravenous infusion of cipaglucosidase alfa-atga, including provider/supplier acquisition and clinical supervision of oral administration of miglustat in preparation of receipt of cipaglucosidase alfa-atga","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1187","name":"Pt w/ esrd","description":"Patients with a diagnosis of end stage renal disease (esrd)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81003","name":"Urinalysis auto w/o scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; automated, without microscopy","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4343","name":"Dermacyte ac matrx per sq cm","description":"Dermacyte ac matrix amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0717T","name":"Adrc ther prtl rc tear","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; adipose tissue harvesting, isolation and preparation of harvested cells, including incubation with cell dissociation enzymes, filtration, washing, and concentration of adrcs","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0998T","name":"Precuneus mag stimj tx dlvr","description":"Precuneus magnetic stimulation; personalized treatment delivery of magnetic stimulation therapy to a prespecified target area derived from analysis of evoked potentials within the precuneus, utilizing magnetic resonance imaging-based neuronavigation, with management, per day","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87183","name":"Sc std carbapenem resist gen","description":"Susceptibility studies, antimicrobial agent; carbapenem resistance genes (eg, blakpc, blandm, blavim, blaoxa-48, blaimp), amplified probe technique, per isolate","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93788","name":"Ambl bp mntr w/sw a/r","description":"Ambulatory blood pressure monitoring, utilizing report-generating software, automated, worn continuously for 24 hours or longer; scanning analysis with report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3471","name":"Surg rep root res anterior","description":"Surg rep root res anterior","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1458","name":"Pt died bef end meas pd","description":"Patient died prior to the end of the performance period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1415","name":"No pos pdl1 bef ici ther","description":"Patients who did not have a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0539","name":"Initial care training 30 m","description":"Caregiver training in behavior management/modification for caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face; initial 30 minutes","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4323","name":"Alloply, per sq cm","description":"Alloply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0455U","name":"Nfct agt sti mult amp prb ur","description":"Nfct agt sti mult amp prb ur","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1452","name":"Pt dx dementia ever","description":"Patient ever had a diagnosis of dementia","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4261","name":"Tag, per square centimeter","description":"Tag, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1464","name":"No record of f/u by 180 days","description":"No documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9054","name":"Inj bortezomib boruzu 0.1 mg","description":"Injection, bortezomib (boruzu), 0.1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33882","name":"Evasc rpr ta dplmt mltpc sys","description":"Endovascular repair of the thoracic aorta by deployment of a branched endograft multipiece system involving an aorto-aortic tube device with a fenestration for the left subclavian artery stent graft(s) and all aortic tube endograft extension(s) placed from the level of the left common carotid artery","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6034","name":"Part hand finger distal amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s)/thumb, amputation at distal to metacarpal joint, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l669","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":353.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0786T","name":"Insj/rplcmt prq ra sac nstim","description":"Insertion or replacement of percutaneous electrode array, sacral, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0931T","name":"Ephys eval ccm-d ld separate","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), separate from initial implantation or replacement with testing of cardiac cont","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37260","name":"Revsc evasc ivt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5130","name":"Inj, fylnetra, 0.5 mg","description":"Injection, pegfilgrastim-pbbk (fylnetra), biosimilar, 0.5 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52700","name":"Drainage of prostate abscess","description":"Transurethral drainage of prostatic abscess","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":457.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1251","name":"Pts proxy cmplt hu surv","description":"Patients for whom a proxy completed the entire hu survey on their behalf for any reason (no patient involvement)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1353","name":"Sealant repair per tooth","description":"Sealant repair per tooth","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64622","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0865T","name":"Quan mri alys brn w/o dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion identification, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transm","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34704","name":"Evasc rpr a-unilac ndgft rpt","description":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-uni-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in th","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0461U","name":"Onc rxgenom alys rtpcr 24gen","description":"Onc rxgenom alys rtpcr 24gen","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65805","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86581","name":"Strptcs pneum antb serot ia","description":"Streptococcus pneumoniae antibody (igg), serotypes, multiplex immunoassay, quantitative","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4375","name":"Duograft ac per sq cm","description":"Duograft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99306","name":"1st nf care high mdm 50","description":"Initial nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 50 minutes must be met or exceed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":216.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90822","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4148","name":"Enteral feed elastomer daily","description":"Enteral feeding supply kit; elastomeric control fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1440","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6193","name":"Replace implnt screw","description":"Replace implnt screw","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1016T","name":"Elec alys npgs esoph intraop","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87250","name":"Virus inoculate eggs/animal","description":"Virus isolation; inoculation of embryonated eggs, or small animal, includes observation and dissection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5133","name":"Inj, tofidence, 1 mg","description":"Injection, tocilizumab-bavi (tofidence), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0989T","name":"Revj/rmvl ins ptn subq&subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1004T","name":"Elec alys s-scl eeg wo prgrm","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; without programming","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9956","name":"Admin home sleep apnea test","description":"Admin home sleep apnea test","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76511","name":"Oph us dx quan a-scan only","description":"Ophthalmic ultrasound, diagnostic; quantitative a-scan only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1419","name":"Pt not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3471","name":"Surg rep root res anterior","description":"Surg rep root res anterior","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0912T","name":"Elec alys nstim sys vgs smpl","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; with simple programming by physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4261","name":"Tag, per square centimeter","description":"Tag, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4007","name":"General surgery ss","description":"General surgery mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0167","name":"Inj epinephrine (hospira)","description":"Injection, epinephrine (hospira), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1012T","name":"Mtrz ab ntrno trph scl/tr mw","description":"Motorized ab interno trephination of sclera (sclerostomy), or trabecular meshwork (trabeculostomy), 1 or more, including injection of antifibrotic agents, when performed","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3471","name":"Surg rep root res anterior","description":"Surg rep root res anterior","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0751","name":"Hiv prep, ftc/taf 200/25mg","description":"Emtricitabine 200mg and tenofovir alafenamide 25mg, oral, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0513","name":"Prolong prev svcs, first 30m","description":"Prolonged preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient contact beyond the usual service; first 30 minutes (list separately in addition to code for preventive service)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":53.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0538U","name":"Onc sol tum ngts ffpe 600gen","description":"Onc sol tum ngts ffpe 600gen","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1188","name":"Pt w/ ckd stg 5","description":"Patients with a diagnosis of chronic kidney disease (ckd) stage 5","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4241","name":"Gngvl flap w rootplan 1-3 th","description":"Gingival flap procedure including root planing - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0997T","name":"Precuneus mag stimj tx plng","description":"Precuneus magnetic stimulation; treatment planning using magnetic resonance imaging-guided neuronavigation to determine optimal location, dose, and intensity for magnetic stimulation therapy, derived from evoked potentials from single pulses of electromagnetic energy recorded by 64-channel electroen","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0114","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1214","name":"Spiro results wth obs doc","description":"Spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and reviewed","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87468","name":"Anaplsma phgcytophlm amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); anaplasma phagocytophilum, amplified probe technique","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87564","name":"Mtb rifampin rst amp prb tq","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacterium tuberculosis, rifampin resistance, amplified probe technique","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2019","name":"Kerecis marigen shld sq cm","description":"Kerecis omega3 marigen shield, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0530","name":"Adult daycare center, 8 hr u","description":"Adult day center, 8-hour unit, for use in cmmi model","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40808","name":"Biopsy of mouth lesion","description":"Biopsy, vestibule of mouth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0168","name":"Epinephrine (intl med sys)","description":"Injection, epinephrine (international medication systems), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0311U","name":"Nfct ds bct quan antmcrb sc","description":"Nfct ds bct quan antmcrb sc","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1710","name":"Moderna vacc admin 3rd dose","description":"Moderna vacc admin 3rd dose","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6584","name":"Grad com wrap w straps","description":"Gradient compression wrap with adjustable straps, not otherwise specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64872","name":"Subsequent repair of nerve","description":"Suture of nerve; requiring secondary or delayed suture (list separately in addition to code for primary neurorrhaphy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1388","name":"Pt doc exm rec melmn","description":"Patients with documentation of an exam performed for recurrence of melanoma","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6094","name":"Abut support crown titanium","description":"Abutment supported crown - (titanium)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0910T","name":"Rmvl int nstim sys vagus nrv","description":"Removal of integrated neurostimulation system, vagus nerve","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52240","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; large bladder tumor(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7521","name":"Incision/drain abscess extra","description":"Incision and drainage of abscess - extraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4429","name":"Dermbnd chn, chx per sq cm","description":"Dermabind ch n or dermabind ch x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9596","name":"Gallium illuccix 1 millicure","description":"Gallium ga-68 gozetotide, diagnostic, (illuccix), 1 millicurie","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55845","name":"Extensive prostate surgery","description":"Prostatectomy, retropubic radical, with or without nerve sparing; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1805.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59426","name":"Antepartum care only","description":"Antepartum care only; 7 or more visits","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":672.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":992.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0991T","name":"Cysto lo-nrg lithtrp&mcrsphr","description":"Cystourethroscopy, with low-energy lithotripsy and acoustically actuated microspheres, including imaging","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37280","name":"Revsc evsc tpvt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0425U","name":"Genom rpd seq alys ea cmprtr","description":"Genom rpd seq alys ea cmprtr","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0261U","name":"Onc clrct ca img alys w/ai","description":"Oncology (colorectal cancer), image analysis with artificial intelligence assessment of 4 histologic and immunohistochemical features (cd3 and cd8 within tumor-stroma border and tumor core), tissue, reported as immune response and recurrence-risk score","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0924T","name":"Rpos prv ccm-d trnsvns eltrd","description":"Repositioning of previously implanted cardiac contractility modulation-defibrillation transvenous electrode(s)/lead(s), including fluoroscopic guidance and programming of sensing and therapeutic parameters","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1193","name":"Rpts w/ imp/con mmr/msi","description":"Surgical pathology reports that contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37290","name":"Revsc evsc tpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9955","name":"Oral app thxpy titration vis","description":"Oral app thxpy titration vis","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86825","name":"Hla x-math non-cytotoxic","description":"Human leukocyte antigen (hla) crossmatch, non-cytotoxic (eg, using flow cytometry); first serum sample or dilution","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87153","name":"Dna/rna sequencing","description":"Culture, typing; identification by nucleic acid sequencing method, each isolate (eg, sequencing of the 16s rrna gene)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0327U","name":"Ftl aneuploidy trsmy dna seq","description":"Ftl aneuploidy trsmy dna seq","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0429U","name":"Hpv orop swab 14 hi-risk typ","description":"Hpv orop swab 14 hi-risk typ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76883","name":"Us nrv&acc strux 1xtr compre","description":"Ultrasound, nerve(s) and accompanying structures throughout their entire anatomic course in one extremity, comprehensive, including real-time cine imaging with image documentation, per extremity","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5931","name":"Surgical obturator","description":"Obturator prosthesis surgical","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0897T","name":"N-invas augmnt arrhyt alys","description":"Noninvasive augmentative arrhythmia analysis derived from quantitative computational cardiac arrhythmia simulations, based on selected intervals of interest from 12-lead electrocardiogram and uploaded clinical parameters, including uploading clinical parameters with interpretation and report","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22532","name":"Arthrd lat xtrcvtry tq thrc","description":"Arthrodesis, lateral extracavitary technique, including minimal discectomy to prepare interspace (other than for decompression); thoracic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1948.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4397","name":"Summit aaa per sq cm","description":"Summit aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1270","name":"Pts no kid transplt wtlst","description":"Patients not on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1309","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77439","name":"Surf rad thr img gdn us plmt","description":"Surface radiation therapy; superficial or orthovoltage, image guidance, ultrasound for placement of radiation therapy fields for treatment of cutaneous tumors, per course of treatment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3425","name":"Hydroxocobalamin im 10mcg","description":"Injection, hydroxocobalamin, intramuscular, 10 mcg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1025T","name":"Alt elec fld dos&dlv sim mdl","description":"Alternating electric fields dosimetry and delivery-simulation modeling, creation and selection of patient-specific array layouts, and placement verification","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0850T","name":"Dgtz gls mcrscp ish ea mult","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4366","name":"Dl amnio bur x-mem per sq cm","description":"Dual layer amnio burgeon x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68841","name":"Insj rx elut implt lac canal","description":"Insertion of drug-eluting implant, including punctal dilation when performed, into lacrimal canaliculus, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87812","name":"Sarscov2&inf typ a&b w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) and influenza virus types a and b","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4286","name":"Remove non-resorb barrier","description":"Remove non-resorb barrier","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0543","name":"Group train w/o patient","description":"Group caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient pre","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3502","name":"Surg exp root surf premolar","description":"Surg exp root surf premolar","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92945","name":"Prq trl rvs ch occ ant&rtrgr","description":"Percutaneous transluminal revascularization of chronic total occlusion, single coronary artery, coronary artery branch, or coronary artery bypass graft, and/or subtended major coronary artery branches of the bypass graft, any combination of intracoronary stent, atherectomy and angioplasty; combined ","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0583U","name":"Rare ds rpd whlgen cmptr dna","description":"Rare ds rpd whlgen cmptr dna","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1430","name":"Ret exm ou no retinopthy doc","description":"Retinal exam finding without evidence of retinopathy in both eyes with severity level documented (in measurement year or in the prior year)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15014","name":"Prepj skn cll ssp agrft ea","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; each additional 25 sq cm of harvested skin or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","name":"Gait mod systm rhym auditory","description":"Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1178.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0598U","name":"Gi ibs igg antb 18food items","description":"Gi ibs igg antb 18food items","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90684","name":"Pcv21 vaccine im","description":"Pneumococcal conjugate vaccine, 21 valent (pcv21), for intramuscular use","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5934","name":"Mandibular flange prosthesis","description":"Mandibular resection prosthesis with guide flange","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74328","name":"X-ray bile duct endoscopy","description":"Endoscopic catheterization of the biliary ductal system, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0603U","name":"Rx asy prsmv 77rx/metablt ur","description":"Rx asy prsmv 77rx/metablt ur","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9997","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83521","name":"Ig light chains free each","description":"Immunoglobulin light chains (ie, kappa, lambda), free, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4199","name":"Cygnus matrix, per sq cm","description":"Cygnus matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4313","name":"Dermabind fm, per sq cm","description":"Dermabind fm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0688","name":"Inj cefazolin sodium, hikma","description":"Injection, cefazolin sodium (hikma), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93598","name":"Car outp meas drg cath chd","description":"Cardiac output measurement(s), thermodilution or other indicator dilution method, performed during cardiac catheterization for the evaluation of congenital heart defects (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J0550","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93151","name":"Interrog&prgrmg ipnss","description":"Interrogation and programming (minimum one parameter) of implanted phrenic nerve stimulator system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":33.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76090","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0032","name":"2+ antipsy schiz","description":"Two or more antipsychotic prescriptions ordered for patients who had a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder on or between january 1 of the year prior to the measurement period and the index prescription start date (ipsd) for antipsychotics","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0541U","name":"Cv ds hdl rct cec lc-ms/ms 5","description":"Cv ds hdl rct cec lc-ms/ms 5","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25622","name":"Cltx carpl scphd fx w/o mnpj","description":"Closed treatment of carpal scaphoid (navicular) fracture; without manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0818T","name":"Revj/rmvl ins ptn subq","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0011","name":"Hiv prep counsel, md 15-30m","description":"Individual counseling for pre-exposure prophylaxis (prep) by physician or qualified health care professional (qhp) to prevent human immunodeficiency virus (hiv), includes hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence, 15-30 minutes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0043","name":"Pt mech pros ht valv","description":"Patients with mechanical prosthetic heart valve","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4348","name":"Sentry sl matrix per sq cm","description":"Sentry sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0866T","name":"Quan mri alys brn w/dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion detection, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transmissio","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9359","name":"Inj lon tesirin-lpyl 0.075mg","description":"Injection, loncastuximab tesirine-lpyl, 0.075 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60521","name":"Removal of thymus gland","description":"Thymectomy, partial or total; sternal split or transthoracic approach, without radical mediastinal dissection (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1400.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5945","name":"Mand implt sup remv part","description":"Mand implt sup remv part","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42975","name":"Dise eval slp do brth flx dx","description":"Drug-induced sleep endoscopy, with dynamic evaluation of velum, pharynx, tongue base, and larynx for evaluation of sleep-disordered breathing, flexible, diagnostic","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9244","name":"Office min sed drug enteral","description":"Office min sed drug enteral","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0478U","name":"Onc nsclc dna&rna dpcr 9 gen","description":"Onc nsclc dna&rna dpcr 9 gen","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15853","name":"Removal sutr/stapl xreq anes","description":"Removal of sutures or staples not requiring anesthesia (list separately in addition to e/m code)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87269","name":"Giardia ag if","description":"Infectious agent antigen detection by immunofluorescent technique; giardia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19368","name":"Brst rcnstj 1pdcl tram anast","description":"Breast reconstruction; with single-pedicled transverse rectus abdominis myocutaneous (tram) flap, requiring separate microvascular anastomosis (supercharging)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2578.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33250","name":"Ablate heart dysrhythm focus","description":"Operative ablation of supraventricular arrhythmogenic focus or pathway (eg, wolff-parkinson-white, atrioventricular node re-entry), tract(s) and/or focus (foci); without cardiopulmonary bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1612.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0722T","name":"Quan ct tiss charac w/ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained with concurrent ct examination of any structure contained in the concurrently acquired diagnostic imaging dataset (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1238","name":"Doc 2nd recom hzv 2-6 mo int","description":"Documentation that administration of second recombinant zoster vaccine could not occur during the performance period due to the recommended 2-6 month interval between doses (i.e, first dose received after october 31)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15110","name":"Epidrm agrft t/a/l 1st 100","description":"Epidermal autograft, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":807.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11307","name":"Shave skin lesion 1.1-2.0 cm","description":"Shaving of epidermal or dermal lesion, single lesion, scalp, neck, hands, feet, genitalia; lesion diameter 1.1 to 2.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0740T","name":"Rem auton alg nsln cal setup","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; initial set-up and patient education","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26843","name":"Fusion of hand joint","description":"Arthrodesis, carpometacarpal joint, digit, other than thumb, each;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0342U","name":"Onc pncrtc ca mult ia eclia","description":"Onc pncrtc ca mult ia eclia","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0562","name":"Complex simulation w/pet-ct","description":"Therapeutic radiology simulation-aided field setting; complex, including acquisition of pet and ct imaging data required for radiopharmaceutical-directed radiation therapy treatment planning (i.e., modeling)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27888","name":"Amputation of foot at ankle","description":"Amputation, ankle, through malleoli of tibia and fibula (eg, syme, pirogoff type procedures), with plastic closure and resection of nerves","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":849.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0786T","name":"Insj/rplcmt prq ra sac nstim","description":"Insertion or replacement of percutaneous electrode array, sacral, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01942","name":"Anes neuromd/ntrvrt lmbr/sac","description":"Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41823","name":"Excision of gum lesion","description":"Excision of osseous tuberosities, dentoalveolar structures","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9370","name":"Vincristine sulfate 1 mg inj","description":"Vincristine sulfate, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0274U","name":"Hem gen pltlt do 43 genes","description":"Hematology (genetic platelet disorders), genomic sequence analysis of 43 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90937","name":"Hemodialysis repeated eval","description":"Hemodialysis procedure requiring repeated evaluation(s) with or without substantial revision of dialysis prescription","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59515","name":"Cesarean delivery","description":"Cesarean delivery only; including postpartum care","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1330.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0570U","name":"Neurol tbi alys gfap&uch-l1","description":"Neurol tbi alys gfap&uch-l1","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97608","name":"Neg prs wnd ther ndme>50sqcm","description":"Negative pressure wound therapy, (eg, vacuum assisted drainage collection), utilizing disposable, non-durable medical equipment including provision of exudate management collection system, topical application(s), wound assessment, and instructions for ongoing care, per session; total wound(s) surfac","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":467.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":24.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50782","name":"Reimplant ureter in bladder","description":"Ureteroneocystostomy; anastomosis of duplicated ureter to bladder","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1310.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27424","name":"Revision/removal of kneecap","description":"Reconstruction of dislocating patella; with patellectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":895.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9154","name":"Artificial saliva, 1 ml","description":"Artificial saliva, 1 ml","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0304U","name":"Hem rbc ads whl bld normoxic","description":"Hem rbc ads whl bld normoxic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77437","name":"Surf radj ther supfc<=150kv","description":"Surface radiation therapy; superficial, delivery, </=150 kv, per fraction (eg, electronic brachytherapy)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92634","name":"Hearing aid fitg svc 1st 60","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; first 60 minutes","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64728","name":"Dcmprn median nrv carpl tunl","description":"Decompression; median nerve at the carpal tunnel, percutaneous, with intracarpal tunnel balloon dilation, including ultrasound guidance","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82233","name":"Beta-amyloid 1-40 (abeta 40)","description":"Beta-amyloid; 1-40 (abeta 40)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59020","name":"Fetal contract stress test","description":"Fetal contraction stress test","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58140","name":"Myomectomy abdom method","description":"Myomectomy, excision of fibroid tumor(s) of uterus, 1 to 4 intramural myoma(s) with total weight of 250 g or less and/or removal of surface myomas; abdominal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01938","name":"Anes drg/aspir lmbr/sac","description":"Anesthesia for percutaneous image-guided injection, drainage or aspiration procedures on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15013","name":"Prepj skn cll ssp agrft 1st","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; first 25 sq cm or less of harvested skin","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81001","name":"Urinalysis auto w/scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; automated, with microscopy","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2015","name":"Phoenix wnd mtrx, per sq cm","description":"Phoenix wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0534U","name":"Onc prst8 mirna snp 32 vrnt","description":"Onc prst8 mirna snp 32 vrnt","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2003","name":"Inj, lidocaine hcl, 1 mg","description":"Injection, lidocaine hydrochloride, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0518U","name":"Ther rx mntr 90+ pn&mtl hlth","description":"Ther rx mntr 90+ pn&mtl hlth","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55713","name":"Bx prst8 in-bore ct/mri bx 1","description":"Biopsy, prostate, in-bore ct- or mri-guided (ie, sextant), with biopsy of additional targeted lesion(s), first targeted lesion","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0511U","name":"Onc sol tum 3dmicroenvir 36+","description":"Onc sol tum 3dmicroenvir 36+","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26727","name":"Treat finger fracture each","description":"Percutaneous skeletal fixation of unstable phalangeal shaft fracture, proximal or middle phalanx, finger or thumb, with manipulation, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9244","name":"Office min sed drug enteral","description":"Office min sed drug enteral","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4440","name":"Curamatrix per sq cm","description":"Curamatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64656","name":"Revj/rplcmt bat mod sys pg","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; pulse generator only","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15011","name":"Hrv skn cll ssp agrft 1st 25","description":"Harvest of skin for skin cell suspension autograft; first 25 sq cm or less","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9196","name":"Inj gemcitabine hcl (accord)","description":"Injection, gemcitabine hydrochloride (accord), not therapeutically equivalent to j9201, 200 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1419","name":"Pt not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0285U","name":"Onc rsps radj cll fr dna tox","description":"Onc rsps radj cll fr dna tox","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64657","name":"Rmvl bat modulj sys tot sys","description":"Removal of baroreflex activation therapy (bat) modulation system; total system, including lead and pulse generator","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90484","name":"Imm cnsl not admn sm>20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 20 minutes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"Adju cgm supply allowance","description":"Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37265","name":"Revsc evsc fpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64584","name":"Rmvl hpglsl nstim ary pg","description":"Removal of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93593","name":"R hrt cath chd nml nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; normal native connections","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1167","name":"Hspc dur meas pd","description":"In hospice or using hospice services during the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0739T","name":"Abltj mal prst8 mag fld ndct","description":"Ablation of malignant prostate tissue by magnetic field induction, including all intraprocedural, transperineal needle/catheter placement for nanoparticle installation and intraprocedural temperature monitoring, thermal dosimetry, bladder irrigation, and magnetic field nanoparticle activation","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1352","name":"Suicd c-ssrs assessment, equ","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs or equivalent assessment","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0739","name":"Rehab sys active assist rt","description":"Rehabilitation system with interactive interface providing active assistance in rehabilitation therapy, includes all components and accessories, motors, microprocessors, sensors","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0724T","name":"Qmrcp w/dx mri same anatomy","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained with diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in additio","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9275","name":"Inj cosibelimab-ipdl, 2 mg","description":"Injection, cosibelimab-ipdl, 2 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87516","name":"Hepatitis b dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis b virus, amplified probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97008","name":"Mchnl sclp cool prep plmt","description":"Mechanical scalp cooling; including hair preparation, individual cap placement, therapy initiation, and precooling period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11740","name":"Evacuation subungual hmtma","description":"Evacuation of subungual hematoma","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0460U","name":"Onc whl bld/bucc rtpcr 24gen","description":"Onc whl bld/bucc rtpcr 24gen","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0385U","name":"Neph ckd alg rsk dbtc kdn ds","description":"Neph ckd alg rsk dbtc kdn ds","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0684T","name":"Peri-px dev eval isdss ip","description":"Peri-procedural device evaluation (in-person) and programming of device system parameters before or after a surgery, procedure, or test with analysis, review, and report by a physician or other qualified health care professional, permanent implantable synchronized diaphragmatic stimulation system fo","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0987T","name":"Iv img icr cere vsl oct ea","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0697T","name":"Quan mr tis wo mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained without diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, targ","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0879","name":"Difelikefalin, esrd on dialy","description":"Injection, difelikefalin, 0.1 microgram, (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7472","name":"Removal of torus palatinus","description":"Removal of torus palatinus","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1402","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1431","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37160","name":"Revision of circulation","description":"Venous anastomosis, open; caval-mesenteric","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1498.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37258","name":"Revsc evasc ivt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92636","name":"Hearing aid post-fitg f-up 1","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91113","name":"Gi trc img intral colon i&r","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9255","name":"Inj, methotrexate (accord)","description":"Injection, methotrexate (accord), not therapeutically equivalent to j9260, 50 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33949","name":"Ecmo/ecls daily mgmt artery","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; daily management, each day, veno-arterial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80505","name":"Path clin consltj high 41-60","description":"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patients history and medical records and high level of medical decision making when using time for code selection, 41-60 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"Evaluation of wheezing","description":"Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6602","name":"Cst hgh nble mtl inlay 2 srf","description":"Inlay - cast high noble metal two surfaces","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0558","name":"Adv prim care mgmt lvl 3","description":"Advanced primary care management services for a patient that is a qualified medicare beneficiary with multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, which place the patient at significant risk of death, acute exacerbation/decompensat","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1272","name":"Pts kid transplt wtlst","description":"Patients observed on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9596","name":"Gallium illuccix 1 millicure","description":"Gallium ga-68 gozetotide, diagnostic, (illuccix), 1 millicurie","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49618","name":"Rpr aa hrn rcr > 10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, incarcerated or strangulate","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2470","name":"Inj pantoprazole sodium 40mg","description":"Injection, pantoprazole sodium, 40 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92629","name":"Eval hearing aid cand ea add","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0827T","name":"Dgtz gls mcrscp cytp smears","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; smears with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0945T","name":"Intraop assmt abnl tum tiss","description":"Intraoperative assessment for abnormal (tumor) tissue, in-vivo, following partial mastectomy (eg, lumpectomy) using computer-aided fluorescence imaging (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4325","name":"Acapatch, per sq cm","description":"Acapatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0426U","name":"Genome ultra-rapid seq alys","description":"Genome ultra-rapid seq alys","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0031","name":"Pall serv during meas","description":"Palliative care services given to patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4356","name":"Abio mem abio hyd per sq cm","description":"Abiomend membrane and abiomend hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0702","name":"2d cephal radio image","description":"2d cephal radio image","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49550","name":"Rpr rem hernia init reduce","description":"Repair initial femoral hernia, any age; reducible","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":620.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82271","name":"Occult blood other sources","description":"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; other sources","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84425","name":"Assay of vitamin b-1","description":"Thiamine (vitamin b-1)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":946.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2596","name":"Vasopressin (long grove) 1 u","description":"Injection, vasopressin (long grove), not therapeutically equivalent to j2598, 1 unit","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29895","name":"Ankle arthroscopy/surgery","description":"Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; synovectomy, partial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":617.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97550","name":"Caregiver traing 1st 30 min","description":"Caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patie","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0832T","name":"Dgtz gls mcrscp cytp oth scr","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99242","name":"Off/op consltj new/est sf 20","description":"Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":53.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2516","name":"Inj, pentamidine isethionate","description":"Injection, pentamidine isethionate, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86258","name":"Dgp antibody each ig class","description":"Gliadin (deamidated) (dgp) antibody, each immunoglobulin (ig) class","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0612U","name":"Onc lvr alys >1000 mr cfdna","description":"Onc lvr alys >1000 mr cfdna","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76810","name":"Ob us >/= 14 wks addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0274U","name":"Hem gen pltlt do 43 genes","description":"Hematology (genetic platelet disorders), genomic sequence analysis of 43 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0457U","name":"Pfas 9 cmpnd lcms/ms pls/sr","description":"Pfas 9 cmpnd lcms/ms pls/sr","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0527","name":"Mgt est pt dmentia low cmplx","description":"Management of established patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1195","name":"Rpt wo imp/con mmr/msi","description":"Surgical pathology reports that do not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both, reason not given","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0033","name":"2+ benzo seiz","description":"Two or more benzodiazepine prescriptions ordered for patients who had a diagnosis of seizure disorders, rapid eye movement sleep behavior disorder, benzodiazepine withdrawal, ethanol withdrawal, or severe generalized anxiety disorder on or between january 1 of the year prior to the measurement perio","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9224","name":"Gen anes adv air-15 min","description":"Gen anes adv air-15 min","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0742T","name":"Aqmbf spect xers/strs & rest","description":"Absolute quantitation of myocardial blood flow (aqmbf), single-photon emission computed tomography (spect), with exercise or pharmacologic stress, and at rest, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86638","name":"Q fever antibody","description":"Antibody; coxiella burnetii (q fever)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0744T","name":"Insj bioprostc vlv fem vn","description":"Insertion of bioprosthetic valve, open, femoral vein, including duplex ultrasound imaging guidance, when performed, including autogenous or nonautogenous patch graft (eg, polyester, eptfe, bovine pericardium), when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86042","name":"Acetylcholn rcptr blckg antb","description":"Acetylcholine receptor (achr); blocking antibody","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55877","name":"Abltj ire prst8 1+ tum perq","description":"Ablation, irreversible electroporation, prostate, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1419","name":"Pt not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0476U","name":"Rx metab psyc 14gen&cyp2d6","description":"Rx metab psyc 14gen&cyp2d6","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1214","name":"Spiro results wth obs doc","description":"Spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and reviewed","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5158","name":"Inj, denosumab-bnht, 1 mg","description":"Injection, denosumab-bnht (bomyntra/conexxence), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0910T","name":"Rmvl int nstim sys vagus nrv","description":"Removal of integrated neurostimulation system, vagus nerve","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49905","name":"Omental flap intra-abdom","description":"Omental flap, intra-abdominal (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86041","name":"Acetylcholn rcptr bndng antb","description":"Acetylcholine receptor (achr); binding antibody","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1420","name":"Complete ophthalmologic mvp","description":"Complete ophthalmologic care mips value pathway","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0387","name":"Comp image capture only","description":"Comp image capture only","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33900","name":"Perq p-art revsc 1 nm nt uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, unilateral","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0024","name":"Pin srv add 30 min pr m","description":"Principal illness navigation services, additional 30 minutes per calendar month (list separately in addition to g0023)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37288","name":"Revsc evsc tpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99445","name":"Rem mntr physiol param 2-15","description":"Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate); device(s) supply with daily recording(s) or programmed alert(s) transmission, 2-15 days in a 30-day period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4420","name":"Nuform per sq cm","description":"Nuform, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1424","name":"Pulmonology care mvp","description":"Pulmonology care mips value pathway","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1412","name":"Met nsclc w/ egfr alk oth ab","description":"Patients with metastatic nsclc with epidermal growth factor receptor (egfr) mutations, alk genomic tumor aberrations, or other targetable genomic abnormalities with approved first-line targeted therapy, such as nsclc with ros1 rearrangement, braf v600e mutation, ntrk 1/2/3 gene fusion, met ex14 skip","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G3002","name":"Chronic pain mgmt 30 mins","description":"Chronic pain management and treatment, monthly bundle including, diagnosis; assessment and monitoring; administration of a validated pain rating scale or tool; the development, implementation, revision, and/or maintenance of a person-centered care plan that includes strengths, goals, clinical needs,","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1301","name":"Immunization counseling","description":"Immunization counseling","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0593U","name":"Nfct ds gu pthgn dna 46trgt","description":"Nfct ds gu pthgn dna 46trgt","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4330","name":"Total, per sq cm","description":"Total, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0946T","name":"Ortho impl mvmt alys pair ct","description":"Orthopedic implant movement analysis using paired computed tomography (ct) examination of the target structure, including data acquisition, data preparation and transmission, interpretation and report (including ct scan of the joint or extremity performed with paired views)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49596","name":"Rpr aa hrn 1st > 10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, incarcerated or strangulated","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7956","name":"Tiss regen edent resorb","description":"Tiss regen edent resorb","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4330","name":"Total, per sq cm","description":"Total, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5148","name":"Inj, nyposi 1 mcg","description":"Injection, filgrastim-txid (nypozi), biosimilar, 1 microgram","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0772T","name":"Vr px dissoc svc sm phy ea","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92623","name":"Dx aly aud oi snd prcsr each","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; each additional 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4253","name":"Zenith amniotic membrane psc","description":"Zenith amniotic membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0676T","name":"Laps insj nw/rpcmt isdss ea","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional lead (list separately in addition to code for primary ","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1254","name":"Pts deceased prior hu surv","description":"Patients who were deceased when the hu survey reached them","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76642","name":"Ultrasound breast limited","description":"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0520","name":"Bethanechol chloride inject","description":"Injection, bethanechol chloride, myotonachol or urecholine, up to 5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65286","name":"Repair of eye wound","description":"Repair of laceration; application of tissue glue, wounds of cornea and/or sclera","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65781","name":"Ocular reconst transplant","description":"Ocular surface reconstruction; limbal stem cell allograft (eg, cadaveric or living donor)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1394.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0749T","name":"B1 str&fx rsk assmt dxr-bmd","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93153","name":"Interrog w/o prgrmg ipnss","description":"Interrogation without programming of implanted phrenic nerve stimulator system","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1166","name":"Path rpt tis spec wle/reexc","description":"Pathology report for tissue specimens produced from wide local excisions or re-excisions","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9596","name":"Gallium illuccix 1 millicure","description":"Gallium ga-68 gozetotide, diagnostic, (illuccix), 1 millicurie","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0701T","name":"Molec fluor img sus nev ea","description":"Molecular fluorescent imaging of suspicious nevus; each additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87484","name":"Ehrlicha chaffeensis amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); ehrlichia chaffeensis, amplified probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0501U","name":"Onc clrc bld quan meas cfdna","description":"Onc clrc bld quan meas cfdna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20827","name":"Replantation thumb complete","description":"Replantation, thumb (includes distal tip to mp joint), complete amputation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3054.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"Sup/ext non-ins inf pump syr","description":"Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31243","name":"Nsl/sinus ndsc cryoabltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by cryoablation, posterior nasal nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4312","name":"Acesso ac, per sq cm","description":"Acesso ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53451","name":"Tprnl balo cntnc dev bi","description":"Periurethral transperineal adjustable balloon continence device; bilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2642","name":"Dental onlay porcelin 2 surf","description":"Onlay - porcelain/ceramic - two surfaces","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51585","name":"Removal of bladder & nodes","description":"Cystectomy, complete, with ureterosigmoidostomy or ureterocutaneous transplantations; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2237.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0286U","name":"Cep72 nudt15&tpmt gene alys","description":"Cep72 nudt15&tpmt gene alys","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87273","name":"Herpes simplex 2 ag if","description":"Infectious agent antigen detection by immunofluorescent technique; herpes simplex virus type 2","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6517","name":"Grad com wrap w strap bn cus","description":"Gradient compression wrap with adjustable straps, below knee, each, custom","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9246","name":"Mod sedation noniv-15 min","description":"Mod sedation noniv-15 min","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6036","name":"Prosthetic thumb mechanical","description":"Prosthetic thumb, mechanical, can include metacarpophalangeal (mcp), interphalangeal (ip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15016","name":"App skn cl ssp agrf t/a/l ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; each additional 480 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81456","name":"So/hl 51/>gsap rna alys","description":"Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic sequence analysis panel, interrogation for sequence variants and copy number variants or rearrangements, or isoform expression or mrna expression levels, if performed; rna analysis","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1033","name":"Sv doula brth wrk per diem","description":"Services performed by a doula birth worker, per diem","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0717T","name":"Adrc ther prtl rc tear","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; adipose tissue harvesting, isolation and preparation of harvested cells, including incubation with cell dissociation enzymes, filtration, washing, and concentration of adrcs","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4263","name":"Surgraft tl, per sq cm","description":"Surgraft tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4372","name":"Amchoplast excl per sq cm","description":"Amchoplast excel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3055","name":"Inj talquetamab-tgvs 0.25 mg","description":"Injection, talquetamab-tgvs, 0.25 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1444","name":"Del < 39 weeks gest","description":"Delivery at < 39 weeks of gestation","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0705T","name":"Rem tx amblyopia tech sprt","description":"Remote treatment of amblyopia using an eye tracking device; surveillance center technical support including data transmission with analysis, with a minimum of 18 training hours, each 30 days","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44640","name":"Repair bowel-skin fistula","description":"Closure of intestinal cutaneous fistula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1463.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0414","name":"Lab process microbial spec","description":"Lab process microbial spec","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1488","name":"Dx dementia in msr timeframe","description":"Patients with a diagnosis for dementia in the year before or during the period of evaluation","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0136","name":"Inj, acetaminophen (b braun)","description":"Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98015","name":"Synch audio-only est high 40","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selec","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83018","name":"Heavy metal quan each nes","description":"Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); quantitative, each, not elsewhere specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1369","name":"Qualcare mental hlth/sud mvp","description":"Quality care in mental health and substance use disorders mips value pathway","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37265","name":"Revsc evsc fpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5160","name":"Inj, jobevne, 10 mg","description":"Injection, bevacizumab-nwgd (jobevne), biosimilar, 10 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2028","name":"Micromatrix flex per mg","description":"Micromatrix flex, per mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95028","name":"Iq tsts allergy delayed rxn","description":"Intracutaneous (intradermal) tests with allergenic extracts, delayed type reaction, including reading, specify number of tests","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78491","name":"Myocrd img pet 1std rst/strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); single study, at rest or stress (exercise or pharmacologic)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J9080","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9064","name":"Inj, cabazitaxel (sandoz)","description":"Injection, cabazitaxel (sandoz), not therapeutically equivalent to j9043, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2371","name":"Inj phenylephrine hcl 20 mcg","description":"Injection, phenylephrine hydrochloride, 20 micrograms","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90637","name":"Vacc qirv mrna 30mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 30 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0270U","name":"Hem cgen coagj do 20 genes","description":"Hematology (congenital coagulation disorders), genomic sequence analysis of 20 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3421","name":"Root surgery bicuspid","description":"Apicoectomy/periradicular surgery-bicuspid (first root)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4413","name":"Cygnus solo per sq cm","description":"Cygnus solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2794","name":"Inj risperdal consta, 0.5 mg","description":"Injection, risperidone (risperdal consta), 0.5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98000","name":"Synch audio-video new sf 15","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 15 minutes must be met or exceeded.","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37257","name":"Revsc evsc ivt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":94.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1279","name":"Pre-htn/htn, no f/u, not gvn","description":"Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55874","name":"Tprnl plmt biodegrdabl matrl","description":"Transperineal placement of biodegradable material, peri-prostatic, single or multiple injection(s), including image guidance, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4399.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":164.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15011","name":"Hrv skn cll ssp agrft 1st 25","description":"Harvest of skin for skin cell suspension autograft; first 25 sq cm or less","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4545","name":"Suppl accessor tibial stim","description":"Supplies and accessories for external tibial nerve stimulator (e.g., socks, gel pads, electrodes, etc.), needed for one month","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0536U","name":"Rbcag ftl rhd pcr alys exon4","description":"Rbcag ftl rhd pcr alys exon4","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37284","name":"Revsc evasc tpvt st sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93588","name":"Vngrph chd vnvn cltrl below","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating below the heart (eg, from the inferior vena cava) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90834","name":"Psytx w pt 45 minutes","description":"Psychotherapy, 45 minutes with patient","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":120.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0619U","name":"Pulm copd dna alys >18000","description":"Pulm copd dna alys >18000","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0546","name":"Phone/internet ehr assess","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty   whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patien","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0688","name":"Inj cefazolin sodium, hikma","description":"Injection, cefazolin sodium (hikma), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43645","name":"Lap gastr bypass incl smll i","description":"Laparoscopy, surgical, gastric restrictive procedure; with gastric bypass and small intestine reconstruction to limit absorption","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2017.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0329U","name":"Onc neo xome&trns seq alys","description":"Onc neo xome&trns seq alys","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0409U","name":"Onc sld tum dna 80 & rna 36","description":"Onc sld tum dna 80 & rna 36","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0738T","name":"Tx pln mag fld abltj prst8","description":"Treatment planning for magnetic field induction ablation of malignant prostate tissue, using data from previously performed magnetic resonance imaging (mri) examination","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4385","name":"Apollo ft per sq cm","description":"Apollo ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0668","name":"Team remote e/m est pt 40 mn","description":"Team remote e/m est. pt 40mins","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61606","name":"Resect/excise cranial lesion","description":"Resection or excision of neoplastic, vascular or infectious lesion of infratemporal fossa, parapharyngeal space, petrous apex; intradural, including dural repair, with or without graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3343.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1381","name":"Pt sec strk wthin 5 days","description":"Patients with secondary stroke (e.g., a subsequent stroke that may occur with vasospasm in the setting of subarachnoid hemorrhage) within 5 days of the initial procedure","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0791T","name":"Motr cog vr gait train ea 15","description":"Motor-cognitive, semi-immersive virtual reality-facilitated gait training, each 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0818T","name":"Revj/rmvl ins ptn subq","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0835T","name":"Dgtz gls mcrscp fna 1st ea","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2034","name":"Found drs solo, per sq cm","description":"Foundation drs solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5877","name":"Dup of complt dent-maxill","description":"Dup of complt dent-maxill","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1449","name":"Pt dx scz/pys bef end msr pd","description":"Patients with an active diagnosis of schizophrenia or psychotic disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55882","name":"Ablt trurl prst8 tis trnsdcr","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation; with insertion of transurethral ultrasound transducer for delivery of thermal ultrasound, including suprapubic tube placement and placement of ","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0835T","name":"Dgtz gls mcrscp fna 1st ea","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4271","name":"Complete ft per sq cm","description":"Complete ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0906T","name":"Coms ther 1st appl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; first application, total wound(s) surface area less than or equal to 50 sq cm","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4012","name":"Interventional rad ss","description":"Interventional radiology mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15017","name":"App skn cll ssp f/n/g/hf 1st","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 480 sq cm or less","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81339","name":"Mpl gene seq alys exon 10","description":"Mpl (mpl proto-oncogene, thrombopoietin receptor) (eg, myeloproliferative disorder) gene analysis; sequence analysis, exon 10","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5152","name":"Inj, eculizumab-aeeb, 2 mg","description":"Injection, eculizumab-aeeb (bkemv), biosimilar, 2 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59130","name":"Treat ectopic pregnancy","description":"Surgical treatment of ectopic pregnancy; abdominal pregnancy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1026.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87469","name":"Babesia microti amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); babesia microti, amplified probe technique","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0038","name":"Clin pt no ref","description":"Clinician determines patient does not require referral","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0493U","name":"Trnspl med quan dd-cfdna ngs","description":"Trnspl med quan dd-cfdna ngs","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44204","name":"Laparo partial colectomy","description":"Laparoscopy, surgical; colectomy, partial, with anastomosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1690.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0423","name":"Genetic test spec analysis","description":"Genetic test spec analysis","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86684","name":"Hemophilus influenza antibdy","description":"Antibody; haemophilus influenza","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86064","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0534U","name":"Onc prst8 mirna snp 32 vrnt","description":"Onc prst8 mirna snp 32 vrnt","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4015","name":"Neurology ss","description":"Neurology mips specialty set","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1494","name":"Fall rep since last visit","description":"Patients that reported a fall since the last visit","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9957","name":"Screening sleep disorders","description":"Screening sleep disorders","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49594","name":"Rpr aa hrn 1st 3-10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, incarcerated or strangulated","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1383","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81441","name":"Ibmfs seq alys pnl 30 genes","description":"Inherited bone marrow failure syndromes (ibmfs) (eg, fanconi anemia, dyskeratosis congenita, diamond-blackfan anemia, shwachman-diamond syndrome, gata2 deficiency syndrome, congenital amegakaryocytic thrombocytopenia) sequence analysis panel, must include sequencing of at least 30 genes, including b","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0350","name":"Oral/facial photo images","description":"Oral/facial photographic images","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63266","name":"Excise intrspinl lesion thrc","description":"Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; thoracic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1889.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0527U","name":"Hsv 1&2 vzv amp prb tq pthgn","description":"Hsv 1&2 vzv amp prb tq pthgn","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0343U","name":"Onc prst8 xom aly 442 sncrna","description":"Onc prst8 xom aly 442 sncrna","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0314U","name":"Onc cutan mlnma mrna 35 gene","description":"Onc cutan mlnma mrna 35 gene","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4395","name":"Acelagraft per sq cm","description":"Acelagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15015","name":"App skn cl ssp agrft t/a/l 1","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; first 480 sq cm or less","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0472","name":"Gross exam prep & report","description":"Accession of tissue gross examination preparation and transmission of written report","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3402","name":"Inj. remestemcel-l-rknd/ td","description":"Injection, remestemcel-l-rknd, per therapeutic dose","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0019","name":"Comm hlth intg svs sdoh 60mn","description":"Community health integration services performed by certified or trained auxiliary personnel, including a community health worker, under the direction of a physician or other practitioner; 60 minutes per calendar month, in the following activities to address social determinants of health (sdoh) need(","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0282U","name":"Rbc dna gntyp 12 bld grp gen","description":"Red blood cell antigen typing, dna, genotyping of 12 blood group system genes to predict 44 red blood cell antigen phenotypes","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0184","name":"Inj, amisulpride, 1 mg","description":"Injection, amisulpride, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5137","name":"Inj, wezlana, sub cu, 1 mg","description":"Injection, ustekinumab-auub (wezlana), biosimilar, subcutaneous, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0610U","name":"Nfct ds antmcr sc phenotypic","description":"Nfct ds antmcr sc phenotypic","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1205","name":"Isa reduced >=3","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0269U","name":"Hem aut dm cgen trmbctpna 14","description":"Hematology (autosomal dominant congenital thrombocytopenia), genomic sequence analysis of 14 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70473","name":"Ct cere prfu aly c+wo ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed without concurrent ct or ct angiography of the same anatomy","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0175","name":"Inj, donanemab-azbt, 2 mg","description":"Injection, donanemab-azbt, 2 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0443U","name":"Neurflmnt lt chn ultrsens ia","description":"Neurflmnt lt chn ultrsens ia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1231","name":"Pt hcv tst no reactive res","description":"Patient receives hcv antibody test with nonreactive result","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6519","name":"Grad com garm noc night use","description":"Gradient compression garment, not otherwise specified, for nighttime use, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0718T","name":"Adrc ther prtl rc tear njx","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; injection into supraspinatus tendon including ultrasound guidance, unilateral","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4028","name":"Podiatry ss","description":"Podiatry mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4438","name":"Pretect per sq cm","description":"Pretect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0948T","name":"Rem interrog dev ccm phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system with interim analysis, review, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2820","name":"Sargramostim injection","description":"Injection, sargramostim (gm-csf), 50 mcg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0566U","name":"Onc lng qpcr-bsd alys 13dmrs","description":"Onc lng qpcr-bsd alys 13dmrs","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37270","name":"Revsc evasc fpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1468","name":"Hep b vaccine received","description":"Patient received recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67450","name":"Explore/biopsy eye socket","description":"Orbitotomy with bone flap or window, lateral approach (eg, kroenlein); for exploration, with or without biopsy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1296.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64605","name":"Injection treatment of nerve","description":"Destruction by neurolytic agent, trigeminal nerve; second and third division branches at foramen ovale","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0371","name":"Sialoendoscopy capt & interp","description":"Sialoendoscopy capt & interp","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0044","name":"Pt mitral stenosis","description":"Patients with moderate or severe mitral stenosis","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61600","name":"Resect/excise cranial lesion","description":"Resection or excision of neoplastic, vascular or infectious lesion of base of anterior cranial fossa; extradural","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2230.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9011","name":"Datopotamab deruxtecan, 1 mg","description":"Injection, datopotamab deruxtecan-dlnk, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0134","name":"Inj acetaminophen -fresenius","description":"Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32200","name":"Drain open lung lesion","description":"Pneumonostomy, with open drainage of abscess or cyst","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1157.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1316","name":"Tobacco non-user","description":"Current tobacco non-user","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1299","name":"Inj, eculizumab, 2 mg","description":"Injection, eculizumab, 2 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69550","name":"Exc aurl glomus tum trnscanl","description":"Excision aural glomus tumor; transcanal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1214.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0537U","name":"Onc clrct ca cfdna >2500 dmr","description":"Onc clrct ca cfdna >2500 dmr","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0957T","name":"Rev s-sclp eltr ra rcvr&tlmt","description":"Revision of sub-scalp implanted electrode array, receiver, and telemetry unit for electrode, when required, including imaging guidance","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0712T","name":"N-nvs artl plaq alys quan","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess atherosclerotic plaque stability","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99437","name":"Chrnc care mgmt phys ea addl","description":"Chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, or funct","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50021","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9266","name":"Pegaspargase injection","description":"Injection, pegaspargase, per single dose vial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1459.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0506U","name":"Gi barretts esophgl cell 89","description":"Gi barretts esophgl cell 89","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1290","name":"Pt not eli d/t act dig htn","description":"Patient not eligible due to active diagnosis of hypertension","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0460U","name":"Onc whl bld/bucc rtpcr 24gen","description":"Onc whl bld/bucc rtpcr 24gen","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1011T","name":"Pbm therapy of oral cavity","description":"Photobiomodulation (pbm) therapy of oral cavity, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75580","name":"N-invas est c ffr sw aly cta","description":"Noninvasive estimate of coronary fractional flow reserve (ffr) derived from augmentative software analysis of the data set from a coronary computed tomography angiography, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2031","name":"Mirodry, per sq cm","description":"Mirodry wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0690T","name":"Quan us tis charac w/dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained with diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0339U","name":"Onc prst8 mrna hoxc6 & dlx1","description":"Onc prst8 mrna hoxc6 & dlx1","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87513","name":"H pylri clrthmcn rst amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); helicobacter pylori (h. pylori), clarithromycin resistance, amplified probe technique","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4253","name":"Zenith amniotic membrane psc","description":"Zenith amniotic membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33269","name":"Excl laa thrscp any method","description":"Exclusion of left atrial appendage, thoracoscopic, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0559","name":"Unrelat prac follow up visit","description":"Post-operative follow-up visit complexity inherent to evaluation and management services addressing surgical procedure(s), provided by a physician or qualified health care professional who is not the practitioner who performed the procedure (or in the same group practice) and is of the same or of a ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1194","name":"Med rsn no imp/con mmr/msi","description":"Documentation of medical reason(s) surgical pathology reports did not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both tests were not included (e.g., patient will not be treated with checkpoint inhibitor therap","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0706","name":"Caffeine citrate injection","description":"Injection, caffeine citrate, 5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0294U","name":"Lngvty&mrtlty rsk mrna 18gen","description":"Lngvty&mrtlty rsk mrna 18gen","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0709","name":"Intraoral cmplt radio images","description":"Intraoral cmplt radio images","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0859T","name":"Ncntc ifr spctrsc o/t pad ea","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), other than for screening for peripheral arterial disease, image acquisition, interpretation, and report; each additional anatomic site (list separately in addition to code ","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35351","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; iliac","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1606.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6596","name":"G comp bandge conform gauze","description":"Gradient compression bandaging supply, conforming gauze, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0486U","name":"Onc pan sol tum ngs cfctdna","description":"Onc pan sol tum ngs cfctdna","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69729","name":"Impl oi implt sk tc esp>=100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside of the mastoid and resulting in removal of greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9027","name":"Rbc o2 co2 reduced","description":"Red blood cells, leukocytes reduced, oxygen/ carbon dioxide reduced, each unit","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98003","name":"Synch audio-video new hi 60","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high medical decision making. when using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87494","name":"Chlmy trch&neisra gonor mult","description":"Infectious agent detection by nucleic acid (dna or rna); chlamydia trachomatis and neisseria gonorrhoeae, multiplex amplified probe technique","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55708","name":"Bx prst8 trct us w/mri fus 1","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant) with mri-fusion-guidance, first targeted lesion","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1393","name":"Pr no dx rec mlnm","description":"Patients who were not diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45389","name":"Colonoscopy w/stent plcmt","description":"Colonoscopy, flexible; with endoscopic stent placement (includes pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":284.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S0191","name":"Misoprostol, oral, 200 mcg","description":"Misoprostol, oral, 200 mcg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1304","name":"Inj tofersen intrathec 1 mg","description":"Injection, tofersen, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1411","name":"1st ln ici no chemo","description":"Currently on first-line immune checkpoint inhibitors without chemotherapy","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0521","name":"Supply fee hiv prep fda appr","description":"Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1182","name":"Not elg pre ex ibd/uc/crohn","description":"Patients not eligible due to pre-existing inflammatory bowel disease (ibd) (e.g., ulcerative colitis, crohns disease)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37273","name":"Revsc evsc fpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1284","name":"Pt 66+ snp or ltc pos > 90d","description":"Patients age 66 or older in institutional special needs plans (snp) or residing in long term care with pos code 32, 33, 34, 54, or 56 for more than 90 consecutive days during the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0742T","name":"Aqmbf spect xers/strs & rest","description":"Absolute quantitation of myocardial blood flow (aqmbf), single-photon emission computed tomography (spect), with exercise or pharmacologic stress, and at rest, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2711","name":"Inj neostigmin/glycopyrrolat","description":"Injection, neostigmine methylsulfate 0.1 mg and glycopyrrolate 0.02 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0781T","name":"Brnchsc rf dstrj pulm nrv bi","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; bilateral mainstem bronchi","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77438","name":"Surf rad thr orthvlt>150-500","description":"Surface radiation therapy; orthovoltage, delivery, >150-500 kv, per fraction","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1456","name":"Pt had htx","description":"Patient had a heart transplant","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5137","name":"Inj, wezlana, sub cu, 1 mg","description":"Injection, ustekinumab-auub (wezlana), biosimilar, subcutaneous, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53235","name":"Removal of urethra lesion","description":"Excision of urethral diverticulum (separate procedure); male","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":691.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2782","name":"Inj avacincaptad pegol 0.1mg","description":"Injection, avacincaptad pegol, 0.1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37258","name":"Revsc evasc ivt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0250","name":"Adm tocilizu covid-19 2nd","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51784","name":"Anal/urinary muscle study","description":"Electromyography studies (emg) of anal or urethral sphincter, other than needle, any technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0906T","name":"Coms ther 1st appl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; first application, total wound(s) surface area less than or equal to 50 sq cm","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1365","name":"Hosp+pall care spec code 17","description":"Patient encounter during the performance period with hospice and palliative care specialty code 17","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0623U","name":"Ai ms dna mthyl alys >5000","description":"Ai ms dna mthyl alys >5000","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0856T","name":"Dgtz gls mcrscp electron mic","description":"Digitization of glass microscope slides for electron microscopy, diagnostic (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0310U","name":"Ped vsclts kd alys 3 bmrks","description":"Ped vsclts kd alys 3 bmrks","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0999T","name":"Autol musc cell therapy hrvg","description":"Autologous muscle cell therapy, harvesting of muscle progenitor cells, including ultrasound guidance, when performed","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6599","name":"G comp bandage short stretch","description":"Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77438","name":"Surf rad thr orthvlt>150-500","description":"Surface radiation therapy; orthovoltage, delivery, >150-500 kv, per fraction","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7415","name":"Excision malig les complicat","description":"Excision of malignant lesion complicated","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1401","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1380","name":"2 rx in perf pd any com meds","description":"Filled at least two prescriptions during the performance period for any combination of the qualifying oral antipsychotic medications listed under denominator note or the long-acting injectable antipsychotic medications listed under denominator note","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0032","name":"2+ antipsy schiz","description":"Two or more antipsychotic prescriptions ordered for patients who had a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder on or between january 1 of the year prior to the measurement period and the index prescription start date (ipsd) for antipsychotics","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97007","name":"Mchnl sclp cool meas fitg","description":"Mechanical scalp cooling, including individual cap supply with head measurement, fitting, and patient education","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":929.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1324","name":"Pts intravitreal/pci","description":"Patients who had an intravitreal or periocular corticosteroid injection (e.g., triamcinolone, preservative-free triamcinolone, dexamethasone, dexamethasone intravitreal implant, or fluocinolone intravitreal implant)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61608","name":"Resect/excise cranial lesion","description":"Resection or excision of neoplastic, vascular or infectious lesion of parasellar area, cavernous sinus, clivus or midline skull base; intradural, including dural repair, with or without graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3635.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6607","name":"G com bandage tub protct lyr","description":"Gradient compression bandaging supply, tubular protective absorption layer, per linear yard, any width, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1349","name":"No pam inc 3 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 3 points within a 4 to 12 month period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0489U","name":"Ob sgnipt cfdna seq alys 1+","description":"Ob sgnipt cfdna seq alys 1+","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0411U","name":"Psyc genom alys pnl 15 gen","description":"Psyc genom alys pnl 15 gen","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47720","name":"Fuse gallbladder & bowel","description":"Cholecystoenterostomy; direct","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1136.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0493U","name":"Trnspl med quan dd-cfdna ngs","description":"Trnspl med quan dd-cfdna ngs","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97552","name":"Group caregiver training","description":"Group caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0563","name":"Sbrt w/positron emission del","description":"Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance and real-time positron emissions-based delivery adjustments to 1 or more lesions, entire course not to exceed 5 fractions","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1259","name":"Pt stat doc <= 1 yr dialysis","description":"Patient status documented within the first year of initiating dialysis","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0923T","name":"Rmvl&rplcmt perm ccm-d pg","description":"Removal and replacement of permanent cardiac contractility modulation-defibrillation pulse generator only","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5878","name":"Dup of complt dent-mandib","description":"Dup of complt dent-mandib","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86005","name":"Allg spec ige multiallg scr","description":"Allergen specific ige; qualitative, multiallergen screen (eg, disk, sponge, card)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0531","name":"Fclty-based respite, 24 hr u","description":"Facility-based respite, 24-hour unit, for use in cmmi model","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77436","name":"Surf radj ther tx planning","description":"Surface radiation therapy; superficial or orthovoltage, treatment planning and simulation-aided field setting","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1286","name":"Bmi doc onl fup not cmpltd","description":"Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84377","name":"Sugars multiple qual","description":"Sugars (mono-, di-, and oligosaccharides); multiple qualitative, each specimen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0233","name":"Intra inf, toci, first dose","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4100","name":"Nosht skin sub fda clrd nos","description":"Non-sheet form skin substitute, fda cleared as a device, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0681","name":"App of non-sheet skin sub","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; first 25 sq cm or less of wound surface area","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0713T","name":"N-nvs artl plaq alys rvw i&r","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data review, interpretation and report","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0548","name":"Phone/inter svs 21-30 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42860","name":"Excision of tonsil tags","description":"Excision of tonsil tags","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0837T","name":"Dgtz gls mcrscp fna i&r","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; interpretation and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4253","name":"Zenith amniotic membrane psc","description":"Zenith amniotic membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2019","name":"Kerecis marigen shld sq cm","description":"Kerecis omega3 marigen shield, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9359","name":"Inj lon tesirin-lpyl 0.075mg","description":"Injection, loncastuximab tesirine-lpyl, 0.075 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32994","name":"Ablate pulm tumor perq crybl","description":"Ablation therapy for reduction or eradication of 1 or more pulmonary tumor(s) including pleura or chest wall when involved by tumor extension, percutaneous, including imaging guidance when performed, unilateral; cryoablation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5389.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":438.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33367","name":"Replace aortic valve w/byp","description":"Transcatheter aortic valve replacement (tavr/tavi) with prosthetic valve; cardiopulmonary bypass support with percutaneous peripheral arterial and venous cannulation (eg, femoral vessels) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81558","name":"Trnspl rej kdn mrna qpcr 139","description":"Transplantation medicine (allograft rejection, kidney), mrna, gene expression profiling by quantitative polymerase chain reaction (qpcr) of 139 genes, utilizing whole blood, algorithm reported as a binary categorization as transplant excellence, which indicates immune quiescence, or not transplant e","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1199","name":"Pt recg rrt","description":"Patients receiving rrt","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0236","name":"Intrav inf, mon anti, sec do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33463","name":"Valvuloplasty tricuspid","description":"Valvuloplasty, tricuspid valve; without ring insertion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1897.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0732T","name":"Immntx admn electroporatn im","description":"Immunotherapy administration with electroporation, intramuscular","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0759T","name":"Dgtz gls mcrscp sl sp grpiii","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group iii, for enzyme constituents (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5939","name":"Resct proth mand comp remov","description":"Resct proth mand comp remov","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9024","name":"Inj atezolizumb 5mg hya-tqjs","description":"Injection, atezolizumab, 5 mg and hyaluronidase-tqjs","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1283","name":"Pt scrn tbco and id as user","description":"Patient screened for tobacco use and identified as a tobacco user","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86362","name":"Mog-igg1 antb cba each","description":"Myelin oligodendrocyte glycoprotein (mog-igg1) antibody; cell-based immunofluorescence assay (cba), each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0483U","name":"Nfct ds ng gyra s91f pt mut","description":"Nfct ds ng gyra s91f pt mut","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5422","name":"Dentures adjust part mandbl","description":"Adjust partial denture - mandibular","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1405","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0976T","name":"Slctv nzmtc dbrdmt s/n/hf ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; each additional 100 sq cm (list separately in addition to code for p","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6032","name":"Part handfng ultralite tcf/=","description":"Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82962","name":"Glucose blood test","description":"Glucose, blood by glucose monitoring device(s) cleared by the fda specifically for home use","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0938T","name":"Xtrnl ecg rec>15d<30d rec","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; recording (including connection and initial recording)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0678T","name":"Laps repos lead isdss ea add","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional repositioned lead (list separately in addition to code for primary proce","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0289U","name":"Neuro alzheimer mrna 24 gen","description":"Neuro alzheimer mrna 24 gen","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9912","name":"Pre-visit patient screening","description":"Pre-visit patient screening","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0551","name":"Phn/intr svs fr dx treat 30m","description":"Interprofessional telephone/internet/electronic health record referral service(s) provided by a treating/requesting practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, 30 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1028","name":"Take home supply 8mg per 0.1","description":"Take-home supply of nasal naloxone; 2-pack of 8mg per 0.1 ml nasal spray (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61546","name":"Removal of pituitary gland","description":"Craniotomy for hypophysectomy or excision of pituitary tumor, intracranial approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2599.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0770T","name":"Vr technology assist therapy","description":"Virtual reality technology to assist therapy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0341U","name":"Ftl aneup dna seq cmpr alys","description":"Ftl aneup dna seq cmpr alys","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2801","name":"Inj, rykindo, 0.5 mg","description":"Injection, risperidone (rykindo), 0.5 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1351","name":"Dental sealant per tooth","description":"Sealant-per tooth","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0338U","name":"Onc sld tum crcg tum cl slct","description":"Onc sld tum crcg tum cl slct","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0602","name":"Sevelamer carbonate pdr 20mg","description":"Sevelamer carbonate (renvela or therapeutically equivalent), oral, powder, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0931T","name":"Ephys eval ccm-d ld separate","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), separate from initial implantation or replacement with testing of cardiac cont","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2989","name":"Excavate tooth non-restorabl","description":"Excavate tooth non-restorabl","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82465","name":"Assay bld/serum cholesterol","description":"Cholesterol, serum or whole blood, total","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[3]}]},{"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":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1218","name":"Pt copd symptoms","description":"Patient has copd symptoms (e.g., dyspnea, cough/sputum, wheezing)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35650","name":"Bpg axillary-axillary","description":"Bypass graft, with other than vein; axillary-axillary","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1343.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3473","name":"Surg rep root res molar","description":"Surg rep root res molar","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1481","name":"Pt in hosp/pal care who died","description":"Patients receiving hospice or palliative care or who died during the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26550","name":"Pollicization digit","description":"Pollicization of a digit","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1859.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15778","name":"Impl absrb msh/prsth dly cls","description":"Implantation of absorbable mesh or other prosthesis for delayed closure of defect(s) (ie, external genitalia, perineum, abdominal wall) due to soft tissue infection or trauma","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0814T","name":"Prq njx biod osteo matrl fem","description":"Percutaneous injection of calcium-based biodegradable osteoconductive material, proximal femur, including imaging guidance, unilateral","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62256","name":"Remove brain cavity shunt","description":"Removal of complete cerebrospinal fluid shunt system; without replacement","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91321","name":"Sarscov2 vac 25 mcg/.25ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 25 mcg/0.25 ml dosage, for intramuscular use","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7972","name":"Surg redct fibrous tuberosit","description":"Surgical reduction of fibrous tuberosity","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75577","name":"Quan&char c athrosclrtc plaq","description":"Quantification and characterization of coronary atherosclerotic plaque to assess severity of coronary disease, derived from augmentative software analysis of the data set from a coronary computed tomographic angiography, with interpretation and report by a physician or other qualified health care pr","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0372","name":"Tomo comp series images","description":"Tomo comp series images","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92629","name":"Eval hearing aid cand ea add","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1386","name":"Exc sx melmn or mlnm is","description":"Patients with an excisional surgery for melanoma or melanoma in situ in the past 5 years with an initial ajcc staging of 0, i, or ii at the start of the performance period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86850","name":"Rbc antibody screen","description":"Antibody screen, rbc, each serum technique","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9999","name":"Inj ustekinumab-aauz 1 mg","description":"Injection, ustekinumab-aauz (otulfi), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3911","name":"Intraorifice barrier","description":"Intraorifice barrier","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9949","name":"Repair sleep apnea appliance","description":"Repair sleep apnea appliance","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9075","name":"Inj, cyclophosphamide, nos","description":"Injection, cyclophosphamide, not otherwise specified, 5 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93227","name":"Xtrnl ecg rec<48 hr r&i","description":"External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage; review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1171","name":"Pt recd 1 td/tdap 9yrs prior","description":"Patient received at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4343","name":"Dermacyte ac matrx per sq cm","description":"Dermacyte ac matrix amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51721","name":"Ins trurl ablt trnsdc thr us","description":"Insertion of transurethral ablation transducer for delivery of thermal ultrasound for prostate tissue ablation, including suprapubic tube placement during the same session and placement of an endorectal cooling device, when performed","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81449","name":"So neo gsap 5-50 rna alys","description":"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; rna analysis","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4400","name":"Polygon3 per sq cm","description":"Polygon3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0758T","name":"Dgtz gls mcrscp sl spc hchem","description":"Digitization of glass microscope slides for special stain, including interpretation and report, histochemical stain on frozen tissue block (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52204","name":"Cystoscopy w/biopsy(s)","description":"Cystourethroscopy, with biopsy(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84157","name":"Assay of protein other","description":"Protein, total, except by refractometry; other source (eg, synovial fluid, cerebrospinal fluid)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81025","name":"Urine pregnancy test","description":"Urine pregnancy test, by visual color comparison methods","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0935T","name":"Cysto w/rnl pel symp dnrvtj","description":"Cystourethroscopy with renal pelvic sympathetic denervation, radiofrequency ablation, retrograde ureteral approach, including insertion of guide wire, selective placement of ureteral sheath(s) and multiple conformable electrodes, contrast injection(s), and fluoroscopy, bilateral","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J0880","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2526","name":"Cntct lens blue violet","description":"Contact lens, hydrophilic, with blue-violet filter, per lens","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2865","name":"Inj sulfameth/trim 5 mg/1 mg","description":"Injection, sulfamethoxazole 5 mg and trimethoprim 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0561","name":"Temp tube delivery, unil","description":"Tympanostomy with local or topical anesthesia and insertion of a ventilating tube when performed with tympanostomy tube delivery device, unilateral (list separately in addition to 69433) (do not use in conjunction with 0583t)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1163","name":"Inj, diltiazem hcl, 0.5 mg","description":"Injection, diltiazem hydrochloride, 0.5 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0389","name":"Periopic image capture only","description":"Periopic image capture only","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0894T","name":"Cannulation liver allograft","description":"Cannulation of the liver allograft in preparation for connection to the normothermic perfusion device and decannulation of the liver allograft following normothermic perfusion","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71022","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1326","name":"Inj, zolbetuximab-clzb, 2 mg","description":"Injection, zolbetuximab-clzb, 2 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0537U","name":"Onc clrct ca cfdna >2500 dmr","description":"Onc clrct ca cfdna >2500 dmr","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34716","name":"Opn ax/subcla art expos cndt","description":"Open axillary/subclavian artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass, by infraclavicular or supraclavicular incision, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2799","name":"Inj, uzedy, 1 mg","description":"Injection, risperidone (uzedy), 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7939","name":"Indexing for osteotomy","description":"Indexing for osteotomy","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0520","name":"New pt-cg dyad dem mod cmplx","description":"Management of new patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9993","name":"Pall serv during meas","description":"Patient was provided palliative care services any time during the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9888","name":"5% wl maintnd from bsline wt","description":"Maintenance 5% wl from baseline weight in months 7-12","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0279U","name":"Hem vw factor&clgn iii bndg","description":"Hematology (von willebrand disease [vwd]), von willebrand factor (vwf) and collagen iii binding by enzyme-linked immunosorbent assays (elisa), plasma, report of collagen iii binding","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1477","name":"Dx delirium","description":"Diagnosis of delirium","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31750","name":"Tracheoplasty cervical","description":"Tracheoplasty; cervical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1440.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0478U","name":"Onc nsclc dna&rna dpcr 9 gen","description":"Onc nsclc dna&rna dpcr 9 gen","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37254","name":"Revsc evasc ivt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55715","name":"Bx prst8 ea add mri-us/ct/mr","description":"Biopsy, prostate, each additional, mri-ultrasound fusion or in-bore ct- or mri-guided targeted lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0901T","name":"Plmt bone marrow smplg port","description":"Placement of bone marrow sampling port, including imaging guidance when performed","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5227","name":"Immed max part denture","description":"Immed max part denture","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0359U","name":"Onc prst8 ca alys all psa","description":"Onc prst8 ca alys all psa","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9277","name":"Pembrolizumab 1mg berahyalur","description":"Injection, pembrolizumab, 1 mg and berahyaluronidase alfa-pmph","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9002","name":"Intra-vag motion sens biofk","description":"Intra-vaginal motion sensor system, provides biofeedback for pelvic floor muscle rehabilitation device","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37272","name":"Revsc evsc fpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6612","name":"Onlay cst base mtl 2 surface","description":"Onlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31546","name":"Remove vc lesion scope/graft","description":"Laryngoscopy, direct, operative, with operating microscope or telescope, with submucosal removal of non-neoplastic lesion(s) of vocal cord; reconstruction with graft(s) (includes obtaining autograft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":682.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27429","name":"Reconstruction knee","description":"Ligamentous reconstruction (augmentation), knee; intra-articular (open) and extra-articular","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1398.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81524","name":"Onc cns tum dna mthyl 10,000","description":"Oncology (central nervous system tumor), dna methylation analysis of at least 10,000 methylation sites, utilizing dna extracted from formalin-fixed tumor tissue, algorithm(s) reported as probability of matching a reference tumor family and class, and mgmt (o-6-methylguanine-dna methyltransferase) pr","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2042","name":"Foundation drs+ solo, sq cm","description":"Foundation drs+ solo, per square centimeter","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0464U","name":"Onc clrct scr qrtsa dna mrk","description":"Onc clrct scr qrtsa dna mrk","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11055","name":"Paring/cutg b9 hyprker les 1","description":"Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); single lesion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1190","name":"Dexrazoxane hcl injection","description":"Injection, dexrazoxane hydrochloride, per 250 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27003","name":"Tnot adductr subq opn neurct","description":"Tenotomy, adductor, subcutaneous, open, with obturator neurectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0371","name":"Sialoendoscopy capt & interp","description":"Sialoendoscopy capt & interp","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53451","name":"Tprnl balo cntnc dev bi","description":"Periurethral transperineal adjustable balloon continence device; bilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92625","name":"Tinnitus assessment","description":"Assessment of tinnitus (includes pitch, loudness matching, and masking)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0758T","name":"Dgtz gls mcrscp sl spc hchem","description":"Digitization of glass microscope slides for special stain, including interpretation and report, histochemical stain on frozen tissue block (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2799","name":"Inj, uzedy, 1 mg","description":"Injection, risperidone (uzedy), 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0279U","name":"Hem vw factor&clgn iii bndg","description":"Hematology (von willebrand disease [vwd]), von willebrand factor (vwf) and collagen iii binding by enzyme-linked immunosorbent assays (elisa), plasma, report of collagen iii binding","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1952","name":"Afo spiral prefab ots","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, off-the-shelf","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87084","name":"Culture of specimen by kit","description":"Culture, presumptive, pathogenic organisms, screening only; with colony estimation from density chart","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96410","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55874","name":"Tprnl plmt biodegrdabl matrl","description":"Transperineal placement of biodegradable material, peri-prostatic, single or multiple injection(s), including image guidance, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":4299.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1344","name":"No bsln/2nd pam score 4-12mo","description":"Patients who did not have a baseline pam score and/or a second score within 4 to 12 months of baseline pam score","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87564","name":"Mtb rifampin rst amp prb tq","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacterium tuberculosis, rifampin resistance, amplified probe technique","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7172","name":"Inj marstacim-hncq, 0.5 mg","description":"Injection, marstacimab-hncq, 0.5 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90637","name":"Vacc qirv mrna 30mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 30 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49614","name":"Rpr aa hrn rcr < 3 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1259","name":"Pt stat doc <= 1 yr dialysis","description":"Patient status documented within the first year of initiating dialysis","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72220","name":"X-ray exam sacrum tailbone","description":"Radiologic examination, sacrum and coccyx, minimum of 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0422","name":"Collect & prep genetic samp","description":"Collect & prep genetic samp","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4560","name":"Nmes disposable","description":"Neuromuscular electrical stimulator (nmes), disposable, replacement only","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1362","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1425","name":"Surgical care mvp","description":"Surgical care mips value pathway","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86317","name":"Immunoassay infectious agent","description":"Immunoassay for infectious agent antibody, quantitative, not otherwise specified","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0707T","name":"Njx b1 sub mtrl sbchdrl dfct","description":"Injection(s), bone-substitute material (eg, calcium phosphate) into subchondral bone defect (ie, bone marrow lesion, bone bruise, stress injury, microtrabecular fracture), including imaging guidance and arthroscopic assistance for joint visualization","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1484","name":"No rpt hcv rna perf med rsn","description":"Patients who did not have a repeat hcv rna labs performed for medical reasons documented by clinician (e.g., patient with limited life expectancy, delay in treatment of hcv related to treatment of hiv, hbv, hepatocellular carcinoma, decompensated cirrhosis)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87110","name":"Chlamydia culture","description":"Culture, chlamydia, any source","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1399","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0312U","name":"Ai ds sle alys 8 igg autoant","description":"Ai ds sle alys 8 igg autoant","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12007","name":"Rpr s/n/ax/gen/trnk >30.0 cm","description":"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); over 30.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43351","name":"Surgical opening esophagus","description":"Esophagostomy, fistulization of esophagus, external; thoracic approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1370.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9129","name":"Photobio therpy-sub 15 mins","description":"Photobio therpy-sub 15 mins","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6596","name":"G comp bandge conform gauze","description":"Gradient compression bandaging supply, conforming gauze, per linear yard, any width, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0706T","name":"Rem tx amblyopia i&r phy/qhp","description":"Remote treatment of amblyopia using an eye tracking device; interpretation and report by physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69730","name":"Rplc oi implt sk tc esp>=100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87627","name":"Jt spc pthgn&rx rsist gen26+","description":"Infectious agent detection by nucleic acid (dna or rna); joint space pathogens and drug resistance genes, multiplex amplified probe technique, 26 or more targets","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0327U","name":"Ftl aneuploidy trsmy dna seq","description":"Ftl aneuploidy trsmy dna seq","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43652","name":"Laparoscopy vagus nerve","description":"Laparoscopy, surgical; transection of vagus nerves, selective or highly selective","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":867.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85041","name":"Automated rbc count","description":"Blood count; red blood cell (rbc), automated","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2043","name":"Biobrane, per sq cm","description":"Biobrane, per square centimeter","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1011T","name":"Pbm therapy of oral cavity","description":"Photobiomodulation (pbm) therapy of oral cavity, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4313","name":"Dermabind fm, per sq cm","description":"Dermabind fm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0479U","name":"Tau phosphorylated ptau217","description":"Tau phosphorylated ptau217","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0849T","name":"Dgtz gls mcrscp ish ea adl 1","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0897T","name":"N-invas augmnt arrhyt alys","description":"Noninvasive augmentative arrhythmia analysis derived from quantitative computational cardiac arrhythmia simulations, based on selected intervals of interest from 12-lead electrocardiogram and uploaded clinical parameters, including uploading clinical parameters with interpretation and report","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1437","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1351","name":"Dental sealant per tooth","description":"Sealant-per tooth","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6093","name":"Recement supp part denture","description":"Recement implant/abutment supported fixed partial denture","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92636","name":"Hearing aid post-fitg f-up 1","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1274","name":"Pts snf exl mo","description":"Patients who were admitted to a skilled nursing facility (snf) during the month of evaluation were excluded from that month","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0281","name":"Inj aminocaproic acid 1 gram","description":"Injection, aminocaproic acid, 1 gram","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69727","name":"Rmv ntr oi imp sk tc esp<100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":266.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4291","name":"Lamellas xt, per sq cm","description":"Lamellas xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0880T","name":"Augmnt alys ch ct ild i&r","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5940","name":"Resct proth max part remov","description":"Resct proth max part remov","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98009","name":"Synch audio-only new low 30","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 30 m","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1377","name":"Fu colscop 10 yr doc w/ disc","description":"Recommended follow-up interval for repeat colonoscopy of 10 years documented  in colonoscopy report and communicated with patient","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0664","name":"Team remote e/m new pt 60 mn","description":"Team remote e/m new pt 60mins","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30469","name":"Rpr nsl vlv collapse w/rmdlg","description":"Repair of nasal valve collapse with low energy, temperature-controlled (ie, radiofrequency) subcutaneous/submucosal remodeling","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85651","name":"Rbc sed rate nonautomated","description":"Sedimentation rate, erythrocyte; non-automated","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9184","name":"Inj gemcitabin (avyxa) 200mg","description":"Injection, gemcitabine hydrochloride (avyxa), 200 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66683","name":"Implantation iris prosthesis","description":"Implantation of iris prosthesis, including suture fixation and repair or removal of iris, when performed","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7111","name":"Extraction coronal remnants","description":"Extraction coronal remnants - deciduous tooth","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64835","name":"Repair of hand or foot nerve","description":"Suture of 1 nerve; median motor thenar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":920.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9324","name":"Inj, pemrydi rtu, 10 mg","description":"Injection, pemetrexed (pemrydi rtu), 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1350","name":"Pt w/ suic saf pln init rev","description":"Patients who had a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0390U","name":"Ob pe kdr eng&rbp4 ia alg","description":"Ob pe kdr eng&rbp4 ia alg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87003","name":"Small animal inoculation","description":"Animal inoculation, small animal, with observation and dissection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29898","name":"Ankle arthroscopy/surgery","description":"Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; debridement, extensive","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0889T","name":"Prsnlz trgt dvl arhfcmrigtbs","description":"Personalized target development for accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation derived from a structural and resting-state functional mri, including data preparation and transmission, generation of the target, motor threshold-starting location, neuro","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0885T","name":"Colsc flx 1st tndsc dilat","description":"Colonoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0696T","name":"Bdy surf mapg pm/cvdfb f/up","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of follow-up interrogation or programming device evaluatio","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84145","name":"Procalcitonin (pct)","description":"Procalcitonin (pct)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J0128","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31775","name":"Reconstruct bronchus","description":"Bronchoplasty; excision stenosis and anastomosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1711.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0262U","name":"Onc sld tum rt-pcr 7 gen","description":"Oncology (solid tumor), gene expression profiling by real-time rt-pcr of 7 gene pathways (er, ar, pi3k, mapk, hh, tgfb, notch), formalin-fixed paraffin-embedded (ffpe), algorithm reported as gene pathway activity score","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0483","name":"Indirect immunofluorescence","description":"Indirect immunofluorescence","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9038","name":"Inj axatilimab-csfr 0.1 mg","description":"Injection, axatilimab-csfr, 0.1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6071","name":"Abutment supported retainer","description":"Abutment supported retainer for porcelain fused to metal fpd (noble metal)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23930","name":"I&d upr a/e dp absc/hmtma","description":"Incision and drainage, upper arm or elbow area; deep abscess or hematoma","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64449","name":"Njx aa&/strd lmbr plex nfs","description":"Injection(s), anesthetic agent(s) and/or steroid; lumbar plexus, posterior approach, continuous infusion by catheter (including catheter placement)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27808","name":"Treatment of ankle fracture","description":"Closed treatment of bimalleolar ankle fracture (eg, lateral and medial malleoli, or lateral and posterior malleoli or medial and posterior malleoli); without manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":321.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0562","name":"Complex simulation w/pet-ct","description":"Therapeutic radiology simulation-aided field setting; complex, including acquisition of pet and ct imaging data required for radiopharmaceutical-directed radiation therapy treatment planning (i.e., modeling)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80197","name":"Assay of tacrolimus","description":"Tacrolimus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1184","name":"Doc med rsn no cst/ist rx","description":"Documentation of medical reason(s) for not prescribing or administering corticosteroid or immunosuppressant treatment (e.g., allergy, intolerance, infectious etiology, pancreatic insufficiency, hyperthyroidism, prior bowel surgical interventions, celiac disease, receiving other medication, awaiting ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0683T","name":"Prgrmg dev eval isdss ip","description":"Programming device evaluation (in-person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional, permanent implantable synchroni","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28470","name":"Cltx metatarsal fx wo mnp ea","description":"Closed treatment of metatarsal fracture; without manipulation, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8541","name":"Oral, hemady, 0.25 mg","description":"Dexamethasone (hemady), oral, 0.25 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33426","name":"Repair of mitral valve","description":"Valvuloplasty, mitral valve, with cardiopulmonary bypass; with prosthetic ring","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2468.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2780","name":"Crown 3/4 cast hi noble met","description":"Crown - 3/4 cast high noble metal","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0248","name":"Inj, remdesivir, 1 mg","description":"Injection, remdesivir, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0907T","name":"Coms ther ea addl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; each additional application, total wound(s) surface area less than or equal to 50 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87183","name":"Sc std carbapenem resist gen","description":"Susceptibility studies, antimicrobial agent; carbapenem resistance genes (eg, blakpc, blandm, blavim, blaoxa-48, blaimp), amplified probe technique, per isolate","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9054","name":"Inj bortezomib boruzu 0.1 mg","description":"Injection, bortezomib (boruzu), 0.1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0709","name":"Intraoral cmplt radio images","description":"Intraoral cmplt radio images","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78428","name":"Cardiac shunt imaging","description":"Cardiac shunt detection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0759","name":"Inj, clevidipine, 1 mg","description":"Injection, clevidipine butyrate, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0947T","name":"Mrgfus strtctc bl-br disrpj","description":"Magnetic resonance image guided low intensity focused ultrasound (mrgfus), stereotactic blood-brain barrier disruption using microbubble resonators to increase the concentration of blood-based biomarkers of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8541","name":"Oral, hemady, 0.25 mg","description":"Dexamethasone (hemady), oral, 0.25 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99382","name":"Init pm e/m new pat 1-4 yrs","description":"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; early childhood ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":134.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1010T","name":"Cptr oph alys monoc eye mvmt","description":"Computerized ophthalmic analysis of monocular eye movements using retinal-based eye-tracking without spatial calibration, including fixation, microsaccades, drift, and horizontal saccades, when performed, unilateral or bilateral, with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1478","name":"Psychoactive sub abuse","description":"Psychoactive substance abuse","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0342U","name":"Onc pncrtc ca mult ia eclia","description":"Onc pncrtc ca mult ia eclia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0312U","name":"Ai ds sle alys 8 igg autoant","description":"Ai ds sle alys 8 igg autoant","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83655","name":"Assay of lead","description":"Lead","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0422U","name":"Onc pan solid tum alys dna","description":"Onc pan solid tum alys dna","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0452U","name":"Onc bldr mthyl penk lte-qmsp","description":"Onc bldr mthyl penk lte-qmsp","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2014","name":"Omeza collag compl 100 mg","description":"Omeza collagen matrix or omeza complete matrix, per 100 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1414","name":"Inj, beqvez, per tx dose","description":"Injection, fidanacogene elaparvovec-dzkt, per therapeutic dose","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0581U","name":"Trnspl med antb nohla 39trgt","description":"Trnspl med antb nohla 39trgt","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36837","name":"Prq av fstl crt uxtr sep acs","description":"Percutaneous arteriovenous fistula creation, upper extremity, separate access sites of the peripheral artery and peripheral vein, including fistula maturation procedures (eg, transluminal balloon angioplasty, coil embolization) when performed, including all vascular access, imaging guidance and radi","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87102","name":"Fungus isolation culture","description":"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; other source (except blood)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87182","name":"Sc std carbapenemase nzm det","description":"Susceptibility studies, antimicrobial agent; carbapenemase enzyme detection (eg, klebsiella pneumoniae carbapenemase [kpc], new delhi metallo-beta-lactamase [ndm], verona integron-encoded metallo-beta-lactamase [vim]), multiplex immunoassay, qualitative, per isolate","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":6.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33958","name":"Ecmo/ecls repos perph cnula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; reposition peripheral (arterial and/or venous) cannula(e), percutaneous, 6 years and older (includes fluoroscopic guidance, when performed)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0871T","name":"Rplcmt subq prtl ascites pmp","description":"Replacement of a subcutaneous peritoneal ascites pump, including reconnection between pump and indwelling bladder and peritoneal catheters, including initial programming and imaging, when performed","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35092","name":"Repair artery rupture aorta","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, abdominal aorta involving visceral vessels (mesenteric, celiac, renal)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3071.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0534","name":"Coordinated care/or referral","description":"Coordinated care and/or referral services, such as to adequate and accessible community resources to address unmet health-related social needs, including harm reduction interventions and recovery support services a patient needs and wishes to pursue, which significantly limit the ability to diagnose","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0570","name":"Care manage serv, pr cal mo","description":"Care management services for behavioral health conditions, directed by a physician or other qualified health care professional, per calendar month, with the following required elements: initial assessment or follow-up monitoring, including the use of applicable validated rating scales, behavioral he","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36225","name":"Place cath subclavian art","description":"Selective catheter placement, subclavian or innominate artery, unilateral, with angiography of the ipsilateral vertebral circulation and all associated radiological supervision and interpretation, includes angiography of the cervicocerebral arch, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1955.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4013","name":"Mntal/behav/psych hlth ss","description":"Mental/behavioral and psychiatry mips specialty set","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4363","name":"Am bur mem hydro per sq cm","description":"Amnio burgeon membrane and hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99471","name":"Ped critical care initial","description":"Initial inpatient pediatric critical care, per day, for the evaluation and management of a critically ill infant or young child, 29 days through 24 months of age","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5228","name":"Immed mand part denture","description":"Immed mand part denture","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9957","name":"Screening sleep disorders","description":"Screening sleep disorders","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59830","name":"Treat uterus infection","description":"Treatment of septic abortion, completed surgically","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":391.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4421","name":"Biolab wrap solo per sq cm","description":"Biolab membrane wrap solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21390","name":"Opn tx orbit periorbtl implt","description":"Open treatment of orbital floor blowout fracture; periorbital approach, with alloplastic or other implant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":842.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5155","name":"Inj, aflibercept-jbvf, 1 mg","description":"Injection, aflibercept-jbvf (yesafili), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71034","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0999T","name":"Autol musc cell therapy hrvg","description":"Autologous muscle cell therapy, harvesting of muscle progenitor cells, including ultrasound guidance, when performed","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4409","name":"Amniomatrixf3x per sq cm","description":"Amniomatrixf3x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0734T","name":"Rem r-t mtn nrehab tx mgmt","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; treatment management services by a physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0703","name":"2d oral/facial photo image","description":"2d oral/facial photo image","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1426","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9986","name":"Missed appointment","description":"Missed appointment","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54820","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":373.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91320","name":"Sarscv2 vac 30mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 30 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0975T","name":"Slctv nzmtc dbrdmt s/n/hf 1","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; first 100 sq cm","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1270","name":"Pts no kid transplt wtlst","description":"Patients not on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0569","name":"Subs psych care mng, subs mo","description":"Subsequent psychiatric collaborative care management, in a subsequent month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required elements: tracking ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64659","name":"Rmvl bat modulj sys pg only","description":"Removal of baroreflex activation therapy (bat) modulation system; pulse generator only","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0477U","name":"Rx metab psy 14&cyp2d6 gn-rx","description":"Rx metab psy 14&cyp2d6 gn-rx","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6049","name":"Scale implt peri-implt inflm","description":"Scale implt peri-implt inflm","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4393","name":"Surgraft ac per sq cm","description":"Surgraft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35460","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1375","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0705","name":"Extra oral post radio image","description":"Extra oral post radio image","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1449","name":"Inj eflapegrastim-xnst 0.1mg","description":"Injection, eflapegrastim-xnst, 0.1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0393U","name":"Neu prksn msfl a-syncln prtn","description":"Neu prksn msfl a-syncln prtn","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":823.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0782T","name":"Brnchsc rf dstrj plm nrv uni","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; unilateral mainstem bronchus","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91323","name":"Sarscov2 vac 10 mcg/0.2ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 10 mcg/0.2 ml dosage, for intramuscular use","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0444","name":"Depression screen annual","description":"Annual depression screening, 5 to 15 minutes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":8.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8005","name":"Grip glove w microprocessor","description":"Powered, cable driven grip assist glove, hand, finger, includes microprocessor, pressure sensors, all components and accessories, custom fitted","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1452","name":"Pt dx dementia ever","description":"Patient ever had a diagnosis of dementia","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43497","name":"Transorl lwr esophgl myotomy","description":"Lower esophageal myotomy, transoral (ie, peroral endoscopic myotomy [poem])","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":452.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26593","name":"Release muscles of hand","description":"Release, intrinsic muscles of hand, each muscle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96161","name":"Caregiver health risk assmt","description":"Administration of caregiver-focused health risk assessment instrument (eg, depression inventory) for the benefit of the patient, with scoring and documentation, per standardized instrument","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6106","name":"Tissue regen resorbable","description":"Tissue regen resorbable","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27458","name":"Osteot femur imed lngth dev","description":"Osteotomy(ies), femur, unilateral, with insertion of an externally controlled intramedullary lengthening device, including iliotibial band release when performed, imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0553","name":"Monthly tx for dmht 20mins","description":"First 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing information related to the use of","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0431","name":"Diag tst detect mucos abnorm","description":"Adjunctive pre-diagnostic test that aids in detection of mucosal abnormalities including premalignant and malignant lesions not to include cytology or biopsy","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0605","name":"Antibody test pub hlth path","description":"Antibody test pub hlth path","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0672T","name":"Ndovag cryg rf remdl tiss","description":"Endovaginal cryogen-cooled, monopolar radiofrequency remodeling of the tissues surrounding the female bladder neck and proximal urethra for urinary incontinence","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9278","name":"Inj, carboplatin (avyxa)","description":"Injection, carboplatin (avyxa), 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68720","name":"Create tear sac drain","description":"Dacryocystorhinostomy (fistulization of lacrimal sac to nasal cavity)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":769.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2041","name":"Foundation drs+ duo pr sq cm","description":"Foundation drs+ duo, per square centimeter","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6105","name":"Remove implant body","description":"Remove implant body","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1265","name":"Cms 2728 completed","description":"Cms medical evidence form 2728 for dialysis patients: initial form completed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1217","name":"Sys rsn no doc spiro","description":"Documentation of system reason(s) for not documenting and reviewing spirometry results (e.g., spirometry equipment not available at the time of the encounter)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4017","name":"Nutrition/dietician ss","description":"Nutrition/dietician mips specialty set","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4429","name":"Dermbnd chn, chx per sq cm","description":"Dermabind ch n or dermabind ch x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0550","name":"Phone/inter for dx/treat >5m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a written report to the patients treating/r","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9342","name":"Inj thiotepa nos 1 mg","description":"Injection, thiotepa, not otherwise specified, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33961","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":672.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"Endoskel posit rotat unit","description":"Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59012","name":"Fetal cord puncture prenatal","description":"Cordocentesis (intrauterine), any method","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57010","name":"Colpotomy drg pel abscess","description":"Colpotomy; with drainage of pelvic abscess","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47384","name":"Abltj ire liver 1+ tum perq","description":"Ablation, irreversible electroporation, liver, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0201","name":"Pne flu hepb cov home admin","description":"Administration of pneumococcal, influenza, hepatitis b, and/or covid-19 vaccine inside a patients home; reported only once per individual home per date of service when such vaccine administration(s) are performed at the patients home","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0565U","name":"Onc hcc ngs detc 6626epigalt","description":"Onc hcc ngs detc 6626epigalt","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99231","name":"Sbsq hosp ip/obs sf/low 25","description":"Subsequent hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward or low level of medical decision making. when using total time on the date of the encounter for code selec","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2026","name":"Restrata minimatrix, 5 mg","description":"Restrata minimatrix, 5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0605","name":"Antibody test pub hlth path","description":"Antibody test pub hlth path","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3501","name":"Surg exp root surf anterior","description":"Surg exp root surf anterior","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4261","name":"Tag, per square centimeter","description":"Tag, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1368","name":"Prev trt inf d/o hiv/hep mvp","description":"Prevention and treatment of infectious disorders including hepatitis c and hiv mips value pathway","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1000T","name":"Autol musc cell therapy admn","description":"Autologous muscle cell therapy, administration of muscle progenitor cells into the urethral sphincter, including cystoscopy and post-void residual ultrasound, when performed","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2024","name":"Resolve or xenopatch sq cm","description":"Resolve matrix or xenopatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5099","name":"Inj ustekinumab-stba, 1 mg","description":"Injection, ustekinumab-stba (steqeyma), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0708","name":"Intraoral bite radio image","description":"Intraoral bite radio image","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4034","name":"Speech language path ss","description":"Speech language pathology mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0562","name":"Complex simulation w/pet-ct","description":"Therapeutic radiology simulation-aided field setting; complex, including acquisition of pet and ct imaging data required for radiopharmaceutical-directed radiation therapy treatment planning (i.e., modeling)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37278","name":"Rvsc evsc fpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0154A","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6032","name":"Part handfng ultralite tcf/=","description":"Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1429","name":"Retinopathy in od, os, ou","description":"Retinal exam finding with evidence of retinopathy in left, right or both eyes with severity level documented","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37262","name":"Iv lithotrp ivt w/in sm art","description":"Intravascular lithotripsy(ies), iliac vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2642","name":"Dental onlay porcelin 2 surf","description":"Onlay - porcelain/ceramic - two surfaces","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0555U","name":"Repr med pga embryonic te qc","description":"Repr med pga embryonic te qc","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0789T","name":"Elec aly cpx iins sp/sac nrv","description":"Electronic analysis with complex programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detect","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0285U","name":"Onc rsps radj cll fr dna tox","description":"Onc rsps radj cll fr dna tox","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0786T","name":"Insj/rplcmt prq ra sac nstim","description":"Insertion or replacement of percutaneous electrode array, sacral, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64469","name":"Thrc fascial pln blk bi nfs","description":"Thoracic fascial plane block, bilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48100","name":"Biopsy of pancreas open","description":"Biopsy of pancreas, open (eg, fine needle aspiration, needle core biopsy, wedge biopsy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":863.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0370","name":"Max ultrasound capt & interp","description":"Max ultrasound capt & interp","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0603","name":"Sevelamer hydrochloride 20mg","description":"Sevelamer hydrochloride (renagel or therapeutically equivalent), oral, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1202","name":"Pt rsn no ace-i/arb rx","description":"Documentation of patient reason(s) for not prescribing ace inhibitor or arb therapy during the measurement period, (e.g., patient declined, other patient reasons)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0177","name":"Hydroxyzine pamoate 25mg","description":"Hydroxyzine pamoate, 25 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90483","name":"Imm cnsl not admn sm>10<20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 10 minutes up to 20 minutes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2039","name":"Innovamatrix fd, per sq cm","description":"Innovamatrix fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2599","name":"Inj vasopressin (am reg) 1 u","description":"Injection, vasopressin (american regent), not therapeutically equivalent to j2598, 1 unit","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51721","name":"Ins trurl ablt trnsdc thr us","description":"Insertion of transurethral ablation transducer for delivery of thermal ultrasound for prostate tissue ablation, including suprapubic tube placement during the same session and placement of an endorectal cooling device, when performed","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3389","name":"Topi adm prad zami per treat","description":"Topical administration, prademagene zamikeracel, per treatment","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37288","name":"Revsc evsc tpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77436","name":"Surf radj ther tx planning","description":"Surface radiation therapy; superficial or orthovoltage, treatment planning and simulation-aided field setting","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1439","name":"Sig ocu cond imp surg out","description":"Significant ocular conditions that impact the visual outcome of surgery","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1295","name":"Pt hx tot col or colon ca","description":"Patients with a diagnosis or past history of total colectomy or colorectal cancer","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27707","name":"Osteotomy fibula","description":"Osteotomy; fibula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":462.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55712","name":"Bx prst8 tprnl mri-us 1st","description":"Biopsy, prostate, transperineal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71555","name":"Mri angio chest w or w/o dye","description":"Magnetic resonance angiography, chest (excluding myocardium), with or without contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95783","name":"Polysom <6 yrs cpap/bilvl","description":"Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bi-level ventilation, attended by a technologist","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1232.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82379","name":"Assay of carnitine","description":"Carnitine (total and free), quantitative, each specimen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81517","name":"Liver ds alys 3 bmrk srm alg","description":"Liver disease, analysis of 3 biomarkers (hyaluronic acid [ha], procollagen iii amino terminal peptide [piiinp], tissue inhibitor of metalloproteinase 1 [timp-1]), using immunoassays, utilizing serum, prognostic algorithm reported as a risk score and risk of liver fibrosis and liver-related clinical ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7413","name":"Excision malig lesion<=1.25c","description":"Excision of malignant lesion up to 1.25 cm","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99425","name":"Prin care mgmt phys ea addl","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6610","name":"G com stcking bk 18-30 custm","description":"Gradient compression stocking, below knee, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86043","name":"Acetylcholn rcptr modlg antb","description":"Acetylcholine receptor (achr); modulating antibody","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33900","name":"Perq p-art revsc 1 nm nt uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, unilateral","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1405","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1449","name":"Pt dx scz/pys bef end msr pd","description":"Patients with an active diagnosis of schizophrenia or psychotic disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0503U","name":"Neuro alz ds bamyl&tau prtn","description":"Neuro alz ds bamyl&tau prtn","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86615","name":"Bordetella antibody","description":"Antibody; bordetella","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0408U","name":"Iaad blk ac wv bsnsr sarscv2","description":"Iaad blk ac wv bsnsr sarscv2","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0571","name":"Intraop nerve cryoablation","description":"Intraoperative nerve(s) cryoablation for post-surgical pain relief (list separately in addition to code for primary service)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4035","name":"Thoracic surgery ss","description":"Thoracic surgery mips specialty set","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0882T","name":"Intraop ther estim pn ue 1st","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; initial nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0912T","name":"Elec alys nstim sys vgs smpl","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; with simple programming by physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28193","name":"Removal of foot foreign body","description":"Removal of foreign body, foot; complicated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0298U","name":"Onc pan tum whl trns seq rna","description":"Onc pan tum whl trns seq rna","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1323","name":"Pts 7wk inj, scrn iop >25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop >25 mm hg and a plan of care was documented","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78492","name":"Myocrd img pet mlt rst&strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); multiple studies at rest and stress (exercise or pharmacologic)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":105.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0693T","name":"Compre ful bdy 3d mtn alys","description":"Comprehensive full body computer-based markerless 3d kinematic and kinetic motion analysis and report","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0134","name":"Inj acetaminophen -fresenius","description":"Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6561","name":"G stockng full/chap 40+ cust","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, custom, each","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2016","name":"Permeaderm b, per sq cm","description":"Permeaderm b, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0201","name":"Pne flu hepb cov home admin","description":"Administration of pneumococcal, influenza, hepatitis b, and/or covid-19 vaccine inside a patients home; reported only once per individual home per date of service when such vaccine administration(s) are performed at the patients home","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0807T","name":"Pulm tiss vntj alys prev ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with previously acquired computed tomography (ct) images, including data preparation and transmission, quantification of pulmonary tissue ventilation, data re","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2044","name":"Biobrane glove, each","description":"Biobrane glove, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0535U","name":"Pfas lc-ms/ms plsm/srm quan","description":"Pfas lc-ms/ms plsm/srm quan","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0824T","name":"Tcat rmv 1chmbr ldls pm ra","description":"Transcatheter removal of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography), when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53866","name":"Cathj rmvl dev ischmc rmdlg","description":"Catheterization with removal of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63032","name":"Lamot rpr anulr dfct 1 lmbr","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; with repair of annular defect by implantation of bone-anchored annular closure device, including all imaging guidance, 1 interspace, lumbar","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6031","name":"Rep interface handfng molded","description":"Replacement socket/interface, partial hand including fingers, molded to patient model, for use with or without external power","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82166","name":"Assay anti-mullerian horm","description":"Anti-mullerian hormone (amh)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5938","name":"Resct proth max comp remov","description":"Resct proth max comp remov","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1487","name":"Pt adm to hospice dur eval","description":"Patients in hospice in the year before or during the period of evaluation","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6081","name":"Scale & debride, single imp","description":"Scale & debride, single imp","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0572U","name":"Onc prst8 httl qfish whl bld","description":"Onc prst8 httl qfish whl bld","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0879","name":"Difelikefalin, esrd on dialy","description":"Injection, difelikefalin, 0.1 microgram, (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65235","name":"Remove foreign body from eye","description":"Removal of foreign body, intraocular; from anterior chamber of eye or lens","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":653.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0507U","name":"Onc ovr dna whole gen w/5hmc","description":"Onc ovr dna whole gen w/5hmc","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4257","name":"Relese, per sq cm","description":"Relese, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2356","name":"Inj tezepelumab-ekko, 1mg","description":"Injection, tezepelumab-ekko, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4212","name":"Gingivectomy/plasty rest","description":"Gingivectomy/plasty rest","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54015","name":"I&d penis deep","description":"Incision and drainage of penis, deep","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22325","name":"Treat spine fracture","description":"Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; lumbar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1567.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0686T","name":"Histotripsy mal hepatcel tis","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant hepatocellular tissue, including image guidance","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60661","name":"Abltj 1/+thyr ndul addl prq","description":"Ablation of 1 or more thyroid nodule(s), additional lobe, percutaneous, including imaging guidance, radiofrequency (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6028","name":"Part hand finger metacar amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s) /thumb, amputation at metacarpal level, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0682T","name":"Removal pulse gen only isdss","description":"Removal of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4380","name":"Advograft one per sq cm","description":"Advograft one, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1305","name":"Pneum vax admin 19+","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0662","name":"Team remote e/m new pt 30 mn","description":"Team remote e/m new pt 30 mins","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0111A","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0658","name":"Seg pneum comp 2 arm chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63032","name":"Lamot rpr anulr dfct 1 lmbr","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; with repair of annular defect by implantation of bone-anchored annular closure device, including all imaging guidance, 1 interspace, lumbar","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5765","name":"Liner compl/partial rem dent","description":"Liner compl/partial rem dent","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9154","name":"Artificial saliva, 1 ml","description":"Artificial saliva, 1 ml","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1399","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2991","name":"App of hydroxyapatite","description":"App of hydroxyapatite","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0471U","name":"Onc clrc ca 35 vrn kras&nras","description":"Onc clrc ca 35 vrn kras&nras","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1211","name":"Gsa level>9.0%","description":"Most recent glycemic status assessment (hba1c or gmi) level > 9.0%","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1451","name":"Pt dx ppd dur id/pf pd","description":"Patients with an active diagnosis of pervasive developmental disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0521U","name":"Rf iga&igm ccp antb sr-a ia","description":"Rf iga&igm ccp antb sr-a ia","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1463","name":"2 f/u wthn 180 day rx atmp","description":"Documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9248","name":"Inj melphalan (hepzato) 1 mg","description":"Injection, melphalan (hepzato), 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33287","name":"Rmv&rplcmt phrnc nrv stim pg","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88261","name":"Chromosome analysis 5","description":"Chromosome analysis; count 5 cells, 1 karyotype, with banding","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9887","name":"Distance learning attendance","description":"Behavioral counseling for diabetes prevention, distance learning, 60 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90637","name":"Vacc qirv mrna 30mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 30 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9278","name":"Inj, carboplatin (avyxa)","description":"Injection, carboplatin (avyxa), 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0374","name":"Tomo periapical image","description":"Tomo periapical image","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0862T","name":"Rlcj pg wcs lv battery only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; battery component only","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9988","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4302","name":"Complete aca, per sq cm","description":"Complete aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0505U","name":"Nfct ds vag infctj id 32orgs","description":"Nfct ds vag infctj id 32orgs","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9361","name":"Inj, efbemalenograstim alfa-","description":"Injection, efbemalenograstim alfa-vuxw, 0.5 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0840T","name":"Dgtz gls mcrscp cslt compre","description":"Digitization of glass microscope slides for consultation, comprehensive, with review of records and specimens, with report on referred material (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7939","name":"Indexing for osteotomy","description":"Indexing for osteotomy","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0917T","name":"Insj perm ccm-d sys 1 lead","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; single transvenous lead (pacing or defibrillation) only","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77306","name":"Telethx isodose plan simple","description":"Teletherapy isodose plan; simple (1 or 2 unmodified ports directed to a single area of interest), includes basic dosimetry calculation(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99221","name":"1st hosp ip/obs sf/low 40","description":"Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward or low level medical decision making. when using total time on the date of the encounter for code selection, ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0984T","name":"Iv img xtrc cere vsl oct 1st","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35572","name":"Harvest femoropopliteal vein","description":"Harvest of femoropopliteal vein, 1 segment, for vascular reconstruction procedure (eg, aortic, vena caval, coronary, peripheral artery) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37255","name":"Revsc evasc ivt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9616","name":"Gallium gozellix 1 millicuri","description":"Gallium ga-68 gozetotide (gozellix), diagnostic, 1 millicurie","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83529","name":"Asay of interleukin-6 (il-6)","description":"Interleukin-6 (il-6)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84393","name":"Tau phosphorylated ea","description":"Tau, phosphorylated (eg, ptau 181, ptau 217), each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01940","name":"Anes nulyt agt lmbr/sac","description":"Anesthesia for percutaneous image-guided destruction procedures by neurolytic agent on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01940","name":"Anes nulyt agt lmbr/sac","description":"Anesthesia for percutaneous image-guided destruction procedures by neurolytic agent on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82166","name":"Assay anti-mullerian horm","description":"Anti-mullerian hormone (amh)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96377","name":"Applicaton on-body injector","description":"Application of on-body injector (includes cannula insertion) for timed subcutaneous injection","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4288","name":"Dermabind ch, per sq cm","description":"Dermabind ch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86366","name":"Muscle-specific kinase antb","description":"Muscle-specific kinase (musk) antibody","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1192","name":"Pt w/ dx sq cell ca of esoph","description":"Patients with an existing diagnosis of squamous cell carcinoma of the esophagus","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0281U","name":"Hem vwd propeptide ag lvl","description":"Hematology (von willebrand disease [vwd]), von willebrand propeptide, enzyme-linked immunosorbent assays (elisa), plasma, diagnostic report of von willebrand factor (vwf) propeptide antigen level","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62115","name":"Reduction of skull defect","description":"Reduction of craniomegalic skull (eg, treated hydrocephalus); not requiring bone grafts or cranioplasty","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1796.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5100","name":"Inj ustekinumab-kfce, 1 mg","description":"Injection, ustekinumab-kfce (yesintek), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1235","name":"Doc pt hcv aby rna tst","description":"Documentation or patient report of hcv antibody test or hcv rna test which occurred prior to the performance period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93597","name":"R&l hrt cath chd abnl nt cnj","description":"Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); abnormal native connections","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4328","name":"Most, per sq cm","description":"Most, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97550","name":"Caregiver traing 1st 30 min","description":"Caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patie","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82947","name":"Assay glucose blood quant","description":"Glucose; quantitative, blood (except reagent strip)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9345","name":"Inj, retifanlimab-dlwr, 1 mg","description":"Injection, retifanlimab-dlwr, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81558","name":"Trnspl rej kdn mrna qpcr 139","description":"Transplantation medicine (allograft rejection, kidney), mrna, gene expression profiling by quantitative polymerase chain reaction (qpcr) of 139 genes, utilizing whole blood, algorithm reported as a binary categorization as transplant excellence, which indicates immune quiescence, or not transplant e","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90637","name":"Vacc qirv mrna 30mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 30 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0528","name":"Mgt est pt dem mod-hi cmplx","description":"Management of established patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87001","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90637","name":"Vacc qirv mrna 30mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 30 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01937","name":"Anes drg/aspir crv/thrc","description":"Anesthesia for percutaneous image-guided injection, drainage or aspiration procedures on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0336U","name":"Rare ds whl gen seq bld/slv","description":"Rare ds whl gen seq bld/slv","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99476","name":"Ped crit care age 2-5 subsq","description":"Subsequent inpatient pediatric critical care, per day, for the evaluation and management of a critically ill infant or young child, 2 through 5 years of age","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99425","name":"Prin care mgmt phys ea addl","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22860","name":"Tot disc arthrp 2ntrspc lmbr","description":"Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression); second interspace, lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4412","name":"Choriofix per sq cm","description":"Choriofix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0576U","name":"Trnsplj med lar quan ddcfdna","description":"Trnsplj med lar quan ddcfdna","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29131","name":"Appl finger splint dynamic","description":"Application of finger splint; dynamic","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":68.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5228","name":"Immed mand part denture","description":"Immed mand part denture","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93586","name":"Vngrph chd coronary sinus","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; coronary sinus (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98011","name":"Synch audio-only new high 60","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 60 ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0751T","name":"Dgtz gls mcrscp sld level ii","description":"Digitization of glass microscope slides for level ii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9956","name":"Admin home sleep apnea test","description":"Admin home sleep apnea test","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58301","name":"Remove intrauterine device","description":"Removal of intrauterine device (iud)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":120.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87088","name":"Urine bacteria culture","description":"Culture, bacterial; with isolation and presumptive identification of each isolate, urine","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21248","name":"Reconstruction of jaw","description":"Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); partial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0570","name":"Care manage serv, pr cal mo","description":"Care management services for behavioral health conditions, directed by a physician or other qualified health care professional, per calendar month, with the following required elements: initial assessment or follow-up monitoring, including the use of applicable validated rating scales, behavioral he","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1444","name":"Del < 39 weeks gest","description":"Delivery at < 39 weeks of gestation","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37288","name":"Revsc evsc tpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97552","name":"Group caregiver training","description":"Group caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77439","name":"Surf rad thr img gdn us plmt","description":"Surface radiation therapy; superficial or orthovoltage, image guidance, ultrasound for placement of radiation therapy fields for treatment of cutaneous tumors, per course of treatment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0781T","name":"Brnchsc rf dstrj pulm nrv bi","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; bilateral mainstem bronchi","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0458","name":"Aztreonam/avibactam 10 mg","description":"Injection, aztreonam/avibactam, 7.5 mg/2.5 mg (10 mg)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4371","name":"Neoguard per sq cm","description":"Neoguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5878","name":"Dup of complt dent-mandib","description":"Dup of complt dent-mandib","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92632","name":"Hearing aid slctn svc ea add","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0929T","name":"Rem interrog dev ccm-d tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49520","name":"Rerepair ing hernia reduce","description":"Repair recurrent inguinal hernia, any age; reducible","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4315","name":"Regenelink amniotic mem allo","description":"Regenelink amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0709","name":"Intraoral cmplt radio images","description":"Intraoral cmplt radio images","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6038","name":"Multiax rotation attachment","description":"Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J8520","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1274","name":"Pts snf exl mo","description":"Patients who were admitted to a skilled nursing facility (snf) during the month of evaluation were excluded from that month","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0762T","name":"Dgtz gls mcrscp sl imm ea m","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, each multiplex antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24545","name":"Optx hum fx wo ntrcndylr xtn","description":"Open treatment of humeral supracondylar or transcondylar fracture, includes internal fixation, when performed; without intercondylar extension","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":945.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0019","name":"Comm hlth intg svs sdoh 60mn","description":"Community health integration services performed by certified or trained auxiliary personnel, including a community health worker, under the direction of a physician or other practitioner; 60 minutes per calendar month, in the following activities to address social determinants of health (sdoh) need(","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0745T","name":"Car ablt rad arr n-invas loc","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; noninvasive arrhythmia localization and mapping of arrhythmia site (nidus), derived from anatomical image data (eg, ct, mri, or myocardial perfusion scan) and electrical data (eg, 12-lead ecg data), and identification of areas of avo","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5725","name":"Rebase hybrid prosthesis","description":"Rebase hybrid prosthesis","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1387","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93237","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9275","name":"Inj cosibelimab-ipdl, 2 mg","description":"Injection, cosibelimab-ipdl, 2 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3501","name":"Surg exp root surf anterior","description":"Surg exp root surf anterior","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98975","name":"Rtm 1st set-up&pt educaj eqp","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); initial set-up and patient education on use of equipment","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0051","name":"Traditional healing service","description":"Traditional healing service","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5946","name":"Max implt sup fix","description":"Max implt sup fix","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4264","name":"Cocoon membrane, per sq cm","description":"Cocoon membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49186","name":"Opn exc/dstr ntra-abd 5 cm/<","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5 cm or less","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99357","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2393","name":"Post 3 srfc resinbased cmpst","description":"Resin-based composite - three surfaces posterior","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1382","name":"Enc dur perf pd pos 11","description":"Patient encounter during the performance period with place of service code 11","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21452","name":"Perq tx mndblr fx xtrnl fixj","description":"Percutaneous treatment of mandibular fracture, with external fixation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2779","name":"Inj, susvimo 0.1 mg","description":"Injection, ranibizumab, via intravitreal implant (susvimo), 0.1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1297","name":"Bmi not doc medrsn ptref","description":"Bmi not documented due to medical reason or patient refusal of height or weight measurement","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0411","name":"Hba1c in office testing","description":"Hba1c in office testing","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1456","name":"Inj, fosaprepitant (teva)","description":"Injection, fosaprepitant (teva), not therapeutically equivalent to j1453, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0848T","name":"Dgtz gls mcrscp ish 1st","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11463","name":"Exc skn hdrdnt ing complex","description":"Excision of skin and subcutaneous tissue for hidradenitis, inguinal; with complex repair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":321.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7671","name":"Alveolus open reduction","description":"Alveolus - open reduction may include stabilization of teeth","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0581U","name":"Trnspl med antb nohla 39trgt","description":"Trnspl med antb nohla 39trgt","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7111","name":"Extraction coronal remnants","description":"Extraction coronal remnants - deciduous tooth","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87513","name":"H pylri clrthmcn rst amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); helicobacter pylori (h. pylori), clarithromycin resistance, amplified probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93010","name":"Electrocardiogram report","description":"Electrocardiogram, routine ecg with at least 12 leads; interpretation and report only","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0359U","name":"Onc prst8 ca alys all psa","description":"Onc prst8 ca alys all psa","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0673T","name":"Abltj b9 thyr ndul perq lasr","description":"Ablation, benign thyroid nodule(s), percutaneous, laser, including imaging guidance","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1332","name":"Pts no eval ini xm no 2 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 2 weeks","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53453","name":"Tprnl balo cntnc dev rmvl ea","description":"Periurethral transperineal adjustable balloon continence device; removal, each balloon","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0890T","name":"Arhfcmrigtbs 1st tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including target assessment, initial motor threshold determination, neuronavigation, delivery and management, initial treatment day","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1350","name":"Pt w/ suic saf pln init rev","description":"Patients who had a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1483","name":"Neg quan hep c or qual rna","description":"Patients who achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0211","name":"Inj, nithiodote, 3mg / 125mg","description":"Injection, sodium nitrite 3 mg and sodium thiosulfate 125 mg (nithiodote)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1385","name":"Pt rsn not seen 2nd pam","description":"Documentation of patient reasons for patients who were not seen for the second pam survey (e.g., less than four months between baseline pam assessment and follow-up","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0739T","name":"Abltj mal prst8 mag fld ndct","description":"Ablation of malignant prostate tissue by magnetic field induction, including all intraprocedural, transperineal needle/catheter placement for nanoparticle installation and intraprocedural temperature monitoring, thermal dosimetry, bladder irrigation, and magnetic field nanoparticle activation","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7111","name":"Extraction coronal remnants","description":"Extraction coronal remnants - deciduous tooth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2372","name":"Inj, biorphen, 20 micrograms","description":"Injection, phenylephrine hydrochloride (biorphen), 20 micrograms","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0688T","name":"Tx amblyopia assmt w/report","description":"Treatment of amblyopia using an online digital program; assessment of patient performance and program data by physician or other qualified health care professional, with report, per calendar month","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93586","name":"Vngrph chd coronary sinus","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; coronary sinus (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59300","name":"Episiotomy or vaginal repair","description":"Episiotomy or vaginal repair, by other than attending","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":124.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4438","name":"Pretect per sq cm","description":"Pretect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2919","name":"Inj, methylpred sod succ 5mg","description":"Injection, methylprednisolone sodium succinate, 5 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4011","name":"Internal medicine ss","description":"Internal medicine mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0887T","name":"End-tidal ctrl inhaled anes","description":"End-tidal control of inhaled anesthetic agents and oxygen to assist anesthesia care delivery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9607","name":"Lutetium lu 177 vipivotide","description":"Lutetium lu 177 vipivotide tetraxetan, therapeutic, 1 millicurie","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9075","name":"Inj, cyclophosphamide, nos","description":"Injection, cyclophosphamide, not otherwise specified, 5 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5939","name":"Resct proth mand comp remov","description":"Resct proth mand comp remov","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0132","name":"Acetylcysteine injection","description":"Injection, acetylcysteine, 100 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1438","name":"Lst knwn well <=210 min","description":"Time last known well to hospital arrival less than or equal to 3.5 hours (<= 210 minutes)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0266U","name":"Unxpl cnst hrtbl do gn xprsn","description":"Unexplained constitutional or other heritable disorders or syndromes, tissue-specific gene expression by whole-transcriptome and next-generation sequencing, blood, formalin-fixed paraffin-embedded (ffpe) tissue or fresh frozen tissue, reported as presence or absence of splicing or expression changes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","name":"Scoliosis orth sag/ cor","description":"Scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla to trochanter, includes all accessory pads, straps and interface, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual ","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6093","name":"Recement supp part denture","description":"Recement implant/abutment supported fixed partial denture","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6518","name":"Grad com wrap w strap arm cu","description":"Gradient compression wrap with adjustable straps, arm, each, custom","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2542","name":"Dental onlay metallic 2 surf","description":"Onlay-metallic-two surfaces","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0294U","name":"Lngvty&mrtlty rsk mrna 18gen","description":"Lngvty&mrtlty rsk mrna 18gen","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3391","name":"Inj, atidarsagene autotemcel","description":"Injection, atidarsagene autotemcel, per treatment","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1428","name":"Bilateral absence of eyes","description":"Patients who have bilateral absence of eyes any time during the patients history through the end of the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76830","name":"Transvaginal us non-ob","description":"Ultrasound, transvaginal","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0599U","name":"Onc pncrtc ca mult ia serum","description":"Onc pncrtc ca mult ia serum","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0975T","name":"Slctv nzmtc dbrdmt s/n/hf 1","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; first 100 sq cm","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4377","name":"Trigraft ft per sq cm","description":"Trigraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64866","name":"Fusion of facial/other nerve","description":"Anastomosis; facial-spinal accessory","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1400.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1498","name":"Diagnostic radiology mvp","description":"Diagnostic radiology mips value pathway","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1713","name":"Pfizer vacc adm ped 1st dose","description":"Pfizer vacc adm ped 1st dose","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33280","name":"Rmvl phrnc nrv stim pg only","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7193","name":"Factor ix non-recombinant","description":"Factor ix (antihemophilic factor, purified, non-recombinant) per i.u.","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0922T","name":"Rmvl perm ccm-d sys dual ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); dual (pacing and defibrillation) transvenous leads only","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6614","name":"Onlay cst nbl mtl 2 surfaces","description":"Onlay - cast noble metal two surfaces","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0568","name":"Int psych care mng, 1 cal mo","description":"Initial psychiatric collaborative care management, in the first calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required elements: outrea","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4428","name":"Dermbnd sln sl+ slx sq cm","description":"Dermabind sl n or dermabind sl + or dermabind sl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3389","name":"Topi adm prad zami per treat","description":"Topical administration, prademagene zamikeracel, per treatment","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1502","name":"Podiatry mvp","description":"Podiatry mips value pathway","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4401","name":"Absolv3 per sq cm","description":"Absolv3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81195","name":"Cytog genom-wid alys hem mal","description":"Cytogenomic (genome-wide) analysis, hematologic malignancy, structural variants and copy number variants, optical genome mapping (ogm)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33820","name":"Repair pda by ligation","description":"Repair of patent ductus arteriosus; by ligation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1215.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0457","name":"Injection, aztreonam, 100 mg","description":"Injection, aztreonam, 100 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1398","name":"Bslne and  fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0437U","name":"Psyc anxiety do mrna 15 bmrk","description":"Psyc anxiety do mrna 15 bmrk","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87557","name":"M.tuberculo dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacteria tuberculosis, quantification","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82489","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5930","name":"Max guid prothes w/o flange","description":"Max guid prothes w/o flange","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53865","name":"Cysto insj dev ischmc rmdlg","description":"Cystourethroscopy with insertion of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27232","name":"Treat thigh fracture","description":"Closed treatment of femoral fracture, proximal end, neck; with manipulation, with or without skeletal traction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0395U","name":"Onc lng multiomics plsm alg","description":"Onc lng multiomics plsm alg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1267","name":"Pt no act kid transplt wtlst","description":"Patients not observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86258","name":"Dgp antibody each ig class","description":"Gliadin (deamidated) (dgp) antibody, each immunoglobulin (ig) class","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0666","name":"Inj, bupivacaine liposome","description":"Injection, bupivacaine liposome, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6603","name":"G com bandge low dn foamchnl","description":"Gradient compression bandaging supply, low density channel foam sheet, per 250 square centimeters, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37290","name":"Revsc evsc tpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9602","name":"Fluorodopa f-18 diag per mci","description":"Fluorodopa f-18, diagnostic, per millicurie","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1163","name":"Inj, diltiazem hcl, 0.5 mg","description":"Injection, diltiazem hydrochloride, 0.5 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0889T","name":"Prsnlz trgt dvl arhfcmrigtbs","description":"Personalized target development for accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation derived from a structural and resting-state functional mri, including data preparation and transmission, generation of the target, motor threshold-starting location, neuro","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0949T","name":"Rem interrog dev ccm tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3432","name":"Guided tissue regeneration","description":"Guided tissue regeneration","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0712T","name":"N-nvs artl plaq alys quan","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess atherosclerotic plaque stability","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42809","name":"Remove pharynx foreign body","description":"Removal of foreign body from pharynx","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25820","name":"Arthrd wrist lmtd w/o b1 grf","description":"Arthrodesis, wrist; limited, without bone graft (eg, intercarpal or radiocarpal)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4437","name":"Revival ac per sq cm","description":"Revival ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1392","name":"Pt rsn no exm or lst to fu","description":"Documentation of patient reasons for no examination, i.e., refusal of examination or lost to follow-up (documentation must include information that the clinician was unable to reach the patient by phone, mail or secure electronic mail - at least one method must be documented)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31529","name":"Laryngoscopy and dilation","description":"Laryngoscopy direct, with or without tracheoscopy; with dilation, subsequent","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21210","name":"Face bone graft","description":"Graft, bone; nasal, maxillary or malar areas (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":944.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2390","name":"Ant resin-based cmpst crown","description":"Resin-based composite crown anterior","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1447","name":"Pt dx bd bef end meas pd","description":"Patients with an active diagnosis of bipolar disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86362","name":"Mog-igg1 antb cba each","description":"Myelin oligodendrocyte glycoprotein (mog-igg1) antibody; cell-based immunofluorescence assay (cba), each","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49419","name":"Insert tun ip cath w/port","description":"Insertion of tunneled intraperitoneal catheter, with subcutaneous port (ie, totally implantable)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0710T","name":"N-invas artl plaq alys","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; including data preparation and transmission, quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess a","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4342","name":"Theramend, per sq cm","description":"Theramend, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98977","name":"Rtm dev sply mscskl 16-30 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of musculoskeletal system, 16-30 days in a 30-day period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0137","name":"Inten outpt svs,min 9 pr 7 d","description":"Intensive outpatient services; weekly bundle, minimum of 9 services over a 7 contiguous day period, which can include individual and group therapy with physicians or psychologists (or other mental health professionals to the extent authorized under state law); occupational therapy requiring the skil","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0926T","name":"Prgrmg dev eval ccm-d ip","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, including review and report, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9046","name":"Inj, bortezomib, dr. reddys","description":"Injection, bortezomib (dr. reddys), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1249","name":"Pt resp true imprt to me","description":"Patient responded completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4339","name":"Artacent vericlen, per sq cm","description":"Artacent vericlen, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1480","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0442","name":"Annual alcohol screen 15 min","description":"Annual alcohol misuse screening, 5 to 15 minutes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":21.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4431","name":"Pma skin substitute, nos","description":"Pma skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4007","name":"General surgery ss","description":"General surgery mips specialty set","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15011","name":"Hrv skn cll ssp agrft 1st 25","description":"Harvest of skin for skin cell suspension autograft; first 25 sq cm or less","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93573","name":"Njx cath slct p-art angrp bi","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, bilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0136","name":"Adm of pa/n assess 5-15 m","description":"Administration of a standardized, evidence-based assessment of physical activity and nutrition, 5-15 minutes, not more often than every 6 months","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7473","name":"Remove torus mandibularis","description":"Removal of torus mandibularis","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99212","name":"Office o/p est sf 10 min","description":"Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 10 minutes must be met o","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":69.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":35.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64893","name":"Nrv grf 1strnd arm/leg >4 cm","description":"Nerve graft (includes obtaining graft), single strand, arm or leg; more than 4 cm length","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1274.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1473","name":"Pt func cap not allow impr","description":"Patient situations, at any point during the denominator identification period, where the patients functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools, such as delirium, dementia, intellectual disabilities, and pervasive and specific de","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4199","name":"Cygnus matrix, per sq cm","description":"Cygnus matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0501U","name":"Onc clrc bld quan meas cfdna","description":"Onc clrc bld quan meas cfdna","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36511","name":"Apheresis wbc","description":"Therapeutic apheresis; for white blood cells","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"U0002","name":"Covid-19 lab test non-cdc","description":"2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1387","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1448","name":"Pt dx pd bef end meas pd","description":"Patients with an active diagnosis of personality disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0289","name":"Arthro, loose body + chondro","description":"Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty) at the time of other surgical knee arthroscopy in a different compartment of the same knee","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91113","name":"Gi trc img intral colon i&r","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0783T","name":"Tc auriculr neurostimulation","description":"Transcutaneous auricular neurostimulation, set-up, calibration, and patient education on use of equipment","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9595","name":"Piflu f-18, dia 1 millicurie","description":"Piflufolastat f-18, diagnostic, 1 millicurie","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J0704","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15012","name":"Hrv skn cll ssp agrft ea add","description":"Harvest of skin for skin cell suspension autograft; each additional 25 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0888T","name":"Histotripsy mal renal tissue","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant renal tissue, including imaging guidance","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6107","name":"Tissue regen non-resorbable","description":"Tissue regen non-resorbable","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21083","name":"Impres&prep paltl lft prosth","description":"Impression and custom preparation; palatal lift prosthesis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1659.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":949.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61737","name":"Litt icr mlt trj mlt/cplx ls","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; multiple trajectories for multiple or complex lesion(s)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6596","name":"G comp bandge conform gauze","description":"Gradient compression bandaging supply, conforming gauze, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1265.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0236","name":"Intrav inf, mon anti, sec do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9002","name":"Intra-vag motion sens biofk","description":"Intra-vaginal motion sensor system, provides biofeedback for pelvic floor muscle rehabilitation device","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1814","name":"Inj. insulin (lyumjev)","description":"Insulin (lyumjev), per 5 units","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0396","name":"Alcohol/subs interv 15-30mn","description":"Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":32.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0404U","name":"Onc brst semiq meas thym kn","description":"Onc brst semiq meas thym kn","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23585","name":"Optx scapular fx w/int fixj","description":"Open treatment of scapular fracture (body, glenoid or acromion) includes internal fixation, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":829.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75580","name":"N-invas est c ffr sw aly cta","description":"Noninvasive estimate of coronary fractional flow reserve (ffr) derived from augmentative software analysis of the data set from a coronary computed tomography angiography, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0518","name":"Remove w insert drug implant","description":"Removal with reinsertion, non-biodegradable drug delivery implants, 4 or more (services for subdermal implants)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":340.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96381","name":"Admn rsv monoc antb im njx","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1268","name":"Pt ac stat kid trnsplt wtlst","description":"Patients observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0716T","name":"Car acous wavfrm rec cad rsk","description":"Cardiac acoustic waveform recording with automated analysis and generation of coronary artery disease risk score","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP06","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1452","name":"Pt dx dementia ever","description":"Patient ever had a diagnosis of dementia","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9342","name":"Inj thiotepa nos 1 mg","description":"Injection, thiotepa, not otherwise specified, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0467U","name":"Onc bldr dna ngs 60gen&aneup","description":"Onc bldr dna ngs 60gen&aneup","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33419","name":"Repair tcat mitral valve","description":"Transcatheter mitral valve repair, percutaneous approach, including transseptal puncture when performed; additional prosthesis(es) during same session (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4423","name":"Biolab tri wrap fl per sq cm","description":"Biolab tri-membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2038","name":"Skill train and dev/diem","description":"Skills training and development, per diem","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2042","name":"Foundation drs+ solo, sq cm","description":"Foundation drs+ solo, per square centimeter","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1351","name":"Pt cmplt suicd saf pln 120dy","description":"Patients who had a suicide safety plan initiated, reviewed, or updated and reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64584","name":"Rmvl hpglsl nstim ary pg","description":"Removal of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4258","name":"Enverse, per sq cm","description":"Enverse, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87513","name":"H pylri clrthmcn rst amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); helicobacter pylori (h. pylori), clarithromycin resistance, amplified probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0305U","name":"Hem rbc fnclty&dfrm shr strs","description":"Hem rbc fnclty&dfrm shr strs","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27430","name":"Revision of thigh muscles","description":"Quadricepsplasty (eg, bennett or thompson type)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":884.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1214","name":"Spiro results wth obs doc","description":"Spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and reviewed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4367","name":"Amniocore sl, per sq cm","description":"Amniocore sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93146","name":"Interrog crtd sins bat ip w/","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9997","name":"Ustekinumab-ttwe iv inj 1 mg","description":"Injection, ustekinumab-ttwe (pyzchiva), intravenous, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6037","name":"Postop dsg cast chg handfing","description":"Immediate post-surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, partial hand including fingers","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0551","name":"Phn/intr svs fr dx treat 30m","description":"Interprofessional telephone/internet/electronic health record referral service(s) provided by a treating/requesting practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, 30 minutes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33365","name":"Replace aortic valve open","description":"Transcatheter aortic valve replacement (tavr/tavi) with prosthetic valve; transaortic approach (eg, median sternotomy, mediastinotomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2159.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0675T","name":"Laps insj nw/rpcmt isdss 1ld","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first lead","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76818","name":"Fetal biophys profile w/nst","description":"Fetal biophysical profile; with non-stress testing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0806T","name":"Tcat s&ivc prstc vl impl opn","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); open femoral vein approach","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0896T","name":"Connj lvr algrft prfu dev ea","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; each additional hour, including physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary bicarbonate, lactate ","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9331","name":"Inj sirolimus prot part 1 mg","description":"Injection, sirolimus protein-bound particles, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0725T","name":"Vestibular dev impltj uni","description":"Vestibular device implantation, unilateral","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0816T","name":"Opn insj/rplcmt ins ptn subq","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0672T","name":"Ndovag cryg rf remdl tiss","description":"Endovaginal cryogen-cooled, monopolar radiofrequency remodeling of the tissues surrounding the female bladder neck and proximal urethra for urinary incontinence","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2725","name":"Inj protirelin per 250 mcg","description":"Injection, protirelin, per 250 mcg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77290","name":"Ther rad simulaj field cplx","description":"Therapeutic radiology simulation-aided field setting; complex","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":428.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0609U","name":"Onc prostate ia tot&free psa","description":"Onc prostate ia tot&free psa","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1814","name":"Inj. insulin (lyumjev)","description":"Insulin (lyumjev), per 5 units","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1174","name":"Pt w/ 2 hzv 10/2017 - mp","description":"Patient received at least two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95978","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15016","name":"App skn cl ssp agrf t/a/l ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; each additional 480 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":79.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9324","name":"Inj, pemrydi rtu, 10 mg","description":"Injection, pemetrexed (pemrydi rtu), 10 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3501","name":"Surg exp root surf anterior","description":"Surg exp root surf anterior","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0406U","name":"Onc lung flow cytmtry 5 mrk","description":"Onc lung flow cytmtry 5 mrk","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10121","name":"Inc&rmvl fb subq tiss comp","description":"Incision and removal of foreign body, subcutaneous tissues; complicated","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":262.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1451","name":"Pt dx ppd dur id/pf pd","description":"Patients with an active diagnosis of pervasive developmental disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4414","name":"Simplichor per sq cm","description":"Simplichor, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0489U","name":"Ob sgnipt cfdna seq alys 1+","description":"Ob sgnipt cfdna seq alys 1+","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0705","name":"Extra oral post radio image","description":"Extra oral post radio image","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87327","name":"Cryptococcus neoform ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; cryptococcus neoformans","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70472","name":"Ct cere prfu alys c+w/ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed with concurrent ct or ct angiography of the same anatomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2026","name":"Restrata minimatrix, 5 mg","description":"Restrata minimatrix, 5 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0978T","name":"Submucosal cryolysis therapy","description":"Submucosal cryolysis therapy; soft palate, base of tongue, and lingual tonsil","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0852T","name":"Dgtz gls mcrscp mphmtrc ea 1","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76987","name":"Dx intraop epicar car us chd","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; including placement and manipulation of transducer, image acquisition, interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1411","name":"Inj, hemgenix, per tx dose","description":"Injection, etranacogene dezaparvovec-drlb, per therapeutic dose","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43286","name":"Esphg tot w/laps moblj","description":"Esophagectomy, total or near total, with laparoscopic mobilization of the abdominal and mediastinal esophagus and proximal gastrectomy, with laparoscopic pyloric drainage procedure if performed, with open cervical pharyngogastrostomy or esophagogastrostomy (ie, laparoscopic transhiatal esophagectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3583.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11045","name":"Dbrdmt subq tiss each addl","description":"Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); each additional 20 sq cm, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":45.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D8091","name":"Compre ortho treat w surg","description":"Compre ortho treat w surg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1311","name":"Aphlx to vax bef enc","description":"Anaphylaxis due to the vaccine on or before the date of the encounter","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82271","name":"Occult blood other sources","description":"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; other sources","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3424","name":"Inj hydroxocobalamin iv 25mg","description":"Injection, hydroxocobalamin, intravenous, 25 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4345","name":"Matrix hd allogrft per sq cm","description":"Matrix hd allograft dermis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0980T","name":"Sbmcsl crylys ther tng&tnsl","description":"Submucosal cryolysis therapy; base of tongue and lingual tonsil only","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9602","name":"Fluorodopa f-18 diag per mci","description":"Fluorodopa f-18, diagnostic, per millicurie","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9332","name":"Inj efgartigimod 2mg","description":"Injection, efgartigimod alfa-fcab, 2mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5945","name":"Mand implt sup remv part","description":"Mand implt sup remv part","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0592","name":"Buprenorphine hydrochloride","description":"Injection, buprenorphine hydrochloride, 0.1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0525","name":"Inj cefotetan disodium 10 mg","description":"Injection, cefotetan disodium, 10 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2802","name":"Inj, romiplostim 1 microgram","description":"Injection, romiplostim, 1 microgram","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77090","name":"Tbs techl prep&transmis data","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0617U","name":"Cv ascvd dna alys >20000","description":"Cv ascvd dna alys >20000","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77081","name":"Dxa bone density appendiculr","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6193","name":"Replace implnt screw","description":"Replace implnt screw","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27745","name":"Reinforce tibia","description":"Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate, tibia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":910.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0495U","name":"Onc prst8 alys crcg plsm prt","description":"Onc prst8 alys crcg plsm prt","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9393","name":"Inj, fulvestrant (teva)","description":"Injection, fulvestrant (teva), not therapeutically equivalent to j9395, 25 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93587","name":"Vngrph chd vnvn cltrl at/abv","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating at or above the heart (eg, from innominate vein) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9322","name":"Inj pemetrexed (bluepoint)","description":"Injection, pemetrexed (bluepoint), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0925T","name":"Rlcj skin pocket ccm-d pg","description":"Relocation of skin pocket for implanted cardiac contractility modulation-defibrillation pulse generator","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50605","name":"Insert ureteral support","description":"Ureterotomy for insertion of indwelling stent, all types","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1041.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87484","name":"Ehrlicha chaffeensis amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); ehrlichia chaffeensis, amplified probe technique","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1426","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92628","name":"Eval hearing aid cand 1st 30","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83893","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88318","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90828","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36557","name":"Insert tunneled cv cath","description":"Insertion of tunneled centrally inserted central venous catheter, without subcutaneous port or pump; younger than 5 years of age","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26596","name":"Excision constricting tissue","description":"Excision of constricting ring of finger, with multiple z-plasties","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":875.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0831T","name":"Dgtz gls mcrscp cytp c/v","description":"Digitization of glass microscope slides for cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1821","name":"Ko elas w/ condyle pads otf","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, off the shelf","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95807","name":"Sleep study attended","description":"Sleep study, simultaneous recording of ventilation, respiratory effort, ecg or heart rate, and oxygen saturation, attended by a technologist","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":669.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97012","name":"Mechanical traction therapy","description":"Application of a modality to 1 or more areas; traction, mechanical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1271","name":"Pts dem any time/dur mo","description":"Patients with dementia at any time prior to or during the month","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9268","name":"Pentostatin injection","description":"Injection, pentostatin, 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1870.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5878","name":"Dup of complt dent-mandib","description":"Dup of complt dent-mandib","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9954","name":"Fab/del oral appliance thxpy","description":"Fab/del oral appliance thxpy","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0766T","name":"Tc mag stimj pn 1st nerve","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; first nerve","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45020","name":"Drainage of rectal abscess","description":"Incision and drainage of deep supralevator, pelvirectal, or retrorectal abscess","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2251","name":"Inj midazolam in 0.9% nacl","description":"Injection, midazolam in 0.9% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0799","name":"Hiv prep, fda approved, noc","description":"Fda approved prescription drug, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv), not otherwise classified","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6034","name":"Part hand finger distal amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s)/thumb, amputation at distal to metacarpal joint, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l669","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2373","name":"Inj, immphentiv, 20 mcg","description":"Injection, phenylephrine hydrochloride (immphentiv), 20 micrograms","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80194","name":"Assay of quinidine","description":"Quinidine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0238","name":"Intrav inf, toci, second dos","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68700","name":"Repair tear ducts","description":"Plastic repair of canaliculi","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":575.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96002","name":"Dynamic surface emg","description":"Dynamic surface electromyography, during walking or other functional activities, 1-12 muscles","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2472","name":"Inj, pantoprazole sodium chl","description":"Injection, pantoprazole sodium in sodium chloride (baxter), 40 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6584","name":"Grad com wrap w straps","description":"Gradient compression wrap with adjustable straps, not otherwise specified","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5158","name":"Inj, denosumab-bnht, 1 mg","description":"Injection, denosumab-bnht (bomyntra/conexxence), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4543","name":"Supply trans elec nerve stim","description":"Supplies for transcutaneous electrical nerve stimulator, for nerves in the auricular region, per month","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84145","name":"Procalcitonin (pct)","description":"Procalcitonin (pct)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4542","name":"Supp ext up limb tremor stim","description":"Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0351U","name":"Nfct ds bct/viral trail ip10","description":"Nfct ds bct/viral trail ip10","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0690T","name":"Quan us tis charac w/dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained with diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0427U","name":"Monocyte dstrbj wdth whl bld","description":"Monocyte dstrbj wdth whl bld","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0866T","name":"Quan mri alys brn w/dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion detection, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transmissio","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84433","name":"Asy thiopurin s-mthyltrnsfrs","description":"Thiopurine s-methyltransferase (tpmt)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"Sup/ext non-ins inf pump syr","description":"Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1311","name":"Aphlx to vax bef enc","description":"Anaphylaxis due to the vaccine on or before the date of the encounter","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"Non-adju cgm supply allow","description":"Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9321","name":"Inj epcoritamab-bysp 0.16 mg","description":"Injection, epcoritamab-bysp, 0.16 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1165","name":"Pt use hspc dur meas pd","description":"Patients who use hospice services any time during the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4311","name":"Acesso, per sq cm","description":"Acesso, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0527U","name":"Hsv 1&2 vzv amp prb tq pthgn","description":"Hsv 1&2 vzv amp prb tq pthgn","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55867","name":"Laps surg prst8ect smpl stot","description":"Laparoscopy, surgical prostatectomy, simple subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy), includes robotic assistance, when performed","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4406","name":"Xwrap fenestra per sq cm","description":"Xwrap fenestra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1395","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75580","name":"N-invas est c ffr sw aly cta","description":"Noninvasive estimate of coronary fractional flow reserve (ffr) derived from augmentative software analysis of the data set from a coronary computed tomography angiography, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4379","name":"Amniodefend ft per sq cm","description":"Amniodefend ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90695","name":"H5n8 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n8, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1303","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0281","name":"Inj aminocaproic acid 1 gram","description":"Injection, aminocaproic acid, 1 gram","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4264","name":"Cocoon membrane, per sq cm","description":"Cocoon membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88235","name":"Tissue culture placenta","description":"Tissue culture for non-neoplastic disorders; amniotic fluid or chorionic villus cells","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0531","name":"Fclty-based respite, 24 hr u","description":"Facility-based respite, 24-hour unit, for use in cmmi model","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1489","name":"Pt status doc","description":"Patient status documented","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69726","name":"Rmv ntr oi implt skl prq esp","description":"Removal, entire osseointegrated implant, skull; with percutaneous attachment to external speech processor","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9506","name":"Tc-99m graphite crucible","description":"Graphite crucible for preparation of technetium tc 99m-labeled carbon aerosol, one crucible","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0537","name":"Risk ascvd tst once pr 12 mo","description":"Administration of a standardized, evidence-based atherosclerotic cardiovascular disease (ascvd) risk assessment, 5-15 minutes, not more often than every 12 months","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40843","name":"Reconstruction of mouth","description":"Vestibuloplasty; posterior, bilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":953.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76062","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0473","name":"Micro exam prep & report","description":"Accession of tissue gross and microscopic examination preparation and transmission of written report","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12052","name":"Intmd rpr face/mm 2.6-5.0 cm","description":"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.6 cm to 5.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0521","name":"Supply fee hiv prep fda appr","description":"Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1681","name":"Ho bilateral hip abduction","description":"Hip orthosis, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":2795.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9293","name":"Fertility cycl tracking soft","description":"Fertility cycle (contraception & conception) tracking software application, fda cleared, per month, includes accessories (e.g., thermometer)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5060.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27466","name":"Lengthening of thigh bone","description":"Osteoplasty, femur; lengthening","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1408.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0547U","name":"Neurflmnt lt chn cleia plsm","description":"Neurflmnt lt chn cleia plsm","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6601","name":"Porc/ceram inlay >= 3 surfac","description":"Inlay - porcelain/ceramic three or more surfaces","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9072","name":"Inj cyclophos frindovyx 5 mg","description":"Injection, cyclophosphamide (frindovyx), 5 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1709","name":"Pfizer vaccine admin booster","description":"Pfizer vaccine admin booster","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99418","name":"Prolng ip/obs e/m ea 15 min","description":"Prolonged inpatient or observation evaluation and management service(s) time with or without direct patient contact beyond the required time of the primary service when the primary service level has been selected using total time, each 15 minutes of total time (list separately in addition to the cod","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51550","name":"Partial removal of bladder","description":"Cystectomy, partial; simple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1041.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68040","name":"Treatment of eyelid lesions","description":"Expression of conjunctival follicles (eg, for trachoma)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81001","name":"Urinalysis auto w/scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; automated, with microscopy","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0739","name":"Rehab sys active assist rt","description":"Rehabilitation system with interactive interface providing active assistance in rehabilitation therapy, includes all components and accessories, motors, microprocessors, sensors","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP10","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0427U","name":"Monocyte dstrbj wdth whl bld","description":"Monocyte dstrbj wdth whl bld","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33501","name":"Repair heart vessel fistula","description":"Repair of coronary arteriovenous or arteriocardiac chamber fistula; without cardiopulmonary bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1234.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1171","name":"Pt recd 1 td/tdap 9yrs prior","description":"Patient received at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87812","name":"Sarscov2&inf typ a&b w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) and influenza virus types a and b","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2599","name":"Inj vasopressin (am reg) 1 u","description":"Injection, vasopressin (american regent), not therapeutically equivalent to j2598, 1 unit","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2014","name":"Omeza collag compl 100 mg","description":"Omeza collagen matrix or omeza complete matrix, per 100 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95913","name":"Nrv cndj test 13/> studies","description":"Nerve conduction studies; 13 or more studies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22840","name":"Insert spine fixation device","description":"Posterior non-segmental instrumentation (eg, harrington rod technique, pedicle fixation across 1 interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at c1, facet screw fixation) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":997.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7412","name":"Excision benign lesion compl","description":"Excision of benign lesion complicated","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82190","name":"Atomic absorption","description":"Atomic absorption spectroscopy, each analyte","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78608","name":"Brain imaging (pet)","description":"Brain imaging, positron emission tomography (pet); metabolic evaluation","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1771.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1553","name":"Inj yimmugo 100 mg","description":"Injection, immune globulin (yimmugo), 100 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6561","name":"G stockng full/chap 40+ cust","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, custom, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34502","name":"Reconstruct vena cava","description":"Reconstruction of vena cava, any method","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1912.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93146","name":"Interrog crtd sins bat ip w/","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0164","name":"Epinephrine in nacl (baxter)","description":"Injection, epinephrine in sodium chloride (baxter), 0.1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0898","name":"Argatroban nonesrd (auromed)","description":"Injection, argatroban (auromedics), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1160F","name":"Rvw meds by rx/dr in rcrd","description":"Review of all medications by a prescribing practitioner or clinical pharmacist (such as, prescriptions, otcs, herbal therapies and supplements) documented in the medical record (coa)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76018","name":"Mr safety implant elec prepj","description":"Mr safety implant electronics preparation under supervision of physician or other qualified health care professional, including mr-specific programming of pulse generator and/or transmitter to verify device integrity, protection of device internal circuitry from mr electromagnetic fields, and protec","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0311U","name":"Nfct ds bct quan antmcrb sc","description":"Nfct ds bct quan antmcrb sc","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25125","name":"Remove/graft forearm lesion","description":"Excision or curettage of bone cyst or benign tumor of radius or ulna (excluding head or neck of radius and olecranon process); with autograft (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":987.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0350","name":"Oral/facial photo images","description":"Oral/facial photographic images","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0363","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87494","name":"Chlmy trch&neisra gonor mult","description":"Infectious agent detection by nucleic acid (dna or rna); chlamydia trachomatis and neisseria gonorrhoeae, multiplex amplified probe technique","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0705T","name":"Rem tx amblyopia tech sprt","description":"Remote treatment of amblyopia using an eye tracking device; surveillance center technical support including data transmission with analysis, with a minimum of 18 training hours, each 30 days","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0547U","name":"Neurflmnt lt chn cleia plsm","description":"Neurflmnt lt chn cleia plsm","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0625U","name":"Endocrinol op dna alys>5000","description":"Endocrinol op dna alys>5000","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51030","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33269","name":"Excl laa thrscp any method","description":"Exclusion of left atrial appendage, thoracoscopic, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61736","name":"Litt icr 1 traj 1 smpl les","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; single trajectory for 1 simple lesion","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9382","name":"Inj zenocutuzumab-zbco 1 mg","description":"Injection, zenocutuzumab-zbco, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0937T","name":"Xtrnl ecg rec>15d<30d","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; including recording, scanning analysis with report, review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0946T","name":"Ortho impl mvmt alys pair ct","description":"Orthopedic implant movement analysis using paired computed tomography (ct) examination of the target structure, including data acquisition, data preparation and transmission, interpretation and report (including ct scan of the joint or extremity performed with paired views)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33781","name":"Rpr tga rcnstj rpr sbpl obst","description":"Repair of transposition of the great arteries, aortic pulmonary artery reconstruction (eg, jatene type); with repair of subpulmonic obstruction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2502.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50800","name":"Implant ureter in bowel","description":"Ureteroenterostomy, direct anastomosis of ureter to intestine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77091","name":"Tbs techl calculation only","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical calculation only","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4366","name":"Dl amnio bur x-mem per sq cm","description":"Dual layer amnio burgeon x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1325","name":"Doc med rsn not seen","description":"Patients who were not seen for reasons documented by clinician for patient or medical reasons (e.g., inadequate time for follow-up, patients who received a prior intravitreal or periocular steroid injection within the last six (6) months and had a subsequent iop evaluation with iop <25mm hg within s","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5931","name":"Surgical obturator","description":"Obturator prosthesis surgical","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92230","name":"Fluorescein angioscopy i&r","description":"Fluorescein angioscopy with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1278","name":"Pre-htn or htn doc, f/u indc","description":"Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0029","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0263U","name":"Neuro asd meas 16 c metblt","description":"Neurology (autism spectrum disorder [asd]), quantitative measurements of 16 central carbon metabolites (ie, a-ketoglutarate, alanine, lactate, phenylalanine, pyruvate, succinate, carnitine, citrate, fumarate, hypoxanthine, inosine, malate, s-sulfocysteine, taurine, urate, and xanthine), liquid chrom","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0549","name":"Phone/inter for treat>31m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80400","name":"Acth stimulation panel","description":"Acth stimulation panel; for adrenal insufficiency this panel must include the following: cortisol (82533 x 2)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0375U","name":"Onc ovrn bchm asy 7 prtn alg","description":"Onc ovrn bchm asy 7 prtn alg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0493U","name":"Trnspl med quan dd-cfdna ngs","description":"Trnspl med quan dd-cfdna ngs","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76883","name":"Us nrv&acc strux 1xtr compre","description":"Ultrasound, nerve(s) and accompanying structures throughout their entire anatomic course in one extremity, comprehensive, including real-time cine imaging with image documentation, per extremity","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1385","name":"Pt rsn not seen 2nd pam","description":"Documentation of patient reasons for patients who were not seen for the second pam survey (e.g., less than four months between baseline pam assessment and follow-up","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1469","name":"Hx of hep b, or pos bld test","description":"Patient has a history of hepatitis b illness or received a hepatitis b surface antigen, hepatitis b surface antibody, or total antibody to hepatitis b core antigen test with a positive result any time before or during the measurement period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1345","name":"Pt bsln pam, 2nd scr 4-12 mo","description":"Patients who had a baseline pam score and a second score within 4 to 12 month of baseline pam score","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D8091","name":"Compre ortho treat w surg","description":"Compre ortho treat w surg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1384","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49186","name":"Opn exc/dstr ntra-abd 5 cm/<","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5 cm or less","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1354","name":"Pt no suicd saf pln 120dy","description":"Patients who did not have a suicide safety plan initiated, reviewed, or updated or reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1387","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2390","name":"Ant resin-based cmpst crown","description":"Resin-based composite crown anterior","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5933","name":"Refitting of obturator","description":"Obturator prosthesis modification","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4030","name":"Pulmonology ss","description":"Pulmonology mips specialty set","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1349","name":"No pam inc 3 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 3 points within a 4 to 12 month period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17110","name":"Destruction b9 les up to 14","description":"Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), of benign lesions other than skin tags or cutaneous vascular proliferative lesions; up to 14 lesions","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":59.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0658","name":"Seg pneum comp 2 arm chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0932T","name":"N-invs det hrt fail aug echo","description":"Noninvasive detection of heart failure derived from augmentative analysis of an echocardiogram that demonstrated preserved ejection fraction, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68760","name":"Close tear duct opening","description":"Closure of the lacrimal punctum; by thermocauterization, ligation, or laser surgery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1808","name":"Inj, folic acid, 0.1 mg","description":"Injection, folic acid, 0.1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11755","name":"Biopsy nail unit","description":"Biopsy of nail unit (eg, plate, bed, matrix, hyponychium, proximal and lateral nail folds) (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5939","name":"Resct proth mand comp remov","description":"Resct proth mand comp remov","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84394","name":"Total tau","description":"Tau, total (ttau)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0802","name":"Inj. (ani), up to 40 units","description":"Injection, corticotropin (ani), up to 40 units","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1010","name":"Inj, methylpred acetate 1 mg","description":"Injection, methylprednisolone acetate, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81449","name":"So neo gsap 5-50 rna alys","description":"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; rna analysis","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97551","name":"Caregiver traing ea addl 15","description":"Caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patie","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87181","name":"Sc std agar dilution per agt","description":"Susceptibility studies, antimicrobial agent; agar dilution method, per agent (eg, antibiotic gradient strip)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":4.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54250","name":"Nctrnl pen tmscn&/rgdity tst","description":"Nocturnal penile tumescence and/or rigidity test","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46270","name":"Remove anal fist subq","description":"Surgical treatment of anal fistula (fistulectomy/fistulotomy); subcutaneous","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38225","name":"Car-t hrv bld-drv t lymphcyt","description":"Chimeric antigen receptor t-cell (car-t) therapy; harvesting of blood-derived t lymphocytes for development of genetically modified autologous car-t cells, per day","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1376","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6193","name":"Replace implnt screw","description":"Replace implnt screw","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1268","name":"Pt ac stat kid trnsplt wtlst","description":"Patients observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9360","name":"Vinblastine sulfate inj","description":"Injection, vinblastine sulfate, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0671T","name":"Insj ant sgm aq drg dev 1+","description":"Insertion of anterior segment aqueous drainage device into the trabecular meshwork, without external reservoir, and without concomitant cataract removal, one or more","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54450","name":"Preputial stretching","description":"Foreskin manipulation including lysis of preputial adhesions and stretching","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95806","name":"Sleep study unatt&resp efft","description":"Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (eg, thoracoabdominal movement)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2025","name":"Miro3d per cubic cm","description":"Miro3d, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49615","name":"Rpr aa hrn rcr 3-10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, reducible","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0683T","name":"Prgrmg dev eval isdss ip","description":"Programming device evaluation (in-person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional, permanent implantable synchroni","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"Ctlso a-p-l control custom","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2249.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12011","name":"Rpr f/e/e/n/l/m 2.5 cm/<","description":"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":132.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1470","name":"Hep b vac not recd med rsn","description":"Documentation of medical reason(s) for not administering hepatitis b vaccine (e.g., prior anaphylaxis due to the hepatitis b vaccine)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0782T","name":"Brnchsc rf dstrj plm nrv uni","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; unilateral mainstem bronchus","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27596","name":"Amputation follow-up surgery","description":"Amputation, thigh, through femur, any level; re-amputation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":856.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5152","name":"Inj, eculizumab-aeeb, 2 mg","description":"Injection, eculizumab-aeeb (bkemv), biosimilar, 2 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9610","name":"Xe129 xenon, diagnostic","description":"Xenon xe-129 hyperpolarized gas, diagnostic, per study dose","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0048","name":"Pall serv during meas","description":"Patients who receive palliative care services any time during the intake period through the end of the measurement year","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15854","name":"Removal sutr&stapl xreq anes","description":"Removal of sutures and staples not requiring anesthesia (list separately in addition to e/m code)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0792T","name":"Appl slvr diamn fluoride 38%","description":"Application of silver diamine fluoride 38%, by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0752T","name":"Dgtz gls mcrscp sld lvl iii","description":"Digitization of glass microscope slides for level iii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5995","name":"Peri medicament w/seal, max","description":"Peri medicament w/seal, max","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27519","name":"Treat thigh fx growth plate","description":"Open treatment of distal femoral epiphyseal separation, includes internal fixation, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1329.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83884","name":"Assay neurflmnt light chain","description":"Neurofilament light chain (nfl)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1266","name":"Pts admit snf","description":"Patients admitted to a skilled nursing facility (snf)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46070","name":"Incision anal septum infant","description":"Incision, anal septum (infant)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":220.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65855","name":"Trabeculoplasty laser surg","description":"Trabeculoplasty by laser surgery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80503","name":"Path clin consltj sf 5-20","description":"Pathology clinical consultation; for a clinical problem, with limited review of patients history and medical records and straightforward medical decision making when using time for code selection, 5-20 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86037","name":"Anca titer each antibody","description":"Antineutrophil cytoplasmic antibody (anca); titer, each antibody","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83036","name":"Hemoglobin glycosylated a1c","description":"Hemoglobin; glycosylated (a1c)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53865","name":"Cysto insj dev ischmc rmdlg","description":"Cystourethroscopy with insertion of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0019","name":"Comm hlth intg svs sdoh 60mn","description":"Community health integration services performed by certified or trained auxiliary personnel, including a community health worker, under the direction of a physician or other practitioner; 60 minutes per calendar month, in the following activities to address social determinants of health (sdoh) need(","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75577","name":"Quan&char c athrosclrtc plaq","description":"Quantification and characterization of coronary atherosclerotic plaque to assess severity of coronary disease, derived from augmentative software analysis of the data set from a coronary computed tomographic angiography, with interpretation and report by a physician or other qualified health care pr","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0791T","name":"Motr cog vr gait train ea 15","description":"Motor-cognitive, semi-immersive virtual reality-facilitated gait training, each 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0029","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0040","name":"Pt phys/occ therapy","description":"Patient already receiving physical/occupational/speech/recreational therapy during the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0703","name":"2d oral/facial photo image","description":"2d oral/facial photo image","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2471","name":"Inj pantoprazole(hikma) 40mg","description":"Injection, pantoprazole (hikma), not therapeutically equivalent to j2470, 40 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3502","name":"Surg exp root surf premolar","description":"Surg exp root surf premolar","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0804","name":"3d facial scan indirect","description":"3d facial scan indirect","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1476","name":"Pt dx cog imp or ad","description":"Patients with diagnosis of cognitive impairment or alzheimers disease","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5098","name":"Inj ustekinumab-srlf, 1 mg","description":"Injection, ustekinumab-srlf (imuldosa), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0530","name":"Adult daycare center, 8 hr u","description":"Adult day center, 8-hour unit, for use in cmmi model","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0162","name":"Inj epinephrine (fresenius)","description":"Injection, epinephrine (fresenius), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36215","name":"Place catheter in artery","description":"Selective catheter placement, arterial system; each first order thoracic or brachiocephalic branch, within a vascular family","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90809","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31625","name":"Bronchoscopy w/biopsy(s)","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial or endobronchial biopsy(s), single or multiple sites","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0368","name":"Cone beam ct interprete tmj","description":"Cone beam ct interprete tmj","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4023","name":"Pathology ss","description":"Pathology mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0323U","name":"Iadna cns pthgn next gen seq","description":"Iadna cns pthgn next gen seq","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0023","name":"Pin service 60m per month","description":"Principal illness navigation services by certified or trained auxiliary personnel under the direction of a physician or other practitioner, including a patient navigator; 60 minutes per calendar month, in the following activities:  person-centered assessment, performed to better understand the indiv","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49614","name":"Rpr aa hrn rcr < 3 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0566U","name":"Onc lng qpcr-bsd alys 13dmrs","description":"Onc lng qpcr-bsd alys 13dmrs","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38226","name":"Car-t prep t lymphcyt f/trns","description":"Chimeric antigen receptor t-cell (car-t) therapy; preparation of blood-derived t lymphocytes for transportation (eg, cryopreservation, storage)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0268","name":"Removal of impacted wax md","description":"Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6074","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (noble metal)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0138","name":"Iv cipaglucosidase alfa-atga","description":"Intravenous infusion of cipaglucosidase alfa-atga, including provider/supplier acquisition and clinical supervision of oral administration of miglustat in preparation of receipt of cipaglucosidase alfa-atga","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44402","name":"Colonoscopy w/stent plcmt","description":"Colonoscopy through stoma; with endoscopic stent placement (including pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0616","name":"Inj metoprolol tartrate 1 mg","description":"Injection, metoprolol tartrate, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7354","name":"Cantharidin top, applicator","description":"Cantharidin for topical administration, 0.7%, single unit dose applicator (3.2 mg)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9993","name":"Pall serv during meas","description":"Patient was provided palliative care services any time during the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1435","name":"Oral chemo in perf pd","description":"Patient on oral chemotherapy during the performance period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4373","name":"Membrane wrp lt per sq cm","description":"Membrane wrap lite, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4271","name":"Complete ft per sq cm","description":"Complete ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4298","name":"Amniocore pro, per sq cm","description":"Amniocore pro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0552U","name":"Repr med pga gdo te bx locus","description":"Repr med pga gdo te bx locus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1821","name":"Ko elas w/ condyle pads otf","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, off the shelf","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2008","name":"Theragenesis, per sq cm","description":"Theragenesis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0732T","name":"Immntx admn electroporatn im","description":"Immunotherapy administration with electroporation, intramuscular","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63015","name":"Remove spine lamina >2 crvcl","description":"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), more than 2 vertebral segments; cervical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1659.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1334","name":"Pts act pvd 2 wks 2 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 2 weeks after initial acute pvd encounter","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0381U","name":"Maple syrup ur ds mntr quan","description":"Maple syrup ur ds mntr quan","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9329","name":"Inj, tislelizumab-jsgr","description":"Injection, tislelizumab-jsgr, 1mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0518U","name":"Ther rx mntr 90+ pn&mtl hlth","description":"Ther rx mntr 90+ pn&mtl hlth","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5947","name":"Mand implt sup fix","description":"Mand implt sup fix","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4423","name":"Biolab tri wrap fl per sq cm","description":"Biolab tri-membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69730","name":"Rplc oi implt sk tc esp>=100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0575U","name":"Trnsplj med lar rtpcr 4genes","description":"Trnsplj med lar rtpcr 4genes","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1433","name":"Oral chemo wthn 30 days enc","description":"Patient on oral chemotherapy on or within 30 days before denominator eligible encounter","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0832T","name":"Dgtz gls mcrscp cytp oth scr","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64655","name":"Revj/rplcmt bat mod sys lead","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; lead only","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87182","name":"Sc std carbapenemase nzm det","description":"Susceptibility studies, antimicrobial agent; carbapenemase enzyme detection (eg, klebsiella pneumoniae carbapenemase [kpc], new delhi metallo-beta-lactamase [ndm], verona integron-encoded metallo-beta-lactamase [vim]), multiplex immunoassay, qualitative, per isolate","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99470","name":"Rpm tx mgmt 1st 10 min","description":"Remote physiologic monitoring treatment management services, clinical staff/physician/other qualified health care professional time in a calendar month requiring 1 real-time interactive communication with the patient/caregiver during the calendar month; first 10 minutes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0379U","name":"Tgsap sl or neo dna523&rna55","description":"Tgsap sl or neo dna523&rna55","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44205","name":"Lap colectomy part w/ileum","description":"Laparoscopy, surgical; colectomy, partial, with removal of terminal ileum with ileocolostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1499.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27614","name":"Biopsy lower leg soft tissue","description":"Biopsy, soft tissue of leg or ankle area; deep (subfascial or intramuscular)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":492.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"U0002","name":"Covid-19 lab test non-cdc","description":"2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2801","name":"Inj, rykindo, 0.5 mg","description":"Injection, risperidone (rykindo), 0.5 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96202","name":"Mlt fam grp bhv train 1st 60","description":"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face with multiple sets of paren","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0521","name":"New pt-cg dyad dem hig cmplx","description":"Management of new patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85675","name":"Thrombin time titer","description":"Thrombin time; titer","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87556","name":"M.tuberculo dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacteria tuberculosis, amplified probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9376","name":"Inj pozelimab-bbfg, 1 mg","description":"Injection, pozelimab-bbfg, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45108","name":"Anorectal myomectomy","description":"Anorectal myomectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2011","name":"Supra sdrm, per sq cm","description":"Supra sdrm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93727","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2351","name":"Inj ocrelizumab 1mg hya-ocsq","description":"Injection, ocrelizumab, 1 mg and hyaluronidase-ocsq","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99484","name":"Care mgmt svc bhvl hlth cond","description":"Care management services for behavioral health conditions, at least 20 minutes of clinical staff time, directed by a physician or other qualified health care professional, per calendar month, with the following required elements: initial assessment or follow-up monitoring, including the use of appli","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":43.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0402","name":"Inj, abilify asimtufii, 1 mg","description":"Injection, aripiprazole (abilify asimtufii), 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0465","name":"Home vent invasive interface","description":"Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58580","name":"Transcrv abltj utrn fibrd rf","description":"Transcervical ablation of uterine fibroid(s), including intraoperative ultrasound guidance and monitoring, radiofrequency","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0955T","name":"Tot impl amei removal","description":"Totally implantable active middle ear hearing implant; removal, including removal of sound processor and all implant components","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0651","name":"Inj, levothyroxine, freskabi","description":"Injection, levothyroxine sodium (fresenius kabi), not therapeutically equivalent to j0650, 10 mcg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11771","name":"Exc pilonidal cyst xtnsv","description":"Excision of pilonidal cyst or sinus; extensive","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79101","name":"Nuclear rx iv admin","description":"Radiopharmaceutical therapy, by intravenous administration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0721T","name":"Quan ct tiss charac w/o ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17274","name":"Dstr mal les s/n/h/f/g 3.1-4","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia; lesion diameter 3.1 to 4.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29889","name":"Arthrs aid pcl rpr/agmntj","description":"Arthroscopically aided posterior cruciate ligament repair/augmentation or reconstruction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1422.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4276","name":"Orion, per sq cm","description":"Orion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81524","name":"Onc cns tum dna mthyl 10,000","description":"Oncology (central nervous system tumor), dna methylation analysis of at least 10,000 methylation sites, utilizing dna extracted from formalin-fixed tumor tissue, algorithm(s) reported as probability of matching a reference tumor family and class, and mgmt (o-6-methylguanine-dna methyltransferase) pr","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84393","name":"Tau phosphorylated ea","description":"Tau, phosphorylated (eg, ptau 181, ptau 217), each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0443U","name":"Neurflmnt lt chn ultrsens ia","description":"Neurflmnt lt chn ultrsens ia","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0979T","name":"Sbmcsl crylys ther sft palt","description":"Submucosal cryolysis therapy; soft palate only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4368","name":"Amchothick per sq cm","description":"Amchothick, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0474U","name":"Hered pan ca gsap 88gene ngs","description":"Hered pan ca gsap 88gene ngs","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0367U","name":"Onc bldr 10 flwg trurl rescj","description":"Onc bldr 10 flwg trurl rescj","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9202","name":"Goserelin acetate implant","description":"Goserelin acetate implant, per 3.6 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35301","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; carotid, vertebral, subclavian, by neck incision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1335.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9049","name":"Inj, bortezomib, hospira","description":"Injection, bortezomib (hospira), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82233","name":"Beta-amyloid 1-40 (abeta 40)","description":"Beta-amyloid; 1-40 (abeta 40)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0716T","name":"Car acous wavfrm rec cad rsk","description":"Cardiac acoustic waveform recording with automated analysis and generation of coronary artery disease risk score","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69726","name":"Rmv ntr oi implt skl prq esp","description":"Removal, entire osseointegrated implant, skull; with percutaneous attachment to external speech processor","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66711","name":"Ecp ciliary body destruction","description":"Ciliary body destruction; cyclophotocoagulation, endoscopic, without concomitant removal of crystalline lens","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33974","name":"Remove intra-aortic balloon","description":"Removal of intra-aortic balloon assist device from the ascending aorta, including repair of the ascending aorta, with or without graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1069.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99437","name":"Chrnc care mgmt phys ea addl","description":"Chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, or funct","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4402","name":"Xwrap 2.0 per sq cm","description":"Xwrap 2.0, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1412","name":"Met nsclc w/ egfr alk oth ab","description":"Patients with metastatic nsclc with epidermal growth factor receptor (egfr) mutations, alk genomic tumor aberrations, or other targetable genomic abnormalities with approved first-line targeted therapy, such as nsclc with ros1 rearrangement, braf v600e mutation, ntrk 1/2/3 gene fusion, met ex14 skip","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92637","name":"Hearing aid pst-fitg f-up ea","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1181","name":"Gr 2 or> dia or gr2 or> col","description":"Grade 2 or above diarrhea and/or grade 2 or above colitis","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37290","name":"Revsc evsc tpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1456","name":"Pt had htx","description":"Patient had a heart transplant","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7299","name":"Rem anchorage device w/flap","description":"Rem anchorage device w/flap","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0733T","name":"Rem r-t mtn nrehab ther sply","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; supply and technical support, per 30 days","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88371","name":"Protein western blot tissue","description":"Protein analysis of tissue by western blot, with interpretation and report;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1221","name":"Dre w/o rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; without evidence of retinopathy","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6280","name":"Implt maint procd remv implt","description":"Implt maint procd remv implt","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27556","name":"Treat knee dislocation","description":"Open treatment of knee dislocation, includes internal fixation, when performed; without primary ligamentous repair or augmentation/reconstruction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1303.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4025","name":"Physical medicine ss","description":"Physical medicine mips specialty set","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0225","name":"Inj, vutrisiran, 1 mg","description":"Injection, vutrisiran, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0500U","name":"Autoinflam ds vexas synd dna","description":"Autoinflam ds vexas synd dna","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2427","name":"Inj, invega hafyera/trinza","description":"Injection, paliperidone palmitate extended release (invega hafyera, or invega trinza), 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0453U","name":"Onc clrct ca cfdna qpcr asy","description":"Onc clrct ca cfdna qpcr asy","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29844","name":"Wrist arthroscopy/surgery","description":"Arthroscopy, wrist, surgical; synovectomy, partial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44180","name":"Lap enterolysis","description":"Laparoscopy, surgical, enterolysis (freeing of intestinal adhesion) (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1003.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99252","name":"Ip/obs consltj new/est sf 35","description":"Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 35 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5124","name":"Inj. byooviz, 0.1 mg","description":"Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32035","name":"Thoracostomy w/rib resection","description":"Thoracostomy; with rib resection for empyema","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":711.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9603","name":"Inj, pafolacianine, 0.1 mg","description":"Injection, pafolacianine, 0.1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92972","name":"Perq trluml coronry lithotrp","description":"Percutaneous transluminal coronary lithotripsy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94656","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86366","name":"Muscle-specific kinase antb","description":"Muscle-specific kinase (musk) antibody","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0549","name":"Phone/inter for treat>31m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92637","name":"Hearing aid pst-fitg f-up ea","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84393","name":"Tau phosphorylated ea","description":"Tau, phosphorylated (eg, ptau 181, ptau 217), each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1442","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4317","name":"Vitograft, per sq cm","description":"Vitograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74327","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1301","name":"Immunization counseling","description":"Immunization counseling","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0272U","name":"Hem genetic bld do 51 genes","description":"Hematology (genetic bleeding disorders), genomic sequence analysis of 51 genes, blood, buccal swab, or amniotic fluid, comprehensive","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22305","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1454","name":"New cied","description":"New cied","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69716","name":"Impl oi implt sk tc esp<100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or resulting in removal of less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0041A","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7214","name":"Altuviiio per factor viii iu","description":"Injection, factor viii/von willebrand factor complex, recombinant (altuviiio), per factor viii i.u.","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60660","name":"Abltj 1/+thyr ndul 1lobe prq","description":"Ablation of 1 or more thyroid nodule(s), one lobe or the isthmus, percutaneous, including imaging guidance, radiofrequency","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5126","name":"Inj alymsys 10 mg","description":"Injection, bevacizumab-maly, biosimilar, (alymsys), 10 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87075","name":"Cultr bacteria except blood","description":"Culture, bacterial; any source, except blood, anaerobic with isolation and presumptive identification of isolates","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1565.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0321","name":"Audio-only hhs","description":"Home health services furnished using synchronous telemedicine rendered via telephone or other real-time interactive audio-only telecommunications system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0558","name":"Adv prim care mgmt lvl 3","description":"Advanced primary care management services for a patient that is a qualified medicare beneficiary with multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, which place the patient at significant risk of death, acute exacerbation/decompensat","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38227","name":"Car-t receipt&prepj admn","description":"Chimeric antigen receptor t-cell (car-t) therapy; receipt and preparation of car-t cells for administration","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1266","name":"Pts admit snf","description":"Patients admitted to a skilled nursing facility (snf)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4225","name":"Amnio or derma tl, per sq cm","description":"Amniobind or dermabind tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1237","name":"Pt rsn no scrn","description":"Patient reason for not screening for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety (e.g., patient declined or other patient reasons)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2525","name":"Cl, hydrophilic, dual focus","description":"Contact lens, hydrophilic, dual focus, per lens","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"Basic vestibular evaluation","description":"Basic vestibular evaluation, includes spontaneous nystagmus test with eccentric gaze fixation nystagmus, with recording, positional nystagmus test, minimum of 4 positions, with recording, optokinetic nystagmus test, bidirectional foveal and peripheral stimulation, with recording, and oscillating tra","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93587","name":"Vngrph chd vnvn cltrl at/abv","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating at or above the heart (eg, from innominate vein) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5228","name":"Immed mand part denture","description":"Immed mand part denture","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7299","name":"Rem anchorage device w/flap","description":"Rem anchorage device w/flap","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76984","name":"Dx intraop thoracic aorta us","description":"Ultrasound, intraoperative thoracic aorta (eg, epiaortic), diagnostic","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0302U","name":"Iadna brtnla ddpcr flwg liq","description":"Iadna brtnla ddpcr flwg liq","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6032","name":"Part handfng ultralite tcf/=","description":"Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2041","name":"Foundation drs+ duo pr sq cm","description":"Foundation drs+ duo, per square centimeter","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0422U","name":"Onc pan solid tum alys dna","description":"Onc pan solid tum alys dna","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0827T","name":"Dgtz gls mcrscp cytp smears","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; smears with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4437","name":"Revival ac per sq cm","description":"Revival ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62161","name":"Dissect brain w/scope","description":"Neuroendoscopy, intracranial; with dissection of adhesions, fenestration of septum pellucidum or intraventricular cysts (including placement, replacement, or removal of ventricular catheter)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1721.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0317U","name":"Onc lung ca 4-prb fish assay","description":"Onc lung ca 4-prb fish assay","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0460U","name":"Onc whl bld/bucc rtpcr 24gen","description":"Onc whl bld/bucc rtpcr 24gen","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87154","name":"Cul typ id bld pthgn 6+ trgt","description":"Culture, typing; identification of blood pathogen and resistance typing, when performed, by nucleic acid (dna or rna) probe, multiplexed amplified probe technique including multiplex reverse transcription, when performed, per culture or isolate, 6 or more targets","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99238","name":"Hosp ip/obs dschrg mgmt 30/<","description":"Hospital inpatient or observation discharge day management; 30 minutes or less on the date of the encounter","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0666","name":"Team remote e/m est pt 15 mn","description":"Team remote e/m est. pt 15mins","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67909","name":"Revise eyelid defect","description":"Reduction of overcorrection of ptosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":474.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0018","name":"Crisis psychotherapy add 30m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); each additional 30 minutes (list separately in addition to code for primary service)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0271U","name":"Hem cgen neutropenia 23 gen","description":"Hematology (congenital neutropenia), genomic sequence analysis of 23 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2023","name":"Innovamatrix pd, 1 mg","description":"Innovamatrix pd, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4311","name":"Acesso, per sq cm","description":"Acesso, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5612","name":"Rep resin part dent base max","description":"Rep resin part dent base max","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38780","name":"Remove abdomen lymph nodes","description":"Retroperitoneal transabdominal lymphadenectomy, extensive, including pelvic, aortic, and renal nodes (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1185.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J0970","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0498U","name":"Onc clrct ngs mut detc 43gen","description":"Onc clrct ngs mut detc 43gen","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4020","name":"Ophthalmology/optometry ss","description":"Ophthalmology/optometry mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37267","name":"Revsc evsc fpvt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0520U","name":"Ther rx mntr 200+ rx/sbsts","description":"Ther rx mntr 200+ rx/sbsts","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0277U","name":"Hem gen pltlt funcj do 31","description":"Hematology (genetic platelet function disorder), genomic sequence analysis of 31 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76819","name":"Fetal biophys profil w/o nst","description":"Fetal biophysical profile; without non-stress testing","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1360","name":"Suicd c-ssrs assessment","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1425","name":"Surgical care mvp","description":"Surgical care mips value pathway","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99411","name":"Preventive counseling group","description":"Preventive medicine counseling and/or risk factor reduction intervention(s) provided to individuals in a group setting (separate procedure); approximately 30 minutes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":19.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4030","name":"Pulmonology ss","description":"Pulmonology mips specialty set","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86825","name":"Hla x-math non-cytotoxic","description":"Human leukocyte antigen (hla) crossmatch, non-cytotoxic (eg, using flow cytometry); first serum sample or dilution","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7356","name":"Inj foscarb/foslevodopa 5 mg","description":"Injection, foscarbidopa 0.25 mg/foslevodopa 5 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0716T","name":"Car acous wavfrm rec cad rsk","description":"Cardiac acoustic waveform recording with automated analysis and generation of coronary artery disease risk score","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87469","name":"Babesia microti amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); babesia microti, amplified probe technique","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1390","name":"Pt no doc exm for rec","description":"Patients who do not have a documented exam performed for recurrence of melanoma or no documentation within the performance period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9196","name":"Inj gemcitabine hcl (accord)","description":"Injection, gemcitabine hydrochloride (accord), not therapeutically equivalent to j9201, 200 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76014","name":"Mr sfty implt&/fb asmt stf 1","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2009","name":"Symphony, per sq cm","description":"Symphony, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4322","name":"Splint intra-coronal","description":"Splint intra-coronal","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0791T","name":"Motr cog vr gait train ea 15","description":"Motor-cognitive, semi-immersive virtual reality-facilitated gait training, each 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64760","name":"Incision of vagus nerve","description":"Transection or avulsion of; vagus nerve (vagotomy), abdominal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":497.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97763","name":"Orthc/prostc mgmt sbsq enc","description":"Orthotic(s)/prosthetic(s) management and/or training, upper extremity(ies), lower extremity(ies), and/or trunk, subsequent orthotic(s)/prosthetic(s) encounter, each 15 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6604","name":"Cst bse mtl inlay 2 surfaces","description":"Inlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0813T","name":"Egd vol adjmt bariatric balo","description":"Esophagogastroduodenoscopy, flexible, transoral, with volume adjustment of intragastric bariatric balloon","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4313","name":"Dermabind fm, per sq cm","description":"Dermabind fm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0546","name":"Phone/internet ehr assess","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty   whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patien","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4384","name":"Axolotl dual ult per sq cm","description":"Axolotl dualgraft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0838T","name":"Dgtz gls mcrscp cslt sld els","description":"Digitization of glass microscope slides for consultation and report on referred slides prepared elsewhere (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27497","name":"Decompression of thigh/knee","description":"Decompression fasciotomy, thigh and/or knee, 1 compartment (flexor or extensor or adductor); with debridement of nonviable muscle and/or nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":625.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1408","name":"Gmln brca bef dx ca","description":"Patients who have germline brca testing completed before diagnosis of epithelial ovarian, fallopian tube, or primary peritoneal cancer","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68761","name":"Close tear duct opening","description":"Closure of the lacrimal punctum; by plug, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90833","name":"Psytx w pt w e/m 30 min","description":"Psychotherapy, 30 minutes with patient when performed with an evaluation and management service (list separately in addition to the code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":69.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87070","name":"Culture othr specimn aerobic","description":"Culture, bacterial; any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0869T","name":"Njx b1 sub mtrl hw fixj aug","description":"Injection(s), bone-substitute material for bone and/or soft tissue hardware fixation augmentation, including intraoperative imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0608","name":"Lanthanum carbonate pwdr 5mg","description":"Lanthanum carbonate, oral, powder, 5 mg, not therapeutically equivalent to j0607 (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4009","name":"Hospitalists ss","description":"Hospitalists mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99386","name":"Prev visit new age 40-64","description":"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; 40-64 years","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":150.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78803","name":"Rp loclzj tum spect 1 area","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (spect), single area (eg, head, neck, chest, pelvis) or acquisition, single day imaging","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61684","name":"Intracranial vessel surgery","description":"Surgery of intracranial arteriovenous malformation; infratentorial, simple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3342.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0801","name":"3d dental scan direct","description":"3d dental scan direct","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4380","name":"Advograft one per sq cm","description":"Advograft one, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97008","name":"Mchnl sclp cool prep plmt","description":"Mechanical scalp cooling; including hair preparation, individual cap placement, therapy initiation, and precooling period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64450","name":"Njx aa&/strd other pn/branch","description":"Injection(s), anesthetic agent(s) and/or steroid; other peripheral nerve or branch","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0654","name":"Inj, liothyronine, 1 mcg","description":"Injection, liothyronine, 1 mcg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1329","name":"Pts act pvd 2 wks 8 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 8 weeks after initial acute pvd encounter","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51736","name":"Urine flow measurement","description":"Simple uroflowmetry (ufr) (eg, stop-watch flow rate, mechanical uroflowmeter)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86305","name":"Human epididymis protein 4","description":"Human epididymis protein 4 (he4)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0617U","name":"Cv ascvd dna alys >20000","description":"Cv ascvd dna alys >20000","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0821T","name":"Mntr psychdlc med 2ndphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; second physician or other qualified health care professional, concurrent with first physician or other qualified health care professional, each hour (list sepa","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0750T","name":"B1 str&fx rsk asmt dxrbmd1vw","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27450","name":"Incision of thigh","description":"Osteotomy, femur, shaft or supracondylar; with fixation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1229.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0557U","name":"Nfct ds bv dna mrk vag fluid","description":"Nfct ds bv dna mrk vag fluid","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54205","name":"Njx px peyronie ds exps plaq","description":"Injection procedure for peyronie disease; with surgical exposure of plaque","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0650","name":"Lso sc r ant/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, inclu","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":809.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4023","name":"Pathology ss","description":"Pathology mips specialty set","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1392","name":"Pt rsn no exm or lst to fu","description":"Documentation of patient reasons for no examination, i.e., refusal of examination or lost to follow-up (documentation must include information that the clinician was unable to reach the patient by phone, mail or secure electronic mail - at least one method must be documented)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6105","name":"Remove implant body","description":"Remove implant body","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55881","name":"Ablt trurl prst8 tis thrm us","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation;","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86352","name":"Cell function assay w/stim","description":"Cellular function assay involving stimulation (eg, mitogen or antigen) and detection of biomarker (eg, atp)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4269","name":"Surgraft xt per sq cm","description":"Surgraft xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98984","name":"Rtm dev sply resp sys 2-15 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of respiratory system, 2-15 days in a 30-day period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15778","name":"Impl absrb msh/prsth dly cls","description":"Implantation of absorbable mesh or other prosthesis for delayed closure of defect(s) (ie, external genitalia, perineum, abdominal wall) due to soft tissue infection or trauma","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2253","name":"Inj midazolam (seizalam)","description":"Injection, midazolam (seizalam), 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99308","name":"Sbsq nf care low mdm 20","description":"Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 20 minutes must be met or exce","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":75.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86701","name":"Hiv-1antibody","description":"Antibody; hiv-1","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0888T","name":"Histotripsy mal renal tissue","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant renal tissue, including imaging guidance","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81441","name":"Ibmfs seq alys pnl 30 genes","description":"Inherited bone marrow failure syndromes (ibmfs) (eg, fanconi anemia, dyskeratosis congenita, diamond-blackfan anemia, shwachman-diamond syndrome, gata2 deficiency syndrome, congenital amegakaryocytic thrombocytopenia) sequence analysis panel, must include sequencing of at least 30 genes, including b","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0677T","name":"Laps repos lead isdss 1st ld","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first repositioned lead","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1482","name":"Pos quan hep c or qual rna","description":"Positive/detectable hepatitis c virus quantitative or qualitative rna test result during the denominator identification period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1401","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9359","name":"Inj lon tesirin-lpyl 0.075mg","description":"Injection, loncastuximab tesirine-lpyl, 0.075 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87493","name":"C diff amplified probe","description":"Infectious agent detection by nucleic acid (dna or rna); clostridium difficile, toxin gene(s), amplified probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69727","name":"Rmv ntr oi imp sk tc esp<100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0637","name":"Caspofungin acetate","description":"Injection, caspofungin acetate, 5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64734","name":"Incision of cheek nerve","description":"Transection or avulsion of; infraorbital nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":451.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22836","name":"Ant thrc vrt body tethrg <7","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; up to 7 vertebral segments","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90964","name":"Esrd home pt serv p mo 2-11","description":"End-stage renal disease (esrd) related services for home dialysis per full month, for patients 2-11 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":570.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0713","name":"Inj ceftazidime per 500 mg","description":"Injection, ceftazidime, per 500 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92145","name":"Corneal hysteresis deter","description":"Corneal hysteresis determination, by air impulse stimulation, unilateral or bilateral, with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2039","name":"Innovamatrix fd, per sq cm","description":"Innovamatrix fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9332","name":"Inj efgartigimod 2mg","description":"Injection, efgartigimod alfa-fcab, 2mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93511","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2219.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0931T","name":"Ephys eval ccm-d ld separate","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), separate from initial implantation or replacement with testing of cardiac cont","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55714","name":"Bx prst8 in-bore ct/mri 1","description":"Biopsy, prostate, in-bore ct- or mri-guided targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0898T","name":"N-invas prst8 cancer est map","description":"Noninvasive prostate cancer estimation map, derived from augmentative analysis of image-guided fusion biopsy and pathology, including visualization of margin volume and location, with margin determination and physician interpretation and report","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80061","name":"Lipid panel","description":"Lipid panel this panel must include the following: cholesterol, serum, total (82465) lipoprotein, direct measurement, high density cholesterol (hdl cholesterol) (83718) triglycerides (84478)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4020","name":"Ophthalmology/optometry ss","description":"Ophthalmology/optometry mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1413","name":"Pos pdl1 bef init ici tx","description":"Patients who had a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27320","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":574.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2792","name":"Crown full cast noble metal","description":"Crown-full cast noble metal","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55150","name":"Removal of scrotum","description":"Resection of scrotum","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G3002","name":"Chronic pain mgmt 30 mins","description":"Chronic pain management and treatment, monthly bundle including, diagnosis; assessment and monitoring; administration of a validated pain rating scale or tool; the development, implementation, revision, and/or maintenance of a person-centered care plan that includes strengths, goals, clinical needs,","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0613","name":"Calcium glucon (wg critical)","description":"Injection, calcium gluconate (wg critical care), not therapeutically equivalent to j0612, 10 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0391","name":"Inj, artesunate, 1mg","description":"Injection, artesunate, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0910T","name":"Rmvl int nstim sys vagus nrv","description":"Removal of integrated neurostimulation system, vagus nerve","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4275","name":"Esano aca, per sq cm","description":"Esano aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2791","name":"Crown full cast base metal","description":"Crown-full cast predominantly base metal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0261U","name":"Onc clrct ca img alys w/ai","description":"Oncology (colorectal cancer), image analysis with artificial intelligence assessment of 4 histologic and immunohistochemical features (cd3 and cd8 within tumor-stroma border and tumor core), tissue, reported as immune response and recurrence-risk score","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2027","name":"Matriderm per sq cm","description":"Matriderm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1171","name":"Inj, hydromorphone, 0.1 mg","description":"Injection, hydromorphone, 0.1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9563","name":"Ht inj immuno diem","description":"Home injectable therapy, immunotherapy, 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":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0802","name":"3d dental scan indirect","description":"3d dental scan indirect","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0614U","name":"Iem pmd alys 4 nzm cplx page","description":"Iem pmd alys 4 nzm cplx page","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46601","name":"Diagnostic anoscopy","description":"Anoscopy; diagnostic, with high-resolution magnification (hra) (eg, colposcope, operating microscope) and chemical agent enhancement, including collection of specimen(s) by brushing or washing, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":97.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0039","name":"Pt no ref, rn spec","description":"Patient not referred, reason not otherwise specified","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"Evoked auditory test limited","description":"Distortion product evoked otoacoustic emissions; limited evaluation (to confirm the presence or absence of hearing disorder, 3-6 frequencies) or transient evoked otoacoustic emissions, with interpretation and report","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1201","name":"Med rsn no ace-i/arb rx","description":"Documentation of medical reason(s) for not prescribing ace inhibitor (ace-i) or arb therapy during the measurement period (e.g., pregnancy, history of angioedema to ace-i, other allergy to ace-i and arb, hyperkalemia or history of hyperkalemia while on ace-i or arb therapy, acute kidney injury due t","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1203","name":"No rsn ace-i/arb rx","description":"Ace inhibitor or arb therapy not prescribed during the measurement period, reason not given","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1834","name":"Inj, isoniazid, 1 mg","description":"Injection, isoniazid, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53452","name":"Tprnl balo cntnc dev uni","description":"Periurethral transperineal adjustable balloon continence device; unilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4026","name":"Phys/occ therapy ss","description":"Physical therapy/occupational therapy mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1681","name":"Ho bilateral hip abduction","description":"Hip orthosis, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4433","name":"361 hct/p skin subs, nos","description":"361 hct/p skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0865T","name":"Quan mri alys brn w/o dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion identification, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transm","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0975T","name":"Slctv nzmtc dbrdmt s/n/hf 1","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; first 100 sq cm","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15937","name":"Exc sac pr ulc prep mus ostc","description":"Excision, sacral pressure ulcer, in preparation for muscle or myocutaneous flap or skin graft closure; with ostectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1177.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1267","name":"Pt no act kid transplt wtlst","description":"Patients not observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3374","name":"Inj, vancomycin (mylan) 10mg","description":"Injection, vancomycin hydrochloride (mylan) not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7519","name":"Inj. mycophenolate mofetil","description":"Injection, mycophenolate mofetil, 10 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0993T","name":"N-invas assmt car rsk w/ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat with concurrent computed tomography scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional (list s","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1171","name":"Inj, hydromorphone, 0.1 mg","description":"Injection, hydromorphone, 0.1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1414","name":"Med rsn no pdl1 bef 1st ther","description":"Documentation of medical reason(s) for not performing the pd-l1 biomarker expression test prior to initiation of first-line immune checkpoint inhibitor therapy (e.g., patient is in an urgent or emergent situation where delay of treatment would jeopardize the patients health status; other medical rea","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33224","name":"Insert pacing lead & connect","description":"Insertion of pacing electrode, cardiac venous system, for left ventricular pacing, with attachment to previously placed pacemaker or implantable defibrillator pulse generator (including revision of pocket, removal, insertion, and/or replacement of existing generator)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":593.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0566","name":"3d bn img algor drvd fr mri","description":"3d radiodensity-value bone imaging, algorithm derived, from previous magnetic resonance examination of the same anatomy","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0001","name":"Advancing cancer care mvp","description":"Advancing cancer care mips value pathways","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4439","name":"Instagraft per sq cm","description":"Instagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0898","name":"Argatroban nonesrd (auromed)","description":"Injection, argatroban (auromedics), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37263","name":"Revsc evasc fpvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":191.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1164","name":"Pt w/ dementia any time","description":"Patients with dementia any time during the patients history through the end of the measurement period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1320","name":"Pts scrn + hrsn","description":"Patients who screened positive for at least 1 of the 5 hrsns","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1416","name":"Pt rec hosp","description":"Patient received hospice services any time during the performance period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55869","name":"Lap srg prst8ct bi pl lmphad","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0831T","name":"Dgtz gls mcrscp cytp c/v","description":"Digitization of glass microscope slides for cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55713","name":"Bx prst8 in-bore ct/mri bx 1","description":"Biopsy, prostate, in-bore ct- or mri-guided (ie, sextant), with biopsy of additional targeted lesion(s), first targeted lesion","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0892T","name":"Arhfcmrigtbs sbsq per tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent motor threshold redetermination with delivery and management, per treatment day","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49623","name":"Rmvl ninfct mesh hernia rpr","description":"Removal of total or near total non-infected mesh or other prosthesis at the time of initial or recurrent anterior abdominal hernia repair or parastomal hernia repair, any approach (ie, open, laparoscopic, robotic) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58580","name":"Transcrv abltj utrn fibrd rf","description":"Transcervical ablation of uterine fibroid(s), including intraoperative ultrasound guidance and monitoring, radiofrequency","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80505","name":"Path clin consltj high 41-60","description":"Pathology clinical consultation; for a highly complex clinical problem, with comprehensive review of patients history and medical records and high level of medical decision making when using time for code selection, 41-60 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6106","name":"Tissue regen resorbable","description":"Tissue regen resorbable","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4018","name":"Ob/gyn ss","description":"Obstetrics/gynecology mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4394","name":"Surgraft aca per sq cm","description":"Surgraft aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0854T","name":"Dgtz gls mcrscp bld smr prph","description":"Digitization of glass microscope slides for blood smear, peripheral, interpretation by physician with written report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0256U","name":"Tma/tmao prfl ms/ms ur alg","description":"Trimethylamine/trimethylamine n-oxide (tma/tmao) profile, tandem mass spectrometry (ms/ms), urine, with algorithmic analysis and interpretive report","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37276","name":"Rvsc evsc fpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7472","name":"Removal of torus palatinus","description":"Removal of torus palatinus","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66989","name":"Xcpsl ctrc rmvl cplx insj 1+","description":"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification), complex, requiring devices or techniques not generally used in routine cataract surgery (eg, iris expansion device,","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0437U","name":"Psyc anxiety do mrna 15 bmrk","description":"Psyc anxiety do mrna 15 bmrk","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4383","name":"Axolotl graft ult per sq cm","description":"Axolotl graft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1478","name":"Psychoactive sub abuse","description":"Psychoactive substance abuse","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0568U","name":"Neurol dementia bamyl ptau","description":"Neurol dementia bamyl ptau","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38500","name":"Biopsy/removal lymph nodes","description":"Biopsy or excision of lymph node(s); open, superficial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35876","name":"Removal of clot in graft","description":"Thrombectomy of arterial or venous graft (other than hemodialysis graft or fistula); with revision of arterial or venous graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1201.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9912","name":"Pre-visit patient screening","description":"Pre-visit patient screening","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J0540","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1331","name":"Pts eval ini xm 8 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 8 weeks from initial exam","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0678T","name":"Laps repos lead isdss ea add","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional repositioned lead (list separately in addition to code for primary proce","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61736","name":"Litt icr 1 traj 1 smpl les","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; single trajectory for 1 simple lesion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0033","name":"2+ benzo seiz","description":"Two or more benzodiazepine prescriptions ordered for patients who had a diagnosis of seizure disorders, rapid eye movement sleep behavior disorder, benzodiazepine withdrawal, ethanol withdrawal, or severe generalized anxiety disorder on or between january 1 of the year prior to the measurement perio","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5145","name":"Inj, abrilada, 1 mg","description":"Injection, adalimumab-afzb (abrilada), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4564","name":"Pessary, disposable any type","description":"Pessary, disposable, any type","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0755T","name":"Dgtz gls mcrscp sld level vi","description":"Digitization of glass microscope slides for level vi, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1274","name":"Pts snf exl mo","description":"Patients who were admitted to a skilled nursing facility (snf) during the month of evaluation were excluded from that month","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0905T","name":"Ecg alg 12 ld rdcd i&r only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; interpretation and report only","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2023","name":"Innovamatrix pd, 1 mg","description":"Innovamatrix pd, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0403U","name":"Onc prst8 mrna 18 gen dre ur","description":"Onc prst8 mrna 18 gen dre ur","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1270","name":"Pts no kid transplt wtlst","description":"Patients not on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4426","name":"Dermbnd tl+, tlx per sq cm","description":"Dermabind tl + or dermabind tl x,  per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7413","name":"Excision malig lesion<=1.25c","description":"Excision of malignant lesion up to 1.25 cm","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9685","name":"Acute nursing facility care","description":"Physician service or other qualified health care professional for the evaluation and management of a beneficiarys acute change in condition in a nursing facility. this service is for a demonstration project","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6072","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (high noble metal)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81523","name":"Onc brst mrna 70 cnt 31 gene","description":"Oncology (breast), mrna, next-generation sequencing gene expression profiling of 70 content genes and 31 housekeeping genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as index related to risk to distant metastasis","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4271","name":"Home lancing/test cartridges","description":"Integrated lancing and blood sample testing cartridges for home blood glucose monitor, per 50 tests","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90806","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27437","name":"Revise kneecap","description":"Arthroplasty, patella; without prosthesis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":786.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0473","name":"Micro exam prep & report","description":"Accession of tissue gross and microscopic examination preparation and transmission of written report","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1340","name":"Indx whodas 2.0 or sds","description":"Index assessment completed using the 12-item whodas 2.0 or sds during the denominator identification period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1296","name":"Calc bmi norm parameters","description":"Bmi is documented within normal parameters and no follow-up plan is required","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76805","name":"Ob us >/= 14 wks sngl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0954T","name":"Tot impl amei rplc snd proc","description":"Totally implantable active middle ear hearing implant; replacement of sound processor only, with attachment to existing transducers","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76019","name":"Mr safety implt pos&/immoblj","description":"Mr safety implant positioning and/or immobilization under supervision of physician or other qualified health care professional, including application of physical protections to secure implanted medical device from mr-induced translational or vibrational forces, magnetically induced functional change","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87451","name":"Polyvalent mult org ea ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; polyvalent for multiple organisms, each polyvalent antiserum","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33918","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1918.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1166","name":"Path rpt tis spec wle/reexc","description":"Pathology report for tissue specimens produced from wide local excisions or re-excisions","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4386","name":"Acesso trifaca per sq cm","description":"Acesso trifaca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1191","name":"Hspc svc any time in meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4343","name":"Dermacyte ac matrx per sq cm","description":"Dermacyte ac matrix amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2428","name":"Inj, erzofri, 1 mg","description":"Injection, paliperidone palmitate extended release (erzofri), 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64468","name":"Thrc fascial pln blk bi njx","description":"Thoracic fascial plane block, bilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93041","name":"Rhythm ecg tracing","description":"Rhythm ecg, 1-3 leads; tracing only without interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2221","name":"Ank mcrop plant & dorsi flex","description":"Addition to lower extremity orthosis, ankle system, microprocessor-controlled feature plantarflexion and/or dorsiflexion, includes power source","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23107","name":"Arthrt glenhumrl jt w/expl","description":"Arthrotomy, glenohumeral joint, with joint exploration, with or without removal of loose or foreign body","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22556","name":"Arthrd ant ntrbd min dsc thc","description":"Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); thoracic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1922.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1310","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33025","name":"Incision of heart sac","description":"Creation of pericardial window or partial resection for drainage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0902T","name":"Qtc ntrvl augmnt alg aly ecg","description":"Qtc interval derived by augmentative algorithmic analysis of input from an external, patient-activated mobile ecg device","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4014","name":"Nephrology ss","description":"Nephrology mips specialty set","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4329","name":"Singlay, per sq cm","description":"Singlay, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25405","name":"Repair/graft radius or ulna","description":"Repair of nonunion or malunion, radius or ulna; with autograft (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1559.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0746T","name":"Car ablt rad arr cnv loc map","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; conversion of arrhythmia localization and mapping of arrhythmia site (nidus) into a multidimensional radiation treatment plan","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0941T","name":"Cysto flx ins&xpns urtl scaf","description":"Cystourethroscopy, flexible; with insertion and expansion of prostatic urethral scaffold using integrated cystoscopic visualization","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67039","name":"Laser treatment of retina","description":"Vitrectomy, mechanical, pars plana approach; with focal endolaser photocoagulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1214.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0943T","name":"Cysto flx rmvl urtl scaffold","description":"Cystourethroscopy, flexible; with removal of prostatic urethral scaffold","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1450","name":"Pt hos/pal care dur id/pf pd","description":"Patients who received hospice or palliative care service any time during denominator identification period or the measure assessment period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2019","name":"Kerecis marigen shld sq cm","description":"Kerecis omega3 marigen shield, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17340","name":"Cryotherapy for acne","description":"Cryotherapy (co2 slush, liquid n2) for acne","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1192","name":"Pt w/ dx sq cell ca of esoph","description":"Patients with an existing diagnosis of squamous cell carcinoma of the esophagus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11043","name":"Dbrdmt musc&/fsca 1st 20/<","description":"Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); first 20 sq cm or less","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":162.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":113.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4414","name":"Simplichor per sq cm","description":"Simplichor, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9381","name":"Inj teplizumab mzwv 5 mcg","description":"Injection, teplizumab-mzwv, 5 mcg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1403","name":"Bslne and fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4292","name":"Lamellas, per sq cm","description":"Lamellas, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99202","name":"Office o/p new sf 15 min","description":"Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 15 minutes must be met or exceede","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":81.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4262","name":"Dual layer impax, per sq cm","description":"Dual layer impax membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0437U","name":"Psyc anxiety do mrna 15 bmrk","description":"Psyc anxiety do mrna 15 bmrk","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76510","name":"Oph us dx b-scan&quan a-scan","description":"Ophthalmic ultrasound, diagnostic; b-scan and quantitative a-scan performed during the same patient encounter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1193","name":"Rpts w/ imp/con mmr/msi","description":"Surgical pathology reports that contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75968","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":453.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","name":"Gait mod systm rhym auditory","description":"Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0682","name":"App non-sheet skin sub add","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (list separately in addition to code for pri","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4288","name":"Replacement breastpump valve","description":"Valve for breast pump, replacement","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0502U","name":"Hpv e6/e7 mrk hi-rsk typ crv","description":"Hpv e6/e7 mrk hi-rsk typ crv","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7294","name":"Seg acet and eth estr yearly","description":"Segesterone acetate and ethinyl estradiol 0.15mg, 0.013mg per 24 hours; yearly vaginal system, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0662","name":"Team remote e/m new pt 30 mn","description":"Team remote e/m new pt 30 mins","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85610","name":"Prothrombin time","description":"Prothrombin time;","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9268","name":"Programmer orally ingest cap","description":"Programmer for transient, orally ingested capsule","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98016","name":"Brief comunicaj tech-bsd svc","description":"Brief communication technology-based service (eg, virtual check-in) by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related evaluation and management service provided within the p","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1367","name":"Qual care ent disorder mvp","description":"Quality care for the treatment of ear, nose, and throat disorders mips value pathway","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0381U","name":"Maple syrup ur ds mntr quan","description":"Maple syrup ur ds mntr quan","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4285","name":"Nudyn dl or dl mesh pr sq cm","description":"Nudyn dl or nudyn dl mesh, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4016","name":"Neurosurgical ss","description":"Neurosurgical mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84145","name":"Procalcitonin (pct)","description":"Procalcitonin (pct)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88233","name":"Tissue culture skin/biopsy","description":"Tissue culture for non-neoplastic disorders; skin or other solid tissue biopsy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0476U","name":"Rx metab psyc 14gen&cyp2d6","description":"Rx metab psyc 14gen&cyp2d6","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1316","name":"Tobacco non-user","description":"Current tobacco non-user","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0009","name":"Admin pneumococcal vaccine","description":"Administration of pneumococcal vaccine","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87220","name":"Tissue exam for fungi","description":"Tissue examination by koh slide of samples from skin, hair, or nails for fungi or ectoparasite ova or mites (eg, scabies)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1813","name":"Lyumjev for insulin pump use","description":"Insulin (lyumjev) for administration through dme (i.e., insulin pump) per 50 units","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2006","name":"Novosorb synpath per sq cm","description":"Novosorb synpath dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0714T","name":"Tpla b9 prst8 hyprplsa<50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume less than 50 ml","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86652","name":"Encephaltis east eqne anbdy","description":"Antibody; encephalitis, eastern equine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1467","name":"Pt dx lynch syn","description":"Patients with an existing diagnosis of lynch syndrome","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9322","name":"Inj pemetrexed (bluepoint)","description":"Injection, pemetrexed (bluepoint), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81354","name":"Cytog alys chrml abnor ogm","description":"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of structural and copy number variants, optical genome mapping (ogm)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2428","name":"Inj, erzofri, 1 mg","description":"Injection, paliperidone palmitate extended release (erzofri), 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9072","name":"Inj cyclophos frindovyx 5 mg","description":"Injection, cyclophosphamide (frindovyx), 5 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0684T","name":"Peri-px dev eval isdss ip","description":"Peri-procedural device evaluation (in-person) and programming of device system parameters before or after a surgery, procedure, or test with analysis, review, and report by a physician or other qualified health care professional, permanent implantable synchronized diaphragmatic stimulation system fo","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0255U","name":"Andrology infertility assmt","description":"Andrology (infertility), sperm-capacitation assessment of ganglioside gm1 distribution patterns, fluorescence microscopy, fresh or frozen specimen, reported as percentage of capacitated sperm and probability of generating a pregnancy score","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0826T","name":"Prgrmg evl ldls pm 1chmbr ip","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional, leadless pacemaker system in si","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0278","name":"Amikacin sulfate injection","description":"Injection, amikacin sulfate, 100 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0652","name":"Inj, levothyroxine, hikma","description":"Injection, levothyroxine sodium (hikma), not therapeutically equivalent to j0650, 10 mcg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9246","name":"Mod sedation noniv-15 min","description":"Mod sedation noniv-15 min","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01939","name":"Anes nulyt agt crv/thrc","description":"Anesthesia for percutaneous image-guided destruction procedures by neurolytic agent on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0994T","name":"Evasc dlvr a-wal stbl rx prq","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; percutaneous","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59830","name":"Treat uterus infection","description":"Treatment of septic abortion, completed surgically","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":456.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0286U","name":"Cep72 nudt15&tpmt gene alys","description":"Cep72 nudt15&tpmt gene alys","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61210","name":"Burr hole implt ventr cath","description":"Burr hole(s); for implanting ventricular catheter, reservoir, eeg electrode(s), pressure recording device, or other cerebral monitoring device (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20970","name":"Bone/skin graft iliac crest","description":"Free osteocutaneous flap with microvascular anastomosis; iliac crest","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3388.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2351","name":"Inj ocrelizumab 1mg hya-ocsq","description":"Injection, ocrelizumab, 1 mg and hyaluronidase-ocsq","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77092","name":"Tbs i&r fx rsk qhp","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; interpretation and report on fracture-risk only by other qualified health care professional","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5127","name":"Inj, stimufend, 0.5 mg","description":"Injection, pegfilgrastim-fpgk (stimufend), biosimilar, 0.5 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75580","name":"N-invas est c ffr sw aly cta","description":"Noninvasive estimate of coronary fractional flow reserve (ffr) derived from augmentative software analysis of the data set from a coronary computed tomography angiography, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1014T","name":"Lap rv/rmv eso sph nstm eltr","description":"Laparoscopic revision or removal, lower esophageal sphincter neurostimulator electrodes","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0372","name":"Tomo comp series images","description":"Tomo comp series images","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76856","name":"Us exam pelvic complete","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26010","name":"Drainage of finger abscess","description":"Drainage of finger abscess; simple","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":157.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74420","name":"Urography rtrgr +-kub","description":"Urography, retrograde, with or without kub","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78190","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6605","name":"G com bandage padded foam","description":"Gradient compression bandaging supply, padded foam, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":1.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1446","name":"Pt died bef end meas pd","description":"Patients who died any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0875T","name":"Prgrm subq prtl asct pmp sys","description":"Programming of subcutaneously implanted peritoneal ascites pump system by physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1152","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24110","name":"Exc/curtg b1 cst/b9 tum hum","description":"Excision or curettage of bone cyst or benign tumor, humerus;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":699.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0747T","name":"Car ablt rad arrhyt dlvr rad","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; delivery of radiation therapy, arrhythmia","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21147","name":"Rcnstj mdfc lefort i 3/>grf","description":"Reconstruction midface, lefort i; 3 or more pieces, segment movement in any direction, requiring bone grafts (includes obtaining autografts) (eg, ungrafted bilateral alveolar cleft or multiple osteotomies)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1719.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23455","name":"Repair shoulder capsule","description":"Capsulorrhaphy, anterior; with labral repair (eg, bankart procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1243.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4293","name":"Acesso dl, per sq cm","description":"Acesso dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1326","name":"Pts dx hypotony","description":"Patients with a diagnosis of hypotony","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1274","name":"Pts snf exl mo","description":"Patients who were admitted to a skilled nursing facility (snf) during the month of evaluation were excluded from that month","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1289","name":"No pt tbco cess interv rng","description":"Patient identified as tobacco user did not receive tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92629","name":"Eval hearing aid cand ea add","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64583","name":"Rev/rplct hpglsl nstm ary pg","description":"Revision or replacement of hypoglossal nerve neurostimulator array and distal respiratory sensor electrode or electrode array, including connection to existing pulse generator","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1168","name":"Pt recd flu vax 7/1-6/30","description":"Patient received an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90635","name":"H5n1 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n1, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9950","name":"Inj sulf hexa lipid microsph","description":"Injection, sulfur hexafluoride lipid microspheres, per ml","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0690T","name":"Quan us tis charac w/dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained with diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2054","name":"Lisocabtagene mara car pos t","description":"Lisocabtagene maraleucel, up to 110 million autologous anti-cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1018T","name":"Elec alys npgs esoph sbsq w/","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1203","name":"Inj, cipaglucosidase, 5 mg","description":"Injection, cipaglucosidase alfa-atga, 5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1424","name":"Pulmonology care mvp","description":"Pulmonology care mips value pathway","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15854","name":"Removal sutr&stapl xreq anes","description":"Removal of sutures and staples not requiring anesthesia (list separately in addition to e/m code)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5422","name":"Dentures adjust part mandbl","description":"Adjust partial denture - mandibular","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91320","name":"Sarscv2 vac 30mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 30 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0862T","name":"Rlcj pg wcs lv battery only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; battery component only","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0457","name":"Injection, aztreonam, 100 mg","description":"Injection, aztreonam, 100 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53454","name":"Tprnl balo cntnc dev adjmt","description":"Periurethral transperineal adjustable balloon continence device; percutaneous adjustment of balloon(s) fluid volume","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1322","name":"Pts 7wk inj, scrn iop =<25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop =<25 mm hg for injected eye","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1291","name":"Pt 66+ frailty and med dem","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4395","name":"Acelagraft per sq cm","description":"Acelagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46255","name":"Remove int/ext hem 1 group","description":"Hemorrhoidectomy, internal and external, single column/group;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82653","name":"El-1 fecal quantitative","description":"Elastase, pancreatic (el-1), fecal; quantitative","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9297","name":"Inj pemetrexed (sandoz) 10mg","description":"Injection, pemetrexed (sandoz), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57268","name":"Repair of bowel bulge","description":"Repair of enterocele, vaginal approach (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":524.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46937","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6593","name":"Grad com accessory gmt_wrap","description":"Accessory for gradient compression garment or wrap with adjustable straps, not-otherwise specified","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0551","name":"Phn/intr svs fr dx treat 30m","description":"Interprofessional telephone/internet/electronic health record referral service(s) provided by a treating/requesting practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, 30 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0907T","name":"Coms ther ea addl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; each additional application, total wound(s) surface area less than or equal to 50 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0489U","name":"Ob sgnipt cfdna seq alys 1+","description":"Ob sgnipt cfdna seq alys 1+","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9286","name":"Inj glofitamab gxbm, 2.5 mg","description":"Injection, glofitamab-gxbm, 2.5 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0612","name":"Inj, calcium gluconate, nos","description":"Injection, calcium gluconate, not otherwise specified, 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49596","name":"Rpr aa hrn 1st > 10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, incarcerated or strangulated","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0685T","name":"Interrog dev eval isdss ip","description":"Interrogation device evaluation (in-person) with analysis, review and report by a physician or other qualified health care professional, including connection, recording and disconnection per patient encounter, permanent implantable synchronized diaphragmatic stimulation system for augmentation of ca","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5136","name":"Inj. denosumab-bbdz, 1 mg","description":"Injection, denosumab-bbdz (jubbonti/wyost), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0771T","name":"Vr px dissoc svc sm phy 1st","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37273","name":"Revsc evsc fpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4000","name":"Dermatology ss","description":"Dermatology mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63052","name":"Lam facetc/frmt arthrd lum 1","description":"Laminectomy, facetectomy, or foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s] [eg, spinal or lateral recess stenosis]), during posterior interbody arthrodesis, lumbar; single vertebral segment (list separately in addition to code for primary ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93585","name":"Vngrph chd azygs/hemiazygs","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; azygos/hemiazygos venous system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0945T","name":"Intraop assmt abnl tum tiss","description":"Intraoperative assessment for abnormal (tumor) tissue, in-vivo, following partial mastectomy (eg, lumpectomy) using computer-aided fluorescence imaging (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0535","name":"Pt navigat svs direct/ref","description":"Patient navigational services, provided directly or by referral; including helping the patient to navigate health systems and identify care providers and supportive services, to build patient self-advocacy and communication skills with care providers, and to promote patient-driven action plans and g","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2403","name":"Chloroprocaine opht gel, 1mg","description":"Chloroprocaine hcl ophthalmic, 3% gel, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90624","name":"Menb-4c&menacwy vacc im","description":"Meningococcal pentavalent vaccine, men b-4c recombinant proteins and outer membrane vesicle and conjugated men a, c, w, y-diphtheria toxoid carrier, for intramuscular use","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1428","name":"Bilateral absence of eyes","description":"Patients who have bilateral absence of eyes any time during the patients history through the end of the measurement period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1388","name":"Pt doc exm rec melmn","description":"Patients with documentation of an exam performed for recurrence of melanoma","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1418","name":"Med rsn not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination because of a medical contraindication documented by clinician","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90481","name":"Admn sarscov2 vac ea add cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; each additional component administered (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0847T","name":"Dgtz gls mcrscp xm arch tiss","description":"Digitization of glass microscope slides for examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, kras mutational analysis) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0602","name":"Sevelamer carbonate pdr 20mg","description":"Sevelamer carbonate (renvela or therapeutically equivalent), oral, powder, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0388","name":"Bitewing image capture only","description":"Bitewing image capture only","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4019","name":"Oncology/hema ss","description":"Oncology/hematology mips specialty set","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0882T","name":"Intraop ther estim pn ue 1st","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; initial nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5135","name":"Inj, tyenne, 1 mg","description":"Injection, tocilizumab-aazg (tyenne), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5141","name":"Inj adalimumab-aaty, 1 mg","description":"Injection, adalimumab-aaty, biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0726T","name":"Rmvl implt vstibular dev uni","description":"Removal of implanted vestibular device, unilateral","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15015","name":"App skn cl ssp agrft t/a/l 1","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; first 480 sq cm or less","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1447","name":"Pt dx bd bef end meas pd","description":"Patients with an active diagnosis of bipolar disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53866","name":"Cathj rmvl dev ischmc rmdlg","description":"Catheterization with removal of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0432U","name":"Klhl11 antb sr/csf asy qual","description":"Klhl11 antb sr/csf asy qual","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0582","name":"Bivalirudin (endo) 1 mg","description":"Injection, bivalirudin (endo), not therapeutically equivalent to j0583, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31242","name":"Nsl/sinus ndsc rf abltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by radiofrequency ablation, posterior nasal nerve","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45346","name":"Sigmoidoscopy w/ablation","description":"Sigmoidoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2938.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":161.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74018","name":"Radex abdomen 1 view","description":"Radiologic examination, abdomen; 1 view","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0281U","name":"Hem vwd propeptide ag lvl","description":"Hematology (von willebrand disease [vwd]), von willebrand propeptide, enzyme-linked immunosorbent assays (elisa), plasma, diagnostic report of von willebrand factor (vwf) propeptide antigen level","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0563","name":"Sbrt w/positron emission del","description":"Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance and real-time positron emissions-based delivery adjustments to 1 or more lesions, entire course not to exceed 5 fractions","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6034","name":"Part hand finger distal amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s)/thumb, amputation at distal to metacarpal joint, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l669","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11640","name":"Exc f/e/e/n/l mal+mrg 0.5cm<","description":"Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 0.5 cm or less","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49188","name":"Opn exc/dst ntra-abd 10.1-20","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 10.1 to 20 cm","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3030","name":"Sumatriptan succinate / 6 mg","description":"Injection, sumatriptan succinate, 6 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0701","name":"Inj. cefepime hcl (baxter)","description":"Injection, cefepime hydrochloride (baxter), not therapeutically equivalent to maxipime, 500 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38227","name":"Car-t receipt&prepj admn","description":"Chimeric antigen receptor t-cell (car-t) therapy; receipt and preparation of car-t cells for administration","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1370","name":"Rehab support msk care mvp","description":"Rehabilitative support for musculoskeletal care mips value pathway","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1383","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52284","name":"Cysto rx balo cath urtl strx","description":"Cystourethroscopy, with mechanical urethral dilation and urethral therapeutic drug delivery by drug-coated balloon catheter for urethral stricture or stenosis, male, including fluoroscopy, when performed","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1428","name":"Bilateral absence of eyes","description":"Patients who have bilateral absence of eyes any time during the patients history through the end of the measurement period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9046","name":"Inj, bortezomib, dr. reddys","description":"Injection, bortezomib (dr. reddys), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0605U","name":"All&immunology hat tpsab1","description":"All&immunology hat tpsab1","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0810T","name":"Subrta njx rx agt w/vtrc","description":"Subretinal injection of a pharmacologic agent, including vitrectomy and 1 or more retinotomies","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0783T","name":"Tc auriculr neurostimulation","description":"Transcutaneous auricular neurostimulation, set-up, calibration, and patient education on use of equipment","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0902T","name":"Qtc ntrvl augmnt alg aly ecg","description":"Qtc interval derived by augmentative algorithmic analysis of input from an external, patient-activated mobile ecg device","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4390","name":"Ascendion per sq cm","description":"Ascendion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0429U","name":"Hpv orop swab 14 hi-risk typ","description":"Hpv orop swab 14 hi-risk typ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0378U","name":"Rfc1 repeat xpnsj vrnt alys","description":"Rfc1 repeat xpnsj vrnt alys","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0140","name":"Nav srv peer sup 60 min pr m","description":"Principal illness navigation - peer support by certified or trained auxiliary personnel under the direction of a physician or other practitioner, including a certified peer specialist; 60 minutes per calendar month, in the following activities:  person-centered interview, performed to better underst","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1337","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5913","name":"Nasal prosthesis","description":"Nasal prosthesis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2018","name":"Permeaderm c, per sq cm","description":"Permeaderm c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2711","name":"Inj neostigmin/glycopyrrolat","description":"Injection, neostigmine methylsulfate 0.1 mg and glycopyrrolate 0.02 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1206","name":"Isa not red 3pts/no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4325","name":"Acapatch, per sq cm","description":"Acapatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49060","name":"Drain open retroperi abscess","description":"Drainage of retroperitoneal abscess, open","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1110.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9289","name":"Inj nivolumab 2 mg hyaluron","description":"Injection, nivolumab, 2 mg and hyaluronidase-nvhy","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1313","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0975T","name":"Slctv nzmtc dbrdmt s/n/hf 1","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; first 100 sq cm","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9393","name":"Inj, fulvestrant (teva)","description":"Injection, fulvestrant (teva), not therapeutically equivalent to j9395, 25 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37262","name":"Iv lithotrp ivt w/in sm art","description":"Intravascular lithotripsy(ies), iliac vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84145","name":"Procalcitonin (pct)","description":"Procalcitonin (pct)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26742","name":"Treat finger fracture each","description":"Closed treatment of articular fracture, involving metacarpophalangeal or interphalangeal joint; with manipulation, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1342","name":"Pts died perf per","description":"Patients who died during the performance period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0956T","name":"Prt crn ch cr&tun elt s-sclp","description":"Partial craniectomy, channel creation, and tunneling of electrode for sub-scalp implantation of an electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1736","name":"Inj meloxicam (delova) 1mg","description":"Injection, meloxicam (delova), 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43361","name":"Gastrointestinal repair","description":"Gastrointestinal reconstruction for previous esophagectomy, for obstructing esophageal lesion or fistula, or for previous esophageal exclusion; with colon interposition or small intestine reconstruction, including intestine mobilization, preparation, and anastomosis(es)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2734.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0881T","name":"Cryotherapy oral cavity","description":"Cryotherapy of the oral cavity using temperature regulated fluid cooling system, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83068","name":"Hemoglobin unstable screen","description":"Hemoglobin; unstable, screen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2035","name":"Corpl p therac p allac p mg","description":"Corplex p or theracor p or allacor p, per milligram","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55710","name":"Bx prst8 tprn us w/mri fus 1","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant) with mri-fusion-guidance biopsy, first targeted lesion","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"Home vent dual fnct incl all","description":"Home ventilator, dual-function respiratory device, also performs additional function of cough stimulation, includes all accessories, components and supplies for all functions","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0562","name":"Complex simulation w/pet-ct","description":"Therapeutic radiology simulation-aided field setting; complex, including acquisition of pet and ct imaging data required for radiopharmaceutical-directed radiation therapy treatment planning (i.e., modeling)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0787T","name":"Revj/rmvl nea sac w/nstim","description":"Revision or removal of neurostimulator electrode array, sacral, with integrated neurostimulator","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21494","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53453","name":"Tprnl balo cntnc dev rmvl ea","description":"Periurethral transperineal adjustable balloon continence device; removal, each balloon","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86318","name":"Ia infectious agent antibody","description":"Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip);","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2051","name":"Support broker waiver/diem","description":"Supports brokerage, self-directed, waiver; per diem","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0179","name":"Md recertification hha pt","description":"Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initi","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5933","name":"Refitting of obturator","description":"Obturator prosthesis modification","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0483","name":"Indirect immunofluorescence","description":"Indirect immunofluorescence","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92623","name":"Dx aly aud oi snd prcsr each","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; each additional 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0034","name":"Pall serv during meas","description":"Patients receiving palliative care during the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24505","name":"Cltx humrl shft fx w/mnpj","description":"Closed treatment of humeral shaft fracture; with manipulation, with or without skeletal traction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":523.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46606","name":"Anoscopy and biopsy","description":"Anoscopy; with biopsy, single or multiple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66683","name":"Implantation iris prosthesis","description":"Implantation of iris prosthesis, including suture fixation and repair or removal of iris, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0746T","name":"Car ablt rad arr cnv loc map","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; conversion of arrhythmia localization and mapping of arrhythmia site (nidus) into a multidimensional radiation treatment plan","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33279","name":"Rmvl phrnc nrv stim transvns","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s) only","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1486","name":"Pt admitted to snf dur eval","description":"Patients admitted to a skilled nursing facility (snf) during the period of evaluation","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0704T","name":"Rem tx amblyopia setup&edu","description":"Remote treatment of amblyopia using an eye tracking device; device supply with initial set-up and patient education on use of equipment","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0779T","name":"Gi myoelectrical actv study","description":"Gastrointestinal myoelectrical activity study, stomach through colon, with interpretation and report","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1434","name":"Orl chemo wthn 30 d post enc","description":"Patient on oral chemotherapy on or within 30 days after denominator eligible encounter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1487","name":"Pt adm to hospice dur eval","description":"Patients in hospice in the year before or during the period of evaluation","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9616","name":"Gallium gozellix 1 millicuri","description":"Gallium ga-68 gozetotide (gozellix), diagnostic, 1 millicurie","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0363U","name":"Onc urthl mrna 5 gen alg","description":"Onc urthl mrna 5 gen alg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2394","name":"Post >=4srfc resinbase cmpst","description":"Resin-based composite - four or more surfaces posterior","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6612","name":"Onlay cst base mtl 2 surface","description":"Onlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0760T","name":"Dgtz gls mcrscp sl imm 1st","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1375","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58951","name":"Resect ovarian malignancy","description":"Resection (initial) of ovarian, tubal or primary peritoneal malignancy with bilateral salpingo-oophorectomy and omentectomy; with total abdominal hysterectomy, pelvic and limited para-aortic lymphadenectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1573.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1502","name":"Podiatry mvp","description":"Podiatry mips value pathway","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37291","name":"Revsc evsc tpvt athr cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78473","name":"Gated heart multiple","description":"Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and stress (exercise and/or pharmacologic), with or without additional quantification","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":512.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1813","name":"Lyumjev for insulin pump use","description":"Insulin (lyumjev) for administration through dme (i.e., insulin pump) per 50 units","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4342","name":"Theramend, per sq cm","description":"Theramend, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92998","name":"Pul art balloon repr percut","description":"Percutaneous transluminal pulmonary artery balloon angioplasty; each additional vessel (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1253","name":"Pts hu surv no amb plltv","description":"Patients who respond on the patient experience hu survey that they did not receive care by the listed ambulatory palliative care provider in the last 60 days (disavowal)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95868","name":"Ndl emg cranial nrv musc bi","description":"Needle electromyography; cranial nerve supplied muscles, bilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0391U","name":"Onc sld tum dna&rna 437 gen","description":"Onc sld tum dna&rna 437 gen","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5421","name":"Dentures adjust part maxill","description":"Adjust partial denture - maxillary","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62330","name":"Dcmprn prq rmv lig flv 1lmbr","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; one interspace, lumbar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7355","name":"Inj travoprost intra impl","description":"Injection, travoprost, intracameral implant, 1 microgram","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55711","name":"Bx prst8 trct mri-us 1st","description":"Biopsy, prostate, transrectal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1161","name":"Pt anphx due to dtp bef 13","description":"Patient had anaphylaxis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27686","name":"Revise lower leg tendons","description":"Lengthening or shortening of tendon, leg or ankle; multiple tendons (through same incision), each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":694.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82160","name":"Assay of androsterone","description":"Androsterone","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44500","name":"Intro gastrointestinal tube","description":"Introduction of long gastrointestinal tube (eg, miller-abbott) (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90483","name":"Imm cnsl not admn sm>10<20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 10 minutes up to 20 minutes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0754T","name":"Dgtz gls mcrscp sld level v","description":"Digitization of glass microscope slides for level v, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0548U","name":"Gfap cleia plasma","description":"Gfap cleia plasma","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90695","name":"H5n8 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n8, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1235","name":"Doc pt hcv aby rna tst","description":"Documentation or patient report of hcv antibody test or hcv rna test which occurred prior to the performance period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0947T","name":"Mrgfus strtctc bl-br disrpj","description":"Magnetic resonance image guided low intensity focused ultrasound (mrgfus), stereotactic blood-brain barrier disruption using microbubble resonators to increase the concentration of blood-based biomarkers of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2184","name":"Inj, meropenem (b. braun)","description":"Injection, meropenem (b. braun), not therapeutically equivalent to j2185, 100 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57500","name":"Biopsy of cervix","description":"Biopsy of cervix, single or multiple, or local excision of lesion, with or without fulguration (separate procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":174.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0879","name":"Difelikefalin, esrd on dialy","description":"Injection, difelikefalin, 0.1 microgram, (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2993","name":"Reteplase injection","description":"Injection, reteplase, 18.1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":877.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63032","name":"Lamot rpr anulr dfct 1 lmbr","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; with repair of annular defect by implantation of bone-anchored annular closure device, including all imaging guidance, 1 interspace, lumbar","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0687T","name":"Tx amblyopia dev setup 1st","description":"Treatment of amblyopia using an online digital program; device supply, educational set-up, and initial session","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9073","name":"Inj cyclophos dr reddys 5 mg","description":"Injection, cyclophosphamide (dr. reddys), 5 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1000T","name":"Autol musc cell therapy admn","description":"Autologous muscle cell therapy, administration of muscle progenitor cells into the urethral sphincter, including cystoscopy and post-void residual ultrasound, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0662","name":"Team remote e/m new pt 30 mn","description":"Team remote e/m new pt 30 mins","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0916T","name":"Insj perm ccm-d sys pg only","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator only","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7174","name":"Injection fitusiran 0.04 mg","description":"Injection, fitusiran, 0.04 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0930T","name":"Ephys eval ccm-d ld 1st impl","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), at time of initial implantation or replacement with testing of cardiac contrac","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9298","name":"Inj nivol relatlimab 3mg/1mg","description":"Injection, nivolumab and relatlimab-rmbw, 3 mg/1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1278","name":"Pre-htn or htn doc, f/u indc","description":"Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27350","name":"Removal of kneecap","description":"Patellectomy or hemipatellectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":769.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1952","name":"Afo spiral prefab ots","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, off-the-shelf","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30469","name":"Rpr nsl vlv collapse w/rmdlg","description":"Repair of nasal valve collapse with low energy, temperature-controlled (ie, radiofrequency) subcutaneous/submucosal remodeling","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1836","name":"Inj, metronidazole, 10 mg","description":"Injection, metronidazole, 10 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87084","name":"Culture of specimen by kit","description":"Culture, presumptive, pathogenic organisms, screening only; with colony estimation from density chart","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4031","name":"Radiation oncology ss","description":"Radiation oncology mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6598","name":"G comp bandage med stretch","description":"Gradient compression bandage roll, elastic medium stretch, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69730","name":"Rplc oi implt sk tc esp>=100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1449","name":"Pt dx scz/pys bef end msr pd","description":"Patients with an active diagnosis of schizophrenia or psychotic disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35281","name":"Rpr blvsl gr ot/th vn ntr-ab","description":"Repair blood vessel with graft other than vein; intra-abdominal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1947.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53454","name":"Tprnl balo cntnc dev adjmt","description":"Periurethral transperineal adjustable balloon continence device; percutaneous adjustment of balloon(s) fluid volume","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1495","name":"Fall w/ poc, no fall","description":"Patients that reported a fall occurred who had a plan of care for falls documented or patients that did not report a fall","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87807","name":"Rsv assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; respiratory syncytial virus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33370","name":"Tcat plmt&rmvl cepd perq","description":"Transcatheter placement and subsequent removal of cerebral embolic protection device(s), including arterial access, catheterization, imaging, and radiological supervision and interpretation, percutaneous (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0018","name":"Crisis psychotherapy add 30m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); each additional 30 minutes (list separately in addition to code for primary service)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16030","name":"Dress/debrid p-thick burn l","description":"Dressings and/or debridement of partial-thickness burns, initial or subsequent; large (eg, more than 1 extremity, or greater than 10% total body surface area)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":232.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9183","name":"Gemcitabine intravesical sys","description":"Gemcitabine intravesical system, 225 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0801T","name":"Tcat rmv&rpl 2chmbr ldls pm","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; dual-cha","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1412","name":"Inj roctavian ml 2x10^13vc g","description":"Injection, valoctocogene roxaparvovec-rvox, per ml, containing nominal 2 x 10^13 vector genomes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9038","name":"Inj axatilimab-csfr 0.1 mg","description":"Injection, axatilimab-csfr, 0.1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9341","name":"Inj thiotepa (tepylute) 1 mg","description":"Injection, thiotepa (tepylute), 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0458","name":"Aztreonam/avibactam 10 mg","description":"Injection, aztreonam/avibactam, 7.5 mg/2.5 mg (10 mg)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2526","name":"Cntct lens blue violet","description":"Contact lens, hydrophilic, with blue-violet filter, per lens","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1369","name":"Qualcare mental hlth/sud mvp","description":"Quality care in mental health and substance use disorders mips value pathway","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0472","name":"Gross exam prep & report","description":"Accession of tissue gross examination preparation and transmission of written report","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0514U","name":"Gi ibd ia quan deter adl lvl","description":"Gi ibd ia quan deter adl lvl","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0543U","name":"Onc sol tum ngs dna 517 gens","description":"Onc sol tum ngs dna 517 gens","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81451","name":"Hl neo gsap 5-50 rna alys","description":"Hematolymphoid neoplasm or disorder, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants, and copy number variants or rearrangements, or isoform expression or mrna expression levels, if performed; rna analysis","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9376","name":"Inj pozelimab-bbfg, 1 mg","description":"Injection, pozelimab-bbfg, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0598U","name":"Gi ibs igg antb 18food items","description":"Gi ibs igg antb 18food items","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2017","name":"Permeaderm glove, each","description":"Permeaderm glove, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1373","name":"Mst rec gsa >=8 and <=9","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 8.0% and <= 9.0%","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4287","name":"Disp col sto bag breast milk","description":"Disposable collection and storage bag for breast milk, any size, any type, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67906","name":"Repair eyelid defect","description":"Repair of blepharoptosis; superior rectus technique with fascial sling (includes obtaining fascia)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":544.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0591U","name":"Onc prst8 ca 3prtns plsm srm","description":"Onc prst8 ca 3prtns plsm srm","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1422","name":"Gastroenterology care mvp","description":"Gastroenterology care mips value pathway","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0550","name":"Phone/inter for dx/treat >5m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a written report to the patients treating/r","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0237","name":"Intrav inf, toci, first dose","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4293","name":"Acesso dl, per sq cm","description":"Acesso dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1002T","name":"Air displacmnt plethysmograp","description":"Air displacement plethysmography, whole-body composition assessment, with interpretation and report","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90684","name":"Pcv21 vaccine im","description":"Pneumococcal conjugate vaccine, 21 valent (pcv21), for intramuscular use","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99204","name":"Office o/p new mod 45 min","description":"Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 45 minutes must be met or excee","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":130.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33288","name":"Rmv&rplcmt phrnc nrv stim ld","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":431.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0013","name":"Esketamine, nasal spray","description":"Esketamine, nasal spray, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4354","name":"Palingen dl-palingen dl-x","description":"Palingen dual-layer membrane and dual-layer palingen x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2011","name":"Supra sdrm, per sq cm","description":"Supra sdrm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97550","name":"Caregiver traing 1st 30 min","description":"Caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patie","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9220","name":"Indigotindisulfonate sod 1mg","description":"Injection, indigotindisulfonate sodium, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28024","name":"Exploration of toe joint","description":"Arthrotomy, including exploration, drainage, or removal of loose or foreign body; interphalangeal joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":402.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99175","name":"Induction of vomiting","description":"Ipecac or similar administration for individual emesis and continued observation until stomach adequately emptied of poison","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2036","name":"Cohealyx col dml mx pr sq cm","description":"Cohealyx collagen dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0473","name":"Micro exam prep & report","description":"Accession of tissue gross and microscopic examination preparation and transmission of written report","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0886T","name":"Sgmdsc flx 1st tndsc dilat","description":"Sigmoidoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9697","name":"Inj, magtrace per study dose","description":"Injection, carboxydextran-coated superparamagnetic iron oxide, per study dose","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43260","name":"Ercp w/specimen collection","description":"Endoscopic retrograde cholangiopancreatography (ercp); diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33277","name":"Insj phrnc nrv stim transvns","description":"Insertion of phrenic nerve stimulator transvenous sensing lead (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0820T","name":"Mntr psychdlc med 1stphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; first physician or other qualified health care professional, each hour","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4004","name":"Endocrinology ss","description":"Endocrinology mips specialty set","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59840","name":"Induced abortion d&c","description":"Induced abortion, by dilation and curettage","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":229.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87153","name":"Dna/rna sequencing","description":"Culture, typing; identification by nucleic acid sequencing method, each isolate (eg, sequencing of the 16s rrna gene)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0479U","name":"Tau phosphorylated ptau217","description":"Tau phosphorylated ptau217","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82530","name":"Cortisol free","description":"Cortisol; free","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95936","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0661","name":"Team remote e/m new pt 20 mn","description":"Team remote e/m new pt 20mins","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0388U","name":"Onc nonsm cll lng ca 37 gen","description":"Onc nonsm cll lng ca 37 gen","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32442","name":"Sleeve pneumonectomy","description":"Removal of lung, pneumonectomy; with resection of segment of trachea followed by broncho-tracheal anastomosis (sleeve pneumonectomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2018.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1312","name":"No pt tbco scrn rng","description":"Patient not screened for tobacco use","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1394","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0566U","name":"Onc lng qpcr-bsd alys 13dmrs","description":"Onc lng qpcr-bsd alys 13dmrs","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0853T","name":"Dgtz gls mcrscp mphmtrc ea m","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93319","name":"3d echo img cgen car anomal","description":"3d echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac structure(s) (eg, cardiac chambers and valves, left atrial appendage, interatrial septum, interventricular","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9997","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5947","name":"Mand implt sup fix","description":"Mand implt sup fix","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4418","name":"Biolab wrap flow per sq cm","description":"Biolab membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0558","name":"Adv prim care mgmt lvl 3","description":"Advanced primary care management services for a patient that is a qualified medicare beneficiary with multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, which place the patient at significant risk of death, acute exacerbation/decompensat","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80100","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15833","name":"Exc excessive skin leg","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy); leg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":916.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4323","name":"Alloply, per sq cm","description":"Alloply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4003","name":"Emergency med ss","description":"Emergency medicine mips specialty set","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26261","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":737.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29825","name":"Sho arthrs srg lss&rescj ads","description":"Arthroscopy, shoulder, surgical; with lysis and resection of adhesions, with or without manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":717.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47384","name":"Abltj ire liver 1+ tum perq","description":"Ablation, irreversible electroporation, liver, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33770","name":"Rpr tga w/o surg enlgmnt vsd","description":"Repair of transposition of the great arteries with ventricular septal defect and subpulmonary stenosis; without surgical enlargement of ventricular septal defect","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2571.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41806","name":"Removal foreign body jawbone","description":"Removal of embedded foreign body from dentoalveolar structures; bone","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23076","name":"Exc shoulder tum deep < 5 cm","description":"Excision, tumor, soft tissue of shoulder area, subfascial (eg, intramuscular); less than 5 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":646.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27713","name":"Osteot tibia imed lngth dev","description":"Osteotomy(ies), tibia, including fibula when performed, unilateral, with insertion of an externally controlled intramedullary lengthening device, including imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9073","name":"Inj cyclophos dr reddys 5 mg","description":"Injection, cyclophosphamide (dr. reddys), 5 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1494","name":"Fall rep since last visit","description":"Patients that reported a fall since the last visit","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2251","name":"Inj midazolam in 0.9% nacl","description":"Injection, midazolam in 0.9% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33894","name":"Evasc st rpr thrc/aa acrs br","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; across major side branches","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38542","name":"Explore deep node(s) neck","description":"Dissection, deep jugular node(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":493.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6518","name":"Grad com wrap w strap arm cu","description":"Gradient compression wrap with adjustable straps, arm, each, custom","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0043","name":"Pt mech pros ht valv","description":"Patients with mechanical prosthetic heart valve","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69603","name":"Revj mstdc rsltg rad mstdc","description":"Revision mastoidectomy; resulting in radical mastoidectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1521.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99306","name":"1st nf care high mdm 50","description":"Initial nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 50 minutes must be met or exceed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":216.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93575","name":"Njx cath slct p angrph mapca","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary angiography of major aortopulmonary collateral arteries (mapcas) arising off the aorta or its systemic branches, during cardiac catheterization for congenital heart d","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98000","name":"Synch audio-video new sf 15","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 15 minutes must be met or exceeded.","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3501","name":"Surg exp root surf anterior","description":"Surg exp root surf anterior","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0751","name":"Hiv prep, ftc/taf 200/25mg","description":"Emtricitabine 200mg and tenofovir alafenamide 25mg, oral, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9161","name":"Inj denileuk difti-cxdl 1mcg","description":"Injection, denileukin diftitox-cxdl, 1 mcg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29866","name":"Autgrft implnt knee w/scope","description":"Arthroscopy, knee, surgical; osteochondral autograft(s) (eg, mosaicplasty) (includes harvesting of the autograft[s])","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1263.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0371U","name":"Iadna gu pthgn semiq dna16&1","description":"Iadna gu pthgn semiq dna16&1","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1450","name":"Pt hos/pal care dur id/pf pd","description":"Patients who received hospice or palliative care service any time during denominator identification period or the measure assessment period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0484","name":"Consult slides prep elsewher","description":"Consultation on slides prepared elsewhere","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69632","name":"Rebuild eardrum structures","description":"Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; with ossicular chain reconstruction (eg, postfenestration)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1228.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1167","name":"Hspc dur meas pd","description":"In hospice or using hospice services during the measurement period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4304","name":"Grafix plus, per sq cm","description":"Grafix plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0040","name":"Pt phys/occ therapy","description":"Patient already receiving physical/occupational/speech/recreational therapy during the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1473","name":"Pt func cap not allow impr","description":"Patient situations, at any point during the denominator identification period, where the patients functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools, such as delirium, dementia, intellectual disabilities, and pervasive and specific de","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34703","name":"Evasc rpr a-unilac ndgft","description":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-uni-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in th","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1165.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4373","name":"Membrane wrp lt per sq cm","description":"Membrane wrap lite, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59514","name":"Cesarean delivery only","description":"Cesarean delivery only;","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":894.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1358","name":"Pts no <suicd idea 120 dys","description":"Patients who did not have a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0886T","name":"Sgmdsc flx 1st tndsc dilat","description":"Sigmoidoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0840T","name":"Dgtz gls mcrscp cslt compre","description":"Digitization of glass microscope slides for consultation, comprehensive, with review of records and specimens, with report on referred material (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2022","name":"Innovabrn/innovamatx xl sqcm","description":"Innovaburn or innovamatrix xl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6611","name":"Onlay cst hgh nbl mtl >=3srf","description":"Onlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4288","name":"Dermabind ch, per sq cm","description":"Dermabind ch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0546U","name":"Ldns lrp4 antb imflr livecll","description":"Ldns lrp4 antb imflr livecll","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42505","name":"Repair salivary duct","description":"Plastic repair of salivary duct, sialodochoplasty; secondary or complicated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":542.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1015T","name":"Rev/rmv lw esoph sphnc npg/r","description":"Revision or removal, lower esophageal sphincter neurostimulator pulse generator or receiver","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0681","name":"App of non-sheet skin sub","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; first 25 sq cm or less of wound surface area","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1323","name":"Pts 7wk inj, scrn iop >25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop >25 mm hg and a plan of care was documented","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0875T","name":"Prgrm subq prtl asct pmp sys","description":"Programming of subcutaneously implanted peritoneal ascites pump system by physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0778T","name":"Smmg cncrnt appl imu snr","description":"Surface mechanomyography (smmg) with concurrent application of inertial measurement unit (imu) sensors for measurement of multi-joint range of motion, posture, gait, and muscle function","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35021","name":"Repair defect of artery","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, innominate, subclavian artery, by thoracic incision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1426.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0866T","name":"Quan mri alys brn w/dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion detection, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transmissio","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0811T","name":"Rem mlt day uroflow setup","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); set-up and patient education on use of equipment","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65103","name":"Remove eye/insert implant","description":"Enucleation of eye; with implant, muscles not attached to implant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":796.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22800","name":"Arthrd pst dfrm<6 vrt sgm","description":"Arthrodesis, posterior, for spinal deformity, with or without cast; up to 6 vertebral segments","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1591.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49614","name":"Rpr aa hrn rcr < 3 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, incarcerated or strangulated","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0889T","name":"Prsnlz trgt dvl arhfcmrigtbs","description":"Personalized target development for accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation derived from a structural and resting-state functional mri, including data preparation and transmission, generation of the target, motor threshold-starting location, neuro","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1473","name":"Pt func cap not allow impr","description":"Patient situations, at any point during the denominator identification period, where the patients functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools, such as delirium, dementia, intellectual disabilities, and pervasive and specific de","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1403","name":"Bslne and fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69725","name":"Release facial nerve","description":"Decompression facial nerve, intratemporal; including medial to geniculate ganglion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2147.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7771","name":"Alveolus clsd reduc stblz te","description":"Alveolus closed reduction stabilization of teeth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25490","name":"Prophylactic tx radius","description":"Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate; radius","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1138.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4008","name":"Geriatrics ss","description":"Geriatrics mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44901","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0035","name":"Pt ed pos 23","description":"Patient has any emergency department encounter during the performance period with place of service indicator 23","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99404","name":"Prev med cnsl indiv apprx 60","description":"Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 60 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":93.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4385","name":"Apollo ft per sq cm","description":"Apollo ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2013","name":"Innovamatrix fs, per sq cm","description":"Innovamatrix fs, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2010","name":"Apis, per square centimeter","description":"Apis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0396","name":"3d print of 3d surface scan","description":"3d print of 3d surface scan","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33904","name":"Perq p-art revsc each addl","description":"Percutaneous pulmonary artery revascularization by stent placement, each additional vessel or separate lesion, normal or abnormal connections (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9376","name":"Inj pozelimab-bbfg, 1 mg","description":"Injection, pozelimab-bbfg, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30469","name":"Rpr nsl vlv collapse w/rmdlg","description":"Repair of nasal valve collapse with low energy, temperature-controlled (ie, radiofrequency) subcutaneous/submucosal remodeling","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99489","name":"Cplx chrnc care ea addl 30","description":"Complex chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":48.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31630","name":"Bronchoscopy dilate/fx repr","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with tracheal/bronchial dilation or closed reduction of fracture","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63053","name":"Lam factc/frmt arthrd lum ea","description":"Laminectomy, facetectomy, or foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s] [eg, spinal or lateral recess stenosis]), during posterior interbody arthrodesis, lumbar; each additional vertebral segment (list separately in addition to code for","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0529","name":"In home respite care, 4 hr u","description":"In-home respite care, 4-hour unit, for use in cmmi model","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0856T","name":"Dgtz gls mcrscp electron mic","description":"Digitization of glass microscope slides for electron microscopy, diagnostic (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0933T","name":"Tcat impl wrls l atr prs snr","description":"Transcatheter implantation of wireless left atrial pressure sensor for long-term left atrial pressure monitoring, including sensor calibration and deployment, right heart catheterization, transseptal puncture, imaging guidance, and radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76857","name":"Us exam pelvic limited","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0940T","name":"Xtrnl ecg rec>15d<30d r&i","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1371","name":"Mst rec gsa<7","description":"Most recent glycemic status assessment (hba1c or gmi) level < 7.0%","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0601U","name":"Nfct ds pji alys 11 bmrks ia","description":"Nfct ds pji alys 11 bmrks ia","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49400","name":"Air injection into abdomen","description":"Injection of air or contrast into peritoneal cavity (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0946T","name":"Ortho impl mvmt alys pair ct","description":"Orthopedic implant movement analysis using paired computed tomography (ct) examination of the target structure, including data acquisition, data preparation and transmission, interpretation and report (including ct scan of the joint or extremity performed with paired views)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0615U","name":"Bbrgdrferi ld antb detcj 26","description":"Bbrgdrferi ld antb detcj 26","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1307","name":"Inj, crovalimab-akkz, 10 mg","description":"Injection, crovalimab-akkz, 10 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37263","name":"Revsc evasc fpvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0396","name":"3d print of 3d surface scan","description":"3d print of 3d surface scan","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90935","name":"Hemodialysis one evaluation","description":"Hemodialysis procedure with single evaluation by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0515U","name":"Gi ibd ia quan deter ifx lvl","description":"Gi ibd ia quan deter ifx lvl","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1377","name":"Fu colscop 10 yr doc w/ disc","description":"Recommended follow-up interval for repeat colonoscopy of 10 years documented  in colonoscopy report and communicated with patient","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47490","name":"Incision of gallbladder","description":"Cholecystostomy, percutaneous, complete procedure, including imaging guidance, catheter placement, cholecystogram when performed, and radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":586.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87220","name":"Tissue exam for fungi","description":"Tissue examination by koh slide of samples from skin, hair, or nails for fungi or ectoparasite ova or mites (eg, scabies)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27458","name":"Osteot femur imed lngth dev","description":"Osteotomy(ies), femur, unilateral, with insertion of an externally controlled intramedullary lengthening device, including iliotibial band release when performed, imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1388","name":"Pt doc exm rec melmn","description":"Patients with documentation of an exam performed for recurrence of melanoma","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70471","name":"Cta h&n c+ w/noncontrast img","description":"Computed tomographic angiography (cta), head and neck, with contrast material(s), including noncontrast images, when performed, and image postprocessing","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1010T","name":"Cptr oph alys monoc eye mvmt","description":"Computerized ophthalmic analysis of monocular eye movements using retinal-based eye-tracking without spatial calibration, including fixation, microsaccades, drift, and horizontal saccades, when performed, unilateral or bilateral, with interpretation and report","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93896","name":"Vsrctv std tcd icr art compl","description":"Vasoreactivity study performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0303U","name":"Hem rbc ads whl bld hypoxic","description":"Hem rbc ads whl bld hypoxic","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1468","name":"Hep b vaccine received","description":"Patient received recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42975","name":"Dise eval slp do brth flx dx","description":"Drug-induced sleep endoscopy, with dynamic evaluation of velum, pharynx, tongue base, and larynx for evaluation of sleep-disordered breathing, flexible, diagnostic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4018","name":"Ob/gyn ss","description":"Obstetrics/gynecology mips specialty set","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0697T","name":"Quan mr tis wo mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained without diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, targ","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4305","name":"Amer am ac tri-lay per sq cm","description":"American amnion ac tri-layer, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55715","name":"Bx prst8 ea add mri-us/ct/mr","description":"Biopsy, prostate, each additional, mri-ultrasound fusion or in-bore ct- or mri-guided targeted lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80069","name":"Renal function panel","description":"Renal function panel this panel must include the following: albumin (82040) calcium, total (82310) carbon dioxide (bicarbonate) (82374) chloride (82435) creatinine (82565) glucose (82947) phosphorus inorganic (phosphate) (84100) potassium (84132) sodium (84295) urea nitrogen (bun) (84520)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92972","name":"Perq trluml coronry lithotrp","description":"Percutaneous transluminal coronary lithotripsy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0804","name":"3d facial scan indirect","description":"3d facial scan indirect","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4148","name":"Enteral feed elastomer daily","description":"Enteral feeding supply kit; elastomeric control fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87797","name":"Detect agent nos dna dir","description":"Infectious agent detection by nucleic acid (dna or rna), not otherwise specified; direct probe technique, each organism","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0933T","name":"Tcat impl wrls l atr prs snr","description":"Transcatheter implantation of wireless left atrial pressure sensor for long-term left atrial pressure monitoring, including sensor calibration and deployment, right heart catheterization, transseptal puncture, imaging guidance, and radiological supervision and interpretation","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69210","name":"Remove impacted ear wax uni","description":"Removal impacted cerumen requiring instrumentation, unilateral","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0318U","name":"Ped whl gen mthyltn alys 50+","description":"Ped whl gen mthyltn alys 50+","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4437","name":"Revival ac per sq cm","description":"Revival ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0752T","name":"Dgtz gls mcrscp sld lvl iii","description":"Digitization of glass microscope slides for level iii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4021","name":"Orthopedic surgery ss","description":"Orthopedic surgery mips specialty set","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1166","name":"Path rpt tis spec wle/reexc","description":"Pathology report for tissue specimens produced from wide local excisions or re-excisions","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4368","name":"Amchothick per sq cm","description":"Amchothick, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4391","name":"Amnioplast double per sq cm","description":"Amnioplast double, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16025","name":"Dress/debrid p-thick burn m","description":"Dressings and/or debridement of partial-thickness burns, initial or subsequent; medium (eg, whole face or whole extremity, or 5% to 10% total body surface area)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":195.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":54.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64583","name":"Rev/rplct hpglsl nstm ary pg","description":"Revision or replacement of hypoglossal nerve neurostimulator array and distal respiratory sensor electrode or electrode array, including connection to existing pulse generator","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"Ctlso a-p-l control custom","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61518","name":"Removal of brain lesion","description":"Craniectomy for excision of brain tumor, infratentorial or posterior fossa; except meningioma, cerebellopontine angle tumor, or midline tumor at base of skull","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3137.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22102","name":"Remove part lumbar vertebra","description":"Partial excision of posterior vertebral component (eg, spinous process, lamina or facet) for intrinsic bony lesion, single vertebral segment; lumbar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":896.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1720","name":"Influenza vacc admin","description":"Influenza vacc admin","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1444","name":"Del < 39 weeks gest","description":"Delivery at < 39 weeks of gestation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58300","name":"Insert intrauterine device","description":"Insertion of intrauterine device (iud)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":42.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9054","name":"Inj bortezomib boruzu 0.1 mg","description":"Injection, bortezomib (boruzu), 0.1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4422","name":"Ac wrap per sq cm","description":"A/c wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4256","name":"Mlg complet, per sq cm","description":"Mlg-complete, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4294","name":"Amnio quad-core, per sq cm","description":"Amnio quad-core, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5135","name":"Inj, tyenne, 1 mg","description":"Injection, tocilizumab-aazg (tyenne), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99393","name":"Prev visit est age 5-11","description":"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; late ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":62.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64475","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3393","name":"Inj, betibeglogene autotemce","description":"Injection, betibeglogene autotemcel, per treatment","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1459","name":"Pt hosp/pal care dur perf pd","description":"Patient was in hospice or receiving palliative care services at any time during the performance period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59072","name":"Umbilical cord occlud w/us","description":"Fetal umbilical cord occlusion, including ultrasound guidance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1941","name":"Inj, furoscix, 20 mg","description":"Injection, furosemide (furoscix), 20 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2941","name":"Somatropin injection","description":"Injection, somatropin, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4468","name":"Exsuff belt incl all sup acc","description":"Exsufflation belt, includes all supplies and accessories","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5992","name":"Low prosth foot shell repl","description":"All lower extremity prosthesis, foot shell for modular foot/non-solid ankle cushion heel (sach) replacement only","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9996","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0928T","name":"Rem interrog dev ccm-d phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system with interim analysis and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4034","name":"Speech language path ss","description":"Speech language pathology mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27403","name":"Repair of knee cartilage","description":"Arthrotomy with meniscus repair, knee","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":775.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86622","name":"Brucella antibody","description":"Antibody; brucella","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0332U","name":"Onc pan tum gen prflg 8 dna","description":"Onc pan tum gen prflg 8 dna","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4345","name":"Matrix hd allogrft per sq cm","description":"Matrix hd allograft dermis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0745T","name":"Car ablt rad arr n-invas loc","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; noninvasive arrhythmia localization and mapping of arrhythmia site (nidus), derived from anatomical image data (eg, ct, mri, or myocardial perfusion scan) and electrical data (eg, 12-lead ecg data), and identification of areas of avo","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0548","name":"Phone/inter svs 21-30 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0789T","name":"Elec aly cpx iins sp/sac nrv","description":"Electronic analysis with complex programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detect","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0605","name":"Antibody test pub hlth path","description":"Antibody test pub hlth path","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69719","name":"Rplcm oi implt sk tc esp<100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or involving a bony defect less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3393","name":"Inj, betibeglogene autotemce","description":"Injection, betibeglogene autotemcel, per treatment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0589U","name":"Pfas24cmpnd hi-perf lc-ms/ms","description":"Pfas24cmpnd hi-perf lc-ms/ms","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40527","name":"Reconstruct lip with flap","description":"Excision of lip; full thickness, reconstruction with cross lip flap (abbe-estlander)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":785.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2001","name":"Suct pum ext mgmt sys","description":"Suction pump, home model, portable or stationary, electric, any type, for use with external urine and/or fecal management system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1166","name":"Path rpt tis spec wle/reexc","description":"Pathology report for tissue specimens produced from wide local excisions or re-excisions","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2320","name":"Nandrolone decanoate 50 mg","description":"Injection, nandrolone decanoate, up to 50 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3911","name":"Intraorifice barrier","description":"Intraorifice barrier","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36560","name":"Insert tunneled cv cath","description":"Insertion of tunneled centrally inserted central venous access device, with subcutaneous port; younger than 5 years of age","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":434.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7962","name":"Lingual frenectomy","description":"Lingual frenectomy","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94450","name":"Breathing response hypoxia","description":"Breathing response to hypoxia (hypoxia response curve)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1490","name":"Pt status not doc","description":"Patient status not documented","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1253","name":"Pts hu surv no amb plltv","description":"Patients who respond on the patient experience hu survey that they did not receive care by the listed ambulatory palliative care provider in the last 60 days (disavowal)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0166","name":"Inj epinephrine (bpi)","description":"Injection, epinephrine (bpi), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0591U","name":"Onc prst8 ca 3prtns plsm srm","description":"Onc prst8 ca 3prtns plsm srm","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0398U","name":"Gi baret esph dna mthyln aly","description":"Gi baret esph dna mthyln aly","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4283","name":"Biovance tri or 3l, sq cm","description":"Biovance tri-layer or biovance 3l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4417","name":"Alexiguard dl-t per sq cm","description":"Alexiguard dl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84545","name":"Urea-n clearance test","description":"Urea nitrogen, clearance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1343","name":"Pt pam lvl 4 base or srt lin","description":"Patients who are at pam level 4 at baseline or patients who are flagged with extreme straight line response sets on the pam or with excessive missing responses","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87594","name":"Pneumcysts jirovecii amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); pneumocystis jirovecii, amplified probe technique","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94626","name":"Phy/qhp op pulm rhb w/mntr","description":"Physician or other qualified health care professional services for outpatient pulmonary rehabilitation; with continuous oximetry monitoring (per session)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43889","name":"Gstr rstcv px trnsorl esg","description":"Gastric restrictive procedure, transoral, endoscopic sleeve gastroplasty (esg), including argon plasma coagulation, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0550","name":"Phone/inter for dx/treat >5m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a written report to the patients treating/r","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85610","name":"Prothrombin time","description":"Prothrombin time;","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5934","name":"Mandibular flange prosthesis","description":"Mandibular resection prosthesis with guide flange","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0703","name":"Inj, cefepime hcl (b braun)","description":"Injection, cefepime hydrochloride (b braun), not therapeutically equivalent to maxipime, 500 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0726T","name":"Rmvl implt vstibular dev uni","description":"Removal of implanted vestibular device, unilateral","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58580","name":"Transcrv abltj utrn fibrd rf","description":"Transcervical ablation of uterine fibroid(s), including intraoperative ultrasound guidance and monitoring, radiofrequency","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6072","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (high noble metal)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38227","name":"Car-t receipt&prepj admn","description":"Chimeric antigen receptor t-cell (car-t) therapy; receipt and preparation of car-t cells for administration","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0373","name":"Tomo bitewing image","description":"Tomo bitewing image","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0781T","name":"Brnchsc rf dstrj pulm nrv bi","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; bilateral mainstem bronchi","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5612","name":"Rep resin part dent base max","description":"Rep resin part dent base max","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7261","name":"Primary closure sinus perf","description":"Primary closure of a sinus perforation","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63706","name":"Repair of spinal herniation","description":"Repair of myelomeningocele; larger than 5 cm diameter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2036.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4031","name":"Radiation oncology ss","description":"Radiation oncology mips specialty set","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82638","name":"Assay of dibucaine number","description":"Dibucaine number","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1246","name":"Pt othr thn true imprt to me","description":"Patient provided a response other than completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1427","name":"Doc med rsn bone scn","description":"Documentation of medical reason(s) for performing a bone scan (including documented pain related to prostate cancer, salvage therapy, other medical reasons)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0483","name":"Indirect immunofluorescence","description":"Indirect immunofluorescence","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9996","name":"Ustekinumab- ttwe sub cu inj","description":"Injection, ustekinumab-ttwe (pyzchiva), subcutaneous, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0934T","name":"Rem mntr wrls l atr prs snr","description":"Remote monitoring of a wireless left atrial pressure sensor for up to 30 days, including data from daily uploads of left atrial pressure recordings, interpretation(s) and trend analysis, with adjustments to the diuretics plan, treatment paradigm thresholds, medications or lifestyle modifications, wh","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0947T","name":"Mrgfus strtctc bl-br disrpj","description":"Magnetic resonance image guided low intensity focused ultrasound (mrgfus), stereotactic blood-brain barrier disruption using microbubble resonators to increase the concentration of blood-based biomarkers of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0801","name":"3d dental scan direct","description":"3d dental scan direct","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6074","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (noble metal)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91124","name":"Rct snsatn tone&cmplianc std","description":"Rectal sensation, tone, and compliance study (eg, barostat)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1267","name":"Pt no act kid transplt wtlst","description":"Patients not observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36466","name":"Njx noncmpnd sclrsnt mlt vn","description":"Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate, inclusive of all imaging guidance and monitoring; multiple incompetent truncal veins (eg, great saphenous vein, accessory saphenous vein), same leg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1593.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":159.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25630","name":"Cltx carpl fx w/o mnpj ea b1","description":"Closed treatment of carpal bone fracture (excluding carpal scaphoid [navicular]); without manipulation, each bone","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0567","name":"Screening hep c detect","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis c, screening, amplified probe technique","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0540U","name":"Trnsplj med quan dd-cfdna","description":"Trnsplj med quan dd-cfdna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99204","name":"Office o/p new mod 45 min","description":"Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 45 minutes must be met or excee","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":170.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4023","name":"Pathology ss","description":"Pathology mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0689","name":"Inj cefazolin sodium, baxter","description":"Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5909","name":"Max guid prothes w/ flange","description":"Max guid prothes w/ flange","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54161","name":"Circum 28 days or older","description":"Circumcision, surgical excision other than clamp, device, or dorsal slit; older than 28 days of age","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33279","name":"Rmvl phrnc nrv stim transvns","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s) only","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4545","name":"Suppl accessor tibial stim","description":"Supplies and accessories for external tibial nerve stimulator (e.g., socks, gel pads, electrodes, etc.), needed for one month","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43889","name":"Gstr rstcv px trnsorl esg","description":"Gastric restrictive procedure, transoral, endoscopic sleeve gastroplasty (esg), including argon plasma coagulation, when performed","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0452U","name":"Onc bldr mthyl penk lte-qmsp","description":"Onc bldr mthyl penk lte-qmsp","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2020","name":"Ac5 wound system","description":"Ac5 advanced wound system (ac5)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98012","name":"Synch audio-only est sf 10","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0259U","name":"Neph ckd nuc mrs meas gfr","description":"Nephrology (chronic kidney disease), nuclear magnetic resonance spectroscopy measurement of myo-inositol, valine, and creatinine, algorithmically combined with cystatin c (by immunoassay) and demographic data to determine estimated glomerular filtration rate (gfr), serum, quantitative","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1643","name":"Inj heparin, pfizer, 1000u","description":"Injection, heparin sodium (pfizer), not therapeutically equivalent to j1644, per 1000 units","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51721","name":"Ins trurl ablt trnsdc thr us","description":"Insertion of transurethral ablation transducer for delivery of thermal ultrasound for prostate tissue ablation, including suprapubic tube placement during the same session and placement of an endorectal cooling device, when performed","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0756T","name":"Dgtz gls mcrscp sld spc grpi","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group i, for microorganisms (eg, acid fast, methenamine silver) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29580","name":"Strapping unna boot","description":"Strapping; unna boot","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":24.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1434","name":"Inj, focinvez, 1mg","description":"Injection, fosaprepitant (focinvez), 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0603","name":"Sevelamer hydrochloride 20mg","description":"Sevelamer hydrochloride (renagel or therapeutically equivalent), oral, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1477","name":"Dx delirium","description":"Diagnosis of delirium","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0455","name":"Tlso flex trnk sj-t9 pre ots","description":"Tlso, flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, pref","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5827","name":"Endo knee shin single axis","description":"Endoskeletal knee-shin system, single axis, electromechanical swing and stance phase control, with or without shock absorption and stance extension damping","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0913T","name":"Prq tcat ther rx ntrac balo1","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting), including mechanical dilation by nondrug-delivery balloon angioplasty, endoluminal imaging using intravascular ultrasound (ivus) or optical coherence tomography (oct) when per","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0876T","name":"Duplex scan hemo fstl lmtd","description":"Duplex scan of hemodialysis fistula, computer-aided, limited (volume flow, diameter, and depth, including only body of fistula)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0993T","name":"N-invas assmt car rsk w/ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat with concurrent computed tomography scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional (list s","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4187","name":"Omegaven, 10 grams lipids","description":"Omegaven, 10 grams lipids","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63172","name":"Drainage of spinal cyst","description":"Laminectomy with drainage of intramedullary cyst/syrinx; to subarachnoid space","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1514.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78205","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4322","name":"Caregraft, per sq cm","description":"Caregraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6107","name":"Tissue regen non-resorbable","description":"Tissue regen non-resorbable","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44820","name":"Excision of mesentery lesion","description":"Excision of lesion of mesentery (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":851.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1321","name":"Pts no 7wk inj,no iop,iop>25","description":"Patients who were not seen within 7 weeks following the date of injection for follow up or who did not have a documented iop or no plan of care documented if the iop was >25 mm hg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1430","name":"Ret exm ou no retinopthy doc","description":"Retinal exam finding without evidence of retinopathy in both eyes with severity level documented (in measurement year or in the prior year)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1289","name":"No pt tbco cess interv rng","description":"Patient identified as tobacco user did not receive tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4329","name":"Singlay, per sq cm","description":"Singlay, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1425","name":"Surgical care mvp","description":"Surgical care mips value pathway","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1452","name":"Pt dx dementia ever","description":"Patient ever had a diagnosis of dementia","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0500","name":"Dicyclomine injection","description":"Injection, dicyclomine hcl, up to 20 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99304","name":"1st nf care sf/low mdm 25","description":"Initial nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward or low level of medical decision making. when using total time on the date of the encounter for code selection, 25 minutes mus","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":86.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0610U","name":"Nfct ds antmcr sc phenotypic","description":"Nfct ds antmcr sc phenotypic","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81515","name":"Nfct ds bv&vaginitis dna alg","description":"Infectious disease, bacterial vaginosis and vaginitis, real-time pcr amplification of dna markers for atopobium vaginae, atopobium species, megasphaera type 1, and bacterial vaginosis associated bacteria-2 (bvab-2), utilizing vaginal-fluid specimens, algorithm reported as positive or negative for hi","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0030","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1383","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2406","name":"Injection, oritavancin 10 mg","description":"Injection, oritavancin (kimyrsa), 10 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92577","name":"Stenger test speech","description":"Stenger test, speech","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59350","name":"Repair of uterus","description":"Hysterorrhaphy of ruptured uterus","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0218","name":"Inj olipudase alfa-rpcp 1mg","description":"Injection, olipudase alfa-rpcp, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6599","name":"G comp bandage short stretch","description":"Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1472","name":"Hep b vaccine not received","description":"Patient did not receive recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92635","name":"Hearing aid fitg svc ea addl","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; each additional 15 minutes (list separately in addition to code","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4316","name":"Amchoplast, per sq cm","description":"Amchoplast, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1317","name":"Pts counsl cpt opt out","description":"Patients who are counseled on connection with a csp and explicitly opt out","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0803T","name":"Tcat rmv&rpl2chmb ldls pm rv","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ve","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0481U","name":"Idh1 idh2&tert promoter ngs","description":"Idh1 idh2&tert promoter ngs","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0617U","name":"Cv ascvd dna alys >20000","description":"Cv ascvd dna alys >20000","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1275","name":"Pts hosp exl","description":"Patients determined to be in hospice were excluded from month of evaluation and the remainder of reporting period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0667","name":"Team remote e/m est pt 25 mn","description":"Team remote e/m est. pt 25mins","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64447","name":"Njx aa&/strd femoral nrv img","description":"Injection(s), anesthetic agent(s) and/or steroid; femoral nerve, including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1286","name":"Bmi doc onl fup not cmpltd","description":"Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0052","name":"Mmip mental health and care","description":"Missing and murdered indigenous persons (mmip) mental health and clinical care","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2001","name":"Suct pum ext mgmt sys","description":"Suction pump, home model, portable or stationary, electric, any type, for use with external urine and/or fecal management system","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0396","name":"Alcohol/subs interv 15-30mn","description":"Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":39.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90635","name":"H5n1 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n1, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0873","name":"Inj daptomycin (xellia)","description":"Injection, daptomycin (xellia), not therapeutically equivalent to j0878 or j0872, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87627","name":"Jt spc pthgn&rx rsist gen26+","description":"Infectious agent detection by nucleic acid (dna or rna); joint space pathogens and drug resistance genes, multiplex amplified probe technique, 26 or more targets","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1488","name":"Dx dementia in msr timeframe","description":"Patients with a diagnosis for dementia in the year before or during the period of evaluation","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3465","name":"Injection, voriconazole","description":"Injection, voriconazole, 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7295","name":"Eth estr and eton monthly","description":"Ethinyl estradiol and etonogestrel 0.015mg, 0.12mg per 24 hours; monthly vaginal ring, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4006","name":"Gastroenterology ss","description":"Gastro-enterology mips specialty set","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94617","name":"Exercise tst brncspsm w/ecg","description":"Exercise test for bronchospasm, including pre- and post-spirometry and pulse oximetry; with electrocardiographic recording(s)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2019","name":"Kerecis marigen shld sq cm","description":"Kerecis omega3 marigen shield, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33120","name":"Exc icar tum resc w/card byp","description":"Excision of intracardiac tumor, resection with cardiopulmonary bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1782.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0286U","name":"Cep72 nudt15&tpmt gene alys","description":"Cep72 nudt15&tpmt gene alys","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98986","name":"Rtm dev sply cbt 2-15 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of cognitive behavioral therapy, 2-15 days in a 30-day period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1181","name":"Gr 2 or> dia or gr2 or> col","description":"Grade 2 or above diarrhea and/or grade 2 or above colitis","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1445","name":"Pp care visit by 12 weeks","description":"Postpartum care visit before or at 12 weeks of giving birth","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5657","name":"Add low ext man aut vol any","description":"Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0651","name":"Inj, levothyroxine, freskabi","description":"Injection, levothyroxine sodium (fresenius kabi), not therapeutically equivalent to j0650, 10 mcg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0466U","name":"Crd cad dna gwas 564856 snp","description":"Crd cad dna gwas 564856 snp","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77293","name":"Respirator motion mgmt simul","description":"Respiratory motion management simulation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75660","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1205","name":"Isa reduced >=3","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92975","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4212","name":"Gingivectomy/plasty rest","description":"Gingivectomy/plasty rest","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0462","name":"Atropine sulf, nte, 0.01 mg","description":"Injection, atropine sulfate, not therapeutically equivalent to j0461, 0.01 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9294","name":"Inj pemetrexed, hospira 10mg","description":"Injection, pemetrexed (hospira), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1026","name":"Pt hemo > 3mo","description":"The number of adult patient-months in the denominator who were on maintenance hemodialysis using a catheter continuously for three months or longer under the care of the same practitioner or group partner as of the last hemodialysis session of the reporting month","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87209","name":"Smear complex stain","description":"Smear, primary source with interpretation; complex special stain (eg, trichrome, iron hemotoxylin) for ova and parasites","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59821","name":"Treatment of miscarriage","description":"Treatment of missed abortion, completed surgically; second trimester","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":523.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":413.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":423.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47612","name":"Removal of gallbladder","description":"Cholecystectomy with exploration of common duct; with choledochoenterostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1297.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0553","name":"Monthly tx for dmht 20mins","description":"First 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing information related to the use of","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01938","name":"Anes drg/aspir lmbr/sac","description":"Anesthesia for percutaneous image-guided injection, drainage or aspiration procedures on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4272","name":"Esano a, per sq cm","description":"Esano a, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64597","name":"Ins/rplcm prq eltrd ra pn ea","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; each additional electrode array (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27591","name":"Amputate leg at thigh","description":"Amputation, thigh, through femur, any level; immediate fitting technique including first cast","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1055.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0873T","name":"Revj subq prtl asct pmp sys","description":"Revision of a subcutaneously implanted peritoneal ascites pump system, any component (ascites pump, associated peritoneal catheter, associated bladder catheter), including imaging and programming, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75894","name":"X-rays transcath therapy","description":"Transcatheter therapy, embolization, any method, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1322.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86771","name":"Shigella antibody","description":"Antibody; shigella","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0481","name":"Electron microscopy diagnost","description":"Electron microscopy - diagnostic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0652","name":"Inj, levothyroxine, hikma","description":"Injection, levothyroxine sodium (hikma), not therapeutically equivalent to j0650, 10 mcg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81441","name":"Ibmfs seq alys pnl 30 genes","description":"Inherited bone marrow failure syndromes (ibmfs) (eg, fanconi anemia, dyskeratosis congenita, diamond-blackfan anemia, shwachman-diamond syndrome, gata2 deficiency syndrome, congenital amegakaryocytic thrombocytopenia) sequence analysis panel, must include sequencing of at least 30 genes, including b","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1293","name":"Calc bmi abv up param f/u","description":"Bmi is documented above normal parameters and a follow-up plan is documented","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2956","name":"Indirect rest remov","description":"Indirect rest remov","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0615","name":"Calcium acetate, oral, 23 mg","description":"Calcium acetate, oral, 23 mg (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2291","name":"Inj, nafcillin (baxter) 20mg","description":"Injection, nafcillin sodium (baxter), 20 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90839","name":"Psytx crisis initial 60 min","description":"Psychotherapy for crisis; first 60 minutes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":136.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4366","name":"Dl amnio bur x-mem per sq cm","description":"Dual layer amnio burgeon x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0512U","name":"Onc prst8 alys dgtz img msi","description":"Onc prst8 alys dgtz img msi","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7485","name":"Surg reduct osseoustuberosit","description":"Surgical reduction of osseous tuberosity","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0964T","name":"I&cust prep jaw xpnsj 1arch","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; single arch, without mandibular advancement mechanism","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9607","name":"Lutetium lu 177 vipivotide","description":"Lutetium lu 177 vipivotide tetraxetan, therapeutic, 1 millicurie","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4038","name":"Vascular surgery ss","description":"Vascular surgery mips specialty set","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5142","name":"Inj adalimumab-ryvk, 1 mg","description":"Injection, adalimumab-ryvk biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86850","name":"Rbc antibody screen","description":"Antibody screen, rbc, each serum technique","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3502","name":"Surg exp root surf premolar","description":"Surg exp root surf premolar","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1748","name":"Inj, zymfentra, 10 mg","description":"Injection, infliximab-dyyb (zymfentra), 10 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0342U","name":"Onc pncrtc ca mult ia eclia","description":"Onc pncrtc ca mult ia eclia","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0569","name":"Subs psych care mng, subs mo","description":"Subsequent psychiatric collaborative care management, in a subsequent month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required elements: tracking ","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31560","name":"Laryngoscop w/arytenoidectom","description":"Laryngoscopy, direct, operative, with arytenoidectomy;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1199","name":"Pt recg rrt","description":"Patients receiving rrt","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1301","name":"Pt recv tbco cess interv","description":"Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43286","name":"Esphg tot w/laps moblj","description":"Esophagectomy, total or near total, with laparoscopic mobilization of the abdominal and mediastinal esophagus and proximal gastrectomy, with laparoscopic pyloric drainage procedure if performed, with open cervical pharyngogastrostomy or esophagogastrostomy (ie, laparoscopic transhiatal esophagectomy","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2774.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1278","name":"Pre-htn or htn doc, f/u indc","description":"Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98013","name":"Synch audio-only est low 20","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code select","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0665","name":"Team remote e/m est pt 10 mn","description":"Team remote e/m est. pt 10mins","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0304U","name":"Hem rbc ads whl bld normoxic","description":"Hem rbc ads whl bld normoxic","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0906T","name":"Coms ther 1st appl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; first application, total wound(s) surface area less than or equal to 50 sq cm","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86581","name":"Strptcs pneum antb serot ia","description":"Streptococcus pneumoniae antibody (igg), serotypes, multiplex immunoassay, quantitative","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49623","name":"Rmvl ninfct mesh hernia rpr","description":"Removal of total or near total non-infected mesh or other prosthesis at the time of initial or recurrent anterior abdominal hernia repair or parastomal hernia repair, any approach (ie, open, laparoscopic, robotic) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1446","name":"Pt died bef end meas pd","description":"Patients who died any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33010","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9056","name":"Inj, vivimusta, 1 mg","description":"Injection, bendamustine hydrochloride (vivimusta), 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0714T","name":"Tpla b9 prst8 hyprplsa<50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume less than 50 ml","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36466","name":"Njx noncmpnd sclrsnt mlt vn","description":"Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate, inclusive of all imaging guidance and monitoring; multiple incompetent truncal veins (eg, great saphenous vein, accessory saphenous vein), same leg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1576.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":151.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1442","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4384","name":"Axolotl dual ult per sq cm","description":"Axolotl dualgraft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1360","name":"Suicd c-ssrs assessment","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1195","name":"Rpt wo imp/con mmr/msi","description":"Surgical pathology reports that do not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both, reason not given","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54535","name":"Extensive testis surgery","description":"Orchiectomy, radical, for tumor; with abdominal exploration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":819.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5992","name":"Low prosth foot shell repl","description":"All lower extremity prosthesis, foot shell for modular foot/non-solid ankle cushion heel (sach) replacement only","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4424","name":"Revive ft per sq cm","description":"Revive ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92945","name":"Prq trl rvs ch occ ant&rtrgr","description":"Percutaneous transluminal revascularization of chronic total occlusion, single coronary artery, coronary artery branch, or coronary artery bypass graft, and/or subtended major coronary artery branches of the bypass graft, any combination of intracoronary stent, atherectomy and angioplasty; combined ","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1714","name":"Pfizer vacc adm ped 2nd dose","description":"Pfizer vacc adm ped 2nd dose","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87513","name":"H pylri clrthmcn rst amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); helicobacter pylori (h. pylori), clarithromycin resistance, amplified probe technique","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0755T","name":"Dgtz gls mcrscp sld level vi","description":"Digitization of glass microscope slides for level vi, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37605","name":"Ligation int/com carotid art","description":"Ligation; internal or common carotid artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":988.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88140","name":"Sex chromatin identification","description":"Sex chromatin identification; peripheral blood smear, polymorphonuclear drumsticks","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0795T","name":"Tcat ins 2chmbr ldls pm cmpl","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; complete system (ie, r","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0679T","name":"Laps rmvl lead isdss","description":"Laparoscopic removal of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78465","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":695.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85025","name":"Complete cbc w/auto diff wbc","description":"Blood count; complete (cbc), automated (hgb, hct, rbc, wbc and platelet count) and automated differential wbc count","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9887","name":"Distance learning attendance","description":"Behavioral counseling for diabetes prevention, distance learning, 60 minutes","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0612U","name":"Onc lvr alys >1000 mr cfdna","description":"Onc lvr alys >1000 mr cfdna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1472","name":"Hep b vaccine not received","description":"Patient did not receive recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97037","name":"Appl modality 1+lllt po pain","description":"Application of a modality to 1 or more areas; low-level laser therapy (ie, nonthermal and non-ablative) for post-operative pain reduction","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4402","name":"Xwrap 2.0 per sq cm","description":"Xwrap 2.0, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93261","name":"Interrogate subq defib","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; implantable subcutaneous lead defibrillator system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64628","name":"Trml dstrj ios bvn 1st 2 l/s","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; first 2 vertebral bodies, lumbar or sacral","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9129","name":"Photobio therpy-sub 15 mins","description":"Photobio therpy-sub 15 mins","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0571U","name":"Onc sol tum dna80&rna10g ngs","description":"Onc sol tum dna80&rna10g ngs","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78491","name":"Myocrd img pet 1std rst/strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); single study, at rest or stress (exercise or pharmacologic)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1215.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0903T","name":"Ecg alg 12 lead reduced i&r","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; with interpretation and report","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61891","name":"Rev/rplcmt sk-mnt crnl nstm","description":"Revision or replacement of skull-mounted cranial neurostimulator pulse generator or receiver with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93146","name":"Interrog crtd sins bat ip w/","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0606U","name":"Hem red cll memb do rbc oge","description":"Hem red cll memb do rbc oge","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9291","name":"Pres dig cog behav thera fda","description":"Prescription digital cognitive and/or behavioral therapy, fda cleared, per course of treatment","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0745T","name":"Car ablt rad arr n-invas loc","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; noninvasive arrhythmia localization and mapping of arrhythmia site (nidus), derived from anatomical image data (eg, ct, mri, or myocardial perfusion scan) and electrical data (eg, 12-lead ecg data), and identification of areas of avo","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77436","name":"Surf radj ther tx planning","description":"Surface radiation therapy; superficial or orthovoltage, treatment planning and simulation-aided field setting","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0423","name":"Genetic test spec analysis","description":"Genetic test spec analysis","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0906T","name":"Coms ther 1st appl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; first application, total wound(s) surface area less than or equal to 50 sq cm","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87183","name":"Sc std carbapenem resist gen","description":"Susceptibility studies, antimicrobial agent; carbapenem resistance genes (eg, blakpc, blandm, blavim, blaoxa-48, blaimp), amplified probe technique, per isolate","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4276","name":"Orion, per sq cm","description":"Orion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12036","name":"Intmd rpr s/a/t/ext 20.1-30","description":"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 20.1 cm to 30.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97007","name":"Mchnl sclp cool meas fitg","description":"Mechanical scalp cooling, including individual cap supply with head measurement, fitting, and patient education","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75995","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":889.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37271","name":"Revsc evsc fpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5421","name":"Dentures adjust part maxill","description":"Adjust partial denture - maxillary","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0893T","name":"N-invas assmt bld oxygnation","description":"Noninvasive assessment of blood oxygenation, gas exchange efficiency, and cardiorespiratory status, with physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4258","name":"Enverse, per sq cm","description":"Enverse, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0857T","name":"Opto-acoustic img breast uni","description":"Opto-acoustic imaging, breast, unilateral, including axilla when performed, real-time with image documentation, augmentative analysis and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4423","name":"Biolab tri wrap fl per sq cm","description":"Biolab tri-membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6555","name":"G com stcking bk 40+ custm","description":"Gradient compression stocking, below knee, 40 mmhg or greater, custom, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85007","name":"Bl smear w/diff wbc count","description":"Blood count; blood smear, microscopic examination with manual differential wbc count","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1433","name":"Oral chemo wthn 30 days enc","description":"Patient on oral chemotherapy on or within 30 days before denominator eligible encounter","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1024T","name":"Perq tiss dsplmt soft tissue","description":"Percutaneous tissue displacement, any method, including imaging guidance; soft tissue (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4358","name":"Xwrap dual, per sq cm","description":"Xwrap dual, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8605","name":"Inj bulking agent anal canal","description":"Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, anal canal, 1 ml, includes shipping and necessary supplies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":860.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71047","name":"X-ray exam chest 3 views","description":"Radiologic examination, chest; 3 views","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58605","name":"Division of fallopian tube","description":"Ligation or transection of fallopian tube(s), abdominal or vaginal approach, postpartum, unilateral or bilateral, during same hospitalization (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":389.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1198","name":"Isa not red 3pts /no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82272","name":"Occult bld feces 1-3 tests","description":"Blood, occult, by peroxidase activity (eg, guaiac), qualitative, feces, 1-3 simultaneous determinations, performed for other than colorectal neoplasm screening","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5765","name":"Liner compl/partial rem dent","description":"Liner compl/partial rem dent","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0760T","name":"Dgtz gls mcrscp sl imm 1st","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43246","name":"Egd place gastrostomy tube","description":"Esophagogastroduodenoscopy, flexible, transoral; with directed placement of percutaneous gastrostomy tube","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J9094","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1311","name":"Aphlx to vax bef enc","description":"Anaphylaxis due to the vaccine on or before the date of the encounter","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1416","name":"Pt rec hosp","description":"Patient received hospice services any time during the performance period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9887","name":"Distance learning attendance","description":"Behavioral counseling for diabetes prevention, distance learning, 60 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1189","name":"Doc khe pef w/efgr/uacr","description":"Documentation of a kidney health evaluation defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr) performed","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1017T","name":"Elec aly npgs esoph sbsq w/o","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74740","name":"X-ray female genital tract","description":"Hysterosalpingography, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4276","name":"Orion, per sq cm","description":"Orion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62331","name":"Dcmprn prq rmv lig flv addl","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; additional interspace(s), lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1032","name":"Sv doula brth wrk per 15 min","description":"Services performed by a doula birth worker, per 15 minutes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0218","name":"Inj olipudase alfa-rpcp 1mg","description":"Injection, olipudase alfa-rpcp, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0469U","name":"Rare ds whl gen seq ftl samp","description":"Rare ds whl gen seq ftl samp","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0686T","name":"Histotripsy mal hepatcel tis","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant hepatocellular tissue, including image guidance","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0848T","name":"Dgtz gls mcrscp ish 1st","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1483","name":"Neg quan hep c or qual rna","description":"Patients who achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95929","name":"C motor evoked lwr limbs","description":"Central motor evoked potential study (transcranial motor stimulation); lower limbs","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":220.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0539","name":"Initial care training 30 m","description":"Caregiver training in behavior management/modification for caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face; initial 30 minutes","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77436","name":"Surf radj ther tx planning","description":"Surface radiation therapy; superficial or orthovoltage, treatment planning and simulation-aided field setting","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93733","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1254","name":"Pts deceased prior hu surv","description":"Patients who were deceased when the hu survey reached them","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0894T","name":"Cannulation liver allograft","description":"Cannulation of the liver allograft in preparation for connection to the normothermic perfusion device and decannulation of the liver allograft following normothermic perfusion","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37282","name":"Rvsc evsc tpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0799T","name":"Tcat rmvl 2chmbr ldls pm ra","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right atrial pacemaker component","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0723T","name":"Qmrcp w/o dx mri sm anat ses","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained without diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) during the same session","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98979","name":"Rtm tx mgmt 1st 10 min","description":"Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least 1 real-time interactive communication with the patient or caregiver during the calendar month; first 10 minutes","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1239","name":"Pt no resp heard","description":"Patient did not respond to the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0391","name":"Inj, artesunate, 1mg","description":"Injection, artesunate, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9998","name":"Doc med rsn <3 colon","description":"Documentation of medical reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., last colonoscopy incomplete, last colonoscopy had inadequate prep, piecemeal removal of adenomas, or sessile serrated polyps >= 20 mm in size, last colonoscopy found greater than 10 adenomas, lo","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6198","name":"Remove interim implant","description":"Remove interim implant","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4370","name":"Aeroguard per sq cm","description":"Aeroguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98014","name":"Synch audio-only est mod 30","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code s","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0751T","name":"Dgtz gls mcrscp sld level ii","description":"Digitization of glass microscope slides for level ii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01941","name":"Anes neuromd/ntrvrt crv/thrc","description":"Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0534U","name":"Onc prst8 mirna snp 32 vrnt","description":"Onc prst8 mirna snp 32 vrnt","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52332","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with insertion of indwelling ureteral stent (eg, gibbons or double-j type)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61710","name":"Revise circulation to head","description":"Surgery of aneurysm, vascular malformation or carotid-cavernous fistula; by intra-arterial embolization, injection procedure, or balloon catheter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2147.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0328U","name":"Drug assay 120+ rx&metablt","description":"Drug assay 120+ rx&metablt","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63307","name":"Remov vert idrl bdy lmbr/sac","description":"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, lumbar or sacral by transperitoneal or retroperitoneal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2374.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0484","name":"Consult slides prep elsewher","description":"Consultation on slides prepared elsewhere","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98002","name":"Synch audio-video new mod 45","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate medical decision making. when using total time on the date of the encounter for code selection, 45 minutes must be met or exceeded.","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1197","name":"Isa reduced >=3 fr ixv","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61108","name":"Tdh pnxr evac&/drg sdrl hmta","description":"Twist drill hole(s) for subdural, intracerebral, or ventricular puncture; for evacuation and/or drainage of subdural hematoma","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":922.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1362","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1363","name":"Pts no f/u 120 dys","description":"Patients who did not have a follow-up assessment within 120 days of the index assessment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2802","name":"Inj, romiplostim 1 microgram","description":"Injection, romiplostim, 1 microgram","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4343","name":"Dermacyte ac matrx per sq cm","description":"Dermacyte ac matrix amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"Basic vestibular evaluation","description":"Basic vestibular evaluation, includes spontaneous nystagmus test with eccentric gaze fixation nystagmus, with recording, positional nystagmus test, minimum of 4 positions, with recording, optokinetic nystagmus test, bidirectional foveal and peripheral stimulation, with recording, and oscillating tra","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93588","name":"Vngrph chd vnvn cltrl below","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating below the heart (eg, from the inferior vena cava) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98004","name":"Synch audio-video est sf 10","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 10 minutes must be met or e","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1383","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2403","name":"Chloroprocaine opht gel, 1mg","description":"Chloroprocaine hcl ophthalmic, 3% gel, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9332","name":"Inj efgartigimod 2mg","description":"Injection, efgartigimod alfa-fcab, 2mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0701","name":"Pano radio image","description":"Pano radio image","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0692T","name":"Therapeutic ultrafiltration","description":"Therapeutic ultrafiltration","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1472","name":"Hep b vaccine not received","description":"Patient did not receive recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4300","name":"Acesso tl, per sq cm","description":"Acesso tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12002","name":"Rpr s/n/ax/gen/trnk2.6-7.5cm","description":"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 2.6 cm to 7.5 cm","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":162.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4251","name":"Vim, per square centimeter","description":"Vim, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9219","name":"Leuprolide acetate implant","description":"Leuprolide acetate implant, 65 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2206.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37255","name":"Revsc evasc ivt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22214","name":"Incis 1 vertebral seg lumbar","description":"Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; lumbar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1701.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5995","name":"Peri medicament w/seal, max","description":"Peri medicament w/seal, max","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76883","name":"Us nrv&acc strux 1xtr compre","description":"Ultrasound, nerve(s) and accompanying structures throughout their entire anatomic course in one extremity, comprehensive, including real-time cine imaging with image documentation, per extremity","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1417","name":"Pt up to date cov","description":"Patients who are up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0564U","name":"Nfct ds pthgn-sna 10vir&4bct","description":"Nfct ds pthgn-sna 10vir&4bct","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28060","name":"Partial removal foot fascia","description":"Fasciectomy, plantar fascia; partial (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0408","name":"Inpt/tele follow up 35","description":"Follow-up inpatient consultation, complex, physicians typically spend 35 minutes communicating with the patient via telehealth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1434","name":"Inj, focinvez, 1mg","description":"Injection, fosaprepitant (focinvez), 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69662","name":"Revise middle ear bone","description":"Revision of stapedectomy or stapedotomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1363.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27479","name":"Surgery to stop leg growth","description":"Arrest, epiphyseal, any method (eg, epiphysiodesis); combined distal femur, proximal tibia and fibula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1161.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1783","name":"Vac admin human pap dose 3","description":"Vac admin human pap dose 3","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4017","name":"Nutrition/dietician ss","description":"Nutrition/dietician mips specialty set","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6081","name":"Scale & debride, single imp","description":"Scale & debride, single imp","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0422","name":"Collect & prep genetic samp","description":"Collect & prep genetic samp","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37267","name":"Revsc evsc fpvt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0559U","name":"Onc brs quan elisa bf9ag srm","description":"Onc brs quan elisa bf9ag srm","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29280","name":"Strapping of hand or finger","description":"Strapping; hand or finger","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9999","name":"Doc sys rsn <3 colon","description":"Documentation of system reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., unable to locate previous colonoscopy report, patient cannot provide precise date or details from previous colonoscopy, previous colonoscopy report was incomplete)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0963T","name":"Anosc sbmcsl njx bulking agt","description":"Anoscopy with directed submucosal injection of bulking agent into anal canal","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0722T","name":"Quan ct tiss charac w/ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained with concurrent ct examination of any structure contained in the concurrently acquired diagnostic imaging dataset (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0898T","name":"N-invas prst8 cancer est map","description":"Noninvasive prostate cancer estimation map, derived from augmentative analysis of image-guided fusion biopsy and pathology, including visualization of margin volume and location, with margin determination and physician interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1783","name":"Vac admin human pap dose 3","description":"Vac admin human pap dose 3","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1565.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0874T","name":"Rmvl pertl ascites pmp sys","description":"Removal of a peritoneal ascites pump system, including implanted peritoneal ascites pump and indwelling bladder and peritoneal catheters","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9955","name":"Oral app thxpy titration vis","description":"Oral app thxpy titration vis","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1185","name":"Imm ckpt inhib not hld no rx","description":"Documentation of immune checkpoint inhibitor therapy not held and/or corticosteroids or immunosuppressants prescribed or administered was not performed, reason not given","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0201","name":"Pne flu hepb cov home admin","description":"Administration of pneumococcal, influenza, hepatitis b, and/or covid-19 vaccine inside a patients home; reported only once per individual home per date of service when such vaccine administration(s) are performed at the patients home","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1455","name":"Rep/rev cied","description":"Replaced or revised cied","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1493","name":"No fall doc med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76805","name":"Ob us >/= 14 wks sngl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93152","name":"Interrog&prgrmg ipnss polysm","description":"Interrogation and programming of implanted phrenic nerve stimulator system during polysomnography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0961T","name":"Shortwave ifr radiation img","description":"Shortwave infrared radiation imaging, surgical pathology specimen, to assist gross examination for lymph node localization in fibroadipose tissue, per specimen (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"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":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0725T","name":"Vestibular dev impltj uni","description":"Vestibular device implantation, unilateral","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12056","name":"Intmd rpr face/mm 20.1-30.0","description":"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 20.1 cm to 30.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":394.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0368U","name":"Onc clrct ca mut&mthyltn mrk","description":"Onc clrct ca mut&mthyltn mrk","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0879","name":"Difelikefalin, esrd on dialy","description":"Injection, difelikefalin, 0.1 microgram, (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0138","name":"Inj acetaminoph 10mg/ibu 3mg","description":"Injection, acetaminophen 10 mg and ibuprofen 3 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76987","name":"Dx intraop epicar car us chd","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; including placement and manipulation of transducer, image acquisition, interpretation and report","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5946","name":"Max implt sup fix","description":"Max implt sup fix","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6107","name":"Tissue regen non-resorbable","description":"Tissue regen non-resorbable","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0500U","name":"Autoinflam ds vexas synd dna","description":"Autoinflam ds vexas synd dna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6560","name":"G stckng full/chap30-40 cust","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, custom, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0898T","name":"N-invas prst8 cancer est map","description":"Noninvasive prostate cancer estimation map, derived from augmentative analysis of image-guided fusion biopsy and pathology, including visualization of margin volume and location, with margin determination and physician interpretation and report","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0414U","name":"Onc lng aug alg aly whl sld8","description":"Onc lng aug alg aly whl sld8","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20206","name":"Biopsy muscle perq needle","description":"Biopsy, muscle, percutaneous needle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55868","name":"Lap srg prst8ct lymph nod bx","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with lymph node biopsy(ies) (limited pelvic lymphadenectomy)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61558","name":"Excision of skull/sutures","description":"Extensive craniectomy for multiple cranial suture craniosynostosis (eg, cloverleaf skull); not requiring bone grafts","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1798.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64582","name":"Opn mpltj hpglsl nstm ary pg","description":"Open implantation of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0368U","name":"Onc clrct ca mut&mthyltn mrk","description":"Onc clrct ca mut&mthyltn mrk","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35361","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; combined aortoiliac","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1960.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0785T","name":"Revj/rmvl nea spi w/nstim","description":"Revision or removal of neurostimulator electrode array, spinal, with integrated neurostimulator","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88264","name":"Chromosome analysis 20-25","description":"Chromosome analysis; analyze 20-25 cells","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5150","name":"Inj, aflibercept-mrbb, 1 mg","description":"Injection, aflibercept-mrbb (ahzantive), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37262","name":"Iv lithotrp ivt w/in sm art","description":"Intravascular lithotripsy(ies), iliac vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7171","name":"Inj, adzynma, 10 iu","description":"Injection, adamts13, recombinant-krhn, 10 iu","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1160","name":"Pt anphx due to mengb bef 13","description":"Patient had anaphylaxis due to the meningococcal vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36227","name":"Place cath xtrnl carotid","description":"Selective catheter placement, external carotid artery, unilateral, with angiography of the ipsilateral external carotid circulation and all associated radiological supervision and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9002","name":"Intra-vag motion sens biofk","description":"Intra-vaginal motion sensor system, provides biofeedback for pelvic floor muscle rehabilitation device","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0588U","name":"Nfct ds bct/vir 32genes mrna","description":"Nfct ds bct/vir 32genes mrna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4212","name":"Gingivectomy/plasty rest","description":"Gingivectomy/plasty rest","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98978","name":"Rtm dev sply cbt 16-30 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of cognitive behavioral therapy, 16-30 days in a 30-day period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9249","name":"Inj, melphalan (apotex) 1 mg","description":"Injection, melphalan (apotex), 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9956","name":"Admin home sleep apnea test","description":"Admin home sleep apnea test","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0682T","name":"Removal pulse gen only isdss","description":"Removal of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0541","name":"No pt prsnt train initial 30","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1179","name":"No pcv recd","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine, on or after their 19th birthday and before or during measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64597","name":"Ins/rplcm prq eltrd ra pn ea","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; each additional electrode array (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1198","name":"Isa not red 3pts /no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53865","name":"Cysto insj dev ischmc rmdlg","description":"Cystourethroscopy with insertion of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1240","name":"Pt no resp best int","description":"Patient did not respond to the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0777T","name":"R-t prs sensing edrl gdn sys","description":"Real-time pressure-sensing epidural guidance system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34715","name":"Opn ax/subcla art expos","description":"Open axillary/subclavian artery exposure for delivery of endovascular prosthesis by infraclavicular or supraclavicular incision, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0973T","name":"Slctv nzmtc dbrdmt t/a/l 1st","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; first 100 sq cm","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0723T","name":"Qmrcp w/o dx mri sm anat ses","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained without diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) during the same session","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1240","name":"Pt no resp best int","description":"Patient did not respond to the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2038","name":"Skill train and dev/diem","description":"Skills training and development, per diem","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1385","name":"Pt rsn not seen 2nd pam","description":"Documentation of patient reasons for patients who were not seen for the second pam survey (e.g., less than four months between baseline pam assessment and follow-up","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1021T","name":"Active thrc irrigation spx","description":"Active thoracic irrigation (separate procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4385","name":"Apollo ft per sq cm","description":"Apollo ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9004","name":"Va whole health partner serv","description":"Department of veterans affairs whole health partner services","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0035","name":"Pt ed pos 23","description":"Patient has any emergency department encounter during the performance period with place of service indicator 23","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0957T","name":"Rev s-sclp eltr ra rcvr&tlmt","description":"Revision of sub-scalp implanted electrode array, receiver, and telemetry unit for electrode, when required, including imaging guidance","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76802","name":"Ob us < 14 wks addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0681","name":"App of non-sheet skin sub","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; first 25 sq cm or less of wound surface area","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1412","name":"Met nsclc w/ egfr alk oth ab","description":"Patients with metastatic nsclc with epidermal growth factor receptor (egfr) mutations, alk genomic tumor aberrations, or other targetable genomic abnormalities with approved first-line targeted therapy, such as nsclc with ros1 rearrangement, braf v600e mutation, ntrk 1/2/3 gene fusion, met ex14 skip","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0706","name":"Intraoral occlus radio image","description":"Intraoral occlus radio image","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9029","name":"Instill adstiladrin, tx dose","description":"Intravesical instillation, nadofaragene firadenovec-vncg, per therapeutic dose","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99255","name":"Ip/obs consltj new/est hi 80","description":"Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 80 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0458","name":"Aztreonam/avibactam 10 mg","description":"Injection, aztreonam/avibactam, 7.5 mg/2.5 mg (10 mg)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36836","name":"Prq av fstl crtj uxtr 1 acs","description":"Percutaneous arteriovenous fistula creation, upper extremity, single access of both the peripheral artery and peripheral vein, including fistula maturation procedures (eg, transluminal balloon angioplasty, coil embolization) when performed, including all vascular access, imaging guidance and radiolo","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1952","name":"Afo spiral prefab ots","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, off-the-shelf","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":1007.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0465","name":"Autolog prp diab wound ulcer","description":"Autologous platelet rich plasma (prp) or other blood-derived product for diabetic chronic wounds/ulcers, using an fda-cleared device for this indication, (includes as applicable administration, dressings, phlebotomy, centrifugation or mixing, and all other preparatory procedures, per treatment)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4313","name":"Dermabind fm, per sq cm","description":"Dermabind fm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1494","name":"Fall rep since last visit","description":"Patients that reported a fall since the last visit","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0030","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64472","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2022","name":"Innovabrn/innovamatx xl sqcm","description":"Innovaburn or innovamatrix xl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1193","name":"Rpts w/ imp/con mmr/msi","description":"Surgical pathology reports that contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0889T","name":"Prsnlz trgt dvl arhfcmrigtbs","description":"Personalized target development for accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation derived from a structural and resting-state functional mri, including data preparation and transmission, generation of the target, motor threshold-starting location, neuro","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6610","name":"G com stcking bk 18-30 custm","description":"Gradient compression stocking, below knee, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1226","name":"Iop not doc","description":"Iop measurement not documented, reason not otherwise specified","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94240","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0401U","name":"Crd c hrt ds 9 gen 12 vrnts","description":"Crd c hrt ds 9 gen 12 vrnts","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0457U","name":"Pfas 9 cmpnd lcms/ms pls/sr","description":"Pfas 9 cmpnd lcms/ms pls/sr","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0953T","name":"Tot impl amei rev/rplc w/o","description":"Totally implantable active middle ear hearing implant; revision or replacement, without mastoidectomy and replacement of sound processor","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1302","name":"Scrn mam perf rslts doc","description":"Screening, diagnostic, film digital or digital breast tomosynthesis (3d) mammography results documented and reviewed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5150","name":"Inj, aflibercept-mrbb, 1 mg","description":"Injection, aflibercept-mrbb (ahzantive), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76815","name":"Ob us limited fetus(s)","description":"Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0933T","name":"Tcat impl wrls l atr prs snr","description":"Transcatheter implantation of wireless left atrial pressure sensor for long-term left atrial pressure monitoring, including sensor calibration and deployment, right heart catheterization, transseptal puncture, imaging guidance, and radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93896","name":"Vsrctv std tcd icr art compl","description":"Vasoreactivity study performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1359","name":"Indx suicd idea, no 0 scr","description":"Index assessment during the denominator period when the suicidal ideation and/or behavior symptoms or increased suicide risk by clinician determination occurs and a non-zero c-ssrs score is obtained","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64655","name":"Revj/rplcmt bat mod sys lead","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; lead only","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95903","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0293U","name":"Psyc suicidal idea mrna 54","description":"Psyc suicidal idea mrna 54","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0872T","name":"Rplcmt ndwllg bldr&prtl cath","description":"Replacement of indwelling bladder and peritoneal catheters, including tunneling of catheter(s) and connection with previously implanted peritoneal ascites pump, including imaging and programming, when performed","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86042","name":"Acetylcholn rcptr blckg antb","description":"Acetylcholine receptor (achr); blocking antibody","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0668","name":"Instill, bupivac and meloxic","description":"Instillation, bupivacaine and meloxicam, 1 mg/0.03 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97810","name":"Acup 1/> wo estim 1st 15 min","description":"Acupuncture, 1 or more needles; without electrical stimulation, initial 15 minutes of personal one-on-one contact with the patient","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":26.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0164","name":"Epinephrine in nacl (baxter)","description":"Injection, epinephrine in sodium chloride (baxter), 0.1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4271","name":"Home lancing/test cartridges","description":"Integrated lancing and blood sample testing cartridges for home blood glucose monitor, per 50 tests","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":34.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90635","name":"H5n1 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n1, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0628U","name":"Nfro kdn ds genetic cond 449","description":"Nfro kdn ds genetic cond 449","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2038","name":"Marigen pacto, per sq cm","description":"Marigen pacto, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0701","name":"Inj. cefepime hcl (baxter)","description":"Injection, cefepime hydrochloride (baxter), not therapeutically equivalent to maxipime, 500 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0275U","name":"Hem heprn nduc trmbctpna srm","description":"Hematology (heparin-induced thrombocytopenia) platelet antibody reactivity by flow cytometry, serum","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0852T","name":"Dgtz gls mcrscp mphmtrc ea 1","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5909","name":"Max guid prothes w/ flange","description":"Max guid prothes w/ flange","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0939T","name":"Xtrnl ecg rec>15d<30d scan","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; scanning analysis with report","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"Non-adju cgm supply allow","description":"Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82274","name":"Assay test for blood fecal","description":"Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0268","name":"Removal of impacted wax md","description":"Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0913T","name":"Prq tcat ther rx ntrac balo1","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting), including mechanical dilation by nondrug-delivery balloon angioplasty, endoluminal imaging using intravascular ultrasound (ivus) or optical coherence tomography (oct) when per","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25259","name":"Manipulate wrist w/anesthes","description":"Manipulation, wrist, under anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":465.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1375","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1203","name":"Inj, cipaglucosidase, 5 mg","description":"Injection, cipaglucosidase alfa-atga, 5 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75577","name":"Quan&char c athrosclrtc plaq","description":"Quantification and characterization of coronary atherosclerotic plaque to assess severity of coronary disease, derived from augmentative software analysis of the data set from a coronary computed tomographic angiography, with interpretation and report by a physician or other qualified health care pr","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81003","name":"Urinalysis auto w/o scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; automated, without microscopy","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6597","name":"G comp bandage long stretch","description":"Gradient compression bandage roll, elastic long stretch, linear yard, any width, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4013","name":"Mntal/behav/psych hlth ss","description":"Mental/behavioral and psychiatry mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38225","name":"Car-t hrv bld-drv t lymphcyt","description":"Chimeric antigen receptor t-cell (car-t) therapy; harvesting of blood-derived t lymphocytes for development of genetically modified autologous car-t cells, per day","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0859T","name":"Ncntc ifr spctrsc o/t pad ea","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), other than for screening for peripheral arterial disease, image acquisition, interpretation, and report; each additional anatomic site (list separately in addition to code ","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1400","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75872","name":"Vein x-ray skull epidural","description":"Venography, epidural, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":720.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0623U","name":"Ai ms dna mthyl alys >5000","description":"Ai ms dna mthyl alys >5000","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1211","name":"Gsa level>9.0%","description":"Most recent glycemic status assessment (hba1c or gmi) level > 9.0%","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34713","name":"Perq access & clsr fem art","description":"Percutaneous access and closure of femoral artery for delivery of endograft through a large sheath (12 french or larger), including ultrasound guidance, when performed, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0882T","name":"Intraop ther estim pn ue 1st","description":"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; initial nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0902T","name":"Qtc ntrvl augmnt alg aly ecg","description":"Qtc interval derived by augmentative algorithmic analysis of input from an external, patient-activated mobile ecg device","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93618","name":"Indctj arrhythmia elec pacg","description":"Induction of arrhythmia by electrical pacing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99235","name":"Hosp ip/obs same date mod 70","description":"Hospital inpatient or observation care, for the evaluation and management of a patient including admission and discharge on the same date, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encount","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5146","name":"Inj, hercessi, 10 mg","description":"Injection, trastuzumab-strf (hercessi), biosimilar, 10 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82947","name":"Assay glucose blood quant","description":"Glucose; quantitative, blood (except reagent strip)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4034","name":"Speech language path ss","description":"Speech language pathology mips specialty set","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1470","name":"Hep b vac not recd med rsn","description":"Documentation of medical reason(s) for not administering hepatitis b vaccine (e.g., prior anaphylaxis due to the hepatitis b vaccine)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1307","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0562U","name":"Onc sol tum tgsa 33gens snvs","description":"Onc sol tum tgsa 33gens snvs","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0799","name":"Hiv prep, fda approved, noc","description":"Fda approved prescription drug, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv), not otherwise classified","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93575","name":"Njx cath slct p angrph mapca","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary angiography of major aortopulmonary collateral arteries (mapcas) arising off the aorta or its systemic branches, during cardiac catheterization for congenital heart d","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0865T","name":"Quan mri alys brn w/o dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion identification, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transm","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0701","name":"Inj. cefepime hcl (baxter)","description":"Injection, cefepime hydrochloride (baxter), not therapeutically equivalent to maxipime, 500 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0225","name":"Inj, vutrisiran, 1 mg","description":"Injection, vutrisiran, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1834","name":"Inj, isoniazid, 1 mg","description":"Injection, isoniazid, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4375","name":"Duograft ac per sq cm","description":"Duograft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0677T","name":"Laps repos lead isdss 1st ld","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first repositioned lead","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7173","name":"Inj. concizumab-mtci, 0.5 mg","description":"Injection, concizumab-mtci, 0.5 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2021","name":"Inj, linezolid (hospira)","description":"Injection, linezolid (hospira), not therapeutically equivalent to j2020, 200 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9992","name":"Pall serv during meas","description":"Palliative care services used by patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4411","name":"Amniomatrixf4x per sq cm","description":"Amniomatrixf4x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4426","name":"Dermbnd tl+, tlx per sq cm","description":"Dermabind tl + or dermabind tl x,  per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85027","name":"Complete cbc automated","description":"Blood count; complete (cbc), automated (hgb, hct, rbc, wbc and platelet count)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":6.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4400","name":"Polygon3 per sq cm","description":"Polygon3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0758T","name":"Dgtz gls mcrscp sl spc hchem","description":"Digitization of glass microscope slides for special stain, including interpretation and report, histochemical stain on frozen tissue block (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3373","name":"Inj, vancomycin hcl, 10 mg","description":"Injection, vancomycin hydrochloride, 10 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0699T","name":"Njx pst chmbr eye medication","description":"Injection, posterior chamber of eye, medication","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28825","name":"Partial amputation of toe","description":"Amputation, toe; interphalangeal joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66991","name":"Xcapsl ctrc rmvl insj 1+","description":"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); with insertion of intraocular (eg, trabecular meshwork, supraciliary, suprachoroidal) anterior segment aqueous drai","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4365","name":"Amnio bur dl mem per sq cm","description":"Amnio burgeon dual-layer membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0461U","name":"Onc rxgenom alys rtpcr 24gen","description":"Onc rxgenom alys rtpcr 24gen","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4338","name":"Artacent velos, per sq cm","description":"Artacent velos, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1270","name":"Pts no kid transplt wtlst","description":"Patients not on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9292","name":"Pres dig visual therapy fda","description":"Prescription digital visual therapy, software-only, fda cleared, per course of treatment","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6564","name":"G com stckng waist 40+ cust","description":"Gradient compression stocking, waist length, 40 mmhg or greater, custom, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1093.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0988T","name":"Opn ins/rplc ins ptn sbq&sbf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93596","name":"R&l hrt cath chd nml nt cnj","description":"Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); normal native connections","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0520","name":"New pt-cg dyad dem mod cmplx","description":"Management of new patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10061","name":"I&d abscess comp/multiple","description":"Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); complicated or multiple","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":198.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1212","name":"Dimethyl sulfoxide 50% 50 ml","description":"Injection, dmso, dimethyl sulfoxide, 50%, 50 ml","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1378","name":"Med rsn no 10 yr fu colscope","description":"Documentation of medical reason(s) for not recommending a 10 year follow-up interval (e.g., inadequate prep, familial or personal history of colonic polyps, patient had no adenoma and age is >= 66 years old, or life expectancy < 10 years, other medical reasons)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74355","name":"X-ray guide intestinal tube","description":"Percutaneous placement of enteroclysis tube, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69552","name":"Exc aurl glomus tum trnsmstd","description":"Excision aural glomus tumor; transmastoid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1878.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99245","name":"Off/op consltj new/est hi 55","description":"Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 55 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9361","name":"Inj, efbemalenograstim alfa-","description":"Injection, efbemalenograstim alfa-vuxw, 0.5 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4306","name":"Americ amnion ac per sq cm","description":"American amnion ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1175","name":"Doc med rsn no hzv","description":"Documentation of medical reason(s) for not administering zoster vaccine (e.g., prior anaphylaxis due to the zoster vaccine)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63086","name":"Remove vertebral body add-on","description":"Vertebral corpectomy (vertebral body resection), partial or complete, transthoracic approach with decompression of spinal cord and/or nerve root(s); thoracic, each additional segment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1322","name":"Pts 7wk inj, scrn iop =<25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop =<25 mm hg for injected eye","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4006","name":"Gastroenterology ss","description":"Gastro-enterology mips specialty set","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93581","name":"Transcath closure of vsd","description":"Percutaneous transcatheter closure of a congenital ventricular septal defect with implant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1544.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1941","name":"Inj, furoscix, 20 mg","description":"Injection, furosemide (furoscix), 20 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32603","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0597U","name":"Onc breast rna xprsn 329gens","description":"Onc breast rna xprsn 329gens","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9611","name":"Flurpiridaz f18, diag, 1 mci","description":"Flurpiridaz f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0526U","name":"Nefro rnl trnspl quan cxcl10","description":"Nefro rnl trnspl quan cxcl10","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0798T","name":"Tcat rmv 2chmbr ldls pm cmpl","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; complete system (ie, right atrial and right ventricular pacemaker components)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87070","name":"Culture othr specimn aerobic","description":"Culture, bacterial; any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37287","name":"Revsc evasc tpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9277","name":"Pembrolizumab 1mg berahyalur","description":"Injection, pembrolizumab, 1 mg and berahyaluronidase alfa-pmph","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49592","name":"Rpr aa hrn 1st < 3 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1463","name":"2 f/u wthn 180 day rx atmp","description":"Documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0739","name":"Hiv prep, inj, cabotegravir","description":"Injection, cabotegravir, 1mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4257","name":"Relese, per sq cm","description":"Relese, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1457","name":"Dx asth dur crnt/prv perf pd","description":"Patient had a diagnosis of asthma with any contact during the current or prior performance period or had asthma present on an active problem list any time during the performance period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0473","name":"Micro exam prep & report","description":"Accession of tissue gross and microscopic examination preparation and transmission of written report","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93583","name":"Perq transcath septal reduxn","description":"Percutaneous transcatheter septal reduction therapy (eg, alcohol septal ablation) including temporary pacemaker insertion when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":819.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6112","name":"Imp/abut rem dent part max","description":"Imp/abut rem dent part max","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0852T","name":"Dgtz gls mcrscp mphmtrc ea 1","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"X-ray exam chest 2 views","description":"Radiologic examination, chest; 2 views","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17260","name":"Dstrj mal les t/a/l 0.5 cm/<","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), trunk, arms or legs; lesion diameter 0.5 cm or less","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2016","name":"Permeaderm b, per sq cm","description":"Permeaderm b, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4363","name":"Am bur mem hydro per sq cm","description":"Amnio burgeon membrane and hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78483","name":"Heart first pass multiple","description":"Cardiac blood pool imaging (planar), first pass technique; multiple studies, at rest and with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantification","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":493.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5159","name":"Inj, denosumab-dssb, 1 mg","description":"Injection, denosumab-dssb (ospomyv/xbryk), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1168","name":"Pt recd flu vax 7/1-6/30","description":"Patient received an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37261","name":"Revsc evasc ivt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0998T","name":"Precuneus mag stimj tx dlvr","description":"Precuneus magnetic stimulation; personalized treatment delivery of magnetic stimulation therapy to a prespecified target area derived from analysis of evoked potentials within the precuneus, utilizing magnetic resonance imaging-based neuronavigation, with management, per day","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81001","name":"Urinalysis auto w/scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; automated, with microscopy","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1316","name":"Tobacco non-user","description":"Current tobacco non-user","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87651","name":"Strep a dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); streptococcus, group a, amplified probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1012T","name":"Mtrz ab ntrno trph scl/tr mw","description":"Motorized ab interno trephination of sclera (sclerostomy), or trabecular meshwork (trabeculostomy), 1 or more, including injection of antifibrotic agents, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81457","name":"So neo gsap dna mcrstl ins","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis, microsatellite instability","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1324","name":"Pts intravitreal/pci","description":"Patients who had an intravitreal or periocular corticosteroid injection (e.g., triamcinolone, preservative-free triamcinolone, dexamethasone, dexamethasone intravitreal implant, or fluocinolone intravitreal implant)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61151","name":"Burr hole/treph sbsq tapping","description":"Burr hole(s) or trephine; with subsequent tapping (aspiration) of intracranial abscess or cyst","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1390","name":"Pt no doc exm for rec","description":"Patients who do not have a documented exam performed for recurrence of melanoma or no documentation within the performance period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57456","name":"Endocerv curettage w/scope","description":"Colposcopy of the cervix including upper/adjacent vagina; with endocervical curettage","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":143.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0134","name":"Inj acetaminophen -fresenius","description":"Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2802","name":"Inj, romiplostim 1 microgram","description":"Injection, romiplostim, 1 microgram","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5124","name":"Inj. byooviz, 0.1 mg","description":"Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0622U","name":"Psyc mdd dna alys >20000","description":"Psyc mdd dna alys >20000","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0780T","name":"Instlj fecal microbiota ssp","description":"Instillation of fecal microbiota suspension via rectal enema into lower gastrointestinal tract","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0134","name":"Inj acetaminophen -fresenius","description":"Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0461U","name":"Onc rxgenom alys rtpcr 24gen","description":"Onc rxgenom alys rtpcr 24gen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4264","name":"Cocoon membrane, per sq cm","description":"Cocoon membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43500","name":"Surgical opening of stomach","description":"Gastrotomy; with exploration or foreign body removal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":776.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2406","name":"Injection, oritavancin 10 mg","description":"Injection, oritavancin (kimyrsa), 10 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0267U","name":"Rare do id opt gen mapg&seq","description":"Rare constitutional and other heritable disorders, identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping and whole-genome sequencing","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48140","name":"Partial removal of pancreas","description":"Pancreatectomy, distal subtotal, with or without splenectomy; without pancreaticojejunostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1577.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92638","name":"Bhvl verif of amplification","description":"Behavioral verification of amplification including aided thresholds, functional gain, speech-in-noise, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7171","name":"Inj, adzynma, 10 iu","description":"Injection, adamts13, recombinant-krhn, 10 iu","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4311","name":"Acesso, per sq cm","description":"Acesso, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37290","name":"Revsc evsc tpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85055","name":"Reticulated platelet assay","description":"Reticulated platelet assay","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97037","name":"Appl modality 1+lllt po pain","description":"Application of a modality to 1 or more areas; low-level laser therapy (ie, nonthermal and non-ablative) for post-operative pain reduction","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1164","name":"Pt w/ dementia any time","description":"Patients with dementia any time during the patients history through the end of the measurement period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0296U","name":"Onc orl&/orop ca 20 mlc feat","description":"Onc orl&/orop ca 20 mlc feat","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94350","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37283","name":"Rvsc evsc tpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37261","name":"Revsc evasc ivt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0293U","name":"Psyc suicidal idea mrna 54","description":"Psyc suicidal idea mrna 54","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5930","name":"Max guid prothes w/o flange","description":"Max guid prothes w/o flange","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0682T","name":"Removal pulse gen only isdss","description":"Removal of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0626U","name":"Neurol pd dna alys >20000","description":"Neurol pd dna alys >20000","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0896T","name":"Connj lvr algrft prfu dev ea","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; each additional hour, including physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary bicarbonate, lactate ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0136","name":"Inj, acetaminophen (b braun)","description":"Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87564","name":"Mtb rifampin rst amp prb tq","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacterium tuberculosis, rifampin resistance, amplified probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1393","name":"Pr no dx rec mlnm","description":"Patients who were not diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0806T","name":"Tcat s&ivc prstc vl impl opn","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); open femoral vein approach","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0824T","name":"Tcat rmv 1chmbr ldls pm ra","description":"Transcatheter removal of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography), when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1152","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1002T","name":"Air displacmnt plethysmograp","description":"Air displacement plethysmography, whole-body composition assessment, with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99396","name":"Prev visit est age 40-64","description":"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 40-64","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":89.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27323","name":"Biopsy thigh soft tissues","description":"Biopsy, soft tissue of thigh or knee area; superficial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11401","name":"Exc tr-ext b9+marg 0.6-1 cm","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 0.6 to 1.0 cm","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":168.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7355","name":"Inj travoprost intra impl","description":"Injection, travoprost, intracameral implant, 1 microgram","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4012","name":"Interventional rad ss","description":"Interventional radiology mips specialty set","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35189","name":"Rpr acq av fistula thrx&abd","description":"Repair, acquired or traumatic arteriovenous fistula; thorax and abdomen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1961.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1214","name":"Spiro results wth obs doc","description":"Spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and reviewed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1265","name":"Cms 2728 completed","description":"Cms medical evidence form 2728 for dialysis patients: initial form completed","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1320","name":"Pts scrn + hrsn","description":"Patients who screened positive for at least 1 of the 5 hrsns","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D8091","name":"Compre ortho treat w surg","description":"Compre ortho treat w surg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9026","name":"Cryo fib comp path redu each","description":"Cryoprecipitated fibrinogen complex, pathogen reduced, each unit","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4004","name":"Endocrinology ss","description":"Endocrinology mips specialty set","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2989","name":"Excavate tooth non-restorabl","description":"Excavate tooth non-restorabl","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4327","name":"Duoamnion, per sq cm","description":"Duoamnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1463","name":"2 f/u wthn 180 day rx atmp","description":"Documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81458","name":"So gsap dna cpy nmbr&mcrstl","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis, copy number variants and microsatellite instability","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61715","name":"Mrgfus strtctc ablt trgt icr","description":"Magnetic resonance image guided high intensity focused ultrasound (mrgfus), stereotactic ablation of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69155","name":"Extensive ear/neck surgery","description":"Radical excision external auditory canal lesion; with neck dissection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1905.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0224","name":"Pemivibart infusion","description":"Intravenous infusion, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppr","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6196","name":"Remv of ind rest on implt","description":"Remv of ind rest on implt","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0583U","name":"Rare ds rpd whlgen cmptr dna","description":"Rare ds rpd whlgen cmptr dna","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0703","name":"Inj, cefepime hcl (b braun)","description":"Injection, cefepime hydrochloride (b braun), not therapeutically equivalent to maxipime, 500 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1160","name":"Pt anphx due to mengb bef 13","description":"Patient had anaphylaxis due to the meningococcal vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1337","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91319","name":"Sarscv2 vac 10mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 10 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1812","name":"Inj. insulin (fiasp)","description":"Insulin (fiasp), per 5 units","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0023","name":"Pin service 60m per month","description":"Principal illness navigation services by certified or trained auxiliary personnel under the direction of a physician or other practitioner, including a patient navigator; 60 minutes per calendar month, in the following activities:  person-centered assessment, performed to better understand the indiv","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4343","name":"Dermacyte ac matrx per sq cm","description":"Dermacyte ac matrix amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0403","name":"Ekg for initial prevent exam","description":"Electrocardiogram, routine ecg with 12 leads; performed as a screening for the initial preventive physical examination with interpretation and report","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26210","name":"Removal of finger lesion","description":"Excision or curettage of bone cyst or benign tumor of proximal, middle, or distal phalanx of finger;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":518.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0162","name":"Inj epinephrine (fresenius)","description":"Injection, epinephrine (fresenius), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0860T","name":"Ncntc ifr spctrsc scr pad","description":"Noncontact near-infrared spectroscopy (eg, for measurement of deoxyhemoglobin, oxyhemoglobin, and ratio of tissue oxygenation), for screening for peripheral arterial disease, including provocative maneuvers, image acquisition, interpretation, and report, one or both lower extremities","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6611","name":"Grad com wrap w strap ak cus","description":"Gradient compression wrap with adjustable straps, above knee, each, custom","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69716","name":"Impl oi implt sk tc esp<100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, within the mastoid and/or resulting in removal of less than 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9610","name":"Xe129 xenon, diagnostic","description":"Xenon xe-129 hyperpolarized gas, diagnostic, per study dose","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2543","name":"Piperacillin/tazobactam","description":"Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82106","name":"Alpha-fetoprotein amniotic","description":"Alpha-fetoprotein (afp); amniotic fluid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1272","name":"Pts kid transplt wtlst","description":"Patients observed on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63032","name":"Lamot rpr anulr dfct 1 lmbr","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; with repair of annular defect by implantation of bone-anchored annular closure device, including all imaging guidance, 1 interspace, lumbar","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2020","name":"Ac5 wound system","description":"Ac5 advanced wound system (ac5)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0467U","name":"Onc bldr dna ngs 60gen&aneup","description":"Onc bldr dna ngs 60gen&aneup","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0842T","name":"Dgtz gls mcrscp pth cslt ea","description":"Digitization of glass microscope slides for pathology consultation during surgery; each additional tissue block with frozen section(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0905T","name":"Ecg alg 12 ld rdcd i&r only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; interpretation and report only","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1242","name":"Pt no resp imprt to me","description":"Patient did not respond to the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2976","name":"Band stabilization per tooth","description":"Band stabilization per tooth","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0299U","name":"Onc pan tum whl gen opt mapg","description":"Onc pan tum whl gen opt mapg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0549U","name":"Onc urthl dna mthyltd rt pcr","description":"Onc urthl dna mthyltd rt pcr","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0322U","name":"Neuro asd meas 14 acyl carn","description":"Neuro asd meas 14 acyl carn","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0287U","name":"Onc thyr dna&mrna 112 genes","description":"Onc thyr dna&mrna 112 genes","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9953","name":"Inj fe-based mr contrast,1ml","description":"Injection, iron-based magnetic resonance contrast agent, per ml","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0535","name":"Pt navigat svs direct/ref","description":"Patient navigational services, provided directly or by referral; including helping the patient to navigate health systems and identify care providers and supportive services, to build patient self-advocacy and communication skills with care providers, and to promote patient-driven action plans and g","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1409","name":"Recd gmln brca1/brca2 couns","description":"Patients who received germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0941T","name":"Cysto flx ins&xpns urtl scaf","description":"Cystourethroscopy, flexible; with insertion and expansion of prostatic urethral scaffold using integrated cystoscopic visualization","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0574U","name":"Mtb cfp-10 serum/plsm lc-ms","description":"Mtb cfp-10 serum/plsm lc-ms","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0863T","name":"Rlcj pg wcs lv trnsmtr only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; transmitter component only","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6614","name":"Onlay cst nbl mtl 2 surfaces","description":"Onlay - cast noble metal two surfaces","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1474","name":"Pt dx dementia","description":"Patients with diagnosis of dementia","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1486","name":"Pt admitted to snf dur eval","description":"Patients admitted to a skilled nursing facility (snf) during the period of evaluation","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9074","name":"Inj, cyclophosphamd, sandoz","description":"Injection, cyclophosphamide (sandoz), 5 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0619U","name":"Pulm copd dna alys >18000","description":"Pulm copd dna alys >18000","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86331","name":"Immunodiffusion ouchterlony","description":"Immunodiffusion; gel diffusion, qualitative (ouchterlony), each antigen or antibody","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15013","name":"Prepj skn cll ssp agrft 1st","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; first 25 sq cm or less of harvested skin","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58575","name":"Laps tot hyst resj mal","description":"Laparoscopy, surgical, total hysterectomy for resection of malignancy (tumor debulking), with omentectomy including salpingo-oophorectomy, unilateral or bilateral, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1917.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0461","name":"Testing for cracked tooth","description":"Testing for cracked tooth","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37293","name":"Rvsc evsc tpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1172","name":"Doc med rsn no td/tdap","description":"Documentation of medical reason(s) for not administering td or tdap vaccine (e.g., prior anaphylaxis due to the td or tdap vaccine or history of encephalopathy within seven days after a previous dose of a td-containing vaccine)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84378","name":"Sugars single quant","description":"Sugars (mono-, di-, and oligosaccharides); single quantitative, each specimen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4334","name":"Amnioplast 1, per sq cm","description":"Amnioplast 1, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81020","name":"Urinalysis glass test","description":"Urinalysis; 2 or 3 glass test","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60280","name":"Remove thyroid duct lesion","description":"Excision of thyroglossal duct cyst or sinus;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":495.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4397","name":"Summit aaa per sq cm","description":"Summit aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0801T","name":"Tcat rmv&rpl 2chmbr ldls pm","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; dual-cha","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6251","name":"Bridge resin base metal","description":"Pontic-resin with predominantly base metal","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5098","name":"Inj ustekinumab-srlf, 1 mg","description":"Injection, ustekinumab-srlf (imuldosa), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0791T","name":"Motr cog vr gait train ea 15","description":"Motor-cognitive, semi-immersive virtual reality-facilitated gait training, each 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0802T","name":"Tcat rmv&rpl2chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right at","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0137","name":"Inten outpt svs,min 9 pr 7 d","description":"Intensive outpatient services; weekly bundle, minimum of 9 services over a 7 contiguous day period, which can include individual and group therapy with physicians or psychologists (or other mental health professionals to the extent authorized under state law); occupational therapy requiring the skil","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0573U","name":"Onc pancreas 3bmrk pclf alg","description":"Onc pancreas 3bmrk pclf alg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"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":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0842T","name":"Dgtz gls mcrscp pth cslt ea","description":"Digitization of glass microscope slides for pathology consultation during surgery; each additional tissue block with frozen section(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2373","name":"Inj, immphentiv, 20 mcg","description":"Injection, phenylephrine hydrochloride (immphentiv), 20 micrograms","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0498U","name":"Onc clrct ngs mut detc 43gen","description":"Onc clrct ngs mut detc 43gen","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0902T","name":"Qtc ntrvl augmnt alg aly ecg","description":"Qtc interval derived by augmentative algorithmic analysis of input from an external, patient-activated mobile ecg device","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3376","name":"Inj vancomycin (hikma) 10mg","description":"Injection, vancomycin hcl (hikma), not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0211","name":"Inj, nithiodote, 3mg / 125mg","description":"Injection, sodium nitrite 3 mg and sodium thiosulfate 125 mg (nithiodote)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52597","name":"Trurl rbtc wtrjt rescj prst8","description":"Transurethral robotic-assisted waterjet resection of prostate, including intraoperative planning, ultrasound guidance, control of postoperative bleeding, complete, including vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53453","name":"Tprnl balo cntnc dev rmvl ea","description":"Periurethral transperineal adjustable balloon continence device; removal, each balloon","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0741","name":"Inj, cabote rilpivir 2mg 3mg","description":"Injection, cabotegravir and rilpivirine, 2mg/3mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1014T","name":"Lap rv/rmv eso sph nstm eltr","description":"Laparoscopic revision or removal, lower esophageal sphincter neurostimulator electrodes","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0414","name":"Lab process microbial spec","description":"Lab process microbial spec","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34710","name":"Dlyd plmt xtn prosth 1st vsl","description":"Delayed placement of distal or proximal extension prosthesis for endovascular repair of infrarenal abdominal aortic or iliac aneurysm, false aneurysm, dissection, endoleak, or endograft migration, including pre-procedure sizing and device selection, all nonselective catheterization(s), all associate","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":680.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1465","name":"F/u > 180 days after rx","description":"Patient follow up more than 180 days after treatment","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85009","name":"Manual diff wbc count b-coat","description":"Blood count; manual differential wbc count, buffy coat","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1457","name":"Dx asth dur crnt/prv perf pd","description":"Patient had a diagnosis of asthma with any contact during the current or prior performance period or had asthma present on an active problem list any time during the performance period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99385","name":"Prev visit new age 18-39","description":"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; 18-39 years","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":152.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4435","name":"Renati membrane per sq cm","description":"Renati membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0494U","name":"Rbc ag ftl rhd gene alys ngs","description":"Rbc ag ftl rhd gene alys ngs","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0589","name":"Inj daxibotulinumtoxina-lanm","description":"Injection, daxibotulinumtoxina-lanm, 1 unit","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9245","name":"Admin mod sedation-enteral","description":"Admin mod sedation-enteral","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0725T","name":"Vestibular dev impltj uni","description":"Vestibular device implantation, unilateral","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0668","name":"Instill, bupivac and meloxic","description":"Instillation, bupivacaine and meloxicam, 1 mg/0.03 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0417U","name":"Rare ds alys 335 nuc genes","description":"Rare ds alys 335 nuc genes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0981T","name":"Tcat impl wrls ivc snr","description":"Transcatheter implantation of wireless inferior vena cava sensor for long-term hemodynamic monitoring, including deployment of the sensor, radiological supervision and interpretation, right heart catheterization, and inferior vena cava venography, when performed","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2022","name":"Innovabrn/innovamatx xl sqcm","description":"Innovaburn or innovamatrix xl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31540","name":"Laryngoscopy w/exc of tumor","description":"Laryngoscopy, direct, operative, with excision of tumor and/or stripping of vocal cords or epiglottis;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":310.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59001","name":"Amniocentesis therapeutic","description":"Amniocentesis; therapeutic amniotic fluid reduction (includes ultrasound guidance)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1836","name":"Inj, metronidazole, 10 mg","description":"Injection, metronidazole, 10 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78584","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1349","name":"No pam inc 3 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 3 points within a 4 to 12 month period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1003T","name":"Arthrp 1st crp/mtcrpl prostc","description":"Arthroplasty, first carpometacarpal joint, with distal trapezial and proximal first metacarpal prosthetic replacement (eg, first carpometacarpal total joint)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1254","name":"Pts deceased prior hu surv","description":"Patients who were deceased when the hu survey reached them","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1200","name":"Ace-i/arb rx","description":"Ace inhibitor (ace-i) or arb therapy prescribed during the measurement period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1223","name":"Glaucoma plan of care doc","description":"Glaucoma plan of care documented","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99205","name":"Office o/p new hi 60 min","description":"Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":274.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":184.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":73.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0502","name":"Other oral pathology procedu","description":"Other oral pathology procedures by report","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72147","name":"Mri chest spine w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; with contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":805.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68360","name":"Revise eyelid lining","description":"Conjunctival flap; bridge or partial (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":390.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6611","name":"Grad com wrap w strap ak cus","description":"Gradient compression wrap with adjustable straps, above knee, each, custom","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5947","name":"Mand implt sup fix","description":"Mand implt sup fix","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83529","name":"Asay of interleukin-6 (il-6)","description":"Interleukin-6 (il-6)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9286","name":"Inj glofitamab gxbm, 2.5 mg","description":"Injection, glofitamab-gxbm, 2.5 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0913T","name":"Prq tcat ther rx ntrac balo1","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting), including mechanical dilation by nondrug-delivery balloon angioplasty, endoluminal imaging using intravascular ultrasound (ivus) or optical coherence tomography (oct) when per","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32852","name":"Lung transplant with bypass","description":"Lung transplant, single; with cardiopulmonary bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3670.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27435","name":"Incision of knee joint","description":"Capsulotomy, posterior capsular release, knee","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44384","name":"Small bowel endoscopy","description":"Ileoscopy, through stoma; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1023T","name":"Prq tis dsplmt intrathoracic","description":"Percutaneous tissue displacement, any method, including imaging guidance; intrathoracic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1370","name":"Inj, esomeprazole sod, 1 mg","description":"Injection, esomeprazole sodium, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4405","name":"Xwrap fenestra plus sq cm","description":"Xwrap fenestra plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85025","name":"Complete cbc w/auto diff wbc","description":"Blood count; complete (cbc), automated (hgb, hct, rbc, wbc and platelet count) and automated differential wbc count","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26496","name":"Revise thumb tendon","description":"Opponensplasty; other methods","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1117.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3373","name":"Inj, vancomycin hcl, 10 mg","description":"Injection, vancomycin hydrochloride, 10 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33269","name":"Excl laa thrscp any method","description":"Exclusion of left atrial appendage, thoracoscopic, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63655","name":"Implant neuroelectrodes","description":"Laminectomy for implantation of neurostimulator electrodes, plate/paddle, epidural","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6212","name":"Bridge noble metal cast","description":"Pontic-cast noble metal","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6602","name":"G com bandge hgh dn foamroll","description":"Gradient compression bandaging supply, high density foam roll for bandage, per linear yard, any width, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99347","name":"Home/res vst est sf mdm 20","description":"Home or residence visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 20 minutes must be met or exceede","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":51.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4002","name":"Ep cardio ss","description":"Electrophysiology cardiac specialist mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1007T","name":"Eeg impl s-sclp eeg w/o vid","description":"Electroencephalogram from implanted sub-scalp continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9341","name":"Inj thiotepa (tepylute) 1 mg","description":"Injection, thiotepa (tepylute), 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0766T","name":"Tc mag stimj pn 1st nerve","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; first nerve","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7471","name":"Rem exostosis any site","description":"Removal of lateral exostosis (maxilla or mandible)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90474","name":"Immune admin oral/nasal addl","description":"Immunization administration by intranasal or oral route; each additional vaccine (single or combination vaccine/toxoid) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1290","name":"Pt not eli d/t act dig htn","description":"Patient not eligible due to active diagnosis of hypertension","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9154","name":"Artificial saliva, 1 ml","description":"Artificial saliva, 1 ml","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71100","name":"X-ray exam ribs uni 2 views","description":"Radiologic examination, ribs, unilateral; 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37260","name":"Revsc evasc ivt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15350","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":377.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"X-ray exam chest 2 views","description":"Radiologic examination, chest; 2 views","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1596","name":"Inj, glycopyrrolate, 0.1 mg","description":"Injection, glycopyrrolate, 0.1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1292","name":"Pt 66+ frail inpt adv ill","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and an advanced illness diagnosis during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2643","name":"Dental onlay porcelin 3 surf","description":"Onlay - porcelain/ceramic - three surfaces","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53445","name":"Insert uro/ves nck sphincter","description":"Insertion of inflatable urethral/bladder neck sphincter, including placement of pump, reservoir, and cuff","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":971.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4006","name":"Gastroenterology ss","description":"Gastro-enterology mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82234","name":"Beta-amyloid 1-42 (abeta 42)","description":"Beta-amyloid; 1-42 (abeta 42)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1448","name":"Pt dx pd bef end meas pd","description":"Patients with an active diagnosis of personality disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35602","name":"Bpg crtd-clat crtd","description":"Bypass graft, with other than vein; carotid-contralateral carotid","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61510","name":"Crnec treph exc brn tum sttl","description":"Craniectomy, trephination, bone flap craniotomy; for excision of brain tumor, supratentorial, except meningioma","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2421.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0349","name":"Inj, rezafungin, 1 mg","description":"Injection, rezafungin, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4272","name":"Esano a, per sq cm","description":"Esano a, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21810","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":577.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49617","name":"Rpr aa hrn rcr > 10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, reducible","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4417","name":"Alexiguard dl-t per sq cm","description":"Alexiguard dl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0834T","name":"Dgtz gls mcrscp cytp oth xtn","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7356","name":"Inj foscarb/foslevodopa 5 mg","description":"Injection, foscarbidopa 0.25 mg/foslevodopa 5 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27441","name":"Revision of knee joint","description":"Arthroplasty, knee, tibial plateau; with debridement and partial synovectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":880.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6609","name":"G compression bandaging","description":"Gradient compression bandaging supply, not otherwise specified","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0626U","name":"Neurol pd dna alys >20000","description":"Neurol pd dna alys >20000","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80434","name":"Insulin tolerance panel","description":"Insulin tolerance panel; for acth insufficiency this panel must include the following: cortisol (82533 x 5) glucose (82947 x 5)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1422","name":"Gastroenterology care mvp","description":"Gastroenterology care mips value pathway","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0570U","name":"Neurol tbi alys gfap&uch-l1","description":"Neurol tbi alys gfap&uch-l1","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37260","name":"Revsc evasc ivt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45387","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80182","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0414U","name":"Onc lng aug alg aly whl sld8","description":"Onc lng aug alg aly whl sld8","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1225","name":"Iop dec>=20% from base","description":"Intraocular pressure (iop) reduced by a value of greater than or equal to 20% from the pre-intervention level","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0502","name":"Other oral pathology procedu","description":"Other oral pathology procedures by report","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49565","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":816.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0411","name":"Hba1c in office testing","description":"Hba1c in office testing","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92930","name":"Prq tcat plmt ntrac st 2+les","description":"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 2 or more distinct coronary lesions with 2 or more coronary stents deployed in 2 or more coronary segments, or a bifurcation lesion requiring ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0755T","name":"Dgtz gls mcrscp sld level vi","description":"Digitization of glass microscope slides for level vi, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4403","name":"Xwrap dual plus per sq cm","description":"Xwrap dual plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25118","name":"Excise wrist tendon sheath","description":"Synovectomy, extensor tendon sheath, wrist, single compartment;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50130","name":"Pyelotomy w/removal calculus","description":"Pyelotomy; with removal of calculus (pyelolithotomy, pelviolithotomy, including coagulum pyelolithotomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1119.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4148","name":"Enteral feed elastomer daily","description":"Enteral feeding supply kit; elastomeric control fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87182","name":"Sc std carbapenemase nzm det","description":"Susceptibility studies, antimicrobial agent; carbapenemase enzyme detection (eg, klebsiella pneumoniae carbapenemase [kpc], new delhi metallo-beta-lactamase [ndm], verona integron-encoded metallo-beta-lactamase [vim]), multiplex immunoassay, qualitative, per isolate","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7771","name":"Alveolus clsd reduc stblz te","description":"Alveolus closed reduction stabilization of teeth","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64628","name":"Trml dstrj ios bvn 1st 2 l/s","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; first 2 vertebral bodies, lumbar or sacral","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4342","name":"Theramend, per sq cm","description":"Theramend, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0374","name":"Tomo periapical image","description":"Tomo periapical image","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86317","name":"Immunoassay infectious agent","description":"Immunoassay for infectious agent antibody, quantitative, not otherwise specified","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49594","name":"Rpr aa hrn 1st 3-10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, incarcerated or strangulated","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4384","name":"Axolotl dual ult per sq cm","description":"Axolotl dualgraft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27278","name":"Arthrd si jt plmt iartic dev","description":"Arthrodesis, sacroiliac joint, percutaneous or minimally invasive, with image guidance, includes obtaining bone graft when performed, unilateral; placement of intra-articular device(s), without cortical piercing","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2642","name":"Dental onlay porcelin 2 surf","description":"Onlay - porcelain/ceramic - two surfaces","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0003A","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0665","name":"Team remote e/m est pt 10 mn","description":"Team remote e/m est. pt 10mins","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3387","name":"Inj elivaldogene autotemecel","description":"Injection, elivaldogene autotemcel, per treatment","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0559","name":"Unrelat prac follow up visit","description":"Post-operative follow-up visit complexity inherent to evaluation and management services addressing surgical procedure(s), provided by a physician or qualified health care professional who is not the practitioner who performed the procedure (or in the same group practice) and is of the same or of a ","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0332U","name":"Onc pan tum gen prflg 8 dna","description":"Onc pan tum gen prflg 8 dna","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52320","name":"Cystoscopy and treatment","description":"Cystourethroscopy (including ureteral catheterization); with removal of ureteral calculus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":289.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4326","name":"Woundplus, per sq cm","description":"Woundplus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0517U","name":"Ther rx mntr 80+ psyactiv rx","description":"Ther rx mntr 80+ psyactiv rx","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1326","name":"Inj, zolbetuximab-clzb, 2 mg","description":"Injection, zolbetuximab-clzb, 2 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1395","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0541","name":"No pt prsnt train initial 30","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4015","name":"Neurology ss","description":"Neurology mips specialty set","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50972","name":"Ureter endoscopy & catheter","description":"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without dilation of ureter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":428.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0525","name":"Est pt-cg dyad dem mod cmplx","description":"Management of established patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0717T","name":"Adrc ther prtl rc tear","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; adipose tissue harvesting, isolation and preparation of harvested cells, including incubation with cell dissociation enzymes, filtration, washing, and concentration of adrcs","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76987","name":"Dx intraop epicar car us chd","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; including placement and manipulation of transducer, image acquisition, interpretation and report","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4368","name":"Amchothick per sq cm","description":"Amchothick, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0441U","name":"Nfct ds bct fngl/viral semiq","description":"Nfct ds bct fngl/viral semiq","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4354","name":"Palingen dl-palingen dl-x","description":"Palingen dual-layer membrane and dual-layer palingen x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82725","name":"Assay of blood fatty acids","description":"Fatty acids, nonesterified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0525","name":"Inj cefotetan disodium 10 mg","description":"Injection, cefotetan disodium, 10 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1410","name":"No gmln brca1/brca2 couns","description":"Patients who did not have germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35606","name":"Bpg carotid-subclavian","description":"Bypass graft, with other than vein; carotid-subclavian","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1360.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6599","name":"G comp bandage short stretch","description":"Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33287","name":"Rmv&rplcmt phrnc nrv stim pg","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0890T","name":"Arhfcmrigtbs 1st tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including target assessment, initial motor threshold determination, neuronavigation, delivery and management, initial treatment day","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83655","name":"Assay of lead","description":"Lead","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51580","name":"Remove bladder/revise tract","description":"Cystectomy, complete, with ureterosigmoidostomy or ureterocutaneous transplantations;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1995.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1186","name":"Pt w/ rx for hspc/plltv care","description":"Patients who have an order for or are receiving hospice or palliative care","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4431","name":"Pma skin substitute, nos","description":"Pma skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1326","name":"Pts dx hypotony","description":"Patients with a diagnosis of hypotony","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6612","name":"Onlay cst base mtl 2 surface","description":"Onlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9997","name":"Ustekinumab-ttwe iv inj 1 mg","description":"Injection, ustekinumab-ttwe (pyzchiva), intravenous, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0770T","name":"Vr technology assist therapy","description":"Virtual reality technology to assist therapy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1186","name":"Pt w/ rx for hspc/plltv care","description":"Patients who have an order for or are receiving hospice or palliative care","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66605","name":"Removal of iris","description":"Iridectomy, with corneoscleral or corneal section; with cyclectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1045.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0616","name":"Inj metoprolol tartrate 1 mg","description":"Injection, metoprolol tartrate, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24361","name":"Reconstruct elbow joint","description":"Arthroplasty, elbow; with distal humeral prosthetic replacement","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1218.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4008","name":"Geriatrics ss","description":"Geriatrics mips specialty set","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5612","name":"Rep resin part dent base max","description":"Rep resin part dent base max","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69730","name":"Rplc oi implt sk tc esp>=100","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0372","name":"Tomo comp series images","description":"Tomo comp series images","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1370","name":"Rehab support msk care mvp","description":"Rehabilitative support for musculoskeletal care mips value pathway","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0703","name":"2d oral/facial photo image","description":"2d oral/facial photo image","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0492U","name":"Onc sol tum ctc slctn pd-l1","description":"Onc sol tum ctc slctn pd-l1","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83615","name":"Lactate (ld) (ldh) enzyme","description":"Lactate dehydrogenase (ld), (ldh);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9948","name":"Adjust sleep apnea appliance","description":"Adjust sleep apnea appliance","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2012","name":"Suprathel, per sq cm","description":"Suprathel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1247","name":"Pt resp true best int","description":"Patient responded completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62331","name":"Dcmprn prq rmv lig flv addl","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; additional interspace(s), lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3110","name":"Teriparatide injection","description":"Injection, teriparatide, 10 mcg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0267U","name":"Rare do id opt gen mapg&seq","description":"Rare constitutional and other heritable disorders, identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping and whole-genome sequencing","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0962T","name":"Asstv alg alys acous&ecg rec","description":"Assistive algorithmic analysis of acoustic and electrocardiogram recording for detection of cardiac dysfunction (eg, reduced ejection fraction, cardiac murmurs, atrial fibrillation), with review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1356","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2041","name":"Coord special care encounter","description":"Coordinated specialty care, team-based, for first episode psychosis, per encounter","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86366","name":"Muscle-specific kinase antb","description":"Muscle-specific kinase (musk) antibody","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9997","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0705T","name":"Rem tx amblyopia tech sprt","description":"Remote treatment of amblyopia using an eye tracking device; surveillance center technical support including data transmission with analysis, with a minimum of 18 training hours, each 30 days","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1316","name":"Tobacco non-user","description":"Current tobacco non-user","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0808T","name":"Pulm tiss vntj alys w/ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with computed tomography (ct) images taken for the purpose of pulmonary tissue ventilation analysis, including data preparation and transmission, quantificati","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69420","name":"Incision of eardrum","description":"Myringotomy including aspiration and/or eustachian tube inflation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9949","name":"Repair sleep apnea appliance","description":"Repair sleep apnea appliance","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27691","name":"Revise lower leg tendon","description":"Transfer or transplant of single tendon (with muscle redirection or rerouting); deep (eg, anterior tibial or posterior tibial through interosseous space, flexor digitorum longus, flexor hallucis longus, or peroneal tendon to midfoot or hindfoot)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":882.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0956T","name":"Prt crn ch cr&tun elt s-sclp","description":"Partial craniectomy, channel creation, and tunneling of electrode for sub-scalp implantation of an electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0431","name":"Diag tst detect mucos abnorm","description":"Adjunctive pre-diagnostic test that aids in detection of mucosal abnormalities including premalignant and malignant lesions not to include cytology or biopsy","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9224","name":"Gen anes adv air-15 min","description":"Gen anes adv air-15 min","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1363","name":"Pts no f/u 120 dys","description":"Patients who did not have a follow-up assessment within 120 days of the index assessment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1320","name":"Amitriptyline injection","description":"Injection, amitriptyline hcl, up to 20 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64629","name":"Trml dstrj ios bvn ea addl","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; each additional vertebral body, lumbar or sacral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33645","name":"Revision of heart veins","description":"Direct or patch closure, sinus venosus, with or without anomalous pulmonary venous drainage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1805.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43497","name":"Transorl lwr esophgl myotomy","description":"Lower esophageal myotomy, transoral (ie, peroral endoscopic myotomy [poem])","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5141","name":"Inj adalimumab-aaty, 1 mg","description":"Injection, adalimumab-aaty, biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87523","name":"Hepatitis d quantification","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis d (delta), quantification, including reverse transcription, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"Breathing capacity test","description":"Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement(s), with or without maximal voluntary ventilation","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76942","name":"Echo guide for biopsy","description":"Ultrasonic guidance for needle placement (eg, biopsy, aspiration, injection, localization device), imaging supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28280","name":"Fusion of toes","description":"Syndactylization, toes (eg, webbing or kelikian type procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0728T","name":"Dx alys vstblr implt uni 1st","description":"Diagnostic analysis of vestibular implant, unilateral; with initial programming","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0894T","name":"Cannulation liver allograft","description":"Cannulation of the liver allograft in preparation for connection to the normothermic perfusion device and decannulation of the liver allograft following normothermic perfusion","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5878","name":"Dup of complt dent-mandib","description":"Dup of complt dent-mandib","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37286","name":"Revsc evasc tpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0530","name":"Adult daycare center, 8 hr u","description":"Adult day center, 8-hour unit, for use in cmmi model","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4002","name":"Ep cardio ss","description":"Electrophysiology cardiac specialist mips specialty set","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0989T","name":"Revj/rmvl ins ptn subq&subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5827","name":"Endo knee shin single axis","description":"Endoskeletal knee-shin system, single axis, electromechanical swing and stance phase control, with or without shock absorption and stance extension damping","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","name":"Gait mod systm rhym auditory","description":"Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0872T","name":"Rplcmt ndwllg bldr&prtl cath","description":"Replacement of indwelling bladder and peritoneal catheters, including tunneling of catheter(s) and connection with previously implanted peritoneal ascites pump, including imaging and programming, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0410U","name":"Onc pncrtc dna whl gn seq 5-","description":"Onc pncrtc dna whl gn seq 5-","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98003","name":"Synch audio-video new hi 60","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high medical decision making. when using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0521","name":"New pt-cg dyad dem hig cmplx","description":"Management of new patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1813","name":"Lyumjev for insulin pump use","description":"Insulin (lyumjev) for administration through dme (i.e., insulin pump) per 50 units","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0744T","name":"Insj bioprostc vlv fem vn","description":"Insertion of bioprosthetic valve, open, femoral vein, including duplex ultrasound imaging guidance, when performed, including autogenous or nonautogenous patch graft (eg, polyester, eptfe, bovine pericardium), when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20910","name":"Remove cartilage for graft","description":"Cartilage graft; costochondral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50360","name":"Rnl altrnsplj w/o rcp nfrct","description":"Renal allotransplantation, implantation of graft; without recipient nephrectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2262.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2025","name":"Miro3d per cubic cm","description":"Miro3d, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0545","name":"Inherent visit to inpt","description":"Visit complexity inherent to hospital inpatient or observation care associated with a confirmed or suspected infectious disease by an infectious diseases specialist, including disease transmission risk assessment and mitigation, public health investigation, analysis, and testing, and complex antimic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9246","name":"Mod sedation noniv-15 min","description":"Mod sedation noniv-15 min","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76818","name":"Fetal biophys profile w/nst","description":"Fetal biophysical profile; with non-stress testing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1345","name":"Pt bsln pam, 2nd scr 4-12 mo","description":"Patients who had a baseline pam score and a second score within 4 to 12 month of baseline pam score","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0803","name":"3d facial scan direct","description":"3d facial scan direct","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36160","name":"Establish access to aorta","description":"Introduction of needle or intracatheter, aortic, translumbar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0587U","name":"Ther rx mntr 60-150rx&metabl","description":"Ther rx mntr 60-150rx&metabl","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9074","name":"Inj, cyclophosphamd, sandoz","description":"Injection, cyclophosphamide (sandoz), 5 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1188","name":"Pt w/ ckd stg 5","description":"Patients with a diagnosis of chronic kidney disease (ckd) stage 5","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89049","name":"Chct for mal hyperthermia","description":"Caffeine halothane contracture test (chct) for malignant hyperthermia susceptibility, including interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11306","name":"Shave skin lesion 0.6-1.0 cm","description":"Shaving of epidermal or dermal lesion, single lesion, scalp, neck, hands, feet, genitalia; lesion diameter 0.6 to 1.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76019","name":"Mr safety implt pos&/immoblj","description":"Mr safety implant positioning and/or immobilization under supervision of physician or other qualified health care professional, including application of physical protections to secure implanted medical device from mr-induced translational or vibrational forces, magnetically induced functional change","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1233","name":"Pt no hcv aby or result","description":"Patient does not receive hcv antibody test or patient does receive hcv antibody test but results not documented, reason not given","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1018T","name":"Elec alys npgs esoph sbsq w/","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4391","name":"Amnioplast double per sq cm","description":"Amnioplast double, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84238","name":"Assay nonendocrine receptor","description":"Receptor assay; non-endocrine (specify receptor)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1181","name":"Gr 2 or> dia or gr2 or> col","description":"Grade 2 or above diarrhea and/or grade 2 or above colitis","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0349U","name":"Rx metab/pcx dna 27gen rx ia","description":"Rx metab/pcx dna 27gen rx ia","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0707","name":"Intraoral periap radio image","description":"Intraoral periap radio image","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98001","name":"Synch audio-video new low 30","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0578U","name":"Onc cutan mln rna qpcr 10gen","description":"Onc cutan mln rna qpcr 10gen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0475U","name":"Hered prst8 ca gsap 23 genes","description":"Hered prst8 ca gsap 23 genes","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1484","name":"No rpt hcv rna perf med rsn","description":"Patients who did not have a repeat hcv rna labs performed for medical reasons documented by clinician (e.g., patient with limited life expectancy, delay in treatment of hcv related to treatment of hiv, hbv, hepatocellular carcinoma, decompensated cirrhosis)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36405","name":"Vnpnxr<3yrs phy/qhp scalp vn","description":"Venipuncture, younger than age 3 years, necessitating the skill of a physician or other qualified health care professional, not to be used for routine venipuncture; scalp vein","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":13.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57452","name":"Exam of cervix w/scope","description":"Colposcopy of the cervix including upper/adjacent vagina;","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":78.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24351","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":588.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1932","name":"Inj, lanreotide, (cipla) 1mg","description":"Injection, lanreotide, (cipla), 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1455","name":"Rep/rev cied","description":"Replaced or revised cied","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0814T","name":"Prq njx biod osteo matrl fem","description":"Percutaneous injection of calcium-based biodegradable osteoconductive material, proximal femur, including imaging guidance, unilateral","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0348U","name":"Rx metab/pcx dna 25 gen alys","description":"Rx metab/pcx dna 25 gen alys","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91304","name":"Sarscov2 vac 5mcg/0.5ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, 5 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0663","name":"Team remote e/m new pt 45 mn","description":"Team remote e/m new pt 45mins","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21700","name":"Revision of neck muscle","description":"Division of scalenus anticus; without resection of cervical rib","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4560","name":"Nmes disposable","description":"Neuromuscular electrical stimulator (nmes), disposable, replacement only","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0521U","name":"Rf iga&igm ccp antb sr-a ia","description":"Rf iga&igm ccp antb sr-a ia","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9988","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0330","name":"Succinycholine chloride inj","description":"Injection, succinylcholine chloride, up to 20 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4288","name":"Replacement breastpump valve","description":"Valve for breast pump, replacement","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3263","name":"Inj, toripalimab-tpzi, 1 mg","description":"Injection, toripalimab-tpzi, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9948","name":"Adjust sleep apnea appliance","description":"Adjust sleep apnea appliance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92550","name":"Tympanometry & reflex thresh","description":"Tympanometry and reflex threshold measurements","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1180","name":"Pt imm ckpt inhib therapy","description":"Patients on immune checkpoint inhibitor therapy","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0873T","name":"Revj subq prtl asct pmp sys","description":"Revision of a subcutaneously implanted peritoneal ascites pump system, any component (ascites pump, associated peritoneal catheter, associated bladder catheter), including imaging and programming, when performed","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9341","name":"Inj thiotepa (tepylute) 1 mg","description":"Injection, thiotepa (tepylute), 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5156","name":"Inj, tocilizumab-anoh, 1 mg","description":"Injection, tocilizumab-anoh (avtozma), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0534U","name":"Onc prst8 mirna snp 32 vrnt","description":"Onc prst8 mirna snp 32 vrnt","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0597U","name":"Onc breast rna xprsn 329gens","description":"Onc breast rna xprsn 329gens","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1326","name":"Inj, zolbetuximab-clzb, 2 mg","description":"Injection, zolbetuximab-clzb, 2 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2003","name":"Inj, lidocaine hcl, 1 mg","description":"Injection, lidocaine hydrochloride, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D8671","name":"Periodic orth treat w surg","description":"Periodic orth treat w surg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0527U","name":"Hsv 1&2 vzv amp prb tq pthgn","description":"Hsv 1&2 vzv amp prb tq pthgn","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92628","name":"Eval hearing aid cand 1st 30","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2253","name":"Inj midazolam (seizalam)","description":"Injection, midazolam (seizalam), 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49595","name":"Rpr aa hrn 1st > 10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, reducible","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2327","name":"Inj risankizumab-rzaa 1 mg","description":"Injection, risankizumab-rzaa, intravenous, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15782","name":"Dermabrasion other than face","description":"Dermabrasion; regional, other than face","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":510.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0462","name":"Atropine sulf, nte, 0.01 mg","description":"Injection, atropine sulfate, not therapeutically equivalent to j0461, 0.01 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0546U","name":"Ldns lrp4 antb imflr livecll","description":"Ldns lrp4 antb imflr livecll","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0603","name":"Sevelamer hydrochloride 20mg","description":"Sevelamer hydrochloride (renagel or therapeutically equivalent), oral, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0513U","name":"Onc prst8 alg alys msi&hrd","description":"Onc prst8 alg alys msi&hrd","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59852","name":"Induced abortion 1+njx hyst","description":"Induced abortion, by 1 or more intra-amniotic injections (amniocentesis-injections), including hospital admission and visits, delivery of fetus and secundines; with hysterotomy (failed intra-amniotic injection)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":693.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":653.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99235","name":"Hosp ip/obs same date mod 70","description":"Hospital inpatient or observation care, for the evaluation and management of a patient including admission and discharge on the same date, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encount","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5657","name":"Add low ext man aut vol any","description":"Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55712","name":"Bx prst8 tprnl mri-us 1st","description":"Biopsy, prostate, transperineal, mri-ultrasound-fusion guided, targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3424","name":"Inj hydroxocobalamin iv 25mg","description":"Injection, hydroxocobalamin, intravenous, 25 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0236","name":"Intrav inf, mon anti, sec do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4373","name":"Membrane wrp lt per sq cm","description":"Membrane wrap lite, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J1850","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0514U","name":"Gi ibd ia quan deter adl lvl","description":"Gi ibd ia quan deter adl lvl","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58262","name":"Vag hyst including t/o","description":"Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s), and/or ovary(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1066.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7473","name":"Remove torus mandibularis","description":"Removal of torus mandibularis","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85027","name":"Complete cbc automated","description":"Blood count; complete (cbc), automated (hgb, hct, rbc, wbc and platelet count)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6251","name":"Bridge resin base metal","description":"Pontic-resin with predominantly base metal","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0814T","name":"Prq njx biod osteo matrl fem","description":"Percutaneous injection of calcium-based biodegradable osteoconductive material, proximal femur, including imaging guidance, unilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1342","name":"Pts died perf per","description":"Patients who died during the performance period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1552","name":"Inj, alyglo, 500 mg","description":"Injection, immune globulin (alyglo), 500 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60661","name":"Abltj 1/+thyr ndul addl prq","description":"Ablation of 1 or more thyroid nodule(s), additional lobe, percutaneous, including imaging guidance, radiofrequency (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5943","name":"Proth mandib implt sup remv","description":"Proth mandib implt sup remv","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24220","name":"Injection px for elbow arthg","description":"Injection procedure for elbow arthrography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32557","name":"Insert cath pleura w/ image","description":"Pleural drainage, percutaneous, with insertion of indwelling catheter; with imaging guidance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1391.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4404","name":"Xwrap hydro plus per sq cm","description":"Xwrap hydro plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76975","name":"Gi endoscopic ultrasound","description":"Gastrointestinal endoscopic ultrasound, supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9245","name":"Admin mod sedation-enteral","description":"Admin mod sedation-enteral","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2039","name":"Innovamatrix fd, per sq cm","description":"Innovamatrix fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":442.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0839T","name":"Dgtz gls mcrscp cslt mat prp","description":"Digitization of glass microscope slides for consultation and report on referred material requiring preparation of slides (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19103","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66683","name":"Implantation iris prosthesis","description":"Implantation of iris prosthesis, including suture fixation and repair or removal of iris, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91319","name":"Sarscv2 vac 10mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 10 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1359","name":"Indx suicd idea, no 0 scr","description":"Index assessment during the denominator period when the suicidal ideation and/or behavior symptoms or increased suicide risk by clinician determination occurs and a non-zero c-ssrs score is obtained","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2997","name":"Alteplase recombinant","description":"Injection, alteplase recombinant, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27140","name":"Transplant femur ridge","description":"Osteotomy and transfer of greater trochanter of femur (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1081.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37264","name":"Revsc evasc fpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1448","name":"Injection, trilaciclib, 1mg","description":"Injection, trilaciclib, 1mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0371","name":"Sialoendoscopy capt & interp","description":"Sialoendoscopy capt & interp","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22534","name":"Arthrd lat xtrcvtry tq ea ad","description":"Arthrodesis, lateral extracavitary technique, including minimal discectomy to prepare interspace (other than for decompression); thoracic or lumbar, each additional vertebral segment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":465.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0686T","name":"Histotripsy mal hepatcel tis","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant hepatocellular tissue, including image guidance","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37275","name":"Rvsc evsc fpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9616","name":"Gallium gozellix 1 millicuri","description":"Gallium ga-68 gozetotide (gozellix), diagnostic, 1 millicurie","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0963T","name":"Anosc sbmcsl njx bulking agt","description":"Anoscopy with directed submucosal injection of bulking agent into anal canal","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2799","name":"Inj, uzedy, 1 mg","description":"Injection, risperidone (uzedy), 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0507U","name":"Onc ovr dna whole gen w/5hmc","description":"Onc ovr dna whole gen w/5hmc","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP02","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49596","name":"Rpr aa hrn 1st > 10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0521","name":"New pt-cg dyad dem hig cmplx","description":"Management of new patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58558","name":"Hysteroscopy biopsy","description":"Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without d & c","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1207.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":195.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49616","name":"Rpr aa hrn rcr 3-10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, incarcerated or strangulated","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1282","name":"Pt scrn tbco id as non user","description":"Patient screened for tobacco use and identified as a tobacco non-user","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4379","name":"Amniodefend ft per sq cm","description":"Amniodefend ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98012","name":"Synch audio-only est sf 10","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2028","name":"Micromatrix flex per mg","description":"Micromatrix flex, per mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1410","name":"No gmln brca1/brca2 couns","description":"Patients who did not have germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94618","name":"Pulmonary stress testing","description":"Pulmonary stress testing (eg, 6-minute walk test), including measurement of heart rate, oximetry, and oxygen titration, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82415","name":"Assay of chloramphenicol","description":"Chloramphenicol","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55869","name":"Lap srg prst8ct bi pl lmphad","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7521","name":"Tacrolim granules oral susp","description":"Tacrolimus, granules, oral suspension, 0.1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1299","name":"Flu immunize order/admin","description":"Influenza immunization administered or previously received","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0725T","name":"Vestibular dev impltj uni","description":"Vestibular device implantation, unilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1749","name":"Inj, iloprost, 0.1 mcg","description":"Injection, iloprost, 0.1 mcg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61323","name":"Crnec/crnot dcmprv w/lobec","description":"Craniectomy or craniotomy, decompressive, with or without duraplasty, for treatment of intracranial hypertension, without evacuation of associated intraparenchymal hematoma; with lobectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2543.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9225","name":"Gen anes adv air-sub 15 min","description":"Gen anes adv air-sub 15 min","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58340","name":"Catheter for hysterography","description":"Catheterization and introduction of saline or contrast material for saline infusion sonohysterography (sis) or hysterosalpingography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4279","name":"Vendaje ac, per sq cm","description":"Vendaje ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8694","name":"Aoi transducer/actuator repl","description":"Auditory osseointegrated device, transducer/actuator, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1134.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0764T","name":"Asstv alg ecg rsk asmt cncrt","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to concurrently performed electrocardiogram (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0705","name":"Extra oral post radio image","description":"Extra oral post radio image","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85018","name":"Hemoglobin","description":"Blood count; hemoglobin (hgb)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2525","name":"Cl, hydrophilic, dual focus","description":"Contact lens, hydrophilic, dual focus, per lens","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0778T","name":"Smmg cncrnt appl imu snr","description":"Surface mechanomyography (smmg) with concurrent application of inertial measurement unit (imu) sensors for measurement of multi-joint range of motion, posture, gait, and muscle function","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2035","name":"Corpl p therac p allac p mg","description":"Corplex p or theracor p or allacor p, per milligram","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0554U","name":"Repr med pga 24chrm te bx qc","description":"Repr med pga 24chrm te bx qc","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0034","name":"Pall serv during meas","description":"Patients receiving palliative care during the measurement period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0359U","name":"Onc prst8 ca alys all psa","description":"Onc prst8 ca alys all psa","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0757T","name":"Dgtz gls mcrscp sl spc grpii","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group ii, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistochemistry (list separately in addition to code for primary","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27330","name":"Biopsy knee joint lining","description":"Arthrotomy, knee; with synovial biopsy only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":473.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1180","name":"Pt imm ckpt inhib therapy","description":"Patients on immune checkpoint inhibitor therapy","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86041","name":"Acetylcholn rcptr bndng antb","description":"Acetylcholine receptor (achr); binding antibody","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0527U","name":"Hsv 1&2 vzv amp prb tq pthgn","description":"Hsv 1&2 vzv amp prb tq pthgn","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1016T","name":"Elec alys npgs esoph intraop","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1476","name":"Pt dx cog imp or ad","description":"Patients with diagnosis of cognitive impairment or alzheimers disease","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2506","name":"Inj pegfilgrast ex bio 0.5mg","description":"Injection, pegfilgrastim, excludes biosimilar, 0.5 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0813T","name":"Egd vol adjmt bariatric balo","description":"Esophagogastroduodenoscopy, flexible, transoral, with volume adjustment of intragastric bariatric balloon","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0963T","name":"Anosc sbmcsl njx bulking agt","description":"Anoscopy with directed submucosal injection of bulking agent into anal canal","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33670","name":"Repair of heart chambers","description":"Repair of complete atrioventricular canal, with or without prosthetic valve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2347.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90635","name":"H5n1 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n1, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1249","name":"Pt resp true imprt to me","description":"Patient responded completely true for the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1486","name":"Pt admitted to snf dur eval","description":"Patients admitted to a skilled nursing facility (snf) during the period of evaluation","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01937","name":"Anes drg/aspir crv/thrc","description":"Anesthesia for percutaneous image-guided injection, drainage or aspiration procedures on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0487U","name":"Onc sol tum cfcdna tgsap 84","description":"Onc sol tum cfcdna tgsap 84","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4398","name":"Summit ac per sq cm","description":"Summit ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0109","name":"Diab manage trn ind/group","description":"Diabetes outpatient self-management training services, group session (2 or more), per 30 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":12.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99418","name":"Prolng ip/obs e/m ea 15 min","description":"Prolonged inpatient or observation evaluation and management service(s) time with or without direct patient contact beyond the required time of the primary service when the primary service level has been selected using total time, each 15 minutes of total time (list separately in addition to the cod","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0481","name":"Electron microscopy diagnost","description":"Electron microscopy - diagnostic","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0530","name":"Adult daycare center, 8 hr u","description":"Adult day center, 8-hour unit, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62330","name":"Dcmprn prq rmv lig flv 1lmbr","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; one interspace, lumbar","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1369","name":"Qualcare mental hlth/sud mvp","description":"Quality care in mental health and substance use disorders mips value pathway","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37256","name":"Revsc evasc ivt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1347","name":"Pt pam incr 3 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 3 points in a 4 to 12 month period (passing)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0593U","name":"Nfct ds gu pthgn dna 46trgt","description":"Nfct ds gu pthgn dna 46trgt","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6600","name":"G com bandge hgh dn foam sht","description":"Gradient compression bandaging supply, high density foam sheet, per 250 square centimeters, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1836","name":"Inj, metronidazole, 10 mg","description":"Injection, metronidazole, 10 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0478U","name":"Onc nsclc dna&rna dpcr 9 gen","description":"Onc nsclc dna&rna dpcr 9 gen","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74742","name":"X-ray fallopian tube","description":"Transcervical catheterization of fallopian tube, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0043","name":"Pt mech pros ht valv","description":"Patients with mechanical prosthetic heart valve","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1324","name":"Pts intravitreal/pci","description":"Patients who had an intravitreal or periocular corticosteroid injection (e.g., triamcinolone, preservative-free triamcinolone, dexamethasone, dexamethasone intravitreal implant, or fluocinolone intravitreal implant)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99480","name":"Sbsq ic inf pbw 2,501-5,000","description":"Subsequent intensive care, per day, for the evaluation and management of the recovering infant (present body weight of 2,501-5,000 grams)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":60.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82233","name":"Beta-amyloid 1-40 (abeta 40)","description":"Beta-amyloid; 1-40 (abeta 40)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87484","name":"Ehrlicha chaffeensis amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); ehrlichia chaffeensis, amplified probe technique","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87637","name":"Sarscov2&inf a&b&rsv amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), influenza virus types a and b, and respiratory syncytial virus, multiplex amplified probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7962","name":"Lingual frenectomy","description":"Lingual frenectomy","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1280","name":"Bilat mast/hx bi /unilat mas","description":"Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9321","name":"Inj epcoritamab-bysp 0.16 mg","description":"Injection, epcoritamab-bysp, 0.16 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49618","name":"Rpr aa hrn rcr > 10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, incarcerated or strangulate","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5145","name":"Inj, abrilada, 1 mg","description":"Injection, adalimumab-afzb (abrilada), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99470","name":"Rpm tx mgmt 1st 10 min","description":"Remote physiologic monitoring treatment management services, clinical staff/physician/other qualified health care professional time in a calendar month requiring 1 real-time interactive communication with the patient/caregiver during the calendar month; first 10 minutes","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1283","name":"Pt scrn tbco and id as user","description":"Patient screened for tobacco use and identified as a tobacco user","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47630","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":643.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98981","name":"Rtm tx mgmt ea addl 20 min","description":"Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least 1 real-time interactive communication with the patient or caregiver during the calendar month; each additional 20 minutes (list separately in","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4343","name":"Dermacyte ac matrx per sq cm","description":"Dermacyte ac matrix amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1073","name":"Testosterone pellet 75 mg","description":"Testosterone pellet, implant, 75 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27485","name":"Surgery to stop leg growth","description":"Arrest, hemiepiphyseal, distal femur or proximal tibia or fibula (eg, genu varus or valgus)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":812.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0465U","name":"Onc urthl carc dna qmsp 2gen","description":"Onc urthl carc dna qmsp 2gen","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37283","name":"Rvsc evsc tpvt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57510","name":"Cauterization of cervix","description":"Cautery of cervix; electro or thermal","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":110.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65436","name":"Curette/treat cornea","description":"Removal of corneal epithelium; with application of chelating agent (eg, edta)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1173","name":"Pt no rec td/tdap 9yrs prior","description":"Patient did not receive at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7252","name":"Part extract for implant","description":"Part extract for implant","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1265","name":"Cms 2728 completed","description":"Cms medical evidence form 2728 for dialysis patients: initial form completed","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0208","name":"Inj, pedmark, 100 mg","description":"Injection, sodium thiosulfate (pedmark), 100 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0405","name":"Ekg interpret & report preve","description":"Electrocardiogram, routine ecg with 12 leads; interpretation and report only, performed as a screening for the initial preventive physical examination","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1347","name":"Pt pam incr 3 pt 4-12 mo","description":"Patients who achieved a net increase in pam score of at least 3 points in a 4 to 12 month period (passing)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95962","name":"Electrode stim brain add-on","description":"Functional cortical and subcortical mapping by stimulation and/or recording of electrodes on brain surface, or of depth electrodes, to provoke seizures or identify vital brain structures; each additional hour of attendance by a physician or other qualified health care professional (list separately i","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":284.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4298","name":"Amniocore pro, per sq cm","description":"Amniocore pro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"13120","name":"Cmplx rpr s/a/l 1.1-2.5 cm","description":"Repair, complex, scalp, arms, and/or legs; 1.1 cm to 2.5 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27680","name":"Release of lower leg tendon","description":"Tenolysis, flexor or extensor tendon, leg and/or ankle; single, each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0425U","name":"Genom rpd seq alys ea cmprtr","description":"Genom rpd seq alys ea cmprtr","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1437","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"14040","name":"Tis trnfr f/c/c/m/n/a/g/h/f","description":"Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; defect 10 sq cm or less","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":705.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67700","name":"Blepharotomy drg absc eyelid","description":"Blepharotomy, drainage of abscess, eyelid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1466","name":"Pt disc/lam proc same day","description":"Patient had a lumbar fusion on the same date as the discectomy/laminectomy procedure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0791T","name":"Motr cog vr gait train ea 15","description":"Motor-cognitive, semi-immersive virtual reality-facilitated gait training, each 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93613","name":"Intracardiac ephys 3d mapg","description":"Intracardiac electrophysiologic 3-dimensional mapping (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1390","name":"Pt no doc exm for rec","description":"Patients who do not have a documented exam performed for recurrence of melanoma or no documentation within the performance period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37294","name":"Rvsc evsc tpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0982T","name":"Rem mntr impl ivc snr set-up","description":"Remote monitoring of implantable inferior vena cava sensor, physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate), initial set-up and patient education on use of equipment","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7473","name":"Remove torus mandibularis","description":"Removal of torus mandibularis","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0001","name":"Advancing cancer care mvp","description":"Advancing cancer care mips value pathways","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1342","name":"Pts died perf per","description":"Patients who died during the performance period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J2513","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99281","name":"Emr dpt vst mayx req phy/qhp","description":"Emergency department visit for the evaluation and management of a patient that may not require the presence of a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99470","name":"Rpm tx mgmt 1st 10 min","description":"Remote physiologic monitoring treatment management services, clinical staff/physician/other qualified health care professional time in a calendar month requiring 1 real-time interactive communication with the patient/caregiver during the calendar month; first 10 minutes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1305","name":"Inj, evinacumab-dgnb, 5mg","description":"Injection, evinacumab-dgnb, 5mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36837","name":"Prq av fstl crt uxtr sep acs","description":"Percutaneous arteriovenous fistula creation, upper extremity, separate access sites of the peripheral artery and peripheral vein, including fistula maturation procedures (eg, transluminal balloon angioplasty, coil embolization) when performed, including all vascular access, imaging guidance and radi","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59618","name":"Attempted vbac delivery","description":"Routine obstetric care including antepartum care, cesarean delivery, and postpartum care, following attempted vaginal delivery after previous cesarean delivery","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2958.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2643","name":"Dental onlay porcelin 3 surf","description":"Onlay - porcelain/ceramic - three surfaces","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0789T","name":"Elec aly cpx iins sp/sac nrv","description":"Electronic analysis with complex programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detect","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64469","name":"Thrc fascial pln blk bi nfs","description":"Thoracic fascial plane block, bilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0732T","name":"Immntx admn electroporatn im","description":"Immunotherapy administration with electroporation, intramuscular","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9076","name":"Inj, cyclophos (baxter) 5mg","description":"Injection, cyclophosphamide (baxter), 5 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85004","name":"Automated diff wbc count","description":"Blood count; automated differential wbc count","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0431","name":"Diag tst detect mucos abnorm","description":"Adjunctive pre-diagnostic test that aids in detection of mucosal abnormalities including premalignant and malignant lesions not to include cytology or biopsy","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5932","name":"Postsurgical obturator","description":"Obturator prosthesis definitive","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2802","name":"Inj, romiplostim 1 microgram","description":"Injection, romiplostim, 1 microgram","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0314U","name":"Onc cutan mlnma mrna 35 gene","description":"Onc cutan mlnma mrna 35 gene","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35207","name":"Rpr bld vsl dir hand finger","description":"Repair blood vessel, direct; hand, finger","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":856.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2030","name":"Miro3d fibers, per mg","description":"Miro3d fibers, per milligram","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4308","name":"Sanopellis, per sq cm","description":"Sanopellis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59610","name":"Vbac delivery","description":"Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care, after previous cesarean delivery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2887.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60281","name":"Remove thyroid duct lesion","description":"Excision of thyroglossal duct cyst or sinus; recurrent","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":671.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62147","name":"Crnop w/autograft>5 cm diam","description":"Cranioplasty with autograft (includes obtaining bone grafts); larger than 5 cm diameter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1601.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90382","name":"Rsv monoc antb seasn .7ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose, 0.7 ml, for intramuscular use","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1180","name":"Pt imm ckpt inhib therapy","description":"Patients on immune checkpoint inhibitor therapy","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1293","name":"Calc bmi abv up param f/u","description":"Bmi is documented above normal parameters and a follow-up plan is documented","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9161","name":"Inj denileuk difti-cxdl 1mcg","description":"Injection, denileukin diftitox-cxdl, 1 mcg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0782T","name":"Brnchsc rf dstrj plm nrv uni","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; unilateral mainstem bronchus","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2031","name":"Mirodry, per sq cm","description":"Mirodry wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44382","name":"Small bowel endoscopy","description":"Ileoscopy, through stoma; with biopsy, single or multiple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87181","name":"Sc std agar dilution per agt","description":"Susceptibility studies, antimicrobial agent; agar dilution method, per agent (eg, antibiotic gradient strip)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0001","name":"Advancing cancer care mvp","description":"Advancing cancer care mips value pathways","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61571","name":"Incise skull for brain wound","description":"Craniectomy or craniotomy; with treatment of penetrating wound of brain","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2239.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0706T","name":"Rem tx amblyopia i&r phy/qhp","description":"Remote treatment of amblyopia using an eye tracking device; interpretation and report by physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0209","name":"Inj, sod thiosulfate (hope)","description":"Injection, sodium thiosulfate (hope), 100 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1282","name":"Pt scrn tbco id as non user","description":"Patient screened for tobacco use and identified as a tobacco non-user","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86015","name":"Actin antibody each","description":"Actin (smooth muscle) antibody (asma), each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0419U","name":"Nrpsyc gen seq vrnt aly 13","description":"Nrpsyc gen seq vrnt aly 13","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86364","name":"Tiss trnsgltmnase ea ig clas","description":"Tissue transglutaminase, each immunoglobulin (ig) class","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88305","name":"Tissue exam by pathologist","description":"Level iv - surgical pathology, gross and microscopic examination abortion - spontaneous/missed artery, biopsy bone marrow, biopsy bone exostosis brain/meninges, other than for tumor resection breast, biopsy, not requiring microscopic evaluation of surgical margins breast, reduction mammoplasty bronc","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9986","name":"Missed appointment","description":"Missed appointment","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1170","name":"Pt w/o flu vax 7/1-6/30","description":"Patient did not receive an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2030","name":"Miro3d fibers, per mg","description":"Miro3d fibers, per milligram","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6519","name":"Grad com garm noc night use","description":"Gradient compression garment, not otherwise specified, for nighttime use, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1211","name":"Gsa level>9.0%","description":"Most recent glycemic status assessment (hba1c or gmi) level > 9.0%","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92628","name":"Eval hearing aid cand 1st 30","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55877","name":"Abltj ire prst8 1+ tum perq","description":"Ablation, irreversible electroporation, prostate, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46917","name":"Laser surgery anal lesions","description":"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; laser surgery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9293","name":"Fertility cycl tracking soft","description":"Fertility cycle (contraception & conception) tracking software application, fda cleared, per month, includes accessories (e.g., thermometer)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1171","name":"Inj, hydromorphone, 0.1 mg","description":"Injection, hydromorphone, 0.1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1306","name":"Pt anphx due to pneum","description":"Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8612","name":"Oral methotrexate (xatmep)","description":"Methotrexate (xatmep), oral, 2.5 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4261","name":"Tag, per square centimeter","description":"Tag, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0851T","name":"Dgtz gls mcrscp mphmtrc 1st","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54400","name":"Insert semi-rigid prosthesis","description":"Insertion of penile prosthesis; non-inflatable (semi-rigid)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":612.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9051","name":"Inj, bortezomib (maia)","description":"Injection, bortezomib (maia), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86364","name":"Tiss trnsgltmnase ea ig clas","description":"Tissue transglutaminase, each immunoglobulin (ig) class","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4401","name":"Absolv3 per sq cm","description":"Absolv3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29131","name":"Appl finger splint dynamic","description":"Application of finger splint; dynamic","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":64.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0377U","name":"Cv ds quan advsrm/plsm lprtn","description":"Cv ds quan advsrm/plsm lprtn","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0739T","name":"Abltj mal prst8 mag fld ndct","description":"Ablation of malignant prostate tissue by magnetic field induction, including all intraprocedural, transperineal needle/catheter placement for nanoparticle installation and intraprocedural temperature monitoring, thermal dosimetry, bladder irrigation, and magnetic field nanoparticle activation","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63053","name":"Lam factc/frmt arthrd lum ea","description":"Laminectomy, facetectomy, or foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s] [eg, spinal or lateral recess stenosis]), during posterior interbody arthrodesis, lumbar; each additional vertebral segment (list separately in addition to code for","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":544.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1185","name":"Imm ckpt inhib not hld no rx","description":"Documentation of immune checkpoint inhibitor therapy not held and/or corticosteroids or immunosuppressants prescribed or administered was not performed, reason not given","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0972T","name":"Asstv alg clsfctn burn hlg","description":"Assistive algorithmic classification of burn healing (ie, healing or nonhealing) by noninvasive multispectral imaging, including system set-up and acquisition, selection, and transmission of images, with automated generation of report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2041","name":"Coord special care encounter","description":"Coordinated specialty care, team-based, for first episode psychosis, per encounter","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1815","name":"Insulin injection","description":"Injection, insulin, per 5 units","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0569","name":"Subs psych care mng, subs mo","description":"Subsequent psychiatric collaborative care management, in a subsequent month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required elements: tracking ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0905T","name":"Ecg alg 12 ld rdcd i&r only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; interpretation and report only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1598","name":"Inj glycopyrrolate fres kabi","description":"Injection, glycopyrrolate (fresenius kabi), not therapeutically equivalent to j1596, 0.1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1161","name":"Pt anphx due to dtp bef 13","description":"Patient had anaphylaxis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1203","name":"Inj, cipaglucosidase, 5 mg","description":"Injection, cipaglucosidase alfa-atga, 5 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33902","name":"Perq p-art revsc 1 abnor uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, unilateral","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64468","name":"Thrc fascial pln blk bi njx","description":"Thoracic fascial plane block, bilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32440","name":"Remove lung pneumonectomy","description":"Removal of lung, pneumonectomy;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1861.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4262","name":"Dual layer impax, per sq cm","description":"Dual layer impax membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30903","name":"Control of nosebleed","description":"Control nasal hemorrhage, anterior, complex (extensive cautery and/or packing) any method","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9993","name":"Pall serv during meas","description":"Patient was provided palliative care services any time during the measurement period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93574","name":"Njx cath slct pulm vn angrph","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary venous angiography of each distinct pulmonary vein during cardiac catheterization (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54600","name":"Reduce testis torsion","description":"Reduction of torsion of testis, surgical, with or without fixation of contralateral testis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":486.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9326","name":"Telisotuzumab vedotin-tllv","description":"Injection, telisotuzumab vedotin-tllv, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6595","name":"G comp bandge liner upr extr","description":"Gradient compression bandaging supply, bandage liner, upper extremity, any size or length, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35474","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":473.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59856","name":"Induced ab 1+vag supp d&c","description":"Induced abortion, by 1 or more vaginal suppositories (eg, prostaglandin) with or without cervical dilation (eg, laminaria), including hospital admission and visits, delivery of fetus and secundines; with dilation and curettage and/or evacuation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":556.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0539","name":"Initial care training 30 m","description":"Caregiver training in behavior management/modification for caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face; initial 30 minutes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0482","name":"Direct immunofluorescence","description":"Direct immunofluorescence","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0654","name":"Inj, liothyronine, 1 mcg","description":"Injection, liothyronine, 1 mcg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0418U","name":"Onc brst aug alg aly whl sl8","description":"Onc brst aug alg aly whl sl8","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93930","name":"Upper extremity study","description":"Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0584U","name":"Neuro csf prion prtn qual","description":"Neuro csf prion prtn qual","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1032","name":"Sv doula brth wrk per 15 min","description":"Services performed by a doula birth worker, per 15 minutes","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0618","name":"Inj, calcium chloride, 2 mg","description":"Injection, calcium chloride, 2 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5138","name":"Inj, wezlana, iv, 1 mg","description":"Injection, ustekinumab-auub (wezlana), biosimilar, intravenous, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57170","name":"Fitting of diaphragm/cap","description":"Diaphragm or cervical cap fitting with instructions","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27840","name":"Treat ankle dislocation","description":"Closed treatment of ankle dislocation; without anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":394.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0384U","name":"Neph ckd rsk hi stg kdn ds","description":"Neph ckd rsk hi stg kdn ds","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98009","name":"Synch audio-only new low 30","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 30 m","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88249","name":"Chromosome analysis 100","description":"Chromosome analysis for breakage syndromes; score 100 cells, clastogen stress (eg, diepoxybutane, mitomycin c, ionizing radiation, uv radiation)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0269U","name":"Hem aut dm cgen trmbctpna 14","description":"Hematology (autosomal dominant congenital thrombocytopenia), genomic sequence analysis of 14 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1252","name":"Pts no cmplt hu survey","description":"Patients who did not complete at least one of the four patient experience hu survey items and return the hu survey within 60 days of the ambulatory palliative care visit","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81462","name":"So gsap cll fr dna/dna&rna","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants and rearrangements","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52648","name":"Laser surgery of prostate","description":"Laser vaporization of prostate, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, internal urethrotomy and transurethral resection of prostate are included if performed)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67312","name":"Revise two eye muscles","description":"Strabismus surgery, recession or resection procedure; 2 horizontal muscles","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":695.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5996","name":"Peri medicament w/seal, mand","description":"Peri medicament w/seal, mand","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0521U","name":"Rf iga&igm ccp antb sr-a ia","description":"Rf iga&igm ccp antb sr-a ia","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27607","name":"Treat lower leg bone lesion","description":"Incision (eg, osteomyelitis or bone abscess), leg or ankle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":703.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0337U","name":"Onc plsm cell do&myeloma id","description":"Onc plsm cell do&myeloma id","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1439","name":"Sig ocu cond imp surg out","description":"Significant ocular conditions that impact the visual outcome of surgery","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95858","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60210","name":"Partial thyroid excision","description":"Partial thyroid lobectomy, unilateral; with or without isthmusectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":789.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7261","name":"Primary closure sinus perf","description":"Primary closure of a sinus perforation","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"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":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1413","name":"Inj delandistrogene mox rokl","description":"Injection, delandistrogene moxeparvovec-rokl, per therapeutic dose","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2690","name":"Procainamide hcl injection","description":"Injection, procainamide hcl, up to 1 gm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1302","name":"Scrn mam perf rslts doc","description":"Screening, diagnostic, film digital or digital breast tomosynthesis (3d) mammography results documented and reviewed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0482U","name":"Ob pe biochem asy sfit1&pigf","description":"Ob pe biochem asy sfit1&pigf","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0892","name":"Argatroban dialysis (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0520","name":"New pt-cg dyad dem mod cmplx","description":"Management of new patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0364U","name":"Onc hl neo gen seq alys alg","description":"Onc hl neo gen seq alys alg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53500","name":"Urethrlys transvag w/ scope","description":"Urethrolysis, transvaginal, secondary, open, including cystourethroscopy (eg, postsurgical obstruction, scarring)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0043","name":"Pt mech pros ht valv","description":"Patients with mechanical prosthetic heart valve","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64628","name":"Trml dstrj ios bvn 1st 2 l/s","description":"Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; first 2 vertebral bodies, lumbar or sacral","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9249","name":"Inj, melphalan (apotex) 1 mg","description":"Injection, melphalan (apotex), 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5124","name":"Inj. byooviz, 0.1 mg","description":"Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0891","name":"Argatroban nonesrd (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2526","name":"Cntct lens blue violet","description":"Contact lens, hydrophilic, with blue-violet filter, per lens","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1821","name":"Ko elas w/ condyle pads otf","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, off the shelf","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4298","name":"Amniocore pro, per sq cm","description":"Amniocore pro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0572U","name":"Onc prst8 httl qfish whl bld","description":"Onc prst8 httl qfish whl bld","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1445","name":"Pp care visit by 12 weeks","description":"Postpartum care visit before or at 12 weeks of giving birth","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0780T","name":"Instlj fecal microbiota ssp","description":"Instillation of fecal microbiota suspension via rectal enema into lower gastrointestinal tract","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1276","name":"Calc bmi out nrm param nof/u","description":"Bmi documented outside normal parameters, no follow-up plan documented, no reason given","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45990","name":"Surg dx exam anorectal","description":"Anorectal exam, surgical, requiring anesthesia (general, spinal, or epidural), diagnostic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0901T","name":"Plmt bone marrow smplg port","description":"Placement of bone marrow sampling port, including imaging guidance when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78608","name":"Brain imaging (pet)","description":"Brain imaging, positron emission tomography (pet); metabolic evaluation","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1453.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6192","name":"Semi precision attachment","description":"Semi precision attachment","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0777T","name":"R-t prs sensing edrl gdn sys","description":"Real-time pressure-sensing epidural guidance system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4211","name":"Gingivectomy/plasty per toot","description":"Gingivectomy or gingivoplasty - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37278","name":"Rvsc evsc fpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4211","name":"Gingivectomy/plasty per toot","description":"Gingivectomy or gingivoplasty - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9129","name":"Photobio therpy-sub 15 mins","description":"Photobio therpy-sub 15 mins","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1437","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23075","name":"Exc shoulder les sc < 3 cm","description":"Excision, tumor, soft tissue of shoulder area, subcutaneous; less than 3 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0136","name":"Adm of pa/n assess 5-15 m","description":"Administration of a standardized, evidence-based assessment of physical activity and nutrition, 5-15 minutes, not more often than every 6 months","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1401","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5938","name":"Resct proth max comp remov","description":"Resct proth max comp remov","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9003","name":"Leupro inj, camcevi etm, 1mg","description":"Leuprolide injectable (camcevi etm), 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0619U","name":"Pulm copd dna alys >18000","description":"Pulm copd dna alys >18000","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0973T","name":"Slctv nzmtc dbrdmt t/a/l 1st","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; first 100 sq cm","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11056","name":"Parng/cutg b9 hyprkr les 2-4","description":"Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); 2 to 4 lesions","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99231","name":"Sbsq hosp ip/obs sf/low 25","description":"Subsequent hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward or low level of medical decision making. when using total time on the date of the encounter for code selec","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61736","name":"Litt icr 1 traj 1 smpl les","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; single trajectory for 1 simple lesion","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99188","name":"App topical fluoride varnish","description":"Application of topical fluoride varnish by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2601","name":"Inj, vasopressin (baxter)","description":"Injection, vasopressin (baxter), 1 unit","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66505","name":"Incision of iris","description":"Iridotomy by stab incision (separate procedure); with transfixion as for iris bombe","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0663","name":"Team remote e/m new pt 45 mn","description":"Team remote e/m new pt 45mins","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1020T","name":"Raman spectroscopy 1+skn les","description":"Raman spectroscopy of 1 or more skin lesions, with probability score for malignant risk derived by algorithmic analysis of data from each lesion","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0527","name":"Mgt est pt dmentia low cmplx","description":"Management of established patient with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0622U","name":"Psyc mdd dna alys >20000","description":"Psyc mdd dna alys >20000","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2011","name":"Supra sdrm, per sq cm","description":"Supra sdrm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0774T","name":"Vr px dissoc svc oth phy ea","description":"Virtual reality (vr) procedural dissociation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports; each additiona","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4435","name":"Renati membrane per sq cm","description":"Renati membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0884T","name":"Esphgsc flx 1st tndsc dilat","description":"Esophagoscopy, flexible, transoral, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for esophageal stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9224","name":"Gen anes adv air-15 min","description":"Gen anes adv air-15 min","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0180","name":"Agalsidase beta injection","description":"Injection, agalsidase beta, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1207","name":"Pt scrn sdoh","description":"Patient is screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49615","name":"Rpr aa hrn rcr 3-10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, reducible","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4304","name":"Grafix plus, per sq cm","description":"Grafix plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92972","name":"Perq trluml coronry lithotrp","description":"Percutaneous transluminal coronary lithotripsy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0516U","name":"Rx metab rxgenomic gnotyp 40","description":"Rx metab rxgenomic gnotyp 40","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1367","name":"Qual care ent disorder mvp","description":"Quality care for the treatment of ear, nose, and throat disorders mips value pathway","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9274","name":"Inj, tebentafusp-tebn, 1 mcg","description":"Injection, tebentafusp-tebn, 1 microgram","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9248","name":"Inj melphalan (hepzato) 1 mg","description":"Injection, melphalan (hepzato), 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1383","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7021","name":"Suppl and access lung expan","description":"Supplies and accessories for lung expansion airway clearance, continuous high frequency oscillation, and nebulization device (e.g., handset, nebulizer kit, biofilter)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]},{"negotiated_type":"negotiated","negotiated_rate":137.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0993T","name":"N-invas assmt car rsk w/ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat with concurrent computed tomography scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional (list s","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4395","name":"Acelagraft per sq cm","description":"Acelagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92553","name":"Audiometry air & bone","description":"Pure tone audiometry (threshold); air and bone","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33722","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1892.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0892T","name":"Arhfcmrigtbs sbsq per tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent motor threshold redetermination with delivery and management, per treatment day","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4353","name":"Xceed tl matrix per sq cm","description":"Xceed tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4341","name":"Simplimax, per sq cm","description":"Simplimax, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90840","name":"Psytx crisis ea addl 30 min","description":"Psychotherapy for crisis; each additional 30 minutes (list separately in addition to code for primary service)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":84.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37294","name":"Rvsc evsc tpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83036","name":"Hemoglobin glycosylated a1c","description":"Hemoglobin; glycosylated (a1c)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35536","name":"Art byp grft splenorenal","description":"Bypass graft, with vein; splenorenal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2193.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4280","name":"Xcell amnio matrix per sq cm","description":"Xcell amnio matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2351","name":"Inj ocrelizumab 1mg hya-ocsq","description":"Injection, ocrelizumab, 1 mg and hyaluronidase-ocsq","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0622U","name":"Psyc mdd dna alys >20000","description":"Psyc mdd dna alys >20000","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0013","name":"Hiv prep counsel, clin staff","description":"Individual counseling for pre-exposure prophylaxis (prep) by clinical staff to prevent human immunodeficiency virus (hiv), includes: hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0608U","name":"Reprdtve med ema rtpcr 10bct","description":"Reprdtve med ema rtpcr 10bct","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20693","name":"Adjmt/revj ext fixj sys anes","description":"Adjustment or revision of external fixation system requiring anesthesia (eg, new pin[s] or wire[s] and/or new ring[s] or bar[s])","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":562.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1428","name":"Bilateral absence of eyes","description":"Patients who have bilateral absence of eyes any time during the patients history through the end of the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4405","name":"Xwrap fenestra plus sq cm","description":"Xwrap fenestra plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0576U","name":"Trnsplj med lar quan ddcfdna","description":"Trnsplj med lar quan ddcfdna","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0705","name":"Extra oral post radio image","description":"Extra oral post radio image","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1574","name":"Inj, ganciclovir (exela)","description":"Injection, ganciclovir sodium (exela), not therapeutically equivalent to j1570, 500 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0258U","name":"Ai psor mrna 50-100 gen alg","description":"Autoimmune (psoriasis), mrna, next-generation sequencing, gene expression profiling of 50-100 genes, skin- surface collection using adhesive patch, algorithm reported as likelihood of response to psoriasis biologics","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15831","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1004.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6518","name":"Grad com wrap w strap arm cu","description":"Gradient compression wrap with adjustable straps, arm, each, custom","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0281","name":"Inj aminocaproic acid 1 gram","description":"Injection, aminocaproic acid, 1 gram","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98976","name":"Rtm dev sply resp sys 16-30d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of respiratory system, 16-30 days in a 30-day period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0980T","name":"Sbmcsl crylys ther tng&tnsl","description":"Submucosal cryolysis therapy; base of tongue and lingual tonsil only","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77413","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30469","name":"Rpr nsl vlv collapse w/rmdlg","description":"Repair of nasal valve collapse with low energy, temperature-controlled (ie, radiofrequency) subcutaneous/submucosal remodeling","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1502","name":"Podiatry mvp","description":"Podiatry mips value pathway","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0674T","name":"Laps insj nw/rpcmt prm isdss","description":"Laparoscopic insertion of new or replacement of permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including an implantable pulse generator and diaphragmatic lead(s)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27613","name":"Biopsy lower leg soft tissue","description":"Biopsy, soft tissue of leg or ankle area; superficial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9294","name":"Biofeed dig cog behav tx fda","description":"Prescription digital cognitive and/or behavioral therapy, biofeedback, fda cleared, per course of treatment","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1394","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0990T","name":"Trncrv inst biod hydrgl mtrl","description":"Transcervical instillation of biodegradable hydrogel materials, intrauterine","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1152","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5933","name":"Refitting of obturator","description":"Obturator prosthesis modification","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37290","name":"Revsc evsc tpvt athrc cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0848T","name":"Dgtz gls mcrscp ish 1st","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61892","name":"Rmv sk-mnt crnl nstm pg/rcvr","description":"Removal of skull-mounted cranial neurostimulator pulse generator or receiver with cranioplasty, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0872T","name":"Rplcmt ndwllg bldr&prtl cath","description":"Replacement of indwelling bladder and peritoneal catheters, including tunneling of catheter(s) and connection with previously implanted peritoneal ascites pump, including imaging and programming, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4032","name":"Rheumatology ss","description":"Rheumatology mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0401U","name":"Crd c hrt ds 9 gen 12 vrnts","description":"Crd c hrt ds 9 gen 12 vrnts","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1010","name":"Inj, methylpred acetate 1 mg","description":"Injection, methylprednisolone acetate, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0701","name":"Inj. cefepime hcl (baxter)","description":"Injection, cefepime hydrochloride (baxter), not therapeutically equivalent to maxipime, 500 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15789","name":"Chemical peel facial dermal","description":"Chemical peel, facial; dermal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54505","name":"Biopsy of testis","description":"Biopsy of testis, incisional (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4356","name":"Abio mem abio hyd per sq cm","description":"Abiomend membrane and abiomend hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0002","name":"Opt care kidney hlth mvp","description":"Optimal care for kidney health mips value pathways","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0823T","name":"Tcat ins 1chmbr ldls pm ra","description":"Transcatheter insertion of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or programming), when","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0776T","name":"Ther indctj ntrabrn hypthrm","description":"Therapeutic induction of intra-brain hypothermia, including placement of a mechanical temperature-controlled cooling device to the neck over carotids and head, including monitoring (eg, vital signs and sport concussion assessment tool 5 [scat5]), 30 minutes of treatment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4457","name":"Enema tube any type repl","description":"Enema tube, with or without adapter, any type, replacement only, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9025","name":"Plasma cryo redu path each","description":"Plasma, cryoprecipitate reduced, pathogen reduced, each unit","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27455","name":"Realignment of knee","description":"Osteotomy, proximal tibia, including fibular excision or osteotomy (includes correction of genu varus [bowleg] or genu valgus [knock-knee]); before epiphyseal closure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1138.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1396","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0446U","name":"Ai ds sle alys 10 cytokine","description":"Ai ds sle alys 10 cytokine","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0608","name":"Lanthanum carbonate pwdr 5mg","description":"Lanthanum carbonate, oral, powder, 5 mg, not therapeutically equivalent to j0607 (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23184","name":"Prtl excision bone prox hum","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), proximal humerus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":930.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90481","name":"Admn sarscov2 vac ea add cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; each additional component administered (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0586U","name":"Onc mrna gen xprsn 216 genes","description":"Onc mrna gen xprsn 216 genes","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0896T","name":"Connj lvr algrft prfu dev ea","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; each additional hour, including physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary bicarbonate, lactate ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49561","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":987.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0761T","name":"Dgtz gls mcrscp sl imm ea 1","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98979","name":"Rtm tx mgmt 1st 10 min","description":"Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least 1 real-time interactive communication with the patient or caregiver during the calendar month; first 10 minutes","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92642","name":"Hearing asstv dev fitg svc","description":"Hearing assistive device, supplemental technology fitting services (eg, personal frequency modulation [fm]/digital modulation [dm] system, remote microphone, alerting devices)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9049","name":"Inj, bortezomib, hospira","description":"Injection, bortezomib (hospira), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36420","name":"Venipuncture cutdown < 1 yr","description":"Venipuncture, cutdown; younger than age 1 year","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5098","name":"Inj ustekinumab-srlf, 1 mg","description":"Injection, ustekinumab-srlf (imuldosa), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0594U","name":"Nfct ds sepsis pncrtc spc","description":"Nfct ds sepsis pncrtc spc","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0735T","name":"Prep tum cav iort prim crnot","description":"Preparation of tumor cavity, with placement of a radiation therapy applicator for intraoperative radiation therapy (iort) concurrent with primary craniotomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27658","name":"Repair of leg tendon each","description":"Repair, flexor tendon, leg; primary, without graft, each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2057","name":"Afamitresgene autoleucel","description":"Afamitresgene autoleucel, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93153","name":"Interrog w/o prgrmg ipnss","description":"Interrogation without programming of implanted phrenic nerve stimulator system","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3389","name":"Topi adm prad zami per treat","description":"Topical administration, prademagene zamikeracel, per treatment","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6605","name":"G com bandage padded foam","description":"Gradient compression bandaging supply, padded foam, per linear yard, any width, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1439","name":"Sig ocu cond imp surg out","description":"Significant ocular conditions that impact the visual outcome of surgery","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55709","name":"Bx prst8 tprnl us guided","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0786T","name":"Insj/rplcmt prq ra sac nstim","description":"Insertion or replacement of percutaneous electrode array, sacral, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90817","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4211","name":"Gingivectomy/plasty per toot","description":"Gingivectomy or gingivoplasty - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5949","name":"Mand implt sup fix part","description":"Mand implt sup fix part","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0466U","name":"Crd cad dna gwas 564856 snp","description":"Crd cad dna gwas 564856 snp","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86052","name":"Aquaporin-4 antb cba each","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; cell-based immunofluorescence assay (cba), each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26615","name":"Treat metacarpal fracture","description":"Open treatment of metacarpal fracture, single, includes internal fixation, when performed, each bone","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4427","name":"Dermbnd dln dl+ dlx sq cm","description":"Dermabind dl n or dermabind dl + or dermabind dl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4008","name":"Geriatrics ss","description":"Geriatrics mips specialty set","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0601U","name":"Nfct ds pji alys 11 bmrks ia","description":"Nfct ds pji alys 11 bmrks ia","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9871","name":"Bhv couns dm prev, onln 60 m","description":"Behavioral counseling for diabetes prevention, online, 60 minutes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1218","name":"Pt copd symptoms","description":"Patient has copd symptoms (e.g., dyspnea, cough/sputum, wheezing)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57300","name":"Repair rectum-vagina fistula","description":"Closure of rectovaginal fistula; vaginal or transanal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4437","name":"Revival ac per sq cm","description":"Revival ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6034","name":"Part hand finger distal amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s)/thumb, amputation at distal to metacarpal joint, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l669","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1323","name":"Inj, elranatamab-bcmm, 1 mg","description":"Injection, elranatamab-bcmm, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0871T","name":"Rplcmt subq prtl ascites pmp","description":"Replacement of a subcutaneous peritoneal ascites pump, including reconnection between pump and indwelling bladder and peritoneal catheters, including initial programming and imaging, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1191","name":"Hspc svc any time in meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4288","name":"Replacement breastpump valve","description":"Valve for breast pump, replacement","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1366","name":"Focus on womens health mvp","description":"Focusing on womens health mips value pathway","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27558","name":"Treat knee dislocation","description":"Open treatment of knee dislocation, includes internal fixation, when performed; with primary ligamentous repair, with augmentation/reconstruction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1542.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37257","name":"Revsc evsc ivt angio cplx ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4306","name":"Americ amnion ac per sq cm","description":"American amnion ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52620","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":439.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99284","name":"Emergency dept visit mod mdm","description":"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0571","name":"Intraop nerve cryoablation","description":"Intraoperative nerve(s) cryoablation for post-surgical pain relief (list separately in addition to code for primary service)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1341","name":"Pt no f/u 30-180 dys","description":"Patients who did not have a follow-up assessment or did not have an assessment within 30 to 180 days after the index assessment during the performance period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1269","name":"Recd esrd mcp lst day of mo","description":"Receiving esrd mcp dialysis services by the provider on the last day of the reporting month","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0237","name":"Intrav inf, toci, first dose","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1481","name":"Pt in hosp/pal care who died","description":"Patients receiving hospice or palliative care or who died during the measurement period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0846T","name":"Dgtz gls mcrscp imfluor ea","description":"Digitization of glass microscope slides for immunofluorescence, per specimen; each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1432","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1681","name":"Ho bilateral hip abduction","description":"Hip orthosis, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5154","name":"Inj, omlyclo, 5 mg","description":"Injection, omalizumab-igec (omlyclo), biosimilar, 5 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77332","name":"Radiation treatment aid(s)","description":"Treatment devices, design and construction; simple (simple block, simple bolus)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86258","name":"Dgp antibody each ig class","description":"Gliadin (deamidated) (dgp) antibody, each immunoglobulin (ig) class","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0763T","name":"Dgtz gls mcrscp mphmtrc alys","description":"Digitization of glass microscope slides for morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure, manual (list separately in addition to code for primary proced","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5940","name":"Resct proth max part remov","description":"Resct proth max part remov","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","name":"Gait mod systm rhym auditory","description":"Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0536","name":"Peer recover support svs","description":"Peer recovery support services, provided directly or by referral; including leveraging knowledge of the condition or lived experience to provide support, mentorship, or inspiration to meet oud treatment and recovery goals; conducting a person-centered interview to understand the patients life story,","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1445","name":"Pp care visit by 12 weeks","description":"Postpartum care visit before or at 12 weeks of giving birth","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0940T","name":"Xtrnl ecg rec>15d<30d r&i","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6191","name":"Semi precision abutment","description":"Semi precision abutment","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0483","name":"Indirect immunofluorescence","description":"Indirect immunofluorescence","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0975T","name":"Slctv nzmtc dbrdmt s/n/hf 1","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; first 100 sq cm","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81558","name":"Trnspl rej kdn mrna qpcr 139","description":"Transplantation medicine (allograft rejection, kidney), mrna, gene expression profiling by quantitative polymerase chain reaction (qpcr) of 139 genes, utilizing whole blood, algorithm reported as a binary categorization as transplant excellence, which indicates immune quiescence, or not transplant e","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90624","name":"Menb-4c&menacwy vacc im","description":"Meningococcal pentavalent vaccine, men b-4c recombinant proteins and outer membrane vesicle and conjugated men a, c, w, y-diphtheria toxoid carrier, for intramuscular use","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0802T","name":"Tcat rmv&rpl2chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right at","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0385U","name":"Neph ckd alg rsk dbtc kdn ds","description":"Neph ckd alg rsk dbtc kdn ds","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1017T","name":"Elec aly npgs esoph sbsq w/o","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5911","name":"Facial moulage sectional","description":"Facial moulage (sectional)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0037","name":"Pt not able to participate","description":"On date of encounter, patient is not able to participate in assessment or screening, including non-verbal patients, delirious, severely aphasic, severely developmentally delayed, severe visual or hearing impairment and for those patients, no knowledgeable informant available","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0798T","name":"Tcat rmv 2chmbr ldls pm cmpl","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; complete system (ie, right atrial and right ventricular pacemaker components)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86140","name":"C-reactive protein","description":"C-reactive protein;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2042","name":"Foundation drs+ solo, sq cm","description":"Foundation drs+ solo, per square centimeter","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0836T","name":"Dgtz gls mcrscp fna ea addl","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27335","name":"Remove knee joint lining","description":"Arthrotomy, with synovectomy, knee; anterior and posterior including popliteal area","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":912.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1811","name":"Fiasp for insulin pump use","description":"Insulin (fiasp) for administration through dme (i.e., insulin pump) per 50 units","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0257U","name":"Vlcad leuk nzm actv whl bld","description":"Very long chain acyl- coenzyme a (coa) dehydrogenase (vlcad), leukocyte enzyme activity, whole blood","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76018","name":"Mr safety implant elec prepj","description":"Mr safety implant electronics preparation under supervision of physician or other qualified health care professional, including mr-specific programming of pulse generator and/or transmitter to verify device integrity, protection of device internal circuitry from mr electromagnetic fields, and protec","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0331U","name":"Onc hl neo opt gen mapping","description":"Onc hl neo opt gen mapping","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26645","name":"Treat thumb fracture","description":"Closed treatment of carpometacarpal fracture dislocation, thumb (bennett fracture), with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0042","name":"Ref to therapy","description":"Referral to physical, occupational, speech, or recreational therapy","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9948","name":"Adjust sleep apnea appliance","description":"Adjust sleep apnea appliance","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6609","name":"G compression bandaging","description":"Gradient compression bandaging supply, not otherwise specified","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7300","name":"Rem anchorage dev w/o flap","description":"Rem anchorage dev w/o flap","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33406","name":"Replacement aortic valve opn","description":"Replacement, aortic valve, open, with cardiopulmonary bypass; with allograft valve (freehand)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2785.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4325","name":"Acapatch, per sq cm","description":"Acapatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1490","name":"Pt status not doc","description":"Patient status not documented","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1952","name":"Leuprolide inj, camcevi, 1mg","description":"Leuprolide injectable, camcevi, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42340","name":"Removal of salivary stone","description":"Sialolithotomy; parotid, extraoral or complicated intraoral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":402.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43497","name":"Transorl lwr esophgl myotomy","description":"Lower esophageal myotomy, transoral (ie, peroral endoscopic myotomy [poem])","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6612","name":"Onlay cst base mtl 2 surface","description":"Onlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94618","name":"Pulmonary stress testing","description":"Pulmonary stress testing (eg, 6-minute walk test), including measurement of heart rate, oximetry, and oxygen titration, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9029","name":"Instill adstiladrin, tx dose","description":"Intravesical instillation, nadofaragene firadenovec-vncg, per therapeutic dose","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6073","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (predominantly base metal)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0270U","name":"Hem cgen coagj do 20 genes","description":"Hematology (congenital coagulation disorders), genomic sequence analysis of 20 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33903","name":"Perq p-art revsc 1 abnor bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, bilateral","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21184","name":"Reconstruct cranial bone","description":"Reconstruction of orbital walls, rims, forehead, nasoethmoid complex following intra- and extracranial excision of benign tumor of cranial bone (eg, fibrous dysplasia), with multiple autografts (includes obtaining grafts); total area of bone grafting greater than 80 sq cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2968.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1002T","name":"Air displacmnt plethysmograp","description":"Air displacement plethysmography, whole-body composition assessment, with interpretation and report","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69729","name":"Impl oi implt sk tc esp>=100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside of the mastoid and resulting in removal of greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33281","name":"Reposg phrnc nrv stim trnsvn","description":"Repositioning of phrenic nerve stimulator transvenous lead(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":317.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6071","name":"Abutment supported retainer","description":"Abutment supported retainer for porcelain fused to metal fpd (noble metal)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1381","name":"Pt sec strk wthin 5 days","description":"Patients with secondary stroke (e.g., a subsequent stroke that may occur with vasospasm in the setting of subarachnoid hemorrhage) within 5 days of the initial procedure","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5934","name":"Mandibular flange prosthesis","description":"Mandibular resection prosthesis with guide flange","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1711","name":"Moderna vacc admin booster","description":"Moderna vacc admin booster","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80412","name":"Crh stimulation panel","description":"Corticotropic releasing hormone (crh) stimulation panel this panel must include the following: cortisol (82533 x 6) adrenocorticotropic hormone (acth) (82024 x 6)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6634","name":"Onlay titanium","description":"Onlay - titanium","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95909","name":"Nrv cndj tst 5-6 studies","description":"Nerve conduction studies; 5-6 studies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96041","name":"Genetic counseling svc ea 30","description":"Medical genetics and genetic counseling services, each 30 minutes of total time provided by the genetic counselor on the date of the encounter","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1265","name":"Cms 2728 completed","description":"Cms medical evidence form 2728 for dialysis patients: initial form completed","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2051","name":"Support broker waiver/diem","description":"Supports brokerage, self-directed, waiver; per diem","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37264","name":"Revsc evasc fpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9956","name":"Admin home sleep apnea test","description":"Admin home sleep apnea test","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0998T","name":"Precuneus mag stimj tx dlvr","description":"Precuneus magnetic stimulation; personalized treatment delivery of magnetic stimulation therapy to a prespecified target area derived from analysis of evoked potentials within the precuneus, utilizing magnetic resonance imaging-based neuronavigation, with management, per day","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5611","name":"Rep resin part dent base man","description":"Rep resin part dent base man","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27301","name":"Drain thigh/knee lesion","description":"Incision and drainage, deep abscess, bursa, or hematoma, thigh or knee region","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":574.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0723T","name":"Qmrcp w/o dx mri sm anat ses","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained without diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) during the same session","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37296","name":"Revsc evasc imvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0032","name":"2+ antipsy schiz","description":"Two or more antipsychotic prescriptions ordered for patients who had a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder on or between january 1 of the year prior to the measurement period and the index prescription start date (ipsd) for antipsychotics","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76830","name":"Transvaginal us non-ob","description":"Ultrasound, transvaginal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1464","name":"No record of f/u by 180 days","description":"No documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2599","name":"Inj vasopressin (am reg) 1 u","description":"Injection, vasopressin (american regent), not therapeutically equivalent to j2598, 1 unit","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0721T","name":"Quan ct tiss charac w/o ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1269","name":"Recd esrd mcp lst day of mo","description":"Receiving esrd mcp dialysis services by the provider on the last day of the reporting month","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0558","name":"Adv prim care mgmt lvl 3","description":"Advanced primary care management services for a patient that is a qualified medicare beneficiary with multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, which place the patient at significant risk of death, acute exacerbation/decompensat","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0258U","name":"Ai psor mrna 50-100 gen alg","description":"Autoimmune (psoriasis), mrna, next-generation sequencing, gene expression profiling of 50-100 genes, skin- surface collection using adhesive patch, algorithm reported as likelihood of response to psoriasis biologics","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37278","name":"Rvsc evsc fpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4295","name":"Amnio tri-core, per sq cm","description":"Amnio tri-core amniotic, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81003","name":"Urinalysis auto w/o scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; automated, without microscopy","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98981","name":"Rtm tx mgmt ea addl 20 min","description":"Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least 1 real-time interactive communication with the patient or caregiver during the calendar month; each additional 20 minutes (list separately in","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6071","name":"Abutment supported retainer","description":"Abutment supported retainer for porcelain fused to metal fpd (noble metal)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4371","name":"Neoguard per sq cm","description":"Neoguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79470","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"Home vent dual fnct incl all","description":"Home ventilator, dual-function respiratory device, also performs additional function of cough stimulation, includes all accessories, components and supplies for all functions","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30469","name":"Rpr nsl vlv collapse w/rmdlg","description":"Repair of nasal valve collapse with low energy, temperature-controlled (ie, radiofrequency) subcutaneous/submucosal remodeling","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1449","name":"Inj eflapegrastim-xnst 0.1mg","description":"Injection, eflapegrastim-xnst, 0.1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92504","name":"Ear microscopy examination","description":"Binocular microscopy (separate diagnostic procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0719T","name":"Pst vrt jt rplcmt lmbr 1 sgm","description":"Posterior vertebral joint replacement, including bilateral facetectomy, laminectomy, and radical discectomy, including imaging guidance, lumbar spine, single segment","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38228","name":"Car-t admn autologous","description":"Chimeric antigen receptor t-cell (car-t) therapy; car-t cell administration, autologous","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24077","name":"Rad rescj tum tiss a/e <5cm","description":"Radical resection of tumor (eg, sarcoma), soft tissue of upper arm or elbow area; less than 5 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":954.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6609","name":"G compression bandaging","description":"Gradient compression bandaging supply, not otherwise specified","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36218","name":"Place catheter in artery","description":"Selective catheter placement, arterial system; additional second order, third order, and beyond, thoracic or brachiocephalic branch, within a vascular family (list in addition to code for initial second or third order vessel as appropriate)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76017","name":"Mr sfty med physics xm cstmz","description":"Mr safety medical physics examination customization, planning and performance monitoring by medical physicist or mr safety expert, with review and analysis by physician or other qualified health care professional to prioritize and select views and imaging sequences, to tailor mr acquisition specific","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1018T","name":"Elec alys npgs esoph sbsq w/","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69200","name":"Clear outer ear canal","description":"Removal foreign body from external auditory canal; without general anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":48.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":26.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0739","name":"Rehab sys active assist rt","description":"Rehabilitation system with interactive interface providing active assistance in rehabilitation therapy, includes all components and accessories, motors, microprocessors, sensors","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11982.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5877","name":"Dup of complt dent-maxill","description":"Dup of complt dent-maxill","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1326","name":"Pts dx hypotony","description":"Patients with a diagnosis of hypotony","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0035","name":"Pt ed pos 23","description":"Patient has any emergency department encounter during the performance period with place of service indicator 23","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9938","name":"Fab removable appliance","description":"Fab removable appliance","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1954","name":"Inj leu acet lutr dpt 7.5 mg","description":"Injection, leuprolide acetate for depot suspension (lutrate depot), 7.5 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4324","name":"Amniotx, per sq cm","description":"Amniotx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0527U","name":"Hsv 1&2 vzv amp prb tq pthgn","description":"Hsv 1&2 vzv amp prb tq pthgn","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52443","name":"Cysto 1st trurl prst8 comis","description":"Cystourethroscopy with initial transurethral anterior prostate commissurotomy with a nondrug-coated balloon catheter followed by therapeutic drug delivery into the prostate by a drug-coated balloon catheter, including transrectal ultrasound and fluoroscopy, when performed","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0601U","name":"Nfct ds pji alys 11 bmrks ia","description":"Nfct ds pji alys 11 bmrks ia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0797T","name":"Tcat ins 2chmbr ldls pm rv","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ventricular pace","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81451","name":"Hl neo gsap 5-50 rna alys","description":"Hematolymphoid neoplasm or disorder, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants, and copy number variants or rearrangements, or isoform expression or mrna expression levels, if performed; rna analysis","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0799T","name":"Tcat rmvl 2chmbr ldls pm ra","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right atrial pacemaker component","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28261","name":"Revision of foot tendon","description":"Capsulotomy, midfoot; with tendon lengthening","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":926.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6519","name":"Grad com garm noc night use","description":"Gradient compression garment, not otherwise specified, for nighttime use, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9298","name":"Inj nivol relatlimab 3mg/1mg","description":"Injection, nivolumab and relatlimab-rmbw, 3 mg/1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1341","name":"Pt no f/u 30-180 dys","description":"Patients who did not have a follow-up assessment or did not have an assessment within 30 to 180 days after the index assessment during the performance period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1393","name":"Pr no dx rec mlnm","description":"Patients who were not diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1445","name":"Pp care visit by 12 weeks","description":"Postpartum care visit before or at 12 weeks of giving birth","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5941","name":"Resct proth mand part remov","description":"Resct proth mand part remov","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0881T","name":"Cryotherapy oral cavity","description":"Cryotherapy of the oral cavity using temperature regulated fluid cooling system, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77261","name":"Ther radiology tx plng smpl","description":"Therapeutic radiology treatment planning; simple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0708","name":"Intraoral bite radio image","description":"Intraoral bite radio image","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44208","name":"L colectomy/coloproctostomy","description":"Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis) with colostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2173.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0333U","name":"Onc lvr surveilanc hcc cfdna","description":"Onc lvr surveilanc hcc cfdna","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52005","name":"Cysto w/urtrl cathj","description":"Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76883","name":"Us nrv&acc strux 1xtr compre","description":"Ultrasound, nerve(s) and accompanying structures throughout their entire anatomic course in one extremity, comprehensive, including real-time cine imaging with image documentation, per extremity","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1466","name":"Pt disc/lam proc same day","description":"Patient had a lumbar fusion on the same date as the discectomy/laminectomy procedure","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0665","name":"Inj, bupivacaine, nos, 0.5mg","description":"Injection, bupivicaine, not otherwise specified, 0.5 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6555","name":"G com stcking bk 40+ custm","description":"Gradient compression stocking, below knee, 40 mmhg or greater, custom, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4014","name":"Nephrology ss","description":"Nephrology mips specialty set","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5162","name":"Inj, denosumab-nxxp, 1 mg","description":"Injection, denosumab-nxxp (bildyos/bilprevda), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7485","name":"Surg reduct osseoustuberosit","description":"Surgical reduction of osseous tuberosity","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1223","name":"Glaucoma plan of care doc","description":"Glaucoma plan of care documented","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0838T","name":"Dgtz gls mcrscp cslt sld els","description":"Digitization of glass microscope slides for consultation and report on referred slides prepared elsewhere (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33310","name":"Exploratory heart surgery","description":"Cardiotomy, exploratory (includes removal of foreign body, atrial or ventricular thrombus); without bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1375.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0225","name":"Inj, vutrisiran, 1 mg","description":"Injection, vutrisiran, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0836T","name":"Dgtz gls mcrscp fna ea addl","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42962","name":"Control throat bleeding","description":"Control oropharyngeal hemorrhage, primary or secondary (eg, post-tonsillectomy); with secondary surgical intervention","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":609.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":558.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0780T","name":"Instlj fecal microbiota ssp","description":"Instillation of fecal microbiota suspension via rectal enema into lower gastrointestinal tract","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J3140","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4301","name":"Activate matrix, per sq cm","description":"Activate matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0840T","name":"Dgtz gls mcrscp cslt compre","description":"Digitization of glass microscope slides for consultation, comprehensive, with review of records and specimens, with report on referred material (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0374","name":"Tomo periapical image","description":"Tomo periapical image","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2402","name":"Chloroprocaine (clorotekal)","description":"Injection, chloroprocaine hydrochloride (clorotekal), per 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9393","name":"Inj, fulvestrant (teva)","description":"Injection, fulvestrant (teva), not therapeutically equivalent to j9395, 25 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9324","name":"Inj, pemrydi rtu, 10 mg","description":"Injection, pemetrexed (pemrydi rtu), 10 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0183","name":"Software meas of cardiac vol","description":"Quantitative software measurements of cardiac volume, cardiac chambers volumes and left ventricular wall mass derived from ct scan(s) data of the chest/heart (with or without contrast)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93319","name":"3d echo img cgen car anomal","description":"3d echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac structure(s) (eg, cardiac chambers and valves, left atrial appendage, interatrial septum, interventricular","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4363","name":"Am bur mem hydro per sq cm","description":"Amnio burgeon membrane and hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0482U","name":"Ob pe biochem asy sfit1&pigf","description":"Ob pe biochem asy sfit1&pigf","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0209","name":"Inj, sod thiosulfate (hope)","description":"Injection, sodium thiosulfate (hope), 100 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9800","name":"Gallium locametz 1 millicuri","description":"Gallium ga-68 gozetotide, diagnostic, (locametz), 1 millicurie","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2598","name":"Inj, vasopressin, 1 unit","description":"Injection, vasopressin, 1 unit","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84066","name":"Assay prostate phosphatase","description":"Phosphatase, acid; prostatic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0784T","name":"Ins/rplmt eltrd ra spi nstim","description":"Insertion or replacement of percutaneous electrode array, spinal, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0936T","name":"Photobiomodulation ther rta","description":"Photobiomodulation therapy of retina, single session","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2040","name":"Microlyte painguard pr sq cm","description":"Microlyte painguard, per square centimeter","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0812T","name":"Rem mlt day uroflow dev sply","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); device supply with automated report generation, up to 10 days","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0704T","name":"Rem tx amblyopia setup&edu","description":"Remote treatment of amblyopia using an eye tracking device; device supply with initial set-up and patient education on use of equipment","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0801","name":"3d dental scan direct","description":"3d dental scan direct","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27562","name":"Treat kneecap dislocation","description":"Closed treatment of patellar dislocation; requiring anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":523.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69745","name":"Repair facial nerve","description":"Suture facial nerve, intratemporal, with or without graft or decompression; including medial to geniculate ganglion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1464.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1456","name":"Inj, fosaprepitant (teva)","description":"Injection, fosaprepitant (teva), not therapeutically equivalent to j1453, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55877","name":"Abltj ire prst8 1+ tum perq","description":"Ablation, irreversible electroporation, prostate, 1 or more tumors, including imaging guidance, percutaneous","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36430","name":"Transfusion bld/bld compnt","description":"Transfusion, blood or blood components","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6180","name":"Implnt maint proced","description":"Implnt maint proced","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0032","name":"2+ antipsy schiz","description":"Two or more antipsychotic prescriptions ordered for patients who had a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder on or between january 1 of the year prior to the measurement period and the index prescription start date (ipsd) for antipsychotics","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1315","name":"Crc no doc no rsn","description":"Colorectal cancer screening results were not documented and reviewed; reason not otherwise specified","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1331","name":"Pts eval ini xm 8 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 8 weeks from initial exam","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4410","name":"Amchomatrixdl per sq cm","description":"Amchomatrixdl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0475U","name":"Hered prst8 ca gsap 23 genes","description":"Hered prst8 ca gsap 23 genes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90482","name":"Imm cnsl not admn sm 3<10","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; 3 minutes up to 10 minutes","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0741T","name":"Rem auton alg nsln data coll","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; provision of software, data collection, transmission, and storage, each 30 days","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92506","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"Home vent dual fnct incl all","description":"Home ventilator, dual-function respiratory device, also performs additional function of cough stimulation, includes all accessories, components and supplies for all functions","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1397","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0258U","name":"Ai psor mrna 50-100 gen alg","description":"Autoimmune (psoriasis), mrna, next-generation sequencing, gene expression profiling of 50-100 genes, skin- surface collection using adhesive patch, algorithm reported as likelihood of response to psoriasis biologics","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0658","name":"Seg pneum comp 2 arm chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1791.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0607","name":"Lanthanum carbonate oral 5mg","description":"Lanthanum carbonate, oral, 5 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0235","name":"Intrav inf, mon anti, fir do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S4024","name":"Air polymer foam per study","description":"Air polymer-type a intrauterine foam, per study dose","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78492","name":"Myocrd img pet mlt rst&strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); multiple studies at rest and stress (exercise or pharmacologic)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22837","name":"Ant thrc vrt body tethrg 8+","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; 8 or more vertebral segments","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98980","name":"Rtm tx mgmt 1st 20 min","description":"Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least 1 real-time interactive communication with the patient or caregiver during the calendar month; first 20 minutes","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0594U","name":"Nfct ds sepsis pncrtc spc","description":"Nfct ds sepsis pncrtc spc","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1373","name":"Mst rec gsa >=8 and <=9","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 8.0% and <= 9.0%","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6516","name":"Grad com wrap w strap foo cu","description":"Gradient compression wrap with adjustable straps, foot, each, custom","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0393U","name":"Neu prksn msfl a-syncln prtn","description":"Neu prksn msfl a-syncln prtn","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64583","name":"Rev/rplct hpglsl nstm ary pg","description":"Revision or replacement of hypoglossal nerve neurostimulator array and distal respiratory sensor electrode or electrode array, including connection to existing pulse generator","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4027","name":"Plastic surgery ss","description":"Plastic surgery mips specialty set","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0430U","name":"Gi malabs aat calpro pncrtc","description":"Gi malabs aat calpro pncrtc","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63040","name":"Laminotomy single cervical","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; cervical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1609.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0291U","name":"Psyc mood do mrna 144 genes","description":"Psyc mood do mrna 144 genes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42305","name":"Drainage of salivary gland","description":"Drainage of abscess; parotid, complicated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75676","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":728.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50553","name":"Kidney endoscopy","description":"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without dilation of ureter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2042","name":"Foundation drs+ solo, sq cm","description":"Foundation drs+ solo, per square centimeter","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48152","name":"Pancreatectomy","description":"Pancreatectomy, proximal subtotal with total duodenectomy, partial gastrectomy, choledochoenterostomy and gastrojejunostomy (whipple-type procedure); without pancreatojejunostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3017.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0753T","name":"Dgtz gls mcrscp sld level iv","description":"Digitization of glass microscope slides for level iv, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4231","name":"Ana crown exp 1-3 per quad","description":"Anatomical crown exposure - one to three teeth per quadrant","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0224","name":"Pemivibart infusion","description":"Intravenous infusion, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known sars-cov-2 exposure, who either have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppr","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0858T","name":"Ext trnscranl mag stimj meas","description":"Externally applied transcranial magnetic stimulation with concomitant measurement of evoked cortical potentials with automated report","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33979","name":"Insert intracorporeal device","description":"Insertion of ventricular assist device, implantable intracorporeal, single ventricle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3020.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31623","name":"Dx bronchoscope/brush","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with brushing or protected brushings","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0624U","name":"Hep nash dna mthyl alys 5000","description":"Hep nash dna mthyl alys 5000","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95919","name":"Quan puplmtry phy/qhp uni/bi","description":"Quantitative pupillometry with physician or other qualified health care professional interpretation and report, unilateral or bilateral","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2006","name":"Novosorb synpath per sq cm","description":"Novosorb synpath dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2055","name":"Idecabtagene vicleucel car","description":"Idecabtagene vicleucel, up to 510 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4317","name":"Vitograft, per sq cm","description":"Vitograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64655","name":"Revj/rplcmt bat mod sys lead","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; lead only","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22838","name":"Rev rplc/rmv thrc vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracic vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28705","name":"Arthrodesis pantalar","description":"Arthrodesis; pantalar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1556.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34713","name":"Perq access & clsr fem art","description":"Percutaneous access and closure of femoral artery for delivery of endograft through a large sheath (12 french or larger), including ultrasound guidance, when performed, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86364","name":"Tiss trnsgltmnase ea ig clas","description":"Tissue transglutaminase, each immunoglobulin (ig) class","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1388","name":"Pt doc exm rec melmn","description":"Patients with documentation of an exam performed for recurrence of melanoma","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4347","name":"Rampart dl matrix per sq cm","description":"Rampart dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01937","name":"Anes drg/aspir crv/thrc","description":"Anesthesia for percutaneous image-guided injection, drainage or aspiration procedures on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0712T","name":"N-nvs artl plaq alys quan","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess atherosclerotic plaque stability","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1352","name":"Suicd c-ssrs assessment, equ","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs or equivalent assessment","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0907T","name":"Coms ther ea addl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; each additional application, total wound(s) surface area less than or equal to 50 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31786","name":"Remove windpipe lesion","description":"Excision of tracheal tumor or carcinoma; thoracic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1810.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0838T","name":"Dgtz gls mcrscp cslt sld els","description":"Digitization of glass microscope slides for consultation and report on referred slides prepared elsewhere (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0675T","name":"Laps insj nw/rpcmt isdss 1ld","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first lead","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3391","name":"Inj, atidarsagene autotemcel","description":"Injection, atidarsagene autotemcel, per treatment","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93319","name":"3d echo img cgen car anomal","description":"3d echocardiographic imaging and postprocessing during transesophageal echocardiography, or during transthoracic echocardiography for congenital cardiac anomalies, for the assessment of cardiac structure(s) (eg, cardiac chambers and valves, left atrial appendage, interatrial septum, interventricular","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5159","name":"Inj, denosumab-dssb, 1 mg","description":"Injection, denosumab-dssb (ospomyv/xbryk), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0472U","name":"Ca vi psp&sp1 antb sjogren","description":"Ca vi psp&sp1 antb sjogren","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0931T","name":"Ephys eval ccm-d ld separate","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), separate from initial implantation or replacement with testing of cardiac cont","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1338","name":"Pt f/u 30-180 dys no + imprv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who did not demonstrate positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1349","name":"No pam inc 3 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 3 points within a 4 to 12 month period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0668","name":"Instill, bupivac and meloxic","description":"Instillation, bupivacaine and meloxicam, 1 mg/0.03 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0527U","name":"Hsv 1&2 vzv amp prb tq pthgn","description":"Hsv 1&2 vzv amp prb tq pthgn","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6034","name":"Part hand finger distal amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s)/thumb, amputation at distal to metacarpal joint, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l669","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95004","name":"Perq tests w/alrgnc xtrcs","description":"Percutaneous tests (scratch, puncture, prick) with allergenic extracts, immediate type reaction, including test interpretation and report, specify number of tests","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37258","name":"Revsc evasc ivt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99418","name":"Prolng ip/obs e/m ea 15 min","description":"Prolonged inpatient or observation evaluation and management service(s) time with or without direct patient contact beyond the required time of the primary service when the primary service level has been selected using total time, each 15 minutes of total time (list separately in addition to the cod","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0042","name":"Ref to therapy","description":"Referral to physical, occupational, speech, or recreational therapy","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87426","name":"Sarscov coronavirus ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; severe acute respiratory syndrome coronavirus (eg, sars-cov, s","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93016","name":"Cv stress test supvj only","description":"Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; supervision only, without interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1207","name":"Pt scrn sdoh","description":"Patient is screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99496","name":"Transj care mgmt high f2f 7d","description":"Transitional care management services with the following required elements: communication (direct contact, telephone, electronic) with the patient and/or caregiver within 2 business days of discharge high level of medical decision making during the service period face-to-face visit, within 7 calenda","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":162.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0364U","name":"Onc hl neo gen seq alys alg","description":"Onc hl neo gen seq alys alg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58940","name":"Removal of ovary(s)","description":"Oophorectomy, partial or total, unilateral or bilateral;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":549.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1009T","name":"Rem mntr s-sclp cont eeg sys","description":"Remote monitoring of a sub-scalp implanted continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9028","name":"Inj, nogapendekin pmln, 1mcg","description":"Injection, nogapendekin alfa inbakicept-pmln, for intravesical use, 1 microgram","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0590U","name":"Nfct ds bct&fngl dna 44 orgs","description":"Nfct ds bct&fngl dna 44 orgs","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0302U","name":"Iadna brtnla ddpcr flwg liq","description":"Iadna brtnla ddpcr flwg liq","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87428","name":"Sarscov & inf vir a&b ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; severe acute respiratory syndrome coronavirus (eg, sars-cov, s","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74019","name":"Radex abdomen 2 views","description":"Radiologic examination, abdomen; 2 views","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9292","name":"Inj, pemetrexed dipotassium","description":"Injection, pemetrexed dipotassium, 10 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4003","name":"Emergency med ss","description":"Emergency medicine mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0743T","name":"B1 str & fx rsk vrt fx assmt","description":"Bone strength and fracture risk using finite element analysis of functional data and bone mineral density (bmd), with concurrent vertebral fracture assessment, utilizing data from a computed tomography scan, retrieval and transmission of the scan data, measurement of bone strength and bmd and classi","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1205","name":"Isa reduced >=3","description":"Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0523","name":"Mgt nw pt dem mod-high cmplx","description":"Management of a new patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1239","name":"Pt no resp heard","description":"Patient did not respond to the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1023T","name":"Prq tis dsplmt intrathoracic","description":"Percutaneous tissue displacement, any method, including imaging guidance; intrathoracic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2015","name":"Phoenix wnd mtrx, per sq cm","description":"Phoenix wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9244","name":"Office min sed drug enteral","description":"Office min sed drug enteral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0683","name":"App of non-sheet skin sub g","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1072","name":"Inj, testosterone, azmiro","description":"Injection, testosterone cypionate (azmiro), 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1267","name":"Pt no act kid transplt wtlst","description":"Patients not observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23395","name":"Muscle transfer shoulder/arm","description":"Muscle transfer, any type, shoulder or upper arm; single","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1482.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2028","name":"Micromatrix flex per mg","description":"Micromatrix flex, per mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0819T","name":"Revj/rmvl ins ptn subf","description":"Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and imaging, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7299","name":"Rem anchorage device w/flap","description":"Rem anchorage device w/flap","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1329","name":"Pts act pvd 2 wks 8 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 8 weeks after initial acute pvd encounter","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2506","name":"Inj pegfilgrast ex bio 0.5mg","description":"Injection, pegfilgrastim, excludes biosimilar, 0.5 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4294","name":"Amnio quad-core, per sq cm","description":"Amnio quad-core, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9294","name":"Inj pemetrexed, hospira 10mg","description":"Injection, pemetrexed (hospira), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0494U","name":"Rbc ag ftl rhd gene alys ngs","description":"Rbc ag ftl rhd gene alys ngs","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62165","name":"Remove pituit tumor w/scope","description":"Neuroendoscopy, intracranial; with excision of pituitary tumor, transnasal or trans-sphenoidal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1724.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1305","name":"Pneum vax admin 19+","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99213","name":"Office o/p est low 20 min","description":"Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 20 minutes must be met or e","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":102.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6113","name":"Imp/abut rem dent part mand","description":"Imp/abut rem dent part mand","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76883","name":"Us nrv&acc strux 1xtr compre","description":"Ultrasound, nerve(s) and accompanying structures throughout their entire anatomic course in one extremity, comprehensive, including real-time cine imaging with image documentation, per extremity","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97032","name":"Appl modality 1+estim ea 15","description":"Application of a modality to 1 or more areas; electrical stimulation (manual), each 15 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1206","name":"Isa not red 3pts/no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53866","name":"Cathj rmvl dev ischmc rmdlg","description":"Catheterization with removal of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45335","name":"Sigmoidoscopy w/submuc inj","description":"Sigmoidoscopy, flexible; with directed submucosal injection(s), any substance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1188","name":"Pt w/ ckd stg 5","description":"Patients with a diagnosis of chronic kidney disease (ckd) stage 5","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4364","name":"Am bur xp mem xpl hy p sq cm","description":"Amnio burgeon xplus membrane and xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63278","name":"Bx/exc xdrl spine lesn scrl","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, sacral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1716.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0551","name":"Phn/intr svs fr dx treat 30m","description":"Interprofessional telephone/internet/electronic health record referral service(s) provided by a treating/requesting practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, 30 minutes","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55708","name":"Bx prst8 trct us w/mri fus 1","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant) with mri-fusion-guidance, first targeted lesion","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4225","name":"Amnio or derma tl, per sq cm","description":"Amniobind or dermabind tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84433","name":"Asy thiopurin s-mthyltrnsfrs","description":"Thiopurine s-methyltransferase (tpmt)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0688","name":"Inj cefazolin sodium, hikma","description":"Injection, cefazolin sodium (hikma), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0681","name":"Inj ceftobipole medocarl 3mg","description":"Injection, ceftobiprole medocaril sodium, 3 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33894","name":"Evasc st rpr thrc/aa acrs br","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; across major side branches","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0847T","name":"Dgtz gls mcrscp xm arch tiss","description":"Digitization of glass microscope slides for examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, kras mutational analysis) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0343U","name":"Onc prst8 xom aly 442 sncrna","description":"Onc prst8 xom aly 442 sncrna","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81007","name":"Urine screen for bacteria","description":"Urinalysis; bacteriuria screen, except by culture or dipstick","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1714","name":"Pfizer vacc adm ped 2nd dose","description":"Pfizer vacc adm ped 2nd dose","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3425","name":"Hydroxocobalamin im 10mcg","description":"Injection, hydroxocobalamin, intramuscular, 10 mcg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9939","name":"Placemnt removable appliance","description":"Placemnt removable appliance","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4392","name":"Grafix duo per sq cm","description":"Grafix duo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1355","name":"Caries med app per tooth","description":"Caries med app per tooth","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0482U","name":"Ob pe biochem asy sfit1&pigf","description":"Ob pe biochem asy sfit1&pigf","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1176","name":"No 2 hzv 10/2017-meas pd","description":"Patient did not receive two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0877","name":"Inj, daptomycin (hospira)","description":"Injection, daptomycin (hospira), not therapeutically equivalent to j0878, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31525","name":"Dx laryngoscopy excl nb","description":"Laryngoscopy direct, with or without tracheoscopy; diagnostic, except newborn","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0957T","name":"Rev s-sclp eltr ra rcvr&tlmt","description":"Revision of sub-scalp implanted electrode array, receiver, and telemetry unit for electrode, when required, including imaging guidance","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0763T","name":"Dgtz gls mcrscp mphmtrc alys","description":"Digitization of glass microscope slides for morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure, manual (list separately in addition to code for primary proced","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36228","name":"Place cath intracranial art","description":"Selective catheter placement, each intracranial branch of the internal carotid or vertebral arteries, unilateral, with angiography of the selected vessel circulation and all associated radiological supervision and interpretation (eg, middle cerebral artery, posterior inferior cerebellar artery) (lis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1504.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1033","name":"Sv doula brth wrk per diem","description":"Services performed by a doula birth worker, per diem","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0271U","name":"Hem cgen neutropenia 23 gen","description":"Hematology (congenital neutropenia), genomic sequence analysis of 23 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0529","name":"In home respite care, 4 hr u","description":"In-home respite care, 4-hour unit, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37265","name":"Revsc evsc fpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0374","name":"Tomo periapical image","description":"Tomo periapical image","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17283","name":"Dstr mal ls f/e/e/n/l/m2.1-3","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 2.1 to 3.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1179","name":"No pcv recd","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine, on or after their 19th birthday and before or during measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99425","name":"Prin care mgmt phys ea addl","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9602","name":"Fluorodopa f-18 diag per mci","description":"Fluorodopa f-18, diagnostic, per millicurie","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1179","name":"No pcv recd","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine, on or after their 19th birthday and before or during measurement period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2804","name":"Inj, rifampin, 1 mg","description":"Injection, rifampin, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0938T","name":"Xtrnl ecg rec>15d<30d rec","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; recording (including connection and initial recording)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5934","name":"Mandibular flange prosthesis","description":"Mandibular resection prosthesis with guide flange","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47740","name":"Fuse gallbladder & bowel","description":"Cholecystoenterostomy; roux-en-y","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1301.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1574","name":"Inj, ganciclovir (exela)","description":"Injection, ganciclovir sodium (exela), not therapeutically equivalent to j1570, 500 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0465U","name":"Onc urthl carc dna qmsp 2gen","description":"Onc urthl carc dna qmsp 2gen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96041","name":"Genetic counseling svc ea 30","description":"Medical genetics and genetic counseling services, each 30 minutes of total time provided by the genetic counselor on the date of the encounter","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7172","name":"Inj marstacim-hncq, 0.5 mg","description":"Injection, marstacimab-hncq, 0.5 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23420","name":"Repair of shoulder","description":"Reconstruction of complete shoulder (rotator) cuff avulsion, chronic (includes acromioplasty)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1207.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0138","name":"Inj acetaminoph 10mg/ibu 3mg","description":"Injection, acetaminophen 10 mg and ibuprofen 3 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33509","name":"Ndsc hrv uxtr art 1 sgm cab","description":"Harvest of upper extremity artery, 1 segment, for coronary artery bypass procedure, endoscopic","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21346","name":"Opn tx nasomax fx w/fixj","description":"Open treatment of nasomaxillary complex fracture (lefort ii type); with wiring and/or local fixation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1091.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0465U","name":"Onc urthl carc dna qmsp 2gen","description":"Onc urthl carc dna qmsp 2gen","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0867T","name":"Tpla b9 prst8 hyprplsa>=50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume greater or equal to 50 ml","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86381","name":"Mitochondrial antibody each","description":"Mitochondrial antibody (eg, m2), each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1187","name":"Pt w/ esrd","description":"Patients with a diagnosis of end stage renal disease (esrd)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73722","name":"Mri joint of lwr extr w/dye","description":"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; with contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":771.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71110","name":"X-ray exam ribs bil 3 views","description":"Radiologic examination, ribs, bilateral; 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9021","name":"Inj, aspara, rylaze, 0.1 mg","description":"Injection, asparaginase, recombinant, (rylaze), 0.1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5811","name":"Denture interm cmplt mandbl","description":"Interim complete denture (mandibular)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0668","name":"Instill, bupivac and meloxic","description":"Instillation, bupivacaine and meloxicam, 1 mg/0.03 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22836","name":"Ant thrc vrt body tethrg <7","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; up to 7 vertebral segments","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6595","name":"G comp bandge liner upr extr","description":"Gradient compression bandaging supply, bandage liner, upper extremity, any size or length, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2054","name":"Lisocabtagene mara car pos t","description":"Lisocabtagene maraleucel, up to 110 million autologous anti-cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6602","name":"G com bandge hgh dn foamroll","description":"Gradient compression bandaging supply, high density foam roll for bandage, per linear yard, any width, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27530","name":"Treat knee fracture","description":"Closed treatment of tibial fracture, proximal (plateau); without manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":405.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0766T","name":"Tc mag stimj pn 1st nerve","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; first nerve","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2373","name":"Inj, immphentiv, 20 mcg","description":"Injection, phenylephrine hydrochloride (immphentiv), 20 micrograms","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93151","name":"Interrog&prgrmg ipnss","description":"Interrogation and programming (minimum one parameter) of implanted phrenic nerve stimulator system","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9277","name":"Pembrolizumab 1mg berahyalur","description":"Injection, pembrolizumab, 1 mg and berahyaluronidase alfa-pmph","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2007","name":"Restrata, per sq cm","description":"Restrata, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1333","name":"Acute vitreous hemorrhage","description":"Acute vitreous hemorrhage","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27446","name":"Revision of knee joint","description":"Arthroplasty, knee, condyle and plateau; medial or lateral compartment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1362.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4379","name":"Amniodefend ft per sq cm","description":"Amniodefend ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21247","name":"Reconstruct lower jaw bone","description":"Reconstruction of mandibular condyle with bone and cartilage autografts (includes obtaining grafts) (eg, for hemifacial microsomia)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1929.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88400","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1217","name":"Sys rsn no doc spiro","description":"Documentation of system reason(s) for not documenting and reviewing spirometry results (e.g., spirometry equipment not available at the time of the encounter)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1320","name":"Pts scrn + hrsn","description":"Patients who screened positive for at least 1 of the 5 hrsns","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86364","name":"Tiss trnsgltmnase ea ig clas","description":"Tissue transglutaminase, each immunoglobulin (ig) class","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29822","name":"Sho arthrs srg lmtd dbrdmt","description":"Arthroscopy, shoulder, surgical; debridement, limited, 1 or 2 discrete structures (eg, humeral bone, humeral articular cartilage, glenoid bone, glenoid articular cartilage, biceps tendon, biceps anchor complex, labrum, articular capsule, articular side of the rotator cuff, bursal side of the rotator","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92642","name":"Hearing asstv dev fitg svc","description":"Hearing assistive device, supplemental technology fitting services (eg, personal frequency modulation [fm]/digital modulation [dm] system, remote microphone, alerting devices)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2027","name":"Matriderm per sq cm","description":"Matriderm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1294","name":"Bp scrn perf rec interval","description":"Normal blood pressure reading documented, follow-up not required","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87913","name":"Nfct agt gntyp alys sarscov2","description":"Infectious agent genotype analysis by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), mutation identification in targeted region(s)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4363","name":"Am bur mem hydro per sq cm","description":"Amnio burgeon membrane and hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43750","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0701T","name":"Molec fluor img sus nev ea","description":"Molecular fluorescent imaging of suspicious nevus; each additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0449U","name":"Car scr sev inh cond 5 genes","description":"Car scr sev inh cond 5 genes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86381","name":"Mitochondrial antibody each","description":"Mitochondrial antibody (eg, m2), each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6559","name":"G stckng full/chap18-30 cust","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98978","name":"Rtm dev sply cbt 16-30 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of cognitive behavioral therapy, 16-30 days in a 30-day period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4029","name":"Preventive medicine ss","description":"Preventive medicine mips specialty set","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99424","name":"Prin care mgmt phys 1st 30","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2058","name":"Obecbtge autol up to 400 mil","description":"Obecabtagene autoleucel, 10 up to 400 million cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per infusion","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5157","name":"Inj, denosumab-bmwo, 1 mg","description":"Injection, denosumab-bmwo (stoboclo/osenvelt), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":73.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0505U","name":"Nfct ds vag infctj id 32orgs","description":"Nfct ds vag infctj id 32orgs","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6611","name":"Onlay cst hgh nbl mtl >=3srf","description":"Onlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87626","name":"Hpv sep hi-rsk typ&pool rslt","description":"Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), separately reported high-risk types (eg, 16, 18, 31, 45, 51, 52) and high-risk pooled result(s)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4261","name":"Tag, per square centimeter","description":"Tag, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83864","name":"Mucopolysaccharides","description":"Mucopolysaccharides, acid, quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9936","name":"Clean occ guard","description":"Clean occ guard","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0526U","name":"Nefro rnl trnspl quan cxcl10","description":"Nefro rnl trnspl quan cxcl10","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1458","name":"Pt died bef end meas pd","description":"Patient died prior to the end of the performance period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0620U","name":"Onc hcc dna mthyln alys>5000","description":"Onc hcc dna mthyln alys>5000","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1413","name":"Pos pdl1 bef init ici tx","description":"Patients who had a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0249","name":"Tocilizumab for covid-19","description":"Injection, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1821","name":"Ko elas w/ condyle pads otf","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, off the shelf","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81050","name":"Urinalysis volume measure","description":"Volume measurement for timed collection, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0420U","name":"Onc urthl mrna xprsn 6 snp","description":"Onc urthl mrna xprsn 6 snp","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0299U","name":"Onc pan tum whl gen opt mapg","description":"Onc pan tum whl gen opt mapg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86364","name":"Tiss trnsgltmnase ea ig clas","description":"Tissue transglutaminase, each immunoglobulin (ig) class","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4308","name":"Sanopellis, per sq cm","description":"Sanopellis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5909","name":"Max guid prothes w/ flange","description":"Max guid prothes w/ flange","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10081","name":"I&d pilonidal cyst comp","description":"Incision and drainage of pilonidal cyst; complicated","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":160.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4330","name":"Total, per sq cm","description":"Total, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87620","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29860","name":"Hip arthroscopy dx","description":"Arthroscopy, hip, diagnostic with or without synovial biopsy (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":747.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1319","name":"Pts csp doc contact","description":"Patients who had documented contact with a csp for at least one of their screened positive hrsns within 60 days after screening","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1366","name":"Focus on womens health mvp","description":"Focusing on womens health mips value pathway","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0844T","name":"Dgtz gls mcrscp cslt cyt ea","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), each additional site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4423","name":"Biolab tri wrap fl per sq cm","description":"Biolab tri-membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1350","name":"Pt w/ suic saf pln init rev","description":"Patients who had a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4035","name":"Thoracic surgery ss","description":"Thoracic surgery mips specialty set","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0049","name":"Alcohol/drug screening","description":"Alcohol and/or drug screening","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64598","name":"Revj/rmvl nea pn w/int nstim","description":"Revision or removal of neurostimulator electrode array, peripheral nerve, with integrated neurostimulator","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5146","name":"Inj, hercessi, 10 mg","description":"Injection, trastuzumab-strf (hercessi), biosimilar, 10 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90829","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4386","name":"Acesso trifaca per sq cm","description":"Acesso trifaca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59160","name":"D & c after delivery","description":"Curettage, postpartum","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":156.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84106","name":"Test for porphobilinogen","description":"Porphobilinogen, urine; qualitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0660","name":"Team remote e/m new pt 10 mn","description":"Team remote e/m new pt 10mins","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0730T","name":"Trabeculotomy lsr w/oct gdn","description":"Trabeculotomy by laser, including optical coherence tomography (oct) guidance","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87220","name":"Tissue exam for fungi","description":"Tissue examination by koh slide of samples from skin, hair, or nails for fungi or ectoparasite ova or mites (eg, scabies)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0519U","name":"Ther rx mntr meds p/d/a 110+","description":"Ther rx mntr meds p/d/a 110+","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0488U","name":"Ob fetal ag nipt cfdna alys","description":"Ob fetal ag nipt cfdna alys","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9322","name":"Inj pemetrexed (bluepoint)","description":"Injection, pemetrexed (bluepoint), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99239","name":"Hosp ip/obs dschrg mgmt >30","description":"Hospital inpatient or observation discharge day management; more than 30 minutes on the date of the encounter","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5948","name":"Max implt sup fix part","description":"Max implt sup fix part","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4273","name":"Esano aaa, per sq cm","description":"Esano aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93574","name":"Njx cath slct pulm vn angrph","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary venous angiography of each distinct pulmonary vein during cardiac catheterization (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0053","name":"Ht mental health and care","description":"Historical trauma (ht) mental health and clinical care for indigenous persons","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1431","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1175","name":"Doc med rsn no hzv","description":"Documentation of medical reason(s) for not administering zoster vaccine (e.g., prior anaphylaxis due to the zoster vaccine)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0572U","name":"Onc prst8 httl qfish whl bld","description":"Onc prst8 httl qfish whl bld","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37265","name":"Revsc evsc fpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1022T","name":"Prq tis dsplmt ntra-abdl/pel","description":"Percutaneous tissue displacement, any method, including imaging guidance; intra-abdominal/pelvic structures (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1006T","name":"Elec alys s-scl eeg prgrm ea","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, each additional 15 minutes face-to-face time with physician or other qua","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4295","name":"Amnio tri-core, per sq cm","description":"Amnio tri-core amniotic, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6590","name":"Urinary cath disp suc pump","description":"External urinary catheters; disposable, with wicking material, for use with suction pump, per month","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6607","name":"G com bandage tub protct lyr","description":"Gradient compression bandaging supply, tubular protective absorption layer, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0991T","name":"Cysto lo-nrg lithtrp&mcrsphr","description":"Cystourethroscopy, with low-energy lithotripsy and acoustically actuated microspheres, including imaging","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0556","name":"Adv prim care mgmt lvl 1","description":"Advanced primary care management services for a patient with one chronic condition [expected to last at least 12 months, or until the death of the patient, which place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline], or fewer, provided by clinical ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1412","name":"Met nsclc w/ egfr alk oth ab","description":"Patients with metastatic nsclc with epidermal growth factor receptor (egfr) mutations, alk genomic tumor aberrations, or other targetable genomic abnormalities with approved first-line targeted therapy, such as nsclc with ros1 rearrangement, braf v600e mutation, ntrk 1/2/3 gene fusion, met ex14 skip","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0155","name":"Dronabinol (syndros) 0.1 mg","description":"Dronabinol (syndros), 0.1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0993T","name":"N-invas assmt car rsk w/ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat with concurrent computed tomography scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional (list s","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1489","name":"Pt status doc","description":"Patient status documented","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82331","name":"Calcium infusion test","description":"Calcium; after calcium infusion test","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82653","name":"El-1 fecal quantitative","description":"Elastase, pancreatic (el-1), fecal; quantitative","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0388","name":"Bitewing image capture only","description":"Bitewing image capture only","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98977","name":"Rtm dev sply mscskl 16-30 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of musculoskeletal system, 16-30 days in a 30-day period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76018","name":"Mr safety implant elec prepj","description":"Mr safety implant electronics preparation under supervision of physician or other qualified health care professional, including mr-specific programming of pulse generator and/or transmitter to verify device integrity, protection of device internal circuitry from mr electromagnetic fields, and protec","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4420","name":"Nuform per sq cm","description":"Nuform, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0613U","name":"Onc uc dna mthyltn&mut 6bmrk","description":"Onc uc dna mthyltn&mut 6bmrk","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0552","name":"Supply of digital device","description":"Supply of digital mental health treatment device and initial education and onboarding, per course of treatment that augments a behavioral therapy plan","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0705T","name":"Rem tx amblyopia tech sprt","description":"Remote treatment of amblyopia using an eye tracking device; surveillance center technical support including data transmission with analysis, with a minimum of 18 training hours, each 30 days","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5995","name":"Peri medicament w/seal, max","description":"Peri medicament w/seal, max","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1384","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0414","name":"Lab process microbial spec","description":"Lab process microbial spec","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1473","name":"Pt func cap not allow impr","description":"Patient situations, at any point during the denominator identification period, where the patients functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools, such as delirium, dementia, intellectual disabilities, and pervasive and specific de","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0675T","name":"Laps insj nw/rpcmt isdss 1ld","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first lead","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0502U","name":"Hpv e6/e7 mrk hi-rsk typ crv","description":"Hpv e6/e7 mrk hi-rsk typ crv","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0993T","name":"N-invas assmt car rsk w/ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat with concurrent computed tomography scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional (list s","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4416","name":"Alexiguard tl-t per sq cm","description":"Alexiguard tl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"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":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0570","name":"Care manage serv, pr cal mo","description":"Care management services for behavioral health conditions, directed by a physician or other qualified health care professional, per calendar month, with the following required elements: initial assessment or follow-up monitoring, including the use of applicable validated rating scales, behavioral he","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0504U","name":"Nfct ds uti id 17 path orgs","description":"Nfct ds uti id 17 path orgs","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0852T","name":"Dgtz gls mcrscp mphmtrc ea 1","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1185","name":"Imm ckpt inhib not hld no rx","description":"Documentation of immune checkpoint inhibitor therapy not held and/or corticosteroids or immunosuppressants prescribed or administered was not performed, reason not given","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4412","name":"Choriofix per sq cm","description":"Choriofix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0890T","name":"Arhfcmrigtbs 1st tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including target assessment, initial motor threshold determination, neuronavigation, delivery and management, initial treatment day","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82274","name":"Assay test for blood fecal","description":"Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64786","name":"Remove sciatic nerve lesion","description":"Excision of neuroma; sciatic nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1263.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0322U","name":"Neuro asd meas 14 acyl carn","description":"Neuro asd meas 14 acyl carn","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28202","name":"Repair/graft of foot tendon","description":"Repair, tendon, flexor, foot; secondary with free graft, each tendon (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0491","name":"Inj anifrolumab-fnia 1mg","description":"Injection, anifrolumab-fnia, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1204","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6527","name":"G garmt full leg/ft nght cus","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, custom, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1016T","name":"Elec alys npgs esoph intraop","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37289","name":"Revsc evsc tpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43247","name":"Egd remove foreign body","description":"Esophagogastroduodenoscopy, flexible, transoral; with removal of foreign body(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0793T","name":"Prq tcat thrm ablt nrv p-art","description":"Percutaneous transcatheter thermal ablation of nerves innervating the pulmonary arteries, including right heart catheterization, pulmonary artery angiography, and all imaging guidance","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0536","name":"Peer recover support svs","description":"Peer recovery support services, provided directly or by referral; including leveraging knowledge of the condition or lived experience to provide support, mentorship, or inspiration to meet oud treatment and recovery goals; conducting a person-centered interview to understand the patients life story,","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5133","name":"Inj, tofidence, 1 mg","description":"Injection, tocilizumab-bavi (tofidence), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0036","name":"Pt/ptn decln assess","description":"Patient or care partner decline assessment","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0549","name":"Phone/inter for treat>31m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4307","name":"American amnion, per sq cm","description":"American amnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0525","name":"Inj cefotetan disodium 10 mg","description":"Injection, cefotetan disodium, 10 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1327","name":"Pts no eval ini xm no 8 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 8 weeks","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83014","name":"H pylori drug admin","description":"Helicobacter pylori; drug administration","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38220","name":"Dx bone marrow aspirations","description":"Diagnostic bone marrow; aspiration(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4439","name":"Instagraft per sq cm","description":"Instagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0838T","name":"Dgtz gls mcrscp cslt sld els","description":"Digitization of glass microscope slides for consultation and report on referred slides prepared elsewhere (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0139","name":"Inj, adalimumab, 1 mg","description":"Injection, adalimumab, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4398","name":"Summit ac per sq cm","description":"Summit ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69726","name":"Rmv ntr oi implt skl prq esp","description":"Removal, entire osseointegrated implant, skull; with percutaneous attachment to external speech processor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50575","name":"Kidney endoscopy","description":"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with endopyelotomy (includes cystoscopy, ureteroscopy, dilation of ureter and ureteral pelvic junction, incision of ureteral pelvic junction and insertio","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":850.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23190","name":"Ostectomy scapula partial","description":"Ostectomy of scapula, partial (eg, superior medial angle)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":665.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4351","name":"Enclose tl matrix, per sq cm","description":"Enclose tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5941","name":"Resct proth mand part remov","description":"Resct proth mand part remov","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37285","name":"Revsc evasc tpvt st sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":82.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0924T","name":"Rpos prv ccm-d trnsvns eltrd","description":"Repositioning of previously implanted cardiac contractility modulation-defibrillation transvenous electrode(s)/lead(s), including fluoroscopic guidance and programming of sensing and therapeutic parameters","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7165","name":"Inj, human-lans, per i.u","description":"Injection, prothrombin complex concentrate, human-lans, per i.u. of factor ix activity","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87494","name":"Chlmy trch&neisra gonor mult","description":"Infectious agent detection by nucleic acid (dna or rna); chlamydia trachomatis and neisseria gonorrhoeae, multiplex amplified probe technique","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0457U","name":"Pfas 9 cmpnd lcms/ms pls/sr","description":"Pfas 9 cmpnd lcms/ms pls/sr","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0847T","name":"Dgtz gls mcrscp xm arch tiss","description":"Digitization of glass microscope slides for examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, kras mutational analysis) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2427","name":"Inj, invega hafyera/trinza","description":"Injection, paliperidone palmitate extended release (invega hafyera, or invega trinza), 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2267","name":"Inj, mirikizumab-mrkz, 1 mg","description":"Injection, mirikizumab-mrkz, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0704T","name":"Rem tx amblyopia setup&edu","description":"Remote treatment of amblyopia using an eye tracking device; device supply with initial set-up and patient education on use of equipment","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99493","name":"Sbsq psyc collab care mgmt","description":"Subsequent psychiatric collaborative care management, first 60 minutes in a subsequent month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required el","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0035","name":"Pt ed pos 23","description":"Patient has any emergency department encounter during the performance period with place of service indicator 23","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37788","name":"Revascularization penis","description":"Penile revascularization, artery, with or without vein graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1469.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5411","name":"Dentures adjust cmplt mand","description":"Adjust complete denture - mandibular","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0815T","name":"Us rems b1 dns hips plvs/spi","description":"Ultrasound-based radiofrequency echographic multi-spectrometry (rems), bone-density study and fracture-risk assessment, 1 or more sites, hips, pelvis, or spine","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0804","name":"3d facial scan indirect","description":"3d facial scan indirect","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0041","name":"Pt/ptn decln referral","description":"Patient and/or care partner decline referral","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9394","name":"Inj, fulvestrant (fresenius)","description":"Injection, fulvestrant (fresenius kabi) not therapeutically equivalent to j9395, 25 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92920","name":"Prq trluml c angiop 1art&/br","description":"Percutaneous transluminal coronary angioplasty, single major coronary artery and/or its branch(es)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0668","name":"Team remote e/m est pt 40 mn","description":"Team remote e/m est. pt 40mins","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48154","name":"Pancreatectomy","description":"Pancreatectomy, proximal subtotal with near-total duodenectomy, choledochoenterostomy and duodenojejunostomy (pylorus-sparing, whipple-type procedure); without pancreatojejunostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3032.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0891","name":"Argatroban nonesrd (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0042","name":"Ref to therapy","description":"Referral to physical, occupational, speech, or recreational therapy","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0577","name":"Inj, brixadi, 7 days or less","description":"Injection, buprenorphine extended-release (brixadi), less than or equal to 7 days of therapy","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68510","name":"Biopsy of tear gland","description":"Biopsy of lacrimal gland","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0853T","name":"Dgtz gls mcrscp mphmtrc ea m","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2027","name":"Matriderm per sq cm","description":"Matriderm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0136","name":"Adm of pa/n assess 5-15 m","description":"Administration of a standardized, evidence-based assessment of physical activity and nutrition, 5-15 minutes, not more often than every 6 months","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55862","name":"Extensive prostate surgery","description":"Exposure of prostate, any approach, for insertion of radioactive substance; with lymph node biopsy(s) (limited pelvic lymphadenectomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1213.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2030","name":"Miro3d fibers, per mg","description":"Miro3d fibers, per milligram","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6601","name":"G com bandge hgh dn foam pad","description":"Gradient compression bandaging supply, high density foam pad, any size or shape, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0604U","name":"All&immunology crae 4bk pep","description":"All&immunology crae 4bk pep","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1300","name":"Flu imm no admin doc rea","description":"Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5421","name":"Dentures adjust part maxill","description":"Adjust partial denture - maxillary","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1326","name":"Inj, zolbetuximab-clzb, 2 mg","description":"Injection, zolbetuximab-clzb, 2 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0867T","name":"Tpla b9 prst8 hyprplsa>=50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume greater or equal to 50 ml","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70471","name":"Cta h&n c+ w/noncontrast img","description":"Computed tomographic angiography (cta), head and neck, with contrast material(s), including noncontrast images, when performed, and image postprocessing","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4427","name":"Dermbnd dln dl+ dlx sq cm","description":"Dermabind dl n or dermabind dl + or dermabind dl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98975","name":"Rtm 1st set-up&pt educaj eqp","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); initial set-up and patient education on use of equipment","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2791","name":"Crown full cast base metal","description":"Crown-full cast predominantly base metal","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87150","name":"Dna/rna amplified probe","description":"Culture, typing; identification by nucleic acid (dna or rna) probe, amplified probe technique, per culture or isolate, each organism probed","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1328","name":"Pts dx acute vitreous hem","description":"Patients with a diagnosis of acute vitreous hemorrhage","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94761","name":"N-invas ear/pls oximetry mlt","description":"Noninvasive ear or pulse oximetry for oxygen saturation; multiple determinations (eg, during exercise)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1359","name":"Indx suicd idea, no 0 scr","description":"Index assessment during the denominator period when the suicidal ideation and/or behavior symptoms or increased suicide risk by clinician determination occurs and a non-zero c-ssrs score is obtained","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5911","name":"Facial moulage sectional","description":"Facial moulage (sectional)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9174","name":"Inj, docetaxel (beizray) 1mg","description":"Injection, docetaxel (beizray), 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0847T","name":"Dgtz gls mcrscp xm arch tiss","description":"Digitization of glass microscope slides for examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, kras mutational analysis) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3291","name":"Tranexamic acid in sod chlor","description":"Injection, tranexamic acid in sodium chloride, 5 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0381U","name":"Maple syrup ur ds mntr quan","description":"Maple syrup ur ds mntr quan","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0684T","name":"Peri-px dev eval isdss ip","description":"Peri-procedural device evaluation (in-person) and programming of device system parameters before or after a surgery, procedure, or test with analysis, review, and report by a physician or other qualified health care professional, permanent implantable synchronized diaphragmatic stimulation system fo","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23146","name":"Removal of bone lesion","description":"Excision or curettage of bone cyst or benign tumor of clavicle or scapula; with allograft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":746.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0389","name":"Periopic image capture only","description":"Periopic image capture only","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82820","name":"Hemoglobin-oxygen affinity","description":"Hemoglobin-oxygen affinity (po2 for 50% hemoglobin saturation with oxygen)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7021","name":"Suppl and access lung expan","description":"Supplies and accessories for lung expansion airway clearance, continuous high frequency oscillation, and nebulization device (e.g., handset, nebulizer kit, biofilter)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37269","name":"Revsc evasc fpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93898","name":"Ven-artl shunt det mbubb njx","description":"Venous-arterial shunt detection with intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9048","name":"Inj, bortezomib freseniuskab","description":"Injection, bortezomib (fresenius kabi), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49617","name":"Rpr aa hrn rcr > 10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, reducible","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0943T","name":"Cysto flx rmvl urtl scaffold","description":"Cystourethroscopy, flexible; with removal of prostatic urethral scaffold","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50389","name":"Remove renal tube w/fluoro","description":"Removal of nephrostomy tube, requiring fluoroscopic guidance (eg, with concurrent indwelling ureteral stent)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1426","name":"Injection, casimersen, 10 mg","description":"Injection, casimersen, 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0419U","name":"Nrpsyc gen seq vrnt aly 13","description":"Nrpsyc gen seq vrnt aly 13","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80161","name":"Asy carbamazepin 10,11-epxid","description":"Carbamazepine; -10,11-epoxide","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01937","name":"Anes drg/aspir crv/thrc","description":"Anesthesia for percutaneous image-guided injection, drainage or aspiration procedures on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0525U","name":"Onc sphrd cell cul 11-rx pnl","description":"Onc sphrd cell cul 11-rx pnl","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0693T","name":"Compre ful bdy 3d mtn alys","description":"Comprehensive full body computer-based markerless 3d kinematic and kinetic motion analysis and report","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1298","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4325","name":"Acapatch, per sq cm","description":"Acapatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1304","name":"No pneum vax admin 19+","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80506","name":"Path clin consltj prolng svc","description":"Pathology clinical consultation; prolonged service, each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0018","name":"Crisis psychotherapy add 30m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); each additional 30 minutes (list separately in addition to code for primary service)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0725T","name":"Vestibular dev impltj uni","description":"Vestibular device implantation, unilateral","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1441","name":"Init dx slp apn = 1st enc","description":"Encounter corresponds to initial diagnosis of sleep apnea or first contact with sleep apnea diagnosed patient","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26492","name":"Tendon transfer with graft","description":"Opponensplasty; tendon transfer with graft (includes obtaining graft), each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1133.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71048","name":"X-ray exam chest 4+ views","description":"Radiologic examination, chest; 4 or more views","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25810","name":"Arthrd wrst iliac/oth agrft","description":"Arthrodesis, wrist; with iliac or other autograft (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1009.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37260","name":"Revsc evasc ivt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1262","name":"Pts transplt bef dialysis","description":"Patients who had a transplant prior to initiation of dialysis","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88283","name":"Chromosome banding study","description":"Chromosome analysis; additional specialized banding technique (eg, nor, c-banding)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5945","name":"Mand implt sup remv part","description":"Mand implt sup remv part","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0336U","name":"Rare ds whl gen seq bld/slv","description":"Rare ds whl gen seq bld/slv","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37298","name":"Revsc evsc imvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11743.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35216","name":"Rpr blvsl dir ntrthrc wo byp","description":"Repair blood vessel, direct; intrathoracic, without bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1358.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8006","name":"Grip glove replacement only","description":"Powered, cable driven grip assist glove, hand, finger, includes pressure sensors, glove replacement only","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15854","name":"Removal sutr&stapl xreq anes","description":"Removal of sutures and staples not requiring anesthesia (list separately in addition to e/m code)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9184","name":"Inj gemcitabin (avyxa) 200mg","description":"Injection, gemcitabine hydrochloride (avyxa), 200 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7961","name":"Buccal/labial frenectomy","description":"Buccal/labial frenectomy","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9249","name":"Inj, melphalan (apotex) 1 mg","description":"Injection, melphalan (apotex), 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4397","name":"Summit aaa per sq cm","description":"Summit aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4392","name":"Grafix duo per sq cm","description":"Grafix duo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1447","name":"Pt dx bd bef end meas pd","description":"Patients with an active diagnosis of bipolar disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9035","name":"Bevacizumab injection","description":"Injection, bevacizumab, 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0319U","name":"Neph rna pretrnspl perph bld","description":"Neph rna pretrnspl perph bld","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90635","name":"H5n1 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n1, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31225","name":"Removal of upper jaw","description":"Maxillectomy; without orbital exenteration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1740.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1496","name":"No doc of fall or poc","description":"Patients that had a fall who did not have a plan of care for falls documented or do not have documentation of being assessed for falls","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2030","name":"Miro3d fibers, per mg","description":"Miro3d fibers, per milligram","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0984T","name":"Iv img xtrc cere vsl oct 1st","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q4054","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1245","name":"Pt othr thn true person","description":"Patient provided a response other than completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0350U","name":"Rx metab/pcx dna 27 gen alys","description":"Rx metab/pcx dna 27 gen alys","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0351U","name":"Nfct ds bct/viral trail ip10","description":"Nfct ds bct/viral trail ip10","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0418U","name":"Onc brst aug alg aly whl sl8","description":"Onc brst aug alg aly whl sl8","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0542","name":"No pt prsnt train add 15","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0813T","name":"Egd vol adjmt bariatric balo","description":"Esophagogastroduodenoscopy, flexible, transoral, with volume adjustment of intragastric bariatric balloon","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15016","name":"App skn cl ssp agrf t/a/l ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; each additional 480 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99496","name":"Transj care mgmt high f2f 7d","description":"Transitional care management services with the following required elements: communication (direct contact, telephone, electronic) with the patient and/or caregiver within 2 business days of discharge high level of medical decision making during the service period face-to-face visit, within 7 calenda","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":183.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99418","name":"Prolng ip/obs e/m ea 15 min","description":"Prolonged inpatient or observation evaluation and management service(s) time with or without direct patient contact beyond the required time of the primary service when the primary service level has been selected using total time, each 15 minutes of total time (list separately in addition to the cod","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"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":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0801","name":"3d dental scan direct","description":"3d dental scan direct","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55868","name":"Lap srg prst8ct lymph nod bx","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with lymph node biopsy(ies) (limited pelvic lymphadenectomy)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1183","name":"Doc imm ckpt inhib hld","description":"Documentation of immune checkpoint inhibitor therapy held and corticosteroids or immunosuppressants prescribed or administered","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27278","name":"Arthrd si jt plmt iartic dev","description":"Arthrodesis, sacroiliac joint, percutaneous or minimally invasive, with image guidance, includes obtaining bone graft when performed, unilateral; placement of intra-articular device(s), without cortical piercing","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0922T","name":"Rmvl perm ccm-d sys dual ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); dual (pacing and defibrillation) transvenous leads only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9611","name":"Flurpiridaz f18, diag, 1 mci","description":"Flurpiridaz f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1332","name":"Pts no eval ini xm no 2 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 2 weeks","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6590","name":"Urinary cath disp suc pump","description":"External urinary catheters; disposable, with wicking material, for use with suction pump, per month","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3502","name":"Surg exp root surf premolar","description":"Surg exp root surf premolar","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3471","name":"Surg rep root res anterior","description":"Surg rep root res anterior","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1341","name":"Pt no f/u 30-180 dys","description":"Patients who did not have a follow-up assessment or did not have an assessment within 30 to 180 days after the index assessment during the performance period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6071","name":"Abutment supported retainer","description":"Abutment supported retainer for porcelain fused to metal fpd (noble metal)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4037","name":"Urology ss","description":"Urology mips specialty set","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93792","name":"Pt/caregiver traing home inr","description":"Patient/caregiver training for initiation of home international normalized ratio (inr) monitoring under the direction of a physician or other qualified health care professional, face-to-face, including use and care of the inr monitor, obtaining blood sample, instructions for reporting home inr test ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97037","name":"Appl modality 1+lllt po pain","description":"Application of a modality to 1 or more areas; low-level laser therapy (ie, nonthermal and non-ablative) for post-operative pain reduction","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9003","name":"Leupro inj, camcevi etm, 1mg","description":"Leuprolide injectable (camcevi etm), 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4259","name":"Celera per sq cm","description":"Celera dual layer or celera dual membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19294","name":"Prepj tum cav iort prtl mast","description":"Preparation of tumor cavity, with placement of a radiation therapy applicator for intraoperative radiation therapy (iort) concurrent with partial mastectomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81524","name":"Onc cns tum dna mthyl 10,000","description":"Oncology (central nervous system tumor), dna methylation analysis of at least 10,000 methylation sites, utilizing dna extracted from formalin-fixed tumor tissue, algorithm(s) reported as probability of matching a reference tumor family and class, and mgmt (o-6-methylguanine-dna methyltransferase) pr","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4031","name":"Radiation oncology ss","description":"Radiation oncology mips specialty set","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7111","name":"Extraction coronal remnants","description":"Extraction coronal remnants - deciduous tooth","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50980","name":"Ureter endoscopy & treatment","description":"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0751","name":"Hiv prep, ftc/taf 200/25mg","description":"Emtricitabine 200mg and tenofovir alafenamide 25mg, oral, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0390U","name":"Ob pe kdr eng&rbp4 ia alg","description":"Ob pe kdr eng&rbp4 ia alg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6524","name":"G com garmnt lwr leg/ft nght","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37260","name":"Revsc evasc ivt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93503","name":"Insert/place heart catheter","description":"Insertion and placement of flow directed catheter (eg, swan-ganz) for monitoring purposes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1233","name":"Pt no hcv aby or result","description":"Patient does not receive hcv antibody test or patient does receive hcv antibody test but results not documented, reason not given","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0063","name":"Cardiology ss","description":"Cardiology mips specialty set","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87467","name":"Hepatitis b surface ag quan","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; hepatitis b surface antigen (hbsag), quantitative","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6252","name":"Bridge resin w/noble metal","description":"Pontic-resin with noble metal","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4366","name":"Dl amnio bur x-mem per sq cm","description":"Dual layer amnio burgeon x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0256U","name":"Tma/tmao prfl ms/ms ur alg","description":"Trimethylamine/trimethylamine n-oxide (tma/tmao) profile, tandem mass spectrometry (ms/ms), urine, with algorithmic analysis and interpretive report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1288","name":"Doc rsn no hbp scrn or f/u","description":"Documented reason for not screening or recommending a follow-up for high blood pressure","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0796T","name":"Tcat ins 2chmbr ldls pm ra","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right atrial pacemaker","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1268","name":"Pt ac stat kid trnsplt wtlst","description":"Patients observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0722T","name":"Quan ct tiss charac w/ct","description":"Quantitative computed tomography (ct) tissue characterization, including interpretation and report, obtained with concurrent ct examination of any structure contained in the concurrently acquired diagnostic imaging dataset (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1503","name":"Vascular surgery mvp","description":"Vascular surgery mips value pathway","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0278U","name":"Hem gen thrombosis 12 genes","description":"Hematology (genetic thrombosis), genomic sequence analysis of 12 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4312","name":"Acesso ac, per sq cm","description":"Acesso ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0706T","name":"Rem tx amblyopia i&r phy/qhp","description":"Remote treatment of amblyopia using an eye tracking device; interpretation and report by physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6251","name":"Bridge resin base metal","description":"Pontic-resin with predominantly base metal","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2050","name":"Financial mgt waiver/diem","description":"Financial management, self-directed, waiver; per diem","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3472","name":"Surg rep root res premolar","description":"Surg rep root res premolar","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86053","name":"Aqaprn-4 antb flo cytmtry ea","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; flow cytometry (ie, fluorescence-activated cell sorting [facs]), each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69950","name":"Incise inner ear nerve","description":"Vestibular nerve section, transcranial approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2088.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4457","name":"Enema tube any type repl","description":"Enema tube, with or without adapter, any type, replacement only, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43605","name":"Biopsy of stomach","description":"Biopsy of stomach, by laparotomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":839.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2184","name":"Inj, meropenem (b. braun)","description":"Injection, meropenem (b. braun), not therapeutically equivalent to j2185, 100 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99497","name":"Advncd care plan 30 min","description":"Advance care planning including the explanation and discussion of advance directives such as standard forms (with completion of such forms, when performed), by the physician or other qualified health care professional; first 30 minutes, face-to-face with the patient, family member(s), and/or surroga","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":72.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0942T","name":"Cysto flx rmv&rplc urtl scaf","description":"Cystourethroscopy, flexible; with removal and replacement of prostatic urethral scaffold","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0402","name":"Initial preventive exam","description":"Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":196.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0684T","name":"Peri-px dev eval isdss ip","description":"Peri-procedural device evaluation (in-person) and programming of device system parameters before or after a surgery, procedure, or test with analysis, review, and report by a physician or other qualified health care professional, permanent implantable synchronized diaphragmatic stimulation system fo","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22850","name":"Remove spine fixation device","description":"Removal of posterior nonsegmental instrumentation (eg, harrington rod)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0727T","name":"Rmvl&rplcmt implt vstblr dev","description":"Removal and replacement of implanted vestibular device, unilateral","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2371","name":"Inj phenylephrine hcl 20 mcg","description":"Injection, phenylephrine hydrochloride, 20 micrograms","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96380","name":"Admn rsv monoc antb im cnsl","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection, with counseling by physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33276","name":"Insj phrnc nrv stim sys","description":"Insertion of phrenic nerve stimulator system (pulse generator and stimulating lead[s]), including vessel catheterization, all imaging guidance, and pulse generator initial analysis with diagnostic mode activation, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99375","name":"Home health care supervision","description":"Supervision of a patient under care of home health agency (patient not present) in home, domiciliary or equivalent environment (eg, alzheimers facility) requiring complex and multidisciplinary care modalities involving regular development and/or revision of care plans by that individual, review of s","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":83.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0163","name":"Epinephrine in nacl (endo)","description":"Injection, epinephrine in sodium chloride (endo), 0.1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0954T","name":"Tot impl amei rplc snd proc","description":"Totally implantable active middle ear hearing implant; replacement of sound processor only, with attachment to existing transducers","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9064","name":"Inj, cabazitaxel (sandoz)","description":"Injection, cabazitaxel (sandoz), not therapeutically equivalent to j9043, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5134","name":"Inj, tyruko, 1 mg","description":"Injection, natalizumab-sztn (tyruko), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70260","name":"X-ray exam of skull","description":"Radiologic examination, skull; complete, minimum of 4 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1308","name":"Flu immunize no admin","description":"Influenza immunization was not administered, reason not given","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93593","name":"R hrt cath chd nml nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; normal native connections","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1005T","name":"Elec alys s-scl eeg prgr 1st","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, first 15 minutes face-to-face time with physician or other qualified hea","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64659","name":"Rmvl bat modulj sys pg only","description":"Removal of baroreflex activation therapy (bat) modulation system; pulse generator only","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4036","name":"Urgent care ss","description":"Urgent care mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33692","name":"Comp rpr tof wo pulm atresia","description":"Complete repair tetralogy of fallot without pulmonary atresia;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2208.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90624","name":"Menb-4c&menacwy vacc im","description":"Meningococcal pentavalent vaccine, men b-4c recombinant proteins and outer membrane vesicle and conjugated men a, c, w, y-diphtheria toxoid carrier, for intramuscular use","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2010","name":"Apis, per square centimeter","description":"Apis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1446","name":"Pt died bef end meas pd","description":"Patients who died any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0409U","name":"Onc sld tum dna 80 & rna 36","description":"Onc sld tum dna 80 & rna 36","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33279","name":"Rmvl phrnc nrv stim transvns","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s) only","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0977T","name":"Upr gi bld detcj snr capsule","description":"Upper gastrointestinal blood detection, sensor capsule, with interpretation and report","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33268","name":"Excl laa opn oth px any meth","description":"Exclusion of left atrial appendage, open, performed at the time of other sternotomy or thoracotomy procedure(s), any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2043","name":"Biobrane, per sq cm","description":"Biobrane, per square centimeter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67331","name":"Eye surgery follow-up add-on","description":"Strabismus surgery on patient with previous eye surgery or injury that did not involve the extraocular muscles (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6111","name":"Implnt/abut remov dent mand","description":"Implnt/abut remov dent mand","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99403","name":"Prev med cnsl indiv apprx 45","description":"Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 45 minutes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":65.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89225","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92972","name":"Perq trluml coronry lithotrp","description":"Percutaneous transluminal coronary lithotripsy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0985T","name":"Iv img xtrc cere vsl oct ea","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0980T","name":"Sbmcsl crylys ther tng&tnsl","description":"Submucosal cryolysis therapy; base of tongue and lingual tonsil only","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82800","name":"Blood ph","description":"Gases, blood, ph only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7252","name":"Part extract for implant","description":"Part extract for implant","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1235","name":"Doc pt hcv aby rna tst","description":"Documentation or patient report of hcv antibody test or hcv rna test which occurred prior to the performance period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1242","name":"Pt no resp imprt to me","description":"Patient did not respond to the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2791","name":"Crown full cast base metal","description":"Crown-full cast predominantly base metal","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1398.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64746","name":"Incise diaphragm nerve","description":"Transection or avulsion of; phrenic nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64467","name":"Thrc fascial pln blk uni nfs","description":"Thoracic fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0063","name":"Cardiology ss","description":"Cardiology mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7412","name":"Excision benign lesion compl","description":"Excision of benign lesion complicated","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9073","name":"Inj cyclophos dr reddys 5 mg","description":"Injection, cyclophosphamide (dr. reddys), 5 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87523","name":"Hepatitis d quantification","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis d (delta), quantification, including reverse transcription, when performed","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0395U","name":"Onc lng multiomics plsm alg","description":"Onc lng multiomics plsm alg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9887","name":"Distance learning attendance","description":"Behavioral counseling for diabetes prevention, distance learning, 60 minutes","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4371","name":"Neoguard per sq cm","description":"Neoguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0814T","name":"Prq njx biod osteo matrl fem","description":"Percutaneous injection of calcium-based biodegradable osteoconductive material, proximal femur, including imaging guidance, unilateral","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1420","name":"Complete ophthalmologic mvp","description":"Complete ophthalmologic care mips value pathway","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0019M","name":"Cv ds plasma alys prtn bmrk","description":"Cardiovascular disease, plasma, analysis of protein biomarkers by aptamer-based microarray and algorithm reported as 4-year likelihood of coronary event in high-risk populations","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0889T","name":"Prsnlz trgt dvl arhfcmrigtbs","description":"Personalized target development for accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation derived from a structural and resting-state functional mri, including data preparation and transmission, generation of the target, motor threshold-starting location, neuro","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0237","name":"Therapeutic procd strg endur","description":"Therapeutic procedures to increase strength or endurance of respiratory muscles, face to face, one on one, each 15 minutes (includes monitoring)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36405","name":"Vnpnxr<3yrs phy/qhp scalp vn","description":"Venipuncture, younger than age 3 years, necessitating the skill of a physician or other qualified health care professional, not to be used for routine venipuncture; scalp vein","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":23.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6598","name":"G comp bandage med stretch","description":"Gradient compression bandage roll, elastic medium stretch, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67415","name":"Aspiration orbital contents","description":"Fine needle aspiration of orbital contents","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80506","name":"Path clin consltj prolng svc","description":"Pathology clinical consultation; prolonged service, each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4428","name":"Dermbnd sln sl+ slx sq cm","description":"Dermabind sl n or dermabind sl + or dermabind sl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1270","name":"Pts no kid transplt wtlst","description":"Patients not on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1327","name":"Pts no eval ini xm no 8 wks","description":"Patients who were not appropriately evaluated during the initial exam and/or who were not re-evaluated within 8 weeks","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0498U","name":"Onc clrct ngs mut detc 43gen","description":"Onc clrct ngs mut detc 43gen","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0409U","name":"Onc sld tum dna 80 & rna 36","description":"Onc sld tum dna 80 & rna 36","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0570","name":"Care manage serv, pr cal mo","description":"Care management services for behavioral health conditions, directed by a physician or other qualified health care professional, per calendar month, with the following required elements: initial assessment or follow-up monitoring, including the use of applicable validated rating scales, behavioral he","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37272","name":"Revsc evsc fpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0345U","name":"Psyc genom alys pnl 15 gen","description":"Psyc genom alys pnl 15 gen","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1421","name":"Dermatological care mvp","description":"Dermatological care mips value pathway","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37263","name":"Revsc evasc fpvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0734T","name":"Rem r-t mtn nrehab tx mgmt","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; treatment management services by a physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27458","name":"Osteot femur imed lngth dev","description":"Osteotomy(ies), femur, unilateral, with insertion of an externally controlled intramedullary lengthening device, including iliotibial band release when performed, imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9948","name":"Adjust sleep apnea appliance","description":"Adjust sleep apnea appliance","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96110","name":"Developmental screen w/score","description":"Developmental screening (eg, developmental milestone survey, speech and language delay screen), with scoring and documentation, per standardized instrument","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96041","name":"Genetic counseling svc ea 30","description":"Medical genetics and genetic counseling services, each 30 minutes of total time provided by the genetic counselor on the date of the encounter","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98010","name":"Synch audio-only new mod 45","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection,","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4282","name":"Cygnus dual per sq cm","description":"Cygnus dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0457","name":"Injection, aztreonam, 100 mg","description":"Injection, aztreonam, 100 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36836","name":"Prq av fstl crtj uxtr 1 acs","description":"Percutaneous arteriovenous fistula creation, upper extremity, single access of both the peripheral artery and peripheral vein, including fistula maturation procedures (eg, transluminal balloon angioplasty, coil embolization) when performed, including all vascular access, imaging guidance and radiolo","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6038","name":"Multiax rotation attachment","description":"Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0431U","name":"Gly rcptr alpha1 igg srm/csf","description":"Gly rcptr alpha1 igg srm/csf","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4241","name":"Gngvl flap w rootplan 1-3 th","description":"Gingival flap procedure including root planing - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0708T","name":"Id ca immntx prep & 1st njx","description":"Intradermal cancer immunotherapy; preparation and initial injection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0798T","name":"Tcat rmv 2chmbr ldls pm cmpl","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; complete system (ie, right atrial and right ventricular pacemaker components)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1315","name":"Crc no doc no rsn","description":"Colorectal cancer screening results were not documented and reviewed; reason not otherwise specified","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0842T","name":"Dgtz gls mcrscp pth cslt ea","description":"Digitization of glass microscope slides for pathology consultation during surgery; each additional tissue block with frozen section(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0925T","name":"Rlcj skin pocket ccm-d pg","description":"Relocation of skin pocket for implanted cardiac contractility modulation-defibrillation pulse generator","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76642","name":"Ultrasound breast limited","description":"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7473","name":"Remove torus mandibularis","description":"Removal of torus mandibularis","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0753T","name":"Dgtz gls mcrscp sld level iv","description":"Digitization of glass microscope slides for level iv, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82436","name":"Assay of urine chloride","description":"Chloride; urine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1400","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9563","name":"Ht inj immuno diem","description":"Home injectable therapy, immunotherapy, 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":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1370","name":"Rehab support msk care mvp","description":"Rehabilitative support for musculoskeletal care mips value pathway","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7413","name":"Excision malig lesion<=1.25c","description":"Excision of malignant lesion up to 1.25 cm","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0554U","name":"Repr med pga 24chrm te bx qc","description":"Repr med pga 24chrm te bx qc","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4363","name":"Am bur mem hydro per sq cm","description":"Amnio burgeon membrane and hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4018","name":"Ob/gyn ss","description":"Obstetrics/gynecology mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4425","name":"Revive tl per sq cm","description":"Revive tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4015","name":"Neurology ss","description":"Neurology mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97802","name":"Medical nutrition indiv in","description":"Medical nutrition therapy; initial assessment and intervention, individual, face-to-face with the patient, each 15 minutes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":39.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0796T","name":"Tcat ins 2chmbr ldls pm ra","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right atrial pacemaker","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99424","name":"Prin care mgmt phys 1st 30","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0878T","name":"Augmnt alys ch ct ild w/ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained with concurrent ct examination of the same structure","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4010","name":"Infectious disease ss","description":"Infectious disease mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0619U","name":"Pulm copd dna alys >18000","description":"Pulm copd dna alys >18000","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0893T","name":"N-invas assmt bld oxygnation","description":"Noninvasive assessment of blood oxygenation, gas exchange efficiency, and cardiorespiratory status, with physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28140","name":"Removal of metatarsal","description":"Metatarsectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9988","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90612","name":"Inf&sarscov2 vacc 31.7/.32im","description":"Influenza virus vaccine, trivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 31.7 mcg/0.32 ml dosage, for intramuscular use","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2010","name":"Apis, per square centimeter","description":"Apis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2312","name":"Inj naloxone hcl nos, 0.01mg","description":"Injection, naloxone hydrochloride, not otherwise specified, 0.01 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1177","name":"Pt recd pcv on/aft 19","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1552","name":"Inj, alyglo, 500 mg","description":"Injection, immune globulin (alyglo), 500 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89125","name":"Specimen fat stain","description":"Fat stain, feces, urine, or respiratory secretions","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9948","name":"Adjust sleep apnea appliance","description":"Adjust sleep apnea appliance","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61522","name":"Removal of brain abscess","description":"Craniectomy, infratentorial or posterior fossa; for excision of brain abscess","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2471.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4022","name":"Otolaryngology ss","description":"Otolaryngology mips specialty set","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0370","name":"Max ultrasound capt & interp","description":"Max ultrasound capt & interp","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75756","name":"Artery x-rays chest","description":"Angiography, internal mammary, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4350","name":"Palisade dm matrix per sq cm","description":"Palisade dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27605","name":"Incision of achilles tendon","description":"Tenotomy, percutaneous, achilles tendon (separate procedure); local anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0607U","name":"Reprdtve med ema rtpcr 31bct","description":"Reprdtve med ema rtpcr 31bct","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0177","name":"Inj, aflibercept hd, 1 mg","description":"Injection, aflibercept hd, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1242","name":"Pt no resp imprt to me","description":"Patient did not respond to the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0756T","name":"Dgtz gls mcrscp sld spc grpi","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group i, for microorganisms (eg, acid fast, methenamine silver) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7298","name":"Remove screw retained plate","description":"Remove screw retained plate","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0808T","name":"Pulm tiss vntj alys w/ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with computed tomography (ct) images taken for the purpose of pulmonary tissue ventilation analysis, including data preparation and transmission, quantificati","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1214","name":"Spiro results wth obs doc","description":"Spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and reviewed","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1454","name":"New cied","description":"New cied","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0533U","name":"Rx metab advrs gnotyp 16gens","description":"Rx metab advrs gnotyp 16gens","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0708T","name":"Id ca immntx prep & 1st njx","description":"Intradermal cancer immunotherapy; preparation and initial injection","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9052","name":"Inj, carmustine (accord)","description":"Injection, carmustine (accord), not therapeutically equivalent to j9050, 100 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0307U","name":"Onc mrd nxt-gnrj alys sbsq","description":"Onc mrd nxt-gnrj alys sbsq","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1436","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87210","name":"Smear wet mount saline/ink","description":"Smear, primary source with interpretation; wet mount for infectious agents (eg, saline, india ink, koh preps)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6519","name":"Grad com garm noc night use","description":"Gradient compression garment, not otherwise specified, for nighttime use, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91322","name":"Sarscov2 vac 50 mcg/0.5ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 50 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32663","name":"Thoracoscopy w/lobectomy","description":"Thoracoscopy, surgical; with lobectomy (single lobe)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1436.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1487","name":"Pt adm to hospice dur eval","description":"Patients in hospice in the year before or during the period of evaluation","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4266","name":"Neostim per sq cm","description":"Neostim membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4309","name":"Via matrix, per sq cm","description":"Via matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93232","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1186","name":"Pt w/ rx for hspc/plltv care","description":"Patients who have an order for or are receiving hospice or palliative care","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7528","name":"Mycophen mofetil for susp","description":"Mycophenolate mofetil, for suspension, oral, 100 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3391","name":"Inj, atidarsagene autotemcel","description":"Injection, atidarsagene autotemcel, per treatment","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4425","name":"Revive tl per sq cm","description":"Revive tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0260U","name":"Rare ds id opt genome mapg","description":"Rare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1938","name":"Inj, furosemide, 1 mg","description":"Injection, furosemide, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87880","name":"Strep a assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; streptococcus, group a","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0349U","name":"Rx metab/pcx dna 27gen rx ia","description":"Rx metab/pcx dna 27gen rx ia","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1275","name":"Pts hosp exl","description":"Patients determined to be in hospice were excluded from month of evaluation and the remainder of reporting period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1186","name":"Pt w/ rx for hspc/plltv care","description":"Patients who have an order for or are receiving hospice or palliative care","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1053.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1407","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92637","name":"Hearing aid pst-fitg f-up ea","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0992T","name":"N-invas assmt car rsk w/o ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat without concurrent computed tomography (ct) scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0012","name":"Injection of hiv prep drug","description":"Injection of pre-exposure prophylaxis (prep) drug for hiv prevention, under skin or into muscle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0328U","name":"Drug assay 120+ rx&metablt","description":"Drug assay 120+ rx&metablt","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP05","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1456","name":"Pt had htx","description":"Patient had a heart transplant","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97110","name":"Therapeutic exercises","description":"Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexibility","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5151","name":"Inj, eculizumab-aagh, 2 mg","description":"Injection, eculizumab-aagh (epysqli), biosimilar, 2 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64469","name":"Thrc fascial pln blk bi nfs","description":"Thoracic fascial plane block, bilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84166","name":"Protein e-phoresis/urine/csf","description":"Protein; electrophoretic fractionation and quantitation, other fluids with concentration (eg, urine, csf)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3291","name":"Tranexamic acid in sod chlor","description":"Injection, tranexamic acid in sodium chloride, 5 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0791T","name":"Motr cog vr gait train ea 15","description":"Motor-cognitive, semi-immersive virtual reality-facilitated gait training, each 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90613","name":"Inf&sarscov2 vacc 40/0.4 im","description":"Influenza virus vaccine, quadrivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 40 mcg/0.4 ml dosage, for intramuscular use","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0518U","name":"Ther rx mntr 90+ pn&mtl hlth","description":"Ther rx mntr 90+ pn&mtl hlth","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47716","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1177.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75827","name":"Vein x-ray chest","description":"Venography, caval, superior, with serialography, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37282","name":"Rvsc evsc tpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37298","name":"Revsc evsc imvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0410U","name":"Onc pncrtc dna whl gn seq 5-","description":"Onc pncrtc dna whl gn seq 5-","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1362","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1383","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92137","name":"Cptrz oph img pst sg rta oct","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), posterior segment, with interpretation and report, unilateral or bilateral; retina, including oct angiography","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9999","name":"Doc sys rsn <3 colon","description":"Documentation of system reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., unable to locate previous colonoscopy report, patient cannot provide precise date or details from previous colonoscopy, previous colonoscopy report was incomplete)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6193","name":"Replace implnt screw","description":"Replace implnt screw","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2799","name":"Inj, uzedy, 1 mg","description":"Injection, risperidone (uzedy), 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4419","name":"Biolab wrap flw lt per sq cm","description":"Biolab membrane wrap lite flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1017T","name":"Elec aly npgs esoph sbsq w/o","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0928T","name":"Rem interrog dev ccm-d phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system with interim analysis and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0956T","name":"Prt crn ch cr&tun elt s-sclp","description":"Partial craniectomy, channel creation, and tunneling of electrode for sub-scalp implantation of an electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4010","name":"Infectious disease ss","description":"Infectious disease mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0020M","name":"Onc cns alys 30000 dna loci","description":"Oncology (central nervous system), analysis of 30,000 dna methylation loci by methylation array, utilizing dna extracted from tumor tissue, diagnostic algorithm reported as probability of matching a reference tumor subclass","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1331","name":"Pts eval ini xm 8 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 8 weeks from initial exam","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0938T","name":"Xtrnl ecg rec>15d<30d rec","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; recording (including connection and initial recording)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0832T","name":"Dgtz gls mcrscp cytp oth scr","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81449","name":"So neo gsap 5-50 rna alys","description":"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; rna analysis","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0162","name":"Inj epinephrine (fresenius)","description":"Injection, epinephrine (fresenius), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47511","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":707.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93585","name":"Vngrph chd azygs/hemiazygs","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; azygos/hemiazygos venous system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87626","name":"Hpv sep hi-rsk typ&pool rslt","description":"Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), separately reported high-risk types (eg, 16, 18, 31, 45, 51, 52) and high-risk pooled result(s)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5421","name":"Dentures adjust part maxill","description":"Adjust partial denture - maxillary","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17106","name":"Dstr cut vsc prlf les<10sqcm","description":"Destruction of cutaneous vascular proliferative lesions (eg, laser technique); less than 10 sq cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0978T","name":"Submucosal cryolysis therapy","description":"Submucosal cryolysis therapy; soft palate, base of tongue, and lingual tonsil","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1004T","name":"Elec alys s-scl eeg wo prgrm","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; without programming","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2022","name":"Innovabrn/innovamatx xl sqcm","description":"Innovaburn or innovamatrix xl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4325","name":"Acapatch, per sq cm","description":"Acapatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0983T","name":"Rem mntr impl ivc snr phys","description":"Remote monitoring of an implanted inferior vena cava sensor for up to 30 days, including at least weekly downloads of inferior vena cava area recordings, interpretation(s), trend analysis, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7294","name":"Seg acet and eth estr yearly","description":"Segesterone acetate and ethinyl estradiol 0.15mg, 0.013mg per 24 hours; yearly vaginal system, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0476U","name":"Rx metab psyc 14gen&cyp2d6","description":"Rx metab psyc 14gen&cyp2d6","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1321","name":"Pts no 7wk inj,no iop,iop>25","description":"Patients who were not seen within 7 weeks following the date of injection for follow up or who did not have a documented iop or no plan of care documented if the iop was >25 mm hg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0282U","name":"Rbc dna gntyp 12 bld grp gen","description":"Red blood cell antigen typing, dna, genotyping of 12 blood group system genes to predict 44 red blood cell antigen phenotypes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0716T","name":"Car acous wavfrm rec cad rsk","description":"Cardiac acoustic waveform recording with automated analysis and generation of coronary artery disease risk score","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91319","name":"Sarscv2 vac 10mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 10 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5932","name":"Postsurgical obturator","description":"Obturator prosthesis definitive","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4023","name":"Pathology ss","description":"Pathology mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90684","name":"Pcv21 vaccine im","description":"Pneumococcal conjugate vaccine, 21 valent (pcv21), for intramuscular use","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0603U","name":"Rx asy prsmv 77rx/metablt ur","description":"Rx asy prsmv 77rx/metablt ur","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3432","name":"Guided tissue regeneration","description":"Guided tissue regeneration","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0958T","name":"Rmv s-sclp eltr ra rcvr&tlmt","description":"Removal of sub-scalp implanted electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4362","name":"Cygnus disk, per sq cm","description":"Cygnus disk, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0609U","name":"Onc prostate ia tot&free psa","description":"Onc prostate ia tot&free psa","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0756T","name":"Dgtz gls mcrscp sld spc grpi","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group i, for microorganisms (eg, acid fast, methenamine silver) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0270U","name":"Hem cgen coagj do 20 genes","description":"Hematology (congenital coagulation disorders), genomic sequence analysis of 20 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0546U","name":"Ldns lrp4 antb imflr livecll","description":"Ldns lrp4 antb imflr livecll","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0855T","name":"Dgtz gls mcrscp b1 marow smr","description":"Digitization of glass microscope slides for bone marrow, smear interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0571","name":"Intraop nerve cryoablation","description":"Intraoperative nerve(s) cryoablation for post-surgical pain relief (list separately in addition to code for primary service)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0829T","name":"Dgtz gls mcrscp cytp conctrj","description":"Digitization of glass microscope slides for cytopathology, concentration technique, smears, and interpretation (eg, saccomanno technique) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1713","name":"Pfizer vacc adm ped 1st dose","description":"Pfizer vacc adm ped 1st dose","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1343","name":"Pt pam lvl 4 base or srt lin","description":"Patients who are at pam level 4 at baseline or patients who are flagged with extreme straight line response sets on the pam or with excessive missing responses","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95919","name":"Quan puplmtry phy/qhp uni/bi","description":"Quantitative pupillometry with physician or other qualified health care professional interpretation and report, unilateral or bilateral","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0452U","name":"Onc bldr mthyl penk lte-qmsp","description":"Onc bldr mthyl penk lte-qmsp","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59410","name":"Obstetrical care","description":"Vaginal delivery only (with or without episiotomy and/or forceps); including postpartum care","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1058.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0706T","name":"Rem tx amblyopia i&r phy/qhp","description":"Remote treatment of amblyopia using an eye tracking device; interpretation and report by physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5228","name":"Immed mand part denture","description":"Immed mand part denture","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7956","name":"Tiss regen edent resorb","description":"Tiss regen edent resorb","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84394","name":"Total tau","description":"Tau, total (ttau)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75705","name":"Artery x-rays spine","description":"Angiography, spinal, selective, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":779.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37260","name":"Revsc evasc ivt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0965T","name":"I&cst prp jw xpn dl arch non","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, non-fixed hinge mechanism","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1933","name":"Afo rig ant tib tcf/= ots","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, off-the-shelf","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33903","name":"Perq p-art revsc 1 abnor bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, bilateral","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6193","name":"Replace implnt screw","description":"Replace implnt screw","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9196","name":"Inj gemcitabine hcl (accord)","description":"Injection, gemcitabine hydrochloride (accord), not therapeutically equivalent to j9201, 200 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45317","name":"Proctosigmoidoscopy bleed","description":"Proctosigmoidoscopy, rigid; with control of bleeding (eg, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0167","name":"Inj epinephrine (hospira)","description":"Injection, epinephrine (hospira), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0177","name":"Inj, aflibercept hd, 1 mg","description":"Injection, aflibercept hd, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92634","name":"Hearing aid fitg svc 1st 60","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; first 60 minutes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97552","name":"Group caregiver training","description":"Group caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1203","name":"No rsn ace-i/arb rx","description":"Ace inhibitor or arb therapy not prescribed during the measurement period, reason not given","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1360","name":"Suicd c-ssrs assessment","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22505","name":"Manipulation of spine","description":"Manipulation of spine requiring anesthesia, any region","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93597","name":"R&l hrt cath chd abnl nt cnj","description":"Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); abnormal native connections","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":284.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1442","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4017","name":"Nutrition/dietician ss","description":"Nutrition/dietician mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0630U","name":"Onc brst mrna gen prflg 80","description":"Onc brst mrna gen prflg 80","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1435","name":"Oral chemo in perf pd","description":"Patient on oral chemotherapy during the performance period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0579U","name":"Nfro dbtc ckd elisa apoa4","description":"Nfro dbtc ckd elisa apoa4","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0800T","name":"Tcat rmvl 2chmbr ldls pm rv","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right ventricular pacemaker component (when part of a dual-chamber leadless pacem","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91304","name":"Sarscov2 vac 5mcg/0.5ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, 5 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0857T","name":"Opto-acoustic img breast uni","description":"Opto-acoustic imaging, breast, unilateral, including axilla when performed, real-time with image documentation, augmentative analysis and report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0612","name":"Inj, calcium gluconate, nos","description":"Injection, calcium gluconate, not otherwise specified, 10 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93790","name":"Ambl bp mntr w/sw i&r","description":"Ambulatory blood pressure monitoring, utilizing report-generating software, automated, worn continuously for 24 hours or longer; review with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1483","name":"Neg quan hep c or qual rna","description":"Patients who achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82608","name":"B-12 binding capacity","description":"Cyanocobalamin (vitamin b-12); unsaturated binding capacity","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0517","name":"Remove drug implant","description":"Removal of non-biodegradable drug delivery implants, 4 or more (services for subdermal implants)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":103.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0740","name":"Cidofovir injection","description":"Injection, cidofovir, 375 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":762.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0990T","name":"Trncrv inst biod hydrgl mtrl","description":"Transcervical instillation of biodegradable hydrogel materials, intrauterine","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7956","name":"Tiss regen edent resorb","description":"Tiss regen edent resorb","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0023","name":"Pin service 60m per month","description":"Principal illness navigation services by certified or trained auxiliary personnel under the direction of a physician or other practitioner, including a patient navigator; 60 minutes per calendar month, in the following activities:  person-centered assessment, performed to better understand the indiv","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15657.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0519","name":"New pt-cg dyad dem low cmplx","description":"Management of new patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0737","name":"Inj, clindamycin (baxter)","description":"Injection, clindamycin phosphate (baxter), not therapeutically equivalent to j0736, 300 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43108","name":"Removal of esophagus","description":"Total or near total esophagectomy, without thoracotomy; with colon interposition or small intestine reconstruction, including intestine mobilization, preparation and anastomosis(es)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2319.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0611U","name":"Onc lvr alys >1000 mr cfdna","description":"Onc lvr alys >1000 mr cfdna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0784T","name":"Ins/rplmt eltrd ra spi nstim","description":"Insertion or replacement of percutaneous electrode array, spinal, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1162","name":"Pt enceph due to dtp bef 13","description":"Patient had encephalitis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4383","name":"Axolotl graft ult per sq cm","description":"Axolotl graft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4023","name":"Pathology ss","description":"Pathology mips specialty set","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36482","name":"Endoven ther chem adhes 1st","description":"Endovenous ablation therapy of incompetent vein, extremity, by transcatheter delivery of a chemical adhesive (eg, cyanoacrylate) remote from the access site, inclusive of all imaging guidance and monitoring, percutaneous; first vein treated","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":1952.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1365","name":"Hosp+pall care spec code 17","description":"Patient encounter during the performance period with hospice and palliative care specialty code 17","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93585","name":"Vngrph chd azygs/hemiazygs","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; azygos/hemiazygos venous system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1400","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0438U","name":"Rx metab advrs vrnt alys 33","description":"Rx metab advrs vrnt alys 33","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0687","name":"Inj cefazolin (wg crit care)","description":"Injection, cefazolin sodium (wg critical care), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24065","name":"Biopsy arm/elbow soft tissue","description":"Biopsy, soft tissue of upper arm or elbow area; superficial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0909T","name":"Rplcmt int nstim sys vgs nrv","description":"Replacement of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4354","name":"Palingen dl-palingen dl-x","description":"Palingen dual-layer membrane and dual-layer palingen x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22837","name":"Ant thrc vrt body tethrg 8+","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; 8 or more vertebral segments","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0356U","name":"Onc orop 17 dna ddpcr alg","description":"Onc orop 17 dna ddpcr alg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2038","name":"Marigen pacto, per sq cm","description":"Marigen pacto, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89135","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27412","name":"Autochondrocyte implant knee","description":"Autologous chondrocyte implantation, knee","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1936.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3761","name":"Eo, adj lock joint prefab ot","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, off-the-shelf","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":545.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4003","name":"Emergency med ss","description":"Emergency medicine mips specialty set","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4023","name":"Pathology ss","description":"Pathology mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2051","name":"Support broker waiver/diem","description":"Supports brokerage, self-directed, waiver; per diem","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15016","name":"App skn cl ssp agrf t/a/l ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; each additional 480 sq cm or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2041","name":"Foundation drs+ duo pr sq cm","description":"Foundation drs+ duo, per square centimeter","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0719T","name":"Pst vrt jt rplcmt lmbr 1 sgm","description":"Posterior vertebral joint replacement, including bilateral facetectomy, laminectomy, and radical discectomy, including imaging guidance, lumbar spine, single segment","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99466","name":"Ped crit care transport","description":"Critical care face-to-face services, during an interfacility transport of critically ill or critically injured pediatric patient, 24 months of age or younger; first 30-74 minutes of hands-on care during transport","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0707","name":"Intraoral periap radio image","description":"Intraoral periap radio image","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9038","name":"Inj axatilimab-csfr 0.1 mg","description":"Injection, axatilimab-csfr, 0.1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98981","name":"Rtm tx mgmt ea addl 20 min","description":"Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least 1 real-time interactive communication with the patient or caregiver during the calendar month; each additional 20 minutes (list separately in","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95912","name":"Nrv cndj test 11-12 studies","description":"Nerve conduction studies; 11-12 studies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0370","name":"Max ultrasound capt & interp","description":"Max ultrasound capt & interp","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0478U","name":"Onc nsclc dna&rna dpcr 9 gen","description":"Onc nsclc dna&rna dpcr 9 gen","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0710T","name":"N-invas artl plaq alys","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; including data preparation and transmission, quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess a","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41114","name":"Excision of tongue lesion","description":"Excision of lesion of tongue with closure; with local tongue flap","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":740.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27637","name":"Remove/graft leg bone lesion","description":"Excision or curettage of bone cyst or benign tumor, tibia or fibula; with autograft (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":903.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1482","name":"Pos quan hep c or qual rna","description":"Positive/detectable hepatitis c virus quantitative or qualitative rna test result during the denominator identification period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85244","name":"Clot factor viii reltd antgn","description":"Clotting; factor viii related antigen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0476U","name":"Rx metab psyc 14gen&cyp2d6","description":"Rx metab psyc 14gen&cyp2d6","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0751T","name":"Dgtz gls mcrscp sld level ii","description":"Digitization of glass microscope slides for level ii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15733","name":"Musc myoq/fscq flp h&n pedcl","description":"Muscle, myocutaneous, or fasciocutaneous flap; head and neck with named vascular pedicle (ie, buccinators, genioglossus, temporalis, masseter, sternocleidomastoid, levator scapulae)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87153","name":"Dna/rna sequencing","description":"Culture, typing; identification by nucleic acid sequencing method, each isolate (eg, sequencing of the 16s rrna gene)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0880T","name":"Augmnt alys ch ct ild i&r","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0377U","name":"Cv ds quan advsrm/plsm lprtn","description":"Cv ds quan advsrm/plsm lprtn","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6252","name":"Bridge resin w/noble metal","description":"Pontic-resin with noble metal","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4542","name":"Supp ext up limb tremor stim","description":"Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0742T","name":"Aqmbf spect xers/strs & rest","description":"Absolute quantitation of myocardial blood flow (aqmbf), single-photon emission computed tomography (spect), with exercise or pharmacologic stress, and at rest, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58260","name":"Vaginal hysterectomy","description":"Vaginal hysterectomy, for uterus 250 g or less;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":946.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0829T","name":"Dgtz gls mcrscp cytp conctrj","description":"Digitization of glass microscope slides for cytopathology, concentration technique, smears, and interpretation (eg, saccomanno technique) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46250","name":"Remove ext hem groups 2+","description":"Hemorrhoidectomy, external, 2 or more columns/groups","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77092","name":"Tbs i&r fx rsk qhp","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; interpretation and report on fracture-risk only by other qualified health care professional","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64658","name":"Rmvl bat modul sys lead only","description":"Removal of baroreflex activation therapy (bat) modulation system; lead only","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6601","name":"Porc/ceram inlay >= 3 surfac","description":"Inlay - porcelain/ceramic three or more surfaces","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0605","name":"Antibody test pub hlth path","description":"Antibody test pub hlth path","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98977","name":"Rtm dev sply mscskl 16-30 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of musculoskeletal system, 16-30 days in a 30-day period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61892","name":"Rmv sk-mnt crnl nstm pg/rcvr","description":"Removal of skull-mounted cranial neurostimulator pulse generator or receiver with cranioplasty, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25605","name":"Cltx dst rdl fx/ephys sep w/","description":"Closed treatment of distal radial fracture (eg, colles or smith type) or epiphyseal separation, includes closed treatment of fracture of ulnar styloid, when performed; with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95251","name":"Cont gluc mntr analysis i&r","description":"Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; analysis, interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33778","name":"Rpr tga aortic pulm art rcns","description":"Repair of transposition of the great arteries, aortic pulmonary artery reconstruction (eg, jatene type);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2829.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92325","name":"Modification of contact lens","description":"Modification of contact lens (separate procedure), with medical supervision of adaptation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9887","name":"Distance learning attendance","description":"Behavioral counseling for diabetes prevention, distance learning, 60 minutes","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0608","name":"Lanthanum carbonate pwdr 5mg","description":"Lanthanum carbonate, oral, powder, 5 mg, not therapeutically equivalent to j0607 (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99284","name":"Emergency dept visit mod mdm","description":"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17000","name":"Destruct premalg lesion","description":"Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (eg, actinic keratoses); first lesion","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":76.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5943","name":"Proth mandib implt sup remv","description":"Proth mandib implt sup remv","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0322","name":"Home h physio data collec tr","description":"The collection of physiologic data digitally stored and/or transmitted by the patient to the home health agency (i.e., remote patient monitoring)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0690T","name":"Quan us tis charac w/dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained with diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4540","name":"Trans elec nerv periph nerv","description":"Distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0463","name":"Inj atropine (fresenius te)","description":"Injection, atropine sulfate (fresenius and therapeutically equivalent), 0.01 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99493","name":"Sbsq psyc collab care mgmt","description":"Subsequent psychiatric collaborative care management, first 60 minutes in a subsequent month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required el","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":163.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11641","name":"Exc f/e/e/n/l mal+mrg 0.6-1","description":"Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 0.6 to 1.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26518","name":"Fusion of knuckle joints","description":"Capsulodesis, metacarpophalangeal joint; 3 or 4 digits","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1092.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0291U","name":"Psyc mood do mrna 144 genes","description":"Psyc mood do mrna 144 genes","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4316","name":"Amchoplast, per sq cm","description":"Amchoplast, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37254","name":"Revsc evasc ivt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4271","name":"Home lancing/test cartridges","description":"Integrated lancing and blood sample testing cartridges for home blood glucose monitor, per 50 tests","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30462","name":"Revision of nose","description":"Rhinoplasty for nasal deformity secondary to congenital cleft lip and/or palate, including columellar lengthening; tip, septum, osteotomies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1925.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4295","name":"Amnio tri-core, per sq cm","description":"Amnio tri-core amniotic, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2300","name":"Inj nalbuphine hydrochloride","description":"Injection, nalbuphine hydrochloride, per 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0970T","name":"Ablt b9 brst tum perq lsr ea","description":"Ablation, benign breast tumor (eg, fibroadenoma), percutaneous, laser, including imaging guidance when performed, each tumor","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64468","name":"Thrc fascial pln blk bi njx","description":"Thoracic fascial plane block, bilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29580","name":"Strapping unna boot","description":"Strapping; unna boot","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":26.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99427","name":"Prin care mgmt staff ea addl","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0970T","name":"Ablt b9 brst tum perq lsr ea","description":"Ablation, benign breast tumor (eg, fibroadenoma), percutaneous, laser, including imaging guidance when performed, each tumor","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4336","name":"Artecent c, per sq cm","description":"Artacent c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0681","name":"App of non-sheet skin sub","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; first 25 sq cm or less of wound surface area","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33279","name":"Rmvl phrnc nrv stim transvns","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s) only","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70471","name":"Cta h&n c+ w/noncontrast img","description":"Computed tomographic angiography (cta), head and neck, with contrast material(s), including noncontrast images, when performed, and image postprocessing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5148","name":"Inj, nyposi 1 mcg","description":"Injection, filgrastim-txid (nypozi), biosimilar, 1 microgram","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57100","name":"Biopsy vaginal mucosa simple","description":"Biopsy of vaginal mucosa; simple (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63272","name":"Excise intrspinl lesion lmbr","description":"Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; lumbar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2128.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98004","name":"Synch audio-video est sf 10","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 10 minutes must be met or e","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1174","name":"Pt w/ 2 hzv 10/2017 - mp","description":"Patient received at least two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0484U","name":"Nfct ds mgen 23s rrna pt mut","description":"Nfct ds mgen 23s rrna pt mut","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69501","name":"Mastoidectomy","description":"Transmastoid antrotomy (simple mastoidectomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":847.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0535","name":"Pt navigat svs direct/ref","description":"Patient navigational services, provided directly or by referral; including helping the patient to navigate health systems and identify care providers and supportive services, to build patient self-advocacy and communication skills with care providers, and to promote patient-driven action plans and g","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0825T","name":"Tcat rmv&rpl1chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or prog","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4386","name":"Acesso trifaca per sq cm","description":"Acesso trifaca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98005","name":"Synch audio-video est low 20","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low medical decision making. when using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded.","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90857","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44130","name":"Bowel to bowel fusion","description":"Enteroenterostomy, anastomosis of intestine, with or without cutaneous enterostomy (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1003.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2002","name":"Inj, lidocaine in d5w, 1 mg","description":"Injection, lidocaine hcl in 5% dextrose, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9608","name":"Flotufolastat f18 diag 1 mci","description":"Flotufolastat f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21407","name":"Opn tx orbit fx w/implant","description":"Open treatment of fracture of orbit, except blowout; with implant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84432","name":"Assay of thyroglobulin","description":"Thyroglobulin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7471","name":"Rem exostosis any site","description":"Removal of lateral exostosis (maxilla or mandible)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20983","name":"Ablate bone tumor(s) perq","description":"Ablation therapy for reduction or eradication of 1 or more bone tumors (eg, metastasis) including adjacent soft tissue when involved by tumor extension, percutaneous, including imaging guidance when performed; cryoablation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8199.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0289U","name":"Neuro alzheimer mrna 24 gen","description":"Neuro alzheimer mrna 24 gen","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99418","name":"Prolng ip/obs e/m ea 15 min","description":"Prolonged inpatient or observation evaluation and management service(s) time with or without direct patient contact beyond the required time of the primary service when the primary service level has been selected using total time, each 15 minutes of total time (list separately in addition to the cod","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0431U","name":"Gly rcptr alpha1 igg srm/csf","description":"Gly rcptr alpha1 igg srm/csf","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1808","name":"Inj, folic acid, 0.1 mg","description":"Injection, folic acid, 0.1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0820T","name":"Mntr psychdlc med 1stphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; first physician or other qualified health care professional, each hour","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99345","name":"Home/res vst new high mdm 75","description":"Home or residence visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 75 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92547","name":"Supplemental electrical test","description":"Use of vertical electrodes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0277U","name":"Hem gen pltlt funcj do 31","description":"Hematology (genetic platelet function disorder), genomic sequence analysis of 31 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98978","name":"Rtm dev sply cbt 16-30 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of cognitive behavioral therapy, 16-30 days in a 30-day period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0365U","name":"Onc bldr 10 prb bldr ca","description":"Onc bldr 10 prb bldr ca","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28210","name":"Repair/graft of foot tendon","description":"Repair, tendon, extensor, foot; secondary with free graft, each tendon (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":503.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1551","name":"Inj cutaquig 100 mg","description":"Injection, immune globulin (cutaquig), 100 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9953","name":"Reline sleep apnea appliance","description":"Reline sleep apnea appliance","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0552","name":"Supply of digital device","description":"Supply of digital mental health treatment device and initial education and onboarding, per course of treatment that augments a behavioral therapy plan","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77327","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90847","name":"Family psytx w/pt 50 min","description":"Family psychotherapy (conjoint psychotherapy) (with patient present), 50 minutes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":115.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4560","name":"Nmes disposable","description":"Neuromuscular electrical stimulator (nmes), disposable, replacement only","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0443U","name":"Neurflmnt lt chn ultrsens ia","description":"Neurflmnt lt chn ultrsens ia","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1478","name":"Psychoactive sub abuse","description":"Psychoactive substance abuse","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0462","name":"Atropine sulf, nte, 0.01 mg","description":"Injection, atropine sulfate, not therapeutically equivalent to j0461, 0.01 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1411","name":"Inj, hemgenix, per tx dose","description":"Injection, etranacogene dezaparvovec-drlb, per therapeutic dose","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7957","name":"Tiss regen edent nonresorb","description":"Tiss regen edent nonresorb","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1411","name":"1st ln ici no chemo","description":"Currently on first-line immune checkpoint inhibitors without chemotherapy","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76019","name":"Mr safety implt pos&/immoblj","description":"Mr safety implant positioning and/or immobilization under supervision of physician or other qualified health care professional, including application of physical protections to secure implanted medical device from mr-induced translational or vibrational forces, magnetically induced functional change","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0709T","name":"Id ca immntx each addl njx","description":"Intradermal cancer immunotherapy; each additional injection (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97802","name":"Medical nutrition indiv in","description":"Medical nutrition therapy; initial assessment and intervention, individual, face-to-face with the patient, each 15 minutes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":29.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0879T","name":"Augmnt alys ch ct ild prep","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; radiological data preparation and transmission","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0599U","name":"Onc pncrtc ca mult ia serum","description":"Onc pncrtc ca mult ia serum","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0481","name":"Electron microscopy diagnost","description":"Electron microscopy - diagnostic","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1834","name":"Inj, isoniazid, 1 mg","description":"Injection, isoniazid, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4306","name":"Americ amnion ac per sq cm","description":"American amnion ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6081","name":"Scale & debride, single imp","description":"Scale & debride, single imp","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0473","name":"Micro exam prep & report","description":"Accession of tissue gross and microscopic examination preparation and transmission of written report","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J2275","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1280","name":"Bilat mast/hx bi /unilat mas","description":"Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0020M","name":"Onc cns alys 30000 dna loci","description":"Oncology (central nervous system), analysis of 30,000 dna methylation loci by methylation array, utilizing dna extracted from tumor tissue, diagnostic algorithm reported as probability of matching a reference tumor subclass","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0457U","name":"Pfas 9 cmpnd lcms/ms pls/sr","description":"Pfas 9 cmpnd lcms/ms pls/sr","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33894","name":"Evasc st rpr thrc/aa acrs br","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; across major side branches","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49623","name":"Rmvl ninfct mesh hernia rpr","description":"Removal of total or near total non-infected mesh or other prosthesis at the time of initial or recurrent anterior abdominal hernia repair or parastomal hernia repair, any approach (ie, open, laparoscopic, robotic) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34703","name":"Evasc rpr a-unilac ndgft","description":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-uni-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in th","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1445.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01937","name":"Anes drg/aspir crv/thrc","description":"Anesthesia for percutaneous image-guided injection, drainage or aspiration procedures on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9244","name":"Office min sed drug enteral","description":"Office min sed drug enteral","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1187","name":"Pt w/ esrd","description":"Patients with a diagnosis of end stage renal disease (esrd)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33269","name":"Excl laa thrscp any method","description":"Exclusion of left atrial appendage, thoracoscopic, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5126","name":"Inj alymsys 10 mg","description":"Injection, bevacizumab-maly, biosimilar, (alymsys), 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5150","name":"Inj, aflibercept-mrbb, 1 mg","description":"Injection, aflibercept-mrbb (ahzantive), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9269","name":"Programable ingest capsule","description":"Programable, transient, orally ingested capsule, for use with external programmer, per month","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1941","name":"Inj, furoscix, 20 mg","description":"Injection, furosemide (furoscix), 20 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87491","name":"Chlmyd trach dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); chlamydia trachomatis, amplified probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69450","name":"Eardrum revision","description":"Tympanolysis, transcanal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1401","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0387U","name":"Onc mlnma ambra1&amlo","description":"Onc mlnma ambra1&amlo","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6595","name":"G comp bandge liner upr extr","description":"Gradient compression bandaging supply, bandage liner, upper extremity, any size or length, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37296","name":"Revsc evasc imvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64468","name":"Thrc fascial pln blk bi njx","description":"Thoracic fascial plane block, bilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0481U","name":"Idh1 idh2&tert promoter ngs","description":"Idh1 idh2&tert promoter ngs","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2804","name":"Inj, rifampin, 1 mg","description":"Injection, rifampin, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4273","name":"Esano aaa, per sq cm","description":"Esano aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63273","name":"Excise intrspinl lesion scrl","description":"Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; sacral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87484","name":"Ehrlicha chaffeensis amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); ehrlichia chaffeensis, amplified probe technique","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1278","name":"Pre-htn or htn doc, f/u indc","description":"Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1471","name":"Ffs hep b not covered","description":"Documentation that patient is a medicare fee-for-service beneficiary and without additional supplementary insurance coverage for whom hep b vaccination is not reimbursable under current medicare part b coverage rules","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1239","name":"Pt no resp heard","description":"Patient did not respond to the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0468U","name":"Hep nash mir34a5p a2m ykl40","description":"Hep nash mir34a5p a2m ykl40","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1002T","name":"Air displacmnt plethysmograp","description":"Air displacement plethysmography, whole-body composition assessment, with interpretation and report","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0858T","name":"Ext trnscranl mag stimj meas","description":"Externally applied transcranial magnetic stimulation with concomitant measurement of evoked cortical potentials with automated report","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0518","name":"Remove w insert drug implant","description":"Removal with reinsertion, non-biodegradable drug delivery implants, 4 or more (services for subdermal implants)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":176.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1468","name":"Hep b vaccine received","description":"Patient received recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1488","name":"Dx dementia in msr timeframe","description":"Patients with a diagnosis for dementia in the year before or during the period of evaluation","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95912","name":"Nrv cndj test 11-12 studies","description":"Nerve conduction studies; 11-12 studies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46742","name":"Repair of imperforated anus","description":"Repair of high imperforate anus with rectourethral or rectovaginal fistula; combined transabdominal and sacroperineal approaches","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2484.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99402","name":"Prev med cnsl indiv apprx 30","description":"Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 30 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":74.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44402","name":"Colonoscopy w/stent plcmt","description":"Colonoscopy through stoma; with endoscopic stent placement (including pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5228","name":"Immed mand part denture","description":"Immed mand part denture","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2260","name":"Inj milrinone lactate / 5 mg","description":"Injection, milrinone lactate, 5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1073","name":"Testosterone pellet 75 mg","description":"Testosterone pellet, implant, 75 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96380","name":"Admn rsv monoc antb im cnsl","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection, with counseling by physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1016T","name":"Elec alys npgs esoph intraop","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0942T","name":"Cysto flx rmv&rplc urtl scaf","description":"Cystourethroscopy, flexible; with removal and replacement of prostatic urethral scaffold","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29856","name":"Tibial arthroscopy/surgery","description":"Arthroscopically aided treatment of tibial fracture, proximal (plateau); bicondylar, includes internal fixation, when performed (includes arthroscopy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1240.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9024","name":"Inj atezolizumb 5mg hya-tqjs","description":"Injection, atezolizumab, 5 mg and hyaluronidase-tqjs","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78608","name":"Brain imaging (pet)","description":"Brain imaging, positron emission tomography (pet); metabolic evaluation","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4366","name":"Dl amnio bur x-mem per sq cm","description":"Dual layer amnio burgeon x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1250","name":"Pt resp true heard","description":"Patient responded as completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75577","name":"Quan&char c athrosclrtc plaq","description":"Quantification and characterization of coronary atherosclerotic plaque to assess severity of coronary disease, derived from augmentative software analysis of the data set from a coronary computed tomographic angiography, with interpretation and report by a physician or other qualified health care pr","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2018","name":"Permeaderm c, per sq cm","description":"Permeaderm c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0275","name":"Alprostadil urethral suppos","description":"Alprostadil urethral suppository (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1278","name":"Pre-htn or htn doc, f/u indc","description":"Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0727T","name":"Rmvl&rplcmt implt vstblr dev","description":"Removal and replacement of implanted vestibular device, unilateral","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0609","name":"Ferric citrate orl 3 mg iron","description":"Ferric citrate, oral, 3 mg ferric iron, (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4398","name":"Summit ac per sq cm","description":"Summit ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0146","name":"Nav srv peer sup add 30 pr m","description":"Principal illness navigation - peer support, additional 30 minutes per calendar month (list separately in addition to g0140)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72052","name":"X-ray exam neck spine 6/>vws","description":"Radiologic examination, spine, cervical; 6 or more views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55882","name":"Ablt trurl prst8 tis trnsdcr","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation; with insertion of transurethral ultrasound transducer for delivery of thermal ultrasound, including suprapubic tube placement and placement of ","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21025","name":"Excision of bone lower jaw","description":"Excision of bone (eg, for osteomyelitis or bone abscess); mandible","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":940.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5611","name":"Rep resin part dent base man","description":"Rep resin part dent base man","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0864T","name":"Low ntsty eswt corpus cvrnsm","description":"Low-intensity extracorporeal shock wave therapy involving corpus cavernosum, low energy","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0867T","name":"Tpla b9 prst8 hyprplsa>=50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume greater or equal to 50 ml","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37292","name":"Rvsc evsc tpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21249","name":"Reconstruction of jaw","description":"Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); complete","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1477.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59821","name":"Treatment of miscarriage","description":"Treatment of missed abortion, completed surgically; second trimester","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":374.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":465.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0906T","name":"Coms ther 1st appl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; first application, total wound(s) surface area less than or equal to 50 sq cm","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0662","name":"Team remote e/m new pt 30 mn","description":"Team remote e/m new pt 30 mins","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4027","name":"Plastic surgery ss","description":"Plastic surgery mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87253","name":"Virus inoculate tissue addl","description":"Virus isolation; tissue culture, additional studies or definitive identification (eg, hemabsorption, neutralization, immunofluorescence stain), each isolate","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49188","name":"Opn exc/dst ntra-abd 10.1-20","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 10.1 to 20 cm","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0571","name":"Intraop nerve cryoablation","description":"Intraoperative nerve(s) cryoablation for post-surgical pain relief (list separately in addition to code for primary service)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6105","name":"Remove implant body","description":"Remove implant body","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6634","name":"Onlay titanium","description":"Onlay - titanium","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26499","name":"Correction claw finger other","description":"Correction claw finger, other methods","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1076.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1421","name":"Dermatological care mvp","description":"Dermatological care mips value pathway","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49186","name":"Opn exc/dstr ntra-abd 5 cm/<","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5 cm or less","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86666","name":"Ehrlichia antibody","description":"Antibody; ehrlichia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47554","name":"Biliary endoscopy thru skin","description":"Biliary endoscopy, percutaneous via t-tube or other tract; with removal of calculus/calculi","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":588.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4380","name":"Advograft one per sq cm","description":"Advograft one, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9959","name":"Unspec sleep ap proc","description":"Unspec sleep ap proc","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6214","name":"Pontic titanium","description":"Pontic - titanium","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78492","name":"Myocrd img pet mlt rst&strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); multiple studies at rest and stress (exercise or pharmacologic)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1560.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96380","name":"Admn rsv monoc antb im cnsl","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection, with counseling by physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0538","name":"Ascvd rsk mng clin stf pr mo","description":"Atherosclerotic cardiovascular disease (ascvd) risk management services; clinical staff time; per calendar month","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66761","name":"Revision of iris","description":"Iridotomy/iridectomy by laser surgery (eg, for glaucoma) (per session)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67516","name":"Sprchoroidal spc njx rx agt","description":"Suprachoroidal space injection of pharmacologic agent (separate procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88347","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0348U","name":"Rx metab/pcx dna 25 gen alys","description":"Rx metab/pcx dna 25 gen alys","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0609U","name":"Onc prostate ia tot&free psa","description":"Onc prostate ia tot&free psa","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0526","name":"Est pt-cg dyad dem hig cmplx","description":"Management of established patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4397","name":"Summit aaa per sq cm","description":"Summit aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0806T","name":"Tcat s&ivc prstc vl impl opn","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); open femoral vein approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0627U","name":"Psyc scz dna alys >15000","description":"Psyc scz dna alys >15000","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76018","name":"Mr safety implant elec prepj","description":"Mr safety implant electronics preparation under supervision of physician or other qualified health care professional, including mr-specific programming of pulse generator and/or transmitter to verify device integrity, protection of device internal circuitry from mr electromagnetic fields, and protec","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7911","name":"Dental suture wound to 5 cm","description":"Complicated suture-up to 5 cm","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0400U","name":"Ob xpnd car scr 145 genes","description":"Ob xpnd car scr 145 genes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87811","name":"Sars-cov-2 covid19 w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19])","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69642","name":"Revise middle ear & mastoid","description":"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with ossicular chain reconstruction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1549.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0733T","name":"Rem r-t mtn nrehab ther sply","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; supply and technical support, per 30 days","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93308","name":"Tte f-up or lmtd","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, follow-up or limited study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6114","name":"Implnt/abut fixed dent max","description":"Implnt/abut fixed dent max","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23552","name":"Optx acrclv dslc aq/chrn grf","description":"Open treatment of acromioclavicular dislocation, acute or chronic; with fascial graft (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":788.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0779T","name":"Gi myoelectrical actv study","description":"Gastrointestinal myoelectrical activity study, stomach through colon, with interpretation and report","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2001","name":"Suct pum ext mgmt sys","description":"Suction pump, home model, portable or stationary, electric, any type, for use with external urine and/or fecal management system","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90631","name":"H5 vaccine pandemic im use","description":"Influenza virus vaccine (iiv), h5, pandemic formulation, split virus, adjuvanted, for intramuscular use","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0764T","name":"Asstv alg ecg rsk asmt cncrt","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to concurrently performed electrocardiogram (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3921","name":"Decor or submerg erupt tooth","description":"Decor or submerg erupt tooth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1398","name":"Bslne and  fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1412","name":"Met nsclc w/ egfr alk oth ab","description":"Patients with metastatic nsclc with epidermal growth factor receptor (egfr) mutations, alk genomic tumor aberrations, or other targetable genomic abnormalities with approved first-line targeted therapy, such as nsclc with ros1 rearrangement, braf v600e mutation, ntrk 1/2/3 gene fusion, met ex14 skip","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7023","name":"Mech allergen parti barrier","description":"Mechanical allergen particle barrier/inhalation filter, cream, nasal, topical","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0866T","name":"Quan mri alys brn w/dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion detection, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transmissio","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J1590","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1172","name":"Doc med rsn no td/tdap","description":"Documentation of medical reason(s) for not administering td or tdap vaccine (e.g., prior anaphylaxis due to the td or tdap vaccine or history of encephalopathy within seven days after a previous dose of a td-containing vaccine)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1024T","name":"Perq tiss dsplmt soft tissue","description":"Percutaneous tissue displacement, any method, including imaging guidance; soft tissue (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32486","name":"Sleeve lobectomy","description":"Removal of lung, other than pneumonectomy; with circumferential resection of segment of bronchus followed by broncho-bronchial anastomosis (sleeve lobectomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1829.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0237","name":"Inj, tocilizumab-anoh, hospi","description":"Injection, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86596","name":"Voltage-gtd ca chnl antb ea","description":"Voltage-gated calcium channel antibody, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1736","name":"Inj meloxicam (delova) 1mg","description":"Injection, meloxicam (delova), 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0764T","name":"Asstv alg ecg rsk asmt cncrt","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to concurrently performed electrocardiogram (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4387","name":"Neothelium ft per sq cm","description":"Neothelium ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94452","name":"Hast w/i&r phys/qhp","description":"High altitude simulation test (hast), with interpretation and report by a physician or other qualified health care professional;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63032","name":"Lamot rpr anulr dfct 1 lmbr","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; with repair of annular defect by implantation of bone-anchored annular closure device, including all imaging guidance, 1 interspace, lumbar","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0174","name":"Lecanemab-irmb, for iv inj","description":"Lecanemab-irmb, for intravenous injection, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4358","name":"Xwrap dual, per sq cm","description":"Xwrap dual, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2525","name":"Cl, hydrophilic, dual focus","description":"Contact lens, hydrophilic, dual focus, per lens","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33903","name":"Perq p-art revsc 1 abnor bi","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, bilateral","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86362","name":"Mog-igg1 antb cba each","description":"Myelin oligodendrocyte glycoprotein (mog-igg1) antibody; cell-based immunofluorescence assay (cba), each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0759","name":"Inj, clevidipine, 1 mg","description":"Injection, clevidipine butyrate, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4287","name":"Disp col sto bag breast milk","description":"Disposable collection and storage bag for breast milk, any size, any type, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0556","name":"Adv prim care mgmt lvl 1","description":"Advanced primary care management services for a patient with one chronic condition [expected to last at least 12 months, or until the death of the patient, which place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline], or fewer, provided by clinical ","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2028","name":"Micromatrix flex per mg","description":"Micromatrix flex, per mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0012","name":"Injection of hiv prep drug","description":"Injection of pre-exposure prophylaxis (prep) drug for hiv prevention, under skin or into muscle","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98014","name":"Synch audio-only est mod 30","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code s","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77090","name":"Tbs techl prep&transmis data","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76805","name":"Ob us >/= 14 wks sngl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1316","name":"Tobacco non-user","description":"Current tobacco non-user","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0701","name":"Pano radio image","description":"Pano radio image","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1490","name":"Pt status not doc","description":"Patient status not documented","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98013","name":"Synch audio-only est low 20","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code select","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0913T","name":"Prq tcat ther rx ntrac balo1","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting), including mechanical dilation by nondrug-delivery balloon angioplasty, endoluminal imaging using intravascular ultrasound (ivus) or optical coherence tomography (oct) when per","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7939","name":"Indexing for osteotomy","description":"Indexing for osteotomy","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4387","name":"Non-pneum walk boot pre ots","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1435","name":"Oral chemo in perf pd","description":"Patient on oral chemotherapy during the performance period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6553","name":"G com stcking bk 30-40 custm","description":"Gradient compression stocking, below knee, 30-40 mmhg, custom, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37255","name":"Revsc evasc ivt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20805","name":"Replant forearm complete","description":"Replantation, forearm (includes radius and ulna to radial carpal joint), complete amputation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3976.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7411","name":"Excision benign lesion>1.25c","description":"Excision of benign lesion greater than 1.25 cm","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2252","name":"Inj midazolam in 0.8% nacl","description":"Injection, midazolam in 0.8% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0684","name":"App non-sheet skin sb g addl","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area or part thereof, or each additional 1% o","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0899","name":"Argatroban dialysis, auromed","description":"Injection, argatroban (auromedics), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0476U","name":"Rx metab psyc 14gen&cyp2d6","description":"Rx metab psyc 14gen&cyp2d6","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27279","name":"Arthrd si jt plmt tartclr dv","description":"Arthrodesis, sacroiliac joint, percutaneous or minimally invasive, with image guidance, includes obtaining bone graft when performed, unilateral; placement of transarticular device(s) and/or intra-articular device(s) piercing the lateral or medial cortices of the ilium and the lateral cortex of the ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0296U","name":"Onc orl&/orop ca 20 mlc feat","description":"Onc orl&/orop ca 20 mlc feat","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15853","name":"Removal sutr/stapl xreq anes","description":"Removal of sutures or staples not requiring anesthesia (list separately in addition to e/m code)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1836.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76988","name":"Dx ntrop epcr us chd img acq","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; placement, manipulation of transducer, and image acquisition only","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0345U","name":"Psyc genom alys pnl 15 gen","description":"Psyc genom alys pnl 15 gen","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4264","name":"Cocoon membrane, per sq cm","description":"Cocoon membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0525","name":"Inj cefotetan disodium 10 mg","description":"Injection, cefotetan disodium, 10 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","name":"Gait mod systm rhym auditory","description":"Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0808T","name":"Pulm tiss vntj alys w/ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with computed tomography (ct) images taken for the purpose of pulmonary tissue ventilation analysis, including data preparation and transmission, quantificati","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0921T","name":"Rmvl perm ccm-d sys 1 dfb ld","description":"Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous defibrillation lead only","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1200","name":"Ace-i/arb rx","description":"Ace inhibitor (ace-i) or arb therapy prescribed during the measurement period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43030","name":"Cricopharyngeal myotomy","description":"Cricopharyngeal myotomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7485","name":"Surg reduct osseoustuberosit","description":"Surgical reduction of osseous tuberosity","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0793T","name":"Prq tcat thrm ablt nrv p-art","description":"Percutaneous transcatheter thermal ablation of nerves innervating the pulmonary arteries, including right heart catheterization, pulmonary artery angiography, and all imaging guidance","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64584","name":"Rmvl hpglsl nstim ary pg","description":"Removal of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0850T","name":"Dgtz gls mcrscp ish ea mult","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1310","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7241","name":"Impact tooth rem bony w/comp","description":"Removal of impacted tooth-completely bony with unusual surgical complications","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91052","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1276","name":"Calc bmi out nrm param nof/u","description":"Bmi documented outside normal parameters, no follow-up plan documented, no reason given","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1443","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67311","name":"Revise eye muscle","description":"Strabismus surgery, recession or resection procedure; 1 horizontal muscle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9291","name":"Pres dig cog behav thera fda","description":"Prescription digital cognitive and/or behavioral therapy, fda cleared, per course of treatment","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0623U","name":"Ai ms dna mthyl alys >5000","description":"Ai ms dna mthyl alys >5000","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3431","name":"Biological materials","description":"Biological materials","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37270","name":"Revsc evasc fpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93569","name":"Njx cth slct p-art angrp uni","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95971","name":"Alys smpl sp/pn npgt w/prgrm","description":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg, contact group[s], interleaving, amplitude, pulse width, frequency [hz], on/off cycling, burst, magnet mode, dose lockout, patient selectable parameters, responsive neurostimulation, detection algorithms, closed loop pa","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32800","name":"Repair lung hernia","description":"Repair lung hernia through chest wall","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1353","name":"Sealant repair per tooth","description":"Sealant repair per tooth","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93587","name":"Vngrph chd vnvn cltrl at/abv","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating at or above the heart (eg, from innominate vein) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0492U","name":"Onc sol tum ctc slctn pd-l1","description":"Onc sol tum ctc slctn pd-l1","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9183","name":"Gemcitabine intravesical sys","description":"Gemcitabine intravesical system, 225 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1476","name":"Pt dx cog imp or ad","description":"Patients with diagnosis of cognitive impairment or alzheimers disease","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1254","name":"Pts deceased prior hu surv","description":"Patients who were deceased when the hu survey reached them","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3473","name":"Surg rep root res molar","description":"Surg rep root res molar","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1371","name":"Mst rec gsa<7","description":"Most recent glycemic status assessment (hba1c or gmi) level < 7.0%","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33980","name":"Remove intracorporeal device","description":"Removal of ventricular assist device, implantable intracorporeal, single ventricle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4032.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7472","name":"Removal of torus palatinus","description":"Removal of torus palatinus","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0817T","name":"Opn insj/rplcmt ins ptn subf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34710","name":"Dlyd plmt xtn prosth 1st vsl","description":"Delayed placement of distal or proximal extension prosthesis for endovascular repair of infrarenal abdominal aortic or iliac aneurysm, false aneurysm, dissection, endoleak, or endograft migration, including pre-procedure sizing and device selection, all nonselective catheterization(s), all associate","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":843.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99316","name":"Nf dschrg mgmt 30 min+","description":"Nursing facility discharge management; more than 30 minutes total time on the date of the encounter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":30.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":157.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0545U","name":"Achr antb id imfluor livecll","description":"Achr antb id imfluor livecll","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5948","name":"Max implt sup fix part","description":"Max implt sup fix part","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1748","name":"Inj, zymfentra, 10 mg","description":"Injection, infliximab-dyyb (zymfentra), 10 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2394","name":"Post >=4srfc resinbase cmpst","description":"Resin-based composite - four or more surfaces posterior","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0942T","name":"Cysto flx rmv&rplc urtl scaf","description":"Cystourethroscopy, flexible; with removal and replacement of prostatic urethral scaffold","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92635","name":"Hearing aid fitg svc ea addl","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; each additional 15 minutes (list separately in addition to code","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11000","name":"Dbrdmt ecz/infected skin<10%","description":"Debridement of extensive eczematous or infected skin; up to 10% of body surface","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":15.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":27.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82528","name":"Assay of corticosterone","description":"Corticosterone","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61891","name":"Rev/rplcmt sk-mnt crnl nstm","description":"Revision or replacement of skull-mounted cranial neurostimulator pulse generator or receiver with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0690T","name":"Quan us tis charac w/dx us","description":"Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained with diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55707","name":"Bx prst8 trct us guided","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5932","name":"Postsurgical obturator","description":"Obturator prosthesis definitive","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1307","name":"Doc pt pal or hospice","description":"Documentation stating the patient has received or is currently receiving palliative or hospice care","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64658","name":"Rmvl bat modul sys lead only","description":"Removal of baroreflex activation therapy (bat) modulation system; lead only","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6106","name":"Tissue regen resorbable","description":"Tissue regen resorbable","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0305U","name":"Hem rbc fnclty&dfrm shr strs","description":"Hem rbc fnclty&dfrm shr strs","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44340","name":"Revision of colostomy","description":"Revision of colostomy; simple (release of superficial scar) (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40814","name":"Excise/repair mouth lesion","description":"Excision of lesion of mucosa and submucosa, vestibule of mouth; with complex repair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1813","name":"Lyumjev for insulin pump use","description":"Insulin (lyumjev) for administration through dme (i.e., insulin pump) per 50 units","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0517U","name":"Ther rx mntr 80+ psyactiv rx","description":"Ther rx mntr 80+ psyactiv rx","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0766T","name":"Tc mag stimj pn 1st nerve","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; first nerve","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1576","name":"Inj, panzyga, 500 mg","description":"Injection, immune globulin (panzyga), intravenous, non-lyophilized (e.g., liquid), 500 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0695T","name":"Bdy srf mpg pm/cvdfb tm impl","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of implant or replacement","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2034","name":"Found drs solo, per sq cm","description":"Foundation drs solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0591U","name":"Onc prst8 ca 3prtns plsm srm","description":"Onc prst8 ca 3prtns plsm srm","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4310","name":"Procenta, per 100 mg","description":"Procenta, per 100 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9318","name":"Inj romidepsin non-lyo 0.1mg","description":"Injection, romidepsin, non-lyophilized, 0.1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4017","name":"Nutrition/dietician ss","description":"Nutrition/dietician mips specialty set","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1404","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64400","name":"Njx aa&/strd trigeminal nrv","description":"Injection(s), anesthetic agent(s) and/or steroid; trigeminal nerve, each branch (ie, ophthalmic, maxillary, mandibular)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7172","name":"Inj marstacim-hncq, 0.5 mg","description":"Injection, marstacimab-hncq, 0.5 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0264U","name":"Rare ds id opt genome mapg","description":"Rare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0137","name":"Inten outpt svs,min 9 pr 7 d","description":"Intensive outpatient services; weekly bundle, minimum of 9 services over a 7 contiguous day period, which can include individual and group therapy with physicians or psychologists (or other mental health professionals to the extent authorized under state law); occupational therapy requiring the skil","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58750","name":"Repair oviduct","description":"Tubotubal anastomosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1072.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9040","name":"Bleomycin sulfate injection","description":"Injection, bleomycin sulfate, 15 units","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90970","name":"Esrd svc pr day pt 20+","description":"End-stage renal disease (esrd) related services for dialysis less than a full month of service, per day; for patients 20 years of age and older","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49255","name":"Removal of omentum","description":"Omentectomy, epiploectomy, resection of omentum (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":810.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0483","name":"Indirect immunofluorescence","description":"Indirect immunofluorescence","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59025","name":"Fetal non-stress test","description":"Fetal non-stress test","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95913","name":"Nrv cndj test 13/> studies","description":"Nerve conduction studies; 13 or more studies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2249","name":"Inj, remimazolam, 1 mg","description":"Injection, remimazolam, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1306","name":"Injection, inclisiran, 1 mg","description":"Injection, inclisiran, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5162","name":"Inj, denosumab-nxxp, 1 mg","description":"Injection, denosumab-nxxp (bildyos/bilprevda), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1456","name":"Pt had htx","description":"Patient had a heart transplant","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37282","name":"Rvsc evsc tpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5422","name":"Dentures adjust part mandbl","description":"Adjust partial denture - mandibular","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28645","name":"Repair toe dislocation","description":"Open treatment of metatarsophalangeal joint dislocation, includes internal fixation, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0677T","name":"Laps repos lead isdss 1st ld","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first repositioned lead","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1464","name":"No record of f/u by 180 days","description":"No documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87467","name":"Hepatitis b surface ag quan","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; hepatitis b surface antigen (hbsag), quantitative","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0709T","name":"Id ca immntx each addl njx","description":"Intradermal cancer immunotherapy; each additional injection (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53454","name":"Tprnl balo cntnc dev adjmt","description":"Periurethral transperineal adjustable balloon continence device; percutaneous adjustment of balloon(s) fluid volume","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0869T","name":"Njx b1 sub mtrl hw fixj aug","description":"Injection(s), bone-substitute material for bone and/or soft tissue hardware fixation augmentation, including intraoperative imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28124","name":"Partial removal of toe","description":"Partial excision (craterization, saucerization, sequestrectomy, or diaphysectomy) bone (eg, osteomyelitis or bossing); phalanx of toe","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":408.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9326","name":"Telisotuzumab vedotin-tllv","description":"Injection, telisotuzumab vedotin-tllv, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0385U","name":"Neph ckd alg rsk dbtc kdn ds","description":"Neph ckd alg rsk dbtc kdn ds","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29085","name":"Appl cast hand&lwr forearm","description":"Application, cast; hand and lower forearm (gauntlet)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2031","name":"Mirodry, per sq cm","description":"Mirodry wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0804","name":"3d facial scan indirect","description":"3d facial scan indirect","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0590U","name":"Nfct ds bct&fngl dna 44 orgs","description":"Nfct ds bct&fngl dna 44 orgs","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31257","name":"Nsl/sins ndsc tot w/sphendt","description":"Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior), including sphenoidotomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0460U","name":"Onc whl bld/bucc rtpcr 24gen","description":"Onc whl bld/bucc rtpcr 24gen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1335","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4352","name":"Overlay sl matrix, per sq cm","description":"Overlay sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1221","name":"Dre w/o rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; without evidence of retinopathy","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9601","name":"Inj linvoseltamab-gcpt 1 mg","description":"Injection, linvoseltamab-gcpt, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41018","name":"Drainage of mouth lesion","description":"Extraoral incision and drainage of abscess, cyst, or hematoma of floor of mouth; masticator space","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6114","name":"Implnt/abut fixed dent max","description":"Implnt/abut fixed dent max","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0017","name":"Crisis psychotherapy 60m","description":"Psychotherapy for crisis furnished in an applicable site of service (any place of service at which the non-facility rate for psychotherapy for crisis services applies, other than the office setting); first 60 minutes","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99385","name":"Prev visit new age 18-39","description":"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; 18-39 years","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":92.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":154.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0237","name":"Intrav inf, toci, first dose","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2506","name":"Inj pegfilgrast ex bio 0.5mg","description":"Injection, pegfilgrastim, excludes biosimilar, 0.5 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5129","name":"Inj, vegzelma, 10 mg","description":"Injection, bevacizumab-adcd (vegzelma), biosimilar, 10 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86850","name":"Rbc antibody screen","description":"Antibody screen, rbc, each serum technique","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4313","name":"Dermabind fm, per sq cm","description":"Dermabind fm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34712","name":"Tcat dlvr enhncd fixj dev","description":"Transcatheter delivery of enhanced fixation device(s) to the endograft (eg, anchor, screw, tack) and all associated radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":559.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9948","name":"Adjust sleep apnea appliance","description":"Adjust sleep apnea appliance","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99498","name":"Advncd care plan addl 30 min","description":"Advance care planning including the explanation and discussion of advance directives such as standard forms (with completion of such forms, when performed), by the physician or other qualified health care professional; each additional 30 minutes (list separately in addition to code for primary proce","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":87.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96520","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"Adju cgm supply allowance","description":"Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1261","name":"Pts on wtlist bef dialysis","description":"Patients that were on the kidney or kidney-pancreas waitlist prior to initiation of dialysis","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0273U","name":"Hem gen hyprfibrnlysis 8 gen","description":"Hematology (genetic hyperfibrinolysis, delayed bleeding), genomic sequence analysis of 8 genes (f13a1, f13b, fga, fgb, fgg, serpina1, serpine1, serpinf2, plau) blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64484","name":"Njx aa&/strd tfrm epi l/s ea","description":"Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or ct), lumbar or sacral, each additional level (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4366","name":"Dl amnio bur x-mem per sq cm","description":"Dual layer amnio burgeon x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0137","name":"Inten outpt svs,min 9 pr 7 d","description":"Intensive outpatient services; weekly bundle, minimum of 9 services over a 7 contiguous day period, which can include individual and group therapy with physicians or psychologists (or other mental health professionals to the extent authorized under state law); occupational therapy requiring the skil","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0592U","name":"Onc hl neo dna tgs 417 genes","description":"Onc hl neo dna tgs 417 genes","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40761","name":"Repair cleft lip/nasal","description":"Plastic repair of cleft lip/nasal deformity; with cross lip pedicle flap (abbe-estlander type), including sectioning and inserting of pedicle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1212.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9334","name":"Inj efgart-alfa 2mg hya-qvfc","description":"Injection, efgartigimod alfa, 2 mg and hyaluronidase-qvfc","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1364","name":"Ascvd risk >=20pct","description":"Calculated 10-year ascvd risk score of >= 20 percent during the performance period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0829T","name":"Dgtz gls mcrscp cytp conctrj","description":"Digitization of glass microscope slides for cytopathology, concentration technique, smears, and interpretation (eg, saccomanno technique) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1032","name":"Sv doula brth wrk per 15 min","description":"Services performed by a doula birth worker, per 15 minutes","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64597","name":"Ins/rplcm prq eltrd ra pn ea","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; each additional electrode array (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1210","name":">=2 same meds tbl4 not ord","description":"At least two orders for high-risk medications from the same drug class, (table 4), not ordered","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9128","name":"Photobio therpy-first 15 min","description":"Photobio therpy-first 15 min","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9174","name":"Inj, docetaxel (beizray) 1mg","description":"Injection, docetaxel (beizray), 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1308","name":"Inj, famotidine, 0.25 mg","description":"Injection, famotidine, 0.25 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28130","name":"Removal of ankle bone","description":"Talectomy (astragalectomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":731.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0662","name":"Team remote e/m new pt 30 mn","description":"Team remote e/m new pt 30 mins","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0681","name":"Inj ceftobipole medocarl 3mg","description":"Injection, ceftobiprole medocaril sodium, 3 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0911","name":"Inst tauro 1.35mg/hep 100u","description":"Instillation, taurolidine 1.35 mg and heparin sodium 100 units (central venous catheter lock for adult patients receiving chronic hemodialysis)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45390","name":"Colonoscopy w/resection","description":"Colonoscopy, flexible; with endoscopic mucosal resection","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0408U","name":"Iaad blk ac wv bsnsr sarscv2","description":"Iaad blk ac wv bsnsr sarscv2","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27601","name":"Decompression of lower leg","description":"Decompression fasciotomy, leg; posterior compartment(s) only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":512.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J0150","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0801T","name":"Tcat rmv&rpl 2chmbr ldls pm","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; dual-cha","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83036","name":"Hemoglobin glycosylated a1c","description":"Hemoglobin; glycosylated (a1c)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0894T","name":"Cannulation liver allograft","description":"Cannulation of the liver allograft in preparation for connection to the normothermic perfusion device and decannulation of the liver allograft following normothermic perfusion","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2057","name":"Afamitresgene autoleucel","description":"Afamitresgene autoleucel, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0788T","name":"Elec aly smp iins sp/sac nrv","description":"Electronic analysis with simple programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detecti","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0366U","name":"Onc bldr 10 prb recr bldr ca","description":"Onc bldr 10 prb recr bldr ca","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"Add upp ext mec limb vol lam","description":"Addition to upper extremity prosthesis, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6089","name":"Access/retorq implant screw","description":"Access/retorq implant screw","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0828T","name":"Dgtz gls mcrscp cytp smpl fl","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; simple filter method with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0477U","name":"Rx metab psy 14&cyp2d6 gn-rx","description":"Rx metab psy 14&cyp2d6 gn-rx","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0916T","name":"Insj perm ccm-d sys pg only","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator only","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6599","name":"G comp bandage short stretch","description":"Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93594","name":"R hrt cath chd abnl nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; abnormal native connections","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87210","name":"Smear wet mount saline/ink","description":"Smear, primary source with interpretation; wet mount for infectious agents (eg, saline, india ink, koh preps)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71250","name":"Ct thorax dx c-","description":"Computed tomography, thorax, diagnostic; without contrast material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66762","name":"Revision of iris","description":"Iridoplasty by photocoagulation (1 or more sessions) (eg, for improvement of vision, for widening of anterior chamber angle)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2040","name":"Coord specialty care, month","description":"Coordinated specialty care, team-based, for first episode psychosis, per month","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4314","name":"Reeva, per sq cm","description":"Reeva ft, per square cenitmeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15017","name":"App skn cll ssp f/n/g/hf 1st","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 480 sq cm or less","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2471","name":"Inj pantoprazole(hikma) 40mg","description":"Injection, pantoprazole (hikma), not therapeutically equivalent to j2470, 40 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27390","name":"Incision of thigh tendon","description":"Tenotomy, open, hamstring, knee to hip; single tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":520.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01942","name":"Anes neuromd/ntrvrt lmbr/sac","description":"Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1553","name":"Inj yimmugo 100 mg","description":"Injection, immune globulin (yimmugo), 100 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29131","name":"Appl finger splint dynamic","description":"Application of finger splint; dynamic","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":56.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6280","name":"Implt maint procd remv implt","description":"Implt maint procd remv implt","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40804","name":"Removal foreign body mouth","description":"Removal of embedded foreign body, vestibule of mouth; simple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43631","name":"Removal of stomach partial","description":"Gastrectomy, partial, distal; with gastroduodenostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1544.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1283","name":"Pt scrn tbco and id as user","description":"Patient screened for tobacco use and identified as a tobacco user","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49085","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":855.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3392","name":"Inj, exagamglogene autotem","description":"Injection, exagamglogene autotemcel, per treatment","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15854","name":"Removal sutr&stapl xreq anes","description":"Removal of sutures and staples not requiring anesthesia (list separately in addition to e/m code)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0445","name":"High inten beh couns std 30m","description":"High intensity behavioral counseling to prevent sexually transmitted infection; face-to-face, individual, includes: education, skills training and guidance on how to change sexual behavior; performed semi-annually, 30 minutes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":26.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0400U","name":"Ob xpnd car scr 145 genes","description":"Ob xpnd car scr 145 genes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70190","name":"X-ray exam of eye sockets","description":"Radiologic examination; optic foramina","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1811","name":"Fiasp for insulin pump use","description":"Insulin (fiasp) for administration through dme (i.e., insulin pump) per 50 units","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0862T","name":"Rlcj pg wcs lv battery only","description":"Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; battery component only","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1477","name":"Dx delirium","description":"Diagnosis of delirium","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1419","name":"Pt not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0910T","name":"Rmvl int nstim sys vagus nrv","description":"Removal of integrated neurostimulation system, vagus nerve","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78492","name":"Myocrd img pet mlt rst&strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); multiple studies at rest and stress (exercise or pharmacologic)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5612","name":"Rep resin part dent base max","description":"Rep resin part dent base max","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0668","name":"Team remote e/m est pt 40 mn","description":"Team remote e/m est. pt 40mins","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82166","name":"Assay anti-mullerian horm","description":"Anti-mullerian hormone (amh)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27077","name":"Resect hip tum w/innom bone","description":"Radical resection of tumor; innominate bone, total","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3102.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31242","name":"Nsl/sinus ndsc rf abltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by radiofrequency ablation, posterior nasal nerve","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0802","name":"3d dental scan indirect","description":"3d dental scan indirect","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81441","name":"Ibmfs seq alys pnl 30 genes","description":"Inherited bone marrow failure syndromes (ibmfs) (eg, fanconi anemia, dyskeratosis congenita, diamond-blackfan anemia, shwachman-diamond syndrome, gata2 deficiency syndrome, congenital amegakaryocytic thrombocytopenia) sequence analysis panel, must include sequencing of at least 30 genes, including b","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9027","name":"Rbc o2 co2 reduced","description":"Red blood cells, leukocytes reduced, oxygen/ carbon dioxide reduced, each unit","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49623","name":"Rmvl ninfct mesh hernia rpr","description":"Removal of total or near total non-infected mesh or other prosthesis at the time of initial or recurrent anterior abdominal hernia repair or parastomal hernia repair, any approach (ie, open, laparoscopic, robotic) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0372","name":"Tomo comp series images","description":"Tomo comp series images","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0262U","name":"Onc sld tum rt-pcr 7 gen","description":"Oncology (solid tumor), gene expression profiling by real-time rt-pcr of 7 gene pathways (er, ar, pi3k, mapk, hh, tgfb, notch), formalin-fixed paraffin-embedded (ffpe), algorithm reported as gene pathway activity score","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4357","name":"Xwrap plus, per sq cm","description":"Xwrap plus, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1413","name":"Pos pdl1 bef init ici tx","description":"Patients who had a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91322","name":"Sarscov2 vac 50 mcg/0.5ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 50 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9939","name":"Placemnt removable appliance","description":"Placemnt removable appliance","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0773T","name":"Vr px dissoc svc oth phy 1st","description":"Virtual reality (vr) procedural dissociation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports; initial 15 min","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","name":"Scoliosis orth sag/ cor","description":"Scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla to trochanter, includes all accessory pads, straps and interface, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual ","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84060","name":"Assay acid phosphatase","description":"Phosphatase, acid; total","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1315","name":"Crc no doc no rsn","description":"Colorectal cancer screening results were not documented and reviewed; reason not otherwise specified","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01939","name":"Anes nulyt agt crv/thrc","description":"Anesthesia for percutaneous image-guided destruction procedures by neurolytic agent on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1229","name":"Pt w/ +hcv +vir ref win 1 mo","description":"Patient, who has a reactive hcv antibody test, and has a follow up hcv viral test that detected hcv viremia, is referred within 1 month of the reactive hcv antibody test to a clinician who treats hcv infection","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90811","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5914","name":"Auricular prosthesis","description":"Auricular prosthesis","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77080","name":"Dxa bone density axial","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1367","name":"Qual care ent disorder mvp","description":"Quality care for the treatment of ear, nose, and throat disorders mips value pathway","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0833T","name":"Dgtz gls mcrscp cytp oth prp","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; preparation, screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85008","name":"Bl smear w/o diff wbc count","description":"Blood count; blood smear, microscopic examination without manual differential wbc count","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1493","name":"No fall doc med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0583U","name":"Rare ds rpd whlgen cmptr dna","description":"Rare ds rpd whlgen cmptr dna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0395U","name":"Onc lng multiomics plsm alg","description":"Onc lng multiomics plsm alg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0941T","name":"Cysto flx ins&xpns urtl scaf","description":"Cystourethroscopy, flexible; with insertion and expansion of prostatic urethral scaffold using integrated cystoscopic visualization","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37297","name":"Revsc evasc imvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7519","name":"Inj. mycophenolate mofetil","description":"Injection, mycophenolate mofetil, 10 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9382","name":"Inj zenocutuzumab-zbco 1 mg","description":"Injection, zenocutuzumab-zbco, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1328","name":"Pts dx acute vitreous hem","description":"Patients with a diagnosis of acute vitreous hemorrhage","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5124","name":"Inj. byooviz, 0.1 mg","description":"Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81457","name":"So neo gsap dna mcrstl ins","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis, microsatellite instability","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34716","name":"Opn ax/subcla art expos cndt","description":"Open axillary/subclavian artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass, by infraclavicular or supraclavicular incision, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4014","name":"Nephrology ss","description":"Nephrology mips specialty set","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1464","name":"No record of f/u by 180 days","description":"No documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0995T","name":"Evasc dlvr a-wal stbl rx opn","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; open","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26489","name":"Transplant/graft palm tendon","description":"Transfer or transplant of tendon, palmar; with free tendon graft (includes obtaining graft), each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1042.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86052","name":"Aquaporin-4 antb cba each","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; cell-based immunofluorescence assay (cba), each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87467","name":"Hepatitis b surface ag quan","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; hepatitis b surface antigen (hbsag), quantitative","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80160","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4185","name":"Pn soln nos 10 grams lipids","description":"Parenteral nutrition solution, not otherwise specified, 10 grams lipids","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9184","name":"Inj gemcitabin (avyxa) 200mg","description":"Injection, gemcitabine hydrochloride (avyxa), 200 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46610","name":"Anoscopy remove lesion","description":"Anoscopy; with removal of single tumor, polyp, or other lesion by hot biopsy forceps or bipolar cautery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1288","name":"Doc rsn no hbp scrn or f/u","description":"Documented reason for not screening or recommending a follow-up for high blood pressure","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1411","name":"1st ln ici no chemo","description":"Currently on first-line immune checkpoint inhibitors without chemotherapy","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2782","name":"Crown 3/4 cast noble metal","description":"Crown - 3/4 cast noble metal","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2038","name":"Marigen pacto, per sq cm","description":"Marigen pacto, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6518","name":"Grad com wrap w strap arm cu","description":"Gradient compression wrap with adjustable straps, arm, each, custom","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4323","name":"Splint extra-coronal","description":"Splint extra-coronal","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63032","name":"Lamot rpr anulr dfct 1 lmbr","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; with repair of annular defect by implantation of bone-anchored annular closure device, including all imaging guidance, 1 interspace, lumbar","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55714","name":"Bx prst8 in-bore ct/mri 1","description":"Biopsy, prostate, in-bore ct- or mri-guided targeted lesion(s) only, first targeted lesion","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4331","name":"Axolotl graft, per sq cm","description":"Axolotl graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74018","name":"Radex abdomen 1 view","description":"Radiologic examination, abdomen; 1 view","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4283","name":"Biovance tri or 3l, sq cm","description":"Biovance tri-layer or biovance 3l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0758T","name":"Dgtz gls mcrscp sl spc hchem","description":"Digitization of glass microscope slides for special stain, including interpretation and report, histochemical stain on frozen tissue block (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77091","name":"Tbs techl calculation only","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical calculation only","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6608","name":"G com bandage tub protct pad","description":"Gradient compression bandaging supply, tubular protective absorption padded layer, per linear yard, any width, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4038","name":"Vascular surgery ss","description":"Vascular surgery mips specialty set","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0523U","name":"Onc soltum dna ngs snv 22gen","description":"Onc soltum dna ngs snv 22gen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1444","name":"Del < 39 weeks gest","description":"Delivery at < 39 weeks of gestation","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0369","name":"Max mri capture & interprete","description":"Max mri capture & interprete","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1433","name":"Oral chemo wthn 30 days enc","description":"Patient on oral chemotherapy on or within 30 days before denominator eligible encounter","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29851","name":"Knee arthroscopy/surgery","description":"Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; with internal or external fixation (includes arthroscopy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1152.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0864T","name":"Low ntsty eswt corpus cvrnsm","description":"Low-intensity extracorporeal shock wave therapy involving corpus cavernosum, low energy","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0408U","name":"Iaad blk ac wv bsnsr sarscv2","description":"Iaad blk ac wv bsnsr sarscv2","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9936","name":"Clean occ guard","description":"Clean occ guard","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0406U","name":"Onc lung flow cytmtry 5 mrk","description":"Onc lung flow cytmtry 5 mrk","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0465","name":"Autolog prp diab wound ulcer","description":"Autologous platelet rich plasma (prp) or other blood-derived product for diabetic chronic wounds/ulcers, using an fda-cleared device for this indication, (includes as applicable administration, dressings, phlebotomy, centrifugation or mixing, and all other preparatory procedures, per treatment)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0540U","name":"Trnsplj med quan dd-cfdna","description":"Trnsplj med quan dd-cfdna","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4370","name":"Aeroguard per sq cm","description":"Aeroguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4392","name":"Grafix duo per sq cm","description":"Grafix duo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0885T","name":"Colsc flx 1st tndsc dilat","description":"Colonoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98005","name":"Synch audio-video est low 20","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low medical decision making. when using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0934T","name":"Rem mntr wrls l atr prs snr","description":"Remote monitoring of a wireless left atrial pressure sensor for up to 30 days, including data from daily uploads of left atrial pressure recordings, interpretation(s) and trend analysis, with adjustments to the diuretics plan, treatment paradigm thresholds, medications or lifestyle modifications, wh","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43634","name":"Removal of stomach partial","description":"Gastrectomy, partial, distal; with formation of intestinal pouch","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1714.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0802T","name":"Tcat rmv&rpl2chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right at","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0318U","name":"Ped whl gen mthyltn alys 50+","description":"Ped whl gen mthyltn alys 50+","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77436","name":"Surf radj ther tx planning","description":"Surface radiation therapy; superficial or orthovoltage, treatment planning and simulation-aided field setting","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4284","name":"Dermabind sl, per sq cm","description":"Dermabind sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0412U","name":"Beta amyloid ab42/40 imprcip","description":"Beta amyloid ab42/40 imprcip","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9174","name":"Inj, docetaxel (beizray) 1mg","description":"Injection, docetaxel (beizray), 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86689","name":"Htlv/hiv confirmj antibody","description":"Antibody; htlv or hiv antibody, confirmatory test (eg, western blot)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27177","name":"Treat slipped epiphysis","description":"Open treatment of slipped femoral epiphysis; single or multiple pinning or bone graft (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1303.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8611","name":"Oral methotrexate (jylamvo)","description":"Methotrexate (jylamvo), oral, 2.5 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76883","name":"Us nrv&acc strux 1xtr compre","description":"Ultrasound, nerve(s) and accompanying structures throughout their entire anatomic course in one extremity, comprehensive, including real-time cine imaging with image documentation, per extremity","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1782","name":"Vac admin human pap dose 2","description":"Vac admin human pap dose 2","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1473","name":"Pt func cap not allow impr","description":"Patient situations, at any point during the denominator identification period, where the patients functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools, such as delirium, dementia, intellectual disabilities, and pervasive and specific de","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0521","name":"Supply fee hiv prep fda appr","description":"Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0736","name":"Inj, clindamycin phosp 300mg","description":"Injection, clindamycin phosphate, 300 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1305","name":"Inj, evinacumab-dgnb, 5mg","description":"Injection, evinacumab-dgnb, 5mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4415","name":"Alexiguard st-l per sq cm","description":"Alexiguard sl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87271","name":"Cytomegalovirus dfa","description":"Infectious agent antigen detection by immunofluorescent technique; cytomegalovirus, direct fluorescent antibody (dfa)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1483.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0137","name":"Inten outpt svs,min 9 pr 7 d","description":"Intensive outpatient services; weekly bundle, minimum of 9 services over a 7 contiguous day period, which can include individual and group therapy with physicians or psychologists (or other mental health professionals to the extent authorized under state law); occupational therapy requiring the skil","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83036","name":"Hemoglobin glycosylated a1c","description":"Hemoglobin; glycosylated (a1c)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98010","name":"Synch audio-only new mod 45","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection,","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"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":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1500","name":"Neuropsychology mvp","description":"Neuropsychology mips value pathway","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31298","name":"Nsl/sins ndsc surg frnt&sphn","description":"Nasal/sinus endoscopy, surgical, with dilation (eg, balloon dilation); frontal and sphenoid sinus ostia","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3440.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":245.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52341","name":"Cysto w/ureter stricture tx","description":"Cystourethroscopy; with treatment of ureteral stricture (eg, balloon dilation, laser, electrocautery, and incision)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1194","name":"Med rsn no imp/con mmr/msi","description":"Documentation of medical reason(s) surgical pathology reports did not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both tests were not included (e.g., patient will not be treated with checkpoint inhibitor therap","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0613","name":"Calcium glucon (wg critical)","description":"Injection, calcium gluconate (wg critical care), not therapeutically equivalent to j0612, 10 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0914T","name":"Prq tcat thr rx ntrc bal sep","description":"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting) performed on a separate target lesion from the target lesion treated with balloon angioplasty, coronary stent placement or coronary atherectomy, including mechanical dilation b","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0415U","name":"Cv ds acs bld alg 5 yr score","description":"Cv ds acs bld alg 5 yr score","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87494","name":"Chlmy trch&neisra gonor mult","description":"Infectious agent detection by nucleic acid (dna or rna); chlamydia trachomatis and neisseria gonorrhoeae, multiplex amplified probe technique","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4540","name":"Trans elec nerv periph nerv","description":"Distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9024","name":"Inj atezolizumb 5mg hya-tqjs","description":"Injection, atezolizumab, 5 mg and hyaluronidase-tqjs","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1709","name":"Pfizer vaccine admin booster","description":"Pfizer vaccine admin booster","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0683","name":"App of non-sheet skin sub g","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1328","name":"Pts dx acute vitreous hem","description":"Patients with a diagnosis of acute vitreous hemorrhage","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1304","name":"Inj tofersen intrathec 1 mg","description":"Injection, tofersen, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1330","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2472","name":"Inj, pantoprazole sodium chl","description":"Injection, pantoprazole sodium in sodium chloride (baxter), 40 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4407","name":"Xwrap tribus per sq cm","description":"Xwrap tribus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0596U","name":"Neuro alzds plsm 3dstnct isp","description":"Neuro alzds plsm 3dstnct isp","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48146","name":"Pancreatectomy","description":"Pancreatectomy, distal, near-total with preservation of duodenum (child-type procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1866.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0515U","name":"Gi ibd ia quan deter ifx lvl","description":"Gi ibd ia quan deter ifx lvl","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94453","name":"Hast w/suppl oxygen titrj","description":"High altitude simulation test (hast), with interpretation and report by a physician or other qualified health care professional; with supplemental oxygen titration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8005","name":"Grip glove w microprocessor","description":"Powered, cable driven grip assist glove, hand, finger, includes microprocessor, pressure sensors, all components and accessories, custom fitted","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5611","name":"Rep resin part dent base man","description":"Rep resin part dent base man","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0474","name":"Micro w exam of surg margins","description":"Accession of tissue gross and microscopic examination including assessment of surgical margins for presence of disease preparation and transmission of writte","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99471","name":"Ped critical care initial","description":"Initial inpatient pediatric critical care, per day, for the evaluation and management of a critically ill infant or young child, 29 days through 24 months of age","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":41.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2359","name":"Inj. olanzapine, 0.5mg","description":"Injection, olanzapine, 0.5 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1289","name":"No pt tbco cess interv rng","description":"Patient identified as tobacco user did not receive tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45113","name":"Partial proctectomy","description":"Proctectomy, partial, with rectal mucosectomy, ileoanal anastomosis, creation of ileal reservoir (s or j), with or without loop ileostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2058.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2012","name":"Suprathel, per sq cm","description":"Suprathel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15778","name":"Impl absrb msh/prsth dly cls","description":"Implantation of absorbable mesh or other prosthesis for delayed closure of defect(s) (ie, external genitalia, perineum, abdominal wall) due to soft tissue infection or trauma","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6526","name":"G com garmt full leg/ft nght","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0218","name":"Inj olipudase alfa-rpcp 1mg","description":"Injection, olipudase alfa-rpcp, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3471","name":"Surg rep root res anterior","description":"Surg rep root res anterior","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0482","name":"Direct immunofluorescence","description":"Direct immunofluorescence","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93898","name":"Ven-artl shunt det mbubb njx","description":"Venous-arterial shunt detection with intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4386","name":"Acesso trifaca per sq cm","description":"Acesso trifaca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86480","name":"Tb test cell immun measure","description":"Tuberculosis test, cell mediated immunity antigen response measurement; gamma interferon","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1310","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0335U","name":"Rare ds whl gen seq fetal","description":"Rare ds whl gen seq fetal","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73120","name":"X-ray exam of hand","description":"Radiologic examination, hand; 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0379U","name":"Tgsap sl or neo dna523&rna55","description":"Tgsap sl or neo dna523&rna55","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1301","name":"Immunization counseling","description":"Immunization counseling","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4241","name":"Gngvl flap w rootplan 1-3 th","description":"Gingival flap procedure including root planing - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28615","name":"Repair foot dislocation","description":"Open treatment of tarsometatarsal joint dislocation, includes internal fixation, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":784.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26545","name":"Reconstruct finger joint","description":"Reconstruction, collateral ligament, interphalangeal joint, single, including graft, each joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5939","name":"Resct proth mand comp remov","description":"Resct proth mand comp remov","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4256","name":"Mlg complet, per sq cm","description":"Mlg-complete, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0781T","name":"Brnchsc rf dstrj pulm nrv bi","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; bilateral mainstem bronchi","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1159F","name":"Med list docd in rcrd","description":"Medication list documented in medical record (coa)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9886","name":"In-person attendance g code","description":"Behavioral counseling for diabetes prevention, in-person, group, 60 minutes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33269","name":"Excl laa thrscp any method","description":"Exclusion of left atrial appendage, thoracoscopic, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4305","name":"Amer am ac tri-lay per sq cm","description":"American amnion ac tri-layer, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49593","name":"Rpr aa hrn 1st 3-10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, reducible","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0404U","name":"Onc brst semiq meas thym kn","description":"Onc brst semiq meas thym kn","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1245","name":"Dipyridamole injection","description":"Injection, dipyridamole, per 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9074","name":"Inj, cyclophosphamd, sandoz","description":"Injection, cyclophosphamide (sandoz), 5 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49615","name":"Rpr aa hrn rcr 3-10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, reducible","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4329","name":"Singlay, per sq cm","description":"Singlay, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0618U","name":"Psyc bd dna mthyl alys>10000","description":"Psyc bd dna mthyl alys>10000","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2038","name":"Skill train and dev/diem","description":"Skills training and development, per diem","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83071","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98986","name":"Rtm dev sply cbt 2-15 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of cognitive behavioral therapy, 2-15 days in a 30-day period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9052","name":"Inj, carmustine (accord)","description":"Injection, carmustine (accord), not therapeutically equivalent to j9050, 100 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0617U","name":"Cv ascvd dna alys >20000","description":"Cv ascvd dna alys >20000","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4016","name":"Neurosurgical ss","description":"Neurosurgical mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0513U","name":"Onc prst8 alg alys msi&hrd","description":"Onc prst8 alg alys msi&hrd","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19287","name":"Perq dev breast 1st mr guide","description":"Placement of breast localization device(s) (eg clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; first lesion, including magnetic resonance guidance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":958.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2022","name":"Innovabrn/innovamatx xl sqcm","description":"Innovaburn or innovamatrix xl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6613","name":"Onlay cst base mtl >=3 surfa","description":"Onlay - cast predominantly base metal three or more surfaces","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2045","name":"Novashield/novogen pr sq cm","description":"Novashield or novogen wound matrix, per square centimeter","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1210","name":">=2 same meds tbl4 not ord","description":"At least two orders for high-risk medications from the same drug class, (table 4), not ordered","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4377","name":"Trigraft ft per sq cm","description":"Trigraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0306U","name":"Onc mrd nxt-gnrj alys 1st","description":"Onc mrd nxt-gnrj alys 1st","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4418","name":"Biolab wrap flow per sq cm","description":"Biolab membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4390","name":"Ascendion per sq cm","description":"Ascendion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1195","name":"Rpt wo imp/con mmr/msi","description":"Surgical pathology reports that do not contain impression or conclusion of or recommendation for testing of mmr by immunohistochemistry, msi by dna-based testing status, or both, reason not given","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0496U","name":"Onc clrct cfdna 8/7 genes","description":"Onc clrct cfdna 8/7 genes","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0952T","name":"Tot impl amei rev/rplc mstdc","description":"Totally implantable active middle ear hearing implant; revision or replacement, with mastoidectomy and replacement of sound processor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4309","name":"Via matrix, per sq cm","description":"Via matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2599","name":"Inj vasopressin (am reg) 1 u","description":"Injection, vasopressin (american regent), not therapeutically equivalent to j2598, 1 unit","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98010","name":"Synch audio-only new mod 45","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection,","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0844T","name":"Dgtz gls mcrscp cslt cyt ea","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), each additional site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86787","name":"Varicella-zoster antibody","description":"Antibody; varicella-zoster","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2029","name":"Mirotract matrix sheet","description":"Mirotract wound matrix sheet, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J1940","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"Ctlso a-p-l control custom","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0004","name":"Qual care neurologic cnd mvp","description":"Quality care for patients with neurological conditions mips value pathway","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1199","name":"Pt recg rrt","description":"Patients receiving rrt","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76857","name":"Us exam pelvic limited","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0667","name":"Team remote e/m est pt 25 mn","description":"Team remote e/m est. pt 25mins","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1342","name":"Pts died perf per","description":"Patients who died during the performance period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8612","name":"Oral methotrexate (xatmep)","description":"Methotrexate (xatmep), oral, 2.5 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5161","name":"Inj, denosumab-kyqq, 1 mg","description":"Injection, denosumab-kyqq (aukelso/bosaya), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0507U","name":"Onc ovr dna whole gen w/5hmc","description":"Onc ovr dna whole gen w/5hmc","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19120","name":"Removal of breast lesion","description":"Excision of cyst, fibroadenoma, or other benign or malignant tumor, aberrant breast tissue, duct lesion, nipple or areolar lesion (except 19300), open, male or female, 1 or more lesions","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6198","name":"Remove interim implant","description":"Remove interim implant","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62141","name":"Crnop skull defect>5 cm diam","description":"Cranioplasty for skull defect; larger than 5 cm diameter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1267.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2013","name":"Innovamatrix fs, per sq cm","description":"Innovamatrix fs, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1417","name":"Pt up to date cov","description":"Patients who are up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1433","name":"Oral chemo wthn 30 days enc","description":"Patient on oral chemotherapy on or within 30 days before denominator eligible encounter","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0615U","name":"Bbrgdrferi ld antb detcj 26","description":"Bbrgdrferi ld antb detcj 26","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0372","name":"Tomo comp series images","description":"Tomo comp series images","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0705T","name":"Rem tx amblyopia tech sprt","description":"Remote treatment of amblyopia using an eye tracking device; surveillance center technical support including data transmission with analysis, with a minimum of 18 training hours, each 30 days","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82435","name":"Assay of blood chloride","description":"Chloride; blood","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0682","name":"App non-sheet skin sub add","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute for a wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (list separately in addition to code for pri","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1429","name":"Retinopathy in od, os, ou","description":"Retinal exam finding with evidence of retinopathy in left, right or both eyes with severity level documented","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4293","name":"Acesso dl, per sq cm","description":"Acesso dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1805","name":"Inj, esmolol hcl, 10mg","description":"Injection, esmolol hydrochloride, 10 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1009T","name":"Rem mntr s-sclp cont eeg sys","description":"Remote monitoring of a sub-scalp implanted continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93000","name":"Electrocardiogram complete","description":"Electrocardiogram, routine ecg with at least 12 leads; with interpretation and report","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90483","name":"Imm cnsl not admn sm>10<20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 10 minutes up to 20 minutes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37295","name":"Rvsc evsc tpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9294","name":"Biofeed dig cog behav tx fda","description":"Prescription digital cognitive and/or behavioral therapy, biofeedback, fda cleared, per course of treatment","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85018","name":"Hemoglobin","description":"Blood count; hemoglobin (hgb)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81449","name":"So neo gsap 5-50 rna alys","description":"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; rna analysis","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92632","name":"Hearing aid slctn svc ea add","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82166","name":"Assay anti-mullerian horm","description":"Anti-mullerian hormone (amh)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1807","name":"Inj, ethacrynate sod, 1 mg","description":"Injection, ethacrynate sodium, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2991","name":"App of hydroxyapatite","description":"App of hydroxyapatite","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0374","name":"Tomo periapical image","description":"Tomo periapical image","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2029","name":"Mirotract matrix sheet","description":"Mirotract wound matrix sheet, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1196","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4295","name":"Amnio tri-core, per sq cm","description":"Amnio tri-core amniotic, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6553","name":"G com stcking bk 30-40 custm","description":"Gradient compression stocking, below knee, 30-40 mmhg, custom, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58558","name":"Hysteroscopy biopsy","description":"Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without d & c","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":1508.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":333.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9051","name":"Inj, bortezomib (maia)","description":"Injection, bortezomib (maia), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4379","name":"Amniodefend ft per sq cm","description":"Amniodefend ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3291","name":"Tranexamic acid in sod chlor","description":"Injection, tranexamic acid in sodium chloride, 5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85025","name":"Complete cbc w/auto diff wbc","description":"Blood count; complete (cbc), automated (hgb, hct, rbc, wbc and platelet count) and automated differential wbc count","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98006","name":"Synch audio-video est mod 30","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0519","name":"New pt-cg dyad dem low cmplx","description":"Management of new patient-caregiver dyad with dementia, low complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0293U","name":"Psyc suicidal idea mrna 54","description":"Psyc suicidal idea mrna 54","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9506","name":"Tc-99m graphite crucible","description":"Graphite crucible for preparation of technetium tc 99m-labeled carbon aerosol, one crucible","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4024","name":"Pediatrics ss","description":"Pediatrics mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3222","name":"Part pulp for apexogenesis","description":"Partial pulpotomy for apexogenesis - permanent tooth with incomplete root development","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77081","name":"Dxa bone density appendiculr","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4402","name":"Xwrap 2.0 per sq cm","description":"Xwrap 2.0, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0612U","name":"Onc lvr alys >1000 mr cfdna","description":"Onc lvr alys >1000 mr cfdna","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0942T","name":"Cysto flx rmv&rplc urtl scaf","description":"Cystourethroscopy, flexible; with removal and replacement of prostatic urethral scaffold","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1018T","name":"Elec alys npgs esoph sbsq w/","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0846T","name":"Dgtz gls mcrscp imfluor ea","description":"Digitization of glass microscope slides for immunofluorescence, per specimen; each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7411","name":"Excision benign lesion>1.25c","description":"Excision of benign lesion greater than 1.25 cm","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88165","name":"Cytopath tbs c/v redo","description":"Cytopathology, slides, cervical or vaginal (the bethesda system); with manual screening and rescreening under physician supervision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1402","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6091","name":"Repl semi/precision attach","description":"Replacement of semi-precision or precision attachment (male or female component) of implant/abutment supported prosthesis per attachment","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86052","name":"Aquaporin-4 antb cba each","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; cell-based immunofluorescence assay (cba), each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65920","name":"Remove implant of eye","description":"Removal of implanted material, anterior segment of eye","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":756.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4310","name":"Procenta, per 100 mg","description":"Procenta, per 100 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0958T","name":"Rmv s-sclp eltr ra rcvr&tlmt","description":"Removal of sub-scalp implanted electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0763T","name":"Dgtz gls mcrscp mphmtrc alys","description":"Digitization of glass microscope slides for morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure, manual (list separately in addition to code for primary proced","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1250","name":"Pt resp true heard","description":"Patient responded as completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31632","name":"Bronchoscopy/lung bx addl","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial lung biopsy(s), each additional lobe (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1008T","name":"Rem mntr s-scl eeg sys setup","description":"Remote monitoring of sub-scalp implanted continuous bilateral electroencephalography monitoring system, device fitting, initial set-up, and patient education in wearing of system and use of equipment","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1016T","name":"Elec alys npgs esoph intraop","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90638","name":"Vacc qirv mrna 60mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 60 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98981","name":"Rtm tx mgmt ea addl 20 min","description":"Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least 1 real-time interactive communication with the patient or caregiver during the calendar month; each additional 20 minutes (list separately in","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85303","name":"Clot inhibit prot c activity","description":"Clotting inhibitors or anticoagulants; protein c, activity","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1172","name":"Doc med rsn no td/tdap","description":"Documentation of medical reason(s) for not administering td or tdap vaccine (e.g., prior anaphylaxis due to the td or tdap vaccine or history of encephalopathy within seven days after a previous dose of a td-containing vaccine)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27030","name":"Arthrotomy hip w/drainage","description":"Arthrotomy, hip, with drainage (eg, infection)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1134.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0013","name":"Esketamine, nasal spray","description":"Esketamine, nasal spray, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9255","name":"Inj, methotrexate (accord)","description":"Injection, methotrexate (accord), not therapeutically equivalent to j9260, 50 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1405","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1365","name":"Hosp+pall care spec code 17","description":"Patient encounter during the performance period with hospice and palliative care specialty code 17","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0732T","name":"Immntx admn electroporatn im","description":"Immunotherapy administration with electroporation, intramuscular","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1309","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0409U","name":"Onc sld tum dna 80 & rna 36","description":"Onc sld tum dna 80 & rna 36","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1334","name":"Pts act pvd 2 wks 2 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 2 weeks after initial acute pvd encounter","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4256","name":"Mlg complet, per sq cm","description":"Mlg-complete, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0605","name":"Antibody test pub hlth path","description":"Antibody test pub hlth path","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0377U","name":"Cv ds quan advsrm/plsm lprtn","description":"Cv ds quan advsrm/plsm lprtn","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0037","name":"Pt not able to participate","description":"On date of encounter, patient is not able to participate in assessment or screening, including non-verbal patients, delirious, severely aphasic, severely developmentally delayed, severe visual or hearing impairment and for those patients, no knowledgeable informant available","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33900","name":"Perq p-art revsc 1 nm nt uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, unilateral","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99383","name":"Prev visit new age 5-11","description":"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; late childhood (","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":140.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0492U","name":"Onc sol tum ctc slctn pd-l1","description":"Onc sol tum ctc slctn pd-l1","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95909","name":"Nrv cndj tst 5-6 studies","description":"Nerve conduction studies; 5-6 studies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37278","name":"Rvsc evsc fpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2020","name":"Ac5 wound system","description":"Ac5 advanced wound system (ac5)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2791","name":"Crown full cast base metal","description":"Crown-full cast predominantly base metal","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73050","name":"X-ray exam of shoulders","description":"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0388U","name":"Onc nonsm cll lng ca 37 gen","description":"Onc nonsm cll lng ca 37 gen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31032","name":"Explore sinus remove polyps","description":"Sinusotomy, maxillary (antrotomy); radical (caldwell-luc) with removal of antrochoanal polyps","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":650.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4377","name":"Trigraft ft per sq cm","description":"Trigraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0799T","name":"Tcat rmvl 2chmbr ldls pm ra","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right atrial pacemaker component","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1480","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0845T","name":"Dgtz gls mcrscp imfluor 1st","description":"Digitization of glass microscope slides for immunofluorescence, per specimen; initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1207","name":"Pt scrn sdoh","description":"Patient is screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0861T","name":"Rmvl pg wcs lv both compnt","description":"Removal of pulse generator for wireless cardiac stimulator for left ventricular pacing; both components (battery and transmitter)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46230","name":"Removal of anal tags","description":"Excision of multiple external papillae or tags, anus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50955","name":"Ureter endoscopy & biopsy","description":"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96411","name":"Chemo iv push addl drug","description":"Chemotherapy administration; intravenous, push technique, each additional substance/drug (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0013","name":"Esketamine, nasal spray","description":"Esketamine, nasal spray, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49613","name":"Rpr aa hrn rcr < 3 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, reducible","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37292","name":"Rvsc evsc tpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0654","name":"Inj, liothyronine, 1 mcg","description":"Injection, liothyronine, 1 mcg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6197","name":"Replace material prosthesis","description":"Replace material prosthesis","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0261U","name":"Onc clrct ca img alys w/ai","description":"Oncology (colorectal cancer), image analysis with artificial intelligence assessment of 4 histologic and immunohistochemical features (cd3 and cd8 within tumor-stroma border and tumor core), tissue, reported as immune response and recurrence-risk score","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0345U","name":"Psyc genom alys pnl 15 gen","description":"Psyc genom alys pnl 15 gen","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0660","name":"Team remote e/m new pt 10 mn","description":"Team remote e/m new pt 10mins","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1300","name":"Flu imm no admin doc rea","description":"Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5130","name":"Inj, fylnetra, 0.5 mg","description":"Injection, pegfilgrastim-pbbk (fylnetra), biosimilar, 0.5 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0685T","name":"Interrog dev eval isdss ip","description":"Interrogation device evaluation (in-person) with analysis, review and report by a physician or other qualified health care professional, including connection, recording and disconnection per patient encounter, permanent implantable synchronized diaphragmatic stimulation system for augmentation of ca","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4032","name":"Rheumatology ss","description":"Rheumatology mips specialty set","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2508","name":"Pegunigalsidase alfa-iwxj","description":"Injection, pegunigalsidase alfa-iwxj, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0489U","name":"Ob sgnipt cfdna seq alys 1+","description":"Ob sgnipt cfdna seq alys 1+","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95117","name":"Immunotherapy injections","description":"Professional services for allergen immunotherapy not including provision of allergenic extracts; 2 or more injections","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70450","name":"Ct head/brain w/o dye","description":"Computed tomography, head or brain; without contrast material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4295","name":"Amnio tri-core, per sq cm","description":"Amnio tri-core amniotic, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99231","name":"Sbsq hosp ip/obs sf/low 25","description":"Subsequent hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward or low level of medical decision making. when using total time on the date of the encounter for code selec","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":14.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49187","name":"Opn exc/dstr ntra-abd 5.1-10","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5.1 to 10 cm","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0581U","name":"Trnspl med antb nohla 39trgt","description":"Trnspl med antb nohla 39trgt","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0396","name":"3d print of 3d surface scan","description":"3d print of 3d surface scan","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0829T","name":"Dgtz gls mcrscp cytp conctrj","description":"Digitization of glass microscope slides for cytopathology, concentration technique, smears, and interpretation (eg, saccomanno technique) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7259","name":"Nerve dissection","description":"Nerve dissection","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0526U","name":"Nefro rnl trnspl quan cxcl10","description":"Nefro rnl trnspl quan cxcl10","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1502","name":"Podiatry mvp","description":"Podiatry mips value pathway","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92555","name":"Speech threshold audiometry","description":"Speech audiometry threshold;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0871T","name":"Rplcmt subq prtl ascites pmp","description":"Replacement of a subcutaneous peritoneal ascites pump, including reconnection between pump and indwelling bladder and peritoneal catheters, including initial programming and imaging, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0954T","name":"Tot impl amei rplc snd proc","description":"Totally implantable active middle ear hearing implant; replacement of sound processor only, with attachment to existing transducers","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0391","name":"Inj, artesunate, 1mg","description":"Injection, artesunate, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4286","name":"Nudyn sl or slw, per sq cm","description":"Nudyn sl or nudyn slw, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0298U","name":"Onc pan tum whl trns seq rna","description":"Onc pan tum whl trns seq rna","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37276","name":"Rvsc evsc fpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72193","name":"Ct pelvis w/dye","description":"Computed tomography, pelvis; with contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92622","name":"Dx aly aud oi snd prcsr 1st","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; first 60 minutes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4357","name":"Xwrap plus, per sq cm","description":"Xwrap plus, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0803","name":"3d facial scan direct","description":"3d facial scan direct","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4363","name":"Am bur mem hydro per sq cm","description":"Amnio burgeon membrane and hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0944T","name":"3d cntr simula trgt lvr les","description":"3d contour simulation of target liver lesion(s) and margin(s) for image-guided percutaneous microwave ablation","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1390","name":"Pt no doc exm for rec","description":"Patients who do not have a documented exam performed for recurrence of melanoma or no documentation within the performance period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1243","name":"Pt othr thn true heard","description":"Patient provided a response other than completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10180","name":"I&d complex po wound infctj","description":"Incision and drainage, complex, postoperative wound infection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73550","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6517","name":"Grad com wrap w strap bn cus","description":"Gradient compression wrap with adjustable straps, below knee, each, custom","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86671","name":"Fungus nes antibody","description":"Antibody; fungus, not elsewhere specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1026","name":"Pt hemo > 3mo","description":"The number of adult patient-months in the denominator who were on maintenance hemodialysis using a catheter continuously for three months or longer under the care of the same practitioner or group partner as of the last hemodialysis session of the reporting month","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0709T","name":"Id ca immntx each addl njx","description":"Intradermal cancer immunotherapy; each additional injection (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9595","name":"Piflu f-18, dia 1 millicurie","description":"Piflufolastat f-18, diagnostic, 1 millicurie","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0977T","name":"Upr gi bld detcj snr capsule","description":"Upper gastrointestinal blood detection, sensor capsule, with interpretation and report","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20982","name":"Ablate bone tumor(s) perq","description":"Ablation therapy for reduction or eradication of 1 or more bone tumors (eg, metastasis) including adjacent soft tissue when involved by tumor extension, percutaneous, including imaging guidance when performed; radiofrequency","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":481.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4424","name":"Revive ft per sq cm","description":"Revive ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"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":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0407U","name":"Neph dbtc ckd mult eclia alg","description":"Neph dbtc ckd mult eclia alg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6605","name":"G com bandage padded foam","description":"Gradient compression bandaging supply, padded foam, per linear yard, any width, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37272","name":"Revsc evsc fpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1338","name":"Pt f/u 30-180 dys no + imprv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who did not demonstrate positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0896T","name":"Connj lvr algrft prfu dev ea","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; each additional hour, including physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary bicarbonate, lactate ","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0133","name":"Acyclovir injection","description":"Injection, acyclovir, 5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1451","name":"Pt dx ppd dur id/pf pd","description":"Patients with an active diagnosis of pervasive developmental disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7165","name":"Inj, human-lans, per i.u","description":"Injection, prothrombin complex concentrate, human-lans, per i.u. of factor ix activity","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9601","name":"Inj linvoseltamab-gcpt 1 mg","description":"Injection, linvoseltamab-gcpt, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42971","name":"Control nose/throat bleeding","description":"Control of nasopharyngeal hemorrhage, primary or secondary (eg, postadenoidectomy); complicated, requiring hospitalization","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":529.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91065","name":"Breath hydrogen/methane test","description":"Breath hydrogen or methane test (eg, for detection of lactase deficiency, fructose intolerance, bacterial overgrowth, or oro-cecal gastrointestinal transit)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4383","name":"Axolotl graft ult per sq cm","description":"Axolotl graft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1231","name":"Pt hcv tst no reactive res","description":"Patient receives hcv antibody test with nonreactive result","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0903T","name":"Ecg alg 12 lead reduced i&r","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; with interpretation and report","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36837","name":"Prq av fstl crt uxtr sep acs","description":"Percutaneous arteriovenous fistula creation, upper extremity, separate access sites of the peripheral artery and peripheral vein, including fistula maturation procedures (eg, transluminal balloon angioplasty, coil embolization) when performed, including all vascular access, imaging guidance and radi","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0759","name":"Inj, clevidipine, 1 mg","description":"Injection, clevidipine butyrate, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0491","name":"Inj anifrolumab-fnia 1mg","description":"Injection, anifrolumab-fnia, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0812T","name":"Rem mlt day uroflow dev sply","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); device supply with automated report generation, up to 10 days","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55715","name":"Bx prst8 ea add mri-us/ct/mr","description":"Biopsy, prostate, each additional, mri-ultrasound fusion or in-bore ct- or mri-guided targeted lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0565U","name":"Onc hcc ngs detc 6626epigalt","description":"Onc hcc ngs detc 6626epigalt","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87901","name":"Nfct agt gntyp alys hiv1 rev","description":"Infectious agent genotype analysis by nucleic acid (dna or rna); hiv-1, reverse transcriptase and protease regions","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1208","name":"Pt no scrn sdoh","description":"Patient is not screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5133","name":"Inj, tofidence, 1 mg","description":"Injection, tocilizumab-bavi (tofidence), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43290","name":"Egd flx trnsorl dplmnt balo","description":"Esophagogastroduodenoscopy, flexible, transoral; with deployment of intragastric bariatric balloon","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1212","name":"Missing gsa not perf","description":"Glycemic status assessment (hba1c or gmi) level is missing, or was not performed during the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41250","name":"Repair tongue laceration","description":"Repair of laceration 2.5 cm or less; floor of mouth and/or anterior two-thirds of tongue","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98001","name":"Synch audio-video new low 30","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42281","name":"Insertion palate prosthesis","description":"Insertion of pin-retained palatal prosthesis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4292","name":"Lamellas, per sq cm","description":"Lamellas, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1322","name":"Pts 7wk inj, scrn iop =<25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop =<25 mm hg for injected eye","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4287","name":"Disp col sto bag breast milk","description":"Disposable collection and storage bag for breast milk, any size, any type, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6593","name":"Grad com accessory gmt_wrap","description":"Accessory for gradient compression garment or wrap with adjustable straps, not-otherwise specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0951T","name":"Tot impl amei 1st plmt","description":"Totally implantable active middle ear hearing implant; initial placement, including mastoidectomy, placement of and attachment to sound processor","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36566","name":"Insert tunneled cv cath","description":"Insertion of tunneled centrally inserted central venous access device, requiring 2 catheters via 2 separate venous access sites; with subcutaneous port(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0893T","name":"N-invas assmt bld oxygnation","description":"Noninvasive assessment of blood oxygenation, gas exchange efficiency, and cardiorespiratory status, with physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9888","name":"5% wl maintnd from bsline wt","description":"Maintenance 5% wl from baseline weight in months 7-12","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2057","name":"Afamitresgene autoleucel","description":"Afamitresgene autoleucel, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"Basic vestibular evaluation","description":"Basic vestibular evaluation, includes spontaneous nystagmus test with eccentric gaze fixation nystagmus, with recording, positional nystagmus test, minimum of 4 positions, with recording, optokinetic nystagmus test, bidirectional foveal and peripheral stimulation, with recording, and oscillating tra","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5940","name":"Resct proth max part remov","description":"Resct proth max part remov","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59840","name":"Induced abortion d&c","description":"Induced abortion, by dilation and curettage","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":234.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37265","name":"Revsc evsc fpvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0164","name":"Epinephrine in nacl (baxter)","description":"Injection, epinephrine in sodium chloride (baxter), 0.1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0774T","name":"Vr px dissoc svc oth phy ea","description":"Virtual reality (vr) procedural dissociation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports; each additiona","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0661","name":"Team remote e/m new pt 20 mn","description":"Team remote e/m new pt 20mins","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94618","name":"Pulmonary stress testing","description":"Pulmonary stress testing (eg, 6-minute walk test), including measurement of heart rate, oximetry, and oxygen titration, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4278","name":"Epieffect, per sq cm","description":"Epieffect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4426","name":"Dermbnd tl+, tlx per sq cm","description":"Dermabind tl + or dermabind tl x,  per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0984T","name":"Iv img xtrc cere vsl oct 1st","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1287","name":"Calc bmi blw low param f/u","description":"Bmi is documented below normal parameters and a follow-up plan is documented","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77090","name":"Tbs techl prep&transmis data","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0611U","name":"Onc lvr alys >1000 mr cfdna","description":"Onc lvr alys >1000 mr cfdna","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4225","name":"Amnio or derma tl, per sq cm","description":"Amniobind or dermabind tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6081","name":"Scale & debride, single imp","description":"Scale & debride, single imp","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7997","name":"Appliance removal","description":"Appliance removal (not by dentist who placed appliance) includes removal of archbar","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0257U","name":"Vlcad leuk nzm actv whl bld","description":"Very long chain acyl- coenzyme a (coa) dehydrogenase (vlcad), leukocyte enzyme activity, whole blood","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"Endoskel posit rotat unit","description":"Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0565U","name":"Onc hcc ngs detc 6626epigalt","description":"Onc hcc ngs detc 6626epigalt","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9220","name":"Indigotindisulfonate sod 1mg","description":"Injection, indigotindisulfonate sodium, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4283","name":"Biovance tri or 3l, sq cm","description":"Biovance tri-layer or biovance 3l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0470U","name":"Onc orop detcj mrd 8 dna hpv","description":"Onc orop detcj mrd 8 dna hpv","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0930T","name":"Ephys eval ccm-d ld 1st impl","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), at time of initial implantation or replacement with testing of cardiac contrac","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1007T","name":"Eeg impl s-sclp eeg w/o vid","description":"Electroencephalogram from implanted sub-scalp continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1426","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0681T","name":"Rlcj pulse gen only isdss","description":"Relocation of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing dual leads","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0806T","name":"Tcat s&ivc prstc vl impl opn","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); open femoral vein approach","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0560","name":"Safety plan interven","description":"Safety planning interventions, each 20 minutes personally performed by the billing practitioner, including assisting the patient in the identification of the following personalized elements of a safety plan: recognizing warning signs of an impending suicidal or substance use-related crisis; employin","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91319","name":"Sarscv2 vac 10mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 10 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7471","name":"Rem exostosis any site","description":"Removal of lateral exostosis (maxilla or mandible)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0505U","name":"Nfct ds vag infctj id 32orgs","description":"Nfct ds vag infctj id 32orgs","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43251","name":"Egd remove lesion snare","description":"Esophagogastroduodenoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7047","name":"Resp suction oral interface","description":"Oral interface used with respiratory suction pump, each","date_of_service":"2026-06-05","zip":"10985","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33509","name":"Ndsc hrv uxtr art 1 sgm cab","description":"Harvest of upper extremity artery, 1 segment, for coronary artery bypass procedure, endoscopic","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81462","name":"So gsap cll fr dna/dna&rna","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants and rearrangements","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9913","name":"Admin of neuromod","description":"Admin of neuromod","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0167","name":"Inj epinephrine (hospira)","description":"Injection, epinephrine (hospira), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0288U","name":"Onc lung mrna quan pcr 11&3","description":"Onc lung mrna quan pcr 11&3","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1232","name":"Pt hcv tst reactive result","description":"Patient receives hcv antibody test with reactive result","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0781T","name":"Brnchsc rf dstrj pulm nrv bi","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; bilateral mainstem bronchi","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22836","name":"Ant thrc vrt body tethrg <7","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; up to 7 vertebral segments","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0874","name":"Inj, daptomycin (baxter)","description":"Injection, daptomycin (baxter), not therapeutically equivalent to j0878, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0758T","name":"Dgtz gls mcrscp sl spc hchem","description":"Digitization of glass microscope slides for special stain, including interpretation and report, histochemical stain on frozen tissue block (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1436","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4376","name":"Duograft aa per sq cm","description":"Duograft aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1488","name":"Dx dementia in msr timeframe","description":"Patients with a diagnosis for dementia in the year before or during the period of evaluation","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1251","name":"Pts proxy cmplt hu surv","description":"Patients for whom a proxy completed the entire hu survey on their behalf for any reason (no patient involvement)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0309U","name":"Crd cv ds aly 4 prtn plm alg","description":"Crd cv ds aly 4 prtn plm alg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33269","name":"Excl laa thrscp any method","description":"Exclusion of left atrial appendage, thoracoscopic, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0705T","name":"Rem tx amblyopia tech sprt","description":"Remote treatment of amblyopia using an eye tracking device; surveillance center technical support including data transmission with analysis, with a minimum of 18 training hours, each 30 days","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37292","name":"Rvsc evsc tpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67115","name":"Release encircling material","description":"Release of encircling material (posterior segment)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9183","name":"Gemcitabine intravesical sys","description":"Gemcitabine intravesical system, 225 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0619U","name":"Pulm copd dna alys >18000","description":"Pulm copd dna alys >18000","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0474","name":"Micro w exam of surg margins","description":"Accession of tissue gross and microscopic examination including assessment of surgical margins for presence of disease preparation and transmission of writte","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0733T","name":"Rem r-t mtn nrehab ther sply","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; supply and technical support, per 30 days","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78464","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":428.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9247","name":"Mod sedation noniv-sub15min","description":"Mod sedation noniv-sub15min","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0282U","name":"Rbc dna gntyp 12 bld grp gen","description":"Red blood cell antigen typing, dna, genotyping of 12 blood group system genes to predict 44 red blood cell antigen phenotypes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0618U","name":"Psyc bd dna mthyl alys>10000","description":"Psyc bd dna mthyl alys>10000","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20920","name":"Removal of fascia for graft","description":"Fascia lata graft; by stripper","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":457.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29888","name":"Arthrs aid acl rpr/agmntj","description":"Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1207.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4259","name":"Celera per sq cm","description":"Celera dual layer or celera dual membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1708","name":"Pfizer vacc admin 3rd dose","description":"Pfizer vacc admin 3rd dose","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34711","name":"Dlyd plmt xtn prosth ea addl","description":"Delayed placement of distal or proximal extension prosthesis for endovascular repair of infrarenal abdominal aortic or iliac aneurysm, false aneurysm, dissection, endoleak, or endograft migration, including pre-procedure sizing and device selection, all nonselective catheterization(s), all associate","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0601U","name":"Nfct ds pji alys 11 bmrks ia","description":"Nfct ds pji alys 11 bmrks ia","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45121","name":"Removal of rectum and colon","description":"Proctectomy, complete (for congenital megacolon), abdominal and perineal approach; with subtotal or total colectomy, with multiple biopsies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1834.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66991","name":"Xcapsl ctrc rmvl insj 1+","description":"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); with insertion of intraocular (eg, trabecular meshwork, supraciliary, suprachoroidal) anterior segment aqueous drai","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9888","name":"5% wl maintnd from bsline wt","description":"Maintenance 5% wl from baseline weight in months 7-12","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0702","name":"2d cephal radio image","description":"2d cephal radio image","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1007T","name":"Eeg impl s-sclp eeg w/o vid","description":"Electroencephalogram from implanted sub-scalp continuous bilateral electroencephalography monitoring system, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and report, up to 30 days of recording without video","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0390U","name":"Ob pe kdr eng&rbp4 ia alg","description":"Ob pe kdr eng&rbp4 ia alg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1372","name":"Mst rec gsa >=7 and<8","description":"Most recent glycemic status assessment (hba1c or gmi) level >= 7.0% and < 8.0%","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7213","name":"Inj, ixinity, 1 i.u.","description":"Injection, coagulation factor ix (recombinant), ixinity, 1 i.u.","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23172","name":"Sequestrectomy scapula","description":"Sequestrectomy (eg, for osteomyelitis or bone abscess), scapula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":646.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1232","name":"Pt hcv tst reactive result","description":"Patient receives hcv antibody test with reactive result","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0146","name":"Nav srv peer sup add 30 pr m","description":"Principal illness navigation - peer support, additional 30 minutes per calendar month (list separately in addition to g0140)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7939","name":"Indexing for osteotomy","description":"Indexing for osteotomy","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4024","name":"Pediatrics ss","description":"Pediatrics mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2008","name":"Theragenesis, per sq cm","description":"Theragenesis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93588","name":"Vngrph chd vnvn cltrl below","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating below the heart (eg, from the inferior vena cava) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29130","name":"Appl finger splint static","description":"Application of finger splint; static","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":53.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1252","name":"Pts no cmplt hu survey","description":"Patients who did not complete at least one of the four patient experience hu survey items and return the hu survey within 60 days of the ambulatory palliative care visit","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98000","name":"Synch audio-video new sf 15","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 15 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92928","name":"Prq tcat plmt ntrac st 1 les","description":"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 1 lesion involving 1 or more coronary segments","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0355U","name":"Apol1 risk variants","description":"Apol1 risk variants","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6193","name":"Replace implnt screw","description":"Replace implnt screw","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1313","name":"No tob scr/cess int","description":"Tobacco screening not performed or tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4394","name":"Surgraft aca per sq cm","description":"Surgraft aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1336","name":"Pts eval ini xm 2 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 2 weeks","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1248","name":"Pt resp true seen as person","description":"Patient responded completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7172","name":"Inj marstacim-hncq, 0.5 mg","description":"Injection, marstacimab-hncq, 0.5 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1028","name":"Take home supply 8mg per 0.1","description":"Take-home supply of nasal naloxone; 2-pack of 8mg per 0.1 ml nasal spray (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0469","name":"Tlso rig fram pelvic pre ots","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal and coronal ","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0752T","name":"Dgtz gls mcrscp sld lvl iii","description":"Digitization of glass microscope slides for level iii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4413","name":"Cygnus solo per sq cm","description":"Cygnus solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82390","name":"Assay of ceruloplasmin","description":"Ceruloplasmin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99437","name":"Chrnc care mgmt phys ea addl","description":"Chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, or funct","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"Non-adju cgm supply allow","description":"Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1302","name":"Inj, sutimlimab-jome, 10 mg","description":"Injection, sutimlimab-jome, 10 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78215","name":"Lvr&spleen img static only","description":"Liver and spleen imaging; static only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86037","name":"Anca titer each antibody","description":"Antineutrophil cytoplasmic antibody (anca); titer, each antibody","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34421","name":"Removal of vein clot","description":"Thrombectomy, direct or with catheter; vena cava, iliac, femoropopliteal vein, by leg incision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":887.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0463U","name":"Onc crvx mrna genxprsn 14bmk","description":"Onc crvx mrna genxprsn 14bmk","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9183","name":"Gemcitabine intravesical sys","description":"Gemcitabine intravesical system, 225 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96202","name":"Mlt fam grp bhv train 1st 60","description":"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face with multiple sets of paren","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5141","name":"Inj adalimumab-aaty, 1 mg","description":"Injection, adalimumab-aaty, biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0777T","name":"R-t prs sensing edrl gdn sys","description":"Real-time pressure-sensing epidural guidance system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0473","name":"Micro exam prep & report","description":"Accession of tissue gross and microscopic examination preparation and transmission of written report","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6072","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (high noble metal)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0259U","name":"Neph ckd nuc mrs meas gfr","description":"Nephrology (chronic kidney disease), nuclear magnetic resonance spectroscopy measurement of myo-inositol, valine, and creatinine, algorithmically combined with cystatin c (by immunoassay) and demographic data to determine estimated glomerular filtration rate (gfr), serum, quantitative","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1281","name":"Bp scrn no perf at interval","description":"Blood pressure reading not documented, reason not given","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0799T","name":"Tcat rmvl 2chmbr ldls pm ra","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right atrial pacemaker component","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33418","name":"Repair tcat mitral valve","description":"Transcatheter mitral valve repair, percutaneous approach, including transseptal puncture when performed; initial prosthesis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2048.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87510","name":"Gardner vag dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); gardnerella vaginalis, direct probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43249","name":"Esoph egd dilation <30 mm","description":"Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic balloon dilation of esophagus (less than 30 mm diameter)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1231","name":"Pt hcv tst no reactive res","description":"Patient receives hcv antibody test with nonreactive result","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86403","name":"Particle agglut antbdy scrn","description":"Particle agglutination; screen, each antibody","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0967T","name":"Tranal ins tmp clrc anst dev","description":"Transanal insertion of endoluminal temporary colorectal anastomosis protection device, including vacuum anchoring component and flexible sheath connected to external vacuum source and monitoring system","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34703","name":"Evasc rpr a-unilac ndgft","description":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-uni-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in th","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1508.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1167","name":"Hspc dur meas pd","description":"In hospice or using hospice services during the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0004","name":"Qual care neurologic cnd mvp","description":"Quality care for patients with neurological conditions mips value pathway","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82271","name":"Occult blood other sources","description":"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; other sources","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0035","name":"Pt ed pos 23","description":"Patient has any emergency department encounter during the performance period with place of service indicator 23","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1011T","name":"Pbm therapy of oral cavity","description":"Photobiomodulation (pbm) therapy of oral cavity, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9002","name":"Intra-vag motion sens biofk","description":"Intra-vaginal motion sensor system, provides biofeedback for pelvic floor muscle rehabilitation device","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1416","name":"Pt rec hosp","description":"Patient received hospice services any time during the performance period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94260","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0614","name":"Inj, treosulfan, 50 mg","description":"Injection, treosulfan, 50 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71045","name":"X-ray exam chest 1 view","description":"Radiologic examination, chest; single view","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43800","name":"Pyloroplasty","description":"Pyloroplasty","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":952.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2028","name":"Micromatrix flex per mg","description":"Micromatrix flex, per mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1252","name":"Pts no cmplt hu survey","description":"Patients who did not complete at least one of the four patient experience hu survey items and return the hu survey within 60 days of the ambulatory palliative care visit","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1457","name":"Dx asth dur crnt/prv perf pd","description":"Patient had a diagnosis of asthma with any contact during the current or prior performance period or had asthma present on an active problem list any time during the performance period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0544","name":"Post d/c phone follow up","description":"Post discharge telephonic follow-up contacts performed in conjunction with a discharge from the emergency department for behavioral health or other crisis encounter, 4 calls per calendar month","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0663","name":"Team remote e/m new pt 45 mn","description":"Team remote e/m new pt 45mins","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93569","name":"Njx cth slct p-art angrp uni","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0520","name":"New pt-cg dyad dem mod cmplx","description":"Management of new patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75774","name":"Artery x-ray each vessel","description":"Angiography, selective, each additional vessel studied after basic examination, radiological supervision and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":670.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15014","name":"Prepj skn cll ssp agrft ea","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; each additional 25 sq cm of harvested skin or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64596","name":"Ins/rplcmt prq eltrd ra pn 1","description":"Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; initial electrode array","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35122","name":"Repair artery rupture belly","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, hepatic, celiac, renal, or mesenteric artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2383.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84252","name":"Assay of vitamin b-2","description":"Riboflavin (vitamin b-2)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88373","name":"M/phmtrc alys ishquant/semiq","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99412","name":"Preventive counseling group","description":"Preventive medicine counseling and/or risk factor reduction intervention(s) provided to individuals in a group setting (separate procedure); approximately 60 minutes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":10.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2056","name":"Ciltacabtagene car-pos t","description":"Ciltacabtagene autoleucel, up to 100 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0966T","name":"I&cst prp jw xpn dl arch fxd","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, fixed hinge mechanism","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44322","name":"Colostomy with biopsies","description":"Colostomy or skin level cecostomy; with multiple biopsies (eg, for congenital megacolon) (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":995.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0810T","name":"Subrta njx rx agt w/vtrc","description":"Subretinal injection of a pharmacologic agent, including vitrectomy and 1 or more retinotomies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0735T","name":"Prep tum cav iort prim crnot","description":"Preparation of tumor cavity, with placement of a radiation therapy applicator for intraoperative radiation therapy (iort) concurrent with primary craniotomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0956T","name":"Prt crn ch cr&tun elt s-sclp","description":"Partial craniectomy, channel creation, and tunneling of electrode for sub-scalp implantation of an electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1431","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98008","name":"Synch audio-only new sf 15","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code sel","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1481","name":"Pt in hosp/pal care who died","description":"Patients receiving hospice or palliative care or who died during the measurement period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7962","name":"Lingual frenectomy","description":"Lingual frenectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2430","name":"Pamidronate disodium /30 mg","description":"Injection, pamidronate disodium, per 30 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64420","name":"Njx aa&/strd ntrcost nrv 1","description":"Injection(s), anesthetic agent(s) and/or steroid; intercostal nerve, single level","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61530","name":"Removal of brain lesion","description":"Craniectomy, bone flap craniotomy, transtemporal (mastoid) for excision of cerebellopontine angle tumor; combined with middle/posterior fossa craniotomy/craniectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3366.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5945","name":"Mand implt sup remv part","description":"Mand implt sup remv part","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0530","name":"Adult daycare center, 8 hr u","description":"Adult day center, 8-hour unit, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0274U","name":"Hem gen pltlt do 43 genes","description":"Hematology (genetic platelet disorders), genomic sequence analysis of 43 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4344","name":"Tri membrane wrap, per sq cm","description":"Tri-membrane wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2596","name":"Vasopressin (long grove) 1 u","description":"Injection, vasopressin (long grove), not therapeutically equivalent to j2598, 1 unit","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88358","name":"Analysis tumor","description":"Morphometric analysis; tumor (eg, dna ploidy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0756T","name":"Dgtz gls mcrscp sld spc grpi","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group i, for microorganisms (eg, acid fast, methenamine silver) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1428","name":"Bilateral absence of eyes","description":"Patients who have bilateral absence of eyes any time during the patients history through the end of the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4354","name":"Palingen dl-palingen dl-x","description":"Palingen dual-layer membrane and dual-layer palingen x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4361","name":"Epixpress, per sq cm","description":"Epixpress, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88356","name":"Analysis nerve","description":"Morphometric analysis; nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7300","name":"Rem anchorage dev w/o flap","description":"Rem anchorage dev w/o flap","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0567","name":"Screening hep c detect","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis c, screening, amplified probe technique","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0688","name":"Inj cefazolin sodium, hikma","description":"Injection, cefazolin sodium (hikma), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22842","name":"Insert spine fixation device","description":"Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":995.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21031","name":"Remove exostosis mandible","description":"Excision of torus mandibularis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4028","name":"Podiatry ss","description":"Podiatry mips specialty set","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25001","name":"Incise flexor carpi radialis","description":"Incision, flexor tendon sheath, wrist (eg, flexor carpi radialis)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":373.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37263","name":"Revsc evasc fpvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81349","name":"Cytog alys chrml abnr lw-ps","description":"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and loss-of-heterozygosity variants, low-pass sequencing analysis","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2991","name":"App of hydroxyapatite","description":"App of hydroxyapatite","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2470","name":"Inj pantoprazole sodium 40mg","description":"Injection, pantoprazole sodium, 40 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4395","name":"Acelagraft per sq cm","description":"Acelagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9029","name":"Instill adstiladrin, tx dose","description":"Intravesical instillation, nadofaragene firadenovec-vncg, per therapeutic dose","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4025","name":"Physical medicine ss","description":"Physical medicine mips specialty set","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23140","name":"Removal of bone lesion","description":"Excision or curettage of bone cyst or benign tumor of clavicle or scapula;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":597.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28030","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":473.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4274","name":"Esano ac, per sq cm","description":"Esano ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0337U","name":"Onc plsm cell do&myeloma id","description":"Onc plsm cell do&myeloma id","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21048","name":"Remove maxilla cyst complex","description":"Excision of benign tumor or cyst of maxilla; requiring intra-oral osteotomy (eg, locally aggressive or destructive lesion[s])","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26587","name":"Reconstruct extra finger","description":"Reconstruction of polydactylous digit, soft tissue and bone","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1108.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45160","name":"Excision of rectal lesion","description":"Excision of rectal tumor by proctotomy, transsacral or transcoccygeal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1045.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4010","name":"Infectious disease ss","description":"Infectious disease mips specialty set","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1483","name":"Neg quan hep c or qual rna","description":"Patients who achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45388","name":"Colonoscopy w/ablation","description":"Colonoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3155.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":277.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92636","name":"Hearing aid post-fitg f-up 1","description":"Hearing aid post-fitting follow-up services, unilateral or bilateral, including confirmation of physical fit, validation of patient benefit and performance, sound quality of device, adjustment(s) (eg, verification, programming adjustment[s], device connection[s], and device training), as indicated, ","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0465","name":"Autolog prp diab wound ulcer","description":"Autologous platelet rich plasma (prp) or other blood-derived product for diabetic chronic wounds/ulcers, using an fda-cleared device for this indication, (includes as applicable administration, dressings, phlebotomy, centrifugation or mixing, and all other preparatory procedures, per treatment)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2526","name":"Cntct lens blue violet","description":"Contact lens, hydrophilic, with blue-violet filter, per lens","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1340","name":"Indx whodas 2.0 or sds","description":"Index assessment completed using the 12-item whodas 2.0 or sds during the denominator identification period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91304","name":"Sarscov2 vac 5mcg/0.5ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, 5 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7471","name":"Rem exostosis any site","description":"Removal of lateral exostosis (maxilla or mandible)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9027","name":"Rbc o2 co2 reduced","description":"Red blood cells, leukocytes reduced, oxygen/ carbon dioxide reduced, each unit","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0211","name":"Inj, nithiodote, 3mg / 125mg","description":"Injection, sodium nitrite 3 mg and sodium thiosulfate 125 mg (nithiodote)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43291","name":"Egd flx trnsorl rmvl balo","description":"Esophagogastroduodenoscopy, flexible, transoral; with removal of intragastric bariatric balloon(s)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96041","name":"Genetic counseling svc ea 30","description":"Medical genetics and genetic counseling services, each 30 minutes of total time provided by the genetic counselor on the date of the encounter","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0940T","name":"Xtrnl ecg rec>15d<30d r&i","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33277","name":"Insj phrnc nrv stim transvns","description":"Insertion of phrenic nerve stimulator transvenous sensing lead (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0801","name":"3d dental scan direct","description":"3d dental scan direct","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0663","name":"Team remote e/m new pt 45 mn","description":"Team remote e/m new pt 45mins","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49615","name":"Rpr aa hrn rcr 3-10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, reducible","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2036","name":"Cohealyx col dml mx pr sq cm","description":"Cohealyx collagen dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63053","name":"Lam factc/frmt arthrd lum ea","description":"Laminectomy, facetectomy, or foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s] [eg, spinal or lateral recess stenosis]), during posterior interbody arthrodesis, lumbar; each additional vertebral segment (list separately in addition to code for","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64913","name":"Nrv rpr w/nrv algrft ea addl","description":"Nerve repair; with nerve allograft, each additional strand (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1392","name":"Pt rsn no exm or lst to fu","description":"Documentation of patient reasons for no examination, i.e., refusal of examination or lost to follow-up (documentation must include information that the clinician was unable to reach the patient by phone, mail or secure electronic mail - at least one method must be documented)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85004","name":"Automated diff wbc count","description":"Blood count; automated differential wbc count","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0850T","name":"Dgtz gls mcrscp ish ea mult","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1405","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9871","name":"Bhv couns dm prev, onln 60 m","description":"Behavioral counseling for diabetes prevention, online, 60 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81457","name":"So neo gsap dna mcrstl ins","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis, microsatellite instability","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7514","name":"Mycophenol (myhibbin) 100 mg","description":"Mycophenolate mofetil (myhibbin), oral suspension, 100 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0257U","name":"Vlcad leuk nzm actv whl bld","description":"Very long chain acyl- coenzyme a (coa) dehydrogenase (vlcad), leukocyte enzyme activity, whole blood","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0907T","name":"Coms ther ea addl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; each additional application, total wound(s) surface area less than or equal to 50 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4022","name":"Otolaryngology ss","description":"Otolaryngology mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0905T","name":"Ecg alg 12 ld rdcd i&r only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; interpretation and report only","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59850","name":"Induced abortion 1+ njx","description":"Induced abortion, by 1 or more intra-amniotic injections (amniocentesis-injections), including hospital admission and visits, delivery of fetus and secundines;","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7355","name":"Inj travoprost intra impl","description":"Injection, travoprost, intracameral implant, 1 microgram","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0615","name":"Calcium acetate, oral, 23 mg","description":"Calcium acetate, oral, 23 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35188","name":"Rpr acq av fistula head&neck","description":"Repair, acquired or traumatic arteriovenous fistula; head and neck","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1083.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1159","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4316","name":"Amchoplast, per sq cm","description":"Amchoplast, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5932","name":"Postsurgical obturator","description":"Obturator prosthesis definitive","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86318","name":"Ia infectious agent antibody","description":"Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip);","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1252","name":"Pts no cmplt hu survey","description":"Patients who did not complete at least one of the four patient experience hu survey items and return the hu survey within 60 days of the ambulatory palliative care visit","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1437","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1470","name":"Hep b vac not recd med rsn","description":"Documentation of medical reason(s) for not administering hepatitis b vaccine (e.g., prior anaphylaxis due to the hepatitis b vaccine)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50328","name":"Prep renal graft/arterial","description":"Backbench reconstruction of cadaver or living donor renal allograft prior to transplantation; arterial anastomosis, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0603U","name":"Rx asy prsmv 77rx/metablt ur","description":"Rx asy prsmv 77rx/metablt ur","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0529","name":"In home respite care, 4 hr u","description":"In-home respite care, 4-hour unit, for use in cmmi model","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88362","name":"Nerve teasing preparations","description":"Nerve teasing preparations","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0797T","name":"Tcat ins 2chmbr ldls pm rv","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ventricular pace","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0714T","name":"Tpla b9 prst8 hyprplsa<50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume less than 50 ml","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68705","name":"Revise tear duct opening","description":"Correction of everted punctum, cautery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0481","name":"Electron microscopy diagnost","description":"Electron microscopy - diagnostic","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0553U","name":"Repr med pga embry te strux","description":"Repr med pga embry te strux","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0535","name":"Pt navigat svs direct/ref","description":"Patient navigational services, provided directly or by referral; including helping the patient to navigate health systems and identify care providers and supportive services, to build patient self-advocacy and communication skills with care providers, and to promote patient-driven action plans and g","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4401","name":"Absolv3 per sq cm","description":"Absolv3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92632","name":"Hearing aid slctn svc ea add","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94625","name":"Phy/qhp op pulm rhb w/o mntr","description":"Physician or other qualified health care professional services for outpatient pulmonary rehabilitation; without continuous oximetry monitoring (per session)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0533","name":"Buprenorphone inj weekly","description":"Medication assisted treatment, buprenorphine (injectable) administered on a weekly basis; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid tre","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69726","name":"Rmv ntr oi implt skl prq esp","description":"Removal, entire osseointegrated implant, skull; with percutaneous attachment to external speech processor","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90471","name":"Immunization admin","description":"Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); 1 vaccine (single or combination vaccine/toxoid)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":25.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5154","name":"Inj, omlyclo, 5 mg","description":"Injection, omalizumab-igec (omlyclo), biosimilar, 5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0740T","name":"Rem auton alg nsln cal setup","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; initial set-up and patient education","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61892","name":"Rmv sk-mnt crnl nstm pg/rcvr","description":"Removal of skull-mounted cranial neurostimulator pulse generator or receiver with cranioplasty, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64567","name":"Perq elec nrv field stimj cn","description":"Percutaneous electrical nerve field stimulation, cranial nerves, without implantation","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1026","name":"Pt hemo > 3mo","description":"The number of adult patient-months in the denominator who were on maintenance hemodialysis using a catheter continuously for three months or longer under the care of the same practitioner or group partner as of the last hemodialysis session of the reporting month","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33287","name":"Rmv&rplcmt phrnc nrv stim pg","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4212","name":"Gingivectomy/plasty rest","description":"Gingivectomy/plasty rest","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37286","name":"Revsc evasc tpvt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0908T","name":"Opn imp int nstm sys vgs nrv","description":"Open implantation of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0815T","name":"Us rems b1 dns hips plvs/spi","description":"Ultrasound-based radiofrequency echographic multi-spectrometry (rems), bone-density study and fracture-risk assessment, 1 or more sites, hips, pelvis, or spine","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0358U","name":"Neuro alys b-amyl 1-42&1-40","description":"Neuro alys b-amyl 1-42&1-40","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4457","name":"Enema tube any type repl","description":"Enema tube, with or without adapter, any type, replacement only, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90837","name":"Psytx w pt 60 minutes","description":"Psychotherapy, 60 minutes with patient","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":183.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":145.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0457U","name":"Pfas 9 cmpnd lcms/ms pls/sr","description":"Pfas 9 cmpnd lcms/ms pls/sr","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2050","name":"Financial mgt waiver/diem","description":"Financial management, self-directed, waiver; per diem","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0534U","name":"Onc prst8 mirna snp 32 vrnt","description":"Onc prst8 mirna snp 32 vrnt","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98009","name":"Synch audio-only new low 30","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 30 m","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4241","name":"Gngvl flap w rootplan 1-3 th","description":"Gingival flap procedure including root planing - one to three contiguous teeth or bounded teeth spaces per quadrant","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0887T","name":"End-tidal ctrl inhaled anes","description":"End-tidal control of inhaled anesthetic agents and oxygen to assist anesthesia care delivery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3402","name":"Inj. remestemcel-l-rknd/ td","description":"Injection, remestemcel-l-rknd, per therapeutic dose","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81463","name":"So gsap cl fr cpy nmbr&mcrst","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis, copy number variants, and microsatellite instability","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64467","name":"Thrc fascial pln blk uni nfs","description":"Thoracic fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78020","name":"Thyroid met uptake","description":"Thyroid carcinoma metastases uptake (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1409","name":"Recd gmln brca1/brca2 couns","description":"Patients who received germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9939","name":"Placemnt removable appliance","description":"Placemnt removable appliance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0969T","name":"Removal epicranial nstim sys","description":"Removal of epicranial neurostimulator system","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2045","name":"Novashield/novogen pr sq cm","description":"Novashield or novogen wound matrix, per square centimeter","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0935T","name":"Cysto w/rnl pel symp dnrvtj","description":"Cystourethroscopy with renal pelvic sympathetic denervation, radiofrequency ablation, retrograde ureteral approach, including insertion of guide wire, selective placement of ureteral sheath(s) and multiple conformable electrodes, contrast injection(s), and fluoroscopy, bilateral","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9002","name":"Intra-vag motion sens biofk","description":"Intra-vaginal motion sensor system, provides biofeedback for pelvic floor muscle rehabilitation device","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76830","name":"Transvaginal us non-ob","description":"Ultrasound, transvaginal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86651","name":"Encephalitis californ antbdy","description":"Antibody; encephalitis, california (la crosse)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1262","name":"Pts transplt bef dialysis","description":"Patients who had a transplant prior to initiation of dialysis","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1163","name":"Pt anphx due to hpv bef 13","description":"Patient had anaphylaxis due to the hpv vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1434","name":"Inj, focinvez, 1mg","description":"Injection, fosaprepitant (focinvez), 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0297U","name":"Onc pan tum whl gen seq dna","description":"Onc pan tum whl gen seq dna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64473","name":"Lwr xtr fscl pln blk uni njx","description":"Lower extremity fascial plane block, unilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0832T","name":"Dgtz gls mcrscp cytp oth scr","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0681T","name":"Rlcj pulse gen only isdss","description":"Relocation of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing dual leads","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6634","name":"Onlay titanium","description":"Onlay - titanium","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0831T","name":"Dgtz gls mcrscp cytp c/v","description":"Digitization of glass microscope slides for cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82787","name":"Igg 1 2 3 or 4 each","description":"Gammaglobulin (immunoglobulin); immunoglobulin subclasses (eg, igg1, 2, 3, or 4), each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1111F","name":"Dschrg med/current med merge","description":"Discharge medications reconciled with the current medication list in outpatient medical record (coa) (ger)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70471","name":"Cta h&n c+ w/noncontrast img","description":"Computed tomographic angiography (cta), head and neck, with contrast material(s), including noncontrast images, when performed, and image postprocessing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42900","name":"Repair throat wound","description":"Suture pharynx for wound or injury","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":421.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33403","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1921.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0378U","name":"Rfc1 repeat xpnsj vrnt alys","description":"Rfc1 repeat xpnsj vrnt alys","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0613","name":"Calcium glucon (wg critical)","description":"Injection, calcium gluconate (wg critical care), not therapeutically equivalent to j0612, 10 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84393","name":"Tau phosphorylated ea","description":"Tau, phosphorylated (eg, ptau 181, ptau 217), each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1821","name":"Ko elas w/ condyle pads otf","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, off the shelf","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":169.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9888","name":"5% wl maintnd from bsline wt","description":"Maintenance 5% wl from baseline weight in months 7-12","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4253","name":"Zenith amniotic membrane psc","description":"Zenith amniotic membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5411","name":"Dentures adjust cmplt mand","description":"Adjust complete denture - mandibular","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99355","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64573","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":655.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1485","name":"Neg viro resp hep c/qual rna","description":"Patients who did not achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1297","name":"Bmi not doc medrsn ptref","description":"Bmi not documented due to medical reason or patient refusal of height or weight measurement","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0973T","name":"Slctv nzmtc dbrdmt t/a/l 1st","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; first 100 sq cm","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4414","name":"Simplichor per sq cm","description":"Simplichor, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3421","name":"Root surgery bicuspid","description":"Apicoectomy/periradicular surgery-bicuspid (first root)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0658","name":"Seg pneum comp 2 arm chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2468","name":"Inj, palonosetron (posfrea)","description":"Injection, palonosetron hydrochloride (posfrea), 25 micrograms","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92930","name":"Prq tcat plmt ntrac st 2+les","description":"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 2 or more distinct coronary lesions with 2 or more coronary stents deployed in 2 or more coronary segments, or a bifurcation lesion requiring ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0558U","name":"Onc clrct elisa bf7 ag serum","description":"Onc clrct elisa bf7 ag serum","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4320","name":"Pellograft, per sq cm","description":"Pellograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76016","name":"Mr safety deter phys/qhp","description":"Mr safety determination by a physician or other qualified health care professional responsible for the safety of the mr procedure, including review of implant mr conditions for indicated mr examination, analysis of risk vs clinical benefit of performing mr examination, and determination of mr equipm","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0560U","name":"Onc mrd gsa cfdna baseline","description":"Onc mrd gsa cfdna baseline","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0371","name":"Sialoendoscopy capt & interp","description":"Sialoendoscopy capt & interp","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1432","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9616","name":"Gallium gozellix 1 millicuri","description":"Gallium ga-68 gozetotide (gozellix), diagnostic, 1 millicurie","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1420","name":"Complete ophthalmologic mvp","description":"Complete ophthalmologic care mips value pathway","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4297","name":"Emerge matrix, per sq cm","description":"Emerge matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82757","name":"Assay of semen fructose","description":"Fructose, semen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9954","name":"Fab/del oral appliance thxpy","description":"Fab/del oral appliance thxpy","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11602","name":"Exc tr-ext mal+marg 1.1-2 cm","description":"Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 1.1 to 2.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64656","name":"Revj/rplcmt bat mod sys pg","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; pulse generator only","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78305","name":"Bone imaging multiple areas","description":"Bone and/or joint imaging; multiple areas","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99224","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2644","name":"Dental onlay porc 4/more sur","description":"Onlay - porcelain/ceramic - four or more surfaces","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0881T","name":"Cryotherapy oral cavity","description":"Cryotherapy of the oral cavity using temperature regulated fluid cooling system, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63300","name":"Remove vert xdrl body crvcl","description":"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, cervical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2041.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6071","name":"Abutment supported retainer","description":"Abutment supported retainer for porcelain fused to metal fpd (noble metal)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99477","name":"Init day hosp neonate care","description":"Initial hospital care, per day, for the evaluation and management of the neonate, 28 days of age or younger, who requires intensive observation, frequent interventions, and other intensive care services","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44005","name":"Freeing of bowel adhesion","description":"Enterolysis (freeing of intestinal adhesion) (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1113.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4301","name":"Activate matrix, per sq cm","description":"Activate matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1175","name":"Doc med rsn no hzv","description":"Documentation of medical reason(s) for not administering zoster vaccine (e.g., prior anaphylaxis due to the zoster vaccine)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97597","name":"Dbrdmt opn wnd 1st 20 cm/<","description":"Debridement (eg, high pressure waterjet with/without suction, sharp selective debridement with scissors, scalpel and forceps), open wound, (eg, fibrin, devitalized epidermis and/or dermis, exudate, debris, biofilm), including topical application(s), wound assessment, use of a whirlpool, when perform","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0420U","name":"Onc urthl mrna xprsn 6 snp","description":"Onc urthl mrna xprsn 6 snp","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85810","name":"Blood viscosity examination","description":"Viscosity","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4322","name":"Splint intra-coronal","description":"Splint intra-coronal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86378","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1244","name":"Pt othr thn true best int","description":"Patient provided a response other than completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0789T","name":"Elec aly cpx iins sp/sac nrv","description":"Electronic analysis with complex programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detect","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0168","name":"Epinephrine (intl med sys)","description":"Injection, epinephrine (international medication systems), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9608","name":"Flotufolastat f18 diag 1 mci","description":"Flotufolastat f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1225","name":"Iop dec>=20% from base","description":"Intraocular pressure (iop) reduced by a value of greater than or equal to 20% from the pre-intervention level","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64653","name":"Chemodenerv eccrine glands","description":"Chemodenervation of eccrine glands; other area(s) (eg, scalp, face, neck), per day","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0842T","name":"Dgtz gls mcrscp pth cslt ea","description":"Digitization of glass microscope slides for pathology consultation during surgery; each additional tissue block with frozen section(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99243","name":"Off/op cnsltj new/est low 30","description":"Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":120.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4418","name":"Biolab wrap flow per sq cm","description":"Biolab membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7411","name":"Excision benign lesion>1.25c","description":"Excision of benign lesion greater than 1.25 cm","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9260","name":"Inj methotrexate sodium 50mg","description":"Injection, methotrexate sodium, 50 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0763T","name":"Dgtz gls mcrscp mphmtrc alys","description":"Digitization of glass microscope slides for morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure, manual (list separately in addition to code for primary proced","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78492","name":"Myocrd img pet mlt rst&strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); multiple studies at rest and stress (exercise or pharmacologic)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1535.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4271","name":"Home lancing/test cartridges","description":"Integrated lancing and blood sample testing cartridges for home blood glucose monitor, per 50 tests","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99344","name":"Home/res vst new mod mdm 60","description":"Home or residence visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78014","name":"Thyroid imaging w/blood flow","description":"Thyroid imaging (including vascular flow, when performed); with single or multiple uptake(s) quantitative measurement(s) (including stimulation, suppression, or discharge, when performed)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0038","name":"Clin pt no ref","description":"Clinician determines patient does not require referral","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37254","name":"Revsc evasc ivt angio sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpreta","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53230","name":"Removal of urethra lesion","description":"Excision of urethral diverticulum (separate procedure); female","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":659.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0563U","name":"Nfct ds pthgn-sna 11vir&4bct","description":"Nfct ds pthgn-sna 11vir&4bct","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1338","name":"Pt f/u 30-180 dys no + imprv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who did not demonstrate positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50570","name":"Kidney endoscopy","description":"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":582.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0166","name":"Inj epinephrine (bpi)","description":"Injection, epinephrine (bpi), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4358","name":"Xwrap dual, per sq cm","description":"Xwrap dual, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96547","name":"Intraop hipec px 1st 60 min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; first 60 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64583","name":"Rev/rplct hpglsl nstm ary pg","description":"Revision or replacement of hypoglossal nerve neurostimulator array and distal respiratory sensor electrode or electrode array, including connection to existing pulse generator","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0613","name":"Calcium glucon (wg critical)","description":"Injection, calcium gluconate (wg critical care), not therapeutically equivalent to j0612, 10 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92930","name":"Prq tcat plmt ntrac st 2+les","description":"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 2 or more distinct coronary lesions with 2 or more coronary stents deployed in 2 or more coronary segments, or a bifurcation lesion requiring ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6624","name":"Inlay titanium","description":"Inlay - titanium","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93153","name":"Interrog w/o prgrmg ipnss","description":"Interrogation without programming of implanted phrenic nerve stimulator system","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0834T","name":"Dgtz gls mcrscp cytp oth xtn","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9292","name":"Inj, pemetrexed dipotassium","description":"Injection, pemetrexed dipotassium, 10 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37267","name":"Revsc evsc fpvt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0484U","name":"Nfct ds mgen 23s rrna pt mut","description":"Nfct ds mgen 23s rrna pt mut","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0778T","name":"Smmg cncrnt appl imu snr","description":"Surface mechanomyography (smmg) with concurrent application of inertial measurement unit (imu) sensors for measurement of multi-joint range of motion, posture, gait, and muscle function","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86352","name":"Cell function assay w/stim","description":"Cellular function assay involving stimulation (eg, mitogen or antigen) and detection of biomarker (eg, atp)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0062","name":"Audiology ss","description":"Audiology mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2393","name":"Post 3 srfc resinbased cmpst","description":"Resin-based composite - three surfaces posterior","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0283U","name":"Vw factor type 2b eval plsm","description":"Von willebrand factor (vwf), type 2b, platelet-binding evaluation, radioimmunoassay, plasma","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4372","name":"Amchoplast excl per sq cm","description":"Amchoplast excel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32310","name":"Removal of chest lining","description":"Pleurectomy, parietal (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1023.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1941","name":"Inj, furoscix, 20 mg","description":"Injection, furosemide (furoscix), 20 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92629","name":"Eval hearing aid cand ea add","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1161","name":"Pt anphx due to dtp bef 13","description":"Patient had anaphylaxis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9063","name":"Inj, elahere, 1 mg","description":"Injection, mirvetuximab soravtansine-gynx, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0439","name":"Ppps, subseq visit","description":"Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2327","name":"Inj risankizumab-rzaa 1 mg","description":"Injection, risankizumab-rzaa, intravenous, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1474","name":"Pt dx dementia","description":"Patients with diagnosis of dementia","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97802","name":"Medical nutrition indiv in","description":"Medical nutrition therapy; initial assessment and intervention, individual, face-to-face with the patient, each 15 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":29.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1293","name":"Calc bmi abv up param f/u","description":"Bmi is documented above normal parameters and a follow-up plan is documented","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1215","name":"Med rsn for no doc spiro","description":"Documentation of medical reason(s) for not documenting and reviewing spirometry results (e.g., patients with dementia or tracheostomy)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92639","name":"Hearing aid meas verif","description":"Hearing-aid measurement, verification with probe-microphone (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6614","name":"Onlay cst nbl mtl 2 surfaces","description":"Onlay - cast noble metal two surfaces","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6071","name":"Abutment supported retainer","description":"Abutment supported retainer for porcelain fused to metal fpd (noble metal)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2802","name":"Inj, romiplostim 1 microgram","description":"Injection, romiplostim, 1 microgram","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4479","name":"Transanal irrigation, electr","description":"Electronic transanal irrigation system, includes electronic pump, water reservoir, tubing, and accessories, without catheter, any type","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0686T","name":"Histotripsy mal hepatcel tis","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant hepatocellular tissue, including image guidance","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1262","name":"Pts transplt bef dialysis","description":"Patients who had a transplant prior to initiation of dialysis","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5941","name":"Resct proth mand part remov","description":"Resct proth mand part remov","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1218","name":"Pt copd symptoms","description":"Patient has copd symptoms (e.g., dyspnea, cough/sputum, wheezing)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3394","name":"Inj, lovotibeglogene autotem","description":"Injection, lovotibeglogene autotemcel, per treatment","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4356","name":"Abio mem abio hyd per sq cm","description":"Abiomend membrane and abiomend hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0031","name":"Pall serv during meas","description":"Palliative care services given to patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0363U","name":"Onc urthl mrna 5 gen alg","description":"Onc urthl mrna 5 gen alg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0774T","name":"Vr px dissoc svc oth phy ea","description":"Virtual reality (vr) procedural dissociation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports; each additiona","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4403","name":"Xwrap dual plus per sq cm","description":"Xwrap dual plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43201","name":"Esoph scope w/submucous inj","description":"Esophagoscopy, flexible, transoral; with directed submucosal injection(s), any substance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01942","name":"Anes neuromd/ntrvrt lmbr/sac","description":"Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77409","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0680","name":"Cr art clc art vlv clc w rpt","description":"Detection and quantification of coronary artery calcium and/or aortic valve calcification from algorithmic analysis of computed tomography of the chest with report","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1409","name":"Recd gmln brca1/brca2 couns","description":"Patients who received germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55715","name":"Bx prst8 ea add mri-us/ct/mr","description":"Biopsy, prostate, each additional, mri-ultrasound fusion or in-bore ct- or mri-guided targeted lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97007","name":"Mchnl sclp cool meas fitg","description":"Mechanical scalp cooling, including individual cap supply with head measurement, fitting, and patient education","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4034","name":"Speech language path ss","description":"Speech language pathology mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3394","name":"Inj, lovotibeglogene autotem","description":"Injection, lovotibeglogene autotemcel, per treatment","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1323","name":"Pts 7wk inj, scrn iop >25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop >25 mm hg and a plan of care was documented","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4305","name":"Amer am ac tri-lay per sq cm","description":"American amnion ac tri-layer, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0734T","name":"Rem r-t mtn nrehab tx mgmt","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; treatment management services by a physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80181","name":"Drug assay flecainide","description":"Flecainide","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2327","name":"Inj risankizumab-rzaa 1 mg","description":"Injection, risankizumab-rzaa, intravenous, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0562U","name":"Onc sol tum tgsa 33gens snvs","description":"Onc sol tum tgsa 33gens snvs","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37291","name":"Revsc evsc tpvt athr cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5947","name":"Mand implt sup fix","description":"Mand implt sup fix","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1342","name":"Pts died perf per","description":"Patients who died during the performance period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7049","name":"Epap nasal valve","description":"Expiratory positive airway pressure intranasal resistance valve","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9025","name":"Plasma cryo redu path each","description":"Plasma, cryoprecipitate reduced, pathogen reduced, each unit","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30901","name":"Control of nosebleed","description":"Control nasal hemorrhage, anterior, simple (limited cautery and/or packing) any method","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":47.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1216","name":"No spiro doc no res doc","description":"No spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) documented and/or no spirometry performed with results documented during the encounter","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1253","name":"Pts hu surv no amb plltv","description":"Patients who respond on the patient experience hu survey that they did not receive care by the listed ambulatory palliative care provider in the last 60 days (disavowal)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9999","name":"Inj ustekinumab-aauz 1 mg","description":"Injection, ustekinumab-aauz (otulfi), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1431","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0409U","name":"Onc sld tum dna 80 & rna 36","description":"Onc sld tum dna 80 & rna 36","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68841","name":"Insj rx elut implt lac canal","description":"Insertion of drug-eluting implant, including punctal dilation when performed, into lacrimal canaliculus, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93602","name":"Intra-atrial recording","description":"Intra-atrial recording","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15834","name":"Exc excessive skin hip","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy); hip","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":912.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83014","name":"H pylori drug admin","description":"Helicobacter pylori; drug administration","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0679T","name":"Laps rmvl lead isdss","description":"Laparoscopic removal of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0948T","name":"Rem interrog dev ccm phys","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system with interim analysis, review, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0472U","name":"Ca vi psp&sp1 antb sjogren","description":"Ca vi psp&sp1 antb sjogren","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9913","name":"Admin of neuromod","description":"Admin of neuromod","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76830","name":"Transvaginal us non-ob","description":"Ultrasound, transvaginal","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0374","name":"Tomo periapical image","description":"Tomo periapical image","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34203","name":"Removal of leg artery clot","description":"Embolectomy or thrombectomy, with or without catheter; popliteal-tibio-peroneal artery, by leg incision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1204.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1328","name":"Pts dx acute vitreous hem","description":"Patients with a diagnosis of acute vitreous hemorrhage","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0796T","name":"Tcat ins 2chmbr ldls pm ra","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right atrial pacemaker","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6516","name":"Grad com wrap w strap foo cu","description":"Gradient compression wrap with adjustable straps, foot, each, custom","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9948","name":"Adjust sleep apnea appliance","description":"Adjust sleep apnea appliance","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2034","name":"Found drs solo, per sq cm","description":"Foundation drs solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11980","name":"Implant hormone pellet(s)","description":"Subcutaneous hormone pellet implantation (implantation of estradiol and/or testosterone pellets beneath the skin)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0817T","name":"Opn insj/rplcmt ins ptn subf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subfascial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7516","name":"Inj, cyclosporine 250mg","description":"Injection, cyclosporine, 250 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0751T","name":"Dgtz gls mcrscp sld level ii","description":"Digitization of glass microscope slides for level ii, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0271U","name":"Hem cgen neutropenia 23 gen","description":"Hematology (congenital neutropenia), genomic sequence analysis of 23 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1353","name":"Pts no cmplt suicd saf pln","description":"Patients who did not have a completed suicide safety plan initiated, reviewed or updated in collaboration with their clinician (concurrent or within 24 hours) of the index clinical encounter","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70471","name":"Cta h&n c+ w/noncontrast img","description":"Computed tomographic angiography (cta), head and neck, with contrast material(s), including noncontrast images, when performed, and image postprocessing","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33245","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1086.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5138","name":"Inj, wezlana, iv, 1 mg","description":"Injection, ustekinumab-auub (wezlana), biosimilar, intravenous, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0616U","name":"Neurol dementia alys >30000","description":"Neurol dementia alys >30000","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0217","name":"Inj velmanase alfa-tycv 1 mg","description":"Injection, velmanase alfa-tycv, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0529","name":"In home respite care, 4 hr u","description":"In-home respite care, 4-hour unit, for use in cmmi model","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0476U","name":"Rx metab psyc 14gen&cyp2d6","description":"Rx metab psyc 14gen&cyp2d6","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0275U","name":"Hem heprn nduc trmbctpna srm","description":"Hematology (heparin-induced thrombocytopenia) platelet antibody reactivity by flow cytometry, serum","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0694T","name":"3d vol img&rcnstj brst/ax","description":"3-dimensional volumetric imaging and reconstruction of breast or axillary lymph node tissue, each excised specimen, 3-dimensional automatic specimen reorientation, interpretation and report, real-time intraoperative","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16000","name":"Initial treatment of burn(s)","description":"Initial treatment, first degree burn, when no more than local treatment is required","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":48.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1381","name":"Pt sec strk wthin 5 days","description":"Patients with secondary stroke (e.g., a subsequent stroke that may occur with vasospasm in the setting of subarachnoid hemorrhage) within 5 days of the initial procedure","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0939T","name":"Xtrnl ecg rec>15d<30d scan","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; scanning analysis with report","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0868T","name":"Hi-res gastric ep mapping","description":"High-resolution gastric electrophysiology mapping with simultaneous patient-symptom profiling, with interpretation and report","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49613","name":"Rpr aa hrn rcr < 3 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, reducible","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2801","name":"Inj, rykindo, 0.5 mg","description":"Injection, risperidone (rykindo), 0.5 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0629U","name":"Nfct ds tb dna aly 1trgt pcr","description":"Nfct ds tb dna aly 1trgt pcr","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4407","name":"Xwrap tribus per sq cm","description":"Xwrap tribus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55715","name":"Bx prst8 ea add mri-us/ct/mr","description":"Biopsy, prostate, each additional, mri-ultrasound fusion or in-bore ct- or mri-guided targeted lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0317U","name":"Onc lung ca 4-prb fish assay","description":"Onc lung ca 4-prb fish assay","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1261","name":"Pts on wtlist bef dialysis","description":"Patients that were on the kidney or kidney-pancreas waitlist prior to initiation of dialysis","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0464U","name":"Onc clrct scr qrtsa dna mrk","description":"Onc clrct scr qrtsa dna mrk","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4288","name":"Replacement breastpump valve","description":"Valve for breast pump, replacement","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0209","name":"Inj, sod thiosulfate (hope)","description":"Injection, sodium thiosulfate (hope), 100 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0844T","name":"Dgtz gls mcrscp cslt cyt ea","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), each additional site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4350","name":"Palisade dm matrix per sq cm","description":"Palisade dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0414U","name":"Onc lng aug alg aly whl sld8","description":"Onc lng aug alg aly whl sld8","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1497","name":"No doc fall med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50690","name":"Injection for ureter x-ray","description":"Injection procedure for visualization of ileal conduit and/or ureteropyelography, exclusive of radiologic service","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1311","name":"Aphlx to vax bef enc","description":"Anaphylaxis due to the vaccine on or before the date of the encounter","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99244","name":"Off/op cnsltj new/est mod 40","description":"Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0535U","name":"Pfas lc-ms/ms plsm/srm quan","description":"Pfas lc-ms/ms plsm/srm quan","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1198","name":"Isa not red 3pts /no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33870","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3071.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1343","name":"Pt pam lvl 4 base or srt lin","description":"Patients who are at pam level 4 at baseline or patients who are flagged with extreme straight line response sets on the pam or with excessive missing responses","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99184","name":"Hypothermia ill neonate","description":"Initiation of selective head or total body hypothermia in the critically ill neonate, includes appropriate patient selection by review of clinical, imaging and laboratory data, confirmation of esophageal temperature probe location, evaluation of amplitude eeg, supervision of controlled hypothermia, ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9224","name":"Gen anes adv air-15 min","description":"Gen anes adv air-15 min","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0315U","name":"Onc cutan sq cll ca mrna 40","description":"Onc cutan sq cll ca mrna 40","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87154","name":"Cul typ id bld pthgn 6+ trgt","description":"Culture, typing; identification of blood pathogen and resistance typing, when performed, by nucleic acid (dna or rna) probe, multiplexed amplified probe technique including multiplex reverse transcription, when performed, per culture or isolate, 6 or more targets","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1312","name":"No pt tbco scrn rng","description":"Patient not screened for tobacco use","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1281","name":"Bp scrn no perf at interval","description":"Blood pressure reading not documented, reason not given","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3373","name":"Inj, vancomycin hcl, 10 mg","description":"Injection, vancomycin hydrochloride, 10 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1710","name":"Moderna vacc admin 3rd dose","description":"Moderna vacc admin 3rd dose","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81515","name":"Nfct ds bv&vaginitis dna alg","description":"Infectious disease, bacterial vaginosis and vaginitis, real-time pcr amplification of dna markers for atopobium vaginae, atopobium species, megasphaera type 1, and bacterial vaginosis associated bacteria-2 (bvab-2), utilizing vaginal-fluid specimens, algorithm reported as positive or negative for hi","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1019T","name":"Lymphovenous bypass per xtr","description":"Lymphovenous bypass, including robotic assistance, when performed, per extremity","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4307","name":"American amnion, per sq cm","description":"American amnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26541","name":"Repair hand joint with graft","description":"Reconstruction, collateral ligament, metacarpophalangeal joint, single; with tendon or fascial graft (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1074.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1312","name":"No pt tbco scrn rng","description":"Patient not screened for tobacco use","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0382U","name":"Hyprphenylalninmia mntr quan","description":"Hyprphenylalninmia mntr quan","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1324","name":"Pts intravitreal/pci","description":"Patients who had an intravitreal or periocular corticosteroid injection (e.g., triamcinolone, preservative-free triamcinolone, dexamethasone, dexamethasone intravitreal implant, or fluocinolone intravitreal implant)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0718T","name":"Adrc ther prtl rc tear njx","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; injection into supraspinatus tendon including ultrasound guidance, unilateral","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4311","name":"Acesso, per sq cm","description":"Acesso, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99274","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44405","name":"Colonoscopy w/dilation","description":"Colonoscopy through stoma; with transendoscopic balloon dilation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":725.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9041","name":"Injection, bortezomib, 0.1mg","description":"Injection, bortezomib, 0.1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0997T","name":"Precuneus mag stimj tx plng","description":"Precuneus magnetic stimulation; treatment planning using magnetic resonance imaging-guided neuronavigation to determine optimal location, dose, and intensity for magnetic stimulation therapy, derived from evoked potentials from single pulses of electromagnetic energy recorded by 64-channel electroen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0387U","name":"Onc mlnma ambra1&amlo","description":"Onc mlnma ambra1&amlo","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77092","name":"Tbs i&r fx rsk qhp","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; interpretation and report on fracture-risk only by other qualified health care professional","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1152","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82355","name":"Calculus analysis qual","description":"Calculus; qualitative analysis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1167","name":"Hspc dur meas pd","description":"In hospice or using hospice services during the measurement period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1452","name":"Pt dx dementia ever","description":"Patient ever had a diagnosis of dementia","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7771","name":"Alveolus clsd reduc stblz te","description":"Alveolus closed reduction stabilization of teeth","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2373","name":"Inj, immphentiv, 20 mcg","description":"Injection, phenylephrine hydrochloride (immphentiv), 20 micrograms","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0786T","name":"Insj/rplcmt prq ra sac nstim","description":"Insertion or replacement of percutaneous electrode array, sacral, with integrated neurostimulator, including imaging guidance, when performed","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0062","name":"Audiology ss","description":"Audiology mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9246","name":"Mod sedation noniv-15 min","description":"Mod sedation noniv-15 min","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90481","name":"Admn sarscov2 vac ea add cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; each additional component administered (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1236","name":"Baseline mrs > 2","description":"Baseline mrs > 2","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9988","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4296","name":"Rebound matrix, per sq cm","description":"Rebound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31635","name":"Bronchoscopy w/fb removal","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with removal of foreign body","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0313U","name":"Onc pncrs dna&mrna seq 74","description":"Onc pncrs dna&mrna seq 74","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76815","name":"Ob us limited fetus(s)","description":"Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64834","name":"Repair of hand or foot nerve","description":"Suture of 1 nerve; hand or foot, common sensory nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":851.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0772T","name":"Vr px dissoc svc sm phy ea","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1781","name":"Vac admin human pap dose 1","description":"Vac admin human pap dose 1","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0051","name":"Traditional healing service","description":"Traditional healing service","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0704T","name":"Rem tx amblyopia setup&edu","description":"Remote treatment of amblyopia using an eye tracking device; device supply with initial set-up and patient education on use of equipment","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86510","name":"Histoplasmosis skin test","description":"Skin test; histoplasmosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90484","name":"Imm cnsl not admn sm>20","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; greater than 20 minutes","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88344","name":"Imhchem/imcytchm ea mlt antb","description":"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61516","name":"Crnec treph exc cyst sttl","description":"Craniectomy, trephination, bone flap craniotomy; for excision or fenestration of cyst, supratentorial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2089.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95919","name":"Quan puplmtry phy/qhp uni/bi","description":"Quantitative pupillometry with physician or other qualified health care professional interpretation and report, unilateral or bilateral","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7511","name":"Incision/drain abscess intra","description":"Incision and drainage of abscess - intraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43270","name":"Egd lesion ablation","description":"Esophagogastroduodenoscopy, flexible, transoral; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34800","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1427.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4033","name":"Skilled nursing facility ss","description":"Skilled nursing facility mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0288U","name":"Onc lung mrna quan pcr 11&3","description":"Onc lung mrna quan pcr 11&3","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9318","name":"Inj romidepsin non-lyo 0.1mg","description":"Injection, romidepsin, non-lyophilized, 0.1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24138","name":"Sequestrectomy olecrn proces","description":"Sequestrectomy (eg, for osteomyelitis or bone abscess), olecranon process","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":785.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6081","name":"Scale & debride, single imp","description":"Scale & debride, single imp","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1379","name":"10 yr fu no rec rsn not giv","description":"A 10 year follow-up interval for colonoscopy not recommended, reason not otherwise specified","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66991","name":"Xcapsl ctrc rmvl insj 1+","description":"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); with insertion of intraocular (eg, trabecular meshwork, supraciliary, suprachoroidal) anterior segment aqueous drai","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0474U","name":"Hered pan ca gsap 88gene ngs","description":"Hered pan ca gsap 88gene ngs","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0473","name":"Micro exam prep & report","description":"Accession of tissue gross and microscopic examination preparation and transmission of written report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33278","name":"Rmvl phrnc nrv stim sys","description":"Removal of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; system, including pulse generator and lead(s)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P3001","name":"Screening pap smear by phys","description":"Screening papanicolaou smear, cervical or vaginal, up to three smears, requiring interpretation by physician","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0484","name":"Consult slides prep elsewher","description":"Consultation on slides prepared elsewhere","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9331","name":"Inj sirolimus prot part 1 mg","description":"Injection, sirolimus protein-bound particles, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0935T","name":"Cysto w/rnl pel symp dnrvtj","description":"Cystourethroscopy with renal pelvic sympathetic denervation, radiofrequency ablation, retrograde ureteral approach, including insertion of guide wire, selective placement of ureteral sheath(s) and multiple conformable electrodes, contrast injection(s), and fluoroscopy, bilateral","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0482","name":"Direct immunofluorescence","description":"Direct immunofluorescence","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61535","name":"Remove brain electrodes","description":"Craniotomy with elevation of bone flap; for removal of epidural or subdural electrode array, without excision of cerebral tissue (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27202","name":"Treat tail bone fracture","description":"Open treatment of coccygeal fracture","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1163.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0711T","name":"N-nvs artl plaq alys dat prp","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data preparation and transmission","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1414","name":"Med rsn no pdl1 bef 1st ther","description":"Documentation of medical reason(s) for not performing the pd-l1 biomarker expression test prior to initiation of first-line immune checkpoint inhibitor therapy (e.g., patient is in an urgent or emergent situation where delay of treatment would jeopardize the patients health status; other medical rea","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0684T","name":"Peri-px dev eval isdss ip","description":"Peri-procedural device evaluation (in-person) and programming of device system parameters before or after a surgery, procedure, or test with analysis, review, and report by a physician or other qualified health care professional, permanent implantable synchronized diaphragmatic stimulation system fo","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6028","name":"Part hand finger metacar amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s) /thumb, amputation at metacarpal level, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6074","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (noble metal)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92945","name":"Prq trl rvs ch occ ant&rtrgr","description":"Percutaneous transluminal revascularization of chronic total occlusion, single coronary artery, coronary artery branch, or coronary artery bypass graft, and/or subtended major coronary artery branches of the bypass graft, any combination of intracoronary stent, atherectomy and angioplasty; combined ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37263","name":"Revsc evasc fpvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1176","name":"No 2 hzv 10/2017-meas pd","description":"Patient did not receive two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1392","name":"Pt rsn no exm or lst to fu","description":"Documentation of patient reasons for no examination, i.e., refusal of examination or lost to follow-up (documentation must include information that the clinician was unable to reach the patient by phone, mail or secure electronic mail - at least one method must be documented)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1429","name":"Retinopathy in od, os, ou","description":"Retinal exam finding with evidence of retinopathy in left, right or both eyes with severity level documented","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1203","name":"Inj, cipaglucosidase, 5 mg","description":"Injection, cipaglucosidase alfa-atga, 5 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26478","name":"Lengthening of hand tendon","description":"Lengthening of tendon, flexor, hand or finger, each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":860.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0011","name":"Hiv prep counsel, md 15-30m","description":"Individual counseling for pre-exposure prophylaxis (prep) by physician or qualified health care professional (qhp) to prevent human immunodeficiency virus (hiv), includes hiv risk assessment (initial or continued assessment of risk), hiv risk reduction and medication adherence, 15-30 minutes","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52010","name":"Cystoscopy & duct catheter","description":"Cystourethroscopy, with ejaculatory duct catheterization, with or without irrigation, instillation, or duct radiography, exclusive of radiologic service","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9245","name":"Admin mod sedation-enteral","description":"Admin mod sedation-enteral","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69602","name":"Rev mstdc rslt mod rad mstdc","description":"Revision mastoidectomy; resulting in modified radical mastoidectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1253.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3379","name":"Inj, valproate sod, 5 mg","description":"Injection, valproate sodium, 5 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4013","name":"Mntal/behav/psych hlth ss","description":"Mental/behavioral and psychiatry mips specialty set","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98985","name":"Rtm dev sply mscsk sys 2-15d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of musculoskeletal system, 2-15 days in a 30-day period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0696T","name":"Bdy surf mapg pm/cvdfb f/up","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of follow-up interrogation or programming device evaluatio","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7214","name":"Altuviiio per factor viii iu","description":"Injection, factor viii/von willebrand factor complex, recombinant (altuviiio), per factor viii i.u.","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11045","name":"Dbrdmt subq tiss each addl","description":"Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); each additional 20 sq cm, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":39.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2642","name":"Dental onlay porcelin 2 surf","description":"Onlay - porcelain/ceramic - two surfaces","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24366","name":"Reconstruct head of radius","description":"Arthroplasty, radial head; with implant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76984","name":"Dx intraop thoracic aorta us","description":"Ultrasound, intraoperative thoracic aorta (eg, epiaortic), diagnostic","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0547U","name":"Neurflmnt lt chn cleia plsm","description":"Neurflmnt lt chn cleia plsm","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0871T","name":"Rplcmt subq prtl ascites pmp","description":"Replacement of a subcutaneous peritoneal ascites pump, including reconnection between pump and indwelling bladder and peritoneal catheters, including initial programming and imaging, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1012T","name":"Mtrz ab ntrno trph scl/tr mw","description":"Motorized ab interno trephination of sclera (sclerostomy), or trabecular meshwork (trabeculostomy), 1 or more, including injection of antifibrotic agents, when performed","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7241","name":"Impact tooth rem bony w/comp","description":"Removal of impacted tooth-completely bony with unusual surgical complications","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2267","name":"Inj, mirikizumab-mrkz, 1 mg","description":"Injection, mirikizumab-mrkz, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1492","name":"No reported fall","description":"Patients who did not report a fall","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4416","name":"Alexiguard tl-t per sq cm","description":"Alexiguard tl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5827","name":"Endo knee shin single axis","description":"Endoskeletal knee-shin system, single axis, electromechanical swing and stance phase control, with or without shock absorption and stance extension damping","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":7671.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37188","name":"Ven mechnl thrmbc repeat tx","description":"Percutaneous transluminal mechanical thrombectomy, vein(s), including intraprocedural pharmacological thrombolytic injections and fluoroscopic guidance, repeat treatment on subsequent day during course of thrombolytic therapy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4419","name":"Biolab wrap flw lt per sq cm","description":"Biolab membrane wrap lite flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0263U","name":"Neuro asd meas 16 c metblt","description":"Neurology (autism spectrum disorder [asd]), quantitative measurements of 16 central carbon metabolites (ie, a-ketoglutarate, alanine, lactate, phenylalanine, pyruvate, succinate, carnitine, citrate, fumarate, hypoxanthine, inosine, malate, s-sulfocysteine, taurine, urate, and xanthine), liquid chrom","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0531U","name":"Nfct ds afb&inv fng 673orgs","description":"Nfct ds afb&inv fng 673orgs","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1403","name":"Bslne and fu promis doc","description":"Patients with baseline and follow-up promis surveys documented in the medical record","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0741","name":"Inj, cabote rilpivir 2mg 3mg","description":"Injection, cabotegravir and rilpivirine, 2mg/3mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6032","name":"Part handfng ultralite tcf/=","description":"Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77080","name":"Dxa bone density axial","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1199","name":"Pt recg rrt","description":"Patients receiving rrt","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0933T","name":"Tcat impl wrls l atr prs snr","description":"Transcatheter implantation of wireless left atrial pressure sensor for long-term left atrial pressure monitoring, including sensor calibration and deployment, right heart catheterization, transseptal puncture, imaging guidance, and radiological supervision and interpretation","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0673T","name":"Abltj b9 thyr ndul perq lasr","description":"Ablation, benign thyroid nodule(s), percutaneous, laser, including imaging guidance","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0661","name":"Team remote e/m new pt 20 mn","description":"Team remote e/m new pt 20mins","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5877","name":"Dup of complt dent-maxill","description":"Dup of complt dent-maxill","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63053","name":"Lam factc/frmt arthrd lum ea","description":"Laminectomy, facetectomy, or foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s] [eg, spinal or lateral recess stenosis]), during posterior interbody arthrodesis, lumbar; each additional vertebral segment (list separately in addition to code for","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6081","name":"Scale & debride, single imp","description":"Scale & debride, single imp","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0602U","name":"Endocrin dm ins gen mthyltn","description":"Endocrin dm ins gen mthyltn","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0283","name":"Elec stim other than wound","description":"Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0567U","name":"Rare ds whl gen seq srs&lrs","description":"Rare ds whl gen seq srs&lrs","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43639","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2010.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"Endoskel posit rotat unit","description":"Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37267","name":"Revsc evsc fpvt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9263","name":"Oxaliplatin","description":"Injection, oxaliplatin, 0.5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91125","name":"Anrct mano rct snsatn&balo","description":"Anorectal manometry, with rectal sensation and rectal balloon expulsion test, when performed","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0778T","name":"Smmg cncrnt appl imu snr","description":"Surface mechanomyography (smmg) with concurrent application of inertial measurement unit (imu) sensors for measurement of multi-joint range of motion, posture, gait, and muscle function","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4020","name":"Ophthalmology/optometry ss","description":"Ophthalmology/optometry mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17110","name":"Destruction b9 les up to 14","description":"Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), of benign lesions other than skin tags or cutaneous vascular proliferative lesions; up to 14 lesions","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":72.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":130.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9049","name":"Inj, bortezomib, hospira","description":"Injection, bortezomib (hospira), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0018M","name":"Trnsplj rnl meas cd154+cll","description":"Transplantation medicine (allograft rejection, renal), measurement of donor and third-party-induced cd154+t-cytotoxic memory cells, utilizing whole peripheral blood, algorithm reported as a rejection risk score","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0321U","name":"Iadna gu pthgn 20bct&fng org","description":"Iadna gu pthgn 20bct&fng org","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0714T","name":"Tpla b9 prst8 hyprplsa<50ml","description":"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume less than 50 ml","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64408","name":"Njx aa&/strd vagus nrv","description":"Injection(s), anesthetic agent(s) and/or steroid; vagus nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2312","name":"Inj naloxone hcl nos, 0.01mg","description":"Injection, naloxone hydrochloride, not otherwise specified, 0.01 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61737","name":"Litt icr mlt trj mlt/cplx ls","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; multiple trajectories for multiple or complex lesion(s)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81523","name":"Onc brst mrna 70 cnt 31 gene","description":"Oncology (breast), mrna, next-generation sequencing gene expression profiling of 70 content genes and 31 housekeeping genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as index related to risk to distant metastasis","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1495","name":"Fall w/ poc, no fall","description":"Patients that reported a fall occurred who had a plan of care for falls documented or patients that did not report a fall","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92226","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5376.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0137","name":"Inten outpt svs,min 9 pr 7 d","description":"Intensive outpatient services; weekly bundle, minimum of 9 services over a 7 contiguous day period, which can include individual and group therapy with physicians or psychologists (or other mental health professionals to the extent authorized under state law); occupational therapy requiring the skil","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0629U","name":"Nfct ds tb dna aly 1trgt pcr","description":"Nfct ds tb dna aly 1trgt pcr","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80424","name":"Glucagon tolerance panel","description":"Glucagon tolerance panel; for pheochromocytoma this panel must include the following: catecholamines, fractionated (82384 x 2)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33968","name":"Remove aortic assist device","description":"Removal of intra-aortic balloon assist device, percutaneous","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0895T","name":"Connj lvr algrft prfu dev 1","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; initial 4 hours of monitoring time, including hourly physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0896T","name":"Connj lvr algrft prfu dev ea","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; each additional hour, including physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary bicarbonate, lactate ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0548","name":"Phone/inter svs 21-30 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72255","name":"Myelography thoracic spine","description":"Myelography, thoracic, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":274.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1223","name":"Glaucoma plan of care doc","description":"Glaucoma plan of care documented","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36837","name":"Prq av fstl crt uxtr sep acs","description":"Percutaneous arteriovenous fistula creation, upper extremity, separate access sites of the peripheral artery and peripheral vein, including fistula maturation procedures (eg, transluminal balloon angioplasty, coil embolization) when performed, including all vascular access, imaging guidance and radi","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4302","name":"Complete aca, per sq cm","description":"Complete aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0872T","name":"Rplcmt ndwllg bldr&prtl cath","description":"Replacement of indwelling bladder and peritoneal catheters, including tunneling of catheter(s) and connection with previously implanted peritoneal ascites pump, including imaging and programming, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4382","name":"Advograft dual per sq cm","description":"Advograft dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0872","name":"Daptomycin (xellia) unrefrig","description":"Injection, daptomycin (xellia), unrefrigerated, not therapeutically equivalent to j0878 or j0873, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37278","name":"Rvsc evsc fpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3404","name":"Inj zopapogene per ther dose","description":"Injection, zopapogene imadenovec-drba suspension, per therapeutic dose","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82805","name":"Blood gases w/o2 saturation","description":"Gases, blood, any combination of ph, pco2, po2, co2, hco3 (including calculated o2 saturation); with o2 saturation, by direct measurement, except pulse oximetry","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90382","name":"Rsv monoc antb seasn .7ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose, 0.7 ml, for intramuscular use","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0236","name":"Intrav inf, mon anti, sec do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22837","name":"Ant thrc vrt body tethrg 8+","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; 8 or more vertebral segments","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0053","name":"Ht mental health and care","description":"Historical trauma (ht) mental health and clinical care for indigenous persons","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0748T","name":"Njx stm cl prdct anl sft tis","description":"Injections of stem cell product into perianal perifistular soft tissue, including fistula preparation (eg, removal of setons, fistula curettage, closure of internal openings)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71048","name":"X-ray exam chest 4+ views","description":"Radiologic examination, chest; 4 or more views","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76018","name":"Mr safety implant elec prepj","description":"Mr safety implant electronics preparation under supervision of physician or other qualified health care professional, including mr-specific programming of pulse generator and/or transmitter to verify device integrity, protection of device internal circuitry from mr electromagnetic fields, and protec","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0384U","name":"Neph ckd rsk hi stg kdn ds","description":"Neph ckd rsk hi stg kdn ds","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9608","name":"Flotufolastat f18 diag 1 mci","description":"Flotufolastat f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0543U","name":"Onc sol tum ngs dna 517 gens","description":"Onc sol tum ngs dna 517 gens","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3501","name":"Surg exp root surf anterior","description":"Surg exp root surf anterior","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0383U","name":"Tyrosinemia typ i mntr quan","description":"Tyrosinemia typ i mntr quan","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66683","name":"Implantation iris prosthesis","description":"Implantation of iris prosthesis, including suture fixation and repair or removal of iris, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28570","name":"Treat foot dislocation","description":"Closed treatment of talotarsal joint dislocation; without anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0848T","name":"Dgtz gls mcrscp ish 1st","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22860","name":"Tot disc arthrp 2ntrspc lmbr","description":"Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression); second interspace, lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1247","name":"Pt resp true best int","description":"Patient responded completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57460","name":"Bx of cervix w/scope leep","description":"Colposcopy of the cervix including upper/adjacent vagina; with loop electrode biopsy(s) of the cervix","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85007","name":"Bl smear w/diff wbc count","description":"Blood count; blood smear, microscopic examination with manual differential wbc count","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49592","name":"Rpr aa hrn 1st < 3 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0518U","name":"Ther rx mntr 90+ pn&mtl hlth","description":"Ther rx mntr 90+ pn&mtl hlth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0421U","name":"Onc clrct scr sgl amp 8 rna","description":"Onc clrct scr sgl amp 8 rna","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2781","name":"Inj, pegcetacoplan, 1mg","description":"Injection, pegcetacoplan, intravitreal, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87594","name":"Pneumcysts jirovecii amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); pneumocystis jirovecii, amplified probe technique","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7412","name":"Excision benign lesion compl","description":"Excision of benign lesion complicated","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0678T","name":"Laps repos lead isdss ea add","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional repositioned lead (list separately in addition to code for primary proce","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0844T","name":"Dgtz gls mcrscp cslt cyt ea","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), each additional site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9955","name":"Oral app thxpy titration vis","description":"Oral app thxpy titration vis","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90684","name":"Pcv21 vaccine im","description":"Pneumococcal conjugate vaccine, 21 valent (pcv21), for intramuscular use","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0184","name":"Inj, amisulpride, 1 mg","description":"Injection, amisulpride, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7171","name":"Inj, adzynma, 10 iu","description":"Injection, adamts13, recombinant-krhn, 10 iu","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2801","name":"Inj, rykindo, 0.5 mg","description":"Injection, risperidone (rykindo), 0.5 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7414","name":"Excision malig lesion>1.25cm","description":"Excision of malignant lesion greater than 1.25 cm","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0528U","name":"Lrt iad 18bct/8vir&7arg rna","description":"Lrt iad 18bct/8vir&7arg rna","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1279","name":"Pre-htn/htn, no f/u, not gvn","description":"Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91113","name":"Gi trc img intral colon i&r","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), colon, with interpretation and report","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0806T","name":"Tcat s&ivc prstc vl impl opn","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); open femoral vein approach","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2032","name":"Myriad matrix, per sq cm","description":"Myriad matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93508","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":931.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57307","name":"Fistula repair & colostomy","description":"Closure of rectovaginal fistula; abdominal approach, with concomitant colostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1104.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0053","name":"Ht mental health and care","description":"Historical trauma (ht) mental health and clinical care for indigenous persons","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87220","name":"Tissue exam for fungi","description":"Tissue examination by koh slide of samples from skin, hair, or nails for fungi or ectoparasite ova or mites (eg, scabies)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0138","name":"Iv cipaglucosidase alfa-atga","description":"Intravenous infusion of cipaglucosidase alfa-atga, including provider/supplier acquisition and clinical supervision of oral administration of miglustat in preparation of receipt of cipaglucosidase alfa-atga","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37268","name":"Revsc evasc fpvt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":91.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6596","name":"G comp bandge conform gauze","description":"Gradient compression bandaging supply, conforming gauze, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64584","name":"Rmvl hpglsl nstim ary pg","description":"Removal of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29365","name":"Appl cylinder cast","description":"Application of cylinder cast (thigh to ankle)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0413U","name":"Onc hl neo opt gen mapg dna","description":"Onc hl neo opt gen mapg dna","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87428","name":"Sarscov & inf vir a&b ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; severe acute respiratory syndrome coronavirus (eg, sars-cov, s","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7485","name":"Surg reduct osseoustuberosit","description":"Surgical reduction of osseous tuberosity","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1336","name":"Pts eval ini xm 2 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 2 weeks","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53451","name":"Tprnl balo cntnc dev bi","description":"Periurethral transperineal adjustable balloon continence device; bilateral insertion, including cystourethroscopy and imaging guidance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96119","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0105","name":"Colorectal scrn; hi risk ind","description":"Colorectal cancer screening; colonoscopy on individual at high risk","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9959","name":"Unspec sleep ap proc","description":"Unspec sleep ap proc","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24076","name":"Ex arm/elbow tum deep < 5 cm","description":"Excision, tumor, soft tissue of upper arm or elbow area, subfascial (eg, intramuscular); less than 5 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5154","name":"Inj, omlyclo, 5 mg","description":"Injection, omalizumab-igec (omlyclo), biosimilar, 5 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0898T","name":"N-invas prst8 cancer est map","description":"Noninvasive prostate cancer estimation map, derived from augmentative analysis of image-guided fusion biopsy and pathology, including visualization of margin volume and location, with margin determination and physician interpretation and report","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4357","name":"Xwrap plus, per sq cm","description":"Xwrap plus, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0145","name":"Scr c/v cyto,thinlayer,rescr","description":"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under physician supervision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64752","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":550.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93594","name":"R hrt cath chd abnl nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; abnormal native connections","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9004","name":"Va whole health partner serv","description":"Department of veterans affairs whole health partner services","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0978T","name":"Submucosal cryolysis therapy","description":"Submucosal cryolysis therapy; soft palate, base of tongue, and lingual tonsil","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0801","name":"3d dental scan direct","description":"3d dental scan direct","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D8091","name":"Compre ortho treat w surg","description":"Compre ortho treat w surg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27822","name":"Treatment of ankle fracture","description":"Open treatment of trimalleolar ankle fracture, includes internal fixation, when performed, medial and/or lateral malleolus; without fixation of posterior lip","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1078.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0800T","name":"Tcat rmvl 2chmbr ldls pm rv","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right ventricular pacemaker component (when part of a dual-chamber leadless pacem","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2251","name":"Inj midazolam in 0.9% nacl","description":"Injection, midazolam in 0.9% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0744T","name":"Insj bioprostc vlv fem vn","description":"Insertion of bioprosthetic valve, open, femoral vein, including duplex ultrasound imaging guidance, when performed, including autogenous or nonautogenous patch graft (eg, polyester, eptfe, bovine pericardium), when performed","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5939","name":"Resct proth mand comp remov","description":"Resct proth mand comp remov","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64468","name":"Thrc fascial pln blk bi njx","description":"Thoracic fascial plane block, bilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1709","name":"Pfizer vaccine admin booster","description":"Pfizer vaccine admin booster","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3921","name":"Decor or submerg erupt tooth","description":"Decor or submerg erupt tooth","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3473","name":"Surg rep root res molar","description":"Surg rep root res molar","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83937","name":"Assay of osteocalcin","description":"Osteocalcin (bone g1a protein)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37298","name":"Revsc evsc imvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90960","name":"Esrd srv 4 visits p mo 20+","description":"End-stage renal disease (esrd) related services monthly, for patients 20 years of age and older; with 4 or more face-to-face visits by a physician or other qualified health care professional per month","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":417.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2028","name":"Micromatrix flex per mg","description":"Micromatrix flex, per mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0695T","name":"Bdy srf mpg pm/cvdfb tm impl","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of implant or replacement","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1447","name":"Pt dx bd bef end meas pd","description":"Patients with an active diagnosis of bipolar disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27472","name":"Repair/graft of thigh","description":"Repair, nonunion or malunion, femur, distal to head and neck; with iliac or other autogenous bone graft (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1523.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0394U","name":"Pfas 16 pfas compnd lc ms/ms","description":"Pfas 16 pfas compnd lc ms/ms","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81007","name":"Urine screen for bacteria","description":"Urinalysis; bacteriuria screen, except by culture or dipstick","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93151","name":"Interrog&prgrmg ipnss","description":"Interrogation and programming (minimum one parameter) of implanted phrenic nerve stimulator system","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12041","name":"Intmd rpr n-hf/genit 2.5cm/<","description":"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 2.5 cm or less","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9026","name":"Cryo fib comp path redu each","description":"Cryoprecipitated fibrinogen complex, pathogen reduced, each unit","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1383","name":"Acute pvd","description":"Acute pvd","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0685T","name":"Interrog dev eval isdss ip","description":"Interrogation device evaluation (in-person) with analysis, review and report by a physician or other qualified health care professional, including connection, recording and disconnection per patient encounter, permanent implantable synchronized diaphragmatic stimulation system for augmentation of ca","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7961","name":"Buccal/labial frenectomy","description":"Buccal/labial frenectomy","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74175","name":"Cta abdomen w/contrast","description":"Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0803T","name":"Tcat rmv&rpl2chmb ldls pm rv","description":"Transcatheter removal and replacement of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ve","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1180","name":"Pt imm ckpt inhib therapy","description":"Patients on immune checkpoint inhibitor therapy","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1397","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1073","name":"Testosterone pellet 75 mg","description":"Testosterone pellet, implant, 75 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1254","name":"Pts deceased prior hu surv","description":"Patients who were deceased when the hu survey reached them","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1254","name":"Pts deceased prior hu surv","description":"Patients who were deceased when the hu survey reached them","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0987T","name":"Iv img icr cere vsl oct ea","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9912","name":"Pre-visit patient screening","description":"Pre-visit patient screening","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0344U","name":"Hep nafld semiq evl 28 lipid","description":"Hep nafld semiq evl 28 lipid","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0155","name":"Dronabinol (syndros) 0.1 mg","description":"Dronabinol (syndros), 0.1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5151","name":"Inj, eculizumab-aagh, 2 mg","description":"Injection, eculizumab-aagh (epysqli), biosimilar, 2 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4426","name":"Dermbnd tl+, tlx per sq cm","description":"Dermabind tl + or dermabind tl x,  per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4403","name":"Xwrap dual plus per sq cm","description":"Xwrap dual plus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0988T","name":"Opn ins/rplc ins ptn sbq&sbf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2025","name":"Miro3d per cubic cm","description":"Miro3d, per cubic centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2183","name":"Inj meropenem (wg crit care)","description":"Injection, meropenem (wg critical care), not therapeutically equivalent to j2185, 100 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5228","name":"Immed mand part denture","description":"Immed mand part denture","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1301","name":"Immunization counseling","description":"Immunization counseling","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4362","name":"Cygnus disk, per sq cm","description":"Cygnus disk, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2865","name":"Inj sulfameth/trim 5 mg/1 mg","description":"Injection, sulfamethoxazole 5 mg and trimethoprim 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46700","name":"Repair of anal stricture","description":"Anoplasty, plastic operation for stricture; adult","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":630.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64474","name":"Lwr xtr fscl pln blk uni nfs","description":"Lower extremity fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31766","name":"Carinal reconstruction","description":"Carinal reconstruction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2179.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1073","name":"Testosterone pellet 75 mg","description":"Testosterone pellet, implant, 75 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J1751","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9318","name":"Inj romidepsin non-lyo 0.1mg","description":"Injection, romidepsin, non-lyophilized, 0.1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0591U","name":"Onc prst8 ca 3prtns plsm srm","description":"Onc prst8 ca 3prtns plsm srm","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0708T","name":"Id ca immntx prep & 1st njx","description":"Intradermal cancer immunotherapy; preparation and initial injection","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37201","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69540","name":"Excision aural polyp","description":"Excision aural polyp","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54901","name":"Fusion of spermatic ducts","description":"Epididymovasostomy, anastomosis of epididymis to vas deferens; bilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1202.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4387","name":"Neothelium ft per sq cm","description":"Neothelium ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0335U","name":"Rare ds whl gen seq fetal","description":"Rare ds whl gen seq fetal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49623","name":"Rmvl ninfct mesh hernia rpr","description":"Removal of total or near total non-infected mesh or other prosthesis at the time of initial or recurrent anterior abdominal hernia repair or parastomal hernia repair, any approach (ie, open, laparoscopic, robotic) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91304","name":"Sarscov2 vac 5mcg/0.5ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, 5 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0990T","name":"Trncrv inst biod hydrgl mtrl","description":"Transcervical instillation of biodegradable hydrogel materials, intrauterine","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6071","name":"Abutment supported retainer","description":"Abutment supported retainer for porcelain fused to metal fpd (noble metal)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1323","name":"Pts 7wk inj, scrn iop >25","description":"Patients seen within 7 weeks following the date of injection and are screened for elevated intraocular pressure (iop) with tonometry with documented iop >25 mm hg and a plan of care was documented","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92622","name":"Dx aly aud oi snd prcsr 1st","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; first 60 minutes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0793T","name":"Prq tcat thrm ablt nrv p-art","description":"Percutaneous transcatheter thermal ablation of nerves innervating the pulmonary arteries, including right heart catheterization, pulmonary artery angiography, and all imaging guidance","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2780","name":"Crown 3/4 cast hi noble met","description":"Crown - 3/4 cast high noble metal","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9914","name":"Admin of dermal fill","description":"Admin of dermal fill","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99254","name":"Ip/obs cnsltj new/est mod 60","description":"Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0281U","name":"Hem vwd propeptide ag lvl","description":"Hematology (von willebrand disease [vwd]), von willebrand propeptide, enzyme-linked immunosorbent assays (elisa), plasma, diagnostic report of von willebrand factor (vwf) propeptide antigen level","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26861","name":"Fusion of finger jnt add-on","description":"Arthrodesis, interphalangeal joint, with or without internal fixation; each additional interphalangeal joint (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3421","name":"Root surgery bicuspid","description":"Apicoectomy/periradicular surgery-bicuspid (first root)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2041","name":"Coord special care encounter","description":"Coordinated specialty care, team-based, for first episode psychosis, per encounter","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0447U","name":"Ai ds sle alys 11 cytokine","description":"Ai ds sle alys 11 cytokine","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1444","name":"Del < 39 weeks gest","description":"Delivery at < 39 weeks of gestation","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61330","name":"Dcmprn orbit only transcrnl","description":"Decompression of orbit only, transcranial approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1752.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0535","name":"Pt navigat svs direct/ref","description":"Patient navigational services, provided directly or by referral; including helping the patient to navigate health systems and identify care providers and supportive services, to build patient self-advocacy and communication skills with care providers, and to promote patient-driven action plans and g","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0560","name":"Safety plan interven","description":"Safety planning interventions, each 20 minutes personally performed by the billing practitioner, including assisting the patient in the identification of the following personalized elements of a safety plan: recognizing warning signs of an impending suicidal or substance use-related crisis; employin","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0682T","name":"Removal pulse gen only isdss","description":"Removal of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7252","name":"Part extract for implant","description":"Part extract for implant","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0308U","name":"Crd cad alys 3 prtn plsm alg","description":"Crd cad alys 3 prtn plsm alg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1471","name":"Ffs hep b not covered","description":"Documentation that patient is a medicare fee-for-service beneficiary and without additional supplementary insurance coverage for whom hep b vaccination is not reimbursable under current medicare part b coverage rules","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4389","name":"Neothelium 4l+ per sq cm","description":"Neothelium 4l+, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5945","name":"Mand implt sup remv part","description":"Mand implt sup remv part","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0013A","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0704T","name":"Rem tx amblyopia setup&edu","description":"Remote treatment of amblyopia using an eye tracking device; device supply with initial set-up and patient education on use of equipment","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0467U","name":"Onc bldr dna ngs 60gen&aneup","description":"Onc bldr dna ngs 60gen&aneup","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46740","name":"Construction of absent anus","description":"Repair of high imperforate anus with rectourethral or rectovaginal fistula; perineal or sacroperineal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2000.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6526","name":"G com garmt full leg/ft nght","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0019","name":"Comm hlth intg svs sdoh 60mn","description":"Community health integration services performed by certified or trained auxiliary personnel, including a community health worker, under the direction of a physician or other practitioner; 60 minutes per calendar month, in the following activities to address social determinants of health (sdoh) need(","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0771T","name":"Vr px dissoc svc sm phy 1st","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44188","name":"Lap colostomy","description":"Laparoscopy, surgical, colostomy or skin level cecostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1283.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85018","name":"Hemoglobin","description":"Blood count; hemoglobin (hgb)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2016","name":"Permeaderm b, per sq cm","description":"Permeaderm b, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37297","name":"Revsc evasc imvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76987","name":"Dx intraop epicar car us chd","description":"Intraoperative epicardial cardiac ultrasound (ie, echocardiography) for congenital heart disease, diagnostic; including placement and manipulation of transducer, image acquisition, interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4283","name":"Biovance tri or 3l, sq cm","description":"Biovance tri-layer or biovance 3l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0877","name":"Inj, daptomycin (hospira)","description":"Injection, daptomycin (hospira), not therapeutically equivalent to j0878, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37294","name":"Rvsc evsc tpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1493","name":"No fall doc med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0553U","name":"Repr med pga embry te strux","description":"Repr med pga embry te strux","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5134","name":"Inj, tyruko, 1 mg","description":"Injection, natalizumab-sztn (tyruko), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2037","name":"G4derm plus/suprello, pr ml","description":"G4derm plus/suprello, per milliliter","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77436","name":"Surf radj ther tx planning","description":"Surface radiation therapy; superficial or orthovoltage, treatment planning and simulation-aided field setting","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1159","name":"Hospc serv dur meas pd","description":"Hospice services provided to patient any time during the measurement period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2281","name":"Inj moxifloxacin (fres kabi)","description":"Injection, moxifloxacin (fresenius kabi), not therapeutically equivalent to j2280, 100 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0271U","name":"Hem cgen neutropenia 23 gen","description":"Hematology (congenital neutropenia), genomic sequence analysis of 23 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0875T","name":"Prgrm subq prtl asct pmp sys","description":"Programming of subcutaneously implanted peritoneal ascites pump system by physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1184","name":"Doc med rsn no cst/ist rx","description":"Documentation of medical reason(s) for not prescribing or administering corticosteroid or immunosuppressant treatment (e.g., allergy, intolerance, infectious etiology, pancreatic insufficiency, hyperthyroidism, prior bowel surgical interventions, celiac disease, receiving other medication, awaiting ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1346","name":"No pam inc 6 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 6 points within a 4 to 12 month period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2506","name":"Inj pegfilgrast ex bio 0.5mg","description":"Injection, pegfilgrastim, excludes biosimilar, 0.5 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99493","name":"Sbsq psyc collab care mgmt","description":"Subsequent psychiatric collaborative care management, first 60 minutes in a subsequent month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required el","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":95.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99341","name":"Home/res vst new sf mdm 15","description":"Home or residence visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 15 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54120","name":"Partial removal of penis","description":"Amputation of penis; partial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":670.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1301","name":"Immunization counseling","description":"Immunization counseling","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86596","name":"Voltage-gtd ca chnl antb ea","description":"Voltage-gated calcium channel antibody, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":12.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1198","name":"Isa not red 3pts /no assess","description":"Itch severity assessment score was not reduced by at least 3 points from initial (index) score to the follow-up visit score or assessment was not completed during the follow-up encounter","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0798T","name":"Tcat rmv 2chmbr ldls pm cmpl","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; complete system (ie, right atrial and right ventricular pacemaker components)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0790T","name":"Revj rplcmt/rmvl vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracolumbar or lumbar vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6601","name":"G com bandge hgh dn foam pad","description":"Gradient compression bandaging supply, high density foam pad, any size or shape, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1305","name":"Pneum vax admin 19+","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46608","name":"Anoscopy remove for body","description":"Anoscopy; with removal of foreign body","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95923","name":"Autonomic nrv syst funj test","description":"Testing of autonomic nervous system function; sudomotor, including 1 or more of the following: quantitative sudomotor axon reflex test (qsart), silastic sweat imprint, thermoregulatory sweat test, and changes in sympathetic skin potential","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9601","name":"Flortaucipir inj 1 millicuri","description":"Flortaucipir f 18 injection, diagnostic, 1 millicurie","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1461","name":"Pt dx chron hepc","description":"Patient diagnosis for chronic hepatitis c","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7509","name":"Marsupialization odon cyst","description":"Marsupialization odon cyst","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0396","name":"3d print of 3d surface scan","description":"3d print of 3d surface scan","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"Ak 4 bar link hydl swg/stanc","description":"Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9272","name":"Inj, dostarlimab-gxly, 10 mg","description":"Injection, dostarlimab-gxly, 10 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1196","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4261","name":"Tag, per square centimeter","description":"Tag, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1467","name":"Pt dx lynch syn","description":"Patients with an existing diagnosis of lynch syndrome","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4268","name":"Surgraft ft per sq cm","description":"Surgraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0582U","name":"Rare ds rpd whlgen dna vrnts","description":"Rare ds rpd whlgen dna vrnts","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69728","name":"Rmv ntr oi imp sk tc>=100","description":"Removal, entire osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77470","name":"Special radiation treatment","description":"Special treatment procedure (eg, total body irradiation, hemibody radiation, per oral or endocavitary irradiation)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":698.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1251","name":"Pts proxy cmplt hu surv","description":"Patients for whom a proxy completed the entire hu survey on their behalf for any reason (no patient involvement)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41874","name":"Alveoloplasty each quadrant","description":"Alveoloplasty, each quadrant (specify)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85025","name":"Complete cbc w/auto diff wbc","description":"Blood count; complete (cbc), automated (hgb, hct, rbc, wbc and platelet count) and automated differential wbc count","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"Non-adju cgm supply allow","description":"Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KF"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4545","name":"Suppl accessor tibial stim","description":"Supplies and accessories for external tibial nerve stimulator (e.g., socks, gel pads, electrodes, etc.), needed for one month","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21230","name":"Rib cartilage graft","description":"Graft; rib cartilage, autogenous, to face, chin, nose or ear (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":904.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99475","name":"Ped crit care age 2-5 init","description":"Initial inpatient pediatric critical care, per day, for the evaluation and management of a critically ill infant or young child, 2 through 5 years of age","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":531.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22533","name":"Arthrd lat xtrcvtry tq lmbr","description":"Arthrodesis, lateral extracavitary technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1777.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2035","name":"Corpl p therac p allac p mg","description":"Corplex p or theracor p or allacor p, per milligram","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1432","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0457U","name":"Pfas 9 cmpnd lcms/ms pls/sr","description":"Pfas 9 cmpnd lcms/ms pls/sr","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9347","name":"Inj, tremelimumab-actl, 1 mg","description":"Injection, tremelimumab-actl, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1286","name":"Bmi doc onl fup not cmpltd","description":"Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":878.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0898","name":"Argatroban nonesrd (auromed)","description":"Injection, argatroban (auromedics), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1484","name":"No rpt hcv rna perf med rsn","description":"Patients who did not have a repeat hcv rna labs performed for medical reasons documented by clinician (e.g., patient with limited life expectancy, delay in treatment of hcv related to treatment of hiv, hbv, hepatocellular carcinoma, decompensated cirrhosis)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1467","name":"Pt dx lynch syn","description":"Patients with an existing diagnosis of lynch syndrome","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72240","name":"Myelography neck spine","description":"Myelography, cervical, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33267","name":"Excl laa open any method","description":"Exclusion of left atrial appendage, open, any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70473","name":"Ct cere prfu aly c+wo ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed without concurrent ct or ct angiography of the same anatomy","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87467","name":"Hepatitis b surface ag quan","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; hepatitis b surface antigen (hbsag), quantitative","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1448","name":"Injection, trilaciclib, 1mg","description":"Injection, trilaciclib, 1mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3360","name":"Diazepam injection","description":"Injection, diazepam, up to 5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4383","name":"Axolotl graft ult per sq cm","description":"Axolotl graft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0355U","name":"Apol1 risk variants","description":"Apol1 risk variants","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0849T","name":"Dgtz gls mcrscp ish ea adl 1","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19371","name":"Peri-implt capslc brst compl","description":"Peri-implant capsulectomy, breast, complete, including removal of all intracapsular contents","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":857.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0492U","name":"Onc sol tum ctc slctn pd-l1","description":"Onc sol tum ctc slctn pd-l1","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82307","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99427","name":"Prin care mgmt staff ea addl","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80504","name":"Path clin consltj mod 21-40","description":"Pathology clinical consultation; for a moderately complex clinical problem, with review of patients history and medical records and moderate level of medical decision making when using time for code selection, 21-40 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2801","name":"Inj, rykindo, 0.5 mg","description":"Injection, risperidone (rykindo), 0.5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92570","name":"Acoustic immitance testing","description":"Acoustic immittance testing, includes tympanometry (impedance testing), acoustic reflex threshold testing, and acoustic reflex decay testing","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":23.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0374","name":"Tomo periapical image","description":"Tomo periapical image","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4457","name":"Enema tube any type repl","description":"Enema tube, with or without adapter, any type, replacement only, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33370","name":"Tcat plmt&rmvl cepd perq","description":"Transcatheter placement and subsequent removal of cerebral embolic protection device(s), including arterial access, catheterization, imaging, and radiological supervision and interpretation, percutaneous (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81007","name":"Urine screen for bacteria","description":"Urinalysis; bacteriuria screen, except by culture or dipstick","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1406","name":"Pt lve prac","description":"Patients who leave the practice during the follow-up period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29705","name":"Rmvl/bivlv full arm/leg cast","description":"Removal or bivalving; full arm or full leg cast","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83625","name":"Assay of ldh enzymes","description":"Lactate dehydrogenase (ld), (ldh); isoenzymes, separation and quantitation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0382U","name":"Hyprphenylalninmia mntr quan","description":"Hyprphenylalninmia mntr quan","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83876","name":"Assay myeloperoxidase","description":"Myeloperoxidase (mpo)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9602","name":"Fluorodopa f-18 diag per mci","description":"Fluorodopa f-18, diagnostic, per millicurie","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4409","name":"Amniomatrixf3x per sq cm","description":"Amniomatrixf3x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0672T","name":"Ndovag cryg rf remdl tiss","description":"Endovaginal cryogen-cooled, monopolar radiofrequency remodeling of the tissues surrounding the female bladder neck and proximal urethra for urinary incontinence","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4284","name":"Dermabind sl, per sq cm","description":"Dermabind sl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96547","name":"Intraop hipec px 1st 60 min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; first 60 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0688","name":"Inj cefazolin sodium, hikma","description":"Injection, cefazolin sodium (hikma), not therapeutically equivalent to j0690, 500 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2024","name":"Resolve or xenopatch sq cm","description":"Resolve matrix or xenopatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87210","name":"Smear wet mount saline/ink","description":"Smear, primary source with interpretation; wet mount for infectious agents (eg, saline, india ink, koh preps)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5930","name":"Max guid prothes w/o flange","description":"Max guid prothes w/o flange","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0954T","name":"Tot impl amei rplc snd proc","description":"Totally implantable active middle ear hearing implant; replacement of sound processor only, with attachment to existing transducers","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87154","name":"Cul typ id bld pthgn 6+ trgt","description":"Culture, typing; identification of blood pathogen and resistance typing, when performed, by nucleic acid (dna or rna) probe, multiplexed amplified probe technique including multiplex reverse transcription, when performed, per culture or isolate, 6 or more targets","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0827T","name":"Dgtz gls mcrscp cytp smears","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; smears with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99238","name":"Hosp ip/obs dschrg mgmt 30/<","description":"Hospital inpatient or observation discharge day management; 30 minutes or less on the date of the encounter","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45100","name":"Biopsy of rectum","description":"Biopsy of anorectal wall, anal approach (eg, congenital megacolon)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":289.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97007","name":"Mchnl sclp cool meas fitg","description":"Mechanical scalp cooling, including individual cap supply with head measurement, fitting, and patient education","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99424","name":"Prin care mgmt phys 1st 30","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2028","name":"Micromatrix flex per mg","description":"Micromatrix flex, per mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01939","name":"Anes nulyt agt crv/thrc","description":"Anesthesia for percutaneous image-guided destruction procedures by neurolytic agent on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35456","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":495.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0048","name":"Pall serv during meas","description":"Patients who receive palliative care services any time during the intake period through the end of the measurement year","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1471","name":"Ffs hep b not covered","description":"Documentation that patient is a medicare fee-for-service beneficiary and without additional supplementary insurance coverage for whom hep b vaccination is not reimbursable under current medicare part b coverage rules","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96365","name":"Ther/proph/diag iv inf init","description":"Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); initial, up to 1 hour","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0343U","name":"Onc prst8 xom aly 442 sncrna","description":"Onc prst8 xom aly 442 sncrna","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1501","name":"Pathology mvp","description":"Pathology mips value pathway","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4312","name":"Acesso ac, per sq cm","description":"Acesso ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37287","name":"Revsc evasc tpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0555","name":"Replacment pt electronic sys","description":"Provision of replacement patient electronics system (e.g., system pillow, handheld reader) for home pulmonary artery pressure monitoring","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3387","name":"Inj elivaldogene autotemecel","description":"Injection, elivaldogene autotemcel, per treatment","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0772T","name":"Vr px dissoc svc sm phy ea","description":"Virtual reality (vr) procedural dissociation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports, requiring the presence of an independent, trained observer to assist in the ","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0651","name":"Inj, levothyroxine, freskabi","description":"Injection, levothyroxine sodium (fresenius kabi), not therapeutically equivalent to j0650, 10 mcg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53665","name":"Dilation of urethra","description":"Dilation of female urethra, general or conduction (spinal) anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G3002","name":"Chronic pain mgmt 30 mins","description":"Chronic pain management and treatment, monthly bundle including, diagnosis; assessment and monitoring; administration of a validated pain rating scale or tool; the development, implementation, revision, and/or maintenance of a person-centered care plan that includes strengths, goals, clinical needs,","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4392","name":"Grafix duo per sq cm","description":"Grafix duo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6214","name":"Pontic titanium","description":"Pontic - titanium","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6596","name":"G comp bandge conform gauze","description":"Gradient compression bandaging supply, conforming gauze, per linear yard, any width, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0290U","name":"Pain mgmt mrna gen xprsn 36","description":"Pain mgmt mrna gen xprsn 36","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37606","name":"Lig int/com carotid art occl","description":"Ligation; internal or common carotid artery, with gradual occlusion, as with selverstone or crutchfield clamp","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":553.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9956","name":"Admin home sleep apnea test","description":"Admin home sleep apnea test","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1498","name":"Diagnostic radiology mvp","description":"Diagnostic radiology mips value pathway","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0596U","name":"Neuro alzds plsm 3dstnct isp","description":"Neuro alzds plsm 3dstnct isp","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1320","name":"Pts scrn + hrsn","description":"Patients who screened positive for at least 1 of the 5 hrsns","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1021T","name":"Active thrc irrigation spx","description":"Active thoracic irrigation (separate procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0350","name":"Oral/facial photo images","description":"Oral/facial photographic images","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37274","name":"Rvsc evsc fpvt athrc cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4014","name":"Nephrology ss","description":"Nephrology mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61070","name":"Brain canal shunt procedure","description":"Puncture of shunt tubing or reservoir for aspiration or injection procedure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1644","name":"Inj heparin sodium per 1000u","description":"Injection, heparin sodium, per 1000 units","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75980","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35483","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":544.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37259","name":"Revsc evasc ivt stent sf ea","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36836","name":"Prq av fstl crtj uxtr 1 acs","description":"Percutaneous arteriovenous fistula creation, upper extremity, single access of both the peripheral artery and peripheral vein, including fistula maturation procedures (eg, transluminal balloon angioplasty, coil embolization) when performed, including all vascular access, imaging guidance and radiolo","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0760T","name":"Dgtz gls mcrscp sl imm 1st","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1291","name":"Pt 66+ frailty and med dem","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2009","name":"Symphony, per sq cm","description":"Symphony, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1338","name":"Pt f/u 30-180 dys no + imprv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who did not demonstrate positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0347U","name":"Rx metab/pcx dna 16 gen alys","description":"Rx metab/pcx dna 16 gen alys","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61888","name":"Revise/remove neuroreceiver","description":"Revision or removal of cranial neurostimulator pulse generator or receiver","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":462.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78291","name":"Pertl-ven shunt patency test","description":"Peritoneal-venous shunt patency test (eg, for leveen, denver shunt)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2014","name":"Omeza collag compl 100 mg","description":"Omeza collagen matrix or omeza complete matrix, per 100 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6604","name":"G com bandge low dn foam flt","description":"Gradient compression bandaging supply, low density flat foam sheet, per 250 square centimeters, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1239","name":"Pt no resp heard","description":"Patient did not respond to the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1440","name":"Telehealth enc","description":"Encounters conducted via telehealth","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6593","name":"Grad com accessory gmt_wrap","description":"Accessory for gradient compression garment or wrap with adjustable straps, not-otherwise specified","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37258","name":"Revsc evasc ivt stent sf 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0680","name":"Cr art clc art vlv clc w rpt","description":"Detection and quantification of coronary artery calcium and/or aortic valve calcification from algorithmic analysis of computed tomography of the chest with report","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4286","name":"Nudyn sl or slw, per sq cm","description":"Nudyn sl or nudyn slw, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0184","name":"Inj, amisulpride, 1 mg","description":"Injection, amisulpride, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0739","name":"Hiv prep, inj, cabotegravir","description":"Injection, cabotegravir, 1mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1653","name":"Ho abduction static ots","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, off the shelf","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0998T","name":"Precuneus mag stimj tx dlvr","description":"Precuneus magnetic stimulation; personalized treatment delivery of magnetic stimulation therapy to a prespecified target area derived from analysis of evoked potentials within the precuneus, utilizing magnetic resonance imaging-based neuronavigation, with management, per day","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0566U","name":"Onc lng qpcr-bsd alys 13dmrs","description":"Onc lng qpcr-bsd alys 13dmrs","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1243","name":"Pt othr thn true heard","description":"Patient provided a response other than completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61500","name":"Crnec exc tum/bone les skull","description":"Craniectomy; with excision of tumor or other bone lesion of skull","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1502.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2008","name":"Theragenesis, per sq cm","description":"Theragenesis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27752","name":"Treatment of tibia fracture","description":"Closed treatment of tibial shaft fracture (with or without fibular fracture); with manipulation, with or without skeletal traction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0412U","name":"Beta amyloid ab42/40 imprcip","description":"Beta amyloid ab42/40 imprcip","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0675T","name":"Laps insj nw/rpcmt isdss 1ld","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first lead","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75901","name":"Remove cva device obstruct","description":"Mechanical removal of pericatheter obstructive material (eg, fibrin sheath) from central venous device via separate venous access, radiologic supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4350","name":"Palisade dm matrix per sq cm","description":"Palisade dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92288","name":"Scr dark adaptation meas i&r","description":"Screening dark adaptation measurement (eg, rod recovery intercept time), with interpretation and report","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93888","name":"Intracranial limited study","description":"Transcranial doppler study of the intracranial arteries; limited study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0531","name":"Fclty-based respite, 24 hr u","description":"Facility-based respite, 24-hour unit, for use in cmmi model","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0435U","name":"Onc chemo rx cytox csc 14 rx","description":"Onc chemo rx cytox csc 14 rx","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59025","name":"Fetal non-stress test","description":"Fetal non-stress test","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2792","name":"Crown full cast noble metal","description":"Crown-full cast noble metal","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0237","name":"Intrav inf, toci, first dose","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0802","name":"Inj. (ani), up to 40 units","description":"Injection, corticotropin (ani), up to 40 units","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82128","name":"Amino acids mult qual","description":"Amino acids; multiple, qualitative, each specimen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9999","name":"Inj ustekinumab-aauz 1 mg","description":"Injection, ustekinumab-aauz (otulfi), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0996T","name":"Ins&sclr fix caps bag prosth","description":"Insertion and scleral fixation of a capsular bag prosthesis containing an intraocular lens prosthesis, with vitrectomy, including removal of crystalline lens or dislocated intraocular lens prosthesis, when performed","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2011","name":"Supra sdrm, per sq cm","description":"Supra sdrm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0705","name":"Extra oral post radio image","description":"Extra oral post radio image","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1203","name":"Inj, cipaglucosidase, 5 mg","description":"Injection, cipaglucosidase alfa-atga, 5 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11305","name":"Shave skin lesion 0.5 cm/<","description":"Shaving of epidermal or dermal lesion, single lesion, scalp, neck, hands, feet, genitalia; lesion diameter 0.5 cm or less","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":31.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0548","name":"Phone/inter svs 21-30 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4438","name":"Adhesive clip ext ens contr","description":"Adhesive clip applied to the skin to secure external electrical nerve stimulator controller, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1346","name":"No pam inc 6 pts 4-12 mo","description":"Patients who did not have a net increase in pam score of at least 6 points within a 4 to 12 month period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1932","name":"Inj, lanreotide, (cipla) 1mg","description":"Injection, lanreotide, (cipla), 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1405","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1005T","name":"Elec alys s-scl eeg prgr 1st","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, first 15 minutes face-to-face time with physician or other qualified hea","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0680T","name":"Insj/rplcmt pg only isdss","description":"Insertion or replacement of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing lead(s)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90862","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4408","name":"Xwrap hydro per sq cm","description":"Xwrap hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0255U","name":"Andrology infertility assmt","description":"Andrology (infertility), sperm-capacitation assessment of ganglioside gm1 distribution patterns, fluorescence microscopy, fresh or frozen specimen, reported as percentage of capacitated sperm and probability of generating a pregnancy score","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0607","name":"Lanthanum carbonate oral 5mg","description":"Lanthanum carbonate, oral, 5 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0360U","name":"Onc lung elisa 7 autoant alg","description":"Onc lung elisa 7 autoant alg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1782","name":"Vac admin human pap dose 2","description":"Vac admin human pap dose 2","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0019M","name":"Cv ds plasma alys prtn bmrk","description":"Cardiovascular disease, plasma, analysis of protein biomarkers by aptamer-based microarray and algorithm reported as 4-year likelihood of coronary event in high-risk populations","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4293","name":"Acesso dl, per sq cm","description":"Acesso dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77081","name":"Dxa bone density appendiculr","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1360","name":"Suicd c-ssrs assessment","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0537","name":"Risk ascvd tst once pr 12 mo","description":"Administration of a standardized, evidence-based atherosclerotic cardiovascular disease (ascvd) risk assessment, 5-15 minutes, not more often than every 12 months","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2032","name":"Myriad matrix, per sq cm","description":"Myriad matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3403","name":"Revakinagene, per implant","description":"Revakinagene taroretcel-lwey, per implant","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7939","name":"Indexing for osteotomy","description":"Indexing for osteotomy","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0261U","name":"Onc clrct ca img alys w/ai","description":"Oncology (colorectal cancer), image analysis with artificial intelligence assessment of 4 histologic and immunohistochemical features (cd3 and cd8 within tumor-stroma border and tumor core), tissue, reported as immune response and recurrence-risk score","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90481","name":"Admn sarscov2 vac ea add cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; each additional component administered (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0208","name":"Inj, pedmark, 100 mg","description":"Injection, sodium thiosulfate (pedmark), 100 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21343","name":"Open tx dprsd front sinus fx","description":"Open treatment of depressed frontal sinus fracture","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1362.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2865","name":"Inj sulfameth/trim 5 mg/1 mg","description":"Injection, sulfamethoxazole 5 mg and trimethoprim 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1368","name":"Prev trt inf d/o hiv/hep mvp","description":"Prevention and treatment of infectious disorders including hepatitis c and hiv mips value pathway","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1428","name":"Bilateral absence of eyes","description":"Patients who have bilateral absence of eyes any time during the patients history through the end of the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1300","name":"Flu imm no admin doc rea","description":"Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0551","name":"Phn/intr svs fr dx treat 30m","description":"Interprofessional telephone/internet/electronic health record referral service(s) provided by a treating/requesting practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, 30 minutes","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27041","name":"Biopsy of soft tissues","description":"Biopsy, soft tissue of pelvis and hip area; deep, subfascial or intramuscular","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":803.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"Ak 4 bar link hydl swg/stanc","description":"Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3431","name":"Biological materials","description":"Biological materials","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0960T","name":"Rpl s-sclp eltr ra rcvr&tlmt","description":"Replacement of sub-scalp implanted electrode array, receiver, and telemetry unit with tunneling of electrode for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93152","name":"Interrog&prgrmg ipnss polysm","description":"Interrogation and programming of implanted phrenic nerve stimulator system during polysomnography","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0993T","name":"N-invas assmt car rsk w/ct","description":"Noninvasive assessment of cardiac risk derived from augmentative software analysis of perivascular fat with concurrent computed tomography scan of the heart, including patient-specific clinical factors, with interpretation and report by a physician or other qualified health care professional (list s","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0217","name":"Inj velmanase alfa-tycv 1 mg","description":"Injection, velmanase alfa-tycv, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7174","name":"Injection fitusiran 0.04 mg","description":"Injection, fitusiran, 0.04 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99233","name":"Sbsq hosp ip/obs high 50","description":"Subsequent hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 50 minutes m","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0547","name":"Phone/internet svs 11-20 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0201","name":"Pne flu hepb cov home admin","description":"Administration of pneumococcal, influenza, hepatitis b, and/or covid-19 vaccine inside a patients home; reported only once per individual home per date of service when such vaccine administration(s) are performed at the patients home","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81462","name":"So gsap cll fr dna/dna&rna","description":"Solid organ neoplasm, genomic sequence analysis panel, cell-free nucleic acid (eg, plasma), interrogation for sequence variants; dna analysis or combined dna and rna analysis, copy number variants and rearrangements","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0465U","name":"Onc urthl carc dna qmsp 2gen","description":"Onc urthl carc dna qmsp 2gen","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5099","name":"Inj ustekinumab-stba, 1 mg","description":"Injection, ustekinumab-stba (steqeyma), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98008","name":"Synch audio-only new sf 15","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code sel","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76818","name":"Fetal biophys profile w/nst","description":"Fetal biophysical profile; with non-stress testing","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95924","name":"Ans parasymp & symp w/tilt","description":"Testing of autonomic nervous system function; combined parasympathetic and sympathetic adrenergic function testing with at least 5 minutes of passive tilt","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99215","name":"Office o/p est hi 40 min","description":"Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 40 minutes must be met or ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":217.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0031","name":"Pall serv during meas","description":"Palliative care services given to patient any time during the measurement period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0326U","name":"Trgt gen seq alys pnl 83+","description":"Trgt gen seq alys pnl 83+","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1421","name":"Dermatological care mvp","description":"Dermatological care mips value pathway","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0521","name":"Supply fee hiv prep fda appr","description":"Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0708T","name":"Id ca immntx prep & 1st njx","description":"Intradermal cancer immunotherapy; preparation and initial injection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49420","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4273","name":"Esano aaa, per sq cm","description":"Esano aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9296","name":"Inj pemetrexed (accord) 10mg","description":"Injection, pemetrexed (accord), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0296U","name":"Onc orl&/orop ca 20 mlc feat","description":"Onc orl&/orop ca 20 mlc feat","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99285","name":"Emergency dept visit hi mdm","description":"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0391","name":"Inj, artesunate, 1mg","description":"Injection, artesunate, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92288","name":"Scr dark adaptation meas i&r","description":"Screening dark adaptation measurement (eg, rod recovery intercept time), with interpretation and report","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3502","name":"Surg exp root surf premolar","description":"Surg exp root surf premolar","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70460","name":"Ct head/brain w/dye","description":"Computed tomography, head or brain; with contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67225","name":"Eye photodynamic ther add-on","description":"Destruction of localized lesion of choroid (eg, choroidal neovascularization); photodynamic therapy, second eye, at single session (list separately in addition to code for primary eye treatment)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1413","name":"Pos pdl1 bef init ici tx","description":"Patients who had a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93597","name":"R&l hrt cath chd abnl nt cnj","description":"Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); abnormal native connections","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1932","name":"Inj, lanreotide, (cipla) 1mg","description":"Injection, lanreotide, (cipla), 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4396","name":"Natalin per sq cm","description":"Natalin, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99427","name":"Prin care mgmt staff ea addl","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1408","name":"Gmln brca bef dx ca","description":"Patients who have germline brca testing completed before diagnosis of epithelial ovarian, fallopian tube, or primary peritoneal cancer","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0305U","name":"Hem rbc fnclty&dfrm shr strs","description":"Hem rbc fnclty&dfrm shr strs","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63741","name":"Install spinal shunt","description":"Creation of shunt, lumbar, subarachnoid-peritoneal, -pleural, or other; percutaneous, not requiring laminectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5933","name":"Refitting of obturator","description":"Obturator prosthesis modification","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0462","name":"Atropine sulf, nte, 0.01 mg","description":"Injection, atropine sulfate, not therapeutically equivalent to j0461, 0.01 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0678T","name":"Laps repos lead isdss ea add","description":"Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional repositioned lead (list separately in addition to code for primary proce","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99383","name":"Prev visit new age 5-11","description":"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; late childhood (","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":133.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0465U","name":"Onc urthl carc dna qmsp 2gen","description":"Onc urthl carc dna qmsp 2gen","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0973T","name":"Slctv nzmtc dbrdmt t/a/l 1st","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; first 100 sq cm","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J0900","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2034","name":"Found drs solo, per sq cm","description":"Foundation drs solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33410","name":"Replacement aortic valve opn","description":"Replacement, aortic valve, open, with cardiopulmonary bypass; with stentless tissue valve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2409.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87594","name":"Pneumcysts jirovecii amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); pneumocystis jirovecii, amplified probe technique","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0679T","name":"Laps rmvl lead isdss","description":"Laparoscopic removal of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0546U","name":"Ldns lrp4 antb imflr livecll","description":"Ldns lrp4 antb imflr livecll","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86036","name":"Anca screen each antibody","description":"Antineutrophil cytoplasmic antibody (anca); screen, each antibody","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4311","name":"Acesso, per sq cm","description":"Acesso, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98008","name":"Synch audio-only new sf 15","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code sel","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0335U","name":"Rare ds whl gen seq fetal","description":"Rare ds whl gen seq fetal","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0537","name":"Risk ascvd tst once pr 12 mo","description":"Administration of a standardized, evidence-based atherosclerotic cardiovascular disease (ascvd) risk assessment, 5-15 minutes, not more often than every 12 months","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0539U","name":"Onc sol tumor cfctdna 152gen","description":"Onc sol tumor cfctdna 152gen","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0955T","name":"Tot impl amei removal","description":"Totally implantable active middle ear hearing implant; removal, including removal of sound processor and all implant components","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59020","name":"Fetal contract stress test","description":"Fetal contraction stress test","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27517","name":"Treat thigh fx growth plate","description":"Closed treatment of distal femoral epiphyseal separation; with manipulation, with or without skin or skeletal traction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":791.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0554","name":"Add 20 m of monthly tx","description":"Each additional 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing data generated from the","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7171","name":"Inj, adzynma, 10 iu","description":"Injection, adamts13, recombinant-krhn, 10 iu","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98007","name":"Synch audio-video est hi 40","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high medical decision making. when using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded.","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4305","name":"Amer am ac tri-lay per sq cm","description":"American amnion ac tri-layer, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37298","name":"Revsc evsc imvt angio cplx 1","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7962","name":"Lingual frenectomy","description":"Lingual frenectomy","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99242","name":"Off/op consltj new/est sf 20","description":"Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":59.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2404","name":"Inj, nicardipine 0.1 mg","description":"Injection, nicardipine, 0.1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81349","name":"Cytog alys chrml abnr lw-ps","description":"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and loss-of-heterozygosity variants, low-pass sequencing analysis","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5145","name":"Inj, abrilada, 1 mg","description":"Injection, adalimumab-afzb (abrilada), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76831","name":"Echo exam uterus","description":"Saline infusion sonohysterography (sis), including color flow doppler, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1451","name":"Pt dx ppd dur id/pf pd","description":"Patients with an active diagnosis of pervasive developmental disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5098","name":"Inj ustekinumab-srlf, 1 mg","description":"Injection, ustekinumab-srlf (imuldosa), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0986T","name":"Iv img icr cere vsl oct 1st","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0607","name":"Lanthanum carbonate oral 5mg","description":"Lanthanum carbonate, oral, 5 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0701","name":"Inj. cefepime hcl (baxter)","description":"Injection, cefepime hydrochloride (baxter), not therapeutically equivalent to maxipime, 500 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2802","name":"Inj, romiplostim 1 microgram","description":"Injection, romiplostim, 1 microgram","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1230","name":"Methadone injection","description":"Injection, methadone hcl, up to 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3404","name":"Inj zopapogene per ther dose","description":"Injection, zopapogene imadenovec-drba suspension, per therapeutic dose","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0578U","name":"Onc cutan mln rna qpcr 10gen","description":"Onc cutan mln rna qpcr 10gen","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96547","name":"Intraop hipec px 1st 60 min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; first 60 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0433U","name":"Onc prst8 5 dna reg mrk pcr","description":"Onc prst8 5 dna reg mrk pcr","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37275","name":"Rvsc evsc fpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85025","name":"Complete cbc w/auto diff wbc","description":"Blood count; complete (cbc), automated (hgb, hct, rbc, wbc and platelet count) and automated differential wbc count","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0423U","name":"Psyc genomic alys pnl 26 gen","description":"Psyc genomic alys pnl 26 gen","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29824","name":"Sho arthrs srg dstl claviclc","description":"Arthroscopy, shoulder, surgical; distal claviculectomy including distal articular surface (mumford procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0573U","name":"Onc pancreas 3bmrk pclf alg","description":"Onc pancreas 3bmrk pclf alg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99459","name":"Pelvic examination","description":"Pelvic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0009","name":"Admin pneumococcal vaccine","description":"Administration of pneumococcal vaccine","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0319","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1451","name":"Pt dx ppd dur id/pf pd","description":"Patients with an active diagnosis of pervasive developmental disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0741","name":"Inj, cabote rilpivir 2mg 3mg","description":"Injection, cabotegravir and rilpivirine, 2mg/3mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1284","name":"Pt 66+ snp or ltc pos > 90d","description":"Patients age 66 or older in institutional special needs plans (snp) or residing in long term care with pos code 32, 33, 34, 54, or 56 for more than 90 consecutive days during the measurement period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1315","name":"Crc no doc no rsn","description":"Colorectal cancer screening results were not documented and reviewed; reason not otherwise specified","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26542","name":"Repair hand joint with graft","description":"Reconstruction, collateral ligament, metacarpophalangeal joint, single; with local tissue (eg, adductor advancement)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32940","name":"Revision of lung","description":"Pneumonolysis, extraperiosteal, including filling or packing procedures","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1419.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0586U","name":"Onc mrna gen xprsn 216 genes","description":"Onc mrna gen xprsn 216 genes","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1336","name":"Pts eval ini xm 2 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 2 weeks","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4271","name":"Complete ft per sq cm","description":"Complete ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6032","name":"Part handfng ultralite tcf/=","description":"Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1171","name":"Pt recd 1 td/tdap 9yrs prior","description":"Patient received at least one td vaccine or one tdap vaccine between nine years prior to the encounter and the end of the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51010","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0575U","name":"Trnsplj med lar rtpcr 4genes","description":"Trnsplj med lar rtpcr 4genes","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81195","name":"Cytog genom-wid alys hem mal","description":"Cytogenomic (genome-wide) analysis, hematologic malignancy, structural variants and copy number variants, optical genome mapping (ogm)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0565U","name":"Onc hcc ngs detc 6626epigalt","description":"Onc hcc ngs detc 6626epigalt","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48400","name":"Injection intraop add-on","description":"Injection procedure for intraoperative pancreatography (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0683","name":"App of non-sheet skin sub g","description":"Application of a premarket approval (pma), 510(k), 361 human cells, tissues or cellular and tissue-based products (hct/p) non-sheet form skin substitute graft for a wound surface greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67350","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1485","name":"Neg viro resp hep c/qual rna","description":"Patients who did not achieve sustained virological response as identified by an hcv rna test (cpt 87522) or (cpt 87521) with a negative/undetectable hcv rna result that occurred 20 weeks to 12 months after the first positive/detectable hcv rna test result within the denominator identification period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2022","name":"Innovabrn/innovamatx xl sqcm","description":"Innovaburn or innovamatrix xl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4422","name":"Ac wrap per sq cm","description":"A/c wrap, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2034","name":"Found drs solo, per sq cm","description":"Foundation drs solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J2780","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99213","name":"Office o/p est low 20 min","description":"Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 20 minutes must be met or e","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":56.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1351","name":"Pt cmplt suicd saf pln 120dy","description":"Patients who had a suicide safety plan initiated, reviewed, or updated and reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4331","name":"Axolotl graft, per sq cm","description":"Axolotl graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6039","name":"Passive custom digit/thumb","description":"Passive prosthetic digit or thumb prosthesis not including hand restoration partial hand, full or partial, custom made, any material, initial or replacement, per single passive prosthetic digit or thumb","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7173","name":"Inj. concizumab-mtci, 0.5 mg","description":"Injection, concizumab-mtci, 0.5 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9886","name":"In-person attendance g code","description":"Behavioral counseling for diabetes prevention, in-person, group, 60 minutes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59300","name":"Episiotomy or vaginal repair","description":"Episiotomy or vaginal repair, by other than attending","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":181.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":166.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81449","name":"So neo gsap 5-50 rna alys","description":"Solid organ neoplasm, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants and copy number variants or rearrangements, if performed; rna analysis","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0832T","name":"Dgtz gls mcrscp cytp oth scr","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0890T","name":"Arhfcmrigtbs 1st tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including target assessment, initial motor threshold determination, neuronavigation, delivery and management, initial treatment day","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77080","name":"Dxa bone density axial","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5612","name":"Rep resin part dent base max","description":"Rep resin part dent base max","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2679","name":"Inj fluphenazine hcl 1.25 mg","description":"Injection, fluphenazine hcl, 1.25 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80202","name":"Assay of vancomycin","description":"Vancomycin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15852","name":"Dressing change not for burn","description":"Dressing change (for other than burns) under anesthesia (other than local)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0621U","name":"Nfct ds lb dna alys>10000","description":"Nfct ds lb dna alys>10000","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0465","name":"Home vent invasive interface","description":"Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0736","name":"Inj, clindamycin phosp 300mg","description":"Injection, clindamycin phosphate, 300 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4388","name":"Neothelium 4l per sq cm","description":"Neothelium 4l, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0269U","name":"Hem aut dm cgen trmbctpna 14","description":"Hematology (autosomal dominant congenital thrombocytopenia), genomic sequence analysis of 14 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0294U","name":"Lngvty&mrtlty rsk mrna 18gen","description":"Lngvty&mrtlty rsk mrna 18gen","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1456","name":"Inj, fosaprepitant (teva)","description":"Injection, fosaprepitant (teva), not therapeutically equivalent to j1453, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60661","name":"Abltj 1/+thyr ndul addl prq","description":"Ablation of 1 or more thyroid nodule(s), additional lobe, percutaneous, including imaging guidance, radiofrequency (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1480","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2031","name":"Mirodry, per sq cm","description":"Mirodry wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82163","name":"Assay of angiotensin ii","description":"Angiotensin ii","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4479","name":"Transanal irrigation, electr","description":"Electronic transanal irrigation system, includes electronic pump, water reservoir, tubing, and accessories, without catheter, any type","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":706.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73565","name":"X-ray exam of knees","description":"Radiologic examination, knee; both knees, standing, anteroposterior","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1244","name":"Pt othr thn true best int","description":"Patient provided a response other than completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96380","name":"Admn rsv monoc antb im cnsl","description":"Administration of respiratory syncytial virus, monoclonal antibody, seasonal dose by intramuscular injection, with counseling by physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1576","name":"Inj, panzyga, 500 mg","description":"Injection, immune globulin (panzyga), intravenous, non-lyophilized (e.g., liquid), 500 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0736T","name":"Colonic lavage 35+l water","description":"Colonic lavage, 35 or more liters of water, gravity-fed, with induced defecation, including insertion of rectal catheter","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1002T","name":"Air displacmnt plethysmograp","description":"Air displacement plethysmography, whole-body composition assessment, with interpretation and report","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1172","name":"Doc med rsn no td/tdap","description":"Documentation of medical reason(s) for not administering td or tdap vaccine (e.g., prior anaphylaxis due to the td or tdap vaccine or history of encephalopathy within seven days after a previous dose of a td-containing vaccine)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4545","name":"Suppl accessor tibial stim","description":"Supplies and accessories for external tibial nerve stimulator (e.g., socks, gel pads, electrodes, etc.), needed for one month","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D8091","name":"Compre ortho treat w surg","description":"Compre ortho treat w surg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31256","name":"Exploration maxillary sinus","description":"Nasal/sinus endoscopy, surgical, with maxillary antrostomy;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6035","name":"Prosthetic digit mechanical","description":"Single prosthetic digit, mechanical, can include metacarpophalangeal (mcp), proximal interphalangeal (pip), and/or distal interphalangeal (dip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1395","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0983T","name":"Rem mntr impl ivc snr phys","description":"Remote monitoring of an implanted inferior vena cava sensor for up to 30 days, including at least weekly downloads of inferior vena cava area recordings, interpretation(s), trend analysis, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"Limited visual field xm","description":"Visual field examination, unilateral or bilateral, with interpretation and report; limited examination (eg, tangent screen, autoplot, arc perimeter, or single stimulus level automated test, such as octopus 3 or 7 equivalent)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4370","name":"Aeroguard per sq cm","description":"Aeroguard, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4322","name":"Caregraft, per sq cm","description":"Caregraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2007","name":"Restrata, per sq cm","description":"Restrata, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94375","name":"Respiratory flow volume loop","description":"Respiratory flow volume loop","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]},{"negotiated_type":"negotiated","negotiated_rate":18.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4418","name":"Biolab wrap flow per sq cm","description":"Biolab membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49189","name":"Opn exc/dst ntra-abd 20.1-30","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 20.1 to 30 cm","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1737","name":"Inj meloxicam (azurity) 1mg","description":"Injection, meloxicam (azurity), 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71048","name":"X-ray exam chest 4+ views","description":"Radiologic examination, chest; 4 or more views","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1306","name":"Pt anphx due to pneum","description":"Patient had anaphylaxis due to the pneumococcal vaccine any time during or before the measurement period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0612U","name":"Onc lvr alys >1000 mr cfdna","description":"Onc lvr alys >1000 mr cfdna","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0988T","name":"Opn ins/rplc ins ptn sbq&sbf","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous and subfascial","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1409","name":"Recd gmln brca1/brca2 couns","description":"Patients who received germline testing for brca1 and brca2 or genetic counseling completed within 6 months of diagnosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22860","name":"Tot disc arthrp 2ntrspc lmbr","description":"Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression); second interspace, lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0375U","name":"Onc ovrn bchm asy 7 prtn alg","description":"Onc ovrn bchm asy 7 prtn alg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1294","name":"Bp scrn perf rec interval","description":"Normal blood pressure reading documented, follow-up not required","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1011T","name":"Pbm therapy of oral cavity","description":"Photobiomodulation (pbm) therapy of oral cavity, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4017","name":"Nutrition/dietician ss","description":"Nutrition/dietician mips specialty set","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0208","name":"Inj, pedmark, 100 mg","description":"Injection, sodium thiosulfate (pedmark), 100 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1285","name":"Scrn mam perf rslts not doc","description":"Screening, diagnostic, film, digital or digital breast tomosynthesis (3d) mammography results were not documented and reviewed, reason not otherwise specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99418","name":"Prolng ip/obs e/m ea 15 min","description":"Prolonged inpatient or observation evaluation and management service(s) time with or without direct patient contact beyond the required time of the primary service when the primary service level has been selected using total time, each 15 minutes of total time (list separately in addition to the cod","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1185","name":"Imm ckpt inhib not hld no rx","description":"Documentation of immune checkpoint inhibitor therapy not held and/or corticosteroids or immunosuppressants prescribed or administered was not performed, reason not given","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4560","name":"Nmes disposable","description":"Neuromuscular electrical stimulator (nmes), disposable, replacement only","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0401U","name":"Crd c hrt ds 9 gen 12 vrnts","description":"Crd c hrt ds 9 gen 12 vrnts","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0582U","name":"Rare ds rpd whlgen dna vrnts","description":"Rare ds rpd whlgen dna vrnts","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92632","name":"Hearing aid slctn svc ea add","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81025","name":"Urine pregnancy test","description":"Urine pregnancy test, by visual color comparison methods","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4433","name":"361 hct/p skin subs, nos","description":"361 hct/p skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1211","name":"Gsa level>9.0%","description":"Most recent glycemic status assessment (hba1c or gmi) level > 9.0%","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9064","name":"Inj, cabazitaxel (sandoz)","description":"Injection, cabazitaxel (sandoz), not therapeutically equivalent to j9043, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1011T","name":"Pbm therapy of oral cavity","description":"Photobiomodulation (pbm) therapy of oral cavity, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9224","name":"Gen anes adv air-15 min","description":"Gen anes adv air-15 min","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4029","name":"Preventive medicine ss","description":"Preventive medicine mips specialty set","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1213","name":"No hx spiro prs spiro>=70%","description":"No history of spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) and present spirometry is >= 70%","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74019","name":"Radex abdomen 2 views","description":"Radiologic examination, abdomen; 2 views","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80438","name":"Trh stimulation panel","description":"Thyrotropin releasing hormone (trh) stimulation panel; 1 hour this panel must include the following: thyroid stimulating hormone (tsh) (84443 x 3)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1314","name":"Bmi not calculated","description":"Bmi not documented and no reason is given","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4288","name":"Dermabind ch, per sq cm","description":"Dermabind ch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77090","name":"Tbs techl prep&transmis data","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91124","name":"Rct snsatn tone&cmplianc std","description":"Rectal sensation, tone, and compliance study (eg, barostat)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9161","name":"Inj denileuk difti-cxdl 1mcg","description":"Injection, denileukin diftitox-cxdl, 1 mcg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0929T","name":"Rem interrog dev ccm-d tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0873T","name":"Revj subq prtl asct pmp sys","description":"Revision of a subcutaneously implanted peritoneal ascites pump system, any component (ascites pump, associated peritoneal catheter, associated bladder catheter), including imaging and programming, when performed","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25927","name":"Amputation of hand","description":"Transmetacarpal amputation;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":998.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37272","name":"Revsc evsc fpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0693T","name":"Compre ful bdy 3d mtn alys","description":"Comprehensive full body computer-based markerless 3d kinematic and kinetic motion analysis and report","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99225","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5162","name":"Inj, denosumab-nxxp, 1 mg","description":"Injection, denosumab-nxxp (bildyos/bilprevda), biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7021","name":"Suppl and access lung expan","description":"Supplies and accessories for lung expansion airway clearance, continuous high frequency oscillation, and nebulization device (e.g., handset, nebulizer kit, biofilter)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78608","name":"Brain imaging (pet)","description":"Brain imaging, positron emission tomography (pet); metabolic evaluation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1737.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0522U","name":"Ca vi psp&sp1 antb cl semiql","description":"Ca vi psp&sp1 antb cl semiql","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45347","name":"Sigmoidoscopy w/plcmt stent","description":"Sigmoidoscopy, flexible; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1177","name":"Pt recd pcv on/aft 19","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1275","name":"Pts hosp exl","description":"Patients determined to be in hospice were excluded from month of evaluation and the remainder of reporting period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53000","name":"Incision of urethra","description":"Urethrotomy or urethrostomy, external (separate procedure); pendulous urethra","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87426","name":"Sarscov coronavirus ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; severe acute respiratory syndrome coronavirus (eg, sars-cov, s","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0543U","name":"Onc sol tum ngs dna 517 gens","description":"Onc sol tum ngs dna 517 gens","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0879","name":"Difelikefalin, esrd on dialy","description":"Injection, difelikefalin, 0.1 microgram, (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4437","name":"Revival ac per sq cm","description":"Revival ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0918T","name":"Insj perm ccm-d sys dual ld","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; dual transvenous leads (pacing and defibrillation) only","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1320","name":"Pts scrn + hrsn","description":"Patients who screened positive for at least 1 of the 5 hrsns","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0233","name":"Intra inf, toci, first dose","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0474U","name":"Hered pan ca gsap 88gene ngs","description":"Hered pan ca gsap 88gene ngs","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5948","name":"Max implt sup fix part","description":"Max implt sup fix part","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1017T","name":"Elec aly npgs esoph sbsq w/o","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of waveform, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements), lower esophageal sphincter neurostimulator pulse gener","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4438","name":"Pretect per sq cm","description":"Pretect, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37287","name":"Revsc evasc tpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99465","name":"Nb resuscitation","description":"Delivery/birthing room resuscitation, provision of positive pressure ventilation and/or chest compressions in the presence of acute inadequate ventilation and/or cardiac output","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1354","name":"Int caries med app per tooth","description":"Interim caries med app","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1834","name":"Inj, isoniazid, 1 mg","description":"Injection, isoniazid, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1449","name":"Pt dx scz/pys bef end msr pd","description":"Patients with an active diagnosis of schizophrenia or psychotic disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2012","name":"Suprathel, per sq cm","description":"Suprathel, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21339","name":"Open nasoethmoid fx w/ fixj","description":"Open treatment of nasoethmoid fracture; with external fixation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1055.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33897","name":"Perq trluml angp nt/recr coa","description":"Percutaneous transluminal angioplasty of native or recurrent coarctation of the aorta","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99495","name":"Transj care mgmt mod f2f 14d","description":"Transitional care management services with the following required elements: communication (direct contact, telephone, electronic) with the patient and/or caregiver within 2 business days of discharge at least moderate level of medical decision making during the service period face-to-face visit, wit","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":249.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0597U","name":"Onc breast rna xprsn 329gens","description":"Onc breast rna xprsn 329gens","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85651","name":"Rbc sed rate nonautomated","description":"Sedimentation rate, erythrocyte; non-automated","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50400","name":"Revision of kidney/ureter","description":"Pyeloplasty (foley y-pyeloplasty), plastic operation on renal pelvis, with or without plastic operation on ureter, nephropexy, nephrostomy, pyelostomy, or ureteral splinting; simple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1254.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4326","name":"Woundplus, per sq cm","description":"Woundplus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0595U","name":"Nfct ds tfp vctrbrn&zoonotic","description":"Nfct ds tfp vctrbrn&zoonotic","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1235","name":"Doc pt hcv aby rna tst","description":"Documentation or patient report of hcv antibody test or hcv rna test which occurred prior to the performance period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21440","name":"Cltx mndblr/max alv ridge fx","description":"Closed treatment of mandibular or maxillary alveolar ridge fracture (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98929","name":"Osteopath manj 9-10 regions","description":"Osteopathic manipulative treatment (omt); 9-10 body regions involved","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":58.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1577.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1279","name":"Pre-htn/htn, no f/u, not gvn","description":"Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75822","name":"Vein x-ray arms/legs","description":"Venography, extremity, bilateral, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4318","name":"E-graft, per sq cm","description":"E-graft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0785T","name":"Revj/rmvl nea spi w/nstim","description":"Revision or removal of neurostimulator electrode array, spinal, with integrated neurostimulator","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1380","name":"2 rx in perf pd any com meds","description":"Filled at least two prescriptions during the performance period for any combination of the qualifying oral antipsychotic medications listed under denominator note or the long-acting injectable antipsychotic medications listed under denominator note","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53400","name":"Revise urethra stage 1","description":"Urethroplasty; first stage, for fistula, diverticulum, or stricture (eg, johannsen type)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":868.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99310","name":"Sbsq nf care high mdm 45","description":"Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 45 minutes must be met or exc","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":136.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1386","name":"Exc sx melmn or mlnm is","description":"Patients with an excisional surgery for melanoma or melanoma in situ in the past 5 years with an initial ajcc staging of 0, i, or ii at the start of the performance period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1238","name":"Doc 2nd recom hzv 2-6 mo int","description":"Documentation that administration of second recombinant zoster vaccine could not occur during the performance period due to the recommended 2-6 month interval between doses (i.e, first dose received after october 31)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1253","name":"Pts hu surv no amb plltv","description":"Patients who respond on the patient experience hu survey that they did not receive care by the listed ambulatory palliative care provider in the last 60 days (disavowal)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0912T","name":"Elec alys nstim sys vgs smpl","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; with simple programming by physician or other qualified health care professional","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0049","name":"Main hemo in-cntr","description":"With maintenance hemodialysis (in-center and home hd) for the complete reporting month","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0447U","name":"Ai ds sle alys 11 cytokine","description":"Ai ds sle alys 11 cytokine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6180","name":"Implnt maint proced","description":"Implnt maint proced","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78710","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7957","name":"Tiss regen edent nonresorb","description":"Tiss regen edent nonresorb","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5942","name":"Proth max implt sup remv","description":"Proth max implt sup remv","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6253","name":"Provisional pontic","description":"Provisional pontic","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76819","name":"Fetal biophys profil w/o nst","description":"Fetal biophysical profile; without non-stress testing","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1190","name":"Doc khe not pef w/efgr/uacr","description":"Documentation of a kidney health evaluation was not performed or defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0539U","name":"Onc sol tumor cfctdna 152gen","description":"Onc sol tumor cfctdna 152gen","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0175","name":"Inj, donanemab-azbt, 2 mg","description":"Injection, donanemab-azbt, 2 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0374","name":"Tomo periapical image","description":"Tomo periapical image","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6091","name":"Repl semi/precision attach","description":"Replacement of semi-precision or precision attachment (male or female component) of implant/abutment supported prosthesis per attachment","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1328","name":"Pts dx acute vitreous hem","description":"Patients with a diagnosis of acute vitreous hemorrhage","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9218","name":"Leuprolide acetate injeciton","description":"Leuprolide acetate, per 1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85032","name":"Manual cell count each","description":"Blood count; manual cell count (erythrocyte, leukocyte, or platelet) each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0597U","name":"Onc breast rna xprsn 329gens","description":"Onc breast rna xprsn 329gens","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84488","name":"Test feces for trypsin","description":"Trypsin; feces, qualitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38700","name":"Removal of lymph nodes neck","description":"Suprahyoid lymphadenectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":680.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1244","name":"Pt othr thn true best int","description":"Patient provided a response other than completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1242","name":"Pt no resp imprt to me","description":"Patient did not respond to the question of patient felt this provider and team understood what is important to me in my life","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0403U","name":"Onc prst8 mrna 18 gen dre ur","description":"Onc prst8 mrna 18 gen dre ur","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36512","name":"Apheresis rbc","description":"Therapeutic apheresis; for red blood cells","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1952","name":"Leuprolide inj, camcevi, 1mg","description":"Leuprolide injectable, camcevi, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35471","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":641.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99402","name":"Prev med cnsl indiv apprx 30","description":"Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 30 minutes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":62.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6071","name":"Abutment supported retainer","description":"Abutment supported retainer for porcelain fused to metal fpd (noble metal)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25525","name":"Optx rdl shft fx&cltx rad/ul","description":"Open treatment of radial shaft fracture, includes internal fixation, when performed, and closed treatment of distal radioulnar joint dislocation (galeazzi fracture/ dislocation), includes percutaneous skeletal fixation, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1105.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35626","name":"Bpg aor-subcla/innom/carotid","description":"Bypass graft, with other than vein; aortosubclavian, aortoinnominate, or aortocarotid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1953.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0284U","name":"Vw factor type 2n eval plsm","description":"Von willebrand factor (vwd), type 2n, factor viii and vwf binding evaluation, enzyme-linked immunosorbent assays (elisa), plasma","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19342","name":"Insj/rplcmt brst implt sep d","description":"Insertion or replacement of breast implant on separate day from mastectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":998.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50945","name":"Laparoscopy ureterolithotomy","description":"Laparoscopy, surgical; ureterolithotomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1110.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75580","name":"N-invas est c ffr sw aly cta","description":"Noninvasive estimate of coronary fractional flow reserve (ffr) derived from augmentative software analysis of the data set from a coronary computed tomography angiography, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0396","name":"3d print of 3d surface scan","description":"3d print of 3d surface scan","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0614U","name":"Iem pmd alys 4 nzm cplx page","description":"Iem pmd alys 4 nzm cplx page","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25312","name":"Transplant forearm tendon","description":"Tendon transplantation or transfer, flexor or extensor, forearm and/or wrist, single; with tendon graft(s) (includes obtaining graft), each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1148.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0284U","name":"Vw factor type 2n eval plsm","description":"Von willebrand factor (vwd), type 2n, factor viii and vwf binding evaluation, enzyme-linked immunosorbent assays (elisa), plasma","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1233","name":"Pt no hcv aby or result","description":"Patient does not receive hcv antibody test or patient does receive hcv antibody test but results not documented, reason not given","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0475","name":"Baclofen 10 mg injection","description":"Injection, baclofen, 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34708","name":"Evasc rpr ilio-iliac rpt","description":"Endovascular repair of iliac artery by deployment of an ilio-iliac tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, and all endograft extension(s) proximally to the aortic bifurcation ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1929.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87110","name":"Chlamydia culture","description":"Culture, chlamydia, any source","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1492","name":"No reported fall","description":"Patients who did not report a fall","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67221","name":"Ocular photodynamic ther","description":"Destruction of localized lesion of choroid (eg, choroidal neovascularization); photodynamic therapy (includes intravenous infusion)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80151","name":"Drug assay amiodarone","description":"Amiodarone","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4437","name":"Revival ac per sq cm","description":"Revival ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52301","name":"Cystoscopy and treatment","description":"Cystourethroscopy; with resection or fulguration of ectopic ureterocele(s), unilateral or bilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1477","name":"Dx delirium","description":"Diagnosis of delirium","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1213","name":"No hx spiro prs spiro>=70%","description":"No history of spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) and present spirometry is >= 70%","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0001","name":"Advancing cancer care mvp","description":"Advancing cancer care mips value pathways","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1290","name":"Pt not eli d/t act dig htn","description":"Patient not eligible due to active diagnosis of hypertension","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4378","name":"Renew ft matrix per sq cm","description":"Renew ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83505","name":"Assay total hydroxyproline","description":"Hydroxyproline; total","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0342U","name":"Onc pncrtc ca mult ia eclia","description":"Onc pncrtc ca mult ia eclia","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1330","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4001","name":"Diagnostic rad ss","description":"Diagnostic radiology mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24152","name":"Rad resection tum radial h/n","description":"Radical resection of tumor, radial head or neck","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":874.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2033","name":"Myriad morcells, 4 mg","description":"Myriad morcells, 4 milligrams","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0307U","name":"Onc mrd nxt-gnrj alys sbsq","description":"Onc mrd nxt-gnrj alys sbsq","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0847T","name":"Dgtz gls mcrscp xm arch tiss","description":"Digitization of glass microscope slides for examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, kras mutational analysis) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4256","name":"Mlg complet, per sq cm","description":"Mlg-complete, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2035","name":"Corpl p therac p allac p mg","description":"Corplex p or theracor p or allacor p, per milligram","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1221","name":"Dre w/o rtnopthy","description":"Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist or artificial intelligence (ai) interpretation documented and reviewed; without evidence of retinopathy","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6595","name":"G comp bandge liner upr extr","description":"Gradient compression bandaging supply, bandage liner, upper extremity, any size or length, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9224","name":"Gen anes adv air-15 min","description":"Gen anes adv air-15 min","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4392","name":"Grafix duo per sq cm","description":"Grafix duo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26145","name":"Tendon excision palm/finger","description":"Synovectomy, tendon sheath, radical (tenosynovectomy), flexor tendon, palm and/or finger, each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":608.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4360","name":"Amchoplast fd per sq cm","description":"Amchoplast fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93574","name":"Njx cath slct pulm vn angrph","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary venous angiography of each distinct pulmonary vein during cardiac catheterization (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5912","name":"Facial moulage complete","description":"Facial moulage (complete)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43290","name":"Egd flx trnsorl dplmnt balo","description":"Esophagogastroduodenoscopy, flexible, transoral; with deployment of intragastric bariatric balloon","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36837","name":"Prq av fstl crt uxtr sep acs","description":"Percutaneous arteriovenous fistula creation, upper extremity, separate access sites of the peripheral artery and peripheral vein, including fistula maturation procedures (eg, transluminal balloon angioplasty, coil embolization) when performed, including all vascular access, imaging guidance and radi","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87469","name":"Babesia microti amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); babesia microti, amplified probe technique","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83987","name":"Exhaled breath condensate","description":"Ph; exhaled breath condensate","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6526","name":"G com garmt full leg/ft nght","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77307","name":"Telethx isodose plan cplx","description":"Teletherapy isodose plan; complex (multiple treatment areas, tangential ports, the use of wedges, blocking, rotational beam, or special beam considerations), includes basic dosimetry calculation(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1253","name":"Pts hu surv no amb plltv","description":"Patients who respond on the patient experience hu survey that they did not receive care by the listed ambulatory palliative care provider in the last 60 days (disavowal)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55709","name":"Bx prst8 tprnl us guided","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99301","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4419","name":"Biolab wrap flw lt per sq cm","description":"Biolab membrane wrap lite flow, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76883","name":"Us nrv&acc strux 1xtr compre","description":"Ultrasound, nerve(s) and accompanying structures throughout their entire anatomic course in one extremity, comprehensive, including real-time cine imaging with image documentation, per extremity","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9274","name":"Inj, tebentafusp-tebn, 1 mcg","description":"Injection, tebentafusp-tebn, 1 microgram","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15013","name":"Prepj skn cll ssp agrft 1st","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; first 25 sq cm or less of harvested skin","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"Limited visual field xm","description":"Visual field examination, unilateral or bilateral, with interpretation and report; limited examination (eg, tangent screen, autoplot, arc perimeter, or single stimulus level automated test, such as octopus 3 or 7 equivalent)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1202","name":"Miglustat oral 65 mg","description":"Miglustat, oral, 65 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35721","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":569.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"Add upp ext mec limb vol lam","description":"Addition to upper extremity prosthesis, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":3150.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0291U","name":"Psyc mood do mrna 144 genes","description":"Psyc mood do mrna 144 genes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9073","name":"Inj cyclophos dr reddys 5 mg","description":"Injection, cyclophosphamide (dr. reddys), 5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24150","name":"Rad rescj tum dstl/shft hum","description":"Radical resection of tumor, shaft or distal humerus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1163.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61736","name":"Litt icr 1 traj 1 smpl les","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; single trajectory for 1 simple lesion","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93594","name":"R hrt cath chd abnl nt cnj","description":"Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; abnormal native connections","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0285","name":"Amphotericin b","description":"Injection, amphotericin b, 50 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4288","name":"Dermabind ch, per sq cm","description":"Dermabind ch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51721","name":"Ins trurl ablt trnsdc thr us","description":"Insertion of transurethral ablation transducer for delivery of thermal ultrasound for prostate tissue ablation, including suprapubic tube placement during the same session and placement of an endorectal cooling device, when performed","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4290","name":"Membrane wrap hydr per sq cm","description":"Membrane wrap-hydro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9294","name":"Inj pemetrexed, hospira 10mg","description":"Injection, pemetrexed (hospira), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78801","name":"Rp loclzj tum 2+area 1+d img","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, 2 or more areas (eg, abdomen and pelvis, head and chest), 1 or more days imaging or single area imaging over 2 or m","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99316","name":"Nf dschrg mgmt 30 min+","description":"Nursing facility discharge management; more than 30 minutes total time on the date of the encounter","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":130.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4315","name":"Regenelink amniotic mem allo","description":"Regenelink amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9376","name":"Inj pozelimab-bbfg, 1 mg","description":"Injection, pozelimab-bbfg, 1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93585","name":"Vngrph chd azygs/hemiazygs","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; azygos/hemiazygos venous system (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1321","name":"Couns for high risk sub use","description":"Couns for high risk sub use","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0521","name":"New pt-cg dyad dem hig cmplx","description":"Management of new patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4027","name":"Plastic surgery ss","description":"Plastic surgery mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49623","name":"Rmvl ninfct mesh hernia rpr","description":"Removal of total or near total non-infected mesh or other prosthesis at the time of initial or recurrent anterior abdominal hernia repair or parastomal hernia repair, any approach (ie, open, laparoscopic, robotic) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33287","name":"Rmv&rplcmt phrnc nrv stim pg","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4030","name":"Pulmonology ss","description":"Pulmonology mips specialty set","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4413","name":"Cygnus solo per sq cm","description":"Cygnus solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4393","name":"Surgraft ac per sq cm","description":"Surgraft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0615U","name":"Bbrgdrferi ld antb detcj 26","description":"Bbrgdrferi ld antb detcj 26","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6595","name":"G comp bandge liner upr extr","description":"Gradient compression bandaging supply, bandage liner, upper extremity, any size or length, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":34.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37274","name":"Rvsc evsc fpvt athrc cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0980T","name":"Sbmcsl crylys ther tng&tnsl","description":"Submucosal cryolysis therapy; base of tongue and lingual tonsil only","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7353","name":"Anacaulase-bcdb 8.8% gel 1 g","description":"Anacaulase-bcdb, 8.8% gel, 1 gram","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63302","name":"Remove vert xdrl body thrlmb","description":"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, thoracic by thoracolumbar approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2228.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1814","name":"Inj. insulin (lyumjev)","description":"Insulin (lyumjev), per 5 units","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0391U","name":"Onc sld tum dna&rna 437 gen","description":"Onc sld tum dna&rna 437 gen","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S4024","name":"Air polymer foam per study","description":"Air polymer-type a intrauterine foam, per study dose","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4252","name":"Vendaje, per square centimet","description":"Vendaje, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4225","name":"Amnio or derma tl, per sq cm","description":"Amniobind or dermabind tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22838","name":"Rev rplc/rmv thrc vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracic vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28360","name":"Reconstruct cleft foot","description":"Reconstruction, cleft foot","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31531","name":"Laryngoscopy w/fb & op scope","description":"Laryngoscopy, direct, operative, with foreign body removal; with operating microscope or telescope","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42836","name":"Removal of adenoids","description":"Adenoidectomy, secondary; age 12 or over","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1217","name":"Sys rsn no doc spiro","description":"Documentation of system reason(s) for not documenting and reviewing spirometry results (e.g., spirometry equipment not available at the time of the encounter)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49613","name":"Rpr aa hrn rcr < 3 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, reducible","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0305U","name":"Hem rbc fnclty&dfrm shr strs","description":"Hem rbc fnclty&dfrm shr strs","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82626","name":"Dehydroepiandrosterone","description":"Dehydroepiandrosterone (dhea)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0682T","name":"Removal pulse gen only isdss","description":"Removal of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33420","name":"Revision of mitral valve","description":"Valvotomy, mitral valve; closed heart","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1492.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6037","name":"Postop dsg cast chg handfing","description":"Immediate post-surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, partial hand including fingers","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1502","name":"Podiatry mvp","description":"Podiatry mips value pathway","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"X-ray exam chest 2 views","description":"Radiologic examination, chest; 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]},{"negotiated_type":"negotiated","negotiated_rate":11.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4323","name":"Splint extra-coronal","description":"Splint extra-coronal","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76801","name":"Ob us < 14 wks single fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0420U","name":"Onc urthl mrna xprsn 6 snp","description":"Onc urthl mrna xprsn 6 snp","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1199","name":"Pt recg rrt","description":"Patients receiving rrt","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17280","name":"Dstr mal ls f/e/e/n/l/m .5/<","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 0.5 cm or less","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1412","name":"Inj roctavian ml 2x10^13vc g","description":"Injection, valoctocogene roxaparvovec-rvox, per ml, containing nominal 2 x 10^13 vector genomes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0908T","name":"Opn imp int nstm sys vgs nrv","description":"Open implantation of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0062","name":"Audiology ss","description":"Audiology mips specialty set","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0794T","name":"Pt spec alg rx-onc tx option","description":"Patient-specific, assistive, rules-based algorithm for ranking pharmaco-oncologic treatment options based on the patients tumor-specific cancer marker information obtained from prior molecular pathology, immunohistochemical, or other pathology results which have been previously interpreted and repor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0806T","name":"Tcat s&ivc prstc vl impl opn","description":"Transcatheter superior and inferior vena cava prosthetic valve implantation (ie, caval valve implantation [cavi]); open femoral vein approach","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0750T","name":"B1 str&fx rsk asmt dxrbmd1vw","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0572U","name":"Onc prst8 httl qfish whl bld","description":"Onc prst8 httl qfish whl bld","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6031","name":"Rep interface handfng molded","description":"Replacement socket/interface, partial hand including fingers, molded to patient model, for use with or without external power","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0588U","name":"Nfct ds bct/vir 32genes mrna","description":"Nfct ds bct/vir 32genes mrna","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58290","name":"Vag hyst complex","description":"Vaginal hysterectomy, for uterus greater than 250 g;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1353.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81349","name":"Cytog alys chrml abnr lw-ps","description":"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and loss-of-heterozygosity variants, low-pass sequencing analysis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52356","name":"Cysto/uretero w/lithotripsy","description":"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy including insertion of indwelling ureteral stent (eg, gibbons or double-j type)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37293","name":"Rvsc evsc tpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86713","name":"Legionella antibody","description":"Antibody; legionella","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0898","name":"Argatroban nonesrd (auromed)","description":"Injection, argatroban (auromedics), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64418","name":"Njx aa&/strd sprscap nrv","description":"Injection(s), anesthetic agent(s) and/or steroid; suprascapular nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37271","name":"Revsc evsc fpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, includi","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0279U","name":"Hem vw factor&clgn iii bndg","description":"Hematology (von willebrand disease [vwd]), von willebrand factor (vwf) and collagen iii binding by enzyme-linked immunosorbent assays (elisa), plasma, report of collagen iii binding","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1814","name":"Inj. insulin (lyumjev)","description":"Insulin (lyumjev), per 5 units","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0791T","name":"Motr cog vr gait train ea 15","description":"Motor-cognitive, semi-immersive virtual reality-facilitated gait training, each 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4323","name":"Alloply, per sq cm","description":"Alloply, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33500","name":"Repair heart vessel fistula","description":"Repair of coronary arteriovenous or arteriocardiac chamber fistula; with cardiopulmonary bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1822.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3375","name":"Inj, vanco (tyzavan) 10mg","description":"Injection, vancomycin hydrochloride (tyzavan), not therapeutically equivalent to j3373, 10 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0236","name":"Intrav inf, mon anti, sec do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0442","name":"Annual alcohol screen 15 min","description":"Annual alcohol misuse screening, 5 to 15 minutes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":8.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1271","name":"Pts dem any time/dur mo","description":"Patients with dementia at any time prior to or during the month","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31527","name":"Laryngoscopy for treatment","description":"Laryngoscopy direct, with or without tracheoscopy; with insertion of obturator","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2394","name":"Post >=4srfc resinbase cmpst","description":"Resin-based composite - four or more surfaces posterior","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62331","name":"Dcmprn prq rmv lig flv addl","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; additional interspace(s), lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1021T","name":"Active thrc irrigation spx","description":"Active thoracic irrigation (separate procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0567","name":"Screening hep c detect","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis c, screening, amplified probe technique","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82274","name":"Assay test for blood fecal","description":"Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0012","name":"Injection of hiv prep drug","description":"Injection of pre-exposure prophylaxis (prep) drug for hiv prevention, under skin or into muscle","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35473","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":393.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0235","name":"Intrav inf, mon anti, fir do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0553","name":"Monthly tx for dmht 20mins","description":"First 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing information related to the use of","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98003","name":"Synch audio-video new hi 60","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high medical decision making. when using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0815T","name":"Us rems b1 dns hips plvs/spi","description":"Ultrasound-based radiofrequency echographic multi-spectrometry (rems), bone-density study and fracture-risk assessment, 1 or more sites, hips, pelvis, or spine","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1166","name":"Path rpt tis spec wle/reexc","description":"Pathology report for tissue specimens produced from wide local excisions or re-excisions","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6525","name":"G com garm lwrleg/ft ngt cus","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, custom, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2034","name":"Found drs solo, per sq cm","description":"Foundation drs solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0347","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55710","name":"Bx prst8 tprn us w/mri fus 1","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant) with mri-fusion-guidance biopsy, first targeted lesion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1596","name":"Inj, glycopyrrolate, 0.1 mg","description":"Injection, glycopyrrolate, 0.1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0843T","name":"Dgtz gls mcrscp cslt cyt 1st","description":"Digitization of glass microscope slides for pathology consultation during surgery; cytologic examination (eg, touch preparation, squash preparation), initial site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0577U","name":"Onc ovr serum alys 39 gps","description":"Onc ovr serum alys 39 gps","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49080","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9026","name":"Cryo fib comp path redu each","description":"Cryoprecipitated fibrinogen complex, pathogen reduced, each unit","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0737T","name":"Xenograft impltj artclr surf","description":"Xenograft implantation into the articular surface","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0523","name":"Mgt nw pt dem mod-high cmplx","description":"Management of a new patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5227","name":"Immed max part denture","description":"Immed max part denture","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55300","name":"Prepare sperm duct x-ray","description":"Vasotomy for vasograms, seminal vesiculograms, or epididymograms, unilateral or bilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":220.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9224","name":"Gen anes adv air-15 min","description":"Gen anes adv air-15 min","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22595","name":"Arthrd pst tq atlas-axis","description":"Arthrodesis, posterior technique, atlas-axis (c1-c2)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1682.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0487U","name":"Onc sol tum cfcdna tgsap 84","description":"Onc sol tum cfcdna tgsap 84","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87086","name":"Urine culture/colony count","description":"Culture, bacterial; quantitative colony count, urine","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1380","name":"2 rx in perf pd any com meds","description":"Filled at least two prescriptions during the performance period for any combination of the qualifying oral antipsychotic medications listed under denominator note or the long-acting injectable antipsychotic medications listed under denominator note","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0288U","name":"Onc lung mrna quan pcr 11&3","description":"Onc lung mrna quan pcr 11&3","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0770T","name":"Vr technology assist therapy","description":"Virtual reality technology to assist therapy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0998T","name":"Precuneus mag stimj tx dlvr","description":"Precuneus magnetic stimulation; personalized treatment delivery of magnetic stimulation therapy to a prespecified target area derived from analysis of evoked potentials within the precuneus, utilizing magnetic resonance imaging-based neuronavigation, with management, per day","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4225","name":"Amnio or derma tl, per sq cm","description":"Amniobind or dermabind tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0707T","name":"Njx b1 sub mtrl sbchdrl dfct","description":"Injection(s), bone-substitute material (eg, calcium phosphate) into subchondral bone defect (ie, bone marrow lesion, bone bruise, stress injury, microtrabecular fracture), including imaging guidance and arthroscopic assistance for joint visualization","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0388","name":"Bitewing image capture only","description":"Bitewing image capture only","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1708","name":"Pfizer vacc admin 3rd dose","description":"Pfizer vacc admin 3rd dose","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38227","name":"Car-t receipt&prepj admn","description":"Chimeric antigen receptor t-cell (car-t) therapy; receipt and preparation of car-t cells for administration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2506","name":"Inj pegfilgrast ex bio 0.5mg","description":"Injection, pegfilgrastim, excludes biosimilar, 0.5 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9064","name":"Inj, cabazitaxel (sandoz)","description":"Injection, cabazitaxel (sandoz), not therapeutically equivalent to j9043, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4413","name":"Cygnus solo per sq cm","description":"Cygnus solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6595","name":"G comp bandge liner upr extr","description":"Gradient compression bandaging supply, bandage liner, upper extremity, any size or length, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49623","name":"Rmvl ninfct mesh hernia rpr","description":"Removal of total or near total non-infected mesh or other prosthesis at the time of initial or recurrent anterior abdominal hernia repair or parastomal hernia repair, any approach (ie, open, laparoscopic, robotic) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61570","name":"Remove foreign body brain","description":"Craniectomy or craniotomy; with excision of foreign body from brain","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2013.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1455","name":"Rep/rev cied","description":"Replaced or revised cied","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0960T","name":"Rpl s-sclp eltr ra rcvr&tlmt","description":"Replacement of sub-scalp implanted electrode array, receiver, and telemetry unit with tunneling of electrode for continuous bilateral electroencephalography monitoring system, including imaging guidance","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92631","name":"Hearing aid slctn svc 1st 30","description":"Hearing aid selection services, unilateral or bilateral, including review of audiologic function tests and hearing aid candidacy evaluation, assessment of visual and dexterity limitations, and psychosocial factors, establishment of device type, output requirements, signal processing strategies and a","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0617U","name":"Cv ascvd dna alys >20000","description":"Cv ascvd dna alys >20000","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2976","name":"Band stabilization per tooth","description":"Band stabilization per tooth","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4273","name":"Esano aaa, per sq cm","description":"Esano aaa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33946","name":"Ecmo/ecls initiation venous","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; initiation, veno-venous","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1273","name":"Pts snf 1 yr dialysis","description":"Patients who were admitted to a skilled nursing facility (snf) within one year of dialysis initiation according to the cms-2728 form","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0036","name":"Pt/ptn decln assess","description":"Patient or care partner decline assessment","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1336","name":"Pts eval ini xm 2 wks","description":"Patients who were appropriately evaluated during the initial exam and were re-evaluated no later than 2 weeks","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1323","name":"Inj, elranatamab-bcmm, 1 mg","description":"Injection, elranatamab-bcmm, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74019","name":"Radex abdomen 2 views","description":"Radiologic examination, abdomen; 2 views","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0146","name":"Nav srv peer sup add 30 pr m","description":"Principal illness navigation - peer support, additional 30 minutes per calendar month (list separately in addition to g0140)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0578U","name":"Onc cutan mln rna qpcr 10gen","description":"Onc cutan mln rna qpcr 10gen","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0691T","name":"Auto alys xst ct std vrt fx","description":"Automated analysis of an existing computed tomography study for vertebral fracture(s), including assessment of bone density when performed, data preparation, interpretation, and report","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4310","name":"Procenta, per 100 mg","description":"Procenta, per 100 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96548","name":"Ntraop hipec px ea add 30min","description":"Intraoperative hyperthermic intraperitoneal chemotherapy (hipec) procedure, including separate incision(s) and closure, when performed; each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86825","name":"Hla x-math non-cytotoxic","description":"Human leukocyte antigen (hla) crossmatch, non-cytotoxic (eg, using flow cytometry); first serum sample or dilution","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0394U","name":"Pfas 16 pfas compnd lc ms/ms","description":"Pfas 16 pfas compnd lc ms/ms","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0329U","name":"Onc neo xome&trns seq alys","description":"Onc neo xome&trns seq alys","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31242","name":"Nsl/sinus ndsc rf abltj pnn","description":"Nasal/sinus endoscopy, surgical; with destruction by radiofrequency ablation, posterior nasal nerve","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87523","name":"Hepatitis d quantification","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis d (delta), quantification, including reverse transcription, when performed","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4368","name":"Amchothick per sq cm","description":"Amchothick, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1310","name":"Pt scr tob & cess int","description":"Patient screened for tobacco use and received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1277","name":"Colorectal ca screen doc rev","description":"Colorectal cancer screening results documented and reviewed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1260","name":"Pt not doc <= 1 yr dialysis","description":"Patient status not documented within the first year of initiating dialysis","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4231","name":"Ana crown exp 1-3 per quad","description":"Anatomical crown exposure - one to three teeth per quadrant","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1380","name":"2 rx in perf pd any com meds","description":"Filled at least two prescriptions during the performance period for any combination of the qualifying oral antipsychotic medications listed under denominator note or the long-acting injectable antipsychotic medications listed under denominator note","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6584","name":"Grad com wrap w straps","description":"Gradient compression wrap with adjustable straps, not otherwise specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2004","name":"Inj, lidocaine w epinephrine","description":"Injection, lidocaine hcl with epinephrine, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99345","name":"Home/res vst new high mdm 75","description":"Home or residence visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 75 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6049","name":"Scale implt peri-implt inflm","description":"Scale implt peri-implt inflm","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6072","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (high noble metal)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2033","name":"Myriad morcells, 4 mg","description":"Myriad morcells, 4 milligrams","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0820T","name":"Mntr psychdlc med 1stphy/qhp","description":"Continuous in-person monitoring and intervention (eg, psychotherapy, crisis intervention), as needed, during psychedelic medication therapy; first physician or other qualified health care professional, each hour","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J2271","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98980","name":"Rtm tx mgmt 1st 20 min","description":"Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least 1 real-time interactive communication with the patient or caregiver during the calendar month; first 20 minutes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70200","name":"X-ray exam of eye sockets","description":"Radiologic examination; orbits, complete, minimum of 4 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2001","name":"Suct pum ext mgmt sys","description":"Suction pump, home model, portable or stationary, electric, any type, for use with external urine and/or fecal management system","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0403","name":"Ekg for initial prevent exam","description":"Electrocardiogram, routine ecg with 12 leads; performed as a screening for the initial preventive physical examination with interpretation and report","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q4076","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1260","name":"Pt not doc <= 1 yr dialysis","description":"Patient status not documented within the first year of initiating dialysis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1708","name":"Pfizer vacc admin 3rd dose","description":"Pfizer vacc admin 3rd dose","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9064","name":"Inj, cabazitaxel (sandoz)","description":"Injection, cabazitaxel (sandoz), not therapeutically equivalent to j9043, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99479","name":"Sbsq ic lbw inf 1,500-2,500","description":"Subsequent intensive care, per day, for the evaluation and management of the recovering low birth weight infant (present body weight of 1,500-2,500 grams)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4411","name":"Amniomatrixf4x per sq cm","description":"Amniomatrixf4x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73525","name":"Contrast x-ray of hip","description":"Radiologic examination, hip, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15733","name":"Musc myoq/fscq flp h&n pedcl","description":"Muscle, myocutaneous, or fasciocutaneous flap; head and neck with named vascular pedicle (ie, buccinators, genioglossus, temporalis, masseter, sternocleidomastoid, levator scapulae)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":867.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0492U","name":"Onc sol tum ctc slctn pd-l1","description":"Onc sol tum ctc slctn pd-l1","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0853T","name":"Dgtz gls mcrscp mphmtrc ea m","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each multiplex probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78580","name":"Lung perfusion imaging","description":"Pulmonary perfusion imaging (eg, particulate)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":220.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98010","name":"Synch audio-only new mod 45","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection,","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51575","name":"Removal of bladder & nodes","description":"Cystectomy, complete; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1944.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63052","name":"Lam facetc/frmt arthrd lum 1","description":"Laminectomy, facetectomy, or foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s] [eg, spinal or lateral recess stenosis]), during posterior interbody arthrodesis, lumbar; single vertebral segment (list separately in addition to code for primary ","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0368U","name":"Onc clrct ca mut&mthyltn mrk","description":"Onc clrct ca mut&mthyltn mrk","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0751","name":"Hiv prep, ftc/taf 200/25mg","description":"Emtricitabine 200mg and tenofovir alafenamide 25mg, oral, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9174","name":"Inj, docetaxel (beizray) 1mg","description":"Injection, docetaxel (beizray), 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1301","name":"Pt recv tbco cess interv","description":"Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0540","name":"Train for caregiver add 15","description":"Caregiver training in behavior management/modification for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face; each additional 15 minutes","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4253","name":"Zenith amniotic membrane psc","description":"Zenith amniotic membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0738","name":"Upper extremity rehab","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6028","name":"Part hand finger metacar amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s) /thumb, amputation at metacarpal level, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0276U","name":"Hem inh thrombocytopenia 23","description":"Hematology (inherited thrombocytopenia), genomic sequence analysis of 23 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7521","name":"Tacrolim granules oral susp","description":"Tacrolimus, granules, oral suspension, 0.1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0767T","name":"Tc mag stimj pn ea addl nrv","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; each additional nerve (list separat","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9196","name":"Inj gemcitabine hcl (accord)","description":"Injection, gemcitabine hydrochloride (accord), not therapeutically equivalent to j9201, 200 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95783","name":"Polysom <6 yrs cpap/bilvl","description":"Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bi-level ventilation, attended by a technologist","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97033","name":"App mdlty 1+iontphrsis ea 15","description":"Application of a modality to 1 or more areas; iontophoresis, each 15 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0702","name":"2d cephal radio image","description":"2d cephal radio image","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90613","name":"Inf&sarscov2 vacc 40/0.4 im","description":"Influenza virus vaccine, quadrivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 40 mcg/0.4 ml dosage, for intramuscular use","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0614U","name":"Iem pmd alys 4 nzm cplx page","description":"Iem pmd alys 4 nzm cplx page","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0259U","name":"Neph ckd nuc mrs meas gfr","description":"Nephrology (chronic kidney disease), nuclear magnetic resonance spectroscopy measurement of myo-inositol, valine, and creatinine, algorithmically combined with cystatin c (by immunoassay) and demographic data to determine estimated glomerular filtration rate (gfr), serum, quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0680T","name":"Insj/rplcmt pg only isdss","description":"Insertion or replacement of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing lead(s)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30801","name":"Ablate inf turbinate superf","description":"Ablation, soft tissue of inferior turbinates, unilateral or bilateral, any method (eg, electrocautery, radiofrequency ablation, or tissue volume reduction); superficial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1472","name":"Hep b vaccine not received","description":"Patient did not receive recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6251","name":"Bridge resin base metal","description":"Pontic-resin with predominantly base metal","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20250","name":"Biopsy vrt bdy open thoracic","description":"Biopsy, vertebral body, open; thoracic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2802","name":"Inj, romiplostim 1 microgram","description":"Injection, romiplostim, 1 microgram","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7353","name":"Anacaulase-bcdb 8.8% gel 1 g","description":"Anacaulase-bcdb, 8.8% gel, 1 gram","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4437","name":"Revival ac per sq cm","description":"Revival ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0533","name":"Buprenorphone inj weekly","description":"Medication assisted treatment, buprenorphine (injectable) administered on a weekly basis; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing if performed (provision of the services by a medicare-enrolled opioid tre","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4030","name":"Pulmonology ss","description":"Pulmonology mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5124","name":"Inj. byooviz, 0.1 mg","description":"Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49188","name":"Opn exc/dst ntra-abd 10.1-20","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 10.1 to 20 cm","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4468","name":"Exsuff belt incl all sup acc","description":"Exsufflation belt, includes all supplies and accessories","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S4024","name":"Air polymer foam per study","description":"Air polymer-type a intrauterine foam, per study dose","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31570","name":"Laryngoscope w/vc inj","description":"Laryngoscopy, direct, with injection into vocal cord(s), therapeutic;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77437","name":"Surf radj ther supfc<=150kv","description":"Surface radiation therapy; superficial, delivery, </=150 kv, per fraction (eg, electronic brachytherapy)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0703","name":"2d oral/facial photo image","description":"2d oral/facial photo image","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49592","name":"Rpr aa hrn 1st < 3 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, incarcerated or strangulated","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81354","name":"Cytog alys chrml abnor ogm","description":"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of structural and copy number variants, optical genome mapping (ogm)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0588U","name":"Nfct ds bct/vir 32genes mrna","description":"Nfct ds bct/vir 32genes mrna","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1098","name":"Articaine ophthalmi 8% 0.4ml","description":"Articaine ophthalmic, 8% solution, 0.4 ml","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62192","name":"Establish brain cavity shunt","description":"Creation of shunt; subarachnoid/subdural-peritoneal, -pleural, other terminus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1055.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1309","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1354","name":"Pt no suicd saf pln 120dy","description":"Patients who did not have a suicide safety plan initiated, reviewed, or updated or reviewed and updated in collaboration with the patient and their clinician concurrent or within 24 hours of clinical encounter and within 120 days after initiation","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0312U","name":"Ai ds sle alys 8 igg autoant","description":"Ai ds sle alys 8 igg autoant","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"C9224","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1812.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81441","name":"Ibmfs seq alys pnl 30 genes","description":"Inherited bone marrow failure syndromes (ibmfs) (eg, fanconi anemia, dyskeratosis congenita, diamond-blackfan anemia, shwachman-diamond syndrome, gata2 deficiency syndrome, congenital amegakaryocytic thrombocytopenia) sequence analysis panel, must include sequencing of at least 30 genes, including b","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0536","name":"Peer recover support svs","description":"Peer recovery support services, provided directly or by referral; including leveraging knowledge of the condition or lived experience to provide support, mentorship, or inspiration to meet oud treatment and recovery goals; conducting a person-centered interview to understand the patients life story,","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60000","name":"I&d thyroglssl dux cst infct","description":"Incision and drainage of thyroglossal duct cyst, infected","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93588","name":"Vngrph chd vnvn cltrl below","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; venovenous collaterals originating below the heart (eg, from the inferior vena cava) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1305","name":"Pneum vax admin 19+","description":"Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4414","name":"Simplichor per sq cm","description":"Simplichor, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1435","name":"Oral chemo in perf pd","description":"Patient on oral chemotherapy during the performance period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73223","name":"Mri joint upr extr w/o&w/dye","description":"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1377.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98011","name":"Synch audio-only new high 60","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selection, 60 ","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92641","name":"Hearing dev verif eacous aly","description":"Hearing device verification, electroacoustic analysis","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5612","name":"Rep resin part dent base max","description":"Rep resin part dent base max","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6192","name":"Semi precision attachment","description":"Semi precision attachment","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1493","name":"No fall doc med rsn","description":"Documentation of falls not performed due to medical reasons  (e.g., syncope, vertigo and related disorders, restless leg syndrome, tourette syndrome/tic disorder, back pain, concussion/mild traumatic brain injury (mtbi), cervical dystonia, or epilepsy)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0662","name":"Team remote e/m new pt 30 mn","description":"Team remote e/m new pt 30 mins","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87527","name":"Hepatitis g dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis g, quantification","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31536","name":"Laryngoscopy w/bx & op scope","description":"Laryngoscopy, direct, operative, with biopsy; with operating microscope or telescope","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G3002","name":"Chronic pain mgmt 30 mins","description":"Chronic pain management and treatment, monthly bundle including, diagnosis; assessment and monitoring; administration of a validated pain rating scale or tool; the development, implementation, revision, and/or maintenance of a person-centered care plan that includes strengths, goals, clinical needs,","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1327","name":"Eptifibatide injection","description":"Injection, eptifibatide, 5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0592U","name":"Onc hl neo dna tgs 417 genes","description":"Onc hl neo dna tgs 417 genes","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5151","name":"Inj, eculizumab-aagh, 2 mg","description":"Injection, eculizumab-aagh (epysqli), biosimilar, 2 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0799","name":"Hiv prep, fda approved, noc","description":"Fda approved prescription drug, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv), not otherwise classified","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1426","name":"Injection, casimersen, 10 mg","description":"Injection, casimersen, 10 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9800","name":"Gallium locametz 1 millicuri","description":"Gallium ga-68 gozetotide, diagnostic, (locametz), 1 millicurie","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37288","name":"Revsc evsc tpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15013","name":"Prepj skn cll ssp agrft 1st","description":"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; first 25 sq cm or less of harvested skin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70250","name":"X-ray exam of skull","description":"Radiologic examination, skull; less than 4 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76805","name":"Ob us >/= 14 wks sngl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0706T","name":"Rem tx amblyopia i&r phy/qhp","description":"Remote treatment of amblyopia using an eye tracking device; interpretation and report by physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4015","name":"Neurology ss","description":"Neurology mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1161","name":"Pt anphx due to dtp bef 13","description":"Patient had anaphylaxis due to the tetanus, diphtheria or pertussis vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0681T","name":"Rlcj pulse gen only isdss","description":"Relocation of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing dual leads","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1434","name":"Orl chemo wthn 30 d post enc","description":"Patient on oral chemotherapy on or within 30 days after denominator eligible encounter","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90638","name":"Vacc qirv mrna 60mcg/.5ml im","description":"Influenza virus vaccine, quadrivalent (qirv), mrna; 60 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0523U","name":"Onc soltum dna ngs snv 22gen","description":"Onc soltum dna ngs snv 22gen","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6198","name":"Remove interim implant","description":"Remove interim implant","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0336U","name":"Rare ds whl gen seq bld/slv","description":"Rare ds whl gen seq bld/slv","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37284","name":"Revsc evasc tpvt st sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0543U","name":"Onc sol tum ngs dna 517 gens","description":"Onc sol tum ngs dna 517 gens","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62225","name":"Replace/irrigate catheter","description":"Replacement or irrigation, ventricular catheter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":503.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5411","name":"Dentures adjust cmplt mand","description":"Adjust complete denture - mandibular","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9609","name":"F18 fdg, 15 millicuries","description":"Fludeoxyglucose f18 up to 15 millicuries","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0138","name":"Iv cipaglucosidase alfa-atga","description":"Intravenous infusion of cipaglucosidase alfa-atga, including provider/supplier acquisition and clinical supervision of oral administration of miglustat in preparation of receipt of cipaglucosidase alfa-atga","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0927T","name":"Interrog dev eval ccm-d ip","description":"Interrogation device evaluation (in person) with analysis, review, and report, including connection, recording, and disconnection, per patient encounter, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25316","name":"Revise palsy hand tendon(s)","description":"Flexor origin slide (eg, for cerebral palsy, volkmann contracture), forearm and/or wrist; with tendon(s) transfer","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1389.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0543","name":"Group train w/o patient","description":"Group caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient pre","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0833T","name":"Dgtz gls mcrscp cytp oth prp","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; preparation, screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88366","name":"Insitu hybridization (fish)","description":"In situ hybridization (eg, fish), per specimen; each multiplex probe stain procedure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1297","name":"Bmi not doc medrsn ptref","description":"Bmi not documented due to medical reason or patient refusal of height or weight measurement","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70332","name":"X-ray exam of jaw joint","description":"Temporomandibular joint arthrography, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2036","name":"Cohealyx col dml mx pr sq cm","description":"Cohealyx collagen dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44203","name":"Lap resect s/intestine addl","description":"Laparoscopy, surgical; each additional small intestine resection and anastomosis (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1179","name":"No pcv recd","description":"Patient did not receive any pneumococcal conjugate or polysaccharide vaccine, on or after their 19th birthday and before or during measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17270","name":"Dstr mal les s/n/h/f/g .5 /<","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia; lesion diameter 0.5 cm or less","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1836","name":"Inj, metronidazole, 10 mg","description":"Injection, metronidazole, 10 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28150","name":"Removal of toe","description":"Phalangectomy, toe, each toe","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":357.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46601","name":"Diagnostic anoscopy","description":"Anoscopy; diagnostic, with high-resolution magnification (hra) (eg, colposcope, operating microscope) and chemical agent enhancement, including collection of specimen(s) by brushing or washing, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":96.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98006","name":"Synch audio-video est mod 30","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82465","name":"Assay bld/serum cholesterol","description":"Cholesterol, serum or whole blood, total","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4324","name":"Amniotx, per sq cm","description":"Amniotx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5877","name":"Dup of complt dent-maxill","description":"Dup of complt dent-maxill","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1933","name":"Afo rig ant tib tcf/= ots","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, off-the-shelf","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6106","name":"Tissue regen resorbable","description":"Tissue regen resorbable","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0665","name":"Inj, bupivacaine, nos, 0.5mg","description":"Injection, bupivicaine, not otherwise specified, 0.5 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1163","name":"Pt anphx due to hpv bef 13","description":"Patient had anaphylaxis due to the hpv vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98016","name":"Brief comunicaj tech-bsd svc","description":"Brief communication technology-based service (eg, virtual check-in) by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related evaluation and management service provided within the p","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61345","name":"Oth cranial dcmprn pst fossa","description":"Other cranial decompression, posterior fossa","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2281.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0140","name":"Nav srv peer sup 60 min pr m","description":"Principal illness navigation - peer support by certified or trained auxiliary personnel under the direction of a physician or other practitioner, including a certified peer specialist; 60 minutes per calendar month, in the following activities:  person-centered interview, performed to better underst","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0716T","name":"Car acous wavfrm rec cad rsk","description":"Cardiac acoustic waveform recording with automated analysis and generation of coronary artery disease risk score","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1364","name":"Ascvd risk >=20pct","description":"Calculated 10-year ascvd risk score of >= 20 percent during the performance period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0237","name":"Intrav inf, toci, first dose","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0899T","name":"N-invas deter aqmbf aug cmr","description":"Noninvasive determination of absolute quantitation of myocardial blood flow (aqmbf), derived from augmentative algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (cmr), pharmacologic stress, with interpretation and report by a physician or other qualified health car","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2928","name":"Prefab porc/cer crown perm","description":"Prefab porc/cer crown perm","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0465","name":"Autolog prp diab wound ulcer","description":"Autologous platelet rich plasma (prp) or other blood-derived product for diabetic chronic wounds/ulcers, using an fda-cleared device for this indication, (includes as applicable administration, dressings, phlebotomy, centrifugation or mixing, and all other preparatory procedures, per treatment)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9996","name":"Ustekinumab- ttwe sub cu inj","description":"Injection, ustekinumab-ttwe (pyzchiva), subcutaneous, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5933","name":"Refitting of obturator","description":"Obturator prosthesis modification","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1435","name":"Oral chemo in perf pd","description":"Patient on oral chemotherapy during the performance period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99253","name":"Ip/obs cnsltj new/est low 45","description":"Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 45 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4261","name":"Tag, per square centimeter","description":"Tag, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64895","name":"Nrv grf mltst hnd/foot <4 cm","description":"Nerve graft (includes obtaining graft), multiple strands (cable), hand or foot; up to 4 cm length","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1407.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67915","name":"Repair eyelid defect","description":"Repair of ectropion; thermocauterization","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0520","name":"New pt-cg dyad dem mod cmplx","description":"Management of new patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0932T","name":"N-invs det hrt fail aug echo","description":"Noninvasive detection of heart failure derived from augmentative analysis of an echocardiogram that demonstrated preserved ejection fraction, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0717T","name":"Adrc ther prtl rc tear","description":"Autologous adipose-derived regenerative cell (adrc) therapy for partial thickness rotator cuff tear; adipose tissue harvesting, isolation and preparation of harvested cells, including incubation with cell dissociation enzymes, filtration, washing, and concentration of adrcs","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86051","name":"Aquaporin-4 antb elisa","description":"Aquaporin-4 (neuromyelitis optica [nmo]) antibody; enzyme-linked immunosorbent immunoassay (elisa)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4292","name":"Lamellas, per sq cm","description":"Lamellas, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59610","name":"Vbac delivery","description":"Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care, after previous cesarean delivery","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2757.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1169","name":"Doc med rsn no flu vax","description":"Documentation of medical reason(s) for not administering influenza vaccine (e.g., prior anaphylaxis due to the influenza vaccine)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9021","name":"Inj, aspara, rylaze, 0.1 mg","description":"Injection, asparaginase, recombinant, (rylaze), 0.1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0597U","name":"Onc breast rna xprsn 329gens","description":"Onc breast rna xprsn 329gens","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98002","name":"Synch audio-video new mod 45","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate medical decision making. when using total time on the date of the encounter for code selection, 45 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1239","name":"Pt no resp heard","description":"Patient did not respond to the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69930","name":"Implant cochlear device","description":"Cochlear device implantation, with or without mastoidectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1473.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9028","name":"Inj, nogapendekin pmln, 1mcg","description":"Injection, nogapendekin alfa inbakicept-pmln, for intravesical use, 1 microgram","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0528","name":"Mgt est pt dem mod-hi cmplx","description":"Management of established patient with dementia, moderate to high complexity, for use in cmmi model","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3503","name":"Surg exp root surf molar","description":"Surg exp root surf molar","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4268","name":"Surgraft ft per sq cm","description":"Surgraft ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0590U","name":"Nfct ds bct&fngl dna 44 orgs","description":"Nfct ds bct&fngl dna 44 orgs","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0932T","name":"N-invs det hrt fail aug echo","description":"Noninvasive detection of heart failure derived from augmentative analysis of an echocardiogram that demonstrated preserved ejection fraction, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1321","name":"Pts no 7wk inj,no iop,iop>25","description":"Patients who were not seen within 7 weeks following the date of injection for follow up or who did not have a documented iop or no plan of care documented if the iop was >25 mm hg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0238","name":"Intrav inf, toci, second dos","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0575U","name":"Trnsplj med lar rtpcr 4genes","description":"Trnsplj med lar rtpcr 4genes","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0525","name":"Est pt-cg dyad dem mod cmplx","description":"Management of established patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0368","name":"Cone beam ct interprete tmj","description":"Cone beam ct interprete tmj","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4279","name":"Vendaje ac, per sq cm","description":"Vendaje ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"Endoskel posit rotat unit","description":"Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33895","name":"Evasc st rpr thrc/aa x crsg","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; not crossing major side branches","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0748T","name":"Njx stm cl prdct anl sft tis","description":"Injections of stem cell product into perianal perifistular soft tissue, including fistula preparation (eg, removal of setons, fistula curettage, closure of internal openings)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6595","name":"G comp bandge liner upr extr","description":"Gradient compression bandaging supply, bandage liner, upper extremity, any size or length, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92928","name":"Prq tcat plmt ntrac st 1 les","description":"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 1 lesion involving 1 or more coronary segments","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4358","name":"Xwrap dual, per sq cm","description":"Xwrap dual, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1325","name":"Doc med rsn not seen","description":"Patients who were not seen for reasons documented by clinician for patient or medical reasons (e.g., inadequate time for follow-up, patients who received a prior intravitreal or periocular steroid injection within the last six (6) months and had a subsequent iop evaluation with iop <25mm hg within s","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01938","name":"Anes drg/aspir lmbr/sac","description":"Anesthesia for percutaneous image-guided injection, drainage or aspiration procedures on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4410","name":"Amchomatrixdl per sq cm","description":"Amchomatrixdl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74360","name":"X-ray guide gi dilation","description":"Intraluminal dilation of strictures and/or obstructions (eg, esophagus), radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2956","name":"Indirect rest remov","description":"Indirect rest remov","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0612","name":"Inj, calcium gluconate, nos","description":"Injection, calcium gluconate, not otherwise specified, 10 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7120","name":"Ringers lactate infusion","description":"Ringers lactate infusion, up to 1000 cc","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35701","name":"Expl n/flwd surg neck art","description":"Exploration not followed by surgical repair, artery; neck (eg, carotid, subclavian)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":663.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2253","name":"Inj midazolam (seizalam)","description":"Injection, midazolam (seizalam), 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0359U","name":"Onc prst8 ca alys all psa","description":"Onc prst8 ca alys all psa","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0877T","name":"Augmnt alys ch ct ild w/o ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9156","name":"Oral mucoadhesive per 1 ml","description":"Oral mucoadhesive, any type (liquid, gel, paste, etc.), per 1 ml","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0740T","name":"Rem auton alg nsln cal setup","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; initial set-up and patient education","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58575","name":"Laps tot hyst resj mal","description":"Laparoscopy, surgical, total hysterectomy for resection of malignancy (tumor debulking), with omentectomy including salpingo-oophorectomy, unilateral or bilateral, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2131.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89190","name":"Nasal smear for eosinophils","description":"Nasal smear for eosinophils","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44212","name":"Laparo total proctocolectomy","description":"Laparoscopy, surgical; colectomy, total, abdominal, with proctectomy, with ileostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2207.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0499U","name":"Onc clrct&lng dna ngs 8gene","description":"Onc clrct&lng dna ngs 8gene","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2044","name":"Biobrane glove, each","description":"Biobrane glove, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9048","name":"Plasmaprotein fract,5%,250ml","description":"Infusion, plasma protein fraction (human), 5%, 250 ml","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0329","name":"Electromagntic tx for ulcers","description":"Electromagnetic therapy, to one or more areas for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care as part of a therapy plan of care","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6524","name":"G com garmnt lwr leg/ft nght","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1809","name":"Inj, fosdenopterin, 0.1mg","description":"Injection, fosdenopterin, 0.1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37278","name":"Rvsc evsc fpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86381","name":"Mitochondrial antibody each","description":"Mitochondrial antibody (eg, m2), each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0881T","name":"Cryotherapy oral cavity","description":"Cryotherapy of the oral cavity using temperature regulated fluid cooling system, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31582","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2222.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42325","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0906T","name":"Coms ther 1st appl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; first application, total wound(s) surface area less than or equal to 50 sq cm","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0469U","name":"Rare ds whl gen seq ftl samp","description":"Rare ds whl gen seq ftl samp","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0796T","name":"Tcat ins 2chmbr ldls pm ra","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right atrial pacemaker","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6526","name":"G com garmt full leg/ft nght","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":693.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90461","name":"Im admin each addl component","description":"Immunization administration through 18 years of age via any route of administration, with counseling by physician or other qualified health care professional; each additional vaccine or toxoid component administered (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26706","name":"Pin knuckle dislocation","description":"Percutaneous skeletal fixation of metacarpophalangeal dislocation, single, with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86381","name":"Mitochondrial antibody each","description":"Mitochondrial antibody (eg, m2), each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0870T","name":"Imp subq prtl ascts pmp sys","description":"Implantation of subcutaneous peritoneal ascites pump system, percutaneous, including pump-pocket creation, insertion of tunneled indwelling bladder and peritoneal catheters with pump connections, including all imaging and initial programming, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58300","name":"Insert intrauterine device","description":"Insertion of intrauterine device (iud)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":46.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0790T","name":"Revj rplcmt/rmvl vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracolumbar or lumbar vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0458U","name":"Onc brst ca s100 a8&a9 elisa","description":"Onc brst ca s100 a8&a9 elisa","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45389","name":"Colonoscopy w/stent plcmt","description":"Colonoscopy, flexible; with endoscopic stent placement (includes pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66600","name":"Remove iris and lesion","description":"Iridectomy, with corneoscleral or corneal section; for removal of lesion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":772.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2542","name":"Dental onlay metallic 2 surf","description":"Onlay-metallic-two surfaces","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3424","name":"Inj hydroxocobalamin iv 25mg","description":"Injection, hydroxocobalamin, intravenous, 25 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93924","name":"Lwr xtr vasc stdy bilat","description":"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional doppler waveform or volume plethysmography recording and analysis at rest with ankle/brachial indices immediately after and at timed intervals following performance of a st","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7509","name":"Methylprednisolone oral","description":"Methylprednisolone oral, per 4 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75743","name":"Artery x-rays lungs","description":"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":745.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4424","name":"Revive ft per sq cm","description":"Revive ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2642","name":"Dental onlay porcelin 2 surf","description":"Onlay - porcelain/ceramic - two surfaces","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87513","name":"H pylri clrthmcn rst amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); helicobacter pylori (h. pylori), clarithromycin resistance, amplified probe technique","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0563","name":"Sbrt w/positron emission del","description":"Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance and real-time positron emissions-based delivery adjustments to 1 or more lesions, entire course not to exceed 5 fractions","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0795T","name":"Tcat ins 2chmbr ldls pm cmpl","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; complete system (ie, r","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22328","name":"Treat each add spine fx","description":"Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; each additional fractured vertebra or dislocated segment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"Adju cgm supply allowance","description":"Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KF"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68520","name":"Removal of tear sac","description":"Excision of lacrimal sac (dacryocystectomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":685.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1413","name":"Inj delandistrogene mox rokl","description":"Injection, delandistrogene moxeparvovec-rokl, per therapeutic dose","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0693T","name":"Compre ful bdy 3d mtn alys","description":"Comprehensive full body computer-based markerless 3d kinematic and kinetic motion analysis and report","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9329","name":"Inj, tislelizumab-jsgr","description":"Injection, tislelizumab-jsgr, 1mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0541","name":"No pt prsnt train initial 30","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4407","name":"Xwrap tribus per sq cm","description":"Xwrap tribus, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1377","name":"Fu colscop 10 yr doc w/ disc","description":"Recommended follow-up interval for repeat colonoscopy of 10 years documented  in colonoscopy report and communicated with patient","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1419","name":"Pt not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4327","name":"Duoamnion, per sq cm","description":"Duoamnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"Adju cgm supply allowance","description":"Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9274","name":"Inj, tebentafusp-tebn, 1 mcg","description":"Injection, tebentafusp-tebn, 1 microgram","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1015T","name":"Rev/rmv lw esoph sphnc npg/r","description":"Revision or removal, lower esophageal sphincter neurostimulator pulse generator or receiver","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4010","name":"Infectious disease ss","description":"Infectious disease mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67938","name":"Remove eyelid foreign body","description":"Removal of embedded foreign body, eyelid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0318U","name":"Ped whl gen mthyltn alys 50+","description":"Ped whl gen mthyltn alys 50+","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0434U","name":"Rx metab advrs vrnt alys 25","description":"Rx metab advrs vrnt alys 25","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64479","name":"Njx aa&/strd tfrm epi c/t 1","description":"Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or ct), cervical or thoracic, single level","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1188","name":"Pt w/ ckd stg 5","description":"Patients with a diagnosis of chronic kidney disease (ckd) stage 5","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69726","name":"Rmv ntr oi implt skl prq esp","description":"Removal, entire osseointegrated implant, skull; with percutaneous attachment to external speech processor","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4269","name":"Surgraft xt per sq cm","description":"Surgraft xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58285","name":"Extensive hysterectomy","description":"Vaginal hysterectomy, radical (schauta type operation)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1551.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7356","name":"Inj foscarb/foslevodopa 5 mg","description":"Injection, foscarbidopa 0.25 mg/foslevodopa 5 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1736","name":"Inj meloxicam (delova) 1mg","description":"Injection, meloxicam (delova), 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4347","name":"Rampart dl matrix per sq cm","description":"Rampart dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37299","name":"Revsc evsc imvt angio cpx ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22846","name":"Insert spine fixation device","description":"Anterior instrumentation; 4 to 7 vertebral segments (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":995.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4421","name":"Biolab wrap solo per sq cm","description":"Biolab membrane wrap solo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0552","name":"Supply of digital device","description":"Supply of digital mental health treatment device and initial education and onboarding, per course of treatment that augments a behavioral therapy plan","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6527","name":"G garmt full leg/ft nght cus","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, custom, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0373","name":"Tomo bitewing image","description":"Tomo bitewing image","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52334","name":"Create passage to kidney","description":"Cystourethroscopy with insertion of ureteral guide wire through kidney to establish a percutaneous nephrostomy, retrograde","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92628","name":"Eval hearing aid cand 1st 30","description":"Evaluation for hearing aid candidacy, unilateral or bilateral, including review and integration of audiologic function tests, assessment, and interpretation of hearing needs (eg, speech-in-noise, suprathreshold hearing measures), discussion of candidacy results, counseling on treatment options with ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0550","name":"Phone/inter for dx/treat >5m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a written report to the patients treating/r","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0727T","name":"Rmvl&rplcmt implt vstblr dev","description":"Removal and replacement of implanted vestibular device, unilateral","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2010","name":"Apis, per square centimeter","description":"Apis, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86364","name":"Tiss trnsgltmnase ea ig clas","description":"Tissue transglutaminase, each immunoglobulin (ig) class","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0812T","name":"Rem mlt day uroflow dev sply","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); device supply with automated report generation, up to 10 days","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36465","name":"Njx noncmpnd sclrsnt 1 vein","description":"Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate, inclusive of all imaging guidance and monitoring; single incompetent extremity truncal vein (eg, great saphenous vein, accessory saphenous vein)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1222.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":100.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1479","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0533U","name":"Rx metab advrs gnotyp 16gens","description":"Rx metab advrs gnotyp 16gens","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1429","name":"Retinopathy in od, os, ou","description":"Retinal exam finding with evidence of retinopathy in left, right or both eyes with severity level documented","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33507","name":"Repair art intramural","description":"Repair of anomalous (eg, intramural) aortic origin of coronary artery by unroofing or translocation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2133.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93224","name":"Xtrnl ecg rec up to 48 hrs","description":"External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage; includes recording, scanning analysis with report, review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0824T","name":"Tcat rmv 1chmbr ldls pm ra","description":"Transcatheter removal of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography), when performed","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4026","name":"Phys/occ therapy ss","description":"Physical therapy/occupational therapy mips specialty set","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1312","name":"No pt tbco scrn rng","description":"Patient not screened for tobacco use","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0766T","name":"Tc mag stimj pn 1st nerve","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; first nerve","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0413U","name":"Onc hl neo opt gen mapg dna","description":"Onc hl neo opt gen mapg dna","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0999T","name":"Autol musc cell therapy hrvg","description":"Autologous muscle cell therapy, harvesting of muscle progenitor cells, including ultrasound guidance, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93531","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3067.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7415","name":"Excision malig les complicat","description":"Excision of malignant lesion complicated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33894","name":"Evasc st rpr thrc/aa acrs br","description":"Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; across major side branches","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1321","name":"Couns for high risk sub use","description":"Couns for high risk sub use","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37284","name":"Revsc evasc tpvt st sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inclu","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94690","name":"O2 uptk rest indirect","description":"Oxygen uptake, expired gas analysis; rest, indirect (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90865","name":"Narcosynthesis","description":"Narcosynthesis for psychiatric diagnostic and therapeutic purposes (eg, sodium amobarbital (amytal) interview)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1176","name":"No 2 hzv 10/2017-meas pd","description":"Patient did not receive two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91060","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4010","name":"Infectious disease ss","description":"Infectious disease mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0341U","name":"Ftl aneup dna seq cmpr alys","description":"Ftl aneup dna seq cmpr alys","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1806","name":"Inj esmolol hcl wg crit care","description":"Injection, esmolol hydrochloride (wg critical care), not therapeutically equivalent to j1805, 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95078","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"Limited visual field xm","description":"Visual field examination, unilateral or bilateral, with interpretation and report; limited examination (eg, tangent screen, autoplot, arc perimeter, or single stimulus level automated test, such as octopus 3 or 7 equivalent)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1380","name":"2 rx in perf pd any com meds","description":"Filled at least two prescriptions during the performance period for any combination of the qualifying oral antipsychotic medications listed under denominator note or the long-acting injectable antipsychotic medications listed under denominator note","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0865T","name":"Quan mri alys brn w/o dx mri","description":"Quantitative magnetic resonance image (mri) analysis of the brain with comparison to prior magnetic resonance (mr) study(ies), including lesion identification, characterization, and quantification, with brain volume(s) quantification and/or severity score, when performed, data preparation and transm","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0627U","name":"Psyc scz dna alys >15000","description":"Psyc scz dna alys >15000","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0711T","name":"N-nvs artl plaq alys dat prp","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data preparation and transmission","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76014","name":"Mr sfty implt&/fb asmt stf 1","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0288U","name":"Onc lung mrna quan pcr 11&3","description":"Onc lung mrna quan pcr 11&3","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0592U","name":"Onc hl neo dna tgs 417 genes","description":"Onc hl neo dna tgs 417 genes","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31254","name":"Nsl/sins ndsc w/prtl ethmdct","description":"Nasal/sinus endoscopy, surgical with ethmoidectomy; partial (anterior)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0031","name":"Pall serv during meas","description":"Palliative care services given to patient any time during the measurement period","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5127","name":"Inj, stimufend, 0.5 mg","description":"Injection, pegfilgrastim-fpgk (stimufend), biosimilar, 0.5 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1500","name":"Neuropsychology mvp","description":"Neuropsychology mips value pathway","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87560","name":"M.avium-intra dna dir prob","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacteria avium-intracellulare, direct probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31615","name":"Trcheobrnchsc est trachs inc","description":"Tracheobronchoscopy through established tracheostomy incision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9294","name":"Inj pemetrexed, hospira 10mg","description":"Injection, pemetrexed (hospira), not therapeutically equivalent to j9305, 10 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0728T","name":"Dx alys vstblr implt uni 1st","description":"Diagnostic analysis of vestibular implant, unilateral; with initial programming","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0776T","name":"Ther indctj ntrabrn hypthrm","description":"Therapeutic induction of intra-brain hypothermia, including placement of a mechanical temperature-controlled cooling device to the neck over carotids and head, including monitoring (eg, vital signs and sport concussion assessment tool 5 [scat5]), 30 minutes of treatment","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94669","name":"Mechanical chest wall oscill","description":"Mechanical chest wall oscillation to facilitate lung function, per session","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6074","name":"Abutment supported retainer","description":"Abutment supported retainer for cast metal fpd (noble metal)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9247","name":"Mod sedation noniv-sub15min","description":"Mod sedation noniv-sub15min","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0540","name":"Train for caregiver add 15","description":"Caregiver training in behavior management/modification for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face; each additional 15 minutes","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4307","name":"American amnion, per sq cm","description":"American amnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33985","name":"Ecmo/ecls rmvl ctr cannula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; removal of central cannula(e) by sternotomy or thoracotomy, birth through 5 years of age","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":825.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0813T","name":"Egd vol adjmt bariatric balo","description":"Esophagogastroduodenoscopy, flexible, transoral, with volume adjustment of intragastric bariatric balloon","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76802","name":"Ob us < 14 wks addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42205","name":"Reconstruct cleft palate","description":"Palatoplasty for cleft palate, with closure of alveolar ridge; soft tissue only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22837","name":"Ant thrc vrt body tethrg 8+","description":"Anterior thoracic vertebral body tethering, including thoracoscopy, when performed; 8 or more vertebral segments","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7259","name":"Nerve dissection","description":"Nerve dissection","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1422","name":"Gastroenterology care mvp","description":"Gastroenterology care mips value pathway","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0537","name":"Risk ascvd tst once pr 12 mo","description":"Administration of a standardized, evidence-based atherosclerotic cardiovascular disease (ascvd) risk assessment, 5-15 minutes, not more often than every 12 months","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85014","name":"Hematocrit","description":"Blood count; hematocrit (hct)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4439","name":"Instagraft per sq cm","description":"Instagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0414","name":"Lab process microbial spec","description":"Lab process microbial spec","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37288","name":"Revsc evsc tpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0854T","name":"Dgtz gls mcrscp bld smr prph","description":"Digitization of glass microscope slides for blood smear, peripheral, interpretation by physician with written report (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85018","name":"Hemoglobin","description":"Blood count; hemoglobin (hgb)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3055","name":"Inj talquetamab-tgvs 0.25 mg","description":"Injection, talquetamab-tgvs, 0.25 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49594","name":"Rpr aa hrn 1st 3-10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93146","name":"Interrog crtd sins bat ip w/","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84295","name":"Assay of serum sodium","description":"Sodium; serum, plasma or whole blood","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4393","name":"Surgraft ac per sq cm","description":"Surgraft ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0801","name":"Inj. acthar gel to 40 units","description":"Injection, corticotropin (acthar gel), up to 40 units","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0605U","name":"All&immunology hat tpsab1","description":"All&immunology hat tpsab1","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1292","name":"Pt 66+ frail inpt adv ill","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and an advanced illness diagnosis during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0874","name":"Inj, daptomycin (baxter)","description":"Injection, daptomycin (baxter), not therapeutically equivalent to j0878, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86363","name":"Mog-igg1 antb flo cytmtry ea","description":"Myelin oligodendrocyte glycoprotein (mog-igg1) antibody; flow cytometry (ie, fluorescence-activated cell sorting [facs]), each","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26952","name":"Amputation of finger/thumb","description":"Amputation, finger or thumb, primary or secondary, any joint or phalanx, single, including neurectomies; with local advancement flaps (v-y, hood)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":875.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6602","name":"G com bandge hgh dn foamroll","description":"Gradient compression bandaging supply, high density foam roll for bandage, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0706","name":"Intraoral occlus radio image","description":"Intraoral occlus radio image","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0235","name":"Intrav inf, mon anti, fir do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1025","name":"Pt mnth 1 mcp prov","description":"Patient-months where there are more than one medicare capitated payment (mcp) provider listed for the month","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8522","name":"Capecitabine, oral, 50 mg","description":"Capecitabine, oral, 50 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87476","name":"Lyme dis dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); borrelia burgdorferi, amplified probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1714","name":"Pfizer vacc adm ped 2nd dose","description":"Pfizer vacc adm ped 2nd dose","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0765T","name":"Asstv alg ecg rsk asmt prev","description":"Assistive algorithmic electrocardiogram risk-based assessment for cardiac dysfunction (eg, low-ejection fraction, pulmonary hypertension, hypertrophic cardiomyopathy); related to previously performed electrocardiogram","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99470","name":"Rpm tx mgmt 1st 10 min","description":"Remote physiologic monitoring treatment management services, clinical staff/physician/other qualified health care professional time in a calendar month requiring 1 real-time interactive communication with the patient/caregiver during the calendar month; first 10 minutes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"Motor &/ sens nrve cndj test","description":"Motor and/or sensory nerve conduction, using preconfigured electrode array(s), amplitude and latency/velocity study, each limb, includes f-wave study when performed, with interpretation and report","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0362U","name":"Onc pap thyr ca rna 82&10","description":"Onc pap thyr ca rna 82&10","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0888T","name":"Histotripsy mal renal tissue","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant renal tissue, including imaging guidance","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1355","name":"Suicd based cln eval","description":"Suicide risk based on their clinicians evaluation or a clinician-rated tool","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40810","name":"Excision of mouth lesion","description":"Excision of lesion of mucosa and submucosa, vestibule of mouth; without repair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1375","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99470","name":"Rpm tx mgmt 1st 10 min","description":"Remote physiologic monitoring treatment management services, clinical staff/physician/other qualified health care professional time in a calendar month requiring 1 real-time interactive communication with the patient/caregiver during the calendar month; first 10 minutes","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67973","name":"Reconstruction of eyelid","description":"Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; total eyelid, lower, 1 stage or first stage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1013.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3501","name":"Surg exp root surf anterior","description":"Surg exp root surf anterior","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0877T","name":"Augmnt alys ch ct ild w/o ct","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained without concurrent ct examination of any structure contained in previously acquired diagnostic imaging","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1479","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0608","name":"Lanthanum carbonate pwdr 5mg","description":"Lanthanum carbonate, oral, powder, 5 mg, not therapeutically equivalent to j0607 (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1488","name":"Dx dementia in msr timeframe","description":"Patients with a diagnosis for dementia in the year before or during the period of evaluation","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1491","name":"Recd esrd mcp dur perf pd","description":"Receiving esrd mcp dialysis services by the provider during the performance period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2013","name":"Innovamatrix fs, per sq cm","description":"Innovamatrix fs, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22100","name":"Remove part of neck vertebra","description":"Partial excision of posterior vertebral component (eg, spinous process, lamina or facet) for intrinsic bony lesion, single vertebral segment; cervical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":891.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86366","name":"Muscle-specific kinase antb","description":"Muscle-specific kinase (musk) antibody","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0891","name":"Argatroban nonesrd (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0579U","name":"Nfro dbtc ckd elisa apoa4","description":"Nfro dbtc ckd elisa apoa4","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0891","name":"Argatroban nonesrd (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2928","name":"Prefab porc/cer crown perm","description":"Prefab porc/cer crown perm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81558","name":"Trnspl rej kdn mrna qpcr 139","description":"Transplantation medicine (allograft rejection, kidney), mrna, gene expression profiling by quantitative polymerase chain reaction (qpcr) of 139 genes, utilizing whole blood, algorithm reported as a binary categorization as transplant excellence, which indicates immune quiescence, or not transplant e","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0515U","name":"Gi ibd ia quan deter ifx lvl","description":"Gi ibd ia quan deter ifx lvl","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96161","name":"Caregiver health risk assmt","description":"Administration of caregiver-focused health risk assessment instrument (eg, depression inventory) for the benefit of the patient, with scoring and documentation, per standardized instrument","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81002","name":"Urinalysis nonauto w/o scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; non-automated, without microscopy","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7961","name":"Buccal/labial frenectomy","description":"Buccal/labial frenectomy","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0776T","name":"Ther indctj ntrabrn hypthrm","description":"Therapeutic induction of intra-brain hypothermia, including placement of a mechanical temperature-controlled cooling device to the neck over carotids and head, including monitoring (eg, vital signs and sport concussion assessment tool 5 [scat5]), 30 minutes of treatment","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1234","name":"Pt hcv rctv aby f/u neg","description":"Patient has a reactive hcv antibody test, and has a follow up hcv viral test that does not detect hcv viremia","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0815T","name":"Us rems b1 dns hips plvs/spi","description":"Ultrasound-based radiofrequency echographic multi-spectrometry (rems), bone-density study and fracture-risk assessment, 1 or more sites, hips, pelvis, or spine","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1302","name":"Scrn mam perf rslts doc","description":"Screening, diagnostic, film digital or digital breast tomosynthesis (3d) mammography results documented and reviewed","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1276","name":"Calc bmi out nrm param nof/u","description":"Bmi documented outside normal parameters, no follow-up plan documented, no reason given","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4380","name":"Advograft one per sq cm","description":"Advograft one, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61736","name":"Litt icr 1 traj 1 smpl les","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; single trajectory for 1 simple lesion","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9603","name":"Inj, pafolacianine, 0.1 mg","description":"Injection, pafolacianine, 0.1 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7528","name":"Mycophen mofetil for susp","description":"Mycophenolate mofetil, for suspension, oral, 100 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2018","name":"Permeaderm c, per sq cm","description":"Permeaderm c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0442U","name":"Nfct ds respir nfctj mxa&crp","description":"Nfct ds respir nfctj mxa&crp","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93596","name":"R&l hrt cath chd nml nt cnj","description":"Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); normal native connections","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0590U","name":"Nfct ds bct&fngl dna 44 orgs","description":"Nfct ds bct&fngl dna 44 orgs","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0968T","name":"Insj/rplcmt epcrnl nstim sys","description":"Insertion or replacement of epicranial neurostimulator system, including electrode array and pulse generator, with connection to electrode array","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0733T","name":"Rem r-t mtn nrehab ther sply","description":"Remote real-time, motion capture-based neurorehabilitative therapy ordered by a physician or other qualified health care professional; supply and technical support, per 30 days","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D4323","name":"Splint extra-coronal","description":"Splint extra-coronal","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9871","name":"Bhv couns dm prev, onln 60 m","description":"Behavioral counseling for diabetes prevention, online, 60 minutes","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92288","name":"Scr dark adaptation meas i&r","description":"Screening dark adaptation measurement (eg, rod recovery intercept time), with interpretation and report","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4287","name":"Dermabind dl, per sq cm","description":"Dermabind dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0528U","name":"Lrt iad 18bct/8vir&7arg rna","description":"Lrt iad 18bct/8vir&7arg rna","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51820","name":"Revision of urinary tract","description":"Cystourethroplasty with unilateral or bilateral ureteroneocystostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1231.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5992","name":"Low prosth foot shell repl","description":"All lower extremity prosthesis, foot shell for modular foot/non-solid ankle cushion heel (sach) replacement only","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68500","name":"Removal of tear gland","description":"Excision of lacrimal gland (dacryoadenectomy), except for tumor; total","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":945.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0604U","name":"All&immunology crae 4bk pep","description":"All&immunology crae 4bk pep","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0412U","name":"Beta amyloid ab42/40 imprcip","description":"Beta amyloid ab42/40 imprcip","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4022","name":"Otolaryngology ss","description":"Otolaryngology mips specialty set","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1466","name":"Pt disc/lam proc same day","description":"Patient had a lumbar fusion on the same date as the discectomy/laminectomy procedure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0548U","name":"Gfap cleia plasma","description":"Gfap cleia plasma","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0618","name":"Inj, calcium chloride, 2 mg","description":"Injection, calcium chloride, 2 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5137","name":"Inj, wezlana, sub cu, 1 mg","description":"Injection, ustekinumab-auub (wezlana), biosimilar, subcutaneous, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11760","name":"Repair of nail bed","description":"Repair of nail bed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9601","name":"Flortaucipir inj 1 millicuri","description":"Flortaucipir f 18 injection, diagnostic, 1 millicurie","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92641","name":"Hearing dev verif eacous aly","description":"Hearing device verification, electroacoustic analysis","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54318","name":"Reconstruction of urethra","description":"Urethroplasty for third stage hypospadias repair to release penis from scrotum (eg, third stage cecil repair)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":822.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91323","name":"Sarscov2 vac 10 mcg/0.2ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 10 mcg/0.2 ml dosage, for intramuscular use","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0807T","name":"Pulm tiss vntj alys prev ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with previously acquired computed tomography (ct) images, including data preparation and transmission, quantification of pulmonary tissue ventilation, data re","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5944","name":"Max implt sup remv part","description":"Max implt sup remv part","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61889","name":"Ins sk-mnt crnl nstm pg/rcvr","description":"Insertion of skull-mounted cranial neurostimulator pulse generator or receiver, including craniectomy or craniotomy, when performed, with direct or inductive coupling, with connection to depth and/or cortical strip electrode array(s)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36120","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87478","name":"Borrelia miyamotoi amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); borrelia miyamotoi, amplified probe technique","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47420","name":"Incision of bile duct","description":"Choledochotomy or choledochostomy with exploration, drainage, or removal of calculus, with or without cholecystotomy; without transduodenal sphincterotomy or sphincteroplasty","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1392.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58575","name":"Laps tot hyst resj mal","description":"Laparoscopy, surgical, total hysterectomy for resection of malignancy (tumor debulking), with omentectomy including salpingo-oophorectomy, unilateral or bilateral, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1683.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4545","name":"Suppl accessor tibial stim","description":"Supplies and accessories for external tibial nerve stimulator (e.g., socks, gel pads, electrodes, etc.), needed for one month","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0412U","name":"Beta amyloid ab42/40 imprcip","description":"Beta amyloid ab42/40 imprcip","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":834.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1360","name":"Suicd c-ssrs assessment","description":"Suicidal ideation and/or behavior symptoms based on the c-ssrs","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0852T","name":"Dgtz gls mcrscp mphmtrc ea 1","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0265U","name":"Rar do whl gn&mtcdrl dna als","description":"Rare constitutional and other heritable disorders, whole- genome and mitochondrial dna sequence analysis, blood, frozen and formalin-fixed paraffin-embedded (ffpe) tissue, saliva, buccal swabs or cell lines, identification of single nucleotide and copy number variants","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0672T","name":"Ndovag cryg rf remdl tiss","description":"Endovaginal cryogen-cooled, monopolar radiofrequency remodeling of the tissues surrounding the female bladder neck and proximal urethra for urinary incontinence","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4032","name":"Rheumatology ss","description":"Rheumatology mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1172","name":"Doc med rsn no td/tdap","description":"Documentation of medical reason(s) for not administering td or tdap vaccine (e.g., prior anaphylaxis due to the td or tdap vaccine or history of encephalopathy within seven days after a previous dose of a td-containing vaccine)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1227","name":"Eb therapy prescribed","description":"Evidence-based therapy was prescribed","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0873T","name":"Revj subq prtl asct pmp sys","description":"Revision of a subcutaneously implanted peritoneal ascites pump system, any component (ascites pump, associated peritoneal catheter, associated bladder catheter), including imaging and programming, when performed","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0547","name":"Phone/internet svs 11-20 m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patients","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0664","name":"Team remote e/m new pt 60 mn","description":"Team remote e/m new pt 60mins","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4356","name":"Abio mem abio hyd per sq cm","description":"Abiomend membrane and abiomend hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98003","name":"Synch audio-video new hi 60","description":"Synchronous audio-video visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high medical decision making. when using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61512","name":"Crnec treph exc mngioma sttl","description":"Craniectomy, trephination, bone flap craniotomy; for excision of meningioma, supratentorial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2943.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86362","name":"Mog-igg1 antb cba each","description":"Myelin oligodendrocyte glycoprotein (mog-igg1) antibody; cell-based immunofluorescence assay (cba), each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0673T","name":"Abltj b9 thyr ndul perq lasr","description":"Ablation, benign thyroid nodule(s), percutaneous, laser, including imaging guidance","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9394","name":"Inj, fulvestrant (fresenius)","description":"Injection, fulvestrant (fresenius kabi) not therapeutically equivalent to j9395, 25 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9333","name":"Inj rozanolixizum-noli 1 mg","description":"Injection, rozanolixizumab-noli, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0974T","name":"Slctv nzmtc dbrdmt t/a/l ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; each additional 100 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64655","name":"Revj/rplcmt bat mod sys lead","description":"Revision or replacement of baroreflex activation therapy (bat) modulation system, with intraoperative interrogation and programming; lead only","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78016","name":"Thyroid met imaging/studies","description":"Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9276","name":"Inj zanidatamab-hrii, 2 mg","description":"Injection, zanidatamab-hrii, 2 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90838","name":"Psytx w pt w e/m 60 min","description":"Psychotherapy, 60 minutes with patient when performed with an evaluation and management service (list separately in addition to the code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":151.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2058","name":"Obecbtge autol up to 400 mil","description":"Obecabtagene autoleucel, 10 up to 400 million cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per infusion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0622U","name":"Psyc mdd dna alys >20000","description":"Psyc mdd dna alys >20000","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J7505","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37295","name":"Rvsc evsc tpvt st ath cpx ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0747T","name":"Car ablt rad arrhyt dlvr rad","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; delivery of radiation therapy, arrhythmia","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1413","name":"Inj delandistrogene mox rokl","description":"Injection, delandistrogene moxeparvovec-rokl, per therapeutic dose","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9608","name":"Flotufolastat f18 diag 1 mci","description":"Flotufolastat f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27146","name":"Incision of hip bone","description":"Osteotomy, iliac, acetabular or innominate bone;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1480.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33965","name":"Ecmo/ecls rmvl perph cannula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; removal of peripheral (arterial and/or venous) cannula(e), percutaneous, birth through 5 years of age","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64448","name":"Njx aa&/strd fem nrv nfs img","description":"Injection(s), anesthetic agent(s) and/or steroid; femoral nerve, continuous infusion by catheter (including catheter placement), including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42975","name":"Dise eval slp do brth flx dx","description":"Drug-induced sleep endoscopy, with dynamic evaluation of velum, pharynx, tongue base, and larynx for evaluation of sleep-disordered breathing, flexible, diagnostic","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0023","name":"Pin service 60m per month","description":"Principal illness navigation services by certified or trained auxiliary personnel under the direction of a physician or other practitioner, including a patient navigator; 60 minutes per calendar month, in the following activities:  person-centered assessment, performed to better understand the indiv","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5155","name":"Inj, aflibercept-jbvf, 1 mg","description":"Injection, aflibercept-jbvf (yesafili), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46221","name":"Ligation of hemorrhoid(s)","description":"Hemorrhoidectomy, internal, by rubber band ligation(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4224","name":"Hhf10-p per sq cm","description":"Human health factor 10 amniotic patch (hhf10-p), per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0969T","name":"Removal epicranial nstim sys","description":"Removal of epicranial neurostimulator system","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76819","name":"Fetal biophys profil w/o nst","description":"Fetal biophysical profile; without non-stress testing","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9998","name":"Doc med rsn <3 colon","description":"Documentation of medical reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., last colonoscopy incomplete, last colonoscopy had inadequate prep, piecemeal removal of adenomas, or sessile serrated polyps >= 20 mm in size, last colonoscopy found greater than 10 adenomas, lo","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1012T","name":"Mtrz ab ntrno trph scl/tr mw","description":"Motorized ab interno trephination of sclera (sclerostomy), or trabecular meshwork (trabeculostomy), 1 or more, including injection of antifibrotic agents, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1019T","name":"Lymphovenous bypass per xtr","description":"Lymphovenous bypass, including robotic assistance, when performed, per extremity","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0901","name":"Vadadustat oral 1mg for esrd","description":"Vadadustat, oral, 1 mg (for esrd on dialysis)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42844","name":"Extensive surgery of throat","description":"Radical resection of tonsil, tonsillar pillars, and/or retromolar trigone; closure with local flap (eg, tongue, buccal)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1433.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90967","name":"Esrd svc pr day pt <2","description":"End-stage renal disease (esrd) related services for dialysis less than a full month of service, per day; for patients younger than 2 years of age","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49566","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":997.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77086","name":"Vrt fracture assmt via dxa","description":"Vertebral fracture assessment via dual-energy x-ray absorptiometry (dxa)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7174","name":"Injection fitusiran 0.04 mg","description":"Injection, fitusiran, 0.04 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0330U","name":"Iadna vag pthgn panel 27 org","description":"Iadna vag pthgn panel 27 org","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0892T","name":"Arhfcmrigtbs sbsq per tx day","description":"Accelerated, repetitive high-dose functional connectivity mri-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent motor threshold redetermination with delivery and management, per treatment day","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99304","name":"1st nf care sf/low mdm 25","description":"Initial nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward or low level of medical decision making. when using total time on the date of the encounter for code selection, 25 minutes mus","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9319","name":"Inj romidepsin lyophil 0.1mg","description":"Injection, romidepsin, lyophilized, 0.1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2919","name":"Inj, methylpred sod succ 5mg","description":"Injection, methylprednisolone sodium succinate, 5 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98014","name":"Synch audio-only est mod 30","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, moderate medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code s","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1438","name":"Lst knwn well <=210 min","description":"Time last known well to hospital arrival less than or equal to 3.5 hours (<= 210 minutes)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0535","name":"Pt navigat svs direct/ref","description":"Patient navigational services, provided directly or by referral; including helping the patient to navigate health systems and identify care providers and supportive services, to build patient self-advocacy and communication skills with care providers, and to promote patient-driven action plans and g","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62000","name":"Treat skull fracture","description":"Elevation of depressed skull fracture; simple, extradural","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":837.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9361","name":"Inj, efbemalenograstim alfa-","description":"Injection, efbemalenograstim alfa-vuxw, 0.5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4343","name":"Dermacyte ac matrx per sq cm","description":"Dermacyte ac matrix amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21150","name":"Rcnstj mdfc lefrtii ant ntru","description":"Reconstruction midface, lefort ii; anterior intrusion (eg, treacher-collins syndrome)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1987.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0984T","name":"Iv img xtrc cere vsl oct 1st","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1338","name":"Pt f/u 30-180 dys no + imprv","description":"Patients who had follow-up assessment 30 to 180 days after the index assessment who did not demonstrate positive improvement or maintenance of functioning scores during the performance period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4013","name":"Mntal/behav/psych hlth ss","description":"Mental/behavioral and psychiatry mips specialty set","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4340","name":"Simpligraft, per sq cm","description":"Simpligraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50236","name":"Removal of kidney & ureter","description":"Nephrectomy with total ureterectomy and bladder cuff; through separate incision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1606.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0423","name":"Genetic test spec analysis","description":"Genetic test spec analysis","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0347U","name":"Rx metab/pcx dna 16 gen alys","description":"Rx metab/pcx dna 16 gen alys","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92145","name":"Corneal hysteresis deter","description":"Corneal hysteresis determination, by air impulse stimulation, unilateral or bilateral, with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01941","name":"Anes neuromd/ntrvrt crv/thrc","description":"Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32504","name":"Resect apical lung tum/chest","description":"Resection of apical lung tumor (eg, pancoast tumor), including chest wall resection, rib(s) resection(s), neurovascular dissection, when performed; with chest wall reconstruction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2541.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5932","name":"Postsurgical obturator","description":"Obturator prosthesis definitive","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9249","name":"Inj, melphalan (apotex) 1 mg","description":"Injection, melphalan (apotex), 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0422","name":"Collect & prep genetic samp","description":"Collect & prep genetic samp","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9174","name":"Inj, docetaxel (beizray) 1mg","description":"Injection, docetaxel (beizray), 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77091","name":"Tbs techl calculation only","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; technical calculation only","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33900","name":"Perq p-art revsc 1 nm nt uni","description":"Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, unilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0933T","name":"Tcat impl wrls l atr prs snr","description":"Transcatheter implantation of wireless left atrial pressure sensor for long-term left atrial pressure monitoring, including sensor calibration and deployment, right heart catheterization, transseptal puncture, imaging guidance, and radiological supervision and interpretation","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0313U","name":"Onc pncrs dna&mrna seq 74","description":"Onc pncrs dna&mrna seq 74","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49616","name":"Rpr aa hrn rcr 3-10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, incarcerated or strangulated","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0788T","name":"Elec aly smp iins sp/sac nrv","description":"Electronic analysis with simple programming of implanted integrated neurostimulation system (eg, electrode array and receiver), including contact group(s), amplitude, pulse width, frequency (hz), on/off cycling, burst, dose lockout, patient-selectable parameters, responsive neurostimulation, detecti","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1268","name":"Pt ac stat kid trnsplt wtlst","description":"Patients observed in active status on any kidney or kidney-pancreas transplant waitlist as of the last day of each month during the measurement period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0284U","name":"Vw factor type 2n eval plsm","description":"Von willebrand factor (vwd), type 2n, factor viii and vwf binding evaluation, enzyme-linked immunosorbent assays (elisa), plasma","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0735T","name":"Prep tum cav iort prim crnot","description":"Preparation of tumor cavity, with placement of a radiation therapy applicator for intraoperative radiation therapy (iort) concurrent with primary craniotomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0858T","name":"Ext trnscranl mag stimj meas","description":"Externally applied transcranial magnetic stimulation with concomitant measurement of evoked cortical potentials with automated report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34716","name":"Opn ax/subcla art expos cndt","description":"Open axillary/subclavian artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass, by infraclavicular or supraclavicular incision, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2643","name":"Dental onlay porcelin 3 surf","description":"Onlay - porcelain/ceramic - three surfaces","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1396","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1407","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0250","name":"Adm tocilizu covid-19 2nd","description":"Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, ","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83909","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7511","name":"Incision/drain abscess intra","description":"Incision and drainage of abscess - intraoral soft tissue - complicated (includes drainage of multiple fascial spaces)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1231","name":"Pt hcv tst no reactive res","description":"Patient receives hcv antibody test with nonreactive result","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99445","name":"Rem mntr physiol param 2-15","description":"Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate); device(s) supply with daily recording(s) or programmed alert(s) transmission, 2-15 days in a 30-day period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0723T","name":"Qmrcp w/o dx mri sm anat ses","description":"Quantitative magnetic resonance cholangiopancreatography (qmrcp), including data preparation and transmission, interpretation and report, obtained without diagnostic magnetic resonance imaging (mri) examination of the same anatomy (eg, organ, gland, tissue, target structure) during the same session","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41150","name":"Tongue mouth jaw surgery","description":"Glossectomy; composite procedure with resection floor of mouth and mandibular resection, without radical neck dissection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2245.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1414","name":"Med rsn no pdl1 bef 1st ther","description":"Documentation of medical reason(s) for not performing the pd-l1 biomarker expression test prior to initiation of first-line immune checkpoint inhibitor therapy (e.g., patient is in an urgent or emergent situation where delay of treatment would jeopardize the patients health status; other medical rea","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1401","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0582","name":"Bivalirudin (endo) 1 mg","description":"Injection, bivalirudin (endo), not therapeutically equivalent to j0583, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0869T","name":"Njx b1 sub mtrl hw fixj aug","description":"Injection(s), bone-substitute material for bone and/or soft tissue hardware fixation augmentation, including intraoperative imaging guidance, when performed","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0022","name":"Comm hlth intg svs add 30 m","description":"Community health integration services, each additional 30 minutes per calendar month (list separately in addition to g0019)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84437","name":"Assay of neonatal thyroxine","description":"Thyroxine; requiring elution (eg, neonatal)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1168","name":"Pt recd flu vax 7/1-6/30","description":"Patient received an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60512","name":"Autotransplant parathyroid","description":"Parathyroid autotransplantation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1393","name":"Pr no dx rec mlnm","description":"Patients who were not diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1152","name":"Pt w/ hx trnsplt or lvad","description":"Patients with a history of heart transplant or with a left ventricular assist device (lvad)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4022","name":"Otolaryngology ss","description":"Otolaryngology mips specialty set","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1253","name":"Pts hu surv no amb plltv","description":"Patients who respond on the patient experience hu survey that they did not receive care by the listed ambulatory palliative care provider in the last 60 days (disavowal)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70472","name":"Ct cere prfu alys c+w/ct/cta","description":"Computed tomographic (ct) cerebral perfusion analysis with contrast material(s), including image postprocessing performed with concurrent ct or ct angiography of the same anatomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0552U","name":"Repr med pga gdo te bx locus","description":"Repr med pga gdo te bx locus","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81007","name":"Urine screen for bacteria","description":"Urinalysis; bacteriuria screen, except by culture or dipstick","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0487U","name":"Onc sol tum cfcdna tgsap 84","description":"Onc sol tum cfcdna tgsap 84","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0740T","name":"Rem auton alg nsln cal setup","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; initial set-up and patient education","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21085","name":"Impres&prep oral surg splint","description":"Impression and custom preparation; oral surgical splint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":768.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70551","name":"Mri brain stem w/o dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":664.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74485","name":"Dilation urtr/urt rs&i","description":"Dilation of ureter(s) or urethra, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77080","name":"Dxa bone density axial","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7413","name":"Excision malig lesion<=1.25c","description":"Excision of malignant lesion up to 1.25 cm","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21084","name":"Impres&prep sp aid prosth","description":"Impression and custom preparation; speech aid prosthesis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1903.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1321","name":"Couns for high risk sub use","description":"Couns for high risk sub use","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q2017","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42975","name":"Dise eval slp do brth flx dx","description":"Drug-induced sleep endoscopy, with dynamic evaluation of velum, pharynx, tongue base, and larynx for evaluation of sleep-disordered breathing, flexible, diagnostic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8006","name":"Grip glove replacement only","description":"Powered, cable driven grip assist glove, hand, finger, includes pressure sensors, glove replacement only","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64474","name":"Lwr xtr fscl pln blk uni nfs","description":"Lower extremity fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"Rec cath any transanal, each","description":"Rectal catheter with or without balloon, for use with any type transanal irrigation system, each","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57800","name":"Dilation of cervical canal","description":"Dilation of cervical canal, instrumental (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3393","name":"Inj, betibeglogene autotemce","description":"Injection, betibeglogene autotemcel, per treatment","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27516","name":"Treat thigh fx growth plate","description":"Closed treatment of distal femoral epiphyseal separation; without manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":532.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61703","name":"Clamp neck artery","description":"Surgery of intracranial aneurysm, cervical approach by application of occluding clamp to cervical carotid artery (selverstone-crutchfield type)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1468.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1026","name":"Pt hemo > 3mo","description":"The number of adult patient-months in the denominator who were on maintenance hemodialysis using a catheter continuously for three months or longer under the care of the same practitioner or group partner as of the last hemodialysis session of the reporting month","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67320","name":"Revise eye muscle(s) add-on","description":"Transposition procedure (eg, for paretic extraocular muscle), any extraocular muscle (specify) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4298","name":"Amniocore pro, per sq cm","description":"Amniocore pro, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33277","name":"Insj phrnc nrv stim transvns","description":"Insertion of phrenic nerve stimulator transvenous sensing lead (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0566","name":"3d bn img algor drvd fr mri","description":"3d radiodensity-value bone imaging, algorithm derived, from previous magnetic resonance examination of the same anatomy","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1015T","name":"Rev/rmv lw esoph sphnc npg/r","description":"Revision or removal, lower esophageal sphincter neurostimulator pulse generator or receiver","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0012","name":"Injection of hiv prep drug","description":"Injection of pre-exposure prophylaxis (prep) drug for hiv prevention, under skin or into muscle","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0270","name":"Mnt subs tx for change dx","description":"Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face to face with the patient, each 15 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":24.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0550","name":"Phone/inter for dx/treat >5m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a written report to the patients treating/r","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33276","name":"Insj phrnc nrv stim sys","description":"Insertion of phrenic nerve stimulator system (pulse generator and stimulating lead[s]), including vessel catheterization, all imaging guidance, and pulse generator initial analysis with diagnostic mode activation, when performed","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0613","name":"Calcium glucon (wg critical)","description":"Injection, calcium gluconate (wg critical care), not therapeutically equivalent to j0612, 10 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5944","name":"Max implt sup remv part","description":"Max implt sup remv part","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5162","name":"Inj, denosumab-nxxp, 1 mg","description":"Injection, denosumab-nxxp (bildyos/bilprevda), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0884T","name":"Esphgsc flx 1st tndsc dilat","description":"Esophagoscopy, flexible, transoral, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for esophageal stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34705","name":"Evac rpr a-biiliac ndgft","description":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-bi-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1574.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9800","name":"Gallium locametz 1 millicuri","description":"Gallium ga-68 gozetotide, diagnostic, (locametz), 1 millicurie","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0663","name":"Team remote e/m new pt 45 mn","description":"Team remote e/m new pt 45mins","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9953","name":"Reline sleep apnea appliance","description":"Reline sleep apnea appliance","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0433U","name":"Onc prst8 5 dna reg mrk pcr","description":"Onc prst8 5 dna reg mrk pcr","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0907T","name":"Coms ther ea addl<=50 sq cm","description":"Concurrent optical and magnetic stimulation (coms) therapy, wound assessment and dressing care; each additional application, total wound(s) surface area less than or equal to 50 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5147","name":"Inj, aflibercept-ayyh, 1 mg","description":"Injection, aflibercept-ayyh (pavblu), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1413","name":"Inj delandistrogene mox rokl","description":"Injection, delandistrogene moxeparvovec-rokl, per therapeutic dose","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92634","name":"Hearing aid fitg svc 1st 60","description":"Hearing aid fitting services, unilateral or bilateral, including device analysis, programming, verification, counseling, orientation, and training, and, when performed, hearing assistive device, supplemental technology fitting services; first 60 minutes","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0504U","name":"Nfct ds uti id 17 path orgs","description":"Nfct ds uti id 17 path orgs","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0457","name":"Injection, aztreonam, 100 mg","description":"Injection, aztreonam, 100 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1374","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0832T","name":"Dgtz gls mcrscp cytp oth scr","description":"Digitization of glass microscope slides for cytopathology, smears, any other source; screening and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86850","name":"Rbc antibody screen","description":"Antibody screen, rbc, each serum technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0585U","name":"Tgsap so neo cfdna 521 genes","description":"Tgsap so neo cfdna 521 genes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1305","name":"Inj, evinacumab-dgnb, 5mg","description":"Injection, evinacumab-dgnb, 5mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1402","name":"Init chemo w/def dur ec grp","description":"Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1467","name":"Pt dx lynch syn","description":"Patients with an existing diagnosis of lynch syndrome","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0903T","name":"Ecg alg 12 lead reduced i&r","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; with interpretation and report","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1397","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4317","name":"Vitograft, per sq cm","description":"Vitograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19380","name":"Revj reconstructed breast","description":"Revision of reconstructed breast (eg, significant removal of tissue, re-advancement and/or re-inset of flaps in autologous reconstruction or significant capsular revision combined with soft tissue excision in implant-based reconstruction)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":832.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4354","name":"Palingen dl-palingen dl-x","description":"Palingen dual-layer membrane and dual-layer palingen x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4378","name":"Renew ft matrix per sq cm","description":"Renew ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0966T","name":"I&cst prp jw xpn dl arch fxd","description":"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, fixed hinge mechanism","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2782","name":"Crown 3/4 cast noble metal","description":"Crown - 3/4 cast noble metal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7261","name":"Primary closure sinus perf","description":"Primary closure of a sinus perforation","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90961","name":"Esrd srv 2-3 vsts p mo 20+","description":"End-stage renal disease (esrd) related services monthly, for patients 20 years of age and older; with 2-3 face-to-face visits by a physician or other qualified health care professional per month","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":354.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0237","name":"Intrav inf, toci, first dose","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1213","name":"No hx spiro prs spiro>=70%","description":"No history of spirometry results with confirmed airflow obstruction (fev1/fvc < 70%) and present spirometry is >= 70%","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0898T","name":"N-invas prst8 cancer est map","description":"Noninvasive prostate cancer estimation map, derived from augmentative analysis of image-guided fusion biopsy and pathology, including visualization of margin volume and location, with margin determination and physician interpretation and report","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9003","name":"Leupro inj, camcevi etm, 1mg","description":"Leuprolide injectable (camcevi etm), 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1933","name":"Afo rig ant tib tcf/= ots","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, off-the-shelf","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86317","name":"Immunoassay infectious agent","description":"Immunoassay for infectious agent antibody, quantitative, not otherwise specified","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85013","name":"Spun microhematocrit","description":"Blood count; spun microhematocrit","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29894","name":"Ankle arthroscopy/surgery","description":"Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; with removal of loose body or foreign body","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":628.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0781T","name":"Brnchsc rf dstrj pulm nrv bi","description":"Bronchoscopy, rigid or flexible, with insertion of esophageal protection device and circumferential radiofrequency destruction of the pulmonary nerves, including fluoroscopic guidance when performed; bilateral mainstem bronchi","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01942","name":"Anes neuromd/ntrvrt lmbr/sac","description":"Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93145","name":"Interrog crtd sins bat ip wo","description":"Interrogation device evaluation (in person), carotid sinus baroreflex activation therapy (bat) modulation system including telemetric iterative communication with the implantable device to monitor device diagnostics and programmed therapy values, with interpretation and report (eg, battery status, l","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0975T","name":"Slctv nzmtc dbrdmt s/n/hf 1","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; first 100 sq cm","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10061","name":"I&d abscess comp/multiple","description":"Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); complicated or multiple","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":210.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4292","name":"Lamellas, per sq cm","description":"Lamellas, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1273","name":"Pts snf 1 yr dialysis","description":"Patients who were admitted to a skilled nursing facility (snf) within one year of dialysis initiation according to the cms-2728 form","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56810","name":"Perineoplasty rpr per nonob","description":"Perineoplasty, repair of perineum, nonobstetrical (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0740T","name":"Rem auton alg nsln cal setup","description":"Remote autonomous algorithm-based recommendation system for insulin dose calculation and titration; initial set-up and patient education","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60225","name":"Partial removal of thyroid","description":"Total thyroid lobectomy, unilateral; with contralateral subtotal lobectomy, including isthmusectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1034.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6092","name":"Recement supp crown","description":"Recement implant/abutment supported crown","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0218","name":"Inj olipudase alfa-rpcp 1mg","description":"Injection, olipudase alfa-rpcp, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0969T","name":"Removal epicranial nstim sys","description":"Removal of epicranial neurostimulator system","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1941","name":"Inj, furoscix, 20 mg","description":"Injection, furosemide (furoscix), 20 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90847","name":"Family psytx w/pt 50 min","description":"Family psychotherapy (conjoint psychotherapy) (with patient present), 50 minutes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":108.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1321","name":"Couns for high risk sub use","description":"Couns for high risk sub use","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0613U","name":"Onc uc dna mthyltn&mut 6bmrk","description":"Onc uc dna mthyltn&mut 6bmrk","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99347","name":"Home/res vst est sf mdm 20","description":"Home or residence visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 20 minutes must be met or exceede","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4325","name":"Acapatch, per sq cm","description":"Acapatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6599","name":"G comp bandage short stretch","description":"Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":1.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1248","name":"Pt resp true seen as person","description":"Patient responded completely true for the question of patient felt this provider and team saw me as a person, not just someone with a medical problem","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24360","name":"Reconstruct elbow joint","description":"Arthroplasty, elbow; with membrane (eg, fascial)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4028","name":"Podiatry ss","description":"Podiatry mips specialty set","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9997","name":"Doc pt preg dur msrmt pd","description":"Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2040","name":"Coord specialty care, month","description":"Coordinated specialty care, team-based, for first episode psychosis, per month","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1006T","name":"Elec alys s-scl eeg prgrm ea","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, each additional 15 minutes face-to-face time with physician or other qua","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0379U","name":"Tgsap sl or neo dna523&rna55","description":"Tgsap sl or neo dna523&rna55","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0713T","name":"N-nvs artl plaq alys rvw i&r","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data review, interpretation and report","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98012","name":"Synch audio-only est sf 10","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0706T","name":"Rem tx amblyopia i&r phy/qhp","description":"Remote treatment of amblyopia using an eye tracking device; interpretation and report by physician or other qualified health care professional, per calendar month","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0023","name":"Pin service 60m per month","description":"Principal illness navigation services by certified or trained auxiliary personnel under the direction of a physician or other practitioner, including a patient navigator; 60 minutes per calendar month, in the following activities:  person-centered assessment, performed to better understand the indiv","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4384","name":"Axolotl dual ult per sq cm","description":"Axolotl dualgraft ultra, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9216","name":"Interferon gamma 1-b inj","description":"Injection, interferon, gamma 1-b, 3 million units","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0043","name":"Pt mech pros ht valv","description":"Patients with mechanical prosthetic heart valve","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93597","name":"R&l hrt cath chd abnl nt cnj","description":"Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); abnormal native connections","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4019","name":"Oncology/hema ss","description":"Oncology/hematology mips specialty set","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1404","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78608","name":"Brain imaging (pet)","description":"Brain imaging, positron emission tomography (pet); metabolic evaluation","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87427","name":"Shiga-like toxin ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; shiga-like toxin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5150","name":"Inj, aflibercept-mrbb, 1 mg","description":"Injection, aflibercept-mrbb (ahzantive), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9612","name":"Thera par drugs 2 or > admin","description":"Therapeutic parenteral drugs two or more administrations different medications","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1653","name":"Ho abduction static ots","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, off the shelf","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92996","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4269","name":"Surgraft xt per sq cm","description":"Surgraft xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0826T","name":"Prgrmg evl ldls pm 1chmbr ip","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional, leadless pacemaker system in si","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0891","name":"Argatroban nonesrd (accord)","description":"Injection, argatroban (accord), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82270","name":"Occult blood feces","description":"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (ie, patient was provided 3 cards or single triple card for consecutive collection)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77092","name":"Tbs i&r fx rsk qhp","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; interpretation and report on fracture-risk only by other qualified health care professional","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49591","name":"Rpr aa hrn 1st < 3 cm rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, reducible","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43288","name":"Esphg thrsc moblj","description":"Esophagectomy, total or near total, with thoracoscopic mobilization of the upper, middle, and lower mediastinal esophagus, with separate laparoscopic proximal gastrectomy, with laparoscopic pyloric drainage procedure if performed, with open cervical pharyngogastrostomy or esophagogastrostomy (ie, th","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3262.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0710T","name":"N-invas artl plaq alys","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; including data preparation and transmission, quantification of the structure and composition of the vessel wall and assessment for lipid-rich necrotic core plaque to assess a","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0368U","name":"Onc clrct ca mut&mthyltn mrk","description":"Onc clrct ca mut&mthyltn mrk","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59025","name":"Fetal non-stress test","description":"Fetal non-stress test","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37297","name":"Revsc evasc imvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25265","name":"Repair forearm tendon/muscle","description":"Repair, tendon or muscle, flexor, forearm and/or wrist; secondary, with free graft (includes obtaining graft), each tendon or muscle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1182.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7473","name":"Remove torus mandibularis","description":"Removal of torus mandibularis","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0776T","name":"Ther indctj ntrabrn hypthrm","description":"Therapeutic induction of intra-brain hypothermia, including placement of a mechanical temperature-controlled cooling device to the neck over carotids and head, including monitoring (eg, vital signs and sport concussion assessment tool 5 [scat5]), 30 minutes of treatment","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0543","name":"Group train w/o patient","description":"Group caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient pre","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0749T","name":"B1 str&fx rsk assmt dxr-bmd","description":"Bone strength and fracture-risk assessment using digital x-ray radiogrammetry-bone mineral density (dxr-bmd) analysis of bone mineral density (bmd) utilizing data from a digital x ray, retrieval and transmission of digital x-ray data, assessment of bone strength and fracture risk and bmd, interpreta","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7023","name":"Mech allergen parti barrier","description":"Mechanical allergen particle barrier/inhalation filter, cream, nasal, topical","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96573","name":"Pdt dstr prmlg les phys/qhp","description":"Photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosensitizing drug(s) provided by a physician or other qualified health care professional, per day","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1163","name":"Inj, diltiazem hcl, 0.5 mg","description":"Injection, diltiazem hydrochloride, 0.5 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1501","name":"Pathology mvp","description":"Pathology mips value pathway","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1498","name":"Diagnostic radiology mvp","description":"Diagnostic radiology mips value pathway","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0557","name":"Adv prim care mgmt lvl 2","description":"Advanced primary care management services for a patient with multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, which place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline, provided by c","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0944T","name":"3d cntr simula trgt lvr les","description":"3d contour simulation of target liver lesion(s) and margin(s) for image-guided percutaneous microwave ablation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0529U","name":"Hem vte snp f2&f5 gen leiden","description":"Hem vte snp f2&f5 gen leiden","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2991","name":"App of hydroxyapatite","description":"App of hydroxyapatite","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0139","name":"Inj, adalimumab, 1 mg","description":"Injection, adalimumab, 1 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0415U","name":"Cv ds acs bld alg 5 yr score","description":"Cv ds acs bld alg 5 yr score","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80061","name":"Lipid panel","description":"Lipid panel this panel must include the following: cholesterol, serum, total (82465) lipoprotein, direct measurement, high density cholesterol (hdl cholesterol) (83718) triglycerides (84478)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1150","name":"Lvef <=40% or mod/sev l vsf","description":"Current or prior left ventricular ejection fraction (lvef) less than or equal to 40% or documentation of moderately or severely depressed left ventricular systolic function","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25445","name":"Arthrp w/prostc trapezium","description":"Arthroplasty with prosthetic replacement; trapezium","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":876.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0739T","name":"Abltj mal prst8 mag fld ndct","description":"Ablation of malignant prostate tissue by magnetic field induction, including all intraprocedural, transperineal needle/catheter placement for nanoparticle installation and intraprocedural temperature monitoring, thermal dosimetry, bladder irrigation, and magnetic field nanoparticle activation","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3421","name":"Root surgery bicuspid","description":"Apicoectomy/periradicular surgery-bicuspid (first root)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92638","name":"Bhvl verif of amplification","description":"Behavioral verification of amplification including aided thresholds, functional gain, speech-in-noise, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0571","name":"Intraop nerve cryoablation","description":"Intraoperative nerve(s) cryoablation for post-surgical pain relief (list separately in addition to code for primary service)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3424","name":"Inj hydroxocobalamin iv 25mg","description":"Injection, hydroxocobalamin, intravenous, 25 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0939T","name":"Xtrnl ecg rec>15d<30d scan","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; scanning analysis with report","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0550","name":"Phone/inter for dx/treat >5m","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a written report to the patients treating/r","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2019","name":"Kerecis marigen shld sq cm","description":"Kerecis omega3 marigen shield, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4436","name":"Renati ac membrane per sq cm","description":"Renati ac membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97037","name":"Appl modality 1+lllt po pain","description":"Application of a modality to 1 or more areas; low-level laser therapy (ie, nonthermal and non-ablative) for post-operative pain reduction","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5154","name":"Inj, omlyclo, 5 mg","description":"Injection, omalizumab-igec (omlyclo), biosimilar, 5 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1438","name":"Lst knwn well <=210 min","description":"Time last known well to hospital arrival less than or equal to 3.5 hours (<= 210 minutes)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64728","name":"Dcmprn median nrv carpl tunl","description":"Decompression; median nerve at the carpal tunnel, percutaneous, with intracarpal tunnel balloon dilation, including ultrasound guidance","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92602","name":"Reprogram cochlear implt <7","description":"Diagnostic analysis of cochlear implant, patient younger than 7 years of age; subsequent reprogramming","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0803","name":"3d facial scan direct","description":"3d facial scan direct","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4380","name":"Advograft one per sq cm","description":"Advograft one, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0544","name":"Post d/c phone follow up","description":"Post discharge telephonic follow-up contacts performed in conjunction with a discharge from the emergency department for behavioral health or other crisis encounter, 4 calls per calendar month","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0760T","name":"Dgtz gls mcrscp sl imm 1st","description":"Digitization of glass microscope slides for immunohistochemistry or immunocytochemistry, per specimen, initial single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0348U","name":"Rx metab/pcx dna 25 gen alys","description":"Rx metab/pcx dna 25 gen alys","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1209","name":">=2 same hi-rsk med w/o diag","description":"At least two orders for high-risk medications from the same drug class, (table 4), without appropriate diagnoses","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0736T","name":"Colonic lavage 35+l water","description":"Colonic lavage, 35 or more liters of water, gravity-fed, with induced defecation, including insertion of rectal catheter","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1240","name":"Pt no resp best int","description":"Patient did not respond to the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0358U","name":"Neuro alys b-amyl 1-42&1-40","description":"Neuro alys b-amyl 1-42&1-40","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29580","name":"Strapping unna boot","description":"Strapping; unna boot","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":74.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":27.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0568U","name":"Neurol dementia bamyl ptau","description":"Neurol dementia bamyl ptau","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0442U","name":"Nfct ds respir nfctj mxa&crp","description":"Nfct ds respir nfctj mxa&crp","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0273U","name":"Hem gen hyprfibrnlysis 8 gen","description":"Hematology (genetic hyperfibrinolysis, delayed bleeding), genomic sequence analysis of 8 genes (f13a1, f13b, fga, fgb, fgg, serpina1, serpine1, serpinf2, plau) blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30300","name":"Remove nasal foreign body","description":"Removal foreign body, intranasal; office type procedure","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":133.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93598","name":"Car outp meas drg cath chd","description":"Cardiac output measurement(s), thermodilution or other indicator dilution method, performed during cardiac catheterization for the evaluation of congenital heart defects (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0884T","name":"Esphgsc flx 1st tndsc dilat","description":"Esophagoscopy, flexible, transoral, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for esophageal stricture, including fluoroscopic guidance, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0668","name":"Instill, bupivac and meloxic","description":"Instillation, bupivacaine and meloxicam, 1 mg/0.03 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72131","name":"Ct lumbar spine w/o dye","description":"Computed tomography, lumbar spine; without contrast material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0511U","name":"Onc sol tum 3dmicroenvir 36+","description":"Onc sol tum 3dmicroenvir 36+","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4025","name":"Physical medicine ss","description":"Physical medicine mips specialty set","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0485U","name":"Onc sol tum cfdna&rna ngs gm","description":"Onc sol tum cfdna&rna ngs gm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0935T","name":"Cysto w/rnl pel symp dnrvtj","description":"Cystourethroscopy with renal pelvic sympathetic denervation, radiofrequency ablation, retrograde ureteral approach, including insertion of guide wire, selective placement of ureteral sheath(s) and multiple conformable electrodes, contrast injection(s), and fluoroscopy, bilateral","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81349","name":"Cytog alys chrml abnr lw-ps","description":"Cytogenomic (genome-wide) analysis for constitutional chromosomal abnormalities; interrogation of genomic regions for copy number and loss-of-heterozygosity variants, low-pass sequencing analysis","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1481","name":"Pt in hosp/pal care who died","description":"Patients receiving hospice or palliative care or who died during the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0688T","name":"Tx amblyopia assmt w/report","description":"Treatment of amblyopia using an online digital program; assessment of patient performance and program data by physician or other qualified health care professional, with report, per calendar month","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4435","name":"1pc ost pch drain hgh output","description":"Ostomy pouch, drainable, high output, with extended wear barrier (one-piece system), with or without filter, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37289","name":"Revsc evsc tpvt athrc sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0915T","name":"Insj perm ccm-d sys pg&eltrd","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator and dual transvenous electrodes/leads (pacing and defibrillation)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4542","name":"Supp ext up limb tremor stim","description":"Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1273","name":"Pts snf 1 yr dialysis","description":"Patients who were admitted to a skilled nursing facility (snf) within one year of dialysis initiation according to the cms-2728 form","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81457","name":"So neo gsap dna mcrstl ins","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis, microsatellite instability","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8600","name":"Melphalan oral 2 mg","description":"Melphalan; oral, 2 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1165","name":"Pt use hspc dur meas pd","description":"Patients who use hospice services any time during the measurement period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0521","name":"New pt-cg dyad dem hig cmplx","description":"Management of new patient-caregiver dyad with dementia, high complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5945","name":"Mand implt sup remv part","description":"Mand implt sup remv part","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3247","name":"Inj secukinumab intrav 1mg","description":"Injection, secukinumab, intravenous, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0994T","name":"Evasc dlvr a-wal stbl rx prq","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; percutaneous","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0947T","name":"Mrgfus strtctc bl-br disrpj","description":"Magnetic resonance image guided low intensity focused ultrasound (mrgfus), stereotactic blood-brain barrier disruption using microbubble resonators to increase the concentration of blood-based biomarkers of target, intracranial, including stereotactic navigation and frame placement, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4348","name":"Sentry sl matrix per sq cm","description":"Sentry sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37288","name":"Revsc evsc tpvt athrc sf 1st","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0558","name":"Adv prim care mgmt lvl 3","description":"Advanced primary care management services for a patient that is a qualified medicare beneficiary with multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, which place the patient at significant risk of death, acute exacerbation/decompensat","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9607","name":"Lutetium lu 177 vipivotide","description":"Lutetium lu 177 vipivotide tetraxetan, therapeutic, 1 millicurie","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0589U","name":"Pfas24cmpnd hi-perf lc-ms/ms","description":"Pfas24cmpnd hi-perf lc-ms/ms","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62146","name":"Crnop w/autograft<5 cm diam","description":"Cranioplasty with autograft (includes obtaining bone grafts); up to 5 cm diameter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1346.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1456","name":"Pt had htx","description":"Patient had a heart transplant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0666","name":"Team remote e/m est pt 15 mn","description":"Team remote e/m est. pt 15mins","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83001","name":"Assay of gonadotropin (fsh)","description":"Gonadotropin; follicle stimulating hormone (fsh)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0711T","name":"N-nvs artl plaq alys dat prp","description":"Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography angiography; data preparation and transmission","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6601","name":"Porc/ceram inlay >= 3 surfac","description":"Inlay - porcelain/ceramic three or more surfaces","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4369","name":"Amnioplast 3 per sq cm","description":"Amnioplast 3, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64659","name":"Rmvl bat modulj sys pg only","description":"Removal of baroreflex activation therapy (bat) modulation system; pulse generator only","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6634","name":"Onlay titanium","description":"Onlay - titanium","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1240","name":"Pt no resp best int","description":"Patient did not respond to the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2526","name":"Cntct lens blue violet","description":"Contact lens, hydrophilic, with blue-violet filter, per lens","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97008","name":"Mchnl sclp cool prep plmt","description":"Mechanical scalp cooling; including hair preparation, individual cap placement, therapy initiation, and precooling period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12004","name":"Rpr s/n/ax/gen/trk7.6-12.5cm","description":"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 7.6 cm to 12.5 cm","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":83.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0851T","name":"Dgtz gls mcrscp mphmtrc 1st","description":"Digitization of glass microscope slides for morphometric analysis, in situ hybridization (quantitative or semiquantitative), manual, per specimen; initial single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4262","name":"Dual layer impax, per sq cm","description":"Dual layer impax membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4365","name":"Amnio bur dl mem per sq cm","description":"Amnio burgeon dual-layer membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4432","name":"510(k) skin subs, nos","description":"510(k) skin substitute product, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0541","name":"No pt prsnt train initial 30","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76819","name":"Fetal biophys profil w/o nst","description":"Fetal biophysical profile; without non-stress testing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4410","name":"Amchomatrixdl per sq cm","description":"Amchomatrixdl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87594","name":"Pneumcysts jirovecii amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); pneumocystis jirovecii, amplified probe technique","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43889","name":"Gstr rstcv px trnsorl esg","description":"Gastric restrictive procedure, transoral, endoscopic sleeve gastroplasty (esg), including argon plasma coagulation, when performed","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4401","name":"Absolv3 per sq cm","description":"Absolv3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99460","name":"Init nb em per day hosp","description":"Initial hospital or birthing center care, per day, for evaluation and management of normal newborn infant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":23.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87070","name":"Culture othr specimn aerobic","description":"Culture, bacterial; any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0654","name":"Inj, liothyronine, 1 mcg","description":"Injection, liothyronine, 1 mcg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4282","name":"Cygnus dual per sq cm","description":"Cygnus dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7411","name":"Excision benign lesion>1.25c","description":"Excision of benign lesion greater than 1.25 cm","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9603","name":"Inj, pafolacianine, 0.1 mg","description":"Injection, pafolacianine, 0.1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2406","name":"Injection, oritavancin 10 mg","description":"Injection, oritavancin (kimyrsa), 10 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1782","name":"Vac admin human pap dose 2","description":"Vac admin human pap dose 2","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30901","name":"Control of nosebleed","description":"Control nasal hemorrhage, anterior, simple (limited cautery and/or packing) any method","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":53.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0870","name":"Injection, imetelstat, 1 mg","description":"Injection, imetelstat, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0337U","name":"Onc plsm cell do&myeloma id","description":"Onc plsm cell do&myeloma id","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69726","name":"Rmv ntr oi implt skl prq esp","description":"Removal, entire osseointegrated implant, skull; with percutaneous attachment to external speech processor","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68770","name":"Close tear system fistula","description":"Closure of lacrimal fistula (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":457.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22558","name":"Arthrd ant ntrbd min dsc lum","description":"Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1729.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25040","name":"Arthrt rdcrpl/midcarpl jt","description":"Arthrotomy, radiocarpal or midcarpal joint, with exploration, drainage, or removal of foreign body","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":714.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0443","name":"Brief alcohol misuse counsel","description":"Brief face-to-face behavioral counseling for alcohol misuse, 15 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":29.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25260","name":"Repair forearm tendon/muscle","description":"Repair, tendon or muscle, flexor, forearm and/or wrist; primary, single, each tendon or muscle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6613","name":"Onlay cst base mtl >=3 surfa","description":"Onlay - cast predominantly base metal three or more surfaces","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4280","name":"Xcell amnio matrix per sq cm","description":"Xcell amnio matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2014","name":"Omeza collag compl 100 mg","description":"Omeza collagen matrix or omeza complete matrix, per 100 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49611","name":"Repair umbilical lesion","description":"Repair of omphalocele (gross type operation); second stage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":745.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1466","name":"Pt disc/lam proc same day","description":"Patient had a lumbar fusion on the same date as the discectomy/laminectomy procedure","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11401","name":"Exc tr-ext b9+marg 0.6-1 cm","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 0.6 to 1.0 cm","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":108.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9319","name":"Inj romidepsin lyophil 0.1mg","description":"Injection, romidepsin, lyophilized, 0.1 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55882","name":"Ablt trurl prst8 tis trnsdcr","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation; with insertion of transurethral ultrasound transducer for delivery of thermal ultrasound, including suprapubic tube placement and placement of ","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0022","name":"Comm hlth intg svs add 30 m","description":"Community health integration services, each additional 30 minutes per calendar month (list separately in addition to g0019)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93569","name":"Njx cth slct p-art angrp uni","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1329","name":"Pts act pvd 2 wks 8 wks","description":"Patients with a post-operative encounter of the eye with the acute pvd within 2 weeks before the initial encounter or 8 weeks after initial acute pvd encounter","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4267","name":"Neostim dl per sq cm","description":"Neostim dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64582","name":"Opn mpltj hpglsl nstm ary pg","description":"Open implantation of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5939","name":"Resct proth mand comp remov","description":"Resct proth mand comp remov","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":1015.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1239","name":"Pt no resp heard","description":"Patient did not respond to the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2032","name":"Myriad matrix, per sq cm","description":"Myriad matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1455","name":"Rep/rev cied","description":"Replaced or revised cied","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0351U","name":"Nfct ds bct/viral trail ip10","description":"Nfct ds bct/viral trail ip10","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43239","name":"Egd biopsy single/multiple","description":"Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98016","name":"Brief comunicaj tech-bsd svc","description":"Brief communication technology-based service (eg, virtual check-in) by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related evaluation and management service provided within the p","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0482","name":"Direct immunofluorescence","description":"Direct immunofluorescence","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4564","name":"Pessary, disposable any type","description":"Pessary, disposable, any type","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4037","name":"Urology ss","description":"Urology mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24160","name":"Rmvl prosthhumrl&ulnar cmpnt","description":"Removal of prosthesis, includes debridement and synovectomy when performed; humeral and ulnar components","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":730.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1574","name":"Inj, ganciclovir (exela)","description":"Injection, ganciclovir sodium (exela), not therapeutically equivalent to j1570, 500 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43212","name":"Esophagoscop stent placement","description":"Esophagoscopy, flexible, transoral; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9021","name":"Inj, aspara, rylaze, 0.1 mg","description":"Injection, asparaginase, recombinant, (rylaze), 0.1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0319U","name":"Neph rna pretrnspl perph bld","description":"Neph rna pretrnspl perph bld","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0277U","name":"Hem gen pltlt funcj do 31","description":"Hematology (genetic platelet function disorder), genomic sequence analysis of 31 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0705T","name":"Rem tx amblyopia tech sprt","description":"Remote treatment of amblyopia using an eye tracking device; surveillance center technical support including data transmission with analysis, with a minimum of 18 training hours, each 30 days","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0256U","name":"Tma/tmao prfl ms/ms ur alg","description":"Trimethylamine/trimethylamine n-oxide (tma/tmao) profile, tandem mass spectrometry (ms/ms), urine, with algorithmic analysis and interpretive report","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41510","name":"Tongue to lip surgery","description":"Suture of tongue to lip for micrognathia (douglas type procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":530.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0538","name":"Ascvd rsk mng clin stf pr mo","description":"Atherosclerotic cardiovascular disease (ascvd) risk management services; clinical staff time; per calendar month","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0490U","name":"Onc cutan/uveal mlnma cd146","description":"Onc cutan/uveal mlnma cd146","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0594U","name":"Nfct ds sepsis pncrtc spc","description":"Nfct ds sepsis pncrtc spc","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49623","name":"Rmvl ninfct mesh hernia rpr","description":"Removal of total or near total non-infected mesh or other prosthesis at the time of initial or recurrent anterior abdominal hernia repair or parastomal hernia repair, any approach (ie, open, laparoscopic, robotic) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4313","name":"Dermabind fm, per sq cm","description":"Dermabind fm, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2151","name":"Inj, mannitol, 250 mg","description":"Injection, mannitol, 250 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67210","name":"Treatment of retinal lesion","description":"Destruction of localized lesion of retina (eg, macular edema, tumors), 1 or more sessions; photocoagulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":665.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81458","name":"So gsap dna cpy nmbr&mcrstl","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis, copy number variants and microsatellite instability","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1708","name":"Pfizer vacc admin 3rd dose","description":"Pfizer vacc admin 3rd dose","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1933","name":"Afo rig ant tib tcf/= ots","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, off-the-shelf","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0931T","name":"Ephys eval ccm-d ld separate","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), separate from initial implantation or replacement with testing of cardiac cont","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2040","name":"Coord specialty care, month","description":"Coordinated specialty care, team-based, for first episode psychosis, per month","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0774T","name":"Vr px dissoc svc oth phy ea","description":"Virtual reality (vr) procedural dissociation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the vr procedural dissociation supports; each additiona","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63173","name":"Drainage of spinal cyst","description":"Laminectomy with drainage of intramedullary cyst/syrinx; to peritoneal or pleural space","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1877.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4394","name":"Surgraft aca per sq cm","description":"Surgraft aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69604","name":"Revj mstdc rsltg tympanplsty","description":"Revision mastoidectomy; resulting in tympanoplasty","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1294.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0603","name":"Sevelamer hydrochloride 20mg","description":"Sevelamer hydrochloride (renagel or therapeutically equivalent), oral, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0429U","name":"Hpv orop swab 14 hi-risk typ","description":"Hpv orop swab 14 hi-risk typ","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37260","name":"Revsc evasc ivt st cplx 1st","description":"Revascularization, endovascular, open or percutaneous, iliac vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imagi","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1277","name":"Colorectal ca screen doc rev","description":"Colorectal cancer screening results documented and reviewed","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1292","name":"Pt 66+ frail inpt adv ill","description":"Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and an advanced illness diagnosis during the measurement period or the year prior to the measurement period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93724","name":"Elec alys antitchycar pm sys","description":"Electronic analysis of antitachycardia pacemaker system (includes electrocardiographic recording, programming of device, induction and termination of tachycardia via implanted pacemaker, and interpretation of recordings)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4024","name":"Pediatrics ss","description":"Pediatrics mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26479","name":"Shortening of hand tendon","description":"Shortening of tendon, flexor, hand or finger, each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":846.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4011","name":"Internal medicine ss","description":"Internal medicine mips specialty set","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0549U","name":"Onc urthl dna mthyltd rt pcr","description":"Onc urthl dna mthyltd rt pcr","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0558U","name":"Onc clrct elisa bf7 ag serum","description":"Onc clrct elisa bf7 ag serum","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90612","name":"Inf&sarscov2 vacc 31.7/.32im","description":"Influenza virus vaccine, trivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 31.7 mcg/0.32 ml dosage, for intramuscular use","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49617","name":"Rpr aa hrn rcr > 10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, reducible","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0868T","name":"Hi-res gastric ep mapping","description":"High-resolution gastric electrophysiology mapping with simultaneous patient-symptom profiling, with interpretation and report","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2032","name":"Myriad matrix, per sq cm","description":"Myriad matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4392","name":"Grafix duo per sq cm","description":"Grafix duo, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0696T","name":"Bdy surf mapg pm/cvdfb f/up","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of follow-up interrogation or programming device evaluatio","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0480U","name":"Nfct ds csf metag ngs alys","description":"Nfct ds csf metag ngs alys","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0445U","name":"Abeta42 & ptau181 eclia csf","description":"Abeta42 & ptau181 eclia csf","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4394","name":"Surgraft aca per sq cm","description":"Surgraft aca, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0811T","name":"Rem mlt day uroflow setup","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); set-up and patient education on use of equipment","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5143","name":"Inj adalimumab-adbm, 1 mg","description":"Injection, adalimumab-adbm, biosimilar, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1381","name":"Pt sec strk wthin 5 days","description":"Patients with secondary stroke (e.g., a subsequent stroke that may occur with vasospasm in the setting of subarachnoid hemorrhage) within 5 days of the initial procedure","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88368","name":"Insitu hybridization manual","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; initial single probe stain procedure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15786","name":"Abrasion lesion single","description":"Abrasion; single lesion (eg, keratosis, scar)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1463","name":"2 f/u wthn 180 day rx atmp","description":"Documentation of at least two attempts to follow up with patient within 180 days of treatment","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1244","name":"Pt othr thn true best int","description":"Patient provided a response other than completely true for the question of patient felt this provider and team put my best interests first when making recommendations about my care","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4398","name":"Summit ac per sq cm","description":"Summit ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0736T","name":"Colonic lavage 35+l water","description":"Colonic lavage, 35 or more liters of water, gravity-fed, with induced defecation, including insertion of rectal catheter","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19162","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":966.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0796T","name":"Tcat ins 2chmbr ldls pm ra","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right atrial pacemaker","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37297","name":"Revsc evasc imvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, inframalleolar vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and i","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30469","name":"Rpr nsl vlv collapse w/rmdlg","description":"Repair of nasal valve collapse with low energy, temperature-controlled (ie, radiofrequency) subcutaneous/submucosal remodeling","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82696","name":"Assay of etiocholanolone","description":"Etiocholanolone","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0926T","name":"Prgrmg dev eval ccm-d ip","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, including review and report, implantable cardiac contractility modulation-defibrillation system","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5941","name":"Resct proth mand part remov","description":"Resct proth mand part remov","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87804","name":"Influenza assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; influenza","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2516","name":"Inj, pentamidine isethionate","description":"Injection, pentamidine isethionate, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0295U","name":"Onc brst dux carc 7 proteins","description":"Onc brst dux carc 7 proteins","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1400","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0973T","name":"Slctv nzmtc dbrdmt t/a/l 1st","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs; first 100 sq cm","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11976","name":"Remove contraceptive capsule","description":"Removal, implantable contraceptive capsules","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":57.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":173.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5133","name":"Inj, tofidence, 1 mg","description":"Injection, tocilizumab-bavi (tofidence), biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4542","name":"Supp ext up limb tremor stim","description":"Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":526.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1391","name":"All pt dx w/ rec mlnm","description":"All patients who were diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7173","name":"Inj. concizumab-mtci, 0.5 mg","description":"Injection, concizumab-mtci, 0.5 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87535","name":"Hiv-1 probe&reverse trnscrpj","description":"Infectious agent detection by nucleic acid (dna or rna); hiv-1, amplified probe technique, includes reverse transcription when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0484U","name":"Nfct ds mgen 23s rrna pt mut","description":"Nfct ds mgen 23s rrna pt mut","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0980T","name":"Sbmcsl crylys ther tng&tnsl","description":"Submucosal cryolysis therapy; base of tongue and lingual tonsil only","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1212","name":"Missing gsa not perf","description":"Glycemic status assessment (hba1c or gmi) level is missing, or was not performed during the measurement period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1335","name":"Doc pts rsn no f/u xm","description":"Documentation of patient reason(s) for not having a follow up exam (e.g., inadequate time for follow up)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32520","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1617.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1269","name":"Recd esrd mcp lst day of mo","description":"Receiving esrd mcp dialysis services by the provider on the last day of the reporting month","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0546","name":"Phone/internet ehr assess","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty   whose covered services are limited by statute to services for the diagnosis and treatment of mental illness, including a verbal and written report to the patien","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93595","name":"L hrt cath chd nm/abn nt cnj","description":"Left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone, normal or abnormal native connections","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7165","name":"Inj, human-lans, per i.u","description":"Injection, prothrombin complex concentrate, human-lans, per i.u. of factor ix activity","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7294","name":"Seg acet and eth estr yearly","description":"Segesterone acetate and ethinyl estradiol 0.15mg, 0.013mg per 24 hours; yearly vaginal system, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5943","name":"Proth mandib implt sup remv","description":"Proth mandib implt sup remv","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65755","name":"Corneal transplant","description":"Keratoplasty (corneal transplant); penetrating (in pseudophakia)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1217.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6094","name":"Abut support crown titanium","description":"Abutment supported crown - (titanium)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91035","name":"G-esoph reflx tst w/electrod","description":"Esophagus, gastroesophageal reflux test; with mucosal attached telemetry ph electrode placement, recording, analysis and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0994T","name":"Evasc dlvr a-wal stbl rx prq","description":"Endovascular delivery of aortic wall stabilization drug therapy through a sheath positioned within an abdominal aortic aneurysm, with aortic roadmapping, balloon occlusion, imaging guidance, and radiological supervision and interpretation; percutaneous","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76014","name":"Mr sfty implt&/fb asmt stf 1","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91322","name":"Sarscov2 vac 50 mcg/0.5ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 50 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01940","name":"Anes nulyt agt lmbr/sac","description":"Anesthesia for percutaneous image-guided destruction procedures by neurolytic agent on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35571","name":"Art byp pop-tibl-prl-other","description":"Bypass graft, with vein; popliteal-tibial, -peroneal artery or other distal vessels","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1714.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2031","name":"Mirodry, per sq cm","description":"Mirodry wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55710","name":"Bx prst8 tprn us w/mri fus 1","description":"Biopsy, prostate, transperineal, ultrasound-guided (ie, sextant) with mri-fusion-guidance biopsy, first targeted lesion","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0668","name":"Instill, bupivac and meloxic","description":"Instillation, bupivacaine and meloxicam, 1 mg/0.03 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0337U","name":"Onc plsm cell do&myeloma id","description":"Onc plsm cell do&myeloma id","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9871","name":"Bhv couns dm prev, onln 60 m","description":"Behavioral counseling for diabetes prevention, online, 60 minutes","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94664","name":"Demo&/eval pt use inhaler","description":"Demonstration and/or evaluation of patient utilization of an aerosol generator, nebulizer, metered dose inhaler or ippb device","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1237","name":"Pt rsn no scrn","description":"Patient reason for not screening for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety (e.g., patient declined or other patient reasons)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1499","name":"Interventional radiology mvp","description":"Interventional radiology mips value pathway","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0986T","name":"Iv img icr cere vsl oct 1st","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01942","name":"Anes neuromd/ntrvrt lmbr/sac","description":"Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1448","name":"Injection, trilaciclib, 1mg","description":"Injection, trilaciclib, 1mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1477","name":"Dx delirium","description":"Diagnosis of delirium","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7669","name":"Metaproterenol non-comp unit","description":"Metaproterenol sulfate, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per 10 milligrams","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87075","name":"Cultr bacteria except blood","description":"Culture, bacterial; any source, except blood, anaerobic with isolation and presumptive identification of isolates","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15854","name":"Removal sutr&stapl xreq anes","description":"Removal of sutures and staples not requiring anesthesia (list separately in addition to e/m code)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0620U","name":"Onc hcc dna mthyln alys>5000","description":"Onc hcc dna mthyln alys>5000","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0888T","name":"Histotripsy mal renal tissue","description":"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant renal tissue, including imaging guidance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93573","name":"Njx cath slct p-art angrp bi","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, bilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0040","name":"Pt phys/occ therapy","description":"Patient already receiving physical/occupational/speech/recreational therapy during the measurement period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0767T","name":"Tc mag stimj pn ea addl nrv","description":"Transcutaneous magnetic stimulation by focused low-frequency electromagnetic pulse, peripheral nerve, with identification and mapping of the treatment location, including noninvasive electroneurographic localization (nerve conduction localization), when performed; each additional nerve (list separat","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87426","name":"Sarscov coronavirus ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; severe acute respiratory syndrome coronavirus (eg, sars-cov, s","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5946","name":"Max implt sup fix","description":"Max implt sup fix","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90593","name":"Chikungunya vacc recomb im","description":"Chikungunya virus vaccine, recombinant, for intramuscular use","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97039","name":"Unlisted modality","description":"Unlisted modality (specify type and time if constant attendance)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0053","name":"Ht mental health and care","description":"Historical trauma (ht) mental health and clinical care for indigenous persons","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33732","name":"Repair heart-vein defect","description":"Repair of cor triatriatum or supravalvular mitral ring by resection of left atrial membrane","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2017.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1400","name":"Pt died dur perf pd","description":"Patients who died during the follow-up period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2041","name":"Foundation drs+ duo pr sq cm","description":"Foundation drs+ duo, per square centimeter","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6602","name":"Cst hgh nble mtl inlay 2 srf","description":"Inlay - cast high noble metal two surfaces","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0602","name":"Sevelamer carbonate pdr 20mg","description":"Sevelamer carbonate (renvela or therapeutically equivalent), oral, powder, 20 mg (for esrd on dialysis)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0582U","name":"Rare ds rpd whlgen dna vrnts","description":"Rare ds rpd whlgen dna vrnts","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92288","name":"Scr dark adaptation meas i&r","description":"Screening dark adaptation measurement (eg, rod recovery intercept time), with interpretation and report","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4332","name":"Axolotl dualgraft, per sq cm","description":"Axolotl dualgraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98012","name":"Synch audio-only est sf 10","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11443","name":"Exc face-mm b9+marg 2.1-3 cm","description":"Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 2.1 to 3.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59020","name":"Fetal contract stress test","description":"Fetal contraction stress test","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93574","name":"Njx cath slct pulm vn angrph","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary venous angiography of each distinct pulmonary vein during cardiac catheterization (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9326","name":"Telisotuzumab vedotin-tllv","description":"Injection, telisotuzumab vedotin-tllv, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9611","name":"Flurpiridaz f18, diag, 1 mci","description":"Flurpiridaz f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5611","name":"Rep resin part dent base man","description":"Rep resin part dent base man","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66989","name":"Xcpsl ctrc rmvl cplx insj 1+","description":"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification), complex, requiring devices or techniques not generally used in routine cataract surgery (eg, iris expansion device,","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85540","name":"Wbc alkaline phosphatase","description":"Leukocyte alkaline phosphatase with count","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64727","name":"Internal neurolysis","description":"Internal neurolysis, requiring use of operating microscope (list separately in addition to code for neuroplasty) (neuroplasty includes external neurolysis)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32554","name":"Aspirate pleura w/o imaging","description":"Thoracentesis, needle or catheter, aspiration of the pleural space; without imaging guidance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99477","name":"Init day hosp neonate care","description":"Initial hospital care, per day, for the evaluation and management of the neonate, 28 days of age or younger, who requires intensive observation, frequent interventions, and other intensive care services","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0023","name":"Pin service 60m per month","description":"Principal illness navigation services by certified or trained auxiliary personnel under the direction of a physician or other practitioner, including a patient navigator; 60 minutes per calendar month, in the following activities:  person-centered assessment, performed to better understand the indiv","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0873T","name":"Revj subq prtl asct pmp sys","description":"Revision of a subcutaneously implanted peritoneal ascites pump system, any component (ascites pump, associated peritoneal catheter, associated bladder catheter), including imaging and programming, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93584","name":"Vngrph chd anom/persist svc","description":"Venography for congenital heart defect(s), including catheter placement, and radiological supervision and interpretation; anomalous or persistent superior vena cava when it exists as a second contralateral superior vena cava, with native drainage to heart (list separately in addition to code for pri","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64582","name":"Opn mpltj hpglsl nstm ary pg","description":"Open implantation of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2018","name":"Permeaderm c, per sq cm","description":"Permeaderm c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29325","name":"Appl hip spica cast1&1/2","description":"Application of hip spica cast; 1 and one-half spica or both legs","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0709","name":"Intraoral cmplt radio images","description":"Intraoral cmplt radio images","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23030","name":"I&d shoulder deep absc/hmtma","description":"Incision and drainage, shoulder area; deep abscess or hematoma","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15650","name":"Transfer skin pedicle flap","description":"Transfer, intermediate, of any pedicle flap (eg, abdomen to wrist, walking tube), any location","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":389.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33288","name":"Rmv&rplcmt phrnc nrv stim ld","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; transvenous stimulation or sensing lead(s)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49592","name":"Rpr aa hrn 1st < 3 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, incarcerated or strangulated","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9002","name":"Intra-vag motion sens biofk","description":"Intra-vaginal motion sensor system, provides biofeedback for pelvic floor muscle rehabilitation device","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86757","name":"Rickettsia antibody","description":"Antibody; rickettsia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0238","name":"Intrav inf, toci, second dos","description":"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2018","name":"Permeaderm c, per sq cm","description":"Permeaderm c, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27713","name":"Osteot tibia imed lngth dev","description":"Osteotomy(ies), tibia, including fibula when performed, unilateral, with insertion of an externally controlled intramedullary lengthening device, including imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1289","name":"No pt tbco cess interv rng","description":"Patient identified as tobacco user did not receive tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0870T","name":"Imp subq prtl ascts pmp sys","description":"Implantation of subcutaneous peritoneal ascites pump system, percutaneous, including pump-pocket creation, insertion of tunneled indwelling bladder and peritoneal catheters with pump connections, including all imaging and initial programming, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1012T","name":"Mtrz ab ntrno trph scl/tr mw","description":"Motorized ab interno trephination of sclera (sclerostomy), or trabecular meshwork (trabeculostomy), 1 or more, including injection of antifibrotic agents, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1359","name":"Indx suicd idea, no 0 scr","description":"Index assessment during the denominator period when the suicidal ideation and/or behavior symptoms or increased suicide risk by clinician determination occurs and a non-zero c-ssrs score is obtained","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0984T","name":"Iv img xtrc cere vsl oct 1st","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3403","name":"Revakinagene, per implant","description":"Revakinagene taroretcel-lwey, per implant","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4357","name":"Xwrap plus, per sq cm","description":"Xwrap plus, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92288","name":"Scr dark adaptation meas i&r","description":"Screening dark adaptation measurement (eg, rod recovery intercept time), with interpretation and report","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1362","name":"Pt died dur meas pd","description":"Patients who died during the measurement period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37263","name":"Revsc evasc fpvt angio sf 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervisio","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4373","name":"Membrane wrp lt per sq cm","description":"Membrane wrap lite, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4001","name":"Diagnostic rad ss","description":"Diagnostic radiology mips specialty set","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4100","name":"Nosht skin sub fda clrd nos","description":"Non-sheet form skin substitute, fda cleared as a device, not otherwise specified (list in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0790T","name":"Revj rplcmt/rmvl vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracolumbar or lumbar vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88143","name":"Cytopath c/v thin layer redo","description":"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with manual screening and rescreening under physician supervision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55881","name":"Ablt trurl prst8 tis thrm us","description":"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37262","name":"Iv lithotrp ivt w/in sm art","description":"Intravascular lithotripsy(ies), iliac vascular territory, including all imaging guidance and radiological supervision and interpretation necessary to perform the intravascular lithotripsy(ies) within the same artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7299","name":"Rem anchorage device w/flap","description":"Rem anchorage device w/flap","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85027","name":"Complete cbc automated","description":"Blood count; complete (cbc), automated (hgb, hct, rbc, wbc and platelet count)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0477U","name":"Rx metab psy 14&cyp2d6 gn-rx","description":"Rx metab psy 14&cyp2d6 gn-rx","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93898","name":"Ven-artl shunt det mbubb njx","description":"Venous-arterial shunt detection with intravenous microbubble injection performed with transcranial doppler study of intracranial arteries, complete (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1006T","name":"Elec alys s-scl eeg prgrm ea","description":"Electronic analysis of implanted sub-scalp continuous bilateral electroencephalography monitoring system (eg, contact group[s], gain, bandpass filters) by physician or other qualified health care professional; with programming, each additional 15 minutes face-to-face time with physician or other qua","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1351","name":"Dental sealant per tooth","description":"Sealant-per tooth","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64468","name":"Thrc fascial pln blk bi njx","description":"Thoracic fascial plane block, bilateral; by injection(s), including imaging guidance, when performed","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15018","name":"App skn cll ssp f/n/g/hf ea","description":"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 480 sq cm or part thereof (list separately in addition to code for prima","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35602","name":"Bpg crtd-clat crtd","description":"Bypass graft, with other than vein; carotid-contralateral carotid","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0756T","name":"Dgtz gls mcrscp sld spc grpi","description":"Digitization of glass microscope slides for special stain, including interpretation and report, group i, for microorganisms (eg, acid fast, methenamine silver) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0329U","name":"Onc neo xome&trns seq alys","description":"Onc neo xome&trns seq alys","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2991","name":"App of hydroxyapatite","description":"App of hydroxyapatite","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0344U","name":"Hep nafld semiq evl 28 lipid","description":"Hep nafld semiq evl 28 lipid","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0807T","name":"Pulm tiss vntj alys prev ct","description":"Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph images; in combination with previously acquired computed tomography (ct) images, including data preparation and transmission, quantification of pulmonary tissue ventilation, data re","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0828T","name":"Dgtz gls mcrscp cytp smpl fl","description":"Digitization of glass microscope slides for cytopathology, fluids, washings, or brushings, except cervical or vaginal; simple filter method with interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64861","name":"Repair of arm nerves","description":"Suture of; brachial plexus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1610.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1438","name":"Lst knwn well <=210 min","description":"Time last known well to hospital arrival less than or equal to 3.5 hours (<= 210 minutes)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"U0002","name":"Covid-19 lab test non-cdc","description":"2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4013","name":"Mntal/behav/psych hlth ss","description":"Mental/behavioral and psychiatry mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4029","name":"Preventive medicine ss","description":"Preventive medicine mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0620U","name":"Onc hcc dna mthyln alys>5000","description":"Onc hcc dna mthyln alys>5000","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43117","name":"Partial removal of esophagus","description":"Partial esophagectomy, distal two-thirds, with thoracotomy and separate abdominal incision, with or without proximal gastrectomy; with thoracic esophagogastrostomy, with or without pyloroplasty (ivor lewis)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2776.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1309","name":"Pall serv during meas","description":"Palliative care services provided to patient any time during the measurement period","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7939","name":"Indexing for osteotomy","description":"Indexing for osteotomy","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0916T","name":"Insj perm ccm-d sys pg only","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1384","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4038","name":"Vascular surgery ss","description":"Vascular surgery mips specialty set","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0856T","name":"Dgtz gls mcrscp electron mic","description":"Digitization of glass microscope slides for electron microscopy, diagnostic (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1000T","name":"Autol musc cell therapy admn","description":"Autologous muscle cell therapy, administration of muscle progenitor cells into the urethral sphincter, including cystoscopy and post-void residual ultrasound, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01939","name":"Anes nulyt agt crv/thrc","description":"Anesthesia for percutaneous image-guided destruction procedures by neurolytic agent on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1384","name":"Pt died dur perf pd","description":"Patients who died during the performance period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0577","name":"Inj, brixadi, 7 days or less","description":"Injection, buprenorphine extended-release (brixadi), less than or equal to 7 days of therapy","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1467","name":"Pt dx lynch syn","description":"Patients with an existing diagnosis of lynch syndrome","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0165","name":"Inj epinephrine nos 0.1 mg","description":"Injection, epinephrine, not otherwise specified, 0.1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67930","name":"Repair eyelid wound","description":"Suture of recent wound, eyelid, involving lid margin, tarsus, and/or palpebral conjunctiva direct closure; partial thickness","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59425","name":"Antepartum care only","description":"Antepartum care only; 4-6 visits","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":366.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":540.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97810","name":"Acup 1/> wo estim 1st 15 min","description":"Acupuncture, 1 or more needles; without electrical stimulation, initial 15 minutes of personal one-on-one contact with the patient","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":54.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4339","name":"Artacent vericlen, per sq cm","description":"Artacent vericlen, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0295U","name":"Onc brst dux carc 7 proteins","description":"Onc brst dux carc 7 proteins","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0553","name":"Monthly tx for dmht 20mins","description":"First 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing information related to the use of","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1273","name":"Pts snf 1 yr dialysis","description":"Patients who were admitted to a skilled nursing facility (snf) within one year of dialysis initiation according to the cms-2728 form","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11646","name":"Exc f/e/e/n/l mal+mrg >4 cm","description":"Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter over 4.0 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4349","name":"Mantle dl matrix per sq cm","description":"Mantle dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0986T","name":"Iv img icr cere vsl oct 1st","description":"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; initial vessel (list separately in addition to code for primary","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26370","name":"Repair finger/hand tendon","description":"Repair or advancement of profundus tendon, with intact superficialis tendon; primary, each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1084.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0557","name":"Adv prim care mgmt lvl 2","description":"Advanced primary care management services for a patient with multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, which place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline, provided by c","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0134","name":"Inj acetaminophen -fresenius","description":"Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98005","name":"Synch audio-video est low 20","description":"Synchronous audio-video visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low medical decision making. when using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7700","name":"Pros soc insert gasket/seal","description":"Gasket or seal, for use with prosthetic socket insert, any type, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9052","name":"Inj, carmustine (accord)","description":"Injection, carmustine (accord), not therapeutically equivalent to j9050, 100 mg","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0310U","name":"Ped vsclts kd alys 3 bmrks","description":"Ped vsclts kd alys 3 bmrks","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97007","name":"Mchnl sclp cool meas fitg","description":"Mechanical scalp cooling, including individual cap supply with head measurement, fitting, and patient education","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1176","name":"No 2 hzv 10/2017-meas pd","description":"Patient did not receive two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0727T","name":"Rmvl&rplcmt implt vstblr dev","description":"Removal and replacement of implanted vestibular device, unilateral","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4395","name":"Acelagraft per sq cm","description":"Acelagraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49618","name":"Rpr aa hrn rcr > 10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, incarcerated or strangulate","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0589","name":"Inj daxibotulinumtoxina-lanm","description":"Injection, daxibotulinumtoxina-lanm, 1 unit","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0589","name":"Inj daxibotulinumtoxina-lanm","description":"Injection, daxibotulinumtoxina-lanm, 1 unit","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37650","name":"Ligation of femoral vein","description":"Ligation of femoral vein","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72128","name":"Ct chest spine w/o dye","description":"Computed tomography, thoracic spine; without contrast material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63600","name":"Remove spinal cord lesion","description":"Creation of lesion of spinal cord by stereotactic method, percutaneous, any modality (including stimulation and/or recording)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":921.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68810","name":"Probe nasolacrimal duct","description":"Probing of nasolacrimal duct, with or without irrigation;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1203","name":"No rsn ace-i/arb rx","description":"Ace inhibitor or arb therapy not prescribed during the measurement period, reason not given","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1397","name":"Pt w/ recur/prog","description":"Patients with recurrence/disease progression","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0318U","name":"Ped whl gen mthyltn alys 50+","description":"Ped whl gen mthyltn alys 50+","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1748","name":"Inj, zymfentra, 10 mg","description":"Injection, infliximab-dyyb (zymfentra), 10 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92552","name":"Pure tone audiometry air","description":"Pure tone audiometry (threshold); air only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0365U","name":"Onc bldr 10 prb bldr ca","description":"Onc bldr 10 prb bldr ca","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0615U","name":"Bbrgdrferi ld antb detcj 26","description":"Bbrgdrferi ld antb detcj 26","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2040","name":"Coord specialty care, month","description":"Coordinated specialty care, team-based, for first episode psychosis, per month","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9072","name":"Inj cyclophos frindovyx 5 mg","description":"Injection, cyclophosphamide (frindovyx), 5 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0013","name":"Esketamine, nasal spray","description":"Esketamine, nasal spray, 1 mg","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1435","name":"Oral chemo in perf pd","description":"Patient on oral chemotherapy during the performance period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5765","name":"Liner compl/partial rem dent","description":"Liner compl/partial rem dent","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0470U","name":"Onc orop detcj mrd 8 dna hpv","description":"Onc orop detcj mrd 8 dna hpv","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4008","name":"Geriatrics ss","description":"Geriatrics mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4357","name":"Xwrap plus, per sq cm","description":"Xwrap plus, per square  centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0233","name":"Intra inf, toci, first dose","description":"Intravenous infusion, tocilizumab-aazg, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administra","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1404","name":"Pt ther clin trial","description":"Patients on a therapeutic clinical trial","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0266U","name":"Unxpl cnst hrtbl do gn xprsn","description":"Unexplained constitutional or other heritable disorders or syndromes, tissue-specific gene expression by whole-transcriptome and next-generation sequencing, blood, formalin-fixed paraffin-embedded (ffpe) tissue or fresh frozen tissue, reported as presence or absence of splicing or expression changes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1333","name":"Acute vitreous hemorrhage","description":"Acute vitreous hemorrhage","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1196","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20245","name":"Bone biopsy open deep","description":"Biopsy, bone, open; deep (eg, humeral shaft, ischium, femoral shaft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27685","name":"Revision of lower leg tendon","description":"Lengthening or shortening of tendon, leg or ankle; single tendon (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":588.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37270","name":"Revsc evasc fpvt st cplx ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, inc","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55869","name":"Lap srg prst8ct bi pl lmphad","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1460","name":"Gamma globulin 1 cc inj","description":"Injection, gamma globulin, intramuscular, 1 cc","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5765","name":"Liner compl/partial rem dent","description":"Liner compl/partial rem dent","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39400","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1468","name":"Hep b vaccine received","description":"Patient received recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99436","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77081","name":"Dxa bone density appendiculr","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]},{"negotiated_type":"negotiated","negotiated_rate":10.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9269","name":"Programable ingest capsule","description":"Programable, transient, orally ingested capsule, for use with external programmer, per month","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66683","name":"Implantation iris prosthesis","description":"Implantation of iris prosthesis, including suture fixation and repair or removal of iris, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1472","name":"Hep b vaccine not received","description":"Patient did not receive recommended doses of hepatitis b vaccination based on age","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69210","name":"Remove impacted ear wax uni","description":"Removal impacted cerumen requiring instrumentation, unilateral","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0849T","name":"Dgtz gls mcrscp ish ea adl 1","description":"Digitization of glass microscope slides for in situ hybridization (eg, fish), per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1419","name":"Pt not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0556U","name":"Nfct ds p-s dna&rna 12 trgts","description":"Nfct ds p-s dna&rna 12 trgts","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0732T","name":"Immntx admn electroporatn im","description":"Immunotherapy administration with electroporation, intramuscular","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0345","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4266","name":"Neostim per sq cm","description":"Neostim membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1170","name":"Pt w/o flu vax 7/1-6/30","description":"Patient did not receive an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0629U","name":"Nfct ds tb dna aly 1trgt pcr","description":"Nfct ds tb dna aly 1trgt pcr","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7912","name":"Suture complicate wnd > 5 cm","description":"Complicated suture-greater than 5 cm","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28003","name":"Treatment of foot infection","description":"Incision and drainage below fascia, with or without tendon sheath involvement, foot; multiple areas","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":664.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4391","name":"Amnioplast double per sq cm","description":"Amnioplast double, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27036","name":"Capsulectomy/capsulotomy hip","description":"Capsulectomy or capsulotomy, hip, with or without excision of heterotopic bone, with release of hip flexor muscles (ie, gluteus medius, gluteus minimus, tensor fascia latae, rectus femoris, sartorius, iliopsoas)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1145.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59856","name":"Induced ab 1+vag supp d&c","description":"Induced abortion, by 1 or more vaginal suppositories (eg, prostaglandin) with or without cervical dilation (eg, laminaria), including hospital admission and visits, delivery of fetus and secundines; with dilation and curettage and/or evacuation","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":488.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4409","name":"Amniomatrixf3x per sq cm","description":"Amniomatrixf3x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0790T","name":"Revj rplcmt/rmvl vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracolumbar or lumbar vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90695","name":"H5n8 vacc drv cll cul adj im","description":"Influenza virus vaccine, h5n8, derived from cell cultures, adjuvanted, for intramuscular use","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9954","name":"Fab/del oral appliance thxpy","description":"Fab/del oral appliance thxpy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1401","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85610","name":"Prothrombin time","description":"Prothrombin time;","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51045","name":"Incise bladder/drain ureter","description":"Cystotomy, with insertion of ureteral catheter or stent (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5948","name":"Max implt sup fix part","description":"Max implt sup fix part","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49616","name":"Rpr aa hrn rcr 3-10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27713","name":"Osteot tibia imed lngth dev","description":"Osteotomy(ies), tibia, including fibula when performed, unilateral, with insertion of an externally controlled intramedullary lengthening device, including imaging, alignment assessments, computations of adjustment schedules, and management of the intramedullary lengthening device","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0347U","name":"Rx metab/pcx dna 16 gen alys","description":"Rx metab/pcx dna 16 gen alys","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4416","name":"Alexiguard tl-t per sq cm","description":"Alexiguard tl-t, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1357","name":"Pt w/red suic idea 120 days","description":"Patients who had a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4262","name":"Dual layer impax, per sq cm","description":"Dual layer impax membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0177","name":"Inj, aflibercept hd, 1 mg","description":"Injection, aflibercept hd, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1502","name":"Podiatry mvp","description":"Podiatry mips value pathway","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0367U","name":"Onc bldr 10 flwg trurl rescj","description":"Onc bldr 10 flwg trurl rescj","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34714","name":"Opn fem art expos cndt crtj","description":"Open femoral artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass, by groin incision, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0356U","name":"Onc orop 17 dna ddpcr alg","description":"Onc orop 17 dna ddpcr alg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73218","name":"Mri upper extremity w/o dye","description":"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":643.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1612","name":"Inj glucagon (gvoke) 0.01 mg","description":"Injection, glucagon (gvoke), 0.01 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4295","name":"Amnio tri-core, per sq cm","description":"Amnio tri-core amniotic, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0491","name":"Inj anifrolumab-fnia 1mg","description":"Injection, anifrolumab-fnia, 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86403","name":"Particle agglut antbdy scrn","description":"Particle agglutination; screen, each antibody","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1324","name":"Pts intravitreal/pci","description":"Patients who had an intravitreal or periocular corticosteroid injection (e.g., triamcinolone, preservative-free triamcinolone, dexamethasone, dexamethasone intravitreal implant, or fluocinolone intravitreal implant)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0687T","name":"Tx amblyopia dev setup 1st","description":"Treatment of amblyopia using an online digital program; device supply, educational set-up, and initial session","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0046","name":"No mrs 90 days post stk","description":"Clinical follow-up and mrs score not assessed at 90 days following endovascular stroke intervention","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9298","name":"Inj nivol relatlimab 3mg/1mg","description":"Injection, nivolumab and relatlimab-rmbw, 3 mg/1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1011T","name":"Pbm therapy of oral cavity","description":"Photobiomodulation (pbm) therapy of oral cavity, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90954","name":"Esrd serv 4 vsts p mo 2-11","description":"End-stage renal disease (esrd) related services monthly, for patients 2-11 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 4 or more face-to-face visits by a physician or other qualified health care professional ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1006.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87076","name":"Culture anaerobe ident each","description":"Culture, bacterial; anaerobic isolate, additional methods required for definitive identification, each isolate","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59855","name":"Induced abortion 1+vag supp","description":"Induced abortion, by 1 or more vaginal suppositories (eg, prostaglandin) with or without cervical dilation (eg, laminaria), including hospital admission and visits, delivery of fetus and secundines;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":512.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":477.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47147","name":"Prep donor liver/arterial","description":"Backbench reconstruction of cadaver or living donor liver graft prior to allotransplantation; arterial anastomosis, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0520U","name":"Ther rx mntr 200+ rx/sbsts","description":"Ther rx mntr 200+ rx/sbsts","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4019","name":"Oncology/hema ss","description":"Oncology/hematology mips specialty set","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0738T","name":"Tx pln mag fld abltj prst8","description":"Treatment planning for magnetic field induction ablation of malignant prostate tissue, using data from previously performed magnetic resonance imaging (mri) examination","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37276","name":"Rvsc evsc fpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99215","name":"Office o/p est hi 40 min","description":"Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 40 minutes must be met or ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":139.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0363U","name":"Onc urthl mrna 5 gen alg","description":"Onc urthl mrna 5 gen alg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92018","name":"Compl oph exam general anes","description":"Ophthalmological examination and evaluation, under general anesthesia, with or without manipulation of globe for passive range of motion or other manipulation to facilitate diagnostic examination; complete","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49617","name":"Rpr aa hrn rcr > 10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, reducible","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9269","name":"Programable ingest capsule","description":"Programable, transient, orally ingested capsule, for use with external programmer, per month","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44603","name":"Suture small intestine","description":"Suture of small intestine (enterorrhaphy) for perforated ulcer, diverticulum, wound, injury or rupture; multiple perforations","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1258.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7252","name":"Part extract for implant","description":"Part extract for implant","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0163","name":"Epinephrine in nacl (endo)","description":"Injection, epinephrine in sodium chloride (endo), 0.1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0490U","name":"Onc cutan/uveal mlnma cd146","description":"Onc cutan/uveal mlnma cd146","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26755","name":"Treat finger fracture each","description":"Closed treatment of distal phalangeal fracture, finger or thumb; with manipulation, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2021","name":"Neomatrix per sq cm","description":"Neomatrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55707","name":"Bx prst8 trct us guided","description":"Biopsy, prostate, transrectal, ultrasound-guided (ie, sextant, ultrasound-localized discrete lesion[s])","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2246","name":"Inj, micafungin (baxter)","description":"Injection, micafungin in sodium (baxter), not therapeutically equivalent to j2248, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64657","name":"Rmvl bat modulj sys tot sys","description":"Removal of baroreflex activation therapy (bat) modulation system; total system, including lead and pulse generator","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4322","name":"Caregraft, per sq cm","description":"Caregraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0652","name":"Inj, levothyroxine, hikma","description":"Injection, levothyroxine sodium (hikma), not therapeutically equivalent to j0650, 10 mcg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0421U","name":"Onc clrct scr sgl amp 8 rna","description":"Onc clrct scr sgl amp 8 rna","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88166","name":"Cytopath tbs c/v auto redo","description":"Cytopathology, slides, cervical or vaginal (the bethesda system); with manual screening and computer-assisted rescreening under physician supervision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4399","name":"Summit fx per sq cm","description":"Summit fx, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q9945","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0911T","name":"Elec aly nstm sys vgs nrv wo","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; without programming by physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2516","name":"Inj, pentamidine isethionate","description":"Injection, pentamidine isethionate, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99426","name":"Prin care mgmt staff 1st 30","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0699","name":"Inj, cefiderocol, 10 mg","description":"Injection, cefiderocol, 10 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42970","name":"Control nose/throat bleeding","description":"Control of nasopharyngeal hemorrhage, primary or secondary (eg, postadenoidectomy); simple, with posterior nasal packs, with or without anterior packs and/or cautery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1394","name":"Stg i-iii br ca","description":"Stages i-iii breast cancer","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9323","name":"Inj pemetrexed ditromethamin","description":"Injection, pemetrexed ditromethamine, 10 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55713","name":"Bx prst8 in-bore ct/mri bx 1","description":"Biopsy, prostate, in-bore ct- or mri-guided (ie, sextant), with biopsy of additional targeted lesion(s), first targeted lesion","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0326U","name":"Trgt gen seq alys pnl 83+","description":"Trgt gen seq alys pnl 83+","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4282","name":"Cygnus dual per sq cm","description":"Cygnus dual, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1168","name":"Pt recd flu vax 7/1-6/30","description":"Patient received an influenza vaccine on or between july 1 of the year prior to the measurement period and june 30 of the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5127","name":"Inj, stimufend, 0.5 mg","description":"Injection, pegfilgrastim-fpgk (stimufend), biosimilar, 0.5 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98976","name":"Rtm dev sply resp sys 16-30d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of respiratory system, 16-30 days in a 30-day period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0911","name":"Inst tauro 1.35mg/hep 100u","description":"Instillation, taurolidine 1.35 mg and heparin sodium 100 units (central venous catheter lock for adult patients receiving chronic hemodialysis)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9075","name":"Inj, cyclophosphamide, nos","description":"Injection, cyclophosphamide, not otherwise specified, 5 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0521","name":"Supply fee hiv prep fda appr","description":"Pharmacy supplying fee for hiv pre-exposure prophylaxis fda approved prescription","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85345","name":"Coagulation time lee & white","description":"Coagulation time; lee and white","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2035","name":"Corpl p therac p allac p mg","description":"Corplex p or theracor p or allacor p, per milligram","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1416","name":"Pt rec hosp","description":"Patient received hospice services any time during the performance period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5914","name":"Auricular prosthesis","description":"Auricular prosthesis","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0051","name":"Traditional healing service","description":"Traditional healing service","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95913","name":"Nrv cndj test 13/> studies","description":"Nerve conduction studies; 13 or more studies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92623","name":"Dx aly aud oi snd prcsr each","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; each additional 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4033","name":"Skilled nursing facility ss","description":"Skilled nursing facility mips specialty set","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1280","name":"Bilat mast/hx bi /unilat mas","description":"Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98981","name":"Rtm tx mgmt ea addl 20 min","description":"Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least 1 real-time interactive communication with the patient or caregiver during the calendar month; each additional 20 minutes (list separately in","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43290","name":"Egd flx trnsorl dplmnt balo","description":"Esophagogastroduodenoscopy, flexible, transoral; with deployment of intragastric bariatric balloon","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87810","name":"Chlmyd trach assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; chlamydia trachomatis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2356","name":"Inj tezepelumab-ekko, 1mg","description":"Injection, tezepelumab-ekko, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1502","name":"Podiatry mvp","description":"Podiatry mips value pathway","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80504","name":"Path clin consltj mod 21-40","description":"Pathology clinical consultation; for a moderately complex clinical problem, with review of patients history and medical records and moderate level of medical decision making when using time for code selection, 21-40 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0698T","name":"Quan mr tiss w/mri mlt orgn","description":"Quantitative magnetic resonance for analysis of tissue composition (eg, fat, iron, water content), including multiparametric data acquisition, data preparation and transmission, interpretation and report, obtained with diagnostic mri examination of the same anatomy (eg, organ, gland, tissue, target ","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64726","name":"Dcmprn plantar digital nerve","description":"Decompression; plantar digital nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":338.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0502U","name":"Hpv e6/e7 mrk hi-rsk typ crv","description":"Hpv e6/e7 mrk hi-rsk typ crv","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0565U","name":"Onc hcc ngs detc 6626epigalt","description":"Onc hcc ngs detc 6626epigalt","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2009","name":"Symphony, per sq cm","description":"Symphony, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0745T","name":"Car ablt rad arr n-invas loc","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; noninvasive arrhythmia localization and mapping of arrhythmia site (nidus), derived from anatomical image data (eg, ct, mri, or myocardial perfusion scan) and electrical data (eg, 12-lead ecg data), and identification of areas of avo","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J2324","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0379U","name":"Tgsap sl or neo dna523&rna55","description":"Tgsap sl or neo dna523&rna55","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36471","name":"Njx sclrsnt mlt incmptnt vn","description":"Injection of sclerosant; multiple incompetent veins (other than telangiectasia), same leg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99426","name":"Prin care mgmt staff 1st 30","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57107","name":"Vagnc compl rmvl paravag tis","description":"Vaginectomy, partial removal of vaginal wall; with removal of paravaginal tissue (radical vaginectomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1603.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2045","name":"Novashield/novogen pr sq cm","description":"Novashield or novogen wound matrix, per square centimeter","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99382","name":"Init pm e/m new pat 1-4 yrs","description":"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; early childhood ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":114.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0560U","name":"Onc mrd gsa cfdna baseline","description":"Onc mrd gsa cfdna baseline","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0895T","name":"Connj lvr algrft prfu dev 1","description":"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; initial 4 hours of monitoring time, including hourly physiological and laboratory assessments (eg, perfusate temperature, perfusate ph, hemodynamic parameters, bile production, bile ph, bile glucose, biliary ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77089","name":"Tbs dxa cal w/i&r fx risk","description":"Trabecular bone score (tbs), structural condition of the bone microarchitecture; using dual x-ray absorptiometry (dxa) or other imaging data on gray-scale variogram, calculation, with interpretation and report on fracture-risk","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4269","name":"Surgraft xt per sq cm","description":"Surgraft xt, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0868T","name":"Hi-res gastric ep mapping","description":"High-resolution gastric electrophysiology mapping with simultaneous patient-symptom profiling, with interpretation and report","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0041","name":"Pt/ptn decln referral","description":"Patient and/or care partner decline referral","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3392","name":"Inj, exagamglogene autotem","description":"Injection, exagamglogene autotemcel, per treatment","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86780","name":"Treponema pallidum","description":"Antibody; treponema pallidum","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1423","name":"Opt care urologic cnd mvp","description":"Optimal care for patients with urologic conditions mips value pathway","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7413","name":"Excision malig lesion<=1.25c","description":"Excision of malignant lesion up to 1.25 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61737","name":"Litt icr mlt trj mlt/cplx ls","description":"Laser interstitial thermal therapy (litt) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; multiple trajectories for multiple or complex lesion(s)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1413","name":"Inj delandistrogene mox rokl","description":"Injection, delandistrogene moxeparvovec-rokl, per therapeutic dose","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0552U","name":"Repr med pga gdo te bx locus","description":"Repr med pga gdo te bx locus","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0912T","name":"Elec alys nstim sys vgs smpl","description":"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; with simple programming by physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9608","name":"Flotufolastat f18 diag 1 mci","description":"Flotufolastat f 18, diagnostic, 1 millicurie","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99495","name":"Transj care mgmt mod f2f 14d","description":"Transitional care management services with the following required elements: communication (direct contact, telephone, electronic) with the patient and/or caregiver within 2 business days of discharge at least moderate level of medical decision making during the service period face-to-face visit, wit","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":237.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0482","name":"Direct immunofluorescence","description":"Direct immunofluorescence","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30435","name":"Revision of nose","description":"Rhinoplasty, secondary; intermediate revision (bony work with osteotomies)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1478.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6612","name":"Onlay cst base mtl 2 surface","description":"Onlay - cast predominantly base metal two surfaces","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0418U","name":"Onc brst aug alg aly whl sl8","description":"Onc brst aug alg aly whl sl8","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98015","name":"Synch audio-only est high 40","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, high medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code selec","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1451","name":"Pt dx ppd dur id/pf pd","description":"Patients with an active diagnosis of pervasive developmental disorder any time prior to the end of the measure assessment period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0943T","name":"Cysto flx rmvl urtl scaffold","description":"Cystourethroscopy, flexible; with removal of prostatic urethral scaffold","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49614","name":"Rpr aa hrn rcr < 3 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, incarcerated or strangulated","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1488","name":"Dx dementia in msr timeframe","description":"Patients with a diagnosis for dementia in the year before or during the period of evaluation","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87801","name":"Detect agnt mult dna ampli","description":"Infectious agent detection by nucleic acid (dna or rna), multiple organisms; amplified probe(s) technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6092","name":"Recement supp crown","description":"Recement implant/abutment supported crown","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87329","name":"Giardia ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; giardia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0909T","name":"Rplcmt int nstim sys vgs nrv","description":"Replacement of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1300","name":"Flu imm no admin doc rea","description":"Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43253","name":"Egd us transmural injxn/mark","description":"Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic ultrasound-guided transmural injection of diagnostic or therapeutic substance(s) (eg, anesthetic, neurolytic agent) or fiducial marker(s) (includes endoscopic ultrasound examination of the esophagus, stomach, and either the duoden","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90481","name":"Admn sarscov2 vac ea add cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; each additional component administered (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73620","name":"X-ray exam of foot","description":"Radiologic examination, foot; 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0795T","name":"Tcat ins 2chmbr ldls pm cmpl","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; complete system (ie, r","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49615","name":"Rpr aa hrn rcr 3-10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, reducible","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0262U","name":"Onc sld tum rt-pcr 7 gen","description":"Oncology (solid tumor), gene expression profiling by real-time rt-pcr of 7 gene pathways (er, ar, pi3k, mapk, hh, tgfb, notch), formalin-fixed paraffin-embedded (ffpe), algorithm reported as gene pathway activity score","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0694T","name":"3d vol img&rcnstj brst/ax","description":"3-dimensional volumetric imaging and reconstruction of breast or axillary lymph node tissue, each excised specimen, 3-dimensional automatic specimen reorientation, interpretation and report, real-time intraoperative","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1314","name":"Bmi not calculated","description":"Bmi not documented and no reason is given","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1418","name":"Med rsn not up to date cov","description":"Patients who are not up to date on their covid-19 vaccinations as defined by cdc recommendations on current vaccination because of a medical contraindication documented by clinician","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77437","name":"Surf radj ther supfc<=150kv","description":"Surface radiation therapy; superficial, delivery, </=150 kv, per fraction (eg, electronic brachytherapy)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83014","name":"H pylori drug admin","description":"Helicobacter pylori; drug administration","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7300","name":"Rem anchorage dev w/o flap","description":"Rem anchorage dev w/o flap","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3244","name":"Inj. tigecycline (accord)","description":"Injection, tigecycline (accord), not therapeutically equivalent to j3243, 1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5933","name":"Refitting of obturator","description":"Obturator prosthesis modification","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0933T","name":"Tcat impl wrls l atr prs snr","description":"Transcatheter implantation of wireless left atrial pressure sensor for long-term left atrial pressure monitoring, including sensor calibration and deployment, right heart catheterization, transseptal puncture, imaging guidance, and radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1174","name":"Pt w/ 2 hzv 10/2017 - mp","description":"Patient received at least two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on october 20, 2017, through the end of the measurement period","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1388","name":"Pt doc exm rec melmn","description":"Patients with documentation of an exam performed for recurrence of melanoma","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25448","name":"Arthrp ntrcrpl/crp/mtcrp ssp","description":"Arthroplasty, intercarpal or carpometacarpal joints; suspension, including transfer or transplant of tendon, with interposition, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":479.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"Limited visual field xm","description":"Visual field examination, unilateral or bilateral, with interpretation and report; limited examination (eg, tangent screen, autoplot, arc perimeter, or single stimulus level automated test, such as octopus 3 or 7 equivalent)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4327","name":"Duoamnion, per sq cm","description":"Duoamnion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4267","name":"Neostim dl per sq cm","description":"Neostim dl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62330","name":"Dcmprn prq rmv lig flv 1lmbr","description":"Decompression, percutaneous, with partial removal of the ligamentum flavum, including laminotomy for access, epidurography, and imaging guidance (ie, ct or fluoroscopy), bilateral; one interspace, lumbar","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6214","name":"Pontic titanium","description":"Pontic - titanium","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2058","name":"Obecbtge autol up to 400 mil","description":"Obecabtagene autoleucel, 10 up to 400 million cd19 car-positive viable t cells, including leukapheresis and dose preparation procedures, per infusion","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1308","name":"Flu immunize no admin","description":"Influenza immunization was not administered, reason not given","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43291","name":"Egd flx trnsorl rmvl balo","description":"Esophagogastroduodenoscopy, flexible, transoral; with removal of intragastric bariatric balloon(s)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2643","name":"Dental onlay porcelin 3 surf","description":"Onlay - porcelain/ceramic - three surfaces","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87484","name":"Ehrlicha chaffeensis amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); ehrlichia chaffeensis, amplified probe technique","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0389","name":"Periopic image capture only","description":"Periopic image capture only","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2597","name":"Inj desmopressin acetate","description":"Injection, desmopressin acetate, per 1 mcg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D3502","name":"Surg exp root surf premolar","description":"Surg exp root surf premolar","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0268U","name":"Hem ahus gen seq alys 15 gen","description":"Hematology (atypical hemolytic uremic syndrome [ahus]), genomic sequence analysis of 15 genes, blood, buccal swab, or amniotic fluid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1939","name":"Inj, bumetanide, 0.5 mg","description":"Injection, bumetanide, 0.5 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37277","name":"Rvsc evsc fpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85004","name":"Automated diff wbc count","description":"Blood count; automated differential wbc count","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0952T","name":"Tot impl amei rev/rplc mstdc","description":"Totally implantable active middle ear hearing implant; revision or replacement, with mastoidectomy and replacement of sound processor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97550","name":"Caregiver traing 1st 30 min","description":"Caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patie","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23210","name":"Radical rescj tumor scapula","description":"Radical resection of tumor; scapula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1065.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37292","name":"Rvsc evsc tpvt st athrc sf 1","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0410U","name":"Onc pncrtc dna whl gn seq 5-","description":"Onc pncrtc dna whl gn seq 5-","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0576U","name":"Trnsplj med lar quan ddcfdna","description":"Trnsplj med lar quan ddcfdna","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5126","name":"Inj alymsys 10 mg","description":"Injection, bevacizumab-maly, biosimilar, (alymsys), 10 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20665","name":"Rmvl tongs/halo anthr indiv","description":"Removal of tongs or halo applied by another individual","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1278","name":"Pre-htn or htn doc, f/u indc","description":"Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T2051","name":"Support broker waiver/diem","description":"Supports brokerage, self-directed, waiver; per diem","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0464U","name":"Onc clrct scr qrtsa dna mrk","description":"Onc clrct scr qrtsa dna mrk","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48554","name":"Transpl allograft pancreas","description":"Transplantation of pancreatic allograft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2525.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12001","name":"Rpr s/n/ax/gen/trnk 2.5cm/<","description":"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 2.5 cm or less","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":132.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42975","name":"Dise eval slp do brth flx dx","description":"Drug-induced sleep endoscopy, with dynamic evaluation of velum, pharynx, tongue base, and larynx for evaluation of sleep-disordered breathing, flexible, diagnostic","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4332","name":"Axolotl dualgraft, per sq cm","description":"Axolotl dualgraft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15630","name":"Delay flap eye/nos/ear/lip","description":"Delay of flap or sectioning of flap (division and inset); at eyelids, nose, ears, or lips","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":352.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0317U","name":"Onc lung ca 4-prb fish assay","description":"Onc lung ca 4-prb fish assay","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6605","name":"G com bandage padded foam","description":"Gradient compression bandaging supply, padded foam, per linear yard, any width, each","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7021","name":"Suppl and access lung expan","description":"Supplies and accessories for lung expansion airway clearance, continuous high frequency oscillation, and nebulization device (e.g., handset, nebulizer kit, biofilter)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6197","name":"Replace material prosthesis","description":"Replace material prosthesis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37281","name":"Revsc evsc tpvt angio sf ea","description":"Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal angioplasty, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision ","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0134","name":"Inj acetaminophen -fresenius","description":"Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1413","name":"Pos pdl1 bef init ici tx","description":"Patients who had a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4335","name":"Amnioplast 2, per sq cm","description":"Amnioplast 2, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0746T","name":"Car ablt rad arr cnv loc map","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; conversion of arrhythmia localization and mapping of arrhythmia site (nidus) into a multidimensional radiation treatment plan","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9161","name":"Inj denileuk difti-cxdl 1mcg","description":"Injection, denileukin diftitox-cxdl, 1 mcg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9382","name":"Inj zenocutuzumab-zbco 1 mg","description":"Injection, zenocutuzumab-zbco, 1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61892","name":"Rmv sk-mnt crnl nstm pg/rcvr","description":"Removal of skull-mounted cranial neurostimulator pulse generator or receiver with cranioplasty, when performed","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98013","name":"Synch audio-only est low 20","description":"Synchronous audio-only visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination, low medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code select","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1271","name":"Pts dem any time/dur mo","description":"Patients with dementia at any time prior to or during the month","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42830","name":"Removal of adenoids","description":"Adenoidectomy, primary; younger than age 12","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0554","name":"Add 20 m of monthly tx","description":"Each additional 20 minutes of monthly treatment management services directly related to the patients therapeutic use of the digital mental health treatment (dmht) device that augments a behavioral therapy plan, physician/other qualified health care professional time reviewing data generated from the","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46716","name":"Rep perf anoper/vestib fistu","description":"Repair of low imperforate anus; with transposition of anoperineal or anovestibular fistula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1093.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1284","name":"Pt 66+ snp or ltc pos > 90d","description":"Patients age 66 or older in institutional special needs plans (snp) or residing in long term care with pos code 32, 33, 34, 54, or 56 for more than 90 consecutive days during the measurement period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4271","name":"Home lancing/test cartridges","description":"Integrated lancing and blood sample testing cartridges for home blood glucose monitor, per 50 tests","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59840","name":"Induced abortion d&c","description":"Induced abortion, by dilation and curettage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":270.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":247.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64582","name":"Opn mpltj hpglsl nstm ary pg","description":"Open implantation of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0985T","name":"Iv img xtrc cere vsl oct ea","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76014","name":"Mr sfty implt&/fb asmt stf 1","description":"Mr safety implant and/or foreign body assessment by trained clinical staff, including identification and verification of implant components from appropriate sources (eg, surgical reports, imaging reports, medical device databases, device vendors, review of prior imaging), analyzing current mr condit","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0695T","name":"Bdy srf mpg pm/cvdfb tm impl","description":"Body surface-activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of implant or replacement","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33287","name":"Rmv&rplcmt phrnc nrv stim pg","description":"Removal and replacement of phrenic nerve stimulator, including vessel catheterization, all imaging guidance, and interrogation and programming, when performed; pulse generator","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3244","name":"Inj. tigecycline (accord)","description":"Injection, tigecycline (accord), not therapeutically equivalent to j3243, 1 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98008","name":"Synch audio-only new sf 15","description":"Synchronous audio-only visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination, straightforward medical decision making, and more than 10 minutes of medical discussion. when using total time on the date of the encounter for code sel","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19296","name":"Place po breast cath for rad","description":"Placement of radiotherapy afterloading expandable catheter (single or multichannel) into the breast for interstitial radioelement application following partial mastectomy, includes imaging guidance; on date separate from partial mastectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0830T","name":"Dgtz gls mcrscp cytp slctv","description":"Digitization of glass microscope slides for cytopathology, selective-cellular enhancement technique with interpretation (eg, liquid-based slide preparation method), except cervical or vaginal (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1160","name":"Pt anphx due to mengb bef 13","description":"Patient had anaphylaxis due to the meningococcal vaccine any time on or before the patients 13th birthday","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24365","name":"Reconstruct head of radius","description":"Arthroplasty, radial head;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":777.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1376","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0439U","name":"Crd chd dna alys 5 snp 3 dna","description":"Crd chd dna alys 5 snp 3 dna","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81457","name":"So neo gsap dna mcrstl ins","description":"Solid organ neoplasm, genomic sequence analysis panel, interrogation for sequence variants; dna analysis, microsatellite instability","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69729","name":"Impl oi implt sk tc esp>=100","description":"Implantation, osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside of the mastoid and resulting in removal of greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99203","name":"Office o/p new low 30 min","description":"Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":79.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0804","name":"3d facial scan indirect","description":"3d facial scan indirect","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0918T","name":"Insj perm ccm-d sys dual ld","description":"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; dual transvenous leads (pacing and defibrillation) only","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0949T","name":"Rem interrog dev ccm tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A2017","name":"Permeaderm glove, each","description":"Permeaderm glove, each","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15620","name":"Delay flap f/c/c/n/ax/g/h/f","description":"Delay of flap or sectioning of flap (division and inset); at forehead, cheeks, chin, neck, axillae, genitalia, hands, or feet","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81025","name":"Urine pregnancy test","description":"Urine pregnancy test, by visual color comparison methods","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0825T","name":"Tcat rmv&rpl1chmb ldls pm ra","description":"Transcatheter removal and replacement of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or prog","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33509","name":"Ndsc hrv uxtr art 1 sgm cab","description":"Harvest of upper extremity artery, 1 segment, for coronary artery bypass procedure, endoscopic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96203","name":"Mlt fam grp bhv train ea add","description":"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face with multiple sets of paren","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4317","name":"Vitograft, per sq cm","description":"Vitograft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1164","name":"Inj diltiazem in 0.72% nacl","description":"Injection, diltiazem hydrochloride in 0.72% sodium chloride, 0.5 mg","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1323","name":"Inj, elranatamab-bcmm, 1 mg","description":"Injection, elranatamab-bcmm, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0880T","name":"Augmnt alys ch ct ild i&r","description":"Augmentative analysis of chest computed tomography (ct) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; physician or other qualified health care professional interpretation and report","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4390","name":"Ascendion per sq cm","description":"Ascendion, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63053","name":"Lam factc/frmt arthrd lum ea","description":"Laminectomy, facetectomy, or foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s] [eg, spinal or lateral recess stenosis]), during posterior interbody arthrodesis, lumbar; each additional vertebral segment (list separately in addition to code for","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74182","name":"Mri abdomen w/contrast","description":"Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76815","name":"Ob us limited fetus(s)","description":"Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1333","name":"Acute vitreous hemorrhage","description":"Acute vitreous hemorrhage","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1296","name":"Calc bmi norm parameters","description":"Bmi is documented within normal parameters and no follow-up plan is required","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"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":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1196","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99471","name":"Ped critical care initial","description":"Initial inpatient pediatric critical care, per day, for the evaluation and management of a critically ill infant or young child, 29 days through 24 months of age","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":757.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8522","name":"Capecitabine, oral, 50 mg","description":"Capecitabine, oral, 50 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0329U","name":"Onc neo xome&trns seq alys","description":"Onc neo xome&trns seq alys","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0745T","name":"Car ablt rad arr n-invas loc","description":"Cardiac focal ablation utilizing radiation therapy for arrhythmia; noninvasive arrhythmia localization and mapping of arrhythmia site (nidus), derived from anatomical image data (eg, ct, mri, or myocardial perfusion scan) and electrical data (eg, 12-lead ecg data), and identification of areas of avo","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5943","name":"Proth mandib implt sup remv","description":"Proth mandib implt sup remv","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4360","name":"Amchoplast fd per sq cm","description":"Amchoplast fd, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49595","name":"Rpr aa hrn 1st > 10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, reducible","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81192","name":"Ntrk2 translocation analysis","description":"Ntrk2 (neurotrophic receptor tyrosine kinase 2) (eg, solid tumors) translocation analysis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0931T","name":"Ephys eval ccm-d ld separate","description":"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arrhythmia termination), separate from initial implantation or replacement with testing of cardiac cont","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0872T","name":"Rplcmt ndwllg bldr&prtl cath","description":"Replacement of indwelling bladder and peritoneal catheters, including tunneling of catheter(s) and connection with previously implanted peritoneal ascites pump, including imaging and programming, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0847T","name":"Dgtz gls mcrscp xm arch tiss","description":"Digitization of glass microscope slides for examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, kras mutational analysis) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69209","name":"Remove impacted ear wax uni","description":"Removal impacted cerumen using irrigation/lavage, unilateral","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90482","name":"Imm cnsl not admn sm 3<10","description":"Immunization counseling by physician or other qualified health care professional when immunization(s) is not administered by provider on the same date of service; 3 minutes up to 10 minutes","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0816T","name":"Opn insj/rplcmt ins ptn subq","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0738","name":"Upper extremity rehab","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22804","name":"Arthrd pst dfrm 13+ vrt sgm","description":"Arthrodesis, posterior, for spinal deformity, with or without cast; 13 or more vertebral segments","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3011.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5725","name":"Rebase hybrid prosthesis","description":"Rebase hybrid prosthesis","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D2642","name":"Dental onlay porcelin 2 surf","description":"Onlay - porcelain/ceramic - two surfaces","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0941T","name":"Cysto flx ins&xpns urtl scaf","description":"Cystourethroscopy, flexible; with insertion and expansion of prostatic urethral scaffold using integrated cystoscopic visualization","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0976T","name":"Slctv nzmtc dbrdmt s/n/hf ea","description":"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands, feet, and/or multiple digits; each additional 100 sq cm (list separately in addition to code for p","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4266","name":"Neostim per sq cm","description":"Neostim membrane, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0824T","name":"Tcat rmv 1chmbr ldls pm ra","description":"Transcatheter removal of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography), when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9573","name":"Inj, gadopiclenol, 1 ml","description":"Injection, gadopiclenol, 1 ml","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0542","name":"No pt prsnt train add 15","description":"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present),","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5877","name":"Dup of complt dent-maxill","description":"Dup of complt dent-maxill","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58240","name":"Removal of pelvis contents","description":"Pelvic exenteration for gynecologic malignancy, with total abdominal hysterectomy or cervicectomy, with or without removal of tube(s), with or without removal of ovary(s), with removal of bladder and ureteral transplantations, and/or abdominoperineal resection of rectum and colon and colostomy, or a","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2665.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72295","name":"X-ray of lower spine disk","description":"Discography, lumbar, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0676T","name":"Laps insj nw/rpcmt isdss ea","description":"Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; each additional lead (list separately in addition to code for primary ","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0457","name":"Injection, aztreonam, 100 mg","description":"Injection, aztreonam, 100 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33509","name":"Ndsc hrv uxtr art 1 sgm cab","description":"Harvest of upper extremity artery, 1 segment, for coronary artery bypass procedure, endoscopic","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9394","name":"Inj, fulvestrant (fresenius)","description":"Injection, fulvestrant (fresenius kabi) not therapeutically equivalent to j9395, 25 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92137","name":"Cptrz oph img pst sg rta oct","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), posterior segment, with interpretation and report, unilateral or bilateral; retina, including oct angiography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0666","name":"Inj, bupivacaine liposome","description":"Injection, bupivacaine liposome, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1471","name":"Ffs hep b not covered","description":"Documentation that patient is a medicare fee-for-service beneficiary and without additional supplementary insurance coverage for whom hep b vaccination is not reimbursable under current medicare part b coverage rules","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1311","name":"Aphlx to vax bef enc","description":"Anaphylaxis due to the vaccine on or before the date of the encounter","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0162","name":"Inj epinephrine (fresenius)","description":"Injection, epinephrine (fresenius), not therapeutically equivalent to j0165, 0.1 mg","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4199","name":"Cygnus matrix, per sq cm","description":"Cygnus matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1441","name":"Init dx slp apn = 1st enc","description":"Encounter corresponds to initial diagnosis of sleep apnea or first contact with sleep apnea diagnosed patient","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0985T","name":"Iv img xtrc cere vsl oct ea","description":"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supervision, interpretation, and report; each additional vessel (list separately in addition to code for","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0471U","name":"Onc clrc ca 35 vrn kras&nras","description":"Onc clrc ca 35 vrn kras&nras","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37277","name":"Rvsc evsc fpvt st athr cpx 1","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23397","name":"Muscle transfers","description":"Muscle transfer, any type, shoulder or upper arm; multiple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1371.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75580","name":"N-invas est c ffr sw aly cta","description":"Noninvasive estimate of coronary fractional flow reserve (ffr) derived from augmentative software analysis of the data set from a coronary computed tomography angiography, with interpretation and report by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0703","name":"2d oral/facial photo image","description":"2d oral/facial photo image","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6519","name":"Grad com garm noc night use","description":"Gradient compression garment, not otherwise specified, for nighttime use, each","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1167","name":"Hspc dur meas pd","description":"In hospice or using hospice services during the measurement period","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64430","name":"Njx aa&/strd pudendal nerve","description":"Injection(s), anesthetic agent(s) and/or steroid; pudendal nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0505U","name":"Nfct ds vag infctj id 32orgs","description":"Nfct ds vag infctj id 32orgs","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9172","name":"Docetaxel (docivyx), 1 mg","description":"Injection, docetaxel (docivyx), 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74021","name":"Radex abdomen 3+ views","description":"Radiologic examination, abdomen; 3 or more views","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9244","name":"Office min sed drug enteral","description":"Office min sed drug enteral","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1208","name":"Pt no scrn sdoh","description":"Patient is not screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4263","name":"Surgraft tl, per sq cm","description":"Surgraft tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0362U","name":"Onc pap thyr ca rna 82&10","description":"Onc pap thyr ca rna 82&10","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3404","name":"Inj zopapogene per ther dose","description":"Injection, zopapogene imadenovec-drba suspension, per therapeutic dose","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0739","name":"Rehab sys active assist rt","description":"Rehabilitation system with interactive interface providing active assistance in rehabilitation therapy, includes all components and accessories, motors, microprocessors, sensors","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11982.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0939T","name":"Xtrnl ecg rec>15d<30d scan","description":"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; scanning analysis with report","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0358U","name":"Neuro alys b-amyl 1-42&1-40","description":"Neuro alys b-amyl 1-42&1-40","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9953","name":"Reline sleep apnea appliance","description":"Reline sleep apnea appliance","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0267U","name":"Rare do id opt gen mapg&seq","description":"Rare constitutional and other heritable disorders, identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping and whole-genome sequencing","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0755T","name":"Dgtz gls mcrscp sld level vi","description":"Digitization of glass microscope slides for level vi, surgical pathology, gross and microscopic examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1341","name":"Pt no f/u 30-180 dys","description":"Patients who did not have a follow-up assessment or did not have an assessment within 30 to 180 days after the index assessment during the performance period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64865","name":"Repair of facial nerve","description":"Suture of facial nerve; infratemporal, with or without grafting","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1364.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0674T","name":"Laps insj nw/rpcmt prm isdss","description":"Laparoscopic insertion of new or replacement of permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including an implantable pulse generator and diaphragmatic lead(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86037","name":"Anca titer each antibody","description":"Antineutrophil cytoplasmic antibody (anca); titer, each antibody","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0262U","name":"Onc sld tum rt-pcr 7 gen","description":"Oncology (solid tumor), gene expression profiling by real-time rt-pcr of 7 gene pathways (er, ar, pi3k, mapk, hh, tgfb, notch), formalin-fixed paraffin-embedded (ffpe), algorithm reported as gene pathway activity score","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0532","name":"Take home supp nasal spray","description":"Take-home supply of nasal nalmefene hydrochloride; one carton of two, 2.7 mg per 0.1 ml nasal sprays (provision of the services by a medicare-enrolled opioid treatment program);( list separately in addition to each primary code)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4260","name":"Signature apatch, per sq cm","description":"Signature apatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88267","name":"Chromosome analys placenta","description":"Chromosome analysis, amniotic fluid or chorionic villus, count 15 cells, 1 karyotype, with banding","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0393U","name":"Neu prksn msfl a-syncln prtn","description":"Neu prksn msfl a-syncln prtn","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0835T","name":"Dgtz gls mcrscp fna 1st ea","description":"Digitization of glass microscope slides for cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1426","name":"Injection, casimersen, 10 mg","description":"Injection, casimersen, 10 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0797T","name":"Tcat ins 2chmbr ldls pm rv","description":"Transcatheter insertion of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed; right ventricular pace","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1204","name":"Ixv nrs vrs iqa >=4","description":"Initial (index visit) numeric rating scale (nrs), visual rating scale (vrs), or itchyquant assessment score of greater than or equal to 4","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1425","name":"Surgical care mvp","description":"Surgical care mips value pathway","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D6611","name":"Onlay cst hgh nbl mtl >=3srf","description":"Onlay - cast high noble metal three or more surfaces","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0929T","name":"Rem interrog dev ccm-d tech","description":"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1235","name":"Doc pt hcv aby rna tst","description":"Documentation or patient report of hcv antibody test or hcv rna test which occurred prior to the performance period","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5140","name":"Inj adalimumab-fkjp, 1 mg","description":"Injection, adalimumab-fkjp, biosimilar, 1 mg","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1223","name":"Glaucoma plan of care doc","description":"Glaucoma plan of care documented","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q5127","name":"Inj, stimufend, 0.5 mg","description":"Injection, pegfilgrastim-fpgk (stimufend), biosimilar, 0.5 mg","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"Rec cath any transanal, each","description":"Rectal catheter with or without balloon, for use with any type transanal irrigation system, each","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7049","name":"Epap nasal valve","description":"Expiratory positive airway pressure intranasal resistance valve","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0719T","name":"Pst vrt jt rplcmt lmbr 1 sgm","description":"Posterior vertebral joint replacement, including bilateral facetectomy, laminectomy, and radical discectomy, including imaging guidance, lumbar spine, single segment","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1480","name":"Pt func cap not allow impr","description":"Patients whose functional capacity or motivation (or lack thereof) to improve may impact the accuracy of results of validated tools such as delirium, dementia, intellectual disabilities, and pervasive and specific development disorders","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4028","name":"Podiatry ss","description":"Podiatry mips specialty set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1169","name":"Doc med rsn no flu vax","description":"Documentation of medical reason(s) for not administering influenza vaccine (e.g., prior anaphylaxis due to the influenza vaccine)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81002","name":"Urinalysis nonauto w/o scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; non-automated, without microscopy","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5944","name":"Max implt sup remv part","description":"Max implt sup remv part","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49595","name":"Rpr aa hrn 1st > 10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, reducible","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51050","name":"Removal of bladder stone","description":"Cystolithotomy, cystotomy with removal of calculus, without vesical neck resection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":485.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4265","name":"Neostim tl per sq cm","description":"Neostim tl, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0184","name":"Inj, amisulpride, 1 mg","description":"Injection, amisulpride, 1 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91125","name":"Anrct mano rct snsatn&balo","description":"Anorectal manometry, with rectal sensation and rectal balloon expulsion test, when performed","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0235","name":"Intrav inf, mon anti, fir do","description":"Intravenous infusion, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation,","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4030","name":"Pulmonology ss","description":"Pulmonology mips specialty set","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0533U","name":"Rx metab advrs gnotyp 16gens","description":"Rx metab advrs gnotyp 16gens","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1243","name":"Pt othr thn true heard","description":"Patient provided a response other than completely true for the question of patient felt heard and understood by this provider and team","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1376","name":"Ra dx enc 90 days dur per pd","description":"An additional encounter with an ra diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an ra diagnosis during the performance period","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6609","name":"G compression bandaging","description":"Gradient compression bandaging supply, not otherwise specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0136","name":"Adm of pa/n assess 5-15 m","description":"Administration of a standardized, evidence-based assessment of physical activity and nutrition, 5-15 minutes, not more often than every 6 months","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42335","name":"Removal of salivary stone","description":"Sialolithotomy; submandibular (submaxillary), complicated, intraoral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96574","name":"Dbrdmt prmlg les w/pdt","description":"Debridement of premalignant hyperkeratotic lesion(s) (ie, targeted curettage, abrasion) followed with photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosensitizing drug(s) provide","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90612","name":"Inf&sarscov2 vacc 31.7/.32im","description":"Influenza virus vaccine, trivalent, and severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 31.7 mcg/0.32 ml dosage, for intramuscular use","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0737","name":"Inj, clindamycin (baxter)","description":"Injection, clindamycin phosphate (baxter), not therapeutically equivalent to j0736, 300 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D9954","name":"Fab/del oral appliance thxpy","description":"Fab/del oral appliance thxpy","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82140","name":"Assay of ammonia","description":"Ammonia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75940","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27656","name":"Repair leg fascia defect","description":"Repair, fascial defect of leg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82274","name":"Assay test for blood fecal","description":"Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0812T","name":"Rem mlt day uroflow dev sply","description":"Remote multi-day complex uroflowmetry (eg, calibrated electronic equipment); device supply with automated report generation, up to 10 days","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87428","name":"Sarscov & inf vir a&b ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; severe acute respiratory syndrome coronavirus (eg, sars-cov, s","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0463","name":"Inj atropine (fresenius te)","description":"Injection, atropine sulfate (fresenius and therapeutically equivalent), 0.01 mg","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95956","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4306","name":"Americ amnion ac per sq cm","description":"American amnion ac, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1187","name":"Pt w/ esrd","description":"Patients with a diagnosis of end stage renal disease (esrd)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96041","name":"Genetic counseling svc ea 30","description":"Medical genetics and genetic counseling services, each 30 minutes of total time provided by the genetic counselor on the date of the encounter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4428","name":"Dermbnd sln sl+ slx sq cm","description":"Dermabind sl n or dermabind sl + or dermabind sl x, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9282","name":"Mitomycin intravesical inst","description":"Mitomycin, intravesical instillation, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0383U","name":"Tyrosinemia typ i mntr quan","description":"Tyrosinemia typ i mntr quan","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1459","name":"Pt hosp/pal care dur perf pd","description":"Patient was in hospice or receiving palliative care services at any time during the performance period","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4224","name":"Hhf10-p per sq cm","description":"Human health factor 10 amniotic patch (hhf10-p), per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0790T","name":"Revj rplcmt/rmvl vrt tethrg","description":"Revision (eg, augmentation, division of tether), replacement, or removal of thoracolumbar or lumbar vertebral body tethering, including thoracoscopy, when performed","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7172","name":"Inj marstacim-hncq, 0.5 mg","description":"Injection, marstacimab-hncq, 0.5 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37276","name":"Rvsc evsc fpvt st athr sf ea","description":"Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the arte","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1281","name":"Bp scrn no perf at interval","description":"Blood pressure reading not documented, reason not given","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G1025","name":"Pt mnth 1 mcp prov","description":"Patient-months where there are more than one medicare capitated payment (mcp) provider listed for the month","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1961","name":"Inj lenacapavir (hiv tx) 1mg","description":"Injection, lenacapavir (only for use as hiv treatment), 1 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4328","name":"Most, per sq cm","description":"Most, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0799T","name":"Tcat rmvl 2chmbr ldls pm ra","description":"Transcatheter removal of permanent dual-chamber leadless pacemaker, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography, right ventriculography, femoral venography), when performed; right atrial pacemaker component","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0816T","name":"Opn insj/rplcmt ins ptn subq","description":"Open insertion or replacement of integrated neurostimulation system for bladder dysfunction including electrode(s) (eg, array or leadless), and pulse generator or receiver, including analysis, programming, and imaging guidance, when performed, posterior tibial nerve; subcutaneous","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2428","name":"Inj, erzofri, 1 mg","description":"Injection, paliperidone palmitate extended release (erzofri), 1 mg","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6593","name":"Grad com accessory gmt_wrap","description":"Accessory for gradient compression garment or wrap with adjustable straps, not-otherwise specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93784","name":"Ambl bp mntr w/software","description":"Ambulatory blood pressure monitoring, utilizing report-generating software, automated, worn continuously for 24 hours or longer; including recording, scanning analysis, interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7414","name":"Excision malig lesion>1.25cm","description":"Excision of malignant lesion greater than 1.25 cm","date_of_service":"2026-06-05","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5943","name":"Proth mandib implt sup remv","description":"Proth mandib implt sup remv","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0032","name":"2+ antipsy schiz","description":"Two or more antipsychotic prescriptions ordered for patients who had a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder on or between january 1 of the year prior to the measurement period and the index prescription start date (ipsd) for antipsychotics","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4260","name":"Signature apatch, per sq cm","description":"Signature apatch, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G4037","name":"Urology ss","description":"Urology mips specialty set","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D7485","name":"Surg reduct osseoustuberosit","description":"Surgical reduction of osseous tuberosity","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0904T","name":"Ecg alg 12 ld rdcd trcg only","description":"Electrocardiogram, algorithmically generated 12-lead ecg from a reduced-lead ecg; tracing only","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":878.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44405","name":"Colonoscopy w/dilation","description":"Colonoscopy through stoma; with transendoscopic balloon dilation","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":586.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":156.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1412","name":"Met nsclc w/ egfr alk oth ab","description":"Patients with metastatic nsclc with epidermal growth factor receptor (egfr) mutations, alk genomic tumor aberrations, or other targetable genomic abnormalities with approved first-line targeted therapy, such as nsclc with ros1 rearrangement, braf v600e mutation, ntrk 1/2/3 gene fusion, met ex14 skip","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63182","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1702.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4297","name":"Emerge matrix, per sq cm","description":"Emerge matrix, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0566","name":"3d bn img algor drvd fr mri","description":"3d radiodensity-value bone imaging, algorithm derived, from previous magnetic resonance examination of the same anatomy","date_of_service":"2026-06-05","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0520","name":"New pt-cg dyad dem mod cmplx","description":"Management of new patient-caregiver dyad with dementia, moderate complexity, for use in cmmi model","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0378U","name":"Rfc1 repeat xpnsj vrnt alys","description":"Rfc1 repeat xpnsj vrnt alys","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP20","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0272U","name":"Hem genetic bld do 51 genes","description":"Hematology (genetic bleeding disorders), genomic sequence analysis of 51 genes, blood, buccal swab, or amniotic fluid, comprehensive","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0667","name":"Team remote e/m est pt 25 mn","description":"Team remote e/m est. pt 25mins","date_of_service":"2026-06-05","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1415","name":"No pos pdl1 bef ici ther","description":"Patients who did not have a positive pd-l1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21453","name":"Cltx mndblr fx ntrdntl fixj","description":"Closed treatment of mandibular fracture with interdental fixation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":786.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99350","name":"Home/res vst est high mdm 60","description":"Home or residence visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0972T","name":"Asstv alg clsfctn burn hlg","description":"Assistive algorithmic classification of burn healing (ie, healing or nonhealing) by noninvasive multispectral imaging, including system set-up and acquisition, selection, and transmission of images, with automated generation of report","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0951T","name":"Tot impl amei 1st plmt","description":"Totally implantable active middle ear hearing implant; initial placement, including mastoidectomy, placement of and attachment to sound processor","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D5947","name":"Mand implt sup fix","description":"Mand implt sup fix","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33030","name":"Partial removal of heart sac","description":"Pericardiectomy, subtotal or complete; without cardiopulmonary bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1391.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78601","name":"Brain image w/flow < 4 views","description":"Brain imaging, less than 4 static views; with vascular flow","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9048","name":"Inj, bortezomib freseniuskab","description":"Injection, bortezomib (fresenius kabi), not therapeutically equivalent to j9041, 0.1 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0348U","name":"Rx metab/pcx dna 25 gen alys","description":"Rx metab/pcx dna 25 gen alys","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0137","name":"Inj, acetaminophen (hikma)","description":"Injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 mg","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","date_of_service":"2026-06-05","zip":"10985","rural":"Y","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":96.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4303","name":"Complete aa, per sq cm","description":"Complete aa, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7299","name":"Intraut copp cont (miudella)","description":"Intrauterine copper contraceptive (miudella)","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1183","name":"Doc imm ckpt inhib hld","description":"Documentation of immune checkpoint inhibitor therapy held and corticosteroids or immunosuppressants prescribed or administered","date_of_service":"2026-06-05","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D0472","name":"Gross exam prep & report","description":"Accession of tissue gross examination preparation and transmission of written report","date_of_service":"2026-06-05","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0018M","name":"Trnsplj rnl meas cd154+cll","description":"Transplantation medicine (allograft rejection, renal), measurement of donor and third-party-induced cd154+t-cytotoxic memory cells, utilizing whole peripheral blood, algorithm reported as a rejection risk score","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20552","name":"Njx 1/mlt trigger point 1/2","description":"Injection(s); single or multiple trigger point(s), 1 or 2 muscle(s)","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["55","15","81","32","11","16","71","58","99","04","13","17","49","62","72","65","03","14","33","57","10","25","20","01","12","09","27","54","60","50"]},{"negotiated_type":"negotiated","negotiated_rate":38.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24538","name":"Prq skel fix sprcndlr hum fx","description":"Percutaneous skeletal fixation of supracondylar or transcondylar humeral fracture, with or without intercondylar extension","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4385","name":"Apollo ft per sq cm","description":"Apollo ft, per square centimeter (add-on, list separately in addition to primary procedure)","date_of_service":"2026-06-05","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0395U","name":"Onc lng multiomics plsm alg","description":"Onc lng multiomics plsm alg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49190","name":"Opn exc/dstr ntra-abd >30 cm","description":"Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); greater than 30 cm","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84431","name":"Thromboxane urine","description":"Thromboxane metabolite(s), including thromboxane if performed, urine","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0217","name":"Inj velmanase alfa-tycv 1 mg","description":"Injection, velmanase alfa-tycv, 1 mg","date_of_service":"2026-06-05","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2252","name":"Inj midazolam in 0.8% nacl","description":"Injection, midazolam in 0.8% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg","date_of_service":"2026-06-05","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M1393","name":"Pr no dx rec mlnm","description":"Patients who were not diagnosed with recurrent melanoma during the current performance period","date_of_service":"2026-06-05","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90631","name":"H5 vaccine pandemic im use","description":"Influenza virus vaccine (iiv), h5, pandemic formulation, split virus, adjuvanted, for intramuscular use","date_of_service":"2026-06-05","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9272","name":"Inj, dostarlimab-gxly, 10 mg","description":"Injection, dostarlimab-gxly, 10 mg","date_of_service":"2026-06-05","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92622","name":"Dx aly aud oi snd prcsr 1st","description":"Diagnostic analysis, programming, and verification of an auditory osseointegrated sound processor, any type; first 60 minutes","date_of_service":"2026-06-05","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]}]}